TAPHONOMY OF AMMONITE ASSEMBLAGES FROM THE MIDDLE-UPPER OXFORDIAN (TRANSVERSARIUM? - BIFURCATUS ZONES) IN THE INTERNAL PREBETIC (BETIC CORDILLERA, SOUTHERN SPAIN): TAPHONIC POPULATIONS AND TAPHOFACIES TO SUPPORT ECOSTRATIGRAPHIC INTERPRETATIONS

The taphonomic analysis conducted on ammonoid assemblages has proven useful for palaeobiological and palaeoenvironmental reconstructions in upper Middle-to-lower Upper Oxfordian epicontinental deposits of the Internal Prebetic (southern Spain). Taphonic populations close to type I indicate the proximity, even coincidence, of life areas for neritic ammonites (i.e. parautochthonous assemblages). The relationships among preservation mode, shell size, within-bed position, corrasion, fragmentation, and epibionts (encrustment included), with lumpy-oncolitic and condensed & bioclasts-rich lumpy-oncolitic limestones allows us to typify two taphofacies. Taphofacies I shows higher values of mean shell size, corrasion, epibionts and encrustments, as well as a high number of specimens in quasi-horizontal settlement. The opposite characteristics serve to identify Taphofacies II. Taphonomic features, taphofacies and lithofacies combine in coherence with progressing third-order transgressive-to-highstand system-tract conditions and the resulting ecostratigraphic trends, which are registered by fluctuations in ammonite assemblages

Introducing Fiji and ICY image processing techniques in ichnological research as a tool for sedimentary basin analysis

Some features of trace fossils are not easy to determine due to limited vissibility of trace fossils. Here, we applied two image processing techniques (Fiji and ICY) to ichnological studies and we compare them with the previously used high-resolution image treatment method. , discussing their usefulness for ichnological studies. Then, these are compared with a high resolution image treatment. These techniques are revealed as rapid alternatives for estimation of some ichnological features, being so useful for the first stages of research, when a detailed analysis is not needed

Late Oligocene-Miocene proto-Antarctic Circumpolar Current dynamics off the Wilkes Land margin, East Antarctica

At present, the Southern Ocean plays an important role in the global climate system and in modern Antarctic ice sheet dynamics. Past Southern Ocean configurations are however poorly understood. This information is yet important as it may provide important insights into the climate system and past ice-sheet behavior under warmer than present day climates. Here we study Southern Ocean dynamics during the Oligocene and Miocene when reconstructed atmospheric CO2 concentrations were similar to those expected during this century. We reconstruct snapshots of late Oligocene to earliest Miocene (~24.2–23 Ma) paleoceanographic conditions in the East Antarctic Wilkes Land abyssal plain. For this, we combine marine sedimentological, geochemical (X-ray fluorescence, TEX86,), palynological and isotopic (εNd) records from ocean sediments recovered at Deep Sea Drilling Project (DSDP) Site 269. Overall, we find that sediments, delivered to the site by gravity flows and hemipelagic settling during glacial-interglacial cycles, were persistently reworked by a proto-Circumpolar Deep Water (CDW) with varying strengths that result from climatically controlled frontal system migrations. Just prior to 24 Ma, terrigenous input of predominantly fine-grained sediments deposited under weak proto-CDW intensities and poorly ventilated bottom conditions dominates. In comparison, 24 Ma marks the start of episodic events of enhanced proto-CDW current velocities, associated with coarse-grained deposits and better-ventilated bottom conditions. In particular, the dominance of P-cyst and low Calcium (Ca) in the sediments between ~ 24.2 Ma and 23.6 Ma indicate the presence of an active open ocean upwelling associated with high nutrient conditions. This is supported by TEX86-derived sea surface temperature (SST) data pointing to cool ocean conditions. From ~ 23.6 to 23.2 Ma, our records reveal an enrichment of Ca in the sediments related to increased calcareous microfossil preservation, high amounts of G-cysts and increasing TEX86-SSTs. This implies warmer water masses reaching the Antarctic margin as the polar front migrated southward. Together with the radiogenic Nd isotope data indicating modern-like CDW values, our records suggest a prominent poleward expansion of proto-CDW over our study site and reduced AABW formation during the latest Oligocene (i.e. ~23.2 Ma ago). Our findings support the notion of a fundamentally different Southern Ocean, with a weaker proto-ACC than present during the late Oligocene and the earliest Miocene

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

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

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