The archaeology of South Sudan from c. 3000 BC to AD 1500

This paper reviews the current state of archaeological research within the boundaries of the modern country of South Sudan, with a particular focus on the period between c. 3000 BC and AD 1500. While various historical factors and more recent political unrest have long stymied concerted archaeological efforts in the region, such surveys as have been undertaken are summarised and synthesised here, most notably the four expeditions funded by the British Institute in Eastern Africa between 1977 and 1981. Though scant, the data recovered during these and other research projects point to great diversity within the archaeological record of South Sudan, highlighting the region’s importance for addressing such large-scale issues as the transition between (or indeed the co-occurrence of) Later Stone Age and Early Iron Age lifeways, including the spread of pastoralism, arable agriculture and iron-working technology from northern to eastern Africa. The region likewise appears to have been central to the occurrence of large-scale population movements during both the Early and Later Iron Ages. However, we also emphasise the relevance of the archaeology of this period for better understanding more localised trajectories of socio-cultural change, particularly for adding time-depth to historical narratives of relevance to contemporary South Sudanese communities. / Cet article passe en revue l’état actuel des recherches archéologiques à l’intérieur des frontières de l’État actuel du Sud-Soudan, mettant un accent particulier sur la période entre 3000 av. J.-C. et 1500 après J.-C. Divers facteurs historiques, aussi bien que des troubles politiques plus récents, ont longtemps entravé les efforts archéologiques concertés dans la région. Les enquêtes qui ont néanmoins pu être réalisées sont résumées et synthétisées ici, en particulier les quatre expéditions financées par le British Institute in Eastern Africa entre 1977 et 1981. Bien que minces, les données recueillies au cours de ces projets de recherche et d’autres font ressortir une grande diversité dans les données archéologiques du Sud-Soudan, soulignant l’importance de cette région pour traiter de questions aussi vastes que la transition entre (ou la contemporanéité) des moyens de subsistance de l’âge de pierre final et de l’âge du fer ancien, y compris l’extension du pastoralisme, de l’agriculture arable et de la technologie du travail du fer du nord vers l’est de l’Afrique. La région semble aussi avoir joué un rôle central dans des mouvements de population à grande échelle pendant l’âge du fer aussi bien ancien que plus récent. Cependant, nous soulignons également l’importance de l'archéologie de cette période pour une meilleure compréhension des trajectoires plus locales de changement socioculturel, et en particulier le potentiel qui s’offre de pouvoir ajouter de la profondeur aux récits historiques pertinents pour les communautés actuelles du Sud-Soudan

Patients’ use of information about medicine side effects in relation to experiences of suspected adverse drug reactions

Background Adverse drug reactions (ADRs) are common, and information about medicines is increasingly widely available to the public. However, relatively little work has explored how people use medicines information to help them assess symptoms that may be suspected ADRs. Objective Our objective was to determine how patients use patient information leaflets (PILs) or other medicines information sources and whether information use differs depending on experiences of suspected ADRs. Method This was a cross-sectional survey conducted in six National Health Service (NHS) hospitals in North West England involving medical in-patients taking at least two regular medicines prior to admission. The survey was administered via a questionnaire and covered use of the PIL and other medicines information sources, perceived knowledge about medicines risks/ADRs, experiences of suspected ADRs, plus demographic information. Results Of the 1,218 respondents to the survey, 18.8 % never read the PIL, whilst 6.5 % only do so if something unexpected happens. Educational level was related to perceived knowledge about medicines risks, but not to reading the PIL or seeking further information about medicines risks. Over half the respondents (56.0 %) never sought more information about possible side effects of medicines. A total of 57.2 % claimed they had experienced a suspected ADR. Of these 85.9 % were either very sure or fairly sure this was a reaction to a medicine. Over half of those experiencing a suspected ADR (53.8 %) had read the PIL, of whom 36.2 % did so before the suspected ADR occurred, the remainder afterwards. Reading the PIL helped 84.8 % of these respondents to decide they had experienced an ADR. Educational level, general knowledge of medicines risks and number of regular medicines used all increased the likelihood of experiencing an ADR. Conclusion More patients should be encouraged to read the PIL supplied with medicines. The results support the view that most patients feel knowledgeable about medicines risks and suspected ADRs and value information about side effects, but that reading about side effects in PILs or other medicines information sources does not lead to experiences of suspected ADRs

Challenges and opportunities in the care of chronic subdural haematoma: perspectives from a multi-disciplinary working group on the need for change.

INTRODUCTION: A chronic subdural haematoma (cSDH) is a collection of altered blood products between the dura and brain resulting in a slowly evolving neurological deficit. It is increasingly common and, in high income countries, affects an older, multimorbid population. With changing demographics improving the care of this cohort is of increasing importance. METHODS: We convened a cross-disciplinary working group (the 'Improving Care in Elderly Neurosurgery Initiative') in October 2020. This comprised experts in neurosurgical care and a range of perioperative stakeholders. An Implementation Science framework was used to structure discussions around the challenges of cSDH care within the United Kingdom. The outcomes of these discussions were recorded and summarised, before being circulated to all attendees for comment and refinement. RESULTS: The working group identified four key requirements for improving cSDH care: (1) data, audit, and natural history; (2) evidence-based guidelines and pathways; (3) shared decision-making; and (4) an overarching quality improvement strategy. Frequent transfers between care providers were identified as impacting on both perioperative care and presenting a barrier to effective data collection and teamworking. Improvement initiatives must be cognizant of the complex, system-wide nature of the problem, and may require a combination of targeted trials at points of clinical equipoise (such as anesthetic technique or anticoagulant management), evidence-based guideline development, and a cycle of knowledge acquisition and implementation. CONCLUSION: The care of cSDH is a growing clinical problem. Lessons may be learned from the standardised pathways of care such as those as used in hip fracture and stroke. A defined care pathway for cSDH, encompassing perioperative care and rehabilitation, could plausibly improve patient outcomes but work remains to tailor such a pathway to cSDH care. The development of such a pathway at a national level should be a priority, and the focus of future work

Chiral Polymerization in Open Systems From Chiral-Selective Reaction Rates

We investigate the possibility that prebiotic homochirality can be achieved exclusively through chiral-selective reaction rate parameters without any other explicit mechanism for chiral bias. Specifically, we examine an open network of polymerization reactions, where the reaction rates can have chiral-selective values. The reactions are neither autocatalytic nor do they contain explicit enantiomeric cross-inhibition terms. We are thus investigating how rare a set of chiral-selective reaction rates needs to be in order to generate a reasonable amount of chiral bias. We quantify our results adopting a statistical approach: varying both the mean value and the rms dispersion of the relevant reaction rates, we show that moderate to high levels of chiral excess can be achieved with fairly small chiral bias, below 10%. Considering the various unknowns related to prebiotic chemical networks in early Earth and the dependence of reaction rates to environmental properties such as temperature and pressure variations, we argue that homochirality could have been achieved from moderate amounts of chiral selectivity in the reaction rates.Comment: 15 pages, 6 figures, accepted for publication in Origins of Life and Evolution of Biosphere

The Evolution of Bat Vestibular Systems in the Face of Potential Antagonistic Selection Pressures for Flight and Echolocation

PMCID: PMC3634842This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Computational modelling of cancerous mutations in the EGFR/ERK signalling pathway

This article has been made available through the Brunel Open Access Publishing Fund - Copyright @ 2009 Orton et al.BACKGROUND: The Epidermal Growth Factor Receptor (EGFR) activated Extracellular-signal Regulated Kinase (ERK) pathway is a critical cell signalling pathway that relays the signal for a cell to proliferate from the plasma membrane to the nucleus. Deregulation of the EGFR/ERK pathway due to alterations affecting the expression or function of a number of pathway components has long been associated with numerous forms of cancer. Under normal conditions, Epidermal Growth Factor (EGF) stimulates a rapid but transient activation of ERK as the signal is rapidly shutdown. Whereas, under cancerous mutation conditions the ERK signal cannot be shutdown and is sustained resulting in the constitutive activation of ERK and continual cell proliferation. In this study, we have used computational modelling techniques to investigate what effects various cancerous alterations have on the signalling flow through the ERK pathway. RESULTS: We have generated a new model of the EGFR activated ERK pathway, which was verified by our own experimental data. We then altered our model to represent various cancerous situations such as Ras, B-Raf and EGFR mutations, as well as EGFR overexpression. Analysis of the models showed that different cancerous situations resulted in different signalling patterns through the ERK pathway, especially when compared to the normal EGF signal pattern. Our model predicts that cancerous EGFR mutation and overexpression signals almost exclusively via the Rap1 pathway, predicting that this pathway is the best target for drugs. Furthermore, our model also highlights the importance of receptor degradation in normal and cancerous EGFR signalling, and suggests that receptor degradation is a key difference between the signalling from the EGF and Nerve Growth Factor (NGF) receptors. CONCLUSION: Our results suggest that different routes to ERK activation are being utilised in different cancerous situations which therefore has interesting implications for drug selection strategies. We also conducted a comparison of the critical differences between signalling from different growth factor receptors (namely EGFR, mutated EGFR, NGF, and Insulin) with our results suggesting the difference between the systems are large scale and can be attributed to the presence/absence of entire pathways rather than subtle difference in individual rate constants between the systems.This work was funded by the Department of Trade and Industry (DTI), under their Bioscience Beacon project programme. AG was funded by an industrial PhD studentship from Scottish Enterprise and Cyclacel

The air raids that never were and the war that nobody won: government propaganda in conflict reporting and how journalists should respond to it

During the bombing campaign against Libya in the spring of 2011, the fog of war enveloped not only the shifting frontlines of the battles between forces loyal to the then Libyan leader, Muammar Gaddafi, but also the more comfortable surroundings of British government ministries. A news story of an aborted air raid reflected the huge importance which governments increasingly place upon getting their message across in the international media in times of conflict. Looking at that example from the conflict in Libya, and studying in detail others from Russia’s 2008 war with Georgia, this article argues that journalists must correspondingly be increasingly aware of attempts by governments, and their hired public relations hands, to influence reporting