Garden of the plagues

Includes bibliography.In the month before the outward fleet arrived there came into the bay a giant whale. There it lay, its dark bulk floating just off the shore, watching. The people watched it back. From the bastions of the castle the soldiers trained their guns upon it. All were struck silent by the presence of this great beast; all felt the eye of the devil upon them. So many sins were recalled then, the prayers rose like smoke above the Valley hamlet

Nutritional supplementation for type 2 diabetes: a systematic review

The role of nutritional supplementation is of increasing interest with regard to ocular disease. Randomised controlled trials have demonstrated the effectiveness of supplementation for age-related macular degeneration, and formulations are now being developed for use by people with diabetes and diabetic retinopathy. The aim of this review was to synthesise the evidence for use of nutritional supplementation in type 2 diabetes. MEDLINE and EMBASE databases were searched using a systematic approach. Only double-masked randomised controlled trials were selected. A total of 50 trials were identified as suitable for inclusion. The potential role of alpha-lipoic acid, chromium, folic acid, isoflavones, magnesium, Pycnogenol®, selenium, vitamin C, vitamin E, and zinc in the treatment of type 2 diabetes is discussed. The review of trials identifies positive effects of these nutrients on various outcome measures relating to insulin resistance and cardiovascular factors. Chromium was the most studied supplement, accounting for 16 of the 50 trials. A majority of the trials found a positive effect of chromium on fasting plasma glucose. Isoflavones were found to have a positive effect on insulin resistance and cardiovascular outcome measures, but only when combined with soy proteins. Vitamin E is reported to reduce oxidative stress at levels of 200 mg day-1 or more

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Radiation History of Giant Cluster Particle U2-20GCA, a Probable Cometary IDP

Spallation Ne in the giant U2-20GCA cluster IDP suggests exposure to radiation near the early Sun. Mineral chemistry links it to Comet Wild 2 coma grains

Helium and Neon in Carbon-Rich Phases of Interplanetary Dust Particles

Interplanetary dust particles (IDPs) are exposed to solar wind (SW) and solar energetic particle (SEP) radiation as they spiral sunward by Poynting-Robertson drag. SW ions penetrate particle surfaces to depths of 10s of nanometers; implantation depths of SEP ions are poorly known but are probably on the order of ~1 μm. Saturation doses of SW-He are incident on grain surfaces in just a few centuries of exposure near 1 AU. One would therefore expect the He inventories of IDPs impacting the top of the Earth\u27s atmosphere to be dominated by SW-SEP mixtures residing largely in surficial and thermally labile sites. Measured 3He/4He ratios do indeed fall between the SW and SEP compositions for the majority of IDPs (others, however, display intriguing and as yet unexplained elevations of 3He/4He that cannot be due to solar corpuscular radiation). Flash heating of IDPs during atmospheric drag deceleration depletes these SW-SEP reservoirs and shifts laboratory 4He release profiles toward higher temperatures, to extents that depend on the intensities of drag-heating. These profile shifts have been used as relative measures of IDP atmospheric entry speeds and thus as a way to distinguish between probably asteroidal and probably cometary particles

Carbonaceous Meteor Ash - A Significant Carrier of Carbon, Organic Material and Noble Gas tot he Surfaces of Terrestrial Planets?

Meteor ash — a significant carrier of carbon, noble gas and organic matter to terrestrial planet surfaces