Rubidium in the Interstellar Medium

We present observations of interstellar rubidium toward o Per, zeta Per, AE Aur, HD 147889, chi Oph, zeta Oph, and 20 Aql. Theory suggests that stable 85Rb and long-lived 87Rb are produced predominantly by high-mass stars, through a combination of the weak s- and r-processes. The 85Rb/87Rb ratio was determined from measurements of the Rb I line at 7800 angstroms and was compared to the solar system meteoritic ratio of 2.59. Within 1-sigma uncertainties all directions except HD 147889 have Rb isotope ratios consistent with the solar system value. The ratio toward HD 147889 is much lower than the meteoritic value and similar to that toward rho Oph A (Federman et al. 2004); both lines of sight probe the Rho Ophiuchus Molecular Cloud. The earlier result was attributed to a deficit of r-processed 85Rb. Our larger sample suggests instead that 87Rb is enhanced in these two lines of sight. When the total elemental abundance of Rb is compared to the K elemental abundance, the interstellar Rb/K ratio is significantly lower than the meteoritic ratio for all the sight lines in this study. Available interstellar samples for other s- and r- process elements are used to help interpret these results.Comment: 24 pages, 3 figures. Accepted for publication in Ap

Establishment of Adult Reference Values For Some Biochemical Analytes in A Rwandan Population

Objectives: To establish the reference values for some routinely performed biochemical analytes in CHUK.Design: Cross-sectional descriptive study.Settings: National Center for Blood Transfusion, Rwanda and Kigali University Teaching Hospital,  Laboratory Department. This study was conducted during the period between 15th September 2014 and 23rd February in 2015.Subjects: Blood donors donating blood at National Center for Blood Donation, and recruited by mobile teams across the country.Results: Median (Reference values:2.5th and 97.5th percentiles) for male and female respectively: Bilirubin Direct,3.9(2-6.9) and 3.9(2.6-6.5) μmol/L; Bilirubin Total,10.3(4.8-21.6) and 10.4(5.9-17.3) μmol/L; Aspartate Aminotransferase, 27.8(16.1-49.2) and 26.7(16.8-45.1) U/L;Urea,3.2(1.3-5.8) and 3.1(1.4-5.2)mmol/L; Glucose, 5.0(3.2-7.7) and 4.6(3.1-6.7) mmol/L; Total Proteins, 76.8(68.2-87.7) and 76.9(66.6-85.7)g/L; Albumin, 46.4(39.7-55.5) and 46.7(40-54.5) g/L; Alanine Aminotransferase,  17.1(7.2-36.2) and 16.0(7.3-33.9) U/L; Gamma Glutamyltransferase, 20.3(8-75.6) and 21.1(7.1-63.3) U/L; Alkaline Phosphatase, 74.3(43.8-145.7) and 73.5(50.3-135.4) U/L; Creatinine, 84.4(65.2- 107.1) and 81.1(62.5-98.6) μmol/L; Sodium, 139.0(134.5-145.5) and 141.0(134.5-146.5) mmol/L; Potassium, .4.4(3.7-5) and 4.3(3.5-5.0) mmol/L; Chloride, 95.7(89.9-104.2) and 99.3(90.6-103.1) mmol/L;  Magnesium, 0.9(0.7-1.0) and 0.9(0.7-1) mmol/L; Phosphate, 1.1(0.8-1.5) and 1.2(0.7-1.6) mmol/L.Conclusion: The results of our study on Clinical Chemistry parameters are similar to those published in other African countries, with variations due to the diet and geographical location. This study has shown that a strict adherence to reference ranges developed from industrialised countries could qualify many healthy Rwandans as pathological cases, and also exclude them from participating in clinical trials. Compared to other reference ranges established, reference values in our study presented remarkably low levels of urea which may be due to the diet low in proteins generally in Rwandan population

IN VITRO ANTIOXIDANT ACTIVITY AND QUANTITATIVE ESTIMATION OF PHENOLIC CONTENT OF LAGENARIA SICERARIA

ABSTRACT The plant, Lagenaria siceraria (Family: Cucurbitaceae), known as bottle gourd, Calabash, Doodhi, and Lauki, is a common fruit vegetable used throughout the India. The antioxidant activities of different concentrations of ethanol extracts of fruits of Lagenaria siceraria the were determined by the four assay techniques i.e. DPPH radical scavenging assay, Reducing power ability, Hydrogen peroxide scavenging assay and thiocyanate method. Ethanol extract of fruits of Lagenaria siceraria has shown effective antioxidant activity in all assay techniques. The results obtained in the present study indicate that the fruits of Lagenaria siceraria are a potential source of natural antioxidants

Co-designed weight management intervention for women recovering from oestrogen-receptor positive breast cancer

Background: Weight gain is commonly observed during and after breast cancer treatment and is associated with poorer survival outcomes, particularly in women with oestrogen receptor-positive (ER +) disease. The aim of this study was to co-design (with patients) a programme of tailored, personalised support (intervention), including high-quality support materials, to help female breast cancer patients (BCPs) with ER + disease to develop the skills and confidence needed for sustainable weight loss. Methods: ER + BCPs were recruited from two UK National Health Service (NHS) Trusts. The selection criteria included (i) recent experience of breast cancer treatment (within 36 months of completing primary treatment); (ii) participation in a recent focus group study investigating weight management perceptions and experiences; (iii) willingness to share experiences and contribute to discussions on the support structures needed for sustainable dietary and physical activity behaviour change. Co-design workshops included presentations and interactive activities and were facilitated by an experienced co-design researcher (HH), assisted by other members of the research team (KP, SW and JS). Results: Two groups of BCPs from the North of England (N = 4) and South Yorkshire (N = 5) participated in a two-stage co-design process. The stage 1 and stage 2 co-design workshops were held two weeks apart and took place between Jan–March 2019, with each workshop being approximately 2 h in duration. Guided by the Behaviour Change Wheel, a theoretically-informed weight management intervention was developed on the basis of co-designed strategies to overcome physical and emotional barriers to dietary and physical activity behaviour change. BCPs were instrumental in designing all key features of the intervention, in terms of Capability (e.g., evidence-based information, peer-support and shared experiences), Opportunity (e.g., flexible approach to weight management based on core principles) and Motivation (e.g., appropriate use of goal-setting and high-quality resources, including motivational factsheets) for behaviour change. Conclusion: This co-design approach enabled the development of a theoretically-informed intervention with a content, structure and delivery model that has the potential to address the weight management challenges faced by BCPs diagnosed with ER + disease. Future research is required to evaluate the effectiveness of the intervention for eliciting clinically-important and sustainable weight loss in this population

Dietary approaches to the management of type 2 diabetes (DIAMOND) in primary care: a protocol for a cluster randomised trial

Introduction There is strong evidence that type 2 diabetes (T2D) remission can be achieved by adopting a low-energy diet achieved through total dietary replacement products. There is promising evidence that low-carbohydrate diets can achieve remission of T2D. The Dietary Approaches to the Management of type 2 Diabetes (DIAMOND) programme combines both approaches in a behaviourally informed low-energy, low-carbohydrate diet for people with T2D, delivered by nurses in primary care. This trial compares the effectiveness of the DIAMOND programme to usual care in inducing remission of T2D and in reducing risk of cardiovascular disease. Methods and analysis We aim to recruit 508 people in 56 practices with T2D diagnosed within 6 years, who are demographically representative of the UK population. We will allocate general practices, based on ethnicity and socioeconomic status, to provide usual care for diabetes or offer the DIAMOND programme. Participants in practices offering DIAMOND will see the nurse seven times over 6 months. At baseline, 6 months, and 1 year we will measure weight, blood pressure, HbA1c, lipid profile and risk of fatty liver disease. The primary outcome is diabetes remission at 1 year, defined as HbA1c < 48 mmol/mol and off glucose-lowering medication for at least 6 months. Thereafter, we will assess whether people resume treatment for diabetes and the incidence of microvascular and macrovascular disease through the National Diabetes Audit. Data will be analysed using mixed-effects generalised linear models. This study has been approved by the National Health Service Health Research Authority Research Ethics Committee (Ref: 22/EM/0074). Trial Registration number: ISRCTN46961767

An African Muslim Saint and his Followers in France

This paper explores the practice of Islam among a relatively understudied group of Muslim migrants in France, the Halpulaaren, some of whom have been living in France for more than three decades. Drawing on field research in Senegal, Mali and France, the author considers the contexts for Halpulaaren migration to France, including the West African background to such migration and the situation migrants face in France. The author focuses on a Halpulaaren Muslim religious leader from Senegal, Mansour Baro, who has a reputation as a living Muslim saint, and his followers in France. Tierno Mansour is one of a handful of the most esteemed leaders of the Tijaniyya Sufi order in Senegal. The appeal of this saint, who annually visits Europe, for his followers in France is examined in order to try and understand some of the ways of being Muslim in the shadow of the global city with both its promises and constraints. [Journal abstract]ASC – Publicaties niet-programma gebonde

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation &lt;92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p&lt;0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p&lt;0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research