Start some other way: Edgar Hunt’s career journey through and beyond the 1930s, mainly avoiding Haslemere

Edgar Hunt is remembered and deservedly admired for work he did to promote the revival of the recorder in mid twentieth-century Britain, especially its use in schools. He and Arnold Dolmetsch’s son Carl were close contemporaries, building careers as recorder advocates and expert players at the same time. Since Dolmetsch was a family name synonymous with ‘early music’, and Dolmetsch recorders were the best in the world, Carl enjoyed advantages that Edgar had to manage without. (Though along with the advantages went heavy responsibility, for the livelihoods of Dolmetsch workshop employees and for maintaining traditions that Hunt was free to subvert.) Never at home in Dolmetsch circles, Hunt looked for opportunities elsewhere, and proved remarkably adept at both finding and exploiting them. ‘Start Some Other Way’ follows Hunt on his career journey through the 1930s, on through the Second World War (when military service interrupted it), and out the other side. It sheds new light on episodes omitted from Hunt’s later autobiographical accounts, on lines of development connecting different types of recorder featured in the story, and on Hunt’s role as a design influencer. The British school recorder movement instigated by Hunt massively expanded the market for all makes of instrument. Even Dolmetsch had to adapt their designs and manufacturing methods to keep up with demand.Prior research by Alexandra Williams and Robert Ehrlich is gratefully acknowledged. To tackle questions not so far resolved, this article introduces new evidence – some of it recently unearthed by Professor Ehrlich, and with his permission published here for the first time

Written submission to the Department for Transport’s call for evidence | Decarbonising smaller vessels

This written contribution is a response to the Department for Transport’s call for evidence, and has been prepared by members of the Southampton Marine and Maritime Institute (SMMI) at the University of Southampton

Effect of antidiabetic drug classes on the risk of liver-related events in individuals with T2D and MASLD

Background: we investigated the use of type 2 diabetes (T2D) medications, including pioglitazone, glucagon-like peptide-1 receptor agonists (GLP-1RAs), and sodium-glucose cotransporter-2 (SGLT-2) inhibitors, in individuals with T2D and metabolic dysfunction–associated steatotic liver disease (MASLD), and explored the effect of these medications on long-term risk of liver-related events (LREs) and progression of liver stiffness in a retrospective cohort study.Methods: we enrolled 7867 individuals with T2D and MASLD from 16 tertiary referral centers between February 2004 and January 2023. We recorded the use of pioglitazone, GLP-1RAs, and SGLT-2 inhibitors and analyzed the effects of these antihyperglycemic medications on the risk of developing incident LREs and the progression of liver stiffness over a median of 5.1 years of follow-up.Results: pioglitazone, GLP-1RAs and SGLT-2 inhibitors were prescribed to 1238 (15.7%), 863 (11.0%), and 2386 (30.3%) individuals with T2D and MASLD, respectively. A significant increase in the utilization of GLP-1RAs and SGLT-2 inhibitors was observed from 2010–2017 to 2017–2023, with pioglitazone and SGLT-2 inhibitors being prescribed more frequently in Asian countries than in Western countries (pioglitazone: 17.9% vs 3.8%; SGLT-2 inhibitors: 34.4% vs 7.3%; P < .001). After propensity score matching, in competing risk models, SGLT-2 inhibitor use was significantly associated with a lower risk of developing both LREs (subdistribution hazard ratio, 0.23; 95% confidence interval, 0.08–0.69, P = .009) and liver stiffness progression (hazard ratio, 0.54; 95% confidence interval, 0.35–0.86, P = .008) after adjusting for potential confounders.Conclusions: SGLT-2 inhibitor use is more prevalent among Asian than Western individuals. SGLT-2 inhibitors are associated with a lower risk of LREs in individuals with T2D and MASLD

Multi-modal physiological markers of arousal induced by CO2 inhalation in Virtual Reality

High arousal states, like fear and anxiety, play a crucial role in organisms’ adaptive responses to threats. Yet, inducing and reliably measuring such states within controlled settings presents challenges. This study uses a novel approach of CO2 enriched air vs normal air in a Virtual Reality (VR) con- text to induce high arousal whilst measuring physiological signals such as galvanic skin response (GSR), facial skin impedance, facial electromyography (fEMG), photoplethysmography (PPG), breathing, and pupillometry. In a single-blind study, 63 participants underwent a regimen involving 20 minutes of breathing regular air followed by 20 minutes of 7.5% CO2, separated by a brief interval. Findings demonstrate the efficacy of CO2 inhalation in elicit- ing high arousal, as substantiated by statistically significant changes for all signals, further validated through high (94%) accuracy arousal classification. This study establishes a method for inducing high arousal states within a laboratory context validated through comprehensive multi-sensor data and machine learning analyses. The study underscores the value of employing a suite of physiological measures to comprehensively describe the intricate dynamics of arousal. The generated database is a promising resource for re- searching physiological markers of arousal, panic, fear, and anxiety, offering insights that can potentially resonate within clinical and therapeutic realms.<br/

“We need to help perpetrators understand their behaviours and the impact”: an evaluation of a UK domestic abuse male engagement worker project

Effective perpetrator management can increase safety for domestic abuse victim-survivors. The Young Person’s Male Engagement Worker (MEW) project is a novel approach to working with fathers (18-26 years) exhibiting harmful behaviours to prevent further escalation. MEW seeks to redress the fact that the perpetrators of abuse are often invisible in systems designed to protect victim-survivors. The project is funded and delivered by local government, grounded in the Safe and Together model, working to encourage agencies away from victim culpability to perpetrator accountability. MEW aims to support professionals to better understand the dynamics of domestic abuse, upskill them to hold alleged perpetrators of abuse to account, rather than placing the burden of child protection on mothers.A 12-month study was undertaken to evaluate outcomes and impact, benefits and challenges, to inform future commissioning. A mixed method design was applied, including a review of metric and demographic data, analysis of anonymised case consultation notes (n=30), and interviews with key stakeholders (n=16).Findings showed mean length of perpetrator engagement in MEW was 8.7 months. The majority of participants had intersecting issues including poor mental health, substance use, criminal history, and financial and housing issues. Almost half of participants engaged in some form of behaviour change including goal setting.Stakeholders identified benefits of the programme for perpetrators and victim-survivors. MEW offered perpetrators an opportunity to reflect on their behaviour, have their voice heard and offering a stepping stone to change. For victims, holding perpetrators to account, shared responsibility, risk reduction and monitoring. Other benefits included longer-term resource efficiency, training and upskilling of other services.While benefits of the MEW project were identified, challenges for sustainability were acknowledged. These included: status as a small non-statutory service, securing future funding, and to effect perpetrator behaviour change long-term engagement and commitment to the project is required.<br/

Profile control of fibre-based micro-mirrors using adaptive laser shooting with in-situ imaging

Fiber Fabry-Perot cavities (FFPCs) are used in various studies in cavity quantum electrodynamics (CQED) and quantum technologies due to the cavity’s small mode volume and compact integration with optical fibers. We develop a novel CO 2 laser machining method that produces well-controlled surface profiles on the end facets of cleaved optical fibers. Using multiple shots in distinct spatial distribution patterns, our method employs a shooting algorithm that adaptively changes laser ablation parameters during the shooting to suppress deviations from the desired profile. This is made possible by in situ imaging of the machined profile, its inspection, and the usage of the information in the subsequent steps. Underlying this algorithm is a newly found laser ablation parameter, the pause between shots, which controls the accumulation of heat in between successive laser shots, and as a result, determines the area of impact made by an individual ablation sequence. We fabricate fiber-based micro-mirrors with radii of curvature ranging from 250 µm to 700 µm with an effective mirror diameter of 60 µm in either Gaussian or spherical profiles. Due to the self-correcting nature of our adaptive algorithm, we achieve a near 100% success rate in the production of desired profiles with low ellipticity. After furnishing the laser-machined fiber end facets with high reflectivity coating, FFPCs are formed to demonstrate a high finesse up to 150,000 at an optical wavelength of 854 nm.</p

Digital interventions for anxiety and depressive symptoms in adolescence: systematic review

The rising prevalence of anxiety and depression among adolescents highlights the need for accessible intervention solutions. The objectives of this systematic review were to (1) identify existing digital interventions for adolescent depression and anxiety, (2) assess the promise of those interventions, and (3) identify characteristics of promising interventions. Six databases (PubMed, PsycINFO, Web of Science, Embase, MEDLINE, and Google Scholar) were used to conduct searches between September and October 2023. The searches were re-run in June 2024. Twenty studies met the criteria for inclusion, leading to the identification of 17 distinct interventions for analysis. The promise of the interventions was assessed through their effectiveness, the Reach, Effectiveness, Adoption, Implementation, Maintenance framework dimensions, and risk of bias. The evaluation of interventions' promise deemed three studies as "Quite Promising," six as "Slightly Promising," four as "Inconclusive Promise," and seven as "Not Promising." All promising interventions somewhat met the Reach, Effectiveness, Adoption, Implementation, Maintenance dimensions. Variability was observed in Template for Intervention Description and Replication characteristics, including rationale, intervention provider, length and frequency of intervention, and retention. Factors that potentially contribute to the success or limitation of digital mental health interventions among adolescents are discussed. The review underscores the need to enhance the methodological rigor and to evaluate and report the real-world impact of interventions to ensure they benefit a broader demographic of young people

A viroimmunologic model to characterize the antiviral effect of molnupiravir in outpatients infected with SARS-CoV-2: implication for treatment duration

Background: the antiviral efficacy of molnupiravir against SARS-CoV-2 is controversial. Here, we develop a model integrating viral and immune dynamics to characterize the mechanism of action of molnupiravir in vivo and its impact on viral dynamics during and after treatment. Methods: we analyzed data from the PANORAMIC trial, where 577 outpatients were randomized shortly after symptom onset to receive usual care or molnupiravir for 5 days, with viral and immunologic data collected within 2 weeks. We developed a mathematical model that characterized virus-host interaction, accounting for the impact of molnupiravir on viral replication and mutagenesis. The model was used to explore the impact of longer treatment duration. Results: molnupiravir reduced RNA replication with an efficacy that reached 93% at the end of a 5-day treatment. This effect was mediated through 2 pathways: 1 that increased transition mutation frequency and 1 that directly inhibited viral production. Accordingly, 5-day treatment shortened the median time to clearance of RNA and infectious virus by approximately 2 days. Ten-day treatment could reduce the time to RNA clearance by 5 days and the occurrence of viral rebounds. Longer treatment durations might be needed for postexposure prophylaxis.Conclusions: our model suggests that molnupiravir acts primarily on viral replication, and not specifically on viral infectivity. Longer administration of molnupiravir may reduce the rebound rate, shortening the time to viral clearance.</p

The role of intersectionality in shaping participant engagement with health research through digital methods: findings from a qualitative study

Background: digital research methods were rapidly adopted into clinical trials and health research during the COVID pandemic in 2020. Current UK policy aims to make digital research methods a norm, but their influence on recruitment, retention, and representation in health research remains largely unknown. Whilst efforts have been made to improve engagement with digital health interventions, less attention has been given to digital research methods—such as informed consent, data collection, and research communications—despite their potential to influence study participation and participant experience. Objective: this qualitative study aims to understand the factors influencing the initial uptake and ongoing engagement with digital research methods across diverse populations, capturing experiences and perspectives to inform diverse and efficient health research conduct. Methods: Semi-structured interviews were conducted with 50 people who had participated in health research in the past 12 months. Reflective thematic analysis was used to understand factors influencing study engagement from participant perspectives, acknowledging the role of the researcher in data interpretation. Results: three interconnected themes were identified: (1) Digital Positionality: The Interplay of Social Position, Personal Experience, and Identity; (2) Power Redistribution in Research Relationships: Navigating Vulnerability and Agency; (3) Trust Assemblages: How Intersecting Identities Shape Multi-modal Verification Practices in Research Engagement. These themes illustrate how intersecting identity factors and social contexts shape engagement with digital methods in health research. The first theme revealed how factors such as age, social role, migration, and socioeconomic status create pathways towards or away from engagement with digital methods. The second theme highlights how different digital methods can shift power dynamics in participant-research relationships or expose social vulnerabilities. The third theme uncovered the complex ways participants established trust in research, relying on multi-channel trust makers. Conclusions: the study reveals intersecting factors shaping participant engagement with digital methods, offering insights to enhance research conduct and increase diversity in health research participation. Future studies should integrate theoretical frameworks to examine these influencers and develop effective approaches for optimising diverse engagement with digital methods.</p

Occurrence of psychosis and bipolar disorder in individuals with attention-deficit/hyperactivity disorder treated with stimulants: a systematic review and meta-analysis

Importance: individuals with attention-deficit/hyperactivity disorder (ADHD) may present with psychosis or bipolar disorder (BD) following treatment with stimulants. The extent to which this occurs is currently unclear.Objective: to meta-analytically quantify the occurrence of psychosis or BD after exposure to stimulants in individuals with ADHD and assess possible moderating factors.Data sources: PubMed, Web of Science, Ovid/PsycINFO, and Cochrane Central Register of Reviews were searched from inception until October 1, 2024, without language restrictions.Study selection: studies of any design with DSM or International Classification of Diseases–defined ADHD populations exposed to stimulants, where psychosis or BD outcomes were evaluated.Data extraction and synthesis: PRISMA Preferred Reporting Items for Systematic Reviews and Meta-analyses and MOOSE Meta-analysis of Observational Studies in Epidemiology guidelines were followed, the protocol was registered, and the Newcastle-Ottawa scale and Cochrane risk of bias-2 tool were used for quality appraisal. Random-effects meta-analysis, subgroup analyses, and meta-regressions were conducted.Main outcomes and measures : for the proportion of individuals developing psychotic symptoms, psychotic disorders, and BD, effect sizes are reported as percentages with 95% CIs. For the comparison between amphetamines and methylphenidate, effect sizes are presented as odds ratios with 95% CIs.Results: sixteen studies (N = 391 043; mean [range] age, 12.6 [8.5-31.1] years; 288 199 [73.7%] male) were eligible. Among individuals with ADHD prescribed stimulants, 2.76% (95% CI, 0.73-9.88; k = 10; n = 237 035), 2.29% (95% CI, 1.52-3.40; k = 4; n = 91 437), and 3.72% (95% CI, 0.77-16.05; k = 4; n = 92 945) developed psychotic symptoms, a psychotic disorder, and BD, respectively. Heterogeneity across the studies was significant (I2 &gt; 95%). Psychosis occurrence risk was significantly higher in individuals exposed to amphetamines than to methylphenidate (odds ratio [OR], 1.57, 95% CI, 1.15-2.16; k = 3, n = 231 325). Subgroup analyses showed significantly higher prevalence of psychotic symptoms in studies from North America and in those with longer follow-up periods. Increased psychosis occurrence was associated with a higher proportion of female participants, smaller sample sizes, and higher dose of stimulants.Conclusions and relevance : this systematic review and meta-analysis found a nonnegligible occurrence of psychotic symptoms, psychotic disorders, or BD in individuals with ADHD treated with stimulants. Amphetamines were associated with higher occurrence compared to methylphenidate. The included studies cannot establish causality, highlighting the need for further research, including randomized clinical trials and mirror-image studies comparing individuals exposed and not exposed to stimulants. Nonetheless, clinicians should inform patients about the increased occurrence of psychosis or BD when discussing stimulant pharmacotherapy and systematically monitor for these conditions throughout treatment