Use of an interactive obesity treatment approach in individuals with severe mental illness: Feasibility, acceptability, and proposed engagement criteria

BACKGROUND: Digital and mobile health interventions are increasingly being used to support healthy lifestyle change, including in certain high-risk populations such as those with severe mental illnesses (SMIs). Life expectancy in this population lags 15 years behind counterparts in the general population, primarily due to obesity-related health conditions. OBJECTIVE: We tested the feasibility and usability of a 12-week interactive obesity treatment approach (iOTA) to adults with chronic SMIs (depression, bipolar disorder and schizophrenia spectrum disorder) receiving treatment in community settings. The iOTA incorporates short message service (SMS) text messages to supplement monthly in-person health coaching. METHODS: Factors hypothesized to be associated with weight change were illness severity and treatment engagement. Severe psychiatric symptoms were defined as baseline Clinical Global Impression severity score of \u3e5. Criterion engagement was defined as a text messaging response rate \u3e80% during the first 4 weeks of treatment. Disordered eating, assessed with the Loss of Control Over Eating Scores, was also evaluated. Participants provided qualitative data, further informing assessment of intervention feasibility, usability, and acceptability. RESULTS: A total of 26 participants were enrolled. The mean age was 48.5 (SD 15.67) years; 40% (10/26) were Black and 60% (15/26) female. Participants with lower symptom severity and adequate engagement demonstrated significantly decreased weight (F CONCLUSIONS: These results demonstrate the feasibility of delivering an adapted iOTA to SMI patients receiving care in community settings and suggest testable criteria for defining sufficient treatment engagement and psychiatric symptom severity, two factors known to impact weight loss outcomes. These important findings suggest specific adaptations may be needed for optimal treatment outcomes in individuals with SMI

Adaptation of a mobile interactive obesity treatment approach for early severe mental illness: Protocol for a mixed methods implementation and pilot randomized controlled trial

BACKGROUND: Obesity is common in individuals with severe mental illness (SMI), contributing to a significantly shortened lifespan when compared to the general population. Available weight loss treatments have attenuated efficacy in this population, underscoring the importance of prevention and early intervention. OBJECTIVE: Here, we describe a type 1 hybrid study design for adapting and pilot-testing an existing mobile health intervention for obesity prevention in individuals with early SMI and Class I or early-stage obesity, defined as a BMI of 30-35. METHODS: An existing, evidence-based interactive obesity treatment approach using low-cost, semiautomated SMS text messaging was selected for adaptation. Community mental health clinics and Clubhouse settings in Eastern Missouri and South Florida were identified to participate. This study has the following 3 aims. First, using the Enhanced Framework for Reporting Adaptations and Modifications to Evidence-based interventions, contextual aspects of the clinical and digital treatment environments are identified for adaptation, considering 5 main stakeholder groups (clinical administrators, prescribing clinicians, case managers, nurses, and patients). Following a 2-week trial of unadapted SMS text messaging, Innovation Corps methods are used to discover needed intervention adaptations by stakeholder group and clinical setting. Second, adaptations to digital functionality and intervention content will be made based on themes identified in aim 1, followed by rapid usability testing with key stakeholders. A process for iterative treatment adaptation will be developed for making unplanned modifications during the aim 3 implementation pilot study. Individuals working in partner community mental health clinics and Clubhouse settings will be trained in intervention delivery. Third, in a randomized pilot and feasibility trial, adults with 5 years or less of treatment for an SMI diagnosis will be randomized 2:1 to 6 months of an adapted interactive obesity treatment approach or to an attentional control condition, followed by a 3-month extension phase of SMS text messages only. Changes in weight, BMI, and behavioral outcomes, as well as implementation challenges, will be evaluated at 6 and 9 months. RESULTS: Institutional review board approval for aims 1 and 2 was granted on August 12, 2018, with 72 focus group participants enrolled; institutional review board approval for aim 3 was granted on May 6, 2020. To date, 52 participants have been enrolled in the study protocol. CONCLUSIONS: In this type 1 hybrid study design, we apply an evidence-based treatment adaptation framework to plan, adapt, and feasibility test a mobile health intervention in real-world treatment settings. Resting at the intersection of community mental health treatment and physical health promotion, this study aims to advance the use of simple technology for obesity prevention in individuals with early-stage mental illness. TRIAL REGISTRATION: ClinicalTrials.gov NCT03980743; https://clinicaltrials.gov/ct2/show/NCT03980743. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/42114

Limits to Rest-Frame Ultraviolet Emission From Far-Infrared-Luminous z~6 Quasar Hosts

We report on a Hubble Space Telescope search for rest-frame ultraviolet emission from the host galaxies of five far-infrared-luminous $z\simeq{}6$ quasars and the $z=5.85$ hot-dust free quasar SDSS J0005-0006. We perform 2D surface brightness modeling for each quasar using a Markov-Chain Monte-Carlo estimator, to simultaneously fit and subtract the quasar point source in order to constrain the underlying host galaxy emission. We measure upper limits for the quasar host galaxies of $m_J>22.7$ mag and $m_H>22.4$ mag, corresponding to stellar masses of $M_\ast<2\times10^{11}M_\odot$. These stellar mass limits are consistent with the local $M_{\textrm{BH}}$-$M_\ast$ relation. Our flux limits are consistent with those predicted for the UV stellar populations of $z\simeq6$ host galaxies, but likely in the presence of significant dust ($\langle A_{\mathrm{UV}}\rangle\simeq 2.6$ mag). We also detect a total of up to 9 potential $z\simeq6$ quasar companion galaxies surrounding five of the six quasars, separated from the quasars by 1.4''-3.2'', or 8.4-19.4 kpc, which may be interacting with the quasar hosts. These nearby companion galaxies have UV absolute magnitudes of -22.1 to -19.9 mag, and UV spectral slopes $\beta$ of -2.0 to -0.2, consistent with luminous star-forming galaxies at $z\simeq6$. These results suggest that the quasars are in dense environments typical of luminous $z\simeq6$ galaxies. However, we cannot rule out the possibility that some of these companions are foreground interlopers. Infrared observations with the James Webb Space Telescope will be needed to detect the $z\simeq6$ quasar host galaxies and better constrain their stellar mass and dust content.Comment: 22 pages, 13 figures. Accepted for publication in Ap

PEARLS: Low Stellar Density Galaxies in the El Gordo Cluster Observed with JWST

A full understanding of how unusually large "Ultra Diffuse Galaxies" (UDGs) fit into our conventional understanding of dwarf galaxies remains elusive, despite the large number of objects identified locally. A natural extension of UDG research is the study of similar galaxies at higher redshift to establish how their properties may evolve over time. However, this has been a challenging task given how severely systematic effects and cosmological surface brightness dimming inhibit our ability to study low-surface brightness galaxies at high-$z$. Here, we present an identification of low stellar surface density galaxies (LDGs), likely the progenitors of local UDGs, at moderate redshift with deep near-IR observations of the El Gordo cluster at $z = 0.87$ with JWST. By stacking 8 NIRCAM filters, we are able to achieve an apparent surface brightness sensitivity of $24.59$ mag arcsec$^{-2}$, faint enough to be complete to the bright end of the LDG population. Our analysis identifies significant differences between this population and local UDGs, such as their color and size distributions, which suggest that UDG progenitors are bluer and more extended at high-$z$ than at $z = 0$. This suggests that multiple mechanisms are responsible for UDG formation and that prolonged transformation of cluster dwarfs is not a primary UDG formation mechanism at high-$z$. Furthermore, we find a slight overabundance of LDGs in El Gordo, and, in contrast to findings in local clusters, our analysis does not show a deficit of LDGs in the center of El Gordo, implying that tidal destruction of LDGs is significant between $z = 0.87$ and $z = 0$.Comment: Resubmitted to ApJ after minor revision

JWST NIRCam Photometry: A Study of Globular Clusters Surrounding Bright Elliptical Galaxy VV 191a at z=0.0513

James Webb Space Telescope NIRCam images have revealed 443 globular cluster (GC) candidates around the $z=0.0513$ elliptical galaxy VV 191a. NIRCam broadband observations are made at 0.9-4.5 $\mu$m using filters F090W, F150W, F356W, and F444W. Using photometry, the data is analyzed to present color-magnitude diagrams (CMDs) that suggest a fairly uniform population of GCs. Color histograms show a unimodal color distribution that is well fit by a single Gaussian, using color to primarily trace the metallicity. The findings show the sample's globular cluster luminosity function (GCLF) does not reach the turnover value and is, therefore, more luminous than what is typically expected, with an absolute AB magnitude, $M_{F090W} = -8.70$ mag, reaching within nearly one magnitude of the classical turnover value. We attribute this to the completeness in the sample. Models show that the mass estimate of the GCs detected tends to be more massive, reaching upward of $\simeq 10^7 M_{\odot}$. However, the results show that current GC models do not quite align with the data. We find that the models appear to be bluer than the JWST data in the reddest (F356W-F444W) filters and redder than the data in the bluest (F090W-F150W) filters and may need to be revised to improve the modeling of near-IR colors of old, metal-poor stellar populations.Comment: 11 pages, 7 figure

EPOCHS VII: Discovery of high redshift (6.5<z<126.5 < z < 12) AGN candidates in JWST ERO and PEARLS data

We present an analysis of a sample of robust high redshift galaxies selected photometrically from the `blank' fields of the Prime Extragalactic Areas for Reionization Science (PEARLS) survey and Early Release Observations (ERO) data of the James Webb Space Telescope (JWST) with the aim of selecting candidate high redshift active galactic nuclei (AGN). Sources were identified from the parent sample using a threefold selection procedure, which includes spectral energy distribution (SED) fitting to identify sources that are best fitted by AGN SED templates, a further selection based on the relative performance of AGN and non-AGN models, and finally morphological fitting to identify compact sources of emission, resulting in a purity-oriented procedure. Using this procedure, we identify a sample of nine AGN candidates at $6.5 < z < 12$, from which we constrain their physical properties as well as measure a lower bound on the AGN fraction in this redshift range of $5 \pm 1$\%. As this is an extreme lower limit due to our focus on purity and our SEDs being calibrated for unobscured Type 1 AGN, this demonstrates that AGN are perhaps quite common at this early epoch. The rest-frame UV colors of our candidate objects suggest that these systems are potentially candidate obese black hole galaxies (OBG), or AGN with very little galaxy component. We also investigate emission from our sample sources from fields overlapping with Chandra and VLA surveys, allowing us to place X-ray and 3 GHz radio detection limits on our candidates. Of note is a $z = 11.9$ candidate source exhibiting an abrupt morphological shift in the reddest band as compared to the bluer bands, indicating a potential merger or an unusually strong outflow.Comment: Submitted to MNRAS, 12 pages, 11 figures, typos correcte

Magellanic System Stars Identified in the SMACS J0723.3-7327 JWST ERO Images

We identify 68 distant stars in JWST/NIRCam ERO images of the field of galaxy cluster SMACS J0723.3-7327 (SMACS 0723). Given the relatively small ($\sim$$10^{\circ}$) angular separation between SMACS 0723 and the Large Magellanic Cloud, it is likely that these stars are associated with the LMC outskirts or Leading Arm. This is further bolstered by a spectral energy distribution analysis, which suggests an excess of stars at a physical distance of $40-100$ kpc, consistent with being associated with or located behind the Magellanic system. In particular, we find that the overall surface density of stars brighter than 27.0 mag in the field of SMACS 0723 is $\sim$2.3 times that of stars in a blank field with similar galactic latitude (the North Ecliptic Pole Time Domain Field), and that the density of stars in the SMACS 0723 field with SED-derived distances consistent with the Magellanic system is $\sim$7.3 times larger than that of the blank field. The candidate stars at these distances are consistent with a stellar population at the same distance modulus with [Fe/H] $= -1.0$ and an age of $\sim$$5.0$ Gyr. On the assumption that all of the 68 stars are associated with the LMC, then the stellar density of the LMC at the location of the SMACS 0723 field is $\sim$$710$ stars kpc$^{-3}$, which helps trace the density of stars in the LMC outskirts.Comment: Submitted to ApJ, comments welcom

PEARLS: A Potentially Isolated Quiescent Dwarf Galaxy with a TRGB Distance of 31 Mpc

A wealth of observations have long suggested that the vast majority of isolated classical dwarf galaxies ($M_*=10^7$-$10^9$ M$_\odot$) are currently star-forming. However, recent observations of the large abundance of "Ultra-Diffuse Galaxies" beyond the reach of previous large spectroscopic surveys suggest that our understanding of the dwarf galaxy population may be incomplete. Here we report the serendipitous discovery of an isolated quiescent dwarf galaxy in the nearby Universe, which was imaged as part of the PEARLS GTO program. Remarkably, individual red-giant branch stars are visible in this near-IR imaging, suggesting a distance of $31$ Mpc, and a wealth of archival photometry point to an sSFR of $2\times10^{-12}$ yr$^{-1}$. Spectra obtained with the Lowell Discovery Telescope find a recessional velocity consistent with the Hubble Flow and ${>}1500$ km/s separated from the nearest massive galaxy in SDSS, suggesting that this galaxy was either quenched from internal mechanisms or had a very high-velocity interaction with a nearby massive galaxy in the past. This analysis highlights the possibility that many nearby quiescent dwarf galaxies are waiting to be discovered and that JWST has the potential to identify them.Comment: Submitted to ApJ Letters. Comments welcome

Are JWST/NIRCam color gradients in the lensed z=2.3 dusty star-forming galaxy El Anzuelo due to central dust attenuation or inside-out galaxy growth?

Gradients in the mass-to-light ratio of distant galaxies impede our ability to characterize their size and compactness. The long-wavelength filters of $JWST$'s NIRCam offer a significant step forward. For galaxies at Cosmic Noon ($z\sim2$), this regime corresponds to the rest-frame near-infrared, which is less biased towards young stars and captures emission from the bulk of a galaxy's stellar population. We present an initial analysis of an extraordinary lensed dusty star-forming galaxy (DSFG) at $z=2.3$ behind the $El~Gordo$ cluster ($z=0.87$), named $El~Anzuelo$ ("The Fishhook") after its partial Einstein-ring morphology. The FUV-NIR SED suggests an intrinsic star formation rate of $81^{+7}_{-2}~M_\odot~{\rm yr}^{-1}$ and dust attenuation $A_V\approx 1.6$, in line with other DSFGs on the star-forming main sequence. We develop a parametric lens model to reconstruct the source-plane structure of dust imaged by the Atacama Large Millimeter/submillimeter Array, far-UV to optical light from $Hubble$, and near-IR imaging with 8 filters of $JWST$/NIRCam, as part of the Prime Extragalactic Areas for Reionization and Lensing Science (PEARLS) program. The source-plane half-light radius is remarkably consistent from $\sim 1-4.5~\mu$m, despite a clear color gradient where the inferred galaxy center is redder than the outskirts. We interpret this to be the result of both a radially-decreasing gradient in attenuation and substantial spatial offsets between UV- and IR-emitting components. A spatial decomposition of the SED reveals modestly suppressed star formation in the inner kiloparsec, which suggests that we are witnessing the early stages of inside-out quenching.Comment: 29 pages, 11 figures, 5 tables. Accepted for publication in Ap

JWST's PEARLS: TN J1338-1942 -- I. Extreme jet triggered star-formation in a z=4.11 luminous radio galaxy

We present the first JWST observations of the z = 4.11 luminous radio galaxy TN J1338–1942, obtained as part of the ‘Prime Extragalactic Areas for Reionization and Lensing Science’ (‘PEARLS’) project. Our NIRCam observations, designed to probe the key rest-frame optical continuum and emission line features at this redshift, enable resolved spectral energy distribution modelling that incorporates both a range of stellar population assumptions and radiative shock models. With an estimated stellar mass of log10(M/M) ∼ 10.9, TN J1338–1942 is confirmed to be one of the most massive galaxies known at this epoch. Our observations also reveal extremely high equivalent-width nebular emission coincident with the luminous AGN jets that is best fit by radiative shocks surrounded by extensive recent star formation. We estimate the total star-formation rate (SFR) could be as high as ∼ 1600 M yr−1 , with the SFR that we attribute to the jet induced burst conservatively 500 M yr−1. The mass-weighted age of the star-formation, tmass < 4 Myr, is consistent with the likely age of the jets responsible for the triggered activity and significantly younger than that measured in the core of the host galaxy. The extreme scale of the potential jet-triggered star-formation activity indicates the potential importance of positive AGN feedback in the earliest stages of massive galaxy formation, with our observations also illustrating the extraordinary prospects for detailed studies of high-redshift galaxies with JWST.KJD acknowledges funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement number 892117 (HIZRAD) and support from the STFC through an Ernest Rutherford Fellowship (grant number ST/W003120/1). RAW, SHC, and RAJ acknowledge support from NASA JWST Interdisciplinary Scientist grants NAG5-12460, NNX14AN10G, and 80NSSC18K0200 from GSFC. Work by CJC acknowledges support from the European Research Council (ERC) Advanced Investigator Grant EPOCHS (788113). BLF thanks the Berkeley Center for Theoretical Physics for their hospitality during the writing of this paper. MAM acknowledges the support of a National Research Council of Canada Plaskett Fellowship, and the Australian Research Council center of Excellence for All Sky Astrophysics in 3 Dimensions (ASTRO 3D), through project number CE17010001. CNAW acknowledges funding from the JWST/NIRCam contract NASS-0215 to the University of Arizona. TAH is supported by an appointment to the NASA Postdoctoral Program (NPP) at NASA Goddard Space Flight Center, administered by Oak Ridge Associated Universities under contract with NASA.Peer reviewe