Effective measures in Sustainable urban mobility plans (SUMPs): Analysis of 10 (successful) European cities

The paper presents results of an analysis of measures implemented in various European cities that have been effective in reducing the share of trips by car and increasing the shares of active mobility and public transportation. Ten cities with a significant modal shift from cars to public transportation and/or active mobility in a period of several years were analysed. For each city, an interview was conducted with a local expert. The questions focused on the reasons for successful changes in travel habits and the existence and relevance of the SUMP in bringing about these changes. The results show that all cities analysed have some form of SUMP, and many have additional, more specific documents. Most cities have been developing these documents and implementing the measures in them for many years. Furthermore, the modal shift was always the result of a combination of several push and pull measures. Cities implemented restrictive measures for cars as well as improved conditions for alternative modes of mobility and often focused on road space transformation.

Effective measures in Sustainable urban mobility plans (SUMPs): Analysis of 10 (successful) European cities

The paper presents results of an analysis of measures implemented in various European cities that have been effective in reducing the share of trips by car and increasing the shares of active mobility and public transportation. Ten cities with a significant modal shift from cars to public transportation and/or active mobility in a period of several years were analysed. For each city, an interview was conducted with a local expert. The questions focused on the reasons for successful changes in travel habits and the existence and relevance of the SUMP in bringing about these changes. The results show that all cities analysed have some form of SUMP, and many have additional, more specific documents. Most cities have been developing these documents and implementing the measures in them for many years. Furthermore, the modal shift was always the result of a combination of several push and pull measures. Cities implemented restrictive measures for cars as well as improved conditions for alternative modes of mobility and often focused on road space transformation.

Smart Contract Vulnerability Detection: From Pure Neural Network to Interpretable Graph Feature and Expert Pattern Fusion

Smart contracts hold digital coins worth billions of dollars, their security issues have drawn extensive attention in the past years. Towards smart contract vulnerability detection, conventional methods heavily rely on fixed expert rules, leading to low accuracy and poor scalability. Recent deep learning approaches alleviate this issue but fail to encode useful expert knowledge. In this paper, we explore combining deep learning with expert patterns in an explainable fashion. Specifically, we develop automatic tools to extract expert patterns from the source code. We then cast the code into a semantic graph to extract deep graph features. Thereafter, the global graph feature and local expert patterns are fused to cooperate and approach the final prediction, while yielding their interpretable weights. Experiments are conducted on all available smart contracts with source code in two platforms, Ethereum and VNT Chain. Empirically, our system significantly outperforms state-of-the-art methods. Our code is released.

Enhanced recovery after laryngectomy: A feasibility study in 25 patients

Purpose To describe the development and implementation of an enhanced recovery programme for patients undergoing total laryngectomy. Methods A feasibility study set in a tertiary head and neck unit in London, United Kingdom. The programme was developed based on Enhanced Recovery After Surgery (ERAS) Society guidelines for head and neck cancer surgery and local expert group consensus. An ERAS ‘booklet’ was devised which accompanied all laryngectomy patients during their inpatient stay. Contributors included otolaryngologists, anaesthetists, dieticians, physiotherapists, speech and language therapists and nurses. A 12-month pilot study was undertaken. The main outcome measures were feasibility and adherence. Results An enhanced recovery programme for 25 people undergoing total laryngectomy was successfully piloted in a tertiary referral head and neck unit. Median length of stay was reduced in the post-ERAS group by 1.5 days. No statistically significant difference in length of stay, time to first gastrografin swallow, rate of fistula nor postoperative normalcy of eating between the pre and post-ERAS patients who underwent laryngectomy was observed. Clavien-Dindo-grouped complication rates were significantly higher in the post-ERAS group. Conclusion This enhanced recovery programme for patients undergoing laryngectomy is the first of its kind in the literature. Implementation has been demonstrated feasible. Further longitudinal studies are required to reliably inform us on ERAS programmes’ effects on laryngectomy outcomes.

Developing and Testing a Local Expert-Based Reading Process for Use to Examine Discrepancies Between Guidelines and Current Clinical Practices

The use of relevant guidelines is critical in psychiatric clinical practice to ensure the homogeneity of the global care provided. Consequently, it is important to identify whether they are utilized successfully and, if not, why. This would enable pragmatic solutions to be agreed to improve the organization of care and the removal of any barriers to the guidelines' implementation. The first step in this process, before any exploration of the limitations of the guidelines themselves, involves a determination of whether they are actually applied in clinical practice. We therefore evaluated discrepancies between the guidelines relating to patients with borderline personality disorder and current practices in the psychiatric Emergency Department at Toulouse University Hospital. This was achieved using a reading process involving a panel of eight local experts who analyzed relevant medical files extracted from a database. They were guided by, and instructed to answer, six standardized questions in relation to each file to determine the method's feasibility. A total of 333 files were analyzed to determine whether, in the local experts' judgment, the care provided reflected current guidance. This reading process revealed substantial agreement (0.85%; Fleiss Kappa −0.69), which is a promising outcome and suggests that such methods could be used in future protocols. Moreover, the process is practical and reliable and requires very few materials.

The Complexity of Remote Teaching in Emergency Situations: Initial Basic Principles to Avoiding Technological Boundaries

Considering the challenges of sustainable education in emergency remote teaching (ERT) during the coronavirus (COVID-19) pandemic, this study provides basic principles for future ERT implementation based on the experience of higher education in Indonesia. Seven local expert distance educators reviewed the ERT principles, participating in the early stages to check the relevance, content validity, and readability of the five principles proposed in the context of Indonesian education. After an extensive expert review, the ERT principles were evaluated using quantitative data through an online survey (82 students and 45 faculty members). In addition, open-ended questionnaire responses, experiences, and challenges encountered by 21 respondents (College Dean, Associate Dean of Academics, and faculty quality assurance of seven universities/colleges in three provinces in Indonesia) in ERT were used and analyzed. This study suggests that ERT should be designed based on the principles of simplicity, accessibility, affordability, flexibility, and empathy in all learning activities in unfavorable situations. This study complements previous work and can thus be used for generalized principles for teaching activities in similar emergencies, especially in developing countries.

DIGITALIZATION OF COLLECTIONS IN FORENSIC INVESTIGATION

The paper considers the issue of extensive application of local expert collections in forensic expert practice. The study shows that the necessity of extensive application of such collections and other local reference-assistive means occurs due to criminalistics digitalization. The author specifies the concept of local expert collections; proposes to carry out expert collections digitalization according to the matrix principle of the object’s characteristics fixation. The study identified that the practicality of the extensive application of such collections is caused by the network approach introduction to the forensic expert activity. The author proves the applicability of semantic networks to ensure the efficiency of using expert collections. The necessity to overcome the experienced counter-acting the investigation determines the importance of extensive application of digitalized collections. The author implements the technological approach to the expert studies using the specimen copies from expert collections; proposes to support the information provision block in the forensic expert study technologies with references to the local collections stored in a cloud resource. Within the block of assignments for forensic studies, it is offered to provide an initiative comparison of an object under the study with the collection standards regarding falsification or other change in its characteristics. It provides information security measures. Such measures are the collection exchange channel duplication and block-chain technology. The paper presents a validation procedure for expert collections located in network resources of forensic expert institutions. Expert collection validation involves the research activities regarding the adequacy of their digital representation and the expert collections approval in terms of applicability for solving particular expert tasks. Complex application of expert collections represented in digital format supplies digital criminalistics with new forensic investigation resources.

Onconephrology, an extra year of training: Where do we stand?

Onconephrology is a new subspecialty of nephrology that recognizes the important intersections of kidney disease with cancer. As novel anti cancers are being used to treat patients, we are beginning to see even more kidney-related complications that require close collaboration with hematology and oncology colleagues. Secondary to the increased number and complexity of onconephrology consultations spanning nephrology and oncology, there is a need to expand and focus clinical training in this area. Some authors propose an extra year of fellowship in onconephrology and others propose against extra year of fellowship. An “area of concentration” during the second year of fellowship with 6–9 months of dedicated time might be a solution for a trainee interested in onconephrology. To train the next generation of fellows, all centers should consider at least a local expert in onconephrology and specialty clinics to teach the necessary skills. The large stand-alone cancer centers can then enhance those skills for a specific group of fellows interested by offering an extra year of fellowship. In this editorial, we discuss the pros and cons of having an extra year of training in onconephrology.

Identifying implementation gaps and priorities for the Singapore government to improve food environment policies: perspectives from a local expert panel

Objective: Singapore, an urbanised, developed nation, with a high reliance on food importation and a high prevalence of eating out is facing rising rates of obesity and diabetes. The objective of the current study was to characterise and evaluate the Singapore government’s policies to improve the food environment and to identify and prioritise concrete actions. Design: The Healthy Food Environment Policy Index tool and process were used. An expert panel rated the Singapore government’s implementation of forty-seven indicators compared with international best practice in 2018. Indicators were prioritised, and specific recommendations were proposed by panel. Setting: Singapore. Participants: Twenty experts primarily from academia. Results: As compared with international benchmarks, the level of implementation of most indicators (thirty-three indicators, 70 %) by the Singapore government was evaluated as being at least moderate. Highly rated indicators included those related to provision of healthier meals at school, supporting the use of healthier ingredients by food vendors and governmental leadership. More policy indicators (6, 26 %) as compared with infrastructure support indicators (2, 8 %) received a ‘very little or no implementation’ rating. After rating, the experts prioritised eleven indicators and proposed thirty-one actions informed by several considerations including those of effectiveness, political acceptability, feasibility and unique characteristics of food retail in Singapore. Conclusions: Supported by documented evidence, an independent expert panel identified areas of strengths and provided specific recommendations to meaningfully improve the Singapore food environment to facilitate healthier eating. Fundamental recommendations including improving nutrition profiling and strengthening monitoring systems have the potential to positively influence environments across policy domains.

The paediatrician workforce and its role in addressing neonatal, child and adolescent healthcare in Kenya

ObjectiveTo examine the availability of paediatricians in Kenya and plans for their development.DesignReview of policies and data from multiple sources combined with local expert insight.SettingKenya with a focus on the public, non-tertiary care sector as an example of a low-income and middle-income country aiming to improve the survival and long-term health of newborns, children and adolescents.ResultsThere are 305 practising paediatricians, 1.33 per 100 000 individuals of the population aged <19 years which in total numbers approximately 25 million. Only 94 are in public sector, non-tertiary county hospitals. There is either no paediatrician at all or only one paediatrician in 21/47 Kenyan counties that are home to over a quarter of a million under 19 years of age. Government policy is to achieve employment of 1416 paediatricians in the public sector by 2030, however this remains aspirational as there is no comprehensive training or financing plan to reach this target and health workforce recruitment, financing and management is now devolved to 47 counties. The vast majority of paediatric care is therefore provided by non-specialist healthcare workers.DiscussionThe scale of the paediatric workforce challenge seriously undermines the ability of the Kenyan health system to deliver on the emerging survive, thrive and transform agenda that encompasses more complex health needs. Addressing this challenge may require innovative workforce solutions such as task-sharing, these may in turn require the role of paediatricians to be redefined. Professional paediatric communities in countries like Kenya could play a leadership role in developing such solutions.