990 resultados para 10-89
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Vorbesitzer: Isaachi Castelnuovo; Elia Castelnuovo; Angelo Castelnuovo; Abraham Merzbacher
Resumo:
Number of days spent in acute hospitals (DAH) at the end of life is regarded as an important care quality indicator for cancer patients. We analysed DAH during 90 days prior to death in patients from four Swiss cantons. Claims data from an insurance provider with about 20% market share and patient record review identified 2086 patients as dying of cancer. We calculated total DAH per patient. Multivariable generalised linear modelling served to evaluate potential explanatory variables. Mean DAH was 26 days. In the multivariable model, using complementary and alternative medicine (DAH = 33.9; +8.8 days compared to non-users) and canton of residence (for patient receiving anti-cancer therapy, Zürich DAH = 22.8 versus Basel DAH = 31.4; for other patients, Valais DAH = 22.7 versus Ticino DAH = 33.7) had the strongest influence. Age at death and days spent in other institutions were additional significant predictors. DAH during the last 90 days of life of cancer patients from four Swiss cantons is high compared to most other countries. Several factors influence DAH. Resulting differences are likely to have financial impact, as DAH is a major cost driver for end-of-life care. Whether they are supply- or demand-driven and whether patients would prefer fewer days in hospital remains to be established.
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Aus der Sammlung des Leo Baeck Institute, digitalisiert in Kooperation mit dem Center for Jewish History, NY
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The 16 samples of Deep Sea Drilling Project (DSDP) Leg 89 basalts that we analyzed for whole rock major and trace elements and for mineralogic compositions are identical to some of the basalts recovered during Leg 61. Leg 89 samples are mostly olivine-plagioclase-clinopyroxene sparsely phyric basalts and exhibit a wide variety of textures. These basalts have lower TiO2 at a given Mg/(Mg+Fe2+)*100 than MORB (midocean ridge basalt). We recognize three major chemical types of basalts in the Nauru Basin. We believe that different degrees of partial melting, modified by fractional crystallization and possibly by magma mixing at shallow depths, can explain the chemical differences among the three groups. This petrogenetic model is consistent with the observed downhole chemical-chronostratigraphic relations of the samples. New 87Sr/86Sr and U3Nd/144Nd analyses of basalt samples from DSDP Site 462 indicate that the Nauru Basin igneous complex is within the Sr-Nd isotopic range of ocean island basalt. Thus the Nauru Basin igneous complex resembles MORB in many aspects of its chemistry, morphology, and secondary alteration patterns (Larson, Schlanger, et al., 1981), but not in its isotopic characteristics. If it were not for the unambiguous evidence that the Nauru Basin complex was erupted off-ridge, the complex could easily be interpreted as normal oceanic layer 2. For this reason, we speculate that the Nauru Basin igneous complex was produced in an oceanic riftlike environment when multiple, fast-propagating rifts were formed during the fast seafloor spreading episode in the Cretaceous.
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Cretaceous lava flows overlie Jurassic to Early Cretaceous oceanic crust in the Nauru Basin of the western equatorial Pacific, but their exact age and origin is controversial. In one model, they are generically related to volcanism forming the Ontong Java Plateau. However, paleomagnetic data from basalts recovered by ocean drilling in the Nauru Basin have been interpreted as recording numerous geomagnetic reversals, suggesting the Nauru Basin basalts are older than the Early Aptian flows on the Ontong Java Plateau, and the correlative volcanism seen in the western equatorial and southwestern Pacific Ocean basin. Here, we examine the magnetic fidelity of the Nauru Basin basalts through rock magnetic and paleomagnetic approaches. We find the magnetic carriers in the lavas are unlike most basaltic units recovered by oceanic drilling in that they are magnetically soft. This quality makes the rocks especially prone to the acquisition of secondary magnetic components induced during drilling. We demonstrate that the reversed polarity intervals are illusory, and instead record subtle changes in magnetic hardness that result in partial and complete overprinting by the magnetic field associated with the drill string (e.g., the core barrel, drill pipe and bit). The recognition of these magnetic overprints, the identification of only normal polarity in the Nauru Basin basalts, and a critical consideration of the available radiometric and biostratigraphic age data lead us to conclude that coeval formation of the Nauru Basin basalts and Ontong Java Plateau in Aptian times remains a viable hypothesis.