Conodont biostratigraphy of the Crawford Group, Southern Uplands, Scotland

Extensive new conodont collections from the Crawford Group, the oldest succession in the Southern Uplands of Scotland, support the previously documented biostratigraphical ages for the included formations. The Raven Gill Formation is lower Whitlandian, Arenig (comparable in age to the Dounans Limestone in the Highland Border Complex) and the Kirkton Formation is latest Llandeilian-Aurelucian, Llanvirn to Caradoc in age. It is concluded that there is a significant stratigraphical gap within the Crawford Group. The restricted and probably fault-bounded nature of the Raven Gill outcrops suggests that these may represent olistoliths within a mélange of Llandeilian-Aurelucian age. The chert-bearing succession of the Northern Belt of the Southern Uplands thus represents the juxtaposed sedimentary records of two entirely separate basins – the oldest pre-dates the Grampian assembly of the Laurentian margin, and the younger, the Northern Belt Basin sensu stricto, entirely post-dates this event

Investigating the prevalence and causes of prescribing errors in general practice : the PRACtICe Study

Report prepared by the University of Nottingham, University of Reading and University of Hertfordshir

The Changing Epidemiology of Malaria in Ifakara Town, Southern Tanzania.

Between 1995 and 2000 there were marked changes in the epidemiology of malaria in Ifakara, southern Tanzania. We documented these changes using parasitological and clinical data from a series of community- and hospital-based studies involving children up to the age of 5 years. There was a right shift and lowering in the age-specific parasite prevalence in the community-based cohort studies. The incidence of clinical malaria in placebo-receiving infants in additional study cohorts dropped from 0.8 in 1995 to 0.43 episodes per infant per year in 2000, an incidence rate ratio of 0.53 (95% confidence interval: 0.404, 0.70, P<0.0001). At the same time, there was an increase in the total number of malaria admissions and a marked right shift in the age pattern of these admissions (median age in 1995 1.55 years vs. 2.33 in 2000, P<0.0001). However, the burden of malaria deaths remained in infants. We discuss how these dramatic changes in the epidemiology of malaria may have arisen from the use of currently available malaria control tools. Caution is required in the interpretation of hospital-based data as it is likely to underestimate the impact of anaemia on mortality in the community, where most paediatric deaths occur. Even in low/moderate malaria transmission settings, where older children suffer most malaria episodes, targeting effective malaria control at infants may produce important reductions in infant mortality caused by malaria

Prevalence and treatment implications of ICD-11 complex PTSD in Australian treatment-seeking current and ex-serving military members

Background: Despite growing support for the distinction between posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as separate diagnoses within the ICD-11 psychiatric taxonomy, the prevalence and treatment implications of CPTSD among current and ex-serving military members have not been established. Objective: The study aims were to a) establish the prevalence of provisional ICD-11 CPTSD diagnosis relative to PTSD in an Australian sample of treatment-seeking current and ex-serving military members, and b) examine the implications of CPTSD diagnosis for intake profile and treatment response. Methods: The study analysed data collected routinely from Australian-accredited treatment programmes for military-related PTSD. Participants were 480 current and ex-serving military members in this programmes who received a provisional ICD-11 diagnosis of PTSD or CPTSD at intake using proxy measures. Measures of PTSD symptoms, disturbances in self-organisation, psychological distress, mental health and social relationships were considered at treatment intake, discharge, and 3-month follow-up. Results: Among participants with a provisional ICD-11 diagnosis, 78.2% were classified as having CPTSD, while 21.8% were classified as having PTSD. When compared to ICD-11 PTSD, participants with CPTSD reported greater symptom severity and psychological distress at intake, and lower scores on relationship and mental health dimensions of the quality of life measure. These relative differences persisted at each post-treatment assessment. Decreases in PTSD symptoms between intake and discharge were similar across PTSD (dRM = −0.81) and CPTSD (dRM = −0.76) groups, and there were no significant post-treatment differences between groups when controlling for initial scores. Conclusions: CPTSD is common among treatment-seeking current and ex-serving military members, and is associated with initially higher levels of psychiatric severity, which persist over time. Participants with CPTSD were equally responsive to PTSD treatment; however, the tendency for those with CPTSD to remain highly symptomatic post-treatment suggests additional treatment components should be considered

Development and implementation of a COVID-19 near real time traffic light system in an acute hospital setting

Common causes of death in COVID-19 due to SARS-CoV-2 include thromboembolic disease, cytokine storm and adult respiratory distress syndrome (ARDS). Our aim was to develop a system for early detection of disease pattern in the emergency department (ED) that would enhance opportunities for personalised accelerated care to prevent disease progression. A single Trust’s COVID-19 response control command was established, and a reporting team with bioinformaticians was deployed to develop a real-time traffic light system to support clinical and operational teams. An attempt was made to identify predictive elements for thromboembolism, cytokine storm and ARDS based on physiological measurements and blood tests, and to communicate to clinicians managing the patient, initially via single consultants. The input variables were age, sex, and first recorded blood pressure, respiratory rate, temperature, heart rate, indices of oxygenation and C-reactive protein. Early admissions were used to refine the predictors used in the traffic lights. Of 923 consecutive patients who tested COVID-19 positive, 592 (64%) flagged at risk for thromboembolism, 241/923 (26%) for cytokine storm and 361/923 (39%) for ARDS. Thromboembolism and cytokine storm flags were met in the ED for 342 (37.1%) patients. Of the 318 (34.5%) patients receiving thromboembolism flags, 49 (5.3% of all patients) were for suspected thromboembolism, 103 (11.1%) were high-risk and 166 (18.0%) were medium-risk. Of the 89 (9.6%) who received a cytokine storm flag from the ED, 18 (2.0% of all patients) were for suspected cytokine storm, 13 (1.4%) were high-risk and 58 (6.3%) were medium-risk. Males were more likely to receive a specific traffic light flag. In conclusion, ED predictors were used to identify high proportions of COVID-19 admissions at risk of clinical deterioration due to severity of disease, enabling accelerated care targeted to those more likely to benefit. Larger prospective studies are encouraged

Constraining the long-term evolution of the slip rate for a major extensional fault system in the central Aegean, Greece, using thermochronology

The brittle/ductile transition is a major rheologic boundary in the crust yet little is known about how or if rates of tectonic processes are influenced by this boundary. In this study we examine the slip history of the large-scale Naxos/Paros extensional fault system (NPEFS), Cyclades, Greece, by comparing published slip rates for the ductile crust with new thermochronological constraints on slip rates in the brittle regime. Based on apatite and zircon fission-track (AFT and ZFT) and (U–Th)/He dating we observe variable slip rates across the brittle/ductile transition on Naxos. ZFT and AFT ages range from 11.8 ± 0.8 to 9.7 ± 0.8 Ma and 11.2 ± 1.6 to 8.2 ± 1.2 Ma and (U–Th)/He zircon and apatite ages are between 10.4 ± 0.4 to 9.2 ± 0.3 Ma and 10.7 ± 1.0 to 8.9 ± 0.6 Ma, respectively. On Paros, ZFT and AFT ages range from 13.1 ± 1.4 Ma to 11.1 ± 1.0 Ma and 12.7 ± 2.8 Ma to 10.5 ± 2.0 Ma while the (U–Th)/He zircon ages are slightly younger between 8.3 ± 0.4 Ma and 9.8 ± 0.3 Ma. All ages consistently decrease northwards in the direction of hanging wall transport. Most of our new thermochronological results and associated thermal modeling more strongly support the scenario of an identical fault dip and a constant or slightly accelerating slip rate of 6–8 km Myr− 1 on the NPEFS across the brittle/ductile transition. Even the intrusion of a large granodiorite body into the narrowing fault zone at 12 Ma on Naxos does not seem to have affected the thermal structure of the area in a way that would significantly disturb the slip rate. The data also show that the NPEFS accomplished a minimum total offset of 50 km between 16 and 8 Ma

Debris disks as signposts of terrestrial planet formation. II Dependence of exoplanet architectures on giant planet and disk properties

We present models for the formation of terrestrial planets, and the collisional evolution of debris disks, in planetary systems that contain multiple unstable gas giants. We previously showed that the dynamics of the giant planets introduces a correlation between the presence of terrestrial planets and debris disks. Here we present new simulations that show that this connection is qualitatively robust to changes in: the mass distribution of the giant planets, the width and mass distribution of the outer planetesimal disk, and the presence of gas in the disk. We discuss how variations in these parameters affect the evolution. Systems with equal-mass giant planets undergo the most violent instabilities, and these destroy both terrestrial planets and the outer planetesimal disks that produce debris disks. In contrast, systems with low-mass giant planets efficiently produce both terrestrial planets and debris disks. A large fraction of systems with low-mass outermost giant planets have stable gaps between these planets that are frequently populated by planetesimals. Planetesimal belts between outer giant planets may affect debris disk SEDs. If Earth-mass seeds are present in outer planetesimal disks, the disks radially spread to colder temperatures. We argue that this may explain the very low frequency of > 1 Gyr-old solar-type stars with observed 24 micron excesses. Among the (limited) set of configurations explored, the best candidates for hosting terrestrial planets at ~1 AU are stars older than 0.1-1 Gyr with bright debris disks at 70 micron but with no currently-known giant planets. These systems combine evidence for rocky building blocks, with giant planet properties least likely to undergo destructive dynamical evolution. We predict an anti-correlation between debris disks and eccentric giant planets, and a positive correlation between debris disks and terrestrial planets.Comment: Astronomy and Astrophysics, in press. Movies from simulations are at http://www.obs.u-bordeaux1.fr/e3arths/raymond/movies_debris.htm

A Helicity-Based Method to Infer the CME Magnetic Field Magnitude in Sun and Geospace: Generalization and Extension to Sun-Like and M-Dwarf Stars and Implications for Exoplanet Habitability

Patsourakos et al. (Astrophys. J. 817, 14, 2016) and Patsourakos and Georgoulis (Astron. Astrophys. 595, A121, 2016) introduced a method to infer the axial magnetic field in flux-rope coronal mass ejections (CMEs) in the solar corona and farther away in the interplanetary medium. The method, based on the conservation principle of magnetic helicity, uses the relative magnetic helicity of the solar source region as input estimates, along with the radius and length of the corresponding CME flux rope. The method was initially applied to cylindrical force-free flux ropes, with encouraging results. We hereby extend our framework along two distinct lines. First, we generalize our formalism to several possible flux-rope configurations (linear and nonlinear force-free, non-force-free, spheromak, and torus) to investigate the dependence of the resulting CME axial magnetic field on input parameters and the employed flux-rope configuration. Second, we generalize our framework to both Sun-like and active M-dwarf stars hosting superflares. In a qualitative sense, we find that Earth may not experience severe atmosphere-eroding magnetospheric compression even for eruptive solar superflares with energies ~ 10^4 times higher than those of the largest Geostationary Operational Environmental Satellite (GOES) X-class flares currently observed. In addition, the two recently discovered exoplanets with the highest Earth-similarity index, Kepler 438b and Proxima b, seem to lie in the prohibitive zone of atmospheric erosion due to interplanetary CMEs (ICMEs), except when they possess planetary magnetic fields that are much higher than that of Earth.Comment: http://adsabs.harvard.edu/abs/2017SoPh..292...89

A randomized trial of bevacizumab for newly diagnosed glioblastoma.

BACKGROUND: Concurrent treatment with temozolomide and radiotherapy followed by maintenance temozolomide is the standard of care for patients with newly diagnosed glioblastoma. Bevacizumab, a humanized monoclonal antibody against vascular endothelial growth factor A, is currently approved for recurrent glioblastoma. Whether the addition of bevacizumab would improve survival among patients with newly diagnosed glioblastoma is not known. METHODS: In this randomized, double-blind, placebo-controlled trial, we treated adults who had centrally confirmed glioblastoma with radiotherapy (60 Gy) and daily temozolomide. Treatment with bevacizumab or placebo began during week 4 of radiotherapy and was continued for up to 12 cycles of maintenance chemotherapy. At disease progression, the assigned treatment was revealed, and bevacizumab therapy could be initiated or continued. The trial was designed to detect a 25% reduction in the risk of death and a 30% reduction in the risk of progression or death, the two coprimary end points, with the addition of bevacizumab. RESULTS: A total of 978 patients were registered, and 637 underwent randomization. There was no significant difference in the duration of overall survival between the bevacizumab group and the placebo group (median, 15.7 and 16.1 months, respectively; hazard ratio for death in the bevacizumab group, 1.13). Progression-free survival was longer in the bevacizumab group (10.7 months vs. 7.3 months; hazard ratio for progression or death, 0.79). There were modest increases in rates of hypertension, thromboembolic events, intestinal perforation, and neutropenia in the bevacizumab group. Over time, an increased symptom burden, a worse quality of life, and a decline in neurocognitive function were more frequent in the bevacizumab group. CONCLUSIONS: First-line use of bevacizumab did not improve overall survival in patients with newly diagnosed glioblastoma. Progression-free survival was prolonged but did not reach the prespecified improvement target. (Funded by the National Cancer Institute; ClinicalTrials.gov number, NCT00884741.)

Elephant Moraine 96029, a very mildly aqueously altered and heated CM carbonaceous chondrite: Implications for the drivers of parent body processing

Elephant Moraine (EET) 96029 is a CMcarbonaceous chondrite regolith breccia with evidence for unusually mild aqueous alteration, a later phase of heating and terrestrial weathering. The presence of phyllosilicates and carbonates within chondrules and the fine-grained matrix indicates that this meteorite was aqueously altered in its parent body. Features showing that water-mediated processing was arrested at a very early stage include a matrix with a low magnesium/iron ratio, chondrules whose mesostasis contains glass and/or quench crystallites, and a gehlenite-bearing calcium- and aluminium-rich inclusion. EET 96029 is also rich in Fe,Ni metal relative to other CM chondrites, and more was present prior to its partial replacement by goethite during Antarctic weathering. In combination, these properties indicate that EET 96029 is one of the least aqueously altered CMs yet described (CM2.7) and so provides new insights into the original composition of its parent body. Following aqueous alteration, and whilst still in the parent body regolith, the meteorite was heated to ~400–600 °C by impacts or solar radiation. Heating led to the amorphisation and dehydroxylation of serpentine, replacement of tochilinite by magnetite, loss of sulphur from the matrix, and modification to the structure of organic matter that includes organic nanoglobules. Significant differences between samples in oxygen isotope compositions, and water/hydroxyl contents, suggests that the meteorite contains lithologies that have undergone different intensities of heating. EET 96029 may be more representative of the true nature of parent body regoliths than many other CM meteorites, and as such can help interpret results from the forthcoming missions to study and return samples from C-complex asteroids