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Information from patients who are unable to continue their visits to a study centre may be of major importance for the interpretatio n of results in multiple sclerosis (MS) clinical trials. To validate a questionnaire based on the Expanded Disability Status Scale (EDSS), patients in five different European centres were assessed independently by pairs of trained EDSS raters, first by telepho ne interview and a few days later by standardized neurological examination. Seventy women and 40 men with an average age of 43.7 years (range 19 -74 years) were included in the study. Mean EDSS score at the last visit was 4.5 (0 -9). EDSS assessment by telepho ne was highly correlated with the EDSS determined by physical examination (Pearson’s correlation coefficient -0.95). A n intraclass correlation coefficient (IC C) of 94.8% was found for the total sample; 77.6% and 86%, respectively, for patients with EDSSB-4.5 (n -46) and \\-4.5 (n -64). Kappa values for full agreement were 0.48; for variation by -0.5 steps and -1.0 steps, 0.79 and 0.90, respectively. Best agreement could be found in higher EDSS scores, where assessment by telepho ne interview might be needed most. The telepho ne questionnaire is a valid tool to assess EDSS score in cases where the patient is unable to continue visiting a study centre or in long-term follow-up of trial participants.

An increasing number of studies has observed that immersive virtual reality (iVR) technology using head-mounted displays (HMDs) can facilitate learning outcomes. However, most studies have been exploratory and were executed in laboratory settings instead of being implemented and orchestrated in authentic teaching settings. Furthermore, iVR design approaches based on learning theories in which learning objectives are in line with relevant curricula are still scarce. Thus, we conducted a study to provide insights from a perspective of instruction in authentic settings. We present the design of an iVR learning application that was aligned with curricula and that includes specific design features to foster relevant learning objectives. Orchestrated with additional learning material and learning activities, the iVR learning application was implemented and evaluated in an authentic teaching setting in the field of electrical engineering at a German vocational school. In order to investigate the effects of a lesson orchestrated around the iVR application, we conducted a study ( n  = 29) in a pre-post between-subject design in which we compared learning orchestrated around an iVR experience (iVR group n  = 14) with learning in a more traditional setting consisting of a typical group task (control group n  = 15). Participants were randomly assigned to one of the two groups; in both conditions, the same content was addressed. We compared group differences regarding four dependent variables: motivation, factual knowledge, comprehension and transfer. In both groups, we observed an increase in knowledge and comprehension. The gain in the iVR group was significantly stronger compared to the control group, but we observed no differences in motivation and transfer. We discuss our findings from a perspective of instruction in authentic settings, along with implications for instructional iVR technology design. Despite the high organizational effort still required to embed iVR technology into a classroom setting, we stress that instructional settings that entail complex cognitive and motor tasks can benefit in particular from agency as one of the main affordances provided by iVR technology. More research should be conducted in these settings, and additional research should focus on which design features make these iVR experiences effective, and how it can be assured that transfer of knowledge is also increased.

The Galactic Centre contains a supermassive black hole with a mass of four million Suns 1 within an environment that differs markedly from that of the Galactic disk. Although the black hole is essentially quiescent in the broader context of active galactic nuclei, X-ray observations have provided evidence for energetic outbursts from its surroundings 2 . Also, although the levels of star formation in the Galactic Centre have been approximately constant over the past few hundred million years, there is evidence of increased short-duration bursts 3 , strongly influenced by the interaction of the black hole with the enhanced gas density present within the ring-like central molecular zone 4 at Galactic longitude | l | < 0.7 degrees and latitude | b | < 0.2 degrees. The inner 200-parsec region is characterized by large amounts of warm molecular gas 5 , a high cosmic-ray ionization rate 6 , unusual gas chemistry, enhanced synchrotron emission 7 , 8 , and a multitude of radio-emitting magnetized filaments 9 , the origin of which has not been established. Here we report radio imaging that reveals a bipolar bubble structure, with an overall span of 1 degree by 3 degrees (140 parsecs × 430 parsecs), extending above and below the Galactic plane and apparently associated with the Galactic Centre. The structure is edge-brightened and bounded, with symmetry implying creation by an energetic event in the Galactic Centre. We estimate the age of the bubbles to be a few million years, with a total energy of 7 × 10 52  ergs. We postulate that the progenitor event was a major contributor to the increased cosmic-ray density in the Galactic Centre, and is in turn the principal source of the relativistic particles required to power the synchrotron emission of the radio filaments within and in the vicinity of the bubble cavities. Radio observations show a bipolar bubble structure of size 140 parsecs by 430 parsecs both above and below the Galactic Centre.

Background Chronic viral infections of the heart are considered one antecedent event leading to progressive dysfunction of the myocardium, often with an impaired prognosis due to a virus- or immune-mediated myocardial injury. Symptomatic treatment does not influence the viral cause of heart failure, and the effect of antiviral treatment has not been determined, yet. Methods and results In this phase II study 143 patients with symptoms of heart failure and biopsy-based confirmation of the enterovirus (EV), adenovirus, and/or parvovirus B19 genomes in their myocardial tissue were randomly assigned to double-blind treatment, and received either placebo ( n  = 48) or 4 × 10 6 ( n  = 49) and 8 × 10 6 IU ( n  = 46) interferon beta-1b (IFN-β-1b) for 24 weeks, in addition to standard heart failure treatment. Patients with active myocarditis or other specific causes of heart failure were excluded. Compared to placebo, virus elimination and/or virus load reduction was higher in the IFN-β-1b groups (odds ratio 2.33, p  = 0.048), similarly in both interferon groups and both strata. IFN-β-1b treatment was associated with favourable effects on NYHA functional class ( p  = 0.013 at follow-up week 12), improvement in quality of life (Minnesota Heart Failure score; p  = 0.032 at follow-up week 24) and patient global assessment (follow-up week 12 to follow-up week 24; p  = 0.039). The frequency of adverse cardiac events was not higher in the IFN-β-1b groups compared to the placebo group. Conclusions Immunomodulatory IFN-β-1b treatment is a well-tolerated and safe treatment option, leading to effective virus clearance or reduction of the virus load in patients with chronic viral cardiomyopathy. Favourable clinical effects assess quality of life, NYHA functional class, and patient global assessment. ClinicalTrials.gov identifier: NCT001185250

The inner \\(\\sim\\)200 pc region of the Galaxy contains a 4 million M\\(_{\\odot}\\) supermassive black hole (SMBH), significant quantities of molecular gas, and star formation and cosmic ray energy densities that are roughly two orders of magnitude higher than the corresponding levels in the Galactic disk. At a distance of only 8.2 kpc, the region presents astronomers with a unique opportunity to study a diverse range of energetic astrophysical phenomena, from stellar objects in extreme environments, to the SMBH and star-formation driven feedback processes that are known to influence the evolution of galaxies as a whole. We present a new survey of the Galactic center conducted with the South African MeerKAT radio telescope. Radio imaging offers a view that is unaffected by the large quantities of dust that obscure the region at other wavelengths, and a scene of striking complexity is revealed. We produce total intensity and spectral index mosaics of the region from 20 pointings (144 hours on-target in total), covering 6.5 square degrees with an angular resolution of 4\\(\"\\),at a central frequency of 1.28 GHz. Many new features are revealed for the first time due to a combination of MeerKAT's high sensitivity, exceptional \\(u,v\\)-plane coverage, and geographical vantage point. We highlight some initial survey results, including new supernova remnant candidates, many new non-thermal filament complexes, and enhanced views of the Radio Arc Bubble, Sgr A and Sgr B regions. This project is a SARAO public legacy survey, and the image products are made available with this article.

MeerKAT's large number of antennas, spanning 8 km with a densely packed 1 km core, create a powerful instrument for wide-area surveys, with high sensitivity over a wide range of angular scales. The MeerKAT Galaxy Cluster Legacy Survey (MGCLS) is a programme of long-track MeerKAT L-band (900-1670 MHz) observations of 115 galaxy clusters, observed for \\(\\sim\\)6-10 hours each in full polarisation. The first legacy product data release (DR1), made available with this paper, includes the MeerKAT visibilities, basic image cubes at \\(\\sim\\)8\" resolution, and enhanced spectral and polarisation image cubes at \\(\\sim\\)8\" and 15\" resolutions. Typical sensitivities for the full-resolution MGCLS image products are \\(\\sim\\)3-5 {\\mu}Jy/beam. The basic cubes are full-field and span 4 deg^2. The enhanced products consist of the inner 1.44 deg^2 field of view, corrected for the primary beam. The survey is fully sensitive to structures up to \\(\\sim\\)10' scales and the wide bandwidth allows spectral and Faraday rotation mapping. HI mapping at 209 kHz resolution can be done at \\(0

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