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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.
Recent years have seen increasing calls by a few scientists, largely from the Global North, to explore “solar geoengineering,” a set of speculative technologies that would reflect parts of incoming sunlight back into space and, if deployed at planetary scale, have an average cooling effect. Numerous concerns about the development of such speculative technologies include the many ecological risks and uncertainties as well as unresolved questions of global governance and global justice. This essay starts with the premise that solar geoengineering at planetary scale is unlikely to be governable in a globally inclusive and just manner. Thus, the ethically sound approach is to pursue governance that leads to the nonuse of planetary solar geoengineering. Yet is such a prohibitory agreement feasible, in the face of possible opposition by a few powerful states and other interests? Drawing on social science research and a host of existing transnational and international governance arrangements, this essay offers three illustrative pathways through which a nonuse norm for solar geoengineering could emerge and become diffused and institutionalized in global politics: (1) civil society-led transnational approaches; (2) regionally led state and civil society hybrid approaches; and (3) like-minded or “Schengen-style” club initiatives led by states.
The flow near a moving contact line depends on the dynamic contact angle, viscosity ratio and capillary number. We report experiments involving immersing a plate into a liquid bath, concurrently measuring the interface shape, interfacial velocity and fluid flow using digital image processing and particle image velocimetry. All experiments were performed at low plate speeds to maintain small Reynolds and capillary numbers for comparison with viscous theories. The dynamic contact angle, measured in the viscous phase, was kept below $90^{\circ }$ and the viscosity ratio, $\lambda < 1$. This region of parameter space is largely unexplored for advancing contact lines. An important aim of the present study is to provide new experimental data against which new contact line models can be developed. The flow field is directly compared against the prediction from the viscous theory of Huh & Scriven (J. Colloid Interface Sci., vol. 35, issue 1, 1971, pp. 85–101) but with a slight modification involving the curved interface. Remarkable agreement is found between experiments and theory across a wide parameter range. The prediction for interfacial speed from Huh & Scriven is also in excellent agreement with experiments except in the vicinity of the contact line. Material points along the interface were found to rapidly slow down near the contact line, thus alleviating the singularity at the moving contact line. To the best of our knowledge, such a detailed test of theoretical models has not been performed before and we hope the present study will spur new modelling efforts in the field.
Depression is an independent risk factor for cardiovascular disease (CVD), but it is unknown if successful depression treatment reduces CVD risk.
Methods
Using eIMPACT trial data, we examined the effect of modernized collaborative care for depression on indicators of CVD risk. A total of 216 primary care patients with depression and elevated CVD risk were randomized to 12 months of the eIMPACT intervention (internet cognitive-behavioral therapy [CBT], telephonic CBT, and select antidepressant medications) or usual primary care. CVD-relevant health behaviors (self-reported CVD prevention medication adherence, sedentary behavior, and sleep quality) and traditional CVD risk factors (blood pressure and lipid fractions) were assessed over 12 months. Incident CVD events were tracked over four years using a statewide health information exchange.
Results
The intervention group exhibited greater improvement in depressive symptoms (p < 0.01) and sleep quality (p < 0.01) than the usual care group, but there was no intervention effect on systolic blood pressure (p = 0.36), low-density lipoprotein cholesterol (p = 0.38), high-density lipoprotein cholesterol (p = 0.79), triglycerides (p = 0.76), CVD prevention medication adherence (p = 0.64), or sedentary behavior (p = 0.57). There was an intervention effect on diastolic blood pressure that favored the usual care group (p = 0.02). The likelihood of an incident CVD event did not differ between the intervention (13/107, 12.1%) and usual care (9/109, 8.3%) groups (p = 0.39).
Conclusions
Successful depression treatment alone is not sufficient to lower the heightened CVD risk of people with depression. Alternative approaches are needed.
We present source detection and catalogue construction pipelines to build the first catalogue of radio galaxies from the 270 $\rm deg^2$ pilot survey of the Evolutionary Map of the Universe (EMU-PS) conducted with the Australian Square Kilometre Array Pathfinder (ASKAP) telescope. The detection pipeline uses Gal-DINO computer vision networks (Gupta et al. 2024, PASA, 41, e001) to predict the categories of radio morphology and bounding boxes for radio sources, as well as their potential infrared host positions. The Gal-DINO network is trained and evaluated on approximately 5 000 visually inspected radio galaxies and their infrared hosts, encompassing both compact and extended radio morphologies. We find that the Intersection over Union (IoU) for the predicted and ground-truth bounding boxes is larger than 0.5 for 99% of the radio sources, and 98% of predicted host positions are within $3^{\prime \prime}$ of the ground-truth infrared host in the evaluation set. The catalogue construction pipeline uses the predictions of the trained network on the radio and infrared image cutouts based on the catalogue of radio components identified using the Selavy source finder algorithm. Confidence scores of the predictions are then used to prioritise Selavy components with higher scores and incorporate them first into the catalogue. This results in identifications for a total of 211 625 radio sources, with 201 211 classified as compact and unresolved. The remaining 10 414 are categorised as extended radio morphologies, including 582 FR-I, 5 602 FR-II, 1 494 FR-x (uncertain whether FR-I or FR-II), 2 375 R (single-peak resolved) radio galaxies, and 361 with peculiar and other rare morphologies. Each source in the catalogue includes a confidence score. We cross-match the radio sources in the catalogue with the infrared and optical catalogues, finding infrared cross-matches for 73% and photometric redshifts for 36% of the radio galaxies. The EMU-PS catalogue and the detection pipelines presented here will be used towards constructing catalogues for the main EMU survey covering the full southern sky.
Cerebral microvascular dysfunction may contribute to depression via disruption of brain structures involved in mood regulation, but evidence is limited. We investigated the association of retinal microvascular function, a proxy for microvascular function in the brain, with incidence and trajectories of clinically relevant depressive symptoms.
Methods
Longitudinal data are from The Maastricht Study of 5952 participants (59.9 ± 8.5 years/49.7% women) without clinically relevant depressive symptoms at baseline (2010–2017). Central retinal arteriolar equivalent and central retinal venular equivalent (CRAE and CRVE) and a composite score of flicker light-induced retinal arteriolar and venular dilation were assessed at baseline. We assessed incidence and trajectories of clinically relevant depressive symptoms (9-item Patient Health Questionnaire score ⩾10). Trajectories included continuously low prevalence (low, n = 5225 [87.8%]); early increasing, then chronic high prevalence (early-chronic, n = 157 [2.6%]); low, then increasing prevalence (late-increasing, n = 247 [4.2%]); and remitting prevalence (remitting, n = 323 [5.4%]).
Results
After a median follow-up of 7.0 years (range 1.0–11.0), 806 (13.5%) individuals had incident clinically relevant depressive symptoms. After full adjustment, a larger CRAE and CRVE were each associated with a lower risk of clinically relevant depressive symptoms (hazard ratios [HRs] per standard deviation [s.d.]: 0.89 [95% confidence interval (CI) 0.83–0.96] and 0.93 [0.86–0.99], respectively), while a lower flicker light-induced retinal dilation was associated with a higher risk of clinically relevant depressive symptoms (HR per s.d.: 1.10 [1.01–1.20]). Compared to the low trajectory, a larger CRAE was associated with lower odds of belonging to the early-chronic trajectory (OR: 0.83 [0.69–0.99]) and a lower flicker light-induced retinal dilation was associated with higher odds of belonging to the remitting trajectory (OR: 1.23 [1.07–1.43]).
Conclusions
These findings support the hypothesis that cerebral microvascular dysfunction contributes to the development of depressive symptoms.
Medical assistance in dying for mental illness as a sole underlying medical condition (MAiD MI-SUMC) is a controversial and complex policy in terms of psychosocial and ethical medical practice implications. We discuss the status of MAiD MI-SUMC in Canada and argue for the use of the UK Medical Research Council's framework on complex interventions in programme evaluations of MAiD MI-SUMC. It is imperative to carefully and rigorously evaluate the implementation of MAiD MI-SUMC to ensure an understanding of the multiple facets of implementation in contexts permeated by unique social, economic, cultural and historical influences, with a correspondingly diverse array of outcomes. This requires a complexity-informed programme evaluation focused on context-dependent mechanisms and stakeholder experiences, including patients, service providers and other people affected by the policy. It is also important to consider the economic impact on health and social welfare systems. Such evaluations can provide the data needed to guide evidence-informed decision-making that can contribute to safer implementation and refinement of MAiD MI-SUMC.
In recent years, some scientists have called for research into and potential development of ‘solar geoengineering’ technologies as an option to counter global warming. Solar geoengineering refers to a set of speculative techniques to reflect some incoming sunlight back into space, for example, by continuously spraying reflective sulphur aerosols into the stratosphere over several generations. Because of the significant ecological, social, and political risks posed by such technologies, many scholars and civil society organizations have urged governments to take action to prohibit the development and deployment of solar geoengineering techniques. In this article we take such calls for a prohibitory or a non-use regime on solar geoengineering as a starting point to examine existing international law and governance precedents that could guide the development of such a regime. The precedents we examine include international prohibitory and restrictive regimes that impose bans or restrictions on chemical weapons, biological weapons, weather modification technologies, anti-personnel landmines, substances that deplete the ozone layer, trade in hazardous wastes, deep seabed mining, and mining in Antarctica. We also assess emerging norms and soft law in anticipatory governance of novel technologies, such as human cloning and gene editing. While there is no blueprint for a solar geoengineering non-use regime in international law, our analysis points to numerous specific elements on which governments could draw to constrain or impose an outright prohibition on the development of technologies for solar geoengineering, should they opt to do so.
Monoclonal antibody (mAb) treatment for coronavirus disease 2019 (COVID-19) has been underutilized due to logistical challenges, lack of access, and variable treatment awareness among patients and health-care professionals. The use of telehealth during the pandemic provides an opportunity to increase access to COVID-19 care.
Methods:
This is a single-center descriptive study of telehealth-based patient self-referral for mAb therapy between March 1, 2021, and October 31, 2021, at Baltimore Convention Center Field Hospital (BCCFH).
Results:
Among the 1001 self-referral patients, the mean age was 47, and most were female (57%). White (66%), and had a primary care provider (PCP) (62%). During the study period, self-referrals increased from 14/mo in March to 427 in October resulting in a 30-fold increase. Approximately 57% of self-referred patients received a telehealth visit, and of those 82% of patients received mAb infusion therapy. The median time from self-referral to onsite infusion was 2 d (1-3 IQR).
Discussion:
Our study shows the integration of telehealth with a self-referral process improved access to mAb infusion. A high proportion of self-referrals were appropriate and led to timely treatment. This approach helped those without traditional avenues for care and avoided potential delay for patients seeking referral from their PCPs.
This study examined adherence to dietary guidelines and symptoms of sleep problems (e.g. taking a long time to fall sleep or waking up early) and their associations in a sample of older Australian women (68–73 years of age).
Design:
This was a population-based cross-sectional study. Adherence to the dietary guidelines was measured using a validated FFQ and reported as a diet quality score. Symptoms of sleep problems were measured using five questions and a total score was derived. Multivariate linear regression was used to investigate the association between these outcomes, adjusted for the potential confounding influence of demographic (i.e. age and marital status) and lifestyle (i.e. physical activity, stress, alcohol intake, sleep medication use) variables.
Setting:
Respondents from the 1946–1951 cohort of the Australian Longitudinal Study on Women’s Health who completed Survey 9 were included.
Participants:
Data from n 7956 older women (mean age ± sd: 70·8 ± 1·5) were included.
Results:
70·2 % reported having at least one symptom and 20·5 % had between 3 and 5 symptoms of sleep problems (mean score ± sd: 1·4 ± 1·4, range 0–5). Adherence to dietary guidelines was poor with an average diet quality score of 56·9 ± 10·7 (range 0–100). Better adherence to dietary guidelines was associated with fewer sleep problem symptoms (β: –0·065, 95 % CI: –0·012, –0·005) and remained significant after adjusting for confounding influences.
Conclusions:
These findings support the evidence that adherence to dietary guidelines is associated with symptoms of sleep problems in older women.
Conventional injection medialisation laryngoplasty techniques may be compromised by patient-specific factors such as marked kyphosis, an anteriorly positioned larynx or intolerance to nasendoscopy. This paper describes a technique for successful injection medialisation laryngoplasty where conventional methods are precluded, in an 88-year-old man with presbyphonia on a background of Parkinson's disease.
Methods
After induction of general anaesthesia, a transoral introducing needle, shaped by tactile manipulation to match the curvature of a ‘C-MAC’ intubating video-laryngoscope ‘D-blade’ attachment, was introduced until visible above the glottis. The implant material was then injected into the paraglottic space as normal until satisfactory medialisation of the vocal fold was achieved.
Results
When reviewed in the out-patient clinic four weeks later, the patient's post-operative Voice Handicap Index score fell to 6, from a pre-operative score of 21.
Conclusion
By utilising commonly available equipment and anaesthetic support to recreate the views and access conventional nasendoscopy and laryngoscopy facilitate, this novel procedure provides a viable and proven alternative in uncommon but challenging cases.
We present WALLABY pilot data release 1, the first public release of H i pilot survey data from the Wide-field ASKAP L-band Legacy All-sky Blind Survey (WALLABY) on the Australian Square Kilometre Array Pathfinder. Phase 1 of the WALLABY pilot survey targeted three
$60\,\mathrm{deg}^{2}$
regions on the sky in the direction of the Hydra and Norma galaxy clusters and the NGC 4636 galaxy group, covering the redshift range of
$z \lesssim 0.08$
. The source catalogue, images and spectra of nearly 600 extragalactic H i detections and kinematic models for 109 spatially resolved galaxies are available. As the pilot survey targeted regions containing nearby group and cluster environments, the median redshift of the sample of
$z \approx 0.014$
is relatively low compared to the full WALLABY survey. The median galaxy H i mass is
$2.3 \times 10^{9}\,{\rm M}_{{\odot}}$
. The target noise level of
$1.6\,\mathrm{mJy}$
per 30′′ beam and
$18.5\,\mathrm{kHz}$
channel translates into a
$5 \sigma$
H i mass sensitivity for point sources of about
$5.2 \times 10^{8} \, (D_{\rm L} / \mathrm{100\,Mpc})^{2} \, {\rm M}_{{\odot}}$
across 50 spectral channels (
${\approx} 200\,\mathrm{km \, s}^{-1}$
) and a
$5 \sigma$
H i column density sensitivity of about
$8.6 \times 10^{19} \, (1 + z)^{4}\,\mathrm{cm}^{-2}$
across 5 channels (
${\approx} 20\,\mathrm{km \, s}^{-1}$
) for emission filling the 30′′ beam. As expected for a pilot survey, several technical issues and artefacts are still affecting the data quality. Most notably, there are systematic flux errors of up to several 10% caused by uncertainties about the exact size and shape of each of the primary beams as well as the presence of sidelobes due to the finite deconvolution threshold. In addition, artefacts such as residual continuum emission and bandpass ripples have affected some of the data. The pilot survey has been highly successful in uncovering such technical problems, most of which are expected to be addressed and rectified before the start of the full WALLABY survey.
Three-dimensional computed tomography reconstruction of the face has recently been presented as a newer diagnostic tool in coronavirus disease 2019 associated mucormycosis. This study was conducted to compare three-dimensional computed tomography reconstruction with conventional two-dimensional computed tomography in coronavirus disease 2019 associated mucormycosis.
Methods
A total of 123 mucormycosis patients underwent three-dimensional computed tomography reconstruction after a comprehensive clinical investigation. The involvement of the facial skeleton was noted.
Results
The anterior maxillary wall was most commonly involved (9.8 per cent). Involvement of the lateral maxillary wall was noted in 6.5 per cent of patients. Sixty-seven patients (54.5 per cent) underwent endoscopic surgery, 22 (17.9 per cent) underwent open surgical procedures, and 12 (9.8 per cent) had combined endoscopic and open surgical procedures. In 21 patients (17.1 per cent), open surgery was performed in the first instance based on additional three-dimensional computed tomography findings, and revision surgical procedures were avoided.
Conclusion
Three-dimensional computed tomography of the face was found to be superior in determining the extent of disease. It reduces delays in diagnosis, facilitates surgical planning and minimises the need for multiple surgical procedures.
Background: Mutations in the slow skeletal muscle troponin T (TNNT1) gene cause a congenital nemaline myopathy resulting in death from respiratory insufficiency in early infancy. We report on four French Canadians with a novel congenital TNNT1 myopathy. Methods: Patients underwent lower extremity and paraspinal MRI, quadriceps biopsy and genetic testing. TNNT1 expression in muscle was assessed by quantitative PCR and immunoblotting. Wild type or mutated TNNT1 mRNAs were co-injected with morpholinos in a zebrafish knockdown model to assess for rescue of the morphant phenotype. Results: Four patients shared a novel missense homozygous mutation in TNNT1. They developed from childhood slowly progressive limb-girdle weakness with spinal rigidity and contractures. They suffered from restrictive lung disease and recurrent episodes of rhabdomyolysis. Older patients remained ambulatory into their sixties. Lower extremity MRI showed symmetrical myopathic changes. Paraspinal MRI showed diffuse fibro-fatty involution. Biopsies showed multi-minicores. Nemaline rods were seen in half the patients. TNNT1 mRNA expression was similar in controls and patients, while levels of TNNT1 protein were reduced in patients. Wild type TNNT1 mRNA rescued the zebrafish morphants but mutant transcripts failed to do so. Conclusions: This study expands the spectrum of TNNT1-related myopathy to include a milder clinical phenotype caused by a functionally-confirmed novel mutation.
Prophylaxis against spontaneous bacterial peritonitis (SBP) is recommended for select patients with cirrhosis, but long-term antibiotic therapy has risks. We evaluated concordance with guideline recommendations in 179 veterans with cirrhosis; 55% received guideline-concordant management of SBP prophylaxis. Despite stable guideline recommendations since 2012, guideline adherence remains low.
Surgery is the recommended treatment for resectable T4a laryngeal and hypopharyngeal carcinoma. Non-surgical treatment is an option in a select few patients.
Method
This retrospective study was undertaken to assess the treatment outcomes in patients with resectable T4a carcinoma of the larynx and hypopharynx who received either surgical or non-surgical treatment at our institute and to assess factors influencing these outcomes.
Results
A total of 120 patients were included in the study. They were divided into groups A, B and C based on the presence of extralaryngeal spread through laryngeal membrane, cartilage or both. The overall survival was better among patients who received surgery than those who received non-surgical treatment in the three groups. The factor influencing overall survival was the treatment given in the form of surgical versus non-surgical treatment.
Conclusion
Surgery is the preferred treatment for T4a laryngeal and hypopharyngeal carcinoma, even in patients with extralaryngeal spread without cartilage erosion.
We present the most sensitive and detailed view of the neutral hydrogen (
${\rm H\small I}$
) emission associated with the Small Magellanic Cloud (SMC), through the combination of data from the Australian Square Kilometre Array Pathfinder (ASKAP) and Parkes (Murriyang), as part of the Galactic Australian Square Kilometre Array Pathfinder (GASKAP) pilot survey. These GASKAP-HI pilot observations, for the first time, reveal
${\rm H\small I}$
in the SMC on similar physical scales as other important tracers of the interstellar medium, such as molecular gas and dust. The resultant image cube possesses an rms noise level of 1.1 K (
$1.6\,\mathrm{mJy\ beam}^{-1}$
)
$\mathrm{per}\ 0.98\,\mathrm{km\ s}^{-1}$
spectral channel with an angular resolution of
$30^{\prime\prime}$
(
${\sim}10\,\mathrm{pc}$
). We discuss the calibration scheme and the custom imaging pipeline that utilises a joint deconvolution approach, efficiently distributed across a computing cluster, to accurately recover the emission extending across the entire
${\sim}25\,\mathrm{deg}^2$
field-of-view. We provide an overview of the data products and characterise several aspects including the noise properties as a function of angular resolution and the represented spatial scales by deriving the global transfer function over the full spectral range. A preliminary spatial power spectrum analysis on individual spectral channels reveals that the power law nature of the density distribution extends down to scales of 10 pc. We highlight the scientific potential of these data by comparing the properties of an outflowing high-velocity cloud with previous ASKAP+Parkes
${\rm H\small I}$
test observations.
Cone beam computed tomography is an imaging technique that can be used for the paranasal sinuses. This study assessed how widely it is used and the impact it has on chronic rhinosinusitis management in the ENT department of one hospital.
Method
A nationwide survey was conducted to assess the use of cone beam computed tomography throughout ENT UK members. A retrospective analysis of four-year rhinology clinic data for patients presenting with chronic rhinosinusitis symptoms was subsequently performed to assess how many scans were achieved the same day and the subsequent patient management.
Results
The survey results indicated that a majority of staff do not use cone beam computed tomography to image sinuses (86.5 per cent), and this was largely because of lack of access (92 per cent). This study assessed 355 cone beam computed tomography requests. Overall, 306 cases had a cone beam computed tomography scan on the same day as their clinic appointment with the majority seen back in clinic during the same hospital attendance for the results. Overall, 97 patients were discharged on the same day.
Conclusion
This study suggested a lack of awareness and understanding of cone beam computed tomography in managing rhinosinusitis. The ‘one-stop’ rhinology clinic model offers benefits including reduced patient hospital attendance.