C and O stable isotopes and rare earth elements in the Devonian carbonate host rock of the Pivehzhan iron deposit, NE Iran

The Pivehzhan iron deposit is located at about 80km southwest of Mashhad, NE Iran. It occur within the Devonian carbonates as lenticular and massive bodies, as well as veinlets of magnetite and iron sulphides, transformed to goethite and haematite by weathering process. The hydrothermal calcite is the most important gangue mineral, which is observed in the form of veins/veinlets and open-space filling. The iron ores are accompanied by some minor elements such as Mn, Ti, Cr, and V and negligible amounts of Co and Ni. The distribution pattern of Rare Earth Elements (REEs) normalized to Post Archean Australian Shale (PAAS), which is characterized by the upward convex, as well as the positive Eu anomalies indicate the activity of reduced and acidic hydrothermal fluids. The negative Ce anomalies of host carbonates, although slight, point to the dominance of anoxic conditions during interaction with hydrothermal fluids. The hydrothermal calcite and quartz coexisting with the iron minerals contain principally fluid, which were homogenized into a liquid phase. The Homogenization Temperature (TH) and the salinity of the analysed fluid inclusions range from 129°C to 270°C and from 0.4wt.% to 9.41wt.% NaCl eq., respectively. The δ13CPDB and δ18OSMOW values range from -2.15‰ to -5.77‰ (PeeDee Belemnite PDB standard) and from +19.87‰ to +21.64‰ (Standard Mean Ocean Water SMOW standard) in hydrothermal calcite veinlets occurring with iron minerals, and from -0.66‰ to -4.37‰ (PDB) and from +15.55‰ to +20.14‰ (SMOW) within the host carbonates, respectively. The field relations and petrographic examination along with geochemical and isotopic considerations indicate that the Pivehzhan iron deposit was formed through replacement processes by reducing and acid fluids containing light carbon and oxygen isotopes. Variations in the physico-chemical conditions of hydrothermal fluids and their interaction with carbonates were the most effective mechanisms in the formation of this iron deposit. The potential source of iron was probably the basement magmatic rocks from which iron was leached by hydrothermal solutions

C and O stable isotopes and rare earth elements in the Devonian carbonate host rock of the Pivehzhan iron deposit, NE Iran

The Pivehzhan iron deposit is located at about 80km southwest of Mashhad, NE Iran. It occur within the Devonian carbonates as lenticular and massive bodies, as well as veinlets of magnetite and iron sulphides, transformed to goethite and haematite by weathering process. The hydrothermal calcite is the most important gangue mineral, which is observed in the form of veins/veinlets and open-space filling. The iron ores are accompanied by some minor elements such as Mn, Ti, Cr, and V and negligible amounts of Co and Ni. The distribution pattern of Rare Earth Elements (REEs) normalized to Post Archean Australian Shale (PAAS), which is characterized by the upward convex, as well as the positive Eu anomalies indicate the activity of reduced and acidic hydrothermal fluids. The negative Ce anomalies of host carbonates, although slight, point to the dominance of anoxic conditions during interaction with hydrothermal fluids. The hydrothermal calcite and quartz coexisting with the iron minerals contain principally fluid, which were homogenized into a liquid phase. The Homogenization Temperature (TH) and the salinity of the analysed fluid inclusions range from 129°C to 270°C and from 0.4wt.% to 9.41wt.% NaCl eq., respectively. The δ13CPDB and δ18OSMOW values range from -2.15‰ to -5.77‰ (PeeDee Belemnite PDB standard) and from +19.87‰ to +21.64‰ (Standard Mean Ocean Water SMOW standard) in hydrothermal calcite veinlets occurring with iron minerals, and from -0.66‰ to -4.37‰ (PDB) and from +15.55‰ to +20.14‰ (SMOW) within the host carbonates, respectively. The field relations and petrographic examination along with geochemical and isotopic considerations indicate that the Pivehzhan iron deposit was formed through replacement processes by reducing and acid fluids containing light carbon and oxygen isotopes. Variations in the physico-chemical conditions of hydrothermal fluids and their interaction with carbonates were the most effective mechanisms in the formation of this iron deposit. The potential source of iron was probably the basement magmatic rocks from which iron was leached by hydrothermal solutions

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2

Rationale, design, and baseline characteristics in Evaluation of LIXisenatide in Acute Coronary Syndrome, a long-term cardiovascular end point trial of lixisenatide versus placebo

BACKGROUND: Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Furthermore, patients with T2DM and acute coronary syndrome (ACS) have a particularly high risk of CV events. The glucagon-like peptide 1 receptor agonist, lixisenatide, improves glycemia, but its effects on CV events have not been thoroughly evaluated. METHODS: ELIXA (www.clinicaltrials.gov no. NCT01147250) is a randomized, double-blind, placebo-controlled, parallel-group, multicenter study of lixisenatide in patients with T2DM and a recent ACS event. The primary aim is to evaluate the effects of lixisenatide on CV morbidity and mortality in a population at high CV risk. The primary efficacy end point is a composite of time to CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. Data are systematically collected for safety outcomes, including hypoglycemia, pancreatitis, and malignancy. RESULTS: Enrollment began in July 2010 and ended in August 2013; 6,068 patients from 49 countries were randomized. Of these, 69% are men and 75% are white; at baseline, the mean ± SD age was 60.3 ± 9.7 years, body mass index was 30.2 ± 5.7 kg/m(2), and duration of T2DM was 9.3 ± 8.2 years. The qualifying ACS was a myocardial infarction in 83% and unstable angina in 17%. The study will continue until the positive adjudication of the protocol-specified number of primary CV events. CONCLUSION: ELIXA will be the first trial to report the safety and efficacy of a glucagon-like peptide 1 receptor agonist in people with T2DM and high CV event risk