Underwater Quaternary record of the Cartagena Bay (Murcia, Spain)

Se perforó un sondeo de 30 m en la Bahía de Cartagena. El doble objetivo del mismo fue obtener datos sobre el antiguo frente marítimo de la ciudad romana y establecer la cronoestratigrafía y evolución paleoambiental. El sondeo (E3) se muestreó con alta resolución. Los sedimentos de la parte inferior (30-11,3 m) con predominio de colores marrones que indican condiciones oxidantes, la fauna de aguas salobres (Cerastoderma glaucum/Cyprideis torosa) y la sedimentación dominada por fangos y arenas, permiten interpretar el medio sedimentario estudiado como una llanura fangosa costera ligada a un abanico aluvial. Las edades AAR obtenidas revelan que todo el MIS5 está incluido en el registro. La parte superior (11,3-3,0 m), correspondiente al MIS 1, consiste en fangos orgánicos negros con arena y grava. Aparece una amplia diversidad de moluscos marinos en estadios juveniles de desarrollo. Todo esto representa el “cul de sac” de una bahía protegida donde se acumulaban restos vegetales, periódicamente afectada por llegadas de detríticos aluviales. Existe una somerización a techo del depósitoA new borehole was drilled at the end of the Cartagena Bay. The twofold aim of this operation was to obtain insights into the ancient Roman city seafront, and to establish its cronostratigraphy and paleoenvironmental evolution. A continuous 30 m long core (E3) was drilled and sampled with high resolution. The sediments of the lower part (30-11.3 m) with predominant brown colour indicating oxydizing conditions, the brackish-water fauna (Cerastoderma glaucum/Cyprideis torosa) and mud/sand dominance, allow to interpret the sedimentary environment as formed in a coastal mud flat linked to an alluvial fan. Consistent AAR dating ages reveal that the whole MIS5 record is included. The upper part of the record (11.3-3.0 m), which belongs to MIS 1, is made of black muddy sand and gravel. It appears a high diversity of marine mollusk species mostly in juvenile stage of development. This represents a complex environment: a “cul-d-sac” at the protected end of the bay where plant debris accumulated, being intruded by alluvial inputs. A growing continental influence likely occurred at the to

Fluid hydration to prevent post-ERCP pancreatitis in average- to high-risk patients receiving prophylactic rectal NSAIDs (FLUYT trial): Study protocol for a randomized controlled trial

Background: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is the most common complication of ERCP and may run a severe course. Evidence suggests that vigorous periprocedural hydration can prevent PEP, but studies to date have significant methodological drawbacks. Importantly, evidence for its added value in patients already receiving prophylactic rectal non-steroidal anti-inflammatory drugs (NSAIDs) is lacking and the cost-effectiveness of the approach has not been investigated. We hypothesize that combination therapy of rectal NSAIDs and periprocedural hydration would significantly lower the incidence of post-ERCP pancreatitis compared to rectal NSAIDs alone in moderate- to high-risk patients undergoing ERCP. Methods: The FLUYT trial is a multicenter, parallel group, open label, superiority randomized controlled trial. A total of 826 moderate- to high-risk patients undergoing ERCP that receive prophylactic rectal NSAIDs will be randomized to a control group (no fluids or normal saline with a maximum of 1.5 mL/kg/h and 3 L/24 h) or intervention group (lactated Ringer's solution with 20 mL/kg over 60 min at start of ERCP, followed by 3 mL/kg/h for 8 h thereafter). The primary endpoint is the incidence of post-ERCP pancreatitis. Secondary endpoints include PEP severity, hydration-related complications, and cost-effectiveness. Discussion: The FLUYT trial design, including hydration schedule, fluid type, and sample size, maximize its power of identifying a potential difference in post-ERCP pancreatitis incidence in patients receiving prophylactic rectal NSAIDs

Clip placement to prevent delayed bleeding after colonic endoscopic mucosal resection (CLIPPER): study protocol for a randomized controlled trial

Background: Endoscopic mucosal resection (EMR) for large colorectal polyps is in most cases the preferred treatment to prevent progression to colorectal carcinoma. The most common complication after EMR is delayed bleeding, occurring in 7% overall and in approximately 10% of polyps ≥ 2 cm in the proximal colon. Previous research has suggested that prophylactic clipping of the mucosal defect after EMR may reduce the incidence of delayed bleeding in polyps with a high bleeding risk. Methods: The CLIPPER trial is a multicenter, parallel-group, single blinded, randomized controlled superiority study. A total of 356 patients undergoing EMR for large (≥ 2 cm) non-pedunculated polyps in the proximal colon will be included and randomized to the clip group or the control group. Prophylactic clipping will be performed in the intervention group to close the resection defect after the EMR with a distance of < 1 cm between the clips. Primary outcome is delayed bleeding within 30 days after EMR. Secondary outcomes are recurrent or residual polyps and clip artifacts during surveillance colonoscopy after 6 months, as well as cost-effectiveness of prophylactic clipping and severity of delayed bleeding. Discussion: The CLIPPER trial is a pragmatic study performed in the Netherlands and is powered to determine the real-time efficacy and cost-effectiveness of prophylactic clipping after EMR of proximal colon polyps ≥ 2 cm in the Netherlands. This study will also generate new data on the achievability of complete closure and the effects of clip placement on scar surveillance after EMR, in order to further promote the debate on the role of prophylactic clipping in everyday clinical practice. Trial registration: ClinicalTrials.gov NCT03309683. Registered on 13 October 2017. Start recruitment: 05 March 2018. Planned completion of recruitment: 31 August 2021

Clip placement to prevent delayed bleeding after colonic endoscopic mucosal resection (CLIPPER): study protocol for a randomized controlled trial

Background: Endoscopic mucosal resection (EMR) for large colorectal polyps is in most cases the preferred treatment to prevent progression to colorectal carcinoma. The most common complication after EMR is delayed bleeding, occurring in 7% overall and in approximately 10% of polyps ≥ 2 cm in the proximal colon. Previous research has suggested that prophylactic clipping of the mucosal defect after EMR may reduce the incidence of delayed bleeding in polyps with a high bleeding risk. Methods: The CLIPPER trial is a multicenter, parallel-group, single blinded, randomized controlled superiority study. A total of 356 patients undergoing EMR for large (≥ 2 cm) non-pedunculated polyps in the proximal colon will be included and randomized to the clip group or the control group. Prophylactic clipping will be performed in the intervention group to close the resection defect after the EMR with a distance of < 1 cm between the clips. Primary outcome is delayed bleeding within 30 days after EMR. Secondary outcomes are recurrent or residual polyps and clip artifacts during surveillance colonoscopy after 6 months, as well as cost-effectiveness of prophylactic clipping and severity of delayed bleeding. Discussion: The CLIPPER trial is a pragmatic study performed in the Netherlands and is powered to determine the real-time efficacy and cost-effectiveness of prophylactic clipping after EMR of proximal colon polyps ≥ 2 cm in the Netherlands. This study will also generate new data on the achievability of complete closure and the effects of clip placement on scar surveillance after EMR, in order to further promote the debate on the role of prophylactic clipping in everyday clinical practice. Trial registration: ClinicalTrials.gov NCT03309683. Registered on 13 October 2017. Start recruitment: 05 March 2018. Planned completion of recruitment: 31 August 2021

Die Nitratbelastung der Trinkwasserversorgungsanlagen des Kreises Neuruppin ein gesundheitspolitisches Problem

DB Leipzig(101) - Di 1986 B VD 187 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

Adaptation of Soil Physical Measurement Techniques for the Delineation of Mud and Lakebed Sediments at Neusiedler See

For many water management issues of shallow lakes with non-consolidated sediments hydrographic surveys of the open water area and reed belt areas are required. In the frame of water management strategy for the steppe lake Neusiedler See, located between Austria and Hungary, a hydrographic survey was conducted. In the open water area (water depth ≥1 m) a sediment echosounder was used. To validate these measurements and to distinguish between water, mud, and sediment layers in the shallow lake and reed belt area additional measurements were needed. As no common standard methods are available yet, we developed a measurement system based on two commonly applied soil physical measurement techniques providing reproducible physical values: a capacitive sensor and a cone penetrometer combined with GNSS-positioning enable dynamic measurements of georeferenced vertical water-mud-bedsediments profiles. The system bases on site-specific calibrated sensors and allows instantaneous, in situ measurements. The measurements manifest a sharp water-mud interface by a sudden decline to smaller water content which is a function of the dielectric permittivity. A second decline indicates the transition to compacted mud. That is concurrently the density where the penetrometer starts registering significant penetration resistance. The penetrometer detects shallow lakebed-sediment layers. Within the lake survey this measurement system was successfully tested