Mapping the Steroid Response to Major Trauma From Injury to Recovery : A Prospective Cohort Study

CONTEXT: Survival rates after severe injury are improving, but complication rates and outcomes are variable. OBJECTIVE: This cohort study addressed the lack of longitudinal data on the steroid response to major trauma and during recovery. DESIGN: We undertook a prospective, observational cohort study from time of injury to 6 months postinjury at a major UK trauma centre and a military rehabilitation unit, studying patients within 24 hours of major trauma (estimated New Injury Severity Score (NISS) > 15). MAIN OUTCOME MEASURES: We measured adrenal and gonadal steroids in serum and 24-hour urine by mass spectrometry, assessed muscle loss by ultrasound and nitrogen excretion, and recorded clinical outcomes (ventilator days, length of hospital stay, opioid use, incidence of organ dysfunction, and sepsis); results were analyzed by generalized mixed-effect linear models. FINDINGS: We screened 996 multiple injured adults, approached 106, and recruited 95 eligible patients; 87 survived. We analyzed all male survivors <50 years not treated with steroids (N = 60; median age 27 [interquartile range 24-31] years; median NISS 34 [29-44]). Urinary nitrogen excretion and muscle loss peaked after 1 and 6 weeks, respectively. Serum testosterone, dehydroepiandrosterone, and dehydroepiandrosterone sulfate decreased immediately after trauma and took 2, 4, and more than 6 months, respectively, to recover; opioid treatment delayed dehydroepiandrosterone recovery in a dose-dependent fashion. Androgens and precursors correlated with SOFA score and probability of sepsis. CONCLUSION: The catabolic response to severe injury was accompanied by acute and sustained androgen suppression. Whether androgen supplementation improves health outcomes after major trauma requires further investigation

Study of the doubly charmed tetraquark T+cc

Quantum chromodynamics, the theory of the strong force, describes interactions of coloured quarks and gluons and the formation of hadronic matter. Conventional hadronic matter consists of baryons and mesons made of three quarks and quark-antiquark pairs, respectively. Particles with an alternative quark content are known as exotic states. Here a study is reported of an exotic narrow state in the D0D0π+ mass spectrum just below the D*+D0 mass threshold produced in proton-proton collisions collected with the LHCb detector at the Large Hadron Collider. The state is consistent with the ground isoscalar T+cc tetraquark with a quark content of ccu⎯⎯⎯d⎯⎯⎯ and spin-parity quantum numbers JP = 1+. Study of the DD mass spectra disfavours interpretation of the resonance as the isovector state. The decay structure via intermediate off-shell D*+ mesons is consistent with the observed D0π+ mass distribution. To analyse the mass of the resonance and its coupling to the D*D system, a dedicated model is developed under the assumption of an isoscalar axial-vector T+cc state decaying to the D*D channel. Using this model, resonance parameters including the pole position, scattering length, effective range and compositeness are determined to reveal important information about the nature of the T+cc state. In addition, an unexpected dependence of the production rate on track multiplicity is observed

Genomic epidemiology of SARS-CoV-2 in a UK university identifies dynamics of transmission

AbstractUnderstanding SARS-CoV-2 transmission in higher education settings is important to limit spread between students, and into at-risk populations. In this study, we sequenced 482 SARS-CoV-2 isolates from the University of Cambridge from 5 October to 6 December 2020. We perform a detailed phylogenetic comparison with 972 isolates from the surrounding community, complemented with epidemiological and contact tracing data, to determine transmission dynamics. We observe limited viral introductions into the university; the majority of student cases were linked to a single genetic cluster, likely following social gatherings at a venue outside the university. We identify considerable onward transmission associated with student accommodation and courses; this was effectively contained using local infection control measures and following a national lockdown. Transmission clusters were largely segregated within the university or the community. Our study highlights key determinants of SARS-CoV-2 transmission and effective interventions in a higher education setting that will inform public health policy during pandemics.</jats:p

The injunctions and other ecclesiastical proceedings of Richard Barnes, bishop of Durham, from 1575 to 1587.

Includes indexes."Erratum": p. [xx]Edited by James Raine.In Latin or English.Mode of access: Internet

Neolithic farming in north-western Europe: archaeobotanical evidence from Ireland

This paper presents new insights into the appearance of agriculture at the north-western edge of Europe, focussing on archaeobotanical evidence from Neolithic Ireland (4000–2500 cal BC). Previous studies were based upon a limited plant macro-remains dataset, as much of the Irish evidence is unpublished. A research project, 'Cultivating Societies', was implemented to examine the nature, timing and extent of agricultural activity in Neolithic Ireland through collation and analysis of different strands of published and unpublished archaeological and environmental evidence, with a particular focus on plant macro-remains, pollen, settlement and 14C data. This paper will focus on results of plant macro-remains analyses. Remains from a total of 52 excavated sites were collated and analysed, representing the most comprehensive study to date of Neolithic plant remains from this region. Cereals were present at many locations and site types, sometimes in large quantities and most often at sites dating to the earlier Neolithic (3750–3600 cal BC). Emmer wheat was the dominant crop, at least at this time. Other crops included naked and hulled barley, naked wheat, einkorn wheat and flax. Analysis of arable weeds indicates that early plots were not managed under a shifting cultivation regime, which has new implications for understanding Neolithic settlement practises and how communities engaged with landscapes. The variety of crops cultivated in Neolithic Ireland is similar to that in Britain, reflecting a decreasing diversity in crop types as agriculture spread from south-east to north-west Europe

Experimental investigation of the mechanical properties of synthetic magnesium sulfate hydrates: implications for the strength of hydrated deposits on Mars

[1] We have carried out uniaxial compression experiments to determine the mechanical properties of three crystalline magnesium sulfate hydrates that may be present in the near-surface environment of Mars. Our synthetic samples of kieserite (MgSO4 · H2O), epsomite (MgSO4 · 7H2O), and meridianiite (MgSO4 · 11H2O) have mean values of unconfined compressive strength of 6.3 ± 0.7, 12.9 ± 1.8, and 30.1 ± 4.5 MPa, respectively, Young's modulus of 0.8 ± 0.1, 2.9 ± 0.4, and 5.9 ± 0.8 GPa, respectively, and mean porosity values of 47.8% ± 0.5%, 11.1% ± 0.6%, and 2.9% ± 0.2%, respectively. Although our tests cannot quantify a systematic relationship between hydration state and mechanical properties, the different porosities produced by consistent sample preparation methods suggest that the addition of non-cation-coordinated water molecules likely reduces the strength of individual sulfate hydrate phases. However, the bulk mechanical properties of our synthetic specimens are instead controlled predominantly by the sample porosity; generally, the strength increases as the porosity decreases. We expect the mechanical properties of sulfate hydrate deposits on Mars to be governed by the bulk porosity rather than the strength of the pure solid phase. We have performed cyclic stressing tests, replicating possible periodic depositional and erosional periods on Mars resulting from obliquity changes. A gradual compaction and reduction in sample porosity, rather than an increase in crack damage, is observed with each loading cycle, suggesting that the evolution of mechanical properties will depend on local factors such as bulk density, in addition to the overall stress history