Earth's magnetic field in the early 19th century from French sources

International audienceWe present both a description of a new magnetic data set covering predominantly the 18th and 19th centuries and the results derived from it for the small window 1820-1850, from which the bulk of the data originate. The data set comprises measurements of declination taken overwhelmingly on French naval and hydrographic vessels. A list of the vessels is given for one of the data sets. When augmented by extant inclination measurements, the data are capable of resolving the magnetic field at the core-mantle boundary to a high degree of fidelity and thus are a valuable addition to the data set of historical geomagnetic measurements

Scale, evidence, and community participation matter: lessons in effective and legitimate adaptive governance from decision making for Menindee Lakes in Australia’s Murray-Darling Basin

Rivers and their interdependent human communities form social-ecologically complex systems that reflect basin scale functionally but are often governed by spatially mismatched governance systems. Accounting for this complexity requires flexible adaptive governance systems supported by legitimacy in decision-making processes. Meaningful community dialogue, information exchange, transparency, and scientific rigor are essential to this process. We examined failings in the adaptive governance of the Menindee Lakes system, a major Australian wetland system on the Barka/Darling River of the Murray-Darling Basin. Ecological sustainability of the Menindee Lakes was a casualty of a top-down governance, driven by the New South Wales Government in pursuit of “water savings” for the Murray-Darling Basin, a large scale, federally influenced region. We used quantitative and qualitative methods to analyze long-term social-ecological impacts and stakeholder perceptions of adaptive governance. State and federal government agencies failed basic processes of adaptive governance, ignoring local environmental sustainability in pursuit of basin scale objectives at great cost to governments, communities, humans, and non-humans. This resulted in the development of an ineffective, technocratic solution that lacked community input, leading to a complete loss of support by local communities, including traditional owners. We emphasize the importance of elements of scale in adaptive governance projects, if such projects are going to be effective and legitimate with consequences of coarse commitments to large spatial scale political and environmental objectives

The Dzhungarian fault: Late Quaternary tectonics and slip rate of a major right-lateral strike-slip fault in the northern Tien Shan region

The Dzhungarian strike-slip fault of Central Asia is one of a series of long, NW-SE right-lateral strike-slip faults that are characteristic of the northern Tien Shan region and extends over 300 km from the high mountains into the Kazakh Platform. Our field-based and satellite observations reveal that the Dzhungarian fault can be characterized by three 100 km long sections based on variation in strike direction. Through morphological analysis of offset streams and alluvial fans, and through optically stimulated luminescence dating, we find that the Dzhungarian fault has a minimum average late Quaternary slip rate of 2.2 ± 0.8 mm/yr and accommodates N-S shortening related to the India-Eurasia collision. This shortening may also be partly accommodated by counterclockwise rotation about a vertical axis. Evidence for a possible paleo-earthquake rupture indicates that earthquakes up to at least Mw 7 can be associated with just the partitioned component of reverse slip on segments of the central section of the fault up to 30 km long. An event rupturing longer sections of the Dzhungarian fault has the potential to generate greater magnitude earthquakes (Mw 8); however, long time periods (e.g., thousands of years) are expected in order to accumulate enough strain to generate such earthquakes.We thank the Royal Society International Travel Grant, Mike Coward Fund of the Geological Society of London, Percy Sladen Fund of the Linnean Society, The Gilchrist Educational Trust, and the Earth and Space Foundation for their support in funding this project. GEC’s doctoral studentship is funded by the National Environmental Research Council through NCEO, COMET, and the NERC-ESRC funded Earthquakes without Frontiers (EWF) Project. RTW is supported by a University Research Fellowship awarded by the Royal Society.This is the final version of the article, originally published in the Journal of Geophysical Research: Solid Earth. It is also available from Wiley at http://onlinelibrary.wiley.com/doi/10.1002/jgrb.50367/abstract. © 2013. American Geophysical Unio

Patterns of pneumococcal vaccination and revaccination in elderly and non-elderly adults: a Vaccine Safety Datalink study

<p>Abstract</p> <p>Background</p> <p>Pneumococcal polysaccharide vaccine (PPV) is recommended for all adults 65 years of age and older and for younger adults with high-risk conditions. While data from national surveys provide information on the proportion of adults 65 years of age and older reporting ever receipt of PPV they do not collect more detailed information, such as age at vaccination or the total number of vaccinations received. In addition, there is relatively little information available on PPV coverage in younger adults with chronic conditions. To assess contemporary patterns of pneumococcal vaccination and revaccination of adults, we conducted a cross-sectional study of adults enrolled in medical care organizations (MCOs) participating in the Vaccine Safety Datalink project.</p> <p>Methods</p> <p>The study population included 1.5 million adults 25 years of age and older enrolled in the four participating MCOs on December 1, 2006. PPVs administered to members of the study population prior to that date were identified from computerized immunization registries maintained by the MCOs.</p> <p>Results</p> <p>Among the general population of adults 25 through 64 years of age, vaccine coverage increased from 2% in the 25–29 year old age-group to 26% in the 60–64 year old age-group. In all age-groups, coverage was substantially higher in persons defined as having a chronic high risk condition. This was particularly true for diabetes mellitus, with vaccine coverage of over 50% in the lower age-groups and 75% in those 60–64 years of age. Among adults 65 years of age and older, 82% had received at least one PPV and 18% had received two or more PPVs.</p> <p>Conclusion</p> <p>We found higher levels of PPV coverage among adults 65 years of age and older and among younger adults with diabetes mellitus than reported by national surveys and for those groups PPV coverage approached the <it>Healthy People 2010 </it>national objectives. These results suggest that achieving those objectives for PPV is possible and that high vaccination coverage may be facilitated by vaccine tracking and reminder systems.</p

The single-cell pathology landscape of breast cancer.

Single-cell analyses have revealed extensive heterogeneity between and within human tumours1-4, but complex single-cell phenotypes and their spatial context are not at present reflected in the histological stratification that is the foundation of many clinical decisions. Here we use imaging mass cytometry5 to simultaneously quantify 35 biomarkers, resulting in 720 high-dimensional pathology images of tumour tissue from 352 patients with breast cancer, with long-term survival data available for 281 patients. Spatially resolved, single-cell analysis identified the phenotypes of tumour and stromal single cells, their organization and their heterogeneity, and enabled the cellular architecture of breast cancer tissue to be characterized on the basis of cellular composition and tissue organization. Our analysis reveals multicellular features of the tumour microenvironment and novel subgroups of breast cancer that are associated with distinct clinical outcomes. Thus, spatially resolved, single-cell analysis can characterize intratumour phenotypic heterogeneity in a disease-relevant manner, with the potential to inform patient-specific diagnosis

Imaging mass cytometry and multiplatform genomics define the phenogenomic landscape of breast cancer

Genomic alterations shape cell phenotypes and the structure of tumor ecosystems in poorly defined ways. To investigate these relationships, we used imaging mass cytometry to quantify the expression of 37 proteins with subcellular spatial resolution in 483 tumors from the METABRIC cohort. Single-cell analysis revealed cell phenotypes spanning epithelial, stromal and immune types. Distinct combinations of cell phenotypes and cell–cell interactions were associated with genomic subtypes of breast cancer. Epithelial luminal cell phenotypes separated into those predominantly impacted by mutations and those affected by copy number aberrations. Several features of tumor ecosystems, including cellular neighborhoods, were linked to prognosis, illustrating their clinical relevance. In summary, systematic analysis of single-cell phenotypic and spatial correlates of genomic alterations in cancer revealed how genomes shape both the composition and architecture of breast tumor ecosystems and will enable greater understanding of the phenotypic impact of genomic alterations

Which patients with heart failure should receive specialist palliative care?

AIMS: We investigated which patients with heart failure (HF) should receive specialist palliative care (SPC) by first creating a definition of need for SPC in patients hospitalised with HF using patient-reported outcome measures (PROMs) and then testing this definition using the outcome of days alive and out of hospital (DAOH). We also evaluated which baseline variables predicted need for SPC and whether those with this need received SPC. METHODS AND RESULTS: PROMs assessing quality of life (QoL), symptoms, and mood were administered at baseline and every 4 months. SPC need was defined as persistently severe impairment of any PROM without improvement (or severe impairment immediately preceding death). We then tested whether need for SPC, so defined, was reflected in DAOH, a measure which combines length of stay, days of hospital re-admission, and days lost due to death. Of 272 patients recruited, 74 (27%) met the definition of SPC needs. These patients lived one third fewer DAOH than those without SPC need (and less than a quarter of QoL-adjusted DAOH). A Kansas City Cardiomyopathy Questionnaire (KCCQ) summary score of <29 identified patients who subsequently had SPC needs (area under receiver operating characteristic curve 0.78). Twenty-four per cent of patients with SPC needs actually received SPC (n = 18). CONCLUSIONS: A quarter of patients hospitalised with HF had a need for SPC and were identified by a low KCCQ score on admission. Those with SPC need spent many fewer DAOH and their DAOH were of significantly worse quality. Very few patients with SPC needs accessed SPC services

Home parenteral nutrition with an omega-3-fatty-acid-enriched MCT/LCT lipid emulsion in patients with chronic intestinal failure (the HOME study):study protocol for a randomized, controlled, multicenter, international clinical trial

BACKGROUND: Home parenteral nutrition (HPN) is a life-preserving therapy for patients with chronic intestinal failure (CIF) indicated for patients who cannot achieve their nutritional requirements by enteral intake. Intravenously administered lipid emulsions (ILEs) are an essential component of HPN, providing energy and essential fatty acids, but can become a risk factor for intestinal-failure-associated liver disease (IFALD). In HPN patients, major effort is taken in the prevention of IFALD. Novel ILEs containing a proportion of omega-3 polyunsaturated fatty acids (n-3 PUFA) could be of benefit, but the data on the use of n-3 PUFA in HPN patients are still limited. METHODS/DESIGN: The HOME study is a prospective, randomized, controlled, double-blind, multicenter, international clinical trial conducted in European hospitals that treat HPN patients. A total of 160 patients (80 per group) will be randomly assigned to receive the n-3 PUFA-enriched medium/long-chain triglyceride (MCT/LCT) ILE (Lipidem/Lipoplus® 200 mg/ml, B. Braun Melsungen AG) or the MCT/LCT ILE (Lipofundin® MCT/LCT/Medialipide® 20%, B. Braun Melsungen AG) for a projected period of 8 weeks. The primary endpoint is the combined change of liver function parameters (total bilirubin, aspartate transaminase and alanine transaminase) from baseline to final visit. Secondary objectives are the further evaluation of the safety and tolerability as well as the efficacy of the ILEs. DISCUSSION: Currently, there are only very few randomized controlled trials (RCTs) investigating the use of ILEs in HPN, and there are very few data at all on the use of n-3 PUFAs. The working hypothesis is that n-3 PUFA-enriched ILE is safe and well-tolerated especially with regard to liver function in patients requiring HPN. The expected outcome is to provide reliable data to support this thesis thanks to a considerable number of CIF patients, consequently to broaden the present evidence on the use of ILEs in HPN. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03282955. Registered on 14 September 2017