Dental injuries in association with facial fractures

PURPOSE: The aim of the study was to investigate the association between dental injuries and facial fractures. MATERIALS AND METHODS: We performed a prospective study of 273 patients examined at a level 1 trauma center in Switzerland from September 2005 until August 2006 who had facial fractures. Medical history and clinical and radiologic examination findings were recorded to evaluate demographics, etiology, presentation, and type of facial fracture, as well as its relationship to dental injury site and type. RESULTS: In 273 patients with dentition, we recorded 339 different facial fractures. Of these patients, 130 (47.5%) sustained a fracture in the non-tooth-bearing region, 44 (16%) had a fractured maxilla, and 65 (24%) had a fractured mandible. Among 224 patients with dentition who had a facial fracture in only 1 compartment, 140 injured teeth were found in 50 patients. Of 122 patients with an injury limited to the non-tooth-bearing facial skeleton, 12 sustained dental trauma (10%). In patients with fractures limited to the maxilla (n = 41), 6 patients had dental injuries (14.5%). In patients with fractures to the mandible (n = 61), 24 sustained dental injuries (39%). When we compared the type of tooth lesion and the location, simple crown fractures prevailed in both jaws. Patients with a fracture of the mandible were most likely to have a dental injury (39.3%). The highest incidence of dental lesions was found in the maxilla in combination with fractures of the lower jaw (39%). This incidence was even higher than the incidence of dental lesions in the lower jaw in combination with fractures of the mandible (24%). CONCLUSIONS: Knowledge of the association of dental injuries and maxillofacial fractures is a basic tool for their prevention. Our study showed that in cases of trauma with mandibular fracture, the teeth in the upper jaw might be at higher risk than the teeth in the lower jaw. Further larger-scale studies on this topic could clarify this finding and may provide suggestions for the amelioration of safety devices (such as modified bicycle helmets).

Thoracolumbar spine fractures in patients who have sustained severe trauma: depiction with multi-detector row CT

PURPOSE: To determine if multi–detector row computed tomography (CT) can replace conventional radiography and be performed alone in severe trauma patients for the depiction of thoracolumbar spine fractures. MATERIALS AND METHODS: One hundred consecutive severe trauma patients who underwent conventional radiography of the thoracolumbar spine as well as thoracoabdominal multi–detector row CT were prospectively identified. Conventional radiographs were reviewed independently by three radiologists and two orthopedic surgeons; CT images were reviewed by three radiologists. Reviewers were blinded both to one another’s reviews and to the results of initial evaluation. Presence, location, and stability of fractures, as well as quality of reviewed images, were assessed. Statistical analysis was performed to determine sensitivity and interobserver agreement for each procedure, with results of clinical and radiologic follow-up as the standard of reference. The time to perform each examination and the radiation dose involved were evaluated. A resource cost analysis was performed. RESULTS: Sixty-seven fractured vertebrae were diagnosed in 26 patients. Twelve patients had unstable spine fractures. Mean sensitivity and interobserver agreement, respectively, for detection of unstable fractures were 97.2% and 0.951 for multi–detector row CT and 33.3% and 0.368 for conventional radiography. The median times to perform a conventional radiographic and a multi–detector row CT examination, respectively, were 33 and 40 minutes. Effective radiation doses at conventional radiography of the spine and thoracoabdominal multi–detector row CT, respectively, were 6.36 mSv and 19.42 mSv. Multi–detector row CT enabled identification of 146 associated traumatic lesions. The costs of conventional radiography and multi–detector row CT, respectively, were $145 and $880 per patient. CONCLUSION: Multi–detector row CT is a better examination for depicting spine fractures than conventional radiography. It can replace conventional radiography and be performed alone in patients who have sustained severe trauma.

Footprint of recycled water subsidies downwind of Lake Michigan

Continental evaporation is a significant and dynamic flux within the atmospheric water budget, but few methods provide robust observational constraints on the large-scale hydroclimatological and hydroecological impacts of this ‘recycled-water' flux. We demonstrate a geospatial analysis that provides such information, using stable isotope data to map the distribution of recycled water in shallow aquifers downwind from Lake Michigan. The δ2H and δ18O values of groundwater in the study region decrease from south to north, as expected based on meridional gradients in climate and precipitation isotope ratios. In contrast, deuterium excess (d = δ2H − 8 × δ18O) values exhibit a significant zonal gradient and finer-scale spatially patterned variation. Local d maxima occur in the northwest and southwest corners of the Lower Peninsula of Michigan, where ‘lake-effect' precipitation events are abundant. We apply a published model that describes the effect of recycling from lakes on atmospheric vapor d values to estimate that up to 32% of recharge into individual aquifers may be derived from recycled Lake Michigan water. Applying the model to geostatistical surfaces representing mean d values, we estimate that between 10% and 18% of the vapor evaporated from Lake Michigan is re-precipitated within downwind areas of the Lake Michigan drainage basin. Our approach provides previously unavailable observational constraints on regional land-atmosphere water fluxes in the Great Lakes Basin and elucidates patterns in recycled-water fluxes that may influence the biogeography of the region. As new instruments and networks facilitate enhanced spatial monitoring of environmental water isotopes, similar analyses can be widely applied to calibrate and validate water cycle models and improve projections of regional hydroecological change involving the coupled lake-atmosphere-land system. Read More: http://www.esajournals.org/doi/abs/10.1890/ES12-00062.1

Radiographic and safety details of vertebral body stenting: results from a multicenter chart review

BACKGROUND Up to one third of BKP treated cases shows no appreciable height restoration due to loss of both restored height and kyphotic realignment after balloon deflation. This shortcoming has called for an improved method that maintains the height and realignment reached by the fully inflated balloon until stabilization of the vertebral body by PMMA-based cementation. Restoration of the physiological vertebral body height for pain relief and for preventing further fractures of adjacent and distant vertebral bodies must be the main aim for such a method. A new vertebral body stenting system (VBS) stabilizes the vertebral body after balloon deflation until cementation. The radiographic and safety results of the first 100 cases where VBS was applied are presented. METHODS During the planning phase of an ongoing international multicenter RCT, radiographic, procedural and followup details were retrospectively transcribed from charts and xrays for developing and testing the case report forms. Radiographs were centrally assessed at the institution of the first/senior author. RESULTS 100 patients (62 with osteoporosis) with a total of 103 fractured vertebral bodies were treated with the VBS system. 49 were females with a mean age of 73.2 years; males were 66.7 years old. The mean preoperative anterior-middle-posterior heights were 20.3-17.6-28.0 mm, respectively. The mean local kyphotic angle was 13.1[degree sign]. The mean preoperative Beck Index (anterior edge height/posterior edge height) was 0.73, the mean alternative Beck Index (middle height/posterior edge height) was 0.63. The mean postoperative heights were restored to 24.5-24.6-30.4 mm, respectively. The mean local kyphotic angle was reduced to 8.9[degree sign]. The mean postoperative Beck Index was 0.81, the mean alternative one was 0.82. The overall extrusion rate was 29.1%, the symptomatic one was 1%. In the osteoporosis subgroup there were 23.8% extrusions. Within the three months followup interval there were 9% of adjacent and 4% of remote new fractures, all in the osteoporotic group. CONCLUSIONS VBS showed its strengths especially in realignment of crush and biconcave fractures. Given that fracture mobility is present, the realignment potential is sound and increases with the severity of preoperative vertebral body deformation.

Environmental change within the Balkan region during the past ca. 50 ka recorded in the sediments from lakes Prespa and Ohrid

Abstract. Lakes Prespa and Ohrid, in the Balkan region, are considered to be amongst the oldest lakes in Europe. Both lakes are hydraulically connected via karst aquifers. From Lake Ohrid, several sediment cores up to 15m long have been studied over the last few years. Here, we document the first long sediment record from nearby Lake Prespa to clarify the influence of Lake Prespa on Lake Ohrid and the environmental history of the region. Radiocarbon dating and dated tephra layers provide robust age control and indicate that the 10.5m long sediment record from Lake Prespa reaches back to 48 ka. Glacial sedimentation is characterized by low organic matter content and absence of carbonates in the sediments, which indicate oligotrophic conditions in both lakes. Holocene sedimentation is characterized by particularly high carbonate content in Lake Ohrid and by particularly high organic matter content in Lake Prespa, which indicates a shift towards more mesotrophic conditions in the latter. Long-term environmental change and short-term events, such as related to the Heinrich events during the Pleistocene or the 8.2 ka cooling event during the Holocene, are well recorded in both lakes, but are only evident in certain proxies. The comparison of the sediment cores from both lakes indicates that environmental change affects particularly the trophic state of Lake Prespa due to its lower volume and water depth.

The Wabar impact craters, Saudi Arabia, revisited

The very young Wabar craters formed by impact of an iron meteorite and are known to the scientific community since 1933. We describe field observations made during a visit to the Wabar impact site, provide analytical data on the material collected, and combine these data with poorly known information discovered during the recovery of the largest meteorites. During our visit in March 2008, only two craters (Philby-B and 11 m) were visible; Philby-A was completely covered by sand. Mapping of the ejecta field showed that the outcrops are strongly changing over time. Combining information from different visitors with our own and satellite images, we estimate that the large seif dunes over the impact site migrate by approximately 1.0–2.0 m yr␣1 southward. Shock lithification took place even at the smallest, 11 m crater, but planar fractures (PFs) and undecorated planar deformation features (PDFs), as well as coesite and stishovite, have only been found in shock-lithified material from the two larger craters. Shock-lithified dune sand material shows perfectly preserved sedimentary structures including cross-bedding and animal burrows as well as postimpact structures such as open fractures perpendicular to the bedding, slickensides, and radiating striation resembling shatter cones. The composition of all impact melt glasses can be explained as mixtures of aeolian sand and iron meteorite. We observed a partial decoupling of Fe and Ni in the black impact glass, probably due to partitioning of Ni into unoxidized metal droplets. The absence of a Ca-enriched component demonstrates that the craters did not penetrate the bedrock below the sand sheet, which has an estimated thickness of 20–30 m.

Finite element based estimation of contact areas and pressures of the human scaphoid in various functional positions of the hand

The scaphoid is the most frequently fractured carpal bone. When investigating fixation stability, which may influence healing, knowledge of forces and moments acting on the scaphoid is essential. The aim of this study was to evaluate cartilage contact forces acting on the intact scaphoid in various functional wrist positions using finite element modeling. A novel methodology was utilized as an attempt to overcome some limitations of earlier studies, namely, relatively coarse imaging resolution to assess geometry, assumption of idealized cartilage thicknesses and neglected cartilage pre-stresses in the unloaded joint. Carpal bone positions and articular cartilage geometry were obtained independently by means of high resolution CT imaging and incorporated into finite element (FE) models of the human wrist in eight functional positions. Displacement driven FE analyses were used to resolve inter-penetration of cartilage layers, and provided contact areas, forces and pressure distribution for the scaphoid bone. The results were in the range reported by previous studies. Novel findings of this study were: (i) cartilage thickness was found to be heterogeneous for each bone and vary considerably between carpal bones; (ii) this heterogeneity largely influenced the FE results and (iii) the forces acting on the scaphoid in the unloaded wrist were found to be significant. As major limitations, accuracy of the method was found to be relatively low, and the results could not be compared to independent experiments. The obtained results will be used in a following study to evaluate existing and recently developed screws used to fix scaphoid fractures.

Analysis of polygonal cracking patterns in chloride-bearing terrains on Mars: Indicators of ancient playa settings

The ancient southern highlands on Mars (~3.5 Gyr old) contain > 600 regions that display spectral evidence in the infrared for the presence of chloride-bearing materials. Many of these locations were previously reported to display polygonal cracking patterns. We studied more than 80 of the chloride-bearing terrains using high-resolution (0.25-0.5 m/pixel) images, as well as near-infrared spectral data, to characterize the surface textures and the associated cracking patterns and mineralogies. Our study indicates that ~75% of the studied locations display polygonal cracks that resemble desiccation cracks, while some resemble salt expansion/thrust polygons. Furthermore, we detect, spectrally, the presence of smectites in association with ~30% of the studied fractured terrains. We note that smectites are a special class of swelling clay minerals that can induce formation of large desiccation cracks. As such, we suggest that the cracking patterns are indicative of the presence of smectite phyllosilicates even in the absence of spectral confirmation. Our results suggest that many chloride-bearing terrains have a lacustrine origin and a geologic setting similar to playas on Earth. Such locations would have contained ephemeral lakes that may have undergone repeated cycles of desiccation and recharging by a near-surface fluctuating water table in order to account for the salt-phyllosilicates associations. These results have notable implications for the ancient hydrology of Mars. We propose that the morphologies and sizes of the polygonal cracks can be used as paleoenvironmental, as well as lithological, indicators that could be helpful in planning future missions.

Morphology and evolution of the ejecta of Hale crater in Argyre basin, Mars: Results from high resolution mapping

We use various data sets, including images from the High Resolution Imaging Science Experiment camera (HiRISE), to examine the ejecta of the generally fresh-looking Hale crater that occurs in the rugged mountain terrain of Nereidum Montes in the northern rim materials of the Argyre impact structure on Mars. Our investigation reveals that the distal parts of the Hale crater ejecta and other basin deposits behave like viscous flows, which we attribute to the secondary flow of ejecta mixed with water–ice-rich basin materials. Consistent with water-enrichment of the basin materials, our mapping further reveals occasionally deformed surfaces, including highly conspicuous features such as mounds and fractured plateaus that we interpret to be a result of periglacial modification, subsequent (including possibly present-day) to the transient localized melting and fluvial erosion caused by Hale-impact-generated heating. In particular, our morphometric analysis of a well-defined valley system west of Hale crater suggests that it may have been formed through hydrologic/glacial activity prior to the Hale impact, with additional modification resulting from the impact and subsequent geologic and hydrologic phenomena including glacial and periglacial activity.

The onset of Neoglaciation 6000 years ago in western Mongolia revealed by an ice core from the Tsambagarav mountain range

Glacier highstands since the Last Glacial Maximum are well documented for many regions, but little is known about glacier fluctuations and lowstands during the Holocene. This is because the traces of minimum extents are difficult to identify and at many places are still ice covered, limiting the access to sample material. Here we report a new approach to assess minimal glacier extent, using a 72-m long surface-to-bedrock ice core drilled on Khukh Nuru Uul, a glacier in the Tsambagarav mountain range of the Mongolian Altai (4130 m asl, 48°39.338′N, 90°50.826′E). The small ice cap has low ice temperatures and flat bedrock topography at the drill site. This indicates minimal lateral glacier flow and thereby preserved climate signals. The upper two-thirds of the ice core contain 200 years of climate information with annual resolution, whereas the lower third is subject to strong thinning of the annual layers with a basal ice age of approximately 6000 years before present (BP). We interpret the basal ice age as indicative of ice-free conditions in the Tsambagarav mountain range at 4100 m asl prior to 6000 years BP. This age marks the onset of the Neoglaciation and the end of the Holocene Climate Optimum. The ice-free conditions allow for adjusting the Equilibrium Line Altitude (ELA) and derive the glacier extent in the Mongolian Altai during the Holocene Climate Optimum. Based on the ELA-shift, we conclude that most of the glaciers are not remnants of the Last Glacial Maximum but were formed during the second part of the Holocene. The ice core derived accumulation reconstruction suggests important changes in the precipitation pattern over the last 6000 years. During formation of the glacier, more humid conditions than presently prevailed followed by a long dry period from 5000 years BP until 250 years ago. Present conditions are more humid than during the past millennia. This is consistent with precipitation evolution derived from lake sediment studies in the Altai.

Deciphering the driving forces of erosion rates on millennial to million-year timescales in glacially impacted landscapes: An example from the Western Alps

In many regions, tectonic uplift is the main driver of erosion over million-year (Myr) timescales, but climate changes can markedly affect the link between tectonics and erosion, causing transient variations in erosion rates. Here we study the driving forces of millennial to Myr-scale erosion rates in the French Western Alps, as estimated from in situ produced cosmogenic 10Be and a newly developed approach integrating detrital and bedrock apatite fission-track thermochronology. Millennial erosion rates from 10Be analyses vary between ~0.27 and ~1.33 m/kyr, similar to rates measured in adjacent areas of the Alps. Significant positive correlations of millennial erosion rates with geomorphic measures, in particular with the LGM ice thickness, reveal a strong transient morphological and erosional perturbation caused by repeated Quaternary glaciations. The perturbation appears independent of Myr-scale uplift and erosion gradients, with the effect that millennial erosion rates exceed Myr-scale erosion rates only in the internal Alps where the latter are low (<0.4 km/Myr). These areas, moreover, exhibit channels that clearly plot above a general linear positive relation between Myr-scale erosion rates and normalized steepness index. Glacial erosion acts irrespective of rock uplift and thus not only leads to an overall increase in erosion rates but also regulates landscape morphology and erosion rates in regions with considerable spatial gradients in Myr-scale tectonic uplift. Our study demonstrates that climate change, e.g., through occurrence of major glaciations, can markedly perturb landscape morphology and related millennial erosion rate patterns, even in regions where Myr-scale erosion rates are dominantly controlled by tectonics.

Combining analytical frameworks to assess livelihood vulnerability to climate change and analyse adaptation options

Experts working on behalf of international development organisations need better tools to assist land managers in developing countriesmaintain their livelihoods, as climate change puts pressure on the ecosystemservices that they depend upon. However, current understanding of livelihood vulnerability to climate change is based on a fractured and disparate set of theories andmethods. This reviewtherefore combines theoretical insights from sustainable livelihoods analysis with other analytical frameworks (including the ecosystem services framework, diffusion theory, social learning, adaptive management and transitions management) to assess the vulnerability of rural livelihoods to climate change. This integrated analytical framework helps diagnose vulnerability to climate change,whilst identifying and comparing adaptation options that could reduce vulnerability, following four broad steps: i) determine likely level of exposure to climate change, and how climate change might interact with existing stresses and other future drivers of change; ii) determine the sensitivity of stocks of capital assets and flows of ecosystem services to climate change; iii) identify factors influencing decisions to develop and/or adopt different adaptation strategies, based on innovation or the use/substitution of existing assets; and iv) identify and evaluate potential trade-offs between adaptation options. The paper concludes by identifying interdisciplinary research needs for assessing the vulnerability of livelihoods to climate change.

Bias associated with detrital zircon geochronology and thermochronometry

Detrital studies that utilize zircon U–Pb geochronology and fission-track (FT) thermochronometry are subject to a range of potential sources of bias that should be properly evaluated and minimized. Some of them are common to any single-grain mineral analysis (e.g., variable bedrock mineral fertility, hydraulic sorting during transport, selective grain loss during sample processing), whereas others are intrinsic to zircon, and are related to radiation damage and age discordance. In this article, we quantify the impact of intrinsic bias on detrital studies thanks to the analysis of modern detritus shed from the European Alps, and illustrate the general implications on geological interpretations. We show that detrital zircon U–Pb age distributions based on statistically robust datasets are highly reproducible and representative of the parent bedrock ages in the catchment. Arbitrary or selective removal of discordant grain ages can be minimized by using the Kolmogorov–Smirnov test to identify an appropriate cutoff level. Loss of metamict (α-damaged) zircon has a minor impact on data representativeness, and is mainly controlled by regional metamorphism rather than by mechanical abrasion during river transport. Zircon FT grain-age distributions were found to have poor reproducibility, although age spectra are consistent with bedrock data. However, unlike the U–Pb datasets, U-rich zircon grains (> 1000 ppm) are systematically missed, and undatable grains may exceed 50%. We identify two major sources of distribution bias specific to zircon FT datasets: (i) sediment sources dominated by U-rich zircon grains are markedly underrepresented in the detrital record, because such grains often have uncountable high densities of fission tracks (“U concentration bias”); (ii) sediment sources that shed zircon grains with high levels of α-damage are underrepresented, because these grains are lost during chemical etching for FT revelation (“etching bias”). In the case of multimethod dating on the same grains (e.g., FT and U–Pb double dating), bias affecting detrital zircon FT dating propagates to the entire dataset. These effects may not impact on exhumation-rate studies that utilize the youngest grain ages (i.e., lag-time approach). However, they represent a limiting factor for conventional provenance studies, and generally preclude application of zircon FT dating to sediment budget calculations.

Glacier response to the change in atmospheric circulation in the eastern Mediterranean during the Last Glacial Maximum

In this study, we document glacial deposits and reconstruct the glacial history in the Karagöl valley system in the eastern Uludağ in northwestern Turkey based on 42 cosmogenic 10Be exposure ages from boulders and bedrock. Our results suggest the Last Glacial Maximum (LGM) advance prior to 20.4 ± 1.2 ka and at least three re-advances until 18.6 ± 1.2 ka during the global LGM within Marine Isotope Stage-2. In addition, two older advances of unknown age are geomorphologically well constrained, but not dated due to the absence of suitable boulders. Glaciers advanced again two times during the Lateglacial. The older is exposure dated to not later than 15.9 ± 1.1 ka and the younger is attributed to the Younger Dryas (YD) based on field evidence. The timing of the glaciations in the Karagöl valley correlates well with documented archives in the Anatolian and Mediterranean mountains and the Alps. These glacier fluctuations may be explained by the change in the atmospheric circulation pattern during the different phases of North Atlantic Oscillation (NAO) winter indices.

Late Weichselian local ice dome configuration and chronology in Northwestern Svalbard: early thinning, late retreat

The chronology and configuration of the Svalbard Barents Sea Ice Sheet (SBSIS) during the Late Weichselian (LW) are based on few and geographically scattered data. Thus, the timing and configuration of the SBSIS has been a subject of extensive debate. We present provenance data of erratic boulders and cosmogenic 10Be ages of bedrock and boulders from Northwest Spitsbergen (NWS), Svalbard to determine the thickness, configuration and chronology during the LW. We sampled bedrock and boulders of mountain summits and summit slopes, along with erratic boulders from coastal locations around NWS. We suggest that a local ice dome over central NWS during LW drained radially in all directions. Provenance data from erratic boulders from northern coastal lowland Reinsdyrflya suggest northeastward ice flow through Liefdefjorden. 10Be ages of high-elevation erratic boulders in central NWS (687–836 m above sea level) ranging from 18.3 ± 1.3 ka to 21.7 ± 1.4 ka, indicate that the centre of a local ice dome was at least 300 m thicker than at present. 10Be ages of all high-elevation erratics (>400 m above sea level, central and coastal locations) indicate the onset of ice dome thinning at 25–20 ka. 10Be ages from erratic boulders on Reinsdyrflya ranging from 11.1 ± 0.8 ka to 21.4 ± 1.7 ka, indicate an ice cover over the entire Reinsdyrflya during LW and a complete deglaciation prior to the Holocene, but apparently later than the thinning in the mountains. Lack of moraine deposits, but the preservation of beach terraces, suggest that the ice covering this peninsula possibly was cold-based and that Reinsdyrflya was part of an inter ice-stream area covered by slow-flowing ice, as opposed to the adjacent fjord, which possibly was filled by a fast-flowing ice stream. Despite the early thinning of the ice sheet (25–20 ka) we find a later timing of deglaciation of the fjords and the distal lowlands. Several bedrock samples (10Be) from vertical transects in the central mountains of NWS pre-date the LW, and suggest either ice free or pervasive cold-based ice conditions. Our reconstruction is aligned with the previously suggested hypothesis that a complex multi-dome ice-sheet-configuration occupied Svalbard and the Barents Sea during LW, with numerous drainage basins feeding fast ice streams, separated by slow flowing, possibly cold-based, inter ice-stream areas.