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The associations of spiritual and religious factors with patient-reported outcomes among adolescents with cancer are unknown. To model the association of spiritual and religious constructs with patient-reported outcomes of anxiety, depressive symptoms, fatigue, and pain interference. This cross-sectional study used baseline data, collected from 2016 to 2019, from an ongoing 5-year randomized clinical trial being conducted at 4 tertiary-referral pediatric medical centers in the US. A total of 366 adolescents were eligible for the clinical trial, and 126 were randomized; participants had to be aged 14 to 21 years at enrollment and be diagnosed with any form of cancer. Exclusion criteria included developmental delay, scoring greater than 26 on the Beck Depression Inventory II, non-English speaking, or unaware of cancer diagnosis. Spiritual experiences, values, and beliefs; religious practices; and overall self-ranking of spirituality's importance. Variables were taken from the Brief Multidimensional Measurement of Religiousness/Spirituality (ie, feeling God's presence, daily prayer, religious service attendance, being very religious, and being very spiritual) and the spiritual well-being subscales of the Functional Assessment of Chronic Illness Therapy (meaning/peace and faith). Predefined outcome variables were anxiety, depressive symptoms, fatigue, and pain interference from Patient-Reported Outcomes Measurement Information System pediatric measures. A total of 126 individuals participated (72 [57.1%] female participants; 100 [79.4%] white participants; mean [SD] age, 16.9 [1.9] years). Structural equation modeling showed that meaning and peace were inversely associated with anxiety (β = -7.94; 95% CI, -12.88 to -4.12), depressive symptoms (β = -10.49; 95% CI, -15.92 to -6.50), and fatigue (β = -8.90; 95% CI, -15.34 to -3.61). Feeling God's presence daily was indirectly associated with anxiety (β = -3.37; 95% CI, -6.82 to -0.95), depressive symptoms (β = -4.50; 95% CI, -8.51 to -1.40), and fatigue (β = -3.73; 95% CI, -8.03 to -0.90) through meaning and peace. Considering oneself very religious was indirectly associated with anxiety (β = -2.81; 95% CI, -6.06 to -0.45), depressive symptoms (β = -3.787; 95% CI, -7.68 to -0.61), and fatigue (β = -3.11, 95% CI, -7.31 to -0.40) through meaning and peace. Considering oneself very spiritual was indirectly associated with anxiety (β = 2.11; 95% CI, 0.05 to 4.95) and depression (β = 2.8, 95% CI, 0.07 to 6.29) through meaning and peace. No associations were found between spiritual scales and pain interference. In this study, multiple facets of spirituality and religiousness were associated with anxiety, depression, and fatigue, all of which were indirectly associated with the participant's sense of meaning and peace, which is a modifiable process. Although these results do not establish a causal direction, they do suggest palliative interventions addressing meaning-making, possibly including a spiritual or religious dimension, as a novel focus for intervention development.

Only co-founder Matthew Tweddle cites that redefining what success means to you is key to achieving better work-life balance. Achieving a balance between work and life is something I've always struggled with. At every stage of my career I've made the next creative challenge the most important thing in my life. When the pressure is on, I'm tempted to take on too much and retain control. This is unsustainable and can stifle potential for growth. Taking the time to collaborate is essential. Working through a problem with a talented team is much more rewarding, and different perspectives always improve the solution.

We show that a breaking internal tide at a shelf edge is a fundamental control on the structural and functional properties of ecosystems. Contrasts in vertical mixing of nitrate between the shelf and the open ocean correspond with horizontal and vertical changes in phytoplankton communities, with largest cells found in surface waters at the shelf edge. Intense fishing activity is commonly seen at continental shelf edges, targeting spawning fish stocks. We suggest that the internal tide, a globally ubiquitous physical process at steep shelf edge bathymetry, supports shelf edge fisheries by providing large‐celled phytoplankton for first‐feeding fish larvae. The repeatability of the internal tide removes fish from the need to time spawning with a spring bloom. Also, with large phytoplankton cells dominating particulate organic carbon export, the internal tides could be an important influence on spatial and temporal variability in patterns of global carbon sequestration in deep water and sediments.

Measurements of the intra-tidal and spring-neap variation in the vertical flux of nitrate into the base of the sub-surface chlorophyll maximum (SCM) were made at the shelf edge of the Celtic Sea, a region with strong internal mixing driven by an internal tide. The neap tide daily mean nitrate flux was 1.3 (0.9-1.8, 95% confidence interval) $mmol m^{-2} d^{-1}$. The spring tide flux was initially estimated as 3.5 (2.3-5.2, 95% confidence interval) $mmol m^{-2} d^{-1}$. The higher spring tide nitrate flux was the result of turbulent dissipation occurring within the base of the SCM as compared to deeper dissipation during neap tides and was dominated by short events associated with the passage of internal solitons. Taking into account the likely under-sampling of these short mixing events raised the spring tide nitrate flux estimate to about $9 mmol m^{-2} d^{-1}$. The neap tide nitrate flux was sufficient to support substantial new production and a considerable fraction of the observed rates of carbon fixation. Spring tide fluxes were potentially in excess of the capacity of the phytoplankton community to uptake nitrate. This potential excess nitrate flux during spring tides may be utilized to support new production during the lower mixing associated with the transition toward neap tide. The shelf edge is shown to be a region with a significantly different phytoplankton community as compared to the adjacent Celtic Sea and northeast Atlantic Ocean, highlighting the role of gradients in physical processes leading to gradients in ecosystem structure.

We present the discovery of AT 2024wpp (\"Whippet\"), a fast and luminous 18cow-like transient. At a redshift of z=0.0868, revealed by Keck Cosmic Web Imager spectroscopy of its faint and diffuse star-forming host, it is the fourth-nearest example of its class to date. Rapid identification of the source in the Zwicky Transient Facility data stream permitted ultraviolet-through-optical observations to be obtained prior to peak, allowing the first determination of the peak bolometric luminosity (2x10^45 erg/s), maximum photospheric radius (10^15 cm), and total radiated energy (10^51 erg) of an 18cow-like object. We present results from a comprehensive multiwavelength observing campaign, including a far-UV spectrum from the Cosmic Origins Spectrograph on the Hubble Space Telescope and deep imaging extending >100 days post-explosion from the Very Large Telescope, Hubble Space Telescope, Very Large Array, and Atacama Large Millimetre Array. We interpret the observations under a model in which a powerful rapidly-accreting central engine blows a fast (~0.15c) wind into the surrounding medium and irradiates it with X-rays. The high Doppler velocities and intense ionization within this wind prevent any identifiable features from appearing in the ejecta or in the surrounding circumstellar material, even in the far-ultraviolet. Weak H and He signatures do emerge in the spectra after 35 days in the form of double-peaked narrow lines. Each peak is individually narrow (full width ~3000 km/s) but the two components are separated by ~6600 km/s, indicating stable structures of denser material, possibly representing streams of tidal ejecta or an ablated companion star.