Blind testing of shoreline evolution models

International audienceBeaches around the world continuously adjust to daily and seasonal changes in wave and tide conditions, which are themselves changing over longer timescales. Different approaches to predict multi-year shoreline evolution have been implemented; however, robust and reliable predictions of shoreline evolution are still problematic even in short-term scenarios (shorter than decadal). Here we show results of a modelling competition, where 19 numerical models (a mix of established shoreline models and machine learning techniques) were tested using data collected for tairua beach, new Zealand with 18 years of daily averaged alongshore shoreline position and beach rotation (orientation) data obtained from a camera system. in general, traditional shoreline models and machine learning techniques were able to reproduce shoreline changes during the calibration period (1999-2014) for normal conditions but some of the model struggled to predict extreme and fast oscillations. During the forecast period (unseen data, 2014-2017), both approaches showed a decrease in models' capability to predict the shoreline position. this was more evident for some of the machine learning algorithms. A model ensemble performed better than individual models and enables assessment of uncertainties in model architecture. Research-coordinated approaches (e.g., modelling competitions) can fuel advances in predictive capabilities and provide a forum for the discussion about the advantages/disadvantages of available models. Quantitative prediction of beach erosion and recovery is essential to planning resilient coastal communities with robust strategies to adapt to erosion hazards. Over the last decades, research efforts to understand and predict shoreline evolution have intensified as coastal erosion is likely to be exacerbated by climatic changes 1-5. The social and economic burden of changes in shoreline position are vast, which has inspired development of a growing variety of models based on different approaches and techniques; yet current models can fail (e.g. predicting erosion in accreting conditions). The challenge for shoreline models is, therefore, to provide reliable, robust and realistic predictions of change, with a reasonable computational cost, applicability to a broad variety of systems, and some quantifiable assessment of the uncertainties

Vertebroplasty and kyphoplasty: a comparative review of efficacy and adverse events

Vertebroplasty and kyphoplasty have become common surgical techniques for the treatment of vertebral compression fractures. Vertebroplasty involves the percutaneous injection of bone cement into the cancellous bone of a vertebral body with the goals of pain alleviation and preventing further loss of vertebral body height. Kyphoplasty utilizes an inflatable balloon to create a cavity for the cement with the additional potential goals of restoring height and reducing kyphosis. Vertebroplasty and kyphoplasty are effective treatment options for the reduction of pain associated with vertebral body compression fractures. Biomechanical studies demonstrate that kyphoplasty is initially superior for increasing vertebral body height and reducing kyphosis, but these gains are lost with repetitive loading. Complications secondary to extravasation of cement include compression of neural elements and venous embolism. These complications are rare but more common with vertebroplasty. Vertebroplasty and kyphoplasty are both safe and effective procedures for the treatment of vertebral body compression fractures

Exploring the vulnerability of network infrastructure to disruption

C61, R53, R40, O21,

Coaching and guidance with patient decision aids : A review of theoretical and empirical evidence

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedCoaching and guidance are structured approaches that can be used within or alongside patient decision aids (PtDAs) to facilitate the process of decision making. Coaching is provided by an individual, and guidance is embedded within the decision support materials. The purpose of this paper is to: a) present updated definitions of the concepts “coaching” and “guidance”; b) present an updated summary of current theoretical and empirical insights into the roles played by coaching/guidance in the context of PtDAs; and c) highlight emerging issues and research opportunities in this aspect of PtDA designPeer reviewedFinal Published versio

Inter rater reliability of Pressure Ulcer Scale for Healing (PUSH) in patients with chronic leg ulcers Confiabilidad inter-observadores del Pressure Ulcer Scale for Healing (PUSH) en pacientes con úlceras crónicas en la pierna Confiabilidade interobservadores do Pressure Ulcer Scale for Healing (PUSH), em pacientes com úlceras crônicas de perna

This study aimed to evaluate the inter rater reliability of the Pressure Ulcer Scale for Healing (PUSH), in its version adapted to the Portuguese language, in patients with chronic leg ulcers. Kappa index was used for the analysis. After accomplishing ethical issues, 41 patients with ulcers were examined. A total of 49% of the ulcers were located in the right leg and 36% of them were venous ulcers. The Kappa indices (0.97 to 1.00) obtained in the comparison between the observations of the clinical nurses and the stomal therapists for all sub-scales and for total score, confirmed the tool inter rater reliability, with statistical significance (p<0.001). The PUSH instrument, in its Portuguese adapted version, showed to be reliable to the use in patients with chronic leg ulcers. Further studies should be conducted to evaluate its prospective performance.<br>El objetivo del estúdio fue probar la confiabilidad inter-observadores del Pressure Ulcer Scale for Healing (PUSH), en su versión adaptada al portugués, en pacientes con úlceras crónicas en la pierna. Para el análisis de concordancia se utilizó el Indice Kappa. Posterior a la aprobación del Comité de Ética, 41 pacientes con úlcera fueron examinados, siendo que 49% de las úlceras se localizaron a la derecha y 36% eran de etiología venosa. Los indices Kappa obtenidos (0,97 a 1,00), con un nivel significativo de p<0,001, confirmaron la confiabilidad de los inter-observadores, al obtenerse un nivel de concordancia muy bueno entre el total de las observaciones realizadas por enfermeros clínicos y especialistas en estomatología (patrón-oro), dichos valores obtenidos tanto para todas las sub escalas de PUSH como para el puntaje total. Los resultados permiten concluir que el PUSH, en su versión adaptada para el portugués, mostró confiabilidad para ser utilizado en pacientes con úlceras crónicas en miembros inferiores, debiendo ampliarse el estudio para evaluar su desempeño prospectivo.<br>Testar a confiabilidade interobservadores do Pressure Ulcer Scale for Healing (PUSH), em sua versão adaptada para o português, em pacientes com úlceras crônicas de perna foi o objetivo deste estudo. Para a análise de concordância, utilizou-se o índice Kappa. Após aprovação pelo Comitê de Ética, pacientes com úlceras (41) úlceras foram examinados, sendo que 49% das úlceras localizavam-se à direita e 36% eram de etiologia venosa. Os índices Kappa obtidos (0,97 a 1,00), com significância estatística (p<0,001), ratificaram a confiabilidade interobservadores, ao ser obtida concordância de muito boa a total entre as observações de enfermeiros clínicos e especialistas em estomaterapia (padrão-ouro), para todas as subescalas do PUSH, como para o escore total. Esses resultados permitem concluir que o PUSH, em sua versão adaptada para o português, mostrou confiabilidade para utilização em pacientes com úlceras crônicas de membros inferiores, devendo-se ampliar o estudo para avaliação de seu desempenho prospectivo