Summary Background Hyperglycaemia after acute stroke is a common finding that has been associated with an increased risk of death. We sought to determine whether treatment with ...glucose-potassium-insulin (GKI) infusions to maintain euglycaemia immediately after the acute event reduces death at 90 days. Methods Patients presenting within 24 h of stroke onset and with admission plasma glucose concentration between 6·0–17·0 mmol/L were randomly assigned to receive variable-dose-insulin GKI (intervention) or saline (control) as a continuous intravenous infusion for 24 h. The purpose of GKI infusion was to maintain capillary glucose at 4–7 mmol/L, with no glucose intervention in the control group. The primary outcome was death at 90 days, and the secondary endpoint was avoidance of death or severe disability at 90 days. Additional planned analyses were done to determine any differences in residual disability or neurological and functional recovery. The trial was powered to detect a mortality difference of 6% (sample size 2355), with 83% power, at the 5% two-sided significance level. This study is registered as an International Standard Randomised Controlled Trial (number ISRCTN 31118803) Findings The trial was stopped due to slow enrolment after 933 patients were recruited. For the intention-to-treat data, there was no significant reduction in mortality at 90 days (GKI vs control: odds ratio 1·14, 95% CI 0·86–1·51, p=0·37). There were no significant differences for secondary outcomes. In the GKI group, overall mean plasma glucose and mean systolic blood pressure were significantly lower than in the control group (mean difference in glucose 0·57 mmol/L, p<0·001; mean difference in blood pressure 9·0 mmHg, p<0·0001). Interpretation GKI infusions significantly reduced plasma glucose concentrations and blood pressure. Treatment within the trial protocol was not associated with significant clinical benefit, although the study was underpowered and alternative results cannot be excluded.
There are no evidence-based treatments for severe and enduring anorexia nervosa (SE-AN). This study evaluated the relative efficacy of cognitive behavioral therapy (CBT-AN) and specialist supportive ...clinical management (SSCM) for adults with SE-AN.
Sixty-three participants with a diagnosis of AN, who had at least a 7-year illness history, were treated in a multi-site randomized controlled trial (RCT). During 30 out-patient visits spread over 8 months, they received either CBT-AN or SSCM, both modified for SE-AN. Participants were assessed at baseline, end of treatment (EOT), and at 6- and 12-month post-treatment follow-ups. The main outcome measures were quality of life, mood disorder symptoms and social adjustment. Weight, eating disorder (ED) psychopathology, motivation for change and health-care burden were secondary outcomes.
Thirty-one participants were randomized to CBT-AN and 32 to SSCM with a retention rate of 85% achieved at the end of the study. At EOT and follow-up, both groups showed significant improvement. There were no differences between treatment groups at EOT. At the 6-month follow-up, CBT-AN participants had higher scores on the Weissman Social Adjustment Scale (WSAS; p = 0.038) and at 12 months they had lower Eating Disorder Examination (EDE) global scores (p = 0.004) and higher readiness for recovery (p = 0.013) compared to SSCM.
Patients with SE-AN can make meaningful improvements with both therapies. Both treatments were acceptable and high retention rates at follow-up were achieved. Between-group differences at follow-up were consistent with the nature of the treatments given.
The translocation of genetic material from the viral capsid to the cell is an essential part of the viral infection process. Whether the energetics of this process is driven by the energy stored ...within the confined nucleic acid or cellular processes pull the genome into the cell has been the subject of discussion. However, in vitro studies of genome ejection have been limited to a few head-tailed bacteriophages with a double-stranded DNA genome. Here we describe a DNA release system that operates in an archaeal virus. This virus infects an archaeon Haloarcula hispanica that was isolated from a hypersaline environment. The DNA-ejection velocity of His1, determined by single-molecule experiments, is comparable to that of bacterial viruses. We found that the ejection process is modulated by the external osmotic pressure (polyethylene glycol (PEG)) and by increased ion (Mg2+ and Na+) concentration. The observed ejection was unidirectional, randomly paused, and incomplete, which suggests that cellular processes are required to complete the DNA transfer.
Pollen analysis of a core in Princess Vlei in the Fynbos Biome near Cape Town gives a 4150 year record of vegetation and climate changes followed by disturbance by colonial settlers since c. 300 ...years ago. Their impact replaced climate as a major factor in changing the vegetation. The chronology is based on eight radiocarbon dates. Pollen types such as Restionaceae, Ericaceae, and Proteaceae reflect changes in fynbos. Pollen indicators at the bottom of the core suggest drier conditions followed by an increase in Morella, Cyperaceae and Carpacoce pollen, which might indicate moist conditions c. 3400–2600 cal. yr BP. Drier conditions prevail c. 2600–1900 cal. yr BP. Apparent light disturbance after c. 2000 cal. yr BP might be attributed to Khoi herders. Deeper water and damp surroundings are indicated c. 1900–1000 cal. yr BP. The top of the core shows an increase of Poaceae while Restionaceae decrease with anthropogenic disturbance, including the introduction of neophytes such as Pinus (c. 300 years ago) and Zea mays. Charcoal percentages point to intense fires after the arrival of the Europeans. Water between 105 and 75 cm indicates the development of a floating mat resulting from changes in the hydrological system possibly connected to disturbances by settlers.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Paranthropus boisei was first described in 1959 based on fossils from the Olduvai Gorge and now includes many fossils from Ethiopia to Malawi. Knowledge about its postcranial anatomy has remained ...elusive because, until recently, no postcranial remains could be reliably attributed to this taxon. Here, we report the first associated hand and upper limb skeleton (KNM-ER 47000) of P. boisei from 1.51 to 1.53 Ma sediments at Ileret, Kenya. While the fossils show a combination of primitive and derived traits, the overall anatomy is characterized by primitive traits that resemble those found in Australopithecus, including an oblique scapular spine, relatively long and curved ulna, lack of third metacarpal styloid process, gracile thumb metacarpal, and curved manual phalanges. Very thick cortical bone throughout the upper limb shows that P. boisei had great upper limb strength, supporting hypotheses that this species spent time climbing trees, although probably to a lesser extent than earlier australopiths. Hand anatomy shows that P. boisei, like earlier australopiths, was capable of the manual dexterity needed to create and use stone tools, but lacked the robust thumb of Homo erectus, which arguably reflects adaptations to the intensification of precision grips and tool use. KNM-ER 47000 provides conclusive evidence that early Pleistocene hominins diverged in postcranial and craniodental anatomy, supporting hypotheses of competitive displacement among these contemporaneous hominins.
Archaeological excavations at the DK site in the eastern Olduvai Basin, Tanzania, age-bracketed between ∼1.88 Ma (Bed I Basalt) and ∼1.85 Ma (Tuff IB), record the oldest lahar inundation, ...modification, and preservation of a hominin “occupation” site yet identified. Our landscape approach reconstructs environments and processes at high resolution to explain the distribution and final preservation of archaeological materials at the DK site, where an early hominin (likely Homo habilis) assemblage of stone tools and bones, found close to hominin specimens OH24 and OH56, developed on an uneven heterogeneous surface that was rapidly inundated by a lahar and buried to a depth of 0.4–1.2 m (originally ∼1.0–2.4 m pre-compaction). The incoming intermediate to high viscosity mudflow selectively modified the original accumulation of “occupation debris,” so that it is no longer confined to the original surface. A dispersive debris “halo” was identified within the lahar deposit: debris is densest immediately above the site, but tails off until not present >150 m laterally. Voorhies indices and metrics derived from limb bones are used to define this dispersive halo spatially and might indicate a possible second assemblage to the east that is now eroded away. Based upon our new data and prior descriptions, two possibilities for the OH24 skull are suggested: it was either entrained by the mudflow from the DK surface and floated due to lower density toward its top, or it was deposited upon the solid top surface after its consolidation. Matrix adhering to material found in association with the parietals indicates that OH56 at least was relocated by the mudflow.
Fossil wood is described from the Late Permian Middleton Formation, Adelaide Subgroup, Beaufort Group of the Karoo Supergroup in the Easter Cape Province, South Africa. The wood consists of in situ ...tree trunks up to 9 m long, partially enclosed in fine-grained sandstone surrounded by argillaceous mudstone and siltstone. The strata are poorly exposed due to the eroded and denuded land surface. All are lying horizontally and none are in upright growth positions. Comparisons of the study site lithologies with known surrounding Middleton Formation lithostratigraphy supports the interpretation that the paleoenvironment responsible for the transport and deposition of the fossil wood was fluvial, with sandstone representing in-channel deposits and the mudstone-siltstone flood plain sequences where the trees were originally located before being uprooted and transported within the channels. Thin sections of twenty-nine wood samples revealed the presence of four existing taxa, Agathoxylon africanum, Agathoxylon karooensis, Australoxylon natalense and Australoxylon teixeirae. Growth rings of all the samples show a wide range of ring width from 1 mm to 11 mm, indicating growth under suitable climatic regimes with adequate water supply interspersed by very wet and warm periods. Crushed earlywood, s-shaped cell walls and torn cell walls suggest felling of trees during storm and/or flood events followed by sedimentary transport in paleochannels prior deposition within the channel sands.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Although the lack of Late Quaternary pollen, phytolith and charcoal records for southern Africa has been bemoaned by many, there are a surprising number of publications by a relatively small group of ...researchers. Previous comprehensive reviews covered the research up to 2016 and 2018 so this paper only considers a selection of more recent studies, with a focus on the three types of botanical remains (pollen, phytoliths, micro- and macro-charcoal). The newer works use the traditional approaches of identification of vegetation and the use of modern analogues to reconstruct past climate and relate the results to other works and proxies. Sibudu Cave, with its long record and multi-proxy record is presented as a case study because the vegetation, climate and human behaviour are well integrated together. A more recent and general trend to provide emphasis on identifying climate driving forces and re-interpretation of data have a tendency to obscure the original sound research.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The Olduvai Gorge palaeoanthropological site, in northern Tanzania, encompasses about twomillionyears of earth history. The sedimentary facies of Palaeolake Olduvai have been used to reconstruct lake ...transgressions and regressions, up to total drying out, interpreted to reflect wet/dry climate cycles. Although multidisciplinary research has been conducted during the past decades to reconstruct the palaeoenvironments and palaeolandscapes of the Gorge, very few focused on the DK site located about 2km farther east in the Gorge. We present here a vegetation study at DK for Bed I, the oldest stratum, based upon the phytolith and diatom recovery of the basalt lava to Tuff IB stratigraphic interval. These results have been analysed in relation to the different facies in which they occur: sandy diamictite, sandstone, sandy waxy claystone, waxy claystone, and sandy diatomite. The phytolith results from diamictite samples indicate a similar vegetation composition during these more arid periods. Conversely, waxy claystone and sandy waxy claystone samples show a higher diversity in the vegetation composition. The diatoms were indicative of a fresh water pool environment. Thus the DK site would have provided plant foods for hominins, such as fruits from trees and shrubs and starch-rich rhizomes and tubers from sedges and reeds. Overall, the results at DK site present a different vegetation landscape in comparison to previously published phytolith results from other Olduvai stratigraphic levels and regions.
•We present vegetation reconstruction of DK site, before the deposition of Tuff IB.•Results show shifts in vegetation relating to differing depositional facies and climatic shifts.•Phytoliths show diverse vegetation, with grasses, probably sedges and trees/shrubs.•Diatoms indicate the presence of a fresh water pool.•DK showed abundance of grasses, potentially edible plants and available fresh water.
The homoxylous fossil woods occurring in the Gondwanan continents of South America, Australia, Africa, India and Antarctica during the Jurassic and Early Cretaceous period are considered here. ...Original descriptions of the genera and wherever possible, the type material, have been consulted. Applying the rules of the International Code of Botanical Nomenclature, the generic names of the homoxylous woods have been revised from a nomenclatural point of view. According to this review, out of 31 generic names used for woods from the given time interval and area, 6 are illegitimate later nomenclatural synonyms, 1 is a later homonym, and 5 can be considered as taxonomical synonyms. Moreover, 9 genera have been used erroneously. We propose one new generic name (
Protaxodioxylon n. gen.) and elsewhere we will propose for conservation, with a conserved type one of the illegitimate names and one of the taxonomic synonyms. As a result, we consider that there are only eighteen generic names correctly quoted for the Jurassic–Early Cretaceous of Gondwana, and we provide a taxonomic key for the corresponding genera. This revision is the first step in systematically comparing northern and southern hemisphere woods.
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