Reconstructing fluvial bar surfaces from compound cross-strata and the interpretation of bar accretion direction in large river deposits

The interpretation of fluvial styles from the rock record is based for a significant part on the identification of different types of fluvial bars, characterized by the geometric relationship between structures indicative of palaeocurrent and surfaces interpreted as indicative of bar form and bar accretion direction. These surfaces of bar accretion are the boundaries of flood-related bar increment elements, which are typically less abundant in outcrops than what would be desirable, particularly in large river deposits in which each flood mobilizes large volumes of sediment, causing flood-increment boundary surfaces to be widely spaced. Cross-strata set boundaries, on the other hand, are abundant and indirectly reflect the process of unit bar accretion, inclined due to the combined effect of the unit bar surface inclination and the individual bedform climbing angle, in turn controlled by changes in flow structure caused by local bar-scale morphology. This work presents a new method to deduce the geometry of unit bar surfaces from measured pairs of cross-strata and cross-strata set boundaries. The method can be used in the absence of abundant flood-increment bounding surfaces; the study of real cases shows that, for both downstream and laterally accreting bars, the reconstructed planes are very similar to measured bar increment surfaces.Sao Paulo Research Foundation (FAPESP)CAPESCNPqLiliane JanikianUniv Sao Paulo, Inst Energia & Ambiente, Av Prof Luciano Gualberto 1289,Cidade Univ, BR-05508900 Sao Paulo, SP, BrazilUniv Sao Paulo, Inst Geociencias, Rua Lago 562,Cidade Univ, BR-05508900 Sao Paulo, SP, Brazil|Univ Fed Itajuba, Inst Recursos Nat, Av BPS 1303, BR-37500903 Itajuba, MG, BrazilCPRM Geol Survey Brazil, Rua Costa 55, BR-01304010 Sao Paulo, SP, BrazilUniv Fed Sergipe, Dept Geol, Av Marechal Rondom S-N, BR-49100000 Sao Cristov, SE, BrazilUniv Fed Sao Paulo, Campus Baixada Santista, BR-11030400 Santos, SP, BrazilUniv Fed Sao Paulo, Campus Baixada Santista, BR-11030400 Santos, SP, BrazilFAPESP: 2009/53363-8FAPESP: 2009/52807-0FAPESP: 2009/51766-8FAPESP: 2010/51103-6FAPESP: 2010/51559-0FAPESP: 2013/01825-3FAPESP: 2014/16739-8CAPES: PROEX-558/2011CNPq: 301774/2012-9Liliane Janikian: 301775/2012-5Web of Scienc

Reaction pathways in the solid state synthesis of multiferroic BiFeO 3

The obtaining of multiferroicBiFeO3 as a pure single-phase product is particularly complex since the formation of secondary phases seems to be unavoidable. The process by which these secondary impurities are formed is studied by analyzing the diffusion and solidstate reactivity of the Bi2O3–Fe2O3 system. Experimental evidence is reported which indicates that the progressive diffusion of Bi3+ ions into the Fe2O3 particles governs the solidstatesynthesis of the perovskite BiFeO3 phase. However a competition is established between the diffusion process which tends to complete the formation of BiFeO3, and the crystallization of stable Bi2Fe4O9 mullite crystals, which tend to block that formation reaction

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe