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OBJECTIVE: US trauma centers (TCs) must remain prepared for mass casualty incidents (MCIs). However, trauma surgeons may lack formal MCI training. The recent COVID-19 pandemic drove multiple patient surges, overloaded Emergency Medical Services (EMS) agencies, and stressed TCs. This survey assessed trauma surgeons MCI training, experience, and system and personal preparedness before the pandemic compared with the pandemics third year. METHODS: Survey invitations were emailed to all 1544 members of the American Association for the Surgery of Trauma in 2019, and then resent in 2022 to 1575 members with additional questions regarding the pandemic. Questions assessed practice type, TC characteristics, training, experience, beliefs about personal and hospital preparedness, likelihood of MCI scenarios, interventions desired from membership organizations, and pandemic experiences. RESULTS: The response rate was 16.7% in 2019 and 12% in 2022. In 2022, surgeons felt better prepared than their hospitals for pandemic care, mass shootings, and active shooters, but remained feeling less well prepared for cyberattack and hazardous material events, compared with 2019. Only 35% of the respondents had unintentional MCI response experience in 2019 or 2022, and even fewer had experience with intentional MCI. 78% had completed a Stop the Bleed (STB) course and 63% own an STB kit. 57% had engaged in family preparedness activities; less than 40% had a family action plan if they could not come home during an MCI. 100% of the respondents witnessed pandemic-related adverse events, including colleague and coworker illness, patient surges, and resource limitations, and 17% faced colleague or coworker death. CONCLUSIONS: Trauma surgeons thought that they became better at pandemic care and rated themselves as better prepared than their hospitals for MCI care, which is an opportunity for them to take greater leadership roles. Opportunities remain to improve surgeons family and personal MCI preparedness. Surgeons most desired professional organization interventions include advocacy, national standards for TC preparedness, and online training. LEVEL OF EVIDENCE: VII, survey of expert opinion.

Acetylcholine in the neocortex is critical for executive function [1-3]. Degeneration of cholinergic neurons in aging and Alzheimers dementia is commonly treated with cholinesterase inhibitors [4-7]; however, these are modestly effective and are associated with side effects that preclude effective dosing in many patients [8]. Electrical activation of the nucleus basalis (NB) of Meynert, the source of neocortical acetylcholine [9, 10], provides a potential method of improving cholinergic activation [11, 12]. Here we tested whether NB stimulation would improve performance of a working memory task in a nonhuman primate model. Unexpectedly, intermittent stimulation proved to be most beneficial (60 pulses per second, for 20 s every minute), whereas continuous stimulation often impaired performance. Pharmacological experiments confirmed that the effects depended on cholinergic activation. Donepezil, a cholinesterase inhibitor, restored performance in animals impaired by continuous stimulation but did not improve performance further during intermittent stimulation. Intermittent stimulation was rendered ineffective by either nicotinic or muscarinic receptor antagonists. In the months after stimulation began, performance also improved in sessions without stimulation. Our results reveal that intermittent NB stimulation can improve working memory, a finding that has implications for restoring cognitive function in aging and Alzheimers dementia.

This study presents mineral composition estimates of rock and sediment samples analyzed with the CheMin X-ray diffraction instrument on board the NASA Mars Science Laboratory rover, Curiosity, in Gale crater, Mars. Mineral composition is estimated using crystal-chemically derived algorithms applied to X-ray diffraction data, specifically unit-cell parameters. The mineral groups characterized include those found in major abundance by the CheMin instrument (i.e., feldspar, olivine, pyroxene, and spinel oxide). In addition to estimating the composition of the major mineral phases observed in Gale crater, we place their compositions in a stratigraphic context and provide a comparison to that of martian meteorites. This work provides expanded insights into the mineralogy and chemistry of the martian surface. [ABSTRACT FROM AUTHOR]

Gypsum is a common mineral at Gale crater on Mars, currently being explored by the Mars Science Laboratory (MSL) rover, Curiosity. In this paper, we summarize the associations of gypsum with other sulfate minerals (bassanite, anhydrite, jarosite, starkeyite, and kieserite) from the lowest levels of the crater's northern moat zone (Aeolis Palus) up through ~0.8 km of the stratigraphic section in the lower slopes of the sedimentary mound developed around the central peak, Aeolis Mons (informally, Mount Sharp). The analysis is based on results from the CheMin X-ray diffraction instrument on Curiosity, supplemented with information from the rover's versatile instrument suite. Gypsum does not occur with the same frequency as less hydrous Ca-sulfates, likely, in most cases, because of its dehydration to bassanite and possibly to anhydrite. All three of these Ca-sulfate phases often occur together and, along with other sulfates, in mixed assemblages that are evidence of limited equilibration on a cold, dry planet. In almost all samples, at least one of the Ca-sulfate minerals is present, except for a very limited interval where jarosite is the major sulfate mineral, with the implication of more acidic groundwater at a much later time in Gale crater's history. Although observations from orbit reveal a sulfate-rich surface, currently active dark basaltic dunes at Gale crater have only small amounts of a single sulfate mineral, anhydrite. Gale crater has provided the most complete mineralogical analysis of a site on Mars so far, but the data in hand show that Gale crater mineralogy is not a blueprint with planet-wide application. The concurrent study of Jezero crater by the Mars 2020 mission and comparisons to what is believed to be the most extensive deposit of gypsum on Mars, in the dune fields at the north polar ice cap, show significant diversity. Unraveling the stories of gypsum and other sulfates on Mars is just beginning. [ABSTRACT FROM AUTHOR]

For more than a decade, the CheMin X-ray diffraction instrument on the Mars Science Laboratory rover, Curiosity, has been returning definitive and quantitative mineralogical and mineral–chemistry data from ~3.5-billion-year-old (Ga) sediments in Gale crater, Mars. To date, 40 drilled rock samples and three scooped soil samples have been analyzed during the rover's 30+ km transit. These samples document the mineralogy of over 800 m of flat-lying fluvial, lacustrine, and aeolian sedimentary rocks that comprise the lower strata of the central mound of Gale crater (Aeolis Mons, informally known as Mt. Sharp) and the surrounding plains (Aeolis Palus, informally known as the Bradbury Rise). The principal mineralogy of the sedimentary rocks is of basaltic composition, with evidence of post-depositional diagenetic overprinting. The rocks in many cases preserve much of their primary mineralogy and sedimentary features, suggesting that they were never strongly heated or deformed. Using aeolian soil composition as a proxy for the composition of the deposited and lithified sediment, it appears that, in many cases, the diagenetic changes observed are principally isochemical. Exceptions to this trend include secondary nodules, calcium sulfate veining, and rare Si-rich alteration halos. A surprising and yet poorly understood observation is that nearly all of the ~3.5 Ga sedimentary rocks analyzed to date contain 15–70 wt.% of X-ray amorphous material. Overall, this >800 m section of sedimentary rock explored in lower Mt. Sharp documents a perennial shallow lake environment grading upward into alternating lacustrine/fluvial and aeolian environments, many of which would have been habitable to microbial life. [ABSTRACT FROM AUTHOR]

The Windjana drill sample, a sandstone of the Dillinger member (Kimberley formation, Gale Crater, Mars), was analyzed by CheMin X-ray diffraction (XRD) in the MSL Curiosity rover. From Rietveld refinements of its XRD pattern, Windjana contains the following: sanidine (21% weight, ~Or95); augite (20%); magnetite (12%); pigeonite; olivine; plagioclase; amorphous and smectitic material (~25%); and percent levels of others including ilmenite, fluorapatite, and bassanite. From mass balance on the Alpha Proton X-ray Spectrometer (APXS) chemical analysis, the amorphous material is Fe rich with nearly no other cations-like ferrihydrite. The Windjana sample shows little alteration and was likely cemented by its magnetite and ferrihydrite. From ChemCam Laser-Induced Breakdown Spectrometer (LIBS) chemical analyses, Windjana is representative of the Dillinger and Mount Remarkable members of the Kimberley formation. LIBS data suggest that the Kimberley sediments include at least three chemical components. The most K-rich targets have 5.6% K2O, ~1.8 times that of Windjana, implying a sediment component with >40% sanidine, e.g., a trachyte. A second component is rich in mafic minerals, with little feldspar (like a shergottite). A third component is richer in plagioclase and in Na2O, and is likely to be basaltic. The K-rich sediment component is consistent with APXS and ChemCam observations of K-rich rocks elsewhere in Gale Crater. The source of this sediment component was likely volcanic. The presence of sediment from many igneous sources, in concert with Curiosity's identifications of other igneous materials (e.g., mugearite), implies that the northern rim of Gale Crater exposes a diverse igneous complex, at least as diverse as that found in similar-age terranes on Earth.

The Mars Science Laboratory (MSL) rover Curiosity has documented a section of fluvio-lacustrine strata at Yellowknife Bay (YKB), an embayment on the floor of Gale crater, approximately 500 m east of the Bradbury landing site. X-ray diffraction (XRD) data and evolved gas analysis (EGA) data from the CheMin and SAM instruments show that two powdered mudstone samples (named John Klein and Cumberland) drilled from the Sheepbed member of this succession contain up to ~20 wt% clay minerals. A trioctahedral smectite, likely a ferrian saponite, is the only clay mineral phase detected in these samples. Smectites of the two samples exhibit different 001 spacing under the low partial pressures of H2O inside the CheMin instrument (relative humidity