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Background: Self-harm is a major public health challenge, and repeated self-harm is common in those attending hospital following an episode. Evidence suggests psychological interventions could help people who self-harm, but few definitive studies have assessed their clinical and cost-effectiveness. Repeated self-harm is associated with poor quality of life, depression, suicide and increased health service costs which justify the development of psychotherapeutic interventions tailored for people with repeated self-harm. Methods: FReSH START is a multicentre individually 1:1 randomised controlled trial evaluating the clinical and cost-effectiveness of standard care plus psychological therapy or standard care alone for adults (≥ 18 years) presenting at an emergency department (ED) with repeated self-harm. Recruiting 630 participants, it includes an internal pilot, economic evaluation and process evaluation. The intervention will be delivered by mental health staff working in acute settings, with experience of assessing and managing risk in people presenting to emergency services with self-harm. Staff will be trained and supervised to deliver one of three specially adapted therapies: psychodynamic interpersonal therapy, cognitive behavioural therapy or acceptance and commitment therapy. Participants allocated to the intervention will receive one of the adapted therapies according to therapist allocation for up to 6 months via 12 weekly, one to one, 45–50-min sessions. The primary outcome is quality of life measured by the Clinical Outcomes in Routine Evaluation Outcome Measure at 12 months post-randomisation. Secondary outcomes include suicidal intent, depression and cost-effectiveness. Data are collected using hospital attendance records and online/postal/telephone questionnaires at 6 and 12 months post-randomisation, with resource use additionally collected at 3 and 9 months. Discussion: This protocol outlines a randomised controlled trial to investigate whether modified therapies are cost-effective and improve quality of life for people who repeatedly self-harm. Few interventions are proven to be deliverable in the NHS for this population. This study is strengthened by the involvement of qualified mental health workers experienced in managing risk as therapists. Trial registration: Registered on August 03, 2021. IRAS number: 297939. ISRCTN: https://doi.org/10.1186/ISRCTN73357210. REC reference: 21/EE/0145. Sponsor: University of Leeds. [ABSTRACT FROM AUTHOR]

High‐resolution 2D and 3D data remotely acquired by SuperCam's Remote Micro‐Imager and Mastcam‐Z aboard the Perseverance rover enabled us to characterize the stratigraphic architecture and sedimentary record of the Kodiak butte, an isolated remnant of the western delta fan of Jezero crater. Using these data, we build up on previous interpretations of the butte interpreted as a prograding Gilbert‐type deltaic series. We characterize three individual stratigraphic Units 0 to 2 on the eastern and northern faces of the butte. Each Unit displays the same vertical succession of prodeltaic/lacustrine bottomsets, delta slope toesets and foresets, and fluvially influenced topsets of a deltaic plain with a braided river pattern, shown by 11 individual sedimentary facies. We infer that these individual Units record the formation of three distinct deltaic mouth bars successively across time and space. For the first time on another planet than Earth, we are able to construct a precise sequence stratigraphic framework to highlight lake‐level fluctuations at the time the Kodiak butte was emplaced, during the latest stages of deltaic activity. We identify four hydrogeological cycles indicated by alternating rises and falls of the lake‐level on the order of 5–10 m. These were most probably linked to climatic events and variations controlling lake water inputs in probable relation to an astronomical control. Plain Language Summary: Kodiak butte is an isolated remnant of the main western sedimentary fan of Jezero crater. It displays the characteristic structures of a Gilbert‐type delta, a structure that shows deposition of fluvial material into a standing body of water, here interpreted to be a lake within Jezero crater. 11 individual sedimentary facies (textures, grain‐sizes, and structures) of the rocks exposed at Kodiak suggest that the depositional environments ranged from the fluvial plain to a steep subaqueous slope and into the bottom of the shallow Jezero lake. Our observations further show that Kodiak butte is organized into three distinct stratigraphic Units (0–2), each displaying the same vertical succession of bottomsets, toesets, foresets and topsets. This architecture is interpreted as reflecting three distinct deltaic packages, formed consecutively and not at the same time. Using these facies and stratigraphic architecture data, we are able for the first time on another planet than Earth, to precisely construct a sequence stratigraphic framework for the formation of Kodiak. This framework illustrates with unprecedented precision successive episodes of rises and falls of the paleo‐lake‐level (in the order of 5–10 m) involved in the construction and evolution of the western Jezero delta. Key Points: New observations on the Kodiak delta remnant were carried out to characterize its detailed facies and stratigraphic architectureThree deltaic mouth bars are identified showing 4D succession of depositional settings ranging from deltaic plain to slope to shallow lakeThe first ever sequence stratigraphic framework on Mars shows four cycles of alternating rises and falls of the lake‐level within 5–10 m [ABSTRACT FROM AUTHOR]

The observation that many lavas associated with mantle plumes have higher 3He/4He ratios than the upper convecting mantle underpins geophysical, geodynamic and geochemical models of Earth’s deep interior. High 3He/4He ratios are thought to derive from the solar nebula or from solar-wind-irradiated material that became incorporated into Earth during early planetary accretion. Traditionally, this high-3He/4He component has been considered intrinsic to the mantle, having avoided outgassing caused by giant impacts and billions of years of mantle convection1–4. Here we report the highest magmatic 3He/4He ratio(67.2 ± 1.8 times the atmospheric ratio) yet measured in terrestrial igneous rocks, in olivines from Baffin Island lavas. We argue that the extremely high-3He/4He helium in these lavas might derive from Earth’s core5–9. The viability of the core hypothesis relaxes the long-standing constraint—based on noble gases in lavas associated with mantle plumes globally—that volatile elements from the solar nebula have survived in the mantle since the early stages of accretion.Olivines from Baffin Island lavas have the highest magmatic 3He/4He ratio measured so far in terrestrial igneous rocks, indicating that the helium in these lavas might derive from Earth’s core. [ABSTRACT FROM AUTHOR]

The Atacama Desert, on the western margin of the Central Andes, hosts some of the world's largest porphyry copper deposits (PCDs). Despite a hyperarid climate, many of these PCDs have undergone secondary "supergene" enrichment, whereby copper has been concentrated via groundwater-driven leaching and reprecipitation, yielding supergene profiles containing valuable records of weathering and landscape evolution. We combine hematite (U-Th-Sm)/He geochronology and oxygen isotope analysis to compare the weathering histories of two Andean PCDs and test the relative importance of climate and tectonics in controlling both enrichment and water table movement. At Cerro Colorado, in the Precordillera, hematite precipitation records prolonged weathering from ~31 to ~2 Ma, tracking water table descent following aridity-induced canyon incision from the late Miocene onward. By contrast, hematite at Spence, within the Central Depression, is mostly younger than ~10.5 Ma, suggesting exhumation ended much later. A heavy oxygen isotopic signature for Spence hematite suggests that upwelling formation water has been an important source of groundwater, accounting for a high modern water table despite persistent hyperaridity, whereas isotopically light hematite at Cerro Colorado formed in the presence of meteoric water. Compared with published paleo-environmental and sedimentological records, our data show that weathering can persist beneath appreciable post-exhumation cover, under hyperarid conditions unconducive to enrichment. The susceptibility of each deposit to aridity-induced water table descent, canyon incision and deep weathering has been controlled by recharge characteristics and morphotectonic setting. Erosional exhumation, rather than aridity-induced water table decay, appears to be more important for the development of supergene enrichment. [ABSTRACT FROM AUTHOR]

We built a collector to filter interplanetary dust particles (IDPs) larger than 5 μm from the clean air at the Amundsen Scott South Pole station. Our sampling strategy used long duration, continuous dry filtering of near‐surface air in place of short duration, high‐speed impact collection on flags flown in the stratosphere. We filtered ~107 m3 of clean Antarctic air through 20 cm diameter, 3 µm filters coupled to a suction blower of modest power consumption (5–6 kW). Our collector ran continuously for 2 years and yielded 41 filters for analyses. Based on stratospheric concentrations, we predicted that each month's collection would provide 300–900 IDPs for analysis. We identified 19 extraterrestrial (ET) particles on the 66 cm2 of filter examined, which represented ~0.5% of the exposed filter surfaces. The 11 ET particles larger than 5 µm yield about a fifth of the expected flux based on >5 µm stratospheric ET particle flux. Of the 19 ET particles identified, four were chondritic porous IDPs, seven were FeNiS beads, two were FeNi grains, and six were chondritic material with FeNiS components. Most were <10 µm in diameter and none were cluster particles. Additionally, a carbon‐rich candidate particle was found to have a small 15N isotopic enrichment, supporting an ET origin. Many other candidate grains, including chondritic glasses and C‐rich particles with Mg and Si and FeS grains, require further analysis to determine if they are ET. The vast majority of exposed filter surfaces remain to be examined. [ABSTRACT FROM AUTHOR]

Measuring the abundance and isotopic composition of noble gases in planetary atmospheres can answer fundamental questions in cosmochemistry and comparative planetology. However, noble gases are rare elements, a feature making their measurement challenging even on Earth. Furthermore, in space applications, power consumption, volume and mass constraints on spacecraft instrument accommodations require the development of compact innovative instruments able to meet the engineering requirements of the mission while still meeting the science requirements. Here we demonstrate the ability of the quadrupole ion trap mass spectrometer (QITMS) developed at the Jet Propulsion Laboratory (Caltech, Pasadena) to measure low quantities of heavy noble gases (Kr, Xe) in static operating mode and in the absence of a buffer gas such as helium. The sensitivity reaches 1013 cps Torr−1 (about 1011 cps Pa−1) of gas (Kr or Xe). The instrument is able to measure gas in static mode for extended periods of time (up to 48 h) enabling the acquisition of thousands of isotope ratios per measurement. Errors on isotope ratios follow predictions of the counting statistics and the instrument provides reproducible results over several days of measurements. For example, 1.7 × 10−10 Torr (2.3 × 10−8 Pa) of Kr measured continuously for 7 hours yielded a 0.6‰ precision on the 86Kr/84Kr ratio. Measurements of terrestrial and extraterrestrial samples reproduce values from the literature. A compact instrument based upon the QITMS design would have a sensitivity high enough to reach the precision on isotope ratios (e.g. better than 1% for 129,131–136Xe/130Xe ratios) necessary for a scientific payload measuring noble gases collected in the Venus atmosphere. [ABSTRACT FROM AUTHOR]

Abstract: (U‐Th)/He geochronology and cosmogenic 3He in iron oxides reveal mineral precipitation ages as old as 55 Ma and exposure ages greater than 5 Ma for canga‐cemented plateaus in the Quadrilátero Ferrífero, Brazil, showing that lateritic profiles overlying banded iron‐formation (BIF) landscapes in tropical regions have a long history of surface exposure. The long‐term erosion history obtained from cosmogenic 3He on BIF plateaus confirms that relic surfaces persist in the landscape for millions of years. Combined 3He and (U‐Th)/He dating shows that cangas are preferentially goethite cemented by biogeochemical reactions in the subsurface. Importantly, pebbles of hematite‐magnetite in colluvia or shallow creeks draining the canga‐cemented plateaus record a much longer exposure history than in situ canga blocks, showing that even older duricrusts, now eroded, once blanketed these plateaus. Physically stable but biogeochemically dynamic, cangas armor the landscape by pervasive and recurrent iron cycling and cementation, slowing down the delivery of weathered BIF or friable hematite–magnetite ore to erosion. [ABSTRACT FROM AUTHOR]

Abstract: Following K‐Ar dating of a mudstone and a sandstone, a third sample has been dated by the Curiosity rover exploring Gale Crater. The Mojave 2 mudstone, which contains relatively abundant jarosite, yielded a young K‐Ar bulk age of 2.57 ± 0.39 Ga (1σ precision). A two‐step heating experiment was implemented in an effort to resolve the K‐Ar ages of primary and secondary mineralogical components within the sample. This technique involves measurement of 40Ar released in low‐temperature (500°C) and high‐temperature (930°C) steps, and a model of the potassium distribution within the mineralogical components of the sample. Using this method, the high‐temperature step yields a K‐Ar model age of 4.07 ± 0.63 Ga associated with detrital plagioclase, compatible with the age obtained on the Cumberland mudstone by Curiosity. The low‐temperature step, associated with jarosite mixed with K‐bearing evaporites and/or phyllosilicates, gave a youthful K‐Ar model age of 2.12 ± 0.36 Ga. The interpretation of this result is complicated by the potential for argon loss after mineral formation. Comparison with the results on Cumberland and previously published constraints on argon retentivity of the individual phases likely to be present suggests that the formation age of the secondary materials, correcting for plausible extents of argon loss, is still less than 3 Ga, suggesting post‐3 Ga aqueous processes occurred in the sediments in Gale Crater. Such a result is inconsistent with K‐bearing mineral formation in Gale Lake and instead suggests postdepositional fluid flow at a time after surface fluvial activity on Mars is thought to have largely ceased. [ABSTRACT FROM AUTHOR]

After prolonged mechanical ventilation patients may experience the 'post intensive care syndrome' (PICS) and may be candidates for post-discharge follow-up clinics. We aimed to ascertain the incidence and severity of PICS symptoms in patients surviving prolonged mechanical ventilation and to describe their views regarding follow-up clinics. In a teaching hospital, we conducted a cohort study of all adult patients discharged alive after ventilation in ICU for ≥7 days during 2013. We administered the EuroQol-5D (EQ-5D) and Hospital Anxiety and Depression Scale (HADS) via telephone interview and asked patients their views about the possible utility of a follow-up clinic. We studied 48 patients. At follow-up (average 19.5 months), seven (15%) patients had died and 14 (29%) did not participate (eight declined; two were non-English speakers; four were non-contactable). Among the 27 responders, 16 (59%) reported at least moderate problems in ≥1 EQ-5D dimension; 10 (37%) in ≥2 dimensions, and 8 (30%) in ≥3 dimensions. Moreover, 10 (37%) patients reported marked psychological symptoms; six (22%) scored borderline or abnormal on the HADS for both anxiety and depression; and four (15%) scored borderline or abnormal for one component. Finally, 21/26 (81%) patients stated that an ICU follow-up clinic would have been beneficial. At long-term follow-up, the majority of survivors of prolonged mechanical ventilation reported impaired quality of life and significant psychological symptoms. Most believed that a follow-up clinic would have been beneficial. [ABSTRACT FROM AUTHOR]

The article discusses 10 practical strategies for clinicians to effectively communicate with relatives of patients in intensive care units (ICUs). The impact of critical illness on relatives is explained. The 10 communication strategies include building trust between clinicians and relatives, providing relatives with regular updates, involving the bedside nurse in family meetings, ensuring that the clinician has enough uninterrupted time to talk with relatives, and speaking plainly. [ABSTRACT FROM AUTHOR]

Hotspot lavas erupted at ocean islands exhibit tremendous isotopic variability, indicating that there are numerous mantle components hosted in upwelling mantle plumes that generate volcanism at hotspots like Hawaii and Samoa. However, it is not known how the surface expression of the various geochemical components observed in hotspot volcanoes relates to their spatial distribution within the plume. Here we present a relationship between He and Pb isotopes in Samoan lavas that places severe constraints on the distribution of geochemical species within the plume. The Pb-isotopic compositions of the Samoan lavas reveal several distinct geochemical groups, each corresponding to a different geographic lineament of volcanoes. Each group has a signature associated with one of four mantle endmembers with low 3He/4He: EMII (enriched mantle 2), EMI (enriched mantle 1), HIMU (high µ = 238U/204Pb) and DM (depleted mantle). Critically, these four geochemical groups trend towards a common region of Pb-isotopic space with high 3He/4He. This observation is consistent with several low-3He/4He components in the plume mixing with a common high-3He/4He component, but not mixing much with each other. The mixing relationships inferred from the new He and Pb isotopic data provide the clearest picture yet of the geochemical geometry of a mantle plume, and are best explained by a high-3He/4He plume matrix that hosts, and mixes with, several distinct low-3He/4He components. [ABSTRACT FROM AUTHOR]

A significant role for alveolar macrophages (AM) in the pathophysiology of sepsis-induced acute lung injury (ALl) has been shown; however, the mechanisms behind AM-related lung injury remain relatively uncertain. We examined the role of AM nicotinamide adenine dinucleotide phosphate (NADPH) oxidase in pulmonary endothelial cell septic injury. NADPH oxidase is one of the major sources of cellular reactive oxygen species and has been implicated in endothelial injury in ALL. Pulmonary microvascular endothelial cells (PMVEC) mono-layers were grown on Transwell inserts and incubated with wild-type and NADPH oxidase-deficient AM in the presence or absence of cytomix (equimolar TNF-α, IL-β, and IFN-γ). Injury to the mono layers was assessed by trans-PMVEC Evans blue (EB)-labeled albumin flux. We found AM under cytomix stimulation caused significant EB-albumin flux across the PMVEC monolayers, and this effect was attenuated by the genetic deletion of AM NADPH oxidase. The pharmacological inhibition of AM NADPH oxidase with apocynin and PR-39 also significantly reduced AM-dependent PMVEC injury. In the AM-PMVEC cocultures, we also assessed PMVEC injury through measurement of protein oxidation and lipid peroxidation. AM were shown to cause a significant increase in these markers of PMVEC injury, which was also attenuated by the inhibition of NADPH oxidase or through the use of NADPH oxidase-deficient AM. PMVEC NADPH oxidase was shown not to significantly contribute to PMVEC injury in our studies. From our findings we have concluded that AM NADPH oxidase is crucial for the septic increase in pulmonary vascular permeability. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of a school nutrition programme on the weight gain and growth of Vietnamese schoolchildren.Design: A proximate cluster evaluation of children in seven schools, in which fortified milk and biscuits supplying 300 kcal of energy were being given on school days, compared with children in 14 nearby schools with no feeding. All children were dewormed.Setting: Twenty-one primary schools in Dong Thap Province, Vietnam.Subjects: A cohort of 1080 children in grade 1 of 21 primary schools, and a cross-sectional interview of 400 children in grade 3.Results: The programme gave children the equivalent of 90 kcal day- 1 over 17 months. t-Tests showed a small but statistically significant difference between groups in their average gain in weight and height: 3.19 versus 2.95 kg (P < 0.001) and 8.15 versus 7.88 cm (P = 0.008). A multiple-level model showed that the programme was statistically significant after controlling for clustering of children in schools, sex, age and initial underweight (P = 0.024). A significant impact on height was also seen in a regression model, but not when controlling for school. The most undernourished children tended to gain the least weight. There was no evidence of substitution.Conclusion: The programme had a small but significant effect on weight gain, but the most undernourished children benefited the least. Methods need to be developed to target them. This design may offer a means of estimating the impact of school feeding on growth in other programme settings. [ABSTRACT FROM AUTHOR]

Inducible nitric oxide synthase (iNOS) contributes importantly to septic pulmonary protein leak in mice with septic acute lung injury (ALl). However, the role of alveolar macrophage (AM) iNOS in septic ALl is not known. Thus we assessed the specific effects of AM iNOS in murine septic ALI through selective AM depletion (via intratracheal instillation of clodronate liposomes) and subsequent AM reconstitution (via intratracheal instillation of donor iNOS+/+ or iNOS-/- AM). Sepsis was induced by cecal ligation and perforation, and ALl was assessed at 4 h: protein leak by the Evans blue (EB) dye method, neutrophil infiltration via myeloperoxidase (MPO) activity, and pulmonary iNOS mRNA expression via RT-PCR. In iNOS+/+ mice, AM depletion attenuated the sepsis-induced increases in pulmonary microvascular protein leak (0.3 ± 0.1 vs. 1.4 ± 0.1 µg EB·g lung-1·min-1 P < 0.05) and MPO activity (37 ± 4 vs. 67 ± 8 U/g lung; P < 0.05) compared with that shown in non-AM-depleted mice. In AM-depleted iNOS+/+ mice, septic pulmonary protein leak was restored by AM reconstitution with iNOS+/+ AM (0.9 ± 0.3 µg EB·g lung-1·min-1) but not with iNOS-/- donor AM. In iNOS-/- mice, sepsis did not induce pulmonary protein leak or iNOS mRNA expression, despite increased pulmonary MPO activity. However, AM depletion in iNOS-/- mice and subsequent reconstitution with iNOS+/+ donor AM resulted in significant sepsis-induced pulmonary protein leak and iNOS expression. Septic pulmonary MPO levels were similar in all AM-reconstituted groups. Thus septic pulmonary protein leak is absolutely dependent on the presence of functional AM and specifically on iNOS in AM. AM iNOS-dependent pulmonary protein leak was not mediated through changes in pulmonary neutrophil influx. [ABSTRACT FROM AUTHOR]

Focuses on a study that examined observer perceptions of patients who have undergone venipuncture, a painful medical procedure. Methodology; Results and discussion.

Noble gas isotopic ratios in mantle-derived samples require variability in the time-integrated ratio of volatile to lithophile elements in the Earth. Documentation of mantle [sup 3]He/[sup 4]He variability is becoming increasingly complete, but for the heavier noble gases, the picture is still partly clouded by the effects of atmospheric contamination of mantle samples. Nevertheless, clear variations in mantle Ne, Ar, and Xe isotopic ratios exist, are apparently correlated with[sup 3]He/[sup 4]He, and may be the product of varying degrees of mantle degassing. However, uncertainties in noble gas geochemical behavior and several conflicting observations leave open other possibilities. Recent Ne isotopic data are particularly important because they require that the atmosphere has not been closed to exchange with space. Derivation of much of the atmosphere from a source other than degassing of the mantle is a strong possibility that complicates efforts to model the geochemical evolution of the Earth. [ABSTRACT FROM AUTHOR]

There is acidaemia (low pH), respiratory acidosis (high Paco SB 2 sb ) and metabolic alkalosis (high There is a very severe acidaemia (low pH) with respiratory alkalosis (low Paco SB 2 sb ) and metabolic acidosis (low 15 mmol/L, Na SP + sp 147 mmol/L, K SP + sp 7 mmol/L, Cl SP - sp 95 mmol/L. There is very mild acidaemia (low pH) with respiratory alkalosis (low Paco SB 2 sb ) and metabolic acidosis (low In this case, there are three concomitant disorders: respiratory alkalosis, HAGMA and metabolic alkalosis. [Extracted from the article]

The switching frequency of inductive power transfer may change along with the air gap between two coils due to mutual inductance variation. The mutual inductance is conventionally estimated through experimental measurement or finite element analysis. To simplify this process, a frequency-gap model for series-series compensated inductive power transfer is proposed to calculate the unity-gain frequency based on known air gap and coil geometric parameters. Neumann's formula is applied to compute the mutual inductance of the primary and secondary coils. The experimental results show that the unity-gain frequency can be predicted with varying loads and air gaps (75-250 mm), and a demonstrated unity-gain error of <6%. [ABSTRACT FROM AUTHOR]