Stratigraphy and palaeoenvironment of Early Jurassic dinosaur-bearing volcaniclastic deposits from Toundoute (Province of Ouarzazate, Haut-Atlas, Morocco)

The Early Jurassic dinosaur site of Toundoute which yielded the basal sauropod Tazoudasaurus naimi is examined in the light of its stratigraphic, sedimentological and palaeoenvironmental context. A thin succession of Early Liassic marine carbonates (probably Hettangian-Sinemurian in age) is continuously overlain by continental beds with dinosaurs. These latter are assumed to be of Middle to Late Liassic age. The continental deposits include a large part of volcanoclastics, different from the Triassic basalts. The Jurassic volcanoclastics originated from an unknown but obviously close eruption centre. The continental sediments (channels and flood plain) were deposited under tropical climate conditions with alternating humid and dry episodes. The bones occur as isolated or partly articulated elements (parts of carcasses). The two bone-beds are related to typical mud-flows. This type of transport protected the bones from erosion, and favoured their burying and fossilization.

Deaths rates in public hospitals of eastern cape province of South Africa.

BACKGROUND: South Africa (SA) is experiencing a rapid epidemiologic transition as a consequence of political, economic and social changes. In this study we described, based on hospital data, the mortality patterns of Non communicable Diseases (NCD), Communicable Diseases (CD), the NCD/CD ratios, and the trends of deaths. METHODS: We conducted a cross-sectional survey of all deaths occurring in several public hospitals in the Eastern Cape Province of SA between 2002 and 2006. Causes of deaths were coded according to the ICD 10 Edition. RESULTS: A total of 107380 admissions responded to the inclusion criteria between 2002 and 2006. The crude death rate was 4.3% (n=4566) with a mean age of 46±21 years and a sex ratio of 3.1 men (n=3453): 1 woman (n=1113). Out of all deaths, there were 62.9% NCD (n=2872) vs. 37.1% CD (n=1694) with NCD/CD ratio of 1.7. The ratio NCD/CD deaths in men was 1.3 (n=1951/1502) vs. NCD/CD deaths in women of 1.9 (n=735/378). The peak of deaths was observed in winter season. The majority of NCD deaths were at age of 30-64 years, whereas the highest rate of CD deaths was at age< 30 years. The trend of deaths including the majority of NCD, increased from 2002 to 2006. There was a tendency of increase in tuberculosis deaths, but a tendency of decrease in HIV/AIDS deaths was from 2002 to 2006. CONCLUSION: Non-communicable diseases are the leading causes of deaths in rural Eastern Cape province of SA facing Post-epidemiologic transition stages. We recommend overarching priority actions for the response to the Non-communicable Diseases: policy change, prevention, treatment, international cooperation, research, monitoring, accountability, and re-orientation of health systems.

Factors influencing interprofessional practices of physiotherapists working in private settings with people with low back pain: a qualitative study

Purpose: Collaboration and interprofessional practices are highly valued in health systems everywhere, partly based on the rationale that they improve outcomes of care for people with complex health problems, such as low back pain. Research in the area of low back pain also supports the involvement of different health professionals in the interventions for people who present this condition. The aim of this studywas to identify factors influencing the interprofessional practices of physiotherapists working in private settings with people with low back pain. Relevance: Physiotherapists, like other health professionals, are encouraged to engage in interprofessional practices in their dailywork. However, to date, very little is known of their interprofessional practices, especially in private settings. Understanding physiotherapists' interprofessional practices and their influencing factors will notably advance knowledge relating to the organisation of physiotherapy services for people with low back pain. Participants: Participants in this study were 13 physiotherapists including 10 women and 3 men, having between 3 and 22 years of professional experience, and working in one of 10 regions of the Province of Quebec (Canada). In order to obtain maximal variation in the perspectives, participants were selected using a recruitment matrix including three criteria: duration of professional experience, work location, and physical proximity with other professionals. Methods: Thiswas a descriptive qualitative study using faceto- face semi-structured interviews as the main method of data collection. An interview guide was developed based on an evidence-derived frame of reference. Each interview lasted between 55 and 95 minutes and was transcribed verbatim. Analysis: Qualitative analyses took the form of content analysis, encompassing data coding and general thematic regrouping. NVivo version 8 was used to assist data organisation and analysis. Results: Multiple factors influencing the interprofessional practices of physiotherapists were identified. The main factors include the consulting person's health condition, the extent of knowledge on health professionals' roles and fields of practice, the proximity and availability of professional resources, as well as daily work schedules. Conclusions: Our findings highlight the influence of multiple factors on physiotherapists' interprofessional practices, including professional practice and organisational issues. However, further research on the interprofessional practices of physiotherapists is still required. Research priorities targeting the views of other health professionals, as well as those of services users, would enhance our comprehension of interprofessional practices of physiotherapists. Implications: This study provides new insights that improve our understanding of the interprofessional practices of physiotherapists working in private settings with people with low back pain, more specifically on the factors influencing these practices. Based on our findings, implementing changes such as improving current and future health professionals' knowledge of the fields and roles of other health professionals through training may contribute to positively influencing interprofessional practices. Keywords: Interprofessional practices; Private practice; Low back pain Funding acknowledgements: This research was supported in part by a B.E. Schnurr Memorial Fund Research Grant administered by the Physiotherapy Foundation of Canada, as well as from a clinical research partnership in physiotherapy between the Quebec Rehabilitation Research Network (REPAR) and the Ordre professionnel de la physiothérapie du Québec (OPPQ). KP received doctoral-level scholarships from the Canadian Institutes of Health Research (CIHR) and the Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST). CE Dionne is a FRSQ senior Research Scholar. Ethics approval: This project was approved by the ethics research committee of the Institut de réadaptation en déficience physique de Québec.

Oxygen isotope compositions of iron oxides from high-grade BIF-hosted iron ore deposits of the Central Hamersley Province, Western Australia: Constraints on the evolution of hydrothermal fluids

The Hamersley province of northwest Australia is one of the world's premier iron ore regions with high-grade martite-microplaty hematite iron ore deposits mostly hosted within banded iron formation (BIF) sequences of the Brockman Iron Formations of the Hamersley Group. These high-grade iron ores contain between 60 and 68 wt percent Fe, and formed by the multistage interaction of hydrothermal fluids with the host BIF formation. The oxygen isotope compositions of magnetite and hematite from BIF, hydrothermal alteration assemblages, and high-grade iron Ore were analyzed from the Mount Tom Price, Paraburdoo, and Charmar iron ore deposits. The delta(18)O values of magnetite and hematite from hydrothermal alteration assemblages and high-grade iron ore range from -9.0 to -2.9 per mil, a depletion of 5 to 15 per mil relative to the host BIF. The delta(18)O values are spatially controlled by faults within the deposits, a response to higher fluid flux and larger influence the isotopic compositions by the hydrothermal fluids. The oxygen isotope composition of hydrothermal fluids (delta(18)O(fluid)) indicates that the decrease in the (18)O content of iron oxides was due to the interaction of both basinal brines and meteoric fluids with the original BIF. Late-stage talc-bearing ore at the Mount Tom Price deposit formed in the presence of a pulse of delta(18)O-enriched basinal brine, indicating that hydrothermal fluids may have repeatedly interacted with the BIFs during the Paleoproterozoic.

Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: The manitoba study.

The measurement of BMD by dual-energy X-ray absorptiometry (DXA) is the "gold standard" for diagnosing osteoporosis but does not directly reflect deterioration in bone microarchitecture. The trabecular bone score (TBS), a novel gray-level texture measurement that can be extracted from DXA images, correlates with 3D parameters of bone microarchitecture. Our aim was to evaluate the ability of lumbar spine TBS to predict future clinical osteoporotic fractures. A total of 29,407 women 50 years of age or older at the time of baseline hip and spine DXA were identified from a database containing all clinical results for the Province of Manitoba, Canada. Health service records were assessed for the incidence of nontraumatic osteoporotic fracture codes subsequent to BMD testing (mean follow-up 4.7 years). Lumbar spine TBS was derived for each spine DXA examination blinded to clinical parameters and outcomes. Osteoporotic fractures were identified in 1668 (5.7%) women, including 439 (1.5%) spine and 293 (1.0%) hip fractures. Significantly lower spine TBS and BMD were identified in women with major osteoporotic, spine, and hip fractures (all p < 0.0001). Spine TBS and BMD predicted fractures equally well, and the combination was superior to either measurement alone (p < 0.001). Spine TBS predicts osteoporotic fractures and provides information that is independent of spine and hip BMD. Combining the TBS trabecular texture index with BMD incrementally improves fracture prediction in postmenopausal women. © 2011 American Society for Bone and Mineral Research.

Family physician involvement in cancer care follow-up: the experience of a cohort of patients with lung cancer.

PURPOSE There has been little research describing the involvement of family physicians in the follow up of patients with cancer especially during the primary treatment phase We undertook a prospective longitudinal study of patients with lung cancer to assess their family physician s involvement in their follow up at the different phases of cancer METHODS In 5 hospitals in the province of Quebec Canada patients with a recent diagnosis of lung cancer were surveyed every 3 to 6 months whether they had metastasis or not, for a maximum of 18 months to assess aspects of their family physician s involvement in cancer care RESULTS Of the 395 participating patients 92% had a regular family physician but only 60% had been referred to a specialist by him/her or a colleague for the diagnosis of their lung cancer A majority of patients identified the oncology team or oncologists as mainly responsible for their cancer care throughout their cancer journey except at the advanced phase where a majority attributed this role to their family physician At baseline only 16% of patients perceived a shared care pattern between their family physician and oncologists but this pro portion increased with cancer progression Most patients would have liked their family physician to be more involved in all aspects of cancer care CONCLUSIONS Although patients perceive that the oncology team is the main party responsible for the follow up of their lung cancer they also wish their family physicians to be involved Better communication and collaboration between family physicians and the oncology team are needed to facilitate shared care in cancer follow up

Factors influencing the adoption of an innovation: an examination of the uptake of the Canadian Heart Health Kit (HHK)

BACKGROUND: There is an emerging knowledge base on the effectiveness of strategies to close the knowledge-practice gap. However, less is known about how attributes of an innovation and other contextual and situational factors facilitate and impede an innovation's adoption. The Healthy Heart Kit (HHK) is a risk management and patient education resource for the prevention of cardiovascular disease (CVD) and promotion of cardiovascular health. Although previous studies have demonstrated the HHK's content validity and practical utility, no published study has examined physicians' uptake of the HHK and factors that shape its adoption. OBJECTIVES: Conceptually informed by Rogers' Diffusion of Innovation theory, and Theory of Planned Behaviour, this study had two objectives: (1) to determine if specific attributes of the HHK as well as contextual and situational factors are associated with physicians' intention and actual usage of the HHK kit; and (2), to determine if any contextual and situational factors are associated with individual or environmental barriers that prevent the uptake of the HHK among those physicians who do not plan to use the kit. METHODS: A sample of 153 physicians who responded to an invitation letter sent to all family physicians in the province of Alberta, Canada were recruited for the study. Participating physicians were sent a HHK, and two months later a study questionnaire assessed primary factors on the physicians' clinical practice, attributes of the HHK (relative advantage, compatibility, complexity, trialability, observability), confidence and control using the HHK, barriers to use, and individual attributes. All measures were used in path analysis, employing a causal model based on Rogers' Diffusion of Innovations Theory and Theory of Planned Behaviour. RESULTS: 115 physicians (follow up rate of 75%) completed the questionnaire. Use of the HHK was associated with intention to use the HHK, relative advantage, and years of experience. Relative advantage and the observability of the HHK benefits were also significantly associated with physicians' intention to use the HHK. Physicians working in solo medical practices reported experiencing more individual and environmental barriers to using the HHK. CONCLUSION: The results of this study suggest that future information innovations must demonstrate an advantage over current resources and the research evidence supporting the innovation must be clearly visible. Findings also suggest that the innovation adoption process has a social element, and collegial interactions and discussions may facilitate that process. These results could be valuable for knowledge translation researchers and health promotion developers in future innovation adoption planning.

Effects of antiresorptive agents on bone micro-architecture assessed by Trabecular Bone Score in women age 50 and older. The Manitoba Prospective Study

Antiresorptive agents such as bisphosphonates induce a rapid increase of BMD during the 1st year of treatment and a partial maintenance of bone architecture. Trabecular Bone Score (TBS), a new grey-level texture measurement that can be extracted from the DXA image, correlates with 3D parameters of bone micro-architecture. Aim: To evaluate the longitudinal effect of antiresorptive agents on spine BMD and on site-matched spine microarchitecture as assessed by TBS. Methods: From the BMD database for Province of Manitoba, Canada, we selected women age >50 with paired baseline and follow up spine DXA examinations who had not received any prior HRT or other antiresorptive drug.Women were divided in two subgroups: (1) those not receiving any HRT or antiresorptive drug during follow up (=non-users) and (2) those receiving non-HRT antiresorptive drug during follow up (=users) with high adherence (medication possession ratio >75%) from a provincial pharmacy database system. Lumbar spine TBS was derived by the Bone Disease Unit, University of Lausanne, for each spine DXA examination using anonymized files (blinded from clinical parameters and outcomes). Effects of antiresorptive treatment for users and non-users on TBS and BMD at baseline and during mean 3.7 years follow-up were compared. Results were expressed % change per year. Results: 1150 non-users and 534 users met the inclusion criteria. At baseline, users and non-users had a mean age and BMI of [62.2±7.9 vs 66.1±8.0 years] and [26.3±4.7 vs 24.7±4.0 kg/m²] respectively. Antiresorptive drugs received by users were bisphosphonates (86%), raloxifene (10%) and calcitonin (4%). Significant differences in BMD change and TBS change were seen between users and nonusers during follow-up (p<0.0001). Significant decreases in mean BMD and TBS (−0.36± 0.05% per year; −0.31±0.06% per year) were seen for non-users compared with baseline (p<0.001). A significant increase in mean BMD was seen for users compared with baseline (+1.86±0.0% per year, p<0.0018). TBS of users also increased compared with baseline (+0.20±0.08% per year, p<0.001), but more slowly than BMD. Conclusion: We observed a significant increase in spine BMD and a positive maintenance of bone micro-architecture from TBS with antiresorptive treatment, whereas the treatment naïve group lost both density and micro-architecture. TBS seems to be responsive to treatment and could be suitable for monitoring micro-architecture. This article is part of a Special Issue entitled ECTS 2011. Disclosure of interest: M.-A. Krieg: None declared, A. Goertzen: None declared, W. Leslie: None declared, D. Hans Consulting fees from Medimaps.

Effects of anti-resorptive agents on trabecular bone score (TBS) in older women.

We evaluated the longitudinal effects of anti-resorptive agents (534 treated women vs. 1,150 untreated) on lumbar spine bone mineral density (BMD) and trabecular bone score (TBS). TBS was responsive to treatment in women over age 50. The treatment-related increase in TBS was less than the increase in BMD, which is consistent with bone texture preservation. INTRODUCTION: In addition to inducing an increase in BMD, anti-resorptive agents also help to preserve bone architecture. TBS, a new gray-level texture measurement, correlates with 3D parameters of bone micro-architecture independent of BMD. Our objective was to evaluate the longitudinal effects of anti-resorptive agents on lumbar spine BMD and TBS. METHODS: Women (≥50 years), from the BMD program database for the province of Manitoba, Canada, who had not received any anti-resorptive drug prior to their initial dual X-ray absorptiometry (DXA) exam were divided into two groups: untreated, those without any anti-resorptive drug over the course of follow-up, and treated, those with a non-estrogen anti-resorptive drug (86 % bisphosphonates, 10 % raloxifene, and 4 % calcitonin). Lumbar spine TBS was calculated for each lumbar spine DXA examination. Changes in TBS and BMD between baseline and follow-up (mean follow-up 3.7 years), expressed in percentage per year, were compared between the two groups. RESULTS: A total of 1,150 untreated women and 534 treated women met the inclusion criteria. Only a weak correlation was seen between BMD and TBS in either group. Significant intergroup differences in BMD change and TBS change were observed over the course of follow-up (p < 0.001). Similar mean decreases in BMD and TBS (-0.36 %/year and -0.31 %/year, respectively) were seen for untreated subjects (both p < 0.001). Conversely, treated subjects exhibited a significant mean increase in BMD (+1.86 %/year, p < 0.002) and TBS (+0.20 %/year, p < 0.001). CONCLUSION: TBS is responsive to treatment with non-estrogen anti-resorptive drug therapy in women over age 50. The treatment-related increase in TBS is less than the increase in BMD, which is consistent with bone texture preservation.

The Life-World and Its Multiple Realities: Alfred Schütz's Contribution to the Understanding of the Experience of Illness

Alfred Schütz original contribution to the social sciences refers to his analysis of the structure of the "life-world". This article aims to invigorate interest in the work of this author, little known in the field of health psychology. Key concepts of Schütz' approach will be presented in relation to their potential interest to the understanding of the experience of illness. In particular, we develop the main characteristics of the everyday life and its cognitive style, that is, its finite province of meaning. We propose to adopt this notion to define the experience of chronic or serious illness when the individual is confronted to the medical world. By articulating this analysis with literature in health psychology, we argue that Schütz's perspective brings useful insight to the field, namely because of its ability to study meaning constructions by overcoming the trap of solipsism by embracing intersubjectivity. The article concludes by outlining both, the limitations and research perspectives brought by this phenomenological analysis of the experiences of health and illness.

Lumbar spine texture enhances 10-year fracture probability assessment.

We found that lumbar spine texture analysis using trabecular bone score (TBS) is a risk factor for MOF and a risk factor for death in a retrospective cohort study from a large clinical registry for the province of Manitoba, Canada. INTRODUCTION: FRAX® estimates the 10-year probability of major osteoporotic fracture (MOF) using clinical risk factors and femoral neck bone mineral density (BMD). Trabecular bone score (TBS), derived from texture in the spine dual X-ray absorptiometry (DXA) image, is related to bone microarchitecture and fracture risk independently of BMD. Our objective was to determine whether TBS provides information on MOF probability beyond that provided by the FRAX variables. METHODS: We included 33,352 women aged 40-100 years (mean 63 years) with baseline DXA measurements of lumbar spine TBS and femoral neck BMD. The association between TBS, the FRAX variables, and the risk of MOF or death was examined using an extension of the Poisson regression model. RESULTS: During the mean of 4.7 years, 1,754 women died and 1,872 sustained one or more MOF. For each standard deviation reduction in TBS, there was a 36 % increase in MOF risk (HR 1.36, 95 % CI 1.30-1.42, p < 0.001) and a 32 % increase in death (HR 1.32, 95 % CI 1.26-1.39, p < 0.001). When adjusted for significant clinical risk factors and femoral neck BMD, lumbar spine TBS was still a significant predictor of MOF (HR 1.18, 95 % CI 1.12-1.23) and death (HR 1.20, 95 % CI 1.14-1.26). Models for estimating MOF probability, accounting for competing mortality, showed that low TBS (10th percentile) increased risk by 1.5-1.6-fold compared with high TBS (90th percentile) across a broad range of ages and femoral neck T-scores. CONCLUSIONS: Lumbar spine TBS is able to predict incident MOF independent of FRAX clinical risk factors and femoral neck BMD even after accounting for the increased death hazard.

TBS (trabecular bone score) and diabetes-related fracture risk.

CONTEXT: Type 2 diabetes is associated with increased fracture risk but paradoxically greater bone mineral density (BMD). Trabecular bone score (TBS) is derived from the texture of the spine dual x-ray absorptiometry (DXA) image and is related to bone microarchitecture and fracture risk, providing information independent of BMD. OBJECTIVE: This study evaluated the ability of lumbar spine TBS to account for increased fracture risk in diabetes. DESIGN AND SETTING: We performed a retrospective cohort study using BMD results from a large clinical registry for the province of Manitoba, Canada. Patients: We included 29,407 women 50 years old and older with baseline DXA examinations, among whom 2356 had diagnosed diabetes. MAIN OUTCOME MEASURES: Lumbar spine TBS was derived for each spine DXA examination blinded to clinical parameters and outcomes. Health service records were assessed for incident nontraumatic major osteoporotic fractures (mean follow-up 4.7 years). RESULTS: Diabetes was associated with higher BMD at all sites but lower lumbar spine TBS in unadjusted and adjusted models (all P < .001). The adjusted odds ratio (aOR) for a measurement in the lowest vs the highest tertile was less than 1 for BMD (all P < .001) but was increased for lumbar spine TBS [aOR 2.61, 95% confidence interval (CI) 2.30-2.97]. Major osteoporotic fractures were identified in 175 women (7.4%) with and 1493 (5.5%) without diabetes (P < .001). Lumbar spine TBS was a BMD-independent predictor of fracture and predicted fractures in those with diabetes (adjusted hazard ratio 1.27, 95% CI 1.10-1.46) and without diabetes (hazard ratio 1.31, 95% CI 1.24-1.38). The effect of diabetes on fracture was reduced when lumbar spine TBS was added to a prediction model but was paradoxically increased from adding BMD measurements. CONCLUSIONS: Lumbar spine TBS predicts osteoporotic fractures in those with diabetes, and captures a larger portion of the diabetes-associated fracture risk than BMD.

Clinical factors associated with trabecular bone score.

Dual-energy X-ray absorptiometry (DXA) measurement of bone mineral density (BMD) is the reference standard for diagnosing osteoporosis but does not directly reflect deterioration in bone microarchitecture. The trabecular bone score (TBS), a novel grey-level texture measurement that can be extracted from DXA images, predicts osteoporotic fractures independent of BMD. Our aim was to identify clinical factors that are associated with baseline lumbar spine TBS. In total, 29,407 women ≥50yr at the time of baseline hip and spine DXA were identified from a database containing all clinical results for the Province of Manitoba, Canada. Lumbar spine TBS was derived for each spine DXA examination blinded to clinical parameters and outcomes. Multiple linear regression and logistic regression (lowest vs highest tertile) was used to define the sensitivity of TBS to other risk factors associated with osteoporosis. Only a small component of the TBS measurement (7-11%) could be explained from BMD measurements. In multiple linear regression and logistic regression models, reduced lumbar spine TBS was associated with recent glucocorticoid use, prior major fracture, rheumatoid arthritis, chronic obstructive pulmonary disease, high alcohol intake, and higher body mass index. In contrast, recent osteoporosis therapy was associated with a significantly lower likelihood for reduced TBS. Similar findings were seen after adjustment for lumbar spine or femoral neck BMD. In conclusion, lumbar spine TBS is strongly associated with many of the risk factors that are predictive of osteoporotic fractures. Further work is needed to determine whether lumbar spine TBS can replace some of the clinical risk factors currently used in fracture risk assessment.

Hydrogen isotope fractionations between amphiboles, micas, and fluids in alkaline igneous intrusions

RÉSUMÉ DE LA THÈSE Les teneurs des amphiboles en éléments majeurs et en isotopes stables ont été analysées dans plusieurs complexes ignés alcalins et hyperalcalins, dans le but de déterminer l'importance des variations de composition des minéraux pour le fractionnement isotopique de l'hydrogène dans un système naturel minéral-magma-fluide. Cette étude se concentre principalement sur les syénites néphéliniques de complexes intrusifs alcalins bien connus mais à chimie variable, dont les amphiboles, ainsi que d'autres silicates hydratés tels que micas et eudialytes, lorsque cela était possible, ont été séparés. L'intérêt principal s'est porté sur le complexe alcalin d'Ilímaussaq de la Province du Gardar, au Sud du Groenland. Dans une optique de comparaison, nous avons collecté et analysé d'autres échantillons provenant du complexe de Tugtutôq (Sud Groenland), des complexes de Khibina et Lovozero (Péninsule de Kola, Russie), du Mont St-Hilaire et du Mont Royal (Canada) et de 6 autres du nord-ouest de la Namibie (Cape Cross, Okenyenya, Messum, Etaneno, Kalkfeld,et Okorusu). Les compositions isotopiques de l'hydrogène des amphiboles des ces différentes zones présentent de grandes variations (-227 à -700/00), ce qui est atypique pour des magmas d'origine mantellique. Les valeurs comprises entre -80 et -400/00 indiquent une provenance du manteau. Ces larges variations de compositions ainsi que l'extrême appauvrissement en isotope lourd de l'hydrogène (D), en comparaison avec d'autres roches ignées, semblent être propres.aux roches alcalines et hyperalcalines de ce type, ce qui indiquerait un processus commun. Les différents complexes alcalins choisis présentent un large intervalle de composition chimique des amphiboles. La caractérisation des amphiboles par microscopie électronique et par spectroscopie Mössbauer contribuent à observer le contrôle du Fe sur le fractionnement des isotopes de l'hydrogène. En effet, cela a mis en évidence un contrôle du Fe sur le fractionnement et même, dans le cas du complexe hyperalcalin d'Ilímaussaq, une relation entre le rapport Fei3+/FeT et les variations du rapport D/H. Les complexes étudiés diffèrent de par leur index agpaïtique (Na+K/Al) et également de par leur contenu en fer. Les plus hautes valeurs en Fe (27-35 wt%) et en éléments alcalins dans les amphiboles, ainsi que les teneurs de D/H les plus basses et leur grande variation, sont celles du complexe d'Ilímaussaq. Les amphiboles de la Péninsule de Kola et du Canada sont similaires, mais toutefois moins appauvries en D. En ce qui concerne les amphiboles des complexes du NO de la Namibie, elles présentent des compositions isotopiques de l'hydrogène magmatiques normales (-73 à -100 0/00), contiennent moins de Fe (15-17 wt%) et sont fortement enrichies en Ca et moins en Na. Dans ce cas, l'alcalinité est moins importante en comparaison des autres complexes étudiés. En dehors des teneurs en éléments alcalins des amphiboles, l'alcalinité des fluides s'avère également un facteur important, ce qui est cohérent avec certaines suggestions à partir de systèmes expérimentaux. Afin de mieux contraindre ce facteur, des expériences d'échanges hydrothermaux entre les amphiboles et les fluides de salinité différente ont été effectuées en simulant des conditions naturelles. L'approximation d'amphiboles naturelles de complexes ignés alcalins, couplée aux expériences d'échange, aide à préciser les facteurs contrôlant le fractionnement des isotopes de l'hydrogène dans les roches alcalines. Les valeurs extrêmement basses de 3D des amphiboles de ces complexes alcalins peuvent être dues à une combinaison de différents facteurs, telles qu'une haute alcalinité, une haute teneur en Fe et une faible profondeur d'intrusion. Les grandes variations ainsi que les faibles valeurs de SD des amphiboles étudiées peuvent résulter d'un processus magmatique interne et il est peu probable que de l'eau météorique soit impliquée et/ou que le dégazage magmatique ait joué un rôle. THESIS ABSTRACT Major element and stable isotope compositions of amphiboles were analyzed from a number of alkaline and peralkaline igneous complexes in order to determine the importance of compositional variations in minerals to hydrogen isotope fractionations in natural mineral-melt-fluid systems. The thesis mainly focuses on nepheline syenites of well-studied, but chemically variable alkaline intrusive rocks, from which amphiboles and, if possible, other hydrous silicates such as micas and eudialytes were separated. The system of primary interest was the alkaline Ilímaussaq Complex of the Gardar Province of South Greenland. For the purpose of comparison additional samples were collected and examined from the Tugtutôq Complex (South Greenland), the Khibina and Lovozero Complexes (Kola Peninsular, Russia), Mount St-Hilaire and Mount Royal (Canada) and six further complexes from NW Namibia (Cape Cross, Okenyenya, Messum, Etaneno, Kalkfeld, and Okorusu). The hydrogen isotope compositions of amphiboles from the localities studied differ greatly, which is atypical for amphiboles from mantle, range between - 227 and - 700/00 (latter compatible with a simple mantle origin). As this wide range in compositions and the extreme depletion in the heavy hydrogen isotope (D) content relative to other igneous rocks appear to be unique to alkaline to peralkaline rocks of this type, a common process is indicated. The different alkaline complexes chosen cover a wide range of amphibole chemical compositions. Detailed chemical characterization of amphiboles by electron microprobe and Mössbauer spectroscopy analyses helped to constrain the control of Fe on the H-isotope fractionations. Complete characterization of the chemical compositions of the amphiboles support Fe-control on fractionations and at least for the peralkaline Ilímaussaq complex a relationship between Fe3+/FeT ratios and variations in D/H. The studied complexes differ in their agpaitic index (Na+K/Al) and also in their Fe-content. The most iron (27-35 wt. %) and alkaline element rich amphiboles, with the lowermost D/H ratio, as well with very wide range, are the ones from Ilímaussaq complex. Similar, but less D depleted amphiboles are from the Kola Peninsula and the Canadian localities. The complexes described from NW Namibia have amphiboles with normal magmatic hydrogen isotope composition (-730/00 to -1000/00), and have less Fe-content (15-17 wt. %), and are more Ca-and less Na-rich. In this case alkalinity is not that important in comparison to the other studied complexes. Beside the alkaline element contents in the amphiboles, the alkalinity of the fluids has been found to be an important factor, in conjunction with earlier suggestions from experimental systems. To further constrain this factor, hydrothermal exchange experiments between amphiboles and fluids of different salinity simulating natural conditions were performed. The approach of examining natural amphiboles from alkaline igneous complexes in parallel to performing exchange experiments - helped to further constrain the factors controlling the H-isotope fractionations in alkaline rocks. The observed changes between the hydrogen and oxygen isotope compositions of amphiboles and fluids before and after the experiments suggest that another phase was produced during the experiments, which influenced the final hydrogen isotope composition of the system. This presumably hydrous phase has also influenced the Fe3 +/Fe2+ ratio of the amphiboles, which became more oxidized. The extremely low SD values of amphiboles in these alkaline complexes may be due to a combination of different factors such as high alkalinity, high Fe-content, and shallow intrusion depths. This wide range and the low SD values of the amphiboles studied might be a result of internal, magmatic processes and it is unlikely that meteoric water was involved and/or magmatic degassing played an important role. RÉSUMÉ DE LA THÈSE (pour le grand public) Fractionnement isotopique de l'hydrogène entre amphiboles, micas et fluides dans des intrusions alcalines Zsófia Wáczek Directeur de thèse, Prof. Torsten W. Vennemann Institut de Minéralogie et Géochimie, Université de Lausanne Les roches alcalines et celles qui leurs sont associées sont des sources importantes de nombreux minéraux et minerais, tels l'apatite, le niobium, le diamant et autres pierres précieuses. Cette étude se concentre sur des complexes alcalins localisés dans le sud du Groenland, au Canada, dans la péninsule de Kola en Russie et au nord-ouest de la Namibie. Ces complexes sont composés de roches ayant cristallisé à partir de magmas et de fluides très enrichis en alcalins. Cet enrichissement permet la précipitation de minéraux inhabituels riches en potassium et/ou sodium, telles les amphiboles sodiques, également enrichies en fer. Les amphiboles étudiées ont des compositions calciques, sodi-calciques et sodiques, qui reflètent leurs différents environnements de formation. Des études précédentes ont révélé une large gamme de rapports isotopiques de l'hydrogène dans les amphiboles de roches hyperalcalines, dont certains extrêmement bas. Cette variation importante est très intrigante, sachant que des valeurs entre -40 et -800/00 correspondent à des silicates ignés hydratés et non altérés, alors que des valeurs descendant jusqu'a -1500/00 nécessiteraient une altération par de l'eau météorique et/ou une contamination par les roches environnantes ou des sédiments riches en matière organique. Dans lé cas précis du complexe d'Ilímaussaq (sud du Groenland), aucune de ces explications n'a pu être démontrée et des valeurs encore plus faibles ont été trouvées. Le complexe d'Ilímaussaq présente des valeurs de rapport isotopique de l'hydrogène entre -227 et -500/00 dans les amphiboles. Une origine mantellique permet d'expliquer les valeurs élevées, mais d'autres processus doivent entrer en jeu pour engendrer les valeurs les plus négatives. C'est à l'identification de ces processus que nous nous sommes attachés dans ce travail. Les grandes variations observées dans les teneurs en fer et dans le rapport Fe3+/FeT des roches et des minéraux de ces complexes sont corrélées avec d'autres paramètres chimiques, tels que la composition isotopique de l'hydrogène dans les amphiboles. Nous avons dès lors abordé les questions suivantes: quelle est la relation entre la teneur en fer des amphiboles et leur composition isotopique? Que nous apprennent les changements de la teneur en fer et les changements dans le rapport Fe3+/FeT sur les processus pétrologiques dans ces roches? Pour répondre à ces questions, nous avons analysé les compositions isotopiques de l'oxygène et de l'hydrogène dans les amphiboles et d'autres silicates hydratés. La composition chimique et le rapport Fe3+/FeT des amphiboles ont également été déterminés. Des expériences hydrothermales simulant des conditions naturelles ont été entreprises afin de mieux comprendre les processus de fractionnement isotopiques dans ces systèmes très alcalins. Nos conclusions sont les suivantes: (1) Les valeurs extrêmement faibles ainsi que les larges variations des rapports isotopiques de l'hydrogène des amphiboles de ces complexes alcalins sont dues à une combinaison de facteurs tels que la forte alcalinité, la haute teneur en fer et la profondeur très faible de l'intrusion. (2) Ces valeurs sont probablement le résultat de processus magmatiques internes. (3) Il est peu probable que les eaux météoriques et/ou le dégazage magmatique aient joué un rôle lors de la formation de ces amphiboles. (4) Certaines corrélations, en accord avec les études précédentes, ont pu être trouvées au niveau des concentrations en fer. (5) Dans le cas du complexe d'Ilímaussaq exclusivement, une relation a été trouvée entre le rapport Fe3+/FeT et la composition isotopique de l'hydrogène des amphiboles.

Spine bone texture assessed by trabecular bone score (TBS) predicts osteoporotic fractures in men: The Manitoba Bone Density Program.

INTRODUCTION: One quarter of osteoporotic fractures occur in men. TBS, a gray-level measurement derived from lumbar spine DXA image texture, is related to microarchitecture and fracture risk independently of BMD. Previous studies reported the ability of spine TBS to predict osteoporotic fractures in women. Our aim was to evaluate the ability of TBS to predict clinical osteoporotic fractures in men. METHODS: 3620 men aged ≥50 (mean 67.6years) at the time of baseline DXA (femoral neck, spine) were identified from a database (Province of Manitoba, Canada). Health service records were assessed for the presence of non-traumatic osteoporotic fracture after BMD testing. Lumbar spine TBS was derived from spine DXA blinded to clinical parameters and outcomes. We used Cox proportional hazard regression to analyze time to first fracture adjusted for clinical risk factors (FRAX without BMD), osteoporosis treatment and BMD (hip or spine). RESULTS: Mean followup was 4.5years. 183 (5.1%) men sustain major osteoporotic fractures (MOF), 91 (2.5%) clinical vertebral fractures (CVF), and 46 (1.3%) hip fractures (HF). Correlation between spine BMD and spine TBS was modest (r=0.31), less than correlation between spine and hip BMD (r=0.63). Significantly lower spine TBS were found in fracture versus non-fracture men for MOF (p<0.001), HF (p<0.001) and CVF (p=0.003). Area under the receiver operating characteristic curve (AUC) for incident fracture discrimination with TBS was significantly better than chance (MOF AUC=0.59, p<0.001; HF AUC=0.67, p<0.001; CVF AUC=0.57, p=0.032). TBS predicted MOF and HF (but not CVF) in models adjusted for FRAX without BMD and osteoporosis treatment. TBS remained a predictor of HF (but not MOF) after further adjustment for hip BMD or spine BMD. CONCLUSION: We observed that spine TBS predicted MOF and HF independently of the clinical FRAX score, HF independently of FRAX and BMD in men. Studies with more incident fractures are needed to confirm these findings.