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The Australian offshore oil and gas (O&G) industry is facing a significant decommissioning portfolio over the next few decades. In response to this, in 2019, eight Australian oil and gas operators and the National Energy Resources Australia (NERA) established the National Decommissioning Research Initiative (NDRI) with the aim to fill key knowledge gaps on the potential environmental impacts, risks and benefits of different decommissioning options in Australia’s offshore environment. In phase 1, seven research projects were undertaken covering the interaction that occurs between the environment and O&G infrastructure in Australia’s oceans. Phase 2 of the NDRI has now commenced with a focus on developing an ecological risk assessment guidance document for O&G titleholders to be able to undertake environmental risk assessments to determine if the level of contamination associated with different offshore decommissioning options is environmentally acceptable. The paper would describe the pathway to produce guidance on science-based acceptability criteria for contamination associated with O&G infrastructure: Research needed for the development of screening values to identify if a site-specific ecological risk assessment is required. Research plans are to be developed to identify the lines of evidence that can be used to determine if impacts and risks of any contamination are of an acceptable level. Ongoing engagement of regulators, researchers and other stakeholders is a critical component on the pathway forward.

Endoscopic strip craniectomy with postoperative helmeting (ESCH) for unicoronal synostosis has shown to be a less morbid procedure when compared with fronto-orbital remodeling (FOR). We aim in this pilot study to report objective methods and quantitative morphologic outcomes of endoscopically treated unicoronal synostosis using 3-dimensional surface scans.Our electronic records were reviewed for ophthalmological, neurodevelopmental outcomes, and helmet-related complications. For morphologic outcomes, the following parameters were used: Cranial Index, Cranial Vault Asymmetry Index, Anterior Symmetry Ratio (ASR), and Root Mean Square between the normal and synostotic sides of the head. Three-dimensional stereophotogrammetry scans were evaluated at 3 time points preoperative, 6 months post-op, and at the end of the treatment, which was compared with age-matched scans of normal controls and FOR patients. Nonparametric tests were used for statistical analysis.None of the ESCH cases developed strabismus, major neurodevelopmental delay, or helmet complications. All morphologic parameters improved significantly at 6 months post-op except for the Cranial Vault Asymmetry Index. The ASR was the only parameter to change significantly between 6 months post-op and final scans. At end of helmet treatment, ASR and Root Mean Square differed significantly between the ESCH and both FOR and control groups.Endoscopic strip craniectomy with postoperative helmeting for single unicoronal synostosis had excellent clinical outcomes. Most of the improvement in head morphology occurred in the first 6 months of treatment. Despite the normalization of the overall head shape, there was residual asymmetry in the frontal and temporal regions of the head.

The creation and use of ontologies has become increasingly relevant for complex systems in recent years. This is because of the growing number of use of cases that rely on real-world integration of disparate systems, the need for semantic congruence across boundaries and the expectations of users for conceptual clarity within evolving domains or systems of interest. These needs are evident in most spheres of research involving complex systems, but they are particularly apparent in infrastructure and cities where traditionally siloed and sectoral approaches have dominated, undermining the potential for integration to solve societal challenges such as net zero, resilience to climate change, equity and affordability. This paper reports on findings of a literature review on infrastructure and city ontologies and puts forward some hypotheses inferred from the literature findings. The hypotheses are discussed with reference to the literature and provide avenues for further research on (a) belief systems that underpin non-top-level ontologies and the potential for interference from them, (b) the need for a small number of top-level ontologies and translation mechanisms between them and (c) clarity on the role of standards and information systems in the adaptability and quality of data sets using ontologies. A gap is also identified in the extent that ontologies can support more complex automated coupling and data transformation when dealing with different scales.

OBJECTIVE Endoscopic strip craniectomy with postoperative helmet orthosis therapy (ESCH) has emerged as a less invasive alternative to fronto-orbital remodeling for correction of trigonocephaly. However, there is no standardized objective method for monitoring morphological changes following ESCH. Such a method should be reproducible and avoid the use of ionizing radiation and general anesthesia for diagnostic imaging. The authors analyzed a number of metrics measured using 3D stereophotogrammetry (3DSPG) following ESCH, an imaging alternative that is free of ionizing radiation and can be performed on awake children. METHODS 3DSPG images obtained at two time points (perisurgical and 1-year follow-up [FU]) of children with metopic synostosis who had undergone ESCH were analyzed and compared to 3DSPG images of age-matched control children without craniofacial anomalies. In total, 9 parameters were measured, the frontal angle and anteroposterior volume in addition to 7 novel parameters: anteroposterior area ratio, anteroposterior width ratios 1 and 2, and right and left anteroposterior diagonal ratios 30 and 60. RESULTS Six eligible patients were identified in the operated group, and 15 children were in the control group. All 9 parameters differed significantly between perisurgical and age-matched controls, as well as from perisurgical to FU scans. Comparison of FU scans of metopic synostosis patients who underwent surgery to scans of age-matched controls without metopic synostosis revealed that all parameters were statistically identical, with the exception of the right anteroposterior diagonal ratio 30, which was not fully corrected in the treated patients. The left anterior part of the head showed the most change in surface area maps. CONCLUSIONS In this pilot study, ESCH showed satisfactory results at 1 year, with improvements in all measured parameters compared to perisurgical results and normalization of 8 of 9 parameters compared to an age-matched control group. The results indicate that these parameters may be useful for craniofacial units for monitoring changes in head shape after ESCH for trigonocephaly and that 3DSPG, which avoids the use of anesthesia and ionizing radiation, is a satisfactory monitoring method.

The Australian offshore oil and gas industry is facing a significant decommissioning portfolio over the next few decades. In response to this, in 2019, eight Australian oil and gas operators and the National Energy Resources Australia (NERA) established the National Decommissioning Research Initiative (NDRI) with the aim to fill key knowledge gaps on the potential environmental impacts, risks and benefits of different decommissioning options in Australia’s offshore environment. In Phase 1, seven research projects were undertaken covering the interaction that occurs between the environment and oil and gas infrastructure in Australia’s oceans. These projects focused on habitat, connectivity, invasive marine species, degradation of metals and non-metals and potential contaminants of concern such as mercury and naturally occurring radioactive materials. Two other projects were undertaken to gain insights into regulators, stakeholders, marine users and scientist views on offshore decommissioning risks and opportunities. This paper describes the drivers for NDRI, the outcomes of the Phase 1 projects and the future projects to be undertaken to support the environmental assessment of different decommissioning options.

Purpose of Review As telemedicine gains popularity among providers and patients alike, it is important to ensure the standards of care remain equivalent between the in-person and virtual settings. While bedside manner remains a key competency incorporated into medical school curricula, “webside manner,” or professional standards for virtual care, remains less defined. Recent Findings Best practices exist including guidance prior to the visit, methods to maintain a professional background environment, and translation of core communication competencies for a video interaction. Through application of these practices, a provider can ensure the core interpersonal and communication competencies are fulfilled. These practices have direct application to allergy, asthma, and immunology care. Summary This review provides an overview of best practices for professionalism and patient interaction for virtual care and examines specific applications to allergy, asthma, and immunology visits

Social inequity is a primary driver of health disparities, creating multiple barriers to good health. These inequities were exacerbated during the coronavirus disease 2019 (COVID-19) pandemic, with Latinx communities suffering more than others. Grassroots collaborations have long existed to address disparities.We describe the creation and work of the Latinx Advocacy Team and Interdisciplinary Network for COVID-19 (LATIN-19; http://latin19.org/), a multisector coalition in North Carolina created to address the unique challenges of COVID-19 in the Latinx community.We discuss challenges and solutions that LATIN-19 addressed and the impact of LATIN-19 on community partners and members.LATIN-19 learned of challenges including, lack of awareness, need for data systems to track disparities, the need to increase access to resources, the need for policy changes, and the need to coordinate services by community organizations.LATIN-19 represents a grassroots organization that has had an impact on community and community organizations that spans beyond COVID-19.

Bristol Bay in Alaska is home to the world’s largest commercial salmon fishery. During an average fishing season, the population of the Bristol Bay region more than doubles as thousands of workers from out of state converge on the fishery. In the months leading up to 2020 commercial fishery opening, as the COVID-19 pandemic exploded worldwide, great uncertainty existed about the health risks of opening the fishery. Bristol Bay residents had not yet experienced any cases of COVID-19, yet the livelihoods of most were closely tied to the commercial fishery opening. To better understand how COVID-19 risk perceptions affected decisions to participate in the fishery, we administered an online survey to community members and fishery participants. We collected standard socioeconomic data and posed questions to gauge risk perceptions related to COVID-19. We find that COVID-19 risk perceptions vary across race/ethnic groups by residency and income. People with below median income who are members of minority groups—notably, non-resident Hispanic workers and resident Alaska Native respondents—reported the highest risk perceptions related to COVID-19. This study highlights the important linkages among risk perceptions, socioeconomic characteristics, and employment decisions during an infectious disease outbreak.

Objective Use of colour duplex ultrasound (CDUS) and computed tomography angiography (CTA) for infrarenal endovascular aortic aneurysm repair (EVAR) surveillance differs in internationally published guidelines. This study aimed firstly to compare CDUS detection of significant sac abnormalities with CTA. Secondly, a sensitivity analysis was conducted to compare financial estimates of the, predominantly CDUS based, local and Society of Vascular Surgery (SVS) protocols, the risk stratified European Society of Vascular Surgery (ESVS) protocol, and the CTA based National Institute of Health and Care Excellence (NICE) protocol. Methods Agreement between CDUS and CTA was assessed for detection of significant sac abnormalities. Surveillance protocols were extrapolated from published guidelines and applied to infrarenal EVAR patients active on local surveillance at a large, single centre. Surveillance intensity was dependent on presence of endoleak and subsequent risk of treatment failure in accordance with surveillance recommendations. Estimates for each surveillance protocol were inclusive of a range of published incidences of endoleak, contrast associated acute kidney injury (AKI), and excess hospital bed days, and estimated for a hypothetical five year surveillance period. Results The kappa coefficient between CDUS and CTA for detecting sac abnormalities was 0.68. Maximum five year surveillance cost estimates for the 289 active EVAR patients were £272 359 for SVS, £230 708 for ESVS, £643 802 for NICE, and £266 777 for local protocols, or £1 270, £1 076, £3 003, and £1 244 per patient. Differences in endoleak incidence accounted for a 1.1 to 1.4 fold increase in costs. AKI incidence accounted for a 3.3 to 6.2 fold increase in costs. Conclusion A combined CTA and CDUS EVAR surveillance protocol, with CTA reserved for early seal assessment and confirmatory purposes, provides an economical approach without compromising detection of sac abnormalities. AKI, as opposed to direct imaging costs, accounted for the largest differences in surveillance cost estimates.

Instability of the craniocervical junction in paediatric patients with skeletal dysplasia poses a unique set of challenges including anatomical abnormalities, poor bone quality, skeletal immaturity and associated general anaesthetic risks. Instrumented fixation provides optimal stabilisation and fusion rates. The small vertebrae make the placement of C2 pedicle screws technically demanding with low margins of error between the spinal canal and the vertebral artery. We describe a novel clinical strategy utilising 3D-printed spinal screw trajectory guides (3D-SSTG) for individually planned C2 pedicle and laminar screws. The technique is based on a pre-operative CT scan and does not require intraoperative CT imaging. This reduces the radiation burden to the patient and forgoes the associated time and cost. The time for model generation and sterilisation was

Clamp-on ultrasonic transit time difference flow meters provide opportunities for metering where it is impractical or undesirable to cut into an existing pipeline to install an alternative flow meter. Up until now, it has been difficult to perform this type of measurement on thin-walled metal pipes, due to the difficulty of interpreting the guided wave modes in the combined pipe wall and internal fluid system, but a new method has been reported recently that utilises these guided wave modes for flow measurement. Through computational modelling, and construction and testing of different transducers, the design considerations for clamp-on transducers are highlighted and their impact on guided wave flow rate measurement is evaluated. The design features considered include a curved contact face to provide focusing of the ultrasound within the pipe and a scattering surface to reduce internal reflections. It is found that additional unwanted ultrasonic modes can be minimised by ultrasonic transducer wedge design features such as profiling the curvature of the transducer to conform to the pipe wall or creating a scattering edge to minimise internal wedge reflections. It is also observed that minimising these unwanted modes does not offer any advantage for the transit time difference measurement used in calculating flow.

Previous research has shown an association between individual thunderstorm events in the presence of high pollen, commonly called thunderstorm asthma, and acute severe asthma events, but little work has studied risk over long periods of time, using detailed measurements of storms and pollen.We estimated change in the risk of asthma-related emergency room visits related to thunderstorm asthma events in the Minneapolis-St. Paul metropolitan area over the years 2007-2018. We defined thunderstorm asthma events as daily occurrence of two or more lightning strikes during high pollen periods interpolating weather and pollen monitor data and modeling lightning counts. We acquired daily counts of asthma-related emergency department visits from the Minnesota Hospital Association and used a quasi-Poisson time-series regression to estimate overall relative risk of emergency department visits during thunderstorm asthma events.We observed a 1.047 times higher risk (95% confidence interval = 1.012, 1.083) of asthma-related emergency department visits on the day of thunderstorm asthma event. Our findings are robust to adjustment for temperature, humidity, wind, precipitation, ozone, PM 2.5 , day of week, and seasonal variation in asthma cases. Occurrence of lightning alone or pollen alone showed no association with the risk of severe asthma. A two-stage analysis combining individual zip code-level results shows similar RR, and we see no evidence of spatial correlation or spatial heterogeneity of effect.Our results support an association between co-occurrence of lightning and pollen and risk of severe asthma events. Our approach incorporates lightning and pollen data and small-spatial area exposure and outcome counts.

This commentary describes the rapid development of a COVID-19 data dashboard utilising existing Urban Observatory Internet of Things (IoT) data and analytics infrastructure. Existing data capture systems were rapidly repurposed to provide real-time insights into the impacts of lockdown policy on urban governance.

Police contact may have negative psychological effects on pregnant people, and psychological stress has been linked to preterm birth (ie, birth at37 weeks' gestation). Existing knowledge of racial disparities in policing patterns and their associations with health suggest redesigning public safety policies could contribute to racial health equity.To examine the association between community-level police contact and the risk of preterm birth among White pregnant people, US-born Black pregnant people, and Black pregnant people who were born outside the US.This cross-sectional study used medical record data of 745 White individuals, 121 US-born Black individuals, and 193 Black individuals born outside the US who were Minneapolis residents and gave birth to a live singleton at a large health system between January 1 and December 31, 2016. Data were analyzed from March 2019 to October 2020.Police contact was measured at the level of the census tract where the pregnant people lived. Police incidents per capita (ie, the number of police incidents divided by the census tract population estimate) were dichotomized into high if the value was in the fourth quartile and low for the remaining three quartiles.Preterm birth status was based on the International Statistical Classification of Diseases and Related Health Problems, 10th revision, Clinical Modification (ICD-10-CM) code. Preterm infants were those with ICD-10-CM codes P07.2 and P07.3 documented in their charts.Of 1059 pregnant people (745 [70.3%] White, 121 [11.4%] US-born Black, 193 [18.2%] Black born outside the US) in the sample, 336 White individuals (45.1%) and 62 Black individuals who were born outside the US (32.1%) gave birth between the ages of 30 and 34 years, while US-born Black individuals gave birth at younger ages, with 49 (40.5%) aged 25 years or younger. The incidence of preterm birth was 6.7% for White individuals (50 pregnant people), 14.0% for US-born Black individuals (17 pregnant people), and 5.7% for Black individuals born outside the US (11 pregnant people). In areas with high police contact vs low police contact, the odds of preterm birth were 90% higher for White individuals (odds ratio [OR], 1.9; 95% CI, 1.9-2.0), 100% higher for US-born Black individuals (OR, 2.0; 95% CI, 1.8-2.2), and 10% higher for Black individuals born outside the US (OR, 1.1; 95% CI, 1.0-1.2). Secondary geospatial analysis further revealed that the proportion of Black residents in Minneapolis census tracts was correlated with the number of police incidents reported between 2012 and 2016 (P = .001).In this study, police contact was associated with preterm birth for both Black and White pregnant people. Predominantly Black neighborhoods had greater police contact than predominantly White neighborhoods, indicating that Black pregnant people were more likely to be exposed to police than White pregnant people. These findings suggest that racialized police patterns borne from a history of racism in the United States may contribute to racial disparity in preterm birth.

The aim of this study was to develop and validate a deep learning-based system to detect peripheral neuropathy (DN) from retinal colour images in people with diabetes. Retinal images from 1561 people with diabetes were used to predictDN diagnosed on vibration perception threshold. A total of 189 had diabetic retinopathy (DR), 276 had DN, and 43 had both DR and DN. 90% of the images were used for training and validation and 10% for testing. Deep neural networks, including Squeezenet, Inception, and Densenet were utilized, and the architectures were tested with and without pre-trained weights. Random transform of images was used during training. The algorithm was trained and tested using three sets of data: all retinal images, images without DR and images with DR. Area under the ROC curve (AUC) was used to evaluate performance. The AUC to predict DN on the whole cohort was 0.8013 (±0.0257) on the validation set and 0.7097 (±0.0031) on the test set. The AUC increased to 0.8673 (±0.0088) in the presence of DR. The retinal images can be used to identify individuals with DN and provides an opportunity to educate patients about their DN status when they attend DR screening.

Background: Increasing numbers of adolescents and young adults with cancer (AYACs) are surviving long term, highlighting the importance of effective oncofertility communication. We undertook this s...

Publicly available skin image datasets are increasingly used to develop machine learning algorithms for skin cancer diagnosis. However, the total number of datasets and their respective content is currently unclear. This systematic review aimed to identify and evaluate all publicly available skin image datasets used for skin cancer diagnosis by exploring their characteristics, data access requirements, and associated image metadata. A combined MEDLINE, Google, and Google Dataset search identified 21 open access datasets containing 106 950 skin lesion images, 17 open access atlases, eight regulated access datasets, and three regulated access atlases. Images and accompanying data from open access datasets were evaluated by two independent reviewers. Among the 14 datasets that reported country of origin, most (11 [79%]) originated from Europe, North America, and Oceania exclusively. Most datasets (19 [91%]) contained dermoscopic images or macroscopic photographs only. Clinical information was available regarding age for 81 662 images (76·4%), sex for 82 848 (77·5%), and body site for 79 561 (74·4%). Subject ethnicity data were available for 1415 images (1·3%), and Fitzpatrick skin type data for 2236 (2·1%). There was limited and variable reporting of characteristics and metadata among datasets, with substantial under-representation of darker skin types. This is the first systematic review to characterise publicly available skin image datasets, highlighting limited applicability to real-life clinical settings and restricted population representation, precluding generalisability. Quality standards for characteristics and metadata reporting for skin image datasets are needed.

“Conspirators be they that…bind themselves by Oath…or other Alliance, that every of them shall aid and support the Enterprise of each other falsely and maliciously to indite.”Established in the Third Ordinance of Conspirators in 1304; the first definition of conspiracy was to prevent and punish those who would plan to use children to present their false accusations in court on their behalf (as children could not be criminally liable). The aim of the law on conspiracy, although widening the scope, has been clear from the thirteenth century: to prevent and punish the planning of a criminal offence. However, since expanding, the law on conspiracy has been criticised especially in regard to sentencing as “unduly harsh.” This is the result of numerous problems with the current law on conspiracy to murder, which is in urgent need of reform. “On the 10th of October 2007, the law commission proposed many recommendations on reforms of statutory conspiracy” (Law Commission 2018). The focus of this legal research is to explore the current state of law regarding conspiracy to murder and the legislation, case law, scholarly and media articles discussed in this report will evaluate the effectiveness and fairness of the law on conspiracy to murder. Thus, the question to sum up our legal research “Is the current law on conspiracy to commit murder effective and fair?"