Premodern medicine used a variety of mineral substances for therapeutic purposes. The present article deals with pitch-asphalt, and, in particular, a precious kind of it called mūmiyāʾ originating in Persia. It was first described in detail in the Arabic pharmacological tradition, and its fame spread throughout the medieval Mediterranean, including Byzantium. By editing and examining for the first time a previously unexplored medieval Greek text on mūmiyāʾ, this study offers new insights into the medicinal uses of this substance. It also significantly increases our understanding of the intense cross-cultural transfer of medical knowledge from the Islamicate world to Byzantium by showing that this was not merely based on the translation of a few Arabic medical works into Greek, but was a multifaceted phenomenon involving a complex nexus of sources that require further investigation.

The concept of superposed fracture networks consisting of different generations, and often types, of fractures that have developed sequentially is discussed. Superposed networks can consist of different types of extension or shear fractures, and each fracture may abut, cross or follow (reactivate) earlier fractures. An example of a superposed fracture network in Liassic limestones in Somerset, UK, is presented, which comprises two sets of veins and a later joint network. The veins develop as damage zones around faults, with veins of the later set crossing or trailing along the earlier set. The later joints either cross-cut the earlier veins or reactivate them, the latter being common for the thicker (more than about 5 mm) veins. The veins and joint networks have markedly different geometries and topologies. The veins are spatially clustered and are typically dominated by I-nodes, while the joints are more evenly distributed and tend to be dominated by Y-nodes. The combined network of veins and joints at Lilstock is dominated by X-nodes because so many joints cross-cut the earlier veins. Understanding the development of superposed fracture networks leads to better understanding of the kinematic, mechanical, tectonic and fluid flow history of rocks.

Orogenic forelands host interactions between deformation and static or migrating fluids. Given their accessibility and dimensions, these areas are not only historic landmarks for structural geology, but they are also areas of prime interest for georesource exploration and geological storage, and loci of potential geohazards. Geochemical techniques applied on cements filling tectonic structures and associated trapped fluids can constrain the temperature, pressure, origin and pathways of fluids during deformation and allow the characterization of the past fluid system. In this review focused on calcite cements, we first present and critically discuss the most used geochemical techniques to appraise specific parameters of the fluid system. Second, we summarize the outcomes of selected case studies where the past fluid system was reconstructed with consideration of tectonics, either at the scale of the individual fold/thrust or at the scale of the fold-and-thrust belt. At first order, the past fluid system evolves in a similar way with respect to the considered stage of deformation, being rather closed to external fluids when deformation is bounded to mesoscale structure development, and opening to vertical flow when thrust and folds develop. In a more detailed view, it seems that the past fluid system evolves and distributes under the influence of the structural style, of the geometry of the major faults and of the lithology of the sedimentary succession. Through this review, we illustrate the concept of geochemistry-assisted structural geology through case studies where the geochemistry of calcite veins constrained subsurface geometries and structural developments in orogenic forelands.

Stoats (Mustela erminea) are active hunters and, therefore, one might predict that any broken bones or other injuries impeding active movement would incur a serious risk of starvation. Dead stoats (n = 560) were collected from trappers operating predator control lines in three conservation areas of New Zealand from 1972-1978. Femurs were cleaned and examined for healed injuries and deformities. Five femurs from four stoats (one with both femurs injured) showed traumatic distortions following healing of complete breaks incurred during life. A further case recorded during post-eradication monitoring in 2010 on Rangitoto, an offshore island, is added. These data provide evidence that wild stoats have a remarkable capacity to tolerate catastrophic femur fractures. They can survive long enough, despite the implied limitation to their energetic hunting style, to permit full healing even though the result is a gross distortion of the femoral shaft.

The Niagara Escarpment is a fractured Palaeozoic sedimentary cuesta, subject to year-round weathering in a temperate climate. We examined the temperature of the rock surface and fractures at three in situ sites with varying aspect and lithology, as well as the surface and interior of three control blocks maintained in outdoor conditions between December 2020 and March 2021. The objectives were to examine the interplay between freeze–thaw and thermal weathering in the winter months and to identify potential factors influencing these processes. Both diurnal-scale and prolonged freeze–thaw cycles differing in spatial and temporal extent were identified, coincident with periods of high moisture. We frequently observed rapid temperature changes (>1 °C min−1) at sites with strong insolation, which implies that the temperature regime is suitable for thermal shock and fatigue to occur. Site-specific factors, such as the aspect of the escarpment face and lithology, impact the mechanism and extent of weathering. Southeast-facing sites with high insolation are dominated by diurnal-scale freeze–thaw; west- and east-facing sites with lower insolation experience a more prominent prolonged freeze–thaw cycle. Across all sites there is a gradient between surface and fracture temperature that follows diurnal trends in air temperature and insolation. Variability in the surface-fracture gradient may enhance weathering processes by shifting the orientation and magnitude of stress, and by changing the spatial distribution of freezing and thawing. Our research indicates that site-specific factors and pre-existing fractures moderate the influence of air temperature and insolation on thermal gradients, and ultimately the weathering regime.

The Niagara Escarpment is a geological feature located in southern Ontario, Canada, and the northeastern United States, comprising highly fractured sandstone, shale and carbonates deposited during the Ordovician and Silurian periods. Differential erosion of the strata has generated a steep cliff face which bisects the city of Hamilton, Ontario. Geological fractures are widespread in the escarpment and result in the formation of unstable blocks of rock subject to erosion through rockfall. This presents structural stability issues of concern due to the proximity of the escarpment to urban infrastructure. We quantify and analyse fracture networks in the escarpment using a combined field- and numerical-modelling-based approach. The location, orientation and aperture of fractures were documented from local outcrops using scanline and area survey methods. Clusters of poles describing the orientation of geological discontinuities were identified in spherical projections, defining three sets: (1) a sub-vertical stratabound set striking N–S, (2) a sub-vertical stratabound set striking E–W, and (3) a set parallel to horizontal sedimentary bedding planes which we infer controlled sub-vertical fracture geometry. Discrete fracture network modelling of fracture sets highlights their high degree of connectivity, and contribution to local geohazards, and quantifies their role in controlling fluid flow through escarpment strata, which is dependent on fracture aperture. Additionally, bedding planes have the potential to act as free surfaces, facilitating stress conditions in which approximately cuboid blocks are produced, and increasing the risk of rockfalls. We conclude that fractures present a first-order control on the fluid-flow properties and stability of the Niagara Escarpment.

Understanding the distribution and geometry of faults and fractures is critical for predicting both subsurface permeability architecture and the integrity of geological fluid barriers, particularly in rocks with low primary porosity and permeability. While fracture patterns in relatively competent, weathering-resistant (therefore often well-exposed) rocks are generally well studied in outcrop, the role of mechanically weak layers in defining fracture patterns is frequently overlooked or under-represented. Here we show that rock composition, specifically clay and silicate minerals versus carbonate content, exerts a strong control on fault and fracture propagation and bed-containment within a mechanically layered, Cretaceous carbonate sequence at Canyon Lake Gorge, Texas. We find that relatively incompetent, clay-rich layers limit fault and fracture propagation, and cause bed-containment of fractures in more competent beds. In our results, no clear relationships exist between mechanical layer thickness and fracture abundance. These results are important for understanding the relative importance of composition versus bed thickness on fracture abundance in the subsurface, and for predicting fracture-controlled fluid flow pathways, seals and fracture connectivity across beds with variable compositions, thicknesses and competences.

Bedding-perpendicular joints striking parallel (longitudinal) and perpendicular (transverse) to both the axis of the hosting anticline and the trend of the foredeep-belt system are widely recognized in fold-and-thrust belts. Their occurrence has been commonly attributed to folding-related processes, such as syn-folding outer-arc extension, although they can also be consistent with a pre-folding foredeep-related fracturing stage. Here we report the pre-folding fracture pattern affecting the Pietrasecca Anticline, in the central Apennines (Italy), resolved by a detailed field structural analysis. Field observations, scan-lines and interpretation of virtual outcrops were used to study the intensity, distribution and the orientations of fracture pattern along the anticline. The fracture pattern of the Pietrasecca Anticline consists of longitudinal and transverse joints, oriented approximately perpendicular to bedding, and of a pre-folding longitudinal pressure-solution cleavage set, which is oblique to bedding regardless of the bedding dip. Cross-cutting relationships show that joints predated the development of the pressure-solution cleavage. Furthermore, joint intensity does not relate to the structural position along the anticline. Taken together, these observations suggest that jointing occurred in a foredeep environment before the Pietrasecca Anticline growth. Our work further demonstrates that joints striking parallel and orthogonal to the main fold axis do not necessarily represent syn-folding deformation structures.

The metavolcanics of Chitradurga region host numerous shallow crustal veins and fractures and faults of multiple orientations. Several high and low Pf cycles have been recorded in the region, leading to the reactivation of most of the pre-existing fractures for high Pf and selective reactivation of some well-oriented fractures under low Pf conditions. The pre-existing anisotropy (magnetic fabric) in the metavolcanics acted as the most prominent planar fabric for fracture propagation and vein emplacement under both conditions, thereby attaining maximum vein thickness. In this study, we emphasize the reactivation propensity of these pre-existing fracture planes under conditions of fluid pressure variation, related to the high and low Pf cycles. Multiple cycles of fluid-induced fracture reactivation make it difficult to quantify the maximum/minimum fluid pressure magnitudes. However, in this study we use the most appropriate fluid pressure magnitudes mathematically feasible for a shallow crustal depth of ∼2.4 km. We determine the changes in the reactivation potential with states of stress for the respective fracture orientations under both high and low Pf conditions. Dependence of fluid pressure variation on the opening angle of the fractures is also monitored. Finally, we comment on the failure mode and deformation behaviour of the fractures within the prevailing stress field inducing volumetric changes at the time of deformation. We find that deformation behaviour is directly related to the dip of the fracture planes.

Introduction: Fractures are a common childhood presentation to the emergency department (ED). While ED providers are aware of treating pain, we are less aware of the functional impact of these fractures. Eighty percent of children with a fracture experience compromise in their daily function. Understanding the functional outcomes of fractures will help optimize discharge instructions for at-home care. The primary objective of our study was to describe caregivers' perspectives on the impact of their child's fracture on: (1) child functioning, (2) caregiver functioning and (3) family life. Methods: We performed a qualitative study interviewing caregivers of children (5 to 11 years) who received care for acute (< 24 hours old), non-operative long bone fractures at a Canadian tertiary care pediatric ED. Audio-recorded, semi-structured telephone interviews were completed 1-2 weeks post-ED visit, until thematic saturation was achieved. Transcripts were read and coded by two researchers concurrent with data collection. We applied content analysis to the interview material, explicating themes to summarize the data utilizing NVivo software. Results: Twenty-five interviews were completed. Most children (23/25) suffered upper extremity fractures and most participants were mothers (21/25). All caregivers reported a change in their child's function. The most commonly affected areas included: sleep, play and activities of daily living (ADL's; ie. dressing, bathing, eating). Children were impacted by pain and related negative emotional responses. All children required additional help from their caregivers to carry out ADL's. Strategies included changing household routines and missing work. Importantly, caregivers described a disrupted family dynamic. Adapting to their injured child's functional deficits and caring for pain and distress took time and attention away from the household's previously well-functioning routine. This burden was felt by all family members. Key concerns from caregivers included pain management, fracture healing/complications, and regression of their child's independence. Conclusion: Function is universally impaired in younger children with fractures. We suggest 5 main points to include in discharge instructions: (1) monitoring pain and providing analgesia, (2) helping children with ADL's, even if previously independent, (3) allotting extra time for morning and bedtime routines, (4) offering safe choices for play and (5) coaching children in positive thinking and problem-solving.

Introduction: Distal radial fractures (DRF) remain the most commonly encountered fracture in the Emergency Department (ED). The initial management of displaced DRFs by Emergency Physicians (EP) poses considerable resource allocation. We wished to determine the adequacy of reduction, both initially and at follow up. This data updates previously presented high level findings. Methods: We performed a mixed-methods study including patients who underwent procedural sedation and manipulation by an EP for a DRF. Radiological images performed at initial assessment, post-reduction, and clinic follow up were reviewed by a panel of orthopedic surgeons and radiologists blinded to outcomes, and assessed for evidence of displacement. Demographic data were pooled from patient records and included in statistical analysis. Results: Seventy patients were included and had follow-up completed. Initial reduction was deemed to be adequate in 37 patients (53%; 95% CI 41.32 to 64.10%). At clinic follow-up assessment, 26 reductions remained adequate; a slippage rate of 30% (95% CI of 17.37 to 45.90). Overall 7 patients (10%; 95% CI 4.65 to 19.51%) required revision of the initial reduction in the operating room. Agreement on adequacy of reduction on post-reduction radiographs between radiologists and orthopedic surgeons was 38.6% (95% CI -38.3 to -7.4, Kappa -0.229). The statistical strength of this agreement is worse than what would be expected by chance alone. There was no association found between age, sex, or of time of initial presentation and final outcomes. Conclusion: Although blinded review by specialists determined only half of initial EP DRF reductions to be radiographically adequate, only 10 percent actually required further intervention. Agreement between specialists on adequacy was poor. The majority of DRFs reduced by EPs do not require further surgical intervention.

Introduction: There is an opioid epidemic which has seen an increased mortality rate of 200% related to opioid use over the past decade. Prescription practices amongst ED physicians may be contributing to this problem. Our objective was to analyze ED physician prescription practices for patients discharged from the ED with acute fractures. Methods: We conducted a health records review of ED patients seen at two campuses of a tertiary care hospital with total annual census of 160,000 visits. We evaluated a consecutive sample of patients with acute fractures (January 1 2016–April 15 2016) seen and discharged by ED physicians. Patients admitted to hospital or discharged by consultant services were excluded. The primary outcome measure was the proportion of patients discharged with an opioid prescription. We collected data using a screening list, review of electronic records, and interobserver agreement for measures. We calculated simple descriptive statistics and estimated 4 months would be required to enroll 250 patients receiving opioid prescriptions. Results: We enrolled 816 patients, with 442 females (54.2%), median CTAS score of 3, and median pain score at triage of 6/10. The most common fractures were wrist/hand (35.2%) and foot excluding ankle (14.8%). An ED pain directive was used at triage for 21.2% and 281 patients (34.4%) received an opioid during ED stay, with tramadol (21.2%) being the most common. Overall, 250 patients (30.6%) were discharged with the following opioid prescriptions and median total dosages: hydromorphone (N = 114, median dosage 23mg, range 1–120mg), tramadol (N = 86, 1000mg, 200–2000mg), oxycodone (N = 33, 100mg, 10–170mg), codeine (N = 20, 600mg, 360–1200mg), and morphine (N = 9, 100mg, 25–200mg). Of patients prescribed hydromorphone, 61 (53.5%) were prescribed > 20mg. Overall, 35 patients (4.3%) had a pain related ED visit <1 month after discharge, of which 14 (40%) received an opioid prescription on initial discharge, and 12 (34.2%) received an opioid prescription upon subsequent discharge. Conclusion: Amongst patients presenting to the ED with acute fractures, the majority were not discharged home with an opioid prescription from ED physicians. Hydromorphone was the most common opioid prescribed, with large variations in total dosage. Despite only a minority of patients receiving opioid prescriptions, there were very few return to ED visits. To limit potential abuse, we recommend standardization of opioid prescribing in the ED, with attention to limiting the total dosage given.

Increased pressure on the poultry industry by animal-rights organisations and environmentally-conscious consumers has led to the rising popularity of cage-free housing system for hens. One of the main dangers of cage-free housing systems is the possibility for laying hens to damage their keels. Keel bone fracture incidence rate ranges up to 85%, and can lead to extensive pain in any bird, and potentially be the cause of the death for a hen in a cage-free environment. It was reported that kneel bone damage observed in flocks housed in non-cage systems was 30 to 95% while in furnished cages it was 15 to 55%. The purpose of this review is to compare the prevalence of the problem found in the three main housing systems (conventional, enriched cage, and cage-free), discuss if such damage could affect the behaviour and production of laying hens, and provide potential solutions for reducing the prevalence of keel bone damage. Keel fractures can negatively affect a hen in its day-to-day life by causing pain and restricting its movements. The prevalence of keel bone damage varies considerably among the studies due to differences in the system design, genetic line, age and method for determining the keel damage, which makes difficult to compare the systems. The genetic selection, adequate nutrition and modifications in the house design have shown to be useful tools in reducing keel bone damage in laying hens.

Multi-packer hydraulic tests and radioactive tracer experiments carried out in boreholes in the Carnmenellis granite have shown that the flow of water through the rock is largely confined to narrow zones separated by zones of very low permeability. Correlation of the hydraulic data with geological data from oriented cores has shown that most of the flow is associated with discrete geological features, including pegmatitic and other veins, and elvan (quartz-feldspar porphyry) dykes, characteristic features of the granite of the area. Joints have also been found to conduct water, particularly in the upper 250 m of the granite. The permeability of the granite has been found not to be simply a function of fracture frequency, long sections of highly fractured rock having no associated flow under test conditions. While flow paths have been found to become less frequent with depth, flow rates do not vary over the depths studied, the highest flow rate recorded at the site being associated with a vein at 637 m. Water-conducting fractures have been found to have certain preferred orientations which vary with depth. A set striking 155°C is particularly well developed in the upper 250 m of the granite. This orientation is significant in that it is parallel to the cross-courses in the nearby mineralized belt with which the younger (Tertiary) mineralization tends to be associated and from which thermal brines issue into several local mines. These fractures are also approximately parallel to the maximum horizontal stress which affects the granite and which appears to be responsible for the selective opening of joints of certain orientations.

We aimed to systematically review available data on the association between vitamin C intake and bone mineral density (BMD), as well as risk of fractures and osteoporosis, and to summarise this information through a meta-analysis. Previous studies on vitamin C intake in relation to BMD and risk of fracture and osteoporosis were selected through searching PubMed, Scopus, ISI Web of Science and Google Scholar databases before February 2017, using MeSH and text words. To pool data, either a fixed-effects model or a random-effects model was used, and for assessing heterogeneity, Cochran’s Q and I2 tests were used. Subgroup analysis was applied to define possible sources of heterogeneity. Greater dietary vitamin C intake was positively associated with BMD at femoral neck (pooled r 0·18; 0·06, 0·30) and lumbar spine (pooled r 0·14; 95 % CI 0·06, 0·22); however, significant between-study heterogeneity was found at femoral neck: I2=87·6 %, Pheterogeneity<0·001. In addition, we found a non-significant association between dietary vitamin C intake and the risk of hip fracture (overall relative risk=0·74; 95 % CI 0·51, 1·08). Significant between-study heterogeneity was found (I2=79·1 %, Pheterogeneity<0·001), and subgroup analysis indicated that study design, sex and age were the main sources of heterogeneity. Greater dietary vitamin C intake was associated with a 33 % lower risk of osteoporosis (overall relative risk=0·67; 95 % CI 0·47, 0·94). Greater dietary vitamin C intake was associated with a lower risk of hip fracture and osteoporosis, as well as higher BMD, at femoral neck and lumbar spine.