Search

Recent observations have found a large number of supermassive black holes already in place in the first few hundred million years after the Big Bang, many of which seem to be overmassive relative to their host galaxy stellar mass when compared with local relation 1-9 . Several different models have been proposed to explain these findings, ranging from heavy seeds to light seeds experiencing bursts of high accretion rate 10-16 . Yet, current datasets are unable to differentiate between these various scenarios. Here we report the detection, from the JADES survey, of broad Hα emission in a galaxy at z = 6.68, which traces a black hole with a mass of about 4 × 10 8 M ⊙ and accreting at a rate of only 0.02 times the Eddington limit. The black hole to host galaxy stellar mass ratio is about 0.4-that is, about 1,000 times above the local relation-whereas the system is closer to the local relations in terms of dynamical mass and velocity dispersion of the host galaxy. This object is most likely an indication of a much larger population of dormant black holes around the epoch of reionization. Its properties are consistent with scenarios in which short bursts of super-Eddington accretion have resulted in black hole overgrowth and massive gas expulsion from the accretion disk; in between bursts, black holes spend most of their life in a dormant state., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

The most distant galaxies detected were seen when the Universe was a scant 5% of its current age. At these times, progenitors of galaxies such as the Milky Way were about 10,000 times less massive. Using the James Webb Space Telescope (JWST) combined with magnification from gravitational lensing, these low-mass galaxies can not only be detected but also be studied in detail. Here we present JWST observations of a strongly lensed galaxy at z spec  = 8.296 ± 0.001, showing massive star clusters (the Firefly Sparkle) cocooned in a diffuse arc in the Canadian Unbiased Cluster Survey (CANUCS) 1 . The Firefly Sparkle exhibits traits of a young, gas-rich galaxy in its early formation stage. The mass of the galaxy is concentrated in 10 star clusters (49-57% of total mass), with individual masses ranging from 10 5 M ⊙ to 10 6 M ⊙ . These unresolved clusters have high surface densities (>10 3 M ⊙  pc - 2 ), exceeding those of Milky Way globular clusters and young star clusters in nearby galaxies. The central cluster shows a nebular-dominated spectrum, low metallicity, high gas density and high electron temperature, hinting at a top-heavy initial mass function. These observations provide our first spectrophotometric view of a typical galaxy in its early stages, in a 600-million-year-old Universe., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)

This is a qualitative study exploring the perceptions of mental health among Somali women living in London. Participants, over the age of 18, female and identifying as Somali, were recruited from a community centre in West London. Seven participants were recruited and semi-structured interviews were conducted to better understand perceptions of mental health, care-seeking, treatment and different understandings of these issues within the Somali community in London. Interview transcripts were imported into NVIVO version 14 to be coded, and description-focussed coding and thematic analysis were used to interpret key themes. Concerns around judgement, shame and stigma are key issues affecting attitudes towards mental health in this group. Other important issues affecting conceptualisations and attitudes towards mental health were intergenerational differences, isolation from the community, stigma and secrecy. Participants also reported the importance of protective factors, particularly faith and family in their lives. This research adds to existing literature in exploring perceptions of mental health in Somali communities in the UK and such research is helpful in identifying cultural barriers to recognition and treatment of mental health within this community., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Gonzalez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The first observations of the James Webb Space Telescope (JWST) have revolutionized our understanding of the Universe by identifying galaxies at redshift z ≈ 13 (refs. 1-3 ). In addition, the discovery of many luminous galaxies at Cosmic Dawn (z > 10) has suggested that galaxies developed rapidly, in apparent tension with many standard models 4-8 . However, most of these galaxies lack spectroscopic confirmation, so their distances and properties are uncertain. Here we present JWST Advanced Deep Extragalactic Survey-Near-Infrared Spectrograph spectroscopic confirmation of two luminous galaxies at z = 14.32 - 0.20 + 0.08 and z = 13.90 ± 0.17. The spectra reveal ultraviolet continua with prominent Lyman-α breaks but no detected emission lines. This discovery proves that luminous galaxies were already in place 300 million years after the Big Bang and are more common than what was expected before JWST. The most distant of the two galaxies is unexpectedly luminous and is spatially resolved with a radius of 260 parsecs. Considering also the very steep ultraviolet slope of the second galaxy, we conclude that both are dominated by stellar continuum emission, showing that the excess of luminous galaxies in the early Universe cannot be entirely explained by accretion onto black holes. Galaxy formation models will need to address the existence of such large and luminous galaxies so early in cosmic history., (© 2024. The Author(s).)

Local and low-redshift (z < 3) galaxies are known to broadly follow a bimodal distribution: actively star-forming galaxies with relatively stable star-formation rates and passive systems. These two populations are connected by galaxies in relatively slow transition. By contrast, theory predicts that star formation was stochastic at early cosmic times and in low-mass systems 1-4 . These galaxies transitioned rapidly between starburst episodes and phases of suppressed star formation, potentially even causing temporary quiescence-so-called mini-quenching events 5,6 . However, the regime of star-formation burstiness is observationally highly unconstrained. Directly observing mini-quenched galaxies in the primordial Universe is therefore of utmost importance to constrain models of galaxy formation and transformation 7,8 . Early quenched galaxies have been identified out to redshift z < 5 (refs.  9-12 ) and these are all found to be massive (M ⋆  > 10 10  M ⊙ ) and relatively old. Here we report a (mini-)quenched galaxy at z = 7.3, when the Universe was only 700 Myr old. The JWST/NIRSpec spectrum is very blue (U-V = 0.16 ± 0.03 mag) but exhibits a Balmer break and no nebular emission lines. The galaxy experienced a short starburst followed by rapid quenching; its stellar mass (4-6 × 10 8  M ⊙ ) falls in a range that is sensitive to various feedback mechanisms, which can result in perhaps only temporary quenching., (© 2024. The Author(s).)

Background: 98% of people with surgical conditions living in low- and middle-income countries (LMICs) do not receive safe, timely and affordable surgical and anesthesia care. Research exploring barriers to receiving care has tended to be narrow in focus, often facility-based and ignoring the community beliefs, experiences and behaviours that will be an essential component of closing the gap in surgical care. Using qualitative methods, we captured diverse community perspectives in rural Ethiopia: exploring beliefs, perceptions, knowledge and experiences related to surgical conditions, with the overall aim of (re)constructing explanatory models., Methods: Our study was nested within a community-based survey of surgical conditions conducted in the Butajira Health and Demographic Surveillance Site, southern Ethiopia, and a follow-up study of people accessing surgical care in two local hospitals. We carried out 24 semi-structured interviews. Participants were community members who needed but did/did not access surgical care, community-based healthcare workers and traditional bone-setters. Interviews were conducted in Amharic, audio-recorded, transcribed, and translated into English. We initially carried out thematic analysis and we recognized that emerging themes were aligned with Kleinman's explanatory models framework and decided to use this to guide the final stages of analysis., Results: We found that community members primarily understood surgical conditions according to severity. We identified two categories: conditions you could live with and those which required urgent care, with the latter indicating a clear and direct path to surgical care whilst the former was associated with a longer, more complex and experimental pattern of help-seeking. Fear of surgery and poverty disrupted help-seeking, whilst community narratives based on individual experiences fed into the body of knowledge people used to inform decisions about care., Conclusions: We found explanatory models to be flexible, responsive to new evidence about what might work best in the context of limited community resources. Our findings have important implications for future research and policy, suggesting that community-level barriers have the potential to be responsive to carefully designed interventions which take account of local knowledge and beliefs., (© 2024. The Author(s).)

Competing Interests: We declare no competing interests.

Large dust reservoirs (up to approximately 10 8  M ⊙ ) have been detected 1-3 in galaxies out to redshift z ≃ 8, when the age of the Universe was only about 600 Myr. Generating substantial amounts of dust within such a short timescale has proven challenging for theories of dust formation 4,5 and has prompted the revision of the modelling of potential sites of dust production 6-8 , such as the atmospheres of asymptotic giant branch stars in low-metallicity environments, supernova ejecta and the accelerated growth of grains in the interstellar medium. However, degeneracies between different evolutionary pathways remain when the total dust mass of galaxies is the only available observable. Here we report observations of the 2,175 Å dust attenuation feature, which is well known in the Milky Way and galaxies at z ≲ 3 (refs. 9-11 ), in the near-infrared spectra of galaxies up to z ≃ 7, corresponding to the first billion years of cosmic time. The relatively short timescale implied for the formation of carbonaceous grains giving rise to this feature 12 suggests a rapid production process, possibly in Wolf-Rayet stars or supernova ejecta., (© 2023. The Author(s).)

To achieve universal health coverage, health system strengthening (HSS) is required to support the of delivery of high-quality care. The aim of the National Institute for Health Research Global Research Unit on HeAlth System StrEngThening in Sub-Saharan Africa (ASSET) is to address this need in a four-year programme, with three healthcare platforms involving eight work-packages. Key to effective health system strengthening (HSS) is the pre-implementation phase of research where efforts focus on applying participatory methods to embed the research programme within the existing health system. To conceptualise the approach, we provide an overview of the key methods applied across work-package to address this important phase of research conducted between 2017 and 2021.Work-packages are being undertaken in publicly funded health systems in rural and urban areas in Ethiopia, Sierra Leone, South Africa, and Zimbabwe. Stakeholders including patients and their caregivers, community representatives, clinicians, managers, administrators, and policymakers are the main research participants.In each work-package, initial activities engage stakeholders and build relationships to ensure co-production and ownership of HSSIs. A mixed-methods approach is then applied to understand and address determinants of high-quality care delivery. Methods such as situation analysis, cross-sectional surveys, interviews and focus group discussions are adopted to each work-package aim and context. At the end of the pre-implementation phase, findings are disseminated using focus group discussions and participatory Theory of Change workshops where stakeholders from each work package use findings to select HSSIs and develop a programme theory.ASSET places a strong emphasis of the pre-implementation phase in order to provide an in-depth and systematic diagnosis of the existing heath system functioning, needs for strengthening and stakeholder engagement. This common approach will inform the design and evaluation of the HSSIs to increase effectiveness across work packages and contexts, to better understand what works, for whom, and how.