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Pressurised metered-dose inhalers: How do they work? A short guide for clinicians.
No full textPressurised metered-dose inhalers (pMDIs) are widely used in the treatment of paediatric respiratory diseases. Despite their widespread use, knowledge about effective inhaler technique amongst patients and clinicians is poor. Even amongst well-trained specialists, knowledge about how these devices function is limited. This short review outlines what it is critical to understand about how pMDIs work. This allows advanced troubleshooting of problems for patients and can decrease non-intentional non-adherence from a variety of causes. [Abstract copyright: Copyright © 2025 Elsevier Ltd. All rights reserved.
EXPRESS: The impact of dimension switching on visual short-term memory.
Full text linkVisual short-term memory (vSTM) refers to the subset of the cognitive system responsible for storing visual information over short periods of time. While much research has focussed on its capacity limitations, less is known about how vSTM operates in dynamic environments where priorities shift across feature dimensions. In this study, we bridge research on vSTM and cognitive control by embedding change detection (Experiments 1 and 2) and delayed estimation (Experiment 3) paradigms within a task switching paradigm, where the relevant feature dimension (colour or orientation) either repeated or switched across trials. Across all experiments we observed a cost to vSTM performance on switch relative to repetition trials. Mixture modelling of delayed estimation responses revealed that these switch costs were not due to reduced memory precision or memory failures, but rather to a selective increase in non-target responses reflecting feature--location binding errors. We propose that dimension switching selectively impairs the binding of feature values to locations and allows interference from irrelevant (but recently attended) feature dimensions. Our findings demonstrate that vSTM is sensitive to failures of attentional control, not just capacity limits
The Nearby Evolved Stars Survey III. First data release of JCMT CO-line observations
No full textLow- to intermediate-mass (∼ 0.8−8 M ⊙ ) evolved stars contribute significantly to the chemical enrichment of the interstellar medium in the local Universe. It is therefore crucial to accurately measure the mass return in their final evolutionary stages. The Nearby Evolved Stars Survey (NESS) is a large multi-telescope project targeting a volume-limited sample of ∼ 850 stars within 3 kpc in order to derive the dust and gas return rates in the solar neighbourhood, and to constrain the physics underlying these processes. We present an initial analysis of the CO-line observations, including detection statistics, carbon isotopic ratios, initial mass-loss rates, and gas-to-dust ratios. We describe a new data reduction pipeline for homogeneity, which we use to analyse the available NESS CO data from the James Clerk Maxwell Telescope, measuring line parameters and calculating empirical gas mass-loss rates. We present the first release of the available data on 485 sources, one of the largest homogeneous samples of CO data to date. Comparison with a large combined literature sample finds that high mass-loss rate and especially carbon-rich sources are over-represented in literature, while NESS is probing significantly more sources at low mass-loss rates, detecting 59 sources in CO for the first time and providing useful upper limits on non-detections. CO line detection rates are 81% for the CO(2−1) line and 75% for CO(3−2). The majority (82%) of detected lines conform to the expected soft parabola shape, while eleven sources show a double wind. Calculated mass-loss rates show power-law relations with both the dust-production rates and expansion velocities, up to a mass-loss rate saturation value ∼ 5 × 10 −6 M ⊙ yr −1 . Median gas-to-dust ratios of 250 and 680 are found for oxygen-rich and carbon-rich sources, respectively. Our analysis of CO observations in this first data release highlights the importance of our volume-limited approach in characterizing the local AGB population as a whole
The EBLM project XVI. Moderate spin-orbit misalignment of the low mass eclipsing binary EBLM J0021-16
No full textThousands of tight (<1 AU) main sequence binaries have been discovered, but it is uncertain how they formed. There is likely too much angular momentum in a collapsing, fragmenting protostellar cloud to form such binaries in situ, suggesting some post processing. One probe of a binary’s dynamical history is the angle between the stellar spin and orbital axes – its obliquity. The classical method for determining stellar obliquity is the Rossiter-McLaughlin effect. It has been applied to over 100 hot Jupiters, but less than a dozen stellar binaries. In this paper, we present the Rossiter-McLaughlin measurement of EBLM J0021-16, a 0.19M⊙ M-dwarf eclipsing a 1.05M⊙ G-dwarf on a 5.97 day, almost-circular orbit. We combine CORALIE spectroscopy with TESS photometry and a measured primary star rotation period of 7.04 days, according to star spot modulation. We show that the orbital axis is misaligned with the primary star’s spin axis, with a true 3D obliquity of ψ = 28.9 ± 2.1○. EBLM J0021-16, being neither spin-orbit aligned nor synchronized, yet with an almost circular orbit, is a curious case for tidal evolution in tight binaries. It becomes one of a handful of eclipsing binaries with true obliquity measurements. Finally, we derive the M-dwarf’s mass and radius to a fractional precision better than 1 %. The radius of the M-dwarf is inflated by 6 % (7.4σ) with respect to stellar models, consistent with many other M-dwarfs in the literature
The effectiveness of a motivational interviewing-based intervention for reducing depressive symptoms after stroke compared to an attention control and usual care: study protocol for a multi-centre randomised controlled trial (COMMITS)
No full textBackground: Depression affects almost 60% of stroke survivors, impacting on recovery and quality-of-life. Depression may be treated with medication or talk-based therapies. One randomised controlled trial showed a talk-based therapy called motivational interviewing-based intervention (MIBI) delivered early after stroke reduced depressive symptoms at 3 and 12 months post-stroke compared with receiving usual care alone. However, it was unclear if the benefit was due to the specific MIBI components or simply the additional attention received. This trial aims to determine the effect of MIBI plus usual care on reducing depressive symptoms post-stroke, relative to usual care (UC), and to an attention control (AC) (social attention without therapeutic content, i.e. general conversation). Methods: Patients admitted following acute stroke meeting the study eligibility criteria (not currently receiving talk-based therapy and not currently having severe depression) will be recruited across 18 UK hospitals within 28 days of stroke. A total of 1287 participants will be randomised on a 1:1:1 ratio into three groups: MIBI + UC; AC + UC; UC. Participants in MIBI + UC and AC + UC will additionally have remote (telephone/online) sessions with MIBI therapists or AC providers respectively, for four 45-min weekly sessions, beginning within 6 weeks of randomisation. Participant self-report measures of depression (primary outcome, Patient Health Questionnaire (PHQ-9) at 3 months) and quality-of-life will be collected at baseline, 6 weeks and 3 months post-randomisation. The proposed mechanism of effect, via participants’ self-efficacy and confidence, and the impact of MIBI dose and/or therapeutic alliance on outcome will also be explored. If benefit of MIBI + UC over UC is demonstrated, mixed effects regression will be fitted to outcome data from all three arms, and appropriate parametrisation with MIBI + UC as the reference group. A mixed-methods process evaluation comprising quantitative assessment of intervention adherence and fidelity and semi-structured interviews with a purposive sample of study participants (n ~ 18) and MIBI/AC staff (n ~ 15) will explore participation, acceptability, and considerations for implementation. An economic evaluation will explore cost-effectiveness. Discussion: The results will inform whether any observed improvements in mood are a natural change over time, due to attention, or a therapeutic change attributable to MIBI. If MIBI is shown to effectively reduce depressive symptoms, the process evaluation will inform implementation of the intervention into clinical care. Trial registration: ISRCTN, ISRCTN17065351. Registered 01/02/2022, https://www.isrctn.com/ISRCTN17065351
