An example of enhanced tephra deposition driven by topographically-induced atmospheric turbulence

Spatial variations in the thickness and grain-size characteristics of tephra fall deposits imply that tephra depositional processes cannot be fully captured by models of single-particle sedimentation from the base of the eruption plume. Here, we document a secondary thickness maximum in a ∼9.75 ka tephra fall deposit from Chaitén volcano, Chile (Cha1 eruption). This secondary thickness maximum is notably coarser-grained than documented historical examples, being dominated by medium-grained ash, and an origin via particle aggregation is therefore unlikely. In the region of secondary thickening, we propose that high levels of atmospheric turbulence accelerated particles held within the mid- to lower-troposphere (0 to ∼6 km) towards the ground surface. We suggest that this enhancement in vertical atmospheric mixing was driven by the breaking of lee waves, generated by winds passing over elevated topography beneath the eruption plume. Lower atmospheric circulation patterns may exert a significant control on the dispersal and deposition of tephra from eruption plumes across all spatial scales, particularly in areas of complex topography

From gradual spreading to catastrophic collapse - Reconstruction of the 1888 Ritter Island volcanic sector collapse from high-resolution 3D seismic data

Volcanic island flank collapses have the potential to trigger devastating tsunamis threatening coastal communities and infrastructure. The 1888 sector collapse of Ritter Island, Papua New Guinea (in the following called Ritter) is the most voluminous volcanic island flank collapse in historic times. The associated tsunami had run-up heights of more than 20 m on the neighboring islands and reached settlements 600 km away from its source. This event provides an opportunity to advance our understanding of volcanic landslide-tsunami hazards. Here, we present a detailed reconstruction of the 1888 Ritter sector collapse based on high-resolution 2D and 3D seismic and bathymetric data covering the failed volcanic edifice and the associated mass-movement deposits. The 3D seismic data reveal that the catastrophic collapse of Ritter occurred in two phases: (1) Ritter was first affected by deep-seated, gradual spreading over a long time period, which is manifest in pronounced compressional deformation within the volcanic edifice and the adjacent seafloor sediments. A scoria cone at the foot of Ritter acted as a buttress, influencing the displacement and deformation of the western flank of the volcano and causing shearing within the volcanic edifice. (2) During the final, catastrophic phase of the collapse, about 2.4 km³ of Ritter disintegrated almost entirely and travelled as a highly energetic mass flow, which incised the underlying sediment. The irregular topography west of Ritter is a product of both compressional deformation and erosion. A crater-like depression underlying the recent volcanic cone and eyewitness accounts suggest that an explosion may have accompanied the catastrophic collapse. Our findings demonstrate that volcanic sector collapses may transform from slow gravitational deformation to catastrophic collapse. Understanding the processes involved in such a transformation is crucial for assessing the hazard potential of other volcanoes with slowly deforming flanks such as Mt. Etna or Kilauea

Modelling of the tsunami from the December 22, 2018 lateral collapse of Anak Krakatau volcano in the Sunda Straits, Indonesia

On Dec. 22, 2018, at approximately 20:55–57 local time, Anak Krakatau volcano, located in the Sunda Straits of Indonesia, experienced a major lateral collapse during a period of eruptive activity that began in June. The collapse discharged volcaniclastic material into the 250 m deep caldera southwest of the volcano, which generated a tsunami with runups of up to 13 m on the adjacent coasts of Sumatra and Java. The tsunami caused at least 437 fatalities, the greatest number from a volcanically-induced tsunami since the catastrophic explosive eruption of Krakatau in 1883 and the sector collapse of Ritter Island in 1888. For the first time in over 100 years, the 2018 Anak Krakatau event provides an opportunity to study a major volcanically-generated tsunami that caused widespread loss of life and significant damage. Here, we present numerical simulations of the tsunami, with state-of the-art numerical models, based on a combined landslide-source and bathymetric dataset. We constrain the geometry and magnitude of the landslide source through analyses of pre- and post-event satellite images and aerial photography, which demonstrate that the primary landslide scar bisected the Anak Krakatau volcano, cutting behind the central vent and removing 50% of its subaerial extent. Estimated submarine collapse geometries result in a primary landslide volume range of 0.22–0.30 km3, which is used to initialize a tsunami generation and propagation model with two different landslide rheologies (granular and fluid). Observations of a single tsunami, with no subsequent waves, are consistent with our interpretation of landslide failure in a rapid, single phase of movement rather than a more piecemeal process, generating a tsunami which reached nearby coastlines within ~30 minutes. Both modelled rheologies successfully reproduce observed tsunami characteristics from post-event field survey results, tide gauge records, and eyewitness reports, suggesting our estimated landslide volume range is appropriate. This event highlights the significant hazard posed by relatively small-scale lateral volcanic collapses, which can occur en-masse, without any precursory signals, and are an efficient and unpredictable tsunami source. Our successful simulations demonstrate that current numerical models can accurately forecast tsunami hazards from these events. In cases such as Anak Krakatau’s, the absence of precursory warning signals together with the short travel time following tsunami initiation present a major challenge for mitigating tsunami coastal impact

The relationship between eruptive activity, flank collapse, and sea level at volcanic islands: A long-term (>1 Ma) record offshore Montserrat, Lesser Antilles

Hole U1395B, drilled southeast of Montserrat during Integrated Ocean Drilling Program Expedition 340, provides a long (>1 Ma) and detailed record of eruptive and mass-wasting events (>130 discrete events). This record can be used to explore the temporal evolution in volcanic activity and landslides at an arc volcano. Analysis of tephra fall and volcaniclastic turbidite deposits in the drill cores reveals three heightened periods of volcanic activity on the island of Montserrat (?930 ka to ?900 ka, ?810 ka to ?760 ka, and ?190 ka to ?120 ka) that coincide with periods of increased volcano instability and mass-wasting. The youngest of these periods marks the peak in activity at the Soufrière Hills volcano. The largest flank collapse of this volcano (?130 ka) occurred towards the end of this period, and two younger landslides also occurred during a period of relatively elevated volcanism. These three landslides represent the only large (>0.3 km3) flank collapses of the Soufrière Hills edifice, and their timing also coincides with periods of rapid sea-level rise (>5 m/ka). Available age data from other island arc volcanoes suggests a general correlation between the timing of large landslides and periods of rapid sea-level rise, but this is not observed for volcanoes in intra-plate ocean settings. We thus infer that rapid sea-level rise may modulate the timing of collapse at island arc volcanoes, but not in larger ocean-island settings

Systemic therapy of Cushing’s syndrome

Cushing’s disease (CD) in a stricter sense derives from pathologic adrenocorticotropic hormone (ACTH) secretion usually triggered by micro- or macroadenoma of the pituitary gland. It is, thus, a form of secondary hypercortisolism. In contrast, Cushing’s syndrome (CS) describes the complexity of clinical consequences triggered by excessive cortisol blood levels over extended periods of time irrespective of their origin. CS is a rare disease according to the European orphan regulation affecting not more than 5/10,000 persons in Europe. CD most commonly affects adults aged 20–50 years with a marked female preponderance (1:5 ratio of male vs. female). Patient presentation and clinical symptoms substantially vary depending on duration and plasma levels of cortisol. In 80% of cases CS is ACTH-dependent and in 20% of cases it is ACTH-independent, respectively. Endogenous CS usually is a result of a pituitary tumor. Clinical manifestation of CS, apart from corticotropin-releasing hormone (CRH-), ACTH-, and cortisol-producing (malign and benign) tumors may also be by exogenous glucocorticoid intake. Diagnosis of hypercortisolism (irrespective of its origin) comprises the following: Complete blood count including serum electrolytes, blood sugar etc., urinary free cortisol (UFC) from 24 h-urine sampling and circadian profile of plasma cortisol, plasma ACTH, dehydroepiandrosterone, testosterone itself, and urine steroid profile, Low-Dose-Dexamethasone-Test, High-Dose-Dexamethasone-Test, after endocrine diagnostic tests: magnetic resonance imaging (MRI), ultra-sound, computer tomography (CT) and other localization diagnostics. First-line therapy is trans-sphenoidal surgery (TSS) of the pituitary adenoma (in case of ACTH-producing tumors). In patients not amenable for surgery radiotherapy remains an option. Pharmacological therapy applies when these two options are not amenable or refused. In cases when pharmacological therapy becomes necessary, Pasireotide should be used in first-line in CD. CS patients are at an overall 4-fold higher mortality rate than age- and gender-matched subjects in the general population. The following article describes the most prominent substances used for clinical management of CS and gives a systematic overview of safety profiles, pharmacokinetic (PK)-parameters, and regulatory framework

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Reinterpretation of LHC Results for New Physics: Status and recommendations after Run 2

We report on the status of efforts to improve the reinterpretation of searches and measurements at the LHC in terms of models for new physics, in the context of the LHC Reinterpretation Forum. We detail current experimental offerings in direct searches for new particles, measurements, technical implementations and Open Data, and provide a set of recommendations for further improving the presentation of LHC results in order to better enable reinterpretation in the future. We also provide a brief description of existing software reinterpretation frameworks and recent global analyses of new physics that make use of the current data

Permeability and pressure measurements in Lesser Antilles submarine slides: Evidence for pressure-driven slow-slip failure

Recent studies hypothesize that some submarine slides fail via pressure-driven slow-slip deformation. To test this hypothesis, this study derives pore pressures in failed and adjacent unfailed deep marine sediments by integrating rock physics models, physical property measurements on recovered sediment core, and wireline logs. Two drill sites (U1394 and U1399) drilled through interpreted slide debris; a third (U1395) drilled into normal marine sediment. Near-hydrostatic fluid pressure exists in sediments at site U1395. In contrast, results at both sites U1394 and U1399 indicate elevated pore fluid pressures in some sediment. We suggest that high pore pressure at the base of a submarine slide deposit at site U1394 results from slide shearing. High pore pressure exists throughout much of site U1399, and Mohr circle analysis suggests that only slight changes in the stress regime will trigger motion. Consolidation tests and permeability measurements indicate moderately low (~10⁻¹⁶–10⁻¹⁷ m²) permeability and overconsolidation in fine-grained slide debris, implying that these sediments act as seals. Three mechanisms, in isolation or in combination, may produce the observed elevated pore fluid pressures at site U1399: (1) rapid sedimentation, (2) lateral fluid flow, and (3) shearing that causes sediments to contract, increasing pore pressure. Our preferred hypothesis is this third mechanism because it explains both elevated fluid pressure and sediment overconsolidation without requiring high sedimentation rates. Our combined analysis of subsurface pore pressures, drilling data, and regional seismic images indicates that slope failure offshore Martinique is perhaps an ongoing, creep-like process where small stress changes trigger motion