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Abstract A direct quantization of the Newtonian interaction between two masses is known to establish entanglement, which if detected would witness the quantum nature of the gravitational field. Gravitational interaction is yet compatible also with gravitational decoherence models relying on classical channels, hence unable to create entanglement. Here, we show in paradigmatic cases that, despite the absence of entanglement, a classical-channel model of gravity can still establish quantum correlations in the form of quantum discord between two masses. This is demonstrated for the Kafri–Taylor–Milburn (KTM) model and a recently proposed dissipative extension of this. In both cases, starting from an uncorrelated state, a significant amount of discord is generally created. This eventually decays in the KTM model, while it converges to a small stationary value in its dissipative extension. We also find that initial local squeezing on the state of the masses can significanlty enhance the generated discord.

Introduction: The aim of our study was to evaluate the feasibility of texture analysis of epicardial fat (EF) and thoracic subcutaneous fat (TSF) in patients undergoing cardiac CT (CCT). Materials and methods: We compared a consecutive population of 30 patients with BMI ≤25 kg/m2 (Group A, 60.6 ± 13.7 years) with a control population of 30 patients with BMI >25 kg/m2 (Group B, 63.3 ± 11 years). A dedicated computer application for quantification of EF and a texture analysis application for the study of EF and TSF were employed. Results: The volume of EF was higher in group B (mean 116.1 cm3 vs. 86.3 cm3, p = 0.014), despite no differences were found neither in terms of mean density (−69.5 ± 5 HU vs. −68 ± 5 HU, p = 0.28), nor in terms of quartiles distribution (Q1, p = 0.83; Q2, p = 0.22, Q3, p = 0.83, Q4, p = 0.34). The discriminating parameters of the histogram class were mean (p = 0.02), 0,1st (p = 0.001), 10th (p = 0.002), and 50th percentiles (p = 0.02). DifVarnc was the discriminating parameter of the co-occurrence matrix class (p = 0.007).The TSF thickness was 15 ± 6 mm in group A and 19.5 ± 5 mm in group B (p = 0.003). The TSF had a mean density of −97 ± 19 HU in group A and −95.8 ± 19 HU in group B (p = 0.75). The discriminating parameters of texture analysis were 10th (p = 0.03), 50th (p = 0.01), 90th percentiles (p = 0.04), S(0,1)SumAverg (p = 0.02), S(1,-1)SumOfSqs (p = 0.02), S(3,0)Contrast (p = 0.03), S(3,0)SumAverg (p = 0.02), S(4,0)SumAverg (p = 0.04), Horzl_RLNonUni (p = 0.02), and Vertl_LngREmph (p = 0.0005). Conclusions: Texture analysis provides distinctive radiomic parameters of EF and TSF. EF and TSF had different radiomic features as the BMI varies.

Designing a robust termination scenario for a burning ITER plasma is a challenge that requires extensive core plasma and divertor modelling. The presented work consists of coupled core/edge/SOL/divertor simulations, performed with the JINTRAC code, to study the Q = 10 flat-top phase and exit phase of the ITER 15 MA/5.3 T DT scenario. The modelling utilizes the recently implemented option to treat deuterium and tritium separately in the SOL/divertor, enabling a consistent treatment of deuterium and tritium in the whole plasma volume, which is a unique capability of JINTRAC. In addition, these are the first JINTRAC simulations of this scenario that use a first-principles transport model to self-consistently model the ECRH power deposition and to include tungsten while keeping track of tungsten sputtering and accumulation. The flat-top simulations demonstrate the possibility of sustaining a steady state fusion Q of 10 using pure deuterium gas puffs together with DT mixed pellets, which is an option to make a more effective use of tritium. Simulations of the exit phase are set up sequentially, with each phase providing initial conditions for the next, starting with a density decay at full current and auxiliary power, and demonstrate the possibility of reducing the density robustly within a few seconds. Following the density decay, a subsequent auxiliary power ramp-down in H-mode is performed with a late H–L transition at low auxiliary power, which may provide an option for the optimization of the plasma termination. The final ramp-down phase consists of a current ramp-down in L-mode to 3.75 MA.

Within the 9th European Framework programme, since 2021 EUROfusion is operating five tokamaks under the auspices of a single Task Force called ‘Tokamak Exploitation’. The goal is to benefit from the complementary capabilities of each machine in a coordinated way and help in developing a scientific output scalable to future largre machines. The programme of this Task Force ensures that ASDEX Upgrade, MAST-U, TCV, WEST and JET (since 2022) work together to achieve the objectives of Missions 1 and 2 of the EUROfusion Roadmap: i) demonstrate plasma scenarios that increase the success margin of ITER and satisfy the requirements of DEMO and, ii) demonstrate an integrated approach that can handle the large power leaving ITER and DEMO plasmas. The Tokamak Exploitation task force has therefore organized experiments on these two missions with the goal to strengthen the physics and operational basis for the ITER baseline scenario and for exploiting the recent plasma exhaust enhancements in all four devices (PEX: Plasma EXhaust) for exploring the solution for handling heat and particle exhaust in ITER and develop the conceptual solutions for DEMO. The ITER Baseline scenario has been developed in a similar way in ASDEX Upgrade, TCV and JET. Key risks for ITER such as disruptions and run-aways have been also investigated in TCV, ASDEX Upgrade and JET. Experiments have explored successfully different divertor configurations (standard, super-X, snowflakes) in MAST-U and TCV and studied tungsten melting in WEST and ASDEX Upgrade. The input from the smaller devices to JET has also been proven successful to set-up novel control schemes on disruption avoidance and detachment.

Recent results from MAST Upgrade are presented, emphasising understanding the capabilities of this new device and deepening understanding of key physics issues for the operation of ITER and the design of future fusion power plants. The impact of MHD instabilities on fast ion confinement have been studied, including the first observation of fast ion losses correlated with Compressional and Global Alfvén Eigenmodes. High-performance plasma scenarios have been developed by tailoring the early plasma current ramp phase to avoid internal reconnection events, resulting in a more monotonic q profile with low central shear. The impact of m / n = 3/2, 2/1 and 1/1 modes on thermal plasma confinement and rotation profiles has been quantified, and scenarios optimised to avoid them have transiently reached values of normalised beta approaching 4.2. In pedestal and ELM physics, a maximum pedestal top temperature of ∼350 eV has been achieved, exceeding the value achieved on MAST at similar heating power. Mitigation of type-I ELMs with n = 1 RMPs has been observed. Studies of plasma exhaust have concentrated on comparing conventional and Super-X divertor configurations, while X-point target, X-divertor and snowflake configurations have been developed and studied in parallel. In L-mode discharges, the separatrix density required to detach the outer divertors is approximately a factor 2 lower in the Super-X than the conventional configuration, in agreement with simulations. Detailed analysis of spectroscopy data from studies of the Super-X configuration reveal the importance of including plasma-molecule interactions and D _2 Fulcher band emission to properly quantify the rates of ionisation, plasma-molecule interactions and volumetric recombination processes governing divertor detachment. In H-mode with conventional and Super-X configurations, the outer divertors are attached in the former and detached in the latter with no impact on core or pedestal confinement.

Mucormycosis is known to be a rare opportunistic infection caused by fungal organisms belonging to the Mucorales order, which includes the Syncephalastrum species. These moulds are rarely involved in clinical diseases and are generally seen as contaminants in clinical laboratories. However, in recent years, case reports of human infections due to Syncephalastrum have increased, especially in immunocompromised hosts. In this study, we described two new Syncephalastrum species, which were isolated from human nails and sputum samples from two different patients. We used several methods for genomic and phenotypic characterisation. The phenotypic analysis relied on the morphological features, analysed both by optical and scanning electron microscopy. We used matrix-assisted laser desorption–ionization time-of-flight mass spectrometry, energy-dispersive X-ray spectroscopy, and BiologTM technology to characterise the proteomic, chemical mapping, and carbon source assimilation profiles, respectively. The genomic analysis relied on a multilocus DNA sequence analysis of the rRNA internal transcribed spacers and D1/D2 large subunit domains, fragments of the translation elongation factor-1 alpha, and the β-tubulin genes. The two novel species in the genus Syncephalastrum, namely S. massiliense PMMF0073 and S. timoneanum PMMF0107, presented a similar morphology: irregular branched and aseptate hyphae with ribbon-like aspects and terminal vesicles at the apices all surrounded by cylindrical merosporangia. However, each species displayed distinct phenotypic and genotypic features. For example, S. timoneanum PMMF0107 was able to assimilate more carbon sources than S. massiliense PMMF0073, such as adonitol, α-methyl-D-glucoside, trehalose, turanose, succinic acid mono-methyl ester, and alaninamide. The polyphasic approach, combining the results of complementary phenotypic and genomic assays, was instrumental for describing and characterising these two new Syncephalastrum species.

Mycobacterium chimaera is a slow-growing non-tuberculous mycobacterium already known for being able to colonize cardio surgery heater–cooler units (HCUs). This study aims to describe the real magnitude of the phenomenon, providing a methodological protocol and the results of a longitudinal survey. In the period 1 January 2017–23 May 2022, over 1191 samples were collected on 35 HCUs of two different manufacturers. Among them, we identified 118 (10.3%) positive results for M. chimaera. We propose our 4-year biosurveillance experience as a practical model to minimize microbiological patients’ risk, suggesting the need for new procedures and interventions for a safer and more ecological cardio surgery.

The Stimulated Raman Adiabatic Passage, a very efficient technique for manipulating a quantum system based on the adiabatic theorem, is analyzed in the case where the manipulated physical system is interacting with a spin bath. The exploitation of the rotating wave approximation allows for the identification of a constant of motion, which simplifies both the analytical and the numerical treatment, which allows for evaluating the total unitary evolution of the system and bath. The efficiency of the population transfer process is investigated in several regimes, including the weak and strong coupling with the environment and the off-resonance. The formation of appropriate Zeno subspaces explains the lowering of the efficiency in the strong damping regime.

Project I4 is a federally funded SEED (Supporting Effective Educator Development) grant, a partnership between East Carolina University and the Institute for Educational Leadership. It is a cohort-based, yearlong professional learning experience aimed at reimagining instructional leadership through an equity lens. Specifically, school leader participants build capacity to document evidence-based, equitable academic discourse during classroom observations. To support this, they implemented a nested coaching structure, which creates a vital through line from coaches to school leaders to teachers to impact student outcomes. The model supports school leaders as instructional leaders to work more effectively with teachers in the context of their own schools with a focus on improving teachers' equitable classroom practices. Together, they cultivate stronger relational trust and identify opportunities for more equitable practices. Two interdependent principles guide their work: (1) nested coaching networks are essential; and (2) an equity focus is fundamental. Reform that sticks comes from the inside. The leadership actions that they cultivate through Project I4 are like the superglue of professional development: relational trust, nested coaching structures, evidence-based tools, and effective conversations. If school leaders work with teachers in their schools to address local concerns and engage in community learning exchange processes, they can build stronger internal capacity for change.

Through Project I4 (which aims to lift academic discourse in STEM classes), principals and other school leaders who observe faculty use tools to identify, through evidence and clear criteria, what teachers are doing well and less well. The project's tools, including a post-observation Effective Conversation Guide, address aspects of equity (such as whether all students get a chance to speak) and rigor in lessons observed by leaders.

BackgroundMany studies identify factors that contribute to renal prescribing errors, but few examine how healthcare professionals (HCPs) detect and recover from an error or potential patient safety concern. Knowledge of this information could inform advanced error detection systems and decision support tools that help prevent prescribing errors.ObjectiveTo examine the cognitive strategies that HCPs used to recognise and manage medication-related problems for patients with renal insufficiency.DesignHCPs submitted documentation about medication-related incidents. We then conducted cognitive task analysis interviews. Qualitative data were analysed inductively.SettingInpatient and outpatient facilities at a major US Veterans Affairs Medical Centre.ParticipantsPhysicians, nurses and pharmacists who took action to prevent or resolve a renal-drug problem in patients with renal insufficiency.OutcomesEmergent themes from interviews, as related to recognition of renal-drug problems and decision-making processes.ResultsWe interviewed 20 HCPs. Results yielded a descriptive model of the decision-making process, comprised of three main stages: detect, gather information and act. These stages often followed a cyclical path due largely to the gradual decline of patients' renal function. Most HCPs relied on being vigilant to detect patients' renal-drug problems rather than relying on systems to detect unanticipated cues. At each stage, HCPs relied on different cognitive cues depending on medication type: for renally eliminated medications, HCPs focused on gathering renal dosing guidelines, while for nephrotoxic medications, HCPs investigated the need for particular medication therapy, and if warranted, safer alternatives.ConclusionsOur model is useful for trainees so they can gain familiarity with managing renal-drug problems. Based on findings, improvements are warranted for three aspects of healthcare systems: (1) supporting the cyclical nature of renal-drug problem management via longitudinal tracking mechanisms, (2) providing tools to alleviate HCPs' heavy reliance on vigilance and (3) supporting HCPs' different decision-making needs for renally eliminated versus nephrotoxic medications.

The present research aims at revitalising the archaeological park of Megara Hyblaea through innovative strategies developed within the PON project “An early warning system for cultural heritage/e-WAS”. In this project Sicilian research institutions, universities and companies pursue the common goal of developing new technologies for the protection, enhancement and strategic management of the historical and cultural heritage. The ancient Greek colony of Megara Hyblaea is immersed in an industrial landscape that stretches along the coast of eastern Sicily from Augusta to Syracuse. The sense of the original place has been obliterated by an indiscriminate occupation of the land by industries which have left, here and there, an archipelago of “patrimonial wrecks”, which are equally close to the smelly chimneys and the horizon of the sea. This landscape of contrasts, dominated by petrochemical industries, has over time hindered a cultural tourism appropriate to the representativeness and importance of the asset, despite the efforts made by the authorities responsible for its protection. The paper demonstrates the need for a holistic approach to the revitalisation project of the archaeological site: the strategic design, understood as the story of the overlapping of “invisible cities”, aims to reorganise and re-conquer places through a new narrative coherent with hidden values, going as far as the experimentation of innovative technologies for the creation of facilities for the enjoyment of the park.

Abstract Background The US continues to face public health crises related to both chronic pain and opioid overdoses. Thirty percent of Americans suffer from chronic noncancer pain at an estimated yearly cost of over $600 billion. Most patients with chronic pain turn to primary care clinicians who must choose from myriad treatment options based on relative risks and benefits, patient history, available resources, symptoms, and goals. Recently, with attention to opioid-related risks, prescribing has declined. However, clinical experts have countered with concerns that some patients for whom opioid-related benefits outweigh risks may be inappropriately discontinued from opioids. Unfortunately, primary care clinicians lack usable tools to help them partner with their patients in choosing pain treatment options that best balance risks and benefits in the context of patient history, resources, symptoms, and goals. Thus, primary care clinicians and patients would benefit from patient-centered clinical decision support (CDS) for this shared decision-making process. Methods The objective of this 3-year project is to study the adaptation and implementation of an existing interoperable CDS tool for pain treatment shared decision making, with tailored implementation support, in new clinical settings in the OneFlorida Clinical Research Consortium. Our central hypothesis is that tailored implementation support will increase CDS adoption and shared decision making. We further hypothesize that increases in shared decision making will lead to improved patient outcomes, specifically pain and physical function. The CDS implementation will be guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. The evaluation will be organized by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. We will adapt and tailor PainManager, an open source interoperable CDS tool, for implementation in primary care clinics affiliated with the OneFlorida Clinical Research Consortium. We will evaluate the effect of tailored implementation support on PainManager’s adoption for pain treatment shared decision making. This evaluation will establish the feasibility and obtain preliminary data in preparation for a multi-site pragmatic trial targeting the effectiveness of PainManager and tailored implementation support on shared decision making and patient-reported pain and physical function. Discussion This research will generate evidence on strategies for implementing interoperable CDS in new clinical settings across different types of electronic health records (EHRs). The study will also inform tailored implementation strategies to be further tested in a subsequent hybrid effectiveness-implementation trial. Together, these efforts will lead to important new technology and evidence that patients, clinicians, and health systems can use to improve care for millions of Americans who suffer from pain and other chronic conditions. Trial registration ClinicalTrials.gov, NCT05256394 , Registered 25 February 2022.

Fusion generated within magnetically confined plasmas offers a promising route to clean baseload energy but the intense heat and particle flux generated in the process presents a major challenge for future power plant devices. Through a combination of experiment and computational analysis the authors develop a potential first-principals understanding of turbulent processes in the divertor of their device, where excess heat is handled, paving the way to predictive tokamak solutions for the future.

Purpose: The purpose of this study was to explore the utility of a virtual reality (VR) classroom experience for improving the capacity of instructional leaders. Specifically, school leaders used VR to build their classroom observation and analysis skills to prepare to have more effective post-observation conversations with teachers. The authors provide insights from multiple data points that highlight the affordances of the virtual setting for improving classroom observation skills. Design/methodology/approach: Drawing on the application of simulations to practice classroom observations, the authors developed a VR experience in which participants tag observable elements of academic discourse using codes from two observation protocols. The protocols identify elements of equitable student access: how teachers call on students and how they design questions. Seventy-five school leaders used the VR platform to observe a classroom scenario and code evidence of equitable classroom access. The authors analyzed data from tagging in the virtual reality scenario and triangulated these data with survey data focused on observation practices from participants' schools. A reflection component is included on the platform to collect these qualitative data. Findings: The study results indicate that the virtual reality platform provides an innovative process for leadership professional development focused on building school leaders' capacity to identify elements of academic discourse during classroom observations. Participants reported that the opportunity to practice classroom observations in a risk-free environment was useful. However, for school leaders to fully transfer the data to using in conversations with teachers, they benefit from leadership coaching. Originality/value: This study ascertains the potential effectiveness of an advanced technology for enhancing instructional leadership by using evidence-based classrooms observations to drive improvements in teaching practice. Beyond the utility of the virtual reality tool, this study provides a proof of concept for the next generation of instructional leadership through teacher observations with augmented reality.

The research presented here is part of an on-going research focused on the 3D documentation of rock-cut Underground Built Heritage with a complex morphology and characterised by narrow spaces, the Hypogeum of Calaforno (province of Ragusa, Sicily). It is one of the most interesting prehistoric monuments in Sicily in terms of size and unique rock-cut architecture. Various digital techniques have been tested over the years on the site, to represent its spatiality, such as Laser Scanner and Structure from Motion. The proposed methodological approach for the knowledge and the documentation of this archaeological site is based on an interdisciplinary approach involving archaeological and engineering disciplines. This paper focuses on the use of expeditious techniques such as iMMS (indoor Mobile Mapping Systems) based on SLAM (Simultaneous Localization and Mapping) and on the comparison of different surveying equipment in order to verify data quality and accuracy, as well as the inherent advantages of using one technology over another in relation to the characteristics of the site. Through the global verification of TLS and SLAM model reliability, we maintain that such research can contribute to enriching the protocols surrounding the archaeological investigation of sites characterized by complex morphology, irregular surfaces, narrow spaces, specific chromatic features, scarce or total lack of lighting, and physical obstacles.