Diet quality has been linked to socio-economic status. However, evidence within rural and regional populations is lacking. This cross-sectional study examined the relationship between diet quality and socio-economic position in adults living in rural and regional areas of Australia. The Australian Recommended Food Score (ARFS; range 0–73) measured diet quality (total and subscale scores). Area-level socio-economic position was determined by postcode-linked socio-economic index for areas (SEIFA), Index of Relative Social Advantage and Disadvantage scores, stratified into quintiles. The mean total ARFS (34·7; sd = 9·1; n 836) was classified as ‘getting there’. Findings showed significantly lower mean total ARFS between SEIFA quintile 1 (1 = lowest; mean total ARFS = 30·4; sd = 10·2; categorised as ‘needs work’) compared with all other SEIFA quintiles (F (44 831) = 8·44, P ≤ 0·001). Linear regression, adjusting for age, sex, income, education, employment status and household composition demonstrated significantly lower overall diet quality for SEIFA quintile 1 compared with SEIFA quintile 3 (B = –3·9; 95 % CI (–6·2, −1·5); P < 0·001) and lower subscale scores for vegetables (B = –1·6; 95 % CI (–2·7, −0·6); P = 0·003), fruit (B = –0·9; 95 % CI (–1·6, −0·1); P = 0·018) and grains (B = –0·6; 95 % CI (–1·3, −0·0); P = 0·050). After adjusting for individual confounders of diet quality, results indicate that lower area-level socio-economic position remained associated with poorer diet quality in this sample of rural and regional Australian adults. This suggests that broader social and environmental factors unique to these areas may impact diet quality and amplify individual barriers to achieving a healthy diet.

Current clinical guidelines for people at risk of heart disease in Australia recommend nutrition intervention in conjunction with pharmacotherapy(1). However, Australians living in rural and remote regions have less access to medical nutritional therapy (MNT) provided by Accredited Practising Dietitians (APDs) than their urban counterparts(2). The aim of the HealthyRHearts study was to trial the delivery of MNT by APDs using telehealth to eligible patients of General Practitioners (GPs) located in small to large rural towns in the Hunter New England region(3) of New South Wales, Australia. The study design was a 12-month pragmatic randomised controlled trial. The key outcome was reduced total cholesterol. The study was place-based, meaning many of the research team and APDs were based rurally, to ensure the context of the GPs and patients was already known. Eligible participants were those assessed as moderate-to-high risk of CVD by their GP. People in the intervention group received five MNT consults (totalling two hours) delivered via telehealth by APDs, and also answered a personalised nutrition questionnaire to guide their priorities and to support personalised dietary behaviour change during the counselling. Both intervention and control groups received usual care from their GP and were provided access to the Australian Eating Survey (Heart version), a 242-item online food frequency questionnaire with technology-supported personalised nutrition reports that evaluated intake relative to heart healthy eating principles. Of the 192 people who consented to participate, 132 were eligible due to their moderate-to-high risk. Pre-post participant medication use with a registered indication(4) for hypercholesterolemia, hypertension and glycemic control were documented according to class and strength (defined daily dose: DDD)(5). Nine GP practices (with 91 participants recruited) were randomised to the intervention group and seven practices (41 participants) were randomised to control. Intervention participants attended 4.3 ± 1.4 out of 5 dietetic consultations offered. Of the132 people with baseline clinical chemistry, 103 also provided a 12-month sample. Mean total cholesterol at baseline was 4.97 ± 1.13 mmol/L for both groups, with 12-m reduction of 0.26 ± 0.77 for intervention and 0.28 ± 0.79 for control (p = 0.90, unadjusted value). Median (IQR) number of medications for the intervention group was 2 (1–3) at both baseline and 12 months (p = 0.78) with 2 (1–3) and 3 (2–3) for the control group respectively. Combined DDD of all medications was 2.1 (0.5–3.8) and 2.5 (0.75–4.4) at baseline and 12 months (p = 0.77) for the intervention group and 2.7 (1.5–4.0) and 3.0 (2.0–4.5) for the control group (p = 0.30). Results suggest that medications were a significant contributor to the management of total cholesterol. Further analysis is required to evaluate changes in total cholesterol attributable to medication prescription relative to the MNT counselling received by the intervention group.

There is a growing awareness that diversity, health equity, and inclusion play a significant role in improving patient outcomes and advancing knowledge. The Pediatric Heart Network launched an initiative to incorporate diversity, health equity, and inclusion into its 2021 Scholar Award Funding Opportunity Announcement. This manuscript describes the process of incorporating diversity, health equity, and inclusion into the Pediatric Heart Network Scholar Award and the lessons learned. Recommendations for future Pediatric Heart Network grant application cycles are made which could be replicated by other funding agencies.

We study the dynamics of thermal and momentum boundary regions in three-dimensional direct numerical simulations of Rayleigh–Bénard convection for the Rayleigh-number range $10^5\leq Ra \leq 10^{11}$ and $Pr=0.7$. Using a Cartesian slab with horizontal periodic boundary conditions and an aspect ratio of 4, we obtain statistical homogeneity in the horizontal $x$- and $y$-directions, thus approximating best an extended convection layer relevant for most geo- and astrophysical flow applications. We observe upon canonical use of combined long-time and area averages, with averaging periods of at least 100 free-fall times, that a global coherent mean flow is practically absent and that the magnitude of the velocity fluctuations is larger than the mean by up to 2 orders of magnitude. The velocity field close to the wall is a collection of differently oriented local shear-dominated flow patches interspersed by extensive shear-free incoherent regions which can be as large as the whole cross-section, unlike for a closed cylindrical convection cell of aspect ratio of the order 1. The incoherent regions occupy a 60 % area fraction for all Rayleigh numbers investigated here. Rather than resulting in a pronounced mean flow with small fluctuations about such a mean, as found in small-aspect-ratio convection, the velocity field is dominated by strong fluctuations of all three components around a non-existent or weak mean. We discuss the consequences of these observations for convection layers with larger aspect ratios, including boundary layer instabilities and the resulting turbulent heat transport.

The high-energy/high-intensity laser facility PHELIX of the GSI Helmholtzzentrum für Schwerionenforschung in Darmstadt, Germany, has been in operation since 2008. Here, we review the current system performance, which is the result of continuous development and further improvement. Through its versatile frontend architecture, PHELIX can be operated in both long- and short-pulse modes, corresponding to ns-pulses with up to 1 kJ pulse energy and sub-ps, 200 J pulses, respectively. In the short-pulse mode, the excellent temporal contrast and the control over the wavefront make PHELIX an ideal driver for secondary sources of high-energy ions, neutrons, electrons and X-rays. The long-pulse mode is mainly used for plasma heating, which can then be probed by the heavy-ion beam of the linear accelerator of GSI. In addition, PHELIX can now be used to generate X-rays for studying exotic states of matter created by heavy-ion heating using the ion beam of the heavy-ion synchrotron of GSI.

Research on the gut microbiome and mental health among children and adolescents is growing. This umbrella review provides a high-level overview of current evidence syntheses to amalgamate current research and inform future directions. Searches were conducted across seven databases for peer-reviewed pediatric (<18 years) review literature. Studies reporting gut microbiome composition and/or biotic supplementation on depression, bipolar disorder, anxiety, attention deficit hyperactivity disorder, autism spectrum disorder (ASD), or obsessive-compulsive disorder (OCD) were included. Deduplication and screening took place in Covidence. A sensitivity analysis was conducted to assess the degree of primary study overlap. Among the 39 included review studies, 23 (59%) were observational and 16 (41%) were interventional. Most reviews (92%) focused on ASD. Over half (56%) of the observational and interventional reviews scored low or critically low for methodological quality. A higher abundance of Clostridium clusters and a lower abundance of Bifidobacterium were consistently observed in ASD studies. Biotic supplementation was associated with ASD symptom improvement. Gut microbiome-mental health evidence syntheses in child and youth depression, anxiety, bipolar disorder, and OCD are lacking. Preliminary evidence suggests an association between specific microbiota and ASD symptoms, with some evidence supporting a role for probiotic supplementation ASD therapy.

Electroencephalographic (EEG) abnormalities are greater in mild cognitive impairment (MCI) with Lewy bodies (MCI-LB) than in MCI due to Alzheimer’s disease (MCI-AD) and may anticipate the onset of dementia. We aimed to assess whether quantitative EEG (qEEG) slowing would predict a higher annual hazard of dementia in MCI across these etiologies. MCI patients (n = 92) and healthy comparators (n = 31) provided qEEG recording and underwent longitudinal clinical and cognitive follow-up. Associations between qEEG slowing, measured by increased theta/alpha ratio, and clinical progression from MCI to dementia were estimated with a multistate transition model to account for death as a competing risk, while controlling for age, cognitive function, and etiology classified by an expert consensus panel.

Over a mean follow-up of 1.5 years (SD = 0.5), 14 cases of incident dementia and 5 deaths were observed. Increased theta/alpha ratio on qEEG was associated with increased annual hazard of dementia (hazard ratio = 1.84, 95% CI: 1.01–3.35). This extends previous findings that MCI-LB features early functional changes, showing that qEEG slowing may anticipate the onset of dementia in prospectively identified MCI.

In extensive cohort studies, the ascertainment of covariate information on all individuals can be challenging. In hospital epidemiology, an additional issue is often the time-dependency of the exposure of interest. We revisit and compare two sampling designs constructed for rare time-dependent exposures and possibly common outcomes – the nested exposure case-control design and exposure density sampling. Both designs enable efficient hazard ratio estimation by sampling all exposed individuals but only a small fraction of the unexposed ones. Moreover, they account for time-dependent exposure to avoid immortal time bias. We evaluate and compare their performance using data of patients hospitalised in the neuro-intensive care unit at the Burdenko Neurosurgery Institute in Moscow, Russia. Three different types of hospital-acquired infections with different prevalence are considered. Additionally, inflation factors, a primary performance measure, are discussed. We enhance both designs to allow for a competitive analysis of combined and competing endpoints compared to the full cohort approach while substantially reducing the amount of necessary information. Nonetheless, exposure density sampling outperforms the nested exposure case-control design concerning efficiency and accuracy in most considered settings.

Cholinergic deficits are a hallmark of Alzheimer’s disease (AD) and Lewy body dementia (LBD). The nucleus basalis of Meynert (NBM) provides the major source of cortical cholinergic input; studying its functional connectivity might, therefore, provide a tool for probing the cholinergic system and its degeneration in neurodegenerative diseases. Forty-six LBD patients, 29 AD patients, and 31 healthy age-matched controls underwent resting-state functional magnetic resonance imaging (fMRI). A seed-based analysis was applied with seeds in the left and right NBM to assess functional connectivity between the NBM and the rest of the brain. We found a shift from anticorrelation in controls to positive correlations in LBD between the right/left NBM and clusters in right/left occipital cortex. Our results indicate that there is an imbalance in functional connectivity between the NBM and primary visual areas in LBD, which provides new insights into alterations within a part of the corticopetal cholinergic system that go beyond structural changes.

Direct numerical simulations are carried out to study the flow structure and transport properties in turbulent Rayleigh–Bénard convection in a vertical cylindrical cell of aspect ratio one with an imposed axial magnetic field. Flows at the Prandtl number $0.025$ and Rayleigh and Hartmann numbers up to $10^{9}$ and $1400$, respectively, are considered. The results are consistent with those of earlier experimental and numerical data. As anticipated, the heat transfer rate and kinetic energy are suppressed by a strong magnetic field. At the same time, their growth with Rayleigh number is found to be faster in flows at high Hartmann numbers. This behaviour is attributed to the newly discovered flow regime characterized by prominent quasi-two-dimensional structures reminiscent of vortex sheets observed earlier in simulations of magnetohydrodynamic turbulence. Rotating wall modes similar to those in Rayleigh–Bénard convection with rotation are found in flows near the Chandrasekhar linear stability limit. A detailed analysis of the spatial structure of the flows and its effect on global transport properties is reported.

Columnar-jointed tuffs (bentonites) are located below the Lower Carboniferous Tideswell Dale Sill, Derbyshire, in an abandoned quarry. There are three zones of prismatic joints, columnar joints (∼60 cm thick and mean column width of 4.1 cm) and massive, conchoidally fractured rock sequentially from the dolerite contact downwards. The rocks are very fine-grained (1–10 µm) and consist mainly of sanidine, interlayered illite/smectite, and hematite, with minor quartz, apatite, montmorillonite, anatase and detrital minerals. High K2O and Fe2O3, low Na2O and low MgO are interpreted as due to alteration of felsic volcanic ash. The bentonite was contact-metamorphosed by the sill to temperatures of c. 300 °C. The progression of fracture geometries, thermal considerations and application of theories of column formation indicate that columns formed downwards away from the sill, due to prograde contact metamorphism of the originally clay-rich bentonite. The formation of columnar fracture networks by shrinkage due to igneous heating may have implications for the effectiveness of bentonite as a barrier for disposal of high-level radioactive waste. Regional dimensions include documenting widespread felsic explosive volcanism and inferring a Triassic oxidation event from palaeomagnetic data.

The introduction of a fifth amphibole group, the Na-Ca-Mg-Fe-Mn-Li group, defined by 0.50 < B(Mg,Fe2+,Mn2+,Li) < 1.50 and 0.50 ≤ B(Ca,Na) ≤ 1.50 a.f.p.u. (atoms per formula unit), with members whittakerite and ottoliniite, has been required by recent discoveries of B(LiNa) amphiboles. This, and other new discoveries, such as sodicpedrizite (which, here, is changed slightly, but significantly, from the original idealized formula), necessitate amendments to the IMA 1997 definitions of the Mg-Fe-Mn-Li, calcic, sodic-calcic and sodic groups. The discovery of obertiite and the finding of an incompatibility in the IMA 1997 subdivision of the sodic group, requires further amendments within the sodic group. All these changes, which have IMA approval, are summarized.

Högbomite is reported from two upper-amphibolite and granulite-facies, sapphirine-bearing, Al–Mg–Fe-rich and silica-poor lens-shaped layers within the Bamble Sector, south Norway. Primary assemblages, indicating peak metamorphic conditions of 773-844°C at 7 kbar (Mg–Fe exchange thermometry), are spinel–sapphirine–biotite–gedrite, spinel–corundum–sapphirine–cordierite and orthopyroxene–biotite–cordierite–plagioclase. Högbomite formed by hydrous alteration and oxidation of primary spinel and rutile and/or ilmenite according to the generalised reaction:

Suggested conditions of högbomite formation are 550–620°C and 6–7 kbar. The högbomites contain 10.2–14.7 wt.% MgO, 04).3 wt.% ZnO, 58.9–62.1 wt.% Al2O3 and 15.6-17.6 wt.% Fe as FeO. The two högbomite may belong to different polytypes, as suggested by their differing TiO2 (9.9-10.1 versus 5.7–5.8 wt. %) and calculated Fe3+ – and H2O–contents. The partitioning of Zn between spinel and högbomite is not uniform and is considered to depend upon prevailing fo2 and aH2O.