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Ausgehend von einer differenten Definition und diffusen Methodenvielfalt der Osteopathie sowie einer teilweise inkorrekten Auflistung von Prinzipien wurde in dieser Untersuchung der Versuch unternommen, aus den 4 Werken von A.T. Still, des Begründers der Osteopathie, essenzielle Paradigmata einer ursprünglichen Osteopathie zu extrahieren. Um den Interpretationsspielraum zu minimieren, wurden der genaue Wortlaut und die Beschreibungen des Autors im historischen und soziokulturellen Kontext überwiegend beibehalten. Als Ergebnis konnten 6 Leitideen gefunden werden, welche trotz des chronologischen Unterschiedes auch heute noch als wissenschaftskonform gelten können. Dies ermöglicht es einer auf den Paradigmata der ursprünglichen von A.T. Still aufbauenden Osteopathie, ein integraler Bestandteil aktueller geistes- und naturwissenschaftlicher Fachbereiche zu werden. Based on a different definition and diffuse variety of methods of osteopathy as well as a partially incorrect listing of principles, this study attempted to extract essential paradigms of an original osteopathy from the four works of A.T. Still, the founder of osteopathy. In order to minimise the scope for interpretation, the exact wording and the author's descriptions in the historical and socio-cultural context were predominantly adhered to. As a result, six guiding ideas were found which, despite the chronological difference, can still be considered to be consistent with science today. This enables osteopathy, which is based on the paradigms of the original A.T. Still, to become an integral part of current humanities and natural science disciplines. [ABSTRACT FROM AUTHOR]

"Excited Delirium Syndrome" (ExDS) is a controversial diagnosis. The supposed syndrome is sometimes considered to be a potential cause of death. However, it has been argued that its sole purpose is to cover up excessive police violence because it is mainly used to explain deaths of individuals in custody. In this paper, we examine the epistemic conditions giving rise to the controversial diagnosis by discussing the relation between causal hypotheses, evidence, and data in forensic medicine. We argue that the practitioners' social context affects causal inquiry through background assumptions that enter inquiry at multiple stages. This analysis serves to better understand the wide usage of the controversial diagnosis of ExDS. [ABSTRACT FROM AUTHOR]

We conducted systematic review and meta-analysis to evaluate effects of neoadjuvant chemotherapy on survival and histopathological outcomes of variant histology of urothelial carcinoma of bladder. The present study found that bladder cancer patients with variant histology administration of neoadjuvant chemotherapy before surgery had better survival outcomes and higher pathologic down staging rate than those without administration of neoadjuvant chemotherapy before surgery. Purpose: To conduct systematic review and meta-analysis to evaluate effects of neoadjuvant chemotherapy (NAC) on survival and histopathological outcomes of variant histology (VH) of urothelial carcinoma (UC) of bladder. Methods: This systematic review was registered in PROSPERO (CRD42023389115). Literature search was conducted in PubMed/Medline, Embase, and Cochrane Library for studies published up to January 2023. Population, intervention, comparator, outcome, and study design were as follows: bladder cancer patients with VH (population), neoadjuvant chemotherapy (intervention), radical cystectomy only (comparators), oncological survival and pathologic response (outcomes), and retrospective or prospective (study design). Results: Finally, a total of 17 studies were included in the present study (quantitative analysis, n = 17; qualitative analysis, n = 12). Pooled HR was 0.49 (95% CI: 0.31-0.76; P = .002) for OS. Pooled HR was 0.61 (95% CI: 0.38-0.98; P = .04) for CSS. Pooled HR was 0.44 (95% CI: 0.21-0.93; P = .03) in PFS. Pooled OR was 6.61 (95% CI: 4.50-9.73; P < .00001) in complete pathologic response. Pooled OR was 9.59 (95% CI: 3.56-25.85; P < .00001) in any pathologic response. Evidence quality assessments for each 5 comparisons using the GRADE approach were that Certainty was moderate in 1, low in 1, and very low in 3. Conclusions: Administration of NAC before surgery in bladder cancer patients with VH might confer better survival outcomes and higher pathologic down staging rate than no administration of NAC before surgery. [ABSTRACT FROM AUTHOR]

Evidence-based policy has achieved great relevance in policy-making and social research. Nonetheless, over the past few years, several problematic aspects of this approach have been identified. This paper discusses whether, and to what extent, evidence of mechanisms could contribute to addressing certain difficulties faced by evidence-based policy. I argue that it could play a crucial role in the assessment of the efficacy of interventions, the extrapolation of interventions to target populations, and the identification of side effects. For analysing the potential contribution of evidence of mechanisms, the previous debate on the pluralist approach to evidence-based medicine is taken as reference. [ABSTRACT FROM AUTHOR]

High quality clinical guidelines play a fundamental role in improving healthcare and reducing unwarranted variations in practice. They are based on best available evidence, are developed with the appropriate 'stakeholder' engagement, and are subjected to external peer review. Development of clinical guidelines for children and young people (CYP) may be particularly challenging due to a lack of available evidence in an age group that is dominated by rare disease. Arguably, a lack of quality evidence increases the need for clinical guidelines. This review introduces key concepts in high quality clinical guideline development. [ABSTRACT FROM AUTHOR]

This paper forms the introductory article to the special issue 'Expressing Evidence'. It lays out the background into the pragmatic and semantic research on evidence in language, and positions the collection of papers within this theoretical landscape. The collection stands out in its focus on conceptual issues involved, including the relation between 'grammatical' evidentiality and other constructions that signal evidence and the consequences of these connections for the semantic and pragmatic theory. The special issue aims to bring the work on evidentiality to the attention of a broad audience, including not only linguists, but also language scientists more generally, as well as philosophers of language and science. • Evidential restrictions come in many forms in the grammar. • Studying the relation between evidentials and other evidence signals raises important questions. • It is important to place evidentiality within pragmatics, philosophy of language and epistemology. [ABSTRACT FROM AUTHOR]

Over the last two decades, there has been a growing emphasis on the publication quality in Foot & Ankle research. A level-of-evidence rating system for clinical scientific papers has been proposed by the Centre for Evidence-based medicine in Oxford, United Kingdom. As opposed to other subspecialities, foot & ankle surgery deals with a wide variety of clinical problems and surgical solutions, which in turn leads to a generally low number of patients available for study groups. However, level III and IV studies still have a valuable place in orthopaedic research, given the challenges in running high-level studies.The measurement of outcomes in medicine from the patients' perspective (PROMS:(patient reported outcome measures) has grown almost exponentially in all surgical specialties including foot & ankle surgery. There are many PROMs available to foot & ankle surgeons, but there is little consensus on which assessment is most appropriate for a given procedure or diagnosis. Their use in research and clinical practice offers many advantages in clinical practice and research, however, besides the advantages there are also some downsides. [ABSTRACT FROM AUTHOR]

In recent years, the importance of real-world research based on real-world data has been widely recognized in many countries and regions around the world. Oriented by real-world data, real-world research is conducted to obtain real-world evidence, which becomes a hot spot in clinical study. In such circumstances, how to use the diagnosis and treatment data of clinical practice to evaluate the effect and safety of acupuncture becomes future direction of acupuncture research. This paper analyzed the current situation of the real-world research in the field of acupuncture and put forward the influencing factors and the countermeasures to provide the references for the real-world research of acupuncture. [ABSTRACT FROM AUTHOR]

Like many surgical subspecialties, there have been frequent advancements and discoveries in the field of hand and upper extremity surgery. With a rapidly growing literature base, it can be difficult to remain updated on the latest recommendations. A comprehensive literature search was completed on PubMed using MeSH terms. Topics included nutrition management, anticoagulation, immunosuppressive medication management, antibiotic use, skin preparation, splinting, tourniquet use, and suture choice. Data from articles with a level of evidence 1A-3 C were included. A total of 42 articles were identified and reviewed to provide evidence for recommendations regarding various aspects of pre-, intra-, and post-operative care. The objective of this manuscript is to serve as a resource for evidence-based recommendations by the findings of recent evidence related to perioperative care in elective hand surgery. Additional studies are required in certain areas of the literature in order to provide stronger recommendations. [ABSTRACT FROM AUTHOR]

Because existing publication guidelines and checklists have limitations when used to assess the quality of cost-effectiveness analysis, we developed a novel quality assessment tool for cost-effectiveness analyses, differentiating methods and reporting quality and incorporating the relative importance of different quality attributes. We defined 15 quality domains from a scoping review and identified 72 methods and reporting quality attributes (36 each). After designing a best-worst scaling survey, we fielded an online survey to researchers and practitioners to estimate the relative importance of the attributes in February 2021. We analyzed the survey data using a sequential conditional logit model. The final tool included 48 quality attributes deemed most important for assessing methods and reporting quality (24 each), accompanied by a free and web-based scoring system. A total of 524 participants completed the methodology section, and 372 completed both methodology and reporting sections. Quality attributes pertaining to the "modeling" and "data inputs and evidence synthesis" domains were deemed most important for methods quality, including "structure of the model reflects the underlying condition and intervention's impact" and "model validation is conducted." Quality attributes pertaining to "modeling" and "Intervention/comparator(s)" domains were considered most important for reporting quality, including "model descriptions are detailed enough for replication." Despite its growing prominence, "equity considerations" were not deemed as important as other quality attributes. The Criteria for Health Economic Quality Evaluation tool allows users to differentiate methods and reporting as well as quantifies the relative importance of quality attributes. Alongside other considerations, it could help assess and improve the quality of cost-effectiveness evidence to inform value-based decisions. • Multiple guidelines and checklists on conducting and reporting cost-effectiveness analyses exist, but they often do not differentiate methods versus reporting quality or incorporate the relative importance of different quality attributes. • We developed a novel quality assessment tool for cost-effectiveness analyses—the Criteria for Health Economic Quality Evaluation (CHEQUE)—that offers 3 major enhancements: (1) differentiating methods and reporting quality, (2) quantifying the relative importance of different quality attributes, and (3) providing a web-based, user-friendly CHEQUE tool (https://uchicago.co1.qualtrics.com/jfe/form/SV%5fef9Shen9Ds0JJlk) for accessibility and usability. • Alongside other considerations, the CHEQUE tool could help assess and improve the quality of cost-effectiveness evidence to inform value-based decisions. [ABSTRACT FROM AUTHOR]

In our communication we often make reference to what other people have said. We do so for a variety of different reasons and we draw upon a variety of different constructions. Following earlier joint work together with Emar Maier, I propose a classification of speech reports along two dimensions: at-issueness and eventivity, resulting in four classes of speech reports. I explore the notion of reportative evidentiality against the background of this landscape. I propose that a speech report is used in an evidential way if the actual speaker seems to intend to convey that the fact that the reported speaker uttered this sentence increases the probability of the reported content being true. I furthermore argue that there is a natural link between the class of non-eventive, not-at-issue speech reports and evidentiality. Non-eventive, not-at-issue speech reports are naturally used to provide evidence because (i) the reported content is grammatically marked as the main point, which will be interpreted as a (weak or hedged) proposal to update the common ground, and (ii) other uses of speech reports (e.g. vivid characterizitions of dialogues between characters in a story) are not available due to their non-eventivity. Interestingly, if we switch to this pragmasemantic perspective, some expressions that are traditionally called 'evidential' loose their evidential status. • Pragmatically, there are good reasons to single out some speech reports as evidential. • Speech reports are evidential if speaker intends to convey increased posterior probability. • Modelling the discourse update shows link between evidentiality and at-issueness • Evidentiality follows partially from at-issueness of reported content. • Some 'evidentials' loose evidential status in pragmasemantic approach. [ABSTRACT FROM AUTHOR]

The start of the COVID-19 pandemic presented a situation in which there was an urgent need for decision-making that relates to diagnosis, but the evidence was lacking, of low certainty or constantly changing. Rapid and living guideline development methods were needed and had to be applied to rigorous guideline approaches, such as the Grading of Recommendations Assessment, Development, and Evaluation approach. To describe the process of developing rapid diagnosis guidelines when there is limited and imperfect available data at the time of crisis. Case example from four Infectious Disease Society of America COVID-19 diagnostic guidelines. As the world was experiencing panic with COVID-19, there were serious doubts about the feasibility of following a rigorous process for guideline development when timeliness was of extreme value. The Infectious Disease Society of America guideline panels supported by several methodologists strongly believed that at times of crisis, it is more important than ever to follow a rigorous process. The panel adopted a rapid and living systematic review methodology and applied the Grading of Recommendations Assessment, Development and Evaluation approach to four diagnosis guidelines despite the challenges of scarce and dynamic evidence. We describe the methodological details of the rapid and living approach (data extraction, meta-analysis, Evidence to Decision framework, and recommendation development), the challenge of resources, the challenge of scarce evidence, the challenge of rapidly changing evidence, as well as 'wins' from the Infectious Disease Society of America experience. Mitigation of pandemics relies on rapid and accurate diagnosis, which is challenged by many knowledge gaps. This necessitates emerging evidence is rapidly incorporated in a living fashion with several decisional and contextual factors to ensure the best public health strategies and care for patients. This process must be systematic and transparent for developing trustworthy guidelines and should be supported by all stakeholders, including researchers, editors, publishers, professional societies, and policymakers. [ABSTRACT FROM AUTHOR]

This commentary draws attention to the introduction of data collected by COVID-19 tracing apps as evidence in criminal proceedings and the novel considerations this evidence presents for criminal justice agents and digital forensics professionals. [ABSTRACT FROM AUTHOR]

Shifting the relationship between science and decision making is a key challenge for sustainable development. We conducted a two-part behavioural study linked to the preparation of the Kenya Agroforestry Strategy. Two virtual workshops followed a data visualisation preference survey of 174 technical officers to compare the influence of a peer-led and a facilitated workshop on inclusive, evidence-based decision making. A post-workshop survey, facilitator or observer reports, coded transcriptions of group discussions, root causes capturing social actor perspectives, and strategy content were analysed. Results from the visualisation preference survey indicate that most respondents preferred more straightforward displays like tables and bar charts over the more complex ridge and box plots. Limited exposure to diverse visualisation formats calls for capacity development and innovative ways to share data in multiple formats. Engaging scientists in co-production processes allows more complex data to be accessed and understood by decision makers. Triangulation across diverse data sources associated with the workshops indicates facilitated groups had greater inclusion of participants and better integrated scientific and social actor perspectives in the strategies they developed. The importance of skilled facilitators and engagement processes are therefore highlighted. Small workshop sample sizes and complex interactions indicate that further studies are needed to validate our findings, but the results of this study provide valuable insights for knowledge translation and social learning as part of co-production to support inclusive, evidence-based decision making in agricultural and environmental policy processes. • Technical officers in Kenya prefer tables and bar charts to visualise agroforestry data. • Skilled facilitation is critical for knowledge co-production. • Co-produced outcomes can be measured by inclusion of scientific and social actor knowledge. [ABSTRACT FROM AUTHOR]

Otto Neurath's role in the so-called protocol sentence debates is typically framed as primarily an epistemologically radical rejection of empiricist foundationalism. However, less well recognized is that from this debate, Neurath emerges with a conception of protocol statements that functions as a radical reconceptualization of evidence. Whilst recognizably still empiricist, Neurath's conception of evidence breaks with many of the key assumptions that predominate within the empiricist tradition. In rejecting the assumption of an epistemologically privileged relationship between an observer and their own observation reports, Neurath shifts the emphasis onto the importance of contextualizing information that guarantees the stability of observation reports. In so doing, he not only provides a conception of evidence better suited to the actual role of evidence in science, but also anticipates contemporary discussion of the importance of evidential metadata. [ABSTRACT FROM AUTHOR]

Reducing the intake of total fat, saturated fatty acids (SFA) and dietary cholesterol was a cornerstone of dietary guidance in past decades. This emphasis shifted recently from lowering the intake of total fat to focusing on the quality of dietary fat intake, the avoidance of industrial trans -fatty acids (TFA), and the substitution of SFA with unsaturated fatty acids. There is also a trend towards investigating diet-disease associations of fatty foods rather than nutrients. We aimed to summarize comprehensively the currently available evidence for total dietary fat, fat quality, and fatty foods such as butter, vegetable oils, nuts and seeds on risk of non-communicable diseases including cardiovascular disease (and its risk factors), cancer, type 2 diabetes, and neurodegenerative diseases. The findings from systematic reviews of prospective observational studies, which often compared extreme intake categories, found mainly no association of total fat, monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), and SFA with risk of non-communicable diseases. Systematic reviews of randomized controlled trials indicate that SFA and/or TFA substitution with MUFA and/or PUFA improves blood lipids and markers of glycemic control (observed only for SFA replacement), with the effect of PUFA being more pronounced. A higher intake of total TFA was associated increased risk of cardiovascular disease. In line with current dietary guidelines, the available published evidence deems it reasonable to recommend replacement of SFA with MUFA and PUFA and avoidance of consumption of industrial TFA. • Reducing the intake of total fat, saturated fatty acids and dietary cholesterol was a cornerstone of dietary guidance in past decades. • Findings from systematic reviews of observational studies found mainly no association of total fat and fatty acids with risk of non-communicable diseases. • Systematic reviews of randomized trials indicate that saturated fatty acids and/or trans fatty acids substitution with monounsaturated fatty acids and/or polyunsaturated fatty acids improves blood lipids. • A higher intake of total trans -fatty acids was associated increased risk of cardiovascular disease. • The available evidence deems it reasonable to recommend replacement of saturated fatty acids with unsaturated fatty acids and avoidance of consumption of industrial trans -fat. [ABSTRACT FROM AUTHOR]

• Conventional wisdom assumes evidentiary rules in criminal trials protect defendants. • Evidentiary rules may increase wrongful convictions and reduce rightful convictions. • If adjudicators are unbiased, evidentiary rules cannot improve accuracy in verdicts. • If adjudicators are biased, evidentiary rules may improve accuracy in verdicts. Evidentiary rules for criminal trials disallow various forms of probative evidence. Conventional wisdom assumes these rules benefit all defendants, whether guilty or innocent, and thus reduce wrongful convictions at the price of more wrongful acquittals. We show the conventional view only holds under stylized conditions. We further identify properties of evidence generation mechanisms under which the conventional view is backward: an evidentiary rule will harm the innocent and protect the guilty. However, if adjudicators place too much weight on the evidence, its exclusion can reduce both wrongful convictions and wrongful acquittals. [ABSTRACT FROM AUTHOR]

Reducing the intake of total fat, saturated fatty acids (SFA) and dietary cholesterol was a cornerstone of dietary guidance in past decades. This emphasis shifted recently from lowering the intake of total fat to focusing on the quality of dietary fat intake, the avoidance of industrial trans -fatty acids (TFA), and the substitution of SFA with unsaturated fatty acids. There is also a trend towards investigating diet-disease associations of fatty foods rather than nutrients. We aimed to summarize comprehensively the currently available evidence for total dietary fat, fat quality, and fatty foods such as butter, vegetable oils, nuts and seeds on risk of non-communicable diseases including cardiovascular disease (and its risk factors), cancer, type 2 diabetes, and neurodegenerative diseases. The findings from systematic reviews of prospective observational studies, which often compared extreme intake categories, found mainly no association of total fat, monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), and SFA with risk of non-communicable diseases. Systematic reviews of randomized controlled trials indicate that SFA and/or TFA substitution with MUFA and/or PUFA improves blood lipids and markers of glycemic control (observed only for SFA replacement), with the effect of PUFA being more pronounced. A higher intake of total TFA was associated increased risk of cardiovascular disease. In line with current dietary guidelines, the available published evidence deems it reasonable to recommend replacement of SFA with MUFA and PUFA and avoidance of consumption of industrial TFA. • Reducing the intake of total fat, saturated fatty acids and dietary cholesterol was a cornerstone of dietary guidance in past decades. • Findings from systematic reviews of observational studies found mainly no association of total fat and fatty acids with risk of non-communicable diseases. • Systematic reviews of randomized trials indicate that saturated fatty acids and/or trans fatty acids substitution with monounsaturated fatty acids and/or polyunsaturated fatty acids improves blood lipids. • A higher intake of total trans -fatty acids was associated increased risk of cardiovascular disease. • The available evidence deems it reasonable to recommend replacement of saturated fatty acids with unsaturated fatty acids and avoidance of consumption of industrial trans -fat. [ABSTRACT FROM AUTHOR]

• There is high-level evidence that control of blood pressure and increasing physical activity decrease cognitive decline in older people. • There is less evidence that the interventions of increasing education, smoking cessation, avoiding head injuries, decreasing exposure to air pollution and increased social connections decrease cognitive decline with age, although their other benefits argue for their universal implementation. • It is uncertain whether the interventions of decreasing alcohol ingestion, correction of hearing loss, treatment of depression, dietary interventions, menopausal hormone treatment and monoclonal antibodies directed against amyloid-β prevent cognitive decline. A helpful method to understand cognitive decline in older people is to consider this entity as increasing cognitive frailty caused by a number of interacting pathological processes. Over the last 20 years, multiple lifestyle, environmental and constitutional factors have been linked to the development of cognitive decline. For two interventions based on these factors, increasing physical activity and the control of hypertension, there is class 1 evidence for benefit. Other interventions based on these factors do not have the support of high-level evidence for the alteration of cognitive decline, but their other benefits would argue for their implementation. These interventions include increasing education, smoking cessation, avoiding head injuries, decreasing exposure to air pollution and increased social connections. As cognitive decline is experienced almost universally with ageing, and serious cognitive decline is experienced by substantial numbers of low-risk individuals, whole-of-population intervention strategies are the most effective and efficient. For other interventions to help prevent cognitive decline there is not sufficient evidence for their implementation to be recommended. These include alteration of alcohol ingestion, correction of hearing loss, treatment of depression, dietary interventions, menopausal hormone treatment and monoclonal antibodies directed against amyloid-β. [ABSTRACT FROM AUTHOR]

The pharmacy profession faces a lack of evidence pertaining to pharmaceutical care in oncology, both in terms of its effectiveness and its integration into clinical practice. While Europe-based pharmacists are active in many therapeutic areas, their role in cancer care is less defined. Conversely, the complexity of oncology, increasing cancer cases, and evolving therapies highlight the potential for pharmacists in this field. Their limited involvement in Europe may be attributed to inadequate undergraduate training and research. Collaborative care shows potential in oncology, but still needs more trial evidence. Here, we can learn from pharmaceutical care in cardiology, where more research has been conducted. The limited role of pharmacists in oncology may be due to a lack of focus on oncology research and insufficient education. Addressing the teaching gap requires improving oncology education in pharmacy programs, at both undergraduate and postgraduate levels. Current postgraduate courses and US PharmD programs could serve as models. Equipping pharmacy students with fundamental oncology knowledge is a vital first step, for further meaningful research and practice. Formal education could bridge the gap between evidence and practice in these fields. [ABSTRACT FROM AUTHOR]

• High prevalence of off-label psychotropic use was in adolescents with depression. • Off-label scenarios in high frequency are at a priority for digging evidence. • A significant gap is between limited evidence and pervasive off-label scenarios. • It is concerning to generalize adult use of psychotropic drugs to adolescence use. [ABSTRACT FROM AUTHOR]

• Compared to whole-class discussion, direct peer discourse better supported elementary students' argumentative writing. • The goal of persuasion, compared to deliberation, led to enhanced performance in refuting claims and in using evidence. • Intervention gains showed positive transfer to writing on a non-discourse topic at post-assessment. This study investigates the impact of discourse goals on argumentative writing among Chinese elementary school students. Eight fourth-grade classes were assigned to one of three conditions—Persuasion Dialogue (PD), Deliberation Dialogue (DD) and Control—to discuss four controversial topics designed for the Morality and Law subject. Before writing on the intervention topics, PD and DD students engaged in direct peer-to-peer argumentative written dialogues, while Control students addressed the topics and textbook contents in traditional teacher-led whole-class discussions. In essays on multiple intervention topics and a post-assessment topic, PD and DD students outperformed Control students in considering an alternative viewpoint. PD students, however, showed an advantage over DD students and Control students, in rebutting a counterargument and in attributing these counterarguments to the preceding dialogues, as well as in employing evidence to support claims. DD students, in contrast, were more likely to employ a dismissal strategy over a refutation strategy. Strengths of the argumentative discourse goal of persuasion over deliberation for elementary school students are discussed. [ABSTRACT FROM AUTHOR]

COVID-19 has placed huge pressures on clinicians and front line practitioners across the UK. The focus has been, understandably, on the day to day challenges that the pandemic has brought. But lockdown measures have also put a spotlight on safety in the home – a place where we have all spent so much more time. This is one place where there may be fewer safeguards and less protection from the risks of serious injury, especially to young children. Preventable accidental injury remains a leading cause of death and acquired disability for children in the UK. Moreover, it affects deprived children more. Hospital admission rates from unintentional injuries among the under-fives are significantly higher for children from the most deprived areas compared with those from the least deprived. To give every child the best start in life we need to create a better understanding and awareness of the injuries. To achieve this we need to prioritize learning from injury data and lived experience. We need to be linking with other partners and professionals to build strong collaborations for injury prevention. By working together and taking action we should be leading the way towards safer homes, roads and communities where children can become skilled for life, not scarred for life. This short article highlights what healthcare professionals working with children and families need to know about accidents and accident prevention in a higher income setting. [ABSTRACT FROM AUTHOR]

Results achieved by man trailers/trackers is often accepted as evidence in courts. To be used as such, the results should be founded on scientific proof. With respect to the uniqueness of human individual scent, there is sufficient scientific foundation, but with respect to animal learning and cognition we now know that great care must be taken to ensure animals are responding to the intended cue. A review of man trailing studies indicate that these do not prove the essential question: are the dogs responding to the individual human odor cue when matching a scent article to a track? A suggestion is made for testing individual dogs based on guidelines set by the Scientific Working Group on the use of Dogs and Orthogonal Detector Guidelines. Finally, points that should be addressed when assessing such evidence in courts are provided. [ABSTRACT FROM AUTHOR]

From a pathophysiological point of view, early neurosurgical treatment seems essential to prevent secondary brain injury and has been stated as the "time-is-brain" concept. However, the question immediately rises: "Is there an optimal time window for acute intracranial neurosurgical interventions?" In neurosurgery, treatment modality has been studied far more extensively than timing to surgery ("time-to-surgery"). The majority of acute intracranial neurosurgical interventions are carried out for traumatic brain injury and hemorrhagic or ischemic stroke. Current guidelines for traumatic brain injury, spontaneous intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage, and middle cerebral artery infarction are reviewed and lessons learned from the randomized controlled trials mentioned are discussed. In acute intracranial neurosurgical interventions, "delayed consent" procedures could play an important role for this field of research. Whether there is an optimal time window for acute intracranial neurosurgical interventions seems difficult to be answered with randomized controlled trials referred to in the current guidelines. Observational designs, such as comparative effectiveness research, and special statistical techniques, may provide a better understanding in the optimal "time-to-surgery." [ABSTRACT FROM AUTHOR]

This study aimed to determine the comparative effectiveness of interventions in treatment of sarcopenia. The primary outcome was the measure of treatment effect on muscle mass, and secondary outcomes were the treatment effect on muscle strength and physical performance. Systematic review and network meta-analysis (NMA). Participants with sarcopenia receiving interventions targeting sarcopenia in any setting. Data sources : Relevant RCTs were identified by a systematic search of several electronic databases, including CINAHL, Embase, MEDLINE, and the Cochrane Central Registry of Controlled Trials (CENTRAL) from January 1995 to July 2019. Duplicate title and abstract and full-text screening, data extraction, and risk of bias assessment were performed. Data extraction : All RCTs examining sarcopenia interventions [mixed exercise (combined aerobic and resistance exercise), aerobic exercise, resistance exercise, balance exercise, physical activity and protein or nutrition supplementation, acupuncture, whole-body vibration, protein supplement or interventions to increase protein intake, any nutritional intervention other than protein, and pharmacotherapy] were included. Comparators were standard care, placebo, or another intervention. Data synthesis : We performed Bayesian NMA; continuous outcome data were pooled using the standardized mean difference effect size. Interventions were ranked using the surface under the cumulative ranking curve (SUCRA) for each outcome. A total of 59 RCTs were included after screening of 4315 citations and 313 full-text articles. Network meta-analysis of muscle mass outcome (including 46 RCTs, 3649 participants, 11 interventions) suggested that mixed exercise were the most effective intervention (SUCRA = 93.94%) to increase muscle mass. Physical activity and protein or nutrition supplementation, and aerobic exercise were the most effective interventions to improve muscle strength and physical performance, respectively. Overall, mixed exercise is the most effective intervention in increasing muscle mass and was one of the 3 most effective interventions in increasing muscle strength and physical performance. Mixed exercise and physical activity with nutritional supplementation are the most effective sarcopenia interventions. Most of the included studies have a high risk of bias. More robust RCTs are needed to increase the confidence of our NMA results and the quality of evidence. [ABSTRACT FROM AUTHOR]

This study aims to get the medical management of acupuncture and moxibustion in the countries and regions where the society members of World Federation of Acupuncture-Moxibustion Societies (WFAS) are located, including the educational background of acupuncture and moxibustion practitioners and the local clinical practice of acupuncture and moxibustion, and the demands of the content and evidence types of Clinical Practice Guidelines (CPGs) of acupuncture and moxibustion in accordance with WFAS standards, so as to provide requirements and reference principles for the development of CPGs of acupuncture and moxibustion in accordance with WFAS standards. The convenient sampling method was used to collect the questionnaires, and the WFAS secretariat distributed the questionnaires to 294 contacts of society members from 70 countries and regions in the form of Questionnaire Star four times in April 2020, July 2020, March 2021, and April 2021 respectively. They were then distributed to individual members of acupuncture-moxibustion societies by the contacts. The study content involved the basic information of respondents, including their nationality, occupation, educational background of acupuncture and moxibustion, their local clinical practice and medical management of acupuncture and moxibustion, as well as their demand for CPGs of acupuncture and moxibustion, etc. After the questionnaires were collected, the data were analyzed and described by quantitative research method. In all, 302 respondents from 37 countries of six continents responded. The 302 respondents were members of the WFAS society members. (1) Basic information of respondents. They all had acupuncture and moxibustion learning experience, among which, 76.5% (231/302) had the education background of acupuncture and moxibustion professional college training, and 88.4% (267/302) had experience of acupuncture and moxibustion clinical practice. Acupuncturists or traditional Chinese medicine doctors accounted for 63.9% (193/302), western medicine doctors, nurses, and pharmacists accounted for 18.2% (55/302), and researchers and teachers accounted for 6.3% (19/302). (2) Local clinical practice and medical management of acupuncture and moxibustion. The level of clinical practice of acupuncture and moxibustion varies greatly among the regions where the WFAS society members lived. Among them, more countries in Europe have not included acupuncture and moxibustion in medical insurance than those in other continents (x2=26.049, P < 0.01), and more countries have not included acupuncture and moxibustion in public hospital treatment system than those in other continents (x2=113.488, P < 0.01). (3) Demand for CPGs of acupuncture and moxibustion. A total of 93.0% (281/302) respondents believed that WFAS CPGs of acupuncture and moxibustion would be helpful for their local practice. The order of their demand and concern for WFAS CPGs was: acupuncture manipulation > latest progress of acupuncture treatment > choice of acupuncture therapies > safety of acupuncture and moxibustion > combination of acupuncture and other programs. A total of 87.4% (264/302) respondents believed that ancient classics could guide clinical practice, and the ancient literature should be used as evidence for the development of guidelines. The respondents are those future practitioners of CPGs of acupuncture and moxibustion conforming to WFAS standards. Commonly they have clinical practice experience and professional education background. They believe that guidelines will be of help to the clinical practice of acupuncture and moxibustion, hope that WFAS CPGs would recommend effective guidelines for acupuncture manipulation and provide the latest progress in acupuncture treatment and so on, and they believe that classical ancient books can guide their clinical practice. It indicates the necessity and feasibility of formulating the WFAS CPGs of acupuncture and moxibustion. In view of the results of this study, it is suggested that the formulation process of WFAS CPGs of acupuncture and moxibustion should take into account the clinical practice level of acupuncture and moxibustion in each region, as well as its legislation and management situation of acupuncture and moxibustion, so as to meet the needs of users as much as possible. [ABSTRACT FROM AUTHOR]

We aimed to investigate the quality of evidence and the expected added clinical value of treatments recommended by the Danish Medicines Council (DMC). This was an observational study. The DMC prepares reports on drugs considered for possible new standard treatments in Danish hospitals. These reports evaluate the available evidence on efficacy and safety. The quality of evidence is systematically rated by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria, and estimates of added clinical value are presented. The recommendations take into account expected economic implications of new treatments. The publicly available reports up until December 29, 2021, were downloaded from the DMC Web page. Reports on drugs marked "recommended" were included. Data on quality of evidence, expected clinical value, and economic implications were imputed in a Microsoft Excel spreadsheet. Seventy-nine reports were included in the analysis. In 79% of these, the quality of evidence was rated low (24%) or very low (55%), whereas no recommendations were based on evidence rated as high quality. Three (5%) of recommended treatments were expected to add large clinical value. Most recommendations by the DMC are based on evidence formally rated as low or very low quality by GRADE, and no recommendations were based on evidence rated as high quality. The added clinical value of the treatments was often not documented and rarely large. Continued attention to improve the clinical evidence behind national recommendations is necessary. [ABSTRACT FROM AUTHOR]

The conservation community needs to improve the quality and quantity of evidence to address urgent and complex environmental challenges. The growth of Upstream Conservation Initiatives (UCIs) such as those designed to eliminate deforestation by shifting consumer or corporate behavior, exemplify the tension between the urgency to act and the need to build evidence to enable progressive improvements in implementation. These initiatives—often led by non-governmental organizations (NGOs)—are rarely evaluated rigorously in terms of their causal effect on intended outcomes, contributing to the evidence deficit. Impact evaluations have been useful tools to analyze effectiveness and build evidence in other fields. However, they are seldom used in the conservation field broadly or in UCIs specifically. To help practitioners involved in UCIs make better use of these tools, we introduce the field of impact evaluation, its core concepts, and how it contrasts with and complements traditional performance measurement approaches. Using these concepts, we propose a guidance process which can be used by practitioners at the project design phase to weigh tradeoffs and consider the most appropriate impact evaluation methodologies. We then use this guidance process to analyze two UCIs implemented by an NGO in Indonesia. Through these case studies we show how impact evaluation concepts could have been employed in project design to improve implementation and promote progressive learning, even if actual impact evaluations were infeasible. We conclude by proposing recommendations on how implementers, donors, and academia can build off these ideas to improve learning and strengthen the evidence base. • Impact evaluation is underutilized in the conservation field, limiting evidence. • Upstream Conservation Initiatives (UCIs) can benefit from impact evaluation. • Evaluations of UCIs must balance feasibility, rigor, and relevance. • Concepts from impact evaluation strengthen standard performance measurement. • Implementing organizations can apply principles at low cost to improve evidence. [ABSTRACT FROM AUTHOR]

Performance evaluation of in situ bioremediation processes in the field is difficult due to uncertainty created by matrix and contaminant heterogeneity, inaccessibility to direct observation, expense of sampling, and limitations of some measurements. The goal of this research was to develop a strategy for evaluating in situ bioremediation of light nonaqueous-phase liquid (LNAPL) contamination and demonstrating the occurrence of bioenhanced LNAPL dissolution by: (1) integrating a suite of analyses into a rational evaluation strategy; and (2) demonstrating the strategy's application in intermediate-scale flow-cell (ISFC) experiments simulating an aquifer contaminated with a pool of LNAPL (naphthalene dissolved in dodecane). Two ISFCs were operated to evaluate how the monitored parameters changed between a "no bioremediation" scenario and an "intrinsic in situ bioremediation" scenario. Key was incorporating different measures of microbial activity and contaminant degradation relevant to bioremediation: contaminant loss; consumption of electron acceptors; and changes in total alkalinity, pH, dissolved total inorganic carbon, carbon-stable isotopes, microorganisms, and intermediate metabolites. These measurements were integrated via mass-flux modeling and mass-balance analyses to document that in situ biodegradation of naphthalene was strongly accelerated in the "intrinsic in situ bioremediation" scenario versus "no bioremediation." Furthermore, the integrated strategy provided consistent evidence of bioenhancement of LNAPL dissolution through intrinsic bioremediation by a factor of approximately 2 due to the biodegradation of the naphthalene near the pool/water interface. • A strategy for demonstrating bioenhanced LNAPL dissolution was developed. • A key element is integration of analyses via mass-flux modeling and mass-balances. • The integrated experimental evidence demonstrated bioenhanced LNAPL dissolution. • Biodegradation steepened the concentration gradient and doubled the dissolution rate. [ABSTRACT FROM AUTHOR]

The rules for writing a research report are well defined but novice writers need more clarification on writing scholarly scientific papers for publication. The purpose of this paper is to enable novice writers to confidently apply the skills of scientific writing to the development of a scholarly paper for publication. We highlight the importance of having a clearly defined question or clarity in focus before moving on to consider the components of a scholarly paper including, the question, thesis, introduction, body, discussion, conclusion and finally, an abstract. [ABSTRACT FROM AUTHOR]

In Haiti, pathological confirmation of a cancer diagnosis is often delayed or impossible, imaging is expensive and imperfect, and many tests are unavailable. Physicians frequently struggle to establish cancers at a level of certainty required by "evidence based" standards, delaying definitive diagnosis and rendering some cancers permanently "suspected." I use 22 months of participant observation at the two largest cancer treatment programs in Haiti, as well as throughout Haiti's fragmented healthcare system, to look closely at processes of diagnosis and management of suspected 'cancers' which may never fully come to be. I argue that as global oncology becomes increasingly standardized, local practices are forced into alignment with a global knowledge basis that governs the knowability/unknowability of cancer. Using three case studies drawn from this work, I examine relationships among visibility, power, expertise and the replication of inequity through the governance of knowledge production. Finally, I examine the implications of these processes for cancer care in the global south. • In Haiti, pathological confirmation of cancer is often delayed or impossible. • Local clinical practices are brought into alignment with a global knowledge basis. • This creates complex relationships between visibility, power, and expertise. • The need to adhere to evidentiary standards prevents the creation of evidence. • These ideas have important implications for cancer care in the global south. [ABSTRACT FROM AUTHOR]

Despite much criticism, black-or-white null-hypothesis significance testing with an arbitrary P -value cutoff still is the standard way to report scientific findings. One obstacle to progress is likely a lack of knowledge about suitable alternatives. Here, we suggest language of evidence that allows for a more nuanced approach to communicate scientific findings as a simple and intuitive alternative to statistical significance testing. We provide examples for rewriting results sections in research papers accordingly. Language of evidence has previously been suggested in medical statistics, and it is consistent with reporting approaches of international research networks, like the Intergovernmental Panel on Climate Change, for example. Instead of re-inventing the wheel, ecology and evolution might benefit from adopting some of the 'good practices' that exist in other fields. It has been known for decades that there are severe problems associated with null-hypothesis significance testing (NHST) based on arbitrary P -value thresholds (e.g., P = 0.05). A small literature review indicates that much of the current research in ecology and evolution is still disregarding the warnings and frequently relies on binary decisions based on P -values to report statistical significance. While the P -value itself is a sound mathematical concept that does not have to be banned when used correctly, we should stop using the term 'statistical significance' and replace it with a gradual notion of evidence. Language matters and 'evidence' is an intuitive concept that honestly reflects what the data really tell us. To facilitate rewriting scientific results, we offer generic examples of how to translate (binary) significance language into a gradual language of evidence. [ABSTRACT FROM AUTHOR]

The role of the expert witness is clear in the eyes of the court but that understanding is less consistent for the medical professionals who may be called on in this capacity. The fundamental key is the clinician's purpose in using their experience, knowledge and training as they provide the court with an unbiased assessment of the clinical issues that have arisen in the case. Using the Australian context, this article provides guidance for clinicians who are asked to provide the court with their expertise through written and spoken representations, drawing upon experience and the use of the "Expert Witness Code of Conduct". [ABSTRACT FROM AUTHOR]

Environmental decisions related to policy and practice should be based on the best available evidence. Given the vast amounts of information of varying reliability, an ongoing challenge for decision-makers is how to access, collate, and use this information. The Collaboration for Environmental Evidence (CEE) is dedicated to the synthesis of environmental evidence via systematic reviews (SRs) to advance evidence-informed policy and practice. The CEE has now published 79 completed SRs (as of August 2019), building a wealth of experience and expertise among authors of these works. This article reports meta-data from the 79 completed SRs, as well as findings from a survey of authors (N = 18) regarding their perspectives on the application of the SRs that they have produced (representing a total of 26 SRs). The survey asked authors to evaluate the extent to which the findings from their SRs have been applied, as well as possible facilitators and barriers to application. Based on author-reported perspectives, 13 of 25 cases were identified as having an impact on policy and practice. Respondents felt their work was most successful in identifying research gaps, transferring knowledge, and informing policy and/or practice. The most common barriers experienced by respondents were challenges in communication and engagement with stakeholders, challenges with evidentiary ambiguity arising from SR findings due to overly broad research questions, and limited financial resources. Our findings lead us to posit that, in order to maximise the impact of future SRs, evidence syntheses should: (1) be based on well-defined and policy relevant research questions; (2) involve extensive collaboration among evidence-synthesizers and end users throughout the entire process; (3) create opportunities for partners to build "end user" capacity and awareness of the principles of evidence-based management; (4) develop formal and (eventually) standardized measures and indicators of impact for long-term tracking and comparability purposes. Future research should extend to understanding the perspectives of end users and stakeholders on the relevance of SRs to inform environmental policy and practice. • Environmental decisions related to policy and practice should be based on the best available evidence which demands use of robust evidence syntheses. • We surveyed authors of environmentally-oriented systematic reviews to understand perspectives on the extent to which reviews influenced environmental decisions. • Results were mixed suggesting varied outcomes although there were a number of common barriers and enablers. • To increase impact, reviews should address focused and relevant research questions and better engage with end users throughout the process. • Future research should extend to understanding the perspectives of end users and stakeholders on the relevance of systematic reviews to inform environmental policy and practice. [ABSTRACT FROM AUTHOR]

There are two competing views regarding the role of mechanistic knowledge in inferences about the effectiveness of interventions. One view holds that inferences about the effectiveness of interventions should be based only on data from population-level studies (often statistical evidence from randomised trials). The other view holds that such inferences must be based in part on mechanistic evidence. The competing views are local principles of inference, the plausibility of which can be assessed by a more general normative principle of inference. Bayesianism tells us to base inferences on both the 'likelihood' and the 'prior'. The likelihood represents statistical evidence. One influence on the prior probability of a hypothesis like ' d causes x ' is mechanistic knowledge of how d causes x. Thus, reasoning about such inferences by appealing to both statistical and mechanistic evidence is vindicated by our best general theory of inference. The primary contribution of this paper is to assess the merits and weaknesses of the arguments on both sides of the debate, using the Bayesian framework. This analysis lends support to those who argue that we should base our causal inferences about interventions in part on mechanistic evidence. [ABSTRACT FROM AUTHOR]

Guideline-recommended use of risk calculators to select for statin therapy in primary prevention has never been tested in a randomized controlled trial (RCT). We determined the extent to which guideline-based statin recommendations from the American College of Cardiology/American Heart Association (ACC/AHA), Canadian Cardiovascular Society(CCS), UK National Institute for Health and Care Excellence (NICE), and European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) is supported by available evidence from RCTs. 79,171 individuals from the Copenhagen General Population Study who were free of ASCVD and statin use at baseline were included. RCT evidence supporting guideline-recommended statin allocation and the estimated number needed to treat (NNT) to prevent one ASCVD event were assessed. During 8.2 years of follow-up, 4031 ASCVD events occurred. Of individuals eligible for statin therapy with the ACC/AHA, CCS, NICE and ESC/EAS guidelines, 86%, 88%, 88% and 84% had direct RCT evidence of statin efficacy, respectively (guideline-positive&RCT-positive). This group represented 26–37% of all 79,171 individuals, while guideline-positive&RCT-negative individuals represented 5–7%, guideline-negative&RCT-positive individuals 28–39%, and guideline-negative&RCT-negative individuals represented 30–31%. The ASCVD events per 1000 person-years were 11.4–12.7 (guideline-positive&RCT-positive), 6.3–8.0 (guideline-positive&RCT-negative), 4.2–5.2 (guideline-negative&RCT-positive), and 2.3–2.5 (guideline-negative&RCT-negative), respectively, while the corresponding NNT to prevent one event in 10 years using high-intensity statin were 19–21, 30–32, 48–60, and 105–125, respectively. The far majority of individuals eligible for guideline-recommended primary prevention with statins have direct RCT evidence supporting statin use. Allocating statins based on guideline-criteria is more efficient with lower NNT for preventing ASCVD events than allocating statin therapy based solely on RCT evidence. [Display omitted] • There is a strong correlation between estimated risk and the presence of randomized controlled trial (RCT) evidence. • ≈ 90 % of those recommended statins by guidelines have RCT evidence supporting efficacy. • Allocating statins based on guideline-criteria is superior to RCT criteria. • Our results strongly support the guideline-recommended use of risk calculators. [ABSTRACT FROM AUTHOR]

The evaluation of forensic DNA expert opinions (in some countries expert witness testimonies) and the way it affects criminal judgement is of paramount importance. We have selected one of the largest challenges when it comes to the evaluation of forensic DNA evidence, contamination of DNA samples, and examined how it influences the decisions judges make about the credibility of DNA evidence in Hungary. [ABSTRACT FROM AUTHOR]

After developing an LR-system to calculate weight of evidence from mRNA data [1] we here present how this LR-system is used in forensic casework. We aim to convey the weight of the evidence in forensic reports. [ABSTRACT FROM AUTHOR]

The K -sign depth (K -depth) of a model parameter θ in a data set is the relative number of K -tuples among its residual vector that have alternating signs. The K -depth test based on K -depth, recently proposed by Leckey et al. (2020), is equivalent to the classical residual-based sign test for K = 2 , but is much more powerful for K ≥ 3. This test has two major drawbacks. First, the computation of the K -depth is fairly time consuming having a polynomial time complexity of degree K , and second, the test requires knowledge about the quantiles of the test statistic which previously had to be obtained by simulation for each sample size individually. We tackle both of these drawbacks by presenting a limit theorem for the distribution of the test statistic and deriving an (asymptotically equivalent) form of the K -depth which can be computed efficiently. For K = 3 , such a limit theorem was already derived in Kustosz et al. (2016a) by mimicking the proof for U -statistics. We provide here a much shorter proof based on Donsker's theorem and extend it to any K ≥ 3. As part of the proof, we derive an asymptotically equivalent form of the K-depth which can be computed in linear time. This alternative and the original implementation of the K-depth are compared with respect to their runtimes and absolute difference. [ABSTRACT FROM AUTHOR]

In Siotani and Fujikoshi (1984), a precise local limit theorem for the multinomial distribution is derived by inverting the Fourier transform, where the error terms are explicit up to order N − 1. In this paper, we give an alternative (conceptually simpler) proof based on Stirling's formula and a careful handling of Taylor expansions, and we show how the result can be used to approximate multinomial probabilities on most subsets of R d. Furthermore, we discuss a recent application of the result to obtain asymptotic properties of Bernstein estimators on the simplex, we improve the main result in Carter (2002) on the Le Cam distance bound between multinomial and multivariate normal experiments while simultaneously simplifying the proof, and we mention another potential application related to finely tuned continuity corrections. • Local limit theorem for the multinomial distribution up to an N − 3 ∕ 2 error. • Simple proof using Stirling's formula and Taylor expansions. • Application to obtain asymptotic properties of Bernstein estimators. • Improves Le Cam distance between multinomial and multivariate normal experiments. • Potential applications to continuity corrections and power divergence statistics. [ABSTRACT FROM AUTHOR]

Introduction: Acute heart failure (HF) exacerbation is a serious and common condition seen in the Emergency Department (ED) that has significant morbidity and mortality. There are multiple clinical decision tools that Emergency Physicians (EPs) can use to reach an appropriate evidence-based disposition for these patients.Objective: This narrative review is an evidence-based discussion of clinical decision-making tools aimed to assist EPs risk stratify patients with AHF and determine disposition.Discussion: Risk stratification in patients with AHF exacerbation presenting to the ED is paramount in reaching an appropriate disposition decision. High risk features include hypotension, hypoxemia, elevated brain natriuretic peptide (BNP) and/or troponin, elevated creatinine, and hyponatremia. Patients who require continuous vasoactive infusions, respiratory support, or are initially treatment-resistant generally require intensive care unit admission. In most instances, new-onset AHF patients should be admitted for further evaluation. Other AHF patients in the ED can be risk stratified with the Ottawa HF Risk Score (OHFRS), the Multiple Estimation of Risk Based on Spanish Emergency Department Score (MEESSI), or the Emergency HF Mortality Risk Grade (EHFMRG). These tools take various factors into account such as mode of arrival to the ED, vital signs, laboratory values like troponin and pro-BNP, and clinical course. If used appropriately, these scores can predict patients at low risk for adverse outcomes.Conclusion: This article discusses evidence-based disposition of patients in acute decompensated HF presenting to the ED. Knowledge of these factors and risk tools can assist emergency clinicians in determining appropriate disposition of patients with HF. [ABSTRACT FROM AUTHOR]

We find an expression for the Gateaux derivative of the C ⁎ -algebra norm. Using this, we obtain a characterization of orthogonality of an operator A ∈ B (H , K) to a subspace, under the assumption dist (A , K (H , K)) < ‖ A ‖. We obtain an expression for the subdifferential set of the norm function at A ∈ B (H) when dist (A , K (H)) < ‖ A ‖. We also give new proofs of known results on the closely related notions of smooth points and Birkhoff-James orthogonality for the spaces B (H) and C b (Ω) , respectively. [ABSTRACT FROM AUTHOR]

k -anonymous microaggregation of data in R d with d ≥ 2 is shown to be NP-hard for all k ≥ 4 , extending a previous result for the case k = 3 only. The proof uses similarities between microaggregation and the k -means problem. A reduction of Planar 3-SAT to the k -means clustering problem is adapted to 4-anonymous clustering. Then this construction is extended to arbitrary k ≥ 4. [ABSTRACT FROM AUTHOR]

While presenting a combinatorial point of view to the class of equistable graphs, Miklavič and Milanič pointed out the inclusions among the classes of equistable, general partition and triangle graphs. Orlin conjectured that the first two classes were equivalent, but in 2014, Milanič and Trotignon showed that the three classes are all distinct, leading to the following hierarchy: general partition graphs ⊂ equistable graphs ⊂ triangle graphs. In this paper, we solve an open problem from Anbeek et al. (1997) by showing that all the above classes are equivalent when restricted to planar graphs. Additionally, we present short proofs on some structural properties of the general partition, equistable and triangle classes. In particular, we show that the general partition and triangle classes are both closed under the operations of substitution, induction and contraction of modules which allow us to recover several results in the literature. [ABSTRACT FROM AUTHOR]

Objectives: Despite its importance of quality measures used by the Centers for Medicare and Medicaid Services, the underlying cost-effectiveness evidence has not been examined. This study aimed to analyze cost-effectiveness evidence associated with the Centers for Medicare and Medicaid Services quality measures.Methods: After classifying 23 quality measures with the Donabedian's structure-process-outcome quality of care model, we identified cost-effectiveness analyses (CEAs) relevant to these measures from the Tufts Medical Center CEA Registry based on the PICOTS (population, intervention, comparator, outcome, time horizon, and setting) framework. We then summarized available incremental cost-effectiveness ratios (ICERs) to determine the cost-effectiveness of the quality measures.Results: The 23 quality measures were categorized into 14 process, 7 outcome, and 2 structure measures. Cost-effectiveness evidence was only available for 8 of 14 process measures. Two measures (Tobacco Screening and Hemoglobin bA1c Control) were cost-saving and quality-adjusted life-years (QALYs) improving, and 5 (Depression Screening, Influenza Immunization, Colon Cancer Screening, Breast Cancer Screening, and Statin Therapy) were highly cost-effective (median ICER ≤ $50 000/QALY). The remaining measure (Fall Screening) had a median ICER of $120 000/QALY. No CEAs were available for 15 measures: 10 defined by subjective patient ratings and 5 employed outcome measures without specifying an intervention or process.Conclusions: When relevant CEAs were available, cost-effectiveness evidence was consistent with quality measures (measures were cost-effective). Nevertheless, most quality measures were based on subjective ratings or outcome measures, posing a challenge in identifying supporting economic evidence. Refining and aligning quality measures with cost-effectiveness evidence can help further improve healthcare efficiency by demonstrating that they are good indicators of both quality and cost-effectiveness of care. [ABSTRACT FROM AUTHOR]

The effect of technological innovation on renewable energy development has drawn attention from scholars and policymakers. Based on a panel dataset covering 30 provinces in China from 2005 to 2017, the present study aims to examine how renewable energy technological innovation (RETI), represented by patent stock considering the decay and diffusion of renewable energy technologies, promotes renewable power generation (RPG) by nonspatial and spatial econometric models. The results indicate that 1) a 1% increase in the RETI level of a particular province, on average, leads to a 0.411% increase in RPG in that province directly and a 3.264% increase in RPG in its neighboring provinces through technology diffusion; 2) the effect of RETI on RPG will be underestimated by 12.7% if the decay and diffusion of technologies are not considered; 3) the estimation coefficients of RETI are insufficiently sensitive to the values of the decay and diffusion rates; 4) spatial dependence plays a vital role in exploring the impact of RETI on RPG, and this impact will be underestimated by 34.3% if spatial dependence is ignored. • Renewable energy technological innovation (RETI) contributes to renewable power generation. • Indirect effect of RETI on renewable power generation is 8 times greater than direct effect. • Coefficients can be underestimated if technological decay and diffusion are not considered. • Effect of innovation is not sensitive to the decay or diffusion rates. [ABSTRACT FROM AUTHOR]

In 1988, M.T. Nakao developed an algorithm that was based on the fixed-point theorem on Sobolev spaces for the numerical proof of the existence of solutions to elliptic boundary value problems on a bounded domain with a Lipschitz boundary (Nakao (1988) [9]). Thereafter, many researchers reported that the numerical existence proof algorithm to elliptic boundary value problems is actually significant and sufficiently useful. However, the numerical proof of the non-existence of solutions to the problem has hitherto not been considered due to several challenges. The purpose of this paper is to solve these difficulties and to propose an algorithm for the numerical proof of the non-existence of solutions in a closed ball B ¯ H 0 1 (u ˆ , ρ) = { u ∈ H 0 1 (Ω) | ‖ u − u ˆ ‖ H 0 1 ≤ ρ } to elliptic boundary value problems. We demonstrate some numerical examples that confirm the usefulness of the proposed algorithm. [ABSTRACT FROM AUTHOR]

Uncertainty is inherent in clinical medicine. However, just because absolute certainty is unachievable does not mean that rational and optimal decisions cannot be made. It is argued that we need to distinguish legitimate from illegitimate scientific uncertainties that are generated by manufacturing doubts aiming to create mis- and disinformation. The attempt to create doubts implies that actions under uncertainties are impossible. Such a belief ultimately harms public, which requires reasoned actions within a context of genuine scientific and medical uncertainties. The latter indicates that rational decisions, even in the absence of guaranteed absolute certainty, are not only possible but, on average, beneficial both for society and individuals. [ABSTRACT FROM AUTHOR]