Extreme extension across Seram and Ambon, eastern Indonesia: Evidence for Banda slab rollback

The island of Seram, which lies in the northern part of the 180°-curved Banda Arc, has previously been interpreted as a fold-and-thrust belt formed during arc-continent collision, which incorporates ophiolites intruded by granites thought to have been produced by anatexis within a metamorphic sole. However, new geological mapping and a re-examination of the field relations cause us to question this model. We instead propose that there is evidence for recent and rapid N–S extension that has caused the high-temperature exhumation of lherzolites beneath low-angle lithospheric detachment faults that induced high-temperature metamorphism and melting in overlying crustal rocks. These "Kobipoto Complex" migmatites include highly residual Al–Mg-rich garnet + cordierite + sillimanite + spinel + corundum granulites (exposed in the Kobipoto Mountains) which contain coexisting spinel + quartz, indicating that peak metamorphic temperatures likely approached 900 °C. Associated with these residual granulites are voluminous Mio-Pliocene granitic diatexites, or "cordierite granites", which crop out on Ambon, western Seram, and in the Kobipoto Mountains and incorporate abundant schlieren of spinel- and sillimanite-bearing residuum. Quaternary "ambonites" (cordierite + garnet dacites) emplaced on Ambon were also evidently sourced from the Kobipoto Complex migmatites as demonstrated by granulite-inherited xenoliths. Exhumation of the hot peridotites and granulite-facies Kobipoto Complex migmatites to shallower structural levels caused greenschist- to lower-amphibolite facies metapelites and amphibolites of the Tehoru Formation to be overprinted by sillimanite-grade metamorphism, migmatisation, and limited localised anatexis to form the Taunusa Complex. The extreme extension required to have driven Kobipoto Complex exhumation evidently occurred throughout Seram and along much of the northern Banda Arc. The lherzolites must have been juxtaposed against the crust at typical lithospheric mantle temperatures in order to account for such high-temperature metamorphism and therefore could not have been part of a cooled ophiolite. In central Seram, lenses of peridotites are incorporated with a major left-lateral strike-slip shear zone (the "Kawa Shear Zone"), demonstrating that strike-slip motions likely initiated shortly after the mantle had been partly exhumed by detachment faulting and that the main strike-slip faults may themselves be reactivated and steepened low-angle detachments. The geodynamic driver for mantle exhumation along the detachment faults and strike-slip faulting in central Seram is very likely the same; we interpret the extreme extension to be the result of eastward slab rollback into the Banda Embayment as outlined by the latest plate reconstructions for Banda Arc evolution

Discriminating between the origins of remotely sensed circular structures:carbonate mounds, diapirs or periclinal folds? Purbeck Limestone Group, Weymouth Bay, UK

Many sedimentary rock successions contain plan-view circular structures, such as impacts, diapirs and carbonate build-ups. When remotely sensed, it can be difficult to discriminate between their formation mechanisms. Here we examine this problem by assessing the origins of circular structures imaged in high-resolution multibeam bathymetric data from Weymouth Bay, UK. The imagery shows 30–150 m across, concave-down structures within the upper Purbeck Limestone Group on the southern limb of the Purbeck Anticline. Similar structures have not been identified in the extensive outcrops around the bay. The morphology and geological setting of the structures are consistent with three different interpretations: carbonate mounds, periclinal folds and evaporite diapirs. However, none of these structures has been previously recorded in the upper Purbeck Limestone Group outcrops of this internationally renowned geological region. We apply a scoring system to 25 features of the circular structures to discriminate between these three alternative interpretations. This analysis indicates that evaporite diapirs are the least likely and carbonate mounds the most likely origin of the structures. The presence of carbonate mounds revises the upper Purbeck palaeofacies distribution in its type area and provides an analogue for the exploration for hydrocarbon reservoirs in lacustrine mounds

The Towuti Drilling Project:paleoenvironments, biological evolution, and geomicrobiology of a tropical Pacific lake

The Towuti Drilling Project (TDP) is an international research program, whose goal is to understand long-term environmental and climatic change in the tropical western Pacific, the impacts of geological and environmental changes on the biological evolution of aquatic taxa, and the geomicrobiology and biogeochemistry of metal-rich, ultramafic-hosted lake sediments through the scientific drilling of Lake Towuti, southern Sulawesi, Indonesia. Lake Towuti is a large tectonic lake at the downstream end of the Malili lake system, a chain of five highly biodiverse lakes that are among the oldest lakes in Southeast Asia. In 2015 we carried out a scientific drilling program on Lake Towuti using the International Continental Scientific Drilling Program (ICDP) Deep Lakes Drilling System (DLDS). We recovered a total of  ∼ 1018 m of core from 11 drilling sites with water depths ranging from 156 to 200 m. Recovery averaged 91.7 %, and the maximum drilling depth was 175 m below the lake floor, penetrating the entire sedimentary infill of the basin. Initial data from core and borehole logging indicate that these cores record the evolution of a highly dynamic tectonic and limnological system, with clear indications of orbital-scale climate variability during the mid- to late Pleistocene

Randomised controlled trial of a home-based physical activity intervention in breast cancer survivors

Background: To improve adherence to physical activity (PA), behavioural support in the form of behavioural change counselling may be necessary. However, limited evidence of the effectiveness of home-based PA combined with counselling in breast cancer patients exists. The aim of this current randomised controlled trial with a parallel group design was to evaluate the effectiveness of a home-based PA intervention on PA levels, anthropometric measures, health-related quality of life (HRQoL), and blood biomarkers in breast cancer survivors. Methods: Eighty post-adjuvant therapy invasive breast cancer patients (age = 53.6 ± 9.4 years; height = 161.2 ± 6.8 cm; mass = 68.7 ± 10.5 kg) were randomly allocated to a 6-month home-based PA intervention or usual care. The intervention group received face-to-face and telephone PA counselling aimed at encouraging the achievement of current recommended PA guidelines. All patients were evaluated for our primary outcome, PA (International PA Questionnaire) and secondary outcomes, mass, BMI, body fat %, HRQoL (Functional assessment of Cancer Therapy-Breast), insulin resistance, triglycerides (TG) and total (TC), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) cholesterol were assessed at baseline and at 6-months. Results: On the basis of linear mixed-model analyses adjusted for baseline values performed on 40 patients in each group, total, leisure and vigorous PA significantly increased from baseline to post-intervention in the intervention compared to usual care (between-group differences, 578.5 MET-min∙wk−1, p = .024, 382.2 MET-min∙wk−1, p = .010, and 264.1 MET-min∙wk−1, p = .007, respectively). Both body mass and BMI decreased significantly in the intervention compared to usual care (between-group differences, −1.6 kg, p = .040, and −.6 kg/m2, p = .020, respectively). Of the HRQoL variables, FACT-Breast, Trial Outcome Index, functional wellbeing, and breast cancer subscale improved significantly in the PA group compared to the usual care group (between-group differences, 5.1, p= .024; 5.6, p = .001; 1.9 p = .025; and 2.8, p=.007, respectively). Finally, TC and LDL-C was significantly reduced in the PA group compared to the usual care group (between-group differences, −.38 mmol∙L−1, p=.001; and −.3 mmol∙L−1, p=.023, respectively). Conclusions: We found that home-based PA resulted in significant albeit small to moderate improvements in selfreported PA, mass, BMI, breast cancer specific HRQoL, and TC and LDL-C compared with usual care

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden

A blood atlas of COVID-19 defines hallmarks of disease severity and specificity.

Treatment of severe COVID-19 is currently limited by clinical heterogeneity and incomplete description of specific immune biomarkers. We present here a comprehensive multi-omic blood atlas for patients with varying COVID-19 severity in an integrated comparison with influenza and sepsis patients versus healthy volunteers. We identify immune signatures and correlates of host response. Hallmarks of disease severity involved cells, their inflammatory mediators and networks, including progenitor cells and specific myeloid and lymphocyte subsets, features of the immune repertoire, acute phase response, metabolism, and coagulation. Persisting immune activation involving AP-1/p38MAPK was a specific feature of COVID-19. The plasma proteome enabled sub-phenotyping into patient clusters, predictive of severity and outcome. Systems-based integrative analyses including tensor and matrix decomposition of all modalities revealed feature groupings linked with severity and specificity compared to influenza and sepsis. Our approach and blood atlas will support future drug development, clinical trial design, and personalized medicine approaches for COVID-19