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Active galactic nuclei in diverse galactic environments
Full text linkWe examine how the presence of active galactic nuclei (AGN) correlates with location in large-scale cosmic structures using the Galaxy and Mass Assembly (GAMA) survey across the G09, G12, and G15 fields. Our sample contains 18 927, 9 273, and 1 148 galaxies for highly dense filaments, moderately dense tendrils, and highly underdense voids, respectively. AGN are identified among emission-line galaxies using Baldwin-Phillips-Terlevich (BPT) diagnostic diagrams based on [NII], [SII], and [OI]. We compare AGN fractions across filament, tendril, and void regions and as a function of distance from the nearest filament centreline. Our results reveal a mild excess in filaments compared to voids when using [SII]- and [NII]-based classifications, while no significant environmental dependence is found for [OI]-based classifications. Overall, we find a weak environmental trend with AGN activity, which suggests that the local environment does not always dominate AGN activity; instead, secular processes are likely to be at play. Our findings are consistent with previous studies reporting only marginal preferences for overdense environments for AGN
Exploring newly registered nurses’ experiences of preceptorship in primary care: a literature review
No full textPreceptorship has a crucial role in supporting newly registered nurses as they transition from student status into professional practice. However, the implementation and structure of preceptorship programmes in primary care is variable. This literature review aimed to examine newly registered nurses’ experience of preceptorship in primary care settings. Five articles were selected for review. Overall, the findings suggest that newly registered nurses find the transition into primary care roles challenging, but that effective support, such as access to a nominated preceptor, a clear role description, practical assistance with day-to-day tasks, opportunities to discuss workplace issues, supernumerary status and professional development opportunities, can facilitate this process. The findings also suggest that preceptorship provision and preceptor preparation is variable. Addressing these issues is crucial to optimising the preceptorship experience and could be achieved through wider implementation of structured, funded preceptorship programmes
Corporate Roles in Preventing Species Extinction: Integrating Rewilding through the Taskforce on Nature-related Financial Disclosures.
Full text linkThis study examines how the Taskforce on Nature-related Financial Disclosures (TNFD) can support corporate engagement with biodiversity through rewilding. Although the Kunming–Montreal Global Biodiversity Framework calls on businesses to disclose nature impacts, biodiversity remains weakly represented in ESG metrics and corporate strategy. We conduct qualitative document analysis of TNFD publications, together with policy and academic literature on biodiversity accounting and rewilding. We also compare four illustrative cases (Tompkins Conservation; Yellowstone to Yukon; the Natural Capital Laboratory; and the Dornoch Environmental Enhancement Project) to assess governance, financing, and partnership models. The analysis shows that disclosure can remain decoupled from restoration unless firms report indicators that capture extinction risk and ecological outcomes. Extinction-accounting approaches, used alongside TNFD’s disclosure pillars, help connect reporting to place-based rewilding actions when participatory governance safeguards Indigenous rights and standardized metrics constrain greenwashing. This framing requires moving beyond utilitarian risk management towards ethical commitments to biodiversity recovery. The paper maps rewilding activities to TNFD-aligned governance, strategy, risk management, and metrics/targets disclosures, offering practical entry points for firms, investors, and regulators seeking nature-positive outcomes
Modified thermocatalytic ammonia cracking process for hydrogen production
Full text linkThermocatalytic ammonia cracking (TAC) is a promising method for hydrogen (H2) production. However, the challenges of dealing with high reactor pressures, the use of ammonia (NH3) and/or intermediate products as fuel, present considerable drawbacks. To address these drawbacks, two models, LPR and HPR, were developed by modifying the conventional TAC configuration (C-TAC), which typically operates at high pressures. Gray NH3 is used as a feedstock for the base case. LPR and HPR operate under low and high reactor pressures, respectively. With H2 from C-TAC costing 5.5/kg when nitrogen (N2) is co-produced at 6.68/kg without N2 production. These advantages stem from its low reactor pressure, which reduces reactor costs and increases hydrogen yield. Conversely, HPR emits 2.5% less GHG than LPR, primarily because LPR requires higher compression power. However, with carbon taxation applied, LPR remains the preferred option. Using NH3 or intermediate products as fuel result in a more expensive and less sustainable process. Although green and blue NH3 reduce life-cycle GHG emissions, their high costs make H2 production less competitive. This study demonstrates that operating the TAC reactor at a low pressure improves performance by reducing capital and operating costs. Our modified TAC design enables N2 production while reducing H2 cost and maximizing recovery
Ethnicity and awareness, knowledge, and trust in palliative and end-of-life care: Analysis of a nationally representative survey
Full text linkBackgroundEthnic inequalities in palliative and end-of-life care are well-documented but poorly understood. The study aims to examine awareness, knowledge, and trust in palliative care, by ethnicity.MethodsOnline cross-sectional survey of 2,164 adults living in the UK (2024). Poisson regression models assessed associations between ethnicity and awareness and knowledge of palliative care, and trust in healthcare professionals to provide high-quality end-of-life care.ResultsRegression results reveal that, compared to White British people, people of Asian ethnicity and those of Black, Caribbean or African ethnicity were less likely to: be aware of palliative care; have correct knowledge of palliative care; and trust healthcare professionals to deliver high-quality end-of-life care.ConclusionLower awareness, knowledge, and trust in palliative care may partly explain ethnic inequalities in access to services. Understanding the views and needs of minoritised ethnic groups, and building trust and knowledge about palliative and end-of-life care, should be prioritised
The Vascular Interventions and Surgery in Trauma Audit (VISTA): A Prospective National Service Evaluation of Vascular Trauma in the UK
No full textObjective: The frequency, operative management, and outcomes for patients with traumatic vascular injury in the UK are unknown. The Vascular Interventions and Surgery in Trauma Audit (VISTA) aimed to describe the contemporary landscape of UK vascular trauma compared with retrospective data from the National Vascular Registry (NVR). Methods: A prospective, resident led service evaluation was conducted across UK major trauma centres (MTCs) delivered by the National Trauma and Research Innovation Collaborative and the Vascular and Endovascular Research Network. The evaluation included patients with traumatic injuries to named vessels falling under the management remit of vascular surgery, identified radiologically or intra-operatively, between March and October 2022 and comparative NVR data from 2017 to 2022. Results: VISTA captured 302 patients with 339 vascular injuries from 27 MTCs. The median patient age was 41 years (interquartile range 26, 59) and 78.8% (n = 238) were men. Most injuries resulted from road traffic collisions (42.4%, n = 128). Overall, 38 patients (12.6%) were shocked on arrival at the emergency department. Two thirds of patients (65.6%, n = 198) required surgery, of whom 140 (70.7%) had an open procedure and 58 (29.3%) an endovascular intervention. Open procedures included 86 (61.4%) extremity interventions (including six [4.3%] primary amputations), four (2.9%) carotid repairs, four (2.9%) caval repairs, and two (1.5%) aortic repairs. Endovascular procedures included 23 (40%) thoracic endovascular aortic repairs, two (3%) extremity stents, and one (2%) extremity embolisation. The secondary amputation rate was 12% (10 of 86). Extrapolated annual VISTA data suggest the NVR fails to capture 58% of aortic injuries and 42% of extremity vascular injuries requiring intervention. Conclusion: UK wide registries do not accurately capture surgical volume and outcomes for vascular interventions following trauma. Granular national datasets are required to establish evidence based key performance indicators for life and limb salvage following vascular trauma to improve services, promote safety, and assure patient outcomes
The Role of Dermoscopy in Optimising Surgical Margins for Keratinocyte Cancers: Updated Evidence from a Systematic Review and Meta-Analysis
No full textBackground: Keratinocyte cancer (KC) is the most common malignancy worldwide. Surgical excision is the primary treatment, with clear margin delineation critical for oncological and cosmetic outcomes. Dermoscopy, well-established for diagnosis, has recently been included in updated British guidelines as an alternative method for surgical margin planning and may offer improved border visualisation.Objectives: To update the existing evidence on dermoscopy-guided excision of KC, focusing on margin control and recurrence risk and incorporating newly published studies and re-evaluating its use considering evolving guideline recommendations.Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. PubMed, EMBASE, and CENTRAL were searched to October 2024. Eligible studies compared dermoscopy-guided with conventional surgical excision of histologically confirmed KC. The primary outcome was incomplete excision rate. Risk of bias was assessed using ROBINS-I, and meta-analysis conducted using a DerSimonian-Laird random-effects model.Results: Ten studies (1,151 patients; 1,186 lesions) were included; four contributed to meta-analysis. Most focused on BCC; SCC data were limited. Dermoscopy was associated with improved surgical precision and reduced incomplete excision (pooled OR: 0.30, 95% CI: 0.27–0.34; I² = 0%, P = 0.99), although all studies were observational and at moderate to serious risk of bias. Narrower margins were often achieved without compromising recurrence outcomes.Conclusions: Dermoscopy may enhance preoperative planning in KC excision, but evidence remains limited by methodological constraints. These findings support further high-quality trials to confirm clinical utility and define its role in future surgical guidelines
Defining and measuring unmet palliative care needs among people with life-limiting illness: A scoping review of international evidence
No full textBackground: Quantifying palliative care needs and whether they are met is essential for effective service planning and provision. Estimates of palliative care needs are widely reported but less is known about unmet needs, with no accepted definition of this construct or guidance on how to measure it. Aim: To investigate how unmet palliative care needs for adults with advanced life-limiting illness have been defined, measured, and reported in the evidence. Design: Scoping review following the Joanna Briggs Institute guidelines: protocol registered on Open Science Framework (10.17605/OSF.IO/M8DHA). Data sources: In October 2024, we searched MEDLINE, EMBASE, CINAHL, and PsycINFO for quantitative and mixed-methods studies published after 2000, with backward and forward citation and manual searching of grey literature. Data on definitions, measurement and reporting of unmet needs were extracted, charted, and summarised narratively using inductive content analysis and framework synthesis. Results: Seventy studies were included: 9 reviews and 61 primary evidence studies from 16 countries. Only 11 (16%) studies explicitly defined unmet palliative care needs. We identified three approaches to measurement of unmet palliative care needs: (1) prevalence of symptoms and concerns; (2) access to services (e.g. specialist palliative care); and (3) sufficiency of service provision to resolve symptoms and concerns. Conclusions: This novel review identifies a lack of consensus in defining, measuring and reporting unmet palliative care needs. We propose three distinct approaches to conceptualising unmet palliative care needs and outline their strengths and limitations. Practical guidance on their use is provided to support researchers, clinicians, and policymakers in selecting appropriate approaches for assessment and reporting
Developing a decision support tool for the continuation or deprescribing of antithrombotic therapy in patients receiving end-of-life care: Results of a European Delphi study
No full textINTRODUCTION: To develop a European shared decision-support tool (SDST), a two-round Delphi process was used to achieve consensus on aspects relating to the antithrombotic therapy (ATT) deprescribing discussions and process in end-of-life cancer patients. METHODS: Conducted between September 2024 and March 2025, the Delphi survey was developed by a multidisciplinary 24-member steering committee (SC), including medical specialists in oncology, hematology, palliative care, primary care, geriatrics, and vascular medicine. The survey involved 188 experts from these specialties across eight European countries. Consensus was defined with pooled items as ≥70 % agreement with a final decision by the SC. Themes covered deprescribing timing, stakeholders, reassessment and clinical drivers of patients with ATT, SDST, and choice of outcomes for a randomized controlled trial (RCT) to evaluate the SDST. RESULTS: Round 1 reached consensus for seven pooled questions (37 %), especially the reassessment of ATT deprescribing. Considering these results, the SC reformulated round 2 to reduce ambiguity and move toward consensus. The SC made the final decision. Three medical specialties should be involved in ATT deprescribing: palliative care specialists, oncologists, and general practitioners after a triggering circumstance such as clinical triggers or at 3-month prognosis. For the SDST design, the findings confirmed that this tool would be meaningful to clinicians. Eleven predefined outcomes were selected for a future RCT. CONCLUSION: These results succeeded in shaping the content of the future SDST and mapping its useability in palliative care clinical pathways across Europe, with the perspective to support informed decision-making, reduce complications, and improve quality of life in this population
Achieving Net Zero in a Cluttered Seascape: Policy Gaps, Conflicts and Synergies.
No full textThe global climate crisis requires immediate and comprehensive action to reduce greenhouse gas emissions and limit global temperature rises “well below” 2°C. The UK has committed to reaching Net Zero by 2050 (Scotland 2045) with several policies proposed to achieve this goal and ambitious aims to decarbonise whole industries. The UK marine environment is expanding its activities and capitalising on blue growth. Here, we review current marine policies in the context of Net Zero and find that, despite the proliferation of Net Zero policies, there are crucial gaps impeding how Net Zero will be achieved in the marine environment. With the increasing demand for ocean space and the transition to Net Zero, conflicts have arisen between the drive for green energy through offshore wind (OSW) and maintaining space for existing marine users. Better protection and restoration of blue carbon sites and environmental protection targets will be required to meet Net Zero but could lead to further spatial squeeze. Synergies between marine sectors have emerged or are being considered, which may reduce tensions as industries look to expand to achieve Net Zero, e.g. OSW accommodating certain types of fishing, decarbonising oil and gas production, and decommissioned oil and gas infrastructure being repurposed for green energy production or carbon capture and storage. As marine industries expand and decarbonise, trade-offs are likely, and it remains to be seen whether Net Zero will be prioritised, or if policy gaps and outdated policies will impact the UK meeting its legal Net Zero obligations