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Abstract Among large cetaceans in the Southern Hemisphere, fin whales were the most heavily exploited in terms of numbers taken during the period of intense industrial whaling. Recent studies suggest that, whilst some humpback whale populations in the Southern Hemisphere appears to have almost completely recovered to their estimated pre-whaling abundance, much less is known about the status of Southern Hemisphere fin whales. Circumpolar estimates in the 1990s suggest an abundance of about 5500 animals south of 60° S, while the IDCR/SOWER-2000 survey for the Scotia Sea and Antarctic Peninsula areas estimated 4670 fin whales within this region in the year 2000. More recent studies in smaller regions indicate higher densities, suggesting that previous estimates are overly conservative and/or that fin whales are undergoing a substantial increase. Here we report findings from a recent multi-vessel single-platform sightings survey carried out as part of the 2019 Area 48 Survey for Antarctic krill. While fin whales were encountered throughout the entire survey area, which covered the majority of CCAMLR Management Area 48, they were particularly abundant around the South Orkney Islands and the eastern Bransfield Strait. Large feeding aggregations were also encountered within the central Scotia Sea between South Orkney Islands and South Georgia. Distance sampling analyses suggest an average fin whale density throughout the Scotia Sea of 0.0256 ( $$\text{CV}=0.149$$ CV = 0.149 ) whales per km2, which agrees well with recent density estimates reported from smaller sub-regions within the Scotia Sea. Design-based distance sampling analyses resulted in an estimated total fin whale abundance of 53,873 (CV = 0.15, 95% CI 40,233–72,138), while a density surface model resulted in a slightly lower estimate of 50,837 (CV: 0.136, 95% CI 38,966–66,324). These estimates are at least an order of magnitude greater than the previous estimate from the same region based on the IDCR/SOWER-2000 data, suggesting that fin whales are undergoing a substantial abundance increase in the South Atlantic. This may have important implications for the assessment of cetacean population trends, but also for CCAMLRs spatial overlap analysis process and efforts to implement a Feedback Management system for Antarctic krill. Our abundance estimate suggests an annual summer krill consumption by fin whales in the Antarctic Peninsula and Scotia Sea area of 7.97 (95% CI 4.94–11.91) million tonnes, which would represent around 20 times the total krill catch taken by the commercial fishery in Area 48 in the same season, or about 12.7% of the 2019 summer krill standing stock estimated from data collected during the same survey. This highlights the crucial importance of including cetacean krill predators in assessment and management efforts for living marine resources in the Southern Ocean, and particularly stresses the urgent need for a re-appraisal of abundance, distribution and ecological role of Southern Hemisphere fin whales.

Summary: Background: Bacille Calmette-Guérin (BCG) vaccination has off-target (non-specific) effects that are associated with protection against unrelated infections and decreased all-cause mortality in infants. We aimed to determine whether BCG vaccination prevents febrile and respiratory infections in adults. Methods: This randomised controlled phase 3 trial was done in 36 healthcare centres in Australia, Brazil, the Netherlands, Spain, and the United Kingdom. Healthcare workers were randomised to receive BCG-Denmark (single 0.1 ml intradermal injection) or no BCG in a 1:1 ratio using a web-based procedure, stratified by stage, site, age, and presence of co-morbidity. The difference in occurrence of febrile or respiratory illness were measured over 12 months (prespecified secondary outcome) using the intention-to-treat (ITT) population. This trial is registered with ClinicalTrials.gov, NCT04327206. Findings: Between March 30, 2020, and April 1, 2021, 6828 healthcare workers were randomised to BCG-Denmark (n = 3417) or control (n = 3411; no intervention or placebo) groups. The 12-month adjusted estimated risk of ≥1 episode of febrile or respiratory illness was 66.8% in the BCG group (95% CI 65.3%–68.2%), compared with 63.4% in the control group (95% CI 61.8%–65.0%), a difference of +3.4 percentage points (95% CI +1.3% to +5.5%; p 0.002). The adjusted estimated risk of a severe episode (defined as being incapacitated for ≥3 consecutive days or hospitalised) was 19.4% in the BCG group (95% CI 18.0%–20.7%), compared with 18.8% in the control group (95% CI 17.4%–20.2%) a difference of +0.6 percentage points (95% CI −1.3% to +2.5%; p 0.6). Both groups had a similar number of episodes of illness, pneumonia, and hospitalisation. There were three deaths, all in the control group. There were no safety concerns following BCG vaccination. Interpretation: In contrast to the beneficial off-target effects reported following neonatal BCG in infants, a small increased risk of symptomatic febrile or respiratory illness was observed in the 12 months following BCG vaccination in adults. There was no evidence of a difference in the risk of severe disease. Funding: Bill & Melinda Gates Foundation, Minderoo Foundation, Sarah and Lachlan Murdoch, the Royal Children's Hospital Foundation, Health Services Union NSW, the Peter Sowerby Foundation, SA Health, the Insurance Advisernet Foundation, the NAB Foundation, the Calvert-Jones Foundation, the Modara Pines Charitable Foundation, the UHG Foundation Pty Ltd, Epworth Healthcare, the National Health and Medical Research Council, the Swiss National Science Foundation and individual donors.

Summary: Background: The COVID-19 pandemic led to the rapid development and deployment of several highly effective vaccines against SARS-CoV-2. Recent studies suggest that these vaccines may also have off-target effects on the immune system. We sought to determine and compare the off-target effects of the adenovirus vector ChAdOx1-S (Oxford-AstraZeneca) and modified mRNA BNT162b2 (Pfizer-BioNTech) vaccines on immune responses to unrelated pathogens. Methods: Prospective sub-study within the BRACE trial. Blood samples were collected from 284 healthcare workers before and 28 days after ChAdOx1-S or BNT162b2 vaccination. SARS-CoV-2-specific antibodies were measured using ELISA, and whole blood cytokine responses to specific (SARS-CoV-2) and unrelated pathogen stimulation were measured by multiplex bead array. Findings: Both vaccines induced robust SARS-CoV-2 specific antibody and cytokine responses. ChAdOx1-S vaccination increased cytokine responses to heat-killed (HK) Candida albicans and HK Staphylococcus aureus and decreased cytokine responses to HK Escherichia coli and BCG. BNT162b2 vaccination decreased cytokine response to HK E. coli and had variable effects on cytokine responses to BCG and resiquimod (R848). After the second vaccine dose, BNT162b2 recipients had greater specific and off-target cytokine responses than ChAdOx1-S recipients. Interpretation: ChAdOx1-S and BNT162b2 vaccines alter cytokine responses to unrelated pathogens, indicative of potential off-target effects. The specific and off-target effects of these vaccines differ in their magnitude and breadth. The clinical relevance of these findings is uncertain and needs further study. Funding: Bill & Melinda Gates Foundation, National Health and Medical Research Council, Swiss National Science Foundation and the Melbourne Children’s. BRACE trial funding is detailed in acknowledgements.

Seven passive acoustic surveys for marine mammal sounds were conducted by deploying sonobuoys along ship tracks during Antarctic voyages spanning years 2006-2021. These surveys included nearly 330° of longitude throughout Antarctic (south of 60°S) and sub-Antarctic (between 50-60°S) latitudes. Here, we summarise the presence of calls from critically endangered Antarctic blue whales (Balaenoptera musculus intermedia) detected on all seven of these surveys. We describe and compare the spatial distribution of detections of three different types of Antarctic blue whale calls: unit-A, Z-calls, and D-calls. Three sets of voyages partially overlapped spatially but in different years, providing three regions (Indian Sector, Dumont d’Urville Sea, Ross Sea) to investigate differences over time for these three different call types. The proportion of sonobuoys with calls present was significantly higher in the more recent years for seven of the 15 combinations of years, regions, and call type. The proportion of sonobuoys with calls present was significantly lower only for one of the 15 combinations (unit A in the Ross Sea between 2015 vs 2017), and not significantly different for the remaining seven pairwise comparisons. We discuss possible explanations for these observations including: differences in probability of detection, whale behaviour, whale distribution, and abundance. These explanations are not mutually exclusive and cannot yet be resolved without application of complex analytical methods and collection of additional data. Lastly, we discuss future work that could help clarify the contributions of each of these potential drivers of acoustic detection. We propose continued acoustic data collection, application of new analytical methods, and collection of other synergistic data from Antarctic blue whales on their feeding grounds as a basis for future work on this species. This could provide a cost effective and holistic means of monitoring their status after the effects of 20th century industrial whaling, as well as their responses to natural and anthropogenic changes to their main prey, Antarctic krill, and a changing climate.

Abstract The diagnosis and management of Achilles tendon ailments continue to be widely discussed by the scientific community. Also, the nomenclature used to describe the tendinopathic lesion in patients changed over the last decades together with the evolution in the knowledge of the physiopathology of Achilles tendinopathy, and unfortunately, through ignorance and possibly laziness, confusion still abounds. To emerge from these foggy paths, some clarifications are still necessary. The present Editorial tries to clarify some of these issues.

Abstract Aerial surveys are frequently used to estimate the abundance of marine mammals, but their accuracy is dependent upon obtaining a measure of the availability of animals to visual detection. Existing methods for characterizing availability have limitations and do not necessarily reflect true availability. Here, we present a method of using small, vessel‐launched, multi‐rotor Unoccupied Aerial Vehicles (UAVs, or drones) to collect video of dolphins to characterize availability and investigate error surrounding group size estimates. We collected over 20 h of aerial video of dive‐surfacing behaviour across 32 encounters with Australian humpback dolphins Sousa sahulensis off north‐western Australia. Mean surfacing and dive periods were 7.85 sec (se = 0.26) and 39.27 sec (se = 1.31) respectively. Dolphin encounters were split into 56 focal follows of consistent group composition to which example approaches to estimating availability were applied. Non‐instantaneous availability estimates, assuming a 7 sec observation window, ranged between 0.22 and 0.88, with a mean availability of 0.46 (CV = 0.34). Availability tended to increase with increasing group size. We found a downward bias in group size estimation, with true group size typically one individual more than would have been estimated by a human observer during a standard aerial survey. The variability of availability estimates between focal follows highlights the importance of sampling across a variety of group sizes, compositions and environmental conditions. Through data re‐sampling exercises, we explored the influence of sample size on availability estimates and their precision, with results providing an indication of target sample sizes to minimize bias in future research. We show that UAVs can provide an effective and relatively inexpensive method of characterizing dolphin availability with several advantages over existing approaches. The example estimates obtained for humpback dolphins are within the range of values obtained for other shallow‐water, small cetaceans, and will directly inform a government‐run program of aerial surveys in the region.

There are many advantages to transitioning from conducting marine wildlife surveys via human observers onboard light-aircraft, to capturing aerial imagery using drones. However, it is important to maintain the validity of long-term data series whilst transitioning from observer to imagery surveys. We need to understand how the detection rates of target species in images compare to those collected from observers in piloted aircraft, and the factors influencing detection rates from each platform. We conducted trial ScanEagle drone surveys of dugongs in Shark Bay, Western Australia, covering the full extent of the drone’s range (∼100 km), concurrently with observer surveys, with the drone flying above or just behind the piloted aircraft. We aimed to test the assumption that drone imagery could provide comparable detection rates of dugongs to human observers when influenced by same environmental conditions. Overall, the dugong sighting rate (i.e., count of individual dugongs) was 1.3 (95% CI [0.98–1.84]) times higher from the drone images than from the observers. The group sighting rate was similar for the two platforms, however the group sizes detected within the drone images were significantly larger than those recorded by the observers, which explained the overall difference in sighting rates. Cloud cover appeared to be the only covariate affecting the two platforms differently; the incidence of cloud cover resulted in smaller group sizes being detected by both platforms, but the observer group sizes dropped much more dramatically (by 71% (95% CI [31–88]) compared to no cloud) than the group sizes detected in the drone images (14% (95% CI [−28–57])). Water visibility and the Beaufort sea state also affected dugong counts and group sizes, but in the same way for both platforms. This is the first direct simultaneous comparison between sightings from observers in piloted aircraft and a drone and demonstrates the potential for drone surveys over a large spatial-scale.

Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was $216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with $195 for low FiO2 leading to a −$11 (95% CI: −$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was $1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this.

Abstract Integrable string sigma models on AdS3 backgrounds with 16 supersymmetries have the distinguishing feature that their superisometry group is a direct product. As a result the deformation theory of these models is particularly rich since the two supergroups in the product can be deformed independently. We construct bi-η and bi-λ deformations of two classes of ℤ 4 permutation supercoset sigma models, which describe sectors of the Green-Schwarz and pure-spinor string worldsheet theories on type II AdS3 backgrounds with pure R-R flux. We discuss an important limit of these models when one supergroup is undeformed. The associated deformed supergravity background should preserve 8 supersymmetries and is expected to have better properties than the full bi-deformation. As a step towards investigating the quantum properties of these models, we study the two-loop RG flow of the bosonic truncation of the bi-λ deformation.

Abstract We present a simple, new method for the 1-loop renormalization of integrable σ-models. By treating equations of motion and Bianchi identities on an equal footing, we derive ‘universal’ formulae for the 1-loop on-shell divergences, generalizing case-by-case computations in the literature. Given a choice of poles for the classical Lax connection, the divergences take a theory-independent form in terms of the Lax currents (the residues of the poles), assuming a ‘completeness’ condition on the zero-curvature equations. We compute these divergences for a large class of theories with simple poles in the Lax connection. We also show that ℤ T coset models of ‘pure-spinor’ type and their recently constructed η- and λ-deformations are 1-loop renormalizable, and 1-loop scale-invariant when the Killing form vanishes.

Abstract An automated algorithm for passive acoustic detection of blue whale D‐calls was developed based on established deep learning methods for image recognition via the DenseNet architecture. The detector was trained on annotated acoustic recordings from the Antarctic, and performance of the detector was assessed by calculating precision and recall using a separate independent dataset also from the Antarctic. Detections from both the human analyst and automated detector were then inspected by an independent judge to identify any calls missed by either approach and to adjudicate whether the apparent false‐positive detections from the automated approach were actually true positives. A final performance assessment was conducted using double‐observer methods (via a closed‐population Huggins mark–recapture model) to assess the probability of detection of calls by both the human analyst and automated detector, based on the assumption of false‐positive‐free adjudicated detections. According to our double‐observer analysis, the automated detector showed superior performance with higher recall and fewer false positives than the original human analyst, and with performance similar to existing top automated detectors. To understand the performance of both detectors we inspected the time‐series and signal‐to‐noise ratio (SNR) of detections for the test dataset, and found that most of the advantages from the automated detector occurred at low and medium SNR.

The INterplanetary Flux ROpe Simulator (INFROS) is an observationally constrained analytical model dedicated to forecasting the strength of the southward component ( Bz ) of the magnetic field embedded in interplanetary coronal mass ejections (ICMEs). In this work, we validate the model for six ICMEs sequentially observed by two radially aligned spacecraft positioned at different heliocentric distances. The six selected ICMEs in this study comprise cases associated with isolated coronal mass ejection (CME) evolution as well as those interacting with high-speed streams (HSSs) and high-density streams (HDSs). For the isolated CMEs, our results show that the model outputs at both spacecraft are in good agreement with in situ observations. However, for most of the interacting events, the model correctly captures the CME evolution only at the inner spacecraft. Due to the interaction with HSSs and HDSs, which in most cases occurred at heliocentric distances beyond the inner spacecraft, the ICME evolution no longer remains self-similar. Consequently, the model underestimates the field strength at the outer spacecraft. Our findings indicate that constraining the INFROS model with inner-spacecraft observations significantly enhances the prediction accuracy at the outer spacecraft for the three events undergoing self-similar expansion, achieving a 90% correlation between observed and predicted Bz profiles. This work also presents a quantitative estimation of the ICME magnetic field enhancement due to interaction which may lead to severe space weather. We conclude that the assumption of self-similar expansion provides a lower limit to the magnetic field strength estimated at any heliocentric distance, based on the remote-sensing observations.

Decameter hectometric (DH; 1–14 MHz) type IV radio bursts are produced by flare-accelerated electrons trapped in postflare loops or the moving magnetic structures associated with the coronal mass ejections (CMEs). From a space weather perspective, it is important to systematically compile these bursts, explore their spectrotemporal characteristics, and study the associated CMEs. We present a comprehensive catalog of DH type IV bursts observed by the Radio and Plasma Wave Investigation instruments on board the Wind and Solar TErrestrial RElations Observatory spacecraft covering the period of white-light CME observations by the Large Angle and Spectrometric Coronagraph on board the Solar and Heliospheric Observatory mission between 1996 November and 2023 May. The catalog has 139 bursts, of which 73% are associated with a fast (>900 km s ^−1 ) and wide (>60°) CME, with a mean CME speed of 1301 km s ^−1 . All DH type IV bursts are white-light CME-associated, with 78% of the events associated with halo CMEs. The CME source latitudes are within ±45°. Seventy-seven events had multiple-vantage-point observations from different spacecraft, letting us explore the impact of the line of sight on the dynamic spectra. For 48 of the 77 events, there were good data from at least two spacecraft. We find that, unless occulted by nearby plasma structures, a type IV burst is best viewed when observed within a ±60° line of sight. Also, bursts with a duration above 120 minutes have source longitudes within ±60°. Our inferences confirm the inherent directivity in the type IV emission. Additionally, the catalog forms a Sun-as-a-star DH type IV burst database.

During their propagation, coronal mass ejections (CMEs) and prominences sometimes display a nonradial motion. During the years after the solar minimum, the CME central position angle tended to be offset closer to the equator compared to that of the associated prominence eruptions (PE). No such effect was observed during solar maximum. The purpose of this paper is to investigate the latitudinal offsets of CMEs with respect to their source regions. We study 256 events from SC 24 and SC 25, listed in the Coordinate Data Analysis Workshop Data Center. We analyzed the CMES radial offset from the associated PEs by comparing their latitudes in the plane of the sky. This work is an extension of the previous work by Gopalswamy et al., but with an independent data set. We have confirmed the systematic equatorward offset of CME from the solar source region for the rising phase of Solar Cycle 25. Our analysis of the relation between CME linear speed and PE-CME latitudinal offset indicated that the velocities of the deflected CMEs are mainly in the range of 200 and 800 km s ^−1 . In this study, we compared the nonradial offsets for the rising and decay phases of SC 24 and our analysis has shown that during the decay phase more events deflected toward the pole can be observed. The observed variation is attributed to the presence of a substantial number of low-latitude coronal holes during the decay phase and to the influence from nearby active regions.

There continue to be open questions regarding the solar wind and coronal mass ejections (CMEs). For example: how do magnetic fields within CMEs and corotating/stream interaction regions (CIRs/SIRs) evolve in the inner heliosphere? What is the radially distributed magnetic profile of shock-driving CMEs? What is the internal magnetic structure of CMEs that cause magnetic storms? It is clear that these questions involve the magnetic configurations of solar wind and transient interplanetary plasma structures, for which we have limited knowledge. In order to better understand the origin of the magnetic field variability in steady-state structures and transient events, it is necessary to probe the magnetic field in Earth-directed structures/disturbances. This is the goal of the Multiview Observatory for Solar Terrestrial Science (MOST) mission (Gopalswamy et al., 2022). For MOST to answer the aforementioned questions, we propose the instrument concept of the Faraday Effect Tracker of Coronal and Heliospheric structures (FETCH), a simultaneous quad-line-of-sight polarization radio remote-sensing instrument. With FETCH, spacecraft radio beams passing through the Sun–Earth line offer the possibility of obtaining information of plasma conditions via analysis of radio propagation effects such as Faraday rotation and wave dispersion, which provide information of the magnetic field and total electron content (TEC). This is the goal of the FETCH instrument, one of ten instruments proposed to be hosted on the MOST mission. The MOST mission will provide an unprecedented opportunity to achieve NASA’s heliophysics science goal to “explore and characterize the physical processes in the space environment from the Sun” (Gopalswamy et al., 2022).

Many populations of southern hemisphere baleen whales are recovering and are again becoming dominant consumers in the Southern Ocean. Key to understanding the present and future role of baleen whales in Southern Ocean ecosystems is determining their abundance on foraging grounds. Distance sampling is the standard method for estimating baleen whale abundance but requires specific logistic requirements which are rarely achieved in the remote Southern Ocean. We explore the potential use of tourist vessel-based sampling as a cost-effective solution for conducting distance sampling surveys for baleen whales in the Southern Ocean. We used a dataset of tourist vessel locations from the southwest Atlantic sector of the Southern Ocean and published knowledge from Southern Ocean sighting surveys to determine the number of tourist vessel voyages required for robust abundance estimates. Second, we simulated the abundance and distributions of four baleen whale species for the study area and sampled them with both standardized line transect surveys and non-standardized tourist vessel-based surveys, then compared modeled abundance and distributions from each survey to the original simulation. For the southwest Atlantic, we show that 12-22 tourist vessel voyages are likely required to estimate abundance for humpback and fin whales, with relative estimates for blue, sei, Antarctic minke, and southern right whales. Second, we show tourist vessel-based surveys outperformed standardized line transect surveys at reproducing simulated baleen whale abundances and distribution. These analyses suggest tourist vessel-based surveys are a viable method for estimating baleen whale abundance in remote regions. For the southwest Atlantic, the relatively cost-effective nature of tourist vessel-based survey and regularity of tourist vessel voyages could allow for annual and intra-annual estimates of abundance, a fundamental improvement on current methods, which may capture spatiotemporal trends in baleen whale movements on forging grounds. Comparative modeling of sampling methods provided insights into the behavior of general additive model-based abundance modeling, contributing to the development of detailed guidelines of best practices for these approaches. Through successful engagement with tourist company partners, this method has the potential to characterize abundance across a variety of marine species and spaces globally, and deliver high-quality scientific outcomes relevant to management organizations.

Abstract Background Internationally, people in prison should receive a standard of healthcare provision equivalent to people living in the community. Yet efforts to assess the quality of healthcare through the use of quality indicators or performance measures have been much more widely reported in the community than in the prison setting. This review aims to provide an overview of research undertaken to develop quality indicators suitable for prison healthcare. Methods An international scoping review of articles published in English was conducted between 2004 and 2021. Searches of six electronic databases (MEDLINE, CINAHL, Scopus, Embase, PsycInfo and Criminal Justice Abstracts) were supplemented with journal searches, author searches and forwards and backwards citation tracking. Results Twelve articles were included in the review, all of which were from the United States. Quality indicator selection processes varied in rigour, and there was no evidence of patient involvement in consultation activities. Selected indicators predominantly measured healthcare processes rather than health outcomes or healthcare structure. Difficulties identified in developing performance measures for the prison setting included resource constraints, data system functionality, and the comparability of the prison population to the non-incarcerated population. Conclusions Selecting performance measures for healthcare that are evidence-based, relevant to the population and feasible requires rigorous and transparent processes. Balanced sets of indicators for prison healthcare need to reflect prison population trends, be operable within data systems and be aligned with equivalence principles. More effort needs to be made to meaningfully engage people with lived experience in stakeholder consultations on prison healthcare quality. Monitoring healthcare structure, processes and outcomes in prison settings will provide evidence to improve care quality with the aim of reducing health inequalities experienced by people living in prison.

Abstract Background Numerous conditions are grouped under the generic term exercise‐induced leg pain (EILP), yet clear diagnostic guidelines are lacking. This scoping review was conducted to clarify the definition and diagnostic criteria of nine commonly occurring EILP conditions. Methods Three online databases were searched from inception to April 2022 for any English language original manuscripts identifying, describing, or assessing the clinical presentation and diagnostic criteria of the nine most common conditions that cause EILP. We included manuscripts considering all adults with any reported diagnostic criteria for EILP in any setting. Methodological quality was assessed using the Mixed Method Appraisal tool. Condition definitions were identified and categorised during data charting. Twenty‐five potential elements of the history, 24 symptoms, 41 physical signs, 21 investigative tools, and 26 overarching diagnostic criteria, were identified and coded as counts of recommendation per condition, alongside qualitative analysis of the clinical reasoning. Condition definitions were constructed with 11 standardised elements based on recent consensus exercises for other conditions. Results One hundred nineteen retained manuscripts, of which 18 studied multiple conditions, had a median quality of 2/5. A combination of the history, pain location, symptoms, physical findings, and investigative modalities were fundamental to identify each sub‐diagnosis alongside excluding differentials. The details differed markedly for each sub‐diagnosis. Fifty‐nine manuscripts included data on chronic exertional compartment syndrome (CECS) revealing exertional pain (83% history), dull aching pain (76% symptoms), absence of physical signs (78% physical findings) and elevated intercompartment pressure (93% investigative modality). Twenty‐one manuscripts included data on medial tibial stress syndrome (MTSS), revealing persistent pain upon discontinuation of activity (81% history), diffuse medial tibial pain (100% pain location), dull ache (86% symptoms), diffuse tenderness (95% physical findings) and MRI for exclusion of differentials (62% investigative modality). Similar analyses were performed for stress fractures (SF, n = 31), popliteal artery entrapment syndrome (PAES, n = 22), superficial peroneal nerve entrapment syndrome (SPNES, n = 15), lumbar radiculopathy (n = 7), accessory/low‐lying soleus muscle syndrome (ALLSMS, n = 5), myofascial tears (n = 3), and McArdle's syndrome (n = 2). Conclusion Initial diagnostic frameworks and definitions have been developed for each condition of the nine most common conditions that cause EILP, suitable for clinical consideration and consensus confirmation.

It is known that the weak state of the heliosphere due to diminished solar activity in cycle 24 backreacted on coronal mass ejections (CMEs) to make them appear wider for a given speed. One of the consequences of the weak state of the heliosphere is that more CMEs appear as halo CMEs (HCMEs), and halos are formed at shorter heliocentric distances. Current predictions for the strength of solar cycle (SC) 25 range from half to twice the strength of SC 24. We compare the HCME occurrence rate and other properties during the rise phase of cycles 23, 24, and 25 to weigh in on the strength of SC 25. We find that HCME and solar wind properties in SC 25 are intermediate between SCs 23 and 24, but closer to SC 24. The HCME occurrence rate, normalized to the sunspot number, is higher in SCs 24 and 25 than in SC 23. The solar wind total pressure in SC 25 is ∼35% smaller than that in SC 23. Furthermore, the occurrence rates of high-energy solar energetic particle events and intense geomagnetic storms are well below the corresponding values in SC 23, but similar to those in SC 24. We conclude that cycle 25 is likely to be similar to or slightly stronger than cycle 24, in agreement with polar-field precursor methods for cycle 25 prediction.

Abstract Objective The purpose of this study was to develop a model using dose volume histogram (DVH) and dosiomic features to predict the risk of radiation pneumonitis (RP) in the treatment of esophageal cancer with radiation therapy and to compare the performance of DVH and dosiomic features after adjustment for the effect of fractionation by correcting the dose to the equivalent dose in 2 Gy (EQD2). Materials and methods DVH features and dosiomic features were extracted from the 3D dose distribution of 101 esophageal cancer patients. The features were extracted with and without correction to EQD2. A predictive model was trained to predict RP grade ≥ 1 by logistic regression with L1 norm regularization. The models were then evaluated by the areas under the receiver operating characteristic curves (AUCs). Result The AUCs of both DVH-based models with and without correction of the dose to EQD2 were 0.66 and 0.66, respectively. Both dosiomic-based models with correction of the dose to EQD2 (AUC = 0.70) and without correction of the dose to EQD2 (AUC = 0.71) showed significant improvement in performance when compared to both DVH-based models. There were no significant differences in the performance of the model by correcting the dose to EQD2. Conclusion Dosiomic features can improve the performance of the predictive model for RP compared with that obtained with the DVH-based model.

Abstract This review article summarizes the advancement in the studies of Earth-affecting solar transients in the last decade that encompasses most of solar cycle 24. It is a part of the effort of the International Study of Earth-affecting Solar Transients (ISEST) project, sponsored by the SCOSTEP/VarSITI program (2014–2018). The Sun-Earth is an integrated physical system in which the space environment of the Earth sustains continuous influence from mass, magnetic field, and radiation energy output of the Sun in varying timescales from minutes to millennium. This article addresses short timescale events, from minutes to days that directly cause transient disturbances in the Earth’s space environment and generate intense adverse effects on advanced technological systems of human society. Such transient events largely fall into the following four types: (1) solar flares, (2) coronal mass ejections (CMEs) including their interplanetary counterparts ICMEs, (3) solar energetic particle (SEP) events, and (4) stream interaction regions (SIRs) including corotating interaction regions (CIRs). In the last decade, the unprecedented multi-viewpoint observations of the Sun from space, enabled by STEREO Ahead/Behind spacecraft in combination with a suite of observatories along the Sun-Earth lines, have provided much more accurate and global measurements of the size, speed, propagation direction, and morphology of CMEs in both 3D and over a large volume in the heliosphere. Many CMEs, fast ones, in particular, can be clearly characterized as a two-front (shock front plus ejecta front) and three-part (bright ejecta front, dark cavity, and bright core) structure. Drag-based kinematic models of CMEs are developed to interpret CME propagation in the heliosphere and are applied to predict their arrival times at 1 AU in an efficient manner. Several advanced MHD models have been developed to simulate realistic CME events from the initiation on the Sun until their arrival at 1 AU. Much progress has been made on detailed kinematic and dynamic behaviors of CMEs, including non-radial motion, rotation and deformation of CMEs, CME-CME interaction, and stealth CMEs and problematic ICMEs. The knowledge about SEPs has also been significantly improved. An outlook of how to address critical issues related to Earth-affecting solar transients concludes this article.

Abstract We consider a class of 2d σ-models on products of group spaces that provide new examples of a close connection between integrability and stability under the RG flow. We first study the integrable G × G model derived from the affine Gaudin construction (for which the 1-loop β-functions were found in arXiv:2010.07879 ) and show that its condition of integrability is preserved also by the 2-loop RG flow. We then investigate the RG flow in the gauged G × G/H model, in particular the integrable T 1,1 model found in arXiv:2010.05573 . We also construct a new class of integrable G × G/H models in the case when the subgroup H is abelian. In the simplest case of G = SU 2 , H = U 1 this leads to an integrable σ-model on the T 1,q space (with a particular B-field). This model is also shown to be stable under the 2-loop RG flow, and we relate this property to its invariance under T-duality in an isometric U 1 direction. This T 1,q model may be interpreted as an integrable deformation of the GMM model (of two coupled WZW theories with generic levels) away from the conformal point.

ObjectivesThe purpose of this study was to investigate the stability of dosiomic features under random interfractional error. We investigated the differences in the values of features with different fractions and the error in the values of dosiomic features under interfractional error.Material and MethodsThe isocenters of the treatment plans of 15 lung cancer patients were translated by a maximum of ±3 mm in each axis with a mean of (0, 0, 0) and a standard deviation of (1.2, 1.2, 1.2) mm in the x, y, and z directions for each fraction. A total of 81 dose distributions for each patient were then calculated considering four fraction number groups (2, 10, 20, and 30). A total of 93 dosiomic features were extracted from each dose distribution in four different regions of interest (ROIs): gross tumor volume (GTV), planning target volume (PTV), heart, and both lungs. The stability of dosiomic features was analyzed for each fraction number group by the coefficient of variation (CV) and intraclass correlation coefficient (ICC). The agreements in the means of dosiomic features among the four fraction number groups were tested by ICC. The percent differences (PD) between the dosiomic features extracted from the original dose distribution and the dosiomic features extracted from the dose distribution with interfractional error were calculated.ResultsEleven out of 93 dosiomic features demonstrated a large CV (CV ≥ 20%). Overall CV values were highest in GTV ROIs and lowest in lung ROIs. The stability of dosiomic features decreased as the total number of fractions decreased. The ICC results showed that five out of 93 dosiomic features had an ICC lower than 0.75, which indicates intermediate or poor stability under interfractional error. The mean dosiomic feature values were shown to be consistent with different numbers of fractions (ICC ≥ 0.9). Some of the dosiomic features had PD greater than 50% and showed different PD values with different numbers of fractions.ConclusionSome dosiomic features have low stability under interfractional error. The stability and values of the dosiomic features were affected by the total number of fractions. The effect of interfractional error on dosiomic features should be considered in further studies regarding dosiomics for reproducible results.

Background: The collection of patient experience feedback (PEF) has seen a marked global increase in the past decade. Research about PEF has concentrated mainly on hospital settings albeit a recent interest in primary care. There has been minimal research about PEF in the prison healthcare setting. The aim of this study was to explore the role of prison PEF, the different forms it might take and the perceptions of healthcare staff and people in prison. Methods: Qualitative face to face interview study involving 24 participants across two prisons (male and female) in the North of England, involving 12 healthcare staff and 12 patients. Framework analysis was undertaken. Results: PEF sources were variable, from informal and verbal through to formal and written. The willingness of people in prison to give PEF related to whether they felt sufficiently comfortable to raise concerns, with some feeling too frightened and having apprehension about anonymity. It was viewed as disheartening to give PEF but not be informed of any outcome. Healthcare staff opinions about PEF were divergent but they found PEF unhelpful when it was about prison regime issues rather than healthcare. Suggestions for improving the PEF process were put forward and included accessibility, anonymity and digitalisation. Conclusions: This is the first study to report findings about prison PEF. There are broad similarities between our findings and research examining hospital-based PEF. Prison healthcare services seem to be listening to patients but the ways in which PEF is collected, considered and used could be improved. Experience Framework This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework. (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens.

For decades, observations of Faraday rotation have provided unique insights into the plasma density and magnetic field structure of the solar wind. Faraday rotation (FR) is the rotation of the plane of polarization when linearly polarized radiation propagates through a magnetized plasma, such as the solar corona, coronal mass ejection (CME), or stream interaction region. FR measurements are very versatile: they provide a deeper understanding of the large-scale coronal magnetic field over a range of heliocentric distances (especially ≈1.5 to 20 R⊙) not typically accessible to in situ spacecraft observations; detection of small-timescale variations in FR can provide information on magnetic field fluctuations and magnetohydrodynamic wave activity; and measurement of differential FR can be used to detect electric currents. FR depends on the integrated product of the plasma density and the magnetic field component along the line of sight to the observer; historically, models have been used to distinguish between their contributions to FR. In the last two decades, though, new methods have been developed to complement FR observations with independent measurements of the plasma density based on the choice of background radio source: calculation of the dispersion measure (pulsars), measurement of Thomson scattering brightness (radio galaxies), and application of radio ranging and apparent-Doppler tracking (spacecraft). New methods and new technology now make it possible for FR observations of solar wind structures to return not only the magnitude of the magnetic field, but also the full vector orientation. In the case of a CME, discerning the internal magnetic flux rope structure is critical for space weather applications.

PurposeThe aim was to investigate the advantages of dosiomic and radiomic features over traditional dose-volume histogram (DVH) features for predicting the development of radiation pneumonitis (RP), to validate the generalizability of dosiomic and radiomic features by using features selected from an esophageal cancer dataset and to use these features with a lung cancer dataset.Materials and MethodsA dataset containing 101 patients with esophageal cancer and 93 patients with lung cancer was included in this study. DVH and dosiomic features were extracted from 3D dose distributions. Radiomic features were extracted from pretreatment CT images. Feature selection was performed using only the esophageal cancer dataset. Four predictive models for RP (DVH, dosiomic, radiomic and dosiomic + radiomic models) were compared on the esophageal cancer dataset. We further used a lung cancer dataset for the external validation of the selected dosiomic and radiomic features from the esophageal cancer dataset. The performance of the predictive models was evaluated by the area under the curve (AUC) of the receiver operating characteristic curve (ROCAUC) and the AUC of the precision recall curve (PRAUC) metrics.ResultThe ROCAUCs and PRAUCs of the DVH, dosiomic, radiomic and dosiomic + radiomic models on esophageal cancer dataset were 0.67 ± 0.11 and 0.75 ± 0.10, 0.71 ± 0.10 and 0.77 ± 0.09, 0.71 ± 0.11 and 0.79 ± 0.09, and 0.75 ± 0.10 and 0.81 ± 0.09, respectively. The predictive performance of the dosiomic- and radiomic-based models was significantly higher than that of the DVH-based model with respect to esophageal cancer. The ROCAUCs and PRAUCs of the DVH, dosiomic, radiomic and dosiomic + radiomic models on the lung cancer dataset were 0.64 ± 0.18 and 0.37 ± 0.20, 0.67 ± 0.17 and 0.37 ± 0.20, 0.67 ± 0.16 and 0.45 ± 0.23, and 0.68 ± 0.16 and 0.44 ± 0.22, respectively. On the lung cancer dataset, the predictive performance of the radiomic and dosiomic + radiomic models was significantly higher than that of the DVH-based model. However, the PRAUC of the dosiomic-based model showed no significant difference relative to the corresponding RP prediction performance on the lung cancer dataset.ConclusionThe results suggested that dosiomic and CT radiomic features could improve RP prediction in thoracic radiotherapy. Dosiomic and radiomic feature knowledge might be transferrable from esophageal cancer to lung cancer.

Thailand’s textile industry is the traditional industrial sector which shows the continuous increase in energy consumption and Energy Intensity (EI) index, primarily on electrical and thermal energy. This paper aims to track the implementation of energy conservation measures through the textile industry to meet Thailand’s target of Energy Efficiency Plan 2015- a=2036 (EEP2015), Alternative Energy Development Plan 2015–2036 (AEDP2015) and NDC Road,map by absolute and intensity indicators. As the analyst indicates that energy consumption in this sector will grow while EI can be reduced. 4 Scenarios of energy conservation and the implementation of renewable energy in the sector are studied; (1) BAU, (2) switching to high-efficiency equipment and waste heat recovery, (3) solar PV utilization, and (4) the combination of the equipment switching, heat recovery, and Solar PV utilization. It is deduced that, in 2036, Energy consumption and EI of scenario 2 and 4 is approximately reduced for 16.63% in comparison with BAU which implies the reduction of 373.41 ktoe energy consumption. This is well over the EEP2015 target by 9.94% as solar PV utilization plays small influences. Solar PV systems alone cannot primarily help the textile industry to meet AEDP2015 target. It is recommended that textile industry should implement more renewable-related measures or the alteration of policy and technology is needed. In the case of the environment impacts, GHG emission and GHG mitigation show consistent results with the energy consumption. In 2036, scenario 1 suggests GHG emission of 13,482.58 Gg CO2-eq and GHG Intensity (GHGI) of 29.54 Gg CO2-eq/billion baht. Scenario 2, 3 and 4 possibly reduce GHG emission and GHGI in 2036 as 16.67%, 1.15% and 17.82% above the BAU, respectively. The target of NDC roadmap is to mitigate GHG within 2030. Scenario 4 can mitigate 53.75% over the target while scenario 2 can mitigate more than 41.11%. Keywords: Textile industry, Energy conservation, GHG mitigation, Energy efficiency, Organic Rankine Cycle

One of the most important mechanisms to improve the sustainability of each country are monitoring the performance of the industries not only in the energy perspective but also the environmental point of view and setting the improvement goal. This study presents an indicator that can reflect both of energy consumption and greenhouse gas emission simultaneously called energy-environmental performance index. The cement industry is selected as the case study due to its important role in Thai’s economic system and because it has high energy and greenhouse gas intensities. The performance of the sector during 2010–2016 are evaluated from the statistical data of volume produced, gross outputs in monetary value, energy consumption, raw material-to-clinker ratio, clinker-to-cement ratio and composition of clinker. The result shows that the energy-environmental performance index under the current situation of cement sector is 0.70. This is the average performance for the sector-level and can be used as the benchmarking for the company in the same industry. Since all data required for the calculation are the basic data for most companies, it means that the company can estimate its performance at the company level as well. Besides, this study also uses the statistical data and results in 2010–2016 to forecast the baseline performance in 2025 and then uses the baseline performance including target from the energy conservation plan and greenhouse gas mitigation plan to estimate the performance target. It could be found that the energy-environmental performance target of cement industry in 2025 is 0.75. Keywords: Cement industry, Energy performance, Environmental performance, Integrated indicator

Coronal mass ejections (CMEs) are subject to changes in their direction of propagation, tilt, and other properties. This is because CMEs interact with the ambient solar wind and other large-scale magnetic field structures. In this work, we report on the observations of the 2012 October 5 stealth CME using coronagraphic and heliospheric images. We find clear evidence of a continuous rotation of the CME, i.e., an increase in the tilt angle, estimated using the graduated cylindrical shell (GCS) reconstruction at different heliocentric distances, up to 58 R _⊙ . We find a further increase in the tilt at L1 estimated from the toroidal and cylindrical flux rope fitting on the in situ observations of interplanetary magnetic field (IMF) and solar wind parameters. This study highlights the importance of observations of Heliospheric Imager (HI), on board the Solar Terrestrial Relations Observatory. In particular, the GCS reconstruction of CMEs in the HI field of view promises to bridge the gap between the near-Sun and in situ observations at the L1. The changes in the CME tilt have significant implications for the space weather impact of stealth CMEs.

Coronal mass ejections (CMEs) can generate the most severe geomagnetic disturbances. One of the most critical factors affecting a CME’s geoeffectiveness is its trajectory. It is crucial to determine whether and when CME will hit Earth. It is commonly assumed that CMEs experience a deflection of propagation in the corona and in interplanetary space. In this study, we analyze more than 14,000 CMEs listed in the Coordinate Data Analysis Workshop (CDAW) catalog during 1996–2022 to estimate their deflection in the Large and Spectrometric Coronagraph field of view (LFOV). In our statistical analysis, the deflection was determined using the CME height–time measurements listed in the CDAW catalog. We have shown that, in the solar corona, CME deflection is a common phenomenon, heavily influenced by solar activity cycles as well as phases of these cycles. We have demonstrated that during periods of solar activity minima the deflection of CMEs is mostly toward the equator, and during periods of maxima it is mostly toward the poles. This general trend of deflection is further modified by the specific structure of the magnetic field generated during successive cycles of solar activity (e.g., the asymmetry between the hemispheres). A systematic increase in deflection with time was also recognized. We have also found that the deflection increases linearly with the distance from the Sun in the LFOV (the line slope is 0.5).

The sustained gamma-ray emission (SGRE) from the Sun is a prolonged enhancement of >100 MeV gamma-ray emission that extends beyond the flare impulsive phase. The origin of the >300 MeV protons resulting in SGRE is debated, with both flares and shocks driven by coronal mass ejections (CMEs) being the suggested sites of proton acceleration. We compared the near-Sun acceleration and space speed of CMEs with “Prompt” and “Delayed” (SGRE) gamma-ray components. We found that “Delayed”-component-associated CMEs have higher initial accelerations and space speeds than “Prompt Only”-component-associated CMEs. We selected halo CMEs (HCMEs) associated with type II radio bursts (shock-driving HCMEs) and compared the average acceleration and space speed between HCME populations with or without SGRE events, major solar energetic particle (SEP) events, metric, or decameter-hectometric (DH) type II radio bursts. We found that the SGRE-producing HCMEs associated with a DH type II radio burst and/or a major SEP event have higher space speeds and especially initial accelerations than those without an SGRE event. We estimated the radial distances and speeds of the CME-driven shocks at the end time of the 2012 January 23 and March 7 SGRE events using white-light images of STEREO Heliospheric Imagers and radio dynamic spectra of Wind WAVES. The shocks were at the radial distances of 0.6–0.8 au and their speeds were high enough (≈975 km s ^−1 and ≈750 km s ^−1 , respectively) for high-energy particle acceleration. Therefore, we conclude that our findings support the CME-driven shock as the source of >300 MeV protons.

Abstract Following arXiv:1907.04737 , we continue our investigation of the relation between the renormalizability (with finitely many couplings) and integrability in 2d σ- models. We focus on the “λ-model,” an integrable model associated to a group or symmetric space and containing as special limits a (gauged) WZW model and an “interpolating model” for non-abelian duality. The parameters are the WZ level k and the coupling λ, and the fields are g, valued in a group G, and a 2d vector A± in the corresponding algebra. We formulate the λ-model as a σ-model on an extended G × G × G configuration space (g, h, h ¯ $$ \overline{h} $$ ), defining h and h ¯ $$ \overline{h} $$ by A + = h∂+h −1 , A_ = h ¯ $$ \overline{h} $$ ∂− h ¯ $$ \overline{h} $$ −1. Our central observation is that the model on this extended configuration space is renormalizable without any deformation, with only λ running. This is in contrast to the standard σ-model found by integrating out A ± , whose 2-loop renormalizability is only obtained after the addition of specific finite local counterterms, resulting in a quantum deformation of the target space geometry. We compute the 2-loop β-function of the λ-model for general group and symmetric spaces, and illustrate our results on the examples of SU(2)/U(1) and SU(2). Similar conclusions apply in the non-abelian dual limit implying that non-abelian duality commutes with the RG flow. We also find the 2-loop β-function of a “squashed” principal chiral model.

Abstract Background and aims Diabetes is highly prevalent among individuals with serious mental illness. Managing diabetes in forensic mental health settings presents unique challenges which are under‐reported and poorly understood. This study aimed to explore diabetes care in a medium‐secure setting and identify key areas for improvement. Methods A single case study design used a retrospective chart review. Qualitative interviews and a focus group were analyzed using thematic analysis. Results Prevalence of diabetes was over twice that of the general population and highest in female service users. Evidence suggests limited understanding and lack of diabetes education for staff and service users, and difficulties in accessing external diabetes recourses. Conclusion Constraints inherent to forensic mental health settings contribute to difficulties in accessing external resources and adequate diabetes education. Secure mental health services should adopt a collaborative approach to diabetes care and provide appropriate specialist training to both staff and service users.

The explosion of space weather research since the early 1990s has been partly fueled by the unprecedented, uniform, and extended observations of solar disturbances from space- and ground-based instruments. Coronal mass ejections (CMEs) from closed magnetic field regions and high-speed streams (HSS) from open-field regions on the Sun account for most of the disturbances relevant to space weather. The main consequences of CMEs and HSS are their ability to cause geomagnetic storms and accelerate particles. Particles accelerated by CME-driven shocks can pose danger to humans and their technological structures in space. Geomagnetic storms produced by CMEs and HSS-related stream interaction regions also result in particle energization inside the magnetosphere that can have severe impact on satellites operating in the magnetosphere. Solar flares are another aspect of solar magnetic energy release, mostly characterized by the sudden enhancement in electromagnetic emission at various wavelengths—from radio waves to gamma-rays. Flares are responsible for the sudden ionospheric disturbances and prompt perturbation of Earth’s magnetic field known as magnetic crochet. Nonthermal electrons accelerated during flares can emit intense microwave radiation that can drown spacecraft and radar signals. This review article summarizes major milestones in understanding the connection between solar variability and space weather.