When did modern humans leave Africa?

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Targeting, monitoring and effect of oral iron therapy on haemoglobin levels in older patients discharged to primary care from inpatient rehabilitation:a cohort study using routinely collected data

Background: Oral iron is commonly prescribed to older patients with suspected or confirmed iron deficiency anaemia, however few studies have examined the effectiveness of oral iron therapy in the real world in this population. We therefore determined the prevalence of iron deficiency in older people prescribed oral iron, examined the response mounted to therapy and ascertained predictors of response to oral iron.Methods: We analysed a routinely collected, linked dataset from older patients who had undergone inpatient rehabilitation between 1999 and 2011. An initial analysis examined patients within this cohort who were prescribed iron after rehabilitation and derived three groups based upon their ferritin and transferrin indices; probably, possibly and not iron deficient. A second analysis compared pre- and post-treatment haemoglobin to determine the degree of response to iron therapy across each category of deficiency. Finally, patient demographics, linked biochemistry data and comorbid disease based on International Statistical Classification of Disease (ICD-10) codes from previous hospital admissions were used in regression modelling to evaluate factors affecting response to therapy.Results: 490 patients were prescribed oral iron within 90 days of rehabilitation discharge. 413/490 (84%) had iron indices performed; 94 (23%) were possibly deficient, 224 (54%) were probably deficient, and 95 (23%) were not deficient. 360/490 patients had both pre and post treatment haemoglobin data and iron indices; probably deficient patients mounted a slightly greater response to oral iron (17g/L vs 12g/L for not deficient; p&lt;0.05). Only pre-treatment haemoglobin, mean cell volume (MCV) and lower gastrointestinal pathology were significant predictors of a response to oral iron therapy. Notably, acid-suppressant use was not a predictor of response.Conclusion: We conclude that many older patients are exposed to oral iron without good evidence of either iron deficiency or a significant response to therapy.<br/

Knapping tools in Magdalenian contexts: New evidence from Gough’s Cave (Somerset, UK)

Our knowledge of the recolonization of north-west Europe at the end of the Last Glacial Maximum depends to a large extent on finds from Gough's Cave (Somerset, UK). Ultra-high resolution radiocarbon determinations suggest that the cave was occupied seasonally by Magdalenian hunters for perhaps no more than two or three human generations, centred on 12,600 BP (~14,950-14,750 cal BP). They left behind a rich and diverse assemblage of Magdalenian lithic and osseous artefacts, butchered animal bones, and cannibalised human remains. The faunal assemblage from Gough's Cave is one of the most comprehensively studied from any Magdalenian site, yet new and unexpected discoveries continue to be made. Here, we record previously unrecognized flint-knapping tools that were identified during a survey of the Gough's Cave faunal collection at the Natural History Museum (London). We identified bones used as hammers and teeth manipulated as pressure-flakers to manufacture flint tools. Most of the pieces appear to be ad hoc (single-use?) tools, but a horse molar was almost certainly a curated object that was used over an extended period to work many stone tools. This paper explores how these knapping tools were used to support a more nuanced understanding of Magdalenian stone-tool manufacturing processes. Moreover, we provide a standard for identifying minimally-used knapping tools that will help to establish whether retouchers and other organic stone-working tools are as rare in the Magdalenian archaeological record as current studies suggest

Hydrogen adsorption and cohesive energy of single-walled carbon nanotubes

Hydrogen adsorption on crystalline ropes of carbon single-walled nanotubes (SWNT) was found to exceed 8 wt.%, which is the highest capacity of any carbon material. Hydrogen is first adsorbed on the outer surfaces of the crystalline ropes. At pressures higher than about 40 bar at 80 K, however, a phase transition occurs where there is a separation of the individual SWNTs, and hydrogen is physisorbed on their exposed surfaces. The pressure of this phase transition provides a tube-tube cohesive energy for much of the material of 5 meV/C atom. This small cohesive energy is affected strongly by the quality of crystalline order in the ropes

Research note – barriers and solutions to linking and using health and social care data in Scotland

Integration of health and social care will require integrated data to drive service evaluation, design, joint working and research. We describe the results of a Scottish meeting of key stakeholders in this area. Potential uses for linked data included understanding client populations, mapping trajectories of dependency, identifying at risk groups, predicting required capacity for future service provision, and research to better understand the reciprocal interactions between health, social circumstances and care. Barriers to progress included lack of analytical capacity, incomplete understanding of data provenance and quality, intersystem incompatibility and issues of consent for data sharing. Potential solutions included better understanding the content, quality and provenance of social care data; investment in analytical capacity; improving communication between data providers and users in health and social care; clear guidance to systems developers and procurers; and enhanced engagement with the public. We plan a website for communication across Scotland on health and social care data linkage, educational resources for front line staff and researchers, plus further events for training and information dissemination. We believe that these processes hold lessons for other countries with an interest in linking health and social care data, as well as for cross-sector data linkage initiatives in general.</p

Effect of two different participant information sheets on recruitment to a falls trial:an embedded randomised recruitment trial

Background/Aims: Recruitment to trials of intervention for older people who fall is challenging. Evidence suggests that the word falls has negative connotations for older people, and this may present a barrier to engaging with trials in this area. We therefore tested whether a participant information sheet that minimised reference to falls could improve recruitment rates. Methods: We conducted a study within a trial, embedded within a randomised controlled trial of vitamin K versus placebo to improve postural sway in patients aged 65 and over with a history of falls. Potential participants were identified from primary care lists in 14 practices and were randomised to receive either a standard participant information sheet or an information sheet minimising use of the word falls, instead focussing on maintenance of health, fitness and balance. The primary outcome for this embedded trial was the proportion of responses expressing interest in participating received in each arm. Secondary outcomes were the proportion of those contacted attending a screening visit, consenting at screening, and the proportion contacted who were randomised into the main trial. Results: In all, 4145 invitations were sent, with an overall response rate of 444 (10.7%). In all, 2148 individuals received the new information sheet (minimising reference to falls); 1997 received the standard information sheet. There was no statistically significant difference in response rate between those individuals sent the new information sheet and those sent the standard information sheet (10.1% vs 11.4%; difference 1.3% (95% confidence interval -0.6% to 3.2%); p = 0.19). Similarly, we found no statistically significant difference between the percentage of those who attended and consented at screening in the two groups (2.1% vs 2.7%; difference 0.6% (95% confidence interval: -0.4% to 1.6%); p = 0.20), and no statistically significant difference between the percentage randomised in the two groups (2.0% vs 2.6%; difference 0.6% (95% confidence interval -0.4% to 1.6%); p = 0.20). Conclusions: Use of a participant information sheet minimising reference to falls did not lead to a greater response rate in this trial targeting older people with a history of falls.</p

A 15 year record of high-frequency, in situ measurements of hydrogen at Mace Head, Ireland

Continuous high-frequency measurements of atmospheric molecular hydrogen have been made at Mace Head atmospheric research station on the west coast of Ireland from March 1994 to December 2008. The presented data provides information on long term trends and seasonal cycles of hydrogen in background northern hemispheric air. Individual measurements have been sorted using a Lagrangian dispersion model to separate clean background air from regionally polluted European air masses and those transported from southerly latitudes. No significant trend was observed in background northern hemispheric air over the 15 year record, elevations in yearly means were accounted for from large scale biomass burning events. Seasonal cycles show the expected pattern with maxima in spring and minima in late autumn. The mean hydrogen mole fraction in baseline northern hemispheric air was found to be 500.1 ppb. Air transported from southerly latitudes showed an elevation from baseline mean of 11.0 ppb, reflecting both the latitudinal gradient of hydrogen, with higher concentrations in the Southern Hemisphere, and the photochemical source of hydrogen from low northern latitudes. European polluted air masses arriving at Mace Head showed mean elevation of 5.3 ppb from baseline air masses, reflecting hydrogen's source from primary emissions like fossil fuel combustion. Forward modelling of transport of hydrogen to Mace Head suggests that the ratio of hydrogen to carbon monoxide in primary emissions is considerably less in non-traffic sources than traffic sources