The Frasnian-Famennian mass killing event(s), methods of identification and evaluation

The absence of an abnormally high number of earlier Devonian taxa from Famennian sediments was repeatedly documented and can hardly be questioned. Primary recognition of the event(s) was based on paleontological data, especially common macrofossils. Most paleontologists place the disappearance of these common forms at the gigas/triangularis contact and this boundary was recently proposed as the Frasnian-Famennian (F-F) boundary. Not unexpectedly, alternate F-F positions were suggested caused by temporary Frasnian survivors or sudden post-event radiations of new forms. Secondary supporting evidence for mass killing event(s) is supplied by trace element and stable isotope geochemistry but not with the same success as for the K/T boundary, probably due to additional 300 ma of tectonic and diagenetic overprinting. Another tool is microfacies analysis which is surprisingly rarely used even though it can explain geochemical anomalies or paleontological overlap not detectable by conventional macrofacies analysis. The combination of microfacies analysis and geochemistry was applied at two F-F sections in western Canada and showed how interdependent the two methods are. Additional F-F sections from western Canada, western United States, France, Germany and Australia were sampled or re-sampled and await geochemical/microfacies evaluation

A late Devonian impact event and its association with a possible extinction event on Eastern Gondwana

Evidence from South China and Western Australia for a 365-Ma impact event in the Lower crepida conodont zone of the Famennian stage of the Late Devonian (about 1.5 Ma after the Frasnian/Famennian extinction event) includes microtektitelike glassy microspherules, geochemical anomalies (including a weak Ir), a probable impact crater (greater than 70 k) at Taihu in South China, and an Ir anomaly in Western Australia. A brachiopod faunal turnover in South China, and the 'strangelove ocean'-like c-delta 13 excursions in both Chinese and Australian sections indicate that at least a regional-scale extinction might have occurred at the time of the impact. A paleoreconstruction shows that South China was very close to and facing Western Australia in the Late Devonian. The carbon isotopic excursions, which occur at the same stratigraphic level in both South China and Western Australia cannot be explained as being coincidental. The c-delta 13 excursions and the brachiopod faunal turnover in South China indicate that there might have been at least a regional (possibly global) extinction in the Lower crepida zone. The impact-derived microspherules and geochemical anomalies (especially the Ir) indicate a Lower crepida zone impact event on eastern Gondwana. The location, type of target rocks, and possibly age of the Taihu Lake crater qualify as the probable site of this Late Devonian impact

Studien zur Totalsynthese des Chondrochlorens

[no abstract

The Socio-Demographic Characteristics of Diabetes, Hypertension, and Cardiovascular Disease Risk in India

Cardiovascular disease (CVD) is the leading cause of mortality in India. Yet, the evidence is sparse on how diabetes, hypertension, and predicted CVD risk vary between population groups in the country. This dissertation aimed to determine how the prevalence of diabetes, hypertension, and predicted CVD risk in India varies by state, rural-urban location, and individual-level socio-demographic characteristics. Data were pooled from the Annual Health Survey (2012-2013) and the District-Level Household Survey-4 (2012-2014). Diabetes was defined as a plasma glucose 126 mg/dl if fasted or 200 mg/dl if non-fasted, and hypertension as a systolic blood pressure (BP) 140mmHg or a diastolic BP 90mmHg. Predicted 10-year CVD risk was calculated for each participant aged 30 to 74 years using the Framingham risk score, and dichotomized into high (30%) or low risk (<30%). 1,320,555 adults aged 18 years were included in the diabetes and hypertension analysis, and 797,932 adults aged 30 to 74 years in the CVD risk analysis. The crude prevalence of diabetes, hypertension, and high CVD risk was 7.3% (7.1 - 7.4), 23.6% (23.4 – 23.7), and 14.6% (14.4 – 14.8) among females, respectively, and 7.8% (7.6 - 8.0), 27.3% (27.1 – 27.5), and 31.7% (31.4 – 32.0) among males, respectively. There was substantial variation in the prevalence of each outcome among states. Being in the richest compared to the poorest household wealth quintile was associated with only a modestly higher probability of diabetes (rural: 2.8 [2.5 - 3.1] percentage points; and urban: 3.5 [3.0 - 3.9] percentage points) and hypertension (rural: 4.2 [3.7 - 4.6] percentage points; and urban: 3.0 [2.4 - 3.7] percentage points). The differences in the probability of all conditions by educational category were generally small. The prevalence of diabetes and hypertension in India is high, and predicted CVD risk was approximately twice as high as has been estimated for the United States. The important variation in the prevalence of each outcome by state and socio-demographic characteristics can inform planning and resource allocation as well as effective targeting of CVD programs to reach those most in need

Covid-19 Lockdown Affects Hearing Disability and Handicap in Diverse Ways: A Rapid Online Survey Study

Objectives: The aim of this study was to explore the perceived effects of Covid-19 social distancing restrictions and safety measures on people with hearing loss.Design: Participants were 129 adults (48.1% female, mean age 64.4 years) with an audiometric hearing loss, living in Glasgow, Scotland. A rapidly deployed 24-item online questionnaire asked about the effects of certain aspects of lockdown, including face masks, social distancing, and video calling, on participants’ behaviour, emotions, hearing performance, hearing device problems, and tinnitus. Data were analysed descriptively across the entire sample, and with Chi-squared tests for differences between subgroups self-reporting relatively good and relatively poor unaided hearing, respectively. Additional free-text responses provided further perspectives.Results: Behaviour: Video calls are used more frequently than pre-lockdown. The better hearing group use their hearing aids less. Emotions: There is increased anxiety (especially among the worse hearing group) concerning verbal communication situations and access to audiology services, and greater rumination about one’s own hearing loss. Enjoyment of group video calls is mixed. The worse hearing group show substantial relief at not being obliged to attend challenging social gatherings. Across both groups, a majority would like to see all key workers equipped with transparent face masks. Hearing performance: A large majority find it hard to converse with people in face masks due to muffled sound and lack of speechreading cues, but conversing at a safe distance is not universally problematic. In the worse hearing group, performance in video calls is generally inferior to face-to-face, but similar to telephone calls. Those who use live subtitling in video calls appreciate their value. TV and radio updates about Covid-19 are easy to follow for most respondents. There is only weak evidence of face mask fixtures interfering with hearing aids on the ear, and of tinnitus having worsened during lockdown.Conclusions: With due regard for the limitations of this rapid study, we find that there are many negative – and a few positive - effects of Covid-19 restrictions and safety measures on people with hearing loss. From a societal perspective, the widespread adoption of clear face masks may alleviate some of the difficulties and anxieties this population experience. From an individual perspective, one may consider using live subtitles on video calls. Manufacturers of hearing devices should consider developing processing modes and accessories specifically designed for video calls. Finally, repair and maintenance services should be resumed as soon as it is safe to do so

Costs of Parkinson's Disease and Antiparkinsonian Pharmacotherapy: An Italian Cohort Study

Objective: Antiparkinsonian pharmacotherapy is costly and the determinants of drug costs in Parkinson's disease (PD) have been poorly investigated. The objective of this study was to investigate the costs of PD and antiparkinsonian drugs in an Italian cohort of patients and identify cost-driving factors of drug therapy. Methods: Seventy outpatients with idiopathic PD were recruited in the Department of Neurology, Napoli University, Italy. Data on resource utilization were collected for 6 months using a bottom-up approach. Clinical status was evaluated using the Unified Parkinson's Disease Rating Scale. Direct and indirect costs were calculated from the societal perspective (figures of year 2009). Independent determinants of total costs and costs of antiparkinsonian drugs were identified using multivariate regression analysis. Results: The total costs of PD were EUR 8,640 (95% CI: EUR 6,700-11,240) per patient over a 6-month period. Direct costs accounted for 70% of the total costs. Antiparkinsonian drugs (EUR 1,450; 95% CI: EUR 1,220-1,760) were the primary component of costs paid by the health insurance (39.6%) and one of the most expensive components of the direct costs (24.0%). The highest copayments made by patients were for antiparkinsonian drugs and medical equipment (58%). Independent determinants of the increased costs of antiparkinsonian pharmacotherapy were younger age and occurrence of motor fluctuations. Conclusions: Antiparkinsonian pharmacotherapy is one of the major cost components of PD-related costs for health insurance. It imposes a considerable economic burden on patients and their families as well. Copyright (C) 2010 S. Karger AG, Base

Naturally occurring autoantibodies against beta-amyloid: investigating their role in transgenic animal and in vitro models of Alzheimer's disease

Alzheimer's disease (AD) is a neurodegenerative disorder primarily affecting regions of the brain responsible for higher cognitive functions. Immunization against β-amyloid (Aβ) in animal models of AD has been shown to be effective on the molecular level but also on the behavioral level. Recently, we reported naturally occurring autoantibodies against Aβ (NAbs-Aβ) being reduced in Alzheimer's disease patients. Here, we further investigated their physiological role: in epitope mapping studies, NAbs-Aβ recognized the mid-/C-terminal end of Aβ and preferentially bound to oligomers but failed to bind to monomers/fibrils. NAbs-Aβ were able to interfere with Aβ peptide toxicity, but NAbs-Aβ did not readily clear senile plaques although early fleecy-like plaques were reduced. Administration of NAbs-Aβ in transgenic mice improved the object location memory significantly, almost reaching performance levels of wild-type control mice. These findings suggest a novel physiological mechanism involving NAbs-Aβ to dispose of proteins or peptides that are prone to forming toxic aggregates

The efficiency of chronic disease care in sub-Saharan Africa

The number of people needing chronic disease care is projected to increase in sub-Saharan Africa as a result of expanding human immunodeficiency virus (HIV) treatment coverage, rising life expectancies, and lifestyle changes. Using nationally representative data of healthcare facilities, Di Giorgio et al. found that many HIV clinics in Kenya, Uganda, and Zambia appear to have considerable untapped capacity to provide care for additional patients. These findings highlight the potential for increasing the efficiency of clinical processes for chronic disease care at the facility level. Important questions for future research are how estimates of comparative technical efficiency across facilities change, when they are adjusted for quality of care and the composition of patients by care complexity. Looking ahead, substantial research investment will be needed to ensure that we do not forgo the opportunity to learn how efficiency changes, as chronic care is becoming increasingly differentiated by patient type and integrated across diseases and health systems functions. Please see related article: http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0653-

Use of lifestyle interventions in primary care for individuals with newly diagnosed hypertension, hyperlipidaemia or obesity: a retrospective cohort study

Abstract Summary Objective Lifestyle interventions can be efficacious in reducing cardiovascular disease risk factors and are recommended as first-line interventions in England. However, recent information on the use of these interventions in primary care is lacking. We investigated for how many patients with newly diagnosed hypertension, hyperlipidaemia or obesity, lifestyle interventions were recorded in their primary care electronic health record. Design A retrospective cohort study. Setting English primary care, using UK Clinical Practice Research Datalink. Participants A total of 770,711 patients who were aged 18 years or older and received a new diagnosis of hypertension, hyperlipidaemia or obesity between 2010 and 2019. Main outcome measures Record of lifestyle intervention and/or medication in 12 months before to 12 months after initial diagnosis (2-year timeframe). Results Analyses show varying results across conditions: While 55.6% (95% CI 54.9–56.4) of individuals with an initial diagnosis of hypertension were recorded as having lifestyle support (lifestyle intervention or signposting) within the 2-year timeframe, this number was reduced to 45.2% (95% CI 43.8–46.6) for hyperlipidaemia and 52.6% (95% CI 51.1–54.1) for obesity. For substantial proportions of individuals neither lifestyle support nor medication (hypertension: 12.2%, 95% CI 11.9–12.5; hyperlipidaemia: 32.2%, 95% CI 31.2–33.3; obesity: 43.9%, 95% CI 42.3–45.4) were recorded. Sensitivity analyses confirm that limited proportions of patients had lifestyle support recorded in their electronic health record before they were first prescribed medication (diagnosed and undiagnosed), ranging from 12.1% for hypertension to 19.7% for hyperlipidaemia, and 19.5% for obesity (23.4% if restricted to Orlistat). Conclusions Limited evidence of lifestyle support for individuals with cardiovascular risk factors (hypertension, hyperlipidaemia, obesity) recommended by national guidelines in England may stem from poor recording in electronic health records but may also represent missed opportunities. Given the link between progression to cardiovascular disease and modifiable lifestyle factors, early support for patients to manage their conditions through non-pharmaceutical interventions by establishing lifestyle modification as first-line treatment is crucial