Resolving and correcting for kinetic biases on methane seep paleotemperature using carbonate ∆47/∆48 analysis.

Methane-derived authigenic carbonate often constitutes the sole remaining record of relic methane seeps. The clumped (∆47) and oxygen isotopic composition of seep carbonates often yield inaccurate temperatures, attributed to kinetic isotope effects and modification of seawater isotope composition by hydrate water. Here, we analyzed the dual-clumped isotope (∆47/∆48) composition of authigenic carbonate from a modern methane seep. We demonstrate that aragonite forms closest to isotopic equilibrium such that its ∆47 can directly yield the correct formational temperature, whereas calcite is unambiguously biased by kinetic isotope effects. Numerical models show that the observed bias in the isotopic composition arises from rate-limiting dehydration/dehydroxylation of HCO3- alongside diffusive fractionation, which can be corrected for with analysis of carbonate ∆47/∆48 values. We demonstrate the utility of dual-clumped isotope analysis for studying seep carbonates, as it reveals the origin and magnitude of kinetic biases and can be used to reconstruct paleotemperature and seawater δ18O.

The relationship between menorrhagia, iron deficiency, and anaemia in recreationally active females: An exploratory population based screening study.

OBJECTIVES: Iron deficiency, anaemia, and menorrhagia - or heavy menstrual bleeding - are interrelated conditions that are highly prevalent and commonly underrecognised in exercising females of reproductive age. This study utilised a screening tool to identify risk factors and symptoms associated with heavy menstrual bleeding, iron deficiency, and anaemia in this population. DESIGN: An observational, cross sectional survey study was employed. METHODS: 1042 active females (aged 18-65) completed a comprehensive screening questionnaire and 887 (85 % compliance) provided a fingerprick blood sample for haemoglobin (Hb) concentration measurement. Women that presented as anaemic (defined as a [Hb] < 120 g/L) or deemed to be at risk of iron deficiency (120 < [Hb] < 130 g/L) were asked to complete follow-up blood tests to screen for iron studies. RESULTS: Average [Hb] was 134.2 ±â€¯12.1 g/L, with 94 individuals considered anaemic (10.6 %). Of the sample, 104 underwent follow-up blood tests; 51 (~49 %) presented with iron deficiency (defined as ferritin <30 µg/L). Based on survey responses, 274 (30.9 %) participants were determined to have heavy menstrual bleeding. Those presenting with heavy menstrual bleeding were younger, exercised fewer hours per week, and were more likely to have a history of iron deficiency or anaemia (all p < 0.05). Participants reporting a history of anaemia or iron deficiency were more likely to have heavy menstrual bleeding (anaemia: 39.7 %; iron deficiency; 36.9 %; both p < 0.05). CONCLUSIONS: In this cohort of exercising females of reproductive age, the prevalence of anaemia was 10.6 %. There is a strong association between heavy menstrual bleeding and a self-reported history of iron deficiency and anaemia. Greater awareness of heavy menstrual bleeding and its relationship with iron deficiency and anaemia is needed in this population. Non-invasive screening should be conducted to raise awareness and further understand the associated risk factors and symptomatology.

The Perceived Impact of Iron Deficiency and Iron Therapy Preference in Exercising Females of Reproductive Age: A Cross-Sectional Survey Study.

Background: Patient perceptions of iron deficiency and efficacy of iron therapy may differ from the interpretations of doctors. Qualitative investigation at an individual level related may help define patient expectations and therapeutic targets. Therefore, we aimed to explore this concept in exercising females of reproductive age. Methods: Exercising females (n = 403) who either (a) were currently experiencing iron deficiency, or (b) have experienced iron deficiency in the past were included. A survey comprising open-ended text response questions explored three 'domains': (1) the impact of iron deficiency, (2) the impact of iron tablet supplementation (where applicable), and (3) the impact of iron infusion treatment (where applicable). Questions were asked about training, performance, and recovery from exercise. Survey responses were coded according to their content, and sentiment analysis was conducted to assess responses as positive, negative, or neutral. Results: Exercising females showed negative sentiment toward iron deficiency symptoms (mean range = -0.94 to -0.81), with perception that fatigue significantly impacts performance and recovery. Iron therapies were perceived to improve energy, performance, and recovery time. Participants displayed a strong positive sentiment (mean range = 0.74 to 0.79) toward iron infusion compared to a moderately positive sentiment toward oral iron supplementation (mean range = 0.44 to 0.47), with many participants perceiving that oral iron supplementation had no effect. Conclusion: In Australia, women prefer an iron infusion in treatment of iron deficiency compared to oral iron.

Evidence for heterothermic endothermy and reptile-like eggshell mineralization in Troodon, a non-avian maniraptoran theropod.

The dinosaur-bird transition involved several anatomical, biomechanical, and physiological modifications of the theropod bauplan. Non-avian maniraptoran theropods, such as Troodon, are key to better understand changes in thermophysiology and reproduction occurring during this transition. Here, we applied dual clumped isotope (Δ47 and Δ48) thermometry, a technique that resolves mineralization temperature and other nonthermal information recorded in carbonates, to eggshells from Troodon, modern reptiles, and modern birds. Troodon eggshells show variable temperatures, namely 42 and 29 ± 2 °C, supporting the hypothesis of an endothermic thermophysiology with a heterothermic strategy for this extinct taxon. Dual clumped isotope data also reveal physiological differences in the reproductive systems between Troodon, reptiles, and birds. Troodon and modern reptiles mineralize their eggshells indistinguishable from dual clumped isotope equilibrium, while birds precipitate eggshells characterized by a positive disequilibrium offset in Δ48. Analyses of inorganic calcites suggest that the observed disequilibrium pattern in birds is linked to an amorphous calcium carbonate (ACC) precursor, a carbonate phase known to accelerate eggshell formation in birds. Lack of disequilibrium patterns in reptile and Troodon eggshells implies these vertebrates had not acquired the fast, ACC-based eggshell calcification process characteristic of birds. Observation that Troodon retained a slow reptile-like calcification suggests that it possessed two functional ovaries and was limited in the number of eggs it could produce; thus its large clutches would have been laid by several females. Dual clumped isotope analysis of eggshells of extinct vertebrates sheds light on physiological information otherwise inaccessible in the fossil record.

Using Information Videos to Improve Patient Satisfaction in Endoscopy: A Prospective Service Improvement Project.

BACKGROUND: Endoscopy is a rapidly developing discipline with new techniques and procedures being introduced each year. The consenting process is central to patient perception; using information videos as additional tools to aid consent and improve the quality of care in endoscopy is not well established. Our aim was to develop, implement and validate the use of patient educational videos to improve patients' satisfaction and experience in endoscopy. METHODS AND ANALYSIS: This was a prospective service quality improvement study. Eligible patients were invited to watch the educational videos in addition to standard practice. We compared this group with a matched cohort of patients who were receiving standard care of postal information leaflets. Patient satisfaction was measured through the validated Gastrointestinal Endoscopy Satisfaction Questionnaire (GESQ). RESULTS: Patients in the intervention group scored four questions relating to pre-procedural information significantly higher than the control (p=0.038). The total mean GESQ score was also higher in the intervention group compared to the control, however this was not statistically significant (p=0.397). The intervention group had significantly lower cancellation rate (4%) compared to the control group (20%), p=0.023. CONCLUSIONS: Patients who watched educational videos were more satisfied with pre-procedural information in the consenting period than those who did not. Further research is still needed to determine if they reduce patient anxiety. Meanwhile, it would be appropriate to implement these videos into routine practice as a cost-effective method of improving patient satisfaction.

Non-erythropoiesis-stimulating agent, non-iron therapies for the management of anaemia: protocol for a scoping review.

INTRODUCTION: Preoperative anaemia is associated with poor postoperative outcomes and is the strongest predictor of allogenic blood transfusion, which contributes further to patient morbidity. Emphasis has been placed on correcting anaemia prior to surgery to mitigate these outcomes. Conflicting evidence exists regarding the benefit of currently recommended interventions. With greater understanding of iron haemostasis and erythropoiesis, novel therapies have been identified. These are at varying stages of development with some demonstrating promising results in patients with chronic kidney disease. It is not known how these agents have been studied outside this population, particularly in the perioperative context. To address this, we will conduct a scoping review of the published literature to chart the evidence. METHODS AND ANALYSIS: The scoping review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews framework. The electronic database search will include Scopus, MEDLINE (Ovid) and Excerpta Medica database (Ovid), with no language restrictions, and will include all publications since 1 January 2010. This review will have three objectives: (1) to describe the mechanisms of action for novel agents, (2) to describe the level of evidence and stage of development of novel agents in a perioperative setting, and (3) to determine the potential agents suitable for prospective controlled trials in a preoperative or postoperative patient cohort and aiming to improve patient-centred outcomes. The review process will involve two reviewers with a third reviewer resolving disagreements. Data will be extracted and organised with subsequent analysis. ETHICS AND DISSEMINATION: This scoping review does not require research ethics approval. The results will be published in a peer-reviewed journal and inform the development of future prospective trials based on established evidence from potential therapeutic agents. TRIAL REGISTRATION NUMBER: This protocol has been registered prospectively on the Open Science Framework registry (DOI:10.17605/OSF.IO/SM3UH, https://osf.io/sm3uh/?view_only=39876ccf7a4348dfbd566535b957a7db).Cite Now.

Effects of oxygen plasma ashing treatment on carbonate clumped isotopes.

RATIONALE: For clumped isotope analysis (Δ47 ), hydrocarbon and organic molecules present an important contaminant that cannot always be removed by CO2 purification through a Porapak-Q trap. Low-temperature oxygen plasma ashing (OPA) is a quick and easy approach for treatment; however, the impact of this treatment on the original carbonate clumped isotope values has never been fully studied. METHODS: We tested the isotopic impact of OPA using three natural samples with a large range of initial Δ47 values. Crushed and sieved (125 µm mesh) samples were placed into a Henniker Plasma HPT-100 plasma system and treated at a flow rate of 46 mL/min and a power of 100 W at a vacuum of 0.2 mbar for 10, 20, 30 and 60 min before clumped isotope analysis using two MAT 253 isotope ratio mass spectrometers modified to measure masses 44-49. RESULTS: OPA treatment for 30 min or more on calcite powder samples has the potential to alter the clumped isotopic composition of the samples beyond analytical error. A systematic positive offset is observed in all samples. The magnitude of this alteration translates to a temperature offset from known values ranging from 4°C to 13°C. We postulate that the observed positive offset in Δ47 occurs because the bonds within lighter isotopologues are preferentially broken by plasma treatment, leading to an artificial increase in the 'clumping' value of the sample. CONCLUSIONS: We recommend that any laboratory performing OPA treatments should reduce the runs to 10-20 min or carry out successive runs of 10 min followed by sample stirring, as this procedure showed no alteration in the initial Δ47 values. Our results validate the use of OPA for clumped isotope applications and will allow future research to use clumped isotopes for challenging samples such as oil-stained carbonates, bituminous shales or host rocks with very high organic carbon content.

Reducing contamination parameters for clumped isotope analysis: The effect of lowering Porapak™ Q trap temperature to below -50°C.

RATIONALE: Carbonate clumped isotope thermometry examines the thermodynamic preference of 13 C-18 O bonds to form within the carbonate crystal lattice. The 13 C18 O16 O isotopologue in analyte CO2 has a natural abundance of 44.4 ppm necessitating stringent purification procedures to remove contaminant molecules that may produce significant isobaric effects within range of the mass 47 isotopologue. Strict purifications of analyte CO2 are thus required as well as reliable contamination indicators. METHODS: CO2 purification was carried out by vacuum cryogenic purification through a static trap packed with Porapak™ Q (PPQ). The correlation between mass excesses on m/z 47, 48 and 49 in CO2 produced by acid digestion of 12 natural samples was measured by isotope ratio mass spectrometry (IRMS). CO2 from two contaminated carbonate samples was then purified at PPQ trap temperatures between -25 and -65°C and measured by IRMS to determine changes in mass excesses on m/z 47, 48 and 49. Finally carbonate standards, Carrara marble (CM) and ETH3, were purified at PPQ trap temperatures of -35 and -60°C to identify isotopic fractionation associated with lowering trap temperature. RESULTS: The correlation between mass excesses on m/z 47, 48 and 49 is determined to be sample dependent. Lowering the PPQ trap temperature to -60°C has a 78% success rate in decreasing Δ48offset , a measure of sample contamination, to within an acceptable range (<1.5 ‰). Lowering the PPQ temperature in purification of CM and ETH3 is associated with decreases in the δ13 C and δ18 O values as a result of isotopic fractionation. We demonstrate that we can correct for fractionation at a trap temperature of -60°C. CONCLUSIONS: Lowering the temperature of the Porapak Q trap to -60°C results in improved sample cleaning. It is possible to correct for fractionation in δ13 C and δ18 O values at lower PPQ trap temperatures using identically prepared standards. This result has important connotations for laboratories using similar sample preparation methods.