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The document provides information on the construction of the Elizabeth Line, a new railway system in London. The project involved the construction of 42 km of tunnels, connecting various stations and existing Tube lines. The construction process included the use of tunnel boring machines, ground investigations, and archaeological investigations. Measures were taken to mitigate ground movement and protect existing infrastructure. The project also utilized engineering techniques such as compensation grouting, floating track slabs, and sprayed concrete lining. The Elizabeth Line is expected to greatly increase London's rail capacity. [Extracted from the article]

This article explores the challenges faced in designing and constructing underground engineering projects in cold regions, particularly in the Northern Hemisphere. The presence of permafrost, which is frozen soil, presents unique difficulties due to its varying thickness and temperature. Changes in temperature and heat sources can impact the stability of structures built on or into permafrost. Engineers must consider these factors and adapt their designs accordingly. The article discusses the challenges faced in building structures on permafrost in Alaska, including settlement and instability caused by thawing ice-rich permafrost. Various techniques such as ground exploration, monitoring, and ground-freezing measures are used to mitigate these risks. The article also highlights seismic concerns and soil liquefaction that can occur when permafrost thaws. Successful examples of engineering in cold regions, such as the Trans-Alaska Pipeline System and the Svalbard Global Seed Vault, are mentioned, along with the measures taken to protect them from thawing permafrost. The article also emphasizes the importance of the Permafrost Tunnel Research Facility in studying permafrost and its response to climate change. [Extracted from the article]

Babcock Ranch in Florida is a sustainable and resilient community powered by solar energy and designed to withstand extreme weather. The development prioritized preserving natural wetlands and creating new ones, while also selling a portion of the property to the state for preservation. The town's infrastructure, including water and wastewater systems, had to be built from scratch, with a focus on preserving natural drainage patterns and limiting development to prevent flooding. Babcock Ranch is the first solar-powered town in America, with a utility-scale energy system and 687,000 solar panels. The homes and buildings are designed to withstand hurricanes and are certified under green building standards. The town's stormwater management systems have also been improved with smart pond weirs. The developers acknowledge that there is still room for improvement and lessons to be learned. [Extracted from the article]

This article explores the expansion of engineering firms Walter P Moore and Thornton Tomasetti beyond the United States. Walter P Moore has opened offices in India, Canada, and Mexico, while Thornton Tomasetti has offices in China, India, and the United Arab Emirates. The firms carefully consider factors such as business opportunities, geopolitical issues, and market conditions when deciding to establish new offices. They also rely on employees with cultural ties to assist with the setup of new locations. The article discusses the challenges and opportunities of operating international offices, emphasizing the importance of hiring local engineers and adapting to local regulations. It also highlights the need for cultural integration, technological consistency, and support for employees working abroad. The article addresses challenges such as tax codes, language barriers, and payroll issues. Overall, it provides valuable insights into the complexities of international operations in the civil engineering industry. [Extracted from the article]

This article explores the significance of succession planning and leadership development in civil engineering firms. It showcases the efforts of various successful firms, such as Hatfield Group Engineering, Atlas, and Dewberry, in implementing formal management training programs and succession planning strategies. These programs focus on developing future leaders by enhancing technical knowledge, project management skills, and other essential competencies. Effective communication, collaboration, and personal growth are also emphasized as crucial factors for success in leadership roles. The article underscores the importance of investing in leadership development to ensure long-term success in the industry. [Extracted from the article]

To evaluate the associations between prescription opioid exposures in community-dwelling older adults and gray and white matter structure by magnetic resonance imaging.

Leadership is vital to a well-functioning and effective health system. This importance was underscored during the COVID-19 pandemic. As disparities in infection and mortality rates became pronounced, greater calls for equity-informed healthcare emerged. These calls led some leaders to use the Learning Health System (LHS) approach to quickly transform research into healthcare practice to mitigate inequities causing these rates. The LHS is a relatively new framework informed by many within and outside health systems, supported by decision-makers and financial arrangements and encouraged by a culture that fosters quick learning and improvements. Although studies indicate the LHS can enhance patients’ health outcomes, scarce literature exists on health leaders’ use and incorporation of equity into the LHS. This article begins addressing this gap by examining how equity can be incorporated into LHS activities and discussing ways leaders can ensure equity is considered and achieved in rapid learning cycles.

The article discusses the atmosphere of the National Junior College Athletic Association Division II World Series held in Enid, Michigan, emphasizing the community's passion for baseball and the historic significance of the David Allen Memorial Ballpark. It mentions the event as a nostalgic throwback to traditional baseball, devoid of lucrative endorsements, and highlights the local pride and economic benefits associated with hosting the series in Enid.

The article discusses the creation of a film called "Cities of the Future" produced by MacGillivray Freeman Films in partnership with ASCE (American Society of Civil Engineers). The film was inspired by ASCE's Future World Vision initiative and focuses on the development of a mega city in the year 2070. To create realistic images of the future city, the filmmakers collaborated with engineering experts and used real engineering data. The film also highlights the concept of space solar power and its potential to generate sustainable energy. The collaboration between CGI artists and engineers resulted in visually striking CGI sequences that aligned with the engineers' recommendations and the director's vision, showcasing the potential of future cities. [Extracted from the article]

The article offers travel tips for the Medicine Park town in Oklahoma, which includes information on its history, bars and restaurants, and trails.

ABSTRACTTraditional government support for community development is declining, but a relatively new form of institutional philanthropy is emerging as a player in this space with place-based grantmaking. While institutional philanthropy in the United States has been around for over 130 years, place-specific grantmaking still represents a relatively new philanthropic practice. Interest in this style of grantmaking is growing, but there remains much to learn about how it is practiced. The practice of place-based grantmaking is evolving and it appears there are striking differences in approaches employed by funders based upon where they are physically located. Research suggests local and non-local foundations employ different, often incompatible approaches to community development. Based on data from 91 U.S. foundations, this article explores place-based grantmaking in the United States and how it is practiced by local and non-local foundations.

This article explores the challenges and solutions related to the transition to electric vehicles (EVs) in the United States. It emphasizes the importance of careful planning and proactive measures to ensure that EVs have access to the necessary power and infrastructure. The article also discusses the need for new transmission lines and upgrades to the electric grid to support the increased demand for renewable energy sources. It addresses concerns such as the lack of codes and standards for EV infrastructure and the safety issues associated with EVs. The role of civil engineers in planning and implementing new EV infrastructure is highlighted. The article also delves into the challenges and considerations involved in designing charging infrastructure for electric buses, emphasizing the need for flexibility in design and collaboration with electrical utilities. Safety concerns related to lithium-ion batteries are also addressed. Overall, the article provides valuable insights into the complexities of electrifying transit fleets and the various factors that need to be considered. [Extracted from the article]

The article discusses a film called "Designing Cities of the Future" that aims to make civil engineering look cool and interesting. The film showcases the role of civil engineers in combating climate change, promoting sustainability, and building future cities. It also emphasizes the importance of interdisciplinary skills and knowledge in the field of civil engineering. The film highlights the need for livable cities that prioritize human flourishing and integrate nature into infrastructure. It presents a vision of future cities with advanced technologies like air taxis and satellite-based solar power systems. Civil engineers have a responsibility to ensure that these visions are realistic and constructible by designing well, understanding risks, and effectively communicating with policymakers and society. Overall, the film serves as a love letter to thinking outside the boundaries and inspires both aspiring and established engineers to contribute to the future of cities. [Extracted from the article]

Background: Concurrent substance use among adolescents has been associated with an increase in physical and mental health problems. These outcomes tend to be exacerbated among adolescents of color in underserved urban settings. The purpose of this study was to understand alcohol and concurrent drug use patterns among adolescents in an underserved urban community to provide targeted prevention and treatment recommendations.Method: This study examined data among adolescents in an underserved urban community (N = 1789; 56.90% female; 70.86% Hispanic/Latino/a; meanage= 15.96 ± 1.56). Using latent class analysis (LCA) and multinomial logistic regression modeling, analyses identified independent correlates of latent class membership.Results: Five latent classes (LC) were identified including LC group 1: Predominant alcohol use and limited to no concurrent-drug use (n = 213; 11.9%); LC group 2: Concurrent drug and alcohol use including methamphetamine, marijuana and synthetic marijuana use, and alcohol use (n = 74; 4.2%); LC group 3: Concurrent drug and alcohol use, with no marijuana use (n = 204; 11.39%); LC group 4: High Concurrent drug use and alcohol use (n = 204; 11.40%); and LC group 5: Concurrent drug use without alcohol use (n = 1101; 61.52%). Significant between group differences were noted between latent class groups and sociodemographic characteristics. Multinomial logistic regression models identified the associations between sociodemographic characteristics and corollary clinical features of substance use on latent class groupings of alcohol and concurrent drug use.Conclusion: Understanding concurrent substance use LC groups among adolescents is essential to providing targeted interventions and treatment programs, as well as early intervention programs that may help reduce substance use during adolescence.

In 2014 I discovered that I am a typical voter in Scotland ('The undoing of Nicola Sturgeon', 24 February). I voted Labour in every election from 1983 to 2010. Then [...]

Objective. To describe the modified Patient-Centered Medical Home Assessment (M-PCMH-A) survey module developed to track primary care practices' care delivery approaches over time, assess whether its underlying factor structure is reliable, and produce factor scores that provide a more reliable summary measure of the practice's care delivery than would a simple average of question responses. Data Sources/Study Setting. Survey data collected from diverse practices participating in the Comprehensive Primary Care (CPC) initiative in 2012 (n = 497) and 2014 (n = 493) and matched comparison practices in 2014 (n = 423). Study Design. Confirmatory factor analysis. Data Collection. Thirty-eight questions organized in six domains: Access and Continuity of Care, Planned Care for Chronic Conditions and Preventive Care, Risk-Stratified Care Management, Patient and Caregiver Engagement, Coordination of Care across the Medical Neighborhood, and Continuous Data-Driven Improvement. Principal Findings. Confirmatory factor analysis suggested using seven factors (splitting one domain into two), reassigning two questions to different domain factors, and removing one question, resulting in high reliability, construct validity, and stability in all but one factor. The seven factors together formed a single higher-order factor summary measure. Factor scores guard against potential biases from equal weighting. Conclusions. The M-PCMH-A can validly and reliably track primary care delivery across practices and over time using factors representing seven key components of care as well as an overall score. Researchers should calculate factor loadings for their specific data if possible, but average scores may be suitable if they cannot use factor analysis due to resource or sample constraints. Key Words. Psychometrics, survey research and questionnaire design, quality of care/patient safety, quality improvement/report cards, Payers around the country are testing the patient-centered medical home (PCMH) and similar models to improve primary care delivery. Accurately measuring how primary care practices are transforming care delivery is [...]

I was interested to read Andrew Marr (Politics, 18 March) quoting a senior Labour figure as saying: 'To win the essential number of seats in Scotland, we will have at [...]

Multicancer early detection (MCED) blood tests can detect a cancer signal from circulating cell-free DNA (cfDNA). PATHFINDER was a prospective cohort study investigating the feasibility of MCED testing for cancer screening.

Most people who smoke in Canada (64.4%) report that they want to quit, and half (49.6%) have tried to quit in the past year. (1) Unfortunately, less than five percent [...]

9 a.m. Any promising day in Melbourne begins with a cup or two of coffee. Here, though, you don't order just a 'coffee.' Australia's second largest city has its own [...]

The next step up Mount Norquay requires a lunge of faith. Looking over my sunglasses, slipping in sweat, I see I must now go left and out, across an outcrop [...]

The article offers travel tips for road trips on Jefferson Highway, U.S., a 1,300-mile highway connecting New Orleans with Winnipeg Boston, and includes recommendations for dining, and visiting the Wagoner City Historical Museum.

For the first time since Richard Burns and Colin McRae in 2002, Britain has two drivers in factory seats for its home WRC round. Twelve years ago, Robert Reid co-drove [...]

Background: Family members of patients with coronary artery disease (CAD) have higher risk of vascular events. We conducted a trial to determine if a family heart-health intervention could reduce their risk of CAD. Methods: We assessed coronary risk factors and randomized 426 family members of patients with CAD to a family heart-health intervention (n = 211) or control (n = 215). The intervention included feedback about risk factors, assistance with goal setting and counselling from health educators for 12 months. Reports were sent to the primary care physicians of patients whose lipid levels and blood pressure exceeded threshold values. All participants received printed materials about smoking cessation, healthy eating, weight management and physical activity; the control group received only these materials. The main outcomes (ratio of total cholesterol to high-density lipoprotein [HDL] cholesterol; physical activity; fruit and vegetable consumption) were assessed at 3 and 12 months. We examined group and time effects using mixed models analyses with the baseline values as covariates. The secondary outcomes were plasma lipid levels (total cholesterol, low-density lipoprotein cholesterol, HDL cholesterol and triglycerides); glucose level; blood pressure; smoking status; waist circumference; body mass index; and the use of blood pressure, lipid-lowering and smoking cessation medications. Results: We found no effect of the intervention on the ratio of total cholesterol to HDL cholesterol. However, participants in the intervention group reported consuming more fruit and vegetables (1.2 servings per day more after 3 mo and 0.8 servings at 12 mo; p < 0.001). There was a significant group by time interaction for physical activity (p = 0.03). At 3 months, those in the intervention group reported 65.8 more minutes of physical activity per week (95% confidence interval [CI] 47.0-84.7 min). At 12 months, participants in the intervention group reported 23.9 more minutes each week (95% CI 3.9-44.0 min). Interpretation: A health educator-led heart-health intervention did not improve the ratio of total cholesterol to HDL cholesterol but did increase reported physical activity and fruit and vegetable consumption among family members of patients with CAD. Hospitalization of a spouse, sibling or parent is an opportunity to improve cardiovascular health among other family members. Trial registration: clinicaltrials.gov, no NCT00552591., People with a family history of coronary artery disease (CAD) among their first-degree relatives have an increased risk of vascular events. (1-5) This risk is greater if more than 1 [...]

IntroductionA common barrier identified by individuals trying to quit smoking is the cost of cessation pharmacotherapies. The purpose of this evaluation was to: (1) Assess the feasibility of offering nicotine replacement therapy (NRT) ‘gift cards’ to hospitalised smokers for use posthospitalisation; and, (2) Estimate the effect of providing NRT gift cards on 6-month smoking abstinence.MethodsA prospective, quasi-experimental, before-and-after controlled cohort design with random sampling was used to compare patients who had received the Ottawa Model for Smoking Cessation (OMSC) intervention (‘control’) with patients who received the OMSC plus a $C300 Quit Card (‘QCI’), which they could use to purchase any brand or form of NRT from any Canadian pharmacy.Results750 Quit Cards were distributed to the three participating hospitals of which 707 (94.3%) were distributed to patients. Of the cards received by patients, 532 (75.2%) were used to purchase NRT. A total of 272 participants completed evaluation surveys (148 control; 124 QCI).Point prevalence abstinence rates adjusted for misreporting among survey responders were 15.3% higher in the QCI group, compared with controls (44.4% vs 29.1%; OR 1.95, 1.18–3.21; p=0.009). Satisfaction was high among participants in both groups, and among staff delivering the QCI. QCI participants rated the intervention as high in terms of motivation, ease of use and helpfulness.ConclusionsThe NRT gift card appears to be a feasible and effective smoking cessation tool that removes a primary barrier to the use of evidence-based smoking cessation pharmacotherapies, while motivating both patients and health providers.

Venus' surface and interior dynamics remain largely unconstrained, due in great part to the major obstacles to exploration imposed by its 470°C, 90 bar surface conditions and its thick, opaque atmosphere. Flyby and orbiter‐based thermal emission data provide opportunities to characterize the surface composition of Venus. However, robust interpretations of such data depend on understanding interactions between the planet's surface basaltic rocks and its caustic carbon dioxide (CO2)‐dominant atmosphere, containing trace amounts of sulfur dioxide (SO2). Several studies, using remote sensing, thermodynamic modeling, and laboratory experiments, have placed constraints on basaltic alteration mineralogy and rates. However, constraints on the effects of SO2‐bearing reactions on basalts with diverse compositions remain incomplete. Here, we present new data from a series of gas‐solid reaction experiments, in which samples of two basalt compositions were reacted in an SO2‐bearing CO2atmosphere, at relevant Venus temperatures, pressure, and oxygen fugacity. Reacted specimens were analyzed by scanning electron microscopy and scanning transmission electron microscopy using sample cross‐sections produced with focused ion beam milling. Surface alteration products were characterized, and their abundances estimated; subsurface cation concentrations were mapped to show the depth of alteration. We demonstrate that the initial development of reaction products progresses rapidly over the course of 30‐day runs. Alkaline basalt samples are coated by Na‐sulfate (likely thenardite, Na2SO4) and amorphous calcium carbonate (CaCO3) alteration products, and tholeiitic basalt samples are primarily covered by anhydrite (CaSO4), Fe‐oxide (FexOy: likely magnetite, Fe3O4), and other minor phases. These mineralogies differ from previous experiments in CO2‐only atmospheres. Surface features on Venus, such as volcanic landforms, and their ages can be studied to infer the planet's interior properties. Venus' thick, opaque atmosphere and extreme temperature and pressure limit a detailed study of its surface. Fortunately, sensors aboard Venus‐orbiting spacecraft can “see” its surface using select wavelengths of light to provide opportunities to interpret the composition of its surface. However, these interpretations rely on understanding how Venus' atmosphere might chemically interact with the surface and what mineral products may result. This is not yet fully understood despite the results of several prior studies with objectives similar to ours. Here, we share the results from experiments that mimic these chemical reactions. We used rock types such as those known to be on the surface of Venus and subjected them to relevant temperatures and pressure and a blend of two reactive gases, carbon dioxide and sulfur dioxide, to model Venus' atmosphere. After the experiments, we examined the rocks with microscopic instruments that allowed us to characterize chemical changes from their surfaces to their interiors. Our interpretations suggest that these reactions occur rapidly and that the compositions of the mineral coatings produced are dictated by the rocks' slightly different compositions. Basalts experimentally altered under Venus P‐T conditions and a CO2–SO2atmosphere produce reaction products of Ca‐ and Na‐sulfates, and Fe‐oxidesAlteration products and the advancement of alteration were strongly dependent upon the compositions of the solid reactantsThe rates at which basalts altered in a CO2–SO2atmosphere were greater than rates in a CO2‐only atmosphere Basalts experimentally altered under Venus P‐T conditions and a CO2–SO2atmosphere produce reaction products of Ca‐ and Na‐sulfates, and Fe‐oxides Alteration products and the advancement of alteration were strongly dependent upon the compositions of the solid reactants The rates at which basalts altered in a CO2–SO2atmosphere were greater than rates in a CO2‐only atmosphere

Obesity, type 2 diabetes, and cardiovascular disease correlate with infiltration to adipose tissue of different immune cells, with uncertain influences on metabolism. Rats were fed a diet high in carbohydrates and saturated fats to develop diet-induced obesity over 16 weeks. This nutritional overload caused overexpression and secretion of phospholipase [A.sub.2] group HA (pla2g2a) from immune cells in adipose tissue rather than adipocytes, whereas expression of adipose-specific phospholipase [A.sub.2] (pla2g16) was unchanged. These immune cells produce prostaglandin [E.sub.2] ([PGE.sub.2]), which influences adipocyte signaling. We found that a selective inhibitor of human pla2g2a (5-(4-benzyloxyphenyl)-(4S)-(phenyl-heptanoylamino)pentanoic acid [KH064]) attenuated secretion of [PGE.sub.2] from human immune cells stimulated with the fatty acid, palmitic acid, or with lipopolysaccharide. Oral administration of KH064 (5 mg/kg/ day) to rats fed the high-carbohydrate, high-fat diet prevented the overexpression of pla2g2a and the increased macrophage infiltration and elevated [PGE.sub.2] concentrations in adipose tissue. The treatment also attenuated visceral adiposity and reversed most characteristics of metabolic syndrome, producing marked improvements in insulin sensitivity, glucose intolerance, and cardiovascular abnormalities. We suggest that pla2g2a may have a causal relationship with chronic adiposity and metabolic syndrome and that its inhibition in vivo may be a valuable new approach to treat obesity, type 2 diabetes, and metabolic dysfunction in humans. Diabetes 61:2320-2329, 2012, Obesity is a complex chronic condition in which excess adiposity predisposes the interacting metabolic and immune systems to continuous stress (1-4). Among the dynamic components of adipose tissue are adipocytes [...]