Basin tectonic history and paleo-physiography of the pelagian platform, northern Tunisia, using vitrinite reflectance data

Constraining the thermal, burial and uplift/exhumation history of sedimentary basins is crucial in the understanding of upper crustal strain evolution and also has implications for understanding the nature and timing of hydrocarbon maturation and migration. In this study, we use Vitrinite Reflectance (VR) data to elucidate the paleo‐physiography and thermal history of an inverted basin in the foreland of the Atlasic orogeny in Northern Tunisia. In doing so, it is the primary aim of this study to demonstrate how VR techniques may be applied to unravel basin subsidence/uplift history of structural domains and provide valuable insights into the kinematic evolution of sedimentary basins. VR measurements of both the onshore Pelagian Platform and the Tunisian Furrow in Northern Tunisia are used to impose constraints on the deformation history of a long‐lived structural feature in the studied region, namely the Zaghouan Fault. Previous work has shown that this fault was active as an extensional structure in Lower Jurassic to Aptian times, before subsequently being inverted during the Late Cretaceous Eocene Atlas I tectonic event and Upper Miocene Atlas II tectonic event. Quantifying and constraining this latter inversion stage, and shedding light on the roles of structural inheritance and the basin thermal history, are secondary aims of this study. The results of this study show that the Atlas II WNW‐ESE compressive event deformed both the Pelagian Platform and the Tunisian Furrow during Tortonian‐Messinian times. Maximum burial depth for the Pelagian Platform was reached during the Middle to Upper Miocene, i.e. prior to the Atlas II folding event. VR measurements indicate that the Cretaceous to Ypresian section of the Pelagian Platform was buried to a maximum burial depth of ~3 km, using a geothermal gradient of 30°C/km. Cretaceous rock samples VR values show that the hanging wall of the Zaghouan Fault was buried to a maximum depth of <2 km. This suggests that a vertical km‐scale throw along the Zaghouan Fault pre‐dated the Atlas II shortening, and also proves that the fault controlled the subsidence of the Pelagian Platform during the Oligo‐Miocene. Mean exhumation rates of the Pelagian Platform throughout the Messinian to Quaternary were in the order of 0.3 mm/year. However, when the additional effect of Tortonian‐Messinian folding is accounted for, exhumation rates could have reached 0.6-0.7 mm/year

Inferior vestibular neuritis: 3 cases with clinical features of acute vestibular neuritis, normal calorics but indications of saccular failure

BACKGROUND: Vestibular neuritis (VN) is commonly diagnosed by demonstration of unilateral vestibular failure, as unilateral loss of caloric response. As this test reflects the function of the superior part of the vestibular nerve only, cases of pure inferior nerve neuritis will be lost. CASE PRESENTATIONS: We describe three patients with symptoms suggestive of VN, but normal calorics. All 3 had unilateral loss of vestibular evoked myogenic potential. A slight, asymptomatic position dependent nystagmus, with the pathological ear down, was observed. CONCLUSION: We believe that these patients suffer from pure inferior nerve vestibular neuritis

Identifying National Level Education Reforms in Developing Settings: An Application to Ethiopia

Increasing enrollment in primary education has been at the center of international education policy for well over a decade. In developing parts of the world, significant increases in primary enrollment are often generated by large national level programs, which can simultaneously promote overcrowding and reductions in education quality. However, to analyze the trade-off between increased enrollment and potential reductions in quality one must first identify and evaluate the impact of the national reform on schooling. This paper provides a method with which these types of reforms can be identified in developing settings using both temporal and geographic variation, and readily available data. The method is applied to an early 1990s reform in Ethiopia based around the release of the Education and Training Policy, which removed schooling fees from grades one to ten. The model estimates that the reform led to an increase in schooling of at least 1.2 years, and provides initial evidence that the increased enrollment in Ethiopia outweighed any cost due to reductions in quality

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Abstract: 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

Italian guidelines for primary headaches: 2012 revised version

The first edition of the Italian diagnostic and therapeutic guidelines for primary headaches in adults was published in J Headache Pain 2(Suppl. 1):105–190 (2001). Ten years later, the guideline committee of the Italian Society for the Study of Headaches (SISC) decided it was time to update therapeutic guidelines. A literature search was carried out on Medline database, and all articles on primary headache treatments in English, German, French and Italian published from February 2001 to December 2011 were taken into account. Only randomized controlled trials (RCT) and meta-analyses were analysed for each drug. If RCT were lacking, open studies and case series were also examined. According to the previous edition, four levels of recommendation were defined on the basis of levels of evidence, scientific strength of evidence and clinical effectiveness. Recommendations for symptomatic and prophylactic treatment of migraine and cluster headache were therefore revised with respect to previous 2001 guidelines and a section was dedicated to non-pharmacological treatment. This article reports a summary of the revised version published in extenso in an Italian version