Magmatic carbon outgassing and uptake of CO2 by alkaline waters

Much of Earth's carbon resides in the “deep” realms of our planet: sediments, crust, mantle, and core. The interaction of these deep reservoirs of carbon with the surface reservoir (atmosphere and oceans) leads to a habitable surface environment, with an equitable atmospheric composition and comfortable range in temperature that together have allowed life to proliferate. The Earth in Five Reactions project (part of the Deep Carbon Observatory program) identified the most important carbon-bearing reactions of our planet, defined as those which perhaps make our planet unique among those in our Solar System, to highlight and review how the deep and surface carbon cycles connect. Here we review the important reactions that control the concentration of carbon dioxide in our atmosphere: outgassing from magmas during volcanic eruptions and during magmatic activity; and uptake of CO2 by alkaline surface waters. We describe the state of our knowledge about these reactions and their controls, the extent to which we understand the mass budgets of carbon that are mediated by these reactions, and finally, the implications of these reactions for understanding present-day climate change that is driven by anthropogenic emission of CO2

Detrusor Underactivity and Underactive Bladder in Women : What Is New?

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Geophysical tests for habitability in ice-covered ocean worlds

Geophysical measurements can reveal the structure of icy ocean worlds and cycling of volatiles. The associated density, temperature, sound speed, and electrical conductivity of such worlds thus characterizes their habitability. To explore the variability and correlation of these parameters, and to provide tools for planning and data analyses, we develop 1-D calculations of internal structure, which use available constraints on the thermodynamics of aqueous MgSO$_4$, NaCl (as seawater), and NH$_3$, water ices, and silicate content. Limits in available thermodynamic data narrow the parameter space that can be explored: insufficient coverage in pressure, temperature, and composition for end-member salinities of MgSO$_4$ and NaCl, and for relevant water ices; and a dearth of suitable data for aqueous mixtures of Na-Mg-Cl-SO$_4$-NH$_3$. For Europa, ocean compositions that are oxidized and dominated by MgSO$_4$, vs reduced (NaCl), illustrate these gaps, but also show the potential for diagnostic and measurable combinations of geophysical parameters. The low-density rocky core of Enceladus may comprise hydrated minerals, or anydrous minerals with high porosity comparable to Earth's upper mantle. Titan's ocean must be dense, but not necessarily saline, as previously noted, and may have little or no high-pressure ice at its base. Ganymede's silicious interior is deepest among all known ocean worlds, and may contain multiple phases of high-pressure ice, which will become buoyant if the ocean is sufficiently salty. Callisto's likely near-eutectic ocean cannot be adequately modeled using available data. Callisto may also lack high-pressure ices, but this cannot be confirmed due to uncertainty in its moment of inertia

On the mobilization of metals by CO2leakage into shallow aquifers: exploring release mechanisms by modeling field and laboratory experiments

The dissolution of CO2 in water leads to a pH decrease and a carbonate content increase in affected groundwater, which in turn can drive the mobilization of metals from sediments. The mechanisms of metal release postulated in various field and laboratory studies often differ. Drawing primarily on previously published results, we examine contrasting metal mobilization behaviors at two field tests and in one laboratory study, to investigate whether the same mechanisms could explain metal releases in these different experiments. Numerical modeling of the two field tests reveals that fast Ca-driven cation exchange (from calcite dissolution) can explain the release of most major and trace metal cations at both sites, and their parallel concentration trends. The dissolution of other minerals reacting more slowly (superimposed on cation exchange) also contributes to metal release over longer time frames, but can be masked by fast ambient groundwater velocities. Therefore, the magnitude and extent of mobilization depends not only on metal-mineral associations and sediment pH buffering characteristics, but also on groundwater flow rates, thus on the residence time of CO2-impacted groundwater relative to the rates of metal-release reactions. Sequential leaching laboratory tests modeled using the same metal-release concept as postulated from field experiments show that both field and laboratory data can be explained by the same processes. The reversibility of metal release upon CO2 degassing by de-pressurization is also explored using simple geochemical models, and shows that the sequestration of metals by resorption and re-precipitation upon CO2 exsolution is quite plausible and may warrant further attentio

Comparison of functional outcome after extended versus super-extended pelvic lymph node dissection during radical prostatectomy in high-risk localized prostate cancer

Background: Urinary continence and erectile function (EF) are best preserved whenmeticulous dissection of prostate and nerve sparing technique are used during radicalprostatectomy (RP). However, extent of lymph node dissection (LND) may also adverselyaffect functional results.Objective: To determine whether performing a super-extended LND (seLND) has asignificant effect on recovery of urinary continence and EF after RP.Design, setting, and participants: All patients who underwent RP from January 2007until December 2013 were handed questionnaires assessing continence and EF. Allpatients in whom at least an extended LND (eLND) was performed were selected. Thissearch yielded 526 patients. 172 of these patients had filed out 2 or more questionnairesand were included in our analysis.Outcome measurements and statistical analysis: All questionnaires were reviewed.We used Kaplan–Meier analyses and multivariate Cox analysis to assess the differencein recovery of continence and EF over time for eLND/seLND. Primary endpoints were fullrecovery of continence (no loss of urine) and full recovery of EF (successful intercoursepossible). Patients who did not reach the endpoint when the last questionnaire was filledout were censored at that time. Median follow-up was 12.43 months for continence, and18.97 months for EF.results and limitations: Patients undergoing seLND have a lower chance of regainingboth urinary continence [hazard ratio (HR) 0.59, 95% CI 0.39–0.90, p = 0.026] and EF(HR 0.28, 95% CI 0.13–0.57, p = 0.009). Age at surgery had a significant influence onboth continence and EF in multivariate analysis. Major limitation of the study was that noformal preoperative assessment of continence and potency was done.conclusion: Extending the LND template beyond the eLND template may cause atleast a significant delay in recovery of urinary continence and leads to less recovery of EF.</p

Outcomes of a noninferiority randomised controlled trial of surgery for men with urodynamic stress incontinence after prostate surgery (MASTER)

BackgroundStress urinary incontinence (SUI) is common after radical prostatectomy and likely to persist despite conservative treatment. The sling is an emerging operation for persistent SUI, but randomised controlled trial (RCT) comparison with the established artificial urinary sphincter (AUS) is lacking.ObjectiveTo compare the outcomes of surgery in men with bothersome urodynamic SUI after prostate surgery.Design, setting, and participantsA noninferiority RCT was conducted among men with bothersome urodynamic SUI from 27 UK centres. Blinding was not possible due the surgeries.InterventionParticipants were randomly assigned (1:1) to the male transobturator sling (n = 190) or the AUS (n = 190) group.Outcome measurements and statistical analysisThe primary outcome was patient-reported SUI 12 mo after randomisation, collected from postal questionnaire using a composite outcome from two items in validated International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form questionnaire (ICIQ-UI SF). Noninferiority margin was 15%, thought to be of acceptable lower effectiveness, in return for reduced adverse events (AEs) and easier operation, for the sling. Secondary outcomes were operative and postoperative details, patient-reported measures, and AEs, up to 12 mo after surgery.Results and limitationsA total of 380 participants were included. At 12 mo after randomisation, incontinence rates were 134/154 (87.0%) for male sling versus 133/158 (84.2%) for AUS (difference 3.6% [95% confidence interval {CI} –11.6 to 4.6], pNI = 0.003), showing noninferiority. Incontinence symptoms (ICIQ-UI SF) reduced from scores of 16.1 and 16.4 at baseline to 8.7 and 7.5 for male sling and AUS, respectively (mean difference 1.4 [95% CI 0.2–2.6], p = 0.02). Serious AEs (SAEs) were few: n = 6 and n = 13 for male sling and AUS (one man had three SAEs), respectively. Quality of life scores improved, and satisfaction was high in both groups. All other secondary outcomes that show statistically significant differences favour the AUS.ConclusionsUsing a strict definition, urinary incontinence rates remained high, with no evidence of difference between male sling and AUS. Symptoms and quality of life improved significantly in both groups, and men were generally satisfied with both procedures. Overall, secondary and post hoc analyses were in favour of AUS.Patient summaryUrinary incontinence after prostatectomy has considerable effect on men’s quality of life. MASTER shows that if surgery is needed, both surgical options result in fewer symptoms and high satisfaction, despite most men not being completely dry. However, most other results indicate that men having an artificial urinary sphincter have better outcomes than those who have a sling