Access Zone Research Articles

EDNA Uncovers Hidden Fish Diversity in the Coral Reef Ecosystems of Karimunjawa National Park, Indonesia

Environmental DNA (eDNA) has emerged as a powerful tool for swiftly assessing coral reef ecosystems, particularly for detecting fish diversity. This study focused on employing eDNA to investigate fish biodiversity and its functional traits in the Karimunjawa National Park (KNP), Indonesia. The use of eDNA and then validating with visual census results to reveal fish diversity was implemented across four management zones within the park (i.e., the core zone at Taka Malang, the protection zone at Menjangan Kecil Island, the tourism zone at Cilik Island, and an open access location at Genting Island). Sampling involved collecting one liter of seawater per site, filtering, and processing to target the 12S locus, and then sequencing using the MinION machine (Oxford nanopore). The eDNA results show higher species diversity in the tourism zone compared to the core, protection, and open access zones. However, beta diversity analysis revealed no significant differences in community composition between the zones. Moreover, this research revealed 147 species belonging to 31 families, with 60% species and 30% families identified solely through eDNA, that were not covered by the visual census. This research also reveals that eDNA is an excellent approach to detecting functional trait diversity, including environment preference and migratory and nocturnal behavior. This research underscores the potential of eDNA for evaluating fish diversity in KNP, proposing a combined eDNA and visual census approach to fill existing gaps in biodiversity assessment. Such integration promises to bolster conservation efforts within Marine Protection Areas like KNP.

ACT I early feasibility study of the Voyager Ark vascular access device.

We report the 6-month outcomes of the Ark Cannulation Trial (ACT) I early feasibility study. This investigation examined the Ark as a potential innovative access tool for overcoming cannulation-related challenges and improving arteriovenous fistula (AVF) dependent hemodialysis through targeted cannulation. During this first-in-human, interventional, prospective, single arm, single site investigation, 13 patients were treated. Cohort 1 included patients with existing fistulas meeting the criteria for Ark implantation at planned sites, including depth (4-15 mm), diameter (⩾4 mm), flow (⩾500 mL/min) and a poorly accessible cannulation zone. Cohort 2 included patients who underwent AVF creation and implantation of Arks at time of initial surgery. For both Cohorts, clinical need determined if one or two Arks were implanted. The primary endpoint was effective initial cannulation of the access site after Ark implantation. The secondary endpoint was continued access of the Ark cannulation zone for hemodialysis and evaluation of device or procedure-related adverse events collected for 6 months post-implantation. The exploratory endpoint evaluated the Ark implantation procedure. Of 13 patients, 2 were withdrawn prior to initial cannulation through the Ark-1 patient due to an exacerbated baseline condition and the other patient due to loss of follow-up. In the efficacy analysis, 11 of 13 treated patients demonstrated successful primary and secondary outcomes. Of the 11 treated patients who initiated cannulation through the Arks, 100% experienced successful primary and secondary outcomes. None of the patients experienced adverse events related to the Ark and surgeons had the necessary skills to implant Arks. The results demonstrated the Ark could be used successfully in End-Stage Renal Disease (ESRD) patients undergoing hemodialysis three times a week. These results suggest preliminary safety and efficacy of the Ark as a promising cannulation tool for dialysis vascular access and warrant further exploration of long-term safety and effectiveness through a pivotal clinical study involving a larger population and extended follow-up.

The impact of visual attractions on drivers’ visual performance and mental workload in highway tunnel access zones

The visual attractions present in the access zones of highway tunnels can exert a detrimental effect on drivers’ visual performance and mental workload, thereby posing a significant risk to driving safety. This study aims to evaluate the impact of these eye-catching elements on driving safety performance by comparing and analyzing the influence of various visual attraction conditions in tunnel access zones on both the objective visual performance and subjective mental workload assessments of novice and experienced drivers. Four distinct visual attraction scenarios were selected for implementation in the access zones of highway tunnels: baseline, landscape-inspired architecture, informational tip slogans, and commercial billboards. Naturalistic driving experiments were conducted, supplemented by subjective mental workload measurements, to analyze a range of factors, including drivers’ first fixation duration (FFD), mean fixation duration (MFD), distance from tunnel portal when first fixation occurs at visual attraction (DTP), number of fixations (NOF), pupil diameter (PD), and visual sample entropy (SampEn). Subjective mental workload was assessed using the NASA-TLX scale. The results revealed that visual attractions within tunnel access zones significantly affected drivers’ objective visual performance and subjective mental workload evaluations. Different visual attractions exerted varied effects on visual attention, stability, cognitive workload, and subjective mental workload. Specifically, billboards were found to rapidly capture drivers’ attention, leading to unstable visual performance. Informational tip slogans demanded greater attention and cognitive effort, resulting in increased cognitive workload. Furthermore, novice drivers demonstrated poorer visual performance, stability, and higher workload compared to their experienced counterparts. This research highlights the intricate relationship between visual attractions and their impact on drivers’ visual performance and mental workload, emphasizing the need for targeted interventions and enhancements in visual strategies particularly tailored for novice drivers. The findings contribute to the domain of transportation psychology and offer practical implications for improving the safety and efficiency of tunnel access zones through evidence-based design strategies. Ultimately, the insights gained from this study can guide the design of visual attractions in highway tunnel access zones to optimize drivers’ visual performance and mitigate mental workload.

Armed conflict and maternal health service utilization in Ethiopia’s Tigray Region: a community-based survey

BackgroundEvidence generated on utilization of maternal health services during times of conflict can inform the development of targeted interventions. The deadly war in Tigray caused the health system to collapse. However, utilization of maternal health services is not well documented that might help in design effective interventions applicable during armed conflict. Thus, this study aimed to assess maternal health service utilization and bridge the gap in healthcare provision and support during conflict. .MethodsA community-based cross-sectional survey was conducted among mothers of children under the age of 1 year in six accessible zones of Tigray from August 4–20, 2021. The study participants were selected through a random sampling method. The study was conducted during the armed conflict where the access to health services was limited due to the damaged and looted health facilities. A descriptive study was used to characterize the study population and data were presented using proportions and percentages. A Chi-square test was used for categorical variables and a P-value of 0.05 was considered significant. .ResultsA total of 4,381 participants were included in the study. Modern contraceptives were used by 1002 (22.9%) of women, and injectable contraceptives were the most common method used by 472 (47.1%) women. Likewise, only 830 (36.5%),1956 (47.1%), and 623 (15.0%) respondents reported the use of optimal antenatal care (ANC), skilled delivery, and postnatal care (PNC) in the first 24 h by mothers, respectively. About 34% of women received comprehensive abortion care services. Most delivery services took place in hospitals. Residence has shown a significant difference in using maternal health services at p-value < 0.001.ConclusionThe conflict in Tigray has had a profound impact on maternal health services, resulting in a significant disruption that is disproportionately high in rural areas. Immediate action is required to provide access to lifesaving interventions for basic maternal health services. The timely initiation of these services is crucial in addressing the pressing needs of pregnant women and their infants. By implementing comprehensive and targeted interventions, we can mitigate the potential long-term consequences and ensure that maternal health services are effectively reinstated.

Urban green space availability and change patterns (a case study of Tbilisi, Georgia)

Aim: This research aimed to determine the distribution of different types of Urban green spaces (UGS) in Tbilisi districts, the distribution of access zones, the number of people who have access to UGSs, how current active housing construction affects UGSs and where reduction hotspots are located. Methodology: A 500-m buffer was set around UGSs. UGS changes were detected based on the NDVI from the 2017 and 2023 (June-August) PlanetScope imagery. The NDVI classification thresholds were -1 to 0.19 (nonvegetation), 0.19 to 0.5 (shrubs), and 0.5 or greater (trees). Thereafter, UGS patterns and reduction hotspots were determined in the district. Results: The percentage of access zones was lowest for Didube (5.4%) and highest for Nadzaladevi (14.7%). Chughureti (8.3%), Mtatsminda (8.8%), Isani (9.3%), and Gldani (9.9%) had similar numbers. The worst situation was observed in Samgori (8.9%) whereas the best situation was in Didube (69.8%). UGS degradation was high in Saburtalo (35.3%), and only a 0.6% decrease was found in Chughureti. Interpretation: UGSs are better distributed spatially and available to more people in "old" districts (Mtatsminda, Chughureti) and territories that were developed in the 1970s. The urban green spaces were neglected by contemporary urban sprawl. Though legislation has helped to preserve urban green spaces with status, but locations without status are victims of active development. Key words: Hotspots, Image analysis, Land use and land cover, Normalized difference vegetation index, Tbilisi, Urban green spaces

Modeling Night and Daylighting Toll Road Tunnel Using Dialux to Compare the Performance of HPS and LED Lamp

In toll road tunnels, the lighting at the threshold zone must balance the brightness of the access zone with natural light. Therefore, artificial lighting is strategically placed in that area to match the brightness to the intensity of natural light. This balance shifts during nighttime to ensure uniform brightness throughout the tunnel, equivalent to street lighting. Additionally, a significant amount of power is required to realize this artificial lighting. Two lamp technologies are used for tunnel lighting: HPS lamps with low energy efficiency and LED lamps with better energy efficiency. The challenge is determining artificial lighting in the threshold zone using energy-efficient lamps. To address this issue, simulations were conducted to compare the two lamp types applied in tunnels to achieve the most significant power savings. This research creates a model of toll road tunnel lighting using DIALux software better to understand the characteristics of toll road tunnel lighting using HPS and LED lamps. The SNI and ANSI/IES are the standards used. The Cisumdawu tunnel is used as the case study. The simulation results show that the luminance in the interior zone using LED or HPS lamps meets the SNI standard. Using LED lamps results in higher luminance with less power than using HPS. This discovery can improve energy efficiency in tunnel environments and contribute to lighting solutions for transportation infrastructure.

Spatiotemporal Variation of Correlated Color Temperature in the Tunnel Access Zone

A scientific and logical tunnel entrance lighting environment is an important guarantee for the safety of drivers entering tunnels as well as an essential element for the sustainable development of the tunnel. At present, most of the highway tunnel entrance lighting environment focuses on the road surface luminance and does not consider the variation of correlated color temperatures (CCT) on the driver’s vision in the tunnel access zone. This study analyzes the temporal and spatial variation of the ambient CCT in the driver’s 20° field of view during the approach to the tunnel through field dynamic tests of existing tunnels in the Beijing area. As a result, the CCT received by the driver’s eyes when approaching the tunnel peaks at the midpoint of the tunnel access zone, after which it decreases slowly up to the tunnel portal. Moreover, a calculation model of the CCT outside the tunnel with the solar irradiance, the distance from the tunnel portal, and the CCT of tunnel interior lighting as the input parameters is established. The modeling methodology was validated in a new tunnel, and the calculation model’s average absolute error is within 5%, which could provide guidance for the selection of the tunnel interior lighting CCT and a basis for the design of intelligent control of sustainable lighting systems in tunnels.

Application of an Integrated Model for Analyzing Street Greenery through Image Semantic Segmentation and Accessibility: A Case Study of Nanjing City

Urban street greening, a key component of urban green spaces, significantly impacts residents’ physical and mental well-being, contributing substantially to the overall quality and welfare of urban environments. This paper presents a novel framework that integrates street greenery with accessibility, enabling a detailed evaluation of the daily street-level greenery visible to residents. This pioneering approach introduces a new measurement methodology to quantify the quality of urban street greening, providing robust empirical evidence to support its enhancement. This study delves into Nanjing’s five districts, employing advanced image semantic segmentation based on machine learning techniques to segment and extract green vegetation from Baidu Street View (BSV) images. Leveraging spatial syntax, it analyzes street network data sourced from OpenStreetMap (OSM) to quantify the accessibility values of individual streets. Subsequent overlay analyses uncover areas characterized by high accessibility but inadequate street greening, underscoring the pressing need for street greening enhancements in highly accessible zones, thereby providing valuable decision-making support for urban planners. Key findings revealed that (1) the green view index (GVI) of sampled points within the study area ranged from 15.79% to 38.17%, with notably better street greening conditions observed in the Xuanwu District; (2) the Yuhua District exhibited comparatively lower pedestrian and commuting accessibility than the Xuanwu District; and (3) approximately 139.62 km of roads in the study area demonstrated good accessibility but lacked sufficient greenery visibility, necessitating immediate improvements in their green landscapes. This research utilizes the potential of novel data and methodologies, along with their practical applications in planning and design practices. Notably, this study integrates street greenery visibility with accessibility to explore, from a human-centered perspective, the tangible benefits of green landscapes. These insights highlight the opportunity for local governments to advance urban planning and design by implementing more human-centered green space policies, ultimately promoting societal equity.

Study on the Glare Phenomenon and Time-Varying Characteristics of Luminance in the Access Zone of the East–West Oriented Tunnel

In response to the special feature of the east–west oriented road tunnel entrance being easily exposed to direct sunlight, a study was conducted on the glare phenomenon at the access zone for this type of tunnel and on the time-varying characteristics of the L20(S) value outside the tunnel. First, the actual situation of luminance difference inside and outside the tunnel was considered. Field tests were carried out in a 20° field of view of the human eye within a stopping distance. Then, the environment paraments outside the tunnel were collected by combining the environment schematic method with the digital camera method. Finally, the differences and time-varying characteristics between the measured and recommended values of luminance outside the tunnel were analyzed. The PGSV daylight calculation model was used to analyze the glare effect in the 20° field of view of the human eye. The results indicate that the luminance L20(S) outside the tunnel towards the east (west) generally shows a trend of first increasing and then decreasing, and reaches its maximum value in the morning (afternoon). The difference in the contribution ratio of luminance inside and outside the tunnel for this type shows an overall trend of first increasing and then decreasing, and the maximum difference appears in the morning (afternoon), reaching about 97% and 96% respectively. The time-varying characteristics of glare in the access zone of an east (west) oriented road tunnel are roughly consistent with the variation trend of the luminance L20(S) outside the tunnel and exceed the intolerable glare limit. Due to direct sunlight, the luminance outside the tunnel is too high, resulting in an uncomfortable glare that the driver cannot tolerate, becoming more serious after rainfall, and which affects driving comfort and safety.

Mapping areas suitable for agriculture and their accessibility: The case of the centre region of Cameroon

Given the pressure on land in the Central Region due to economic development and the search for opportunities, the best land for agriculture needs to be identified, so as to preserve it from urbanization, the expansion of mining areas, infrastructure and other occupations. It is in this context that the issue of mapping to identify agricultural zones and assess their accessibility was raised. This is an opportune moment to feed reflections on planning, agricultural production and natural resource management in the Center Region of Cameroon. GIS-based multi-criteria spatial analysis of data on land use, hydrographic network, slopes, soils and their suitability for cultivation provided precise, geolocalized information on land potentially suitable for agriculture in general. Following the analyses, we were able to establish and highlight the areas suitable for agriculture and accessible, which amounted to 8%, or 5662.42 km2 for high-potential and accessible areas. This was followed by 56%, or 37144.95 km2 for medium-potential and accessible zones, and finally 6%, or 4238.93 km2 for low-potential and accessible zones. Once the accessible areas had been removed, 5% or 3028.27 km2 of high-potential inaccessible areas remained, 19%, that is 14639.46 km2 of medium-potential inaccessible areas and 2% that is 967.12km2 of low-potential inaccessible areas.

Triumphs and trials with the UK abortion law: The power of collaboration in abortion reform.

The UK is usually viewed as having liberal abortion regulations, providing good access to abortion care within a publicly funded health service. However, the underlying laws are authoritarian, dating from an era when public executions drew large crowds and 67 years before women were able to vote. Abortion is only legal when two doctors certify it meets the permitted grounds, and the penalty for self-managed abortion is up to life imprisonment for both the woman and any accomplice. These laws had prevented the use of mifepristone and misoprostol at home. Changes to the regulations for misoprostol in 2018 and mifepristone in 2020 permitted home use, but the government announced they were rescinding the approval for mifepristone in 2022. This article discusses how, despite the opposition of government, significant progressive changes to the abortion laws were achieved. Early medical abortion at home is now protected in law, and safe access zones protect patients and staff from harassment and intimidation from protesters. Despite this progress, increasing numbers of women are facing criminal investigation and face long prison sentences if convicted. The need for decriminalization and for abortion care to be regulated like all other health care is the next pressing issue.

The radiographic relationship of the femoral head, inguinal ligament, and common femoral artery bifurcation for optimal vascular access

ObjectiveCommon femoral artery (CFA) access is commonly used for endovascular interventions. Access site complications contribute to significant morbidity and mortality. This study characterizes the radiographic variability in the relationship of the femoral head, the inguinal ligament, and the CFA bifurcation, to identify the zone of optimal CFA access. MethodsHuman cadaver dissection of the inguinal ligament and CFA bifurcation was performed. The inguinal ligament and CFA bifurcation were marked with radiopaque pins and plain anteroposterior radiographs were obtained. Radiographic measurements of the femoral head length, the distance of the top of the femoral head to the inguinal ligament, and to the CFA bifurcation were obtained. Results were reported as percentage of femoral head covered by the inguinal ligament or the CFA bifurcation relative to the top of the femoral head. A heatmap was derived to determine a safe access zone between the inguinal ligament and CFA bifurcation. ResultsForty-five groin dissections (male, n = 20; female, n = 25) were performed in 26 cadavers. The mean overlap of the inguinal ligament with the femoral head was 11.2 mm (range, −19.4 to 27.4 mm). There were no age (<85 vs ≥85 years) or sex-related differences. In 82.6% of cadaveric CFA exposures, there was overlap between the inguinal ligament and femoral head (mean, 27.7%; range, −85.7% to 70.1%), with 55.6% having a >25% overlap. In 11.1%, there was an overlap between the lower one-third of the femoral head and the CFA bifurcation. Cumulatively, heatmap analysis depicted a >80% likelihood of avoiding the inguinal ligament and CFA bifurcation below the midpoint of the femoral head. ConclusionsSignificant variability exists in the relationship between the inguinal ligament, CFA bifurcation, and the femoral head, suggesting the lack of a consistently safe access zone. The safest access zone in >80% of patients lies below the radiographic midpoint of the femoral head and the inferior aspect of the femoral head.

Масштабы рынка труда г. Хабаровска

The article is devoted to assessing the scale of the local labor market in Khabarovsk and its surrounding areas using geographic information analysis tools. The relevance of the study is due to the need to clarify the boundaries of the local labor market in conditions of dynamically developing economic activity and the growth of spatial mobility of the population within the emerging Khabarovsk urban agglomeration. An analysis was carried out of the transport accessibility of places of employment, the scale of economic activity, employment of the population, differentiation of wages in the context of municipalities of the Khabarovsk Territory, concentrated near Khabarovsk, as well as the border region of the neighboring Jewish Autonomous Region (N = 45). To achieve this goal, the following methodological approaches and tools are used: construction of isochrones of transport accessibility; calculation of average wages; formation of cartograms. The information base for the study was provided by Rosstat data on the population of municipalities at the beginning of 2024, data from the statistical tax reporting of the FTS of Russia (Form 5-NDFL) for 2023, data on the number of objects of economic activity within the boundaries of municipalities and geodata GIS «Yandex Map to the Territory of the Russian Federation», NextGIS QGIS, current as of October 2023. Zoning has been completed, the core and boundaries of the local labor market in Khabarovsk have been determined. Based on an analysis of the composition and structure of existing transport accessibility zones, it is substantiated that a reduction in wages moving away from the core increases competition and draws labor resources into the city, «exposing» the periphery and exacerbating spatial heterogeneity

Structural and Geomechanical Analysis of Natural Caves and Rock Shelters: Comparison between Manual and Remote Sensing Discontinuity Data Gathering

The stability of many shallow caves and rock shelters relies heavily on understanding rock discontinuities, such as stratification, faults, and joints. Analyzing these discontinuities and determining their orientations and dispersion are crucial for assessing the overall stability of the cave or shelter. Traditionally, this analysis has been conducted manually using a compass with a clinometer, but it has certain limitations, as only fractures located in accessible areas like the lower part of cave walls and entrances are visible and can be assessed. Over the past decade, remote sensing techniques like LiDAR and photogrammetry have gained popularity in characterizing rocky massifs. These techniques provide 3D point clouds and high-resolution images of the cave or shelter walls and ceilings. With these data, it becomes possible to perform a three-dimensional reconstruction of the cavity and obtain important parameters of the discontinuities, such as orientation, spacing, persistence, or roughness. This paper presents a comparison between the geomechanical data obtained using the traditional manual procedures (compass readings in accessible zones) and a photogrammetric technique called Structure from Motion (SfM). The study was conducted in two caves, namely, the Reguerillo Cave (Madrid) and the Cova dos Mouros (Lugo), along with two rock shelters named Abrigo de San Lázaro and Abrigo del Molino (Segovia). The results of the study demonstrate an excellent correlation between the geomechanical parameters obtained from both methods. Indeed, the combination of traditional manual techniques and photogrammetry (SfM) offers significant advantages in developing a more comprehensive and realistic discontinuity census.

The Safe Access Zones Bill Reference [2022] UKSC 32: clearing the fog of proportionality?

Case commentary on the Safe Access Zones Bill Reference [2022] UKSC 32.

TERRITORIAL ACCESSIBILITY OF MEDICAL INSTITUTIONS FOR THE RESIDENTS OF THE NORTH OF RUSSIA

Access to health care is a key component that determines the possibility of the earliest-possible promotion of health and well-being in the context of everyday life. The article analyzes the spatial accessibility of health services for the population of certain areas of the North of Russia. Urbanized and rural areas in the Arkhangelsk and Murmansk regions and the Yamal-Nenets autonomous region were studied. OpenStreetMap data was used, including information about the location of medical institutions and settlements, and the configuration of road network. Using the ArcGIS Network Analyst toolkit, different accessibility zones were identified for each study area. It was revealed that large cities located in the north of Russia are sufficiently provided with medical care in terms of spatial accessibility. More relevant is the issue of providing specialized types of medical care. Even cities located close to each other show unequal possibilities of obtaining specialized health care. The concentration of specialized care in several centers, without taking into account their transport accessibility, requires additional time and carries risks for the population because of the untimely access to medical care. Rural population remains the most vulnerable in terms of the access to medical care.

Wolny dostęp w Bibliotece Głównej Uniwersytetu Marii Curie-Skłodowskiej w Lublinie – w świetle wyników badań własnych

The article presents the changes that have taken place in the Main Library of the Maria Curie-Skłodowska in Lublin, resulting from the introduction of open access to some of the col- lections. Its main goal was to indicate the problems and benefits resulting from modernization of the existing solutions related to the way of using library collections. The rules of classification of the Library of Congress and process of its implementation in the Main Library of the UMCS were discussed. The case study method and comparative analysis were used to achieve the set goals. The paper presents the results of user satisfaction surveys regarding the use of the open access zone. The conclusions were based on surveys conducted among the Library users (students and employees of Lublin universities). The information obtained during the survey showed streng- ths and weaknesses in the functioning and organization of the open access zone at the Library.

THE USE OF GIS TECHNOLOGIES TO DETERMINE TRANSPORT ACCESSIBILITY IN TOURISM

The article examines the possibilities of using GIS technologies in the tourism sphere. The study focused on the conceptual modeling of tourism and the geoinformation support in planning tourist routes. The subject area of tourism as a conceptual model in terms of database modeling and GIS using UML language was characterized and presented. The method of using the GIS to solve the problem of modeling transport accessibility zones to tourist attractions in shaping transport routes has been proposed. The QGIS was used in tandem with a database management system such as PostgreSQL. GRASS GIS environment was used to perform spatial analysis. The object of this research is the transport network in one of the districts of the Ternopil region. We have tested in practice the proposed technological scheme on the example of the Ternopil district with the use of PostgreSQL database management system, QGIS, and GRAS GIS. We have created a tourist isochrone map of this region with some attractive places. The proposed methodology for determining transport accessibility using spatial analysis tools with the creation of isochrone maps and a flexible system of adjustments in the GIS makes it possible to optimize already existing tourism routes and create new ones.

Digital Rectal Examination Is Not a Useful Screening Test for Prostate Cancer

BackgroundAnnual digital rectal examination (DRE) is recommended as a stand-alone screening test for prostate cancer (PCa) in Germany for 45+ yr olds. DRE diagnostic performance in men as young as 45 yr old has not been proved by a screening trial. ObjectiveTo determine DRE diagnostic performance in a screening trial. Design, setting, and participantsThis analysis was conducted within the multicentric, randomized PROBASE trial, which enrolled >46 000 men at age 45 to test risk-adapted prostate-specific antigen (PSA) screening for PCa. Intervention(1) DRE was analyzed as a one-time, stand-alone screening offer at age 45 in 6537 men in one arm of the trial and (2) PCa detection by DRE was evaluated at the time of PSA-screen–driven biopsies (N = 578). Outcome measurements and statistical analysis(1) True-/false-positive detection rates of DRE as compared with PSA screening and (2) DRE outcome at the time of a prostate biopsy were evaluated. Results and limitations(1) A prospective analysis of 57 men with suspicious DRE at age 45 revealed three PCa. Detection rate by DRE was 0.05% (three of 6537) as compared with a four-fold higher rate by PSA screening (48 of 23 301, 0.21%). The true-positive detection rate by DRE relative to screening by PSA was 0.22 (95% confidence interval [CI] = [0.07–0.72]) and the false-positive detection rate by DRE was 2.2 (95% CI = [1.50–3.17]). (2) Among PSA-screen–detected PCa cases, 86% had unsuspicious DRE (sensitivity relative to PSA was 14%), with the majority of these tumors (86%) located in the potentially accessible zones of the prostate as seen by magnetic resonance imaging. ConclusionsThe performance of stand-alone DRE to screen for PCa is poor. DRE should not be recommended as a PCa screening test in young men. Furthermore, DRE does not improve the detection of PSA-screen–detected PCa. Patient summaryOur report demonstrated the poor diagnostic performance of digital rectal examination in the screening for prostate cancer in young men.

An explosive landscape: Arranging the barnacle goose on the Solway Firth

By the end of the Second World War, the Svalbard barnacle goose population had dwindled to a couple of hundred birds. Flying in from the Arctic to spend the winters on the Solway Firth (the estuary that separates England from Scotland), they were a favourite target of wildfowlers in the area. Since then, a ban on shooting and the Solway goose management scheme that pays farmers to maintain a goose friendly habitat has seen the barnacle goose numbers increase. Today, an uneasy truce has formed between conservationists, farmers and wildfowlers who have different and often conflicting interests in the goose. Adding to that is the Solway's rich military history: once host to huge munitions factories during the First and Second World Wars, this now derelict military infrastructure curates the tidal landscape through awkward access zones, barbed wire fences and secretive burial sites. In this article I argue that the military infrastructure of the Solway, particularly that of the explosive propellants produced in the factories, have left resonances that not only inflect the land itself, but also the trajectory of the barnacle goose. Explosive propellants are used in different ways by the goose's stakeholders: cannon nets by conservationists, bird bangers by farmers, and explosive shot by wildfowlers. Yet this is a dynamic situation that must account for goose agencies and complex entanglements of human, nonhuman, and technology: an explosive landscape that arranges goose life along the flyway.