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A stalagmite from Dim Cave in southern Turkey contains a climate record documenting rapid and significant changes in amounts of precipitation between similar to 132 ka and similar to 128 ka, during the penultimate glacial - interglacial transition. Some U-Th dates have been compromised by carbonate dissolution but rigorous selection and tuning to delta O-18 records from other speleothems has generated a robust age model. Growth rate was initially very slow but a rapid increase at similar to 129 ka was accompanied by strong negative trends in delta O-18 and delta C-13, a combination implying the onset of much wetter conditions. Isotopic values at similar to 129 ka suggest that groundwater recharge rates and biogenic activity in the soil zone exceeded those of the early Holocene. A significant isotopic enrichment event at similar to 128 ka, during which there was alternating aragonite and calcite deposition, documents a strong drying event with a duration of similar to 200 years. A concurrent decrease in Sr-87/Sr-86 ratios indicates increased groundwater residence times and the cumulative evidence suggests amounts of rainfall fell from well above to slightly below present-day levels. Similar delta O-18 enrichment events are present in coeval speleothem records from southwest France and the Northern Alps, and these, together with pollen evidence from Italy, Greece and the Iberian margin of drier conditions at this time, imply that a climate anomaly extended across the northern Mediterranean borderlands. The timing, duration and structure of this episode are consistent with marine evidence of strong North Atlantic cooling early in the last interglacial and there is a resemblance to the Holocene 8.2 ka event recorded globally in many proxy-climate archives.

The second European Rhinology Reserach Forum organized by the European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) was held on 9-10th November 2017, combined with a specific symposium on air pollution and mobile Health technology (mHealth) with the GARD (Global Alliance against Chronic Respiratory Diseases) initiative of WHO (World Health Organization). Physicians from different specialities, researchers, as well as patients and industry representatives from more than 40 countries took part in the Forum. Relevant topics were debated with the aim of allowing the implementation of precision medicine (PM) in daily respiratory care. All debates started with positioning the current state of the art: identification of current gaps in practice, the current consensus and the need for implementation of novel approaches such as endotype-driven treatment, patient empowerment and eHealth tools. This report provides a summry of the outcomes of the brainstorming sessions of the European Rhinology Research Forum 2017, highlighting the research needs in PM, with personalized care, prediction of success of treatment, participation of the patient and prevention of disease as key drivers for improving current clinical practice.

Dripwater hydrology and hydrogeochemistry is particularly useful in constraining the meaning of speleothem palaeoclimate archives, for example using δ18O signatures. Here, we calibrate the relationship between δ18O in precipitation, percolation waters and contemporary calcite deposits, at Tartair cave, Sutherland, NW Scotland, an Atlantic site sensitive to regional changes both of temperature and precipitation. Monthly precipitation displayed a 7.1‰ range in δ18O, a negative linear relationship with rainfall amount, and no correlation with temperature. Autogenically-derived cave percolation waters show little variation in δ18O during the same period and their annual weighted mean is the same as that of the local precipitation. This evidence together with hydrological data and electroconductivity values indicates that percolation waters are well mixed and dominated by stored water. Calculated values of δ18O of calcite deposited in this cave environment indicate that the cave deposits are forming close to isotopic equilibrium and kinetic effects are negligible. Comparison of a high-resolution δ18O stalagmite record with the instrumental record of climate indicates that isotopically heavy values are reflective of relatively cold, dry conditions (and vice-versa for warm, wet condition) and hence that stalagmite oxygen isotopes provide an appropriate means of investigating the palaeoclimate in this location.

Poor chronological control hampers efforts to constrain uplift event frequency in the Eastern Mediterranean Basin and develop regional tectonic models. Borings of the colonial marine mollusc Lithophaga lithophaga are commonly associated with uplifted Mediterranean shorelines and the suitability of its fossil shell for uranium-series dating is investigated to assess its potential for refining uplift chronologies. Living specimens contain very little uranium but Holocene fossils suggest rapid post-mortem uptake from a marine source. However, in common with many other mollusc species, Pleistocene samples show clear evidence of subsequent exchange with uranium from groundwater and although two out of eight samples returned ages compatible with their stratigraphic locations, these may be chance results given the compelling evidence for general open system behaviour. Detrital contamination appears not to be a significant problem in pre-Holocene samples. Open system modelling, using techniques developed to correct for alpha recoil effects in reef corals, shows that the recoil mechanism is inadequate to explain the magnitude of the isotopic alterations observed. Our results show that whilst uranium-series dating of Holocene L. lithophaga shells may be possible, Pleistocene specimens suffer from significant geochemical alteration and cannot be used to refine crustal uplift chronologies over longer timescales.

We explore the expression of early Holocene climatic change in the terrestrial Mediterranean of southern Greece. A regional palaeoclimate record from stable isotope and trace element geochemical proxies in an early Holocene (~12.4 ka to 6.7 ka) stalagmite is compared to the timing of palaeosol (entisol) development on an early Holocene alluvial fan located

Objective The purpose of this paper is to review the experience with the frameless, anchored, GyneFix copper-releasing intrauterine contraceptive devices (IUCDs/IUDs) (Contrel Europe, Belgium), and to demonstrate their high acceptability and low rate of discontinuation of use, which could contribute to current efforts that aim to reduce radically the high number of unintended pregnancies and induced abortions, particularly in young women. Materials and methods This paper is based on studies that examined the differences in uterine volume and cavity size, related to age and parity, and on original clinical research data and practical experience with frameless copper IUDs, as well as on literature data on the IUD-endometrial cavity relationship of conventional IUDs, with special reference to side effects and user discontinuation. Results The mean transverse diameter in nulliparous and parous women is significantly less than the length of the transverse arm of the TCu380A IUD (ParaGard, Duramed, NY, USA) or the levonorgestrel intrauterine system (Mirena, Bayer, Germany). Small, frameless, flexible, and unidimensional copper IUDs appear to be well tolerated, with less impact on menstrual bleeding, resulting in low discontinuation rates when compared with standard-size conventional IUDs, which often result in increased expulsion rates, complaints of pain and erratic or increased menstrual bleeding, and subsequent high rates of discontinuation, particularly in young women. Conclusion The unidimensional GyneFix IUDs fit the majority of uterine cavities. An IUD that fits is likely to result in increased tolerance and continued use of the method. As this would appeal to women, the logical result should be greater use of the method and fewer unintended pregnancies and induced abortions. Recommending the standard TCu380A (ParaGard) IUD or the Mirena levonorgestrel intrauterine system, primarily developed for use in parous women, for general use in nulliparous and adolescent women should be done with caution in the light of current scientific evidence, except if 3-D sonography indicates that the uterine cavity is sufficiently large.

The Gulf of Corinth, central Greece, is a rapidly extending continental rift, the eastern part of which bifurcates into the active northern Alkyonides Gulf and the southern Lechaion Gulf. The Lechaion Gulf is considered an inactive relict of early rifting, yet the presence of late Quaternary shorelines is evidence of continuing uplift of the north, east and south margins of this basin. Models to explain uplift include uplift on the footwall of the southern Alkyonides Gulf fault system and the Xylocastro–Perachora faults or ‘regional9 isostatic uplift independent of fault slip. These models are tested by comparing predicted spatial uplift trends with those observed. Uplift rates since Marine Isotope Stage 7 of 0.31 ± 0.04 mm a −1 on the Lechaion Gulf north coast are explained as displacement on the footwall of active faults. However, the south coast uplift cannot be explained by footwall uplift and is evidence for isostatic uplift that probably affects the whole of the southern Gulf of Corinth rift. Isostatic uplift rates of 0.22 ± 0.01 mm a −1 at the Corinth canal increase westward towards the mouth of the Lechaion Gulf where it meets the modern rift, the Gulf of Corinth. Supplementary material: Details of Holocene marine notches that identify raised shorelines from exposures on the southern Perachora peninsula between Heraion and Loutraki, and of the cumulative displacement of sequences by minor faults on the Isthmus, exposed in the Corinth canal walls, are available at http://www.geolsoc.org.uk/SUP18429.

An understanding of fault kinematics in areas of active tectonic deformation requires detailed knowledge of local and regional ground-surface displacement vectors. Where faulting displaces coastlines, dated raised marine notches can provide reference markers to measure the magnitude, rate and timing of fault displacement [Pirazzoli, 2005]. This is particularly important in areas of multi-generational faulting and where uplift may include both local and regional scale components, features which characterise the actively extending Gulf of Corinth rift (Figure 1). Cooper et al. [2007] interpret the distribution and elevation of raised Holocene and marine isotope stage (MIS) 5 (∼125 ka) fossil shorelines from the Perachora peninsula in the Gulf of Corinth as due to spatially variable uplift along the fault footwall of a western segment to the Pisia fault which ruptured in 1981 [Jackson et al., 1982]. This comment draws attention to previously published studies of raised shorelines in the area and presents new field observations that help test the structural uplift models of Cooper et al. [2007] and Morewood and Roberts [1999].

In 1994, three shallow earthquakes of Mw∼ 6 occurred close together on blind thrusts near Sefidabeh in eastern Iran. In an earlier study of the teleseismic waveforms, the geomorphology and the faulting in the epicentral region, it was suggested that these earthquakes were associated with the growth of a ridge above a blind thrust fault system, whose activity could be detected by its effect on the surface drainage. In this study we present a SAR interferogram that precisely determines the location and amount of coseismic surface displacements, showing that the earthquakes in the Sefidabeh sequence probably occurred on en-echelon fault segments associated with three stepping ridges.We also present U/Th dates of ∼100 ka for lake deposits uplifted by the growing ridge. From the cumulative, dated uplift and knowledge of the surface displacements due to an earthquake sequence, we estimate that ∼120 such events have occurred in the past 100 ka, with an average recurrence interval of 830 yr, and an average convergence rate of 1.5 mm yr-1 on the Sefidabeh thrust; each estimate has an uncertainty of a factor of two, either way.We argue that the Sefidabeh fault originally formed by coalescence of many small fault segments, and has grown in length at about 2 cm yr-1 in the past 100 ka. Though the coseismic surface deformation observed in the SAR interferogram closely resembles folding, the overall topography does not, because of inherited topography associated with earlier geological deformation. In spite of this, the activity of the buried thrust fault can easily be detected by its effect on the surface drainage: a significant lesson when interpreting landscapes that are not entirely due to the present-day deformation. © 2005 RAS.

[1] New evidence for uplift of the southern margin to the Corinth rift, one of the world's most rapidly extending continental regions, defines an area of uniform uplift separating a more rapidly uplifting western rift flank from a slowly backtilting eastern flank. This major tectonic boundary coincides with geophysical evidence for a junction between flat underlying subducted oceanic plate and steep subduction. We propose that trench rollback by the Anatolian plate over the subducting African plate has led to differential uplift and possible migration of active faulting at the southern rift margin in the last few million years.

Although the provision of expensive ART services in resource-poor countries might appear to be incongruous, nevertheless, the number of ART clinics in such settings is on the rise. For example, in Latin America, the first baby conceived after IVF was born in 1984; by 1998, 84 centers were submitting data to the Latin American Registry (1). Similarly, in Egypt, where IVF was introduced in the late 1980s, at least 35 clinics currently provide a range of ART services (2). Since 1981, private clinics in India have offered ART procedures including IVF and intracytoplasmic sperm injection (ICSI), and 60 clinics have been registered by the Ministry of Health (3). China has also experienced a growth in infertility services since the early 1990s (4).

A multinational comparative trial of three IUDs (Copper 7, Lippes loop size D and the Postpartum T) randomly inserted immediately following delivery of the placenta was conducted in six centres. A total of 841 women entered the study. As the predetermined termination indices for expulsions were exceeded at six months the trial was prematurely closed. An excess of expulsions during the first 48 hours following insertion was observed for the Lippes loop compared to the other devices. At six months the expulsion rate for the Lippes loop was significantly higher than that for the Copper 7. In addition, the discontinuation rate for the Lippes loop at 12 months was significantly higher than that for the Copper 7. There were no significant differences in either the expulsion rates or the discontinuation rate at six or twelve months between the postpartum T and the other devices. At 12 months the pregnancy rates with all three devices was high; there were no ectopic pregnancies. Considerable between-centre differences were observed, particularly for expulsion rates. Possible reasons for this are discussed and future research lines are suggested.A multinational comparative of 3 IUDs (Copper 7, Lippes Loop D, and the Postpartum T) randomly inserted immediately following delivery of the placenta was conducted in 6 centers with a total of 841 women participating in the study. As the predetermined termination indices for expulsions were exceded at 6 months, the trial was prematurely closed. An excess of expulsions during the first 48 hours following insertion was observed for the Lippes Loop compared to the other devices. At 6 months the expulsion rate for the Lippes Loop was significantly higher than that for the Copper 7. There were no significant differences in either the expulsion rates or the discontinuation rate at 6 or 12 months between the Postpartum T and the other devices. At 12 months the pregnancy rates with all 3 devices were high; there were no ectopic pregnancies. Considerable between-center differences were observed, particularly for expulsion rates. Possible reasons for this are discussed and future research lines are suggested.