Miaolingian transgression and the <i>Oryctocephalus indicus</i> biozone in the Sumna Valley (Spiti), Himalaya, India

The Oryctocephalus indicus biozone (Wuliuan, Miaolingian) is recognised in the Sumna Valley, in the southeastern part of the Spiti region in the Himalaya, based on the first appearance datum and last appearance datum of Oryctocephalus indicus. The biozone is approximately 5.6 m thick (17.8–23.4 m), and it contains the trilobites Oryctocephalus indicus, Pagetia significans and Kunmingaspis pervulgata. Comparative studies of the lithological variations across the Cambrian Series 2–Wuliuan (Miaolingian) transition in the Parahio and Sumna valleys (southeastern part of the Spiti region) show that the Wuliuan (Miaolingian) deposits transgressed over the undulatory surface of Cambrian Series 2. The uppermost part of the Cambrian Series 2 deposits in the southeastern part of the Spiti region is characterised by a reddish-brown ferruginous, very coarse grained sandstone unit, which indicates a diastem prior to the Wuliuan (Miaolingian) transgression

Miaolingian transgression and the Oryctocephalus indicus biozone in the Sumna Valley (Spiti), Himalaya, India

The Oryctocephalus indicus biozone (Wuliuan, Miaolingian) is recognised in the Sumna Valley, in the southeastern part of the Spiti region in the Himalaya, based on the first appearance datum and last appearance datum of Oryctocephalus indicus. The biozone is approximately 5.6 m thick (17.8–23.4 m), and it contains the trilobites Oryctocephalus indicus, Pagetia significans and Kunmingaspis pervulgata. Comparative studies of the lithological variations across the Cambrian Series 2–Wuliuan (Miaolingian) transition in the Parahio and Sumna valleys (southeastern part of the Spiti region) show that the Wuliuan (Miaolingian) deposits transgressed over the undulatory surface of Cambrian Series 2. The uppermost part of the Cambrian Series 2 deposits in the southeastern part of the Spiti region is characterised by a reddish-brown ferruginous, very coarse grained sandstone unit, which indicates a diastem prior to the Wuliuan (Miaolingian) transgression

Warm-water Dasycladaceae algae from the Late Ordovician of the Parahio Valley, Spiti, India

Warm-water Dasycladaceae algae Mastopora and Cyclocrinites were for the first time recorded from the Takche Formation (Upper Ordovician–lower Silurian), Parahio Valley, Spiti, India. They are preserved as external and internal moulds of the non-globular or possibly bulb-like cortical skeleton showing flattened thalli with a high degree of compaction. The occurrence of abundant cyclocrinitid remains in the Takche Formation indicates that the Spiti region of the northwestern Himalaya must have been located at about 30° palaeolatitude during the Late Ordovician and early Silurian. The cyclocrinitids were warm-water algae and their extinction at the end of the Ordovician is related to cooling and glaciations. The cyclocrinitids in the Ordovician are known from several localities in central and southern Asia, including Kazakhstan and western China

Influence of Cobalt Doping on the Physical Properties of Zn0.9Cd0.1S Nanoparticles

Zn0.9Cd0.1S nanoparticles doped with 0.005–0.24 M cobalt have been prepared by co-precipitation technique in ice bath at 280 K. For the cobalt concentration >0.18 M, XRD pattern shows unidentified phases along with Zn0.9Cd0.1S sphalerite phase. For low cobalt concentration (≤0.05 M) particle size, dXRDis ~3.5 nm, while for high cobalt concentration (>0.05 M) particle size decreases abruptly (~2 nm) as detected by XRD. However, TEM analysis shows the similar particle size (~3.5 nm) irrespective of the cobalt concentration. Local strain in the alloyed nanoparticles with cobalt concentration of 0.18 M increases ~46% in comparison to that of 0.05 M. Direct to indirect energy band-gap transition is obtained when cobalt concentration goes beyond 0.05 M. A red shift in energy band gap is also observed for both the cases. Nanoparticles with low cobalt concentrations were found to have paramagnetic nature with no antiferromagnetic coupling. A negative Curie–Weiss temperature of −75 K with antiferromagnetic coupling was obtained for the high cobalt concentration

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

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Asteriacites and other trace fossils from the Po Formation (Visean–Serpukhovian), Ganmachidam Hill, Spiti Valley (Himalaya) and its paleoenvironmental significance

An assemblage of trace fossils comprising Asteriacites stelliformis, A. quinquefolius, Biformites insolitus, Helminthoidichnites? isp., Lingulichnus isp., Lockeia siliquaria, Palaeophycus tubularis, Planolites isp., Protovirgularia isp. A, Protovirgularia isp. B, Protovirgularia isp. C, Psammichnites isp., Rusophycus isp., and Treptichnus isp. from the Po Formation (Visean-Serpukhovian) exposed along the base of Ganmachidam Hill near the village of Chichong, Spiti Valley in the Himalaya, is described. Storm beds (tempestites) are highly bioturbated. Sedimentary structures such as hummocky cross-stratification (HCS), low-angle planar and trough cross beds, and shallow, slightly asymmetrical gutter casts are observed. The overall trace fossil assemblage indicates the presence of upper shoreface to lower shoreface Cruziana ichnofacies of an open shelf

Cambrian rocks and faunas of the Wachi La, Black Mountains, Bhutan

The Pele La Group in the Wachi La section in the Black Mountains of central Bhutan represents the easternmost exposure of Cambrian strata known in the Himalaya. The group contains a succession of siliciclastic rocks with minor amounts of carbonate, the uppermost unit of which, the Quartzite Formation, bears age-diagnostic trilobite body fossils that are approximately 493 Ma old. Trilobite species include Kaolishania granulosa, Taipaikia glabra and the new species Lingyuanaspis sangae. A billingsellid brachiopod, Billingsella cf. tonkiniana, is co-occurrent. This fauna is precisely correlated with that of a specific stratigraphic horizon within the upper part of the Kaolishania Zone, Stage 9 of the Cambrian System, Furongian Epoch of the North China block, and thus represents the youngest Cambrian sedimentary rocks yet known from the Himalaya. The faunal similarity suggests proximity between North China and the Himalayan margin at this time. This unit was deposited in a predominantly storm-influenced shelf and shoreface environment. U-Pb geochronological data from detrital zircon grains from the fossil-bearing beds of the Quartzite Formation and strata of the underlying Deshichiling Formation show grain age spectra consistent with those from Cambrian rocks of the Lesser and Tethyan Himalaya in Tibet, India and Pakistan. These data support continuity of the northern Gondwanan margin across the Himalaya. Prominent peaks of approximately 500 Ma zircons in both the Quartzite and Deshichiling formations are consistent with the Furongian (late Cambrian) age assignment for these strata. The presence of these relatively young zircon populations implies rapid post-cooling erosion of igneous bodies and subsequent deposition which may reflect the influence of a widespread Cambro-Ordovician orogenic event evident in the western Himalaya

Extraordinary transport and mixing of sediment across Himalayan central Gondwana during the Cambrian-Ordovician

Detrital zircon samples from Cambrian and Lower to Middle Ordovician strata were taken across and along the strike of the Himalaya from Pakistan to Bhutan (~2000 km). By sampling rocks from one time interval for nearly the entire length of an orogen, an