Hydrous oceanic crust hosts megathrust creep at low shear stresses

The rheology of the metamorphosed oceanic crust may be a critical control on megathrust strength and deformation style. However, little is known about the strength and deformation style of metamorphosed basalt. Exhumed megathrust shear zones exposed on Kyushu, SW Japan, contain hydrous metabasalts deformed at temperatures between ~300° and ~500°C, spanning the inferred temperature-controlled seismic-aseismic transition. Field and microstructural observations of these shear zones, combined with quartz grain-size piezometry, indicate that metabasalts creep at shear stresses <100 MPa at ~370°C and at shear stresses <30 MPa at ~500°C. These values are much lower than those suggested by viscous flow laws for basalt. The implication is that relatively weak, hydrous, metamorphosed oceanic crust can creep at low viscosities over a wide shear zone and have a critical influence on plate interface strength and deformation style around the seismic-aseismic transition

Contrasting effects of high-starch and high-sugar diets on ruminal function in cattle

The experiment reported in this research paper aimed to determine whether clinical and subclinical effects on cattle were similar if provided with isoenergetic and isonitrogenous challenge diets in which carbohydrate sources were predominantly starch or sugar. The study was a 3 × 3 Latin square using six adult Jersey cows with rumen cannulae, over 9 weeks. In the first 2 weeks of each 3 week experimental period cows were fed with a maintenance diet and, in the last week, each animal was assigned to one of three diets: a control diet (CON), being a continuation of the maintenance diet; a high starch (HSt) or a high sugar (HSu) diet. Reticuloruminal pH and motility were recorded throughout the study period. Blood and ruminal samples were taken on day-1 (TP-1), day-2 (TP-2) and day-7 (TP-7) of each challenge week. Four clinical variables were recorded daily: diarrhoea, inappetence, depression and ruminal tympany. The effects of treatment, hour of day and day after treatment on clinical parameters were analysed using linear mixed effects (LME) models. Although both challenge diets resulted in a decline in pH, an increase in the absolute pH residuals and an increase in the number of minutes per day under pH 5.8, systemic inflammation was only detected with the HSt diet. The challenge diets differentially modified amplitude and period of reticuloruminal contractions compared with CON diet and both were associated with an increased probability of diarrhoea. The HSu diet reduced the probability of an animal consuming its complete allocation. Because the challenge diets were derived from complex natural materials (barley and molasses respectively), it is not possible to assign all the differential effects to the difference in starch and sugar concentration: non-starch components of barley or non-sugar components of molasses might have contributed to some of the observations. In conclusion, substituting much of the starch with sugar caused no substantial reduction in the acidosis load, but inflammatory response was reduced while feed rejection was increased

Megathrust shear modulated by Albite Metasomatism in subduction mélanges

Aseismic megathrust slip downdip of the seismogenic zone is accommodated by either steady creep or episodic slow slip events (SSEs). However, the geological conditions defining the rheology of megathrust slip remain elusive. We examined exhumed subduction mélanges on Kyushu, Japan, which deformed at ∼370–500°C under greenschist to epidote‐amphibolite facies conditions, comparable to warm‐slab environments. The mélanges recorded fluid release and viscous shear localization associated with metasomatic reactions between juxtaposed metapelitic and metabasaltic rocks. Metasomatic reactions caused albitization of metapelite, resulting in depth‐dependent changes to megathrust rheology. In a mélange deformed at ∼370°C, very fine grained reaction products (metasomatic albite) facilitated grain boundary diffusion creep at stresses of ∼45 MPa, less than those in the surrounding metabasalt. Mineralogical and chemical changes during metasomatic reactions, and their field content, imply an onset of albite metasomatism at ∼350°C. Albite metasomatism therefore potentially contributed to decreased megathrust strength around the inferred thermally controlled base of the seismogenic zone. In a mélange deformed near the mantle wedge corner at ∼500°C, metasomatic reactions promoted local quartz vein formation and localized viscous shear at slow slip strain rates, during which the coarse‐grained metasomatic albite behaved as relatively rigid blocks in a viscous matrix. We suggest that albite metasomatism can facilitate changes in a megathrust slip mode with depth and may explain why slip mode changes from creep to SSEs with tremor with increasing depth

Effect of Soluble Carbohydrate Diets on Reticuloruminal pH and Motility, and on Hematological and Biochemical Health Indicators in Cattle

No abstract available

Effect of Soluble Carbohydrate Diets on Reticuloruminal pH and Motility, and on Hematological and Biochemical Health Indicators in Cattle

No abstract available

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research