Diversity of fluid geochemistry affected by processes during fluid upwelling in active hydrothermal fields in the Izena Hole, the middle Okinawa Trough back-arc basin

Two active hydrothermal fields, Jade and Hakurei fields have been discovered within the Izena Hole, a rectangular 6 km × 3 km shape depression located in the middle Okinawa Trough back arc basin. In both fields, intense hydrothermal activity is represented by venting of high-temperature fluid (>300°C) and occurrence of sulfide/sulfate ore deposits. We collected hydrothermal fluids during dive expeditions of ROV Hyper Dolphin conducted in 2003, 2010 and 2011, in order to analyze both elemental and gas species. The geochemistry of high temperature hydrothermal fluids collected from the Jade and Hakurei fields is very similar to each other with exceptions in minor gas composition. Little temporal variation was observed in geochemistry of the high-temperature hydrothermal fluid of the Jade field over two decades, since a previous study carried out in 1989. These results suggest that these fluids are derived from a common fluid reservoir where fluid chemistry is basically controlled by fluid-mineral equilibria and gas species are dominantly contributed from the same magma. Venting of low temperature fluid (about 104°C) was discovered in the distal part of the Jade field, which was named as the Biwako vent. Chemical composition of the Biwako vent fluid was distinctive from that of the high temperature fluid in the proximal part of the Jade field, and could not be explained by simple dilution or cooling. This intra-field chemical diversity could be caused by phase separation and segregation during fluid upwelling, based on relationships in concentrations of Cl and major cations. On the other hand, the chemical diversity recognized in minor gas composition between the Jade and Hakurei fields is in accordance with results from previous plume survey. Difference in concentrations of minor gases such as H2 is attributed to contribution from thermal degradation of organic matter in the sediment, during fluid upwelling

Medical Decision-Making Incapacity among Newly Diagnosed Older Patients with Hematological Malignancy Receiving First Line Chemotherapy: A Cross-Sectional Study of Patients and Physicians.

Decision-making capacity to provide informed consent regarding treatment is essential among cancer patients. The purpose of this study was to identify the frequency of decision-making incapacity among newly diagnosed older patients with hematological malignancy receiving first-line chemotherapy, to examine factors associated with incapacity and assess physicians' perceptions of patients' decision-making incapacity.Consecutive patients aged 65 years or over with a primary diagnosis of malignant lymphoma or multiple myeloma were recruited. Decision-making capacity was assessed using the Structured Interview for Competency and Incompetency Assessment Testing and Ranking Inventory-Revised (SICIATRI-R). Cognitive impairment, depressive condition and other possible associated factors were also evaluated.Among 139 eligible patients registered for this study, 114 completed the survey. Of these, 28 (25%, 95% confidence interval [CI]: 17%-32%) were judged as having some extent of decision-making incompetency according to SICIATRI-R. Higher levels of cognitive impairment and increasing age were significantly associated with decision-making incapacity. Physicians experienced difficulty performing competency assessment (Cohen's kappa -0.54).Decision-making incapacity was found to be a common and under-recognized problem in older patients with cancer. Age and assessment of cognitive impairment may provide the opportunity to find patients that are at a high risk of showing decision-making incapacity

Demographical and Clinical Characteristics of Patients (<i>n</i> = 114).

<p>Demographical and Clinical Characteristics of Patients (<i>n</i> = 114).</p

Distribution of The Level of Incapacity by SICIATRI-R (<i>n</i> = 114).

<p>^aLevel 0 (L0) of the most impaired status as opposed to Level 4 (L4) of full competence.</p><p>Distribution of The Level of Incapacity by SICIATRI-R (<i>n</i> = 114).</p

Factors associated with incompetency: logistic regression analysis (<i>n</i> = 114).

<p>^aCognitive impairment was assessed by the Mini-Mental State Examination</p><p>^bCoded as: 0 = less than high school; 1 = high school or higher.</p><p>Factors associated with incompetency: logistic regression analysis (<i>n</i> = 114).</p

Factors associated with incompetency: univariate analysis (<i>n</i> = 114).

<p>^aCognitive impairment was assessed by the Mini-Mental State Examination.</p><p>^bDepression was evaluated by the Patient Health Questionnaire 9.</p><p>Factors associated with incompetency: univariate analysis (<i>n</i> = 114).</p