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IntroductionBSG guidance for OGD recommends 8 landmarks for PD during a diagnostic procedure, including the second part of the duodenum, the bulb, pylorus, incisura, gastric body, fundal retroflexion, gastro-oesophageal junction, and the upper oesophagus.1 Failure to adhere to these guidelines may result in inadequate inspection and missed diagnoses. We retrospectively assessed adherence to these PD guidelines, and addressed factors that might influence adherence, within the setting of a busy secondary care endoscopy unit.MethodsA retrospect analysis of 250 consecutive OGDs was conducted over autumn 2023. Data were collected on: referral type (routine/urgent/two-week rule (TWR)/surveillance), total number of photos taken per OGD, location of photos (i.e. correct landmarks), sedation usage (throat spray/sedation/both) and level of endoscopist (medical/surgical/nurse endoscopist). Cases were excluded if the OGD was therapeutic, there were technical issues with image download or there was post-surgical anatomical variance in the upper GI tract. A senior gastroenterology trainee examined all the photos for compliance with the guidelines. A PD score between 0–8 was given for the number of correct photos (e.g. a score of 8 was allocated to any OGD where all landmarks were clearly captured). A multivariate logistic regression model was created to assess variables associated with a PD score ≥6.ResultsAfter exclusions, 195 OGDs were performed (medical 24%, surgical 19%, nurse endoscopist 57%). Mean age of patient was 60.4 years, and 58% were female. Throat spray was used in 13% of cases, sedation only in 17%, and 70% required both. The mean number of photos captured per OGD was 9. Only 8% of OGDs had all 8 recommended landmarks clearly photographed. 36% had a PD score ≥6. The proportion of OGDs in which each individual landmark was captured was: Upper oesophagus: 48%, GOJ: 92%, Fundus: 90%, Body: 30%, Incisura: 21%, Pylorus: 90%, Duodenal bulb: 54%, D2: 93%. Logistic regression analysis indicated medical endoscopists (odds ratio (OR) 5.7, 95% confidence interval (CI) 2.4–13.5, p=0.0001) and a procedure performed under TWR (OR 2.9 (95% CI 1.2–6.7, p=0.02) as independent variables associated with a PD ≥6.ConclusionsPD during OGD was poor in this study, and training of endoscopy staff is warranted to increase adherence to clinical guidelines. Endoscopist level, and urgency of procedural pathway appear to be factors that improve the likelihood of complete PD.ReferenceRey JF, Lambert R, ESGE Quality Assurance Committee. ESGE recommendations for quality control in gastrointestinal endoscopy: guidelines for image documentation in upper and lower GI Endoscopy. Endoscopy 2001 Oct;33(10):901–3. doi:10.1055/s-2001–42537.

CM chondrites are unequilibrated breccias sampling primitive asteroids altered by water-rock interactions. While much research has focused on bulk measurements, only tentative attempts have been made to elucidate the complex petrographic and O-isotopic heterogeneity at the clast and component scale utilising this high precision approach.Clasts of petrologic subtype CM1/2.0 – 2.8 were found in four falls and one very diverse find, LON 94101, the latter of which strengthens the case of a discrete parent body source for CM chondrites. The petrologic subtype of moderately altered clasts ranging from 2.2-2.6 appear to correlate well with variable ‘FeO’/SiO2and Mg# compositions within their phyllosilicates, though this is poorly matched from meteorite to meteorite. Fully altered clasts (CM1/CM2.0) host an array of diverse textures ranging from dark, Mg-dominated matrix-rich clasts to those containing abundant chondrule pseudomorphs, comparable in large part to the diversity seen in CM2 material. An array of rarer, petrographically distinct lithologies, including incipiently altered, predominantly anhydrous examples, attest to the diversity of CM material in the meteorite record.Matrix phyllosilicates from 30 petrographically characterised CM lithologies and 4 cataclastic matrix fractions were micro-sampled to investigate lithology-specific aqueous alteration phenomena through their O-isotopes, obtained via a revised laser fluorination protocol for small, phyllosilicate-rich samples. The exclusion of a significant anhydrous precursor component within these fractions reveals a novel, apparently mass-dependent trend: the CM matrix fractionation line (CMF) at ~ Δ17O = -2.35 ± 0.46‰ (2σ), indicating the CM lithologies were altered within a narrow range of water to rock (WR) ratios and that historical O-isotope variation primarily just reflects variable amounts of anhydrous precursor. This weakens the case for a closed system style of alteration, where variable WR ratios may be expected; indeed, an open system may provide a better explanation where equilibration of water is achieved over a mineralogically diverse area on the CM asteroid.

Although COVID-19 was first recognised as an acute respiratory illness, extra-pulmonary manifestations are increasingly being recognised. Acute gastrointestinal side effects have been well reported with COVID-19 infection and are estimated to affect around 17% of patients. With COVID-19 still being a relatively new illness, the chronic gastrointestinal symptoms are less well characterised. Post-infectious irritable bowel syndrome (IBS) can occur following bacterial and viral infections, and with ACE-2 receptors being shown to be present in the gastrointestinal tract and SARS-Cov-2 RNA being present in stool, SARS-CoV-2 is now appreciated as an enteric pathogen. In our study, we survey acute and chronic gastrointestinal symptoms after COVID-19 infection. We have conducted one of the few UK studies on gastrointestinal symptoms, with the longest follow-up duration of 6 months. We have found that gastrointestinal symptoms are common at 6 months, affecting 43.8% of our patients. Further research is needed to explore whether this represents a new post-COVID-19 IBS, which has not previous been described in the literature, including its clinical course and response to any potential medical therapies.

Volatile and organic-rich C-type asteroids may have been one of the main sources of Earth’s water. Our best insight into their chemistry is currently provided by carbonaceous chondritic meteorites, but the meteorite record is biased: only the strongest types survive atmospheric entry and are then modified by interaction with the terrestrial environment. Here we present the results of a detailed bulk and microanalytical study of pristine Ryugu particles, brought to Earth by the Hayabusa2 spacecraft. Ryugu particles display a close compositional match with the chemically unfractionated, but aqueously altered, CI (Ivuna-type) chondrites, which are widely used as a proxy for the bulk Solar System composition. The sample shows an intricate spatial relationship between aliphatic-rich organics and phyllosilicates and indicates maximum temperatures of ~30 °C during aqueous alteration. We find that heavy hydrogen and nitrogen abundances are consistent with an outer Solar System origin. Ryugu particles are the most uncontaminated and unfractionated extraterrestrial materials studied so far, and provide the best available match to the bulk Solar System composition. The sample taken from carbonaceous asteroid Ryugu and brought back to Earth by the Hayabusa2 spacecraft contains outer Solar System-derived materials uncontaminated by terrestrial processes. Even CI carbonaceous chondrites, despite their closeness to solar abundances, are not pristine.

Ryugu is the C-type asteroid from which material was brought to Earth by the Hayabusa2 mission. A number of individual grains and fine-grained samples analysed so far for noble gases have indicated that solar wind and planetary (known as P1) noble gases are present in Ryugu samples with concentrations higher than those observed in CIs, suggesting the former to be more primitive compared to the latter. Here we present results of analyses of three fine-grained samples from Ryugu, in one of which Xe concentration is an order of magnitude higher than determined so far in other samples from Ryugu. Isotopically, this Xe resembles P1, but with a much stronger isotopic fractionation relative to solar wind and significantly lower 36 Ar/ 132 Xe ratio than in P1. This previously unknown primordial noble gas component (here termed P7) provides clues to constrain how the solar composition was fractionated to form the planetary components. Ryugu is more primitive than carbonaceous chondrites, according to elevated noble gas concentrations. Elevated Xe and its isotopic composition further provide constraints on fractionation of the solar composition to form the early planetary components.

The delivery of water to the inner Solar System, including Earth, is still a debated topic. A preferential role for hydrated asteroids in this process is supported by isotopic measurements. Carbonaceous chondrite (CC) meteorites represent our main source of information about these volatile-rich asteroids. However, the destruction of weaker materials during atmospheric entry creates a bias in our CC data. The return of surface materials from the C-type asteroid 162173 Ryugu by the Hayabusa2 spacecraft provides a unique opportunity to study high-porosity, low-density, primitive materials, unrepresented in the meteorite record. We measured the bulk oxygen isotope composition from four Ryugu particles and show that they most closely resemble the rare CI (CC Ivuna-type) chondrites, but with some differences that we attribute to the terrestrial contamination of the CI meteorites. We suggest that CI-related material is widespread among carbonaceous asteroids and a more important source of Earth’s water and other volatiles than its limited presence in our meteoritic collection indicates.Oxygen isotopic measurements from the Ryugu returned sample suggest that primitive hydrated carbonaceous chondrites are an important source of early water and other volatiles to Earth, despite being underrepresented in our meteorite collection due to their preferential destruction during atmospheric entry.

This paper describes a consumer evaluation that explored the reflections of persons with psychiatric disabilities on receiving individualized feedback following participation in a community research project. Findings indicate that feedback is an important element of research, offering a valued means to reciprocate participants' contributions. Feedback can facilitate mutual learning, fostering hope and empowerment, while participation in performance tests without feedback may reinforce negative self-evaluations. Feedback needs sensitive presentation and discussion, focused on strengths, to be experienced as worthwhile and respectful by people with psychiatric disabilities. This is particularly important as their self-identities may already be undermined by experiences of mental illness. Researchers need dedicated time, resources, and training to incorporate individual feedback in research.

C-type asteroids likely formed in the outer Solar System and were then scattered inwards during giant planet migration (Walsh et al., 2011). They may have transported volatiles to the inner Solar System and created the conditions suitable for life on Earth(Alexander, 2017). Carbonaceous chondrites are fragments from C-type asteroids and provide evidence that these generally organic-rich (Garvie and Buseck, 2007) bodies experienced extensive aqueous alteration early in Solar System history (Alexander et al., 2014). On 6th December 2020, ~5.4g of material was delivered to Earth from the C-type asteroid 162173 Ryugu by the Hayabusa2 spacecraft (Yada et al., 2021). Here we present the results of an integrated bulk and micro-analytical study of Ryugu particles, which provides a unique insight into the interrelationship between aliphatic-rich organics and surrounding hydrous minerals at a sub-micrometer scale. This dataset has clear implications for better understanding the origin and early evolution of Solar System organic matter and demonstrates that Ryugu particles are among the most uncontaminated extraterrestrial materials so far studied.

The vast majority of thoracic aortic aneurysms (TAAs) grow without any symptoms, making detection before rupture or dissection extremely challenging. TAAs that have been diagnosed early are typically detected in patients with an existing connective tissue disorder or noted as an incidental finding on a scan done for another purpose. However, this may not be the case for much longer. Eight clinical markers have been discovered that can indicate the presence of a silent TAA intracranial aneurysms, aortic arch abnormalities, abdominal aortic aneurysms, bicuspid aortic valve, renal cysts, a positive thumb–palm test, family history of aortic disease, and giant cell arteritis. Many of these conditions are thought to share similar genetics or pathophysiology to TAA development. These clinical findings, variants, and diseases have an increased incidence in patients with thoracic aortic disease. If clinicians discover one or more of these markers in a patient, proper investigation could lead to early detection and repair of a TAA, reducing the high morbidity and mortality associated with TAAs.