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Antenatal corticosteroids are given to pregnant people at risk of preterm birth to reduce newborn morbidity, including respiratory distress syndrome. However, there has been concern surrounding potential adverse effects on subsequent generations. Animal studies have demonstrated endocrine and metabolic changes in those exposed to corticosteroids in utero (F1) and in the second generation (F2). We aimed to assess the effects of parental antenatal corticosteroid exposure on health of the second generation (F2) of Auckland Steroid Trial (AST) participants. In the AST, women (F0) expected to birth between 24 and 36 weeks’ gestation were randomised to betamethasone or placebo. When their children (F1) were 50 years old, they and their children (F2) were followed up with a self-report questionnaire and data linkage. The primary outcome for this analysis was body mass index (BMI) z-score in the F2 generation. Secondary outcomes included respiratory, cardiovascular, neurodevelopmental, mental and general health, and social outcomes. Of the 213 F2 participants, 144 had BMI data available. There was no difference in BMI z-score between participants whose parent was exposed to betamethasone versus placebo (mean (SD) 0.63 (1.45), N = 77 vs 0.41 (1.28), N = 67, adjusted mean difference (95% confidence interval) = 0.16 (-0.37, 0.69)). There was no evidence of a difference in rates of overweight, diabetes, respiratory disease, cardiometabolic risk factors, neurodevelopmental difficulties, mental health difficulties and social outcomes between parental betamethasone versus placebo exposure groups, but confidence intervals were wide. These findings are reassuring regarding the intergenerational safety of antenatal corticosteroids.
Knowledge of the status of ecosystems is vital to help develop and implement conservation strategies. This is particularly relevant to the Arctic where the need for biodiversity conservation and monitoring has long been recognised, but where issues of local capacity and logistic barriers make surveys challenging. This paper demonstrates how long-term monitoring programmes outside the Arctic can contribute to developing composite trend indicators, using monitoring of annual abundance and population-level reproduction of species of migratory Arctic-breeding waterbirds on their temperate non-breeding areas. Using data from the UK and the Netherlands, countries with year-round waterbird monitoring schemes and supporting relevant shares of Arctic-breeding populations of waterbirds, we present example multi-species abundance and productivity indicators related to the migratory pathways used by different biogeographical populations of Arctic-breeding wildfowl and wader species in the East Atlantic Flyway. These composite trend indicators show that long-term increases in population size have slowed markedly in recent years and in several cases show declines over, at least, the last decade. These results constitute proof of concept. Some other non-Arctic countries located on the flyways of Arctic-breeding waterbirds also annually monitor abundance and breeding success, and we advocate that future development of “Arctic waterbird indicators” should be as inclusive of data as possible to derive the most robust outputs and help account for effects of current changes in non-breeding waterbird distributions. The incorporation of non-Arctic datasets into assessments of the status of Arctic biodiversity is recognised as highly desirable, because logistic constraints in monitoring within the Arctic region limit effective population-scale monitoring there, in effect enabling “monitoring at a distance”.
Patients with posttraumatic stress disorder (PTSD) exhibit smaller regional brain volumes in commonly reported regions including the amygdala and hippocampus, regions associated with fear and memory processing. In the current study, we have conducted a voxel-based morphometry (VBM) meta-analysis using whole-brain statistical maps with neuroimaging data from the ENIGMA-PGC PTSD working group.
Methods
T1-weighted structural neuroimaging scans from 36 cohorts (PTSD n = 1309; controls n = 2198) were processed using a standardized VBM pipeline (ENIGMA-VBM tool). We meta-analyzed the resulting statistical maps for voxel-wise differences in gray matter (GM) and white matter (WM) volumes between PTSD patients and controls, performed subgroup analyses considering the trauma exposure of the controls, and examined associations between regional brain volumes and clinical variables including PTSD (CAPS-4/5, PCL-5) and depression severity (BDI-II, PHQ-9).
Results
PTSD patients exhibited smaller GM volumes across the frontal and temporal lobes, and cerebellum, with the most significant effect in the left cerebellum (Hedges’ g = 0.22, pcorrected = .001), and smaller cerebellar WM volume (peak Hedges’ g = 0.14, pcorrected = .008). We observed similar regional differences when comparing patients to trauma-exposed controls, suggesting these structural abnormalities may be specific to PTSD. Regression analyses revealed PTSD severity was negatively associated with GM volumes within the cerebellum (pcorrected = .003), while depression severity was negatively associated with GM volumes within the cerebellum and superior frontal gyrus in patients (pcorrected = .001).
Conclusions
PTSD patients exhibited widespread, regional differences in brain volumes where greater regional deficits appeared to reflect more severe symptoms. Our findings add to the growing literature implicating the cerebellum in PTSD psychopathology.
Background: TeleStroke can improve access to stroke care in rural areas. We aim to evaluate the safety and effectiveness of intravenous thrombolysis in our TeleStroke system. Methods: The Manitoba TeleStroke program was rolled out across 7 sites between November 2014 and January 2019. We retrospectively analyzed prospectively collected consecutive acute stroke patients’ data in this duration. The primary outcome was safety and effectiveness measured in terms of 90-day modified Rankin score (mRs). The number of acute ischemic stroke (AIS) patients receiving thrombolysis and endovascular thrombectomy [EVT] and process metrics were also analyzed. R/RStudio version-4.3.2 was used (p<0.05). Results: Of the 1,748 TeleStroke patients (age 71 years [IQR 58-81], female 810[46.3%]), 696 were identified as AIS. Of these, 265(38.1%) received thrombolysis and 48(6.9%) EVT. Ninety-day mortality was 53(20.0%) among those receiving thrombolysis and 117(44.2%) had a favorable outcome (mRs ≤2). Of those who received intravenous thrombolysis, 9 patients (4.2%) were found to have symptomatic intracranial hemorrhage. The median last-seen-normal (LSN)-to-door was121 minutes and the median door-to-needle, 55 minutes. Conclusions: Intravenous thrombolysis was found to be effective with acceptable safety. TeleStroke improved overall access to stroke care and played an important role in identifying AIS patients eligible for thrombolysis and EVT.
Multicenter clinical trials are essential for evaluating interventions but often face significant challenges in study design, site coordination, participant recruitment, and regulatory compliance. To address these issues, the National Institutes of Health’s National Center for Advancing Translational Sciences established the Trial Innovation Network (TIN). The TIN offers a scientific consultation process, providing access to clinical trial and disease experts who provide input and recommendations throughout the trial’s duration, at no cost to investigators. This approach aims to improve trial design, accelerate implementation, foster interdisciplinary teamwork, and spur innovations that enhance multicenter trial quality and efficiency. The TIN leverages resources of the Clinical and Translational Science Awards (CTSA) program, complementing local capabilities at the investigator’s institution. The Initial Consultation process focuses on the study’s scientific premise, design, site development, recruitment and retention strategies, funding feasibility, and other support areas. As of 6/1/2024, the TIN has provided 431 Initial Consultations to increase efficiency and accelerate trial implementation by delivering customized support and tailored recommendations. Across a range of clinical trials, the TIN has developed standardized, streamlined, and adaptable processes. We describe these processes, provide operational metrics, and include a set of lessons learned for consideration by other trial support and innovation networks.
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.
We present a new radio continuum study of the Large Magellanic Cloud supernova remnant (SNR) MC SNR J0519–6902. With a diameter of $\sim$8 pc, this SNR shows a radio ring-like morphology with three bright regions towards the north, east, and south. Its linear polarisation is prominent with average values of $5\pm1$% and $6\pm1$% at 5 500 and 9 000 MHz, and we find a spectral index of ${-0.62\pm0.02}$, typical of a young SNR. The average rotation measure is estimated at ${-124\pm83}$ rad m$^{-2}$ and the magnetic field strength at ${\sim11}\,\mu$G. We also estimate an equipartition magnetic field of ${72\pm 5}\,\mu$G and minimum explosion energy of E$_\textrm{ min}$ = 2.6$\times10^{48}$ erg. Finally, we identified an H i cloud that may be associated with MC SNR J0519–6902, located in the southeastern part of the remnant, along with a potential wind-bubble cavity.
In Australia and other high-income countries, communities are experiencing diet-related diseases due to social inequities and food systems that promote the production and consumption of unhealthy foods(1). Community food hubs have the potential to strengthen local food systems and improve access to healthy, affordable, culturally appropriate food by selling local food to local people(2). The primary aim of this rapid review was to identify short- and medium-term outcomes and long-term impacts associated with community food hubs. In January 2024, four databases and the grey literature were searched for relevant studies and reports published in English between 2013 and 2023. Empirical evaluations of food hubs in high-income countries that included a physical market selling healthy local food were eligible for inclusion. A narrative synthesis was conducted, and descriptive statistics were used to summarise outcomes and impacts under five categories: economic development and viability; ecological sustainability; access to and demand for healthy local food; personal and community wellbeing; and agency and re-localisation of power(3,4). A total of 16 studies/reports were included, reporting on 24 community food hubs (USA n = 16; Australia n = 7; Canada n = 1). Food hubs were often described as farmers’ markets (n = 9, 37% of food hubs), some of which offered financial incentives/subsidies to people living on low incomes. Some food hubs also sold food wholesale and/or provided nutrition education and community gardens. Across the 24 food hubs, a total of 83 short- and medium-term outcomes were assessed. No long-term impacts were evaluated. Outcomes were considered ‘positive’ if evaluation results reflected desirable changes. Overall, 86% of outcomes were positive (n = 71). Within the personal and community wellbeing category, 42 outcomes were assessed, and 83% (n = 35) were positive (e.g., increased fruit and vegetable consumption, increased community connection). Within the access to and demand for healthy local food category, 25 outcomes were assessed, and 96% (n = 24) were positive (e.g., increased access to and/or demand for affordable local produce). Outcomes under the remaining three categories were assessed less frequently. Within the economic development and viability category, 6 outcomes were assessed, and 50% (n = 3) were positive (e.g., access to new markets for food hub suppliers). Within the ecological sustainability category, 6 outcomes were assessed, and 100% (n = 6) were positive (e.g., reduction in food packaging and food waste). Within the agency and re-localisation of power category, 4 outcomes were assessed, and 75% (n = 3) were positive (e.g., integration of community members from low income and cultural minority groups into local food systems). Community food hubs can promote personal and community wellbeing, access to and demand for healthy local food, economic development and viability, ecological sustainability, and agency and re-localisation of power. Future research should focus on methods for evaluating long-term impacts under all five categories.
Posttraumatic stress disorder (PTSD) has been associated with advanced epigenetic age cross-sectionally, but the association between these variables over time is unclear. This study conducted meta-analyses to test whether new-onset PTSD diagnosis and changes in PTSD symptom severity over time were associated with changes in two metrics of epigenetic aging over two time points.
Methods
We conducted meta-analyses of the association between change in PTSD diagnosis and symptom severity and change in epigenetic age acceleration/deceleration (age-adjusted DNA methylation age residuals as per the Horvath and GrimAge metrics) using data from 7 military and civilian cohorts participating in the Psychiatric Genomics Consortium PTSD Epigenetics Workgroup (total N = 1,367).
Results
Meta-analysis revealed that the interaction between Time 1 (T1) Horvath age residuals and new-onset PTSD over time was significantly associated with Horvath age residuals at T2 (meta β = 0.16, meta p = 0.02, p-adj = 0.03). The interaction between T1 Horvath age residuals and changes in PTSD symptom severity over time was significantly related to Horvath age residuals at T2 (meta β = 0.24, meta p = 0.05). No associations were observed for GrimAge residuals.
Conclusions
Results indicated that individuals who developed new-onset PTSD or showed increased PTSD symptom severity over time evidenced greater epigenetic age acceleration at follow-up than would be expected based on baseline age acceleration. This suggests that PTSD may accelerate biological aging over time and highlights the need for intervention studies to determine if PTSD treatment has a beneficial effect on the aging methylome.
Motivated by microfluidic applications, we investigate drag reduction in laminar pressure-driven flows in channels with streamwise-periodic superhydrophobic surfaces (SHSs) contaminated with soluble surfactant. We develop a model in the long-wave and weak-diffusion limit, where the streamwise SHS period is large compared with the channel height and the Péclet number is large. Using asymptotic and numerical techniques, we determine the influence of surfactant on drag reduction in terms of the relative strength of advection, diffusion, Marangoni effects and bulk–surface exchange. In scenarios with strong exchange, the drag reduction exhibits a complex dependence on the thickness of the bulk-concentration boundary layer and surfactant strength. Strong Marangoni effects immobilise the interface through a linear surfactant distribution, whereas weak Marangoni effects yield a quasi-stagnant cap. The quasi-stagnant cap has an intricate structure with an upstream slip region, followed by intermediate inner regions and a quasi-stagnant region that is mediated by weak bulk diffusion. The quasi-stagnant region differs from the immobile region of a classical stagnant cap, observed for instance in surfactant-laden air bubbles in water, by displaying weak slip. As exchange weakens, the bulk and interface decouple: the surfactant distribution is linear when the surfactant is strong, whilst it forms a classical stagnant cap when the surfactant is weak. The asymptotic solutions offer closed-form predictions of drag reduction across much of the parameter space, providing practical utility and enhancing understanding of surfactant dynamics in flows over SHSs.
The Early Minimally Invasive Removal of Intracerebral Hemorrhage (ENRICH) trial demonstrated that minimally invasive surgery to treat spontaneous lobar intracerebral hemorrhage (ICH) improved functional outcomes. We aimed to explore current management trends for spontaneous lobar ICH in Canada to assess practice patterns and determine whether further randomized controlled trials are needed to clarify the role of surgical intervention.
Methods:
Neurologists, neurosurgeons, physiatrists and trainees in these specialties were invited to complete a 16-question survey exploring three areas: (1) current management for spontaneous lobar ICH at their institution, (2) perceived influence of ENRICH on their practice and (3) perceived need for additional clinical trial data. Standard descriptive statistics were used to report categorical variables. The χ2 test was used to compare responses across specialties and career stages.
Results:
The survey was sent to 433 physicians, and 101 (23.3%) responded. Sixty-eight percent of participants reported that prior to publication of the ENRICH trial, spontaneous lobar ICH was primarily managed conservatively, with surgery reserved for life-threatening situations. Forty-three percent of participants did not foresee a significant increase in surgical intervention at their institution. Of neurosurgical respondents, 33% remained hesitant to offer surgical intervention beyond lifesaving operations. Only 5% reported routinely using specifically designed technologies to evacuate ICH. Seventy percent reported that another randomized controlled trial comparing nonsurgical to surgical management for spontaneous lobar ICH is needed.
Conclusions:
There is significant practice variability in the management of spontaneous lobar ICH across Canadian institutions, stressing the need for additional clinical trial data to determine the role of surgical intervention.
Quantum field theory predicts a nonlinear response of the vacuum to strong electromagnetic fields of macroscopic extent. This fundamental tenet has remained experimentally challenging and is yet to be tested in the laboratory. A particularly distinct signature of the resulting optical activity of the quantum vacuum is vacuum birefringence. This offers an excellent opportunity for a precision test of nonlinear quantum electrodynamics in an uncharted parameter regime. Recently, the operation of the high-intensity Relativistic Laser at the X-ray Free Electron Laser provided by the Helmholtz International Beamline for Extreme Fields has been inaugurated at the High Energy Density scientific instrument of the European X-ray Free Electron Laser. We make the case that this worldwide unique combination of an X-ray free-electron laser and an ultra-intense near-infrared laser together with recent advances in high-precision X-ray polarimetry, refinements of prospective discovery scenarios and progress in their accurate theoretical modelling have set the stage for performing an actual discovery experiment of quantum vacuum nonlinearity.
The H3N2 canine influenza virus (CIV) emerged from an avian reservoir in Asia to circulate entirely among dogs for the last 20 years. The virus was first seen circulating outside Asian dog populations in 2015, in North America. Utilizing viral genomic data in addition to clinical reports and diagnostic testing data, we provide an updated analysis of the evolution and epidemiology of the virus in its canine host. CIV in dogs in North America is marked by a complex life history – including local outbreaks, regional lineage die-outs, and repeated reintroductions of the virus (with diverse genotypes) from different regions of Asia. Phylogenetic and Bayesian analysis reveal multiple CIV clades, and viruses from China have seeded recent North American outbreaks, with 2 or 3 introductions in the past 3 years. Genomic epidemiology confirms that within North America the virus spreads very rapidly among dogs in kennels and shelters in different regions – but then dies out locally. The overall epidemic therefore requires longer-distance dispersal of virus to maintain outbreaks over the long term. With a constant evolutionary rate over 20 years, CIV still appears best adapted to transmission in dense populations and has not gained properties for prolonged circulation among dogs.
Duchenne muscular dystrophy is a devastating neuromuscular disorder characterized by the loss of dystrophin, inevitably leading to cardiomyopathy. Despite publications on prophylaxis and treatment with cardiac medications to mitigate cardiomyopathy progression, gaps remain in the specifics of medication initiation and optimization.
Method:
This document is an expert opinion statement, addressing a critical gap in cardiac care for Duchenne muscular dystrophy. It provides thorough recommendations for the initiation and titration of cardiac medications based on disease progression and patient response. Recommendations are derived from the expertise of the Advance Cardiac Therapies Improving Outcomes Network and are informed by established guidelines from the American Heart Association, American College of Cardiology, and Duchenne Muscular Dystrophy Care Considerations. These expert-derived recommendations aim to navigate the complexities of Duchenne muscular dystrophy-related cardiac care.
Results:
Comprehensive recommendations for initiation, titration, and optimization of critical cardiac medications are provided to address Duchenne muscular dystrophy-associated cardiomyopathy.
Discussion:
The management of Duchenne muscular dystrophy requires a multidisciplinary approach. However, the diversity of healthcare providers involved in Duchenne muscular dystrophy can result in variations in cardiac care, complicating treatment standardization and patient outcomes. The aim of this report is to provide a roadmap for managing Duchenne muscular dystrophy-associated cardiomyopathy, by elucidating timing and dosage nuances crucial for optimal therapeutic efficacy, ultimately improving cardiac outcomes, and improving the quality of life for individuals with Duchenne muscular dystrophy.
Conclusion:
This document seeks to establish a standardized framework for cardiac care in Duchenne muscular dystrophy, aiming to improve cardiac prognosis.
Racially and ethnically minoritized individuals, first-generation college students, and women are significantly underrepresented in science, technology, engineering, and mathematics (STEM) careers. This lack of equal representation limits creativity and progress in these fields and perpetuates systemic barriers that discourage students from pursuing STEM pathways. This special communication introduces the three-tiered mentorship model employed in the Teen Science Ambassador Program (TSAP), which incorporates senior mentors, near-peer mentors, and high school ambassadors (i.e., mentees) to promote education, hands-on research, and career development in STEM for underrepresented students. We discuss the benefits and challenges of the three-tiered model and offer recommendations for optimizing its effectiveness to enhance mentorship experiences for all participants. Findings from the TSAP program suggest that the three-tiered approach benefited all participants: high school ambassadors gained STEM skills and confidence, near-peer mentors developed leadership and communication abilities, and senior mentors improved mentorship skills. However, the effectiveness of near-peer mentorship is highly dependent on clearly defined roles and structured involvement. Thus, feedback collected from each mentorship tier was used to inform subsequent iterations of the program. The layered mentorship structure fostered a sense of community and belonging, which is crucial for retaining individuals from underrepresented groups in STEM.
We present the first results from a new backend on the Australian Square Kilometre Array Pathfinder, the Commensal Realtime ASKAP Fast Transient COherent (CRACO) upgrade. CRACO records millisecond time resolution visibility data, and searches for dispersed fast transient signals including fast radio bursts (FRB), pulsars, and ultra-long period objects (ULPO). With the visibility data, CRACO can localise the transient events to arcsecond-level precision after the detection. Here, we describe the CRACO system and report the result from a sky survey carried out by CRACO at 110-ms resolution during its commissioning phase. During the survey, CRACO detected two FRBs (including one discovered solely with CRACO, FRB 20231027A), reported more precise localisations for four pulsars, discovered two new RRATs, and detected one known ULPO, GPM J1839 $-$10, through its sub-pulse structure. We present a sensitivity calibration of CRACO, finding that it achieves the expected sensitivity of 11.6 Jy ms to bursts of 110 ms duration or less. CRACO is currently running at a 13.8 ms time resolution and aims at a 1.7 ms time resolution before the end of 2024. The planned CRACO has an expected sensitivity of 1.5 Jy ms to bursts of 1.7 ms duration or less and can detect $10\times$ more FRBs than the current CRAFT incoherent sum system (i.e. 0.5 $-$2 localised FRBs per day), enabling us to better constrain the models for FRBs and use them as cosmological probes.
This study evaluated the effects of capsaicin (CAP) supplementation on the intake, nutrient digestibility, ruminal fermentation, nitrogen balance, microbial protein synthesis and health traits of bulls managed on pasture. Eight crossbred (Holstein x Zebu) cattle averaging 313 ± 31 kg of body weight (BW) were arranged in a replicated 4 × 4 Latin square design (one square of four bulls, rumen fistulated with 4-inch silicone cannulas and one square of four non-fistulated bulls), which were kept on Pangola grass pasture (Digitaria decumbens). Each experimental period consisted of 21 days, with 7 days for data collection (no washout between periods). Bulls were randomly assigned to the following treatments: CON (control): concentrate supplementation at 0.5% live weight (BW) and no additive (CAPCIN®), or concentrate supplementation at 0.5% BW in association with CAPCIN® (NutriQuest, Campinas, Brazil) fed at the inclusion rates of 150 (CAP150), 300 (CAP300) and 450 (CAP450) mg/animal/day. Digestibilities of dry matter, organic matter and neutral detergent fibre showed quadratic responses to CAP supplementation. Rumen pH linearly increased with CAP supplementation. The numbers of lymphocytes and eosinophils were linearly increased with CAP supplementation. The use of encapsulated pepper in supplements of crossbred (Holstein x Zebu) bulls managed on D. decumbens pasture up to 450 mg/animal/day improves nutrients digestibility and ruminal fermentation and can positively influence the health status of beef cattle managed under tropical conditions.