Effects on obese women of the sugar sucrose added to the diet over 28 d: a quasi-randomised, single-blind, controlled trial

To investigate whether obese women can compensate for sucrose added to the diet when it is given blind, rather than gaining weight or exhibiting dysfunctional regulation of intake, in the present study, forty-one healthy obese (BMI 30–35 kg/m2) women (age 20–50 years), not currently dieting, were randomly assigned to consume sucrose (n 20) or aspartame (n 21) drinks over 4 weeks in a parallel single-blind design. Over the 4 weeks, one group consumed 4 × 250 ml sucrose drinks (total 1800 kJ/d) and the other group consumed 4 × 250 ml aspartame drinks. During the baseline week and experimental weeks, body weight and other biometric data were measured and steps per day, food intake using 7 d unweighed food diaries, and mood using ten- or seven-point Likert scales four times a day were recorded. At the end of the experiment, the participants weighed 1·72 (se 0·47) kg less than the value predicted by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) model; the predicted body weight accounted for 94·3 % of the variance in the observed body weight and experimental group accounted for a further 1·1 % of the variance in the observed body weight, showing that women consuming sucrose drinks gained significantly less weight than predicted. The reported daily energy intake did not increase significantly, and sucrose supplements significantly reduced the reported voluntary sugar, starch and fat intake compared with aspartame. There were no effects on appetite or mood. Over 4 weeks, as part of everyday eating, sucrose given blind in soft drinks was partially compensated for by obese women, as in previous experiments with healthy and overweight participants

Late Quaternary glaciation in the Hebrides sector of the continental shelf : cosmogenic nuclide dating of glacial events on the St Kilda archipelago

The authors thank NERC-CIAF for funding analysis of the 10Be and 36Cl exposure ages (Allocation 9116/0412), the Carnegie Trust for the Universities of Scotland for a grant towards travel expenses.The St Kilda archipelago lies ~65 km west of the Outer Hebrides and ~60 km east of the Atlantic shelf break, and represents a key site for testing the assertion that during the Last Local Glacial Maximum (LLGM; c. 27 ka) the British–Irish Ice Sheet (BIIS) extended to near the shelf edge in all sectors. Two consistent cosmogenic 36Cl exposure ages averaging (≥) 81.6±7.8 ka for perched boulders at 290 m altitude demonstrate that the last ice sheet failed to over-run high ground on the largest island, Hirta. 36Cl and 10Be exposure ages for glacially emplaced boulders on low ground indicate deposition by small, locally nourished glaciers that last occupied a north-facing valley (Gleann Mòr) at c. 30.9±3.2 ka, prior to extension of the last ice sheet to the outer shelf, and a south-facing valley (Village Bay) at c. 19.2±2.3 ka, several millennia after the LLGM. Our dating evidence is consistent with previous interpretations of lithostratigraphical, seismostratigraphical and geomorphological evidence and confirms that the last ice sheet failed to encroach on St Kilda. A simple ice-flow model demonstrates that even if thin, low-gradient ice lobes encircled the archipelago during the LLGM, the ice margin can only have reached the outermost moraine banks, ~40 km west of St Kilda, under extremely low (<2 kPa) driving stresses, implying either surge-like transient streaming behaviour at the ice-sheet margin or that the moraine banks relate to an earlier, more extensive ice sheet. The final glaciation of the Village Bay area at c. 19.2±2.3 ka was out of phase with the behaviour of the BIIS, which was undergoing net retreat during this period.PostprintPeer reviewe

A non-randomised controlled pilot study of clinical pharmacist collaborative intervention for community dwelling patients with COPD

UK, home-based patients with COPD receive specialist care from respiratory physicians, nurses, and general practitioners (GPs), but increasing complexity of therapeutic options and a GP/Nurse workforce crisis suggests merit in testing the role of home visits by a clinical pharmacist. We conducted a non-randomised intervention study with a contemporaneous comparator group, in Glasgow (Scotland). A clinical pharmacist (working closely with a consultant respiratory physician) visited patients with COPD living at home, assessing respiratory and other co-morbid conditions, and medicines then, with patient approval, agreed treatment modifications with a consultant physician. Comparator group-patients were drawn from another hospital out-patient clinic. Main outcomes were exacerbations during 4-months of follow-up and respiratory hospitalisations (number and duration) after 1 year. In the intervention group, 86 patients received a median of three home visits; 87 received usual care (UC). At baseline, patients in the intervention group were similar to those in UC in terms of respiratory hospitalisations although slightly younger, more likely to receive specific maintenance antibiotics/Prednisolone and to have had exacerbations. Sixty-two (72.1%) of the intervention group received dose changes; 45 (52.3%) had medicines stopped/started and 21 (24.4%) received an expedited review at the specialist respiratory consultant clinic; 46 (53.5%) were referred to other healthcare services. Over one-third were referred for bone scans and 11% received additional investigations. At follow-up, 54 (63.5%) of intervention group participants had an exacerbation compared with 75 (86.2%) in the UC group (p = 0.001); fewer had respiratory hospitalisations (39 (45.3%) vs. 66 (76.7%); p &lt; 0.001). Hospitalisations were shorter in the intervention group. Pharmacist-consultant care for community dwelling patients with COPD, changed clinical management and improved outcomes. A randomised controlled trial would establish causality

Possible climatically driven, later prehistoric woodland decline on Ben Lomond, central Scotland

Later prehistoric woodland decline over most parts of Scotland is widely regarded as having been anthropogenic, via a range of mechanisms, to create farmland. Climatic causes are seen only to have driven the rapid expansion and then terminal decline of Pinus sylvestris around 2000 cal BC. Here we report radiocarbon dated analyses of pollen, microscopic charcoal, coprophilous fungal spores and peat humification from a small, water-shedding interfluve peat bog at 230 m elevation on the west-facing slope of the mountain Ben Lomond in west-central Scotland. The record spans the interval ca. 3450 − 200 cal BC. It shows marked and rapid changes in woodland composition before ca. 2600 cal BC, and from then to ca. 1940 cal BC a gradual decline of Betula woodland. This happened with no palaeoecological or archaeological evidence for anthropogenic activity. Woodland decline is interpreted at this site as climatically driven, perhaps through paludification or, more likely, exposure to wind, within a period of pronounced climatic deterioration. Anthropogenic activities are hinted at only after ca. 850 cal BC.Output Status: Forthcoming/Available Onlin

Efficacy and safety of elinzanetant, a selective neurokinin-1,3 receptor antagonist for vasomotor symptoms: a dose-finding clinical trial (SWITCH-1)

OBJECTIVE: Neurokinin (NK)-3 and NK-1 receptors have been implicated in the etiology of vasomotor symptoms (VMS) and sleep disturbances associated with menopause. This phase 2b, adaptive, dose-range finding study aimed to assess the efficacy and safety of multiple doses of elinzanetant (NT-814), a selective NK-1,3 receptor antagonist, in women experiencing VMS associated with menopause, and investigate the impact of elinzanetant on sleep and quality of life. METHODS: Postmenopausal women aged 40 to 65 years who experienced seven or more moderate-to-severe VMS per day were randomized to receive elinzanetant 40, 80, 120, or 160 mg or placebo once daily using an adaptive design algorithm. Coprimary endpoints were reduction in mean frequency and severity of moderate-to-severe VMS at weeks 4 and 12. Secondary endpoints included patient-reported assessments of sleep and quality of life. RESULTS: Elinzanetant 120 mg and 160 mg achieved reductions in VMS frequency versus placebo from week 1 throughout 12 weeks of treatment. Least square mean reductions were statistically significant versus placebo at both primary endpoint time points for elinzanetant 120 mg (week 4: -3.93 [SE, 1.02], P \u3c 0.001; week 12: -2.95 [1.15], P = 0.01) and at week 4 for elinzanetant 160 mg (-2.63 [1.03]; P = 0.01). Both doses also led to clinically meaningful improvements in measures of sleep and quality of life. All doses of elinzanetant were well tolerated. CONCLUSIONS: Elinzanetant is an effective and well-tolerated nonhormone treatment option for postmenopausal women with VMS and associated sleep disturbance. Elinzanetant also improves quality of life in women with VMS

Tropical nighttime warming as a dominant driver of variability in the terrestrial carbon sink

The terrestrial biosphere is currently a strong carbon (C) sink but may switch to a source in the 21st century as climate-driven losses exceed CO2-driven C gains, thereby accelerating global warming. Although it has long been recognized that tropical climate plays a critical role in regulating interannual climate variability, the causal link between changes in temperature and precipitation and terrestrial processes remains uncertain. Here, we combine atmospheric mass balance, remote sensing-modeled datasets of vegetation C uptake, and climate datasets to characterize the temporal variability of the terrestrial C sink and determine the dominant climate drivers of this variability. We show that the interannual variability of global land C sink has grown by 50–100% over the past 50 y. We further find that interannual land C sink variability is most strongly linked to tropical nighttime warming, likely through respiration. This apparent sensitivity of respiration to nighttime temperatures, which are projected to increase faster than global average temperatures, suggests that C stored in tropical forests may be vulnerable to future warming