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The cost-to-charge ratio reflects the markup of hospital services. A lower cost-to-charge ratio indicates lower costs and/or greater charges. This study examines factors associated with cost-to-charge ratio trends to determine whether decreasing cost-to-charge ratio is associated with worse surgical outcomes. The Florida Agency for Healthcare Administration Inpatient database (2018–2020) was queried for common surgical procedures and linked to the Distressed Communities Index, RAND Corporation Hospital data, Center for Medicare Services Cost Reports, and American Hospital Association data. Only hospitals with monotonically increasing or decreasing cost-to-charge ratio were included in the study. Univariable analysis compared these hospitals. Using patient-level data, interpretable machine learning predicted cost-to-charge ratio trend while identifying influential factors. The cohort had 67 hospitals (27 increasing cost-to-charge ratio and 40 decreasing cost-to-charge ratio) with 35,661 surgeries. Decreasing cost-to-charge ratio hospitals were more often proprietarily owned (78% vs 33%, P =.01) and had greater mean total charges ($134,349 ± $114,510 vs $77,185 ± $82,027, P <.01) with marginally greater mean estimated costs ($14,863 ± $12,343 vs $14,458 ± $15,440, P <.01). Patients from decreasing cost-to-charge ratio hospitals had greater rates of most comorbidities (P <.05) but no difference in mortality or overall complications. Machine-learning models revealed charges rather than clinical factors as most influential in cost-to-charge ratio trend prediction. Decreasing cost-to-charge ratio hospitals charge vastly more despite minimally greater estimated costs and no difference in outcomes. Although differences in case-mix existed, charges were the predominant differentiators. Patient clinical factors had far less of an impact. [ABSTRACT FROM AUTHOR]

• Mg-rich nm-scale precipitates exist in the C36 and the C14 laves phases. • The electrochemical activity (C15>C36>α-SS>C14) accounts in the passive state. • Interconnected C14 laves phases increases the corrosion current density. • Small and dispersed C15 laves phases decrease the corrosion current density. • Interconnected C36 laves phases cause minimal corrosion current densities. The electrochemical corrosion mechanisms of Mg alloys were extensively studied in previous investigations of different chemical compositions, modified surface states and various electrolyte conditions. However, recent research focused on the active state of Mg dissolution, leading to unresolved effects of secondary phases adjacent to a stable α-solid solution passive layer. The present study investigates the fundamental electrochemical corrosion mechanisms of three different Laves phases with varying phase morphologies and phase fractions in the passive state of Mg-Al-Ca alloys. The microstructure was characterized by (transmission-) electron microscopy and synchrotron-based transmission X-ray microscopy. The electrochemical corrosion resistance was determined with a standard three-electrode setup and advanced in-situ flow cell measurements. A new electrochemical activity sequence (C15>C36>α-Mg>C14) was obtained, as a result of a stable passive layer formation on the α-solid solution. Furthermore, nm-scale Mg-rich precipitates were identified within the Laves phases, which tend to inhibit the corrosion kinetics. [Display omitted] [ABSTRACT FROM AUTHOR]

Imaging of head and neck cancer at initial staging and as part of post-treatment surveillance is a key component of patient care as it guides treatment strategy and aids determination of prognosis. Head and neck cancer includes a heterogenous group of malignancies encompassing several anatomic sites and histologies, with squamous cell carcinoma the most common. Together this comprises the seventh most common cancer worldwide. At initial staging comprehensive imaging delineating the anatomic extent of the primary site, while also assessing the nodal involvement of the neck is necessary. The treatment of head and neck cancer often includes a combination of surgery, radiation, and chemotherapy. Post-treatment imaging is tailored for the evaluation of treatment response and early detection of local, locoregional, and distant recurrent tumor. Cross-sectional imaging with CT or MRI is recommended for the detailed anatomic delineation of the primary site. PET/CT provides complementary metabolic information and can map systemic involvement. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. [ABSTRACT FROM AUTHOR]

Tinnitus is abnormal perception of sound and has many subtypes. Clinical evaluation, audiometry, and otoscopy should be performed before ordering any imaging, as the choice of imaging will depend on various factors. Type of tinnitus (pulsatile or nonpulsatile) and otoscopy findings of a vascular retrotympanic lesion are key determinants to guide the choice of imaging studies. High-resolution CT temporal bone is an excellent tool to detect glomus tumors, abnormal course of vessels, and some other abnormalities when a vascular retrotympanic lesion is seen on otoscopy. CTA or a combination of MR and MRA/MRV are used to evaluate arterial or venous abnormalities like dural arteriovenous fistula, arteriovenous malformation, carotid stenosis, dural sinus stenosis, and bony abnormalities like sigmoid sinus wall abnormalities in cases of pulsatile tinnitus without a vascular retrotympanic lesion. MR of the brain is excellent in detecting mass lesions such as vestibular schwannomas in cases of unilateral nonpulsatile tinnitus. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation. [ABSTRACT FROM AUTHOR]

Cranial neuropathy can result from pathology affecting the nerve fibers at any point and requires imaging of the entire course of the nerve from its nucleus to the end organ in order to identify a cause. MRI with and without intravenous contrast is often the modality of choice with CT playing a complementary role. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer-reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances in which peer-reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation. [ABSTRACT FROM AUTHOR]

The Atacama Desert is generally considered the driest non-polar desert on Earth and is therefore an ideal study area for exploring the water and biota free endmember of Earth's Critical Zone (ECZ). Single grain (SG) luminescence dating has successfully identified processes in the ECZ. However, SG luminescence dating of Atacama Desert feldspars is challenging and time consuming since only a small fraction of grains emits sufficient luminescence and their potassium (K) contents, needed for internal dose rate calculations, are highly variable. Here we present an adaption of the standardised growth curve (SGC) method adjusted to the conditions of Atacama Desert sediments and a correlation of single-grain geochemistry and luminescence properties. To evaluate if SGCs are suitable for our study site and to determine the influence of the K-content on our luminescence age calculations, we used a set of five samples from the Atacama Desert and five chemically and structurally different feldspar sediment extracts from various geological origins worldwide. We performed a dose recovery test (DRT) using a post-infrared infrared stimulated luminescence (pIRIR) protocol and measured nine major element concentrations, including K, on a single grain level using a scanning electron microscope (SEM) with energy-dispersive X-ray spectroscopy (EDX). The DRT dataset was then used to test the application of SGCs. The accuracy of Atacama feldspar pIRIR measurements fitted onto SGCs frequently suffers from odd values in single measurement cycles, since the SGC approach developed for SG feldspar luminescence (Li et al., 2015b) uses one L x /T x measurement to project the L n /T n values onto a SGC. We investigate the influence of calculating a synthetic regenerative signal (sR) for SGC fitting, to reduce the effect of those odd values on individual grain measurements. Furthermore, we reduced the regenerative cycles used for our sR approach, to test if shorter protocols would result in equivalent dose (D e) estimates in agreement with longer protocols. We then calculated Spearman rank correlations between the results obtained with our modified SGC and the SAR protocol, luminescence signal intensities, and the geochemical dataset. Finally, we present a new method of fitting data onto a SGC which significantly decreases measurement time, without risking the inclusion of outliers. We furthermore show that the luminescence signal intensities, the D e values and their dose recovery ratios obtained with our SGC method and a SAR protocol, are independent of the sample geochemistry. • We established a new method for interpolation L x /T x values onto a SGC. • We correlate geochemical and luminescence data on a single grain level. • We found no correlation between K-content and luminescence signal intensity. [ABSTRACT FROM AUTHOR]

The precise dating of sedimentary archives covering the last 200 years in floodplains massively impacted by human activities is a major challenge. A combination of geochronological approaches is necessary to accurately date post-1800 sedimentary deposits. Here, we use a combination of a wide range of methods to unravel floodplain sedimentary dynamics, through the example of the Upper Rhine which is a highly regulated river. This comprises short--lived radionuclides (137Cs, 210Pb xs) and Infrared Stimulated Luminescence (IRSL) single-grain dating. Luminescence profiling methods (IRSL screening, portable luminescence reader) were also used to further characterise sedimentation dynamics. These were combined with a hydrogeomorphological approach based on historical planimetric and hydrological data, the knowledge of engineering works as well as the morpho-sedimentary adjustments they induced. Our study demonstrates the value of historic maps as well as historical hydrological data, which provide precise time markers for dating the sedimentary archive under study. We illustrate different assumptions, validity domains and limitations inherent to each method, especially the complexity of 137Cs to date floodplain sediments and the potential of luminescence methods for dating and estimating sedimentation continuity. We finally show the advantage of combining geochronological approaches in the construction of robust age models for young floodplain sedimentary archives in highly anthropized fluvial environments. [ABSTRACT FROM AUTHOR]

Poor farmers are particularly vulnerable to environmental stressors and often rely on traditional knowledge and grassroots creativity to help them to adapt. Such adaptation can be enhanced using other knowledge sources, but this requires greater understanding of the processes of knowledge co-production among scientists, local communities and state actors. In this study we undertook knowledge co-production on an experimental basis with two contrasting communities: smallholder farmers in Jind (Haryana) and Adi women in East Siang district (Arunachal Pradesh). We found that the Jind farmers displayed grassroots creativity in coping with salinity induced stresses to rice-wheat cropping systems, while Adi women applied their traditional knowledge of food based on namdung (Perilla ocymoides, a local plant species) to cope with climate variability that affected fermentation. Jind farmers perceived the process of knowledge co-production as moderately credible and salient , but the legitimacy of the exercise was compromised by the relatively low level of participation by state actors. The farmers rated the practical outcomes of the co-produced zero-till wheat as low to moderate for combating salinity-induce risks but as high for a community rice nursery. The knowledge co-production process was considered more credible and salient among younger Adi women than older women, and the utility of the Adi women's co-produced adaptive practices were rated as moderate to high for reducing the impacts of climate variability on namdung based foods. In both cases, an emergent property of the knowledge co-production exercise was creation of a knowledge network that has the potential to lead to ongoing enhanced adaptation to environmental change. Insights from the study could help improve knowledge co-production in similar social-ecological systems, and can be integrated with environmental change policies. [Display omitted] • Resource-poor farmers are particularly vulnerable to environmental change. • Local knowledge with science was used in knowledge co-production for environmental adaptation. • Most farmers viewed the process of knowledge co-production positively. • Knowledge co-production was salient and credible but sometimes lacked legitimacy. • Creation of knowledge networks among participants emerged as an unexpected benefit. [ABSTRACT FROM AUTHOR]

We evaluated the effect of weight loss induced by dietary carbohydrate restriction on health-related quality of life (HRQoL) and cognition in type 2 diabetes (T2D). In this randomised parallel trial, 72 adults with T2D and overweight/obesity (mean ± SD, HbA 1c : 57 ± 8 mmol/mol and BMI: 33 ± 5 kg/m2) were randomly assigned to a carbohydrate-reduced high-protein diet (CRHP: C30E%-P30E%-F40E%) or conventional diabetes diet (CD: C50E%-P17E%-F33E%) for 6 weeks, targeting a 6% weight loss. HRQoL was assessed from the short form 36 (SF-36) questionnaire, including physical and mental component summary (PCS and MCS) scores; global cognition, verbal memory, attention and psychomotor speed, and executive function were assessed from a neuropsychological test battery. Both diet groups achieved a 5.8 kg weight loss and improved PCS (median [25th;75th percentiles], CD: 2.7 [1.1; 4.2] vs. CRHP: 2.1 [0.7; 3.7]), with no difference between diets. The CRHP diet resulted in a clinically relevant improvement of MCS, albeit non-significantly different compared with the change after the CD diet (2.0 [-0.7; 4.8], p = 0.15). Global cognition, attention, and verbal memory were unaffected by the CRHP diet, which selectively worsened the Symbol Digit Modality Test assessing psychomotor speed when compared with the CD diet (−4.1 [-7.2;-1.1], p < 0.01). Physical health improved by weight loss independently of macronutrient distribution, while mental health and cognition may be affected by the amount of carbohydrate, protein and fat in the diet. Collectively, our data suggest that weight loss through moderate carbohydrate restriction has no clinically important impact on HRQoL and global cognition in patients with T2D. Registered under ClinicalTrials.gov Identifier no. NCT03814694. [ABSTRACT FROM AUTHOR]

Maxillofacial trauma patients comprise a significant subset of patients presenting to emergency departments. Before evaluating for facial trauma, an emergency or trauma physician must perform a primary survey to ensure patient stabilization. Following this primary survey, this document discusses the following clinical scenarios for facial trauma: tenderness to palpation or contusion or edema over frontal bone (suspected frontal bone injury); pain with upper jaw manipulation or pain overlying zygoma or zygomatic deformity or facial elongation or malocclusion or infraorbital nerve paresthesia (suspected midface injury); visible nasal deformity or palpable nasal deformity or tenderness to palpation of the nose or epistaxis (suspected nasal bone injury); and trismus or malocclusion or gingival hemorrhage or mucosal hemorrhage or loose teeth or fractured teeth or displaced teeth (suspected mandibular injury). The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. [ABSTRACT FROM AUTHOR]

This article presents guidelines for initial imaging utilization in patients presenting with sinonasal disease, including acute rhinosinusitis without and with suspected orbital and intracranial complications, chronic rhinosinusitis, suspected invasive fungal sinusitis, suspected sinonasal mass, and suspected cerebrospinal fluid leak. CT and MRI are the primary imaging modalities used to evaluate patients with sinonasal disease. Given its detailed depiction of bony anatomy, CT can accurately demonstrate the presence of sinonasal disease, bony erosions, and anatomic variants, and is essential for surgical planning. Given its superior soft tissue contrast, MRI can accurately identify clinically suspected intracranial and intraorbital complications, delineate soft tissue extension of tumor and distinguish mass from obstructed secretions.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. [ABSTRACT FROM AUTHOR]

Hyperparathyroidism is defined as excessive parathyroid hormone production. The diagnosis is made through biochemical testing, in which imaging has no role. However, imaging is appropriate for preoperative parathyroid gland localization with the intent of surgical cure. Imaging is particularly useful in the setting of primary hyperparathyroidism whereby accurate localization of a single parathyroid adenoma can facilitate minimally invasive parathyroidectomy. Imaging can also be useful to localize ectopic or supernumerary parathyroid glands and detail anatomy, which may impact surgery. This document summarizes the literature and provides imaging recommendations for hyperparathyroidism including primary hyperparathyroidism, recurrent or persistent primary hyperparathyroidism after parathyroid surgery, secondary hyperparathyroidism, and tertiary hyperparathyroidism. Recommendations include ultrasound, CT neck without and with contrast, and nuclear medicine parathyroid scans. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. [ABSTRACT FROM AUTHOR]

• Conventional pixel counting of satellite-based land cover maps leads to biased ecosystem extent accounts. • Design-based (survey) methods are necessary complements to satellite-based maps for quantifying uncertainty and mitigating bias. • Simpler ecosystem typologies, longer accounting periods, and custom satellite-based maps reduce uncertainty in extent accounts. • A standard for auditing uncertainty in ecosystem accounts is needed. There are currently no guidelines in the System of Environmental-Economic Accounting Ecosystem Accounting (SEEA EA) for quantifying and disclosing uncertainty. However, without quantifying uncertainty, it is unclear whether or not accounting tables contain biased (erroneous) area estimates which do not reflect real land cover changes. We use Oslo municipality in Norway as a case study to illustrate best practices in quantifying unbiased area estimates using design-based statistical methods. As input for ecosystem extent accounts, we compared a custom Sentinel-2 land cover map with a globally available one called Dynamic World for 2015, 2018 and 2021. The design-based area estimation involved (i) generating a stratified probability sample of locations using the satellite-based maps to define strata, (ii) assigning ecosystem type labels to the samples using photointerpretation according to a response design protocol, and (iii) applying a stratified area estimator to produce 95% confidence intervals around opening, closing and change stocks in the extent accounting table. We found that pixel counting practices, currently adopted by the SEEA EA community, led to biased extent accounts, particularly for ecosystem conversions, with biases averaging 195% of the true change value derived from design-based methods. We found that the uncertainty inherent in state-of-the-art satellite-based maps exceeded the ability to detect real change in extent for some ecosystem types including water and bare/artificial surfaces. In general, uncertainty in extent accounts is higher for ecosystem type conversion classes compared to stable classes, and higher for 3-yr compared to 6-yr accounting periods. Custom, locally calibrated satellite-based maps of ecosystem extent changes were more accurate (81% overall accuracy) than globally available Dynamic World maps (75%). We suggest that rigorous accuracy assessment in SEEA EA will ensure that ecosystem extent (and consequently condition and service) accounts are credible. A standard for auditing uncertainty in ecosystem accounts is needed. [ABSTRACT FROM AUTHOR]

Offshore tsunami deposits have the potential to substantially improve our understanding of long-term tsunami hazard. This may be particularly true for the Portuguese Algarve coast, where onshore sediment records are restricted to the last 3000 years due to scarcity of sediment archives suitable for identifying tsunami deposits. This study investigates the potential of optically stimulated luminescence (OSL) for dating offshore tsunami layers from the Portuguese shelf and its background sedimentation cored during METEOR cruise M-152, by comparing luminescence ages with radiocarbon chronologies. Accurate luminescence ages for both offshore tsunami deposits and constraining shelf sediments can be achieved by using single grains of quartz in combination with the minimum age model. However, even single grain ages significantly over-estimate by several thousand years for some very poorly bleached tsunami deposits and underlying shelf sediments affected by erosion during the event. This demonstrates the necessity of using chronologies that are based on a large number of ages, as well as a combination of direct tsunami ages and limiting ages for background sedimentation. The combination of luminescence ages from this study with radiocarbon ages using a Bayesian approach yields an age of 3600–3800 years for a predecessor event of the 1755 CE Lisbon tsunami, formerly radiocarbon dated in the same offshore sediment cores to ca. 3600 cal years BP. • Direct quartz and feldspar luminescence ages for offshore tsunami deposits. • Evaluation of luminescence dating accuracy against radiocarbon chronology. • New age constraints for a prehistoric predecessor of the 1755 Lisbon tsunami. • Hiatus below event layers allow insights into erosive capacity of tsunami backwash. [ABSTRACT FROM AUTHOR]

In esophageal cancer, histopathologic response following neoadjuvant therapy and transthoracic esophagectomy is a strong predictor of long-term survival. At the present, it is not known whether the initial tumor volume quantified by computed tomography (CT) correlates with the degree of pathologic regression. In a retrospective analysis of a consecutive patient cohort with esophageal adenocarcinoma, tumor volume in CT prior to chemoradiotherapy or chemotherapy alone was quantified using manual segmentation. Primary tumor volume was correlated to the histomorphological regression based on vital residual tumor cells (VRTC) (Cologne regression scale, CRS: grade I, >50% VRTC; grade II, 10–50% VRTC; grade III, <10% VRTC and grade IV, complete response without VRTC). A total of 287 patients, 165 with neoadjuvant chemoradiotherapy according to the CROSS protocol and 122 with chemotherapy according to the FLOT regimen, were included. The initial tumor volume for patients following CROSS and FLOT therapy was measured (CROSS: median 24.8 ml, IQR 13.1–41.1 ml, FLOT: 23.4 ml, IQR 10.6–37.3 ml). All patients underwent an Ivor-Lewis esophagectomy. 180 patients (62.7 %) were classified as minor (CRS I/II) and 107 patients (37.3 %) as major or complete responder (CRS III/IV). The median tumor volume was calculated as 24.2 ml (IQR 11.9–40.3 ml). Ordered logistic regression revealed no significant dependence of CRS from tumor volume (OR = 0.99, p-value = 0.99) irrespective of the type of multimodal treatment. The initial tumor volume on diagnostic CT does not aid to differentiate between potential histopathological responders and non-responders to neoadjuvant therapy in esophageal cancer patients. The results emphasize the need to establish other biological markers of prediction. [ABSTRACT FROM AUTHOR]

• Summary outputs from a multi-stakeholder workshop on Histology-independent drug development. • Histology-independent registrations allow cancer drug development in rare indications. • Innovative trial design with complex statistics are needed in these trials. • Companion biomarker development needs validation across tumour types. • Good data governance and data sharing is essential to facilitate drug development in rare tumours. The Cancer Drug Development Forum (CDDF)'s 'Histology independent drug development – is this the future for cancer drugs?' workshop was set up to explore the current landscape of histology independent drug development, review the current regulatory landscape and propose recommendations for improving the conduct of future trials. The first session considered lessons learnt from previous trials, including innovative solutions for reimbursement. The session explored why overall survival represents the most valuable endpoint, and the importance of duration of response, which can be captured with swimmer and spider plots. The second session on biomarker development and treatment optimisation considered current regulations for companion diagnostics, FDA guidance on histology independent drug development in oncology, and the need to establish cut-offs for the biomarker of tumour mutational burden to identify the patients most likely to benefit from PDL1 treatment. The third session reviewed novel trial designs, including basket, umbrella and platform trials, and statistical approaches of hierarchical modelling where homogeneity between study cohorts enables information to be borrowed between cohorts. The discussion highlighted the need to agree 'common assessment standards' to facilitate pooling of data across studies. In the fourth session, the sharing of data sets was recognised as a key step for improving equity of access to precision medicines across Europe. The session considered how the European Health Data Space (EHDS) could streamline access to medical records, emphasizing the importance of introducing greater accountability into the digital space. In conclusion the workshop proposed 11 recommendations to facilitate histology agnostic drug development. [ABSTRACT FROM AUTHOR]

Absorptive capacity has received considerable scholarly attention due to its ability to explain heterogeneous degrees of learning from complex and dynamic knowledge environments. Extant absorptive capacity frameworks and models unmistakably take firms as the focal unit and level of analysis. Mounting empirical evidence, in contrast, shows the growing importance of teams in acquiring and utilizing external knowledge. Teams are not just scale models of firms; they have unique attributes and function as an active context of organizational learning. However, previous research does not consider such idiosyncrasies when conceptualizing absorptive capacity. We focus on absorptive capacity within the meso-level context of teams and problematize several entrenched assumptions behind existing models. We then propose a re-conceptualization of absorptive capacity with four new dimensions that collectively address these assumptions and pay systematic attention to the distinctive characteristics of teams as active learning contexts. • Absorptive capacity has been mostly treated as a firm-level capability. • Recent evidence highlights teams' role in knowledge acquisition. • Teams are distinct from firms, serving as active learning contexts with unique attributes. • Our study re-conceptualizes absorptive capacity as a team-level phenomenon. • We propose four dimensions that compromise team-level absorptive capacity. [ABSTRACT FROM AUTHOR]

Surface modifications and productivity during laser-induced thermochemical machining (LCM) strongly depend on the thermo-chemical load defined by the used material-electrolyte combination, the phase composition of the workpiece material and the laser parameter setting. Thus, LCM is typically considered as a process with main chemical active impact. The energy for the chemical reaction kinetics is supplied by the thermal energy feed of the laser radiation. This paper investigates the different material removal regimes, which can change from an anodic dissolution to surface melting and evaporation, shifting the main impact of the process from chemical to thermal. Therefore, a quantitative description of the thermal load based on the laser-induced surface temperature is presented. The results show that the processing of 42CrMo4 in sodium nitrate requires a local temperature close to the melt temperature of the material, while processing of titanium in phosphoric acid takes place at significantly lower temperatures. The analyzes of the corrosion potential of 42CrMo4 steel and titanium in acidic and neutral solutions provides an access in understanding the mechanisms in the predominated chemical material removal regime. Furthermore, the productivity in terms of material removal of titanium and 42CrMo4 is in phosphoric acid three times higher than in sodium nitrate. [ABSTRACT FROM AUTHOR]

The influence of amount of intermetallics on the degradation of as-extruded Mg-Nd alloys with different contents of Nd was investigated via immersion testing in DMEM+10% FBS under cell culture conditions and subsequent microstructural characterizations. It is found that the presence of intermetallic particles Mg 41 Nd 5 affects the corrosion of Mg-Nd alloys in two conflicting ways. One is their negative role that their existence enhances the micro-galvanic corrosion. Another is their positive role. Their existence favours the formation of a continuous and compact corrosion layer. At the early stage of immersion, their negative role predominated. The degradation rate of Mg-Nd alloys monotonously increases with increasing the amount of intermetallics. Mg-5Nd alloy with maximum amount of intermetallics suffered from the most severe corrosion. With the immersion proceeding (≥7 days), then the positive role of these intermetallic particles Mg 41 Nd 5 could not be neglected. Owing to the interaction between their positive and negative roles, at the later stage of immersion the corrosion rate of Mg-Nd alloys first increases with increasing the content of Nd, then reaches to the maximum at 2 wt. % Nd. With a further increase of Nd content, a decrease in corrosion rate occurs. The main corrosion products on the surfaces of Mg-Nd alloys include carbonates, calcium-phosphate, neodymium oxide and/or neodymium hydroxide. They are amorphous at the early stage of immersion. With the immersion proceeding, they are transformed to crystalline. The existence of undegradable Mg 41 Nd 5 particles in the corrosion layer can enhance the crystallization of such amorphous corrosion products. Image, graphical abstract [ABSTRACT FROM AUTHOR]

As Thai farmers get older they need to plan what to do with their farm business and land given younger people tend to out-migrate to urban areas and shift their interests away from farming. Such demographic trends may reduce agricultural productivity and increase food insecurity, both among farmers and in the region. Using data collected through interviews with 368 farmers in the Prachin Buri province of Thailand, this research aims to examine how ageing is affecting farm activities of older farmers (60 years and older) and how they are adapting. We found that, while a small percentage of older farmers intended to continue farming without making any changes over the next five years (~9%), most were concerned about their health and farm work capacity, and were looking to leave farming and implement strategies to reduce both work intensity and time. Most farmers intended to stop farming and transfer farmland to their children (~40%), or continue farming while making some changes (~30%), such as employing additional workers or switching to less labour intense crops. Some intended to stop farming altogether and dispose of farmland outside their family (~21%; e.g. leasing out or selling or returning farmland to owner if leased). As expected, the chosen strategy depended on personal (old-age income security and gender) and farm characteristics (e.g. successor, farm activities, and subsidy). Having a dedicated successor had a substantial impact on transferring land to the children, reflecting the importance of commitment for farming by the next generation, which will be challenging. A pension higher than the widely available old-age allowance could support farmers in maintaining a better living standard after retiring. However, only a fraction of farmers currently had access to a pension. Both short- and long-term policies are, therefore, needed to support elderly farmers, improve their living standards after retirement, and attract young people back to farming. • Interviews conducted with 368 elderly Thai farmers about the impacts of ageing and coping strategies. • Elderly Thai farmers suffer age-related chronic illnesses which affect their work capacity. • 61% of farmers intended to exit from farming and 39% to continue. • 40% of those who exit intended to transfer farmland to their children and 21% to lease it out or sell it otherwise. • Having a successor, produce types, subsidy and old-age income security affected farmers' decisions on future land use. [ABSTRACT FROM AUTHOR]

With increasing urbanisation and climate change, more people will be exposed to extreme heat. While health impacts of heat are well known, far less is known about how heat and responses to heat affect daily life. Such information is needed if appropriate advice is to be provided on heat adaptation. This study describes heat-related symptoms that can impact wellbeing but do not necessarily require medical treatment, and how heat changes people's behaviour, including their strategies for relieving heat and seeking heat health advice. Data were collected through an Australia-wide online survey with 1665 responses. We found that heat leads to maladaptive behaviours that could affect long-term health, such as reducing outside activities (67% of respondents) and increasing the consumption of soft drinks (27% of respondents) and alcohol (11% of respondents). Two-thirds of respondents used more air-conditioning to relieve heat stress and many reported poor sleep quality. Behaviour change was strongly correlated with respondents' age, degree of physical activity and the extent to which people sought advice on heat and health (37% of respondents). The results can help identify individuals least likely to cope well with heat and who may benefit most from heat relief advice. • Heat stress compromises wellbeing and exacerbates chronic diseases. • Australian-wide online survey on perceived mild to moderate heat stress related symptoms and adaptive behaviour. • Mostly people adapt by avoiding outdoor exposures and cooling using air-conditioning. • Heat tolerant people less likely to exhibit maladaptive behaviour, such as increasing soft drink intake. • External advice not often sought for heat relief and planning. [ABSTRACT FROM AUTHOR]

• A socio-ecological system was developed to analyse contrasting case studies based on stakeholder perceptions. • Perceptions on agricultural landscape services, biodiversity and changes were systematically gathered. • Climate change is the most often perceived driver for landscape service change, next to policies and markets. • Results indicate complementary knowledge of different stakeholder groups. • Future policies need landscape-specific targets and integrate knowledge of different stakeholders. Many studies have explored farmers' perspectives on biodiversity and ecosystem services, but fewer qualitative and cross-country comparisons exist. We develop a socio-ecological system to analyse agricultural landscape services, biodiversity, and drivers that have affected these services in recent decades. Via a systematic stakeholder mapping and 49 semi-structured interviews, we identify stakeholder perceptions of this system. We compare the perceptions across four regional case studies (Austria, Estonia, Germany, Switzerland), and two stakeholder groups (land managers and administrators). The case studies share certain commonalities in perceptions (e.g., provisioning and regulating services discussed in all of them) but also show differences (e.g., changes in biodiversity and landscape services more often perceived in the Swiss and German cases, but less in the Austrian and Estonian case studies). Across all case studies, typical land use change can be attributed to multiple drivers of various strengths, with climate change being the most often perceived driver directly affecting landscape services, followed by policies and market-based drivers, which affect services and biodiversity indirectly via land use. Compared to the administrators (e.g., decision-makers, scientists), the managers (e.g., farmers, NGOs) discuss more often the drivers, like various biodiversity and landscape service categories, as well as climate change, markets, and technologies. However, the administrators focus more on cultural services, policies as drivers, and consider more often links between drivers and landscape services and/or biodiversity. Hence, both of the groups' (administrators and managers) perceptions partly complement each other. Since policy making should be based on the best knowledge of different stakeholder groups, active knowledge exchange between managers and administrators should be supported and outcome considered in decision making. The resulting regional differences in stakeholder perceptions of the drivers and their respective impact on agricultural landscapes suggest that future agricultural policies need regional targeting and the consideration of landscape-specific characteristics. [ABSTRACT FROM AUTHOR]

Farmers in Nepal face many risks from extreme weather events which detrimentally impact their crop production. To support farmers in risk management, prevent financial losses, and facilitate farmer participation in insurance schemes, the Nepalese government subsidises crop insurance by paying 75% of the premiums. However, the uptake of insurance schemes has been poor. This study aimed to find out why by surveying 350 farmers, and identifying factors that influenced farmers' general interest in, and willingness-to-pay for, crop insurance. Approximately 84% of farmers' were interested in purchasing area-based crop yield insurance and were, on average, willing to pay a premium of USD 42.42/ha/cropping season for paddy rice, and USD 29.52/ha/season for wheat. This amounted to more than three times the price of paddy rice premiums (USD 9.96/ha/season), and nearly three times that of wheat premiums (USD 8.59/ha/season) under the current subsidised scheme. This implies that the cause of low uptake is unlikely to be related to the price of premiums. The results further suggest that in order to increase farmers' uptake of crop insurance, the information of the threats of climate variability to future crop failures should be better communicated; and that the current subsidised insurance scheme should be revised. [ABSTRACT FROM AUTHOR]

• Most respondents to a survey in urban South East Asia had recently felt heat stressed. • Heat stress and risk perception were strongly associated with an intention to move. • Women and older people were more likely to intend to move to cooler places. • Many would move within the neighbourhood, very few overseas. • There is need to understand slow onset hazards on mobility of urban populations. Climate change and associated weather extremes and natural hazards have large impacts on the urban population of the Global South where population growth will rapidly increase the already large number of people who will be affected. Using Protection Motivation Theory (PMT), we investigate how hot temperatures, manifested as heat stress, is affecting the intentions of moving among the urban population in three Asian countries (Indonesia, Malaysia, Philippines). We conducted an online survey with 2219 respondents. Almost all respondents (98%) had experienced heat stress, albeit at different levels. When asked whether respondents would be likely to move away from their current locations because of heat, nearly a quarter (23%) reported that they were very likely to do so, and 50% that they probably would. Stronger moving intentions because of heat were associated with women and older people. Concerns about increases from damage from heat (threat appraisal) were more strongly associated with moving intentions than an understanding of the costs and benefits (coping appraisal). Among the threat appraisal, heat stress levels and risk perception were the strongest predictors of moving intentions because of heat. The results contrast with the findings of migration studies in response to sudden onset hazards and underpin the differences in adaptation behaviour in response to different climate change impacts. Moving away to cooler places as an adaptation strategy to heat may be challenging to foresee in terms of timing, capabilities, destination and potential costs because it may not happen soon. We strongly recommend further research on climate change migration of the urban population, including within urban and urban-to-urban movements. While many people move back after sudden onset disasters, heat potentially leads to permanent movements given it is likely to be better planned, and as the habitability of some places is increasingly compromised. Overall the effects of slow onset environmental hazards such as pollution and heat on migration warrant more research attention given the rapidity of urban population growth, particularly in the global south. [ABSTRACT FROM AUTHOR]

Neuroendocrine dysfunction includes suspected hyper- and hypofunction of the pituitary gland. Causative lesions may include primary masses of the pituitary such as pituitary microadenomas and macroadenomas, as well as extrinsic masses, typically centered in the suprasellar cistern. Clinical syndromes related to hormonal dysfunction can be caused by excessive hormonal secretion or by inhibited secretion due to mass effect upon elements of the hypothalamic-pituitary axis. Additionally, complications such as hemorrhage may be seen in the setting of an underlying mass and can result in hormonal dysfunction. MRI with high-resolution protocols is the best first-line test to evaluate the sella turcica and parasellar region. CT provides complementary information regarding bony anatomy, and may be appropriate as a first-line test in certain instances, but it provides less detail and lesion characterization when compared to MRI. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. [ABSTRACT FROM AUTHOR]

Abstract The ongoing expansion of global trade and human mobility are causing increased occurrences of biosecurity outbreaks, particularly of invasive pests which threaten biodiversity and agricultural production. Smallholder farmers are particularly vulnerable, as they are generally not well-prepared for such incursions. In Australia, farmers with non-English speaking backgrounds are more likely to be influenced by these increasing risks and may need long-term adaptive support. Understanding farmers' perceptions of biosecurity threats, and what drives these perceptions, is a prerequisite for designing effective biosecurity management policies to support livelihoods and food security. In this study, we aim to understand the perceptions of smallholder farmers' on biosecurity threats and the factors influencing their perceptions. Data was obtained from a survey of 101 Vietnamese farmers across three geographically dispersed locations in Australia (Northern Territory, South Australia, and Western Australia). Using the Protection Motivation Theory, we found that 43% of farmers perceived biosecurity threats to be one of the key agricultural risks, preceded by weather-related risk (48%) and produce price fluctuations (45%). Belief in the existence of biosecurity threats and the sources of information on biosecurity matters had a significant positive influence on farmers' overall perceptions of biosecurity threats on four dimensions of their life. English levels had a significant influence on their perceptions of biosecurity threats on crop output whereas farm size, gender, and farmers' age did not significantly affect farmers' overall perceptions of biosecurity threats. The findings of this study could be used by government agencies and industry associations to better target support for farmers to minimise the threats of pest and disease incursions. Support could be delivered through the introduction of relevant extension services and education programs with more transparent and direct communications of risk and compliances, improving farmers' knowledge and belief in biosecurity and fostering trust between farmers and the government. Highlights • Biosecurity threats were perceived as one of key agricultural risks (43%). • Farmers' perceptions of biosecurity threats were explored in four main dimensions of their life. • Belief, information, trust and risk experience had positive influence on farmers' perceptions of biosecurity threats. • English levels were found to have negative influence on farmers' perceptions of biosecurity threats. [ABSTRACT FROM AUTHOR]

Graphical abstract Abstract With the immense pressure to sustain competitiveness in manufacturing, the strategy of digitizing this industry sector is vital. With the onset of new ICT technology and big data capabilities, the physical asset and data computation is integrated in manufacturing through Cyber Physical Systems (CPS). This Industry 4.0 strategy will significantly improve maintenance of machines and processes. Current big-data approaches focus on data available in production systems for monitoring purposes. However, data processing to define critical characteristic values for condition monitoring and maintenance remains challenging. Large and special-purpose machine tools are constantly re-configured regarding process, workpiece and machine itself, thus increasing the complexity of determining limit values. Therefore, it is not possible to execute a robust condition monitoring without structured data-analyses considering different machine states. Fuzzy-clustering of machine states over time creates a stable pool representing different typical machine configuration clusters. Hence, new and discontinuous machine states can be gradually attributed to such clusters to interpret their key characteristic values and limits, even when the concrete configuration never occurred before. [ABSTRACT FROM AUTHOR]

In July 2021, intense rainfall in parts of Western Europe was followed by unprecedented flash flooding. The flooding killed many people, mostly in Germany, which was subsequently blamed on a lack of preparation by either authorities or the broader populace. Knowledge about people's awareness of a hazard, its impacts and possible adaptation can help improve hazard management. We used social media data to assess situational awareness, sentiments and behaviour before, during and after the flood. We analysed nearly 58,000 German Twitter (now X) messages about the flood using machine learning-based unsupervised topic modelling. We showed that message frequency translated into four phases with message content suggesting sender priorities shifted in each phase of the flood. Besides messages with weather updates, correlated topics included 'Solidarity, recovery and aid' and 'Grief and empathy' (together 22% of all tweets) and a set of four topics about climate change attribution, extreme weather, long-term flood protection measures and politics (together 38% of all tweets). Many topics depended on the phase of the flood and on the distance from the affected areas. For those near the affected areas, tweets about evacuation (in peak phase) and damage assessment (in recovery phase) were particularly prominent. The high engagement on Twitter to seek weather information might indicate awareness of the extreme climatic conditions before the flood, but the severity was unexpected. Social media data provided unprecedent citizen-generated real-time information. We discuss how rapid automated analysis could contribute to disaster communication and risk mitigation. [ABSTRACT FROM AUTHOR]

• 80,000 Twitter tweets on Australian bushfires were analysed using machine learning. • Topics and sentiments reflected fire phases, • Concerns about impacts shifted from personal through health to ecological. • Tweets of people in fire affected areas mostly positive, especially during recovery. • Misinformation about fire origins a minor short-lived issue. Social media is widely used in emergencies, but the nature of the communication is poorly understood. We employed unsupervised topic modelling and sentiment analysis to analyse more than 80,000 Twitter tweets posted by users in Australia over a six-month period before, during and after the severe bushfires in 2019–2020, dubbed the 'Black Summer'. While tweets about bushfire updates dominated, politics, donations and support, impacts and public opinion were also prominent themes. Social impacts were important in the early phase of the fires (Sept & Oct 2019) with health impacts discussed when the fires were most intense and ecological impacts becoming important in the recovery phase. Twitter users also talked about emergency responses, mainly evacuation, as the fires were starting, showing that Twitter played an important role in communicating advice to leave early to avoid harm. Although the bushfires caused death, destruction and disruption, the sentiment of tweets was balanced − 40% of all tweets were positive, 36% negative and the remainder neutral (24%). Sentiments shifted little over time, but some topics were strongly associated with the expression of negative sentiments. The unusual severity of the fires was attributed to climate change in the early and recovery phases but misinformation about arson as a cause briefly diverted attention from climate change in the middle. Twitter was used to express anger about a lack of action by the Australian government to address climate change. Unexpectedly, Twitter users from the most affected areas were more likely to post positive tweets than those further away, particular during recovery, suggesting both resilience and gratitude for support provided to them. Analysis of trend data on Twitter using machine learning has the potential to identify, in real time, whether appropriate messages are reaching and being disseminated effectively, provide early warning of potentially harmful misinformation and, if undertaken repeatedly, provide a metric against which responses to fire can be measured. [ABSTRACT FROM AUTHOR]

• 58% of respondents from Australia are satisfied with their climate. • 86% of respondents use air-conditioning (AC) to cool their homes. • The preferred average set-point temperature is 21.7 °C (SD: 2.6 °C). • Heat tolerance affects AC use, set-point temperature and energy needs. • Younger people are less tolerant of warm temperatures than older cohorts. While the optimal mean annual temperature for people and nations is said to be between 13 °C and 18 °C, many people live productive lives in regions or countries that commonly exceed this temperature range. One such country is Australia. We carried out an Australia-wide online survey using a structured questionnaire to investigate what temperature people in Australia prefer, both in terms of the local climate and within their homes. More than half of the 1665 respondents (58%) lived in their preferred climatic zone with 60% of respondents preferring a warm climate. Those living in Australia's cool climate zones least preferred that climate. A large majority (83%) were able to reach a comfortable temperature at home with 85% using air-conditioning for cooling. The preferred temperature setting for the air-conditioning devices was 21.7 °C (SD: 2.6 °C). Higher temperature set-points were associated with age, heat tolerance and location. The frequency of air-conditioning use did not depend on the location but rather on a range of other socio-economic factors including having children in the household, the building type, heat stress and heat tolerance. We discuss the role of heat acclimatisation and impacts of increasing air-conditioning use on energy consumption. [ABSTRACT FROM AUTHOR]

Social capital constitutes an important resource in vulnerable cities of the developing world where formal disaster management capacities are weak, responses are limited, and socio-economic deprivations run deep along spatial dimensions. Yet, little is known about how the different types of social capital contribute to flood preparedness and better community resilience, particularly in informal settlement settings. Drawing on a survey of 391 respondents in Old Fadama, an informal settlement in Ghana, and using structural equation modelling, we found that personal and collective social capitals are significant predictors of flood preparedness and community resilience. However, collective social capital has a stronger predictive ability than personal social capital. Also, flood preparedness mediated the relationship between personal and collective social capital and community resilience. This makes it imperative for disaster managers and policymakers to recognise and work within the existing individual and collective networks, which has the potential to activate "soft" capital accumulation necessary to transition communities from vulnerability to resilience. [ABSTRACT FROM AUTHOR]

Large aortic aneurysm and acute and chronic aortic dissection are pathologies of the aorta requiring surgery. Recent advances in medical intervention have improved patient outcomes; however, a clear understanding of the mechanisms leading to aortic failure and, hence, a better understanding of failure risk, is still missing. Biomechanical analysis of the aorta could provide insights into the development and progression of aortic abnormalities, giving clinicians a powerful tool in risk stratification. The complexity of the aortic system presents significant challenges for a biomechanical study and requires various approaches to analyse the aorta. To address this, here we present a holistic review of the biomechanical studies of the aorta by categorising articles into four broad approaches, namely theoretical, in vivo , experimental and combined investigations. Experimental studies that focus on identifying mechanical properties of the aortic tissue are also included. By reviewing the literature and discussing drawbacks, limitations and future challenges in each area, we hope to present a more complete picture of the state-of-the-art of aortic biomechanics to stimulate research on critical topics. Combining experimental modalities and computational approaches could lead to more comprehensive results in risk prediction for the aortic system. [ABSTRACT FROM AUTHOR]

Abstract Additive manufacturing is used in several industrial sectors where polymers and metals are established materials. Different academic studies prove that additive manufacturing methods can be applied on glass materials using powder or fiber based material sources. In terms of quartz glass, with melting temperatures around 2200°C, laser sources are used to achieve the necessary intensities. In the present study, additive manufacturing of quartz glass is achieved by melting a quartz glass fiber with a CO 2 laser source. A combined laser head focusses the laser radiation onto the glass fiber in order to melt the fiber. A three axis system is used to move the printing stage and glass substrate. The experimental investigations show that CO 2 -laser glass deposition printing allows for the creation of arbitrary 3D quartz glass structures. This method is envisioned to replace conventional manual glass manufacturing processes for production of complex hollow glass structures which are present in the medical sector. [ABSTRACT FROM AUTHOR]

Haplotype-specific extraction (HSE) is a new field of application for the separation of mitochondrial DNA (mtDNA) mixtures and is developed to identify the mtDNA haplotypes of the contributors subsequently by sequencing. Here we show the validation of HSE with an exemplary mitochondrial DNA mixture into its individual haplotypes according to our laboratory standards. These specify several critical areas of assay performance to be tested, such as sensitivity, robustness and mixture studies comprising varying proportions of their components,degraded samples and samples of different qualities and material. Wereport the successful and unambiguous analysis of the exemplary separated mitochondrial DNA mixture under various conditions as well as simulated casework samples, which manifest as mixed nucleotide calls at single base positions previously. Here we demonstrate that the HSE assay is high sensitive, stable against degradation and applicable in a wide range of sample qualities. Based on our findings from the validation study, we believe that this assay has great potential power and may be useful for distinguishing among the mtDNA of individuals and their geographical origin in mixed DNA samples. [ABSTRACT FROM AUTHOR]

Abstract The increasing amount of publicly available data streams of environmental observation stations opens up new opportunities: domain experts are provided with an extensive amount of observations covering large areas with high density of environmental sensors, which could hardly ever be provided by a single organization. However, these opportunities come at the cost of new challenges regarding trustworthiness and comparability of such observations. In this paper, we address the challenges of semantic validation and enrichment of heterogeneous observation streams by exploiting collaboratively created and curated annotations. For this purpose, we introduce and discuss the Linked Stream Annotation Engine (LSane) to validate observation messages from heterogeneous sensors. We enrich these observation messages with provenance information derived from annotations. We present an implementation of LSane with messages from public and private environmental observation stations, which are mapped to explicit semantics, and validate and enrich the mapped messages based on annotations from the LSane collaboration platform. [ABSTRACT FROM AUTHOR]

Abstract Autonomous virtual agents that operate in complex IoT environments and apply machine learning algorithms face two fundamental challenges: (i) they usually lack sufficient start-up knowledge and (ii) hence are incapable to adequately adjust their internal knowledge base and decision-making policies during runtime to meet specific user requirements and preferences. This is problematic in Ambient Assisted Living (AAL) and Health-Care (HC) scenarios, since an agent has to expediently operate from the beginning of its lifecycle and adequately address the target users' needs; without prior user and environmental knowledge, this is not possible. The presented approach addresses these problems by providing a semantic use-case simulation framework that can be tailored to specific AAL and HC use cases. It builds upon a semantic knowledge representation framework to simulate device events and user activities based on semantic task and ambient descriptions. Through such a simulated environment, agents are provided with the ability to learn the best matching actions and to adjust their policies based on generated datasets. We demonstrate the practical applicability of the simulation framework through the evaluation of the chronic kidney disease pathway from the vCare EC project. Thereby, we proof that an agent that uses reinforcement learning (RL) is able to improve its performance during and after the training and thus makes optimal (activity) recommendations to a prospective patient. [ABSTRACT FROM AUTHOR]

Tephra deposits correlated between nearby lakes provide the opportunity to improve age estimates of the sediment sequences, even if the ages of the tephras are previously unknown. We explore this potential using cryptotephras and visible tephra deposits in sediment cores from Upper and Lower Whitshed Lakes near Cordova, Alaska. Each tephra was described in terms of visual stratigraphy and shard morphology, and the major-oxide glass geochemistry was analyzed. Independent age models were developed for the cores using radiocarbon ages and profiles of short-lived radioisotopes for the near-surface sediments. Four tephras were correlated between the two lakes based on the magnitude and spacing of magnetic susceptibility peaks and glass major-oxide geochemistry. These correlations confirm agreement of the age models because the independently modeled confidence intervals overlap for each correlated tephra. The stratigraphic correlations were subsequently used to improve the age models by extracting the subset of possible age-model iterations that produce similar ages for each of the four correlated tephras at the two lakes. The iterations that agree within 25 years for each correlated tephra were used to create tephra-matched age models for both lakes, which narrowed the width of the 95% confidence intervals of the age models by 3% overall and reduced the uncertainty in age estimates of the correlated tephras by 34% on average. This synchronization technique may be useful in other studies that have multiple independently dated records with confident stratigraphic correlations. [ABSTRACT FROM AUTHOR]

The Shirasuka lowlands, located on the Enshu-nada coast of central Japan, record evidence for numerous extreme wave events. Here we test the applicability of using the luminescence signal from feldspars to date these young (<1000 a) extreme wave event deposits. The signal used for dating is the IRSL signal (measured at 50 °C) as part of a post-IR IRSL 130 procedure. We demonstrate that this IRSL 50 (pre-IR 130 ) signal results in reliable ages when corrected for fading, and the post-IR IRSL 130 stimulation functions as an optical wash for both the natural/regenerated luminescence signal (L x ) and the test dose signal (T x ), lowering the recuperation and removing any remaining charge from previous steps in the protocol. The single grain IRSL 50 (pre-IR 130 ) ages generated cover the historical record of the past 800 years and correlate well with past earthquakes and tsunamis in 1361 CE, 1498 CE and 1605 CE. Another identified tsunami deposit may correlate with the 1707 CE earthquake and tsunami. A slope failure deposit, probably caused by the earthquake in 1944 CE, is also identified. This study demonstrates that accurate ages can be determined for the young, extreme wave events at this site using the luminescence signal from feldspars. [ABSTRACT FROM AUTHOR]

Previous research notes difficulties in functioning and low quality of life (QoL) among transition-age youth on the autism spectrum, and poor mental health may contribute to these difficulties. This study examined the role of autism symptom severity and mental health problems on self-reported functioning and QoL in treatment-seeking transition-age autistic youth. The study included 140 autistic youth (16–25 years, M = 20.44 (SD = 2.95); n = 91 females [65%], n = 42 males [30%], n = 7 non-binary [5%]). We assessed functioning using a structured interview and QoL through a self-report questionnaire. Factors potentially associated with functioning and QoL were assessed using standardized self-report questionnaires of autism symptom severity, symptoms of anxiety and depression, and information from medical records. Participants reported functioning on the 90th percentile compared to general population norms, indicating significant disability, and also rated low overall QoL. Regression analysis showed that autism symptom severity and anxiety symptoms, and to some extent gender and having an ADHD diagnosis, explained 46% of the variance in overall functioning. Symptoms of anxiety and depression, and to a lesser extent, active friendship, explained 43% of the variance in QoL. Sampling limitations of the study include the overrepresentation of women and newly diagnosed participants. We highlight that functioning and QoL are multifactorial, necessitating a comprehensive assessment of transition-aged autistic youth, including mental health problems, to plan tangible interventions. • Treatment seeking transition-aged autistic youth without intellectual disability reported functioning difficulties and low quality of life. • Autism symptom severity and mental health problems (symptoms of anxiety or depression; co-occurring ADHD) contributed to low functioning. • The impact of anxiety and depression symptoms on QoL was found to be stronger than the influence of autism symptom severity. • A comprehensive assessment, including self-reported autistic traits and mental health problems, would improve treatment planning. [ABSTRACT FROM AUTHOR]

A particularly challenging aspect of forensic casework is the accurate interpretation of samples that contain DNA from more than one contributor, since DNA analysis of specific identification markers often results in ambiguous mixed profiles. Physically separating the various haploid components of a diploid or polyploid DNA sample or of a specimen containing DNA from multiple individuals can resolve this problem. We adapted and combined previously developed methods of haplotype-specific extraction (HSE) to separate and analyze mitochondrial DNA (mtDNA) in samples containing DNA from two individuals. After optimizing conditions and probes, we performed HSE to separate mitochondrial DNA mixtures, which manifest as mixed nucleotide calls at single base positions. We were able to subsequently identify the DNA of the two individuals by sequencing. Based on our findings from this proof-of-concept experiment, this novel assay will be useful for distinguishing among the mtDNA of individuals in mixed DNA samples. [ABSTRACT FROM AUTHOR]

Introduction Indications and surgical techniques for pulmonary metastasectomy (PME) are controversially discussed issues. Laser-assisted surgery (LAS) is a recent innovation that has been advocated especially in patients with multiple pulmonary metastases (PM). However, there are hardly any studies comparing surgical outcomes after laser-assisted and conventional resection. The aim of the current study was to evaluate the value of LAS in a larger study population. Materials & methods A retrospective analysis was completed on 178 consecutive patients undergoing 236 PMEs at a single center between 2010 and 2015. The main endpoint was survival. Statistical analysis was performed using the Kaplan–Meier method and survival rates were compared with the log rank test. Follow-up was done with special attention to the development of recurrent PM. Local relapse was defined as a recurrent metastasis in direct relation to the previously resected area according to CT scan comparisons. Results LAS was performed on 256 metastases in 99 patients, non-laser-assisted surgery (NLAS) on 127 metastases in 79 patients. 5-year-survival rates were 69.3% in all patients, 65.7% after LAS and 73.6% after NLAS. There was no statistically significant survival difference after LAS or NLAS (p = 0.41). The rate of local relapse was 0.8% after LAS vs 3.1% after NLAS (p = 0.073). Conclusion Despite a larger number of negative predictors for survival in LAS patients, overall survival (OS) was similar in the compared groups. There was also a trend for a lower risk of local relapses after LAS. Therefore, LAS should be considered a promising method for PME. [ABSTRACT FROM AUTHOR]

Purpose: Most patients with juvenile idiopathic arthritis (JIA) have temporomandibular joint (TMJ) involvement, but little is known about the natural history of TMJ disease as these children enter adulthood. The purpose of this study was to evaluate adults with a history of JIA to document the frequency and severity of TMJ abnormalities and morbidity. The authors hypothesized that most would have persistent TMJ disease as adults.Materials and Methods: This cross-sectional study included adults (>19 years of age) with JIA who were managed at Boston Children's Hospital (BCH) as children and at Brigham and Women's Hospital (BWH) as adults. History of a TMJ problem was not considered for enrollment. Patients completed a questionnaire and underwent physical examination and maxillofacial cone-beam computed tomography (CBCT). Additional data were obtained from medical records. Associations between TMJ abnormalities at CBCT and arthritis history, TMJ pain and function, facial asymmetry, malocclusion, and cephalometric analysis were examined.Results: Of 129 eligible patients contacted, 21 (42 TMJs) were enrolled. Mean age was 26.0 ± 6.1 years and mean duration of care for JIA at the BCH and BWH was 13.7 ± 6.5 years. TMJ pain was present in 62% of patients (n = 13); 43% (n = 9) had a TMJ functional limitation and 76% (n = 16) had lower facial asymmetry. Abnormalities were found in the TMJs on 55% of CBCT scans, with 79% showing bilateral deformities. There was at least 1 cephalometric measurement of mandibular size or position that was more than 1 standard deviation beyond normal in 81% of patients (n = 17). Only 4 patients (19%) had previously been evaluated for a TMJ problem.Conclusion: TMJ abnormalities and related morbidity are common in adult patients with a history of JIA. Therefore, an early screening protocol for TMJ involvement in children with a new diagnosis of JIA would be beneficial and long-term follow-up into adulthood should be routine. [ABSTRACT FROM AUTHOR]

Abstract: Large interactive surfaces have found increased popularity in recent years. However, with increased surface size ergonomics become more important, as interacting for extended periods may cause fatigue. Curved is a large-surface interaction device, designed to follow the natural movement of a stretched arm when performing gestures. It tracks one or two hands above the surface, using an array of capacitive proximity sensors and supports both touch and mid-air gestures. It requires specific object tracking methods and the synchronized measurement from 32 sensors. We have created an example application for users wearing a virtual reality headset while seated that may benefit from haptic feedback and ergonomically shaped surfaces. A prototype with adaptive curvature has been created that allows us to evaluate gesture recognition performance and different surface inclinations. [ABSTRACT FROM AUTHOR]

Condition Monitoring and Maintenance prediction are permanent demands of state-of-the-art machine tools. Their IT-infrastructure including drive control systems and specific sensors deliver extensive amounts of data for monitoring. However to combine and link this data to define critical characteristic values remains challenging. The paper presents a novel approach to deal with these tasks. Firstly equal machine states are detected at different times by checking and comparing several parameters. If an equal state is detected an algorithm is executed which leads to a characteristic value. The value as well as its limits is self-adapting and time-depending by constant redefining based on the machine history. [ABSTRACT FROM AUTHOR]

• Strava captures spatial and temporal variation in recreational activity accurately. • Under-representation of young, elderly, and low socioeconomic status groups. • Trend analyses need to account for growth in Strava usership and time of year. • Adoption of Strava in urban planning depends on precision/bias requirements. Recreational activity is the single most valuable ecosystem service in many developed countries with a range of benefits for public health. Crowdsourced recreational activity data is increasingly being adopted in management and monitoring of urban landscapes, however inherent biases in the data make it difficult to generalize patterns to the total population. We used in-situ observations and questionnaires to quantify accuracy in Strava data - a widely used outdoor activity monitoring app – in Oslo, Norway. The precision with which Strava data captured the spatial (R2 = 0.9) and temporal variation (R2 = 0.51) in observed recreational activity (cyclist and pedestrian) was relatively high for monthly time series during summer, although precision degraded at weekly and daily resolutions and during winter. Despite the precision, Strava exhibits significant biases relative to the total recreationist population. Strava activities represented 2.5 % of total recreationist activity in 2016, a proportion that increased steadily to 5.7 % in 2020 due to a growing usership. Strava users are biased toward cyclists (8 % higher than observed), males (15.7 % higher) and middle-aged people (20.4 % higher for ages 35–54). Strava pedestrians that were able to complete a questionnaire survey (>19 years) were biased to higher income brackets and education levels. Future studies using Strava data need to consider these biases – particularly the under-representation of vulnerable age (children/elderly) and socio-economic (poor/uneducated) groups. The implementation of Strava data in urban planning processes will depend on accuracy requirements of the application purpose and the extent to which biases can be corrected for. [ABSTRACT FROM AUTHOR]