Pulsed gravity currents are generated by the sequential release of dense material into a lighter ambient. We investigate the dynamics of pulsed gravity currents using physical scale experiments, two-dimensional depth-averaged shallow water equation (SWE) based models and three-dimensional lattice Boltzmann method (LBM) simulations. Integrating these results we show for the first time that short duration pulsed releases generate intrusive layers, which accelerate front propagation relative to an instantaneously released current of the same total volume. Conversely, a long delay time between pulses produces a current that propagates slower than an equivalent instantaneous release. This finding is supported by physical experiments and depth-resolving LBM simulations. The depth-resolving simulations show that intrusions in pulsed flows experience less drag resistance than those generated by instantaneous releases. The depth-averaged model considered in the present study does not accurately capture the intrusive flow dynamics of pulsed currents. However, the limitations of the finite-depth SWE model may be mitigated by extensions to incorporate entrainment and density stratification. The results also motivate further research into the impact of buoyancy Reynolds number and channel slope on the propagation of pulsed currents.

Paleontology provides insights into the history of the planet, from the origins of life billions of years ago to the biotic changes of the Recent. The scope of paleontological research is as vast as it is varied, and the field is constantly evolving. In an effort to identify “Big Questions” in paleontology, experts from around the world came together to build a list of priority questions the field can address in the years ahead. The 89 questions presented herein (grouped within 11 themes) represent contributions from nearly 200 international scientists. These questions touch on common themes including biodiversity drivers and patterns, integrating data types across spatiotemporal scales, applying paleontological data to contemporary biodiversity and climate issues, and effectively utilizing innovative methods and technology for new paleontological insights. In addition to these theoretical questions, discussions touch upon structural concerns within the field, advocating for an increased valuation of specimen-based research, protection of natural heritage sites, and the importance of collections infrastructure, along with a stronger emphasis on human diversity, equity, and inclusion. These questions offer a starting point—an initial nucleus of consensus that paleontologists can expand on—for engaging in discussions, securing funding, advocating for museums, and fostering continued growth in shared research directions.

Carbonatites are complex rocks yet globally significant hosts of critical mineral resources. Mitigating exploration risk demands robust understanding of their geodynamic setting, which hinges on constraining the timing, duration and nature of associated magmatic and fluid–rock processes. We present multi-method geochronology and isotope geochemistry for the recently discovered Luni and Crean mineralized (Nb, REE, P) carbonatites of the Aileron Province, central Australia. We integrate data from multiple mineral-isotope-pairs: U–Pb and Lu–Hf in zircon, Rb–Sr in biotite and Sr, Lu–Hf, Sm–Nd and (U–Th)/He in apatite. Combined petrological and isotopic evidence resolves distinct geological events over >500 Myr. Zircon U–Pb and biotite Rb–Sr dates range from 831 ± 3 Ma to 796 ± 9 Ma. The oldest dates from less altered minerals reflect primary crystallization, and younger dates relate to pervasive hydrothermal alteration. Radiogenic isotopes (Sr–Nd–Hf) imply a moderately depleted mantle source with negligible recycled sedimentary components in the primary carbonatite magma. Our findings correlate carbonatite magmatism in the Aileron Province at ∼830–820 Ma with the onset of Rodinia Supercontinent breakup, during widespread rift-related extension and mantle-derived magmatism across Australia. Post-emplacement, Lu–Hf apatite dates from 722 ± 17 Ma to 653 ± 22 Ma suggest protracted alteration, whereas apatite (U–Th)/He data indicate exhumation at ∼250 Ma. Carbonatite emplacement probably exploited pre-existing transcrustal corridors during Tonian extension. These zones of structural weakness likely facilitated ascent of volatile-rich, mantle-derived melts to mid–shallow crustal depths, highlighting how regional geodynamics govern the localization and preservation of mineralized carbonatites.

We present the serendipitous radio-continuum discovery of a likely Galactic supernova remnant (SNR) G305.4–2.2. This object displays a remarkable circular symmetry in shape, making it one of the most circular Galactic SNRs known. Nicknamed Teleios due to its symmetry, it was detected in the new Australian Square Kilometre Array Pathfinder (ASKAP) Evolutionary Map of the Universe (EMU) radio–continuum images with an angular size of 1 320$^{\prime\prime}$$\times$1 260$^{\prime\prime}$ and PA = 0$^\circ$. While there is a hint of possible H$\alpha$ and gamma-ray emission, Teleios is exclusively seen at radio–continuum frequencies. Interestingly, Teleios is not only almost perfectly symmetric, but it also has one of the lowest surface brightnesses discovered among Galactic SNRs and a steep spectral index of $\alpha$=–0.6$\pm$0.3. Our best estimates from Hi studies and the $\Sigma$–D relation place Teleios as a type Ia SNR at a distance of either $\sim$2.2 kpc (near-side) or $\sim$7.7 kpc (far-side). This indicates two possible scenarios, either a young (under 1 000 yr) or a somewhat older SNR (over 10 000 yr). With a corresponding diameter of 14/48 pc, our evolutionary studies place Teleios at the either early or late Sedov phase, depending on the distance/diameter estimate. However, our modelling also predicts X-ray emission, which we do not see in the present generation of eROSITA images. We also explored a type Iax explosion scenario that would point to a much closer distance of $\lt$1 kpc and Teleios size of only $\sim$3.3 pc, which would be similar to the only known type Iax remnant SN1181. Unfortunately, all examined scenarios have their challenges, and no definitive Supernova (SN) origin type can be established at this stage. Remarkably, Teleios has retained its symmetrical shape as it aged even to such a diameter, suggesting expansion into a rarefied and isotropic ambient medium. The low radio surface brightness and the lack of pronounced polarisation can be explained by a high level of ambient rotation measure (RM), with the largest RM being observed at Teleios’s centre.

Patient involvement is an increasingly recognized cornerstone of effective Health Technology Assessment (HTA). Clear, accessible information empowers patient organizations to contribute meaningfully to HTA. Therefore, an international Summary Information for Patient Groups template was developed to provide plain language summaries of new medicines being assessed. Pilots using the template were conducted in Australia in 2021 and England in 2022, providing a trial within the HTA process. In Australia, the Consumer Evidence and Engagement Unit (CEEU) used a workshop and survey, together with key stakeholder interviews, to gather feedback. In England, the National Institute for Health and Care Excellence used public consultation, surveys, and a Short-Life Working Group (SLWG). An advisory board with patient organizations provided additional insights. The feedback enabled members of the HTA International Patient and Citizen Involvement in HTA Interest Group to evaluate the potential to enhance patient organization submissions to HTA bodies and to provide recommendations on the template’s implementation in HTA processes. The pilots highlighted that plain language summaries increased confidence and reduced preparation time for patient organization input to HTA. Other nonexpert stakeholders also found them valuable for fostering understanding. However, challenges remain, including mitigating bias in completed templates, allocating sufficient resources, and integrating into existing processes. The evaluation concludes that the approach holds significant potential to enhance patient organization involvement in HTA. Recommendations include setting up multi-stakeholder SLWGs, ensuring early access to summaries, and aligning implementation with local regulations. These insights provide guidance for HTA bodies to develop an approach to support patient involvement.

High-power fiber lasers generate local heat load extremes during their operation, which increase the fiber temperature and lead to adverse thermal effects, such as transverse mode instability or cladding/coating thermal damage. The local temperature extremes are usually located near the end of a fiber where the pump power is delivered. In this paper, longitudinally inhomogeneous doping concentration profiles are applied to reduce the heat load extremes. Utilizing a new degree of freedom, it is shown by both simulations and measurements that the maximal temperature along the fiber can be effectively decreased by using active fibers with an increasing concentration profile in the direction of the pumping power. The concept is studied by a comprehensive numerical model that considers temperature-dependent parameters and is also demonstrated by measurement on an in-house built thulium-doped fiber laser formed by spliced sections with different concentrations. The output power of 54 W with the slope efficiency exceeding 62% was reached.

Cognitive impairments are a core feature of psychotic disorders, but their long-term trajectory remains contentious. Previous meta-analyses focused on the first 5 years following psychosis onset. Here, we evaluated the change in cognitive impairments in psychotic disorders with a meta-analysis of studies with follow-ups of 5+ years. Following preregistration, databases were searched for relevant articles until July 2024. Two authors screened the reports for studies reporting on the change in cognitive impairments in global cognition, verbal learning and memory, visual learning and memory, working memory, attention, speed of processing, reasoning and problem-solving, and verbal fluency in individuals with psychotic disorders, with a minimum follow-up of 5 years. Three authors extracted data, and the PRISMA guidelines were followed. Random-effects meta-analyses and moderator analyses were conducted. Twenty-four studies comprising 2,633 patients and 1,019 controls were included in the study. Over an average of 8.46 years, cognitive impairments remained stable in all eight measures: global cognition (g = 0.09; 95% CI = 0.03–0.20), verbal memory (g = 0.05; 95% CI = −0.11, 0.21), visual memory (g = −0.16; 95% CI = −0.35, 0.03), working memory (g = 0.03; 95% CI = −0.09, 0.14), attention (g = 0.22; 95% CI = −0.36, 0.80), speed of processing (g = 0.10; 95% CI = −0.14, 0.35), reasoning and problem-solving (g = 0.16; 95% CI = −0.03, 0.35), and verbal fluency (g = 0.08; 95% CI = −0.03, 0.19). We conclude that cognitive impairments remain stable over time, consistent with the neurodevelopmental view of psychotic disorders.

Political scientists regularly rely on a selection-on-observables assumption to identify causal effects of interest. Once a causal effect has been identified in this way, a wide variety of estimators can, in principle, be used to consistently estimate the effect of interest. While these estimators are all justified by appeals to the same causal identification assumptions, they often differ greatly in how they make use of the data at hand. For instance, methods based on regression rely on an explicit model of the outcome variable but do not explicitly model the treatment assignment process, whereas methods based on propensity scores explicitly model the treatment assignment process but do not explicitly model the outcome variable. Understanding the tradeoffs between estimation methods is complicated by these seemingly fundamental differences. In this paper we seek to rectify this problem. We do so by clarifying how most estimators of causal effects that are justified by an appeal to a selection-on-observables assumption are all special cases of a general weighting estimator. We then explain how this commonality provides for diagnostics that allow for meaningful comparisons across estimation methods—even when the methods are seemingly very different. We illustrate these ideas with two applied examples.

Aims: The Mental Welfare Commission (MWC) has provided information outlining good practice for consent to treatment in relation to The Mental Health (Care and Treatment) (Scotland) Act 2003. Patients prescribed psychotropic medications beyond two months of initial detention under the Mental Health Act require a statutory T2 or T3 form, depending on the patient’s ability and willingness to consent to treatment. Without a valid form being in place, there is no legal authority to continue to administer medication.

A MWC report in February 2024 highlighted a number of concerns around the use of community Compulsory Treatment Orders (cCTOs). One of the recommendations from this report was the need to ensure audit processes are in place with regards medical treatment given under cCTOs. This initial audit cycle was commissioned in response to the report and aimed to determine whether T2/T3 forms were (i) in place, (ii) valid and (iii) concordant with what the patient was being prescribed in the community.

Methods: Administrative staff from psychiatric subspecialties within NHS Lanarkshire were contacted to gain access to spreadsheets detailing patients detained under a cCTO, as well as online files containing electronic copies of their T2/T3 certificates for review. Patients who were detained under a cCTO at the time of data collection were included (July 2024–October 2024). Review of the patients T2/T3 forms and electronic medical records took place to record whether they were (i) in place, (ii) valid and (iii) reflective of what was currently being prescribed.

Results: 89 patients were identified as being on cCTOs. 3 of those did not have T2 or T3 forms in place yet, all for valid reasons.

For the forms that were in place, 96.5% were considered valid though only 65.9% were concordant with what the patient was being prescribed in the community.

Conclusion: Almost all patients had appropriate T2/T3 forms in place, suggesting the administrative system in place to manage this is working well.

There were significant discrepancies between what medication had been authorised under T2/3 forms and what the patient was prescribed which will require further review by individual teams.

Recommendations include sharing of the findings, as well as the MWC Good Clinical Practice guidelines, with Responsible Medical Officers and General Practitioners to increase awareness of the need for medication regimes to be compliant with the relevant T2/T3 forms. Additionally, ongoing audit within psychiatry units on an annual basis to improve practice in this area is required to maintain and improve standards.

Aims: The Mental Welfare Commission (MWC) released a report in February 2024 recommending the use of audit to ensure good clinical practice in the use of community Compulsory Treatment Orders (cCTO) as part of the Mental Health (Care and Treatment) (Scotland) Act 2003 (MHA). One particular area of concern was the use of care plans under section 76 of the Act.

An audit was performed across NHS Lanarkshire Mental Health services to determine if all patients on cCTOs had Section 76 care plans in place that were valid and compliant with the minimum standards set out by the MWC.

Methods: Medical records administration staff were contacted across all of the psychiatry specialities within the health board, to supply a list of patients on cCTOs. Their electronic medical records were reviewed and relevant data collated by the authors to determine if the appropriate paperwork was in place, was valid, and met the minimum standards, as set out by the MWC.

Results: Within NHS Lanarkshire, there were 89 patients on cCTOs. 87 of these had a Section 76 care plan in place, though one of these was considered invalid.

Only 24% of the care plans were found to meet all of the minimum standards. There was noted to be a high degree of variability in which of the minimum standards were met, how the care plans were documented and the quality of the information contained within them, across the specialties and between individual psychiatrists.

Conclusion: This was the first audit looking at cCTO Section 76 care plans carried out in NHS Lanarkshire. It demonstrated there is a need for standardisation of these care plans across mental health services, to ensure that as a minimum, all statutory information is documented.

Recommendations from the audit included the use of a proforma to capture the information required to meet the minimum standards, as well as provide prompts for additional information to improve the quality of the care plans. It has also been recommended that each psychiatry specialty sets up their own annual audit of care plans, and an audit tool for this has been provided.

We present the Evolutionary Map of the Universe (EMU) survey conducted with the Australian Square Kilometre Array Pathfinder (ASKAP). EMU aims to deliver the touchstone radio atlas of the southern hemisphere. We introduce EMU and review its science drivers and key science goals, updated and tailored to the current ASKAP five-year survey plan. The development of the survey strategy and planned sky coverage is presented, along with the operational aspects of the survey and associated data analysis, together with a selection of diagnostics demonstrating the imaging quality and data characteristics. We give a general description of the value-added data pipeline and data products before concluding with a discussion of links to other surveys and projects and an outline of EMU’s legacy value.

Maladaptive daydreaming is a distinct syndrome in which the main symptom is excessive vivid fantasising that causes clinically significant distress and functional impairment in academic, vocational and social domains. Unlike normal daydreaming, maladaptive daydreaming is persistent, compulsive and detrimental to one’s life. It involves detachment from reality in favour of intense emotional engagement with alternative realities and often includes specific features such as psychomotor stereotypies (e.g. pacing in circles, jumping or shaking one’s hands), mouthing dialogues, facial gestures or enacting fantasy events. Comorbidity is common, but existing disorders do not account for the phenomenology of the symptoms. Whereas non-specific therapy is ineffective, targeted treatment seems promising. Thus, we propose that maladaptive daydreaming be considered a formal syndrome in psychiatric taxonomies, positioned within the dissociative disorders category. Maladaptive daydreaming satisfactorily meets criteria for conceptualisation as a psychiatric syndrome, including reliable discrimination from other disorders and solid interrater agreement. It involves significant dissociative aspects, such as disconnection from perception, behaviour and sense of self, and has some commonalities with but is not subsumed under existing dissociative disorders. Formal recognition of maladaptive daydreaming as a dissociative disorder will encourage awareness of a growing problem and spur theoretical, research and clinical developments.

Vaccines have revolutionised the field of medicine, eradicating and controlling many diseases. Recent pandemic vaccine successes have highlighted the accelerated pace of vaccine development and deployment. Leveraging this momentum, attention has shifted to cancer vaccines and personalised cancer vaccines, aimed at targeting individual tumour-specific abnormalities. The UK, now regarded for its vaccine capabilities, is an ideal nation for pioneering cancer vaccine trials. This article convened experts to share insights and approaches to navigate the challenges of cancer vaccine development with personalised or precision cancer vaccines, as well as fixed vaccines. Emphasising partnership and proactive strategies, this article outlines the ambition to harness national and local system capabilities in the UK; to work in collaboration with potential pharmaceutic partners; and to seize the opportunity to deliver the pace for rapid advances in cancer vaccine technology.