We surveyed physicians and patients to create a novel Desirability of outcome ranking (DOOR) for non-severe community-acquired pneumonia (CAP). Patients generally ranked uncomfortable but non-life-threatening symptoms as less desirable, while physicians focused on traditional medical outcomes. When developing DOORs, both patient and clinician perspectives should be considered.

Background: Dichotomous outcomes rarely capture the range of potential outcomes important to patients and clinicians. To address this limitation, the Desirability of Outcome Ranking (DOOR) score was created to rank potential outcomes from least to most desirable. Currently, there is no standardized method to develop a DOOR score and data are limited on whether patients and their clinicians rank outcomes similarly. We aimed: (a) to develop a novel DOOR score for adults hospitalized with community-acquired pneumonia (CAP) by surveying patients and clinicians on their preferred outcome ranking and (b) to compare their relative DOOR rankings. Methods: We created nine clinical scenarios describing the spectrum of potential outcomes of patients with CAP two weeks after initial emergency department visit. To ascertain clinician DOOR score, we used a snowball sampling method to recruit a target of 25 clinicians in specialties that regularly treat CAP. For the patient DOOR score, we recruited patients hospitalized with CAP by reviewing electronic patient lists for adults hospitalized with pneumonia. Respondents were asked to rank the 9 cases from most to least desirable in REDCap. To create the final DOOR score, we used Friedman rank sum tests to combine/collapse DOOR outcomes with scores that did not significantly differ. We used the Mann Whitney U test to compare DOOR rankings between physicians and patients. Final study results were presented to a national hospital medicine patient and family advisory committee (PFAC) for their impressions. Results: 22 patients (71% response rate) and 25 clinicians responded to our DOOR survey. Their ranked order of DOOR outcomes is shown in Table 1. Combining non-significantly different DOOR outcomes resulted in collapsing of 6 cases into 2 categories for 5 overall DOOR scores that significantly differed from each other (Table 1 for final ranking). Patients and clinicians had significantly different preferred ranking for 6 DOOR cases. Our PFAC had several hypotheses as to why rankings differed (Table 2). Conclusion: We present a novel DOOR score derived from patient and clinician reported preferences for outcomes of hospitalized adult patients with CAP. Clinicians and patients differed in their perception of certain outcomes with patients ranking symptoms that were uncomfortable but not potentially life-threatening as less desirable than physicians. Physicians tended to rank quality linked metrics such as readmission as worse than patients. When designing future trials using DOOR scores, researchers should consider including patients in DOOR score design as their perspectives may differ from clinicians.

The Australian SKA Pathfinder (ASKAP) offers powerful new capabilities for studying the polarised and magnetised Universe at radio wavelengths. In this paper, we introduce the Polarisation Sky Survey of the Universe’s Magnetism (POSSUM), a groundbreaking survey with three primary objectives: (1) to create a comprehensive Faraday rotation measure (RM) grid of up to one million compact extragalactic sources across the southern $\sim50$% of the sky (20,630 deg$^2$); (2) to map the intrinsic polarisation and RM properties of a wide range of discrete extragalactic and Galactic objects over the same area; and (3) to contribute interferometric data with excellent surface brightness sensitivity, which can be combined with single-dish data to study the diffuse Galactic interstellar medium. Observations for the full POSSUM survey commenced in May 2023 and are expected to conclude by mid-2028. POSSUM will achieve an RM grid density of around 30–50 RMs per square degree with a median measurement uncertainty of $\sim$1 rad m$^{-2}$. The survey operates primarily over a frequency range of 800–1088 MHz, with an angular resolution of 20” and a typical RMS sensitivity in Stokes Q or U of 18 $\mu$Jy beam$^{-1}$. Additionally, the survey will be supplemented by similar observations covering 1296–1440 MHz over 38% of the sky. POSSUM will enable the discovery and detailed investigation of magnetised phenomena in a wide range of cosmic environments, including the intergalactic medium and cosmic web, galaxy clusters and groups, active galactic nuclei and radio galaxies, the Magellanic System and other nearby galaxies, galaxy halos and the circumgalactic medium, and the magnetic structure of the Milky Way across a very wide range of scales, as well as the interplay between these components. This paper reviews the current science case developed by the POSSUM Collaboration and provides an overview of POSSUM’s observations, data processing, outputs, and its complementarity with other radio and multi-wavelength surveys, including future work with the SKA.

Expertise exists among all communities of educational practitioners at all levels and in all national contexts. By identifying expert practitioners, learning from them and valuing their professional competence, researchers can support, promote and build upon sustainable, embodied, holistic models of quality in ways that have direct relevance for the classroom, the curriculum and wider educational goals. Yet, despite its potential as a field of research, there have been relatively few studies involving expert language teachers to date. After a brief historical background, this article makes the case for language teacher expertise research, noting its high ecological validity, its great practical utility, its ability to bridge the research–practice divide and its potentially positive impact on teaching communities. Key methodological considerations are also discussed, including defining expertise, identifying expert teachers and looking beyond the limits of subject-specific pedagogy to understand the whole practitioner in their sociocultural context. The article then proposes a framework for future teacher expertise research that spans diverse methodologies. Six example research tasks from within this framework are proposed, each justified and exemplified, incorporating suggestions for research design that are intended to encourage both experienced and novice researchers to engage with teacher expertise as a promising domain for future investigation.

Lungfishes achieved high diversity in the Devonian, but most of these lineages went extinct in the late Devonian mass extinctions. Carboniferous lungfish are generally thought to belong to one larger diversification, Phaneropleuriformes, typically associated with freshwater and estuarine environments. We here use μCT to describe a lungfish occiput from the Tournaisian of Blue Beach, Nova Scotia, Canada, the first lungfish occurrence from the Tournaisian of North America. The occiput is short and high with well-developed dorsolateral cristae, two pairs of spinal nerves posterior to the vagus nerve, and a short triangular posterior stem of the parasphenoid. Although this specimen is too incomplete to place into a phylogenetic analysis, we identify characteristics shared with both holodontids and dipterids and absent within Phaneropleuriformes, suggesting the persistence of a wider range of lungfish lineages through the end-Devonian mass extinction events, in line with recent findings from the Tournaisian-aged Ballagan Formation of Scotland. Differences in the faunal composition of the Blue Beach Member of Nova Scotia and the Ballagan Formation of the Scottish Borders may be a consequence of different paleoenvironments in these roughly coeval formations or of palaeobiogeographical barriers to dispersal between Europe and Atlantic Canada. The possible persistence of a marine or estuarine lungfish into the mid-Tournaisian shows turnover of the marine durophage guild across the Hangenberg extinction was not complete, but may have been sufficient to disrupt incumbency in earliest Carboniferous marine trophic guilds.

Secondary surface layers form by replacement of almandine garnet during chemical weathering. This study tested the hypothesis that the kinetic role of almandine’s weathering products, and the consequent relationships of primary-mineral surface texture and specific assemblages of secondary minerals, both vary with the solid-solution-controlled variations in Fe and Al contents of the specific almandine experiencing weathering.

Surface layers are protective (PSL) when the volume of the products formed by replacement is greater than or equal to the volume of the reactants replaced. Under such circumstances, reaction kinetics at the interface between the garnet and the replacing mineral are transport controlled and either transport of solvents or other reactants to, or products from, the dissolving mineral is rate limiting. Beneath PSLs, almandine garnet surfaces are smooth, rounded, and featureless. Surface layers are unprotective (USL) when the volume of the products formed by replacement is less than the volume of the reactants replaced. Under such circumstances, reaction kinetics at the interface between the garnet and the replacing mineral are interface controlled and the detachment of ions or molecules from the mineral surface is rate limiting. Almandine garnet surfaces beneath USLs exhibit crystallographically oriented etch pits. However, contrary to expectations, etch pits occur on almandine garnet grains beneath some layers consisting of mineral assemblages consistent with PSLs.

Based on the Pilling-Bedworth criterion, surface layers are more likely to be protective over a broad range of reactant-mineral compositions when they contain goethite, kaolinite, and pyrolusite. However, this combination requires specific ranges of Fe and Al content of the natural reacting almandine garnet. To form a PSL of goethite and kaolinite, an almandine garnet must have a minimum Al stoichiometric coefficient of ~3.75 a.p.f.u., and a minimum Fe stoichiometric coefficient of ~2.7 a.p.f.u.

Product minerals also influence the mobility of the least-mobile major rock-forming elements. A PSL consisting of goethite, gibbsite, and kaolinite yields excess Al for export during almandine garnet weathering. As the quantity of kaolinite present in the PSL decreases, the amounts of Al available for export increases.