An exploratory analysis of hospital discharge summaries across Europe

Hospital discharge summaries play a critical role in ensuring safe and efficient continuity of care, particularly through transmission of key information from secondary to primary. This paper aims to explore whether discharge summaries used in European hospitals are adequate to support continuity of care. ..

Fore-arc deformation and underplating at the northern Hikurangi margin, New Zealand

Geophysical investigations of the northern Hikurangi subduction zone northeast of New Zealand, image fore‐arc and surrounding upper lithospheric structures. A seismic velocity (Vp) field is determined from seismic wide‐angle data, and our structural interpretation is supported by multichannel seismic reflection stratigraphy and gravity and magnetic modeling. We found that the subducting Hikurangi Plateau carries about 2 km of sediments above a 2 km mixed layer of volcaniclastics, limestone, and chert. The upper plateau crust is characterized by Vp = 4.9–6.7 km/s overlying the lower crust with Vp > 7.1 km/s. Gravity modeling yields a plateau thickness around 10 km. The reactivated Raukumara fore‐arc basin is >10 km deep, deposited on 5–10 km thick Australian crust. The fore‐arc mantle of Vp > 8 km/s appears unaffected by subduction hydration processes. The East Cape Ridge fore‐arc high is underlain by a 3.5 km deep strongly magnetic (3.3 A/m) high‐velocity zone, interpreted as part of the onshore Matakaoa volcanic allochthon and/or uplifted Raukumara Basin basement of probable oceanic crustal origin. Beneath the trench slope, we interpret low‐seismic‐velocity, high‐attenuation, low‐density fore‐arc material as accreted and recycled, suggesting that underplating and uplift destabilizes East Cape Ridge, triggering two‐sided mass wasting. Mass balance calculations indicate that the proposed accreted and recycled material represents 25–100% of all incoming sediment, and any remainder could be accounted for through erosion of older accreted material into surrounding basins. We suggest that continental mass flux into the mantle at subduction zones may be significantly overestimated because crustal underplating beneath fore‐arc highs have not properly been accounted for

The History, Relevance, and Applications of the Periodic System in Geochemistry

Geochemistry is a discipline in the earth sciences concerned with understanding the chemistry of the Earth and what that chemistry tells us about the processes that control the formation and evolution of Earth materials and the planet itself. The periodic table and the periodic system, as developed by Mendeleev and others in the nineteenth century, are as important in geochemistry as in other areas of chemistry. In fact, systemisation of the myriad of observations that geochemists make is perhaps even more important in this branch of chemistry, given the huge variability in the nature of Earth materials – from the Fe-rich core, through the silicate-dominated mantle and crust, to the volatile-rich ocean and atmosphere. This systemisation started in the eighteenth century, when geochemistry did not yet exist as a separate pursuit in itself. Mineralogy, one of the disciplines that eventually became geochemistry, was central to the discovery of the elements, and nineteenth-century mineralogists played a key role in this endeavour. Early “geochemists” continued this systemisation effort into the twentieth century, particularly highlighted in the career of V.M. Goldschmidt. The focus of the modern discipline of geochemistry has moved well beyond classification, in order to invert the information held in the properties of elements across the periodic table and their distribution across Earth and planetary materials, to learn about the physicochemical processes that shaped the Earth and other planets, on all scales. We illustrate this approach with key examples, those rooted in the patterns inherent in the periodic law as well as those that exploit concepts that only became familiar after Mendeleev, such as stable and radiogenic isotopes

Early influences on cardiovascular and renal development

The hypothesis that a developmental component plays a role in subsequent disease initially arose from epidemiological studies relating birth size to both risk factors for cardiovascular disease and actual cardiovascular disease prevalence in later life. The findings that small size at birth is associated with an increased risk of cardiovascular disease have led to concerns about the effect size and the causality of the associations. However, recent studies have overcome most methodological flaws and suggested small effect sizes for these associations for the individual, but an potential important effect size on a population level. Various mechanisms underlying these associations have been hypothesized, including fetal undernutrition, genetic susceptibility and postnatal accelerated growth. The specific adverse exposures in fetal and early postnatal life leading to cardiovascular disease in adult life are not yet fully understood. Current studies suggest that both environmental and genetic factors in various periods of life may underlie the complex associations of fetal growth retardation and low birth weight with cardiovascular disease in later life. To estimate the population effect size and to identify the underlying mechanisms, well-designed epidemiological studies are needed. This review is focused on specific adverse fetal exposures, cardiovascular adaptations and perspectives for new studies. Copyrigh

The Nevados de Payachata volcanic region (18°S/69°W, N. Chile)

Subduction-related volcanism in the Nevados de Payachata region of the Central Andes at 18°S comprises two temporally and geochemically distinct phases. An older period of magmatism is represented by glaciated stratocones and ignimbrite sheets of late Miocene age. The Pleistocene to Recent phase (≤0.3 Ma) includes the twin stratovolcanoes Volcan Pomerape and Volcan Parinacota (the Nevados de Payachata volcanic group) and two small centers to the west (i. e., Caquena and Vilacollo). Both stratovolcanoes consist of an older dome-and-flow series capped by an andesitic cone. The younger cone, i. e., V. Parinacota, suffered a postglacial cone collapse producing a widespread debris-avalanche deposit. Subsequently, the cone reformed during a brief, second volcanic episode. A number of small, relatively mafic, satellitic cinder cones and associated flows were produced during the most recent activity at V. Parinacota. At the older cone, i. e., V. Pomerape, an early dome sequence with an overlying isolated mafic spatter cone and the cone-forming andesitic-dacitic phase (mostly flows) have been recognized. The two Nevados de Payachata stratovolcanoes display continuous major- and trace-element trends from high-K 2 O basaltic andesites through rhyolites (53%–76% SiO 2 ) that are well defined and distinct from those of the older volcanic centers. Petrography, chemical composition, and eruptive styles at V. Parinacota differ between pre- and post-debris-avalanche lavas. Precollapse flows have abundant amphibole (at SiO 2 > 59 wt%) and lower Mg numbers than postcollapse lavas, which are generally less silicic and more restricted in composition. Compositional variations indicate that the magmas of the Nevados de Payachata volcanic group evolved through a combination of fractional crystallization, crustal assimilation, and intratrend magma mixing. Isotope compositions exhibit only minor variations. Pb-isotope ratios are relatively low ( 206 Pb/ 204 Pb = 17.95–18.20 and 208 Pb/ 204 Pb = 38.2–38.5); 87 Sr/ 86 Sr ratios range 0.70612–0.70707, 143 Nd/ 144 Nd ratios range 0.51238–0.51230, and γ 18 O SMOW values range from + 6.8% o to + 7.6% o SMOW. A comparison with other Central Volcanic Zone centers shows that the Nevados de Payachata magmas are unusually rich in Ba (up to 1800 ppm) and Sr (up to 1700 ppm) and thus represent an unusual chemical signature in the Andean arc. These chemical and isotope variations suggest a complex petrogenetic evolution involving at least three distinct components. Primary mantle-derived melts, which are similar to those generated by subduction processes throughout the Andean arc, are modified by deep crustal interactions to produce magmas that are parental to those erupted at the surface. These magmas subsequently evolve at shallower levels through assimilation-crystallization processes involving upper crust and intratrend magma mixing which in both cases were restricted to end members of low isotopic contrast.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47805/1/445_2005_Article_BF01073587.pd

Earth: Atmospheric Evolution of a Habitable Planet

Our present-day atmosphere is often used as an analog for potentially habitable exoplanets, but Earth's atmosphere has changed dramatically throughout its 4.5 billion year history. For example, molecular oxygen is abundant in the atmosphere today but was absent on the early Earth. Meanwhile, the physical and chemical evolution of Earth's atmosphere has also resulted in major swings in surface temperature, at times resulting in extreme glaciation or warm greenhouse climates. Despite this dynamic and occasionally dramatic history, the Earth has been persistently habitable--and, in fact, inhabited--for roughly 4 billion years. Understanding Earth's momentous changes and its enduring habitability is essential as a guide to the diversity of habitable planetary environments that may exist beyond our solar system and for ultimately recognizing spectroscopic fingerprints of life elsewhere in the Universe. Here, we review long-term trends in the composition of Earth's atmosphere as it relates to both planetary habitability and inhabitation. We focus on gases that may serve as habitability markers (CO2, N2) or biosignatures (CH4, O2), especially as related to the redox evolution of the atmosphere and the coupled evolution of Earth's climate system. We emphasize that in the search for Earth-like planets we must be mindful that the example provided by the modern atmosphere merely represents a single snapshot of Earth's long-term evolution. In exploring the many former states of our own planet, we emphasize Earth's atmospheric evolution during the Archean, Proterozoic, and Phanerozoic eons, but we conclude with a brief discussion of potential atmospheric trajectories into the distant future, many millions to billions of years from now. All of these 'Alternative Earth' scenarios provide insight to the potential diversity of Earth-like, habitable, and inhabited worlds.Comment: 34 pages, 4 figures, 4 tables. Review chapter to appear in Handbook of Exoplanet

Hints of Universality from Inflection Point Inflation

This work aims to understand how cosmic inflation embeds into larger models of particle physics and string theory. Our work operates within a weakened version of the Landscape paradigm, wherein it is assumed that the set of possible Lagrangians is vast enough to admit the notion of a generic model. By focusing on slow-roll inflation, we examine the roles of both the scalar potential and the space of couplings which determine its precise form. In particular, we focus on the structural properties of the scalar potential, and find a surprising result: inflection point inflation emerges as an important —and under certain assumptions, dominant — possibility in the context of generic scalar potentials. We begin by a systematic coarse graining over the set of possible inflection point inflation models using V.I. Arnold’s ADE classification of singularities. Similar to du Val’s pioneering work on surface singularities, these determine structural classes for inflection point inflation which depened on a distinct number of control parameters. We consider both single and multifield inflation, and show how the various structural classes embed within each other. We also show how such control parameters influence the larger physical models in to which inflation is embedded. These techniques are then applied to both MSSM inflation and KKLT-type models of string cosmology. In the former case, we find that the scale of inflation can be entirely encoded within the super- potential of supersymmetric quantum field theories. We show how this relieves the fine-tuning required in such models by upwards of twelve orders of magnitude. Moreover, unnatural tuning between SUSY breaking and SUSY preserving sectors is eliminated without the explicit need for any hidden sector dynamics. In the later case, we discuss how structural stability vastly generalizes — and addresses — the Kallosh-Linde problem. Implications for the spectrum of SUSY breaking soft terms are then discussed, with an emphasis on how they may assist in constraining the inflationary scalar potential. We then pivot to a general discussion of the FLRW-scalar phase space, and show how inflection points induce caustics — or dynamical fixed points — amongst the space of possible trajectories. These fixed points are then used to argue that for uninformative priors on the space of couplings, the likelihood of inflection point inflation scales with the inverse cube of the number of e-foldings. We point out the geometric origin for the known ambiguity in the Liouville measure, and demonstrate of inflection point inflation ameliorates this problem. Finally we investigate the effect of the fixed point structure on the spectrum of density perturbations. We show how an anomaly in the Cosmic Mircowave Background data — low power at large scales — can be explained as a by product of the fixed point dynamics