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Background In Germany, the telephone patient service 116,117 for callers with non-life-threatening health issues is available 24/7. Based on structured initial assessment, urgency and placement of suitable medical care offer have been offered since 2020. The service has been in increasing demand for several years: Depending on time and residence, this can result in longer waiting times. Methods Prospective, two-armed cohort study with two intervention groups and one control group, alternating between blinding and unblinding for employees of 116,117 regarding prioritization status. Two interventions based on automated voice dialogues (1: Simple self-rating tool, 2: Automated brief query of emergency symptoms). In case of high level of urgency, callers are prioritized. Validation of urgency and need for care is carried out routinely based on structured initial assessment. Discussion By creating and providing a largely reproducible documentation of the implemented solutions for a waiting queue management, the developed approach would be available for comparable projects in the German health care system or in the European context. This potentially leads to a reduction in the use of resources in the development of comparable technical solutions based on automated voice dialogs. Trial registration DRKS00031235, registered on 10th November 2023, https://drks.de/search/de/trial/DRKS00031235 .

The dynamic response and failure characteristics of tunnels vary significantly under various dynamic disturbances. These characteristics are crucial for assessing structural stability and designing effective support for surrounding rock. In this study, the theoretical solution for the dynamic stress concentration factor (DSCF) of a circular tunnel subjected to cylindrical and plane P-waves was derived using the wave function expansion method. The existing equivalent blast stress wave was optimized and the Ricker wavelet was introduced to represent the seismic stress waves. By combining Fourier transform and Duhamel’s integral, the transient response of the underground tunnel under near-field blasts and far-field earthquakes was determined in both the frequency and time domains. The theoretical results were validated by comparing them with those obtained from numerical simulations using ANSYS LS-DYNA software. Numerical simulations were conducted to further investigate the damage characteristics of the underground tunnel and evaluate the effect of initial stress on structural failure under both types of disturbances. The theoretical and numerical simulation results indicated that the differences in the dynamic response and damage characteristics of the underground tunnel were primarily due to the curvature of the stress waves and transient load waveform. The locations of the maximum DSCF values differed between near-field blasts and far-field earthquakes, whereas the minimum DSCF values occurred at the same positions. Without initial stress, the blast stress waves caused spalling damage to the rock mass on the wave-facing side. Shear failure occurred near the areas with maximum DSCF values, and tensile failure occurred near the areas with minimum DSCF values. In contrast, damage occurred only near the areas with maximum DSCF values under seismic stress waves. Furthermore, the initial stress exacerbated spalling and shear damage while suppressing tensile failure. Hence, the blast stress waves no longer induced tensile failure on the tunnel sidewalls under initial stress.

Industrial facilities, as an essential part of socio-economic systems, are susceptible to disruptions caused by earthquakes. Such disruptions may result from direct structural damage to facilities or their loss of functionality due to impacts on their support facilities and infrastructure systems. Decisions to improve the seismic performance of industrial facilities should ideally be informed by risk (and resilience) analysis, taking into account their loss of functionality and the following recovery under the influence of various sources of uncertainty. Rather than targeting specific individual facilities like a hazardous chemical plant, our objective is to quantify the resilience of interacting industrial facilities (i.e., networked industrial facilities) in the face of uncertain seismic events while accounting for their functional dependencies on infrastructure systems. A specific facility, such as a hazardous chemical plant, can be a compound node in the network representation, interacting with other facilities and their supporting infrastructure components. In this context, a compound node is a complex system in its own right. To this end, this paper proposes a formulation to model the functionality of interacting industrial facilities and infrastructure using a system of coupled differential equations, representing dynamic processes on interdependent networked systems. The equations are subject to uncertain initial conditions and have uncertain coefficients, capturing the effects of uncertainties in earthquake intensity measures, structural damage, and post-disaster recovery process. The paper presents a computationally tractable approach to quantify and propagate various sources of uncertainty through the formulated equations. It also discusses the recovery of damaged industrial facilities and infrastructure components under resource and implementation constraints. The effects of changes in structural properties and networks’ connectivity are incorporated into the governing equations to model networks’ functionality recovery and quantify their resilience. The paper illustrates the proposed approach for the seismic resilience analysis of a hypothetical but realistic shipping company in the city of Memphis in Tennessee, United States. The example models the effects of dependent water and power infrastructure systems on the functionality disruption and recovery of networked industrial facilities subject to seismic hazards.

Rapid and comprehensive assessment of building damage caused by earthquakes is essential for effective emergency response and rescue efforts in the immediate aftermath. Advanced technologies, including real-time simulations, remote sensing, and multi-sensor systems, can effectively enhance situational awareness and structural damage evaluations. However, most existing methods rely on isolated time snapshots, and few studies have systematically explored the continuous, time-scaled integration and update of building damage estimates from multiple data sources. This study proposes a stepwise framework that continuously updates time-scaled, single-damage estimation outputs using the best available multi-sensor data for estimating earthquake-induced building damage. We demonstrated the framework using the 2024 Noto Peninsula Earthquake as a case study and incorporated official damage reports from the Ishikawa Prefectural Government, real-time earthquake building damage estimation (REBDE) data, and satellite-based damage estimation data (ALOS-2-building damage estimation (BDE)). By integrating the REBDE and ALOS-2-BDE datasets, we created a composite damage estimation product (integrated-BDE). These datasets were statistically validated against official damage records. Our framework showed significant improvements in accuracy, as demonstrated by the mean absolute percentage error, when the datasets were integrated and updated over time: 177.2% for REBDE, 58.1% for ALOS-2-BDE, and 25.0% for integrated-BDE. Finally, for stepwise damage estimation, we proposed a methodological framework that incorporates social media content to further confirm the accuracy of damage assessments. Potential supplementary datasets, including data from Internet of Things-enabled home appliances, real-time traffic data, very-high-resolution optical imagery, and structural health monitoring systems, can also be integrated to improve accuracy. The proposed framework is expected to improve the timeliness and accuracy of building damage assessments, foster shared understanding of disaster impacts across stakeholders, and support more effective emergency response planning, resource allocation, and decision-making in the early stages of disaster management in the future, particularly when comprehensive official damage reports are unavailable.

The origins of uncertainty in climate projections have major consequences for the scientific and policy decisions made in response to climate change. Internal climate variability, for example, is an inherent uncertainty in the climate system that is undersampled by the multimodel ensembles used in most climate impacts research. Because of this, decision makers are left with the question of whether the range of climate projections across models is due to structural model choices, thus requiring more scientific investment to constrain, or instead is a set of equally plausible outcomes consistent with the same warming world. Similarly, many questions faced by scientists require a clear separation of model uncertainty and that arising from internal variability. With this as motivation and the renewed attention to large ensembles given planning for Phase 7 of the Coupled Model Intercomparison Project (CMIP7), we illustrate the scientific and policy value of the attribution and quantification of uncertainty from initial condition large ensembles, particularly when analyzed in conjunction with multimodel ensembles. We focus on how large ensembles can support regional‐scale robust adaptation decision‐making in ways multimodel ensembles alone cannot. We also acknowledge several recently identified problems associated with large ensembles, namely, that they are (1) resource intensive, (2) redundant, and (3) biased. Despite these challenges, we show, using examples from hydroclimate, how large ensembles provide unique information for the scientific and policy communities and can be analyzed appropriately for regional‐scale climate impacts research to help inform risk management in a warming world. Plain Language Summary Estimating uncertainties in projections of climate change poses challenges but is crucial to focusing scientific and policy efforts. Initial condition large ensembles (the same model run many times with the same set of assumptions) has revealed that irreducible uncertainty arising from natural variations in the climate system—called internal variability—can be larger and more persistent than expected when compared to the set of models typically used in climate impacts assessments. Because of this, some argue that the large magnitude of internal variability presents a challenge to effective adaptations in response to climate change. Here we show using examples from water management that characterizing internal variability, even if it is large and irreducible, is the means to more effective decision‐making, pointing to the importance of initial condition large ensembles in this effort. We also discuss the criticisms of large ensembles: that they are costly, redundant, and biased. We show that despite these challenges, large ensembles provide unique information that is consistent with the insights from decision science about how to position effective decisions under conditions of deep uncertainty. Key Points Initial condition large ensembles of climate simulations have their scientific challenges, being expensive, possibly redundant, and biased Despite such challenges, large ensembles provide unique information to the scientific and policy communities Large ensembles are a valuable tool for robust decision‐making, which is a strategy for making difficult decisions under deep uncertainty

The assessment of initial support roughness is of utmost importance in ensuring waterproofing and structural safety in tunnel projects. However, existing measurement methods and evaluation systems fall short of meeting the requirements of efficiency, accuracy, and coverage for roughness measurement and acceptance procedures. This paper introduces an automated measurement method for the initial support roughness utilizing terrestrial laser scanning. This approach significantly enhances the efficiency, accuracy, and automation level of measuring roughness for initial support. In addition, the paper proposes evaluation indicators, such as average deviation, root mean square deviation, and three-dimensional chord ratio, to assess the overall and local roughness of initial support. By extending the assessment of roughness from two-dimensional to three-dimensional, this study improves the accuracy, comprehensiveness, and richness of roughness evaluation. Experimental validation confirms the accuracy and applicability of the proposed method. Furthermore, this paper thoroughly examines the effect of different step length values within the detection area on the accuracy and discriminability of the evaluation indicators when assessing the overall roughness of the initial support. Chromatograms are used to visually present and locate roughness in different areas, greatly aiding in the assessment and treatment of surface diseases in initial support.

To study the damage characteristics of rock mass under multi-level creep load, damage variable D was defined based on the spatio-temporal evolution characteristics of deformation modulus E , and the Kachanov damage theory is used to describe the damage evolution, then the damage evolution equation of the rock mass under multi-level creep load is obtained. Combining the damage evolution equation with the Lemaitre strain equivalence principle, the creep damage constitutive model of rock mass under multi-level creep load considering initial damage is obtained. By comparing the results of uniaxial and triaxial tests with the calculated values of the model, the rationality, reliability, application range of the model proposed in this paper is verified. According to the results of parameter inversion, obtain the relationship between damage, stress and time. Results show that time and stress are the important factors influencing the damage of rock mass under multi-level creep loading, the damage increases with time and stress level. However, the influence of time and stress on damage has a significant stress response characteristics: under low stress, the instantaneous damage D is caused by the instantaneous stress loading is the main reason for the damage. With the increase of the load level, the main cause of the damage gradually changes from the instantaneous loading of the stress to the creep accumulation of the damage, and the greater the initial damage, the higher the time-dependent damage D iT proportion in the global damage.

The mechanical and deformation behaviors of the surrounding rock play a crucial role in the structural safety and stability of tunnel shafts. During drilling and blasting construction, seepage failure and hard brittleness damage of the surrounding rock occur frequently. However, previous discussions on stress deformation in the surrounding rock did not consider these two factors. This paper adopts the theory of elastoplastic to analyze the effects of seepage and hard brittleness damage on the stress and deformation of the surrounding rock of a tunnel shaft. The seepage effect is equivalent to the volumetric force, and a mechanical model of the surrounding rock considering seepage and hard brittleness damage was established. An elastoplastic analytical formula for surrounding rock was derived, and its rationality was verified through numerical examples. Based on these findings, this study revealed the plastic zone as well as stress and deformation laws governing the behavior of surrounding rock. The results showed that the radius of a plastic zone had a significant increase under high geostress conditions, considering the hard brittleness damage characteristics of the surrounding rock. The radius of the plastic zone increased with an increase in the initial water pressure and pore pressure coefficient, and the radius of the plastic zone increased by 5.5% and 3.8% for each 0.2 MPa increase in initial water pressure and 0.2 increase in pore pressure coefficient, respectively. Comparing the significant effects of various factors on the radius of the plastic zone, the effect of support resistance inhibition was the most significant, the effect of the seepage parameter promotion was the second, and the effect of the hard brittleness index promotion was relatively poor. The hard brittleness index and water pressure parameters were positively correlated with the tangential and radial stresses in the surrounding rock, and the radial stresses were overall smaller than the tangential stresses. The deformation of the surrounding rock was twice as large as the initial one when hard brittleness damage and seepage acted together. These findings can provide a reference for the stability evaluation of the surrounding rock in tunnel shafts.

Welding defects are known to cause crack propagation and reduce structural fatigue performance. Based on the Paris theory of fracture mechanics, research is conducted on evaluation methods for analyzing fatigue crack propagation by adopting random loads with long-term distribution that follows the Weibull distribution for the stress ranges of fatigue loads. This approach is combined with the corrective stress intensity factor (SIF) equation and the method for calculating the reference stress and failure criterion. A large container ship is selected for a simulation, and fatigue crack propagation analysis is conducted on typical critical locations. A detailed comparison of the forecasted fatigue life is carried out between fracture mechanics theory and the S-N curve. The results indicate that the fatigue life values obtained using the two methods are of the same magnitude. In general, for the welded structure, the fatigue life value obtained via the fracture mechanics method is shorter than that obtained via the S-N curve method, while, for the free edge of the structure and the unwelded structure, the predicted fatigue life value is closer than that predicted via the S-N curve method. Moreover, the influence of initial crack defects on the fatigue life is investigated, and the results show that the depth of the initial crack will greatly affect the fatigue life of the target ship in typical locations, but the influence of the shape ratio on the fatigue life is limited. Therefore, in the actual ship construction process, controlling the initial crack depth of components is effective for limiting crack propagation and improving fatigue life. The above conclusions and suggestions can serve as a reference for the structural design and fatigue life evaluation of large container ships.

In this paper, seismic behavior of Kiewitt-Sunflower single layer spherical reticulated shells is examined within the time history method, based on our proposed damage constitutive model for thin-walled circular steel tubes. According to a large number of numerical examples, the failure mode of this kind of single layer spherical reticulated shell in the case of earthquake is figured out. In addition, the effect of the damage accumulation, rise-span ratio, initial geometric imperfection, types of seismic wave and amplitude modulation ratio on the dynamic response of the shell structure is explored. Finally, a structural damage factor is proposed and it has a good match with the numerical results, which is productive to assess the damage and failure behavior of such structures suffering the earthquake and post-earthquake.