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Abstract Objective To evaluate the impact of absolute cardiovascular risk counselling on quality-of-life indices within a chest pain clinic. Data sources and study setting Primary data was collected at the Royal Hobart Hospital, Australia, between 2014 and 2020. Study design Patients attending an Australian chest pain clinic were randomised into a prospective, open-label, blinded-endpoint study over a minimum 12-months follow-up. Data collection / extraction methods The SF-36 questionnaire was completed at baseline/follow-up and SF-6D multi-attribute utility instrument’s health state utilities (HSU) were generated using SF-36 responses and the SF-6D’s Australian tariff. SF-6D minimal important difference was 0.04 points. Absolute cardiovascular risk was also stratified into high/intermediate/low-risk categories for exploratory analysis of summary HSUs and dimensional scores. ANZCTR registration number 12617000615381 (registered 28/4/17). Principal findings Of n = 189 patients enrolled, HSUs were generated for 96% at baseline (intervention n = 93, usual care n = 88) and 61% at follow-up. There were no statistical differences in age, sex, absolute cardiovascular risk or mean HSU between groups at baseline. Summary HSUs improved more for the intervention group and the median between-group difference exceeded the minimal important difference threshold (intervention 0.16 utility points, control 0.10 utility points). For Intervention patients with high absolute risk (≥ 15%), HSU did not significantly change. Conclusions Absolute cardiovascular risk counselling in a chest pain clinic yielded clinically meaningful improvement in health-related quality of life.

We present a comprehensive study of the star formation histories of massive-quenched galaxies at |$z=3$| in three semi-analytical models (Shark, gaea, Galform) and three cosmological hydrodynamical simulations (Eagle, IllustrisTNG, Simba). We study the predicted number density and stellar mass function of massive-quenched galaxies, their formation and quenching time-scales and star formation properties of their progenitors. Predictions are disparate in all these diagnostics, for instance: (i) some simulations reproduce the observed number density of very massive-quenched galaxies (⁠|$\gt 10^{11}\, \rm {\rm M}_{\odot }$|⁠) but underpredict the high density of intermediate-mass ones, while others fit well the lower masses but underpredict the higher ones; (ii) in most simulations, except for gaea and Eagle , most massive-quenched galaxies had starburst periods, with the most intense ones happening at |$4\lt z\lt 5$|⁠ ; however, only in Shark and IllustrisTNG we do find a large number of progenitors with star formation rates |$\gt 300\rm \, {\rm M}_{\odot }\, yr^{-1}$|⁠ ; (iii) quenching time-scales are in the range |$\approx 20\!-\!150$| Myr depending on the simulation; among other differences. These disparate predictions can be tied to the adopted active galactic nucleus (AGN) feedback model. For instance, the explicit black hole (BH) mass dependence to trigger the 'radio mode' in IllustrisTNG and Simba makes it difficult to produce quenched galaxies with intermediate stellar masses, also leading to higher baryon collapse efficiencies (⁠|$\approx 15\!-\!30$|  per cent); while the strong bolometric luminosity dependence of the AGN outflow rate in gaea leads to BHs of modest mass quenching galaxies. Current observations are unable to distinguish between these different predictions due to the small sample sizes. However, these predictions are testable with current facilities and upcoming observations, allowing a 'true physics experiment' to be carried out. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of absolute cardiovascular risk counselling on quality-of-life indices within a chest pain clinic. Data sources and study setting: Primary data was collected at the Royal Hobart Hospital, Australia, between 2014 and 2020. Study design: Patients attending an Australian chest pain clinic were randomised into a prospective, open-label, blinded-endpoint study over a minimum 12-months follow-up. Data collection / extraction methods: The SF-36 questionnaire was completed at baseline/follow-up and SF-6D multi-attribute utility instrument's health state utilities (HSU) were generated using SF-36 responses and the SF-6D's Australian tariff. SF-6D minimal important difference was 0.04 points. Absolute cardiovascular risk was also stratified into high/intermediate/low-risk categories for exploratory analysis of summary HSUs and dimensional scores. ANZCTR registration number 12617000615381 (registered 28/4/17). Principal findings: Of n = 189 patients enrolled, HSUs were generated for 96% at baseline (intervention n = 93, usual care n = 88) and 61% at follow-up. There were no statistical differences in age, sex, absolute cardiovascular risk or mean HSU between groups at baseline. Summary HSUs improved more for the intervention group and the median between-group difference exceeded the minimal important difference threshold (intervention 0.16 utility points, control 0.10 utility points). For Intervention patients with high absolute risk (≥ 15%), HSU did not significantly change. Conclusions: Absolute cardiovascular risk counselling in a chest pain clinic yielded clinically meaningful improvement in health-related quality of life. [ABSTRACT FROM AUTHOR]

We present NIRSpec/micro-shutter assembly observations from the JWST large-area survey WIDE, targeting the rest-frame UV–optical spectrum of Ulema, a radio-active galactic nucleus host at redshift |$z=4.6348$|⁠. The low-resolution prism spectrum displays high equivalent width nebular emission, with remarkably high ratios of low-ionization species of oxygen, nitrogen, and sulphur, relative to hydrogen; auroral O |$^+$| emission is clearly detected, possibly also C |$^+$|⁠. From the high-resolution grating spectrum, we measure a gas velocity dispersion of |$\sigma \sim 400$| |$\mathrm{km\, s^{-1}}$|⁠ , broad enough to rule out star-forming gas in equilibrium in the gravitational potential of the galaxy. Diagnostics based on emission-line ratios suggest that the nebular emission is due to a shock which ran out of pre-shock gas. To infer the physical properties of the system, we model simultaneously the galaxy spectral energy distribution and shock-driven line emission under a Bayesian framework. We find a relatively low-mass, star-forming system (⁠|$M_\star = 1.4 \times 10^{10}~{\rm M}_\odot$|⁠ , |$\mathrm{SFR} = 70~{\rm M}_\odot ~{\rm yr^{-1}}$|⁠), where shock-driven emission contributes 50 per cent to the total H β luminosity. The nebular metallicity is near solar – three times higher than that predicted by the mass–metallicity relation at |$z=4.6$|⁠ , possibly related to fast-paced chemical evolution near the galaxy nucleus. We find no evidence for a recent decline in the star-formation rate of the galaxy, meaning that, already at this early epoch, fast radio-mode active galactic nucleus feedback was poorly coupled with the bulk of the star-forming gas; therefore, most of the feedback energy must end up in the galaxy halo, setting the stage for future quenching. [ABSTRACT FROM AUTHOR]