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Coade stone has played a significant role in architectural and ornamental design since its inception in the early 18th century. It is well known that earlier, experimental, architectural stoneware products existed, but few of these have been studied in detail scientifically, and only one major analytical study of Coade stone has appeared in the literature. This paper presents a new spectroscopic analysis of Coade stone along with that of a newly discovered sample from Oxnead Hall in Norfolk where it known that Sir Clement Paston experimented with artificial stone in the late 16th century. The results demonstrate that it is possible to differentiate between the two variants on the basis of both the raw materials used and the different phases formed in their production processes. [ABSTRACT FROM AUTHOR]

The impacts of climate change have sparked policy responses at different governance levels. Studying the central adaptation policies and understanding the interactions and complexities of governmental and non-governmental stakeholders is essential in guiding policymakers at different levels of government to formulate policies and make investment decisions. With strategic and economic significance on the national level, Coastal Virginia has one of the highest rates of sea-level rise in the United States, instigating intensified and more frequent climate hazards such as flooding and storms. This paper strives to characterize the status of adaptation policymaking in this region through a novel keyword analysis method and a thematic analysis of interviews with the main adaptation decision-makers and stakeholders. We identify the central adaptation policies and programmes at the local, regional, state, and federal level, as well as the major relevant players. This provides a comprehensible narrative of adaptation policymaking, which could be exploited to further analyze governance gaps and adaptation challenges. The approach and methodologies of this research could be implemented in similar studies for other areas of the U.S. that are at high climate risk, possibly facilitating an informed national adaptation policy, long overdue by the federal government. The research is also relevant for other jurisdictions at risk of sea-level rise. Key policy insights Coastal adaptation policymaking in Virginia has been a bottom-up and fragmented process initiated by most affected localities, exhibiting the importance of local initiatives in higher-level adaptation policies. The long-lasting impacts of 100 Resilient cities and Dutch Dialogues in the City of Norfolk highlight the value of fostering cross-geographic coordination and capacity-building programmes, confirming the importance of informal policy networks in learning and innovation for adaptation. There is a vast difference among localities in adaptation planning and implementation, creating the need for coordinating state leadership. Adaptation policymaking in Virginia has been influenced by political cycles with priorities drastically altered by each administration change, introducing significant uncertainty for continuation of policies. National policies and programmes, such as the Inflation Reduction Act of 2022, can significantly affect local-level policies and decision-making. [ABSTRACT FROM AUTHOR]

Introduction: Demand for urgent and emergency health care in England has grown over the last decade, for reasons that are not clear. Changes in population demographics may be a cause. This study investigated associations between individuals' characteristics (including socioeconomic deprivation and long term health conditions (LTC)) and the frequency of emergency department (ED) attendances, in the Norfolk and Waveney subregion of the East of England. Methods: The study population was people who were registered with 91 of 106 Norfolk and Waveney general practices during one year from 1 April 2022 to 31 March 2023. Linked primary and secondary care and geographical data included each individual's sociodemographic characteristics, and number of ED attendances during the same year and, for some individuals, LTCs and number of general practice (GP) appointments. Associations between these factors and ED attendances were estimated using Poisson regression models. Results: 1,027,422 individuals were included of whom 57.4% had GP data on the presence or absence of LTC, and 43.1% had both LTC and general practitioner appointment data. In the total population ED attendances were more frequent in individuals aged under five years, (adjusted Incidence Rate Ratio (IRR) 1.25, 95% confidence interval 1.23 to 1.28) compared to 15–35 years); living in more socioeconomically deprived areas (IRR 0.61 (0.60 to 0.63)) for least deprived compared to most deprived,and living closer to the nearest ED. Among individuals with LTC data, each additional LTC was also associated with increased ED attendances (IRR 1.16 (1.15 to 1.16)). Among individuals with LTC and GP appointment data, each additional GP appointment was also associated with increased ED attendances (IRR 1.03 (1.026 to 1.027)). Conclusions: In the Norfolk and Waveney population, ED attendance rates were higher for young children and individuals living in more deprived areas and closer to EDs. In individuals with LTC and GP appointment data, both factors were also associated with higher ED attendance. [ABSTRACT FROM AUTHOR]

Indication-specific optimum field-of-views (FOVs) have been assessed for CBCT scans of impacted maxillary canines and mandibular third molars, as 40∅ × 35 mm and 35∅ × 35 mm, respectively. The objective was to investigate possible changes in absorbed organs and effective doses, for these two imaging indications, performing CBCT examinations with optimum FOV sizes instead of commonly used FOVs. Additionally, radiation exposure-induced cancer risk was calculated for both imaging indications with optimum FOVs. An adult female head phantom (ATOM 702-D, CIRS, Norfolk, VA, USA) was scanned using Planmeca Viso G7 CBCT-device (Planmeca, Helsinki, Finland). Scanning factors, different FOV sizes, dose-area product (DAP) values and anatomical FOV locations were used for Monte Carlo PCXMC-simulation and ImpactMC software. In the PCXMC- simulation, 10-year-old child and 30-year-old adult phantoms were used to estimating effective and absorbed organ doses. The effective dose varied from 58 µSv to 284 µSv for impacted maxillary canines, and from 38 µSv to 122 µSv for mandibular third molars, the lowest dose value for each corresponding to optimum FOV. Effective dose reduction between the optimum FOV and the smallest common FOV of 50∅ × 50 mm, maintaining other scanning factors constant, was 33% for impacted maxillary canines, and 45% for mandibular third molars. At all examinations, the highest absorbed organ doses were in salivary glands or in oral mucosa. Optimum FOVs, 40∅ × 35 mm for impacted maxillary canine and 35∅ × 35 mm for mandibular third molar, could decrease effective doses received by young patients, and improve radiation safety in these common CBCT imaging procedures. [ABSTRACT FROM AUTHOR]

Background: The noise in digital breast tomosynthesis (DBT) includes x‐ray quantum noise and detector readout noise. The total radiation dose of a DBT scan is kept at about the level of a digital mammogram but the detector noise is increased due to acquisition of multiple projections. The high noise can degrade the detectability of subtle lesions, specifically microcalcifications (MCs). Purpose: We previously developed a deep‐learning‐based denoiser to improve the image quality of DBT. In the current study, we conducted an observer performance study with breast radiologists to investigate the feasibility of using deep‐learning‐based denoising to improve the detection of MCs in DBT. Methods: We have a modular breast phantom set containing seven 1‐cm‐thick heterogeneous 50% adipose/50% fibroglandular slabs custom‐made by CIRS, Inc. (Norfolk, VA). We made six 5‐cm‐thick breast phantoms embedded with 144 simulated MC clusters of four nominal speck sizes (0.125–0.150, 0.150–0.180, 0.180–0.212, 0.212–0.250 mm) at random locations. The phantoms were imaged with a GE Pristina DBT system using the automatic standard (STD) mode. The phantoms were also imaged with the STD+ mode that increased the average glandular dose by 54% to be used as a reference condition for comparison of radiologists' reading. Our previously trained and validated denoiser was deployed to the STD images to obtain a denoised DBT set (dnSTD). Seven breast radiologists participated as readers to detect the MCs in the DBT volumes of the six phantoms under the three conditions (STD, STD+, dnSTD), totaling 18 DBT volumes. Each radiologist read all the 18 DBT volumes sequentially, which were arranged in a different order for each reader in a counter‐balanced manner to minimize any potential reading order effects. They marked the location of each detected MC cluster and provided a conspicuity rating and their confidence level for the perceived cluster. The visual grading characteristics (VGC) analysis was used to compare the conspicuity ratings and the confidence levels of the radiologists for the detection of MCs. Results: The average sensitivities over all MC speck sizes were 65.3%, 73.2%, and 72.3%, respectively, for the radiologists reading the STD, dnSTD, and STD+ volumes. The sensitivity for dnSTD was significantly higher than that for STD (p < 0.005, two‐tailed Wilcoxon signed rank test) and comparable to that for STD+. The average false positive rates were 3.9 ± 4.6, 2.8 ± 3.7, and 2.7 ± 3.9 marks per DBT volume, respectively, for reading the STD, dnSTD, and STD+ images but the difference between dnSTD and STD or STD+ did not reach statistical significance. The overall conspicuity ratings and confidence levels by VGC analysis for dnSTD were significantly higher than those for both STD and STD+ (p ≤ 0.001). The critical alpha value for significance was adjusted to be 0.025 with Bonferroni correction. Conclusions: This observer study using breast phantom images showed that deep‐learning‐based denoising has the potential to improve the detection of MCs in noisy DBT images and increase radiologists' confidence in differentiating noise from MCs without increasing radiation dose. Further studies are needed to evaluate the generalizability of these results to the wide range of DBTs from human subjects and patient populations in clinical settings. [ABSTRACT FROM AUTHOR]

Two focus groups were conducted as part of a case study to reflect on dog park success in Norfolk, Virginia. One focus group included administrators from Norfolk Parks and Recreation dog park staff. The second focus group included member residents from neighborhood civic leagues or dog park associations. Two general guiding questions for the focus groups were: (a) What are the essential aspects of successful dog parks? and (b) What policies and procedures were developed for dog parks? Topical areas reflecting the first question included essential aspects of successful dog parks and the general benefits of dog parks. Topical areas reflecting the second question included the reasons why dog parks were established in Norfolk and the policies and procedures for establishing dog parks. City administrators and residents participating in the focus groups agreed overall about why dog parks were established in Norfolk--in response to a community need due to dense population, small yards, and apartment buildings. There was agreement between both groups regarding amenities that make dog parks successful--fencing, water, and shade; however, other amenities for success varied according to structural or functional aspects. Despite the similarities in the two focus group discussions about reasons for dog park establishment, the discussions diverged once researchers asked about policies related to the establishment and maintenance of dog parks. Residents expressed frustration with being charged with half of the establishment and upkeep of the dog park. The discussion followed frameworks of public engagement, power dynamics, and co-production/co-governance. Management implications include revisiting or adjusting policies related to dog park development (including fundraising), taking into consideration a highly transient population and its implications for dog park association leadership, consideration of a dog park liaison, and problems associated with unfenced dog parks. Norfolk dog parks were found to be highly successful and civic leaders noted Norfolk park administrators have been responsive to resident needs, and they were given an opportunity for feedback on the process. [ABSTRACT FROM AUTHOR]

Due to the various hazards of using synthetic chemical compounds in pharmaceutics, agriculture, and industry, scientists and researchers do their best to explore and assess new green natural compounds from natural resources with potent activity. The essential oil (EO) from the resin collected from Araucaria heterophylla Salisb. was extracted by the microwave technique and chemically characterized via GC-MS analysis. Furthermore, the extract EO was assessed for its antioxidant and phytotoxic activities. The EO has 33 compounds, mainly terpenes (98.23%), and the major compounds were α-pinene (62.57%), β-pinene (6.60%), germacrene D (5.88%), and β-caryophyllene (3.56%). The extracted EO showed substantial antioxidant activity, where it showed IC50 values of 142.42 and 118.03 mg L−1 for DPPH and ABTS, respectively. On the other hand, the EO revealed considerable phytotoxicity against the weed Chenopodium murale, where the EO showed IC50 values of 304.0, 230.1, and 147.1 mg L−1, for seed germination, seedling shoot growth, and seedling root growth, respectively. Moreover, the EO showed the same pattern of allelopathic inhibition against the weed Sonchus oleraceus, where it showed IC50 values of 295.7, 224.5, and 106.1 mg L−1, for seed germination, seedling shoot growth, and seedling root growth, respectively. The present study showed that the extraction technique affects the constituents of the EO, particularly the quantitative composition. The EO of A. heterophylla resin also revealed considerable antioxidant and phytotoxic activity against weeds. Therefore, it can be considered a promising natural resource that could be integrated into the weed management approach. However, further study is recommended for deep characterization of their authentic compounds and evaluation of their mode of action(s) on a wide spectrum of weeds. [ABSTRACT FROM AUTHOR]

Fast sea level rise (SLR) is causing a growing risk of flooding to coastal communities around the Chesapeake Bay (hereafter, CB or "the Bay"), but there are also significant differences in sea level variability and sea level rise rates within the bay that have not been fully investigated in the past. Therefore, monthly sea level records for 1975–2021 from eight tide gauge stations, from the upper bay at Baltimore, MD, to the lower bay at Norfolk, VA, are analyzed and compared. The results show significant spatial variations within the Bay over a wide range of time scales. The largest contribution to the seasonal variations of mean sea level in the Bay is from the annual (SA) and semiannual (SSA) tides, while the contribution from thermosteric changes is relatively smaller. The lower Bay has a ~ 5 cm smaller mean annual sea level range than the upper Bay and has a secondary minimum in mid-year due to a larger semiannual tide than the upper Bay which is dominated by the annual tide. Variations in sea level anomaly (after removing the mean seasonal cycle) show anticorrelation between the upper and lower bay. Empirical mode decomposition (EMD) analysis reveals that variations with opposite phases at the two edges of the Bay appear mostly on decadal time scales that are linked with the North Atlantic Oscillation (NAO). Sea level trends vary along the Bay—linear SLR rates (4.5–6.1 mm y−1) increase from north to south, while sea level acceleration rates (all positive in the range 0.012–0.16 mm y−2) increase from south to north. The linear SLR pattern is driven by land subsidence rates, while the acceleration pattern suggests potential impacts from climate change signals that enter the mouth of the Bay in the southeast and amplified farther north by local dynamics. Monthly sea level projections until 2100, based on past trends and the seasonal cycle of each station, are compared with different SLR scenarios based on climate models. The results suggest that accounting for local sea level acceleration in projections can result in large differences in local future sea level rise. [ABSTRACT FROM AUTHOR]

The beach is where the ancient, in the shape of diverse erratics, meets the present in the shape of corrosion, encrusting shells and invertebrate borings. Many of us have favourite beach walks, repeated whenever possible, and educating us in the common and rare clasts that might be encountered in such an ever‐changing environment. After over 12 years of patrolling the coast of north Norfolk, in eastern England, I found a common Chalk echinoid—so why am I excited? [ABSTRACT FROM AUTHOR]

Low-lying coastal cities across the world are vulnerable to the combined impact of rainfall and storm tide. However, existing approaches lack the ability to model the combined effect of these flood mechanisms, especially under climate change and sea level rise (SLR). Thus, to increase flood resilience of coastal cities, modeling techniques to improve the understanding and prediction of the combined effect of these flood hazards are critical. To address this need, this study presents a modeling system for assessing the combined flood impact on coastal cities under selected future climate scenarios that leverages ocean modeling with land surface modeling capable of resolving urban drainage infrastructure within the city. The modeling approach is demonstrated in quantifying the impact of possible future climate scenarios on transportation infrastructure within Norfolk, Virginia, USA. A series of combined storm events are modeled for current (2020) and projected future (2070) climate scenarios. The results show that pluvial flooding causes a larger interruption to the transportation network compared to tidal flooding under current climate conditions. By 2070, however, tidal flooding will be the dominant flooding mechanism with even nuisance flooding expected to happen daily due to SLR. In 2070, nuisance flooding is expected to cause a 4.6% total link close time (TLC), which is more than two times that of a 50-year storm surge (1.8% TLC) in 2020. The coupled flood model was compared with a widely used but physically simplistic bathtub method to assess the difference resulting from the more complex modeling presented in this study. The results show that the bathtub method overestimated the flooded area near the shoreline by 9.5% and 3.1% for a 10-year storm surge event in 2020 and 2070, respectively, but underestimated the flooded area in the inland region by 9.0% and 4.0% for the same events. The findings demonstrate the benefit of sophisticated modeling methods compared to more simplistic bathtub approaches, in climate adaptive planning and policy in coastal communities. [ABSTRACT FROM AUTHOR]

Background: Hand oedema is a common consequence of hand trauma or surgery. There are numerous methods to reduce hand oedema but lack high-quality evidence to support best practice. The primary objective of this pilot trial was to assess study feasibility when comparing treatments for subacute hand oedema after trauma. Methods: A parallel two-arm pilot randomised controlled trial was conducted in the hand therapy department at a regional hospital in Norfolk between October 2017 and July 2018. Patients were eligible if 18 years or over, referred to hand therapy with subacute hand oedema. Randomisation was on a 1:1 basis to treatment as usual (TAU) (compression, elevation and massage) or trial treatment (TT) (kinesiology tape, elevation and massage). One blinded assessor completed all assessments (prior to randomisation, 4 and 12 weeks later). Data on study feasibility, adherence and acceptability of treatments were collected. The primary outcome measure was hand volume (volumetry). Patient-rated severity (0–5 Likert scale), hand health profile of the Patient Evaluation Measure (PEM) and quality of life (EQ-5D-5L) were also recorded. Results: Forty-five patients were screened for eligibility and 26 consented and were randomised with 13 patients in each treatment arm. Twelve participants were lost to follow-up leaving 7 participants in each group included in the analysis. Assessor blinding was maintained in 64% of participants (9/14). Total mean acceptability scores, out of 100, were higher for TAU (87.9) than TT (76.1). Health resource use results showed TT was marginally cheaper (~£2 per patient) than TAU. Individual adherence ranged between 39 and 100%, with higher levels of overall adherence seen in the TAU group. Four participants (28%) reported adverse effects (TT group n = 3, TAU group n = 1). Conclusion: This pilot trial has identified that modifications are required in order to make a full-scale trial feasible. They include a formal assessment of treatment fidelity, research staff assisting with screening and recruitment of participants and multiple blinded assessors at each study site. Whilst not designed as an efficacy trial, it should be acknowledged that the small sample size and high loss to follow-up meant very small numbers were included in the final analysis resulting in wide confidence intervals and therefore low precision in parameter estimates. Trial registration: International Standard Randomised Controlled Trial Number: 94083271. Date of registration 16th August 2017. Trial funding: National Institute for Health Research Trainees Co-ordinating Centre (TCC); Grant Codes: CDRF-2014-05-064 [ABSTRACT FROM AUTHOR]

Poor air quality represents a significant health risk for individuals engaging in recreation activities outdoors in urban parks and trails. This study investigated temporal variability in particulate matter (PM) exposure along an urban waterfront trail. We also used recreation choice frameworks to examine the effects of visitors' perceptions of air quality (AQ) and health benefits on trail use. Average air quality during the collection period was "good" (PM10) to "moderate" (PM2.5). We found that PM density was significantly higher (p < 0.001), though still in the "moderate" range, at 7–9 a.m., 11 a.m.–1 p.m., and 3–5 p.m., and on weekends. Visitors' self-reported perceptions of health outcomes, but not air quality, significantly predicted trail use. Results suggest that these experiential factors may affect recreational choices depending on other factors, such as salience. Further research is merited to determine how experiential factors can be integrated with other theories of motivation to understand recreational decision-making. [ABSTRACT FROM AUTHOR]