Recent Decisions

Comments on recent decisions by Joseph N. Low, Robert A. Stewart, William M. Dickson, Edward G. Coleman, James F. O\u27Rieley, James J. Haranzo, Robert C. Enburg, E. Milton Farley III, Jerome A. Kolenda, Bernard James McGraw, Joseph C. Spalding, R. Emmett Fitzgerald, Joseph T. Helling, John F. Laughlin, Andrew V. Giorgi, and Jack Fena

HI holes in galactic disks: Tracing the dark matter distribution

Multiple SN explosions in disk galaxies efficiently evacuate gas and form cavities with the sizes and shapes of the surrounding envelopes determined by the total amount of injected energy and by the initial gas distribution. Such cavities are seen as HI holes when observed in face-on galaxies. Gas hydrodynamics simulations are performed to obtain the quantitative characteristics of HI holes that could serve for the determination of the gas vertical scale height and the corresponding dark matter content and its distribution. Among these characteristics is the ratio of the maximum column density in the HI ring surrounding the hole to the background HI column density and the vertical expansion velocity of gas in the HI ring. We show that in some cases the extragalactic background ionizing radiation may produce HI holes in the outer regions of galaxies, and can account for the existence of HI holes in nearby face-on galaxies with the apparent lack of an underlying stellar population.Comment: 8 pages, 6 figures, accepted for publication in Astronomy & Astrophysic

Trends in U.S. Local and Regional Food Systems: A Report to Congress

This report provides an overview of local and regional food systems across several dimensions. It details the latest economic information on local food producers, consumers, and policy, relying on findings from several national surveys and a synthesis of recent literature to assess the current size of and recent trends in local and regional food systems. Data are presented on producer characteristics, survival rates and growth, and prices. The local food literature on consumer willingness to pay, environmental impacts, food safety regulations, and local economic impacts is synthesized when nationally representative data are unavailable. Finally, this report provides an overview of Federal and selected State and regional policies designed to support local food systems and collaboration among market participants

Searching for Saturn's Dust Swarm: Limits on the size distribution of Irregular Satellites from km to micron sizes

We describe a search for dust created in collisions between the Saturnian irregular satellites using archival \emph{Spitzer} MIPS observations. Although we detected a degree scale Saturn-centric excess that might be attributed to an irregular satellite dust cloud, we attribute it to the far-field wings of the PSF due to nearby Saturn. The Spitzer PSF is poorly characterised at such radial distances, and we expect PSF characterisation to be the main issue for future observations that aim to detect such dust. The observations place an upper limit on the level of dust in the outer reaches of the Saturnian system, and constrain how the size distribution extrapolates from the smallest known (few km) size irregulars down to micron-size dust. Because the size distribution is indicative of the strength properties of irregulars, we show how our derived upper limit implies irregular satellite strengths more akin to comets than asteroids. This conclusion is consistent with their presumed capture from the outer regions of the Solar System.Comment: accepted to MNRA

Women’s experiences of receiving care for pelvic organ prolapse: a qualitative study

Background Pelvic organ prolapse is a common urogenital condition affecting 41–50% of women over the age of 40. To achieve early diagnosis and appropriate treatment, it is important that care is sensitive to and meets women’s needs, throughout their patient journey. This study explored women’s experiences of seeking diagnosis and treatment for prolapse and their needs and priorities for improving person-centred care. Methods Twenty-two women receiving prolapse care through urogynaecology services across three purposefully selected NHS UK sites took part in three focus groups and four telephone interviews. A topic guide facilitated discussions about women’s experiences of prolapse, diagnosis, treatment, follow-up, interactions with healthcare professionals, overall service delivery, and ideals for future services to meet their needs. Data were analysed thematically. Results Three themes emerged relating to women’s experiences of a) Evaluating what is normal b) Hobson’s choice of treatment decisions, and c) The trial and error of treatment and technique. Women often delayed seeking help for their symptoms due to lack of awareness, embarrassment and stigma. When presented to GPs, their symptoms were often dismissed and unaddressed until they became more severe. Women reported receiving little or no choice in treatment decisions. Choices were often influenced by health professionals’ preferences which were subtly reflected through the framing of the offer. Women’s embodied knowledge of their condition and treatment was largely unheeded, resulting in decisions that were inconsistent with women’s preferences and needs. Physiotherapy based interventions were reported as helping women regain control over their symptoms and life. A need for greater awareness of prolapse and physiotherapy interventions among women, GPs and consultants was identified alongside greater focus on prevention, early diagnosis and regular follow-up. Greater choice and involvement in treatment decision making was desired. Conclusions As prolapse treatment options expand to include more conservative choices, greater awareness and education is needed among women and professionals about these as a first line treatment and preventive measure, alongside a multi-professional team approach to treatment decision making. Women presenting with prolapse symptoms need to be listened to by the health care team, offered better information about treatment choices, and supported to make a decision that is right for them

The Fine-Scale Structure of the neutral Interstellar Medium in nearby Galaxies

We present an analysis of the properties of HI holes detected in 20 galaxies that are part of "The HI Nearby Galaxy Survey" (THINGS). We detected more than 1000 holes in total in the sampled galaxies. Where they can be measured, their sizes range from about 100 pc (our resolution limit) to about 2 kpc, their expansion velocities range from 4 to 36 km/s, and their ages are estimated to range between 3 and 150 Myr. The holes are found throughout the disks of the galaxies, out to the edge of the HI; 23% of the holes fall outside R25. We find that shear limits the age of holes in spirals (shear is less important in dwarf galaxies) which explains why HI holes in dwarfs are rounder, on average than in spirals. Shear, which is particularly strong in the inner part of spiral galaxies, also explains why we find that holes outside R25 are larger and older. We derive the scale height of the HI disk as a function of galactocentric radius and find that the disk flares up in all galaxies. We proceed to derive the surface and volume porosity (Q2D and Q3D) and find that this correlates with the type of the host galaxy: later Hubble types tend to be more porous. The size distribution of the holes in our sample follows a power law with a slope of a ~ -2.9. Assuming that the holes are the result of massive star formation, we derive values for the supernova rate (SNR) and star formation rate (SFR) which scales with the SFR derived based on other tracers. If we extrapolate the observed number of holes to include those that fall below our resolution limit, down to holes created by a single supernova, we find that our results are compatible with the hypothesis that HI holes result from star formation.Comment: 142 pages, 55 figures, accepted for publication in the Astronomical Journa

Hypocapnia is a biological marker for orthostatic intolerance in some patients with chronic fatigue syndrome

CONTEXT: Patients with chronic fatigue syndrome and those with orthostatic intolerance share many symptoms, yet questions exist as to whether CFS patients have physiological evidence of orthostatic intolerance. OBJECTIVE: To determine if some CFS patients have increased rates of orthostatic hypotension, hypertension, tachycardia, or hypocapnia relative to age-matched controls. DESIGN: Assess blood pressure, heart rate, respiratory rate, end tidal CO2 and visual analog scales for orthostatic symptoms when supine and when standing for 8 minutes without moving legs. SETTING: Referral practice and research center. PARTICIPANTS: 60 women and 15 men with CFS and 36 women and 4 men serving as age matched controls with analyses confined to 62 patients and 35 controls showing either normal orthostatic testing or a physiological abnormal test. MAIN OUTCOME MEASURES: Orthostatic tachycardia; orthostatic hypotension; orthostatic hypertension; orthostatic hypocapnia or combinations thereof. RESULTS: CFS patients had higher rates of abnormal tests than controls (53% vs 20%, p < .002), but rates of orthostatic tachycardia, orthostatic hypotension, and orthostatic hypertension did not differ significantly between patients and controls (11.3% vs 5.7%, 6.5% vs 2.9%, 19.4% vs 11.4%, respectively). In contrast, rates of orthostatic hypocapnia were significantly higher in CFS than in controls (20.6% vs 2.9%, p < .02). This CFS group reported significantly more feelings of illness and shortness of breath than either controls or CFS patients with normal physiological tests. CONCLUSION: A substantial number of CFS patients have orthostatic intolerance in the form of orthostatic hypocapnia. This allows subgrouping of patients with CFS and thus reduces patient pool heterogeneity engendered by use of a clinical case definition

Isometric Exercise Training and Arterial Hypertension: An Updated Review

Hypertension is recognised as a leading attributable risk factor for cardiovascular disease and premature mortality. Global initiatives towards the prevention and treatment of arterial hypertension are centred around non-pharmacological lifestyle modification. Exercise recommendations differ between professional and scientific organisations, but are generally unanimous on the primary role of traditional aerobic and dynamic resistance exercise. In recent years, isometric exercise training (IET) has emerged as an effective novel exercise intervention with consistent evidence of reductions in blood pressure (BP) superior to that reported from traditional guideline-recommended exercise modes. Despite a wealth of emerging new data and endorsement by select governing bodies, IET remains underutilised and is not widely prescribed in clinical practice. This expert-informed review critically examines the role of IET as a potential adjuvant tool in the future clinical management of BP. We explore the efficacy, prescription protocols, evidence quality and certainty, acute cardiovascular stimulus, and physiological mechanisms underpinning its anti-hypertensive effects. We end the review with take-home suggestions regarding the direction of future IET research

Neuroimaging and Clinical Findings in Healthy Middle-Aged Adults With Mild Traumatic Brain Injury in the PREVENT Dementia Study

IMPORTANCE: Traumatic brain injuries (TBI) represent an important, potentially modifiable risk factor for dementia. Despite frequently observed vascular imaging changes in individuals with TBI, the relationships between TBI-associated changes in brain imaging and clinical outcomes have largely been overlooked in community cases of TBI.OBJECTIVE: To assess whether TBI are associated with and interact with midlife changes in neuroimaging and clinical features in otherwise healthy individuals.DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional analysis used baseline data from the PREVENT Dementia program collected across 5 sites in the UK and Ireland between 2014 and 2020. Eligible participants were cognitively healthy midlife adults aged between 40 and 59 years. Data were analyzed between January 2023 and April 2024.EXPOSURE: Lifetime TBI history was assessed using the Brain Injury Screening Questionnaire.MAIN OUTCOMES AND MEASURES: Cerebral microbleeds and other markers of cerebral small vessel disease (white matter hyperintensities [WMH], lacunes, perivascular spaces) were assessed on 3T magnetic resonance imaging. Clinical measures were cognition, sleep, depression, gait, and cardiovascular disease (CVD) risk, assessed using Computerized Assessment of Information Processing (COGNITO), Pittsburgh Sleep Quality Index, Center for Epidemiologic Studies Depression Scale, clinical interviews, and the Framingham Risk Score, respectively.RESULTS: Of 617 participants (median [IQR] age, 52 [47-56] years; 380 female [61.6%]), 223 (36.1%) had a history of TBI. TBI was associated with higher microbleed count (β = 0.10; 95% CI, 0.01-0.18; P = .03), with a dose-response association observed with increasing number of TBI events (β = 0.05; 95% CI, 0.01-0.09; P = .03). Conversely, TBI was not associated with other measures of small vessel disease, including WMH. Furthermore, TBI moderated microbleed associations with vascular risk factors and clinical outcomes, such that associations were present only in the absence of TBI. Importantly, observations held when analyses were restricted to individuals reporting only mild TBI.CONCLUSIONS AND RELEVANCE: In this cross-sectional study of healthy middle-aged adults, detectable changes in brain imaging and clinical features were associated with remote, even mild, TBI in the general population. The potential contribution of vascular injury to TBI-related neurodegeneration presents promising avenues to identify potential targets, with findings highlighting the need to reduce TBI through early intervention and prevention in both clinical care and policymaking.</p

Neurovisceral phenotypes in the expression of psychiatric symptoms

This review explores the proposal that vulnerability to psychological symptoms, particularly anxiety, originates in constitutional differences in the control of bodily state, exemplified by a set of conditions that include Joint Hypermobility, Postural Tachycardia Syndrome and Vasovagal Syncope. Research is revealing how brainbody mechanisms underlie individual differences in psychophysiological reactivity that can be important for predicting, stratifying and treating individuals with anxiety disorders and related conditions. One common constitutional difference is Joint Hypermobility, in which there is an increased range of joint movement as a result of a variant of collagen. Joint hypermobility is over-represented in people with anxiety, mood and neurodevelopmental disorders. It is also linked to stress-sensitive medical conditions such as irritable bowel syndrome, chronic fatigue syndrome and fibromyalgia. Structural differences in 'emotional' brain regions are reported in hypermobile individuals, and many people with joint hypermobility manifest autonomic abnormalities, typically Postural Tachycardia Syndrome. Enhanced heart rate reactivity during postural change and as recently recognised factors causing vasodilatation (as noted post prandially, post exertion and with heat) is characteristic of Postural Tachycardia Syndrome, and there is a phenomenological overlap with anxiety disorders, which may be partially accounted for by exaggerated neural reactivity within ventromedial prefrontal cortex. People who experience Vasovagal Syncope, a heritable tendency to fainting induced by emotional challenges (and needle/blood phobia), are also more vulnerable to anxiety disorders. Neuroimaging implicates brainstem differences in vulnerability to faints, yet the structural integrity of the caudate nucleus appears important for the control of fainting frequency in relation to parasympathetic tone and anxiety. Together there is clinical and neuroanatomical evidence to show that common constitutional differences affecting autonomic responsivity are linked to psychiatric symptoms, notably anxiety