Detrital Zircon Evidence for Non-Laurentian Provenance, Mesoproterozoic (ca. 1490-1450 Ma) Deposition and Orogenesis in a Reconstructed Orogenic Belt, Northern New Mexico, USA: Defining the Picuris Orogeny

Detrital zircon and igneous zircon U-Pb ages are reported from Proterozoic metamorphic rocks in northern New Mexico. These data give new insight into the provenance and depositional age of a >3-km-thick metasedimentary succession and help resolve the timing of orogenesis within an area of overlapping accretionary orogens and thermal events related to the Proterozoic tectonic evolution of southwest Laurentia. Three samples from the Paleoproterozoic Vadito Group yield narrow, unimodal detrital zircon age spectra with peak ages near 1710 Ma. Igneous rocks that intrude the Vadito Group include the Cerro Alto metadacite, the Picuris Pueblo granite, and the Penasco quartz monzonite and yield crystallization ages of 1710 +/- 10 Ma, 1699 +/- 3 Ma, and 1450 +/- 10 Ma, respectively. Within the overlying Hondo Group, a metamorphosed tuff layer from the Pilar Formation yields an age of 1488 +/- 6 Ma and represents the first direct depositional age constraint on any part of the Proterozoic metasedimentary succession in northern New Mexico. Detrital zircon from the overlying Piedra Lumbre Formation yield a minimum age peak of 1475 Ma, and similar to 60 grains (similar to 25%) yield ages between 1500 Ma and 1600 Ma, possibly representing non-Laurentian detritus originating from Australia and/or Antarctica. Detrital zircons from the basal metaconglomerate and the middle quartzite member of the Marquenas Formation yield minimum age peaks of 1472 Ma and 1471 Ma, consistent with earlier results. We interpret the onset of ca. 1490-1450 Ma deposition followed by tectonic burial, regional Al2SiO5 triple-point metamorphism, and ductile deformation at depths of 12-18 km to reflect a Mesoproterozoic contractional orogenic event, possibly related to the final suturing of the Mazatzal crustal province to the southern margin of Laurentia. We propose to call this event the Picuris orogeny.

Complicating the Local: Defining the Aymara at Tiwanaku, Bolivia

The archaeological site of Tiwanaku, Bolivia, is commonly held to be the "Spiritual Capital of the Aymara People." But negotiating who qualifies as Aymara, and in what contexts, is decidedly more complicated. Local political divisions between residents of the village of Tiahuanacu (who are seen locally as less-Aymara but not as not-Aymara) and residents of the surrounding rural communities (who are considered to be unquestionably Aymara) structure discussions about who has the right to earn income at the Tiwanaku archaeological site, who manages major public events, and who is responsible for the site's maintenance and security. The situation is complicated further by national-level events such as the Winter Solstice, where urban Aymara travel to Tiwanaku to seek their roots, and Bolivian Presidents and politicians come to participate in national Aymara "culture." I focus on the intervencin ("Intervention") that took place in Tiahuanacu in August 2000, which resulted in the transfer of management of the Tiwanaku archaeological site from the Bolivian state to local municipal and indigenous authorities. Heritage researchers should take such local divisions into account, rather than assuming that "locals" are politically unified or easily delineated by geographical boundaries.

Population-based analysis of 4113 patients with acute cholecystitis: defining the optimal time-point for laparoscopic cholecystectomy

Objective: To compare clinical outcomes after laparoscopic cholecystectomy (LC) for acute cholecystitis performed at various time-points after hospital admission. Background: Symptomatic gallstones represent an important public health problem with LC the treatment of choice. LC is increasingly offered for acute cholecystitis, however, the optimal time-point for LC in this setting remains a matter of debate. Methods: Analysis was based on the prospective database of the Swiss Association of Laparoscopic and Thoracoscopic Surgery and included patients undergoing emergency LC for acute cholecystitis between 1995 and 2006, grouped according to the time-points of LC since hospital admission (admission day (d0), d1, d2, d3, d4/5, d ≥6). Linear and generalized linear regression models assessed the effect of timing of LC on intra- or postoperative complications, conversion and reoperation rates and length of postoperative hospital stay. Results: Of 4113 patients, 52.8% were female, median age was 59.8 years. Delaying LC resulted in significantly higher conversion rates (from 11.9% at d0 to 27.9% at d ≥6 days after admission, P < 0.001), surgical postoperative complications (5.7% to 13%, P < 0.001) and re-operation rates (0.9% to 3%, P = 0.007), with a significantly longer postoperative hospital stay (P < 0.001). Conclusions: Delaying LC for acute cholecystitis has no advantages, resulting in significantly increased conversion/re-operation rate, postoperative complications and longer postoperative hospital stay. This investigation—one of the largest in the literature—provides compelling evidence that acute cholecystitis merits surgery within 48 hours of hospital admission if impact on the patient and health care system is to be minimized.

Defining new criteria for selection of cell-based intestinal models using publicly available databases

The criteria for choosing relevant cell lines among a vast panel of available intestinal-derived lines exhibiting a wide range of functional properties are still ill-defined. The objective of this study was, therefore, to establish objective criteria for choosing relevant cell lines to assess their appropriateness as tumor models as well as for drug absorption studies.

Defining "Drunk" in Early Modern Germany

Explores the role of the drinking of alcoholic beverages in early modern Germany. Definition of drunkenness; Notions on harm caused by alcohol consumption on different types of persons; Recommendation of occasional immoderate drinking to rid the body of impurities.

Variable impact on mortality of AIDS-defining events diagnosed during combination antiretroviral therapy: not all AIDS-defining conditions are created equal

BACKGROUND: The extent to which mortality differs following individual acquired immunodeficiency syndrome (AIDS)-defining events (ADEs) has not been assessed among patients initiating combination antiretroviral therapy. METHODS: We analyzed data from 31,620 patients with no prior ADEs who started combination antiretroviral therapy. Cox proportional hazards models were used to estimate mortality hazard ratios for each ADE that occurred in >50 patients, after stratification by cohort and adjustment for sex, HIV transmission group, number of antiretroviral drugs initiated, regimen, age, date of starting combination antiretroviral therapy, and CD4+ cell count and HIV RNA load at initiation of combination antiretroviral therapy. ADEs that occurred in <50 patients were grouped together to form a "rare ADEs" category. RESULTS: During a median follow-up period of 43 months (interquartile range, 19-70 months), 2880 ADEs were diagnosed in 2262 patients; 1146 patients died. The most common ADEs were esophageal candidiasis (in 360 patients), Pneumocystis jiroveci pneumonia (320 patients), and Kaposi sarcoma (308 patients). The greatest mortality hazard ratio was associated with non-Hodgkin's lymphoma (hazard ratio, 17.59; 95% confidence interval, 13.84-22.35) and progressive multifocal leukoencephalopathy (hazard ratio, 10.0; 95% confidence interval, 6.70-14.92). Three groups of ADEs were identified on the basis of the ranked hazard ratios with bootstrapped confidence intervals: severe (non-Hodgkin's lymphoma and progressive multifocal leukoencephalopathy [hazard ratio, 7.26; 95% confidence interval, 5.55-9.48]), moderate (cryptococcosis, cerebral toxoplasmosis, AIDS dementia complex, disseminated Mycobacterium avium complex, and rare ADEs [hazard ratio, 2.35; 95% confidence interval, 1.76-3.13]), and mild (all other ADEs [hazard ratio, 1.47; 95% confidence interval, 1.08-2.00]). CONCLUSIONS: In the combination antiretroviral therapy era, mortality rates subsequent to an ADE depend on the specific diagnosis. The proposed classification of ADEs may be useful in clinical end point trials, prognostic studies, and patient management.