Core Measurements Research Articles

Call to action: Blueprint for change in acute and critical care nursing

Herein, we propose a blueprint for action to completely measure and recognize the care provided by acute and critical care nurses to be incorporated into policy that shapes and supports practice. We address the nature of nurses’ work by identifying nine practice domains, hospital practice environment assumptions, and expected outcomes. Nurses’ work, as a cross-system process, needs to be included in hospital-based core measures to fully reflect nurses’ impact on patient care. We call for a balanced measurement portfolio focused on patient/family-, unit-, and systems-level outcomes. We focus on what nurses do and what patients and their families can expect rather than only on the elimination of select adverse events. We provide a way forward to allow measure development and implementation with incentives for their use. This approach to making nurses’ contributions and impact on outcomes visible will enhance acute and critical care nursing practice and benefit patients and their families.

Burden of disease due to ambient particulate matter pollution in Germany from 2010 to 2021

Abstract Background Worldwide, according to the global burden of disease (GBD) study, around 118 million disability-adjusted life years (DALYs) were attributable to ambient particulate matter (PM2.5) in 2019. Further, 97% of Europe’s urban population are exposed to annual average levels of PM2.5 above the World Health Organization’s guideline value of 5 µg/m³. In Germany, considerable efforts have been made to reduce PM2.5-emissions, which resulted in a continuous decrease of exposure. We estimated the burden of disease attributable to PM2.5-exposure in Germany for a time series from 2010 to 2021. Methods We used the environmental burden of disease (EBD) methodology developed by the WHO. For the exposure assessment we combined annual average measured and modelled PM2.5-concentrations with information on population density at a 2-by-2 km² grid. Using the exposure-response functions from GBD 2019, we estimated the EBD for chronic obstructive pulmonary diseases, type 2 diabetes mellitus, lung cancer, stroke and ischemic heart diseases (IHD). National surveys and register data were used to estimate the baseline burden of disease. Results In total, we estimated 232,863 (95%-CI: 153,716-314,882) DALYs attributable to PM2.5 in 2021. We observed a reduction of about 50% compared to 2010. The highest attributable burden was estimated for IHD with 70,197 (95%-CI: 42,609-101,785) DALYs, which is about 8% of the overall IHD-burden. The mortality-to-morbidity ratio revealed that years lost due to death (YLLs) had a higher share (69.9%) of overall DALYs with 162,561 (95%-CI: 106,918-222,567) YLLs. Discussion Despite a decreasing trend of the EBD for PM2.5 in Germany since 2010, our results show that there is still a long way to a pollutant free environment as envisaged by the EU’s zero pollution ambition. Using EBD as a standardized methodology and the DALYs as the core measure allows to have a comprehensive and comparable overview of the impact of PM2.5 on population health. Key messages • Ambient particulate matter pollution is an important environmental risk factor in Germany. • The decreasing trends is encouraging but there is still a long way to go to meet the objectives of the EU’s zero pollution ambition.

Performance and trend of core measures among oral cancer patients: A population-based cohort study

Abstract Objectives This study explores the performance and trend of core measures, which were established as evidence-based indicators to assess and improve the quality of care for oral cancer patients. Methods This retrospective cohort study uses the National Health Insurance Research Database (NHIRD), Taiwan Cancer Registry, and Cause of Death Statistics, provided by the Health and Welfare Data Science Center (HWDC), Ministry of Health and Welfare (MOHW). The study population was adult patients hospitalized for oral cancer surgery with stage I-IV between 2014 and 2021. The trend tests and the generalized linear mixed model (GLMM) were applied. Results A total of 23392 oral cancer patients were enrolled. The core measure set used in this study included five indicators (two process-related and three outcome-related indicators). Process indicators’ mean achievement rates significantly increased from 82.6% to 85.7% (p = 0.018, trend test). On the other hand, most patients demonstrated good achievement rates to the outcome indicators (98.9% to 99.3%) (p = 0.218, trend test). Overall indicators’ 100% achievement rate increased over time from 62.9% in 2014 to 66.2% in 2021 (p < 0.001, trend test). Subgroup analyses were performed by age, stage, and comorbidity score. The analysis of the GLMM revealed that the 100% achievement to overall indicators was positively associated with age<45, not-low socioeconomic status, body mass index ≥ 24, squamous cell carcinoma, recent treatment year, treated with surgery only, negative surgical margins, and receiving care in a high-volume hospital (all p < 0.01). Conclusions The results highlight a significant measurable improvement in the quality of oral cancer care. However, there is still room for enhancement in process indicator performance. Key messages • The results highlight a significant measurable improvement in the quality of oral cancer care. • There is still room for enhancement in process indicator performance.

Characteristics, clinical care, and outcomes of sepsis among patients boarding in the emergency department.

Patients who first meet clinical criteria for sepsis while boarding in the emergency department (ED) may not receive optimal sepsis care. Assess the association between ED boarding status and sepsis quality of care and outcomes. We conducted a retrospective cohort study of adult patients admitted to a large academic hospital from July 2021 to October 2023 who had clinical features consistent with sepsis present while physically in the ED. We compared outcomes for patients who experienced time zero (T-0; the time clinical features of sepsis were first present) while boarding in the ED (physically in the ED but admitted to a different service) to those experiencing T-0 while still under the care of the ED provider team. We used logistic regression to estimate the association between ED boarding status at T-0 and compliance with the US Centers for Medicare & Medicaid Services (CMS) Severe Sepsis and Septic Shock: Management Bundle (SEP-1) core measure, individual bundle element compliance, and hospital mortality adjusting for prespecified covariates. In a subgroup analysis among patients who had not already received antibiotics before T-0, we conducted a Cox proportional hazards model to estimate the association between boarding status on time-to-antibiotics. Among 4795 patients meeting a clinical definition of sepsis in the ED, 422 (8.8%) experienced T-0 as ED boarders. These patients were similar in age, sex, and comorbidities compared with patients experiencing T-0 while still under ED care. Fewer patients with T-0 as an ED boarder received SEP-1 compliant care (25% vs. 38%, p < .001), including a lower proportion of fluid resuscitation (15% vs. 26%, p = .004) and lactate assessment (62% vs. 94%, p < .001). Overall, more patients in the ED boarder group received antibiotics within 3 hours, but one-third of patients had already received antibiotics prior to T-0. Among patients who had not already received antibiotics prior to T-0, experiencing T-0 as an ED boarder was associated with a decreased likelihood of receiving antibiotics (hazard ratio [HR]: 0.67 [95% confidence interval [CI], 0.54-0.84]) and longer time to antibiotics from T-0 (142 min vs. 100 min, p = .007). Sepsis patients experiencing T-0 as a boarder in the ED have a lower likelihood of receiving SEP-1 compliant care compared to patients who experience T-0 while still under ED care.

Moving towards a core measures set for patient safety in perioperative care: An e-Delphi consensus study.

A Core Measures Set (CMS) is an agreed standardized group of measures that should be assessed and reported in research for a specific condition or clinical area. This study undertook the development of a CMS for Patient Safety through a two-round, web-based Delphi consensus approach, in the context of the "Improving quality and patient SAFEty in surgical care through STandardisation and harmonization of perioperative care in Europe" (SAFEST) project-a collaborative, patient-centered and evidence-based European Union-funded project that aims to generate action-oriented evidence in perioperative care. We developed an Initial List of Measures via an umbrella review following the deployment of an e-Delphi method with an inclusive panel of experts to prioritize measures towards a consensualized Final List of Measures. All measures were rigorously assessed for both importance and feasibility. After the two rounds of the e-Delphi consensus method we observed 13 preoperative measures (40.6% of the initial number), 24 intraoperative measures (66.7%), 25 postoperative measures (20.3%) and 23 mixed period measures (41.1%) met consensus criteria for both importance and feasibility. Higher scores were detected in importance ratings compared to feasibility across all groups of measures. Importantly, numeric averages regarding pain-related measures differed in the assessment of patients when compared to that of Healthcare Professionals (HCPs). This work not only informs future SAFEST iterations but also sets a precedent for research into valid, patient-centered, and action-oriented perioperative safety measures.

Investigation on electronic and magnetic properties of Cr doped V2O5 thin films prepared by chemical solution deposition method

The present study examines the role of Cr doping on the electronic and magnetic behaviour of V2O5i.e. V2-xCrxO5 (x = 0, 0.05, and 0.10) thin films, prepared by chemical-solution deposition technique on Si (111) substrate. X-Ray diffraction technique shows the purity of the films and confirms no secondary phase formation. The atomic force microscopy was used to confirm the roughness of the films. A morphological investigation is done using High-resolution scanning electron microscopy associated with Energy dispersive X-Ray mapping of each element of the film. Fourier transform Infrared spectroscopy is utilised to identify functional groups that are present in obtained samples. The band-gap of these obtained samples is in the range of 0.8–0.6 eV, as examined by UV–Vis i.e., its value is decreasing with Cr doping. Using vibrating sample magnetometer, it is clear that samples shows ferromagnetic (FM) behaviour with saturation magnetization 0.3–0.6 μB/cc consistent with Langevin function fitting. It concludes the presence of FM behaviour of films and magnetization increases with carrier density, consistent with the carrier-induced origin of the ferromagnetism. X-ray photoemission spectroscopy (XPS) is utilised to understand its electronic properties. Core level spectra measurements suggest that V is in mixed state of 5+ and 4+. However Cr is in 3+ states. XPS and UV–Vis measurements imply that oxygen vacancies significantly contribute to the declination of the band gap and the promotion of FM-like behaviour. This discovery offers a promising pathway for engineering novel devices.

Comparison of depression with anxious distress and melancholic depression from the perspective of psychomotor disturbance.

In the DSM-5, it is specified that severe cases of major depressive disorder with anxious distress (ANXD) may be accompanied with motor agitation. Agitation, on the other hand, is one of the main characteristics of major depressive disorder with melancholic features (MEL). The purpose of this study was to compare ANXD and MEL in terms of psychomotor disturbance. A total of 106 patients with major depressive disorder were included in the study. Psychomotor disturbance was assessed using the CORE measure. The associations of ANXD and MEL with the CORE measure subscales of psychomotor retardation, agitation, and noninteractiveness were analyzed using multivariate logistic analysis. Retardation scores (odds ratio [OR] = 0.63, 95% confidence interval [CI] = 0.52-0.77) were associated with fewer diagnoses of ANXD, whereas agitation scores (OR = 2.23, 95% CI = 1.60-3.13) were associated with more diagnoses of ANXD. Both noninteractiveness (OR = 1.23, 95% CI = 1.06-1.42) and agitation (OR = 1.27, 95% CI = 1.02-1.58) scores were associated with increased diagnoses of MEL. Among the characteristics of psychomotor disturbance, agitation is a common feature of both ANXD and MEL, and ANXD and the agitated type of MEL may be overlapping concepts. On the other hand, ANXD is distinguished from the retarded type of MEL by its low level of retardation, whereas MEL but not ANXD is characterized by noninteractiveness.

A novel dual-core fiber-optic gyroscope with independent rotation rate measurements in different cores of a dual-core optical fiber

A novel dual-core fiber-optic gyroscope with independent rotation rate measurements in different cores of a dual-core optical fiber

Characterizing diffusion-controlled release of small-molecules using quantitative MRI in view of applications to orthopedic infection.

Calcium sulfate is an established carrier for localized drug delivery, but a means to non-invasively measure drug release, which would improve our understanding of localized delivery, remains an unmet need. We aim to quantitatively estimate the diffusion-controlled release of small molecules loaded into a calcium sulfate carrier through a gadobutrol-based contrast agent, which acts as a surrogate small molecule. A central cylindrical core made of calcium sulfate, either alone or within a metal scaffold, is loaded with contrast agents that release into agar. Multi-echo scans are acquired at multiple time points over 4weeks and processed into R2* and quantitative susceptibility mapping (QSM) maps. Mean R2* values are fit to a known drug delivery model, which are then compared with the decrease in core QSM. Fitting R2* measurements of calcium sulfate core while constraining constants to a drug release model results in an R2-value of 0.991, yielding a diffusion constant of 4.59 × 10-11m2s-1. Incorporating the carrier within a metal scaffold results in a slower release. QSM shows the resulting loss of susceptibility in the non-metal core but is unreliable around metal. R2* characterizes the released gadobutrol, and QSM detects the resulting decrease in core susceptibility. The addition of a porous metal scaffold slows the release of gadobutrol, as expected.

Prediction of shear wave velocity in three sedimentary rocks in East Baghdad oilfield using multiple regression analysis

Shear wave is a crucial parameter for assessing the wellbore stability, the stress response, and rock deformation. It is essential for constructing the mechanical earth model (MEM) for many applications related to reservoir geomechanics including wellbore stability, sand production, hydraulic fracturing, and fault reactivation. However, shear sonic data is often omitted during the well-logging measurements for cost and saving purposes. To overcome this challenge, recent research has been focused on determining shear wave velocity through the use of core plugs, empirical correlations, artificial intelligence techniques, and multiple regression to quantify and evaluate the mechanical properties of subsurface formations without performing direct measurements at the wellbore. The greatest difference between this study and the literature is to predict the shear wave velocities for three sedimentary rocks based on conventional well logs. This study has been conducted on datasets of two wells drilled in the East Baghdad oilfield, for which there is a lack of shear wave data. Two formations (Tanuma and Zubair formations) within the production section of this field were conducted to develop new models for determining the shear wave velocity using multiple regression analysis. These two formations primarily consist of three lithologies: limestone, sandstone, and shale. Before the model development, data analysis on the selected data was applied to figure the most influential parameter(s) in determining the shear wave velocity. The results of the developed models are then compared with the previous models in the literature. The results showed that the multiple regression analysis technique is a powerful technique in determining shear wave velocity with high-performance capacity. The correlation coefficient ( ) and the root mean square error (RMSE) were 0.84 and 0.092 for limestone, 0.84 and 0.0972 for sandstone, and 0.86 and 0.0796 for shale respectively. Furthermore, the performance of the developed models is well matched to the actual shear wave data rather than the Castagna correlations. The findings of this study are effective in determining shear wave velocity for future applications related to reservoir geomechanics without needing costly well-log or core measurements.

A soil moisture experiment for validating high-resolution satellite products and monitoring irrigation at agricultural field scale

Validating the satellite soil moisture products is always an active research topic for the application of the products and improvement of the retrieval algorithms, attracting extensive attention. Nevertheless, seldom existing validation activities focus on the validation of high-resolution soil moisture products at the fine scale. To this end, an experiment was conducted in the middle stream of the Heihe River Basin in northwestern China in August to October of 2021, aiming to validate high-resolution satellite remote sensing products of soil moisture. The paper introduces the design, composite, and preliminary results of the experiment. A soil moisture observation network was established with two kinds of sensors (CS616 and Stevens Hydra Probe) validated against soil core measurements. Several synchronized campaigns were performed, and data were collected to validate the SMAP/Sentinel-1 L2 Radiometer/Radar 30-Second Scene 3 and 1 km EASE-Grid Soil Moisture (SPL2SMAP_S) products. Besides, an optical trapezoid model (OPTRAM) and collected Sentinel-2 data were applied to estimate soil moisture and to map irrigated area. Preliminary analyses show that: 1) Steven probes perform best, with an RMSE = 0.040 m3m−3 and ubRMSE=0.034 m3m−3; 2) Both the SPL2SMAP_S products at 3 km and 1 km show large RMSE (0.128 m3m−3 for 3 km and 0.158 m3m−3 for 1 km) and ubRMSE (0.115 m3m−3 for 3 km and 0.158 m3m−3 for 1 km); 3) The OPTRAM retrievals over bare surface present relatively smaller RMSE (0.06 m3m−3) and ubRMSE (0.057 m3m−3), while retrievals over vegetated croplands present a relatively large RMSE/ubRMSE (0.083/0.083 m3m−3), and the retrievals can identify the irrigated area at field scale. Overall, the experiment provides fruitful methodologies and datasets for the validation of high-resolution remote sensing products, benefiting the development and improvement of soil moisture retrieval algorithms and products to support irrigation scheduling and management at a precision agricultural scale in the future.

Accuracy of non-invasive core temperature monitoring in infant and toddler patients: a prospective observational study.

Careful perioperative temperature management is important because it influences clinical outcomes. In pediatric patients, the esophageal temperature is the most accurate indicator of core temperature. However, it requires probe insertion into the body cavity, which is mildly invasive. Therefore, a non-invasive easily and continuously temperature monitor system is ideal. This study aimed to assess the accuracy of Temple Touch Pro™ (TTP), a non-invasive temperature monitoring using the heat flux technique, compared with esophageal (Tesoph) and rectal (Trect) temperature measurements in pediatric patients, especially in infants and toddlers. This single-center prospective observational study included 40 pediatric patients (< 3years old) who underwent elective non-cardiac surgery. The accuracy of TTP was analyzed using Bland-Altman analysis and compared with Tesoph or Trect temperature measurements. The error was within ± 0.5°C and was considered clinically acceptable. The bias ± precision between TTP and Tesoph was 0.09 ± 0.28°C, and 95% limits of agreement were - 0.48 to 0.65°C (error within ± 0.5°C: 94.0%). The bias ± precision between TTP and Trect was 0.41 ± 0.38°C and 95% limits of agreement were - 0.35 to 1.17°C (error within ± 0.5°C: 68.5%). In infants, bias ± precision with 95% limits of agreement were 0.10 ± 0.30°C with - 0.50 to 0.69°C (TTP vs. Tesoph) and 0.35 ± 0.29°C with - 0.23 to 0.92°C (TTP vs. Trect). Core temperature measurements using TTP in infants and toddlers were more accurate with Tesoph than with Trect. In the future, non-invasive TTP temperature monitoring will help perioperative temperature management in pediatric patients.

Upgrade of DIII-D radial interferometer-polarimeter for large bandwidth, low noise, and toroidal mode number measurements.

Near ion-cyclotron frequency (fci) fluctuations, such as those originating from Global and Compressional Alfvén Eigenmodes (GAEs/CAEs), are expected to be present in future fusion reactors but are not well understood due to the limited availability of core measurements in present-day tokamaks. The measurement bandwidth of the Radial Interferometer-Polarimeter (RIP) diagnostic has been upgraded from 1 to 5MHz to detect these fluctuations in DIII-D. RIP adopts the three-wave technique for simultaneous polarimetric and interferometric measurements. Solid-state microwave sources operating at 650GHz are used as probe beams and provide 5MHz bandwidth for both polarimetric and interferometric measurements. Bandwidths of related hardware, including mixer amplifier, signal cable, and digital phase demodulator, are increased correspondingly. Measurement noise is minimized by reducing the time delay between reference and probe signals to nanosecond level and employing correlation-based techniques. Using the upgraded diagnostic, CAE/GAE-like bursting fluctuations are observed in neutral-beam heated plasmas with toroidal magnetic field Bφ ≈ 1 T. Current upgrades being undertaken would enable the evaluation of toroidal mode number for these modes. This work opens the possibility of better understanding near ion-cyclotron frequency fluctuations in fusion relevant plasmas.

Economic growth and national security: Patterns of European countries’ resistance to global turbulences

Macroeconomic stability and national security are core measurement indicators of country performance. Historical, economic, social and other prerequisites contribute to the formation of country-specific patterns of these performance indicators resistance to global turbulences such as COVID-19 pandemic. Pandemic proved that considering of public health issues in promoting economic prosperity, social welfare and environmental security is crucially important. The aim of the research is to identify country-specific (for 34 European countries) patterns of socio-economic (internal) and public health (external) drivers and inhibitors of ensuring economic growth, macroeconomic stability and national security resistance to global turbulences similar to COVID-19 pandemic. Realization of the research objectives involves the implementation of the following stages: 1) identification of the general and country-specific the most influential internal impetus indicators fostering volatility socio-economic development and national security based on multivariate analysis; 2) formation of general and country-specific matrix of influential determinants of ensuring macroeconomic stability and national security resistance to global turbulences similar to COVID-19 pandemic; 3) formalization general and country-specific external drivers and inhibitors of macroeconomic stability and national security volatility within public health determinants. The study is carried out on a sample of 34 European countries for 2000-2022.

Radiated power and soft x-ray diagnostics in the SMART tokamak.

A multi-energy soft x-ray diagnostic is planned to operate in the small aspect ratio tokamak (SMART), consisting of five cameras: one for core measurements, two for edge, and two for divertors. Each camera is equipped with four absolute extreme ultra-violet diodes, with three of them filtered by Ti and Al foils for C and O line emissions, respectively, and Be foils for temperature measurements. In addition, two spectrometers will be installed with a vertical line of sight for impurity control. This study introduces a synthetic model designed to characterize radiated power and soft x-ray emissions. The developed code extracts the radiated power and Zeff values by leveraging distributions of electron density, temperatures, and impurity concentrations. The investigation is centered on the predicted scenarios of SMART's first phase of operation (Ip = 100kA; Bt = 0.1T), employing a double-null configuration with positive and negative triangularity. The anticipated impurities encompass C (1%) and Fe (0.01%) from the vessel, as well as O and N (0.1%) from air and water. For simplicity, the distribution is assumed to be homogeneous within the plasma, considering different mixtures with Zeff values ranging between 1 and 2. Finally, the model estimates signal strength for the diagnostic design, proving its feasibility.

Development of a Core Outcome Measure Instrument; "LeishCOM_LCL", for Localised Cutaneous Leishmaniasis.

Localized cutaneous leishmaniasis (LCL) is a chronic ulcerating disease. A literature review identified inconsistencies in clinical trials. The aims of this study were to reach a consensus on the most important domains to measure when assessing LCL, agree on parameters to measure the domains, and develop a tool representing a Core Outcome Set (COS), for use in clinical assessment of LCL. A literature review was conducted to identify any existing COS for LCL embracing agreed Outcome Domains, i.e. what to measure and any Outcome Measurement Instruments (OMIs). As no COS was available, potential outcome domains for assessment of LCL were identified through an international collaborative approach using e-consultations and virtual discussions with expert stakeholders (n = 20) from geographically different LCL endemic countries. Subsequent judgmental validation process included a face-to-face multidisciplinary stakeholders' meeting adopting the Nominal Group Technique. A final consensual agreement on outcome domains and items required to measure these domains was established. "Clinical Cure" was defined as the ideal overall "General Concept". The five Core Outcome Domains included Signs capturing clinical morphology, diameter, and induration of an index lesion with the aid of a palpability score, Treatment Efficacy assessing percentage change in size of the lesion and re-epithelialization compared to baseline, Treatment Impact which included an investigator and patient visual analogue score, and Clinical Sequelae rating pigment change, atrophic and hypertrophic/keloid scars. It was agreed that two open-ended questions should be included to capture some aspects of Health-Related Quality of Life as a means of capturing a patient-focused approach. LeishCOM_LCL was generated to reflect a COS for LCL. This captured demographic details, agreed outcome domains and measures to assess these domains. Validation of LeishCOM_LCL will be reported in a separate paper. Development of a Patient Reported Outcome Measure will be considered in the future.

State Institutions and Development in South Africa: The Case of Two State-Owned Enterprises

The debate on state institutions in the economic development of developing countries has been ongoing for the past three decades. In the 1980s, the debate was dominated by the importance of state-owned enterprises (SOEs) and transitioned to the privatisation of SOEs in the early1990s. The debate re-emerged in 2010 due to the increasing influence of Chinese SOEs in the global economy. While the corporatisation of SOEs led to financial results being the core measure of good governance and performance, balancing financial performance with societal socio-economic impact is necessary for developing nations as SOEs are established to stimulate social and economic development. This article uses secondary data to explore the social and economic impact of two South African SOEs—the Industrial Development Corporation (IDC) and the Development Bank of Southern Africa (DBSA)—to contribute to the ongoing debate on the importance of state institutions on the development of developing countries. The article demonstrates the criticalness of the IDC in stimulating the country’s industrial development capacity and structural transformation, whereas the DBSA provides infrastructure investment to enable structural transformation through an enabling development ecosystem. While contributing to the merits of the state and development, failures and areas of interventions are also discussed.

Core outcomes measures in dental computer vision studies (DentalCOMS)

ObjectivesTo improve reporting and comparability as well as to reduce bias in dental computer vision studies, we aimed to develop a Core Outcome Measures Set (COMS) for this field. The COMS was derived consensus based as part of the WHO/ITU/WIPO Global Initiative AI for Health (WHO/ITU/WIPO AI4H). MethodsWe first assessed existing guidance documents of diagnostic accuracy studies and conducted interviews with experts in the field. The resulting list of outcome measures was mapped against computer vision modeling tasks, clinical fields and reporting levels. The resulting systematization focused on providing relevant outcome measures whilst retaining details for meta-research and technical replication, displaying recommendations towards (1) levels of reporting for different clinical fields and tasks, and (2) outcome measures. The COMS was consented using a 2-staged e-Delphi, with 26 participants from various IADR groups, the WHO/ITU/WIPO AI4H, ADEA and AAOMFR. ResultsWe assigned agreed levels of reporting to different computer vision tasks. We agreed that human expert assessment and diagnostic accuracy considerations are the only feasible method to achieve clinically meaningful evaluation levels. Studies should at least report on eight core outcome measures: confusion matrix, accuracy, sensitivity, specificity, precision, F-1 score, area-under-the-receiver-operating-characteristic-curve, and area-under-the-precision-recall-curve. ConclusionDental researchers should aim to report computer vision studies along the outlined COMS. Reviewers and editors may consider the defined COMS when assessing studies, and authors are recommended to justify when not employing the COMS. Clinical significanceComparing and synthesizing dental computer vision studies is hampered by the variety of reported outcome measures. Adherence to the defined COMS is expected to increase comparability across studies, enable synthesis, and reduce selective reporting.

Spatial variability of CH4 uptake in aerated soils of Yellow River Delta

The widespread occurrence of aerated plain soils underscores their significant role in the global soil methane (CH4) sink budget. However, plain soils are poorly characterized in terms of spatial variability of CH4 uptake and the relevant control. We investigated the intra- and inter-site spatial variability of CH4 uptake through flux measurements in intact soil cores from five non-wetland sites within the Yellow River Delta, each representing a distinct land use/cover type. Methane uptake rates were highest in undisturbed forest cores. The rates were very low, often falling below the detection limit, in cores from the other four sites. The significant correlation between CH4 uptake and bulk density across sites suggests the integrative role of bulk density for the effects of different disturbances (including salt stress and succession) on CH4 uptake. Methane uptake was heterogeneous at the within-site scale as indicated by large coefficients of variations (CVs). Soil texture variation manipulated the within-site pattern of CH4 uptake in the low-salinity sites. Salt affected the spatial variation of CH4 uptake only at high level of salinity. Neither Potter's nor Ridgwell's models effectively captured the within-site variation of CH4 uptake due to a texture-associated bias in the models. Establishing a quantitative relationship between CH4 uptake and clay content at the field scale in alluvial plain soils will facilitate the refinement of model parameters linked to texture and rectify biases in CH4 estimation. These results provide an insight for the biogeochemical control of CH4 uptake in alluvial plain soils and have important application for improving CH4 models.

Aging in Place

What Is the Issue? Canada is experiencing an important demographic transition toward an increasingly diverse aging population with an increased need for care and support during the later stages of life. Despite older adults’ strong preferences to live in their home or community for as long as possible, health systems are challenged to keep up with growing demands for home care, community care and support services to support conditions to age in place, when appropriate. What Did Canada’s Drug Agency Do? Canada’s Drug Agency prepared an Evidence Assessment report that identified and described the current context of aging and hinderances to aging in place in Canada, considerations relevant to aging in place for equity-deserving groups, strategies and initiatives intended to address unmet needs and improve outcomes, and systemic considerations related to implementing initiatives supporting aging in place. The Health Technology Expert Review Panel (HTERP) used the Canada’s Drug Agency Evidence Assessment report to inform deliberations and to develop objective, impartial, trusted pan-Canadian guidance for decision-makers when considering evidence-informed aging-in-place initiatives to support equitable aging in place in jurisdictions in Canada. What Is HTERP’s Position on Aging in Place? Everyone has the right to age with dignity. Aging is a normal part of life and may be accompanied by changes in health status and/or abilities to complete everyday self-care tasks. Older adults comprise a heterogenous population with a continuum of health care needs and risks, including people living with vitality, those with moderately complex care issues, and those with complex care issues. Health and social systems were originally designed to meet the less complex acute care needs of a younger population and operate largely in silos. They cannot adequately or proactively address the continuum of needs of many older adults and their caregivers. Aging in place is a dynamic and complex experience that occurs within a larger context that is not limited to health systems. Older adults’ autonomy and preferences for care are realized by the active role of informal unpaid caregivers. The population of older adults in Canada is diverse with varying needs, risks, and cultural norms and values related to aging in place. Barriers to aging in place may disproportionately affect members of equity-deserving groups that experience multiple and often intersecting historical, social, cultural, medical, structural, institutional, and environmental barriers to care and support. There must be equity in access to safe, appropriate, and ongoing care to support dignity in living in a place of one’s choosing for older adults as they age. What Is HTERP’s Guidance to Support Aging in Place? foster a system that prioritizes integrated models of care to address current and future unmet needs and bridge gaps in and between services identify interventions that are aligned within an integrated model of care and are responsive to the unique and complex needs of older adults and their unpaid caregivers ensure culturally appropriate and equitable opportunities for positive outcomes standardize core measures or indicators to guide data collection, analysis, use, and reporting that support robust evaluation and cross-jurisdictional comparisons of interventions.