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Rationale, aims and objectives: Patient-centered care is considered a vital component of good quality care for breast cancer patients. Nevertheless, the implementation of this valuable concept in clinical practice appears to be difficult. The goal of this study is to bridge the gap between theoretical elaboration of “patient-centered care” and clinical practice. To that purpose, a scoping analysis was performed of the application of the term “patient-centered care in breast cancer treatment” in present-day literature. Method: For data-extraction, a literature search was performed extracting references that were published in 2018 and included the terms “patient-centered care” and “breast cancer”. The articles were systematically traced for answers to the following three questions: “What is patient-centered care?”, “Why perform patient-centered care?”, and “How to realize patient-centered care?”. For the content analysis, these answers were coded and assembled into meaningful clusters until separate themes arose which concur with various interpretations of the term “patient-centered care”. Results: A total of 60 publications were retained for analysis. Traced answers to the three questions “what”, “why”, and “how” varied considerably in recent literature concerning breast cancer treatment. Despite the inconsistent use of the term “patient-centered care,” we did not find any critical consideration about the nature of the concept, regardless of the applied interpretation. Interventions that are supposed to contribute to the heterogeneous concept of patient-centered care as such, seem to be judged desirable, virtually without empirical justification. Conclusions: We propose, contrary to previous efforts to define “patient-centered care” more accurately, to embrace the heterogeneity of the concept and apply “patient-centered care” as an umbrella-term for all healthcare that intends to contribute to the acknowledgement of the person in the patient. For the justification of measures to realize patient-centered care for breast cancer patients, instead of a mere contribution to the abstract concept, we insist on the demonstration of desirable real-world effects.

In the field of Deep Learning, the long short-term memory (LSTM) networks lie in the category of recurrent neural network (RNN) architectures. The distinctive capability of the LSTM is learning non linear long term dependency structures. This makes the LSTM a good candidate for prediction tasks in non linear time dependent systems such as prediction of runoff in a catchment. In this study, we use a large sample of 740 gauged catchments with very diverse hydro-geo-climatic conditions across France. We present a regime classification based on three hydro-climatic indices to identify and classify catchments with similar hydrological behaviors. We do this because we aim to investigate how regime derived information can be used in training LSTM-based runoff models. The LSTM-based models that we investigate include local models trained on individual catchments as well as regional models trained on a group of catchments. In local training, for each regime, we identify the optimal lookback, i.e. the length of the sequence of past forcing data that the LSTM needs to work through. We then use this length in training regional models that differ in two aspects: 1) hydrological homogeneity of the catchments used in their training, 2) configuration of the static attributes used in their inputs. We examine how each of these aspects contributes to learning of the LSTM in regional training. At every step of this study, we benchmark performances of the LSTM against a conceptual model (GR4J) on both train and unseen data. We show that the optimal lookback is regime dependent and homogeneity of the train catchments in regional training has a more significant contribution to learning of the LSTM than the number of the train catchments.

Background: Epidemiological data on anticoagulation for venous thromboembolism (VTE) in prostate cancer are sparse. We aimed to investigate associations between anticoagulation duration and risks of VTE recurrence after treatment cessation and major on-treatment bleeding in men with prostate cancer in Sweden. Methods: Using nationwide prostate cancer registry and prescribing data, we followed 1413 men with VTE and an outpatient anticoagulant prescription following prostate cancer diagnosis. Men were followed to identify cases of recurrent VTE, and hospitalized major bleeding. We calculated adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) to quantify the association between anticoagulation duration (reference ≤3 months) and recurrent VTE using Cox regression. We estimated 1-year cumulative incidences of major bleedings from anticoagulation initiation.Results: The outpatient anticoagulation prescribed was parenteral (64%), direct oral anticoagulant (31%), and vitamin K antagonist (20%). Median duration of anticoagulation was 7 months. Adjusted HRs (95% CI) for off-treatment recurrent pulmonary embolism (PE) were 0.32 (0.09–1.15) for >3–6 months’ duration, 0.21 (0.06–0.69) for >6–9 months and 0.16 (0.05–0.55) for >9 months; corresponding HRs for deep vein thrombosis (DVT) were 0.67 (0.27–1.66), 0.80 (0.31–2.07), and 1.19 (0.47–3.02). One-year cumulative incidences of intracranial, gastrointestinal and urogenital bleeding were 0.9%, 1.7%, 3.0% during treatment, and 1.2%, 0.9%, 1.6% after treatment cessation.Conclusion: The greatest benefit in reducing recurrent VTE risk was with >9 months anticoagulation for PE and >3–6 months for DVT. Risks of major bleeding were low not being substantially different to the risks after treatment cessation.

Background overview and rationale We co-developed a multi-component virtual care solution (TtLIVE) for the home mechanical ventilation (HMV) population using the aTouchAway™ platform (Aetonix). The TtLIVE intervention includes (1) virtual home visits; (2) customizable care plans; (3) clinical workflows that incorporate reminders, completion of symptom profiles, and tele-monitoring; and (4) digitally secure communication via messaging, audio, and video calls; (5) Resource library including print and audiovisual material. Objectives and brief methods Our primary objective is to evaluate the TtLIVE intervention compared to a usual care control group using an eight-center, pragmatic, parallel-group single-blind (outcome assessors) randomized controlled trial. Eligible patients are children and adults newly transitioning to HMV in Ontario, Canada. Our target sample size is 440 participants (220 each arm). Our co-primary outcomes are a number of emergency department (ED) visits in the 12 months after randomization and change in family caregiver (FC) reported Pearlin Mastery Scale score from baseline to 12 months. Secondary outcomes also measured in the 12 months post randomization include healthcare utilization measured using a hybrid Ambulatory Home Care Record (AHCR-hybrid), FC burden using the Zarit Burden Interview, and health-related quality of life using the EQ-5D. In addition, we will conduct a cost-utility analysis over a 1-year time horizon and measure process outcomes including healthcare provider time using the Care Coordination Measurement Tool. We will use qualitative interviews in a subset of study participants to understand acceptability, barriers, and facilitators to the TtLIVE intervention. We will administer the Family Experiences with Care Coordination (FECC) to interview participants. We will use Poisson regression for a number of ED visits at 12 months. We will use linear regression for the Pearlin Mastery scale score at 12 months. We will adjust for the baseline score to estimate the effect of the intervention on the primary outcomes. Analysis of secondary outcomes will employ regression, causal, and linear mixed modeling. Primary analysis will follow intention-to-treat principles. We have Research Ethics Board approval from SickKids, Children’s Hospital Eastern Ontario, McMaster Children’s Hospital, Children’s Hospital-London Health Sciences, Sunnybrook Hospital, London Health Sciences, West Park Healthcare Centre, and Ottawa Hospital. Discussion This pragmatic randomized controlled single-blind trial will determine the effectiveness and cost-effectiveness of the TtLIVE virtual care solution compared to usual care while providing important data on patient and family experience, as well as process measures such as healthcare provider time to deliver the intervention. Trial registration ClinicalTrials.gov NCT04180722. Registered on November 27, 2019.

Information and communication technologies have opened the way to guide recent developments in the field of parking. In this paper these technologies are applied to model a decision support system that gives insight into 6-months ahead parking occupancy forecasts for 57 off-street parking locations in Amsterdam. An effect analysis was conducted into the influence of weather-, event-, parking tariff-, and public transport attributes on parking occupancy. The most influential factors on the parking occupancy were the scheduling of artistic and sports events, the addition of a public transport line, and the weather variables thunderstorm, average wind speed, temperature, precipitation, and sunshine duration. Parking tariffs did not significantly contribute to model performance, which could have been because of the lack of data and time variability in the parking tariffs of the examined parking locations. The forecasting algorithms compared were the seasonal naive model as a benchmark approach, the Box–Jenkins seasonal autoregressive integrated moving average with and without exogenous regressors (SARIMAX and SARIMA, respectively), exponential smoothing models, and the long short-term memory neural network. The SARIMAX model outperformed the other algorithms for the 6-months ahead forecasts according to the lowest root mean square error (RMSE). By including the event factor, the model improved by 24% based on the RMSE. Weather variables improved the predictive performance by 8%. Future studies could focus on the addition of more event variables, extension into an online model, and the impact of spatial–temporal features on parking occupancy.

Despite the increasing need to address long-term challenges, public sector organizations are incentivized to focus on short-term results. This article uses an ethnographic approach to analyse how members of a regional water authority understand and deal with long-term policy problems as part of their everyday practices. It reveals three specific dilemmas: investing in the realization of objects or objectives, adopting a stable or responsive approach, and taking a proactive or reactive stance towards the external environment. The concept of strategic agility enables organizations to respond proactively to unexpected developments by devising strategies to steer as well as to accommodate change.

The term ‘responsible AI’ has been coined to denote AI that is fair and non-biased, transparent and explainable, secure and safe, privacy-proof, accountable, and to the benefit of mankind. Since 2016, a great many organizations have pledged allegiance to such principles. Amongst them are 24 AI companies that did so by posting a commitment of the kind on their website and/or by joining the ‘Partnership on AI’. By means of a comprehensive web search, two questions are addressed by this study: (1) Did the signatory companies actually try to implement these principles in practice, and if so, how? (2) What are their views on the role of other societal actors in steering AI towards the stated principles (the issue of regulation)? It is concluded that some three of the largest amongst them have carried out valuable steps towards implementation, in particular by developing and open sourcing new software tools. To them, charges of mere ‘ethics washing’ do not apply. Moreover, some 10 companies from both the USA and Europe have publicly endorsed the position that apart from self-regulation, AI is in urgent need of governmental regulation. They mostly advocate focussing regulation on high-risk applications of AI, a policy which to them represents the sensible middle course between laissez-faire on the one hand and outright bans on technologies on the other. The future shaping of standards, ethical codes, and laws as a result of these regulatory efforts remains, of course, to be determined.

Objective:Few studies have evaluated patients with spontaneous subarachnoid haemorrhage (sSAH) from an intensivist perspective. This study aimed to report the results of patients with sSAH in a high-volume centre monitored by a team experienced in the fields of brain surgery, interventional radiology and intensive care.Materials and Methods:Data of patients with sSAH followed up between January 2014 and July 2018 in the intensive care unit (ICU) were retrieved from ICU patient observation charts, file records and hospital automated information system.Results:This study enrolled 150 patients, of which 61 (40.7%) patients died despite receiving intensive care. Mortality rates between patients with (42.8%) and without (40%) vasospasm were comparable (p=0.917). Vasospasm developed in 37.8% of the 45 patients who underwent endovascular coiling and in 19.2% of those who underwent neurosurgical clipping (p=0.044). The median times that elapsed before endovascular or surgical procedures were 2.5 [interquartile range (IQR): 2-5] days in the surviving group and 2 (IQR: 1-5) days in the deceased group (p=0.164). Blood sodium and blood chloride levels were significantly higher in the deceased group from the third day onward. The median blood sodium level exceeded 142 mEq/L in the deceased group, but was lower than 142 mEq/L on the same day in the surviving group.Conclusion:The results of this study suggest that Glasgow coma scale (GCS) at admission to the ICU is one of the important factors that affect treatment success. GCS is an important independent factor in selecting the timing or type of treatment (surgical clipping/endovascular coiling) and medical treatments such as nimodipine in patients with sSAH requiring intensive care. In addition, the incidence of vasospasm was higher in patients who underwent endovascular coiling. Increased sodium and chloride values during follow-up are the only parameters significantly associated with mortality.

Didik Librianto,1 Ismail Hadisoebroto Dilogo,2 Achmad Fauzi Kamal,2 Ifran Saleh,2 Fachrisal Ipang,1 Dina Aprilya2 1Orthopedic Spine Surgeon, Fatmawati General Hospital, Jakarta, Indonesia; 2Department of Orthopedic and Traumatology, Faculty of Medicine Universitas Indonesia, Jakarta, IndonesiaCorrespondence: Dina AprilyaDepartment of Orthopedic and Traumatology, Faculty of Medicine Universitas Indonesia, Prof. Soelarto building, 1st floor, RS Fatmawati Street, Jakarta, 12430, IndonesiaTel +6289655106136Fax +6221-7660616Email dina.cia.aprilya@gmail.comBackground: Kyphosis in spondylitis tuberculosis (STb) is more than just a cosmetic issue. It has a potentially detrimental effect on both spine-associated structures and cardiopulmonary function. It can be corrected in any stage of STb; however, the corrective surgery is challenging, especially in the late case, in which the additional stiffness of the spine can come into consideration. To date, the cantilever technique is still a gold standard for sagittal plane deformity correction. However, no study to date has explored its effectiveness for thoracolumbar kyphotic deformity, especially that caused by spondylitis tuberculosis.Methods: This is a retrospective study of 16 consecutive cases of spondylitis tuberculosis with thoracolumbar kyphosis that underwent corrective surgery in our center in the period of 2020– 2021. We aim to evaluate the effectiveness of the cantilever technique that we use for kyphotic correction in thoracolumbar STb patients.Results: At the 3-months follow-up, the mean Cobb angle was 14.6°± 10.27°, with the mean gain of 20.90°± 12.00° and positively correlate with the thoracolumbar kyphosis (TLK) correction (68.69%, r = 0.654, p = 0.001). The mean thoracic kyphosis, lumbar lordosis, and sagittal vertebral axis were 30.6°± 13.08°, 39.4°± 16.02°, and 1.4± 4.09 cm, respectively, with sagittal Cobb difference of 12.70± 9.85.Conclusion: The kyphotic Cobb angle reduction by cantilever technique in the thoracolumbar area significantly improved the thoracolumbar kyphosis and realign the spinal sagittal axis. Thus, the cantilever technique remains the gold standard for sagittal plane deformity correction which can be applied for kyphotic deformity correction in thoracolumbar STb cases.Keywords: thoracolumbar spine, kyphotic deformity, spondylitis tuberculosis, deformity correction, cantilever technique

Objectives: This study explores the effects of the Active Plus intervention aiming to decrease loneliness among older adults (>65 years) with chronic diseases. Methods: A randomized controlled trial (RCT) was performed (N = 585; age: M = 74.5 years, SD = 6.4), assessing loneliness at baseline, 6 months and 12 months. Outcome measures in the multilevel linear regression analyses were total, social and emotional loneliness. Results: At 12 months, significant decreases in total ( B = −.37, p = .01) and social loneliness ( B = −.24, p = .02) were found. Age was a significant moderator for total and social loneliness; however, the intervention was effective only for participants aged 80 years and older. Discussion: The Active Plus intervention showed a significant decrease in total and social loneliness and was especially beneficial for the vulnerable age group of 80 years and older. A more comprehensive tool for measuring social activity and mobility impairments, and using a longer time frame to detect loneliness changes, may form interesting future research.

Background and Aim Following an index episode of acute pancreatitis, sometimes the inflammation subsides completely, but sometimes inflammation persists and progresses to chronic pancreatitis, which may be or may not be preceded by recurrent acute pancreatitis. Some patients may also develop diabetes mellitus. There is only limited information on the longer‐term outcome of patients with acute pancreatitis. The aim of this study was to evaluate the longer‐term consequences of acute pancreatitis in the form of the development of recurrent attacks of acute pancreatitis, chronic pancreatitis, diabetes, or pancreatic carcinoma. Methods The index study included 122 patients who presented with their first episode of acute pancreatitis. This retrospective, cross‐sectional survey was performed 5 years after the index episode. Results Of the 122 patients, 96 were available for follow‐up while 4 were known to have died (one from pancreatic cancer). On reassessment after 5 years, 28 of 96 patients had further episodes of pancreatitis. Fifteen patients were diagnosed as having recurrent acute pancreatitis, 13 patients were diagnosed as having chronic pancreatitis, while 17 developed new‐onset diabetes. Recurrent acute pancreatitis was more common in younger patients, while chronic pancreatitis was associated with alcohol abuse and a more severe index episode. The development of diabetes was more common with advanced age. Conclusions In this study, a good proportion of patients progressed to chronic pancreatitis and diabetes within 5 years after surviving acute pancreatitis., Cross‐sectional review was done after 5 years of follow‐up of acute pancreatitis. Out of 100 patients, 15% patients developed recurrent acute pancreatitis, 13% patients developed chronic pancreatitis, and 17% patients developed diabetes.

Metformin is the first-line drug for the treatment of type 2 diabetes mellitus, but its role in gestational diabetes mellitus (GDM) management is not clear. Recent evidence suggests a certain beneficial effect of metformin in the treatment of GDM, but a high treatment failure rate leads to the initiation of additional medications, such as insulin. Moreover, since metformin crosses the placental barrier and reaches a significant level in the fetus, it is likely to influence the fetal metabolic milieu. The evidence indicates the long-term safety in children exposed to metformin in utero except for mild adverse anthropometric profiles. Diligent follow-up of metformin-exposed offspring is warranted from the clinician's point of view.

Hydroxyurea therapy is commonly used in the treatment of patients suffering from myeloproliferative diseases, such as polycythemia vera. It is supported by evidence that this type of therapy can generate mild skin lesions like leg ulcers, erythema, and hyperpigmentation. There are also some studies that show an increased risk of development of nonmelanoma skin cancers. We report a 56-year-old man with a 13-year history of polycythemia vera, treated chronically with hydroxyurea. In April 2020, the patient presented a skin lesion on the forehead, skin horn on the left forearm, and hyperkeratosis on the rims of both ears. In the patient’s history, in October 2019, complete excision of the skin lesion in the central area of the forehead was performed. After 4 months, a new skin lesion appeared at the same area of the forehead, which in May 2020 after resection in the histopathological examination was diagnosed as recurrence of squamous cell carcinoma. The aim of the case is to draw the clinicians’ attention to the increased risk of squamous cell carcinoma and basal cell carcinoma in patients treated with hydroxyurea. Increased vigilance would make it possible to recognize them earlier, and thus potentially reduce the undesirable effects associated with the delayed radical treatment of these skin cancers. Randomized clinical trials assessing the potential benefits of oral retinoids for chemoprevention of nonmelanoma skin cancers in the hydroxyurea-treated population should also be considered.

Aim:Limited data are available in the literature about the long-term results of smoking cessation and the relapse rate in older smokers. We aimed to demonstrate the efficacy of short- and long-term smoking cessation behaviors in individuals over 65 years of age.Methods:Patients’ data were analyzed retrospectively from hospital records between 2014 and 2018. All patients received individual behavioral therapy and were prescribed the drugs that were best suited for their individual circumstances, such as nicotine replacement therapy, bupropion, and varenicline. Patients who quit smoking during the three-month period of outpatient follow-up were contacted by phone at least two years later and asked whether they still smoked or not.Results:In total, 68 older participants (13 female and 56 male) were included. In the initial three-month follow-up period, 29 of the participants (42.6%) dropped out of the smoking cessation program after the first interview. Eleven of the smokers (16.2%) did not quit smoking, and 28 (41.1%) did quit smoking. Fourteen participants (20.6%) achieved long-term abstinence (i.e., were not smoking at the two-year follow-up), while the remaining 10 participants (14.7%) had started to smoke again. No statistically significant difference was found between quitters and non-quitters in terms of age, gender, duration of the smoking habit, the number of cigarettes smoked daily, the reason for starting smoking, the reason for the desire to quit smoking, and the treatment methods used.Conclusion:Smoking cessation strategies should be tailored and constantly re-evaluated in elderly people for safe management, and they should be followed up closely to avoid relapse risk.

In 2019, natural gas accounted for 25.4% of gross inland consumption in the European Union (EU), making it one of the most important energy sources in the EU. The importance of natural gas, together with the ongoing liberalization of the gas market, has made the natural gas sector significantly commercially sensitive. To reduce the risk of financial losses, balance group managers often need to have an accurate forecast of natural gas consumption. An accurate forecast will ensure small deviations between actual gas consumption and reserved gas volumes and transmission system capacity resulting in less balancing energy required, which is sold at a higher price in the final balancing process. This paper researches the optimal number of smart meters and best fitted consumption data distribution in order to achieve satisfactory results in terms of the accuracy by using simple forecasting methods. Beside mentioned, this paper provides accuracy overview of various already available forecasting methods, as well as the selection of input parameters for forecasting short term natural gas consumption. Using the calculated linear temperature dependence together with the lognormal distribution, the consumption of natural gas was simulated for 12 different cases. The simulation showed that, if more than 10 000 smart meters were installed, deviation between average estimated natural gas consumption and the real data would be less than ± 2.96 %. In case of 100 000 smart meters installed, deviation would be less than ± 1.20 %, but the “large” partly temperature independent consumers must be disregarded.

Purpose - This paper analyses the growth of tourism in Portugal and in the municipality of Lisbon, with a focus on short-term rentals. Design - The paper begins with the statistical background of the tourism boom that occurred in Portugal in the 2010s. The central part of the paper concentrates on an analysis of the spatial distribution of short-term rental properties, consisting of two parts: i) observation of spatial patterns in Portugal, by NUTS II region; ii) analysis of the municipality of Lisbon, which accounts for 22% of all short-term rentals units registered in Portugal. Methodology - The spatial analysis was carried out within GIS, using an approach based on spatial statistics, with research that involves geographic data and big data. Approach - This study combines a qualitative and quantitative approach. It begins with a theoretical review on the growth of tourism and short-term rental in the last decade, followed by a quantitative-spatial analysis to the case of Portugal and the municipality of Lisbon, and ending with reflections that combine the results of the practical analysis with the most recent literature on the impacts of tourism in Lisbon Findings - The paper ends with some reflections on the excessive concentration of short-term rentals in urban areas and their positive and negative externalities on urban life. The results suggest that the city center presents the highest concentration of short-time rentals, but not the highest concentration of beds. It also shows that the excessive concentration of short-term rentals units may cause serious negative externalities that affect the quality of life in its multiple dimensions. Originality - The results and the final discussion of this paper contributes to a greater knowledge of the spatial distribution of short-term rentals in Portugal and Lisbon and to debate the future of short-term rentals in cities that are among the world’s leading tourism destinations.

Various biological behaviors can only be observed in 3D at high speed over the long term with low phototoxicity. Light-field microscopy (LFM) provides an elegant compact solution to record 3D information in a tomographic manner simultaneously, which can facilitate high photon efficiency. However, LFM still suffers from the missing-cone problem, leading to degraded axial resolution and ringing effects after deconvolution. Here, we propose a mirror-enhanced scanning LFM (MiSLFM) to achieve long-term high-speed 3D imaging at super-resolved axial resolution with a single objective, by fully exploiting the extended depth of field of LFM with a tilted mirror placed below samples. To establish the unique capabilities of MiSLFM, we performed extensive experiments, we observed various organelle interactions and intercellular interactions in different types of photosensitive cells under extremely low light conditions. Moreover, we demonstrated that superior axial resolution facilitates more robust blood cell tracking in zebrafish larvae at high speed., Mirror-enhanced scanning light-field microscopy (MiSLFM) achieves long-term high-speed 3D imaging at near-isotropic subcellular resolution with a single objective, facilitating native observations of various intracellular and intercellular interactions.

Rain‐induced leading‐edge erosion (LEE) of wind turbine blades (WTBs) is associated with high repair and maintenance costs. The effects of LEE can be triggered in less than 1 to 2 years for some wind turbine sites, whereas it may take several years for others. In addition, the growth of erosion may also differ for different blades and turbines operating at the same site. Hence, LEE is a site‐ and turbine‐specific problem. In this paper, we propose a probabilistic long‐term framework for assessing site‐specific lifetime of a WTB coating system. Case studies are presented for 1.5 and 10 MW wind turbines, where geographic bubble charts for the leading‐edge lifetime and number of repairs expected over the blade's service life are established for 31 sites in the Netherlands. The proposed framework efficiently captures the effects of spatial and orographic features of the sites and wind turbine specifications on LEE calculations. For instance, the erosion is highest at the coastal sites and for sites located at higher altitudes. In addition, erosion is faster for turbines associated with higher tip speeds, and the effects are critical for such sites where the exceedance probability for rated wind conditions are high. The study will aid in the development of efficient operation and maintenance strategies for wind farms.

The amount of newly uploaded content on the internet is growing daily: 60 seconds on the web in 2021 consist of more than 500 hours of content uploaded on YouTube, 695,000 stories shared on Instagram, and nearly 70 million messages sent via WhatsApp and Facebook Messenger. The vast majority of them is legal content, but a slice is illegal or harmful. The article analyses the situation and the problems of both human and AI moderation, then it gives an answer how to handle the content on the internet with a shared usage of human and AI moderation as they could perfectly complement each other in a long term.

Introduction and objectives: The results of Magmaris implantation in the acute coronary syndrome setting is uncertain and more studies will be needed to assess the long-term safety profile of these devices. The objective of this work was to conduct an observational study to analyze the clinical safety profile of Magmaris implanted in a single hospital center in the acute coronary syndrome setting beyond 12 months. Methods: Registry of 36 patients with Magmaris devices implanted between November 2016 through November 2018 with a diagnosis of acute coronary syndrome included consecutively. The primary endpoint was considered the device-oriented composite endpoint of target vessel myocardial infarction, target lesion failure, and cardiac death. Secondary endpoints included Magmaris related thrombosis. Results: Regarding the device-oriented combination, no target vessel myocardial infarction was observed, 0 cases (0%), while target lesion failure was seen in 2 cases (5.6%). There were no cases of Magmaris thrombosis at the follow-up and only 1 case of cardiac death (2.8%) was found 36 months after Magmaris implantation. The cause of death could not be determined since no autopsy was performed. Conclusions: Our results with long-term follow-up confirm that Magmaris has a favorable clinical profile in the acute coronary syndrome complex setting.

Background Accurately predicting which patients with chronic heart failure (CHF) are particularly vulnerable for adverse outcomes is of crucial importance to support clinical decision making. The goal of the current study was to examine the predictive value on long term heart failure (HF) hospitalisation and all-cause mortality in CHF patients, by exploring and exploiting machine learning (ML) and traditional statistical techniques on a Dutch health insurance claims database. Methods Our study population consisted of 25,776 patients with a CHF diagnosis code between 2012 and 2014 and one year and three years follow-up HF hospitalisation (1446 and 3220 patients respectively) and all-cause mortality (2434 and 7882 patients respectively) were measured from 2015 to 2018. The area under the receiver operating characteristic (ROC) curve (AUC) was calculated after modelling the data using Logistic Regression, Random Forest, Elastic Net regression and Neural Networks. Results AUC rates ranged from 0.710 to 0.732 for 1-year HF hospitalisation, 0.705–0.733 for 3-years HF hospitalisation, 0.765–0.787 for 1-year mortality and 0.764–0.791 for 3-years mortality. Elastic Net performed best for all endpoints. Differences between techniques were small and only statistically significant between Elastic Net and Logistic Regression compared with Random Forest for 3-years HF hospitalisation. Conclusion In this study based on a health insurance claims database we found clear predictive value for predicting long-term HF hospitalisation and mortality of CHF patients by using ML techniques compared to traditional statistics.

Background: Painful restriction of active and passive shoulder range of motion which cannot be attributed to any internal shoulder pathology is termed as primary frozen shoulder. It has three stages – freezing stage, frozen stage, and thawing stage. Nonsteroidal anti-inflammatory drugs, physiotherapy, intra-articular corticosteroid injection, hydrodilatation, arthroscopic capsular release, and manipulation under anesthesia (MUA) are different modalities of treatment. Aims and Objectives: The main objective of our study was to assess the short-term and long-term outcome of MUA in frozen shoulder once it did not respond to 3 months course of physiotherapy. Materials and Methods: Fifty patients of primary frozen shoulder fulfilling inclusion criteria were manipulated under general anesthesia, and intra-articular Depo-Medrol and bupivacaine were administered. Functional status of the shoulder was assessed using the adjusted Constant-Murley (CM) score preoperatively and in subsequent follow-ups. Results: There was a significant improvement of mean adjusted CM score in short- and long-term follow-ups compared to pre-manipulation value. A significant negative correlation was found between the age of the patient and the final outcome. Conclusion: MUA is an effective modality of treatment in primary frozen shoulder with good short- and long-term outcomes.

Background The COVID-19 pandemic has initiated several initiatives to better understand its behavior, and some projects are monitoring its evolution across countries, which naturally leads to comparisons made by those using the data. However, most “at a glance” comparisons may be misleading because the curve that should explain the evolution of COVID-19 is different across countries, as a result of the underlying geopolitical or socio-economic characteristics. Therefore, this paper contributes to the scientific endeavour by creating a new evaluation framework to help stakeholders adequately monitor and assess the evolution of COVID-19 in countries, considering the occurrence of spikes, "secondary waves" and structural breaks in the time series. Methods Generalized Additive Models were used to model cumulative and daily curves for confirmed cases and deaths. The Root Relative Squared Error and the Percentage Deviance Explained measured how well the models fit the data. A local min-max function was used to identify all local maxima in the fitted values. The pure Markov-Switching and the family of Markov-Switching GARCH models were used to identify structural breaks in the COVID-19 time series. Finally, a quadrants system to identify countries that are more/less efficient in the short/long term in controlling the spread of the virus and the number of deaths was developed. Such methods were applied in the time series of 189 countries, collected from the Centre for Systems Science and Engineering at Johns Hopkins University. Results Our methodology proves more effective in explaining the evolution of COVID-19 than growth functions worldwide, in addition to standardizing the entire estimation process in a single type of function. Besides, it highlights several inflection points and regime-switching moments, as a consequence of people’s diminished commitment to fighting the pandemic. Although Europe is the most developed continent in the world, it is home to most countries with an upward trend and considered inefficient, for confirmed cases and deaths. Conclusions The new outcomes presented in this research will allow key stakeholders to check whether or not public policies and interventions in the fight against COVID-19 are having an effect, easily identifying examples of best practices and promote such policies more widely around the world.

Wind energy is a fluctuating source for power systems, which poses challenges to grid planning for the wind power industry. To improve the short-term wind forecasts at turbine height, the bias correction approach Kalman filter (KF) is applied to 72-h wind speed forecasts from the WRF model in Zhangbei wind farm for a period over two years. The KF approach shows a remarkable ability in improving the raw forecasts by decreasing the root-mean-square error by 16% from 3.58 to 3.01 m s−1, the mean absolute error by 14% from 2.71 to 2.34 m s−1, the bias from 0.22 to − 0.19 m s−1, and improving the correlation from 0.58 to 0.66. The KF significantly reduces random errors of the model, showing the capability to deal with the forecast errors associated with physical processes which cannot be accurately handled by the numerical model. In addition, the improvement of the bias correction is larger for wind speeds sensitive to wind power generation. So the KF approach is suitable for short-term wind power prediction.

Cognitive decline is a well-known chronic side effect of multidisciplinary treatment of pineal region tumors, whereas epilepsy is an under-reported chronic consequence caused by multiple potential factors including radiotherapy, surgery, or chemotherapy. Some long-term survivors have suffered drug-resistant epilepsy after treatment, which impaired the quality of life. We report five consecutive patients with drug-resistant epilepsy after combined treatment of pineal region tumor (5 men, aged 21–42 years) among 1201 epilepsy patients who underwent comprehensive evaluation in our tertiary epilepsy center from 2011 to 2018. The comprehensive epilepsy evaluation included medical interview, long-term video electroencephalography (EEG) monitoring (VEM), and magnetic resonance (MR) imaging. The patients started to have seizures at 2–22 years after initial treatment for the tumor. Four of the five patients had focal impaired awareness seizures, whereas one patient had only visual aura. All patients had EEG seizures during VEM, which confirmed the diagnosis of focal epilepsy, but three patients had no interictal epileptiform discharges (IEDs). Two patients had diagnoses of focal epilepsy arising from the left occipital region based on ictal EEG findings. Both patients had MR imaging lesion in the left occipital lobe, radiation-induced cavernoma, or surgical injury. The remaining three patients showed poor localization of epileptogenic foci based on VEM and MR imaging. Drug-resistant epilepsy after multidisciplinary treatment of pineal region tumor is characterized by focal impaired awareness seizures with poorly localized EEG onset or rare interictal spikes.

In a recent paper, "Environmental DNA: What's behind the term? Clarifying the terminology and recommendations for its future use in biomonitoring," Pawlowski et al. argue that the term eDNA should be used to refer to the pool of DNA isolated from environmental samples, as opposed to only extra-organismal DNA from macro-organisms. We agree with this view. However, we are concerned that their proposed two-level terminology specifying sampling environment and targeted taxa is overly simplistic and might hinder rather than improve clear communication about environmental DNA and its use in biomonitoring. This terminology is based on categories that are often difficult to assign and uninformative, and it overlooks a fundamental distinction within eDNA: the type of DNA (organismal or extra-organismal) from which ecological interpretations are derived., Molecular Ecology, 30 (19), ISSN:0962-1083, ISSN:1365-294X

BACKGROUND Hypertensive intracerebral hemorrhage is a common critical disease of the nervous system, comprising one fifth of all acute cerebrovascular diseases and has a high disability and mortality rate. It severely affects the patients’ quality of life. AIM To analyze the short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage. METHODS From March 2018 to May 2020, 118 patients with hypertensive intracerebral hemorrhage were enrolled in our study and divided into a control group and observation group according to the surgical plan. The control group used a hard-channel minimally invasive puncture and drainage procedure. The observation group underwent minimally invasive neuroendoscopic surgery. The changes in the levels of serum P substances (SP), inflammatory factors [tumor necrosis factor-α, interleukin-6 (IL-6), IL-10], and the National Hospital Stroke Scale (NIHSS) and Barthel index scores were recorded. Surgery related indicators and prognosis were compared between the two groups. RESULTS The operation time (105.26 ± 28.35) of the observation group was min longer than that of the control group, and the volume of intraoperative bleeding was 45.36 ± 10.17 mL more than that of the control group. The hematoma clearance rates were 88.58% ± 4.69% and 94.47% ± 4.02% higher than those of the control group at 48 h and 72 h, respectively. Good prognosis rate (86.44%) was higher in the observation group than in the control group, and complication rate (5.08%) was not significantly different from that of the control group (P > 0.05).The SP level and Barthel index score of the two groups increased (P < 0.05) and the inflammatory factors and NIHSS score decreased (P < 0.05). The cytokine levels, NIHSS score, and Barthel index score were better in the observation group than in the control group (P < 0.05). CONCLUSION Neuroendoscopic minimally invasive surgery is more complicated than hard channel minimally invasive puncture drainage in the treatment of hypertensive intracerebral hemorrhage; however, hematoma clearance is more thorough, and the short-term effect and long-term prognosis are better than hard channel minimally invasive puncture drainage.

Introduction. Cancer is the second cause-of-death mortality pattern in the Republic of Moldova. The study of both cancer mortality by age and its detailed causes is an important tool for evidence-based public health policy. The study aims at comparing recent changes in cancer mortality with long-term trends, depending on specific causes and age. Material and methods. This study was carried out on the reconstructed 1965-2018 death time series, according to the 10th revision of the International Classification of Diseases. Standardized death rates were computed. Results. After a gradual increase in the ‘70s and ‘80s of the last century, cancer mortality rate showed “reversed” patterns and started to decline in the ‘90s. This decline was due to the data quality issue and to the competing risks of dying from other causes sensitive to the social and economic circumstances of the ‘90s. Since the beginning of the millennium, cancer mortality has resumed its growth that continues up to now. Despite the increasing overall trend in cancer mortality rate during 1965-2018, the analysis by age and specific causes revealed opposite trends. Conclusions. The malignant neoplasms specific for certain sites and age groups (stomach, uterus, leukaemia in children) showed, however some therapeutic progress, while the situation for other tumour sites (lung, breast, and intestine) worsened significantly. The moderate decrease in lung cancer in the 1990s should be cautiously interpreted.

With epidemics and pandemics like COVID-19, many offline healthcare services have been suspended and shifted to online, where patients and doctors typically communicate by typing texts. The limited communication poses a threat to the service quality of E-health, and also raises higher demand on the language skills of doctors, in which medical terms are a common concern. Traditional studies of offline healthcare mostly hold a negative attitude towards the use of medical terms by doctors. However, should we still advise doctors to avoid using medical terms in E-health? To answer this question, this paper conducts a study combining technical and empirical analyses based on real data. In this paper, a novel unsupervised text-mining method is proposed to automatically identify medical terms with crowd wisdom from large-scale doctor-patient communication texts. Then, a TREC-type experiment is carried out to validate the proposed method in terms of Precision, Recall, and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$F_1$$\end{document}F1-measure, demonstrating that it can identify accurate and comprehensive medical terms. Based on the identified medical terms, an empirical analysis is conducted to verify the influence of medical terms used by doctors on the service quality of E-health. The analysis results show that for patients with low health literacy, the use of medical terms by doctors would decrease their service quality. However, for patients with high health literacy, the use of medical terms by doctors can significantly increase their service quality, revealing that doctors could improve their service quality in E-health by adjusting their medical term usage according to the health literacy of patients.

Changes in salivary markers have been largely assessed during different modalities of long-term and short-term basketball training across different basketball populations. The aim of this paper was to systematically review the literature assessing changes in salivary markers in basketball following long-term and short-term training periods. An electronic database search of articles published until October 2020 was completed in PubMed, SPORTDiscus, Scopus and Web of Science. Studies were then screened and selected using pre-defined selection criteria with 1080 articles identified. After removing 690 duplicates, 390 articles were included for screening, which revealed 15 articles that met the inclusion criteria. The main findings revealed no changes in testosterone (T), cortisol (C) or their ratio (T:C), while contrasting results were found in immunoglobulin A (IgA) and total protein (TP) levels across long-term periodized training periods in different basketball populations. The analysis of short-term training periods showed that strength-hypertrophy training induced higher C levels compared to a non-exercising day, one-power training and one-endurance training session in female basketball players, while no changes were evident for T and IgA. Moreover, the analysis of salivary markers in response to small-sided games (SSGs) documented a large-to-moderate increase in alpha-amylase (AA) from pre- to post-SSG and inconsistent results of C and T across differently designed SSGs. The current results provide a detailed description of salivary marker changes in response to different basketball long- and short-term training periods, which can help practitioners in designing sound training programmes to optimize players' fitness and health status across different phases of the season.

Purpose User-centred intelligent buildings (IBs) should respond to users’ needs holistically and the demand for end user applications is steadily growing. The purpose of this study is to answer: What are end user applications, what should they be called, and what are their key features? Design/methodology/approach This is a mixed-method study. The authors have used different data sources, such as online research and interviews. In data processing, the authors have used word counting and Latent Dirichlet Allocation topic modeling. Findings These end user applications can provide the missing user-centered elements of IBs. The authors have found that “smart workplace solution” (SWS) is the best term to describe these applications, and they also describe the key features, which include booking, showing free spaces, occupancy tracking, wayfinding and searching. Research limitations/implications As the end user applications are constantly and rapidly evolving, the latest evolving of such applications might not be covered. Furthermore, the authors have relied on companies’ information as given. Originality/value IBs have emerged over 20 years ago, and these are the first solutions that can be considered truly user-centered.

Accurate long-term origin-destination demand (OD) prediction can help understand traffic flow dynamics, which plays an essential role in urban transportation planning. However, the main challenge originates from the complex and dynamic spatial-temporal correlation of the time-varying traffic information. In response, a graph deep learning model for long-term OD prediction (ST-GDL) is proposed in this article, which is among the pioneering work that obtains both short-term and long-term OD predictions simultaneously. ST-GDL avoids the conventional multi-step forecasting and thus prevents learning from prediction errors, rendering better long-term forecasts. The proposed method captures time attributes from multiple time scales, namely closeness, periodicity, and trend, to study the features with temporal dynamics. In addition, two gate mechanisms are introduced over the vanilla convolution operation to alleviates the error accumulation issue of typical recurrent forecast in long-term OD prediction. A method based on graph convolution is proposed to capture the dynamic spatial relationship, which projects the transportation network into a graphical time-series. Finally, the long-term OD prediction results are obtained by combining the extracted spatio-temporal features with external features from the meteorological information. Case studies on practical datasets show that the proposed model is superior to existing methods in long-term OD prediction problems.

In recent years, the use of ride hailing mobile application services is increasing exponentially. Customers’ expectation of these phone services varies and change dynamically as the needs of each individual also vary. Customer reviews about mobile application are honest, voluntary opinions; and these could become essential input for mobile application providers to measure satisfaction. However, managing a large number of reviews into actionable plans could be challenging. This study combines the Term Frequency-Inverse Document Frequency (TF-IDF) and Multiple-Criteria Decision-Making (MCDM)-VIKOR approach to process 600 reviews into a meaningful insight to enhance ride hailing mobile application services. The four-phase method analysis concluded that application ease of use and affordability are the most important aspects that most contribute to customers’ satisfaction in ride hailing mobile application services.

The Northern Sea Route (NSR) has gradually become viable because of sea ice melting in the Artic. There is a large and diverse body of research on the NSR, investigating aspects such as weather, the environment, legal security, infrastructure and technologies, shipping transportation, and economic issues. However, there has been scant research carried out from a macroscopic perspective on NSR research trends. The purpose of this study is to analyze the trends in research about the NSR by applying a social network analysis. By collecting keywords from academic papers on the NSR, a network of keywords and two indexes (degree centrality and betweenness centrality) are accessed and analyzed. The results show that the trends can be divided into three periods (1899–1999, 2000–2009, 2010–2019). Throughout all periods, the issue of climate change causing the ice in the Arctic to melt has been a consideration for many scholars. In addition, “national security” and “oil exploitation” were important keywords in the first period. In the second period (2000–2010), in addition to words related to the environment, such as “sea ice” and “climate change,” the term “ocean transport” appears and becomes a central topic of research. This is because when the NSR has a non-icy period, ocean transport through the NSR can be deployed. The research trends become obvious in the third period (2011–2019) with two primary research areas: climate change and shipping area, which accurately measure the benefit and cost. This paper shows the importance of the NSR, reviews the main research topics involving the NSR, and informs researchers and authorities as to the trends in academic research on the NSR.

The paper presents an analysis of the wind energy availability on long-term basis in the Republic of Moldova. This is motivated by the necessity of increasing the renewable energy sources in the global energy portfolio of the Republic of Moldova. Although there are some studies on this subject, concluding that there is a satisfactory wind energy potential, there are no references on the future evolution of the wind energy. Starting from the analysis of the historical wind speed data corresponding to the 31-year period 1990–2020 and taking into account the most significant geographic and civil requirements, several locations were chosen as possible targets for the future wind farms placement. An analysis of the predicted wind data for the 31-year period 2020–2050 based on RCP4.5 scenario, allowed to identify the optimal areas for the wind energy extraction in the republic of Moldova.

BACKGROUND Pancreatic neoplasms are uncommon in children and in most cases they are benign or have low malignant potential. Pancreatoblastoma and solid pseudopapillary tumor are the most frequent types in early and late childhood, respectively. Complete resection, although burdened by severe complications, is the only curative treatment for these diseases. Pancreatic surgery may result in impaired exocrine and endocrine pancreatic function. However, limited data are available on the long-term pediatric pancreatic function following surgical resection. AIM To investigate endocrine and exocrine pancreatic function and growth after oncological pancreatic surgery in a pediatric series. METHODS A retrospective analysis of all pediatric patients who underwent surgery for pancreatic neoplasm in our Institution from January 31, 2002 to the present was performed. Endocrine and exocrine insufficiency, auxological and fat-soluble vitamin status (A, D, E and clotting tests) were assessed at diagnosis and at every follow-up visit. Exocrine insufficiency was defined as steatorrhea with fecal elastase-1 < 200 µg/g stool, while endocrine insufficiency was identified as onset of Diabetes or Impaired Glucose Tolerance. Growth was evaluated based on body mass index (BMI) z-score trend. RESULTS Sixteen patients (12 girls and 4 boys, mean age 10.7 ± 5.3 years), were included. Nine patients (56%) had a neoplasm in the pancreatic head, 4 in the body/tail, 2 in the tail and 1 in the body. Histological findings were as follows: Solid pseudopapillary tumor in 10 patients (62.5%), insulinoma in 2 patients, neuroendocrine tumor in 2 patients and acinar cell carcinoma in 2 patients. The most frequent surgery was pancreaticoduodenectomy (50%). Exocrine failure occurred in 4 patients (25%) and endocrine failure in 2 patients (12.5%). Exocrine insufficiency occurred early (within 6 mo after surgery) and endocrine insufficiency later (8 and 10 years after surgery). Mean BMI z-score was 0.36 ± 1.1 at diagnosis and 0.27 ± 0.95 at the last assessment. Vitamin D was insufficient (< 30 ng/mL) in 8 of the 16 patients during the follow-up period. Vitamins A, E and clotting test were into the normal ranges in all patients. CONCLUSION Careful and long-term monitoring should follow any pancreatic surgery, to recognize and promptly treat exocrine and endocrine pancreatic insufficiency, which can occur after surgery.

Aim:This study aimed to evaluate the short-term clinical and radiographic results of combined open reduction and internal fixation in the treatment of trans-scaphoid perilunate fracture-dislocation (TSPLFD).Materials and Methods:Data of eight patients diagnosed with TSPLFD who underwent combined open reduction and internal fixation and followed for a minimum of 8 months were retrospectively analyzed. All patients underwent surgical treatment with an Acutrak® screw, ligament repair using suture anchors, and Kirschner wire. The functional outcomes were evaluated using the modified Mayo Wrist Scores and total active range of motion scale. Radiographic outcomes were assessed based on standard X-ray images of the wrist.Results:Of the patients, seven were male and one was female, and the median age was 32 years (range: 20-44). The median follow-up duration was 12 months (range: 8-16). According to the TAROM scores, the outcomes were excellent and good in one and seven patients, respectively. The median Mayo Wrist Scores were 84 (range: 80-95). Good radiographic results were achieved in all patients. No surgery-related complications such as infection, loss of reduction, and Sudeck’s atrophy were observed.Conclusion:Although TSPLFD is a rare condition, early diagnosis and surgical treatment yield favorable functional and radiographic results. However, post-traumatic arthritis and functional dissatisfaction may occur in the long term.

Background Observational studies are increasingly being used to provide supplementary evidence in addition to Randomized Control Trials (RCTs) because they provide a scale and diversity of participants and outcomes that would be infeasible in an RCT. Additionally, they more closely reflect the settings in which the studied interventions will be applied in the future. Well-established propensity-score-based methods exist to overcome the challenges of working with observational data to estimate causal effects. These methods also provide quality assurance diagnostics to evaluate the degree to which bias has been removed and the estimates can be trusted. In large medical datasets it is common to find the same underlying health condition being treated with a variety of distinct drugs or drug combinations. Conventional methods require a manual iterative workflow, making them scale poorly to studies with many intervention arms. In such situations, automated causal inference methods that are compatible with traditional propensity-score-based workflows are highly desirable. Methods We introduce an automated causal inference method BCAUS, that features a deep-neural-network-based propensity model that is trained with a loss which penalizes both the incorrect prediction of the assigned treatment as well as the degree of imbalance between the inverse probability weighted covariates. The network is trained end-to-end by dynamically adjusting the loss term for each training batch such that the relative contributions from the two loss components are held fixed. Trained BCAUS models can be used in conjunction with traditional propensity-score-based methods to estimate causal treatment effects. Results We tested BCAUS on the semi-synthetic Infant Health & Development Program dataset with a single intervention arm, and a real-world observational study of diabetes interventions with over 100,000 individuals spread across more than a hundred intervention arms. When compared against other recently proposed automated causal inference methods, BCAUS had competitive accuracy for estimating synthetic treatment effects and provided highly concordant estimates on the real-world dataset but was an order-of-magnitude faster. Conclusions BCAUS is directly compatible with trusted protocols to estimate treatment effects and diagnose the quality of those estimates, while making the established approaches automatically scalable to an arbitrary number of simultaneous intervention arms without any need for manual iteration.

Atrial fibrillation (AF) is one of the most common arrhythmias diagnosed in clinical practice. Today, AF is associated with an increased risk of mortality, acute brain disorders, and heart failure. The results of many studies suggest that the incidence of AF is directly related to such risk factors (RF) as age, obesity, hypertension, diabetes mellitus, obstructive sleep apnea, alcohol, tobacco smoking etc. Recently published studies have described the positive impact of lifestyle changes on the incidence of AF. Therefore, it is believed that early detection of RF could prevent or delay the onset of AF. New data suggest the need to review the management of patients with AF. In 2020, the American Heart Association has presented a scientific statement that highlighted the relationship between modified RF and AF, discussed the implementation of strategies for effective modification of RF, as well as identified areas for new research. The data allow us to conclude that the correction of RF helps to reduce the incidence of AF. Future research is needed to establish the effects and generalizability of systematic lifestyle and RF modification for AF: to study the role of pericardial/epicardial fat accumulation in risk and progression of AF; determination of the most effective weight loss techniques for long-term success in reducing AF; effects of high-intensity/short-duration interval training on left atrium structural and electric remodeling; the degree of glycemic control for AF.

The environmental monitoring data of Qianfoya Cliff Inscriptions in Guangyuan, Sichuan Province accumulated since 2014 make it possible to analyze the environmental monitoring data in and out of the Experimental Structure of the Conservational Architecture of Qianfoya Cliff Inscriptions which was built in 2016. By comparing the long long-term environmental pattern and differences between the internal and external part of the section, the results indicate that the Conservational Architecture effectively decrease the frequency of short-term sever winds, strong sunshine and extreme high and low temperatures, reduces the short short-term temperature and humidity variation range, which creates a stable microenvironment conducive to the preservation of statues without changing the long long-term environmental transformation pattern. Moreover, a parameter system for evaluating the conservational architecture, which directly related to environmental damage factors and meets the requirement of measurability and controllability, has been established and control threshold of microenvironment adjustment, which divides abnormal environment state in three levels (caution states, Pre-warning states, Warning states), has been chosen so as to quantitatively evaluate the protection effect of the experimental structure and provide data guidance for daily protection work and environmental control. Based on this parameter system and control thresholds , the total duration of warning states in Qianfoya experimental structure can be reduced by 30% compared with that outside the experimental structure , which further proves that the experimental structure plays a significant role in alleviating the main natural deterioration factors in Qianfoya cliff.

The COVID-19 pandemic has significantly impacted the global lifestyle, and the spreading of the virus is unprecedented. This study is aimed at assessing the association between the meteorological indicators such as air temperature (°C), relative humidity (%), wind speed (w/s), solar radiation, and PM2.5 with the COVID-19 infected cases in the hot, arid climate of Bahrain. Kendall and Spearman rank correlation coefficients and quantile on quantile regression were used as main econometric analysis to determine the degree of the relationship between related variables. The dataset analysis was performed from 05 April 2020, to 10 January 2021. The empirical findings indicate that the air temperature, humidity, solar radiation, wind speed indicators, and PM2.5 have a significant association with the COVID-19 newly infected cases. The current study findings allow us to suggest that Bahrain's relatively successful response to neighboring GULF economies can be attributed to the successful environmental reforms and significant upgrades to the health care facilities. We further report that a long-term empirical analysis between meteorological factors and respiratory illness threats will provide useful policy measures against future outbreaks.

We show that an appropriately-designed "Refunding Club" can simultaneously solve both free-riding problems in mitigating climate change-participating in a coalition with an emission reduction target and enduring voluntary compliance with the target once the coalition has been formed. Countries in the Club pay an initial fee into a fund that is invested in assets. In each period, part of the fund is distributed among the Club members in relation to the emission reductions they have achieved, suitably rescaled by a weighting factor. We show that an appropriate refunding scheme can implement any feasible abatement path a Club wants to implement. The contributions to the initial fund can be used to disentangle efficiency and distributional concerns and/or to make a coalition stable. Making the grand coalition stable in the so-called "modesty approach" requires less than 0.5% of World GDP. Finally, we suggest ways to foster initial participation, to incorporate equity concerns with regard to developing countries, and ways to ease the burden to fill the initial fund., Environmental and Resource Economics, 80 (3), ISSN:0924-6460, ISSN:1573-1502

Background Air pollution health studies have been increasingly using prediction models for exposure assessment even in areas without monitoring stations. To date, most studies have assumed that a single exposure model is correct, but estimated effects may be sensitive to the choice of exposure model. Methods We obtained county-level daily cardiovascular (CVD) admissions from the New York (NY) Statewide Planning and Resources Cooperative System (SPARCS) and four sets of fine particulate matter (PM2.5) spatio-temporal predictions (2002–2012). We employed overdispersed Poisson models to investigate the relationship between daily PM2.5 and CVD, adjusting for potential confounders, separately for each state-wide PM2.5 dataset. Results For all PM2.5 datasets, we observed positive associations between PM2.5 and CVD. Across the modeled exposure estimates, effect estimates ranged from 0.23% (95%CI: -0.06, 0.53%) to 0.88% (95%CI: 0.68, 1.08%) per 10 µg/m3 increase in daily PM2.5. We observed the highest estimates using monitored concentrations 0.96% (95%CI: 0.62, 1.30%) for the subset of counties where these data were available. Conclusions Effect estimates varied by a factor of almost four across methods to model exposures, likely due to varying degrees of exposure measurement error. Nonetheless, we observed a consistently harmful association between PM2.5 and CVD admissions, regardless of model choice.

Nuclear emergency preparedness and response is an essential part to ensure the safety of nuclear power plant (NPP). Key support technologies of nuclear emergency decision-making usually consist of accident diagnosis, source term estimation, accident consequence assessment, and protective action recommendation. Source term estimation is almost the most difficult part among them. For example, bad communication, incomplete information, as well as complicated accident scenario make it hard to determine the reactor status and estimate the source term timely in the Fukushima accident. Subsequently, it leads to the hard decision on how to take appropriate emergency response actions. Hence, this paper aims to develop a method for rapid source term estimation to support nuclear emergency decision making in pressurized water reactor NPP. The method aims to make our knowledge on NPP provide better support nuclear emergency. Firstly, this paper studies how to build a Bayesian network model for the NPP based on professional knowledge and engineering knowledge. This paper presents a method transforming the PRA model (event trees and fault trees) into a corresponding Bayesian network model. To solve the problem that some physical phenomena which are modeled as pivotal events in level 2 PRA, cannot find sensors associated directly with their occurrence, a weighted assignment approach based on expert assessment is proposed in this paper. Secondly, the monitoring data of NPP are provided to the Bayesian network model, the real-time status of pivotal events and initiating events can be determined based on the junction tree algorithm. Thirdly, since PRA knowledge can link the accident sequences to the possible release categories, the proposed method is capable to find the most likely release category for the candidate accidents scenarios, namely the source term. The probabilities of possible accident sequences and the source term are calculated. Finally, the prototype software is checked against several sets of accident scenario data which are generated by the simulator of AP1000-NPP, including large loss of coolant accident, loss of main feedwater, main steam line break, and steam generator tube rupture. The results show that the proposed method for rapid source term estimation under nuclear emergency decision making is promising.

Introduction Many health providers and communicators who are concerned that patients will not understand numbers instead use verbal probabilities (e.g., terms such as “rare” or “common”) to convey the gist of a health message. Objective To assess patient interpretation of and preferences for verbal probability information in health contexts. Methods We conducted a systematic review of literature published through September 2020. Original studies conducted in English with samples representative of lay populations were included if they assessed health-related information and elicited either (a) numerical estimates of verbal probability terms or (b) preferences for verbal vs. quantitative risk information. Results We identified 33 original studies that referenced 145 verbal probability terms, 45 of which were included in at least two studies and 19 in three or more. Numerical interpretations of each verbal term were extremely variable. For example, average interpretations of the term “rare” ranged from 7 to 21%, and for “common,” the range was 34 to 71%. In a subset of 9 studies, lay estimates of verbal probability terms were far higher than the standard interpretations established by the European Commission for drug labels. In 10 of 12 samples where preferences were elicited, most participants preferred numerical information, alone or in combination with verbal labels. Conclusion Numerical interpretation of verbal probabilities is extremely variable and does not correspond well to the numerical probabilities established by expert panels. Most patients appear to prefer quantitative risk information, alone or in combination with verbal labels. Health professionals should be aware that avoiding numeric information to describe risks may not match patient preferences, and that patients interpret verbal risk terms in a highly variable way.

Traditional statistical as well as artificial intelligence techniques are widely used for stock market forecasting. Due to the nonlinearity in stock data, a model developed using the traditional or a single intelligent technique may not accurately forecast results. Therefore, there is a need to develop a hybridization of intelligent techniques for an effective predictive model. In this study, we propose an intelligent forecasting method based on a hybrid of an Artificial Neural Network (ANN) and a Genetic Algorithm (GA) and uses two US stock market indices, DOW30 and NASDAQ100, for forecasting. The data were partitioned into training, testing, and validation datasets. The model validation was done on the stock data of the COVID-19 period. The experimental findings obtained using the DOW30 and NASDAQ100 reveal that the accuracy of the GA and ANN hybrid model for the DOW30 and NASDAQ100 is greater than that of the single ANN (BPANN) technique, both in the short and long term.

Commonly described as “gender care gap”, there is a persistent gender difference in the division of unpaid domestic responsibilities in developed countries. We use German survey data to provide novel evidence on short- and long-run effects of an exogenous shock on paternal availability, through a job loss, on the intra-household allocation of domestic work. We find that paternal child care and housework significantly increase in the short run on weekdays, while we do not see any similar shifts on weekends. Effects are positive and persistent for fathers who remain unemployed or have a working partner, but reverse after re-employment. We also find significant changes for female partners as well as in cumulative household time investments and outsourcing of tasks. Our results are in line with theoretical predictions regarding time availability and financial constraints, while we find no strong evidence for changes in bargaining powers, gender role attitudes or emotional bonding.