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Mowing along Indiana's state and interstate highways is currently performed with flex-wing mowers towed by tractors. This configuration can be quite dangerous, incurring several fatal accidents in recent years. INDOT has expressed interest in exploring alternatives that are safer for both motorists and workers on Indiana roadways. The solution being explored in this study is a fleet of smaller autonomous systems to perform the mowing operations instead. Smaller vehicles reduce the severity of any collisions, and smarter autonomy may be better able to avoid collisions entirely. Additionally, this system would physically separate the equipment operator from mowing operations, eliminating risks to them.

Item does not contain fulltext, INTRODUCTION: Chemoradiotherapy (CRT) is the standard of care in inoperable non-small-cell lung cancer (NSCLC) patients, favoring concurrent (cCRT) over sequential CRT (seqCRT), with adjuvant immunotherapy in responders. Elderly and frail NSCLC patients have generally been excluded from trials in the past. In elderly patients however, the higher treatment related morbidity of cCRT, may outweigh the possible lower tumor control of seqCRT. For elderly patients with locally advanced NSCLC real-world data is essential to be able to balance treatment toxicity and treatment outcome. The aim of this study is to analyze acute toxicity and 3-month mortality of curative chemoradiation (CRT) in patients with stage III NSCLC and to analyze whether cCRT for elderly stage III NSCLC patients is safe. METHODS: The Dutch Lung Cancer Audit-Radiotherapy (DLCA-R) is a national lung cancer audit that started in 2013 for patients treated with curative intent radiotherapy. All Dutch patients treated for stage III NSCLC between 2015 and 2018 with seqCRT or cCRT for (primary or recurrent) stage III lung cancer are included in this population-based study. Information was collected on patient, tumor- and treatment characteristics and the incidence and severity of acute non-hematological toxicity (CTCAE-4 version 4.03) and mortality within 3 months after the end of radiotherapy. To evaluate the association between prognostic factors and outcome (acute toxicity and mortality within 3 months), an univariable and multivariable analysis was performed. The definition of cCRT was:radiotherapy started within 30 days after the start of chemotherapy. RESULTS: Out of all 20 Dutch departments of radiation oncology, 19 centers participated in the registry. A total of 2942 NSCLC stage III patients were treated with CRT. Of these 67.2% (n = 1977) were treated with cCRT (median age 66 years) and 32.8% (n = 965) were treated with seqCRT (median age 69 years). Good performance status (WHO 0-1) was scored in 88

This 2023 statement updates clinical guidance for homozygous familial hypercholesterolaemia (HoFH), explains the genetic complexity, and provides pragmatic recommendations to address inequities in HoFH care worldwide. Key strengths include updated criteria for the clinical diagnosis of HoFH and the recommendation to prioritize phenotypic features over genotype. Thus, a low-density lipoprotein cholesterol (LDL-C) >10 mmol/L (>400 mg/dL) is suggestive of HoFH and warrants further evaluation. The statement also provides state-of-the art discussion and guidance to clinicians for interpreting the results of genetic testing and for family planning and pregnancy. Therapeutic decisions are based on the LDL-C level. Combination LDL-C-lowering therapy - both pharmacologic intervention and lipoprotein apheresis (LA) - is foundational. Addition of novel, efficacious therapies (i.e. inhibitors of proprotein convertase subtilisin/kexin type 9, followed by evinacumab and/or lomitapide) offers potential to attain LDL-C goal or reduce the need for LA. To improve HoFH care around the world, the statement recommends the creation of national screening programmes, education to improve awareness, and management guidelines that account for the local realities of care, including access to specialist centres, treatments, and cost. This updated statement provides guidance that is crucial to early diagnosis, better care, and improved cardiovascular health for patients with HoFH worldwide.

The increasing global demand for air cargo shipments, driven by trade growth and the need for fast transportation, creates pressures on the air cargo supply chain to ensure efficient, safe, and reliable operations. The current documentation process, a mix of digital and paper-based systems, introduces inefficiencies and potential safety risks. This thesis explores the barriers, opportunities and potential solutions for a complete e-Freight implementation in the air cargo supply chain, that is, a completely paperless documentation process. Due to the lack of specific literature on the documentation process in the air cargo supply chain and the dearth of empirical studies, the research aims to identify and categorize potential barriers to e-Freight implementation and ascertain the current state of e-Freight implementation within AirFrance-KLM Martinair Cargo (AFKLMP Cargo). The study conducted an extensive literature review on related topics to create a theoretical conceptual barrier overview. An empirical study was executed at AFKLMP Cargo using a single in-depth case study approach with multiple sub-cases at various outstations worldwide. Semi-structured interviews, informal expert conversations, and direct observations were used to gather data, which was then analysed using a bottom-up coding method. The findings revealed 21 barriers to e-Freight implementation, grouped into seven main categories. These barriers are complex, interrelated, and include organizational, social & cultural, economic & financial, technical/technological, market, regulatory, and standardization issues. The lack of unified industry standards complicates the transition, leading to country-specific restrictions and processes that obstruct e-Freight's universal application. The disconnect between the organization and the market exacerbates this issue, failing to effectively communicate the importance and benefits of digital documentation standards. Additionally, the company's, Complex Systems Engineering and Management (CoSEM)

Previous studies regarding sham tDCS have indicated that expectation priming (Rabipour et al, 2018; Turi et al, 2016), and also reward promise have been able to modulate sham tDCS (Jones et al. 2015). The current study aimed to investigate how expectation priming and reward promise affected reaction times and accuracy on a flanker task during sham tDCS. Participants were divided into four groups, receiving either positive or neutral expectation priming, and either a reward promise or no reward promise. A two-factor ANOVA was used to analyse the data. Results indicated no effects of expectation priming nor reward promise on reaction times. Results did indicate that participants who were positively primed made less errors compared to neutrally primed participants. Similarly, participants receiving the extra reward instruction made less errors compared to participants in the no reward condition. The current study findings suggest that expectation priming, and reward promise are able to modulate sham tDCS effects. One important note is that the current study only included sham tDCS, therefore conclusions comparing active and sham tDCS cannot be made. We discussed our current findings and how these relate to previous studies. Recommendations were made for future research regarding investigating the effects of expectation priming and reward in sham tDCS.

This 2023 statement updates clinical guidance for homozygous familial hypercholesterolaemia (HoFH), explains the genetic complexity, and provides pragmatic recommendations to address inequities in HoFH care worldwide. Key strengths include updated criteria for the clinical diagnosis of HoFH and the recommendation to prioritize phenotypic features over genotype. Thus, a low-density lipoprotein cholesterol (LDL-C) >10 mmol/L (>400 mg/dL) is suggestive of HoFH and warrants further evaluation. The statement also provides state-of-the art discussion and guidance to clinicians for interpreting the results of genetic testing and for family planning and pregnancy. Therapeutic decisions are based on the LDL-C level. Combination LDL-C-lowering therapy-both pharmacologic intervention and lipoprotein apheresis (LA)-is foundational. Addition of novel, efficacious therapies (i.e. inhibitors of proprotein convertase subtilisin/kexin type 9, followed by evinacumab and/or lomitapide) offers potential to attain LDL-C goal or reduce the need for LA. To improve HoFH care around the world, the statement recommends the creation of national screening programmes, education to improve awareness, and management guidelines that account for the local realities of care, including access to specialist centres, treatments, and cost. This updated statement provides guidance that is crucial to early diagnosis, better care, and improved cardiovascular health for patients with HoFH worldwide.© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.