Attempted suicide in shanghai districts: A pilot study

This is a pilot study whose objective was to collect data on attempted suicide in 5 districts of Shanghai and to test the feasibility of introducing an ongoing monitoring of attempted suicide. Data on a total of 363 cases were collected. The mean age of the patients was 33 years, 67% being female. Ingesting drugs or other chemical substances was the main method used for self-harm. Reasons for attempted suicide in these districts of Shanghai often appear to be related to family conflicts and unemployment. In spite of methodological limitations, the recorded data allow some preliminary conclusions regarding the characteristics of patients in districts of Shanghai admitted after a suicide attempt. Continuous monitoring of attempted suicide in this urban area of China should be established and data collection improved to raise awareness in health professionals and to develop preventive measures geared toward the needs of these patients.

Detection and management of drug-resistant tuberculosis in HIV-infected patients in lower-income countries.

SETTING Drug resistance threatens tuberculosis (TB) control, particularly among human immunodeficiency virus (HIV) infected persons. OBJECTIVE To describe practices in the prevention and management of drug-resistant TB under antiretroviral therapy (ART) programs in lower-income countries. DESIGN We used online questionnaires to collect program-level data on 47 ART programs in Southern Africa (n = 14), East Africa (n = 8), West Africa (n = 7), Central Africa (n = 5), Latin America (n = 7) and the Asia-Pacific (n = 6 programs) in 2012. Patient-level data were collected on 1002 adult TB patients seen at 40 of the participating ART programs. RESULTS Phenotypic drug susceptibility testing (DST) was available in 36 (77%) ART programs, but was only used for 22% of all TB patients. Molecular DST was available in 33 (70%) programs and was used in 23% of all TB patients. Twenty ART programs (43%) provided directly observed therapy (DOT) during the entire course of treatment, 16 (34%) during the intensive phase only, and 11 (23%) did not follow DOT. Fourteen (30%) ART programs reported no access to second-line anti-tuberculosis regimens; 18 (38%) reported TB drug shortages. CONCLUSIONS Capacity to diagnose and treat drug-resistant TB was limited across ART programs in lower-income countries. DOT was not always implemented and drug supplies were regularly interrupted, which may contribute to the global emergence of drug resistance.

Risk charts to guide targeted HIV-1 viral load monitoring of ART: development and validation in patients from resource-limited settings.

BACKGROUND HIV-1 RNA viral load (VL) testing is recommended to monitor antiretroviral therapy (ART) but not available in many resource-limited settings. We developed and validated CD4-based risk charts to guide targeted VL testing. METHODS We modeled the probability of virologic failure up to 5 years of ART based on current and baseline CD4 counts, developed decision rules for targeted VL testing of 10%, 20% or 40% of patients in seven cohorts of patients starting ART in South Africa, and plotted cut-offs for VL testing on colour-coded risk charts. We assessed the accuracy of risk chart-guided VL testing to detect virologic failure in validation cohorts from South Africa, Zambia and the Asia-Pacific. FINDINGS 31,450 adult patients were included in the derivation and 25,294 patients in the validation cohorts. Positive predictive values increased with the percentage of patients tested: from 79% (10% tested) to 98% (40% tested) in the South African, from 64% to 93% in the Zambian and from 73% to 96% in the Asia-Pacific cohorts. Corresponding increases in sensitivity were from 35% to 68% in South Africa, from 55% to 82% in Zambia and from 37% to 71% in Asia-Pacific. The area under the receiver-operating curve increased from 0.75 to 0.91 in South Africa, from 0.76 to 0.91 in Zambia and from 0.77 to 0.92 in Asia Pacific. INTERPRETATION CD4-based risk charts with optimal cut-offs for targeted VL testing may be useful to monitor ART in settings where VL capacity is limited.

Determinants of Weight Evolution Among HIV-Positive Patients Initiating Antiretroviral Treatment in Low-Resource Settings.

BACKGROUND In resource-limited settings, clinical parameters, including body weight changes, are used to monitor clinical response. Therefore, we studied body weight changes in patients on antiretroviral treatment (ART) in different regions of the world. METHODS Data were extracted from the "International Epidemiologic Databases to Evaluate AIDS," a network of ART programmes that prospectively collects routine clinical data. Adults on ART from the Southern, East, West, and Central African and the Asia-Pacific regions were selected from the database if baseline data on body weight, gender, ART regimen, and CD4 count were available. Body weight change over the first 2 years and the probability of body weight loss in the second year were modeled using linear mixed models and logistic regression, respectively. RESULTS Data from 205,571 patients were analyzed. Mean adjusted body weight change in the first 12 months was higher in patients started on tenofovir and/or efavirenz; in patients from Central, West, and East Africa, in men, and in patients with a poorer clinical status. In the second year of ART, it was greater in patients initiated on tenofovir and/or nevirapine, and for patients not on stavudine, in women, in Southern Africa and in patients with a better clinical status at initiation. Stavudine in the initial regimen was associated with a lower mean adjusted body weight change and with weight loss in the second treatment year. CONCLUSIONS Different ART regimens have different effects on body weight change. Body weight loss after 1 year of treatment in patients on stavudine might be associated with lipoatrophy.

Implementation and Operational Research: Risk Charts to Guide Targeted HIV-1 Viral Load Monitoring of ART: Development and Validation in Patients From Resource-Limited Settings.

BACKGROUND HIV-1 RNA viral load (VL) testing is recommended to monitor antiretroviral therapy (ART) but not available in many resource-limited settings. We developed and validated CD4-based risk charts to guide targeted VL testing. METHODS We modeled the probability of virologic failure up to 5 years of ART based on current and baseline CD4 counts, developed decision rules for targeted VL testing of 10%, 20%, or 40% of patients in 7 cohorts of patients starting ART in South Africa, and plotted cutoffs for VL testing on colour-coded risk charts. We assessed the accuracy of risk chart-guided VL testing to detect virologic failure in validation cohorts from South Africa, Zambia, and the Asia-Pacific. RESULTS In total, 31,450 adult patients were included in the derivation and 25,294 patients in the validation cohorts. Positive predictive values increased with the percentage of patients tested: from 79% (10% tested) to 98% (40% tested) in the South African cohort, from 64% to 93% in the Zambian cohort, and from 73% to 96% in the Asia-Pacific cohort. Corresponding increases in sensitivity were from 35% to 68% in South Africa, from 55% to 82% in Zambia, and from 37% to 71% in Asia-Pacific. The area under the receiver operating curve increased from 0.75 to 0.91 in South Africa, from 0.76 to 0.91 in Zambia, and from 0.77 to 0.92 in Asia-Pacific. CONCLUSIONS CD4-based risk charts with optimal cutoffs for targeted VL testing maybe useful to monitor ART in settings where VL capacity is limited.

(Table 1) Sr, Nd, and Pb isotopic composition of ODP Leg 129 basalts

Basaltic rocks recovered from three drill sites in the western Pacific during Ocean Drilling Program Leg 129 have fairly distinct Sr, Nd, and Pb isotopic compositions. The Cretaceous alkali olivine dolerites from Site 800 in the northern part of Pigafetta Basin have fairly low 87Sr/86Sri (0.70292-0.70320) and 143Nd/144Ndi (0.51277-0.51281) and high present-day Pb isotopic ratios (206Pb/204Pb = 20.53-21.45; 207Pb/204Pb = 15.70-15.77; 208Pb/204Pb = 40.02-40.68). The Middle Jurassic tholeiites from Site 801 in the southern part of the basin have low 87Sr/86Sri (0.70237-0.70248), high 143Nd/144Ndi (0.51298-0.51322), and moderate present-day Pb isotopic ratios (206Pb/204Pb = 18.20-19.12; 207Pb/204Pb = 15.47-15.60; 208Pb/204Pb = 37.56-38.18); isotopic compositions of the alkali olivine basalts overlying the tholeiites fall between those of the tholeiites and Site 800 dolerites. The Cretaceous tholeiites from Site 802 in the East Mariana Basin have high 87Sr/86Sri (0.70360-0.70372), fairly low 143Nd/144Ndi (0.51277-0.51280), and fairly low and homogeneous present-day Pb isotopic ratios (206Pb/204Pb = 18.37-18.39; 207Pb/204Pb = 15.49-15.51; 208Pb/204Pb = 38.34-38.39). Isotopic compositions of Site 801 tholeiites are indistinguishable from those of modern mid-ocean ridge basalts, consistent with the proposal that these tholeiites are a part of the oldest Pacific crust. The diverse isotopic compositions of the younger basalts appear to be the result of Jurassic Pacific plate migration over the geologically anomalous south-central Pacific region, wherein they acquired their distinct isotopic compositions. The anomalous region was volcanically more active during the Cretaceous than at present.

Tab. 1: Trace-element concentrations in ore samples collected from mercury mines and deposits in southwestern Alaska

A belt of small but numerous mercury deposits extends for about 500 km in the Kuskokwim River region of southwestern Alaska. The southwestern Alaska mercury belt is part of widespread mercury deposits of the circum Pacific region that are similar to other mercury deposits throughout the world because they are epithermal with formation temperatures of about 200 °C, the ore is dominantly cinnabar with Hg-Sb-As±Au geochemistry, and mineralized forms include vein, vein breccias, stockworks, replacements, and disseminations. The southwestern Alaska mercury belt has produced about 1400 t of mercury, which is small on an international scale. However, additional mercury deposits are likely to be discovered because the terrain is topographically low with significant vegetation cover. Anomalous concentrations of gold in cinnabar ore suggest that gold deposits are possible in higher temperature environments below some of the Alaska mercury deposits. We correlate mineralization of the southwestern Alaska mercury deposits with Late Cretaceous and early Tertiary igneous activity. Our 40Ar/39Ar ages of 70 ±3 Ma from hydrothermal sericites in the mercury deposits indicate a temporal association of igneous activity and mineralization. Furthermore, we suggest that our geological ancl geochemical data from the mercury deposits indicate that ore fluids were generated primarily in surrounding sedimentary wall rocks when they were cut by Late Cretaceous and early Tertiary intrusions. In our ore genesis model, igneous activity provided the heat to initiate dehydration reactions and expel fluids from hydrous minerals and formational waters in the surrounding sedimentary wall rocks, causing thermal convection and hydrothermal fluid flow through permeable rocks and along fractures and faults. Our isotopic data from sulfide and alteration minerals of the mercury deposits indicate that ore fluids were derived from multiple sources, with most ore fluids originating from the sedimentary wall rocks.

Global distributions of pteropods (Gymnosomata, Thecosomata, Pseudothecosomata) abundance and biomass - Gridded data product (NetCDF) - Contribution to the MAREDAT World Ocean Atlas of Plankton Functional Types

Pteropods are a group of holoplanktonic gastropods for which global biomass distribution patterns remain poorly resolved. The aim of this study was to collect and synthesize existing pteropod (Gymnosomata, Thecosomata and Pseudothecosomata) abundance and biomass data, in order to evaluate the global distribution of pteropod carbon biomass, with a particular emphasis on its seasonal, temporal and vertical patterns. We collected 25 902 data points from several online databases and a number of scientific articles. The biomass data has been gridded onto a 360 x 180° grid, with a vertical resolution of 33 WOA depth levels. Data has been converted to NetCDF format. Data were collected between 1951-2010, with sampling depths ranging from 0-1000 m. Pteropod biomass data was either extracted directly or derived through converting abundance to biomass with pteropod specific length to weight conversions. In the Northern Hemisphere (NH) the data were distributed evenly throughout the year, whereas sampling in the Southern Hemisphere was biased towards the austral summer months. 86% of all biomass values were located in the NH, most (42%) within the latitudinal band of 30-50° N. The range of global biomass values spanned over three orders of magnitude, with a mean and median biomass concentration of 8.2 mg C l-1 (SD = 61.4) and 0.25 mg C l-1, respectively for all data points, and with a mean of 9.1 mg C l-1 (SD = 64.8) and a median of 0.25 mg C l-1 for non-zero biomass values. The highest mean and median biomass concentrations were located in the NH between 40-50° S (mean biomass: 68.8 mg C l-1 (SD = 213.4) median biomass: 2.5 mg C l-1) while, in the SH, they were within the 70-80° S latitudinal band (mean: 10.5 mg C l-1 (SD = 38.8) and median: 0.2 mg C l-1). Biomass values were lowest in the equatorial regions. A broad range of biomass concentrations was observed at all depths, with the biomass peak located in the surface layer (0-25 m) and values generally decreasing with depth. However, biomass peaks were located at different depths in different ocean basins: 0-25 m depth in the N Atlantic, 50-100 m in the Pacific, 100-200 m in the Arctic, 200-500 m in the Brazilian region and >500 m in the Indo-Pacific region. Biomass in the NH was relatively invariant over the seasonal cycle, but more seasonally variable in the SH. The collected database provides a valuable tool for modellers for the study of ecosystem processes and global biogeochemical cycles.

Geochemistry of DSDP Hole 91-596

Geochemical analyses of sediments from the top 24.5 m of Deep Sea Drilling Project hole 596 (23°51.20'S, 169°39.27'W) show great variability in the composition of pelagic clays accumulated in the South Pacific since the late Cretaceous. Elemental associations indicate that most of this variability can be attributed to variations in abundances of six sediment end-member components: detrital (eolian), andesitic (volcanic), hydrothermal, hydrogenous, phosphate (fish debris), and biogenic silica. We develop a sedimentation model which is used to infer processes that might have influenced the accumulation rates of these components over the last 85 million years. The accumulation of eolian detritus in the South Pacific shows some similarities to that observed in the North Pacific and has been largely controlled by global climate trends in the Cenozoic. Much of the variation in the accumulation of other sediment components likely reflects the paleoceanographic evolution of the South Pacific. The most notable change in the sedimentary environment occurred at about the Paleogene/Neogene boundary. At that time, significant changes in the color, mineralogy, and chemistry of the sediment probably reflect major shifts in climate mode as well as oceanic circulation in the central South Pacific region.

Marine diatoms in deep sea sediments

Long-term evolution is thought to take opportunities that arise as a consequence of mass extinction (as argued, for example, by Gould, 2002) and the following biotic recovery, but there is absolutely no evidence for this being the case. However, our study shows that eutrophication by oceanic mixing also played a part in the enhancement of several evolutionary events amongst marine organisms, and these results could indicate that the rates of oceanic biodiversification may be slowed if upwelling becomes weakened by future global warming. This paper defines three distinct evolutionary events of resting spores of the marine diatom genus Chaetoceros, to reconstruct past upwelling through the analysis of several DSDP, ODP and land-based successions from the North, South and equatorial Pacific as well as the Atlantic Ocean during the past 40 million years. The Atlantic Chaetoceros Explosion (ACE) event occurred across the E/O boundary in the North Atlantic, and is characterized by resting spore diversification that occurred as a consequence of the onset of upwelling following changes in thermohaline circulation through global cooling in the early Oligocene. Pacific Chaetoceros Explosion events-1 and -2 (PACE-1 and PACE-2) are characterized by relatively higher occurrences of iron input following the Himalayan uplift and aridification at 8.5 Ma and ca. 2.5 Ma in the North Pacific region. These events not only enhanced the diversification and increased abundance of primary producers, including that of Chaetoceros, other diatoms and seaweeds, but also stimulated the evolution of zooplankton and larger predators, such as copepods and marine mammals, which ate these phytoplankton and plants. Current thinking suggests new evolutionary niches open up after a mass extinction, but our study finds that eutrophication can also stimulate evolutionary diversification. Moreover, in the opposite fashion, our results show that as thermohaline circulation abates, global warming progresses and the ocean surface becomes warmer, many marine organisms will be affected by the environmental degradation.

Miocene to Pliocene planktonic foraminifers in ODP Hole 134-832B

One hundred and sixty core samples were analyzed from Hole 832B to evaluate planktonic foraminiferal datum levels, and to zone and correlate the borehole succession. A total of 32 biostratigraphic events were recognized in the interval from Core 134-832B-59R through 134-832B-73R (702.49 through 846.4 meters below seafloor [mbsf]). These include 17 first appearance datum levels (FAD), 10 last appearance datum levels (LAD), and 5 coiling-change events in trochospiral species. The studied succession has been subdivided into nine planktonic foraminiferal zones (viz. downsequence N.22, N.21, N.20, N.19, N.18, N.17B, N.17A-N.16, N.15, N.8). The zonal index species occur in the expected stratigraphic order for zonal correlation, but some of the zonal boundaries may be diachronous compared to other localities in the western Pacific region. The FAD of Globorotalia (Truncorotalia) truncatulinoides (d' Orbigny) at 714.10 mbsf defines the boundary between the Zone N.22 and N.21; the boundary between Zones N.21 and N.20 at 741.73 mbsf is marked by the FAD of Globorotalia (Truncorotalia) tosaensis Takayanagi and Saito. The lower boundary of Zone N.20 is placed at 747.65 mbsf, based on the FAD of Globorotalia (Truncorotalia) crassaformis s.s. (Galloway and Wissler); the FAD of Sphaeroidinella dehiscens (Parker and Jones) at 756.61 mbsf defines the boundary between Zones N.18 and N.19. The FAD of Globorotalia (Globorotalia) tumida tumida (Brady) at 811.15 mbsf marks the boundary between Zones N.18 and N.17B. The boundary between Zones N.17B and N.17Ais placed at 843.52 mbsf, based on the FAD of Pulleniatina primalis Banner and Blow. A change in depositional conditions occurs at 846.4 mbsf just below the Zone N.17B lower boundary and is marked by the first appearance of abundant planktonic foraminifers in the region. The interval between 849.13 and 856.1 mbsf is placed in undifferentiated Zones N.17A and N.16, based on the rare occurrence of Neogloboquadrina acostaensis (Blow). The sparsely fossiliferous volcanic sandstone unit between 934.19 and 955.67 mbsf is positioned within Zone N.15 based on the presence of Globigerina (Zeaglobigerina) nepenthes Todd and Globigerinoides (Zeaglobigerina) druryi Arkers, and absence of N. acostaensis and Globorotalia (Jenkinsella) siakensis LeRoy. An unconformity between 955.67 and 971.80 mbsf may explain the absence of Zones N.14 through N.9. Basal Zone N.8 is recognized at 971.80 to 1008.60 mbsf by the presence of Globigerinoides sicanus De Stefani and the absence of Praeorbulina and Orbulina spp. The age of the succession between 702.49 and 1008.6 mbsf extends from the latest Pliocene or earliest Pleistocene (Zone N.22) to the earliest middle Miocene (Zone N.8). Among the datum levels evaluated here, the following events are considered to be the most reliable for time correlation in the studied region: the FADs of G. (T.) truncatulinoides, G. (T.) tosaensis, G. (T.) crassaformis, S. dehiscens, G. conglobatus (Brady), G. (G.) tumida tumida, and P. primalis; and the LADs of Globorotalia (Menardella) multicamerata Cushman and Jarvis, and Dentoglobigerina altispira altispira (Cushman and Jarvis). Application of a chronometric scale to part of the succession, suggests that the interval of calcareous sediment between 702.49 and 846.4 mbsf accumulated at about 30 m/m.y.

Paleogene planktonic foraminifera of DSDP Hole 29-277

Stratigraphy of Paleogene deposits from high latitudes of the Pacific region (Koryak Highland, Kamchatka Peninsula, Karaginsky Island - in the northern hemisphere, Australian-Antarctic region - in the southern hemisphere) on planktonic foraminifera are under consideration in the book. Correlation with Paleogene of the warm Pacific belt is given. On the basis of geographic and stratigraphic distributions of planktonic foraminifera climatic zonation and the Paleogene climatic curve are analyzed. Description and photos of 115 species and varieties of planktonic foraminifera are given in the palaeontological part of the book.