The pressure effects on the mixing fields of non-reacting and reacting jets in cross-flow are studied using large eddy simulation (LES). A hydrogen jet diluted with 30 % helium is injected perpendicularly into a cross-stream of air at four different pressures: 1, 4, 7 and 15 bar. The resulting interaction and the mixing fields under non-reacting and reacting conditions are simulated using LES. The subgrid scale combustion is modelled using a revised flamelet model for the partially premixed combustion. Good agreement of computed and measured velocity fields for reacting and non-reacting conditions is observed. Under non-reacting conditions, the mixing field shows no sensitivity to the pressure, whereas notable changes are observed for reacting conditions. The lifted flame at 1 bar moves upstream and attaches to the nozzle as the pressure is increased to 4 bar and remains so for the other elevated pressures because of the increasing burning mass flux with pressure. This attached flame suppresses the fuel–air mixing in the near-nozzle region. The premixed and non-premixed contributions to the overall heat release in the partially premixed combustion are analysed. The non-premixed contribution is generally low and occurs in the near-field region of the fuel jet through fuel-rich mixtures in the shear layer regions, and decreases substantially further with the increase in pressure. Hence, the predominant contributions are observed to come from premixed modes and these contributions increase with pressure.

There is strong evidence that children are particularly vulnerable to the persuasiveness of marketing, and that their exposure to marketing of unhealthy food products influences their preference for and consumption of these products(1). In New Zealand (NZ), marketing is self-regulated by the industry-led Advertising Standards Authority (ASA). The ASA has two relevant codes, the Children’s Advertising and Food and Beverage Advertising Codes; however, product packaging is omitted. We investigated child-appealing marketing techniques displayed on packaged food products in NZ. We also assessed the potential impacts of different nutrient profiling systems to inform future policy design to restrict child-appealing marketing on food products in NZ. This research was conducted using the 2023 Nutritrack dataset, which contains data collected via photographs of packaged food products available in major NZ supermarkets. We focused on product categories that were shown to have a high prevalence of child-appealing marketing in a similar Australian study(2): confectionery, snack foods, cereal bars and breakfast cereals (n=2015 products). The images of products within these selected categories were assessed and coded using the “Child-appealing packaging” criteria developed by Mulligan et al.(3). Mann-Whitney U tests were used to assess differences in nutrient composition between products with and without child-appealing packaging, using information extracted from Nutrient Information Panels. In addition, the Food Standards Australia New Zealand Nutrient Profiling Scoring Criterion (NPSC) and the World Health Organization Nutrient Profiling Model for the Western Pacific Region (WHO WPRO) were applied to all food products identified as appealing to children to determine which products would be ineligible to be marketed to children under these two potential policy options. Overall, 724 (35.9%) of the 2015 products examined had child-appealing packaging. Snack foods had the highest proportion of products with child-appealing packaging (44.5%), followed by confectionery (39.3%), cereal bars (23.3%) and breakfast cereals (22%). The most common type of child-appealing marketing technique used was “child-appealing visual/graphical design of package” which featured on 513 food items. Overall, compared with products without child-appealing packaging, the median content of energy, protein, total fat, and saturated fat was lower, and the median content of sugar and sodium was higher in products with child-appealing packaging (all p<0.05). Of the 724 products that were found to have child-appealing packaging, 566 (78.2%) would be considered ineligible to be marketed to children when assessed using the NPSC and 706 (97.5%) would be ineligible using the WHO WPRO.Our research shows that a considerable number of food products available in New Zealand supermarkets are using marketing techniques on their packaging that appeal to children. If policies were introduced to reduce the use of child-appealing marketing on food packaging, the WHO WPRO would provide the highest level of protection for children.

‘I just don’t know what to eat!’ is a frequent statement from people seeking nutrition support. With a magnitude of information available, confusion and limited confidence is a common complaint. People face myriad challenges in their attempts to have a healthy diet, including cost and time constraints, challenging food environments, and limited knowledge and skills(1). Challenges about eating well are often raised, yet enablers to eating well are not as readily discussed. Intention for healthy behaviours, self-efficacy and social support are examples of favourable elements which support healthy diets(1,2). As such, existing knowledge, skills, and positive influences should also be considered. As part of a wider qualitative study, and using an interpretive description approach, we sought to identify enablers to healthy eating perceived by people engaged with Green Prescription (GRx) and Active Families programmes. Nineteen clients aged 18 years and over, engaged with six GRx services were interviewed between May and October 2023. Eighteen whānau (family) members, (19-53 years) attending Active Families sessions facilitated in the Waitematā area participated in focus group discussions during May-August 2024. Participants were asked in these discussions (kōrero) to share what helps them and their whānau to eat well. Braun and Clarke’s(3) thematic analysis approach was used to analyse responses from these kōrero through data familiarisation, coding, and cyclical review of thematic relationships. Several themes were identified in this analysis: ‘confidence in personal skills,’ ‘supportive environments’, and ‘being open and willing’. Personal skills such as planning meals, managing household budget and efforts to procure ‘good’ food were identified as strengths. These wider food skills have been suggested as potentially more important to enhancing dietary behaviours than cooking skills(4). Participants relayed experiences of developing skills that improved their confidence in eating well including growing, gathering and preserving food, experimenting with recipes, and knowing where to find affordable, nutritious food. Environments where people learned food and cooking skills and household members supported their endeavours to eat well were described as influential to encourage people in their efforts. Participants also expressed that being open to trying new foods and ways of eating led to inspiration and new knowledge. This attitude resulted in increased variety in the diet and further enhanced confidence to seek recipes and food information and spurred on efforts to make changes. People who have sought nutrition advice have often expressed challenges and uncertainty impacting their efforts to eat well. Nevertheless, there are also strengths which have meaningful impact on their eating. In nutrition advice provision, it would be beneficial to thoroughly explore the strengths people exhibit to support healthy eating. Identifying these insights may powerfully effect people’s confidence to eat well and identify more effective support and information provision.

To combat the decline in North American grasslands and prairies, innovative strategies to establish new native grass and forb plantings must be considered. Integrated vegetation management entails the use of many practices to cultivate desirable vegetation along roadsides, including mowing, applying herbicides, burning, and replanting. Currently, only a limited selection of postemergence herbicides are available to improve native plant establishment along roadsides. A greenhouse herbicide screen that included four postemergence herbicides registered for use on Conservation Reserve Program (CRP) acres and rights-of-way was conducted to test their safety for use on four native grasses (big bluestem, buffalograss, sideoats grama, and switchgrass) and seven forb species (ashy sunflower, black-eyed Susan, butterfly milkweed, desert false indigo, Illinois bundleflower, Mexican hat plant, and purple coneflower). Clopyralid (689 g ae ha−1), metsulfuron (4.18 g ai ha−1), and quinclorac (418 g ai ha−1) applied at labeled rates caused no injury to the native grass species or butterfly milkweed. However, florpyrauxifen-benzyl (38.4 g ai ha−1) caused significant injury to buffalograss and switchgrass. None of the herbicides tested were universally safe to use on all forb species evaluated in this trial, with each herbicide causing unacceptable injury (≥25%) to one or more forb species. None of the herbicides studied here would be completely safe for use on mixed stands of native grasses and native forbs at the seedling growth stage, indicating that prairie establishment must use alternative chemistries, plant mixes with fewer species, or avoid postemergence applications shortly after emergence of native forbs.

The linear stability of a thermally stratified fluid layer between horizontal walls, where non-Brownian thermal particles are injected continuously at one boundary and extracted at the other – a system known as particulate Rayleigh–Bénard (pRB) – is studied. For a fixed volumetric particle flux and minimal thermal coupling, reducing the injection velocity stabilises the system when heavy particles are introduced from above, but destabilises it when light particles are injected from below. For very light particles (bubbles), low injection velocities can shift the onset of convection to negative Rayleigh numbers, i.e. heating from above. Particles accumulate non-uniformly near the extraction wall and in regions of strong vertical flow, aligning with either wall-impinging or wall-detaching zones depending on whether injection is at sub- or super-terminal velocity. The increase of the volumetric particle flux always enhances these effects.

The central Maya lowlands (CML) display an uncommon demographic history—the absence of a millennial population rebound from its former occupational peak, about 800 CE. Here we postulate why the loss of a well-populated CML during the Late Classic-Terminal Classic periods failed to regain substantial occupation during the subsequent 700-800 years before the Spanish conquest of the Maya realm. Updating the narrative of stressful human-environmental conditions, shifts in trade routes, and long-term paucity of occupation in the CML, we examine push-pull factors that affected Postclassic Maya population geography. These factors include population pressures, environmental hazards, resource conditions, and livelihood standards that existed in the Postclassic Period between northern and coastal lowlands and the CML. The advantages that the CML maintained before Postclassic times, foremost regaining superior environmental conditions for agriculture, were insufficient pull factors given the low levels of push factors in the northern and coastal lowlands. We draw attention to the under-treated problem—the failure of a population rebound in the CML—and encourage improvements in systematic data and analytics to address it, including consideration of non-material, socio-cultural factors.

This review highlights the importance of dietary fibres (DF) intake and its interconnection with the gut microbiome and psychological well-being, while also exploring the effects of existing DF interventions on these aspects in adults. The gut microbiota is a complex and diverse ecosystem in which microbial species interact, influencing the human host. DF are heterogeneous, requiring different microbial species to degrade the complex DF structures. Emerging evidence suggests that microbial fermentation of DF produces short-chain fatty acids (SCFA), which may play a role in regulating psychological well-being by affecting neurotransmitter levels, including serotonin. The effectiveness of DF interventions depends on factors such as baseline gut microbiota composition, the dosage and the source of DF consumed. Although the gut microbiota of adults is relatively stable, studies have shown that the abundance of the species in the gut microbiota can change within 24 h of an intervention and may return to baseline following the termination of DF intervention. This review underscores the need for larger and well-powered dietary clinical trials incorporating longitudinal biological sample collections, advanced sequencing and omic techniques (including novel dietary biomarkers and microbial metabolites), validated subjective questionnaires and dietary records. Furthermore, mechanistic studies driven by clinical observations are crucial to understanding gut microbiota function and its underlying biological pathways, informing targeted dietary interventions.

Background: Efgartigimod, a human immunoglobulin G1 (IgG1) antibody Fc fragment, reduces IgG levels through neonatal Fc receptor blockade. Efgartigimod PH20 SC (1000-mg fixed dose, coformulated with recombinant human hyaluronidase PH20) is provided in a vial administered via a separate syringe (V+S). Here, we investigate bioequivalence, safety, and tolerability of efgartigimod PH20 SC administered via prefilled syringe (PFS) vs V+S in healthy participants. Methods: Bioequivalence was assessed in a phase 1, open-label study. Healthy participants (n=72) were randomized to receive one injection of efgartigimod PH20 SC via PFS or V+S in a crossover design. Separate studies evaluated feasibility of different injection speeds and usability of the PFS. Results: Bioequivalence between efgartigimod PH20 SC via PFS or V+S was established, as the 90% CI around the geometric least-squares mean ratio of Cmax and AUC0-inf was within predefined criteria (80.00%-125.00%). Most adverse events were mild to moderate. No observed differences in incidence of reported injection site reactions emerged. No serious adverse events or deaths occurred. Rapid (20-second) administration was feasible and the PFS could be safely prepared and administered by participants/caregivers. Conclusions: Efgartigimod PH20 SC administered via PFS is bioequivalent to efgartigimod PH20 SC administered via V+S, which may provide an additional convenient treatment option.

Background: RAISE-XT (NCT04225871; Phase 3 study) showed clinically meaningful and sustained improvements in myasthenia gravis (MG)-specific outcomes with zilucoplan, a macrocyclic peptide complement component 5 inhibitor, in patients with acetylcholine receptor autoantibody-positive generalised MG. Methods: Adults self-administered once-daily subcutaneous zilucoplan 0.3mg/kg. This post hoc analysis assessed durability of response to Week 120 in MG-Activities of Daily Living (MG-ADL) and Quantitative MG (QMG) responders at Week 1 of two double-blind studies (NCT03315130, NCT04115293). Responder definitions: improvements of ≥3-points (MG-ADL) or ≥5-points (QMG) (interim data cut: 11 November 2023). Results: 93 patients were randomised to zilucoplan 0.3mg/kg in the double-blind studies; 43.0% (n=40/93) and 33.3% (n=31/93) were MG-ADL and QMG responders, respectively, at Week 1. Week 1 responders spent a median #of 98.9% (5.8–99.2) and 99.0% (2.5–99.2) time in response up to Week 120 for MG-ADL and QMG. Week 1 non-responders spent# a median #of 84.6% (0.0–98.3) and 66.7% (0.0–98.9) time in response up to Week 120 for MG-ADL and QMG, with most responding later in the study. Conclusions: Among early (Week 1) zilucoplan responders, time in response remained high (99%) up to Week 120. These data demonstrate rapid and sustained efficacy with long-term zilucoplan treatment.#

Background: Traumatic brain injury (TBI) patients exhibit variable post-injury recovery trajectories. Days at Home (DAH) is a patient-centered measure that captures healthcare transitions and offers a more nuanced understanding of recovery. Here, we use DAH to characterize longterm recovery trajectories for moderate to severe TBI (msTBI) survivors. Methods: This multicenter retrospective cohort study utilized population health data from Ontario to identify adults sustaining isolated msTBI hospitalized between 2009-2021. DAH were calculated in distinct 30-day intervals from index admission to 3 years post-injury; latent class mixed modeling identified unique recovery trajectories and trajectory attributes were quantified. Results: There were 2,510 patients eligible for latent class analysis. Four DAH trajectories were identified: early recovery (69.9%), intermediate recovery (11.4%), late recovery (2.9%), and poor recovery (15.8%). Patients in the poor recovery group were older, more frail, and had lower admission GCS scores, while those in early recovery exhibited lower acute care needs. Intermediate and late recovery groups exhibited protracted transitions home, with near-complete reintegration by 24 months. A prediction model distinguished unfavorable trajectories with good accuracy (C-index=0.824). Conclusions: Despite high initial institutional care requirements, 85% of patients reintegrated into the community within three years of msTBI. These findings shed light on post-injury care requirements for brain-injured patients.

Background: Deep brain stimulation (DBS) in Parkinson’s disease (PD) requires extensive trial-and-error programming, often taking over a year to optimize. An objective, rapid biomarker of stimulation success is needed. Our team developed a functional magnetic resonance imaging (fMRI)-based algorithm to identify optimal DBS settings. This study prospectively compared fMRI-guided programming with standard-of-care (SoC) clinical programming in a double-blind, crossover, non-inferiority trial. Methods: Twenty-two PD-DBS patients were prospectively enrolled for fMRI using a 30-sec DBS-ON/OFF cycling paradigm. Optimal settings were identified using our published classification algorithm. Subjects then underwent >1 year of SoC programming. Clinical improvement was assessed under SoC and fMRI-determined stimulation conditions. Results: fMRI optimization significantly reduced the time required to determine optimal settings (1.6 vs. 5.6 months, p<0.001). Unified Parkinson’s Disease Rating Scale (UPDRSIII) improved comparably with both approaches (23.8 vs. 23.6, p=0.9). Non-inferiority was demonstrated within a predefined margin of 5 points (p=0.0018). SoC led to greater tremor improvement (p=0.019), while fMRI showed greater bradykinesia improvement (p=0.040). Conclusions: This is the first prospective evaluation of an algorithm able to suggest stimulation parameters solely from the fMRI response to stimulation. It suggests that fMRI-based programming may achieve equivalent outcomes in less time than SoC, reducing patient burden while potentially enhancing bradykinesia response.

Background: Vasospasm is an important complication of subarachnoid hemorrhage (SAH). Attempts to identify patients at highest risk of vasospasm have not led to practice change. We sought to identify patients at lowest risk of vasospasm by testing the prognostic utility of novel low risk criteria: mean MCA velocities on TCD that peaked and remained below 120 cm/s by the 7th day. Methods: Retrospective observational study of TCD values in patients admitted to The Ottawa Hospital with SAH 2018-2023. The primary outcome was presence of moderate to severe vasospasm (MCA mean velocity >160 cm/s) by day 21. Results: Data were collected on 211 patients, of whom 197 fulfilled inclusion criteria. Only 2 of 104 patients (2%) meeting our low-risk criteria developed the primary outcome, compared to 48 of 93 patients (52%) who did not meet criteria (RR 27). The Negative Predictive Value (NPV) for vasospasm in our low-risk group was 98%. Conclusions: Our low-risk criteria based on TCD patterns in the first 7 days after SAH can identify patients at very low risk of vasospasm with great accuracy. This could inform a future prospective study.