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We present the serendipitous radio-continuum discovery of a likely Galactic supernova remnant (SNR) G305.4–2.2. This object displays a remarkable circular symmetry in shape, making it one of the most circular Galactic SNRs known. Nicknamed Teleios due to its symmetry, it was detected in the new Australian Square Kilometre Array Pathfinder (ASKAP) Evolutionary Map of the Universe (EMU) radio–continuum images with an angular size of 1 320$^{\prime\prime}$$\times$1 260$^{\prime\prime}$ and PA = 0$^\circ$. While there is a hint of possible H$\alpha$ and gamma-ray emission, Teleios is exclusively seen at radio–continuum frequencies. Interestingly, Teleios is not only almost perfectly symmetric, but it also has one of the lowest surface brightnesses discovered among Galactic SNRs and a steep spectral index of $\alpha$=–0.6$\pm$0.3. Our best estimates from Hi studies and the $\Sigma$–D relation place Teleios as a type Ia SNR at a distance of either $\sim$2.2 kpc (near-side) or $\sim$7.7 kpc (far-side). This indicates two possible scenarios, either a young (under 1 000 yr) or a somewhat older SNR (over 10 000 yr). With a corresponding diameter of 14/48 pc, our evolutionary studies place Teleios at the either early or late Sedov phase, depending on the distance/diameter estimate. However, our modelling also predicts X-ray emission, which we do not see in the present generation of eROSITA images. We also explored a type Iax explosion scenario that would point to a much closer distance of $\lt$1 kpc and Teleios size of only $\sim$3.3 pc, which would be similar to the only known type Iax remnant SN1181. Unfortunately, all examined scenarios have their challenges, and no definitive Supernova (SN) origin type can be established at this stage. Remarkably, Teleios has retained its symmetrical shape as it aged even to such a diameter, suggesting expansion into a rarefied and isotropic ambient medium. The low radio surface brightness and the lack of pronounced polarisation can be explained by a high level of ambient rotation measure (RM), with the largest RM being observed at Teleios’s centre.
The advent of next-generation telescope facilities brings with it an unprecedented amount of data, and the demand for effective tools to process and classify this information has become increasingly important. This work proposes a novel approach to quantify the radio galaxy morphology, through the development of a series of algorithmic metrics that can quantitatively describe the structure of radio source, and can be applied to radio images in an automatic way. These metrics are intuitive in nature and are inspired by the intrinsic structural differences observed between the existing Fanaroff-Riley (FR) morphology types. The metrics are defined in categories of asymmetry, blurriness, concentration, disorder, and elongation (ABCDE/single-lobe metrics), as well as the asymmetry and angle between lobes (source metrics). We apply these metrics to a sample of 480 sources from the Evolutionary Map of the Universe Pilot Survey (EMU-PS) and 72 well resolved extensively studied sources from An Atlas of DRAGNs, a subset of the revised Third Cambridge Catalogue of Radio Sources (3CRR). We find that these metrics are relatively robust to resolution changes, independent of each other, and measure fundamentally different structural components of radio galaxy lobes. These metrics work particularly well for sources with reasonable signal-to-noise and well separated lobes. We also find that we can recover the original FR classification using probabilistic combinations of our metrics, highlighting the usefulness of our approach for future large data sets from radio sky surveys.
Background: Epilepsy affects approximately 3% of Canadian children. Despite the availability of standardized seizure abortion guidelines, many patients require personalized treatment plans due to genetic factors, medical contraindications, or a history of adverse medication reactions. This study aims to create and evaluate personalized Acute Seizure Action Plans (ASAPs) for epilepsy patients at the Children’s Hospital of Eastern Ontario (CHEO). Methods: Using a Plan-Do-Check-Act (PDCA) framework, we developed electronic ASAPs for integration into participants’ electronic medical records. The effectiveness and user satisfaction of these ASAPs will be evaluated through electronic surveys administered to Neurology physicians, Emergency Department (ED) physicians, and patient participants at baseline and six months post-implementation. Results: Baseline surveys were administered to ED physicians with a 70% response rate, indicating only 43% satisfaction with current generic seizure treatment practice. One hundred percent of respondents expressed interest in using an ASAP, citing challenges in selecting the appropriate anti-seizure medications and determining when to adjust treatment as priorities. These findings underscore the need for ASAP implementation. Conclusions: ED providers desire improved seizure action plans. ASAP implementation is expected to enhance emergency seizure management, reduce adverse events among epilepsy patients, and increase satisfaction of seizure management among all participants.
Background: Late-onset Pompe disease (LOPD) is caused by a deficiency of acid α-glucosidase (GAA), leading to progressive muscle and respiratory decline. Cipaglucosidase alfa (cipa), a recombinant human GAA naturally enriched with bis-mannose-6-phosphate, exhibits improved muscle uptake but is limited by inactivation at near-neutral blood pH. Miglustat (mig), an enzyme stabiliser, binds competitively and reversibly to cipa, enhancing its stability and activity. Methods: In dose-finding studies, Gaa-/- mice were treated with cipa (20 mg/kg) +/- mig (10 mg/kg; equivalent human dose ~260 mg). Clinical study methodologies have been published (Schoser et al. Lancet Neurol 2021:20;1027–37; Schoser et al. J Neurol 2024:271;2810–23). Results: In Gaa-/- mice, cipa+mig improved muscle glycogen reduction more than cipa alone and grip strength to levels approaching wild-type mice. LOPD patients (n=11) treated with cipa alone showed dose-dependent decreases in hexose tetrasaccharide (Hex4) levels by ~15% from baseline, decreasing another ~10% with added mig (260 mg). In a head-to-head study, cipa+mig had a similar safety profile to alglucosidase alfa. Among 151 patients (three trials), mig-related adverse events occurred in 21 (13.9%), none serious. Conclusions: Mig stabilised cipa in circulation, improving cipa exposure, further reducing Hex4 levels and was well tolerated in clinical studies in patients with LOPD. Sponsored by Amicus Therapeutics, Inc.
We report the radio continuum detection of well known Galactic Planetary Nebula (PN) NGC5189, observed at 943MHz during the Australian Square Kilometre Array Pathfinder (ASKAP) Evolutionary Map of the Universe (EMU) survey. Two detections of NGC5189 have been made during the survey, of better resolution than previous radio surveys. Both measurements of the integrated flux density are consistent with each other, at S943 MHz = 0.33 ± 0.03 Jy, and the spectral luminosity is L943 MHz = 8.89 × 1013 W m–2 Hz–1. Using available flux density measurements for radio-detections of NGC5189, we calculate a radio surface brightness at 1GHz and measure Σ1 GHz = 6.0 × 10–21 W m–2 Hz–1 sr–1, which is in the expected range for Galactic PNe. We measure an apparent size of 3.′4×2.′2 corresponding to physical diameters of 1.48 pc × 0.96 pc, and combine available radio observations of NGC5189 to estimate a spectral index of α = 0.12 ± 0.05. Hence, we agree with previous findings that NGC5189 is a thermal (free–free) emitting nebula. Additional measurements of the optical depth (τ = 0.00246) and electron density (Ne = 138 cm–3) support our findings that NGC5189 is optically thin at 943 MHz. Furthermore, the radio contours from the ASKAP–EMU image have been overlaid onto a Hubble Space Telescope (HST) Wide Field Camera 3 image, demonstrating that the radio morphology closely traces the optical. Notably, the contour alignment for the innermost region highlights the two envelopes of gas previously reported to be low-ionisation structures, which is considered a defining feature of post common–envelope PNe that surround a central Wolf-Rayet star.
The Australian SKA Pathfinder (ASKAP) offers powerful new capabilities for studying the polarised and magnetised Universe at radio wavelengths. In this paper, we introduce the Polarisation Sky Survey of the Universe’s Magnetism (POSSUM), a groundbreaking survey with three primary objectives: (1) to create a comprehensive Faraday rotation measure (RM) grid of up to one million compact extragalactic sources across the southern $\sim50$% of the sky (20,630 deg$^2$); (2) to map the intrinsic polarisation and RM properties of a wide range of discrete extragalactic and Galactic objects over the same area; and (3) to contribute interferometric data with excellent surface brightness sensitivity, which can be combined with single-dish data to study the diffuse Galactic interstellar medium. Observations for the full POSSUM survey commenced in May 2023 and are expected to conclude by mid-2028. POSSUM will achieve an RM grid density of around 30–50 RMs per square degree with a median measurement uncertainty of $\sim$1 rad m$^{-2}$. The survey operates primarily over a frequency range of 800–1088 MHz, with an angular resolution of 20” and a typical RMS sensitivity in Stokes Q or U of 18 $\mu$Jy beam$^{-1}$. Additionally, the survey will be supplemented by similar observations covering 1296–1440 MHz over 38% of the sky. POSSUM will enable the discovery and detailed investigation of magnetised phenomena in a wide range of cosmic environments, including the intergalactic medium and cosmic web, galaxy clusters and groups, active galactic nuclei and radio galaxies, the Magellanic System and other nearby galaxies, galaxy halos and the circumgalactic medium, and the magnetic structure of the Milky Way across a very wide range of scales, as well as the interplay between these components. This paper reviews the current science case developed by the POSSUM Collaboration and provides an overview of POSSUM’s observations, data processing, outputs, and its complementarity with other radio and multi-wavelength surveys, including future work with the SKA.
Edited by
David Mabey, London School of Hygiene and Tropical Medicine,Martin W. Weber, World Health Organization,Moffat Nyirenda, London School of Hygiene and Tropical Medicine,Dorothy Yeboah-Manu, Noguchi Memorial Institute for Medical Research, University of Ghana,Jackson Orem, Uganda Cancer Institute, Kampala,Laura Benjamin, University College London,Michael Marks, London School of Hygiene and Tropical Medicine,Nicholas A. Feasey, Liverpool School of Tropical Medicine
Fever is one of the most common reasons for seeking medical care. The patient may complain of fever (feeling hot), or of symptoms resulting from fever, such as headache or general body pain. Most, but not all, cases will be due to infections. This chapter details the assessment and management of adult patients that present with fever. See Chapter 9 for the management of the febrile child.
New far ultraviolet imaging of the galaxy NGC 205 is presented, which shows the emission is significantly offset ($\sim5^{\prime\prime}$ NW) from the optical and infrared centers of the galaxy. Spectral energy distribution (SED) modelling is applied to investigate the spatial dependence of the star formation history (SFH) of NGC 205, using data from far ultraviolet to far infrared. The SED model includes young and old stellar populations, gas emission, dust emission and dust absorption. The old stellar population has a total mass of $1.1\times10^8$ M$_{\odot}$ whereas the young population has a much smaller total mass of 3 200 M$_{\odot}$. The best forms of SFH for old and young stars are found to be exponentially declining bursts with start times $t_0$ yr ago and e-folding times $\tau$ yr. The old stellar population has uniform $t_0$ = 9.5 Gyr, with $\tau$ decreasing with radius from 1 Gyr to 500 Myr. The young stellar population has $t_0$ = 900 Myr and $\tau$ = 800 Myr, both uniform across NGC 205. The young and old stellar mass surface densities are exponential in radius with scale lengths of 40 and 110 pc, respectively. The dust heating has a $\sim$ 40% contribution from young stars and $\sim$ 60% from old stars.
Inflammation and infections such as malaria affect concentrations of many micronutrient biomarkers and hence estimates of nutritional status. We aimed to assess the relationship between malaria infection and micronutrient biomarker concentrations in pre-school children (PSC), school-age children (SAC) and women of reproductive age (WRA) in Malawi and examine the potential role of malarial immunity on the relationship between malaria and micronutrient biomarkers. Data from the 2015/2016 Malawi micronutrient survey were used. The associations between current or recent malaria infection, detected by rapid diagnostic test and concentration of serum ferritin, soluble transferrin receptor (sTfR), zinc, serum folate, red blood cell folate and vitamin B12 were estimated using multivariable linear regression. Factors related to malarial immunity including age, altitude and presence of hemoglobinopathies were examined as effect modifiers. Serum ferritin, sTfR and zinc were adjusted for inflammation using the BRINDA method. Malaria infection was associated with 68 % (95 % CI 51, 86), 28 % (18, 40) and 34 % (13, 45) greater inflammation-adjusted ferritin in PSC, SAC and WRA, respectively (P < 0·001 for each). In PSC, the positive association was stronger in younger children, high altitude and children who were not carriers of the sickle cell trait. In PSC and SAC, sTfR was elevated (+ 25 % (16, 29) and + 15 % (9, 22) respectively, P < 0·001). Serum folate and erythrocyte folate were elevated in WRA with malaria (+ 18 % (3, 35) and + 11 % (1, 23), P = 0·01 and P = 0·003 respectively). Malaria affects the interpretation of micronutrient biomarker concentrations, and examining factors related to malarial immunity may be informative.
The initial mass function (IMF) is a construct that describes the distribution of stellar masses for a newly formed population of stars. It is a fundamental element underlying all of star and galaxy formation and has been the subject of extensive investigation for more than 60 yr. In the past few decades, there has been a growing, and now substantial, body of evidence supporting the need for a variable IMF. In this light, it is crucial to investigate the IMF’s characteristics across different spatial scales and to understand the factors driving its variability. We make use of spatially resolved spectroscopy to examine the high-mass IMF slope of star-forming galaxies within the SAMI survey. By applying the Kennicutt method and stellar population synthesis models, we estimated both the spaxel-resolved ($\alpha_{res}$) and galaxy-integrated ($\alpha_{int}$) high-mass IMF slopes of these galaxies. Our findings indicate that the resolved and integrated IMF slopes exhibit a near 1:1 relationship for $\alpha_{int}\gtrsim -2.7$. We observe a wide range of $\alpha_{res}$ distributions within galaxies. To explore the sources of this variability, we analyse the relationships between the resolved and integrated IMF slopes and both the star formation rate (SFR) and SFR surface density ($\Sigma_{\textrm{SFR}}$). Our results reveal a strong correlation where flatter/steeper slopes are associated with higher/lower SFR and $\Sigma_{\textrm{SFR}}$. This trend is qualitatively similar for resolved and global scales. Additionally, we identify a mass dependency in the relationship with SFR, though none was found in the relation between the resolved slope and $\Sigma_{\textrm{SFR}}$. These findings suggest an scenario where the formation of high-mass stars is favoured in regions with more concentrated star formation. This may be a consequence of the reduced fragmentation of molecular clouds, which nonetheless accrete more material.
In response to the COVID-19 pandemic, we rapidly implemented a plasma coordination center, within two months, to support transfusion for two outpatient randomized controlled trials. The center design was based on an investigational drug services model and a Food and Drug Administration-compliant database to manage blood product inventory and trial safety.
Methods:
A core investigational team adapted a cloud-based platform to randomize patient assignments and track inventory distribution of control plasma and high-titer COVID-19 convalescent plasma of different blood groups from 29 donor collection centers directly to blood banks serving 26 transfusion sites.
Results:
We performed 1,351 transfusions in 16 months. The transparency of the digital inventory at each site was critical to facilitate qualification, randomization, and overnight shipments of blood group-compatible plasma for transfusions into trial participants. While inventory challenges were heightened with COVID-19 convalescent plasma, the cloud-based system, and the flexible approach of the plasma coordination center staff across the blood bank network enabled decentralized procurement and distribution of investigational products to maintain inventory thresholds and overcome local supply chain restraints at the sites.
Conclusion:
The rapid creation of a plasma coordination center for outpatient transfusions is infrequent in the academic setting. Distributing more than 3,100 plasma units to blood banks charged with managing investigational inventory across the U.S. in a decentralized manner posed operational and regulatory challenges while providing opportunities for the plasma coordination center to contribute to research of global importance. This program can serve as a template in subsequent public health emergencies.
Inflammation and infections such as malaria affect micronutrient biomarker concentrations and hence estimates of nutritional status. It is unknown whether correction for C-reactive protein (CRP) and α1-acid glycoprotein (AGP) fully captures the modification in ferritin concentrations during a malaria infection, or whether environmental and sociodemographic factors modify this association. Cross-sectional data from eight surveys in children aged 6–59 months (Cameroon, Cote d’Ivoire, Kenya, Liberia, Malawi, Nigeria and Zambia; n 6653) from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anaemia (BRINDA) project were pooled. Ferritin was adjusted using the BRINDA adjustment method, with values < 12 μg/l indicating iron deficiency. The association between current or recent malaria infection, detected by microscopy or rapid test kit, and inflammation-adjusted ferritin was estimated using pooled multivariable linear regression. Age, sex, malaria endemicity profile (defined by the Plasmodium falciparum infection prevalence) and malaria diagnostic methods were examined as effect modifiers. Unweighted pooled malaria prevalence was 26·0 % (95 % CI 25·0, 27·1) and unweighted pooled iron deficiency was 41·9 % (95 % CI 40·7, 43·1). Current or recent malaria infection was associated with a 44 % (95 % CI 39·0, 52·0; P < 0·001) increase in inflammation-adjusted ferritin after adjusting for age and study identifier. In children, ferritin increased less with malaria infection as age and malaria endemicity increased. Adjustment for malaria increased the prevalence of iron deficiency, but the effect was small. Additional information would help elucidate the underlying mechanisms of the role of endemicity and age in the association between malaria and ferritin.
We present radio observations of the galaxy cluster Abell S1136 at 888 MHz, using the Australian Square Kilometre Array Pathfinder radio telescope, as part of the Evolutionary Map of the Universe Early Science program. We compare these findings with data from the Murchison Widefield Array, XMM-Newton, the Wide-field Infrared Survey Explorer, the Digitised Sky Survey, and the Australia Telescope Compact Array. Our analysis shows the X-ray and radio emission in Abell S1136 are closely aligned and centered on the Brightest Cluster Galaxy, while the X-ray temperature profile shows a relaxed cluster with no evidence of a cool core. We find that the diffuse radio emission in the centre of the cluster shows more structure than seen in previous low-resolution observations of this source, which appeared formerly as an amorphous radio blob, similar in appearance to a radio halo; our observations show the diffuse emission in the Abell S1136 galaxy cluster contains three narrow filamentary structures visible at 888 MHz, between $\sim$80 and 140 kpc in length; however, the properties of the diffuse emission do not fully match that of a radio (mini-)halo or (fossil) tailed radio source.
We present source detection and catalogue construction pipelines to build the first catalogue of radio galaxies from the 270 $\rm deg^2$ pilot survey of the Evolutionary Map of the Universe (EMU-PS) conducted with the Australian Square Kilometre Array Pathfinder (ASKAP) telescope. The detection pipeline uses Gal-DINO computer vision networks (Gupta et al. 2024, PASA, 41, e001) to predict the categories of radio morphology and bounding boxes for radio sources, as well as their potential infrared host positions. The Gal-DINO network is trained and evaluated on approximately 5 000 visually inspected radio galaxies and their infrared hosts, encompassing both compact and extended radio morphologies. We find that the Intersection over Union (IoU) for the predicted and ground-truth bounding boxes is larger than 0.5 for 99% of the radio sources, and 98% of predicted host positions are within $3^{\prime \prime}$ of the ground-truth infrared host in the evaluation set. The catalogue construction pipeline uses the predictions of the trained network on the radio and infrared image cutouts based on the catalogue of radio components identified using the Selavy source finder algorithm. Confidence scores of the predictions are then used to prioritise Selavy components with higher scores and incorporate them first into the catalogue. This results in identifications for a total of 211 625 radio sources, with 201 211 classified as compact and unresolved. The remaining 10 414 are categorised as extended radio morphologies, including 582 FR-I, 5 602 FR-II, 1 494 FR-x (uncertain whether FR-I or FR-II), 2 375 R (single-peak resolved) radio galaxies, and 361 with peculiar and other rare morphologies. Each source in the catalogue includes a confidence score. We cross-match the radio sources in the catalogue with the infrared and optical catalogues, finding infrared cross-matches for 73% and photometric redshifts for 36% of the radio galaxies. The EMU-PS catalogue and the detection pipelines presented here will be used towards constructing catalogues for the main EMU survey covering the full southern sky.
We report the discovery of a bow-shock pulsar wind nebula (PWN), named Potoroo, and the detection of a young pulsar J1638$-$4713 that powers the nebula. We present a radio continuum study of the PWN based on 20-cm observations obtained from the Australian Square Kilometre Array Pathfinder (ASKAP) and MeerKAT. PSR J1638$-$4713 was identified using Parkes radio telescope observations at frequencies above 3 GHz. The pulsar has the second-highest dispersion measure of all known radio pulsars (1 553 pc cm$^{-3}$), a spin period of 65.74 ms and a spin-down luminosity of $\dot{E}=6.1\times10^{36}$ erg s$^{-1}$. The PWN has a cometary morphology and one of the greatest projected lengths among all the observed pulsar radio tails, measuring over 21 pc for an assumed distance of 10 kpc. The remarkably long tail and atypically steep radio spectral index are attributed to the interplay of a supernova reverse shock and the PWN. The originating supernova remnant is not known so far. We estimated the pulsar kick velocity to be in the range of 1 000–2 000 km s$^{-1}$ for ages between 23 and 10 kyr. The X-ray counterpart found in Chandra data, CXOU J163802.6$-$471358, shows the same tail morphology as the radio source but is shorter by a factor of 10. The peak of the X-ray emission is offset from the peak of the radio total intensity (Stokes $\rm I$) emission by approximately 4.7$^{\prime\prime}$, but coincides well with circularly polarised (Stokes $\rm V$) emission. No infrared counterpart was found.
We propose a new method for identifying active galactic nuclei (AGN) in low mass ($\mathrm{M}_*\leq10^{10}\mathrm{M}_\odot$) galaxies. This method relies on spectral energy distribution (SED) fitting to identify galaxies whose radio flux density has an excess over that expected from star formation alone. Combining data in the Galaxy and Mass Assembly (GAMA) G23 region from GAMA, Evolutionary Map of the Universe (EMU) early science observations, and Wide-field Infrared Survey Explorer (WISE), we compare this technique with a selection of different AGN diagnostics to explore the similarities and differences in AGN classification. We find that diagnostics based on optical and near-infrared criteria (the standard BPT diagram, the WISE colour criterion, and the mass-excitation, or MEx diagram) tend to favour detection of AGN in high mass, high luminosity systems, while the “ProSpect” SED fitting tool can identify AGN efficiently in low mass systems. We investigate an explanation for this result in the context of proportionally lower mass black holes in lower mass galaxies compared to higher mass galaxies and differing proportions of emission from AGN and star formation dominating the light at optical and infrared wavelengths as a function of galaxy stellar mass. We conclude that SED-derived AGN classification is an efficient approach to identify low mass hosts with low radio luminosity AGN.
We demonstrate the importance of radio selection in probing heavily obscured galaxy populations. We combine Evolutionary Map of the Universe (EMU) Early Science data in the Galaxy and Mass Assembly (GAMA) G23 field with the GAMA data, providing optical photometry and spectral line measurements, together with Wide-field Infrared Survey Explorer (WISE) infrared (IR) photometry, providing IR luminosities and colours. We investigate the degree of obscuration in star-forming galaxies, based on the Balmer decrement (BD), and explore how this trend varies, over a redshift range of $0<z<0.345$. We demonstrate that the radio-detected population has on average higher levels of obscuration than the parent optical sample, arising through missing the lowest BD and lowest mass galaxies, which are also the lower star formation rate (SFR) and metallicity systems. We discuss possible explanations for this result, including speculation around whether it might arise from steeper stellar initial mass functions in low mass, low SFR galaxies.
All very massive early-type galaxies contain supermassive blackholes, but are these blackholes all sufficiently active to produce detectable radio continuum sources? We have used the 887.5 MHz Rapid ASKAP Continuum Survey DR1 to measure the radio emission from morphological early-type galaxies brighter than $K_S=9.5$ selected from the 2MASS Redshift Survey, HyperLEDA, and RC3. In line with previous studies, we find median radio power increases with infrared luminosity, with $P_{1.4} \propto L_K^{2.2}$, although the scatter about this relation spans several orders of magnitude. All 40 of the $M_K<-25.7$ early-type galaxies in our sample have measured radio flux densities that are more than $2\sigma$ above the background noise, with $1.4\,{\rm GHz}$ radio powers spanning ${\sim} 3 \times 10^{20}$ to ${\sim} 3\times 10^{25}\,{\rm W/Hz^{-1}}$. Cross-matching our sample with integral field spectroscopy of early-type galaxies reveals that the most powerful radio sources preferentially reside in galaxies with relatively low angular momentum (i.e. slow rotators). While the infrared colours of most galaxies in our early-type sample are consistent with passive galaxies with negligible star formation and the radio emission produced by active galactic nuclei or AGN remnants, very low levels of star formation could power the weakest radio sources with little effect on many other star formation rate tracers.
Residents of long-term care facilities (LTCFs) were disproportionately affected by the COVID-19 pandemic. We assessed the extent to which hospital-associated infections contributed to COVID-19 LTCF outbreaks in England. We matched addresses of cases between March 2020 and June 2021 to reference databases to identify LTCF residents. Linkage to health service records identified hospital-associated infections, with the number of days spent in hospital before positive specimen date used to classify these as definite or probable. Of 149,129 cases in LTCF residents during the study period, 3,748 (2.5%) were definite or probable hospital-associated and discharged to an LTCF. Overall, 431 (0.3%) were identified as index cases of potentially nosocomial-seeded outbreaks (2.7% (431/15,797) of all identified LTCF outbreaks). These outbreaks involved 4,521 resident cases and 1,335 deaths, representing 3.0% and 3.6% of all cases and deaths in LTCF residents, respectively. The proportion of outbreaks that were potentially nosocomial-seeded peaked in late June 2020, early December 2020, mid-January 2021, and mid-April 2021. Nosocomial seeding contributed to COVID-19 LTCF outbreaks but is unlikely to have accounted for a substantial proportion. The continued identification of such outbreaks after the implementation of preventative policies highlights the challenges of preventing their occurrence.
To explore the role environment plays in influencing galaxy evolution at high redshifts, we study $2.0\leq z<4.2$ environments using the FourStar Galaxy Evolution (ZFOURGE) survey. Using galaxies from the COSMOS legacy field with ${\rm log(M_{*}/M_{\odot})}\geq9.5$, we use a seventh nearest neighbour density estimator to quantify galaxy environment, dividing this into bins of low-, intermediate-, and high-density. We discover new high-density environment candidates across $2.0\leq z<2.4$ and $3.1\leq z<4.2$. We analyse the quiescent fraction, stellar mass and specific star formation rate (sSFR) of our galaxies to understand how these vary with redshift and environment. Our results reveal that, across $2.0\leq z<2.4$, the high-density environments are the most significant regions, which consist of elevated quiescent fractions, ${\rm log(M_{*}/M_{\odot})}\geq10.2$ massive galaxies and suppressed star formation activity. At $3.1\leq z<4.2$, we find that high-density regions consist of elevated stellar masses but require more complete samples of quiescent and sSFR data to study the effects of environment in more detail at these higher redshifts. Overall, our results suggest that well-evolved, passive galaxies are already in place in high-density environments at $z\sim2.4$, and that the Butcher–Oemler effect and SFR-density relation may not reverse towards higher redshifts as previously thought.