Beyond the ruins of Embobut: Transforming landscapes and livelihoods in the Cherangani hills, Kenya

The Embobut Forest, western Kenya, can be described as an entanglement of ruins. These ruins are the materialisation of a series of contested ecological debates and political decisions pivoting on the questions of conservation and community rights to land that have resulted in the violent dislocation of local Sengwer and Marakwet communities. In the first instance, this paper aims to contextualise these debates by offering an analytic focus on the process of ruination in order to offer a more nuanced narrative of landscape modification and changing human lives over the past century. Subsequently, I look beyond processes of ruination and towards notions of transformation, in an attempt expound how Embobut has not become a static world of passive ruins but rather is constantly changing as novel forms of dwelling and new ecological relationships continue to unfold in a manner not envisaged by conservation policy

Metabolic profiling reveals coordinated switches in primary carbohydrate metabolism in grape berry (Vitis vinifera L.), a non-climacteric fleshy fruit

Changes in carbohydrate metabolism during grape berry development play a central role in shaping the final composition of the fruit. The present work aimed to identify metabolic switches during grape development and to provide insights into the timing of developmental regulation of carbohydrate metabolism. Metabolites from central carbon metabolism were measured using high-pressure anion-exchange chromatography coupled to tandem mass spectrometry and enzymatic assays during the development of grape berries from either field-grown vines or fruiting cuttings grown in the greenhouse. Principal component analysis readily discriminated the various stages of berry development, with similar trajectories for field-grown and greenhouse samples. This showed that each stage of fruit development had a characteristic metabolic profile and provided compelling evidence that the fruit-bearing cuttings are a useful model system to investigate regulation of central carbon metabolism in grape berry. The metabolites measured showed tight coordination within their respective pathways, clustering into sugars and sugar-phosphate metabolism, glycolysis, and the tricarboxylic acid cycle. In addition, there was a pronounced shift in metabolism around veraison, characterized by rapidly increasing sugar levels and decreasing organic acids. In contrast, glycolytic intermediates and sugar phosphates declined before veraison but remained fairly stable post-veraison. In summary, these detailed and comprehensive metabolite analyses revealed the timing of important switches in primary carbohydrate metabolism, which could be related to transcriptional and developmental changes within the berry to achieve an integrated understanding of grape berry development. The results are discussed in a meta-analysis comparing metabolic changes in climacteric versus non-climacteric fleshy fruits

The archaeology of South Sudan from c. 3000 BC to AD 1500

This paper reviews the current state of archaeological research within the boundaries of the modern country of South Sudan, with a particular focus on the period between c. 3000 BC and AD 1500. While various historical factors and more recent political unrest have long stymied concerted archaeological efforts in the region, such surveys as have been undertaken are summarised and synthesised here, most notably the four expeditions funded by the British Institute in Eastern Africa between 1977 and 1981. Though scant, the data recovered during these and other research projects point to great diversity within the archaeological record of South Sudan, highlighting the region’s importance for addressing such large-scale issues as the transition between (or indeed the co-occurrence of) Later Stone Age and Early Iron Age lifeways, including the spread of pastoralism, arable agriculture and iron-working technology from northern to eastern Africa. The region likewise appears to have been central to the occurrence of large-scale population movements during both the Early and Later Iron Ages. However, we also emphasise the relevance of the archaeology of this period for better understanding more localised trajectories of socio-cultural change, particularly for adding time-depth to historical narratives of relevance to contemporary South Sudanese communities. / Cet article passe en revue l’état actuel des recherches archéologiques à l’intérieur des frontières de l’État actuel du Sud-Soudan, mettant un accent particulier sur la période entre 3000 av. J.-C. et 1500 après J.-C. Divers facteurs historiques, aussi bien que des troubles politiques plus récents, ont longtemps entravé les efforts archéologiques concertés dans la région. Les enquêtes qui ont néanmoins pu être réalisées sont résumées et synthétisées ici, en particulier les quatre expéditions financées par le British Institute in Eastern Africa entre 1977 et 1981. Bien que minces, les données recueillies au cours de ces projets de recherche et d’autres font ressortir une grande diversité dans les données archéologiques du Sud-Soudan, soulignant l’importance de cette région pour traiter de questions aussi vastes que la transition entre (ou la contemporanéité) des moyens de subsistance de l’âge de pierre final et de l’âge du fer ancien, y compris l’extension du pastoralisme, de l’agriculture arable et de la technologie du travail du fer du nord vers l’est de l’Afrique. La région semble aussi avoir joué un rôle central dans des mouvements de population à grande échelle pendant l’âge du fer aussi bien ancien que plus récent. Cependant, nous soulignons également l’importance de l'archéologie de cette période pour une meilleure compréhension des trajectoires plus locales de changement socioculturel, et en particulier le potentiel qui s’offre de pouvoir ajouter de la profondeur aux récits historiques pertinents pour les communautés actuelles du Sud-Soudan

Unhappiness, health and cognitive ability in old age

Background To test whether scores on depression inventories on entry to a longitudinal study predict mental ability over the next 4–16 years. Method Associations between scores on the Beck Depression Inventory and on tests of intelligence, vocabulary and memory were analysed in 5070 volunteers aged 49–93 years after differences in prescribed drug consumption, death and drop-out, sex, socio-economic advantage and recruitment cohort effects had also been considered. Results On all cognitive tasks Beck scores on entry, even in the range 0–7 indicating differences in above average contentment, affected overall levels of cognitive performance but not rates of age-related cognitive decline suggesting effects of differences in life satisfaction rather than in depression. Conclusions A new finding is that, in old age, increments in life satisfaction are associated with better cognitive performance. Implications for interpreting associations between depression inventory scores and cognitive performance in elderly samples are discussed

Early VEGF testing in inflammatory neuropathy avoids POEMS syndrome misdiagnosis and associated costs

BACKGROUND: Prompt diagnosis and early treatment prevents disability in Polyneuropathy Organomegaly Endocrinopathy Monoclonal-protein and Skin Changes (POEMS) syndrome. Delay in diagnosis is common with 55% of patients initially incorrectly diagnosed with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Patients are often treated with intravenous immunoglobulin which is both expensive and ineffective in the treatment of POEMS. Testing patients with acquired demyelinating neuropathy with serum vascular endothelial growth factor (VEGF) more accurately identifies POEMS syndrome than the current standard of care. Incorporating VEGF testing into screening could prevent misdiagnosis and reduce costs. METHODS: We used observed treatment information for patients in the University College London Hospital's POEMS syndrome database (n=100) and from the National Immunoglobulin Database to estimate costs associated with incorrect CIDP diagnoses across our cohort. We conducted a model-based cost-effectiveness analysis to compare the current diagnostic algorithm with an alternative which includes VEGF testing for all patients with an acquired demyelinating neuropathy. RESULTS: Treatment associated with an incorrect CIDP diagnosis led to total wasted healthcare expenditures of between £808 550 and £1 111 756 across our cohort, with an average cost-per-POEMS-patient misdiagnosed of £14 701 to £20 214. Introducing mandatory VEGF testing for patients with acquired demyelinating neuropathy would lead to annual cost-savings of £107 398 for the National Health Service and could prevent misdiagnosis in 16 cases per annum. CONCLUSIONS: Misdiagnosis in POEMS syndrome results in diagnostic delay, disease progression and significant healthcare costs. Introducing mandatory VEGF testing for patients with acquired demyelinating neuropathy is a cost-effective strategy allowing for early POEMS diagnosis and potentially enabling prompt disease-directed therapy

POEMS neuropathy: optimising diagnosis and management

POEMS syndrome is a rare and disabling autoinflammatory condition characterised by a typical peripheral neuropathy and the presence of a monoclonal plasma cell disorder. The acronym 'POEMS' represents the complex and multisystem features of the disease, including polyneuropathy, organomegaly, endocrinopathy, a monoclonal plasma cell disorder and skin disease. The diagnosis of POEMS is a significant challenge because of the heterogeneity of clinical presentations and variation of POEMS features. Patients are often misdiagnosed with another cause of inflammatory neuropathy and receive one or more ineffective immunomodulatory medications, resulting in delayed diagnosis and further clinical deterioration before a diagnosis is made. University College London Hospitals sees one of the largest reported POEMS cohorts in Europe, and runs a multispecialist clinic to assist with diagnosis, treatment and ongoing support. This review draws upon our experience to present the typical features of POEMS syndrome and highlight diagnostic conundrums commonly experienced, supplemented with clinical cases. We provide an investigative guide for clinicians when considering POEMS as the diagnosis, and propose a treatment algorithm that centres on the site and degree of monoclonal cell proliferation