(Table 22-30) Revised composite depth scales of IODP Sites 320-U1331, U1332, U1333, U1334 and ODP Sites 199-1218, 199-1219, 199-1220

Integrated Ocean Drilling Program (IODP) Expedition 320 recovered high-quality paleomagnetic records with over 800 dated reversals and decimeter-scale cyclic sediments which provide an outstanding framework to inter-calibrate major fossil groups and refine magnetic polarity chrons for the early Miocene, the entire Oligocene and the late Eocene Epoch. In order to reconstruct the climate history of the Equatorial Pacific one of the major objectives of the Pacific Equatorial Age Transect (PEAT) is the compilation of a Cenozoic Megasplice which integrates all available bio-, chemo-, and magnetostratigraphic data including key records from Ocean Drilling Program (ODP) Leg 199. Here we present extended post-cruise refinements of the shipboard composite depth scales and composite records of IODP Expedition 320 Sites U1331, U1332, U1333, U1334 as well as ODP Leg 199 Sites 1218, 1219 and 1220. The revised composite records were used to perform a site-to-site correlation and integration of Leg 199 and Exp. 320 sites. Based on this decimeter scale correlation a high resolution integrated paleomagnetic and biostratigraphic framework for the Equatorial Pacific is established covering the time from 20 to 40 Ma. This unprecedented sedimentary compendium from the Equatorial Pacific will be the backbone for paleoceanographic reconstructions for the late Paleogene.

Oxygen and Carbon stable isotope ratios for Site U1334

The Oligocene-Miocene transition (OMT) (~23 Ma) is interpreted as a transient global cooling event, associated with a large-scale Antarctic ice sheet expansion. Here we present a 2.23 Myr long high-resolution (~3 kyr) benthic foraminiferal oxygen and carbon isotope (d18O and d13C) record from Integrated Ocean Drilling Program Site U1334 (eastern equatorial Pacific Ocean), covering the interval from 21.91 to 24.14 Ma. To date, five other high-resolution benthic foraminiferal stable isotope stratigraphies across this time interval have been published, showing a ~1 per mil increase in benthic foraminiferal d18O across the OMT. However, these records are still few and spatially limited and no clear understanding exists of the global versus local imprints. We show that trends and the amplitudes of change are similar at Site U1334 as in other high-resolution stable isotope records, suggesting that these represent global deep water signals. We create a benthic foraminiferal stable isotope stack across the OMT by combining Site U1334 with records from ODP Sites 926, 929, 1090, 1264, and 1218 to best approximate the global signal. We find that isotopic gradients between sites indicate interbasinal and intrabasinal variabilities in deep water masses and, in particular, note an offset between the equatorial Atlantic and the equatorial Pacific, suggesting that a distinct temperature gradient was present during the OMT between these deep water masses at low latitudes. A convergence in the d18O values between infaunal and epifaunal species occurs between 22.8 and 23.2 Ma, associated with the maximum d18O excursion at the OMT, suggesting climatic changes associated with the OMT had an effect on interspecies offsets of benthic foraminifera. Our data indicate a maximum glacioeustatic sea level change of ~50 m across the OMT.

Patellar tendon ultrasonography in asymptomatic active athletes reveals hypoechoic regions : a study of 320 tendons

OBJECTIVE: To compare patellar tendon sonographic findings in active, currently asymptomatic, elite athletes with those in nonathletic controls. DESIGN: Cross-sectional cohort study with convenience control sample. SETTING: The Victorian Institute of Sport Tendon Study Group, an institutional elite athlete study group in Australia. PATIENTS AND PARTICIPANTS: Two hundred elite male and female athletes from the sports of basketball, cricket, netball, and Australian rules football. Forty athletes who had current symptoms of jumper's knee were excluded from analysis, leaving 320 subject tendons in athletes who were currently asymptomatic. Twenty-seven nonathletic individuals served as controls. MAIN OUTCOME MEASURE: Sonographic patellar tendon appearance. We measured the dimensions of subject tendons and noted the presence or absence of hypoechoic regions and tendon calcification. Dimensions of hypoechoic regions were measured, and approximate cross-sectional areas were calculated. Chi-squared analysis was used to test the prevalence of hypoechoic regions in subjects and controls and men and women. RESULTS: In currently asymptomatic subjects, hypoechoic regions were more prevalent in athlete tendons (22%) than in controls (4%), in male subject tendons (30%) than in female subjects (14%), and in basketball players (32%) than in other athletes (9%) (all p < 0.01). Bilateral tendon abnormalities were equally prevalent in men and women but more prevalent in basketball players (15%) than in other athletes (3%) (p < 0.05). Sonographic hypoechoic regions were present in 35 of 250 (14%) patellar tendons in athletes who had never had anterior knee pain. CONCLUSIONS: Patellar tendon sonographic hypoechoic areas were present in asymptomatic patellar tendons of a proportion of elite athletes but rarely present in controls. This has implications for clinicians managing athletes with anterior knee pain.

Health and guardianship law : the decision of X v the Sydney Children's Hospitals Network [2013] NSWCA 320 : mature minors and the refusal of blood products

This recent decision of the New South Wales Court of Appeal considers the scope of the parens patriae jurisdiction in cases where the jurisdiction is invoked for the protection of a Gillick competent minor. As outlined below, in certain circumstances the law recognises that mature minors are able to make their own decisions concerning medical treatment. However, there have been a number of Commonwealth decisions which have addressed the issue of whether mature minors are able to refuse medical procedures in circumstances where refusal will result in the minor dying. Ultimately, this case confirms that the minor does not necessarily have a right to make autonomous decisions; the minor’s right to exercise his or her autonomous decision only exists when such decision accords with what is deemed to be in his or her best interests.