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On 6 April 2009, a moderate earthquake (Mw = 6.3; Ml = 5.8) struck the Abruzzo region in central Italy, causing more than 300 fatalities and heavy damage to L'Aquila and surrounding villages. Coseismic surface effects have been thoroughly documented by timely field surveys as well as by remote sensing analyses of satellite images. The outstanding quality of geological, seismological, geodetic, and interferometric synthetic aperture radar (InSAR) information arguably represents the best ever data set made available immediately after a moderate seismic event. Based on this data set, we aim at testing the capability of coupled geological and InSAR data to map surface faulting patterns associated with moderate earthquakes. Coseismic ground ruptures have been mapped at a scale of 1:500 in the whole epicentral area. Traces of surface ruptures have been inferred from linear phase discontinuities identified in the interferogram. A very good agreement between the two methods resulted in the characterization of the main surface rupture along the Paganica fault. The same approach applied to ground ruptures hypothesized along other capable fault segments provided more questionable results. Thus, the combined field and InSAR approach appeared useful for detecting continuous surface ruptures exceeding 1 km in length and showing displacements greater than a few centimeters. These are the typical faulting parameters for moderate earthquakes (6.0 < Mw < 6.5) in central Apennines. For continuous ground cracks shorter than a few hundred meters and/or that show displacements smaller than 1–2 cm, the described approach may be less helpful, most probably due to the limited resolution of the data.

Using 3D terrestrial laser scan (TLS) technology, we have recorded postseismic deformation on and adjacent to the surface rupture formed during the 6th April 2009 L'Aquila normal faulting earthquake (Mw 6.3). Using surface modeling techniques and repeated surveys 8–124 days after the earthquake, we have produced a 4D dataset of postseismic deformation across a 3 × 65 m area at high horizontal spatial resolution. We detected millimetre‐scale movements partitioned between discrete surface rupture slip and development of a hangingwall syncline over 10's of meters. We interpret the results as the signal of shallow afterslip in the fault zone. We find 52% of the total postseismic hangingwall vertical motion occurs as deformation within 30 m of the surface rupture. The total postseismic vertical motions are approximately 50% that of the coseismic. We highlight the importance of quantifying partitioned postseismic contributions when applying empirical slip‐magnitude datasets to infer palaeoearthquake magnitudes.

Introduction The purpose of this study was to explore nurses' perspectives on Machine Learning Clinical Decision Support (ML CDS) design, development, implementation, and adoption. Design Qualitative descriptive study. Methods Nurses (n = 17) participated in semi‐structured interviews. Data were transcribed, coded, and analyzed using Thematic analysis methods as described by Braun and Clarke. Results Four major themes and 14 sub‐themes highlight nurses' perspectives on autonomy in decision‐making, the influence of prior experience in shaping their preferences for use of novel CDS tools, the need for clarity in why ML CDS is useful in improving practice/outcomes, and their desire to have nursing integrated in design and implementation of these tools. Conclusion This study provided insights into nurse perceptions regarding the utility and usability of ML CDS as well as the influence of previous experiences with technology and CDS, change management strategies needed at the time of implementation of ML CDS, the importance of nurse‐perceived engagement in the development process, nurse information needs at the time of ML CDS deployment, and the perceived impact of ML CDS on nurse decision making autonomy. Clinical Relevance This study contributes to the body of knowledge about the use of AI and machine learning (ML) in nursing practice. Through generation of insights drawn from nurses' perspectives, these findings can inform successful design and adoption of ML Clinical Decision Support.

Purpose Anorectal melanoma (ARM) poses a significant challenge due to the lack of established guidelines and a 5-year overall survival rate of less than 20%. The only recognized death risk factors are positive lymph nodes and positive surgical margins. This study aimed to identify the risk factors for local/distant recurrences and death in a 22-year multi-institutional experience. Methods All patients who underwent curative surgical resection or were referred to after resection at the Mayo Clinic for non-metastatic ARM (2002–2024) were included. Risk factors for local/distant recurrences, and deaths were assessed through multivariable Cox regression. Results Eighty-eight patients were included in the study. Seventy-eight percent of patients had anal melanoma and 22% rectal melanoma. Nineteen percent had clinically positive lymph nodes. The surgical margins were positive in 62% of local surgeries, while they were positive in 13% of radical surgery cases. The first recurrence was often a local recurrence (67%), followed by distant metastasis (21%), with an overall comparable overall survival between the two. Radiotherapy administration, radical surgery, and negative margins were associated with less local recurrence. Clinically positive lymph nodes and local recurrences increased the risk of developing distant metastasis over time. Clinically negative lymph nodes, radiotherapy administration, radical surgery, and negative margins all contributed to a reduced death risk. Conclusion Local recurrences in ARM may influence distant metastasis and death more than what was previously believed. Positive surgical margins in local surgery were remarkably high, reaching 62%. Protective factors for local recurrence and death included radical surgery, negative surgical margins, and radiotherapy.

Despite the increasing importance of innovative medications and bariatric surgery for the treatment of obesity, lifestyle interventions (diet and physical activity) remain the first-line therapy for this disease. The use of digital devices in healthcare aims to respond to the patient's needs, in order to make obesity treatment more accessible, so our study aims to assess the safety and efficacy of a Digital Therapy for Obesity App (DTxO) for achieving weight loss and its maintenance in patients affected with obesity undergoing an experimental non-pharmacological treatment. Here we present the study protocol of a prospective, multicenter, pragmatic, randomized, double-arm, placebo-controlled, parallel, single-blind study on obese patients who will be treated with a new digital therapy to obtain an improvement in their disease condition through the application of different simultaneous strategies (a dietary regimen and personalized advice program, a tailored physical exercise program, a cognitive–behavioural assessment and program, alerts and reminders, dedicated section on prescribed drugs intake, and chat and online visits with clinical professionals). We believe that DTxO will offer a promising intervention channel and self-regulation tool holding the potentiality to decrease treatment burden and treat more patients thanks to the partial replacement of traditional medical consultation with digital or telephone management, improving self- engagement and reducing the high demands the “obesity pandemic” for both patients and national health services in terms of time, cost, and effort. Clinical trial registration : clinicaltrials.gov , identifier, NCT05394779.

The purpose of this study was to investigate the effects of teaching the Test-Taking Strategy to high-functioning adolescents with autism spectrum disorders (ASD) through an intensive after-school program. Four secondary students participated in the study (i.e., one 11th, one 10th, one 8th, and one 6th grader). A multiple-probe design with four phases (i.e., baseline, instruction, generalization, maintenance) was used to measure the effects of the test-taking instruction. The results of this study showed that high-functioning adolescents with ASD can successfully acquire, generalize, and maintain the use of a comprehensive test-taking strategy. In addition, both participants' and their parents' satisfaction related to the test-taking instruction was high.

Because consumption of lead-contaminated sediment has been suspected as the cause of waterfowl mortality in the Coeur d'Alene River basin in Idaho, we studied the bioavailability and toxicity of this sediment to mallards (Anas platyrhynchos). In experiment 1, one of 10 adult male mallards died when fed a pelleted commercial duck diet that contained 24% lead-contaminated sediment (with 3,400 microgram/g lead in the sediment). Protoporphyrin levels in the blood increased as the percentage of lead-contaminated sediment in the diet increased. Birds fed 24% lead-contaminated sediment exhibited atrophy of the breast muscles, green staining of the feathers around the vent, viscous bile, green staining of the gizzard lining, and renal tubular intranuclear inclusion bodies. Mallards fed 24% lead-contaminated sediment had means of 6.1 microgram/g of lead in the blood and 28 microgram/g in the liver (wet-weight basis) and 1,660 microgram/g in the feces (dry-weight basis). In experiment 2, we raised the dietary concentration of the lead-contaminated sediment to 48%, but only about 20% sediment was actually ingested due to food washing by the birds. Protoporphyrin levels were elevated in the lead-exposed birds, and all of the mallards fed 48% lead-contaminated sediment had renal tubular intranuclear inclusion bodies. The concentrations of lead in the liver were 9.1 microgram/g for mallards fed 24% lead-contaminated sediment and 16 microgram/g for mallards fed 48% lead-contaminated sediment. In experiment 3, four of five mallards died when fed a ground corn diet containing 24% lead-contaminated sediment (with 4,000 microgram/g lead in this sample of sediment), but none died when the 24% lead-contaminated sediment was mixed into a nutritionally balanced commercial duck diet; estimated actual ingestion rates for sediment were 14% and 17% for the corn and commercial diets. Lead exposure caused elevations in protoporphyrin, and four of the five mallards fed 24% lead-contaminated sediment in a commercial diet and all five fed the contaminated sediment in a corn diet had renal intranuclear inclusion bodies. Lead was higher in the livers of mallards fed 24% lead-contaminated sediment in the corn diet (38 microgram/g) than in the commercial diet (13 microgram/g).

Sediment ingestion has been identified as an important exposure route for toxicants in waterfowl. The toxicity of lead-contaminated sediment from the Coeur d'Alene River Basin (CDARB) in Idaho was examined on posthatching development of mallard (Anas platyrhynchos) ducklings for 6 weeks. Day-old ducklings received either untreated control diet, clean sediment (24%) supplemented control diet, CDARB sediment (3,449 microg/g lead) supplemented diets at 12% or 24%, or a positive control diet containing lead acetate equivalent to that found in 24% CDARB. The 12% CDARB diet resulted in a geometric mean blood lead concentration of 1.41 ppm (WW) with over 90% depression of red blood cell ALAD activity and over threefold elevation of free erythrocyte protoporphyrin concentration. The 24% CDARB diet resulted in blood lead of 2.56 ppm with over sixfold elevation of protoporphyrin and lower brain weight. In this group the liver lead concentration was 7.92 ppm (WW), and there was a 40% increase in hepatic reduced glutathione concentration. The kidney lead concentration in this group was 7.97 ppm, and acid-fast inclusion bodies were present in the kidneys of four of nine ducklings. The lead acetate positive control group was more adversely affected in most respects than the 24% CDARB group. With a less optimal diet (mixture of two thirds corn and one third standard diet), CDARB sediment was more toxic; blood lead levels were higher, body growth and liver biochemistry (TBARS) were more affected, and prevalence of acid-fast inclusion bodies increased. Lead from CDARB sediment accumulated more readily in duckling blood and liver than reported in goslings, but at given concentrations was generally less toxic to ducklings. Many of these effects are similar to ones reported in wild mallards and geese within the CDARB.

In the framework of the European project \"OHvero\", an experimental olive grove (cv Maiatica) apparently unaffected by olive knot disease was divided in two parts. One, called \"organic\", was managed by cover cropping and compost amendment and the second, called \"tillage\", was managed by soil tillage and burning of pruning material. Foliar fertilization at the flowering and olive stone hardening stages was administered to both areas. In each area, three olive plants in the erosion and accumulation zones, as well as in the zone with a highly active erosive process were selected. Periodically, leaves in the median part of one-year-old twigs were collected and, after washing under agitation, aliquots of the liquid were distributed either on KB or on the semi-selective Pseudomonas savastanoi pv. savastanoi medium ANSS. The majority of the epiphytic bacteria were Gram-positive and most of them in dual agar plate assays inhibited the growth of Ps. pv. savastanoi. No bacteria with the feature of Ps. pv. savastanoi were isolated. In general the epiphytic population density varied with the seasons being higher in late spring (May-June) and lower in late winter (February). In late spring the highest population densities were observed in the accumulation zone where the level of available mineral nutrients was higher. In late winter, the lowest population densities were observed in the accumulation zone of the \"tillage\" area, though no difference in the nutritional state of the trees between the two areas was observed. Apparently other as yet unidentified factors are responsible for the above effect.