Incorporating parent, former patient, and clinician perspectives in the design of a national UK double-cluster, randomised controlled trial addressing uncertainties in preterm nutrition

Background: Comparative effectiveness randomised controlled trials are powerful tools to resolve uncertainties in existing treatments and care processes. We sought parent and patient perspectives on the design of a planned national, double-cluster randomised controlled trial (COLLABORATE) to resolve two longstanding uncertainties in preterm nutrition. Methods: We used qualitative focus groups and interviews with parents, former patients and clinicians. We followed the Consolidated Criteria for Reporting Qualitative Research checklist and conducted framework analysis, a specific methodology within thematic analysis. Results: We identified support for the trial’s methodology and vision, and elicited themes illustrating parents’ emotional needs in relation to clinical research. These were: relieving the pressure on mothers to breastfeed; opt-out consent as reducing parent stress; the desire for research to be a partnership between clinicians, parents and researchers; the value of presenting trial information in a collaborative tone; and in a format that allows assimilation by parents at their own pace. We identified anxiety and cognitive dissonance among some clinicians in which they recognised the uncertainties that justify the trial but felt unable to participate because of their strongly held views. Conclusions: The early involvement of parents and former patients identified the centrality of parents’ emotional needs in the design of comparative effectiveness research. These insights have been incorporated into trial enrolment processes and information provided to participants. Specific outputs were a two-sided leaflet providing very brief as well as more detailed information, and use of language that parents perceive as inclusive and participatory. Further work is warranted to support clinicians to address personal biases that inhibit trial participation

PRIMA General Observer Science Book

PRIMA (The PRobe for-Infrared Mission for Astrophysics) is a concept for a far-infrared (IR) observatory. PRIMA features a cryogenically cooled 1.8 m diameter telescope and is designed to carry two science instruments enabling ultra-high sensitivity imaging and spectroscopic studies in the 24 to 235 microns wavelength range. The resulting observatory is a powerful survey and discovery machine, with mapping speeds better by 2 - 4 orders of magnitude with respect to its far-IR predecessors. The bulk of the observing time on PRIMA should be made available to the community through a General Observer (GO) program offering 75% of the mission time over 5 years. In March 2023, the international astronomy community was encouraged to prepare authored contributions articulating scientific cases that are enabled by the telescope massive sensitivity advance and broad spectral coverage, and that could be performed within the context of GO program. This document, the PRIMA General Observer Science Book, is the edited collection of the 76 received contributions.Comment: A. Moullet, T. Kataria, D. Lis, S. Unwin, Y. Hasegawa, E. Mills, C. Battersby, A. Roc, M. Meixner are the editors of the PRIMA General Observer Science Book. The book compiles 76 authored contributions. 399 page

ALMA uncovers highly filamentary structure towards the Sgr E region

We report on the discovery of linear filaments observed in CO(1-0) emission for a $\sim2'$ field of view toward the Sgr E star forming region centered at (l,b)=(358.720$^\circ$, 0.011$^\circ$). The Sgr E region is thought to be at the turbulent intersection of the ''far dust lane'' associated with the Galactic bar and the Central Molecular Zone (CMZ). This region is subject to strong accelerations which are generally thought to inhibit star formation, yet Sgr E contains a large number of HII regions. We present $^{12}$CO(1-0), $^{13}$CO(1-0), and C$^{18}$O(1-0) spectral line observations from ALMA and provide measurements of the physical and kinematic properties for two of the brightest filaments. These filaments have widths (FWHM) of $\sim0.1$ pc and are oriented nearly parallel to the Galactic plane, with angles from the Galactic plane of $\sim2^\circ$. The filaments are elongated, with lower limit aspect ratios of $\sim$5:1. For both filaments we detect two distinct velocity components that are separated by about 15 km s$^{-1}$. In the C$^{18}$O spectral line data with $\sim$0.09 pc spatial resolution, we find that these velocity components have relatively narrow ($\sim$1-2 km s$^{-1}$) FWHM linewidths when compared to other sources towards the Galactic center. The properties of these filaments suggest that the gas in the Sgr E complex is being ''stretched'' as it is rapidly accelerated by the gravitational field of the Galactic bar while falling towards the CMZ, a result that could provide insight into the extreme environment surrounding this region and the large-scale processes which fuel this environment.Comment: 20 pages, 17 figures, accepted for publication in Ap

Extragalactic Science with the Orbiting Astronomical Satellite Investigating Stellar Systems (OASIS) Observatory

The Orbiting Astronomical Satellite for Investigating Stellar Systems (OASIS), a\ua0proposed Astrophysics MIDEX-class mission concept, has an innovative 14-meter diameter inflatable primary mirror that will provide the sensitivity to study far-infrared continuum and line emission from galaxies at all redshifts with high spectral resolution heterodyne receivers. OASIS will have the sensitivity to follow the water trail from galaxies to the comets that create oceans. It will bring an understanding of the role of water in galaxy evolution and its part of the oxygen budget, by measuring water emission from local to intermediate redshift galaxies, observations that have not been possible from the ground. Observation of the ground-state HD line will accurately measure gas mass in a wide variety of astrophysical objects. Thanks to its exquisite spatial resolution and sensitivity, OASIS will, during its one-year baseline mission, detect water in galaxies with unprecedented statistical significance. This paper reviews the extragalactic science achievable and planned with OASIS

'The Brick' is not a brick : A comprehensive study of the structure and dynamics of the Central Molecular Zone cloud G0.253+0.016

© 2019 The Author(s) Published by Oxford University Press on behalf of the Royal Astronomical Society.In this paper we provide a comprehensive description of the internal dynamics of G0.253+0.016 (a.k.a. 'the Brick'); one of the most massive and dense molecular clouds in the Galaxy to lack signatures of widespread star formation. As a potential host to a future generation of high-mass stars, understanding largely quiescent molecular clouds like G0.253+0.016 is of critical importance. In this paper, we reanalyse Atacama Large Millimeter Array cycle 0 HNCO $J=4(0,4)-3(0,3)$ data at 3 mm, using two new pieces of software which we make available to the community. First, scousepy, a Python implementation of the spectral line fitting algorithm scouse. Secondly, acorns (Agglomerative Clustering for ORganising Nested Structures), a hierarchical n-dimensional clustering algorithm designed for use with discrete spectroscopic data. Together, these tools provide an unbiased measurement of the line of sight velocity dispersion in this cloud, $\sigma_{v_{los}, {\rm 1D}}=4.4\pm2.1$ kms$^{-1}$, which is somewhat larger than predicted by velocity dispersion-size relations for the Central Molecular Zone (CMZ). The dispersion of centroid velocities in the plane of the sky are comparable, yielding $\sigma_{v_{los}, {\rm 1D}}/\sigma_{v_{pos}, {\rm 1D}}\sim1.2\pm0.3$. This isotropy may indicate that the line-of-sight extent of the cloud is approximately equivalent to that in the plane of the sky. Combining our kinematic decomposition with radiative transfer modelling we conclude that G0.253+0.016 is not a single, coherent, and centrally-condensed molecular cloud; 'the Brick' is not a \emph{brick}. Instead, G0.253+0.016 is a dynamically complex and hierarchically-structured molecular cloud whose morphology is consistent with the influence of the orbital dynamics and shear in the CMZ.Peer reviewedFinal Accepted Versio

Simulations of the Milky Way's central molecular zone -- I. Gas dynamics

We use hydrodynamical simulations to study the Milky Way's central molecular zone (CMZ). The simulations include a non-equilibrium chemical network, the gas self-gravity, star formation and supernova feedback. We resolve the structure of the interstellar medium at sub-parsec resolution while also capturing the interaction between the CMZ and the bar-driven large-scale flow out to R\sim 5\kpc. Our main findings are as follows: (1) The distinction between inner ($R\lesssim120$~pc) and outer ($120\lesssim R\lesssim450$~pc) CMZ that is sometimes proposed in the literature is unnecessary. Instead, the CMZ is best described as single structure, namely a star-forming ring with outer radius $R\simeq 200$~pc which includes the 1.3$^\circ$ complex and which is directly interacting with the dust lanes that mediate the bar-driven inflow. (2) This accretion can induce a significant tilt of the CMZ out of the plane. A tilted CMZ might provide an alternative explanation to the $\infty$-shaped structure identified in Herschel data by Molinari et al. 2011. (3) The bar in our simulation efficiently drives an inflow from the Galactic disc ($R\simeq 3$~kpc) down to the CMZ ($R\simeq200$~pc) of the order of $1\rm\,M_\odot\,yr^{-1}$, consistent with observational determinations. (4) Supernova feedback can drive an inflow from the CMZ inwards towards the circumnuclear disc of the order of $\sim0.03\,\rm M_\odot\,yr^{-1}$. (5) We give a new interpretation for the 3D placement of the 20 and 50 km s$^{-1}$ clouds, according to which they are close ($R\lesssim30$~pc) to the Galactic centre, but are also connected to the larger-scale streams at $R\gtrsim100$~pc.Comment: Accepted for publication in MNRAS. Movies of the simulations can be found at: https://www.youtube.com/channel/UCwnzfO-xLxzRDz9XsexfPo

The United Kingdom National Neonatal Research Database: A validation study.

BACKGROUND: The National Neonatal Research Database (NNRD) is a rich repository of pre-defined clinical data extracted at regular intervals from point-of-care, clinician-entered electronic patient records on all admissions to National Health Service neonatal units in England, Wales, and Scotland. We describe population coverage for England and assess data completeness and accuracy. METHODS: We determined population coverage of the NNRD in 2008-2014 through comparison with data on live births in England from the Office for National Statistics. We determined the completeness of seven data items on the NNRD. We assessed the accuracy of 44 data items (16 patient characteristics, 17 processes, 11 clinical outcomes) for infants enrolled in the multi-centre randomised controlled trial, Probiotics in Preterm Study (PiPs). We compared NNRD to PiPs data, the gold standard, and calculated discordancy rates using predefined criteria, and sensitivity, specificity and positive predictive values (PPV) of binary outcomes. RESULTS: The NNRD holds complete population data for England for infants born alive from 25+0 to 31+6 (completed weeks) of gestation; and 70% and 90% for those born at 23 and 24 weeks respectively. Completeness of patient characteristics was over 90%. Data were linked for 2257 episodes of care received by 1258 of the 1310 babies recruited to PiPs. Discordancy rates were 85% for all outcomes; sensitivity ranged from 50-100%; PPV ranged from 58.8 (95% CI 40.8-75.4%) for porencephalic cyst to 99.7 (95% CI 99.2, 99.9%) for survival to discharge. CONCLUSIONS: The completeness and quality of data held in the NNRD is high, providing assurance in relation to use for multiple purposes, including national audit, health service evaluations, quality improvement, and research

Education and older adults at the University of the Third Age

This article reports a critical analysis of older adult education in Malta. In educational gerontology, a critical perspective demands the exposure of how relations of power and inequality, in their myriad forms, combinations, and complexities, are manifest in late-life learning initiatives. Fieldwork conducted at the University of the Third Age (UTA) in Malta uncovered the political nature of elder-learning, especially with respect to three intersecting lines of inequality - namely, positive aging, elitism, and gender. A cautionary note is, therefore, warranted at the dominant positive interpretations of UTAs since late-life learning, as any other education activity, is not politically neutral.peer-reviewe

Toward gas exhaustion in the W51 high-mass protoclusters

Reproduced with permission from Astronomy & Astrophysics, © 2016 ESOWe present new JVLA observations of the high-mass cluster-forming region W51A from 2 to 16 GHz with resolution θfwhm ≈ 0.3−0.5″. The data reveal a wealth of observational results: (1) Currently forming, very massive (proto-O) stars are traced by o - H2CO21,1−21,2 emission, suggesting that this line can be used efficiently as a massive protostar tracer; (2) there is a spatially distributed population of ≲mJy continuum sources, including hypercompact H ii regions and candidate colliding wind binaries, in and around the W51 proto-clusters; and (3) there are two clearly detected protoclusters, W51e and W51 IRS2, that are gas-rich but may have most of their mass in stars within their inner ≲0.05 pc. The majority of the bolometric luminosity in W51 most likely comes from a third population of OB stars between these clusters. The presence of a substantial population of exposed O-stars coincident with a population of still-forming massive stars, together with a direct measurement of the low mass loss rate via ionized gas outflow from W51 IRS2, implies that feedback is ineffective at halting star formation in massive protoclusters. Instead, feedback may shut off the large-scale accretion of diffuse gas onto the W51 protoclusters, implying that they are evolving toward a state of gas exhaustion rather than gas expulsion. Recent theoretical models predict gas exhaustion to be a necessary step in the formation of gravitationally bound stellar clusters, and our results provide an observational validation of this process.Peer reviewedFinal Published versio

JWST reveals widespread CO ice and gas absorption in the Galactic Center cloud G0.253+0.016

We report JWST NIRCam observations of G0.253+0.016, the molecular cloud in the Central Molecular Zone known as The Brick, with the F182M, F187N, F212N, F410M, F405N, and F466N filters. We catalog 56,146 stars detected in all 6 filters using the crowdsource package. Stars within and behind The Brick exhibit prodigious absorption in the F466N filter that is produced by a combination of CO ice and gas. In support of this conclusion, and as a general resource, we present models of CO gas and ice and CO$_2$ ice in the F466N, F470N, and F410M filters. Both CO gas and ice may contribute to the observed stellar colors. We show, however, that CO gas does not absorb the Pf$\beta$ and Hu$\epsilon$ lines in F466N, but that these lines show excess absorption, indicating that CO ice is also present and contributes to observed F466N absorption. The most strongly absorbed stars in F466N are extincted by $\sim$ 2 magnitudes, corresponding to $>$ 80\% flux loss. This high observed absorption requires very high column densities of CO, requiring total CO column that is in tension with standard CO abundance and/or gas-to-dust ratios. There is therefore likely to be a greater CO/H$_2$ ratio (X$_{CO} > 10^{-4}$) and more dust per H$_2$ molecule ($>0.01$) in the Galactic Center than the Galactic disk. Ice and/or gas absorption is observed even in the cloud outskirts, implying that additional caution is needed when interpreting stellar photometry in filters that overlap with ice bands throughout our Galactic Center. The widespread CO absorption in our Galactic Center hints that significant ice absorption is likely present in other galactic centers.Comment: Submitted to ApJ. Revised after second referee report. 16 pages, 11 figure