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The First Large Absorption Survey in H i (FLASH) is a large-area radio survey for neutral hydrogen in and around galaxies in the intermediate redshift range $0.4\lt z\lt1.0$, using the 21-cm H i absorption line as a probe of cold neutral gas. The survey uses the ASKAP radio telescope and will cover 24,000 deg$^2$ of sky over the next five years. FLASH breaks new ground in two ways – it is the first large H i absorption survey to be carried out without any optical preselection of targets, and we use an automated Bayesian line-finding tool to search through large datasets and assign a statistical significance to potential line detections. Two Pilot Surveys, covering around 3000 deg$^2$ of sky, were carried out in 2019-22 to test and verify the strategy for the full FLASH survey. The processed data products from these Pilot Surveys (spectral-line cubes, continuum images, and catalogues) are public and available online. In this paper, we describe the FLASH spectral-line and continuum data products and discuss the quality of the H i spectra and the completeness of our automated line search. Finally, we present a set of 30 new H i absorption lines that were robustly detected in the Pilot Surveys, almost doubling the number of known H i absorption systems at $0.4\lt z\lt1$. The detected lines span a wide range in H i optical depth, including three lines with a peak optical depth $\tau\gt1$, and appear to be a mixture of intervening and associated systems. Interestingly, around two-thirds of the lines found in this untargeted sample are detected against sources with a peaked-spectrum radio continuum, which are only a minor (5–20%) fraction of the overall radio-source population. The detection rate for H i absorption lines in the Pilot Surveys (0.3 to 0.5 lines per 40 deg$^2$ ASKAP field) is a factor of two below the expected value. One possible reason for this is the presence of a range of spectral-line artefacts in the Pilot Survey data that have now been mitigated and are not expected to recur in the full FLASH survey. A future paper in this series will discuss the host galaxies of the H i absorption systems identified here.
Head and neck cancer (HNC) often requires complex management and care. While the primary goal of treatment is curative, some advanced cases require consideration of non-curative pathways to optimize patients’ quality of life (QOL) and survival. This narrative review describes important aspects of palliative care and highlights strategies for employing these non-curative options in HNC.
Methods
We identified peer-reviewed articles on the state of palliative care in HNC and its implementation. We searched for articles using terms including “palliative care,” “non-curative care,” “comfort care,” “head and neck cancer,” and “head and neck squamous cell carcinoma.”
Results
HNC is associated with a high disease burden; patients report high levels of pain, and both disease and treatment often compromise ability to carry out activities of daily living. There exist several non-curative routes of treatment, including palliation of symptoms, acute end-of-life (EOL) care, and hospice and home care. These care options provide comfort and optimize QOL of patients. Unfortunately, non-curative care could be misconstrued as withdrawal of treatment, or the provider team “giving up” on patient; these misconception can discourage patients from embracing palliative measures designed to alleviate symptom burden. Proper physician–patient communication, normalization, and early incorporation of these non-curative strategies into mainstream treatment could potentially ease patient concerns, and, eventually in EOL cases, help patients achieve dignified deaths.
Significance of results
Patients with HNC have unique palliative care needs due to their complex treatment and symptom burden. Early incorporation of non-curative plans such as palliative care alongside active treatment could help reduce symptom burden. Clinicians should strive to build trusting relationships with patients with HNC and effectively communicate with them about palliative care options. Guidelines that include such recommendations can help physicians regularly introduce palliation into the realm of active HNC treatment for advanced/incurable disease.
The Automated Meteorology—Ice—Geophysics Observation System 3 (AMIGOS-3) is a multi-sensor on-ice ocean mooring and weather, camera and precision GPS measurement station, controlled by a Python script. The station is designed to be deployed on floating ice in the polar regions and operate unattended for up to several years. Ocean mooring sensors (SeaBird MicroCAT and Nortek Aquadopp) record conductivity, temperature and depth (reported at 10 min intervals), and current velocity (hourly intervals). A Silixa XT fiber-optic distributed temperature sensing system provides a temperature profile time-series through the ice and ocean column with a cadence of 6 d−1 to 1 week−1 depending on available station power. A subset of the station data is telemetered by Iridium modem. Two-way communication, using both single-burst data and file transfer protocols, facilitates station data collection changes and power management. Power is supplied by solar panels and a sealed lead-acid battery system. Two AMIGOS-3 systems were installed on the Thwaites Eastern Ice Shelf in January 2020, providing data well into 2022. We discuss the components of the system and present several of the data sets, summarizing observed climate, ice and ocean conditions.
The Organisation for Economic and Cultural Development (OECD) works with countries worldwide to implement testing in the areas of science, mathematics and reading through the Programme for International Student Assessment (PISA) every three years, and this process is recognised to influence education systems through areas such as curriculum. Over the past decade, the OECD increasingly has acknowledged the need to include a greater emphasis on environmental issues, including developing student competencies specifically in this area. For the 2025 PISA round, we were invited as environmental science education experts to contribute to the Science Framework, which underpins the science assessment. This paper explains how we responded to that invitation, including foregrounding the urgent need to understand the competencies of 15 year-olds to address critical socio-ecological challenges such as climate change. We argue that this provides environmental education practitioners and scholars with a powerful opportunity to gain world-scale data for research and advocacy, which could enhance the visibility and leverage for our field in curriculum, whilst also recognising the political process within which we were engaged.
Major Depressive Disorder (MDD) is a complex mental health condition characterized by a wide spectrum of symptoms. According to the Diagnostic Statistical Manual 5 (DSM-5) criteria, patients can present with up to 1,497 different symptom combinations, yet all receive the same MDD diagnosis. This diversity in symptom presentation poses a significant challenge to understanding the disorder in the wider population. Subtyping offers a way to unpick this phenotypic diversity and enable improved characterization of the disorder. According to reviews, MDD subtyping work to date has lacked consistency in results due to inadequate statistics, non-transparent reporting, or inappropriate sample choice. By addressing these limitations, the current study aims to extend past phenotypic subtyping studies in MDD.
Objectives
(1) To investigate phenotypic subtypes at baseline in a sample of people with MDD;
(2) To determine if subtypes are consistent between baseline 6- and 12-month follow-ups; and
(3) To examine how participants move between subtypes over time.
Methods
This was a secondary analysis of a one-year longitudinal observational cohort study. We collected data from individuals with a history of recurrent MDD in the United Kingdom, the Netherlands and Spain (N=619). The presence or absence of symptoms was tracked at three-month intervals through the Inventory of Depressive Symptomatology: Self-Report (IDS-SR) assessment. We used latent class and three-step latent transition analysis to identify subtypes at baseline, determined their consistency at 6- and 12-month follow-ups, and examined participants’ transitions over time.
Results
We identified a 4-class solution based on model fit and interpretability, including (Class 1) severe with appetite increase, (Class 2), severe with appetite decrease, (Class 3) moderate, and (Class 4) low severity. The classes mainly differed in terms of severity (the varying likelihood of symptom endorsement) and, for the two more severe classes, the type of neurovegetative symptoms reported (Figure 1). The four classes were stable over time (measurement invariant) and participants tended to remain in the same class over baseline and follow-up (Figure 2).
Image:
Image 2:
Conclusions
We identified four stable subtypes of depression, with individuals most likely to remain in their same class over 1-year follow-up. This suggests a chronic nature of depression, with (for example) individuals in severe classes more likely to remain in the same class throughout follow-up. Despite the vast heterogeneous symptom combinations possible in MDD, our results emphasize differences across severity rather than symptom type. This raises questions about the meaningfulness of these subtypes beyond established measures of depression severity. Implications of these findings and recommendations for future research are made.
Disclosure of Interest
C. Oetzmann Grant / Research support from: C.O. is supported by the UK Medical Research Council (MR/N013700/1) and King’s College London member of the MRC Doctoral Training Partnership in Biomedical Sciences., N. Cummins: None Declared, F. Lamers: None Declared, F. Matcham: None Declared, K. White: None Declared, J. Haro: None Declared, S. Siddi: None Declared, S. Vairavan Employee of: S.V is an employee of Janssen Research & Development, LLC and hold company stocks/stock options., B. Penninx : None Declared, V. Narayan: None Declared, M. Hotopf Grant / Research support from: M.H. is the principal investigator of the RADAR-CNS programme, a precompetitive public–private partnership funded by the Innovative Medicines Initiative and the European Federation of Pharmaceutical Industries and Associations. The programme received support from Janssen, Biogen, MSD, UCB and Lundbeck., E. Carr: None Declared
Prenatal vitamin D deficiency is widely reported and may affect perinatal outcomes. In this secondary analysis of the UK Pregnancies Better Eating and Activity Trial, we examined vitamin D status and its relationship with selected pregnancy outcomes in women with obesity (BMI ≥ 30 kg/m2) from multi-ethnic inner-city settings in the UK. Determinants of vitamin D status at a mean of 17 ± 1 weeks’ gestation were assessed using multivariable linear regression and reported as percent differences in serum 25-hydroxyvitamin D (25(OH)D). Associations between 25(OH)D and clinical outcomes were examined using logistic regression. Among 1089 participants, 67 % had 25(OH)D < 50 nmol/l and 26 % had concentrations < 25 nmol/l. In fully adjusted models accounting for socio-demographic and anthropometric characteristics, 25(OH)D was lower among women of Black (% difference = −33; 95 % CI: −39, −27), Asian (% difference = −43; 95 % CI: −51, −35) and other non-White (% difference = −26; 95 % CI: −35, −14) ethnicity compared with women of White ethnicity (n 1086; P < 0·001 for all). In unadjusted analysis, risk of gestational diabetes was greater in women with 25(OH)D < 25 nmol/l compared with ≥ 50 nmol/l (OR = 1·58; 95 % CI: 1·09, 2·31), but the magnitude of effect estimates was attenuated in the multivariable model (OR = 1·33; 95 % CI: 0·88, 2·00). There were no associations between 25(OH)D and risk of preeclampsia, preterm birth or small for gestational age or large-for-gestational-age delivery. These findings demonstrate low 25(OH)D among pregnant women with obesity and highlight ethnic disparities in vitamin D status in the UK. However, evidence for a greater risk of adverse perinatal outcomes among women with vitamin D deficiency was limited.
The role of adsorbed and structural Fe3+ in palygorskite and sepiolite with respect to the oxidation of hydrocortisone in aqueous suspension has been evaluated using electron spin resonance and UV-visible spectroscopy. Natural surface-adsorbed Fe3+ showed an important activity in the oxidation process, although smaller than octahedral Fe3+. The kinetics of oxidative degradation of hydrocortisone by palygorskite appear to be composed of two apparent first order reactions which may be associated with two kinds of sites for Fe in palygorskite. The lower oxidizing power of sepiolite for hydrocortisone degradation is due to its very low Fe3+ content.
Many of the presently oxidized Georgia kaolins probably existed originally in the reduced (gray) state. For that reason, the distribution of iron sulfides in presently gray kaolins may elucidate features observed in oxidized kaolins. An understanding of the nature of gray kaolins may also aid in the development of processing strategies for the exploitation of these abundant resources. The size, morphology, and degree of crystallite bonding of iron sulfides (pyrite and marcasite) in three gray kaolin cores from the Macon, Georgia kaolin district were examined by X-ray powder diffraction, X-ray fluorescence, scanning electron microscopy, and other physical and chemical methods. Pyrite and marcasite were identified as dominantly gravel- and sand-size equant crystals and crystal aggregates, rather than as framboids. Pyrite crystals commonly showed rough octahedral faces, which extended over minor cube faces. Locally, spiral growth dislocations were also observed. Marcasite was found in radiating, prismatic, and tabular crystals. In general, the marcasite crystal aggregates were much more fragile than those of pyrite. The dominance of octahedral crystal shapes and textures of the pyrite suggest inorganic precipitation from solutions supersaturated with respect to octahedral crystal faces.
There are numerous challenges pertaining to epilepsy care across Ontario, including Epilepsy Monitoring Unit (EMU) bed pressures, surgical access and community supports. We sampled the current clinical, community and operational state of Ontario epilepsy centres and community epilepsy agencies post COVID-19 pandemic. A 44-item survey was distributed to all 11 district and regional adult and paediatric Ontario epilepsy centres. Qualitative responses were collected from community epilepsy agencies. Results revealed ongoing gaps in epilepsy care across Ontario, with EMU bed pressures and labour shortages being limiting factors. A clinical network advising the Ontario Ministry of Health will improve access to epilepsy care.
One Tertiary and two Cretaceous gray kaolin sites in Georgia were examined using X-ray radiography of core sections to determine the processes of formation of the deposits. The Tertiary kaolin was oxidized in the upper 3 m of the deposit and reduced below that point. The two Cretaceous kaolins were reduced from the top of the deposit to an abrupt boundary with oxidized red kaolin below. Radiography of the first Cretaceous core revealed thin laminar bedding in the gray kaolin and in the underlying red kaolin. The laminae continue without interruption across the gray kaolin/red kaolin boundary. The laminae were not visible in the gray kaolin except in radiographs. Sedimentary bedding was not observed visually or radiographically at the Tertiary site nor in sections of the core from the second Cretaceous site where kaolinite was recrystallized to large vermiforms. The original sedimentary structure in the first Cretaceous kaolin was preserved possibly due to the inhibition of kaolinite recrystallization by a higher organic matter content. Recrystallization of kaolinite and iron compounds may have destroyed sedimentary structures in part or all of the other two kaolin cores. It is hypothesized that the first Cretaceous physical and biological mixing. The same hypothesis may apply to the other two kaolins but recrystallization after deposition has destroyed sedimentary structures.
Healthy dietary patterns such as the Mediterranean diet (MeDi), Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) have been evaluated for their potential association with health outcomes. However, the lack of standardisation in scoring methodologies can hinder reproducibility and meaningful cross-study comparisons. Here we provide a reproducible workflow for generating the MeDi, DASH and MIND dietary pattern scores from frequently used dietary assessment tools including the 24-h recall tool and two variations of FFQ. Subjective aspects of the scoring process are highlighted and have led to a recommended reporting checklist. This checklist enables standardised reporting with sufficient detail to enhance the reproducibility and comparability of their outcomes. In addition to these aims, valuable insights in the strengths and limitations of each assessment tool for scoring the MeDi, DASH and MIND diet can be utilised by researchers and clinicians to determine which dietary assessment tool best meets their needs.
We have employed the VULCAN laser facility to generate a laser plasma X-ray source for use in photoionization experiments. A nanosecond laser pulse with an intensity of order 1015 Wcm−2 was used to irradiate thin Ag or Sn foil targets coated onto a parylene substrate, and the L-shell emission in the 3.3–4.4 keV range was recorded for both the laser-irradiated and nonirradiated sides. Both the experimental and simulation results show higher laser to X-ray conversion yields for Ag compared with Sn, with our simulations indicating yields approximately a factor of two higher than those found in the experiments. Although detailed angular data were not available experimentally, the simulations indicate that the emission is quite isotropic on the laser-irradiated side but shows close to a cosine variation on the nonirradiated side of the target as seen experimentally in the previous work.
We present a comparison between the performance of a selection of source finders (SFs) using a new software tool called Hydra. The companion paper, Paper I, introduced the Hydra tool and demonstrated its performance using simulated data. Here we apply Hydra to assess the performance of different source finders by analysing real observational data taken from the Evolutionary Map of the Universe (EMU) Pilot Survey. EMU is a wide-field radio continuum survey whose primary goal is to make a deep ($20\mu$Jy/beam RMS noise), intermediate angular resolution ($15^{\prime\prime}$), 1 GHz survey of the entire sky south of $+30^{\circ}$ declination, and expecting to detect and catalogue up to 40 million sources. With the main EMU survey it is highly desirable to understand the performance of radio image SF software and to identify an approach that optimises source detection capabilities. Hydra has been developed to refine this process, as well as to deliver a range of metrics and source finding data products from multiple SFs. We present the performance of the five SFs tested here in terms of their completeness and reliability statistics, their flux density and source size measurements, and an exploration of case studies to highlight finder-specific limitations.
The latest generation of radio surveys are now producing sky survey images containing many millions of radio sources. In this context it is highly desirable to understand the performance of radio image source finder (SF) software and to identify an approach that optimises source detection capabilities. We have created Hydra to be an extensible multi-SF and cataloguing tool that can be used to compare and evaluate different SFs. Hydra, which currently includes the SFs Aegean, Caesar, ProFound, PyBDSF, and Selavy, provides for the addition of new SFs through containerisation and configuration files. The SF input RMS noise and island parameters are optimised to a 90% ‘percentage real detections’ threshold (calculated from the difference between detections in the real and inverted images), to enable comparison between SFs. Hydra provides completeness and reliability diagnostics through observed-deep ($\mathcal{D}$) and generated-shallow ($\mathcal{S}$) images, as well as other statistics. In addition, it has a visual inspection tool for comparing residual images through various selection filters, such as S/N bins in completeness or reliability. The tool allows the user to easily compare and evaluate different SFs in order to choose their desired SF, or a combination thereof. This paper is part one of a two part series. In this paper we introduce the Hydra software suite and validate its $\mathcal{D/S}$ metrics using simulated data. The companion paper demonstrates the utility of Hydra by comparing the performance of SFs using both simulated and real images.
Background: Saccade and pupil responses are potential neurodegenerative disease biomarkers due to overlap between oculomotor circuitry and disease-affected areas. Instruction-based tasks have previously been examined as biomarker sources, but are arduous for patients with limited cognitive abilities; additionally, few studies have evaluated multiple neurodegenerative pathologies concurrently. Methods: The Ontario Neurodegenerative Disease Research Initiative recruited individuals with Alzheimer’s disease (AD), mild cognitive impairment (MCI), amyotrophic lateral sclerosis (ALS), frontotemporal dementia, progressive supranuclear palsy, or Parkinson’s disease (PD). Patients (n=274, age 40-86) and healthy controls (n=101, age 55-86) viewed 10 minutes of frequently changing video clips without instruction while their eyes were tracked. We evaluated differences in saccade and pupil parameters (e.g. saccade frequency and amplitude, pupil size, responses to clip changes) between groups. Results: Preliminary data indicates low-level behavioural alterations in multiple disease cohorts: increased centre bias, lower overall saccade rate and reduced saccade amplitude. After clip changes, patient groups generally demonstrated lower saccade rate but higher microsaccade rate following clip change to varying degrees. Additionally, pupil responses were blunted (AD, MCI, ALS) or exaggerated (PD). Conclusions: This task may generate behavioural biomarkers even in cognitively impaired populations. Future work should explore the possible effects of factors such as medication and disease stage.
Neuropsychiatric disorders are common in 22q11.2 Deletion Syndrome (22q11DS) with about 25% of affected individuals developing schizophrenia spectrum disorders by young adulthood. Longitudinal evaluation of psychosis spectrum features and neurocognition can establish developmental trajectories and impact on functional outcome.
Methods
157 youth with 22q11DS were assessed longitudinally for psychopathology focusing on psychosis spectrum symptoms, neurocognitive performance and global functioning. We contrasted the pattern of positive and negative psychosis spectrum symptoms and neurocognitive performance differentiating those with more prominent Psychosis Spectrum symptoms (PS+) to those without prominent psychosis symptoms (PS−).
Results
We identified differences in the trajectories of psychosis symptoms and neurocognitive performance between the groups. The PS+ group showed age associated increase in symptom severity, especially negative symptoms and general nonspecific symptoms. Correspondingly, their level of functioning was worse and deteriorated more steeply than the PS− group. Neurocognitive performance was generally comparable in PS+ and PS− groups and demonstrated a similar age-related trajectory. However, worsening executive functioning distinguished the PS+ group from PS− counterparts. Notably, of the three executive function measures examined, only working memory showed a significant difference between the groups in rate of change. Finally, structural equation modeling showed that neurocognitive decline drove the clinical change.
Conclusions
Youth with 22q11DS and more prominent psychosis features show worsening of symptoms and functional decline driven by neurocognitive decline, most related to executive functions and specifically working memory. The results underscore the importance of working memory in the developmental progression of psychosis.
The goal of the Patient-Centered Outcomes Research Partnership was to prepare health care professionals and researchers to conduct patient-centered outcomes and comparative effectiveness research (CER). Substantial evidence gaps, heterogeneous health care systems, and decision-making challenges in the USA underscore the need for evidence-based strategies.
Methods:
We engaged five community-based health care organizations that serve diverse and underrepresented patient populations from Hawai’i to Minnesota. Each partner nominated two in-house scholars to participate in the 2-year program. The program focused on seven competencies pertinent to patient-centered outcomes and CER. It combined in-person and experiential learning with asynchronous, online education, and created adaptive, pragmatic learning opportunities and a Summer Institute. Metrics included the Clinical Research Appraisal Inventory (CRAI), a tool designed to assess research self-efficacy and clinical research skills across 10 domains.
Results:
We trained 31 scholars in 3 cohorts. Mean scores in nine domains of the CRAI improved; greater improvement was observed from the beginning to the midpoint than from the midpoint to conclusion of the program. Across all three cohorts, mean scores on 52 items (100%) increased (p ≤ 0.01), and 91% of scholars reported the program improved their skills moderately/significantly. Satisfaction with the program was high (91%).
Conclusions:
Investigators that conduct patient-centered outcomes and CER must know how to collaborate with regional health care systems to identify priorities; pose questions; design, conduct, and disseminate observational and experimental research; and transform knowledge into practical clinical applications. Training programs such as ours can facilitate such collaborations.
Characterisation of the effect of transport on the welfare of fowl requires common currency methods that can compare the effects of diverse stressors using the same unit of measure. Aversion of broiler chickens (42 ± 1 days old) to vibrational and thermal stressors was investigated in a continuous free-choice procedure. Each choice-chamber had four compartments, connected via a central zone, offering a thermal stressor (T: 40°C, relative humidity 21%), a vibrational stressor (V: 2 Hz, 1 ms−2), concurrent vibrational and thermal stressors (VT), or no applied stressors (N). In experiment 1, there were no significant effects of stressor on the latency to leave the compartments after initial introduction (n = 24). In experiment 2, 12 subjects were introduced individually to a chamber for 4 h during each of a control and two treatment sessions. The results indicated that chickens did not avoid vibration, but significantly avoided the thermal stressor overall (T and VT; P < 0.001). As no interactive effect of the stressors was observed, all avoidance of the combined stressors can be attributed to the effects of the thermal stressor alone. Further work is required to establish ways in which delayed stressors can be studied using behavioural methods before common currency methods can be practicable.