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The history of the British Isles and Ireland is characterized by multiple periods of major cultural change, including the influential transformation after the end of Roman rule, which precipitated shifts in language, settlement patterns and material culture 1 . The extent to which migration from continental Europe mediated these transitions is a matter of long-standing debate 2 – 4 . Here we study genome-wide ancient DNA from 460 medieval northwestern Europeans—including 278 individuals from England—alongside archaeological data, to infer contemporary population dynamics. We identify a substantial increase of continental northern European ancestry in early medieval England, which is closely related to the early medieval and present-day inhabitants of Germany and Denmark, implying large-scale substantial migration across the North Sea into Britain during the Early Middle Ages. As a result, the individuals who we analysed from eastern England derived up to 76% of their ancestry from the continental North Sea zone, albeit with substantial regional variation and heterogeneity within sites. We show that women with immigrant ancestry were more often furnished with grave goods than women with local ancestry, whereas men with weapons were as likely not to be of immigrant ancestry. A comparison with present-day Britain indicates that subsequent demographic events reduced the fraction of continental northern European ancestry while introducing further ancestry components into the English gene pool, including substantial southwestern European ancestry most closely related to that seen in Iron Age France 5 , 6 . Archaeogenetic study of ancient DNA from medieval northwestern Europeans reveals substantial increase of continental northern European ancestry in Britain, suggesting mass migration across the North Sea during the Early Middle Ages.

Written in stone A collection of stone tools from East Anglia has been dated at around 700,000 years old, making them the the earliest signs of human activity in northern Europe by about 200,000 years. Humans were present in sunnier southern Europe before 750,000 years ago, but until now there were no traces of human activity north of the Alps before half a million years ago. The flint artefacts found at Pakefield, near Lowestoft, extend human activity in Britain and the entire northern European landmass back to an antiquity we're more used to from southern Europe. The tools are from the well known Cromer Forest-bed Formation, which has yielded Ice Age fossils for over a century. But this find was notable as the 32 worked flints, including the scraper shown on the cover, were in a clearly datable stratigraphic context. Go to tinyurl.com/d2zko for video clips of the press conference announcing this discovery. The colonization of Eurasia by early humans is a key event after their spread out of Africa, but the nature, timing and ecological context of the earliest human occupation of northwest Europe is uncertain and has been the subject of intense debate 1 . The southern Caucasus was occupied about 1.8 million years (Myr) ago 2 , whereas human remains from Atapuerca-TD6, Spain (more than 780 kyr ago) 3 and Ceprano, Italy (about 800 kyr ago) 4 show that early Homo had dispersed to the Mediterranean hinterland before the Brunhes–Matuyama magnetic polarity reversal (780 kyr ago). Until now, the earliest uncontested artefacts from northern Europe were much younger, suggesting that humans were unable to colonize northern latitudes until about 500 kyr ago 5 , 6 . Here we report flint artefacts from the Cromer Forest-bed Formation at Pakefield (52° N), Suffolk, UK, from an interglacial sequence yielding a diverse range of plant and animal fossils. Event and lithostratigraphy, palaeomagnetism, amino acid geochronology and biostratigraphy indicate that the artefacts date to the early part of the Brunhes Chron (about 700 kyr ago) and thus represent the earliest unequivocal evidence for human presence north of the Alps.

Over the last three decades isotope studies have become a mainstay of archaeological investigations into human diet and mobility. A small comparative sample of faunal remains often underpins these studies, used to create baselines, proxies, and provide relative information for building interpretations of the human isotope values (for example, Katzenberg 2000; Lightfoot et al. 2009; Mays 2000; Müldner 2013; Müldner and Richards 2005; Stevens et al. 2012). In recent years, the value of studying the isotope data of faunal material has been increasingly recognized. Studies of this kind have allowed detailed research into animal diets (Hamilton and Thomas 2012; Madgwick

Over the last three decades isotope studies have become a mainstay of archaeological investigations into human diet and mobility. A small comparative sample of faunal remains often underpins these studies, used to create baselines, proxies, and provide relative information for building interpretations of the human isotope values (for example, Katzenberg 2000; Lightfoot et al. 2009; Mays 2000; Müldner 2013; Müldner and Richards 2005; Stevens et al. 2012). In recent years, the value of studying the isotope data of faunal material has been increasingly recognized. Studies of this kind have allowed detailed research into animal diets (Hamilton and Thomas 2012; Madgwick

Numerous taphonomic processes have the potential to selectively remove animal bones from the archaeological record. This introduces bias into faunal assemblages, which can impact zooarchaeological analyses. Unless this bias is accounted for, there is potential for the misinterpretation of archaeological faunal assemblages. It has long been acknowledged that destructive taphonomic processes are largely mediated by bone density, and relative bone density measurements are frequently used to assess the biases caused by bone destruction. Previous researchers have produced bone density values for a range of animal taxa and skeletal locations. Results are often based on small samples of modern specimens, and methods of density measurement are often problematic. This thesis develops a new bone density measurement method based on photodensitometry, which is used to produce density data for 95 well-provenanced modern sheep skeletons. Age-related density variation is a prime focus for exploration. Results show bone density to be extremely variable between very similar individuals. Bone density is not affected by the method used to deflesh the specimens. Male sheep appear to have higher skeletal densities than castrates. Differences in bone density between breeds may reflect different animal management regimes. Bone density is shown to vary according to the age of an animal in a non-linear manner. The data produced by this project were used to assess the taphonomic histories of faunal material from Catalhoyuk, Turkey. It is apparent that structurally internal areas at the site have been subject to lower levels of taphonomic destruction than external areas, and carnivore gnawing may be largely responsible for this discrepancy. Taphonomic destruction has not significantly altered the age profile of the archaeological material. Density data do not fully explain the observed element frequencies at Catalhoyuk. This suggests that other variables (bone size, direction of force) also contribute to the ability of a bone to survive taphonomic destruction.

On the occasion of the exhibition 'Lowry and the Painting of Modern Life', on view at Tate Britain, London (26 June-20 Oct. 2013), the author argues that the British artist's views of industrialized Manchester reveal an \"alter-city\", comprised of edgelands, wastelands and marginal spaces. He considers works such as 'River Scene (Industrial Landscape)' (1935), and 'The Lake' (1937; col. illus.), suggesting that such visionary images go beyond Lowry's reputation as a painter of gritty reality.

Objectives To investigate the association of lifestyle factors with risk of inflammatory polyarthritis (IP) and rheumatoid arthritis (RA). Methods The European Prospective Investigation of Cancer, Norfolk, UK (EPIC-Norfolk) gathered lifestyle data from participants aged 40–79 years from 1993 to 1997. Individuals who subsequently developed IP were identified by linkage with the Norfolk Arthritis Register. A Cox proportional hazard model was developed, and a score assigned to each risk factor to calculate the odds of developing IP. Results 25 455 EPIC participants were followed for a median (IQR) of 14.2 (12.9, 15.3) years; 184 developed incident IP (138 cumulatively fulfilled criteria for RA; 107 were seropositive). Pack-years of smoking were associated with increased risk of IP and RA in men (HR 1.21 (95% CI 1.08 to 1.37) per 10-pack-years) and seropositive IP (HR 1.24 (95% CI 1.10 to 1.41)) for all. Diabetes mellitus was associated with increased risk of IP (HR 2.54 (95% CI 1.26 to 5.09)), while alcohol (HR 0.86 (95% CI 0.74 to 0.99) per unit/day) and higher social class (HR 0.36 (95% CI 0.15 to 0.89) for professionals vs manual workers) were associated with reduced risk. Body mass index was associated with seronegative IP (HR 2.75 (95% CI 1.39 to 5.46) for obese vs normal-weight participants). In women, parity (HR 2.81 (95% CI 1.37 to 5.76) for ≥2 vs no children) was associated with increased risk, and breast feeding (HR 0.66 (95% CI 0.46 to 0.94) for every 52 weeks of breast feeding) was inversely associated with risk. Risk factors from the model were used to generate a ‘risk score’. A total of 1159 (8.4%) women had scores reflecting a >3-fold increased risk of IP over those with a score of 0. Conclusions Several easily ascertained clinical and lifestyle factors can be used to stratify populations for risk of IP.

Background COVID-19 has challenged health services throughout the world in terms of hospital capacity and put staff and vulnerable populations at risk of infection. In the face of these challenges, many health providers have implemented remote patient monitoring (RPM) of COVID-19 patients in their own homes. However systematic reviews of the literature on these implementations have revealed wide variations in how RPM is implemented; along with variations in particulars of RPM reported on, making comparison and evaluation difficult. A review of reported items is warranted to develop a framework of key items to enhance reporting consistency. The aims of this review of remote monitoring for COVID-19 patients are twofold: (1) to facilitate comparison between RPM implementations by tabulating information and values under common domains. (2) to develop a reporting framework to enhance reporting consistency. Method A review of the literature for RPM for COVID-19 patients was conducted following PRISMA guidelines. The Medline database was searched for articles published between 2020 to February 2023 and studies reporting on items with sufficient detail to compare one with another were included. Relevant data was extracted and synthesized by the lead author. Quality appraisal was not conducted as the the articles considered were evaluated as informational reports of clinical implementations rather than as studies designed to answer a research question. Results From 305 studies retrieved, 23 studies were included in the review: fourteen from the US, two from the UK and one each from Africa, Ireland, China, the Netherlands, Belgium, Australia and Italy. Sixteen generally reported items were identified, shown with the percentage of studies reporting in brackets: Reporting Period (82%), Rationale (100%), Patients (100%), Medical Team (91%) Provider / Infrastructure (91%), Communications Platform (100%), Patient Equipment (100%), Training (48%), Markers (96%), Frequency of prompt / Input (96%),Thresholds (82%), Discharge (61%), Enrolled (96%), Alerts/Escalated (78%), Patient acceptance (43%), and Patient Adherence (52%). Whilst some studies reported on patient training and acceptance, just one reported on staff training and none on staff acceptance. Conclusions Variations in reported items were found. Pending the establishment of a robust set of reporting guidelines, we propose a reporting framework consisting of eighteen reporting items under the following four domains: Context, Technology, Process and Metrics.

IntroductionThe use of remote monitoring technology to manage the care of patients with COVID-19 has been implemented to help reduce the burden placed on healthcare systems during the pandemic and protect the well-being of both staff and patients. Remote monitoring allows patients to record their signs and symptoms remotely (eg, while self-isolating at home) rather than requiring hospitalisation. Healthcare staff can, therefore, continually monitor their symptoms and be notified when the patient is showing signs of clinical deterioration. However, given the recency of the COVID-19 outbreak, there is a lack of research regarding the acceptance of remote monitoring interventions to manage COVID-19. This study will aim to evaluate the use of remote monitoring for managing COVID-19 cases from the perspective of both the patient and healthcare staff.Methods and analysisDischarged patients from a large urban teaching hospital in Ireland, who have undergone remote monitoring for COVID-19, will be recruited to take part in a cross-sectional study consisting of a quantitative survey and a qualitative interview. A mixed methods design will be used to understand the experiences of remote monitoring from the perspective of the patient. Healthcare staff who have been involved in the provision of remote monitoring of patients with COVID-19 will be recruited to take part in a qualitative interview to understand their experiences with the process. Structural equation modelling will be used to examine the acceptance of the remote monitoring technology. Latent class analysis will be used to identify COVID-19 symptom profiles. Interview data will be examined using thematic analysis.Ethics and disseminationEthical approval has been granted by the ethical review boards at University College Dublin and the National Research Ethics Committee for COVID-19-related Research. Findings will be disseminated via publications in scientific journals, policy briefs, short reports and social media.