Sedimentology, geochemistry and ostracodes from Lake Ohrid

Ancient Lake Ohrid, located in the southern Balkan Peninsula in Macedonia and Albania is characterized by a high degree of endemism and it is considered to be the oldest lake in Europe. But its exact age (between one and ten million years) and also its origin are so far not known. To unravel these uncertainties an ICDP (International Continental Scientific Drilling Program) drilling project (Scientific Collaboration On Past Speciation Conditions in Ohrid (SCOPSCO)), started in April 2013. In addition to the investigations about the age and origin, other paleolimnological studies, e.g., the reconstruction of past climate and of past lake level changes, should be performed with the drilled cores. Used proxies in such paleolimnological studies are, e.g., ostracodes because they respond sensitively to environmental changes but an accurate knowledge of their preferences and tolerances to specific environmental conditions is necessary for this purpose. So far, this knowledge about the, mostly endemic, Ohrid ostracodes was limited. Thus, within the framework of this thesis, ostracodes and a multiplicity of environmental data were collected in Lake Ohrid and its adjacent waters during four field campaigns. In a total of 47 ostracode species could be detected in the entire study area and 32 of them were found alive in Lake Ohrid. Multivariate statistic identified that water depth, salinity, conductivity, pH, and dissolved oxygen were the main determining factors for ostracode distribution in the entire study area. In Lake Ohrid, the distribution was mainly controlled by water depth, water temperature, and pH. Some ostracodes were identified as strong indicator species for important environmental variables, e.g., water temperature and water depth. A distinctive feature of Lake Ohrid was the finding of the ostracode genus Amnicythere whose species normally inhabit oligo-(meso-)haline waters and this could point to a marine origin of the lake. So far, the specialized endemic ostracodes show the highest abundances and the greatest spatial distribution in Lake Ohrid but during the sampling eight widespread species were found for the first time in the lake. They inhabited mainly the northern part of the lake, where two cities are located and industry and agriculture play a major role, and they were limited to water depths above 50 m and this could be an evidence for an increasing anthropogenic pressure because widespread ostracode species often replace endemic species. To unravel the human impact on Lake Ohrid during the last decades short sediment cores were taken and the multi-proxy study indicated that the lake productivity between the early 1920s and the late 1980s was relatively low. Diatom assemblages indicate a rising productivity in the southern part of Lake Ohrid since the mid 1970s and geochemical proxies and ostracodes point to an increasing productivity since the late 1980s in the southern and in the northern part. A slight increase in the productivity continued until 2009. Noticeable is the fact that since the early 1990s, the increasing productivity and the increasing concentrations of heavy metals correspond to a decreasing number of ostracodes in the northern part of Lake Ohrid. Perhaps, this indicates that living conditions in this lake part became less favorable for the mostly endemic ostracode species. Furthermore, the sediment samples from the cores show relatively high concentrations of arsenic, iron, and nickel. Fluctuations in ostracode assemblages from three longer sediment cores, the longest spans approximately 136 ka, taken in Lake Ohrid, correspond to fluctuations in the productivity, in the carbonate content, of the lake level, and of climate changes. Between the marine isotope stage (MIS) 6 and MIS 2 the number of ostracode valves is very low or the valves were completely absent. This corresponds to a low lake productivity, a low carbonate content, and a low lake level. At the onset of the Holocene, the number of valves increased markedly and this correlates with an increased productivity and carbonate content and a warmer climate. But during the Little Ice Age (LIA), the number of valves dropped again and species which prefer warmer waters disappeared completely. This drop corresponds also to a low productivity. After the LIA, the number of species increased again but since 1895 AD a strong and abrupt decrease is visible. A reason for this could be an increase in the heavy metal concentrations.

Activity concentrations of radionuclides in 5 short cores taken in 2007-2008 measured by ICP-MS and HPGe gamma spectrometry

Natural radionuclides and man-made 137Cs were analyzed in five short sediment cores taken in northern part of the Gulf of Eilat (Gulf of Aqaba) in order to provide information on sedimentation and mixing rates and sediment sources. The maximum estimates of sedimentation rates based on excess 210Pb were found to vary between 0.105 ± 0.020 and 0.35 ± 0.23 cm · year**-1. Even the lowest estimates are significantly higher than those expected from dust deposition, suggesting other sources and processes being responsible for most of the allochthonous material accumulation, including periodical floods following heavy rain events, internal erosion or triggers, like earthquakes. In 137Cs depth profiles no 1963 related nuclear weapon test maxima were found; instead, the activities decrease monotonically, suggesting that a major process leading to radionuclides' depth distribution might be mixing. The mixing rates calculated from 137Cs, excess 210Pb and excess 228Th reach values up to 2.18 ± 0.69 cm**2 · year**-1.

Manganese concretions from Kara Sea and Karelia

The determinations of the radioactivity of a series of ferro-manganese concretions of the seas and lakes of the U.S.S.R. (especially of the Kara Sea and lakes of Karelia) have brought out certain facts which make possible the determination of the age of the concretions by the content of radium in its different layers.

Madrepora oculata and Lophelia pertusa mass and 210Pb-226Ra chronology, Røst Reef, Norway, 2011

Here we show the use of the 210Pb-226Ra excess method to determine the growth rate of corals from one of the world's largest known cold-water coral reef, the Røst Reef off Norway. Two large branching framework-forming cold-water coral specimens, one Lophelia pertusa and one Madrepora oculata were collected alive at 350 m water depth from the Røst Reef at ~67° N and ~9° E. Pb and Ra isotopes were measured along the major growth axis of both specimens using low level alpha and gamma spectrometry and the corals trace element compositions were studied using ICP-QMS. Due to the different chemical behaviors of Pb and Ra in the marine environment, 210Pb and 226Ra were not incorporated the same way into the aragonite skeleton of those two cold-water corals. Thus to assess of the growth rates of both specimens we have here taken in consideration the exponential decrease of initially incorporated 210Pb as well as the ingrowth of 210Pb from the decay of 226Ra. Moreover a~post-depositional 210Pb incorporation is found in relation to the Mn-Fe coatings that could not be entirely removed from the oldest parts of the skeletons. The 226Ra activities in both corals were fairly constant, then assuming constant uptake of 210Pb through time the 210Pb-226Ra chronology can be applied to calculate linear growth rate. The 45.5 cm long branch of M. oculata reveals an age of 31 yr and a~linear growth rate of 14.4 ± 1.1 mm yr-1, i.e. 2.6 polyps per year. However, a correction regarding a remaining post-depositional Mn-Fe oxide coating is needed for the base of the specimen. The corrected age tend to confirm the radiocarbon derived basal age of 40 yr (using 14C bomb peak) with a mean growth rate of 2 polyps yr-1. This rate is similar to the one obtained in Aquaria experiments under optimal growth conditions. For the 80 cm-long specimen of L. pertusa a remaining contamination of metal-oxides is observed for the middle and basal part of the coral skeleton, inhibiting similar accurate age and growth rate estimates. However, the youngest branch was free of Mn enrichment and this 15 cm section reveals a growth rate of 8 mm yr-1 (~1 polyp every two to three years). However, the 210Pb growth rate estimate is within the lowermost ranges of previous growth rate estimates and may thus reflect that the coral was not developing at optimal growth conditions. Overall, 210Pb-226Ra dating can be successfully applied to determine the age and growth rate of framework-forming cold-water corals, however, removal of post-depositional Mn-Fe oxide deposits is a prerequisite. If successful, large branching M. oculata and L. pertusa coral skeletons provide unique oceanographic archive for studies of intermediate water environmentals with an up to annual time resolution and spanning over many decades.

Cabazitaxel for Hormone-Relapsed Metastatic Prostate Cancer Previously Treated With a Docetaxel-Containing Regimen: An Evidence Review Group Perspective of a NICE Single Technology Appraisal

As part of its single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the company that manufactures cabazitaxel (Jevtana(®), Sanofi, UK) to submit evidence for the clinical and cost effectiveness of cabazitaxel for treatment of patients with metastatic hormone-relapsed prostate cancer (mHRPC) previously treated with a docetaxel-containing regimen. The School of Health and Related Research Technology Appraisal Group at the University of Sheffield was commissioned to act as the independent Evidence Review Group (ERG). The ERG produced a critical review of the evidence for the clinical and cost effectiveness of the technology based upon the company's submission to NICE. Clinical evidence for cabazitaxel was derived from a multinational randomised open-label phase III trial (TROPIC) of cabazitaxel plus prednisone or prednisolone compared with mitoxantrone plus prednisone or prednisolone, which was assumed to represent best supportive care. The NICE final scope identified a further three comparators: abiraterone in combination with prednisone or prednisolone; enzalutamide; and radium-223 dichloride for the subgroup of people with bone metastasis only (no visceral metastasis). The company did not consider radium-223 dichloride to be a relevant comparator. Neither abiraterone nor enzalutamide has been directly compared in a trial with cabazitaxel. Instead, clinical evidence was synthesised within a network meta-analysis (NMA). Results from TROPIC showed that cabazitaxel was associated with a statistically significant improvement in both overall survival and progression-free survival compared with mitoxantrone. Results from a random-effects NMA, as conducted by the company and updated by the ERG, indicated that there was no statistically significant difference between the three active treatments for both overall survival and progression-free survival. Utility data were not collected as part of the TROPIC trial, and were instead taken from the company's UK early access programme. Evidence on resource use came from the TROPIC trial, supplemented by both expert clinical opinion and a UK clinical audit. List prices were used for mitoxantrone, abiraterone and enzalutamide as directed by NICE, although commercial in-confidence patient-access schemes (PASs) are in place for abiraterone and enzalutamide. The confidential PAS was used for cabazitaxel. Sequential use of the advanced hormonal therapies (abiraterone and enzalutamide) does not usually occur in clinical practice in the UK. Hence, cabazitaxel could be used within two pathways of care: either when an advanced hormonal therapy was used pre-docetaxel, or when one was used post-docetaxel. The company believed that the former pathway was more likely to represent standard National Health Service (NHS) practice, and so their main comparison was between cabazitaxel and mitoxantrone, with effectiveness data from the TROPIC trial. Results of the company's updated cost-effectiveness analysis estimated a probabilistic incremental cost-effectiveness ratio (ICER) of £45,982 per quality-adjusted life-year (QALY) gained, which the committee considered to be the most plausible value for this comparison. Cabazitaxel was estimated to be both cheaper and more effective than abiraterone. Cabazitaxel was estimated to be cheaper but less effective than enzalutamide, resulting in an ICER of £212,038 per QALY gained for enzalutamide compared with cabazitaxel. The ERG noted that radium-223 is a valid comparator (for the indicated sub-group), and that it may be used in either of the two care pathways. Hence, its exclusion leads to uncertainty in the cost-effectiveness results. In addition, the company assumed that there would be no drug wastage when cabazitaxel was used, with cost-effectiveness results being sensitive to this assumption: modelling drug wastage increased the ICER comparing cabazitaxel with mitoxantrone to over £55,000 per QALY gained. The ERG updated the company's NMA and used a random effects model to perform a fully incremental analysis between cabazitaxel, abiraterone, enzalutamide and best supportive care using PASs for abiraterone and enzalutamide. Results showed that both cabazitaxel and abiraterone were extendedly dominated by the combination of best supportive care and enzalutamide. Preliminary guidance from the committee, which included wastage of cabazitaxel, did not recommend its use. In response, the company provided both a further discount to the confidential PAS for cabazitaxel and confirmation from NHS England that it is appropriate to supply and purchase cabazitaxel in pre-prepared intravenous-infusion bags, which would remove the cost of drug wastage. As a result, the committee recommended use of cabazitaxel as a treatment option in people with an Eastern Cooperative Oncology Group performance status of 0 or 1 whose disease had progressed during or after treatment with at least 225 mg/m(2) of docetaxel, as long as it was provided at the discount agreed in the PAS and purchased in either pre-prepared intravenous-infusion bags or in vials at a reduced price to reflect the average per-patient drug wastage.

Sesamoids of the metatarsophalangeal joint of the big toe: a sistematic review

Abstract: The first metatarsal sesamoid bones are not always taken into consideration when making a diagnosis, in pathologies that affect the region of the first metatarsal head. This is due to the insufficient knowledge of all the pathologies that can affect the sesamoids and the relative little incidence that they have. With the increment of sports activities, in particular the running, increasingly affects of the symptoms concerning this region are observed. Methods: A literature search was performed in 5 databases (Medline, PubMed, Scopus, Cochrane Library and BUCEA). The terms included in the search were: sesamoids, anatomy, biomechanics, sesamoids review and sesamoids pathology. In the initial search articles with no more than 10 years, only humans and revision texts are considered. Results: 24 articles were selected and include different pathologies with diagnosis using imaging tests and treatments, both conservative and surgical; as well as aspects from the biomechanics of the metatarsal-sesamoid joint. Conclusion: Sesamoids due of his anatomy, topography and function can be involved in a lot of pathologies; with similar signs and symptoms that can confuse the podiatry when he has to make a correct diagnosis or treatment.