HI absorption towards nearby compact radio sources

We present the results of HI absorption measurements towards a sample of nearby Compact Steep-Spectrum (CSS) and Giga-Hertz Peaked Spectrum (GPS) radio sources, the CORALZ sample, using the Giant Metrewave Radio Telescope (GMRT). We observed a sample of 18 sources and find 7 new detections. These sources are of lower luminosity than earlier studies of CSS and GPS objects and we investigate any dependence of HI absorption features on radio luminosity. Within the uncertainties, the detection rates and column densities are similar to the more luminous objects, with the GPS objects exhibiting a higher detection rate than for the CSS objects. The relative velocity of the blueshifted absorption features, which may be due to jet-cloud interactions, are within $\sim$$-$250 km s$^{-1}$ and do not appear to extend to values over 1000 km s$^{-1}$ seen for the more luminous objects. This could be due to the weaker jets in these objects, but requires confirmation from observations of a larger sample of sources. There appears to be no evidence of any dependence of HI column density on either luminosity or redshift, but these new detections are consistent with the inverse relation between HI column density and projected linear size.Comment: 10 pages, 6 figures, accepted for publication in MNRA

Multimodality and Memory in the Mise en page of Guillaume de Machaut's Mass

Guillaume de Machaut’s mass survives in only five manuscripts, which all form part of the surprisingly homogeneous ‘complete works’ set of Machaut manuscripts. In this contribution, I argue that the details of mise en page in these manuscripts are reflective both of scribal memorial processes and multimodality in action: in this work where one of the major modes (image) is absent, the musical notation itself takes on an additional aesthetic role, that of visual beauty. In these manuscripts, the mass takes its place within the music section, surrounded there by lays, motets, virelais, and rondeaux, these surrounded (or preceded) by courtly ‘dits’ and lyrics not set to music. Four of these five manuscripts are illuminated, and all provide musical notation: all, therefore, are overtly multimodal. Despite the lavish illumination in the manuscripts, the mass is never adorned with a miniature, nor is it mentioned in Machaut’s ‘Prologue’ to his works. The aesthetic beauty of the mise en page of the mass, therefore, is derived from the musical notation, while the text-music setting shows a distinct divide between the two contrasting compositional techniques of the mass

ISO observations of the interacting galaxy Markarian 297: with the powerful supernova remnant 1982aa

Markarian (Mkn) 297 is a complex system with two interacting galaxies. Observations were made with ISO using ISOCAM, ISOPHOT and LWS. We present ISOCAM maps at 6.7, 7.7, 12 and 14.3 microns which, with PHT-S spectrometry of the central interacting region, probe the dust obscured star formation and dust properties. ISOCAM reveals that the strongest emission region in the four MIR bands is completely unremarkable at visible and near-IR (e.g. 2MASS) wavelengths, and does not coincide with the nuclear region of either colliding galaxy. It shares this striking characteristic with the overlap region of the colliding galaxies in the Antennae (NGC 4038, 4039), the intragroup region of Stephan's Quintet, and IC 694 in the interacting system Arp 299. At 15 microns, the hidden source in Mkn 297 is, respectively, 14.6 and 3.8 times more luminous than the hidden sources in the Antennae (NGC 4038/4039) and Stephan's Quintet. Numerical simulations indicate that we see the Mkn 297 interaction about 1.5 x 10e8 years after the collision. ISOCAM shows knots and ridges of emission. The 14.3/7.7 micron ratio map implies widespread strong star formation. Strong emission features were detected in the ISOPHOT spectrum, while [OI], [OIII] and [CII] emission lines were seen with LWS. Using data from the three instruments, luminosities and masses for two dust components were determined. The total infrared luminosity is approximately 10e11 L_sol, marginally a LIRG. A 1979 supernova generated one of the most powerful known radio remnants (SN 1982aa) close to the strongest MIR source and identified with star forming region 14 in the optical. This exceptional supernova explosion may have been accompanied by a GRB, and a search for a GRB in this direction in contemporaneous satellite data is recommended.Comment: Accepted for publication in Astronomy and Astrophysics Updated to better use recent SN/GRB work and tune terminology in Sec. 4.

Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial

Background Tranexamic acid reduces surgical bleeding and decreases mortality in patients with traumatic extracranial bleeding. Intracranial bleeding is common after traumatic brain injury (TBI) and can cause brain herniation and death. We aimed to assess the effects of tranexamic acid in patients with TBI. Methods This randomised, placebo-controlled trial was done in 175 hospitals in 29 countries. Adults with TBI who were within 3 h of injury, had a Glasgow Coma Scale (GCS) score of 12 or lower or any intracranial bleeding on CT scan, and no major extracranial bleeding were eligible. The time window for eligibility was originally 8 h but in 2016 the protocol was changed to limit recruitment to patients within 3 h of injury. This change was made blind to the trial data, in response to external evidence suggesting that delayed treatment is unlikely to be effective. We randomly assigned (1:1) patients to receive tranexamic acid (loading dose 1 g over 10 min then infusion of 1 g over 8 h) or matching placebo. Patients were assigned by selecting a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was head injury-related death in hospital within 28 days of injury in patients treated within 3 h of injury. We prespecified a sensitivity analysis that excluded patients with a GCS score of 3 and those with bilateral unreactive pupils at baseline. All analyses were done by intention to treat. This trial was registered with ISRCTN (ISRCTN15088122), ClinicalTrials.gov (NCT01402882), EudraCT (2011-003669-14), and the Pan African Clinical Trial Registry (PACTR20121000441277). Results Between July 20, 2012, and Jan 31, 2019, we randomly allocated 12 737 patients with TBI to receive tranexamic acid (6406 [50·3%] or placebo [6331 [49·7%], of whom 9202 (72·2%) patients were treated within 3 h of injury. Among patients treated within 3 h of injury, the risk of head injury-related death was 18·5% in the tranexamic acid group versus 19·8% in the placebo group (855 vs 892 events; risk ratio [RR] 0·94 [95% CI 0·86-1·02]). In the prespecified sensitivity analysis that excluded patients with a GCS score of 3 or bilateral unreactive pupils at baseline, the risk of head injury-related death was 12·5% in the tranexamic acid group versus 14·0% in the placebo group (485 vs 525 events; RR 0·89 [95% CI 0·80-1·00]). The risk of head injury-related death reduced with tranexamic acid in patients with mild-to-moderate head injury (RR 0·78 [95% CI 0·64-0·95]) but not in patients with severe head injury (0·99 [95% CI 0·91-1·07]; p value for heterogeneity 0·030). Early treatment was more effective than was later treatment in patients with mild and moderate head injury (p=0·005) but time to treatment had no obvious effect in patients with severe head injury (p=0·73). The risk of vascular occlusive events was similar in the tranexamic acid and placebo groups (RR 0·98 (0·74-1·28). The risk of seizures was also similar between groups (1·09 [95% CI 0·90-1·33]). Interpretation Our results show that tranexamic acid is safe in patients with TBI and that treatment within 3 h of injury reduces head injury-related death. Patients should be treated as soon as possible after injury. Funding National Institute for Health Research Health Technology Assessment, JP Moulton Charitable Trust, Department of Health and Social Care, Department for International Development, Global Challenges Research Fund, Medical Research Council, and Wellcome Trust (Joint Global Health Trials scheme)

LEARN: a multicentre, cross-sectional evaluation of Urology teaching in UK medical schools

Objective To evaluate the status of UK undergraduate urology teaching against the British Association of Urological Surgeons (BAUS) Undergraduate Syllabus for Urology. Secondary objectives included evaluating the type and quantity of teaching provided, the reported performance rate of General Medical Council (GMC)-mandated urological procedures, and the proportion of undergraduates considering urology as a career. Subjects and Methods The uroLogical tEAching in bRitish medical schools Nationally (LEARN) study was a national multicentre cross-sectional evaluation. Year 2 to Year 5 medical students and Foundation Year (FY) 1 doctors were invited to complete a survey between 3 October and 20 December 2020, retrospectively assessing the urology teaching received to date. Results are reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results In all, 7063/8346 (84.6%) responses from all 39 UK medical schools were included; 1127/7063 (16.0%) were from FY1 doctors who reported that the most frequently taught topics in undergraduate training were on urinary tract infection (96.5%), acute kidney injury (95.9%) and haematuria (94.4%). The most infrequently taught topics were male urinary incontinence (59.4%), male infertility (52.4%) and erectile dysfunction (43.8%). Male and female catheterisation on patients as undergraduates was performed by 92.1% and 73.0% of FY1 doctors respectively, and 16.9% had considered a career in urology. Theory-based teaching was mainly prevalent in the early years of medical school, with clinical skills teaching, and clinical placements in the later years of medical school. In all, 20.1% of FY1 doctors reported no undergraduate clinical attachment in urology. Conclusion The LEARN Study is the largest ever evaluation of undergraduate urology teaching. In the UK, teaching seemed satisfactory as evaluated against the BAUS undergraduate syllabus. However, many students report having no clinical attachments in Urology and some newly qualified doctors report never having inserted a catheter, which is a GMC mandated requirement. We recommend a greater emphasis on undergraduate clinical exposure to urology and stricter adherence to GMC mandated procedures

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome