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A Bell test is a randomized trial that compares experimental observations against the philosophical worldview of local realism 1 , in which the properties of the physical world are independent of our observation of them and no signal travels faster than light. A Bell test requires spatially distributed entanglement, fast and high-efficiency detection and unpredictable measurement settings 2 , 3 . Although technology can satisfy the first two of these requirements 4 – 7 , the use of physical devices to choose settings in a Bell test involves making assumptions about the physics that one aims to test. Bell himself noted this weakness in using physical setting choices and argued that human ‘free will’ could be used rigorously to ensure unpredictability in Bell tests 8 . Here we report a set of local-realism tests using human choices, which avoids assumptions about predictability in physics. We recruited about 100,000 human participants to play an online video game that incentivizes fast, sustained input of unpredictable selections and illustrates Bell-test methodology 9 . The participants generated 97,347,490 binary choices, which were directed via a scalable web platform to 12 laboratories on five continents, where 13 experiments tested local realism using photons 5 , 6 , single atoms 7 , atomic ensembles 10 and superconducting devices 11 . Over a 12-hour period on 30 November 2016, participants worldwide provided a sustained data flow of over 1,000 bits per second to the experiments, which used different human-generated data to choose each measurement setting. The observed correlations strongly contradict local realism and other realistic positions in bipartite and tripartite 12 scenarios. Project outcomes include closing the ‘freedom-of-choice loophole’ (the possibility that the setting choices are influenced by ‘hidden variables’ to correlate with the particle properties 13 ), the utilization of video-game methods 14 for rapid collection of human-generated randomness, and the use of networking techniques for global participation in experimental science. The BIG Bell Test, which used an online video game with 100,000 participants worldwide to provide random bits to 13 quantum physics experiments, contradicts the Einstein–Podolsky–Rosen worldview of local realism.

Introduction: Cerebral malaria, a syndrome of altered consciousness, is a rare and severe neurologic complication resulting from Plasmodium falciparum.1 Historically, cerebral malaria has been seen more frequently in children rather than adults. To complicate the diagnosis, cerebral malaria has few specific symptoms and neurologic findings can vary with each case. Case Report: We describe a case of a 61-year-old male who returned from the Democratic Republic of Congo and presented to the emergency department with dehydration, fatigue, and intermittent confusion. He was ultimately diagnosed with cerebral malaria caused by P. falciparum. Conclusion: Even with close monitoring and appropriate treatment, cerebral malaria carries a severe risk of long-term neurocognitive deficits and a high mortality rate.

Field studies were conducted in 2016 and 2017 to determine if multispectral imagery collected from an unmanned aerial vehicle (UAV) equipped with a five-band sensor could successfully identify Palmer amaranth (Amaranthus palmeri) infestations of various densities growing among soybeans (Glycine max [L.] Merr.). The multispectral sensor captures imagery from five wavebands: 475 (blue), 560 (green), 668 (red), 840 (near infrared [NIR]), and 717 nm (red-edge). Image analysis was performed to examine the spectral properties of discrete Palmer amaranth and soybean plants at various weed densities using these wavebands. Additionally, imagery was subjected to supervised classification to evaluate the usefulness of classification as a tool to differentiate the two species in a field setting. Date was a significant factor influencing the spectral reflectance values of the Palmer amaranth densities. The effects of altitude on reflectance were less clear and were dependent on band and density being evaluated. The near infrared (NIR) waveband offered the best resolution in separating Palmer amaranth densities. Spectral separability in the other wavebands was less defined, although low weed densities were consistently able to be discriminated from high densities. Palmer amaranth and soybean were found to be spectrally distinct regardless of imaging date, weed density, or waveband. Soybean exhibited overall lower reflectance intensity than Palmer amaranth across all wavebands. The reflectance of both species within blue, green, red, and red-edge wavebands declined as the season progressed, while reflectance in NIR increased. Near infrared and red-edge wavebands were shown to be the most useful for species discrimination and maintained their utility at most weed densities. Palmer amaranth weed densities were found to be spectrally distinct from one another in all wavebands, with greatest distinction when using the red, NIR and red-edge wavebands. Supervised classification in a two-class system was consistently able to discriminate between Palmer amaranth and soybean with at least 80% overall accuracy. The incorporation of a weed density component into these classifications introduced an error of 65% or greater into these classifications. Reducing the number of classes in a supervised classification system could improve the accuracy of discriminating between Palmer amaranth and soybean.

Italian ryegrass [ Lolium perenne L. ssp. multiflorum ( Lam .) Husnot ] is one of the most challenging weeds for winter wheat ( Triticum aestivum L.) growers to manage. Italian ryegrass has evolved resistance to the majority of the herbicides labeled for use in wheat and the competitive ability of the species makes it a significant factor driving winter wheat production practices around the world. Previous research has utilized remotely sensed spectral imagery to detect Italian ryegrass in winter wheat to aid weed control decisions. Two studies from 2016 to 2017 were initiated with the intent of identifying the spectral reflectance properties of Italian ryegrass and winter wheat using an unmanned aerial vehicle (UAV) equipped with a 5-band multispectral sensor. Image analysis was conducted to determine the potential for species discrimination throughout the growing season. Supervised classification of the imagery was used to evaluate the ability of the UAV platform for further discrimination between Italian ryegrass and winter wheat. Species differentiation proved to be possible, however the data was not able to be referenced across dates. Due to light variability, the reflectance values changed to such a degree that unsupervised classifications were not possible using a database of values from previous flights. Supervised classification of the multispectral image resulted in >70% classification accuracy between the species. However, near infrared light consistently differed enough for accurate classification between Italian ryegrass and winter wheat across different weed densities, flight altitudes, and imaging dates. On a single field basis, species differentiation was successful and resulted in classified maps of Italian ryegrass and winter wheat. This study also analyzed the exact accuracy of the species differentiation based on the quality and uniformity of light conditions and growth stage of plants.

Received for publication September 21, 2006. Increased CO2 release from soils resulting from agricultural practices such as tillage has generated concerns about contributions to global warming. Maintaining current levels of soil C and/or sequestering additional C in soils are important mechanisms to reduce CO2 in the atmosphere through production agriculture. We conducted a study in northern Alabama from 2003 to 2006 to measure CO2 efflux and C storage in long-term tilled and non-tilled cotton (Gossypium hirsutum L.) plots receiving poultry litter or ammonium nitrate (AN). Treatments were established in 1996 on a Decatur silt loam (clayey, kaolinitic thermic, Typic Paleudults) and consisted of conventional-tillage (CT), mulch-tillage (MT), and no-tillage (NT) systems with winter rye [Secale cereale (L.)] cover cropping and AN and poultry litter (PL) as nitrogen sources. Cotton was planted in 2003, 2004, and 2006. Corn was planted in 2005 as a rotation crop using a no-till planter in all plots, and no fertilizer was applied. Poultry litter application resulted in higher CO2 emission from soil compared with AN application regardless of tillage system. In 2003 and 2006, CT (4.39 and 3.40 μmol m-2 s-1, respectively) and MT (4.17 and 3.39 μmol m-2 s-1, respectively) with PL at 100 kg N ha-1 (100 PLN) recorded significantly higher CO2 efflux compared with NT with 100 PLN (2.84 and 2.47 μmol m-2 s-1, respectively). Total soil C at 0- to 15-cm depth was not affected by tillage but significantly increased with PL application and winter rye cover cropping. In general, cotton produced with NT conservation tillage in conjunction with PL and winter rye cover cropping reduced CO2 emissions and sequestered more soil C compared with control treatments.

IntroductionInequities in COVID-19 infection and vaccine uptake among historically marginalised racial and ethnic groups in the USA persist. Individuals with rheumatic conditions, especially those who are immunocompromised, are especially vulnerable to severe infection, with significant racialised inequities in infection outcomes and in vaccine uptake. Structural racism, historical injustices and misinformation engender racial and ethnic inequities in vaccine uptake. The Popular Opinion Lleader (POL) model, a community-based intervention that trains trusted community leaders to disseminate health information to their social network members (eg, friends, family and neighbours), has been shown to reduce stigma and improve care-seeking behaviours.Methods and analysisThis is a community-based cluster randomised controlled trial led by a team of community and academic partners to compare the efficacy of training POLs with rheumatic or musculoskeletal conditions using a curriculum embedded with a racial justice vs a biomedical framework to increase COVID-19 vaccine uptake and reduce vaccine hesitancy. This trial began recruitment in February 2024 in Boston, Massachusetts and Chicago, Illinois, USA. Eligible POLs are English-speaking adults who identify as Black and/or of African descent, have a diagnosis of a rheumatic or musculoskeletal condition and have received >=1 COVID-19 vaccine after 31 August 2022. POLs will be randomised to a 6-module virtual educational training; the COVID-19 and vaccine-related content will be the same for both groups however the framing for arm 1 will be with a racial justice lens and for arm 2, a biomedical preventative care-focused lens. Following the training, POLs will disseminate the information they learned to 12–16 social network members who have not received the most recent COVID-19 vaccine, over 4 weeks. The trial’s primary outcome is social network member COVID-19 vaccine uptake, which will be compared between intervention arms.Ethics and disseminationThis trial has ethical approval in the USA. This has been approved by the Mass General Brigham Institutional Review Board (IRB, 2023P000686), the Northwestern University IRB (STU00219053), the Boston University/Boston Medical Center IRB (H-43857) and the Boston Children’s Hospital IRB (P00045404). Results will be published in a publicly accessible peer-reviewed journal.Trial registration numberNCT05822219.

Field experiments were conducted on two North Carolina research stations in 1999, 2000, and 2001; on-farm in Lenoir, Wayne, and Wilson counties, NC, in 2002; and on-farm in Port Royal, VA, in 2000, 2001, and 2002 to evaluate possible gains from site-specific herbicide applications at these locations. Fields were scouted for weed populations using custom software on a handheld computer linked to a Global Positioning System. Scouts generated field-specific sampling grids and recorded weed density information for each grid cell. The decision aid HADSS™ (Herbicide Application Decision Support System) was used to estimate expected net return and yield loss remaining after treatment in each sample grid of every field under differing assumptions of weed size and soil moisture conditions, assuming the field was planted with either conventional or glyphosate-resistant (GR) soybean. The optimal whole-field treatment (that treatment with the highest expected net return summed across all grid cells within a field) resulted in average theoretical net returns of $79/ha (U.S. dollars) and $139/ha for conventional and GR soybean, respectively. When the most economical treatment for each grid cell was used in site-specific weed management, theoretical net returns increased by $13/ha (conventional) and $4.50/ha (GR), and expected yield loss after treatment was reduced by 10.5 and 4%, respectively, compared with the whole-field optimal treatment. When the most effective treatment for each grid cell was used in site-specific weed management, theoretical net returns decreased by $18/ha (conventional) and $4/ha (GR), and expected yield loss after treatment was reduced by 27 and 19%, respectively, compared with the whole-field optimal treatment. Site-specific herbicide applications could have reduced the volume of herbicides sprayed by as much as 70% in some situations but increased herbicide amounts in others. On average, the whole-field treatment was optimal in terms of net return for only 35% (conventional) and 57% (GR) of grid cells.

Phosphorus (P) in runoff from landscapes can promote eutrophication of natural waters. Soluble P released from plant material can contribute significant amounts of P to runoff particularly after plant freezing or drying. This study was conducted to evaluate P losses from alfalfa or grass after freezing or drying as potential contributors to runoff P. Alfalfa (Medicago sativa L.) and grass (principally, Agropyron repens L.) plant samples were subjected to freezing and drying treatments to determine P release. Simulated rainfall runoff and natural runoff from established alfalfa fields and a grass waterway were collected to study P contributions from plant tissue to runoff. The effects of freezing and drying on P released from plant tissue were simulated by a herbicide treatment in selected experiments. Soluble reactive P (SP) extracted from alfalfa and grass samples was markedly increased by freezing or drying. In general, SP extracted from plant samples increased in the order fresh < frozen < frozen/thawed < dried, and averaged 1, 8, 14, and 26% of total P in alfalfa, respectively. Soluble reactive P extracted from alfalfa after freezing or drying increased with increasing soil test P (r2 = 0.64 to 0.68), suggesting that excessive soil P levels increased the risk of plant P contributions to runoff losses. In simulated rainfall studies, paraquat (1,1'-dimethyl-4, 4''-bipyridinium ion) treatment of alfalfa increased P losses in runoff, and results suggested that this treatment simulated the effects of drying on plant P loss. In contrast to the simulated rainfall results, natural runoff studies over 2 yr did not show higher runoff P losses that could be attributed to P from alfalfa. Actual P losses likely depend on the timing and extent of plant freezing and drying and of precipitation events after freezing.

Abstract African-American (AA) family caregivers may have insufficient knowledge to make informed end-of-life (EOL) treatment decisions for relatives with dementia. ACT-Plan, a community-based education intervention, was conducted to enhance knowledge of dementia, cardiopulmonary resuscitation (CPR), mechanical ventilation (MV), tube feeding (TF), self-efficacy to make EOL treatment decisions, and intentions to make EOL care plans in advance. This study evaluated the efficacy of ACT-Plan compared to attention control. In a theoretically based, two-group, cluster-randomized controlled trial, AA caregivers were recruited from four similar Midwestern urban mega-churches randomized to experimental or control conditions. Each church enrolled 5 to 9 participants in 4 weekly 1-hour sessions in concurrent waves (355 total: ACT-Plan n = 171, control n = 184). Dementia, CPR, MV, and TF treatments were discussed in ACT-Plan classes. Attention control addressed health promotion topics. Participants completed assessments before the initial class, after the final class (Week 4), and Week 20. Mixed-effects regression analyses compared the groups, adjusting for cluster randomization and repeated measures. Knowledge of CPR, MV, TF, and self-efficacy to make EOL treatment decisions increased statistically in the ACT-Plan group but not the control group, whereas intentions to administer treatments decreased (Cohen’s d: knowledge 0.41–0.79, self-efficacy 0.45–0.60, intention -0.81 to -0.54, all p < 0.03). Similar proportions of participant groups wrote or intended to write care plans (25% and 55%, respectively; all p > 0.40). While ACT-Plan treatments increased caregivers’ knowledge and self-efficacy and decreased intentions to administer treatments, more support is needed for creating written care plans.