Background: Neurofibromatosis 1 (NF1) is a multisystem neurocutaneous disorder. Treatment involves multiple specialists. There are currently no multidisciplinary clinics for adults with NF1 in BC, which impacts communication between subspecialties. We sought perspectives of patients and providers to identify the impact of and solutions to gaps in care. Methods: Focus groups with patients (2 groups; 9 patients) and physicians (10) who see people with NF1 were conducted. Thematic content analysis was applied to the data to derive major themes. Concurrently, quarterly NF multidisciplinary rounds were initiated to enhance coordination of care. Results: Major themes emerged around the need for increased coordination and communication amongst providers. Specifically, physicians identified working in “siloed care structures”, and patients and providers identified lack of awareness of expertise and barriers to accessing care. Conclusions: Focus groups enable inclusion of patient and provider perspectives in developing solutions to gaps in care. The importance of supporting interdisciplinary communication in caring for NF1 patients was confirmed in focus groups. To date, we have held multidisciplinary NF rounds, with 12 cases discussed. Disciplines represented include neurology, pediatrics, radiology, neuro-ophthalmology, neuro-otology, pathology, orthopedic plastic and neurosurgery, medical and radiation oncology, and the hereditary cancer program. Telehealth format enables participation from distributed centres across BC.

The stars of the Milky Way carry the chemical history of our Galaxy in their atmospheres as they journey through its vast expanse. Like barcodes, we can extract the chemical fingerprints of stars from high-resolution spectroscopy. The fourth data release (DR4) of the Galactic Archaeology with HERMES (GALAH) Survey, based on a decade of observations, provides the chemical abundances of up to 32 elements for 917 588 stars that also have exquisite astrometric data from the Gaia satellite. For the first time, these elements include life-essential nitrogen to complement carbon, and oxygen as well as more measurements of rare-earth elements critical to modern-life electronics, offering unparalleled insights into the chemical composition of the Milky Way. For this release, we use neural networks to simultaneously fit stellar parameters and abundances across the whole wavelength range, leveraging synthetic grids computed with Spectroscopy Made Easy. These grids account for atomic line formation in non-local thermodynamic equilibrium for 14 elements. In a two-iteration process, we first fit stellar labels to all 1 085 520 spectra, then co-add repeated observations and refine these labels using astrometric data from Gaia and 2MASS photometry, improving the accuracy and precision of stellar parameters and abundances. Our validation thoroughly assesses the reliability of spectroscopic measurements and highlights key caveats. GALAH DR4 represents yet another milestone in Galactic archaeology, combining detailed chemical compositions from multiple nucleosynthetic channels with kinematic information and age estimates. The resulting dataset, covering nearly a million stars, opens new avenues for understanding not only the chemical and dynamical history of the Milky Way but also the broader questions of the origin of elements and the evolution of planets, stars, and galaxies.

This systematic review evaluates the use of Normothermic Machine Perfusion (NMP) as a testbed for developing peripheral nerve and muscle interfaces for bionic prostheses. Our findings suggest that NMP offers a viable alternative to traditional models, with significant implications for future research and clinical applications. A literature search was performed using Ovid MEDLINE (1946 to October 2023), revealing 559 abstracts.

No studies using nerve and/or muscle electrodes for the testing or development of bionic interface technologies were identified, except for one conference abstract. NMP could serve as a test bed for future development of interface biocompatibility, selectivity, stability and data transfer, whilst complying with ethical practices and potentially offering greater relevance for human translation. Implemention of machine perfusion requires experienced personnel. Encompassing artificial intelligence alongside machine learning will provide a significant contribution to advancing interface technologies for multiple neurological disorders.

Next generation high-power laser facilities are expected to generate hundreds-of-MeV proton beams and operate at multi-Hz repetition rates, presenting opportunities for medical, industrial and scientific applications requiring bright pulses of energetic ions. Characterizing the spectro-spatial profile of these ions at high repetition rates in the harsh radiation environments created by laser–plasma interactions remains challenging but is paramount for further source development. To address this, we present a compact scintillating fiber imaging spectrometer based on the tomographic reconstruction of proton energy deposition in a layered fiber array. Modeling indicates that spatial resolution of approximately 1 mm and energy resolution of less than 10% at proton energies of more than 20 MeV are readily achievable with existing 100 μm diameter fibers. Measurements with a prototype beam-profile monitor using 500 μm fibers demonstrate active readouts with invulnerability to electromagnetic pulses, and less than 100 Gy sensitivity. The performance of the full instrument concept is explored with Monte Carlo simulations, accurately reconstructing a proton beam with a multiple-component spectro-spatial profile.

Background: Neurofibromatosis 1 is a multisystem, neurocutaneous disorder with a predisposition for various malignancies. There is no established care pathway or multidisciplinary clinic for adult patients with NF1 in British Columbia (BC). Patients may miss timely screening or therapeutic interventions. The development of new therapies for NF1 highlights the urgency for coordinated care. Methods: A review of existing programs and guidelines was conducted. The estimated population with NF1 in BC was determined. A working group consisting of neuromuscular neurology, pediatric neuro-oncology, adult neuro-oncology, and medical genetics identified gaps in care. Results: Approximately 2200 adult individuals with NF1 are estimated to live in BC. A three-prong approach to address identified gaps was developed: A quarterly multidisciplinary NF Case Conference was initiated. The initial session was attended by 18 providers. Focus groups for patients and providers to enhance understanding of both perspectives are being conducted. Informed by the focus groups, an NF1 Care Pathway for BC will be developed. Conclusions: Advances in treatment for NF1 prompted the formation of the BC NF Working Group to develop a strategy to improve longitudinal, multidisciplinary care. The development of a care pathway, with patient input, will improve care coordination and access to care.

Observational studies suggest that 25-hydroxy vitamin D (25(OH)D) concentration is inversely associated with pain. However, findings from intervention trials are inconsistent. We assessed the effect of vitamin D supplementation on pain using data from a large, double-blind, population-based, placebo-controlled trial (the D-Health Trial). 21 315 participants (aged 60–84 years) were randomly assigned to a monthly dose of 60 000 IU vitamin D3 or matching placebo. Pain was measured using the six-item Pain Impact Questionnaire (PIQ-6), administered 1, 2 and 5 years after enrolment. We used regression models (linear for continuous PIQ-6 score and log-binomial for binary categorisations of the score, namely ‘some or more pain impact’ and ‘presence of any bodily pain’) to estimate the effect of vitamin D on pain. We included 20 423 participants who completed ≥1 PIQ-6. In blood samples collected from 3943 randomly selected participants (∼800 per year), the mean (sd) 25(OH)D concentrations were 77 (sd 25) and 115 (sd 30) nmol/l in the placebo and vitamin D groups, respectively. Most (76 %) participants were predicted to have 25(OH)D concentration >50 nmol/l at baseline. The mean PIQ-6 was similar in all surveys (∼50·4). The adjusted mean difference in PIQ-6 score (vitamin D cf placebo) was 0·02 (95 % CI (−0·20, 0·25)). The proportion of participants with some or more pain impact and with the presence of bodily pain was also similar between groups (both prevalence ratios 1·01, 95 % CI (0·99, 1·03)). In conclusion, supplementation with 60 000 IU of vitamin D3/month had negligible effect on bodily pain.

Zn is an essential nutrient for humans; however, a sensitive biomarker to assess Zn status has not been identified. The objective of this study was to determine the reliability and sensitivity of Zn transporter and metallothionein (MT) genes in peripheral blood mononuclear cells (PBMCs) to Zn exposure ex vivo and to habitual Zn intake in human subjects. In study 1, human PBMCs were cultured for 24 h with 0–50 µm ZnSO4 with or without 5 µm N,N,N′,N′-tetrakis(2-pyridylmethyl)ethylenediamine (TPEN), and mRNA expression of SLC30A1-10, SLC39A1-14, MT1 subtypes (A, B, E, F, G, H, L, M and X), MT2A, MT3 and MT4 mRNA was determined. In study 2, fifty-four healthy male and female volunteers (31·9 (sd 13·8) years, BMI 25·7 (sd 2·9) kg/m2) completed a FFQ, blood was collected, PBMCs were isolated and mRNA expression of selected Zn transporters and MT isoforms was determined. Study 1: MT1E, MT1F, MT1G, MT1H, MT1L, MT1M, MT1X, MT2A and SLC30A1 increased with increasing concentrations of Zn and declined with the addition of TPEN. Study 2: Average daily Zn intake was 16·0 (sd 5·3) mg/d (range: 9–31 mg/d), and plasma Zn concentrations were 15·5 (SD 2·8) μmol/l (range 11–23 μmol/l). PBMC MT2A was positively correlated with dietary Zn intake (r 0·306, P = 0·03) and total Zn intake (r 0·382, P < 0·01), whereas plasma Zn was not (P > 0·05 for both). Findings suggest that MT2A mRNA in PBMCs reflects dietary Zn intake in healthy adults and may be a component in determining Zn status.

Laser–solid interactions are highly suited as a potential source of high energy X-rays for nondestructive imaging. A bright, energetic X-ray pulse can be driven from a small source, making it ideal for high resolution X-ray radiography. By limiting the lateral dimensions of the target we are able to confine the region over which X-rays are produced, enabling imaging with enhanced resolution and contrast. Using constrained targets we demonstrate experimentally a $(20\pm 3)~\unicode[STIX]{x03BC}\text{m}$ X-ray source, improving the image quality compared to unconstrained foil targets. Modelling demonstrates that a larger sheath field envelope around the perimeter of the constrained targets increases the proportion of electron current that recirculates through the target, driving a brighter source of X-rays.

Giant electromagnetic pulses (EMP) generated during the interaction of high-power lasers with solid targets can seriously degrade electrical measurements and equipment. EMP emission is caused by the acceleration of hot electrons inside the target, which produce radiation across a wide band from DC to terahertz frequencies. Improved understanding and control of EMP is vital as we enter a new era of high repetition rate, high intensity lasers (e.g. the Extreme Light Infrastructure). We present recent data from the VULCAN laser facility that demonstrates how EMP can be readily and effectively reduced. Characterization of the EMP was achieved using B-dot and D-dot probes that took measurements for a range of different target and laser parameters. We demonstrate that target stalk geometry, material composition, geodesic path length and foil surface area can all play a significant role in the reduction of EMP. A combination of electromagnetic wave and 3D particle-in-cell simulations is used to inform our conclusions about the effects of stalk geometry on EMP, providing an opportunity for comparison with existing charge separation models.

Introduction: Prehospital blood transfusion has been adopted by many civilian helicopter emergency medical service (HEMS) agencies and early outcomes are positive. Shock Trauma Air Rescue Service (STARS) operates six bases in Western Canada and in 2013 implemented a prehospital transfusion program. We describe the processes and standard work ensuring safe storage, administration, and stewardship of this precious resource. Our aim was to produce a sustainable and safe blood storage system that could be carried on each mission flown. Methods: Close collaboration with transfusion services and adherence to Canadian Transfusion Standards was key at each step of development. An inexpensive, reusable, temperature controlled thermal packaging device was obtained along with an electronic temperature logger. Conditioning of the device and temperature maintenance (1 6C) was tested to ensure safe storage conditions. Online training programs were developed for air medical crew (AMC) as well as transport physicians (TPs) regarding administration indications, safety, and stewardship processes. Blood traceability and usage was monitored on an ongoing basis for quality assurance. Results: Two units of O negative packed red blood cells (pRBCs) are now carried on each flight. The blood box is conditioned and prepared by transfusion services for routine exchange every 72 hours. If pRBCs are administered the blood bank is immediately notified for preparation of another cooler. Unused blood is returned to blood bank circulation. Conclusion: The introduction of the STARS blood on board program supports the provision of emergent transfusion to selected patients in the pre-hospital environment. Our standard work and stewardship processes minimize wastage of blood products while keeping it readily available for critically ill and injured patients. Subsequent work will aim to describe characteristics and patient centred outcomes.

The SkyMapper Transient survey (SMT) is exploring variability in the southern sky by performing (a) a rolling search to discover and study supernovæ, and (b) a Target of Opportunity programme that uses the robotic SkyMapper Telescope at Siding Spring Observatory. The supernova survey is obtaining a non-targeted sample of Type Ia supernovæ (SNe Ia) at low redshifts, z < 0.1, and studying other interesting transients found with the search strategy. We have a Target of Opportunity programme with an automatic response mechanism to search for optical counterparts to gravitational-wave and fast radio-burst events; it benefits from SkyMapper’s large field of view of 5.7 sq. deg. and a rapid data reduction pipeline.

We present first results of the SMT survey. The SMT pipeline can process and obtain potential candidates within 12 hours of observation. It disentangles real transients from processing artefacts using a machine-learning algorithm. To date, SMT has discovered over 60 spectroscopically confirmed supernovæ, several peculiar objects, and over 40 SNe Ia including one (SNIa 2016hhd) which was found within the first few days of explosion. We have also participated in searches for optical counterparts of gravitational waves, fast radio bursts and other transients, and have published observations of the optical counterpart of the gravitational-wave event GW170817. We also participate in coordinated observations with the Deeper Wider Faster programme, and the Kepler K2 cosmology project.

The problem in determining the economic feasibility of mechanical, chemical, and combination weed control methods in corn (Zea mays L.) is a complex decision involving many factors. The effects of cost, yield, timeliness, and alternative uses of labor are the factors considered in comparing various methods of weed control in this study. Costs of weed control operations range from $2.84/A for two cultivations to $10.45/A for the most intensive, mechanical-chemical operation studied. Most common weed control methods have costs of approximately $3 to $4/A. Yields range from 83 bu/A for two cultivations to 96 bu/A with the highest cost chemical-mechanical weed control methods. All yields used in this study are supported by agronomic studies and are indexed on the basis of 100 bu/A for weed-free conditions. The consideration of both yields and costs does affect the selection of a weed control method. Considering only these two factors, mechanical methods have a slight advantage over chemical weed control methods. Penalizing mechanical methods because of delay or timeliness characteristics gives chemical methods an advantage by as much as $3.00/A. Alternative uses of labor, even though a common argument in selecting chemical or mechanical methods, is a very small item and has only moderate effects on the changes in net income.

Aeronautics faces new and increased challenges in the 21st century. These include climate change, long-term fuel supply, traffic congestion, and noise pollution. Radical technological steps will be demanded of the industry in order to maintain a sustainable transportation system.

In setting out its ideas for a Sonic Cruiser, Boeing has recently acknowledged that there is a need to look beyond the high-aspect-ratio wing with separate fuselage and podded engine configuration, which it pioneered at the start of the Jet era.

This paper sets out the case for the broad delta including its advantages as a basis for achieving higher transonic cruising speeds, with very long range and large payloads, while providing progressive and significantly improved environmental impact. The work is based on concept designs drawing on flight and weight data from the Vulcan bomber and the Concorde aircraft – both pioneering designs, by no means at the end of their technical potential.

A broad delta is taken to mean an aircraft of aspect ratio in the range 2 to 4. Not only does such a planform have application to many sizes of airliner, cruising at various high subsonic speeds, but also it is inherently well suited to later application of laminar flow. Wing surfaces undisturbed by flaps and slots and unhampered by very thick wing skins, together with favourable engine inlet locations, could be a basis for improved overall aerodynamic efficiency.

Airliners designed for operation in the region of Mach 1 are likely to pose more difficult problems for the aerodynamicist. Designs must cater for both cruise and maximum design speeds, which may encompass the Mach 1 condition.

Since the 1970s, large passenger aircraft design has evolved by modest, but commercially significant, incremental change following the underwing pod concept pioneered by the Boeing 707. In the 21st century, the market is likely to require greater passenger capacity to deal with air-side congestion and higher performance and operational efficiency to justify investment and conserve finite fossil fuel resources. Public opinion will require far greater emphasis on control of noise and engine exhaust pollution. There is likely to be much increased emphasis on pollution in the upper-atmosphere and its environmental impact. In such a situation, it is questionable whether the evolutionary design route can produce the necessary advances and this must stimulate the search for radical design alternatives.

A revolutionary approach, involving the delta planform combined with wing laminar flow control and its impact on overall design, is given a preliminary study in this paper. This has been carried out by assuming that major improvements in drag can be obtained by extensive laminarisation. Using non-dimensional methods, the resulting broad interactive impacts on airframe and engine design and performance are derived. The effect of assuming varying quantities of low-energy air sucked from the foot of the boundary layer is studied and suction-system performance examined.

In addition to the large potential improvements in range, a strong relationship between lower drag, lower cruising altitude and lower cruise engine size is identified. In the study, several factors emerge which may combine to drive large aircraft design towards low aspect ratio and the integrated delta wing planform. This paper is intended as a stimulus and a basis for further study and research.

Background: The infratemporal fossa is an anatomically complex region. Lesions that arise in the infratemporal fossa are uncommon; however, their surgical resection remain challenging. Here we present a modified preauricular subtemporal approach initially described by Obwegeser et al. used in four patients with large skull base lesions. Methods: Retrospective case series of 4 patients Results: Four patients with various lesions of the infratemporal fossa (aneurysmal bone cyst, giant cell tumor of the bone, recurrent melanoma and recurrent clival chordoma) underwent surgical resection using the modified Obwegeser approach. A multidisciplinary team cared for patients consisting of maxillofacial surgery, otolaryngology and neurosurgery. After either nasotracheal intubation or tracheostomy, the patient’s jaw was temporarily wired shut. A curvilinear incision was fashioned and the root of zygoma was exposed (masseter attached) and osteotomized followed by inferior mobilization. The mandibular condyle is osteomized next and TMJ disarticulated with temporalis muscle still attached and reflected superiorly. Surgical resection of tumor then proceeded centered around the region bridging the temporal and infratemporal fossae. Reconstruction was carried out using plates and screws. Conclusions: The modified Obwegeser approach can provide safe and direct access to certain infratemporal fossa lesions with good cosmesis and functional outcome for patients without substantially increasing OR time.

The evidence underpinning the developmental origins of health and disease (DOHaD) is overwhelming. As the emphasis shifts more towards interventions and the translational strategies for disease prevention, it is important to capitalize on collaboration and knowledge sharing to maximize opportunities for discovery and replication. DOHaD meetings are facilitating this interaction. However, strategies to perpetuate focussed discussions and collaborations around and between conferences are more likely to facilitate the development of DOHaD research. For this reason, the DOHaD Society of Australia and New Zealand (DOHaD ANZ) has initiated themed Working Groups, which convened at the 2014–2015 conferences. This report introduces the DOHaD ANZ Working Groups and summarizes their plans and activities. One of the first Working Groups to form was the ActEarly birth cohort group, which is moving towards more translational goals. Reflecting growing emphasis on the impact of early life biodiversity – even before birth – we also have a Working Group titled Infection, inflammation and the microbiome. We have several Working Groups exploring other major non-cancerous disease outcomes over the lifespan, including Brain, behaviour and development and Obesity, cardiovascular and metabolic health. The Epigenetics and Animal Models Working Groups cut across all these areas and seeks to ensure interaction between researchers. Finally, we have a group focussed on ‘Translation, policy and communication’ which focusses on how we can best take the evidence we produce into the community to effect change. By coordinating and perpetuating DOHaD discussions in this way we aim to enhance DOHaD research in our region.