Onshore climate change during the late triassic marine inundation of the Central European Basin

Sedimentological, pedological and palynological evidence reveal radically increasing onshore humidity during the Rhaetian marine invasion of central Europe along the north-eastern margin of the Central European Basin (southern Sweden). Pre-Rhaetian aridity favoured the formation of Carnian redbeds with calcrete, which were succeeded by Norian hematite-cemented conglomerates, arkoses, arkosic wackestones, and smectititic mudstones deposited on braidplains and in lakes. Superimposed autochthonous coals and gleysols indicate the Rhaetian onset of year-round humidity. Chemically mature sandstones, kaolinitic mudstones and luvisols also formed at this time, influenced by a permanent vegetation cover which lowered soil pH and strongly intensified chemical weathering. The Rhaetian deposits accumulated in floodplain lakes repeatedly subjected to sediment infill, plant colonization and palaeosol development. The humidity shift resembles that contemporaneously recorded in the North Sea region

The Outcomes Among Patients Presenting in Primary Care with a Physical Symptom at 5 Years

BACKGROUND: Symptoms are common and often remain medically unexplained. OBJECTIVE: To assess 5-year symptom outcomes, determine how often symptoms remain unexplained and assess their relationship with mental disorders. DESIGN: Prospective cohort study. PARTICIPANTS: Five hundred consecutive patients presenting to a medicine clinic with physical symptoms. MEASUREMENTS PREVISIT: Mental disorders, symptom characteristics, stress, expectations, illness worry, and functional status. Postvisit (immediately, 2 weeks, 3 months, 5 years): unmet expectations, satisfaction, symptom outcome, functional status, and stress. RESULTS: While most subjects (81%) experienced symptom improvement by 5 years, resolution rates were lower (56%), with 35% of symptoms remained medically unexplained. Most patients with medically unexplained symptoms (MUS) did not have a mental disorder. Mood or anxiety disorders were not associated with MUS (relative risks [RR]: 0.94, 95% confidence interval [CI]: 0.79 to 1.13), or with lower rates of symptom improvement (RR: 1.14, 95% CI: 0.60 to 2.2). In contrast, most patients with somatoform disorders had MUS and were unlikely to improve. Worse functioning (RR: 0.95, 95% CI: 0.91 to 0.99), longer duration of symptom at presentation (RR: 0.5, 95% CI: 0.28 to 0.87), illness worry at presentation (RR: 0.56, 95% CI: 0.35 to 0.89), or lack of resolution by 3 months (RR: 0.47, 95% CI: 0.26 to 0.86) reduced the likelihood of symptom improvement at 5 years. CONCLUSIONS: More than half of patients presenting with a physical symptom resolve by 5 years, while a third remain medically unexplained. Most patients whose symptom remained unexplained had no mental disorder. While mood and anxiety disorders were not associated with MUS or worse outcomes, most patients with somatoform disorders had MUS and were unlikely to improve