Evidencias de terremotos cuaternarios en una sima hipogénica: La Sima de Benís (Murcia, SE España)

La interacción entre una cueva hipogénica y la actividad de una falla cuaternaria es la principal responsable de la génesis de la cueva más profunda de la Región de Murcia y una de las mayores cavidades hipogénicas del sur de la península. La Sima de Benís presenta una amplia y única variedad de espeleotemas y de estructuras de disolución que se encuentran afectadas por deformaciones sísmicas producidas tanto por paleoterremotos durante el Pleistoceno Superior, como por terremotos instrumentales (Mw 4,8; VI EMS-98, 1999; Mula). Además, dentro de las zonas más profundas de la cueva aparecen restos fósiles “in situ” de macromamíferos (Lynx pardinus spelaeus), los cuales hemos relacionado con la actividad sísmica en el interior de la caverna. En cuanto a su topografía, esta cavidad presenta dos sectores bien diferenciados: (1) un primer sector de 150-160 m de desarrollo vertical con pozos de origen hipogénico con desarrollo de golpes de gubia y conductos de disolución ascendentes (con “outlets” y “megascallops”) y (2) un segundo sector entre los 150 - 160 m y los 320 m de profundidad, el cual se desarrolla sobre un plano de falla normal de dirección N-S (Falla de Benís). Este segundo sector de la sima es el que presenta evidencias paleosísmicas cuaternarias, dividiéndose a su vez en dos zonas en relación a la dinámica kárstica dominante: (2.a) una zona vadosa dominada por estructuras hipogénicas (donde aparecen folias y corales), junto con marcas cinemáticas de movimiento de la falla (estrías con recristalizaciones y concreciones carbonatadas) y (2.b) una zona freática profunda controlada por la precipitación de nubes de calcita bajo lámina de agua y de tamaño métrico que se desarrolla hasta los - 320 m de profundidad. En cuanto a la parte hipogénica superior de la sima, se desarrolla a favor de una fractura con relleno de calcita y de orientación E-W sobre carbonatos del Cretácico superior y el Paleoceno, con un espesor centimétrico y evidencias de relleno posterior y circulación de fluidos. La potencial actividad paleosísmica ha podido ser datada en 65 ± 17,6 ka (OIS 4) mediante el análisis de racemización de aminoácidos de los colmillos de un lince de las cavernas, el cual pudo ser afectado por un terremoto. Por último, se ha estimado el tamaño del último sismo relacionado con la actividad de la falla a partir de relaciones empíricas, con un valor de Mw oscilando entre 5,5 y 6. Para ello se ha estimado la longitud en superficie de la traza de falla que controla la cueva en profundidad y se ha comparado con el último salto cosísmico observable en el interior de la sima. Estimaciones del salto de falla acumulado y la datación del último paleoterremoto, sugieren que parte de la evolución hipogénica con paleoterremotos de esta cavidad de forma conjunta se produjo al menos, desde hace 250 ka (OIS 7)

Evidencias de terremotos cuaternarios en una sima hipogénica: La Sima de Benís (Murcia, SE España)

[EN] The interaction between karst hypogenic processes and Late Pleistocene active faulting determines the present topography and shape of the Benís Cave within the Cieza Ranges in the eastern Betic Cordillera (SE Spain). This cave represents the explored deepest cave within the Murcia region, reaching the deepest point at -320 m, and showing "in situ" fossil remains of mammal carnivores (Lynx pardinus spelaeus) as well. In addition, this cave displays evidence of paleoseismic activity from broken speleothems, but also from instrumental earthquakes collapsing the cave ceiling hall at -150 m depth (1999 Mula Event). The geometry and speleogenesis of Benís cave from the Late Pleistocene is a combination of two processes: (1) a shallow hypogenic origin related to upwards movement of confined aquifer located between 0 and 150 m depth, with lots of outlets and megascallops, and (2) a deep fault-cave related to the Benís fault developed between 150 - 320 m depth. This fault is N-S trending with normal kinematics and evidence of Late Pleistocene paleoseismic activity. Related to this, different fossil bones of Lynx pardinus spelaeus, was found in situ, which were dated by amino acid racemization in 65 ± 17.6 ka (OIS 4). The estimated size of the last paleoearthquake was around 6 Mw according to the measured coseismic displacement at depth and the length of the Benís fault trace at surface. The combination of the two processes (hypogenic confined aquifer and a seismogenic faulting), controlled the development, geometry and speleogenesis of the Benís Cave during at least the last 250 ka.[ES] La interacción entre una cueva hipogénica y la actividad de una falla cuaternaria es la principal responsable de la génesis de la cueva más profunda de la Región de Murcia y una de las mayores cavidades hipogénicas del sur de la península. La Sima de Benís presenta una amplia y única variedad de espeleotemas y de estructuras de disolución que se encuentran afectadas por deformaciones sísmicas producidas tanto por paleoterremotos durante el Pleistoceno Superior, como por terremotos instrumentales (Mw 4,8; VI EMS-98, 1999; Mula). Además, dentro de las zonas más profundas de la cueva aparecen restos fósiles “in situ” de macromamíferos (Lynx pardinus spelaeus), los cuales hemos relacionado con la actividad sísmica en el interior de la caverna. En cuanto a su topografía, esta cavidad presenta dos sectores bien diferenciados: (1) un primer sector de 150-160 m de desarrollo vertical con pozos de origen hipogénico con desarrollo de golpes de gubia y conductos de disolución ascendentes (con “outlets” y “megascallops”) y (2) un segundo sector entre los 150 - 160 m y los 320 m de profundidad, el cual se desarrolla sobre un plano de falla normal de dirección N-S (Falla de Benís). Este segundo sector de la sima es el que presenta evidencias paleosísmicas cuaternarias, dividiéndose a su vez en dos zonas en relación a la dinámica kárstica dominante: (2.a) una zona vadosa dominada por estructuras hipogénicas (donde aparecen folias y corales), junto con marcas cinemáticas de movimiento de la falla (estrías con recristalizaciones y concreciones carbonatadas) y (2.b) una zona freática profunda controlada por la precipitación de nubes de calcita bajo lámina de agua y de tamaño métrico que se desarrolla hasta los - 320 m de profundidad. En cuanto a la parte hipogénica superior de la sima, se desarrolla a favor de una fractura con relleno de calcita y de orientación E-W sobre carbonatos del Cretácico superior y el Paleoceno, con un espesor centimétrico y evidencias de relleno posterior y circulación de fluidos. La potencial actividad paleosísmica ha podido ser datada en 65 ± 17,6 ka (OIS 4) mediante el análisis de racemización de aminoácidos de los colmillos de un lince de las cavernas, el cual pudo ser afectado por un terremoto. Por último, se ha estimado el tamaño del último sismo relacionado con la actividad de la falla a partir de relaciones empíricas, con un valor de Mw oscilando entre 5,5 y 6. Para ello se ha estimado la longitud en superficie de la traza de falla que controla la cueva en profundidad y se ha comparado con el último salto cosísmico observable en el interior de la sima. Estimaciones del salto de falla acumulado y la datación del último paleoterremoto, sugieren que parte de la evolución hipogénica con paleoterremotos de esta cavidad de forma conjunta se produjo al menos, desde hace 250 ka (OIS 7)

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

GEODIVULGAR: Geología y Sociedad

Fac. de Ciencias GeológicasFALSEsubmitte

Geodivulgar: Geología y Sociedad 2018

Depto. de Geodinámica, Estratigrafía y PaleontologíaFac. de Ciencias GeológicasFALSEsubmitte

Geodivulgar: Geología y Sociedad

Con el lema “Geología para todos” el proyecto Geodivulgar: Geología y Sociedad apuesta por la divulgación de la Geología a todo tipo de público, incidiendo en la importancia de realizar simultáneamente una acción de integración social entre estudiantes y profesores de centros universitarios, de enseñanza infantil, primaria, de educación especial y un acercamiento con público con diversidad funcional

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries