Convergence rate across the Nepal Himalaya and interseismic coupling on the Main Himalayan Thrust: Implications for seismic hazard

We document geodetic strain across the Nepal Himalaya using GPS times series from 30 stations in Nepal and southern Tibet, in addition to previously published campaign GPS points and leveling data and determine the pattern of interseismic coupling on the Main Himalayan Thrust fault (MHT). The noise on the daily GPS positions is modeled as a combination of white and colored noise, in order to infer secular velocities at the stations with consistent uncertainties. We then locate the pole of rotation of the Indian plate in the ITRF 2005 reference frame at longitude = − 1.34° ± 3.31°, latitude = 51.4° ± 0.3° with an angular velocity of Ω = 0.5029 ± 0.0072°/Myr. The pattern of coupling on the MHT is computed on a fault dipping 10° to the north and whose strike roughly follows the arcuate shape of the Himalaya. The model indicates that the MHT is locked from the surface to a distance of approximately 100 km down dip, corresponding to a depth of 15 to 20 km. In map view, the transition zone between the locked portion of the MHT and the portion which is creeping at the long term slip rate seems to be at the most a few tens of kilometers wide and coincides with the belt of midcrustal microseismicity underneath the Himalaya. According to a previous study based on thermokinematic modeling of thermochronological and thermobarometric data, this transition seems to happen in a zone where the temperature reaches 350°C. The convergence between India and South Tibet proceeds at a rate of 17.8 ± 0.5 mm/yr in central and eastern Nepal and 20.5 ± 1 mm/yr in western Nepal. The moment deficit due to locking of the MHT in the interseismic period accrues at a rate of 6.6 ± 0.4 × 10^(19) Nm/yr on the MHT underneath Nepal. For comparison, the moment released by the seismicity over the past 500 years, including 14 M_W ≥ 7 earthquakes with moment magnitudes up to 8.5, amounts to only 0.9 × 10^(19) Nm/yr, indicating a large deficit of seismic slip over that period or very infrequent large slow slip events. No large slow slip event has been observed however over the 20 years covered by geodetic measurements in the Nepal Himalaya. We discuss the magnitude and return period of M > 8 earthquakes required to balance the long term slip budget on the MHT

An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers’ Knowledge, Confidence, and Attitudes

OBJECTIVES The goal of this implementation study was to describe the implementation and evaluation of the impact of an online pediatric palliative care training program in Nepal, using the Project ECHO model. METHODS The study used mixed methods, including a program case study describing the online learning program and before-and-after surveys of program participants, assessing learning through changes in knowledge, comfort, and attitudes. An end-of-program survey was used to evaluate participants’ overall experiences with the learning program and use of the learning resources. RESULTS A literature review, stakeholder surveys, and expert input informed the design of the intervention. The course used the Project ECHO model of online education, with modifications based on the leadership team's previous ECHO experiences and local stakeholder input. The intervention occurred over 9 months, with 22 online teaching sessions. Each session consisted of a didactic lecture, case presentation, and interactive discussion with expert clinical teachers. Fifty-five clinicians in Nepal participated, including physicians (47%), nurses (44%), and psychotherapists (5%). Clinicians reported improvements in knowledge, skills, and attitudes after program participation. Program acceptability scores were high, with 93% of participants reporting that the course provided effective learning. CONCLUSIONS Project ECHO can be successfully implemented to deliver continuing professional development in Nepal. Delivering palliative care education online using the Project ECHO model, leads to improved knowledge, skills, and attitudes for clinicians. Project ECHO suggests an innovative solution which can provide training and support to clinicians in settings where educational opportunities in palliative care are limited

Seasonal variations of seismicity and geodetic strain in the Himalaya induced by surface hydrology

One way to probe earthquake nucleation processes and the relation between stress buildup and seismicity is to analyze the sensitivity of seismicity to stress perturbations. Here, we report evidence for seasonal strain and stress (~ 2–4 kPa) variations in the Nepal Himalaya, induced by water storage variations which correlate with seasonal variations of seismicity. The seismicity rate is twice as high in the winter as in the summer, and correlates with stress rate variations. We infer ~ 10–20 kPa/yr interseismic stress buildup within the seismicity cluster along the high Himalaya front. Given that Earth tides exert little influence on Himalayan seismicity, the correlated seasonal variation of stress and seismicity indicates that the duration of earthquake nucleation in the Himalaya is of the order of days to month, placing constraints on faults friction laws. The unusual sensitivity of seismicity to small stress changes in the Himalaya might be due to high pore pressure at seismogenic depth

sj-docx-2-mde-10.1177_23821205241234541 - Supplemental material for An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers’ Knowledge, Confidence, and Attitudes

Supplemental material, sj-docx-2-mde-10.1177_23821205241234541 for An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers’ Knowledge, Confidence, and Attitudes by Anisha Lynch-Godrei, Sudhir Sapkota, Jennifer Rowe, Bishnu Dutta Paudel, Garima Aryal and Megan Doherty in Journal of Medical Education and Curricular Development</p

sj-docx-3-mde-10.1177_23821205241234541 - Supplemental material for An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers’ Knowledge, Confidence, and Attitudes

Supplemental material, sj-docx-3-mde-10.1177_23821205241234541 for An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers’ Knowledge, Confidence, and Attitudes by Anisha Lynch-Godrei, Sudhir Sapkota, Jennifer Rowe, Bishnu Dutta Paudel, Garima Aryal and Megan Doherty in Journal of Medical Education and Curricular Development</p

sj-docx-1-mde-10.1177_23821205241234541 - Supplemental material for An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers’ Knowledge, Confidence, and Attitudes

Supplemental material, sj-docx-1-mde-10.1177_23821205241234541 for An Online Pediatric Palliative Care Education and Mentoring (Project ECHO) in Nepal: A Program Implementation Case Study and Assessment of Changes in Healthcare Providers’ Knowledge, Confidence, and Attitudes by Anisha Lynch-Godrei, Sudhir Sapkota, Jennifer Rowe, Bishnu Dutta Paudel, Garima Aryal and Megan Doherty in Journal of Medical Education and Curricular Development</p

A direct evidence for high carbon dioxide and radon-222 discharge in Central Nepal

International audienceGas discharges have been identified at the Syabru–Bensi hot springs, located at the front of the High Himalaya in Central Nepal, in the Main Central Thrust zone. The hot spring waters are characterized by a temperature reaching 61 °C, high salinity, high alkalinity and δ13C varying from + 0.7‰ to + 4.8‰. The gas is mainly dry carbon dioxide, with a δ13C of − 0.8‰. The diffuse carbon dioxide flux, mapped by the accumulation chamber method, reached a value of 19 000 g m− 2day− 1, which is comparable with values measured on active volcanoes. Similar values have been observed over a two-year time interval and the integral around the main gas discharge amounts to 0.25 ± 0.07 mol s− 1, or 350 ± 100 ton a− 1. The mean radon-222 concentration in spring water did not exceed 2.5 Bq L− 1, exponentially decreasing with water temperature. In contrast, in gas bubbles collected in the water or in the dry gas discharges, the radon concentration varied from 16 000 to 41 000 Bq m− 3. In the soil, radon concentration varied from 25 000 to more than 50 000 Bq m− 3. Radon flux, measured at more than fifty points, reached extreme values, larger than 2 Bq m− 2s− 1, correlated to the larger values of the carbon dioxide flux. Our direct observation confirms previous studies which indicated large degassing in the Himalaya. The proposed understanding is that carbon dioxide is released at mid-crustal depth by metamorphic reactions within the Indian basement, transported along pre-existing faults by meteoric hot water circulation, and degassed before reaching surface. This work, first, confirms that further studies should be undertaken to better constrain the carbon budget of the Himalaya, and, more generally, the contribution of mountain building to the global carbon balance. Furthermore, the evidenced gas discharges provide a unique natural laboratory for methodological studies, and appear particularly important to study as a function of time, especially in relation to the seismic activity. For this purpose, the observed high radon-222 flux is a particularly interesting asset. Indeed, while the relationship between radon and carbon dioxide needs to be better understood, radon measurements, using the available radon sensors, constitute a powerful tool for robust and cost effective long term monitoring

Large-scale organization of carbon dioxide discharge in the Nepal Himalayas

International audienceGaseous carbon dioxide (CO 2) and radon-222 release from the ground was investigated along the Main Central Thrust zone in the Nepal Himalayas. From 2200 CO 2 and 900 radon-222 flux measurements near 13 hot springs from western to central Nepal, we obtained total CO 2 and radon discharges varying from 10 À3 to 1.6 mol s À1 and 20 to 1600 Bq s À1 , respectively. We observed a coherent organization at spatial scales of ≈ 10 km in a given region: low CO 2 and radon discharges around Pokhara (midwestern Nepal) and in the Bhote Kosi Valley (east Nepal); low CO 2 but large radon discharges in Lower Dolpo (west Nepal); and large CO 2 and radon discharges in the upper Trisuli Valley (central Nepal). A 110 km long CO 2-producing segment, with high carbon isotopic ratios, suggesting metamorphic decarbonation, is thus evidenced from 84.5°E to 85.5°E. This spatial organization could be controlled by geological heterogeneity or large Himalayan earthquakes