Reconstructing 4000 years of mass movement and tsunami history in a deep peri-Alpine lake (Lake Geneva, France-Switzerland)

The study of mass movements in lake sediments provides insights into past natural hazards at historic and prehistoric timescales. Sediments from the deep basin of Lake Geneva reveal a succession of six large-scale (volumes of 22 × 106 to 250 × 106 m3) mass-transport deposits, associated with five mass-movement events within 2600 years (4000 cal bp to 563 ad). The mass-transport deposits result from: (i) lateral slope failures (mass-transport deposit B at 3895 ± 225 cal bp and mass-transport deposits A and C at 3683 ± 128 cal bp); and (ii) Rhône delta collapses (mass-transport deposits D to G dated at 2650 ± 150 cal bp, 2185 ± 85 cal bp, 1920 ± 120 cal bp and 563 ad, respectively). Mass-transport deposits A and C were most probably triggered by an earthquake, whereas the Rhône delta collapses were likely to be due to sediment overload with a rockfall as the external trigger (mass-transport deposit G, the Tauredunum event in 563 ad known from historical records), an earthquake (mass-transport deposit E) or unknown external triggers (mass-transport deposits D and F). Independent of their origin and trigger mechanisms, numerical simulations show that all of these recorded mass-transport deposits are large enough to have generated at least metre-scale tsunamis during mass movement initiation. Since the Tauredunum event in 563 ad, two small-scale (volumes of 1 to 2 × 106 m3) mass-transport deposits (H and I) are present in the seismic record, both of which are associated with small lateral slope failures. Mass-transport deposits H and I might be related to earthquakes in Lausanne/Geneva (possibly) 1322 ad and Aigle 1584 ad, respectively. The sedimentary record of the deep basin of Lake Geneva, in combination with the historical record, show that during the past 3695 years, at least six tsunamis were generated by mass movements, indicating that the tsunami hazard in the Lake Geneva region should not be neglected, although such events are not frequent with a recurrence time of 0·0016 yr−1.

The changing pace of insular life: 5000 years of microevolution in the Orkney vole (Microtus arvalis orcadensis)

Island evolution may be expected to involve fast initial morphological divergence followed by stasis. We tested this model using the dental phenotype of modern and ancient common voles (Microtus arvalis), introduced onto the Orkney archipelago (Scotland) from continental Europe some 5000 years ago. First, we investigated phenotypic divergence of Orkney and continental European populations and assessed climatic influences. Second, phenotypic differentiation among Orkney populations was tested against geography, time, and neutral genetic patterns. Finally, we examined evolutionary change along a time series for the Orkney Mainland. Molar gigantism and anterior-lobe hypertrophy evolved rapidly in Orkney voles following introduction, without any transitional forms detected. Founder events and adaptation appear to explain this initial rapid evolution. Idiosyncrasy in dental features among different island populations of Orkney voles is also likely the result of local founder events following Neolithic translocation around the archipelago. However, against our initial expectations, a second marked phenotypic shift occurred between the 4th and 12th centuries AD, associated with increased pastoral farming and introduction of competitors (mice and rats) and terrestrial predators (foxes and cats). These results indicate that human agency can generate a more complex pattern of morphological evolution than might be expected in island rodents.

Long-term man–environment interactions in the Bolivian Amazon: 8000 years of vegetation dynamics

Only few studies documenting the vegetation history of the Llanos de Moxos, one of the largest seasonally flooded wetland areas in South America, are available and little is known about the environmental impact of pre-Columbian settlements. We use radiocarbon-dated terrestrial plant macrofossils to establish a sound chronology and palynological analyses to reconstruct the vegetation and fire history of the Lago Rogaguado area. The sedimentary pollen and spore record suggests that wetland and wooded savannah (Cerrado) environments occurred around the lake between 8100 and 5800 cal BP. Fire activity was high during this period and was probably connected to the dry Cerrado environments. The pollen evidence suggests early plant cultivation (Zea mays, Annonaceae and Cucurbitaceae) from 6500 cal BP onwards, which is significantly earlier than hitherto assumed for Amazonia. Gallery forests expanded after 5800 cal BP, when fire activity strongly declined. Forest expansion intensified around 2800 cal BP and continued until 2000 cal BP, when forest cover reached its maximum and fire activity its minimum. The late-Holocene forest expansion to the south and the decrease of fire activity may have resulted from a climatic shift to moister conditions (possibly a shorter dry season). New crops (e.g. Avena-type) or adventive plants (e.g. Rumex acetosella-type) document the impact of European economies after ca. 500 cal BP. Land use intensity remained rather stable over the most recent centuries, arguing against a collapse of settlements in response to the arrival of Europeans, as reconstructed from other Amazonian pollen records.

Seven years of annual pollen influx at the forest limit in the Swiss Alps studied by pollen traps: relations to vegetation and climate

Annual pollen influx has been monitored in short transects across the altitudinal tree limit in four areas of the Swiss Alps with the use of modified Tauber traps placed at the ground surface. The study areas are Grindelwald (8 traps), Aletsch (8 traps), Simplon (5 traps), and Zermatt (5 traps). The vegetation around the traps is described. The results obtained are: (1) Peak years of pollen influx (one or two in seven years) follow years of high average air temperatures during June–November of the previous year for Larix and Picea, and less clearly for Pinus non-cembra, but not at all for Pinus cembra and Alnus viridis. (2) At the upper forest limit, the regional pollen influx of trees (trees absent within 100 m of the pollen trap) relates well to the average basal area of the same taxon within 10–15 km of the study areas for Pinus cembra, Larix, and Betula, but not for Picea, Pinus non-cembra, and Alnus viridis. (3) The example of Zermatt shows that pollen influx characterises the upper forest limit, if the latter is more or less intact. (4) Presence/absence of Picea, Pinus cembra, Larix, Pinus non-cembra, and Alnus viridis trees within 50–100 m of the traps is apparent in the pollen influx in peak years of pollen influx but not in other years, suggesting that forest-limit trees produce significant amounts of pollen only in some years. (5) Pollen influx averaged over the study period correlates well with the abundance of plants around the pollen traps for conifer trees (but not deciduous trees), Calluna, Gramineae, and Cyperaceae, and less clearly so Compositae Subfam. Cichorioideae and Potentilla-type. (6) Influx of extra-regional pollen derived from south of the Alps is highest in Simplon, which is open to southerly winds, slightly lower in Aletsch lying just north of Simplon, and lowest in Zermatt sheltered from the south by high mountains and Grindelwald lying north of the central Alps.

Perspectives on the 2014 ESC/EACTS Guidelines on Myocardial Revascularization: Fifty Years of Revascularization: Where Are We and Where Are We Heading?

The joint European Society of Cardiology and European Association of Cardio-Thoracic Surgery (ESC/EACTS) guidelines on myocardial revascularization collect and summarize the evidence regarding decision-making, diagnostics, and therapeutics in various clinical scenarios of coronary artery disease, including elective, urgent, and emergency settings. The 2014 document updates and extends the effort started in 2010, year of the first edition of these guidelines. Importantly, this latest edition provides a systematic review of all randomized clinical trials performed since 1980, comparing different strategies of myocardial revascularization, including coronary artery bypass graft (CABG), balloon angioplasty, percutaneous coronary intervention (PCI) with bare-metal stents (BMS) and first- and second-generation drug-eluting stents (DES). This review aims to highlight the most relevant novelties introduced by the 2014 edition of the ESC/EACTS myocardial revascularization guidelines as compared with the previous edition and to describe similarities and differences with the American societies' guidelines.

Peri-implant bone loss of dental implants with platform-switching design after 5 years of loading: a cross-sectional study

OBJECTIVE The aim of this cross-sectional study was to estimate bone loss of implants with platform-switching design and analyze possible risk indicators after 5 years of loading in a multi-centered private practice network. METHOD AND MATERIALS Peri-implant bone loss was measured radiographically as the distance from the implant shoulder to the mesial and distal alveolar crest, respectively. Risk factor analysis for marginal bone loss included type of implant prosthetic treatment concept and dental status of the opposite arch. RESULTS A total of 316 implants in 98 study patients after 5 years of loading were examined. The overall mean value for radiographic bone loss was 1.02 mm (SD ± 1.25 mm, 95% CI 0.90- 1.14). Correlation analyses indicated a strong association of peri-implant bone loss > 2 mm for removable implant-retained prostheses with an odds ratio of 53.8. CONCLUSION The 5-year-results of the study show clinically acceptable values of mean bone loss after 5 years of loading. Implant-supported removable prostheses seem to be a strong co-factor for extensive bone level changes compared to fixed reconstructions. However, these results have to be considered for evaluation of the included special cohort under private dental office conditions.

15 Years of Microstate Research in Schizophrenia - Where Are We? A Meta-Analysis

Schizophrenia patients show abnormalities in a broad range of task demands. Therefore, an explanation common to all these abnormalities has to be sought independently of any particular task, ideally in the brain dynamics before a task takes place or during resting state. For the neurobiological investigation of such baseline states, EEG microstate analysis is particularly well suited, because it identifies subsecond global states of stable connectivity patterns directly related to the recruitment of different types of information processing modes (e.g., integration of top-down and bottom-up information). Meanwhile, there is an accumulation of evidence that particular microstate networks are selectively affected in schizophrenia. To obtain an overall estimate of the effect size of these microstate abnormalities, we present a systematic meta-analysis over all studies available to date relating EEG microstates to schizophrenia. Results showed medium size effects for two classes of microstates, namely, a class labeled C that was found to be more frequent in schizophrenia and a class labeled D that was found to be shortened. These abnormalities may correspond to core symptoms of schizophrenia, e.g., insufficient reality testing and self-monitoring as during auditory verbal hallucinations. As interventional studies have shown that these microstate features may be systematically affected using antipsychotic drugs or neurofeedback interventions, these findings may help introducing novel diagnostic and treatment options.

Repatriations and 28-day mortality of ill and injured travellers: 12 years of experience in a Swiss emergency department

QUESTIONS UNDER STUDY Many persons are travelling all over the world; the elderly with pre-existing diseases also travel to places with less developed health systems. Reportedly, fewer than 0.5% of all travellers need repatriation. We aimed to analyse and examine people who are injured or ill while abroad, where they travelled to and by what means they were repatriated. METHODS Retrospective cross-sectional study with adult patients repatriated to a single level 1 trauma centre in Switzerland (2000-2011). RESULTS A total of 372 patients were repatriated, with an increasing trend per year. Of these, 67% were male; the median age was 56 years. Forty-nine percent sustained an injury, and 13% had surgical and 38% medical pathologies. Patients with medical conditions were older than those with injuries or surgical emergencies (p <0.001). Seventy-three percent were repatriated from Europe. For repatriation from Africa trauma was slightly more frequent (53%, n = 17) than illnesses, whereas for most other countries illnesses and trauma were equally distributed. Injured patients had a median Injury Severity Score of 8. The majority of illnesses involved the nervous system (38%), mainly stroke. Forty-five percent were repatriated by Swiss Air Ambulance, 26% by ground ambulance, 18% by scheduled flights with or without medical assistance and two patients injured near the Swiss boarder by helicopter. The 28-day mortality was 4%. CONCLUSIONS The numbers of travellers repatriated increased from 2000 to 2011. About half were due to illnesses and half due to injuries. The largest group were elderly Swiss nationals repatriated from European countries. As mortality is relatively high, special consideration to this group of patients is warranted.

Retention in care during the first 3 years of antiretroviral therapy for women in Malawi's option B+ programme: an observational cohort study

Background Studies of Malawi's option B+ programme for HIV-positive pregnant and breastfeeding women have reported high loss to follow-up during pregnancy and at the start of antiretroviral therapy (ART), but few data exist about retention during breastfeeding and after weaning. We examined loss to follow-up and retention in care in patients in the option B+ programme during their first 3 years on ART. Methods We analysed two data sources: aggregated facility-level data about patients in option B+ who started ART between Oct 1, 2011, and June 30, 2012, at 546 health facilities; and patient-level data from 20 large facilities with electronic medical record system for HIV-positive women who started ART between Sept 1, 2011, and Dec 31, 2013, under option B+ or because they had WHO clinical stages 3 or 4 disease or had CD4 counts of less than 350 cells per μL. We used facility-level data to calculate representative estimates of retention and loss to follow-up. We used patient-level data to study temporal trends in retention, timing of loss to follow-up, and predictors of no follow-up and loss to follow-up. We defined patients who were more than 60 days late for their first follow-up visit as having no follow-up and patients who were more than 60 days late for a subsequent visit as being lost to follow-up. We calculated proportions and cumulative probabilities of patients who had died, stopped ART, had no follow-up, were lost to follow-up, or were retained alive on ART for 36 months. We calculated odds ratios and hazard ratios to examine predictors of no follow-up and loss to follow-up. Findings Analysis of facility-level data about patients in option B+ who had not transferred to a different facility showed retention in care to be 76·8% (20 475 of 26 658 patients) after 12 months, 70·8% (18 306 of 25 849 patients) after 24 months, and 69·7% (17 787 of 25 535 patients) after 36 months. Patient-level data included 29 145 patients. 14 630 (50·2%) began treatment under option B+. Patients in option B+ had a higher risk of having no follow-up and, for the first 2 years of ART, higher risk of loss to follow-up than did patients who started ART because they had CD4 counts less than 350 cells per μL or WHO clinical stage 3 or 4 disease. Risk of loss to follow-up during the third year was low and similar for patients retained for 2 years. Retention rates did not change as the option B+ programme matured. Interpretation Our data suggest that pregnant and breastfeeding women who start ART immediately after they are diagnosed with HIV can be retained on ART through the option B+ programme, even after many have stopped breastfeeding. Interventions might be needed to improve retention in the first year on ART in option B+. Funding Bill & Melinda Gates Foundation, Partnerships for Enhanced Engagement in Research Health, and National Institute of Allergy and Infectious Diseases.

Interstellar neutral helium in the heliosphere from Interstellar Boundary Explorer observations. III. Mach number of the flow, velocity vector, and temperature from the first six years of measurements

We analyzed observations of interstellar neutral helium (ISN He) obtained from the Interstellar Boundary Explorer (IBEX) satellite during its first six years of operation. We used a refined version of the ISN He simulation model, presented in the companion paper by Sokol et al. (2015b), along with a sophisticated data correlation and uncertainty system and parameter fitting method, described in the companion paper by Swaczyna et al. We analyzed the entire data set together and the yearly subsets, and found the temperature and velocity vector of ISN He in front of the heliosphere. As seen in the previous studies, the allowable parameters are highly correlated and form a four-dimensional tube in the parameter space. The inflow longitudes obtained from the yearly data subsets show a spread of similar to 6 degrees, with the other parameters varying accordingly along the parameter tube, and the minimum chi(2) value is larger than expected. We found, however, that the Mach number of the ISN He flow shows very little scatter and is thus very tightly constrained. It is in excellent agreement with the original analysis of ISN He observations from IBEX and recent reanalyses of observations from Ulysses. We identify a possible inaccuracy in the Warm Breeze parameters as the likely cause of the scatter in the ISN He parameters obtained from the yearly subsets, and we suppose that another component may exist in the signal or a process that is not accounted for in the current physical model of ISN He in front of the heliosphere. From our analysis, the inflow velocity vector, temperature, and Mach number of the flow are equal to lambda(ISNHe) = 255 degrees.8 +/- 0 degrees.5, beta(ISNHe) = 5 degrees.16 +/- 0 degrees.10, T-ISNHe = 7440 +/- 260 K, nu(SNHe) = 25.8 +/- 0.4 km s(-1), and M-ISNHe = 5.079 +/- 0.028, with uncertainties strongly correlated along the parameter tube.