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This study is based upon a stratigraphic and structural revision of a Middle Jurassic-Upper Cretaceous mostly continental succession exposed between Boumalne Dades and Tinghir (Southern Morocco), and aims at reconstructing the relation among sedimentary, tectonic and magmatic processes that affected a portion of the Central High Atlas domains. Basalts interbedded in the continental deposits have been sampled in the two studied sites for petrographic, geochemical and radiogenic isotope analyses. The results of this study provide: (1) a robust support to the local stratigraphic revision and to a regional lithostratigraphic correlation based on new 40Ar-39Ar ages (ca. 120 Ma) of the intervening basalts; (2) clues for reconstructing the relation between magma emplacement in a structural setting characterized by syn-depositional crustal shortening pre-dating the convergent tectonic inversion of the Atlasic rifted basins; (3) a new and intriguing scenario indicating that the Middle Jurassic-Lower Cretaceous basalts of the Central High Atlas could represent the first signal of the present-day Canary Islands mantle plume impinging, flattening, and delaminating the base of the Moroccan continental lithosphere since the Jurassic, and successively dragged passively by the Africa plate motion to NE. The tectono-sedimentary and magmatic events discussed in this paper are preliminarily extended from their local scale into a peculiar geodynamic setting of a continental plate margin flanked by the opening and spreading Central Atlantic and NW Tethys oceans. It is suggested that during the late Mesozoic this setting created an unprecedented condition of intraplate stress for concurrent crustal shortening, related mountain uplift, and thinning of continental lithosphere. [ABSTRACT FROM AUTHOR]

Background: Evidence-Based Medicine is built on the premise that clinicians can be more confident when their decisions are grounded in high-quality evidence. Furthermore, evidence from studies involving patient-oriented outcomes is preferred when making decisions about tests or treatments. Ideally, the findings of relevant and valid trials should be stable over time, that is, unlikely to be reversed in subsequent research., Objective: To evaluate the stability of evidence from trials relevant to primary healthcare and to identify study characteristics associated with their reversal., Methods: We studied synopses of randomized controlled trials (RCTs) published from 2002 to 2005 as "Daily POEMs" (Patient Oriented Evidence that Matters). The initial evidence (E1) from these POEMs (2002-2005) was compared with the updated evidence (E2) on that same topic in a summary resource (DynaMed 2019). Two physician-raters independently categorized each POEM-RCT as (i) reversed when E1 ≠ E2, or as (ii) not reversed, when E1 = E2. For all "Evidence Reversals" (E1 ≠ E2), we assessed the direction of change in the evidence., Results: We evaluated 408 POEMs on RCTs. Of those, 35 (9%; 95% confidence interval [6-12]) were identified as reversed, 359 (88%) were identified as not reversed, and 14 (3%) were indeterminate. On average, this represents about 2 evidence reversals per annum for POEMs about RCTs., Conclusions: Over 12-17 years, 9% of RCTs summarized as POEMs are reversed. Information alerting services that apply strict criteria for relevance and validity of clinical information are likely to identify RCTs whose findings are stable over time., (© The Author(s) 2021. Published by Oxford University Press. All rights reserved.For permissions, please e-mail: journals.permissions@oup.com.)

Objective: To summarize 10 high-quality studies or guidelines from 2021 that have strong relevance to physicians in comprehensive family practice., Selecting the Evidence: Routine literature surveillance of abstracts in high-impact journals and EvidenceAlerts was completed by the PEER (Patients, Experience, Evidence, Research) team, a group of health care professionals with a research interest in evidence-based medicine and primary care. Abstracts were screened, selected, and ranked by the PEER team., Main Message: The articles from 2021 that are most likely to impact primary care practice discuss the following topics: empagliflozin for heart failure with preserved ejection fraction; semaglutide for weight loss; stopping antidepressants in primary care; inhaled budesonide for COVID-19; acetylsalicylic acid for preeclampsia prevention; quarter-dose blood pressure medications for hypertension; aggressive blood pressure control for elderly patients; kangaroo care for low-birth-weight infants; footwear for knee osteoarthritis; and delayed antibiotics for pediatric respiratory infections. Two "honourable mention" studies are also briefly reviewed., Conclusion: Research from 2021 produced several high-quality studies in cardiovascular care but also addressed a variety of conditions relevant to primary care including weight loss, depression, and COVID-19., (Copyright © 2022 the College of Family Physicians of Canada.)

Aim: To perform a cross-cultural adaptation and validation of the Neurogenic Bladder Symptom Score (NBSS) to Spanish in patients with neurogenic lower urinary tract dysfunction., Materials and Methods: The questionnaire was culturally adapted according to international guidelines. It was applied, twice in a range of 14-28 days. Psychometric properties were tested such as content validity, construct validity, internal consistency, and test-retest reliability., Results: A total of 82 patients between 18 and 78 years old (mean age of 43.9) participated in the study, and completed the first NBSS assessment; only 39 (32.19%) performed the test-retest study. The internal consistency was tested by Cronbach α with a result of 0.86 (95% CI, 0.81-0.90). The reliability was tested by interclass correlation coefficient with a result of 0.91 [0.87-0.95] (p < 0.0001). The construct validity was tested by Pearson correlation between NBSS and Qualiveen-SF, which showed a moderate correlation with a result of 0.57 (p < 0.0001). One-way analysis of variance with trend analysis demonstrated that patients who reported having a more severe problem with their bladder function had a higher NBSS total score (p < 0.001)., Conclusion: The results of this study demonstrated that the Spanish version of the NBSS has a good internal consistency and reliability, proving its applicability., (© 2021 Wiley Periodicals LLC.)

Objective: Early reports have suggested that coronavirus disease 2019 (COVID-19) can present with significant urinary frequency and nocturia, and that these symptoms correlate with markers of inflammation in the urine. We evaluated surrogate markers of chronic urinary symptoms to determine if they were more frequent after COVID-19 infection., Methods: Routinely collected data from the province of Ontario was used to conduct a matched, retrospective cohort study. We identified patients 66 years of age or older who had a positive COVID-19 test between February and May 2020 and survived at least 2 months after their diagnosis. We matched them to two similar patients who did not have a positive COVID-19 test during the same time period. We measured the frequency of urology consultation, cystoscopy, and new prescriptions for overactive bladder medications during a subsequent 3-month period. Proportional hazard models were adjusted for any baseline differences between the groups., Results: We matched 5617 patients with COVID-19 to 11,225 people who did not have COVID-19. The groups were similar, aside from a higher proportion of patients having hypertension and diabetes in the CoVID-19 cohort. There was no significantly increased hazard of new receipt of overactive bladder medication (hazards ratio [HR]: 1.04, p = 0.88), urology consultation (HR: 1.40, p = 0.10), or cystoscopy (HR: 1.14, p = 0.50) among patients who had COVID-19, compared to the matched cohort., Conclusion: Surrogate markers of potential bladder dysfunction were not significantly increased in the 2-5 months after COVID-19 infection., (© 2021 Wiley Periodicals LLC.)

Background: To support student well-being, a mindfulness curriculum in undergraduate medical education was launched at our university in 2014. We describe the program and report 3-year results., Methods: Medical students responded to online questionnaires on mindfulness (Freiburg Mindfulness Inventory), empathy (Jefferson Scale of Physician Empathy), resilience (Connor-Davidson Resilience Scale) and perceived stress (Perceived Stress Scale) and were surveyed for demographics, home practice, and subjective experience at curriculum launch and yearly for 3 years., Results: In respondents, high stress (19.2 (SD=6)) and low resilience (71.2 (SD=12.5)) scores were seen throughout training. Scores for mindfulness correlated positively with those for empathy (r=.217 p < 0.01) and resilience ( r = .539, p < 0.01), and negatively with stress scores ( r = -.380, p < 0.01). While overall scale scores did not statistically change after curriculum implementation, statistically significant increases were seen in mindfulness (12%, p = 0.008), empathy (5%, p = 0.045), and resilience scores (12%, p = 0.002) with a trend toward lower stress scores (8%, p =0.080) in respondents who felt they applied the curriculum principles. Two hours of reported home practice per week was associated with statistically significant changes (14% increased mindfulness scores p < 0.001; 6% increased empathy scores p < 0.001, 10% increased resilience scores p = 0.003; 11% decreased stress scores p = 0.008). Despite positive program evaluations for both mandatory and elective sessions, student attendance at elective sessions was low., Conclusion: A mindfulness curriculum integrated into formal undergraduate medical education is feasible. Benefits may be confined to those students who apply curriculum principles and practice regularly. Further study is needed.Résumé., Contexte: Pour soutenir le bien-être des étudiants, un cursus de méditation pleine conscience dans le cadre du programme de doctorat en médecine a été lancé à notre université en 2014. Nous décrivons le programme et communiquons les résultats après trois ans., Méthodes: Des étudiants en médecine ont répondu à des questionnaires en ligne sur la pleine conscience (inventaire de pleine conscience de Freiburg), l'empathie (Échelle de Jefferson sur l'empathie du médecin), la résilience (échelle de résilience de Connor-Davidson) et le stress perçu (échelle du stress perçu) et ont été interrogés pour les caractéristiques démographiques, la pratique de la méditation pleine conscience à domicile et l'expérience subjective au moment du lancement du cursus et, ensuite, annuellement pendant trois ans., Résultats: Chez les répondants, un degré de stress élevé (19,2 (ET=6)) et une faible résilience (71,2 (ET=12,5)) ont été observés tout au long de la formation. Il y avait une corrélation positive entre les la pleine conscience et l'empathie (r=0,17, p<0,01) et de la résilience (r=0,539, p<0,01), et négative avec le stress (r=-0,380, p<0,01). Alors que les résultats globaux ne changent pas statistiquement après la mise en œuvre du cursus, des augmentations statistiquement significatives ont été observées pour la pleine conscience (12%, p=0,008), l'empathie (5%, p=0,045) et la résilience (12%, p=0,002) avec une tendance vers des résultats inférieurs pour le stress (8%, p=0,080) chez les répondants qui estimaient avoir appliqué les principes du programme. On retrouvait des changements significatifs chez les répondants qui rapportaient avoir pratiqué deux heures par semaine à domicile (résultats accrus de 14% pour la pleine conscience (p<0,001), de 6% pour l'empathie (p<0,001) et de 10% pour la résilience (p= 0,003), et réduits de 11% pour le stress (p=0,008)). Malgré des évaluations de programme positives pour les sessions obligatoires et optionnelles, l'assiduité des étudiants aux sessions optionnelles était faible., Conclusion: Un cursus de méditation pleine conscience intégré dans des études formelles de doctorat en médecine est faisable. Les avantages peuvent être confinés aux étudiants qui appliquent les principes du programme et qui le pratiquent sur une base régulière. D'autres études sont requises., Competing Interests: Conflicts of interest: Dr. MacLean participates in numerous sponsored clinical trials in multiple sclerosis (Bayer, Biogen, Genzyme, Immune Tolerance Network, Novartis, Opexa, Roche, Sanofi-Aventis). Dr. MacLean also wrote and published the Apple iBook, “Mindfulness for Medical School, Residency and Beyond”, which is used as a course guide for our mindfulness curriculum described and referenced in this manuscript. It is available through Apple iBooks as a free download so that students etc. can access it freely. She receives no royalties from the iBook. Drs. MacLean, Gonsalves and Sanchez have received honorariums for delivering educational workshops on mindfulness at local and national venues. Dr. Diana Koszycki has received research grants from the Canadian Institute of Health Research, the Ontario Mental Health Foundation, and the Canadian Medical Association., (© 2020 MacLean, Braschi, Archibald, Sanchez-Campos, Jebanesan, Koszycki, Gonsalves ; licensee Synergies Partners.)

Introduction: Medical education should portray evidence-based medicine (EBM) and shared decision making (SDM) as central to patient care. However, misconceptions regarding EBM and SDM are common in clinical practice, and these biases might unintentionally be transmitted to medical trainees through a hidden curriculum. The current study explores how assumptions of EBM and SDM can be hidden in formal curriculum material such as PowerPoint slides., Methods: We conducted a qualitative content analysis using a purposive sample of 18 PowerPoints on the management of upper respiratory tract infections. We identified concepts pertaining to decision making using theory-driven codes taken from the fields of EBM and SDM. We then re-analyzed the coded text using a constructivist latent thematic approach to develop a rich description of conceptualizations of decision making in relation to EBM and SDM frameworks., Results: PowerPoint slides can relay a hidden curriculum, which can normalize: pathophysiological reasoning, unexplained variations in clinical care, the use of EBM mimics, defensive medicine, an unrealistic portrayal of benefits, and paternalism., Discussion: Addressing the hidden curriculum in formal curricular material should be explored as a novel strategy to foster a positive attitude towards EBM and SDM and to improve patient outcomes by encouraging the use of these skills.

Competing Interests: Competing interests: None declared.

This data article describes the soils characterisation, bedrock geochemical composition and descriptive statistics of 87 Sr/ 86 Sr in wines, grape saps, labile fractions of soils (bio-available), whole soils, and bedrocks used to explore the Sr isotope conservation from rocks and soils to vine and wine. These data also describe the reproducibility of the isotopic composition of wine over four harvest years (2008-2011) on 11 selected experimental parcels (sampling point). The data reported in this paper are related to the research article (Braschi et al., 2018) [1].

Background: While journals and reporting guidelines recommend the presentation of confidence intervals, many authors adhere strictly to statistically significant testing. Our objective was to determine what proportions of not statistically significant (NSS) cardiovascular trials include potentially clinically meaningful effects in primary outcomes and if these are associated with authors' conclusions., Methods: Cardiovascular studies published in six high-impact journals between 1 January 2010 and 31 December 2014 were identified via PubMed. Two independent reviewers selected trials with major adverse cardiovascular events (stroke, myocardial infarction, or cardiovascular death) as primary outcomes and extracted data on trial characteristics, quality, and primary outcome. Potentially clinically meaningful effects were defined broadly as a relative risk point estimate ≤0.94 (based on the effects of ezetimibe) and/or a lower confidence interval ≤0.75 (based on the effects of statins)., Results: We identified 127 randomized trial comparisons from 3200 articles. The primary outcomes were statistically significant (SS) favoring treatment in 21% (27/127), NSS in 72% (92/127), and SS favoring control in 6% (8/127). In 61% of NSS trials (56/92), the point estimate and/or lower confidence interval included potentially meaningful effects. Both point estimate and confidence interval included potentially meaningful effects in 67% of trials (12/18) in which authors' concluded that treatment was superior, in 28% (16/58) with a neutral conclusion, and in 6% (1/16) in which authors' concluded that control was superior. In a sensitivity analysis, 26% of NSS trials would include potential meaningful effects with relative risk thresholds of point estimate ≤0.85 and/or a lower confidence interval ≤0.65., Conclusions: Point estimates and/or confidence intervals included potentially clinically meaningful effects in up to 61% of NSS cardiovascular trials. Authors' conclusions often reflect potentially meaningful results of NSS cardiovascular trials. Given the frequency of potentially clinical meaningful effects in NSS trials, authors should be encouraged to continue to look beyond significance testing to a broader interpretation of trial results.

Constraining the timescales of pre-eruptive magmatic processes in active volcanic systems is paramount to understand magma chamber dynamics and the triggers for volcanic eruptions. Temporal information of magmatic processes is locked within the chemical zoning profiles of crystals but can be accessed by means of elemental diffusion chronometry. Mineral compositional zoning testifies to the occurrence of substantial temperature differences within magma chambers, which often bias the estimated timescales in the case of multi-stage zoned minerals. Here we propose a new Non-Isothermal Diffusion Incremental Step model to take into account the non-isothermal nature of pre-eruptive processes, deconstructing the main core-rim diffusion profiles of multi-zoned crystals into different isothermal steps. The Non-Isothermal Diffusion Incremental Step model represents a significant improvement in the reconstruction of crystal lifetime histories. Unravelling stepwise timescales at contrasting temperatures provides a novel approach to constraining pre-eruptive magmatic processes and greatly increases our understanding of magma chamber dynamics.

(87)Sr/(86)Sr has been determined in wines, musts grape juices, soils and rocks from six selected vineyards of 'Cesanese' wine area. Cesanese is a monocultivar wine from a small region characterised by different geologic substrata, a key locality to test the influence of both substratum and winemaking procedure on the (87)Sr/(86)Sr of wines. Experimental work has been performed on wines from different vintage years to check possible seasonal variations. The data reveal that (87)Sr/(86)Sr does not change through time, to validate the selection of wineries performed, and in addition no isotopic variations are observed during winemaking. Indeed, no significant isotopic variations have been observed in musts and wines. These findings reinforce the hypothesis that the isotopic signature of wines is strongly related to the bioavailable fraction of the soil rather than to its bulk. The data corroborate the possibility that Sr-isotopes of high-quality wines can be used as a reliable tool for fingerprinting wine geographic provenance., (Copyright © 2015 Elsevier Ltd. All rights reserved.)