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Abstract Photovoltaic (PV) panel deployment for decarbonization may reduce local terrestrial albedo, triggering a positive radiative forcing that counteracts the desired negative radiative forcing from carbon emission reductions. Yet, this potential adverse impact remains uncertain due to limited observations at PV sites. Herein we employ a robust linear parameterization method to quantify PV-induced albedo changes based on satellite data globally. We find an overall albedo decrease of −1.28 (−1.80, −0.90) × 10−2 (median and interquartile range), specific for land-cover types and climate regimes. However, the extent of albedo reduction is markedly lower than simplistic assumed values in simulating climate feedback for solar farming in Earth system models. Moreover, the albedo-induced positive radiative forcing can be offset by negative radiative forcing from clean solar generation in most PV farms within one year. Our findings underscore PV’s potential in mitigating global warming and stress the need for more accurate model estimations.

BackgroundCardiac monitoring strategies to detect occult atrial fibrillation (AF) post-stroke differ among healthcare institutions. This may be related to discrepancies in stroke subtype classification/adjudication, and/or consultation of cardiology specialists at Community Hospitals (CoH) and Academic Centers (AcC). Identifying the degree of heterogeneity may encourage development of guideline-directed monitoring protocols, result in higher AF detection rates and treatments, and fewer strokes.MethodsThe DiVERT (SeconDary Stroke PreVEntion ThRough Pathway ManagemenT) study was designed to characterize post-stroke cardiac monitoring practices in a hospital setting. Care pathways were assessed with in-person stakeholder interviews; patient-level data were reviewed using electronic medical records.ResultsDiVERT identified 2,475 patients with diagnoses of cryptogenic (83.6% vs. 33.1%, p

Abstract Atomically thin layered van der Waals heterostructures feature exotic and emergent optoelectronic properties. With growing interest in these novel quantum materials, the microscopic understanding of fundamental interfacial coupling mechanisms is of capital importance. Here, using multidimensional photoemission spectroscopy, we provide a layer- and momentum-resolved view on ultrafast interlayer electron and energy transfer in a monolayer-WSe2/graphene heterostructure. Depending on the nature of the optically prepared state, we find the different dominating transfer mechanisms: while electron injection from graphene to WSe2 is observed after photoexcitation of quasi-free hot carriers in the graphene layer, we establish an interfacial Meitner-Auger energy transfer process following the excitation of excitons in WSe2. By analysing the time-energy-momentum distributions of excited-state carriers with a rate-equation model, we distinguish these two types of interfacial dynamics and identify the ultrafast conversion of excitons in WSe2 to valence band transitions in graphene. Microscopic calculations find interfacial dipole-monopole coupling underlying the Meitner-Auger energy transfer to dominate over conventional Förster- and Dexter-type interactions, in agreement with the experimental observations. The energy transfer mechanism revealed here might enable new hot-carrier-based device concepts with van der Waals heterostructures.

IntroductionThe efficiency and safety of complex high precision human-machine systems such as in aerospace and robotic surgery are closely related to the cognitive readiness, ability to manage workload, and situational awareness of their operators. Accurate assessment of mental workload could help in preventing operator error and allow for pertinent intervention by predicting performance declines that can arise from either work overload or under stimulation. Neuroergonomic approaches based on measures of human body and brain activity collectively can provide sensitive and reliable assessment of human mental workload in complex training and work environments.MethodsIn this study, we developed a new six-cognitive-domain task protocol, coupling it with six biomedical monitoring modalities to concurrently capture performance and cognitive workload correlates across a longitudinal multi-day investigation. Utilizing two distinct modalities for each aspect of cardiac activity (ECG and PPG), ocular activity (EOG and eye-tracking), and brain activity (EEG and fNIRS), 23 participants engaged in four sessions over 4 weeks, performing tasks associated with working memory, vigilance, risk assessment, shifting attention, situation awareness, and inhibitory control.ResultsThe results revealed varying levels of sensitivity to workload within each modality. While certain measures exhibited consistency across tasks, neuroimaging modalities, in particular, unveiled meaningful differences between task conditions and cognitive domains.DiscussionThis is the first comprehensive comparison of these six brain-body measures across multiple days and cognitive domains. The findings underscore the potential of wearable brain and body sensing methods for evaluating mental workload. Such comprehensive neuroergonomic assessment can inform development of next generation neuroadaptive interfaces and training approaches for more efficient human-machine interaction and operator skill acquisition.

Marine renewable energy is gaining prominence as a crucial component of the energy supply in coastal cities due to proximity and minimal land requirements. The synergistic potential of integrating floating photovoltaics with offshore wind turbines presents an encouraging avenue for boosting power production, amplifying spatial energy generation density, and mitigating seasonal output fluctuations. While the global promise of offshore wind-photovoltaic hybrid systems is evident, a definitive understanding of their potential remains elusive. Here, we evaluate the resource potential of the hybrid systems under geographical constraints, offering insights into sustainable and efficient offshore energy solutions. We compile a database with 11,198 offshore wind turbine locations from Sentinel-1 imagery and technical parameters from commercial project details. Our analysis reveals an underutilization of spatial resources within existing offshore wind farms, yielding a modest 26 kWh per square meter. Furthermore, employing realistic climate-driven system simulations, we find an impressive potential photovoltaic generation of 1372 ± 18 TWh annually, over seven times higher than the current offshore wind capacity. Notably, floating photovoltaics demonstrated remarkable efficiency, matching wind turbine output with a mere 17 % of the wind farm area and achieving an average 76 % increase in power generation at equivalent investment costs. Additionally, the hybrid wind and photovoltaic systems exhibit monthly-scale complementarity, reflected by a Pearson correlation coefficient of -0.78, providing a consistent and reliable power supply. These findings support the notion that hybrid offshore renewable energy could revolutionize the renewable energy industry, optimize energy structures, and contribute to a sustainable future for coastal cities.

Abstract Background Insertable cardiac monitors (ICMs) are a clinically effective means of detecting atrial fibrillation (AF) in high-risk patients, and guiding the initiation of non-vitamin K oral anticoagulants (NOACs). Their cost-effectiveness from a US clinical payer perspective is not yet known. The objective of this study was to evaluate the cost-effectiveness of ICMs compared to standard of care (SoC) for detecting AF in patients at high risk of stroke (CHADS2 ≥ 2), in the US. Methods Using patient data from the REVEAL AF trial (n = 393, average CHADS2 score = 2.9), a Markov model estimated the lifetime costs and benefits of detecting AF with an ICM or with SoC (specifically intermittent use of electrocardiograms and 24-h Holter monitors). Ischemic and hemorrhagic strokes, intra- and extra-cranial hemorrhages, and minor bleeds were modelled. Diagnostic and device costs, costs of treating stroke and bleeding events and medical therapy—specifically costs of NOACs were included. Costs and health outcomes, measured as quality-adjusted life years (QALYs), were discounted at 3% per annum, in line with standard practice in the US setting. One-way deterministic and probabilistic sensitivity analyses (PSA) were undertaken. Results Lifetime per-patient cost for ICM was $31,116 versus $25,330 for SoC. ICMs generated a total of 7.75 QALYs versus 7.59 for SoC, with 34 fewer strokes projected per 1000 patients. The model estimates a number needed to treat of 29 per stroke avoided. The incremental cost-effectiveness ratio was $35,528 per QALY gained. ICMs were cost-effective in 75% of PSA simulations, using a $50,000 per QALY threshold, and a 100% probability of being cost-effective at a WTP threshold of $150,000 per QALY. Conclusions The use of ICMs to identify AF in a high-risk population is likely to be cost-effective in the US healthcare setting.

Here, the authors observe tightly bound, valley-polarized, UV-emissive trions in monolayer transition metal dichalcogenide transistors. These are quasiparticles composed of an electron from a high-lying conduction band with negative effective mass, a hole from the first valence band, and an additional charge from a band-edge state.

Abstract Terrestrial ecosystems are fully coupled with the climate. The planet has been greening owing to the increased vegetation growth in response to the changing atmosphere, which in turn has feedback on the climate. Greening has slowed down the rise in global land-surface air temperature mainly through a coincident increase of evapotranspiration and precipitation in wet regions. In dry regions, greening intensifies the decrease in soil moisture induced by greening-enhanced transpiration. Uncertain, however, is how the climate effects of greening in semi-arid lands might differ for variable wet and dry conditions. Here, we focus on the biosphere–atmosphere interactions in Australia by modeling the perturbation of vegetation changes under various states of sea surface temperature (SST), including the climatology mean, El Niño, and La Niña conditions. For the dry conditions of El Niño, greening exacerbates water stress and largely depletes the soil moisture, while for the wet conditions of La Niña, greening-enhanced evapotranspiration and precipitation resupply the soil moisture. For the normal conditions using the climatology mean SST, a small decrease in soil moisture occurs but with large spatial contrast because of heterogeneous changes of evapotranspiration and precipitation induced by greening. We emphasize that the alternating dry and wet conditions modulated by the large-scale climate variability are vital to understanding the response of climate to greening. Furthermore, vegetation-based warming mitigation policies need to be cautious when inferring distinct climate effects associated with greening.

Introduction To investigate the associations of a lifestyle score with various cardiovascular risk markers, indicators for fatty liver disease as well as MRI-determined total, subcutaneous and visceral adipose tissue mass in adults with new-onset diabetes.Research design and methods This cross-sectional analysis included 196 individuals with type 1 (median age: 35 years; median body mass index (BMI): 24 kg/m²) and 272 with type 2 diabetes (median age: 53 years; median BMI: 31 kg/m²) from the German Diabetes Study. A healthy lifestyle score was generated based on healthy diet, moderate alcohol consumption, recreational activity, non-smoking and non-obese BMI. These factors were summed to form a score ranging from 0 to 5. Multivariable linear and non-linear regression models were used.Results In total, 8.1% of the individuals adhered to none or one, 17.7% to two, 29.7% to three, 26.7% to four, and 17.7% to all five favorable lifestyle factors. High compared with low adherence to the lifestyle score was associated with more favorable outcome measures, including triglycerides (β (95% CI) −49.1 mg/dL (−76.7; −21.4)), low-density lipoprotein (−16.7 mg/dL (−31.3; −2.0)), and high-density lipoprotein cholesterol (13.5 mg/dL (7.6; 19.4)), glycated hemoglobin (−0.5% (−0.8%; −0.1%)), high-sensitivity C reactive protein (−0.4 mg/dL (−0.6; −0.2)), as well as lower hepatic fat content (−8.3% (−11.9%; −4.7%)), and visceral adipose tissue mass (−1.8 dm³ (−2.9; −0.7)). The dose–response analyses showed that adherence to every additional healthy lifestyle factor was associated with more beneficial risk profiles.Conclusions Adherence to each additional healthy lifestyle factor was beneficially associated with cardiovascular risk markers, indicators of fatty liver disease and adipose tissue mass. Strongest associations were observed for adherence to all healthy lifestyle factors in combination.Trial registration number NCT01055093.

Abstract Background Urban agriculture is potentially an important piece of the food security puzzle for a rapidly growing urban world population. Community gardening is also promoted as a safe and viable form of exercise for aging populations in crowded settings where opportunities to participate in other action activities may be limited. Knowledge of potential site-specific health risks to environmental contaminants is important in dialogues promoting urban farming. Methods We assess the pseudo-total concentrations of selected potentially toxic elements (PTEs) in the soils of community gardens, public parks, and woodlands in the tropical urban island nation of Singapore. We compare concentrations of cadmium, copper, lead, and zinc with amalgamated risk guidelines to form a baseline understanding of the level of contamination in these spaces. We also perform providence tracking with lead isotopes to identify potential sources of contaminants. Results All pseudo-total concentrations of Cd, Cu, Pb, and Zn in the soil were below threshold concentrations considered to represent substantial risk. Further, PTE concentrations in gardens were largely equivalent to those found in community parks and woodlands, but the geographical distribution varied. Provenance tracking with Pb isotopes indicated Pb in gardens was both anthropogenic and natural, but spatially variable. The lack of strong spatial clustering of areas with the highest PTE concentrations was inconsistent with a common point source of contamination. However, the correlation between Cu and Zn suggest a common source for these elements, such as road/trafficking or atmospheric deposition. Conclusion We find limited risk of urban gardeners to exposure to Cd, Cu, Pb, and Zn—elements that are commonly abundant in urban settings with dense transportation networks and substantial industrial activities. The low levels of PTEs are encouraging for the promotion of urban farming for food production and leisure in this dense urban setting. However, as concentrations were low, we did not assess bioavailability and bioaccessibility of the PTEs. These assessments would need to be determined in cases of with higher levels of contamination to provide a more thorough consideration of actual human risk.

Abstract The sixth assessment report of the IPCC indicates low-to-high confidence in trends of extreme rainfall with regional inconsistency in the tropics, where a key phenomenon causing intra-seasonal variations in weather is the Madden–Julian Oscillation (MJO). It remains unknown how the MJO-induced extreme rainfall and the societal exposure may change in response to global warming and climate mitigation attempts. Here, using eight CMIP6 models that capture the eastward-propagating MJO structure and amplitude, we detect a nearly 60% increase in extreme rainfall over tropical Asia and Australia by the end of the 21st century under the fossil-fueled warming scenario (SSP5-8.5); 84% of this change is associated with MJO-induced extreme rainfall. Extreme rainfall increases are modulated by the warming-induced asymmetric changes in MJO phase characteristics, occurring mostly over the lands with distinct zonal differences. The region that is most likely to be affected includes Malaysia, Indonesia, and northern Australia where 96.68 million people and 9.72 million km2 of urban areas are exposed to potential danger stemming from extreme rainfall. More than 95% (99%) of the population (urban) exposure can be potentially avoided under the “middle of the road” development (SSP2-4.5) scenario, whereby CO2 emissions hover around current levels before starting to fall mid-century.

Background: Lower heart rates (HRs) prolong diastole, which increases filling pressures and wall stress. As a result, lower HRs may be associated with higher brain natriuretic peptide (BNP) levels and incident atrial fibrillation (AF). Beta-blockers may increase the risk for AF due to suppression of resting HRs. Objective: Examine the relationships of HR, BNP, beta-blockers and new-onset AF in the REVEAL-AF and SPRINT cohort of subjects at risk for developing AF. Methods: In REVEAL-AF, 383 subjects without a history of AF and a mean CHA2DS2VASC score of 4.4 ± 1.3 received an insertable cardiac monitor and were followed up to 30 months. In SPRINT, 7595 patients without prior history of AF and a mean CHA2DS2VASC score of 2.3 ± 1.2 were followed up to 60 months. Results: The median daytime HR in the REVEAL-AF cohort was 75bpm [IQR 68–83]. Subjects with below-median HRs had 2.4-fold higher BNP levels compared to subjects with above-median HRs (median BNP [IQR]: 62 pg/dl [37−112] vs. 26 pg/dl [13–53], p

This study examined the effects of two substrates (SOIL and COMMERCIAL) and grass on the green roof runoff quality in Singapore. Ten events were sampled over a 9-month period. Rainfall and green roof runoff from grass and bare experimental configurations were tested for total organic carbon (TOC), nitrogen and phosphorus nutrients (NO3−-N and PO43−-P), cations/anions and trace metals (Fe, Cu, Zn, Cd and Pb). All configuration units neutralised acid rainfall and removed metals except Fe despite their proximity to an industrial area. Concentrations decrease over the monitoring period for most water quality variables. The COMMERCIAL (COM) configurations elevated Cl− (3.8–10.8 ppm), SO42− (1.5–32.4 ppm), NO3−-N (7.8–75.6 ppm) and NH4+-N (22.0–53.1 ppm) concentrations in the runoff. Concentrations of NO3−-N (4.5–67.7 ppm) and NH4+-N (14.7–53.0 ppm) remained high at the end of the monitoring period for the COMgrass configuration, even with dilution from monsoon rainfall, making it suitable as an irrigation water source and a fertiliser substitute. The SOIL substrate retained N-nutrients, TOC and trace metals with concentrations comparable or below rainfall inputs. This substrate is suitable for widespread green roof applications in Singapore and other tropical cities. We recommend substrate testing before their approval for use on green roofs and encourage the long-term monitoring of these systems. HIGHLIGHTS All configurations removed trace metals and neutralised acid rainfall despite close proximity to an industrial area.; Substrates low in organic matter content were found to be suitable for widespread implementation in Singapore.; High nutrient concentrations in green roof runoff make them suitable for irrigating urban greenery.;

The accuracy of existing forest cover products typically suffers from “rounding” errors arising from classifications that estimate the fractional cover of forest in each pixel, which often exclude the presence of large, isolated trees and small or narrow forest clearings, and is primarily attributable to the moderate resolution of the imagery used to make maps. However, the degree to which such high-resolution imagery can mitigate this problem, and thereby improve large-area forest cover maps, is largely unexplored. Here, we developed an approach to map tropical forest cover at a fine scale using Planet and Sentinel-1 synthetic aperture radar (SAR) imagery in the Google Earth Engine platform and used it to map all of Southeastern Asia’s forest cover. The machine learning approach, based on the Random Forests models and trained and validated using a total of 37,345 labels collected from Planet imagery across the entire region, had an accuracy of 0.937 and an F1 score of 0.942, while a version based only on Planet imagery had an accuracy of 0.908 and F1 of 0.923. We compared the accuracy of our resulting maps with 5 existing forest cover products derived from medium-resolution optical-only or combined optical-SAR approaches at 3,000 randomly selected locations. We found that our approach overall achieved higher accuracy and helped minimize the rounding errors commonly found along small or narrow forest clearings and deforestation frontiers where isolated trees are common. However, the forest area estimates varied depending on topographic location and showed smaller differences in highlands (areas >300 m above sea level) but obvious differences in complex lowland landscapes. Overall, the proposed method shows promise for monitoring forest changes, particularly those caused by deforestation frontiers. Our study also represents one of the most extensive applications of Planet imagery to date, resulting in an open, high-resolution map of forest cover for the entire Southeastern Asia region.

This study investigates the presence and concentrations of emerging and persistent contaminants (EPCs) in rainwater and throughfall water collected from urban areas and agricultural lands in northern Thailand. It focuses on one daily-use compound (caffeine), two industrial compounds (4-nitrophenol and tris(2-butoxyethyl) phosphate (TBEP)), and three agrichemicals (atrazine, fenobucarb, and 2,4-D). Additionally, information is provided regarding the presence of acetaminophen, fexofenadine, diphenhydramine, and gabapentin. Small differences in the chemical composition of the six main contaminants were observed between rainwater and forest throughfall water. However, significant variations were found in the concentration ranges of each EPC. In most cases, throughfall samples exhibited slightly higher concentrations, suggesting a limited contribution from dry deposition compared to rainfall. Limited reliable evidence was found concerning seasonal patterns in EPC concentrations in precipitation (rainfall and throughfall) and surface water samples in remote ponds and reservoirs. The transportation of EPCs via rainwater appears to vary among the compounds tested and is likely to vary from one rainfall event to another, rather than showing a strong and common seasonal response within the monsoon rainfall regime. These findings suggest that the transport of EPCs to remote areas via rainfall does occur for some EPCs. However, the dominance of this process over other transport mechanisms could not be determined with high confidence.

Here, the authors report on evidence of an excitonic species formed by electrons in high-energy conduction band states with a negative effective mass, explaining previous observations of quantum interference phenomena in two-dimensional semiconductors.

Abstract This paper proposes a regionalization method for streamflow prediction in ungauged watersheds in the 7461 km2 area above the Gharehsoo Hydrometry Station in the Ardabil Province, in the north of Iran. First, the Fuzzy c-means clustering method (FCM) was used to divide 46 gauged (19) and ungauged (27) watersheds into homogenous groups based on a variety of topographical and climatic factors. After identifying the homogenous watersheds, the Soil and Water Assessment Tool (SWAT) was calibrated and validated using data from the gauged watersheds in each group. The calibrated parameters were then tested in another gauged watershed that we considered as a pseudo ungauged watershed in each group. Values of R-Squared and Nash–Sutcliffe efficiency (NSE) were both ≥ 0.70 during the calibration and validation phases; and ≥ 0.80 and ≥ 0.74, respectively, during the testing in the pseudo ungauged watersheds. Based on these metrics, the validated regional models demonstrated a satisfactory result for predicting streamflow in the ungauged watersheds within each group. These models are important for managing stream quantity and quality in the intensive agriculture study area.

Abstract Objective Prevention of recurrent stroke in patients with embolic stroke of undetermined source (ESUS) is challenging. The advent of safer anticoagulation in the form of direct oral anticoagulants (DOACs) has prompted exploration of prophylactic anticoagulation for all ESUS patients, rather than anticoagulating just those with documented atrial fibrillation (AF). However, recent trials have failed to demonstrate a clinical benefit, while observing increased bleeding. We modeled the economic impact of anticoagulating ESUS patients without documented AF across multiple geographies. Methods CRYSTAL-AF trial data were used to assess ischaemic stroke event rates in ESUS patients confirmed AF-free after long-term monitoring. Anticipated bleeding event rates (including both minor and major bleeds) with aspirin, dabigatran 150 mg, and rivaroxaban 20 mg were sourced from published meta-analyses, whilst a 30% ischaemic stroke reduction for both DOACs was assumed. Cost data for clinical events and pharmaceuticals were collected from the local payer perspective. Results Compared with aspirin, dabigatran and rivaroxaban resulted in 17.9 and 29.9 additional bleeding events per 100 patients over a patient’s lifetime, respectively. Despite incorporating into our model the proposed 30% reduction in ischaemic stroke risk, both DOACs were cost-additive over patient lifetime, as the costs of bleeding events and pharmaceuticals outweighed cost savings associated with the reduction in ischaemic strokes. DOACs added £5953–£7018 per patient (UK), €6683–€7368 (Netherlands), €4933–€9378 (Spain), AUD$5353–6539 (Australia) and $26,768–$32,259 (US) of payer cost depending on the agent prescribed. Additionally, in the U.S. patient pharmacy co-payments ranged from $2468–$12,844 depending on agent and patient plan. In all settings, cost-savings could not be demonstrated even when the modelling assumed 100% protection from recurrent ischaemic strokes, due to the very low underlying risk of recurrent ischaemic stroke in this population (1.27 per 100 patient-years). Conclusions Anticoagulation of non-AF patients may cause excess bleeds and add substantial costs for uncertain benefits, suggesting a personalised approach to anticoagulation in ESUS patients.

In an effort to improve tools for effective flood risk assessment, we applied machine learning algorithms to predict flood-prone areas in Amol city (Iran), a site with recent floods (2017–2018). An ensemble approach was then implemented to predict hazard probabilities using the best machine learning algorithms (boosted regression tree, multivariate adaptive regression spline, generalized linear model, and generalized additive model) based on a receiver operator characteristic-area under the curve (ROC-AUC) assessment. The algorithms were all trained and tested on 92 randomly selected points, information from a flood inundation survey, and geospatial predictor variables (precipitation, land use, elevation, slope percent, curve number, distance to river, distance to channel, and depth to groundwater). The ensemble model had 0.925 and 0.892 accuracy for training and testing data, respectively. We then created a vulnerability map from data on building density, building age, population density, and socio-economic conditions and assessed risk as a product of hazard and vulnerability. The results indicated that distance to channel, land use, and runoff generation were the most important factors associated with flood hazard, while population density and building density were the most important factors determining vulnerability. Areas of highest and lowest flood risks were identified, leading to recommendations on where to implement flood risk reduction measures to guide flood governance in Amol city.

As forest loss is accelerating in tropical mountains globally, protected areas (PAs) are seen as bastions to protect sensitive ecosystems, preserve biodiversity, and safeguard headwater catchments from degradation. However, the effectiveness of PAs in preventing forest conversion has rarely been determined. Complicating the issue is that many PAs are inhabited to some extent by long-standing residents, causing illegal logging that is commonly reported. To assess the effectiveness of PAs in preserving forests, as well as investigate the drivers of forest loss in/near PAs, we compare forest loss rates inside and outside PAs before and after their establishment in a tropical mountain region (northern Thailand, the epicenter of mainland Southeast Asia, including 84 PAs). Over the 17-year period from 2000 to 2016, we found that the percentage of forest loss was lower within the PAs than outside (1.69% versus 4.94%). Mean annual forest loss in the PAs was 20% of that in unprotected area. Total forest loss inside PAs included 888.12 km2 (1.93%) in national parks, 325.18 km2 (1.34%) in wildlife sanctuaries/conservation areas and 16.37 km2 (0.65%) in no hunting areas. Forest loss also tended to be highest along boundaries within a 300-m buffer both inside and outside the PAs. Using gradient boosting decision trees, we determined that accessibility variables (elevation, and distance to road) and population were key drivers associated with forest loss in PAs. Further, we found a two-year lagged correlation between forest loss in PAs and international maize price (R2 = 0.73, p

Training to master a new skill often takes a lot of time, effort, and financial resources, particularly when the desired skill is complex, time sensitive, or high pressure where lives may be at risk. Professions such as aircraft pilots, surgeons, and other mission-critical operators that fall under this umbrella require extensive domain-specific dedicated training to enable learners to meet real-world demands. In this study, we describe a novel neuroadaptive training protocol to enhance learning speed and efficiency using a neuroimaging-based cognitive workload measurement system in a flight simulator. We used functional near-infrared spectroscopy (fNIRS), which is a wearable, mobile, non-invasive neuroimaging modality that can capture localized hemodynamic response and has been used extensively to monitor the anterior prefrontal cortex to estimate cognitive workload. The training protocol included four sessions over 2 weeks and utilized realistic piloting tasks with up to nine levels of difficulty. Learners started at the lowest level and their progress adapted based on either behavioral performance and fNIRS measures combined (neuroadaptive) or performance measures alone (control). Participants in the neuroadaptive group were found to have significantly more efficient training, reaching higher levels of difficulty or significantly improved performance depending on the task, and showing consistent patterns of hemodynamic-derived workload in the dorsolateral prefrontal cortex. The results of this study suggest that a neuroadaptive personalized training protocol using non-invasive neuroimaging is able to enhance learning of new tasks. Finally, we outline here potential avenues for further optimization of this fNIRS based neuroadaptive training approach. As fNIRS mobile neuroimaging is becoming more practical and accessible, the approaches developed here can be applied in the real world in scale.

Reforestation is an eco-friendly strategy for countering rising carbon dioxide concentrations in the atmosphere and the negative effects of forest loss and degradation. China, with one of the world’s most considerable afforestation rates, has increased its forest cover from 16.6% 20 years ago to 23.0% by 2020. However, the maximum potential forest coverage achieved via tree planting and restoration is uncertain. To map potential tree coverage across China, we developed a random forest regression model relating environmental factors and appropriate forest types. We estimate 67.2 million hectares of land currently available for tree restoration after excluding existing forested areas, urban areas, and agriculture land covers/uses, which is 50% higher than the current understanding. Converting these lands to the forest would generate 3.99 gigatons of new above- and belowground carbon stocks, representing an important contribution to achieving carbon neutrality. This potential is spatially imbalanced, with the largest restorable carbon potential being located in the southwest (29.5%), followed by the northeast (17.2%) and northwest (16.8%). Our study highlights the need to align tree restoration areas with the uneven distribution of carbon sequestration potential. In addition to being a biological mitigation strategy to partially offset carbon dioxide emissions from fossil fuel burning, reforestation should provide other environmental services such as the restoration of degraded soils, conservation of biological diversity, revitalization of hydrological integrity, localized cooling, and improvement in air quality. Because of the collective benefits of forest restoration, we encourage that such activities be ecosystem focused as opposed to solely focusing on tree planting.

Diagnosing cardiac pauses that could produce syncopal episodes is important to guide appropriate therapy. However, the infrequent nature of these episodes can make detection challenging with conventional monitoring (CM) strategies with short-term ECG monitors. Insertable cardiac monitors (ICMs) continuously monitor for arrhythmias but present a higher up-front cost. It is not well understood whether these higher costs are offset by the costs of repeat evaluation in CM strategies. We simulated the likelihood of diagnostic success and cost-per-diagnosis of pause arrhythmias with CM strategies compared to ICM monitoring. ICM device data from syncope patients diagnosed with pause arrhythmias was utilized to simulate patient pathways and diagnostic success with CM. We assumed that detected true pause episodes (≥5 seconds) were symptomatic and prompted a hospital encounter and further evaluation with CM. Subsequent true pause episodes in yet-undiagnosed patients triggered additional rounds of CM. Costs of monitoring were accrued at each encounter and represent the U.S. payer perspective. Cost per diagnosed patient was calculated as the total costs accrued for all patients divided by the number of patients diagnosed, across 1,000 simulations. During a mean 505±333 days of monitoring ICM detected 2.4±2.7 pause events per patient, with an average of 109±94 days until the first event. CM was projected to diagnose between 13.8% (24-hour Holter) and 30.2% (two 30-day monitors) of the ICM-diagnosed patients. Total diagnostic costs per ICM-diagnosed patient averaged $7,847, whereas in the CM strategies average cost-per-diagnosis ranged from $12,950±2,589 with 24-hour Holter to $32,977±14,749 for two 30-day monitors. Relative to patients diagnosed with pause arrhythmias via ICM, CM strategies diagnose fewer patients and incur higher costs per diagnosed patient.

We report an experimental study of temperature-dependent spectral line shapes of phonon sideband emission stemming from dark excitons in monolayer and bilayer WSe_{2}. Using photoluminescence spectroscopy in the range from 4 to 100 K, we observe a pronounced asymmetry in the phonon-assisted luminescence from momentum-indirect exciton reservoirs. We demonstrate that the corresponding spectral profiles are distinct from those of bright excitons with direct radiative decay pathways. The line-shape asymmetry reflects thermal distribution of exciton states with finite center-of-mass momenta, characteristic for phonon sideband emission. The extracted temperature of the exciton reservoirs is found to generally follow that of the crystal lattice, with deviations reflecting overheated populations. The latter are most pronounced in the bilayer case and at lowest temperatures. Our results add to the understanding of phonon-assisted recombination of momentum-dark excitons and, more generally, establish means to access the thermal distribution of finite-momentum excitons in atomically thin semiconductors with indirect band gaps.

The capacity factor (CF) is a vital parameter used to quantify the performance and efficiency of a wind turbine. An increase in generation efficiency leads to higher wind power production, improving the economics within the growing global wind market. In this research, we use a data-driven statistical method to explore the contributions of the three main drivers of CF change: turbine aging, changes in wind speed, and technological improvements. We find that for the group of old turbines (operated before 2008) with an unchanging technical condition, wind increases contributed ∼10% to the increasing CF on average from 2010 to 2020. For new turbines (built from 2008 to 2020), technological improvements had a strong positive effect on CF from 2015 to 2020, exceeding the effect of wind increases and offsetting the effects of aging. On average, rising wind speeds increased CF by ∼5% per year, while technological improvements increased it by ∼12%. As the installed capacity of wind turbines grew, technological progress became the dominant driver in CF increase. However, poor site selection potentially compromised the positive effect on CF afforded by technology changes early in the decade.

Stimulated Raman scattering (SRS) microscopy enables label-free chemical imaging at high speed, but has been limited by low sensitivity. Here, the authors demonstrate plasmon-enhanced SRS microscopy and achieve single molecule detection sensitivity.

Background Guideline recommendations for oral anticoagulation (OAC) in patients with atrial fibrillation (AF) are based on CHA2DS2‐VASc score alone. Patients with cardiac implantable electronic devices provide an opportunity to assess how the interaction between AF duration and CHA2DS2‐VASc score influences OAC prescription rates. Methods and Results Data from the Optum de‐identified Electronic Health Record data set were linked to the Medtronic CareLink database of cardiac implantable electronic devices. An index date was assigned as the later of 6 months after device implant or 1 year after Electronic Health Record data availability. Maximum daily AF duration (no AF, 6 minutes–23.5 hours, and >23.5 hours) was assessed for 6 months before index date. OAC prescription rates were computed as a function of both AF duration and CHA2DS2‐VASc score. A total of 35 779 patients with CHA2DS2‐VASc scores ≥1 were identified, including 27 198 not prescribed OAC. Overall OAC prescription rate among the 12 938 patients with device‐detected AF >6 minutes was 36.7% and significantly higher in those with a maximum daily AF duration >23.5 hours (45.4%) compared with those with 6 minutes to 23.5 hours (28.7%). OAC prescription rates increased monotonically with both increasing AF duration and CHA2DS2‐VASc score, reaching a maximum of 67.2% for patients with AF >23.5 hours and a CHA2DS2‐VASc score ≥5. Conclusions Real‐world prescription of OAC increased with both increasing duration of AF and CHA2DS2‐VASc score. This highlights the need for further research into the role of AF duration, stroke risk, and the need for anticoagulation in patients with devices capable of long‐term AF monitoring.

Abstract To address the lack of adequate measures for flood risk reduction in Nepal, where recurrent flood‐related hazards have had grave consequences for many people over the past decades, we develop a flood risk assessment model for a study area in the Sindhupalchok District. The model considers direct and indirect damages that are assigned to four asset categories (hydropower plants, roads, houses, and farmlands) and two scenarios (low‐exposure‐low‐flood and high‐exposure‐high‐flood scenarios). Model results indicate the following: (a) the planned expansion of hydropower plants reflected in the high exposure scenario is responsible for a substantial increase of economic damage compared with the low scenario and (b) for both scenarios, flood damage is largely related to road closures, which result in the loss of income for villagers and the loss of customs revenues. As this study aims both to provide methods for the assessment of flood risk and to demonstrate them in a case study, we discuss future work related to model‐based flood risk assessments that are needed towards flood risk reduction in Nepal.

Piperlongumine (PL), a natural small molecule derived from the Piper longum Linn plant, has received growing interest as a prooxidative drug with promising anticancer properties. Yet, the influence of PL on primary human T cells remained elusive. Knowledge of this is of crucial importance, however, since T cells in particular play a critical role in tumor control. Therefore, we investigated the effects of PL on the survival and function of primary human peripheral blood T cells (PBTs). While PL was not cytotoxic to PBTs, it interfered with several stages of T cell activation as it inhibited T cell/APC immune synapse formation, co-stimulation-induced upregulation of CD69 and CD25, T cell proliferation and the secretion of proinflammatory cytokines. PL-induced immune suppression was prevented in the presence of thiol-containing antioxidants. In line with this finding, PL increased the levels of intracellular reactive oxygen species and decreased glutathione in PBTs. Diminished intracellular glutathione was accompanied by a decrease in S-glutathionylation on actin suggesting a global alteration of the antioxidant response. Gene expression analysis demonstrated that TH17-related genes were predominantly inhibited by PL. Consistently, the polarization of primary human naïve CD4+ T cells into TH17 subsets was significantly diminished while differentiation into Treg cells was substantially increased upon PL treatment. This opposed consequence for TH17 and Treg cells was again abolished by thiol-containing antioxidants. Taken together, PL may act as a promising agent for therapeutic immunosuppression by exerting prooxidative effects in human T cells resulting in a diminished TH17 but enhanced Treg cell differentiation.

China has realized a 56-fold increase in installed wind capacity, from 5.9 GW in 2007 to 328 GW in 2021. In addition to increasing installed capacity, plans to substantially increase wind energy production for climate change mitigation also depend on future wind speeds, which strongly influences the efficiencies of installed turbines within individual wind farms. A reversal in globally decreasing wind speeds over several decades has been reported previously. However, subsequent studies using other data sources reported only a slight increase or no reversal in China. These uncertainties regarding China’s wind energy production hamper estimates of wind energy production potential. Here, our analysis of quality-controlled wind speed measurements from in-situ stations shows that the wind speed decline in China reversed significantly since 2012 ( P < 0.001), but with substantial spatio-temporal variability. We further estimated the capacity factor (CF) growth and the wind power gain solely associated with the changes in wind speed ranges from 31.6 to 56.5 TWh yr ^−1 based on the 2019 installed capacity. This estimate explains 22.0%–39.3% of the rapid increase in wind generation CF in China during 2012–2019. The result implies that the site selection of wind farms should consider both current wind situation and future wind speed trends. Further studies are needed to understand the driving factor of wind speed recovery in support of the wind energy industry.

The impact of rapid urbanization on the spatiotemporal pattern of short-term extreme precipitation in China remains unclear at the subnational scale. In this study, we present a general framework that measures urbanization-induced variation in hourly extreme wet season precipitation (April–October) from 1985 to 2012, with reference to a dynamic urban–rural station classification based on annual changes in urban extent. We found that urbanization in south China (

Objective To evaluate the cost-effectiveness of insertable cardiac monitors (ICMs) compared with standard of care (SoC) for detecting atrial fibrillation (AF) in patients at high risk of stroke (CHADS2 >2), using a UK National Health Service (NHS) perspective.Methods Using patient characteristics and clinical data from the REVEAL AF trial, a Markov model assessed the cost-effectiveness of detecting AF with an ICM compared with SoC. Costs and benefits were extrapolated across modelled patient lifetime. Ischaemic and haemorrhagic strokes, intracranial and extracranial haemorrhages and minor bleeds were modelled. Diagnostic and device costs were included, plus costs of treating stroke and bleeding events and costs of oral anticoagulants (OACs). Costs and health outcomes, measured as quality-adjusted life years (QALYs), were discounted at 3.5% per annum. One-way deterministic and probabilistic sensitivity analyses (PSA) were undertaken.Results The total per-patient cost for ICM was £13 360 versus £11 936 for SoC (namely, annual 24 hours Holter monitoring). ICMs generated a total of 6.50 QALYs versus 6.30 for SoC. The incremental cost-effectiveness ratio (ICER) was £7140/QALY gained, below the £20 000/QALY acceptability threshold. ICMs were cost-effective in 77.4% of PSA simulations. The number of ICMs needed to prevent one stroke was 21 and to cause a major bleed was 37. ICERs were sensitive to assumed proportions of patients initiating or discontinuing OAC after AF diagnosis, type of OAC used and how intense the traditional monitoring was assumed to be under SoC.Conclusions The use of ICMs to identify AF in a high-risk population is cost-effective for the UK NHS.

Background: The HAVOC score was previously developed to predict the risk of atrial fibrillation (AF) after cryptogenic stroke (CS) or transient ischemic attack (TIA). The purpose of this study was to apply the HAVOC score to patients who received insertable cardiac monitors (ICMs) in the CRYSTAL AF study. Methods: All patients from the CRYSTAL AF study who received an ICM were included. HAVOC score (one point each for peripheral vascular disease and obesity with body mass index >30, two points each for hypertension, age ⩾ 75, valvular heart disease, and coronary artery disease, 4 points for congestive heart failure) was computed for all patients. The primary endpoint was AF detection by 12 months of ICM monitoring. Results: A total of 214 patients who received ICM were included. AF was detected in 40 patients while the remaining 174 patients were AF negative. The HAVOC score was significantly higher among patients with AF [median 3.0 with interquartile range (IQR) 2–4] than those without AF [median 2.0 (IQR 0–3)], p = 0.01. AF increased significantly across the three HAVOC score groups: 11% in Group A (score 0–1), 18% in Group B (score 2–3), and 32 % in Group C (score ⩾ 4) with p = 0.02. Conclusions: The HAVOC score was shown in this post hoc analysis of CRYSTAL AF to successfully stratify AF risk post CS or TIA. The 11% AF rate in the lowest HAVOC score group highlights the significance of nontraditional contributors to AF and ischemic stroke.

The interception and smoothing effect of forest canopies on pulses of incident rainfall and its delivery to the soil has been suggested as a factor in moderating peak pore water pressure in soil mantles, thus reducing the risk of shallow landslides. Here we provide 3 years of rainfall and throughfall data in a tropical secondary dipterocarp forest characterized by few large trees in northern Thailand, along with selected soil moisture dynamics, to address this issue. Throughfall was an estimated 88 % of rainfall, varying from 86 to 90 % in individual years. Data from 167 events demonstrate that canopy interception was only weakly associated (via a nonlinear relationship) with total event rainfall, but not significantly correlated with duration, mean intensity, or antecedent 2-day precipitation (API2). Mean interception during small events (≤ 35 mm) was 17 % (n = 135 events) compared with only 7 % for large events (> 35 mm; n = 32). Examining small temporal intervals within the largest and highest intensity events that would potentially trigger landslides revealed complex patterns of interception. The tropical forest canopy had little smoothing effect on incident rainfall during the largest events. During events with high peak intensities, high wind speeds, and/or moderate-to-high pre-event wetting, measured throughfall was occasionally higher than rainfall during large event peaks, demonstrating limited buffering. However, in events with little wetting and low-to-moderate wind speed, early event rainfall peaks were buffered by the canopy. As rainfall continued during most large events, there was little difference between rainfall and throughfall depths. A comparison of both rainfall and throughfall depths to conservative mean intensity–duration thresholds for landslide initiation revealed that throughfall exceeded the threshold in 75 % of the events in which rainfall exceeded the threshold for both wet and dry conditions. Throughfall intensity for the 11 largest events (rainfall = 65–116 mm) plotted near or above the intensity–duration threshold for landslide initiation during wet conditions; 5 of the events were near or above the threshold for dry conditions. Soil moisture responses during large events were heavily and progressively buffered at depths of 1 to 2 m, indicating that the timescale of any short-term smoothing of peak rainfall inputs (i.e., ≤ 1 h) has little influence on peak pore water pressure at depths where landslides would initiate in this area. Given these findings, we conclude that canopy interception would have little effect on mitigating shallow landslide initiation during the types of monsoon rainfall conditions in this and similar tropical secondary forest sites.