New stratigraphic and structural evidence for Late Pleistocene surface faulting along the Monte Olimpino Backthrust (Lombardia, N Italy)

We summarize some preliminary results achieved during the investigations conducted for the CARG Project, geological sheet n. 75 “Como”, i.e. the analysis of the Quaternary evolution of the “Monte Olimpino Backthrust” and the evaluation of its seismogenic activity. Cross-border field mapping between Ticino (CH) and Lombardia (IT) resulted in the finding of new outcrops (Borgo Vico site, in the north-western sector of the urban area of Como) located along the front of the Monte Olimpino Backthrust, that allowed to recognize evidence for Late Pleistocene reverse surface faulting along this structure. At Borgo Vico, a clastic Tertiary unit, the Villa Olmo Conglomerate, intercalated in the Chiasso Fm. of Early Oligocene age, is thrust over a Late Pleistocene fluvioglacial and glacio-lacustrine sequence (Comerci et alii, 2007). Until now, the Monte Olimpino Backthrust was supposed by most authors to have been active until Tortonian times. Sileo et alii (2007) inferred a Pliocene activity and proposed, based on geomorphic evidence, that fault displacement was still taking place during Pleistocene. However, this is the first time that Pleistocene activity along the Monte Olimpino Backthrust has been documented by unequivocal tectonic offset of late Pleistocene deposits. Paleoseismological analyses are in progress in order to distinguish potential coseismic movement from fault creep during the observed recent displacement

Quaternary capable folds and seismic hazard in Lombardia (Northern Italy): the Castenedolo structure near Brescia.

We identify evidence of late Quaternary compressive tectonics in the Northern sector of the Central Po Plain through a systematic revision of the literature, new field mapping, and a new study of seismic reflection data obtained by ENI E&P. In particular, the reinterpretation of ca. 18.000 km of seismic profiles clearly shows a belt of segmented, 10 to 20 km long, fault propagation folds, controlled by the Plio-Quaternary growth of several out-of-sequence thrusts. As an example of this active structural style, in this paper we focus on a buried fold located just south of the Castenedolo Hill, a few km SE of Brescia. Although the Castenedolo anticline has long ago been described as a young compressional structure (e.g., DESIO, 1965), no detailed structural analysis of this feature has been performed until now. We calculated the uplift rates of this fold through the analysis of its syntectonic sedimentary record as imaged by the extremely high quality ENI E&P subsurface data available in the area. The evolution of this anticline was a discontinuous process characterized by several tectonic uplift pulses (with rates of ca. 0.1 mm/yr) of different duration, separated by periods of variable extent in which no fold growth occurred. The Quaternary growth history of this anticline and the presence of faulted and folded late Pleistocene to Holocene deposits at nearby sites (Ciliverghe and Monte Netto) demonstrate that the significant seismicity of this area (e.g., the December 25, 1222, Io = IX MCS Brescia earthquake, MAGRI & MOLIN, 1986; GUIDOBONI, 1986) must be related to active compressional structures within the Brescia piedmont belt. Our regional investigations show that the structural and paleoseismic setting illustrated near Castenedolo is typical of the whole Lombardia domain of the Southern Alps. This implies that the currently accepted seismotectonic model for this region, and related seismic hazard assessment, should be thoroughly and carefully re-evaluated

Masculinity and engagement in HIV care among male fisherfolk on HIV treatment in Uganda.

This study explored the intersection of masculinity and HIV care engagement among fishermen and other male fisherfolk on antiretroviral therapy (ART) in Wakiso District, Uganda. We conducted 30 in-depth interviews with men on ART recruited from HIV treatment sites and used a thematic analysis approach. Since HIV diagnosis and ART initiation, men had adopted masculine identities more conducive to HIV care engagement. The masculine roles of worker and provider, husband and sexual partner and the appearance of physical strength were compromised by HIV, but restored by ART's positive effects on health. Peers also emerged as facilitators to HIV care, with men supporting each other to seek testing and treatment. However, structural and occupational barriers to HIV care associated with the masculine role of worker remained a barrier to care engagement. Findings suggest that emphasising the benefits of ART in bolstering men's ability to fulfil the roles important to them may improve the effectiveness of HIV testing and treatment messaging for men. Differentiated care models that address structural-level barriers to care, and community-level gender-transformative programming to help fishermen engage in HIV care, may be beneficial

What influences aggression and foraging activity in social birds? Measuring individual, group and environmental characteristics

This is the final version. Available from Wiley via the DOI in this record.For specialised feeders, accessing food resources may impact on the performance of appetitive foraging and social behaviours at individual and population levels. Flamingos are excellent examples of social species with complex, species‐specific feeding strategies. As attainment of coloured plumage depends upon intake of dietary carotenoids, and as study of free‐ranging flamingos shows that foraging is disrupted by aggression from other birds, we investigated the effect of four feeding styles on foraging and aggression in captive lesser flamingos. We evaluated individual and group differences in foraging and aggression when birds consumed bespoke “flamingo pellet” from a bowl, an indoor feeding pool and an outdoor feeding section of their pool. Natural foraging (when birds were feeding irrespective of the presence of pellet) was recorded for comparison with artificial feeding styles. One‐minute long video footage of the birds' activities in these different locations, recorded between 2013 and 2016, was used to evaluate behaviour. Total number of seconds engaged in feeding and in aggression was recorded by continuous sampling. The colour of individual birds was scored from 1 (mainly white) to 4 (mainly pink). For natural filter feeding in the outdoor pool, maximum foraging was twice as much as bowl feeding, whilst aggression was less than half as much as other feeding methods. Overall, a more restricted feeding style significantly predicted aggression, along with increasing group size. Plumage colour significantly influenced aggression (brightest flamingos were more aggressive) and showed a non‐significant trend with foraging (brighter birds fed less than paler birds). No sex effect on feeding or aggression was found. This study enhances our understanding of husbandry and species' biology impacts on captive behaviour and provides data‐based evidence to improve food presentation. For flamingos, implementation of spacious outdoor feeding areas can encourage natural foraging patterns by reducing excess aggression and enhances welfare by improving flock social stability

Perinatal outcome of monochorionic triamniotic triplet pregnancy: multicenter cohort study

Objective Monochorionic (MC) triplet pregnancies are extremely rare and information on these pregnancies and their complications is limited. We aimed to investigate the risk of early and late pregnancy complications, perinatal outcome and the timing and methods of fetal intervention in these pregnancies.Methods This was a multicenter retrospective cohort study of MC triamniotic (TA) triplet pregnancies managed in 21 participating centers around the world from 2007 onwards. Data on maternal age, mode of conception, diagnosis of major fetal structural anomalies or aneuploidy, gestational age (GA) at diagnosis of anomalies, twin-to-twin transfusion syndrome (TTTS), twin anemia-polycythemia sequence (TAPS), twin reversed arterial perfusion (TRAP) sequence and or selective fetal growth restriction (sFGR) were retrieved from patient records. Data on antenatal interventions were collected, including data on selective fetal reduction (three to two or three to one), laser surgery and any other active fetal intervention (including amniodrainage). Data on perinatal outcome were collected, including numbers of live birth, intrauterine demise, neonatal death, perinatal death and termination of fetus or pregnancy (TOP). Neonatal data such as GA at birth, birth weight, admission to neonatal intensive care unit and neonatal morbidity were also collected. Perinatal outcomes were assessed according to whether the pregnancy was managed expectantly or underwent fetal intervention.Results Of an initial cohort of 174 MCTA triplet pregnancies, 11 underwent early TOP, three had an early miscarriage, six were lost to follow-up and one was ongoing at the time of writing. Thus, the study cohort included 153 pregnancies, of which the majority (92.8%) were managed expectantly. The incidence of pregnancy affected by one or more fetal structural abnormality was 13.7% (21/153) and that of TRAP sequence was 5.2% (8/153). The most common antenatal complication related to chorionicity was TTTS, which affected just over one quarter (27.6%; 42/152, after removing a pregnancy with TOP < 24 weeks for fetal anomalies) of the pregnancies, followed by sFGR (16.4%; 25/152), while TAPS (spontaneous or post TTTS with or without laser treatment) occurred in only 4.6% (7/152) of pregnancies. No monochorionicity-related antenatal complication was recorded in 49.3% (75/152) of pregnancies. Survival was apparently associated largely with the development of these complications: there was at least one survivor beyond the neonatal period in 85.1% (57/67) of pregnancies without antenatal complications, in 100% (25/25) of those complicated by sFGR and in 47.6% (20/42) of those complicated by TTTS. The overall rate of preterm birth prior to 28 weeks was 14.5% (18/124) and that prior to 32 weeks' gestation was 49.2% (61/124).Conclusion Monochorionicity-related complications, which can impact adversely perinatal outcome, occur in almost half of MCTA triplet pregnancies, creating a challenge with regard to counseling, surveillance and management. (c) 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology

multicenter cohort study

Publisher Copyright: © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.Objective: Monochorionic (MC) triplet pregnancies are extremely rare and information on these pregnancies and their complications is limited. We aimed to investigate the risk of early and late pregnancy complications, perinatal outcome and the timing and methods of fetal intervention in these pregnancies. Methods: This was a multicenter retrospective cohort study of MC triamniotic (TA) triplet pregnancies managed in 21 participating centers around the world from 2007 onwards. Data on maternal age, mode of conception, diagnosis of major fetal structural anomalies or aneuploidy, gestational age (GA) at diagnosis of anomalies, twin-to-twin transfusion syndrome (TTTS), twin anemia–polycythemia sequence (TAPS), twin reversed arterial perfusion (TRAP) sequence and or selective fetal growth restriction (sFGR) were retrieved from patient records. Data on antenatal interventions were collected, including data on selective fetal reduction (three to two or three to one), laser surgery and any other active fetal intervention (including amniodrainage). Data on perinatal outcome were collected, including numbers of live birth, intrauterine demise, neonatal death, perinatal death and termination of fetus or pregnancy (TOP). Neonatal data such as GA at birth, birth weight, admission to neonatal intensive care unit and neonatal morbidity were also collected. Perinatal outcomes were assessed according to whether the pregnancy was managed expectantly or underwent fetal intervention. Results: Of an initial cohort of 174 MCTA triplet pregnancies, 11 underwent early TOP, three had an early miscarriage, six were lost to follow-up and one was ongoing at the time of writing. Thus, the study cohort included 153 pregnancies, of which the majority (92.8%) were managed expectantly. The incidence of pregnancy affected by one or more fetal structural abnormality was 13.7% (21/153) and that of TRAP sequence was 5.2% (8/153). The most common antenatal complication related to chorionicity was TTTS, which affected just over one quarter (27.6%; 42/152, after removing a pregnancy with TOP < 24 weeks for fetal anomalies) of the pregnancies, followed by sFGR (16.4%; 25/152), while TAPS (spontaneous or post TTTS with or without laser treatment) occurred in only 4.6% (7/152) of pregnancies. No monochorionicity-related antenatal complication was recorded in 49.3% (75/152) of pregnancies. Survival was apparently associated largely with the development of these complications: there was at least one survivor beyond the neonatal period in 85.1% (57/67) of pregnancies without antenatal complications, in 100% (25/25) of those complicated by sFGR and in 47.6% (20/42) of those complicated by TTTS. The overall rate of preterm birth prior to 28 weeks was 14.5% (18/124) and that prior to 32 weeks' gestation was 49.2% (61/124). Conclusion: Monochorionicity-related complications, which can impact adversely perinatal outcome, occur in almost half of MCTA triplet pregnancies, creating a challenge with regard to counseling, surveillance and management.publishersversionpublishe

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome