A systematic study of the corrosion layers on excavated coins from varying historical periods

This research presents the results of a scientific study of archaeological copper and silver coins from three collections belonging to Roman, Medieval and Modern periods discovered in the UK. The morphology of the corrosion products was studied using Optical Microscopy (OM) and Scanning Electron Microscopy (SEM) to understand the formation of corrosion. Morphologically it was found that the surface corrosion of both metals was similar, a uniform layer of corrosion was identified with a general attack of the surface. Both copper and silver coins demonstrated a distinct layering with a metal core followed by an initial oxide layer and an external layer bearing soil markers and secondary corrosion products where present. X-ray diffraction, X-ray fluorescence and SEM-EDS were employed to characterise the corrosion products and determine the basic elemental composition of the corrosion layers. The study successfully identified the primary corrosion products present on the copper coins as copper, cuprite and quartz with the inclusion of other compounds such as kaolinite, cassiterite and malachite across some samples. Silver and Chlorargyrite were identified as the main components of all silver surfaces in the study with hexagonal silver oxide present in certain samples. The elemental composition, pH and texture of soil samples from the areas of excavation in Brough, Nottinghamshire, England were studied alongside the excavated coins and the direct influence the burial environment had on the corrosion process discussed. A novel technique in the field of corrosion studies on artefacts, Medium Energy Ion Scattering, was developed with the intention of attaining information about the structure and composition of the samples surface; preliminary results could only provide compositional information already attainable using existing techniques. This study provides valuable information to both scientists and conservators to maintain and protect archaeological objects; as well as providing significant information for corrosion science

Channel incision into a submarine landslide on a Carboniferous basin margin, San Juan, Argentina: Evidence for the role of knickpoints

Emplacement of submarine landslides, or mass-transport deposits, can radically reshape the physiography of continental margins, and strongly influence subsequent sedimentary processes and dispersal patterns. Typically, progressive healing of the complicated relief generated by the submarine landslide occurs prior to progradation of sedimentary systems. However, subsurface and seabed examples show that submarine channels can incise directly into submarine landslides. Here, the evolution of a unique exhumed example of two adjacent, and partially contemporaneous, submarine channel-fills is documented. The channels show deep incision (>75 m), and steep lateral margins (up to 70°), cut into a >200 m thick submarine landslide. The stepped basal erosion surface, and multiple terrace surfaces, are mantled by clasts (gravels to cobbles) reflecting periods of bedload-derived sedimentation, punctuated by phases of downcutting and sediment bypass. The formation of multiple terrace surfaces in a low aspect ratio confinement is consistent with the episodic migration of knickpoints during entrenchment on the dip slope of the underlying submarine landslide. Overlying sandstone-rich channel-fills mark a change to aggradation. Laterally stacked channel bodies coincide with steps in the original large-scale erosion surface, recording widening of the conduit; this is followed by tabular, highly aggradational fill. The upper fill, above a younger erosional surface, shows an abrupt change to partially confined tabular sandstones with normally graded caps, interpreted as lobe fringe deposits, which formed due to down-dip confinement, followed by prograding lobe deposits. Overlying this, an up-dip avulsion induced lobe switching and back-stepping, and subsequent failure of a sandstone body up-dip led to emplacement of a sandstone-rich submarine landslide within the conduit. Collectively, this outcrop represents episodic knickpoint-generated incision, and later infill, of a slope adjusting to equilibrium. The depositional signature of knickpoints is very different from existing models, but is probably reflective of other highly erosional settings undergoing large-scale slope adjustment.Fil: Allen, Charlotte. University of Leeds; Reino UnidoFil: Gomis Cartesio, Luz E.. No especifíca;Fil: Hodgson, David M.. University of Leeds; Reino UnidoFil: Peakall, Jeff. University of Leeds; Reino UnidoFil: Milana, Juan Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan. Centro de Investigaciones de la Geosfera y Biosfera. Universidad Nacional de San Juan. Facultad de Ciencias Exactas Físicas y Naturales. Centro de Investigaciones de la Geosfera y Biosfera; Argentin

Global consumption patterns of combination hypertension medication: an analysis of pharmaceutical sales data from 2010–2021

Hypertension is the most significant risk factor for cardiovascular disease and mortality worldwide, affecting 1.3 billion adults. Global disparities in hypertension control are widening with low- and middle-income countries (LMIC) having the fastest growing rates of hypertension and low rates of control. Treatment for hypertension can be challenging, with multiple drug classes and dosing schedules. Combination antihypertensives have been suggested as a solution for their efficacy and potential to improve adherence. Global consumption of combination and non-combination antihypertensives across 75 countries and 2 regions from 2010 to 2021 was estimated using the IQVIA MIDAS database on pharmaceutical sales. Consumption rates were standardized using Standard Units (SUs) and analysed by high-income (HIC), upper-middle income (UMIC), and LMIC income classification. Global median consumption rate of all antihypertensives per 1000 inhabitants per day increased from 184.78 SUs in 2010 to 325.6 SUs in 2021, with HICs consistently having the highest rates. Median consumption rates of combination and non-combination antihypertensives increased across all country income groups but combination drugs were consumed at a lower rate and proportion. LMICs consumed a higher percentage of combination antihypertensives relative to non-combination (45.5%) than UMICs (24.3%) and HICs (24.4%) in 2021. While combination antihypertensives may be preferred for their potential for increased adherence and effectiveness, their global uptake is inconsistent. HICs consume less combination medication relative to non-combination, despite higher overall consumption rates of antihypertensives. LMICs show increasing use of combination medications, indicating a shift towards their use

Repositioning postnatal care in a high HIV environment: Swaziland

This Horizons report from the Swaziland Ministry of Health and Social Welfare discusses findings from an intervention which aimed to reposition postnatal care within the context of a high HIV prevalence environment. The objectives were to determine if changes to the sexual and reproductive health guidelines on postnatal care would result in the timely and quality provision of key components of essential maternal and newborn care in the postnatal period, increase utilization of postnatal care services among all postpartum women, and improve the care and follow up of HIV-positive postpartum women and their infants. The study confirms that the introduction of an improved postnatal package with revised timing and content provides key components of maternal, newborn, and HIV care, and increases the utilization of services among postpartum women and their infants

Human settlement of East Polynesia earlier, incremental, and coincident with prolonged South Pacific drought

The timing of human colonization of East Polynesia, a vast area lying between Hawai‘i, Rapa Nui, and New Zealand, is much debated and the underlying causes of this great migration have been enigmatic. Our study generates evidence for human dispersal into eastern Polynesia from islands to the west from around AD 900 and contemporaneous paleoclimate data from the likely source region. Lake cores from Atiu, Southern Cook Islands (SCIs) register evidence of pig and/or human occupation on a virgin landscape at this time, followed by changes in lake carbon around AD 1000 and significant anthropogenic disturbance from c. AD 1100. The broader paleoclimate context of these early voyages of exploration are derived from the Atiu lake core and complemented by additional lake cores from Samoa (directly west) and Vanuatu (southwest) and published hydroclimate proxies from the Society Islands (northeast) and Kiribati (north). Algal lipid and leaf wax biomarkers allow for comparisons of changing hydroclimate conditions across the region before, during, and after human arrival in the SCIs. The evidence indicates a prolonged drought in the likely western source region for these colonists, lasting c. 200 to 400 y, contemporaneous with the phasing of human dispersal into the Pacific. We propose that drying climate, coupled with documented social pressures and societal developments, instigated initial eastward exploration, resulting in SCI landfall(s) and return voyaging, with colonization a century or two later. This incremental settlement process likely involved the accumulation of critical maritime knowledge over several generations

Assessing the efficacy, safety and utility of closed-loop insulin delivery compared with sensor-augmented pump therapy in very young children with type 1 diabetes (KidsAP02 study): an open-label, multicentre, multinational, randomised cross-over study protocol

Introduction: Diabetes management in very young children remains challenging. Glycaemic targets are achieved at the expense of high parental diabetes management burden and frequent hypoglycaemia, impacting quality of life for the whole family. Our objective is to assess whether automated insulin delivery can improve glycaemic control and alleviate the burden of diabetes management in this particular age group. Methods and analysis: The study adopts an open-label, multinational, multicentre, randomised, crossover design and aims to randomise 72 children aged 1-7 years with type 1 diabetes on insulin pump therapy. Following screening, participants will receive training on study insulin pump and study continuous glucose monitoring devices. Participants will be randomised to 16-week use of the hybrid closed-loop system (intervention period) or to 16-week use of sensor-augmented pump therapy (control period) with 1-4 weeks washout period before crossing over to the other arm. The order of the two study periods will be random. The primary endpoint is the between-group difference in time spent in the target glucose range from 3.9 to 10.0 mmol/L based on sensor glucose readings during the 16-week study periods. Analyses will be conducted on an intention-to-treat basis. Key secondary endpoints are between group differences in time spent above and below target glucose range, glycated haemoglobin and average sensor glucose. Participants' and caregivers' experiences will be evaluated using questionnaires and qualitative interviews, and sleep quality will be assessed. A health economic analysis will be performed. Ethics and dissemination: Ethics approval has been obtained from Cambridge East Research Ethics Committee (UK), Ethics Committees of the University of Innsbruck, the University of Vienna and the University of Graz (Austria), Ethics Committee of the Medical Faculty of the University of Leipzig (Germany) and Comité National d'Ethique de Recherche (Luxembourg). The results will be disseminated by peer-reviewed publications and conference presentations

Assessing the efficacy, safety and utility of 6-month day-and-night automated closed-loop insulin delivery under free-living conditions compared with insulin pump therapy in children and adolescents with type 1 diabetes: an open-label, multicentre, multinational, single-period, randomised, parallel group study protocol.

INTRODUCTION: Closed-loop systems titrate insulin based on sensor glucose levels, providing novel means to reduce the risk of hypoglycaemia while improving glycaemic control. We will assess effectiveness of 6-month day-and-night closed-loop insulin delivery compared with usual care (conventional or sensor-augmented pump therapy) in children and adolescents with type 1 diabetes. METHODS AND ANALYSIS: The trial adopts an open-label, multicentre, multinational (UK and USA), randomised, single-period, parallel design. Participants (n=130) are children and adolescents (aged ≥6 and 16.7 mmol/L (300 mg/dL), area under the curve of glucose >10.0 mmol/L (180 mg/dL), total, basal and bolus insulin dose, body mass index z-score and blood pressure. Cognitive, emotional and behavioural characteristics of participants and caregivers and their responses to the closed-loop and clinical trial will be assessed. An incremental cost-effectiveness ratio for closed-loop will be estimated. ETHICS AND DISSEMINATION: Cambridge South Research Ethics Committee and Jaeb Center for Health Research Institutional Review Office approved the study. The findings will be disseminated by peer-review publications and conference presentations. TRIAL REGISTRATION NUMBER: NCT02925299; Pre-results