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This graduation project takes place in Kampala, Uganda, in collaboration with Design without Borders Africa (Dwb). The aim of the project is threefold: Create social impact in the domain of value exchange in the public space of Kampala, Apply the Vision in Product design (ViP) method for the first time in the designer’s career and Evaluate the responsibility of the designer in relation to a cross-cultural design project. After establishing the ViP domain as ‘value exchange in the public space’ and performing two deconstructions (one by the designer and one by Dwb) extensive research is performed. It focuses on a time 10 years ahead (2034) and collects 215 factors (statements about the domain): 161 from literature, and 54 from interviews with 35 vendors in Kampala. The factors are clustered into 16 driving forces of the future context. With the driving forces a framework is constructed of 12 cells, the directions the future context can move into. The axes of the framework reveal the root of the problems around street vending. (1*) the organization of public space: Kampala’s public space receives meaning from many, misaligned origins. Government planning is not consistent with the use of space. (*2) socio-economic uncertainty: the sheer numbers of people combined with a lack of jobs creates uncertainty to which people react in different ways. These reactions create their motive to participate in value exchange. 3 cells are chosen to formulate a vision statement. We want to decrease discrimination, provide stability for hustlers and steer investments to where they are needed. Three goals which correspond to the main stakeholders: vendors, clients and the local authority (KCCA). The lost in translation between them must be addressed to enable any social transformation. Integration of vendors must become the goal rather than expulsion. To achieve this we want to reveal the value of value exchange: showing v, Integrated Product Design

UNLABELLED: Current morphologic features defining advanced adenomas (size ≥10 mm, high-grade dysplasia or ≥25% villous component) cannot optimally distinguish individuals at high risk or low risk of metachronous colorectal cancer (me-CRC), which may result in suboptimal surveillance. Certain DNA copy-number alterations (CNAs) are associated with adenoma-to-carcinoma progression. We aimed to evaluate whether these molecular features can better predict an individual's risk of me-CRC than the morphologic advanced adenoma features.In this nested case-control study, 529 individuals with a single adenoma at first colonoscopy were selected from a Norwegian adenoma cohort. DNA copy-number profiles were determined, by low-coverage whole-genome sequencing. Prevalence of CNAs in advanced and non-advanced adenomas and its association (OR) with me-CRC was assessed. For the latter, cases (with me-CRC) were matched to controls (without me-CRC) on follow-up, age and sex.CNAs associated with adenoma-to-carcinoma progression were observed in 85/267 (32%) of advanced adenomas and in 27/262 (10%) of non-advanced adenomas. me-CRC was statistically significantly associated, also after adjustment for other variables, with age at baseline [OR, 1.14; 95% confidence interval CI), 1.03-1.26; P = 0.012], advanced adenomas (OR, 2.46; 95% CI, 1.50-4.01; P < 0.001) and with the presence of ≥3 DNA copy-number losses (OR, 1.90; 95% CI. 1.02-3.54; P = 0.043).Molecularly-defined high-risk adenomas were associated with me-CRC, but the association of advanced adenoma with me-CRC was stronger.SIGNIFICANCE: Identifying new biomarkers may improve prediction of me-CRC for individuals with adenomas and optimize surveillance intervals to reduce risk of colorectal cancer and reduce oversurveillance of patients with low risk of colorectal cancer. Use of DNA CNAs alone does not improve prediction of me-CRC. Further research to improve risk classification is required.

This thesis is about self-management, confidence, and secondary health conditions of people who were recently confronted with spinal cord injury. Spinal cord injury is a relative rare condition that not only causes paralysis and sensibility defects it may also affect autonomic functions like control over bladder and bowel functioning. These changes make self-management important in preventing secondary health conditions, for instance pressure injuries, urinary tract infections, pain, but also anxiety and depressive mood, if possible. The execution of self-management by people with a spinal cord injury depends on knowledge, skills and confidence in their ability to manage their condition. The results of the seven presented studies show that confidence in their ability to manage their condition is an important factor for the occurrence of mental secondary health conditions. For the physical secondary health conditions more research necessary. Further it was found that the questionnaires, currently used to measure confidence, measure mostly personality traits and not the state aspects of confidence. While these state aspects are supposed to highly correlated with adjustment after spinal cord injury, there is a need for a sensitive state questionnaire in clinical practice. Confidence being an important aspect of adjusting after spinal cord injury, this should be emphasized during rehabilitation after spinal cord injury. This can be done by making confidence an important rehabilitation target. The whole rehabilitation team can work on this target in an interdisciplinary approach.

The Victorian Specialist Immunization Services (VicSIS) was established in Victoria, Australia, in February 2021, aiming to enhance vaccine safety services for Coronavirus disease (COVID-19) vaccines. VicSIS supports practitioners and patients with complex vaccine safety questions, including those who experience adverse events following immunization (AEFI) after COVID-19 vaccines. VicSIS provides individual vaccination recommendations, allergy testing, vaccine challenges, and vaccination under supervision. VicSIS initially comprised of eight adult COVID-19 specialist vaccination clinics, subsequently, expanding to better support pediatric patients as the Australian vaccine roll-out extended to adolescents and children. Since their establishment to September 2021, the inaugural VicSIS clinics received a total of 26,401 referrals and reviewed 6,079 patients. Consults were initially predominantly for pre-vaccination reviews, later predominantly becoming post-vaccination AEFI reviews as the program progressed. Regardless of the type of consult, the most common consult outcome was a recommendation for routine vaccination (73% and 55% of consult outcomes respectively). VicSIS is an integral component of the COVID-19 vaccination program and supports confidence in COVID-19 vaccine safety by providing consistent advice across the state. VicSIS aims to strengthen the health system through the pandemic, bolstering specialist immunization services beyond COVID-19 vaccines, including training the next generation of vaccinology experts.

Bacille Calmette-Guérin (BCG), the only currently licenced tuberculosis vaccine, may exert beneficial non-specific effects (NSE) in reducing infant mortality. We conducted a randomised controlled clinical study in healthy UK adults to evaluate potential NSE using functional in-vitro growth inhibition assays (GIAs) as a surrogate of protection from four bacteria implicated in infant mortality. Volunteers were randomised to receive BCG intradermally (n = 27) or to be unvaccinated (n = 8) and were followed up for 84 days; laboratory staff were blinded until completion of the final visit. Using GIAs based on peripheral blood mononuclear cells, we observed a significant reduction in the growth of the Gram-negative bacteria Escherichia coli and Klebsiella pneumonia following BCG vaccination, but no effect for the Gram-positive bacteria Staphylococcus aureus and Streptococcus agalactiae. There was a modest association between S. aureus nasal carriage and growth of S. aureus in the GIA. Our findings support a causal link between BCG vaccination and improved ability to control growth of heterologous bacteria. Unbiased assays such as GIAs are potentially useful tools for the assessment of non-specific as well as specific effects of TB vaccines. This study was funded by the Bill and Melinda Gates Foundation and registered with ClinicalTrials.gov (NCT02380508, 05/03/2015; completed).

This annex on Definitions, Units and Conventions provides background information on material used in the Working Group III contribution to the Intergovernmental Panel on Climate Change (IPCC) Sixth Assessment Report (AR6 WGIII). The material presented in this annex documents metrics and common datasets that are typically used across multiple chapters of the report. In a few instances there are no updates to what was adopted by WGIII during the production of the Fifth Assessment Report (AR5), in which case this annex refers to Annex II of AR5 (Krey et al. 2014).

The Working Group III (WGIII) contribution to the IPCC’s Sixth Assessment Report (AR6) assesses literature on the scientific, technological, environmental, economic and social aspects of mitigation of climate change.The report reflects new findings in the relevant literature and builds on previous IPCC reports, including the WGIII contribution to the IPCC’s Fifth Assessment Report (AR5), the WGI and WGII contributions to AR6 and the three Special Reports in the Sixth Assessment cycle, as well as other UN assessments.

Chapter 3 assesses the emissions pathways literature in order to identify their key characteristics (both in commonalities and differences) and to understand how societal choices may steer the system into a particular direction (high confidence). More than 2000 quantitative emissions pathways were submitted to the IPCC’s Sixth Assessment Report AR6 scenarios database, out of which 1202 scenarios included sufficient information for assessing the associated warming consistent with WGI.

The Agriculture, Forestry and Other Land Use (AFOLU) sector encompasses managed ecosystems and offers significant mitigation opportunities while delivering food, wood and other renewable resources as well as biodiversity conservation, provided the sector adapts to climate change. Land-based mitigation measures represent some of the most important options currently available. They can both deliver carbon dioxide removal (CDR) and substitute for fossil fuels, thereby enabling emissions reductions in other sectors. The rapid deployment of AFOLU measures is essential in all pathways staying within the limits of the remaining budget for a 1.5°C target (high confidence). Where carefully and appropriately implemented, AFOLU mitigation measures are uniquely positioned to deliver substantial co-benefits and help address many of the wider challenges associated with land management. If AFOLU measures are deployed badly then, when taken together with the increasing need to produce sufficient food, feed, fuel and wood, they may exacerbate trade-offs with the conservation of habitats, adaptation, biodiversity and other services. At the same time the capacity of the land to support these functions may be threatened by climate change itself (high confidence).

The total emission mitigation potential achievable by the year 2030, calculated based on sectoral assessments, is sufficient to reduce global greenhouse gas emissions to half of the current (2019) level or less (robust evidence, high agreement). This potential (32–44 GtCO2-eq) requires implementation of a wide range of mitigation options. Options with mitigation costs lower than USD20 tCO2 –1 make up more than half of this potential and are available for all sectors.

Meeting climate mitigation goals would require transformative changes in the transport sector (high confidence). In 2019, direct greenhouse gas (GHG) emissions from the transport sector were 8.7 GtCO2-eq (up from 5.0 GtCO2-eq in 1990) and accounted for 23% of global energy-related CO2 emissions. 70% of direct transport emissions came from road vehicles, while 1%, 11%, and 12% came from rail, shipping, and aviation, respectively. Emissions from shipping and aviation continue to grow rapidly. Transport related emissions in developing regions of the world have increased more rapidly than in Europe or North America, a trend that is likely to continue in coming decades (high confidence).

Global net anthropogenic greenhouse gas (GHG) emissions during the last decade (2010–2019) were higher than at any previous time in human history (high confidence). Since 2010, GHG emissions have continued to grow, reaching 59 ± 6.6 GtCO2-eq in 2019,1 but the average annual growth in the last decade (1.3%, 2010–2019) was lower than in the previous decade (2.1%, 2000–2009) (high confidence). Average annual GHG emissions were 56 ± 6.0 GtCO2-eq yr –1 for the decade 2010–2019 growing by about 9.1 GtCO2-eq yr –1 from the previous decade (2000–2009) – the highest decadal average on record (high confidence).

The use of scenarios and modelling methods are pillars in IPCC Working Group III (WGIII) Assessment Reports. Past WGIII assessment report cycles identified knowledge gaps about the integration of modelling across scales and disciplines, mainly between global integrated assessment modelling methods and bottom-up modelling insights of mitigation responses. The need to improve the transparency of model assumptions and enhance the communication of scenario results was also recognised. This annex on Scenarios and Modelling Methods aims to address some of these gaps by detailing the modelling frameworks applied in the WGIII Sixth Assessment Report (AR6) chapters and disclose scenario assumptions and its key parameters. It has been explicitly included in the Scoping Meeting Report of the WGIII contribution to the AR6 and approved by the IPCC Panel at the 46th Session of the Panel.

Warming cannot be limited to well below 2°C without rapid and deep reductions in energy system carbon dioxide (CO2) and greenhouse gas (GHG) emissions. In scenarios limiting warming to 1.5°C (>50%) with no or limited overshoot (2°C (>67%) with action starting in 2020), net energy system CO2 emissions (interquartile range) fall by 87–97% (60–79%) in 2050. In 2030, in scenarios limiting warming to 1.5°C (>50%) with no or limited overshoot, net CO2 and GHG emissions fall by 35–51% and 38–52% respectively. In scenarios limiting warming to 1.5°C (>50%) with no or limited overshoot (2°C (>67%)), net electricity sector CO2 emissions reach zero globally between 2045 and 2055 (2050 and 2080). (high confidence).

This chapter focuses on accelerating mitigation and on shifting development pathways to increased sustainability, based on literature particularly at national scale. While previous WGIII assessments have discussed mitigation pathways, focus on development pathways is more recent. The timeframe is the near term (now up to 2030) to mid-term (2030 to 2050), complementing Chapter 3 on the long term (from 2050 onward).

Assessment of the social science literature and regional case studies reveals how social norms, culture, and individual choices interact with infrastructure and other structural changes over time. This provides new insight into climate change mitigation strategies, and how economic and social activity might be organised across sectors to support emission reductions. To enhance well-being, people demand services and not primary energy and physical resources per se. Focusing on demand for services and the different social and political roles people play broadens the participation in climate action.

This chapter focuses on accelerating mitigation and on shifting development pathways to increased sustainability, based on literature particularly at national scale. While previous WGIII assessments have discussed mitigation pathways, focus on development pathways is more recent. The timeframe is the near term (now up to 2030) to mid-term (2030 to 2050), complementing Chapter 3 on the long term (from 2050 onward).

Meeting climate mitigation goals would require transformative changes in the transport sector (high confidence). In 2019, direct greenhouse gas (GHG) emissions from the transport sector were 8.7 GtCO2-eq (up from 5.0 GtCO2-eq in 1990) and accounted for 23% of global energy-related CO2 emissions. 70% of direct transport emissions came from road vehicles, while 1%, 11%, and 12% came from rail, shipping, and aviation, respectively. Emissions from shipping and aviation continue to grow rapidly. Transport related emissions in developing regions of the world have increased more rapidly than in Europe or North America, a trend that is likely to continue in coming decades (high confidence).

Global net anthropogenic greenhouse gas (GHG) emissions during the last decade (2010–2019) were higher than at any previous time in human history (high confidence). Since 2010, GHG emissions have continued to grow, reaching 59 ± 6.6 GtCO2-eq in 2019,1 but the average annual growth in the last decade (1.3%, 2010–2019) was lower than in the previous decade (2.1%, 2000–2009) (high confidence). Average annual GHG emissions were 56 ± 6.0 GtCO2-eq yr –1 for the decade 2010–2019 growing by about 9.1 GtCO2-eq yr –1 from the previous decade (2000–2009) – the highest decadal average on record (high confidence).

The use of scenarios and modelling methods are pillars in IPCC Working Group III (WGIII) Assessment Reports. Past WGIII assessment report cycles identified knowledge gaps about the integration of modelling across scales and disciplines, mainly between global integrated assessment modelling methods and bottom-up modelling insights of mitigation responses. The need to improve the transparency of model assumptions and enhance the communication of scenario results was also recognised. This annex on Scenarios and Modelling Methods aims to address some of these gaps by detailing the modelling frameworks applied in the WGIII Sixth Assessment Report (AR6) chapters and disclose scenario assumptions and its key parameters. It has been explicitly included in the Scoping Meeting Report of the WGIII contribution to the AR6 and approved by the IPCC Panel at the 46th Session of the Panel.

Warming cannot be limited to well below 2°C without rapid and deep reductions in energy system carbon dioxide (CO2) and greenhouse gas (GHG) emissions. In scenarios limiting warming to 1.5°C (>50%) with no or limited overshoot (2°C (>67%) with action starting in 2020), net energy system CO2 emissions (interquartile range) fall by 87–97% (60–79%) in 2050. In 2030, in scenarios limiting warming to 1.5°C (>50%) with no or limited overshoot, net CO2 and GHG emissions fall by 35–51% and 38–52% respectively. In scenarios limiting warming to 1.5°C (>50%) with no or limited overshoot (2°C (>67%)), net electricity sector CO2 emissions reach zero globally between 2045 and 2055 (2050 and 2080). (high confidence).

Chapter 3 assesses the emissions pathways literature in order to identify their key characteristics (both in commonalities and differences) and to understand how societal choices may steer the system into a particular direction (high confidence). More than 2000 quantitative emissions pathways were submitted to the IPCC’s Sixth Assessment Report AR6 scenarios database, out of which 1202 scenarios included sufficient information for assessing the associated warming consistent with WGI.

The total emission mitigation potential achievable by the year 2030, calculated based on sectoral assessments, is sufficient to reduce global greenhouse gas emissions to half of the current (2019) level or less (robust evidence, high agreement). This potential (32–44 GtCO2-eq) requires implementation of a wide range of mitigation options. Options with mitigation costs lower than USD20 tCO2 –1 make up more than half of this potential and are available for all sectors.

The Agriculture, Forestry and Other Land Use (AFOLU) sector encompasses managed ecosystems and offers significant mitigation opportunities while delivering food, wood and other renewable resources as well as biodiversity conservation, provided the sector adapts to climate change. Land-based mitigation measures represent some of the most important options currently available. They can both deliver carbon dioxide removal (CDR) and substitute for fossil fuels, thereby enabling emissions reductions in other sectors. The rapid deployment of AFOLU measures is essential in all pathways staying within the limits of the remaining budget for a 1.5°C target (high confidence). Where carefully and appropriately implemented, AFOLU mitigation measures are uniquely positioned to deliver substantial co-benefits and help address many of the wider challenges associated with land management. If AFOLU measures are deployed badly then, when taken together with the increasing need to produce sufficient food, feed, fuel and wood, they may exacerbate trade-offs with the conservation of habitats, adaptation, biodiversity and other services. At the same time the capacity of the land to support these functions may be threatened by climate change itself (high confidence).

Assessment of the social science literature and regional case studies reveals how social norms, culture, and individual choices interact with infrastructure and other structural changes over time. This provides new insight into climate change mitigation strategies, and how economic and social activity might be organised across sectors to support emission reductions. To enhance well-being, people demand services and not primary energy and physical resources per se. Focusing on demand for services and the different social and political roles people play broadens the participation in climate action.

The Working Group III (WGIII) contribution to the IPCC’s Sixth Assessment Report (AR6) assesses literature on the scientific, technological, environmental, economic and social aspects of mitigation of climate change.The report reflects new findings in the relevant literature and builds on previous IPCC reports, including the WGIII contribution to the IPCC’s Fifth Assessment Report (AR5), the WGI and WGII contributions to AR6 and the three Special Reports in the Sixth Assessment cycle, as well as other UN assessments.

Global net anthropogenic greenhouse gas (GHG) emissions during the last decade (2010–2019) were higher than at any previous time in human history (high confidence). Since 2010, GHG emissions have continued to grow, reaching 59 ± 6.6 GtCO2-eq in 2019,1 but the average annual growth in the last decade (1.3%, 2010–2019) was lower than in the previous decade (2.1%, 2000–2009) (high confidence). Average annual GHG emissions were 56 ± 6.0 GtCO2-eq yr –1 for the decade 2010–2019 growing by about 9.1 GtCO2-eq yr –1 from the previous decade (2000–2009) – the highest decadal average on record (high confidence).

The Working Group III (WGIII) contribution to the IPCC’s Sixth Assessment Report (AR6) assesses literature on the scientific, technological, environmental, economic and social aspects of mitigation of climate change.The report reflects new findings in the relevant literature and builds on previous IPCC reports, including the WGIII contribution to the IPCC’s Fifth Assessment Report (AR5), the WGI and WGII contributions to AR6 and the three Special Reports in the Sixth Assessment cycle, as well as other UN assessments.

The use of scenarios and modelling methods are pillars in IPCC Working Group III (WGIII) Assessment Reports. Past WGIII assessment report cycles identified knowledge gaps about the integration of modelling across scales and disciplines, mainly between global integrated assessment modelling methods and bottom-up modelling insights of mitigation responses. The need to improve the transparency of model assumptions and enhance the communication of scenario results was also recognised. This annex on Scenarios and Modelling Methods aims to address some of these gaps by detailing the modelling frameworks applied in the WGIII Sixth Assessment Report (AR6) chapters and disclose scenario assumptions and its key parameters. It has been explicitly included in the Scoping Meeting Report of the WGIII contribution to the AR6 and approved by the IPCC Panel at the 46th Session of the Panel.

Meeting climate mitigation goals would require transformative changes in the transport sector (high confidence). In 2019, direct greenhouse gas (GHG) emissions from the transport sector were 8.7 GtCO2-eq (up from 5.0 GtCO2-eq in 1990) and accounted for 23% of global energy-related CO2 emissions. 70% of direct transport emissions came from road vehicles, while 1%, 11%, and 12% came from rail, shipping, and aviation, respectively. Emissions from shipping and aviation continue to grow rapidly. Transport related emissions in developing regions of the world have increased more rapidly than in Europe or North America, a trend that is likely to continue in coming decades (high confidence).

The total emission mitigation potential achievable by the year 2030, calculated based on sectoral assessments, is sufficient to reduce global greenhouse gas emissions to half of the current (2019) level or less (robust evidence, high agreement). This potential (32–44 GtCO2-eq) requires implementation of a wide range of mitigation options. Options with mitigation costs lower than USD20 tCO2 –1 make up more than half of this potential and are available for all sectors.

Assessment of the social science literature and regional case studies reveals how social norms, culture, and individual choices interact with infrastructure and other structural changes over time. This provides new insight into climate change mitigation strategies, and how economic and social activity might be organised across sectors to support emission reductions. To enhance well-being, people demand services and not primary energy and physical resources per se. Focusing on demand for services and the different social and political roles people play broadens the participation in climate action.

Chapter 3 assesses the emissions pathways literature in order to identify their key characteristics (both in commonalities and differences) and to understand how societal choices may steer the system into a particular direction (high confidence). More than 2000 quantitative emissions pathways were submitted to the IPCC’s Sixth Assessment Report AR6 scenarios database, out of which 1202 scenarios included sufficient information for assessing the associated warming consistent with WGI.

This chapter focuses on accelerating mitigation and on shifting development pathways to increased sustainability, based on literature particularly at national scale. While previous WGIII assessments have discussed mitigation pathways, focus on development pathways is more recent. The timeframe is the near term (now up to 2030) to mid-term (2030 to 2050), complementing Chapter 3 on the long term (from 2050 onward).

Warming cannot be limited to well below 2°C without rapid and deep reductions in energy system carbon dioxide (CO2) and greenhouse gas (GHG) emissions. In scenarios limiting warming to 1.5°C (>50%) with no or limited overshoot (2°C (>67%) with action starting in 2020), net energy system CO2 emissions (interquartile range) fall by 87–97% (60–79%) in 2050. In 2030, in scenarios limiting warming to 1.5°C (>50%) with no or limited overshoot, net CO2 and GHG emissions fall by 35–51% and 38–52% respectively. In scenarios limiting warming to 1.5°C (>50%) with no or limited overshoot (2°C (>67%)), net electricity sector CO2 emissions reach zero globally between 2045 and 2055 (2050 and 2080). (high confidence).

The Agriculture, Forestry and Other Land Use (AFOLU) sector encompasses managed ecosystems and offers significant mitigation opportunities while delivering food, wood and other renewable resources as well as biodiversity conservation, provided the sector adapts to climate change. Land-based mitigation measures represent some of the most important options currently available. They can both deliver carbon dioxide removal (CDR) and substitute for fossil fuels, thereby enabling emissions reductions in other sectors. The rapid deployment of AFOLU measures is essential in all pathways staying within the limits of the remaining budget for a 1.5°C target (high confidence). Where carefully and appropriately implemented, AFOLU mitigation measures are uniquely positioned to deliver substantial co-benefits and help address many of the wider challenges associated with land management. If AFOLU measures are deployed badly then, when taken together with the increasing need to produce sufficient food, feed, fuel and wood, they may exacerbate trade-offs with the conservation of habitats, adaptation, biodiversity and other services. At the same time the capacity of the land to support these functions may be threatened by climate change itself (high confidence).

A spatiotemporal machine learning framework for automated prediction and analysis of long-term Land Use/Land Cover dynamics is presented. The framework includes: (1) harmonization and preprocessing of spatial and spatiotemporal input datasets (GLAD Landsat, NPP/VIIRS) including five million harmonized LUCAS and CORINE Land Cover-derived training samples, (2) model building based on spatial k-fold cross-validation and hyper-parameter optimization, (3) prediction of the most probable class, class probabilities and model variance of predicted probabilities per pixel, (4) LULC change analysis on time-series of produced maps. The spatiotemporal ensemble model consists of a random forest, gradient boosted tree classifier, and an artificial neural network, with a logistic regressor as meta-learner. The results show that the most important variables for mapping LULC in Europe are: seasonal aggregates of Landsat green and near-infrared bands, multiple Landsat-derived spectral indices, long-term surface water probability, and elevation. Spatial cross-validation of the model indicates consistent performance across multiple years with overall accuracy (a weighted F1-score) of 0.49, 0.63, and 0.83 when predicting 43 (level-3), 14 (level-2), and five classes (level-1). Additional experiments show that spatiotemporal models generalize better to unknown years, outperforming single-year models on known-year classification by 2.7% and unknown-year classification by 3.5%. Results of the accuracy assessment using 48,365 independent test samples shows 87% match with the validation points. Results of time-series analysis (time-series of LULC probabilities and NDVI images) suggest forest loss in large parts of Sweden, the Alps, and Scotland. Positive and negative trends in NDVI in general match the land degradation and land restoration classes, with “urbanization” showing the most negative NDVI trend. An advantage of using spatiotemporal ML is that the fitted model can be used to predict

Mitigation option are not yet being implemented at the scale required to limit global warming to well below 2°C. Various factors have been identified that inhibit the implementation of specific mitigation options. Yet, an integrated assessment of key barriers and enablers is lacking. Here we present a comprehensive framework to assess which factors inhibit and enable the implementation of mitigation options. The framework comprises six dimensions, each encompassing different criteria: geophysical, environmental-ecological, technological, economic, sociocultural, and institutional feasibility. We demonstrate the approach by assessing to what extent each criterion and dimension affects the feasibility of six mitigation options. The assessment reveals that institutional factors inhibit the implementation of many options that need to be addressed to increase their feasibility. Of all the options assessed, many factors enable the implementation of solar energy, while only a few barriers would need to be addressed to implement solar energy at scale.

Early identification of "patients at risk" for not completing regular treatment or not benefitting (sufficiently) from treatment might be among the most cost-effective strategies in mental health care. The recently introduced concept of epistemic trust (ET) may have the potential value to predict patients at risk and therefore act as a marker of treatment outcome. We argue that ET may be the final common pathway through which aversive relational experiences in the past result in interpersonal dysfunctioning, which in turn result in dysfunctional therapeutic relationships, rendering it difficult for patients to trust whatever is offered to learn in therapy. Hence, the concept of ET can play an essential role in personalized medicine, allowing for a more tailored treatment assignment to specific patients' characteristics, which may improve treatment outcomes. In this brief report, we define the clinical features of ET by describing its core domains based on consensus of expert opinion on the concept. The response rate was high, and there was a high level of agreement across experts, demonstrating a strong consensus between experts on the definition and clinical features of ET and mistrust and its significance to the understanding of personality disorders. By means of having a clear definition of the clinical features of ET, we hope to make it accessible for assessment.

Background and aims: In this study, we investigated whether increased renin angiotensin aldosterone system (RAAS) activation and endothelin-1 levels are related to coronary artery calcium (CAC) score, total plaque volume (TPV), high risk plaque, hyperemic myocardial blood flow (MBF) and coronary microvascular dysfunction (CMD). Methods: In a prospective, observational, cross-sectional cohort, renin as a marker for RAAS activation and endothelin-1 were measured in peripheral venous blood of 205 patients (64% men; age 58 ± 8.7 years) with suspected coronary artery disease (CAD) who underwent coronary computed tomography angiography (CCTA), [15O]H2O positron emission tomography (PET) perfusion imaging and invasive fractional flow reserve (FFR) measurements. Patients were categorized into three groups based on FFR (≤0.80) and hyperemic MBF <2.3 ml/min/g: [1] obstructive CAD (n = 92), [2] CMD (n = 26) or [3] no or non-obstructive CAD (n = 85). Results: After correction for baseline characteristics, including RAAS inhibiting therapy, renin associated positively with CAC score and TPV, but not with hyperemic MBF (p < 0.01; p = 0.02 and p = 0.23). Patients with high risk plaque displayed higher levels of renin (mean logarithmic renin 1.25 ± 0.43 vs. 1.12 ± 0.35 pg/ml; p = 0.04), but not endothelin-1. Compared to no or non-obstructive CAD patients, renin was significantly elevated in obstructive CAD patients but not in CMD patients (mean logarithmic renin 1.06 ± 0.34 vs. 1.23 ± 0.36; p < 0.01 and 1.06 ± 0.34 vs. 1.16 ± 0.41 pg/ml; p = 0.65). Endothelin-1 did not differ between the three patient groups. Conclusions: Our report provides evidence that RAAS activity measured by renin concentration is elevated in patients with coronary atherosclerosis and high risk plaque but not in patients with CMD, whereas endothelin-1 is not related to either.

Innovation in climate mitigation technologies has seen enormous activity and significant progress in recent years. Innovation has also led to, and exacerbated, trade-offs in relation to sustainable development. (high confidence). Innovation, can leverage action to mitigate climate change by reinforcing other interventions. In conjunction with other enabling conditions innovation can support system transitions to limit warming and help shift development pathways. The currently widespread implementation of solar photovoltaic (solar PV) and LEDs, for instance, could not have happened without technological innovation (high confidence). Technological innovation can also bring about new and improved ways of0 delivering services that are essential to human well-being. At the same time as delivering benefits, innovation can result in trade-offs that undermine both progress on mitigation and progress towards other sustainable development goals. Trade-offs include negative externalities – for instance greater environmental pollution and social inequalities – rebound effects leading to lower net emission reductions or even increases in emissions, and increased dependency on foreign knowledge and providers (high confidence). Effective governance and policy has the potential to avoid and minimise such misalignments (medium evidence, high agreement).

This article critically engages with intersecting tropes of immersion central to both notions of ethnography and technologically-enabled “extended reality” (XR). The authors build on Pauwelussen’s experience of disorientation while doing research within the dynamic land-sea environment of the Makassar Strait in Indonesia by hacking 360° video technologies to juxtapose multiple scenes of ‘flat’ video. These techniques of spatial montage enabled the authors to destabilize the assumption of ‘omni-scopic’ spherical holism and reconceptualize the ontological complexity of these entangled lifeworlds. Unexpectedly, this multimodal assemblage of agencies offered a kaleidoscopic perspective on immersive ethnography comprised of dynamic perception and speculative thinking.

Aim of the study: The coronavirus disease 2019 (COVID-19) pandemic significantly impacted cancer care. In this study, clinical patient characteristics related to COVID-19 outcomes and advanced care planning, in terms of non-oncological treatment restrictions (e.g. do-not-resuscitate codes), were studied in patients with cancer and COVID-19. Methods: The Dutch Oncology COVID-19 Consortium registry was launched in March 2020 in 45 hospitals in the Netherlands, primarily to identify risk factors of a severe COVID-19 outcome in patients with cancer. Here, an updated analysis of the registry was performed, and treatment restrictions (e.g. do-not-intubate codes) were studied in relation to COVID-19 outcomes in patients with cancer. Oncological treatment restrictions were not taken into account. Results: Between 27th March 2020 and 4th February 2021, 1360 patients with cancer and COVID-19 were registered. Follow-up data of 830 patients could be validated for this analysis. Overall, 230 of 830 (27.7%) patients died of COVID-19, and 60% of the remaining 600 patients with resolved COVID-19 were admitted to the hospital. Patients with haematological malignancies or lung cancer had a higher risk of a fatal outcome than other solid tumours. No correlation between anticancer therapies and the risk of a fatal COVID-19 outcome was found. In terms of end-of-life communication, 50% of all patients had restrictions regarding life-prolonging treatment (e.g. do-not-intubate codes). Most identified patients with treatment restrictions had risk factors associated with fatal COVID-19 outcome. Conclusion: There was no evidence of a negative impact of anticancer therapies on COVID-19 outcomes. Timely end-of-life communication as part of advanced care planning could save patients from prolonged suffering and decrease burden in intensive care units. Early discussion of treatment restrictions should therefore be part of routine oncological care, especially during the COVID-19 pandemic.

BACKGROUND: Victoria experienced the greatest burden of COVID-19 in Australia in 2020. This report describes key epidemiological characteristics and corresponding control measures between 17 January 2020 and 26 March 2021. METHODS: COVID-19 notifications made to the State Government Department of Health were used in this analysis. Epidemiological features are described over 4 phases, including enhancements to testing, contact tracing and public health interventions. Demographic and clinical features of cases are described. FINDINGS: Victoria recorded 20,483 cases of COVID-19, of which 1073 (5•2%) were acquired overseas and 19,360 (95%) were locally acquired. The initial epidemic (Phase I) was well-contained through public health interventions and was followed by relaxation of restrictions and low-level community transmission (Phase II). However, an outbreak in a hotel used to quarantine returned travellers led to wide-scale community transmission accounting for a majority (91%) of cases (Phase III). Outbreaks occurred in vulnerable settings including aged care and hospitals, contributing to high hospitalisation (12%) and case fatality rates (3•7%). Aggressive restrictions ultimately led to local elimination, and subsequent outbreaks have been swiftly managed with improved processes (Phase IV). The demographic composition of cases evolved across phases from an older, wealthier population to a less advantaged younger population, with many from culturally and linguistically diverse backgrounds. INTERPRETATION: Over time, adaptations to the public health response have strengthened capacity to respond to new cases and outbreaks in a more effective manner. The Victorian experience underscores the importance of authentic engagement with diverse communities and balancing restrictions with livelihoods.