Ultra-processed plant-based foods, such as plant-based burgers, have gained in popularity. Particularly in the out-of-home (OOH) environment, evidence regarding their nutritional profile and environmental sustainability is still evolving. Plant-based burgers available at selected OOH sites were randomly sampled in Amsterdam, Copenhagen, Lisbon and London. Plant-based burgers (patty, bread and condiment) (n 41) were lab analysed for their energy, macronutrients, amino acids and minerals content per 100 g and serving and were compared with reference values. For the plant-based burgers, the median values per 100 g were 234 kcal, 20·8 g carbohydrates, 3·5 g dietary fibre and 12·0 g fat, including 0·08 g TFS and 2·2 g SFA. Protein content was 8·9 g/100 g, with low protein quality according to amino acid composition. Median Na content was 389 mg/100 g, equivalent to 1 g salt. Compared with references, the median serving provided 31% of energy intake based on a 2000 kcal per day and contributed to carbohydrates (17–28%), dietary fibre (42%), protein (40%), total fat (48%), SFA (26%) and Na (54%). One serving provided 15–23% of the reference values for Ca, K and Mg, while higher contributions were found for Zn, Mn, P and Fe (30–67%). The ultra-processed plant-based burgers provide protein, dietary fibre and essential minerals and contain relatively high levels of energy, Na and total fats. The amino acid composition indicated low protein quality. The multifaceted nutritional profile of plant-based burgers highlights the need for manufacturers to implement improvements to better support healthy dietary habits, including reducing energy, Na and total fats.

Gravitational waves from coalescing neutron stars encode information about nuclear matter at extreme densities, inaccessible by laboratory experiments. The late inspiral is influenced by the presence of tides, which depend on the neutron star equation of state. Neutron star mergers are expected to often produce rapidly rotating remnant neutron stars that emit gravitational waves. These will provide clues to the extremely hot post-merger environment. This signature of nuclear matter in gravitational waves contains most information in the 2–4 kHz frequency band, which is outside of the most sensitive band of current detectors. We present the design concept and science case for a Neutron Star Extreme Matter Observatory (NEMO): a gravitational-wave interferometer optimised to study nuclear physics with merging neutron stars. The concept uses high-circulating laser power, quantum squeezing, and a detector topology specifically designed to achieve the high-frequency sensitivity necessary to probe nuclear matter using gravitational waves. Above 1 kHz, the proposed strain sensitivity is comparable to full third-generation detectors at a fraction of the cost. Such sensitivity changes expected event rates for detection of post-merger remnants from approximately one per few decades with two A+ detectors to a few per year and potentially allow for the first gravitational-wave observations of supernovae, isolated neutron stars, and other exotica.

Auditory vocal hallucinations (AVH) in general had limited functional impact in 7–8 year old children. However, transitory developmental expression of psychotic symptoms may become more persistent (and clinically relevant), depending on the degree of exposure to environmental risk factors. Therefore, in a five-year follow-up study of a case-control sample associations of (severity of) AVH with social adversity (traumatic experiences and stressful events) and the formation of delusional ideation were examined. In total 337 children (mean age 13.1 years; SD = 0.5) were reassessed. Forty children had continued to hear voices (24%, persistent group), 15 had heard voices for the first time (9%, incident group), 130 children no longer reported AVH (remitted group) and 152 never heard voices (referent group). Early social adversity was strongly associated with both incident and persistent AVH, and predicted greater AVH severity at follow-up. Children with both AVH and delusions were more likely to have experienced traumatic or stressful events than children with either symptom alone. AVH severity was shown to be a mediator in the association between TE (but not SE) and delusion formation. These results suggest that, although hearing voices in 7–8 year olds is in most cases benign, experience of social adversity can predict persistence and onset of new AVH closer to puberty. Given evidence for the association with delusion formation, they do pose a significant clinical risk.

Pyroxene phase relations in the Mg-rich corner of the pyroxene quadrilateral, at 1 atmosphere, have been reinvestigated. Experimental studies on sixteen selected compositions in the systems CMS and CFMS were undertaken in the temperature range 1100–1400 °C. The results of this study clarify our understanding of the pyroxene stability relations at low pressure. In particular, the demonstration that there is a high-temperature stability field of orthoenstatite denies the existence of a stable (or real) invariant point defined by the reactions OE = PE + DI, PE + DI = PI, and OE + DI = PI, in the system CaMgSi2O6-Mg2Si2O6. New phase relations, consistent with the experimental findings of this and other studies, for the Mg-rich corner of the pyroxene quadrilateral are presented. These new phase relations may be of use in interpreting the origin of volcanic rocks containing magnesian pigeonite.

The Lake Ambrose volcanic belt (LAVB) outcrops as a 45 km long northeast-trending belt of mafic and felsic volcanic rocks along the eastern side of the Victoria Lake Group in south-central Newfoundland. It comprises roughly equal proportions of mafic pillow basalt and high silica rhyolite, locally interbedded with epiclastic turbidites. Volcanic rocks have been metamorphosed in the greenschist facies and are extensively carbonatized.

U-Pb (zircon) dates from rhyolite at two, widely separated localities give identical ages of 513 ± 2 Ma (Upper Cambrian), and this is interpreted as the eruptive age of the volcanic sequence. Primitive arc and low-K tholeiites can be recognized on the basis of major and trace element geochemistry, ranging from LREE-depleted to LREE-enriched. Geochemical variation between mafic volcanic types is interpreted predominantly to reflect contrasts in source characteristics and degree of partial melting; some variation within each geochemical type attributable to fractional crystallization can be recognized. Detailed examination of some samples indicates that the heavy REE and related elements have locally been mobile, probably as a result of carbonate complexing.

The LAVB is the oldest well-dated island arc sequence in Newfoundland, and perhaps in the Appalachian–Caledonian Orogen. Its age requires modification of widely held models for the tectonic history of central Newfoundland. It is older than the oldest known ophiolite, demonstrating that arc volcanism was extant before the generation of the oldest known oceanic crust in this part of Iapetus. It further demonstrates that there was a maximum of approximately 30 Ma between the rift-drift transition which initiated Iapetus, and the initiation of subduction. This suggests that the oceanic sequences preserved in Newfoundland represent a series of arcs and back arc basins marginal to the main Iapetus Ocean, and brings into question whether the Appalachian accreted terranes contain any remnants of normal mid-ocean ridge type Iapetan crust.

Background. The long-term outcome of major depression is often unfavorable, and because most cases of depression are managed by general practitioners (GPs), this places stress on the need to improve treatment in primary care. This study evaluated the long-term effects of enhancing the GP's usual care (UC) with three experimental interventions.

Method. A randomized controlled trial was conducted from 1998 to 2003. The main inclusion criterion was receiving GP treatment for a depressive episode. We compared: (1) UC (n=72) with UC enhanced with: (2) a psycho-educational prevention (PEP) program (n=112); (3) psychiatrist-enhanced PEP (n=37); and (4) brief cognitive behavioral therapy followed by PEP (CBT-enhanced PEP) (n=44). We assessed depression status quarterly during a 3-year follow-up.

Results. Pooled across groups, depressive disorder-free and symptom-free times during follow-up were 83% and 17% respectively. Almost 64% of the patients had a relapse or recurrence, the median time to recurrence was 96 weeks, and the mean Beck Depression Inventory (BDI) score over 12 follow-up assessments was 9·6. Unexpectedly, PEP patients had no better outcomes than UC patients. However, psychiatrist-enhanced PEP and CBT-enhanced PEP patients reported lower BDI severity during follow-up than UC patients [mean difference 2·07 (95% confidence interval (CI) 1·13–3·00) and 1·62 (95% CI 0·70–2·55) respectively] and PEP patients [2·37 (95% CI 1·35–3·39) and 1·93 (95% CI 0·92–2·94) respectively].

Conclusions. The PEP program had no extra benefit compared to UC and may even worsen outcome in severely depressed patients. Enhancing treatment of depression in primary care with psychiatric consultation or brief CBT seems to improve the long-term outcome, but findings need replication as the interventions were combined with the ineffective PEP program.

This work describes the feasibility of using a polymer-based tissue equivalent gel for measuring radiation doses in situ. The gel is based on the MAGIC formulation thereby enabling it to be manufactured under normal atmospheric conditions. Its composition has been altered to achieve a similar sensitivity to the more widely used, but technically more difficult to produce, PAG gels. Irradiation of the gel material causes polymerisation of the molecular structure resulting in a shortening of transverse relaxation time (T2), which can be imaged using Magnetic Resonance Imaging (MRI). This work calibrates the radiation response in terms of transverse relaxation rate (R2) and uses this information to provide absolute dose verification in a separate gel, which has been previously irradiated to a known configuration. Results demonstrate that this technique is able to verify radiation doses to within a few percent of delivered intent in three dimensions and with high spatial resolution. This work may be followed by anyone with an interest in the quality assurance of advanced conformal radiotherapy delivery methods.

Background. Depression is a highly prevalent, often recurring or persistent disorder. The majority of patients are initially seen and treated in primary care. Effective treatments are available, but possibilities for providing adequate follow-up care are often limited in this setting. This study assesses the effectiveness of primary-care-based enhanced treatment modalities on short-term patient outcomes.

Method. In a randomized controlled trial we evaluated a psycho-educational self-management intervention. We included 267 adult patients meeting criteria for a DSM-IV diagnosis of major depressive disorder, assessed by a structured psychiatric interview. Patients were randomly assigned to: the Depression Recurrence Prevention (DRP) program (n=112); a combination of the DRP program with psychiatric consultation (PC+DRP, n=39); a combination with brief cognitive behavior therapy (CBT+DRP, n=44); and care as usual (CAU, n=72). Follow-up assessments were made at 3 months (response 90%) and 6 months (85%).

Results. Patient acceptance of enhanced care was good. The mean duration of the index episode was 11 weeks (S.D.=9·78) and similar in CAU and enhanced care. Recovery rate after 6 months was 67% overall; 17% of all participants remained depressed for the entire 6-month period.

Conclusion. Enhanced care did not result in better short-term outcomes. We found no evidence that the DRP program was more effective than CAU and no indications for added beneficial effects of either the psychiatric evaluation or the CBT treatment to the basic format of the DRP program. Observed depression treatment rates in CAU were high.

Background. We developed a comprehensive, 20-hour training programme for primary-care physicians, that sought to improve their ability to detect, diagnose and manage depression. We evaluated the effects of physician training on patient outcomes, using a pre-post design.

Methods. In the pre-training phase of the study, we sampled 1834 consecutive patients of 17 primary-care physicians and evaluated 518 of these patients for the presence of depression. We measured outcomes of all patients with depression at 3 months and 1 year. The outcome measures were: severity of psychopathology; duration of depressive episode; and level of daily functioning. After the 17 physicians completed the training, we drew a new sample from their practices (498 of 1785 consecutive patients were evaluated for depression) and measured outcomes for the depressed patients.

Results. We found an effect of the training on short-term outcome, particularly for patients with a recent-onset depression. At 3-month follow-up depressed patients whose physicians had received training had less severe psychopathology and patients with recent-onset depression also showed higher levels of daily functioning than patients of the same physicians prior to the training. The patients with a recent-onset depression that was recognized by trained physicians had shorter depressive episodes, but this was not statistically significant. At 1-year follow-up, all training effects had faded away.

Conclusions. Training primary-care physicians to recognize, diagnose and manage depression can improve short-term patient outcomes, especially for patients with a recent onset of depression. Patients suffering from a recurrent or chronic depression may need more specific interventions, both for acute treatment and long-term management.

In a general population survey by Gallup in Great Britain of 4148 subjects, 7.7% had taken benzodiazepines within the last year (male:female ratio 106:212). Younger subjects tended to take anxiolytics for shorter periods compared with older subjects, who often took hypnotics chronically. This pattern was most marked among females. Dosage escalation, tolerance, high daily dose usage, and hoarding were not common. A substantial proportion of current users had experienced difficulty in stopping their medication. Withdrawal problems were associated with being older than 45 years and consuming benzodiazepines for over 12 months. This lends support to the idea of benzodiazepine dependency. However, the appropriateness of long-term therapy for chronic symptoms cannot be ruled out.

As a result of three decades of painstaking work, R. Gjessing (1932–1960) published ten classical Beiträge zur Somatologie der periodischen Katatonie. These studies are being continued by L. R. Gjessing (1956, 1958, 1964, 1965) on some of the original patients and on additional subjects.