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Background: \ud As digital tools are increasingly used to support COVID-19 contact tracing, the equity implications must be considered. As part of a study to understand the public's views of digital contact tracing tools developed for the national ‘Test and Protect’ programme in Scotland, we aimed to explore the views of groups often excluded from such discussions. This paper reports on their views about the potential for contact tracing to exacerbate inequalities.\ud \ud Methods: \ud A qualitative study was carried out; interviews were conducted with key informants from organizations supporting people in marginalized situations, followed by interviews and focus groups with people recruited from these groups. Participants included, or represented, minority ethnic groups, asylum seekers and refugees and those experiencing multiple disadvantage including severe and enduring poverty.\ud \ud Results: \ud A total of 42 people participated: 13 key informants and 29 members of the public. While public participants were supportive of contact tracing, key informants raised concerns. Both sets of participants spoke about how contact tracing, and its associated digital tools, might increase inequalities. Barriers included finances (inability to afford smartphones or the data to ensure access to the internet); language (digital tools were available only in English and required a degree of literacy, even for English speakers); and trust (many marginalized groups distrusted statutory organizations and there were concerns that data may be passed to other organizations). One strength was that NHS Scotland, the data guardian, is seen as a generally trustworthy organization. Poverty was recognized as a barrier to people's ability to self-isolate. Some participants were concerned about giving contact details of individuals who might struggle to self-isolate for financial reasons.\ud \ud Conclusions: \ud The impact of contact tracing and associated digital tools on marginalized populations needs careful monitoring. This should include the contact tracing process and the ability of people to self-isolate. Regular clear messaging from trusted groups and community members could help maintain trust and participation in the programme.\ud \ud Patient and Public Contribution: \ud Our patient and public involvement coapplicant, L. L., was involved in all aspects of the study including coauthorship. Interim results were presented to our local Public and Patient Involvement and Engagement Group, who commented on interpretation and made suggestions about further recruitment.

Anna Taylor,1 Andrew Cushing,2 Morgan Dow,2 Jacqueline Anderson,1 Grace McDowell,1 Stephanie Lua,1 Maureen Manthe,1 Sandosh Padmanabhan,3 Shane Burns,2 Paul McGinness,2 David J Lowe,1,4 Christopher Carlin1 1Departments of Respiratory and Emergency Medicine, Queen Elizabeth University Hospital, NHS Greater Glasgow & Clyde, Glasgow, Scotland; 2Lenus Health Ltd, Edinburgh, Scotland; 3Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland; 4Institute of Health and Wellbeing, University of Glasgow, Glasgow, ScotlandCorrespondence: Christopher Carlin, Department of Respiratory and Emergency Medicine, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow, G51 4TF, Scotland, Tel + 44 141 451 6088, Email christopher.carlin@ggc.scot.nhs.ukPurpose: Digital tools may improve chronic obstructive pulmonary disease (COPD) management, but further evidence of significant, persisting benefits are required. The RECEIVER trial was devised to evaluate the Lenus COPD support service by determining if people with severe COPD would continue to utilize the co-designed patient web application throughout study follow-up and to explore the impact of this digital service on clinical outcomes with its adoption alongside routine care.Patients and Methods: The prospective observational cohort hybrid implementation-effectiveness study began in September 2019 and included 83 participants. Recruitment stopped in March 2020 due to COVID-19, but follow-up continued as planned. A contemporary matched control cohort was identified to compare participant clinical outcomes with and minimize biases associated with wider COVID-19 impacts. Utilization was determined by daily COPD assessment test (CAT) completion through the application. Survival metrics and post-index date changes in annual hospitalizations were compared between the RECEIVER and control cohorts. Longitudinal quality of life and symptom burden data and community-managed exacerbation events were also captured through the application.Results: High and sustained application utilization was noted across the RECEIVER cohort with a mean follow-up of 78 weeks (64/83 participants completed at least one CAT entry on ≥ 50% of possible follow-up weeks). Subgroup analysis of participants resident in more socioeconomically deprived postcode areas revealed equivalent utilization. Median time to death or a COPD or respiratory-related admission was higher in the RECEIVER cohort compared to control (335 days vs 155 days). Mean reduction in annual occupied bed days was 8.12 days vs 3.38 days in the control cohort. Quality of life and symptom burden remained stable despite the progressive nature of COPD.Conclusion: The sustained utilization of the co-designed patient application and improvements in participant outcomes observed in the RECEIVER trial support scale-up implementation with continued evaluation of this digital service.Keywords: COPD, self-management, remote monitoring, patient-reported outcomes

BackgroundThe majority of patients with suspected acute coronary syndrome presenting to the emergency department will be discharged once myocardial infarction has been ruled out, although a proportion will have unrecognised coronary artery disease. In this setting, high-sensitivity cardiac troponin identifies those at increased risk of future cardiac events. In patients with intermediate cardiac troponin concentrations in whom myocardial infarction has been ruled out, this trial aims to investigate whether outpatient computed tomography coronary angiography (CTCA) reduces subsequent myocardial infarction or cardiac death.MethodsTARGET-CTCA is a multicentre prospective randomised open label with blinded endpoint parallel group event driven trial. After myocardial infarction and clear alternative diagnoses have been ruled out, participants with intermediate cardiac troponin concentrations (5 ng/L to 99th centile upper reference limit) will be randomised 1:1 to outpatient CTCA plus standard of care or standard of care alone. The primary endpoint is myocardial infarction or cardiac death. Secondary endpoints include clinical, patient-centred, process and cost-effectiveness. Recruitment of 2270 patients will give 90% power with a two-sided P value of 0.05 to detect a 40% relative risk reduction in the primary endpoint. Follow-up will continue until 97 primary outcome events have been accrued in the standard care arm with an estimated median follow-up of 36 months.DiscussionThis randomised controlled trial will determine whether high-sensitivity cardiac troponin-guided CTCA can improve outcomes and reduce subsequent major adverse cardiac events in patients presenting to the emergency department who do not have myocardial infarction.Trial registrationClinicalTrials.gov Identifier: NCT03952351. Registered on May 16, 2019.

Previous studies on the natural history of long-COVID have been few and selective. Without comparison groups, disease progression cannot be differentiated from symptoms originating from other causes. The Long-COVID in Scotland Study (Long-CISS) is a Scotland-wide, general population cohort of adults who had laboratory-confirmed SARS-CoV-2 infection matched to PCR-negative adults. Serial, self-completed, online questionnaires collected information on pre-existing health conditions and current health six, 12 and 18 months after index test. Of those with previous symptomatic infection, 35% reported persistent incomplete/no recovery, 12% improvement and 12% deterioration. At six and 12 months, one or more symptom was reported by 71.5% and 70.7% respectively of those previously infected, compared with 53.5% and 56.5% of those never infected. Altered taste, smell and confusion improved over time compared to the never infected group and adjusted for confounders. Conversely, late onset dry and productive cough, and hearing problems were more likely following SARS-CoV-2 infection.

The RGD (Arg-Gly-Asp)-binding integrins αvβ6 and αvβ8 are clinically validated cancer and fibrosis targets of considerable therapeutic importance. Compounds that can discriminate between the two closely related integrin proteins and other RGD integrins, stabilize specific conformational states, and have sufficient stability enabling tissue restricted administration could have considerable therapeutic utility. Existing small molecules and antibody inhibitors do not have all of these properties, and hence there is a need for new approaches. Here we describe a method for computationally designing hyperstable RGD-containing miniproteins that are highly selective for a single RGD integrin heterodimer and conformational state, and use this strategy to design inhibitors of αvβ6 and αvβ8 with high selectivity. The αvβ6 and αvβ8 inhibitors have picomolar affinities for their targets, and >1000-fold selectivity over other RGD integrins. CryoEM structures are within 0.6-0.7Å root-mean-square deviation (RMSD) to the computational design models; the designed αvβ6 inhibitor and native ligand stabilize the open conformation in contrast to the therapeutic anti-αvβ6 antibody BG00011 that stabilizes the bent-closed conformation and caused on-target toxicity in patients with lung fibrosis, and the αvβ8 inhibitor maintains the constitutively fixed extended-closed αvβ8 conformation. In a mouse model of bleomycin-induced lung fibrosis, the αvβ6 inhibitor potently reduced fibrotic burden and improved overall lung mechanics when delivered via oropharyngeal administration mimicking inhalation, demonstrating the therapeutic potential of de novo designed integrin binding proteins with high selectivity.

Additional file 1: Supplementary Table 1. List of participating hospitals and sites.

Additional file 2.

We consider gravity in 3+1 spacetime dimensions coupled to $N$ scalar matter fields in a semiclassical limit where $N\to\infty$. The dynamical evolution of a black hole including the back-reaction of the Hawking radiation on the metric is formulated as an initial value problem. The quantum stress energy tensor is evaluated using a point splitting regularization along spacelike geodesics. To account for the quantum entanglement of the matter fields, they are treated as a set of bilocal collective fields defined on spacelike hypersurfaces. The resulting semiclassical field equations include terms up to fourth order in derivatives that can be treated in a perturbative $\hbar$ expansion. The formulation we arrive at should be amenable to numerical simulation of time dependent semiclassical spacetime., 24 pages

Background COVID-19 has overwhelmed health services across the world; its global death toll has exceeded 5.3 million and continues to grow. There have been almost 15 million cases of COVID-19 in the UK. The need for rapid accurate identification, appropriate clinical care and decision making, remains a priority for UK ambulance service. To support identification and conveyance decisions of patients presenting with COVID-19 symptoms the Scottish Ambulance Service introduced the revised Medical Priority Dispatch System Protocol 36, enhanced physician led decision support and prehospital clinical guidelines. This study aimed to characterise the impact of these changes on the pathways and outcomes of people attended by the SAS) with potential COVID-19. Methods A retrospective record linkage cohort study using National Data collected from NHS Scotland over a 5 month period (April–August 2020). Results The SAS responded to 214,082 emergency calls during the study time period. The positive predictive value of the Protocol 36 to identify potentially COVID-19 positive patients was low (17%). Approximately 60% of those identified by Protocol 36 as potentially COVID-19 positive were conveyed. The relationship between conveyance and mortality differed between Protocol 36 Covid-19 positive calls and those that were not. In those identified by Protocol 36 as Covid-19 negative, 30 day mortality was higher in those not conveyed (not conveyed 9.2%; conveyed 6.6%) but in the Protocol 36 Covid-19 positive calls, mortality was higher in those conveyed (not conveyed 4.3% conveyed 8.8%). Thirty-day mortality rates of those with COVID-19 diagnosed through virology was between 28.8 and 30.2%. Conclusion The low positive predictive value (17%) of Protocol 36 in identifying potential COVID-19 in patients emphasises the importance of ambulance clinicians approaching each call as involving COVID-19, reinforcing the importance of adhering to existing policy and continued use of PPE at all calls. The non-conveyance rate of people that were categorised as COVID-19 negative was higher than in the preceding year in the same service. The reasons for the higher rates of non-conveyance and the relationship between non conveyance rates and death at 3 and 30 days post index call are unknown and would benefit from further study.

It is traditionally believed that the effects of exposure to noise cease once the exposure itself has ceased. If this is the case, exposure to noise relatively early in life, for example during military service, should not affect the subsequent progression of hearing loss. However, recent data from studies using animals suggest that noise exposure can accelerate the subsequent progression of hearing loss. This paper presents new longitudinal data obtained from 29 former male military personnel. Audiograms obtained at the end of military service were compared with those obtained at least five years later. Rates of change of hearing threshold level (HTL) in dB/year were compared with those expected from ISO7029 (2017) for men at the 50th percentile. The results are consistent with the hypothesis that noise exposure during military service accelerates the progression of hearing loss for frequencies where the hearing loss is absent or mild at the end of military service, by about 1.7 dB/year on average for frequencies from 3 to 8 kHz, but has no effect on or slows the progression of hearing loss for frequencies where the hearing loss exceeds about 50 dB. Acceleration appears to occur over a wide frequency range, including 1 kHz. There remains a need for further longitudinal studies using larger sample sizes. Longitudinal studies are also needed to establish whether exposure to other types of sounds, for example at rock concerts or from work in heavy industries, affects the subsequent progression of hearing loss., MRC

It is traditionally believed that the effects of exposure to noise cease once the exposure itself has ceased. If this is the case, exposure to noise relatively early in life, for example during military service, should not affect the subsequent progression of hearing loss. However, recent data from studies using animals suggest that noise exposure can accelerate the subsequent progression of hearing loss. This paper presents new longitudinal data obtained from 29 former male military personnel. Audiograms obtained at the end of military service were compared with those obtained at least five years later. Rates of change of hearing threshold level (HTL) in dB/year were compared with those expected from ISO7029 (2017) for men at the 50th percentile. The results are consistent with the hypothesis that noise exposure during military service accelerates the progression of hearing loss for frequencies where the hearing loss is absent or mild at the end of military service, by about 1.7 dB/year on average for frequencies from 3 to 8 kHz, but has no effect on or slows the progression of hearing loss for frequencies where the hearing loss exceeds about 50 dB. Acceleration appears to occur over a wide frequency range, including 1 kHz. There remains a need for further longitudinal studies using larger sample sizes. Longitudinal studies are also needed to establish whether exposure to other types of sounds, for example at rock concerts or from work in heavy industries, affects the subsequent progression of hearing loss., MRC

The pathophysiology and trajectory of post-Coronavirus Disease 2019 (COVID-19) syndrome is uncertain. To clarify multisystem involvement, we undertook a prospective cohort study including patients who had been hospitalized with COVID-19 (ClinicalTrials.gov ID NCT04403607). Serial blood biomarkers, digital electrocardiography and patient-reported outcome measures were obtained in-hospital and at 28–60 days post-discharge when multisystem imaging using chest computed tomography with pulmonary and coronary angiography and cardio-renal magnetic resonance imaging was also obtained. Longer-term clinical outcomes were assessed using electronic health records. Compared to controls (n = 29), at 28–60 days post-discharge, people with COVID-19 (n = 159; mean age, 55 years; 43% female) had persisting evidence of cardio-renal involvement and hemostasis pathway activation. The adjudicated likelihood of myocarditis was ‘very likely’ in 21 (13%) patients, ‘probable’ in 65 (41%) patients, ‘unlikely’ in 56 (35%) patients and ‘not present’ in 17 (11%) patients. At 28–60 days post-discharge, COVID-19 was associated with worse health-related quality of life (EQ-5D-5L score 0.77 (0.23) versus 0.87 (0.20)), anxiety and depression (PHQ-4 total score 3.59 (3.71) versus 1.28 (2.67)) and aerobic exercise capacity reflected by predicted maximal oxygen utilization (20.0 (7.6) versus 29.5 (8.0) ml/kg/min) (all P

寄稿論文, Special Contribution

Extended abstract presented at the CRIS2022 conference in Dubrovnik.-- Event programme available at https://cris2022.srce.hr/#section-program 16 slides.-- Presentation delivered within the VIVO Track at CRIS2022 In 2019 and 2020, the Office of Scholarly Communications pursued a strategy of enhancing the interoperability of our scholarly communication systems to make the systems more useful to researchers, specifically our repository (DSpace), research information management system (VIVO) and Altmetrics from Digital Science. These systems can be used to “publish” a range of documents, represent the publications on faculty Scholars@TAMU profiles, and collect engagement metrics for the publications. In this talk, we will discuss the needs and interests of faculty, the role played by the library in supporting these projects, and the features of the scholarly communication systems at Texas A&M that allowed all of this to happen, specifically the role of persistent identifiers, a consistent ontology and APIs.

Supplemental Material for Multimorbidity, disease count, mortality and emergency care use in persons attending the emergency department: a cross-sectional data-linkage study by Chris McParland, Mark A Cooper, David J Lowe, Bethany Stanley, Bridget Johnston in Journal of Multimorbidity and Comorbidity

Additional file 1. Transcripts of five cases.

This research provides an assessment of the effectiveness of Law 3028/2002 – the principal legislation concerning the regulation of cultural heritage and archaeological research in Greece. Two deficiencies were observed within the current academic treatments of this law. Firstly, a limited engagement with Law 3028/2002 from the archaeological perspective has left such discussions about the law being primarily directed from a legalistic viewpoint. Secondly, whilst much has been written on the provisions, purposes, and implementation of Law 3028/2002, such themes have seldom been considered in a unified manner. In light of these identified shortfalls, an evaluation test has been developed and applied that merges legal opinions of Law 3028/2002 with archaeological sensitivities to assess the performance of the law in the field. As the first example of such an approach, this assessment measures Law 3028/2002 according to its objectives, how well it protects cultural heritage, and the degree to which it meets the interests of archaeological and non-archaeological stakeholders. By specifically targeting those provisions where archaeology and law intersect under Law 3028/2002, this research shows that, whilst Law 3028/2002 has improved on earlier legislation in some measures and has proven to be effective in safeguarding monuments and sites directly, it falls short of reaching its full potential. This inefficiency is identified as stemming from two main issues: (1) the law favours a centralist structure of protection that is hindered by its own bureaucratic weight and political agenda, and (2) that this centralised structure divorces the Greek public and academics from engaging with cultural heritage as active stakeholders.

Supplemental Material for Multimorbidity, disease count, mortality and emergency care use in persons attending the emergency department: a cross-sectional data-linkage study by Chris McParland, Mark A Cooper, David J Lowe, Bethany Stanley, Bridget Johnston in Journal of Multimorbidity and Comorbidity

Supplemental Material for Multimorbidity, disease count, mortality and emergency care use in persons attending the emergency department: a cross-sectional data-linkage study by Chris McParland, Mark A Cooper, David J Lowe, Bethany Stanley, Bridget Johnston in Journal of Multimorbidity and Comorbidity

Supplemental Material for Multimorbidity, disease count, mortality and emergency care use in persons attending the emergency department: a cross-sectional data-linkage study by Chris McParland, Mark A Cooper, David J Lowe, Bethany Stanley, Bridget Johnston in Journal of Multimorbidity and Comorbidity

Tephrochronology is a correlational and age-equivalent dating method whereby practitioners characterize, map, and date tephra (or volcanic ash) layers and use them stratigraphically as connecting and dating tools in the geosciences (including volcanology) and in studies of past environments and archaeology. Modern tephra studies per se began around 100 years ago (in the 1920s), but the first collective of tephrochronologists with a common purpose and nascent global outlook was not formed until 7 September 1961 in Warsaw, Poland. On that date, the inaugural “Commission on Tephrochronology” (COT) was ratified under the aegis of the International Union for Quaternary Research (INQUA). The formation of COT is attributable largely to the leadership of Kunio Kobayashi of Japan, the commission's president for its first 12 years. We were motivated to record and evaluate the function and importance of COT because tephrochronology continues to grow globally and its heritage needs to be understood, appreciated, and preserved. In addition, studies on cryptotephras, which are fine-grained glass-shard and/or crystal concentrations preserved in sediments or soils but insufficiently numerous to be visible as a layer to the naked eye, have also expanded dramatically in recent times. Therefore, in this article, we review the role and impacts of COT under the umbrella of INQUA for 53 of the last 60 years or under IAVCEI (International Association of Volcanology and Chemistry of the Earth's Interior) for 7 of the last 60 years, including since 2019. The commission also functioned under other names (abbreviated as COTS, CEV, ICCT, COTAV, SCOTAV, and INTAV; see Table 2 for definitions). As well as identifying key persons of influence, we describe the development of the commission, its leaders, and its activities, which include organizing nine specialist tephra field meetings in seven different countries. Members of the commission have participated in numerous other conferences (including specialist tephra sessions) or workshops of regional to international scale, and they have played leading roles in international projects such as INTIMATE (INTegrating Ice-core, MArine and TErrestrial records) and SMART (Synchronising Marine And ice-core Records using Tephrochronology). As well as strongly supporting early-career researchers including graduate students, the commission has generated 10 tephra-themed journal volumes and two books. It has published numerous other articles including field guidebooks, reports, and specialist internet documents/sites. Although its fortunes have ebbed as well as flowed, the commission began to prosper after 1987 when key changes in leadership occurred. COT has blossomed further, especially in the past decade or so, as an entire new cohort of specialists, including many engaged in cryptotephra studies, has emerged alongside new geoanalytical and dating techniques or protocols to become a vibrant global group today. We name 29 elected officers who have been involved with COT since 1961 as well as 15 honorary life members. After reviewing the aims of the commission, we conclude by evaluating its legacies and by documenting current and future work.

Supplemental Material for Multimorbidity, disease count, mortality and emergency care use in persons attending the emergency department: a cross-sectional data-linkage study by Chris McParland, Mark A Cooper, David J Lowe, Bethany Stanley, Bridget Johnston in Journal of Multimorbidity and Comorbidity

Additional file 2. Predictive value of Protocol 36 of COVID-19 status across the 5 month study period.

Supplemental Material for Multimorbidity, disease count, mortality and emergency care use in persons attending the emergency department: a cross-sectional data-linkage study by Chris McParland, Mark A Cooper, David J Lowe, Bethany Stanley, Bridget Johnston in Journal of Multimorbidity and Comorbidity

Supplementary Material for Pulse pressure within the first 2 days of veno-arterial extracorporeal membrane oxygenation is predictive of death prior to hospital discharge, renal dysfunction requiring dialysis and pulmonary oedema by Maithri Siriwardena, Jeff Breeding, Mani Gopalakrishnan, Paul Jansz, Emily K Granger, Andrew Jackson, Peter S MacDonald, David Lowe, Hergen Buscher, and Priya Nair in Perfusion.

Additional file 1. Protocol 36 COVID-19 status by SIMD quintile.

No abstract available.

In HLA-incompatible kidney transplantation, monitoring donor-specific antibodies (DSA) plays a crucial role in providing appropriate treatment and increases kidney survival times. This work aimed to determine if early post-transplant DSA dynamics inform graft outcome over and above other predictive factors. Eighty-eight cases were classified by unsupervised machine learning into five distinct DSA response groups: no response, fast modulation, slow modulation, rise to sustained and sustained. Fast modulation dynamics gave an 80% rate for early acute rejection, whereas the sustained group was associated with the lowest rejection rates (19%). In complete contrast, the five-year graft failure was lowest in the modulation groups (4–7%) and highest in the sustained groups (25–31%). Multivariable analysis showed that a higher pre-treatment DSA level, male gender and absence of early acute rejection were strongly associated with a sustained DSA response. The modulation group had excellent five-year outcomes despite higher rates of early rejection episodes. This work further develops an understanding of post-transplant DSA dynamics and their influence on graft survival following HLA-incompatible kidney transplantation.

This report outlines the context, methods,data, and findings of the Arts and HumanitiesResearch Council funded project British RitualInnovation under Covid-19 [BRIC-19]. Theproject ran from August 2020 to September 2021,with the aim of documenting and analysingchanges to British communal religious lifeduring the Covid-19 pandemic and associatedlockdowns, and of providing best practicerecommendations for religious communitiesadapting their practice to address similar crisissituations in the future. Particular effort hasbeen made to include data that reflects, to theextent possible, the geographic and religiousdiversity of Britain, by focussing on questionsof religious practice rather than on theologicalquestions or issues of belief which are specific tofaith traditions.

Background: \ud This study sought to establish the long-term effects of Covid-19 following hospitalisation.\ud Methods: \ud 327 hospitalised participants, with SARS-CoV-2 infection were recruited into a prospective multicentre cohort study at least 3 months post-discharge. The primary outcome was self-reported recovery at least ninety days after initial Covid-19 symptom onset. Secondary outcomes included new symptoms, disability (Washington group short scale), breathlessness (MRC Dyspnoea scale) and quality of life (EQ5D-5L).\ud Findings: \ud 55% of participants reported not feeling fully recovered. 93% reported persistent symptoms, with fatigue the most common (83%), followed by breathlessness (54%). 47% reported an increase in MRC dyspnoea scale of at least one grade. New or worse disability was reported by 24% of participants. The EQ5D-5L summary index was significantly worse following acute illness (median difference 0.1 points on a scale of 0 to 1, IQR: -0.2 to 0.0). Females under the age of 50 years were five times less likely to report feeling recovered (adjusted OR 5.09, 95% CI 1.64 to 15.74), were more likely to have greater disability (adjusted OR 4.22, 95% CI 1.12 to 15.94), twice as likely to report worse fatigue (adjusted OR 2.06, 95% CI 0.81 to 3.31) and seven times more likely to become more breathless (adjusted OR 7.15, 95% CI 2.24 to 22.83) than men of the same age.\ud Interpretation: \ud Survivors of Covid-19 experienced long-term symptoms, new disability, increased breathlessness, and reduced quality of life. These findings were present in young, previously healthy working age adults, and were most common in younger females.\ud Funding: \ud National Institute for Health Research, UK Medical Research Council, Wellcome Trust, Department for International Development and the Bill and Melinda Gates Foundation.

Moore (2020) proposed a method for diagnosing noise-induced hearing loss (NIHL) sustained during military service, based on an analysis of the shapes of the audiograms of military personnel. The method, denoted M-NIHL, was estimated to have high sensitivity but low-to-moderate specificity. Here, a revised version of the method, denoted rM-NIHL, was developed that gave a better balance between sensitivity and specificity. A database of 285 audiograms of military noise-exposed men was created by merging two previously used databases with a new database, randomly shuffling, and then splitting into two, one for development of the revised method and one for evaluation. Two comparable databases of audiograms of 185 non-exposed men were also created, again one for development and one for evaluation. Based on the evaluation databases, the rM-NIHL method has slightly lower sensitivity than the M-NIHL method, but the specificity is markedly higher. The two methods have similar overall diagnostic performance. If an individual is classified as having NIHL based on a positive diagnosis for either ear, the rM-NIHL method has a sensitivity of 0.98 and a specificity of 0.63. Based on a positive diagnosis for both ears, the rM-NIHL method has a sensitivity of 0.76 and a specificity of 0.95., Medical Research Council

The soil science community needs to communicate about soils and the use of soil information to various audiences, especially to the general public and public authorities. In this global review article, we synthesis information pertaining to museums solely dedicated to soils or which contain a permanent exhibition on soils. We identified 38 soil museums specifically dedicated to soils, 34 permanent soil exhibitions, and 32 collections about soils that are accessible by appointment. We evaluate the growth of the number of museums since the early 1900s, their geographical distribution, their contents, and their attendance. The number of museums has been continuously growing since the early 1900s. A noticeable increase was observed from 2015 to 2019. Europe (in a geographical sense), Eastern and South-East Asia have the highest concentration of soil museums and permanent exhibitions related to soils. Most of the museums' attendance ranged from 1000 to 10,000 visitors per year. Russia has the largest number of soil monoliths exhibited across the world's museums, whereas the ISRIC-World Soil Museum has the richest and the most diverse collection of soil monoliths. Museums, collections, and exhibitions of soil play an important role in educating the population about this finite natural resource that maintains life on the planet, and for this reason, they must be increasingly supported, extended, and protected.

This paper develops a probabilistic multimodal adaptive control approach for systems that are characterised by temporal multimodality where the system dynamics are subject to abrupt mode switching at arbitrary times. In this framework, the control objective is redefined such that it utilises the complete probability distribution of the system dynamics. The derived probabilistic control law is thus of a dual type that incorporates the functional uncertainty of the controlled system. A multi-modal density model with prediction error-dependent mixing coefficients is introduced to effect the mode switching. This approach can deal with arbitrary noise distributions, nonlinear plant dynamics and arbitrary mode switching. For the affine systems focussed upon for illustration in this paper the approach has global stability. The theoretical architecture constructs are verified by validation on a simulation example.