Search

Abstract Background Mental ill-health and substance use bear a substantial burden and harm on young people and often arise from co-occurring and compounding risk factors, such as traumatic stress. Trauma-informed prevention of mental ill-health and substance use demonstrates significant promise in reducing this burden. A systematic literature review is required to identify and summarise the effectiveness, feasibility, acceptability, and design principles underpinning existing trauma-informed mental ill-health and/or substance use prevention programmes for young people aged 12–24 years. Methods MEDLINE, Embase, CINAHL, PsychINFO, and Cochrane Library will be searched from 2012 through September 2022. Reference lists of included articles will be citation-chained. Title and abstracts will be screened and two reviewers will review articles full-text. One reviewer will extract data from eligible articles using a piloted data extraction form, and 20% of the data will be verified by a second reviewer. Risk of bias will be assessed using the Cochrane risk-of-bias tool for randomised trials (RoB 2), Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I), and The Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies and The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research (CASP), depending on the study type. Characteristics of existing trauma-informed mental ill-health and/or substance use prevention programmes for young people will be summarised narratively. Effectiveness, feasibility, and acceptability will be qualitatively described and summarised, with proportions and effect sizes quantitatively synthesised, where possible. Discussion Trauma-informed approaches to prevention demonstrate significant promise, yet to date, no study has systematically summarised and synthesised the available literature. To fill this gap, the present review will systematically identify and summarise the effectiveness, feasibility, acceptability, and design principles underpinning existing trauma-informed mental health and/or substance use prevention programmes for young people aged 12–24. This review will inform the development, adaptation, evaluation, and implementation of future trauma-informed mental ill-health and substance use prevention programmes for young people. Findings will inform critical efforts to interrupt and prevent already elevated trajectories of mental ill-health, substance use, and related harms among those young people exposed to adversity. Systematic review registration PROSPERO CRD42022353883.

The low-lying structure of 15C has been investigated via the neutron-removal 16C(d,t) reaction. Along with the known bound neutron sd-shell states, unbound p-shell hole states have been observed. The excitation energies and the deduced spectroscopic factors of the cross-shell states are an important measure of the [(p)−1(sd)2] neutron configurations in 15C. Our results show a very good agreement with shell-model calculations using the SFO-tls interaction for 15C. However, this same interaction predicted energies that were too low for the corresponding hole states in the N=9 isotone 17O and adjustment of the p-sd and sd-sd monopole terms was required to match the 17O energies. In addition, the excitation energies and spectroscopic factors have been compared to the first calculations of 15C with the ab initio self-consistent Green's function method employing the NNLOsat interaction. The results show the sensitivity to the size of the N=8 shell gap and highlight the need to go beyond the current truncation scheme.

Highly multiplexed, robotic, fiber-fed spectroscopic surveys are observing tens of millions of stars and galaxies. For many systems, accurate positioning relies on imaging the fibers in the focal plane and feeding that information back to the robotic positioners to correct their positions. Inhomogeneities and turbulence in the air between the focal plane and the imaging camera can affect the measured positions of fibers, limiting the accuracy with which fibers can be placed on targets. For the Dark Energy Spectroscopic Instrument, we dramatically reduced the effect of turbulence on measurements of positioner locations in the focal plane by taking advantage of stationary positioners and the correlation function of the turbulence. We were able to reduce positioning errors from 7.3 to 3.5 μ m, speeding the survey by 1.6% under typical conditions.

The Dark Energy Spectroscopic Instrument (DESI) completed its 5 month Survey Validation in 2021 May. Spectra of stellar and extragalactic targets from Survey Validation constitute the first major data sample from the DESI survey. This paper describes the public release of those spectra, the catalogs of derived properties, and the intermediate data products. In total, the public release includes good-quality spectral information from 466,447 objects targeted as part of the Milky Way Survey, 428,758 as part of the Bright Galaxy Survey, 227,318 as part of the Luminous Red Galaxy sample, 437,664 as part of the Emission Line Galaxy sample, and 76,079 as part of the Quasar sample. In addition, the release includes spectral information from 137,148 objects that expand the scope beyond the primary samples as part of a series of secondary programs. Here, we describe the spectral data, data quality, data products, Large-Scale Structure science catalogs, access to the data, and references that provide relevant background to using these spectra.

Highly multiplexed, fiber-fed spectroscopy is enabling surveys of millions of stars and galaxies. The performance of these surveys depends on accurately positioning fibers in the focal plane to capture target light. We describe a technique to measure the positioning accuracy of fibers by dithering fibers slightly around their ideal locations. This approach also enables measurement of the total system throughput and point-spread function delivered to the focal plane. We then apply this technique to observations from the Dark Energy Survey Instrument (DESI), and demonstrate that DESI positions fibers to within 0.″08 of their targets (5% of a fiber diameter) and achieves a system throughput within about 7% of expectations.

The Dark Energy Spectroscopic Instrument (DESI) was designed to conduct a survey covering 14,000 deg ^2 over 5 yr to constrain the cosmic expansion history through precise measurements of baryon acoustic oscillations (BAO). The scientific program for DESI was evaluated during a 5 month survey validation (SV) campaign before beginning full operations. This program produced deep spectra of tens of thousands of objects from each of the stellar Milky Way Survey (MWS), Bright Galaxy Survey (BGS), luminous red galaxy (LRG), emission line galaxy (ELG), and quasar target classes. These SV spectra were used to optimize redshift distributions, characterize exposure times, determine calibration procedures, and assess observational overheads for the 5 yr program. In this paper, we present the final target selection algorithms, redshift distributions, and projected cosmology constraints resulting from those studies. We also present a One-Percent Survey conducted at the conclusion of SV covering 140 deg ^2 using the final target selection algorithms with exposures of a depth typical of the main survey. The SV indicates that DESI will be able to complete the full 14,000 deg ^2 program with spectroscopically confirmed targets from the MWS, BGS, LRG, ELG, and quasar programs with total sample sizes of 7.2, 13.8, 7.46, 15.7, and 2.87 million, respectively. These samples will allow exploration of the Milky Way halo, clustering on all scales, and BAO measurements with a statistical precision of 0.28% over the redshift interval z < 1.1, 0.39% over the redshift interval 1.1 < z < 1.9, and 0.46% over the redshift interval 1.9 < z < 3.5.

Since early 2000, NASA's Multi-angle Imaging SpectroRadiometer (MISR) instrument has been performing remote sensing retrievals of aerosol optical properties from the polar-orbiting Terra spacecraft. A noteworthy aspect of MISR observations over the ocean is that, for much of the Earth, some of the multi-angle views have contributions from solar reflection by the ocean surface (glint, or glitter), while others do not. Aerosol retrieval algorithms often discard these glint-influenced observations because they can overwhelm the signal and are difficult to predict without knowledge of the (wind-speed-driven) ocean surface roughness. However, theoretical studies have shown that multi-angle observations of a location at geometries with and without reflected sun glint can be a rich source of information, sufficient to support simultaneous retrieval of both the aerosol state and the wind speed at the ocean surface. We are in the early stages of creating such an algorithm. In this paper, we describe our assessment of the appropriate level of parameterization for simultaneous aerosol and ocean surface property retrievals using sun glint. For this purpose, we use generalized nonlinear retrieval analysis (GENRA), an information content assessment (ICA) technique employing Bayesian inference, and simulations from the Ahmad–Fraser iterative radiative transfer code. We find that four parameters are suitable: aerosol optical depth (τ), particle size distribution (expressed as the fine mode fraction f of small particles in a bimodal size distribution), surface wind speed (w), and relative humidity (r, to define the aerosol water content and complex refractive index). None of these parameters define ocean optical properties, as we found that the aerosol state could be retrieved with the nine MISR near-infrared views alone, where the ocean body is strongly absorbing in the open ocean. We also found that retrieval capability varies with observation geometry and that as τ increases so does the ability to determine aerosol intensive optical properties (r and f, while it decreases for w). Increases in w decrease the ability to determine the true value of that parameter but have minimal impact on retrieval of aerosol properties. We explored the benefit of excluding the two most extreme MISR view angles for which radiative transfer with the plane-parallel approximation is less certain, but we found no advantage in doing so. Finally, the impact of treating wind speed as a scalar parameter, rather than as a two-parameter directional wind, was tested. While the simpler scalar model does contribute to overall aerosol uncertainty, it is not sufficiently large to justify the addition of another dimension to parameter space. An algorithm designed upon these principles is in development. It will be used to perform an atmospheric correction with MISR for coincident ocean color (OC) observations by the Moderate Resolution Imaging Spectroradiometer (MODIS) instrument, also on the NASA Terra spacecraft. Unlike MISR, MODIS is a single-view-angle instrument, but it has a more complete set of spectral channels ideal for determination of optical ocean properties. The atmospheric correction of MODIS OC data can therefore benefit from MISR aerosol retrievals. Furthermore, higher-spatial-resolution data from coincident MISR observations may also improve glint screening.

Abstract We present the new MSHT20 set of parton distribution functions (PDFs) of the proton, determined from global analyses of the available hard scattering data. The PDFs are made available at NNLO, NLO, and LO, and supersede the MMHT14 sets. They are obtained using the same basic framework, but the parameterisation is now adapted and extended, and there are 32 pairs of eigenvector PDFs. We also include a large number of new data sets: from the final HERA combined data on total and heavy flavour structure functions, to final Tevatron data, and in particular a significant number of new LHC 7 and 8 TeV data sets on vector boson production, inclusive jets and top quark distributions. We include up to NNLO QCD corrections for all data sets that play a major role in the fit, and NLO EW corrections where relevant. We find that these updates have an important impact on the PDFs, and for the first time the NNLO fit is strongly favoured over the NLO, reflecting the wider range and in particular increased precision of data included in the fit. There are some changes to central values and a significant reduction in the uncertainties of the PDFs in many, though not all, cases. Nonetheless, the PDFs and the resulting predictions are generally within one standard deviation of the MMHT14 results. The major changes are the $$u-d$$ u - d valence quark difference at small x, due to the improved parameterisation and new precise data, the $${\bar{d}}, {\bar{u}}$$ d ¯ , u ¯ difference at small x, due to a much improved parameterisation, and the strange quark PDF due to the effect of LHC W, Z data and inclusion of new NNLO corrections for dimuon production in neutrino DIS. We discuss the phenomenological impact of our results, and in general find reduced uncertainties in predictions for processes such as Higgs, top quark pair and W, Z production at post LHC Run-II energies.

Abstract We present the results of a PDF fit to differential top quark production within the MMHT framework. We in particular consider ATLAS data in the lepton + jet and dilepton channels and CMS data in the lepton + jet channel, at 8 TeV. While the fit quality to the ATLAS dilepton data is good, for the CMS case we see some issues in achieving a good fit quality for certain distributions. However, we focus on the ATLAS lepton + jet data, for which correlations of the statistical and systematic errors are provided across the four relevant distributions for PDF determination, namely $$p_T^t$$ pTt , $$M_{tt}$$ Mtt , $$y_t$$ yt and $$y_{tt}$$ ytt . We find severe difficulties in fitting these distributions simultaneously, with particular sensitivity to the precise degree of correlation taken between the dominant two-point MC uncertainties in the data. We investigate the effect of some reasonable decorrelation of these uncertainties, finding the impact on the fit quality to be significant and the resultant gluon not negligible. This is in particular found to be larger than the effect of including NNLO QCD and NLO EW corrections in the top quark pair production cross section on the fit, motivating a closer understanding of the physics underlying these errors sources and in particular the uncertainty on the degree of correlation in them.

We apply the color–magnitude intercept calibration method (CMAGIC) to the Nearby Supernova Factory SNe Ia spectrophotometric data set. The currently existing CMAGIC parameters are the slope and intercept of a straight line fit to the linear region in the color–magnitude diagram, which occurs over a span of approximately 30 days after maximum brightness. We define a new parameter, ω _XY , the size of the “bump” feature near maximum brightness for arbitrary filters X and Y . We find a significant correlation between the slope of the linear region, β _XY , in the CMAGIC diagram and ω _XY . These results may be used to our advantage, as they are less affected by extinction than parameters defined as a function of time. Additionally, ω _XY is computed independently of templates. We find that current empirical templates are successful at reproducing the features described in this work, particularly SALT3, which correctly exhibits the negative correlation between slope and “bump” size seen in our data. In 1D simulations, we show that the correlation between the size of the “bump” feature and β _XY can be understood as a result of chemical mixing due to large-scale Rayleigh–Taylor instabilities.

The Dark Energy Spectroscopic Instrument (DESI) Survey has obtained a set of spectroscopic measurements of galaxies to validate the final survey design and target selections. To assist in these tasks, we visually inspect DESI spectra of approximately 2500 bright galaxies, 3500 luminous red galaxies (LRGs), and 10,000 emission-line galaxies (ELGs) to obtain robust redshift identifications. We then utilize the visually inspected redshift information to characterize the performance of the DESI operation. Based on the visual inspection (VI) catalogs, our results show that the final survey design yields samples of bright galaxies, LRGs, and ELGs with purity greater than 99%. Moreover, we demonstrate that the precision of the redshift measurements is approximately 10 km s ^−1 for bright galaxies and ELGs and approximately 40 km s ^−1 for LRGs. The average redshift accuracy is within 10 km s ^−1 for the three types of galaxies. The VI process also helps improve the quality of the DESI data by identifying spurious spectral features introduced by the pipeline. Finally, we show examples of unexpected real astronomical objects, such as Ly α emitters and strong lensing candidates, identified by VI. These results demonstrate the importance and utility of visually inspecting data from incoming and upcoming surveys, especially during their early operation phases.

The Dark Energy Spectroscopic Instrument (DESI) is carrying out a five-year survey that aims to measure the redshifts of tens of millions of galaxies and quasars, including 8 million luminous red galaxies (LRGs) in the redshift range 0.4 < z ≲ 1.0. Here we present the selection of the DESI LRG sample and assess its spectroscopic performance using data from Survey Validation (SV) and the first two months of the Main Survey. The DESI LRG sample, selected using g , r , z , and W 1 photometry from the DESI Legacy Imaging Surveys, is highly robust against imaging systematics. The sample has a target density of 605 deg ^−2 and a comoving number density of 5 × 10 ^−4 h ^3 Mpc ^−3 in 0.4 < z < 0.8; this is a significantly higher density than previous LRG surveys (such as SDSS, BOSS, and eBOSS) while also extending to z ∼ 1. After applying a bright star veto mask developed for the sample, 98.9% of the observed LRG targets yield confident redshifts (with a catastrophic failure rate of 0.2% in the confident redshifts), and only 0.5% of the LRG targets are stellar contamination. The LRG redshift efficiency varies with source brightness and effective exposure time, and we present a simple model that accurately characterizes this dependence. In the appendices, we describe the extended LRG samples observed during SV.

A key component of the Dark Energy Spectroscopic Instrument (DESI) survey validation (SV) is a detailed visual inspection (VI) of the optical spectroscopic data to quantify key survey metrics. In this paper we present results from VI of the quasar survey using deep coadded SV spectra. We show that the majority (≈70%) of the main-survey targets are spectroscopically confirmed as quasars, with ≈16% galaxies, ≈6% stars, and ≈8% low-quality spectra lacking reliable features. A nonnegligible fraction of the quasars are misidentified by the standard spectroscopic pipeline, but we show that the majority can be recovered using post-pipeline “afterburner” quasar-identification approaches. We combine these “afterburners” with our standard pipeline to create a modified pipeline to increase the overall quasar yield. At the depth of the main DESI survey, both pipelines achieve a good-redshift purity (reliable redshifts measured within 3000 km s ^−1 ) of ≈99%; however, the modified pipeline recovers ≈94% of the visually inspected quasars, as compared to ≈86% from the standard pipeline. We demonstrate that both pipelines achieve a median redshift precision and accuracy of ≈100 km s ^−1 and ≈70 km s ^−1 , respectively. We constructed composite spectra to investigate why some quasars are missed by the standard pipeline and find that they are more host-galaxy dominated (i.e., distant analogs of “Seyfert galaxies”) and/or more dust reddened than the standard-pipeline quasars. We also show example spectra to demonstrate the overall diversity of the DESI quasar sample and provide strong-lensing candidates where two targets contribute to a single spectrum.

The Dark Energy Spectroscopic Instrument (DESI) will precisely constrain cosmic expansion and the growth of structure by collecting ∼40 million extragalactic redshifts across ∼80% of cosmic history and one-third of the sky. The Emission Line galaxy (ELG) sample, which will comprise about one-third of all DESI tracers, will be used to probe the universe over the 0.6 < z < 1.6 range, including the 1.1 < z < 1.6 range, which is expected to provide the tightest constraints. We present the target selection for the DESI Survey Validation (SV) and Main Survey ELG samples, which relies on the imaging of the Legacy Surveys. The Main ELG selection consists of a g -band magnitude cut and a ( g − r ) versus ( r − z ) color box, while the SV selection explores extensions of the Main selection boundaries. The Main ELG sample is composed of two disjoint subsamples, which have target densities of about 1940 deg ^−2 and 460 deg ^−2 , respectively. We first characterize their photometric properties and density variations across the footprint. We then analyze the DESI spectroscopic data that have been obtained from 2020 December to 2021 December in the SV and Main Survey. We establish a preliminary criterion for selecting reliable redshifts, based on the [O ii ] flux measurement, and assess its performance. Using this criterion, we are able to present the spectroscopic efficiency of the Main ELG selection, along with its redshift distribution. We thus demonstrate that the Main selection 1940 deg ^−2 subsample alone should provide 400 deg ^−2 and 460 deg ^−2 reliable redshifts in the 0.6 < z < 1.1 and the 1.1 < z < 1.6 ranges, respectively.

We describe the spectroscopic data processing pipeline of the Dark Energy Spectroscopic Instrument (DESI), which is conducting a redshift survey of about 40 million galaxies and quasars using a purpose-built instrument on the 4 m Mayall Telescope at Kitt Peak National Observatory. The main goal of DESI is to measure with unprecedented precision the expansion history of the universe with the baryon acoustic oscillation technique and the growth rate of structure with redshift space distortions. Ten spectrographs with three cameras each disperse the light from 5000 fibers onto 30 CCDs, covering the near-UV to near-infrared (3600–9800 Å) with a spectral resolution ranging from 2000 to 5000. The DESI data pipeline generates wavelength- and flux-calibrated spectra of all the targets, along with spectroscopic classifications and redshift measurements. Fully processed data from each night are typically available to the DESI collaboration the following morning. We give details about the pipeline’s algorithms, and provide performance results on the stability of the optics, the quality of the sky background subtraction, and the precision and accuracy of the instrumental calibration. This pipeline has been used to process the DESI Survey Validation data set, and has exceeded the project’s requirements for redshift performance, with high efficiency and a purity greater than 99% for all target classes.

The first investigation of the single-particle structure of the bound states of 17C, via the d(16C,p) transfer reaction, has been undertaken. The measured angular distributions confirm the spin-parity assignments of 1/2+ and 5/2+ for the excited states located at 217 and 335 keV, respectively. The spectroscopic factors deduced for these states exhibit a marked single-particle character, in agreement with shell model and particle-core model calculations, and combined with their near degeneracy in energy provide clear evidence for the absence of the N=14 sub-shell closure. The very small spectroscopic factor found for the 3/2+ ground state is consistent with theoretical predictions and indicates that the ν1d3/2 strength is carried by unbound states. With a dominant ℓ=0 valence neutron configuration and a very low separation energy, the 1/2+ excited state is a one-neutron halo candidate.

The Dark Energy Spectroscopic Instrument (DESI) embarked on an ambitious 5 yr survey in 2021 May to explore the nature of dark energy with spectroscopic measurements of 40 million galaxies and quasars. DESI will determine precise redshifts and employ the baryon acoustic oscillation method to measure distances from the nearby universe to beyond redshift z > 3.5, and employ redshift space distortions to measure the growth of structure and probe potential modifications to general relativity. We describe the significant instrumentation we developed to conduct the DESI survey. This includes: a wide-field, 3.°2 diameter prime-focus corrector; a focal plane system with 5020 fiber positioners on the 0.812 m diameter, aspheric focal surface; 10 continuous, high-efficiency fiber cable bundles that connect the focal plane to the spectrographs; and 10 identical spectrographs. Each spectrograph employs a pair of dichroics to split the light into three channels that together record the light from 360–980 nm with a spectral resolution that ranges from 2000–5000. We describe the science requirements, their connection to the technical requirements, the management of the project, and interfaces between subsystems. DESI was installed at the 4 m Mayall Telescope at Kitt Peak National Observatory and has achieved all of its performance goals. Some performance highlights include an rms positioner accuracy of better than 0.″1 and a median signal-to-noise ratio of 7 of the [O ii ] doublet at 8 × 10 ^−17 erg s ^−1 cm ^−2 in 1000 s for galaxies at z = 1.4–1.6. We conclude with additional highlights from the on-sky validation and commissioning, key successes, and lessons learned.

The exchange of trace gases between the Earth's surface and atmosphere strongly influences atmospheric composition. Airborne eddy covariance can quantify surface fluxes at local to regional scales (1–1000 km), potentially helping to bridge gaps between top-down and bottom-up flux estimates and offering novel insights into biophysical and biogeochemical processes. The NASA Carbon Airborne Flux Experiment (CARAFE) utilizes the NASA C-23 Sherpa aircraft with a suite of commercial and custom instrumentation to acquire fluxes of carbon dioxide, methane, sensible heat, and latent heat at high spatial resolution. Key components of the CARAFE payload are described, including the meteorological, greenhouse gas, water vapor, and surface imaging systems. Continuous wavelet transforms deliver spatially resolved fluxes along aircraft flight tracks. Flux analysis methodology is discussed in depth, with special emphasis on quantification of uncertainties. Typical uncertainties in derived surface fluxes are 40–90 % for a nominal resolution of 2 km or 16–35 % when averaged over a full leg (typically 30–40 km). CARAFE has successfully flown two missions in the eastern US in 2016 and 2017, quantifying fluxes over forest, cropland, wetlands, and water. Preliminary results from these campaigns are presented to highlight the performance of this system.

A global heat flux model based on a fractional derivative of plasma pressure is proposed for the heat transport in fusion plasmas. The degree of the fractional derivative of the heat flux, α, is defined through the power balance analysis of the steady state. The model was used to obtain the experimental values of α for a large database of the Joint European Torus (JET) carbon-wall as well as ITER like-wall plasmas. The fractional degrees of the electron heat flux are found to be α

AbstractBackground.Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care.Methods.The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions.Results.We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures.Conclusions.We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.

Objectives To determine the need for recovery (NFR) among emergency physicians and to identify demographic and occupational characteristics associated with higher NFR scores.Design Cross-sectional electronic survey.Setting Emergency departments (EDs) (n=112) in the UK and Ireland.Participants Emergency physicians, defined as any registered physician working principally within the ED, responding between June and July 2019.Main outcome measure NFR Scale, an 11-item self-administered questionnaire that assesses how work demands affect intershift recovery.Results The median NFR Score for all 4247 eligible, consented participants with a valid NFR Score was 70.0 (95% CI: 65.5 to 74.5), with an IQR of 45.5–90.0. A linear regression model indicated statistically significant associations between gender, health conditions, type of ED, clinical grade, access to annual and study leave, and time spent working out-of-hours. Groups including male physicians, consultants, general practitioners (GPs) within the ED, those working in paediatric EDs and those with no long-term health condition or disability had a lower NFR Score. After adjusting for these characteristics, the NFR Score increased by 3.7 (95% CI: 0.3 to 7.1) and 6.43 (95% CI: 2.0 to 10.8) for those with difficulty accessing annual and study leave, respectively. Increased percentage of out-of-hours work increased NFR Score almost linearly: 26%–50% out-of-hours work=5.7 (95% CI: 3.1 to 8.4); 51%–75% out-of-hours work=10.3 (95% CI: 7.6 to 13.0); 76%–100% out-of-hours work=14.5 (95% CI: 11.0 to 17.9).Conclusion Higher NFR scores were observed among emergency physicians than reported in any other profession or population to date. While out-of-hours working is unavoidable, the linear relationship observed suggests that any reduction may result in NFR improvement. Evidence-based strategies to improve well-being such as proportional out-of-hours working and improved access to annual and study leave should be carefully considered and implemented where feasible.

Long-term streamflow datasets inevitably include gaps, which must be filled to allow estimates of runoff and ultimately catchment water budgets. Uncertainty introduced by filling gaps in discharge records is rarely, if ever, reported. We characterized the uncertainty due to streamflow gaps in a reference watershed at the Hubbard Brook Experimental Forest (HBEF) from 1996 to 2009 by simulating artificial gaps of varying duration and flow rate, with the objective of quantifying their contribution to uncertainty in annual streamflow. Gaps were filled using an ensemble of regressions relating discharge from nearby streams, and the predicted flow was compared to the actual flow. Differences between the predicted and actual runoff increased with both gap length and flow rate, averaging 2.8% of the runoff during the gap. At the HBEF, the sum of gaps averaged 22 days per year, with the lowest and highest annual uncertainties due to gaps ranging from 1.5 mm (95% confidence interval surrounding mean runoff) to 21.1 mm. As a percentage of annual runoff, uncertainty due to gap filling ranged from 0.2–2.1%, depending on the year. Uncertainty in annual runoff due to gaps was small at the HBEF, where infilling models are based on multiple similar catchments in close proximity to the catchment of interest. The method demonstrated here can be used to quantify uncertainty due to gaps in any long-term streamflow data set, regardless of the gap-filling model applied.

Due to their overall immunocompromised state, lung transplant recipients (LTRs) are at increased risk for the development of viral respiratory infections compared to the general population. Such respiratory infections often lead to poor transplant outcomes. We performed a systematic review of the last 30 years of medical literature to summarize the impact of specific respiratory viruses on LTRs. After screening 2,150 articles for potential inclusion, 39 manuscripts were chosen for final review. We found evidence for an association of respiratory viruses including respiratory syncytial virus (RSV), parainfluenza virus, and influenza viruses with increased morbidity following transplant. Through the literature search, we also documented associations of RSV and adenovirus infections with increased mortality among LTRs. We posit that the medical literature supports aggressive surveillance for respiratory viruses among this population.

Trauma is among the leading causes of death in the United States. Technological advancements have led to the development of resuscitative endovascular balloon occlusion of the aorta (REBOA) which offers a pre-hospital option to non-compressible hemorrhage control. Due to the prevalence of concomitant traumatic brain injury (TBI), an understanding of the effects of REBOA on cerebral physiology is critical. To further this understanding, we employed a rat model of penetrating ballistic-like brain injury (PBBI). PBBI produced an injury pattern within the right frontal cortex and striatum that replicates the pathology from a penetrating ballistic round. Aortic occlusion was initiated 30 min post-PBBI and maintained continuously (cAO) or intermittently (iAO) for 30 min. Continuous measurements of mean arterial pressure (MAP), intracranial pressure (ICP), cerebral blood flow (CBF), and brain tissue oxygen tension (PbtO2) were recorded during, and for 60 min following occlusion. PBBI increased ICP and decreased CBF and PbtO2. The arterial balloon catheter effectively occluded the descending aorta which augmented MAP in the carotid artery. Despite this, CBF levels were not changed by aortic occlusion. iAO caused sustained adverse effects to ICP and PbtO2 while cAO demonstrated no adverse effects on either. Temporary increases in PbtO2 were observed during occlusion, along with restoration of sham levels of ICP for the remainder of the recordings. These results suggest that iAO may lead to prolonged cerebral hypertension following PBBI. Following cAO, ICP, and PbtO2 levels were temporarily improved. This information warrants further investigation using TBI-polytrauma model and provides foundational knowledge surrounding the non-hemorrhage applications of REBOA including neurogenic shock and stroke.

Surface waters used for drinking water supply often receive upstream wastewater effluent inputs, resulting in de facto wastewater reuse for drinking water and recreation. As populations grow, demands on water supplies increase. As this trend continues, it creates the need to understand the risks associated with such reuse. In North Carolina, potable reuse has been proposed as a combination of at least 80% surface water with up to 20% tertiary-treated, dual-disinfected, reclaimed wastewater, which is then stored for 5 days and further treated using conventional drinking water treatment methods. The state of North Carolina has set standards for both intake surface water and for the reclaimed water produced by wastewater utilities, using indicator microorganisms to measure compliance. The goal of this study was to quantify fecal indicator microorganisms, specifically E. coli, coliphages, and C. perfringens as well as key pathogens, specifically Salmonella spp. bacteria, adenoviruses, noroviruses, and the protozoan parasites Cryptosporidium and Giardia, in two types of water representing potential candidates for potable reuse in North Carolina, (1) run of river surface water and (2) sewage-impacted surface waters, with the purpose of determining if there are predictive relationships between these two microorganism groups that support microbial indicator reliability.

Chronic pain is highly prevalent worldwide and represents a significant socioeconomic and public health burden. Several aspects of chronic pain, for example back pain and a severity-related phenotype 'chronic pain grade', have been shown previously to be complex heritable traits with a polygenic component. Additional pain-related phenotypes capturing aspects of an individual's overall sensitivity to experiencing and reporting chronic pain have also been suggested as a focus for investigation. We made use of a measure of the number of sites of chronic pain in individuals within the UK general population. This measure, termed Multisite Chronic Pain (MCP), is a complex trait and its genetic architecture has not previously been investigated. To address this, we carried out a large-scale genome-wide association study (GWAS) of MCP in ~380,000 UK Biobank participants. Our findings were consistent with MCP having a significant polygenic component, with a Single Nucleotide Polymorphism (SNP) heritability of 10.2%. In total 76 independent lead SNPs at 39 risk loci were associated with MCP. Additional gene-level association analyses identified neurogenesis, synaptic plasticity, nervous system development, cell-cycle progression and apoptosis genes as enriched for genetic association with MCP. Genetic correlations were observed between MCP and a range of psychiatric, autoimmune and anthropometric traits, including major depressive disorder (MDD), asthma and Body Mass Index (BMI). Furthermore, in Mendelian randomisation (MR) analyses a causal effect of MCP on MDD was observed. Additionally, a polygenic risk score (PRS) for MCP was found to significantly predict chronic widespread pain (pain all over the body), indicating the existence of genetic variants contributing to both of these pain phenotypes. Overall, our findings support the proposition that chronic pain involves a strong nervous system component with implications for our understanding of the physiology of chronic pain. These discoveries may also inform the future development of novel treatment approaches.