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Objective Methods Results Conclusion Induction of labor (IOL) is a controversial topic in contemporary obstetric practice, with some suggesting that the increase in elective induction (eIOL) as a potential contributor to increasing cesarean delivery (CD) rates. The objectives of this single‐center study were to examine the rates of IOL, trends in indications for IOL, and the contribution of IOL to the overall CD rate at one of Europe's largest obstetric hospitals.This retrospective observational cohort study evaluated the outcomes of patients who were delivered following IOL from 2018 to 2022 inclusive at the largest obstetric hospital in Ireland.A total of 36 938 women (16 155 nulliparous and 20 783 multiparous) were delivered during the 5‐year study period, of whom 8072 nulliparous and 6343 multiparous women underwent IOL. There was a significant increase in rates of induction, increasing from 42% to 57% (P <0.001) in nulliparous women, and from 27% to 33% (P < 0.001) in multiparous women. The highest contributions to the hospital CD rate were from those being induced for ‘fetal’ (5%), spontaneous rupture of membranes (‘SROM’) (4%), and ‘maternal’ (4%) reasons, with the lowest CD rates in the eIOL category (<1%) in both groups.Our data confirm that the rate of IOL is increasing. The contribution of maternal and fetal reasons for IOL to the overall CD rate may reflect increasing numbers of higher‐risk pregnancies. Despite current controversy regarding the role of eIOL, our data do not confirm a significant contribution to either the overall IOL or CD rates in this center. [ABSTRACT FROM AUTHOR]

We present BIOPERIANT12, a regional model configuration of the Southern Ocean (SO) at a mesoscale-resolving 1/12°. This is a stable, ocean–ice–biogeochemical configuration derived from the Nucleus for European Modelling of the Ocean (NEMO) modelling platform. It is specifically designed to investigate questions related to the mean state, seasonal cycle variability and mesoscale processes in the mixed layer and within the upper ocean (<1000 m). In particular, the focus is on understanding processes behind carbon and heat exchange, systematic errors in biogeochemistry and assumptions underlying the parameters chosen to represent these SO processes. The dynamics of the ocean model play a large role in driving ocean biogeochemistry and we show that over the chosen period of analysis 2000–2009 that the simulated dynamics in the upper ocean provide a stable mean state, as compared to observation-based datasets (themselves subject to biases such as sparsity of data, cloud cover, etc.), and through which the characteristics of variability can be described. Using ocean biomes to delineate the major regions of the SO, the model demonstrates a useful representation of ocean biogeochemistry and partial pressure of carbon dioxide (pCO2). In addition to a reasonable model mean state performance, through model–data metrics BIOPERIANT12 highlights several pathways for improving Southern Ocean model simulations such as the representation of temporal variability and the overestimation of biological biomass. [ABSTRACT FROM AUTHOR]

Objectives: Individuals from deprived areas are less likely to attend breast screening. Inequalities in the coverage of breast screening are associated with poorer cancer outcomes. Individuals who have a positive first experience are more likely to attend subsequent mammograms. This work evaluates the provision of an additional telephone call to individuals who have never attended breast screening, to establish whether this increases attendance. Setting and Methods: 1423 patients from four general practitioner practices within socially deprived areas of National Health Service Tayside (UK) comprised the study population. In addition to their standard appointment letter, individuals were to receive a call at least 24 h prior to their appointment. The call identified barriers to screening, and offered a supportive, problem-solving approach to overcoming these barriers. Data collected included: age, Scottish Index of Multiple Deprivation, first-time invite or previous non-attender, if contactable, duration of call, number of days prior to appointment, and confirmation appointment letter was received. The primary outcome was attendance at the screening. Results: Contact by phone was made with 678 (47.6%) of the study population. Of those, 483 (71.2%) attended their appointment, 122 (18%) cancelled and 73 (10.8%) did not attend (DNA), versus 344 (46.2%) attending, 34 (4.6%) cancelling and 367 (49.3%) not attending among those who were not able to be contacted. Those who received a call were more likely to attend their appointment and less likely to DNA compared to individuals not receiving the call. Conclusion: The intervention is simple and low cost; results indicate that the additional call may increase attendance and reduce DNA appointments at breast screening. [ABSTRACT FROM AUTHOR]

COVID-19 presented significant challenges to psychiatric staff, while social distancing and remote working necessitated digital communications. NHS England prioritised staff wellbeing. Arts-based creativity interventions appear to improve psychological wellbeing, so this study evaluated online Creativity Workshops as a staff support response for COVID-19-related stress. Participants were staff from a South London NHS psychiatric hospital. Group Creativity Workshops were facilitated via Microsoft Teams. Acceptability data on pre- and post-workshop mood and attitudes were self-reported by participants. Feasibility data were gathered from adherence to number of workshop components delivered. Eight workshops were delivered in May-September 2020 (N = 55) with high adherence to components. Participants reported significantly increased positive mood and attitudes towards themselves and others; and decreased stress and anxiety. Online Creativity Workshops appear feasible and acceptable in reducing stress in psychiatric staff. Integrating a programme of Creativity Workshops within healthcare staff support may benefit staff wellbeing. [ABSTRACT FROM AUTHOR]

BACKGROUND: LMD in children with recurrent medulloblastoma and other PNETs carries a poor prognosis and novel therapies are urgently needed to improve disease control. Somatostatin receptor-2 (SSR-2)is overexpressed in medulloblastoma and other central PNETs and can serve as a target for radionuclide tagged somatostatin analogues like 177Lu-DOTA-TATE that has shown considerable efficacy in adults with SSR-2 positive neuro-endocrine tumors. As a preliminary step prior to testing this agent in children with LMD, we performed an efficacy study of i.t. 177Lu-DOTA-TATE in athymic rats bearing LMD from MBL. METHODS: The subarachnoid space was accessed through the animal's cervical spine and a catheter was threaded along the dorsal aspect of spinal cord to the lumbar region and injected with 1 x 107 D341 human MBL cells and treatment initiated 3 days later. Groups of 10 animals received a single i.t. dose of 2, 3, or 5 mCi of 177Lu- DOTA-TATE or saline control. Animals were followed 300 days for survival. RESULTS: Treatment with 2 mCi resulted in an increase in median survival of 58.3% compared with saline control (p < 0.001). Treatment with 5.0 mCi of 177Lu-DOTA-TATE increased median survival by 75.0% compared with the saline control group while a single dose of 3.0 mCi 177Lu-DOTA-TATE increased median survival compared with saline controls by 519.4%. Long-term survivors were seen in 0 of 10 animals treated with saline, 4 of 11 treated with 3 mCi, and 3 of 12 treated with 5.0 mCi. CONCLUSION: Intrathecal 177Lu- DOTA TATE is efficacious in controlling LMD from medulloblastoma in athymic rats. A phase I trial of this agent is being planned in children with LMD from recurrent MBL and other CNS PNETs. INTRODUCTION: Medulloblastoma/PNET is the most common malignant brain tumor in children. For children older than 3 years, the treatment of high risk group includes surgery, craniospinal (CSI) radiation therapy (30-36 Gy) plus local boost radiotherapy (54-56 Gy) and adjuvant chemotherapy, such as cisplatinum, carboplatin, lomustine, cyclophosphamide, and vincristine. The results have demonstrated 5-year overall survival (OS) of 40-60%. This study aimed to evaluate the outcomes of high risk medulloblastoma/PNET patients who were treated with radiation and adjuvant chemotherapy. METHODS: Patients were diagnosed with high risk medulloblastoma/PNET according to the histopathology, medulloblastoma risk classification by an evidence of metastasis or the residual tumor more than 1.5 cm2 and evidence of residual tumor after surgery in PNET. Treatment protocol was CSI RT 36 Gy with local boost at tumor 54-56 Gy. Two to four weeks after RT, patients received 8 courses of chemotherapy consisting of cyclophosphamide 800 mg/m2, day 1-3 and vincristine 2 mg/m2, week 1-3, alternated with carboplatin 200 mg/m2, day 1-3 and etoposide 150 mg/m2, day 1-3. RESULTS: Total of 25 patients, male: female of 2.6:1 and mean ± SD for age of 9.7± 3.0 years, were enrolled. The 5-year progression free survival and OS were 41.6± 11.7% and 61.5± 12.9%,respectively. The age and sex did not determine the difference in outcomes. The hematotoxic side effect, according to the National Cancer Institute's Common Terminology Criteria, were grade 4 leucopenia 60%, grade 4 neutropenia 60%, grade 4 anemia 20%, grade 4 thrombocytopenia 16%, grade 3 leucopenia 20%, grade 3 neutropenia 20%, grade 3 anemia 40%, and grade 3 thrombocytopenia 36%. Febrile neutropenia was found in 11 patients (44%). CONCLUSION: The present study demonstrated the similar outcomes of high risk medulloblastoma/PNET with the previous studies. Although, the grade 3 and 4 hematologic toxicity was high, no treatment related death was found. OBJECTIVE: Recent investigations revealed an association between transcriptional subtypes and morphological features in medulloblastoma. Since both characteristics are of prognostic significance, a precise correlation between them should be well established. Therefore we re-examined paediatric nodular medulloblastoma tumours for correlation with molecular subtypes of disease. METHODS: Paediatric patients with previously diagnosed desmoplastic/nodular (D/N) or medulloblastoma with extensive nodularity (MBEN) histopathology were re-analysed by two neuropathologists. In addition to H&E-stained slides, reticulin preparations were simultaneously analysed from the same FFPE blocks. For identification of transcriptional subtypes of tumours immunohistopathological analyses were performed using a panel of representative antibodies. MYCC amplification was detected by FISH. RESULTS: Altogether 28 tumours with original MBEN or D/N diagnosis where molecular subtypes could be determined were identified. All tumours with MBEN histology belonged to SHH group and displayed distinctive reticulin-positive internodular reaction. However, only ∼60% of tumours with original D/N diagnosis were reticulin-positive. They belonged to SHH type, were mainly infantile and patients are still alive. Among reticulin-negative tumours only two were of the SHH type and were subsequently reclassified as classic and anaplastic tumours with pseudonodules. Importantly, all remaining reticulin-negative tumours with a presence of nodules in H&E staining belonged to the non-WNT,SHH type. Therefore the original diagnosis was again reclassified as classic or anaplastic tumours with pseudonodules. Patients from this group were only males, with median age 14 years old, one had MYCC amplification and two of them died because of disease. Therefore, non-WNT,SHH tumours did not display typical desmoplastic/nodular histology accompanied by reticulin positive reaction as opposite to truly D/N tumours being typical for SHH molecular group (p < 0.001). CONCLUSION: Reticulin staining is necessary to distinguish two different biologically and clinically group of nodular tumours which appear morphologically similar under H&E staining alone. BACKGROUND: In the PNET4 European randomised controlled trial, children with standard risk medulloblastoma were allocated to HFRT or to STRT. All received maintenance chemotherapy. Event-free survival was similar between the two treatment arms. HFRT was associated with worse growth and better questionnaire-based executive function 6.1 years post-diagnosis, especially in children aged 8 years at diagnosis. In children aged .10); WMI (5.20 [-2.07 to 12.47], p > .10), PSI (10.91 [-1.54 to 23.36], p = .08; FSIQ (5.28 [-4.23 to 14.79], p > .10). CONCLUSION: HFRT was associated with higher verbal IQ in children aged

The sub‐seasonal CO2 flux (FCO2) variability across the Southern Ocean is poorly understood due to sparse observations at the required temporal and spatial scales. Twinned surface and profiling gliders experiments were used to investigate how storms influence FCO2 through the air‐sea gradient in partial pressure of CO2 (ΔpCO2) in the sub‐Antarctic zone. Winter‐spring storms caused ΔpCO2 to weaken (by 22–37 μatm) due to mixing/entrainment and weaker stratification. This weakening in ΔpCO2 was in phase with the increase in wind stress resulting in a reduction of the storm‐driven CO2 uptake by 6%–27%. During summer, stronger stratification explained the weaker sensitivity of ΔpCO2 to storms, instead temperature changes dominated the ΔpCO2 variability. These results highlight the importance of observing synoptic‐scale variability in ΔpCO2, the absence of which may propagate significant biases to the mean annual FCO2 estimates from large‐scale observing programmes and reconstructions. Plain Language Summary: The sub‐Antarctic zone of the Southern Ocean is a region that mostly experiences carbon dioxide (CO2) uptake because of its low temperature, strong winds and lower CO2 content. The wind can influence the CO2 uptake through two pathways: the speed of CO2 transfer between the air‐sea interface (kw) and the difference in CO2 concentration in the surface ocean and overlying atmosphere (ΔpCO2). Using autonomous robots that can measure hourly air and water conditions simultaneously, we show that not resolving ΔpCO2 during a storm event can lead to overestimating the CO2 uptake. This is particularly important during winter and spring when the ocean's surface layers are less stratified. The warmer temperatures during summer meant a more stratified surface layer resulting in a weaker and delayed impact of storms on the ΔpCO2. This study shows that the various annual CO2 uptake estimation methods used by the research community should not neglect ΔpCO2 responses during storms. Key Points: Hourly glider observations show that the impact of storms on both kw and ΔpCO2 simultaneously modulates the ocean CO2 uptake variabilityWinter‐spring storms weaken ΔpCO2 through enhanced entrainment and mixing, partially counteracting the increase in CO2 uptake due to kw aloneBy not accounting for the storm‐linked positive feedback in ΔpCO2, the cumulative seasonal CO2 uptake was found to be overestimated by ∼6% [ABSTRACT FROM AUTHOR]

Phytoplankton bloom phenology is an important indicator for the monitoring and management of marine resources and the assessment of climate change impacts on ocean ecosystems. Despite its relevance, there is no long-term and sustained observational phytoplankton phenological product available for global ocean implementation. The data product presented here addresses this need through the development of phenological detection algorithms (including among other seasonal metrics, the bloom initiation, termination, duration, and amplitude timing) using satellite derived chlorophyll-a data from the Ocean Colour Climate Change Initiative. This product provides the phenology output from three widely used bloom detection algorithms at three different spatial resolutions (4, 9 and 25 km) allowing for both regional and global-scale applications. In this study, the mean global phenology is characterised according to the three phenological detection methods and the different resolutions, which are compared to one another. In general, there is good agreement between the detection methods and between different resolutions on global scales. Regional differences are evident in coastal domains (particularly for resolution) and in regions with strong transitions between phytoplankton seasonal characteristics. This product can be used towards the development of national and global biodiversity assessments, pelagic ecosystem mapping and for monitoring change in climate sensitive regions relevant for ecosystem services. The dataset is published in the Zenodo repository under the following DOIs, 4 km: https://doi.org/10.5281/zenodo.8402932. 9 km: https://doi.org/10.5281/zenodo.8402847 and 25 km: https://doi.org/10.5281/zenodo.8402823 (Nicholson et al., 2023a, b, c) and will be updated regularly. [ABSTRACT FROM AUTHOR]