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Most of the forensic evidence evaluations given activity level propositions are centered around an item which is assumed to be linked to an alleged activity. However, the relation between an item of interest and an activity may be contested. This study presents a template Bayesian network (BN) for the evaluation of transfer evidence given activity level propositions considering a dispute about the relation of an item to one or more activities. The template BN includes a set of association propositions that enables the combined evaluation of evidence concerning alleged activities of the suspect and evidence concerning the use of an alleged item in those activities. Since the two types of evidence are often from different forensic disciplines, the BN is especially useful in interdisciplinary casework. Throughout the paper, we use a fictive case example that captures the essence of cases for which the template model can be used. The template BN provides a flexible starting point that can be adapted to specific case situations and supports structured probabilistic reasoning by a forensic scientist.

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High-level literacy skills are required for full participation in the democratic process through voting. Consequently, adults with low-level literacy skills are at a disadvantage. This work investigated the disparity between the readability of U.S. ballot propositions for year 2022 state elections and grade level reading estimates (≤eighth grade) for adults. Educational attainment was also examined. Propositions (n = 140) from 38 states were included. Mean readability was 18 (range 7.0-64.0). Only four measures (3%) fell within range of national estimates for adult reading ability. Thirty-nine percent of adults completed high school or less, yet 74% of ballots were written well above a high school reading level. There is a discrepancy between the literacy skills of the average voter and the readability of most propositions. The findings of this study have important implications for individuals with learning disabilities. Policy changes and educational support efforts should be initiated.

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Artificial intelligence (AI) applications pave the way for innovations in the healthcare (HC) industry. However, their adoption in HC organizations is still nascent as organizations often face a fragmented and incomplete picture of how they can capture the value of AI applications on a managerial level. To overcome adoption hurdles, HC organizations would benefit from understanding how they can capture AI applications' potential.We conduct a comprehensive systematic literature review and 11 semi-structured expert interviews to identify, systematize, and describe 15 business objectives that translate into six value propositions of AI applications in HC.Our results demonstrate that AI applications can have several business objectives converging into risk-reduced patient care, advanced patient care, self-management, process acceleration, resource optimization, and knowledge discovery.We contribute to the literature by extending research on value creation mechanisms of AI to the HC context and guiding HC organizations in evaluating their AI applications or those of the competition on a managerial level, to assess AI investment decisions, and to align their AI application portfolio towards an overarching strategy.

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For many criminal cases, the source of who deposited the DNA is not what the prosecutor and the defense are trying to dispute. In court, the question may be how the DNA was deposited at the crime scene rather than who the DNA came from. Although laboratories in many countries have begun to evaluate DNA evidence given formal activity-level propositions (ALPs), it is unknown how much other forensic practitioners know and what they think about activity-level evaluative reporting (ALR). To collect this information, a survey with 21 questions was submitted to international forensic science organizations across Europe, Australia, South America, Canada, Asia, and Africa. The survey combined open-ended and multiple-choice questions and received 162 responses. Responses revealed a wide range of knowledge on the topic. Overall, most respondents were somewhat knowledgeable about ALR, ALP, and current practices in court and expressed their support of the concept. A majority of participants identified gaps and obstacles regarding ALR they would like to see addressed. Examples include (1) need for more education/training at all stakeholder levels, (2) need for more DNA evidence-related data under realistic case scenarios, (3) need to internally implement and validate a formalized and objective approach for reporting, and (4) in some countries the need to achieve court admissibility. This global survey gathered the current concerns of forensic DNA practitioners and outlined several operational concerns. The information can be used to advance the implementation of ALR in laboratories and court testimony worldwide.

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In forensic investigations, DNA profiles are routinely obtained from firearms evidence and alternative hypotheses may be proposed for consideration on the activity level. DNA profiles found to be consistent with the DNA profile of a specific individual could be a result of directly handling the firearm or other modes of transfer of DNA. Sixteen law-enforcement-owned firearms were evaluated with samples collected from the frame and slide area, the trigger and trigger guard area, and the front and rear sights after brief handling by laboratory personnel. Twenty-two out of forty-eight samples resulted in DNA profiles suitable for comparison, of which six resulted in likelihood ratios (LR) that demonstrated support for the hypothesis that included the brief handler as a contributor to the DNA profile obtained from the sample. Five of these samples were obtained from the frame and slide and one was from the trigger and trigger guard area. None of the DNA profiles obtained from the sights supported the inclusion of the brief handler as a contributor to the DNA profile. Gaining knowledge and supporting data on the nature of DNA profiles typically obtained from both owners and brief handlers can be useful for the purposes of evaluative reporting when considering results obtained from firearm evidence.

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Evidential value of DNA mixtures is typically expressed by a likelihood ratio. However, selecting appropriate propositions can be contentious, because assumptions may need to be made around, for example, the contribution of a complainant's profile, or relatedness between contributors. A choice made one way or another disregards any uncertainty that may be present about such an assumption. To address this, a complex proposition that considers multiple sub-propositions with different assumptions may be more appropriate. While the use of complex propositions has been advocated in the literature, the uptake in casework has been limited. We provide a mathematical framework for evaluating DNA evidence given complex propositions and discuss its implementation in the DBLR™ software. The software simultaneously handles multiple mixed samples, reference profiles and relationships as described by a pedigree, which unlocks a variety of applications. We provide several examples to illustrate how complex propositions can efficiently evaluate DNA evidence. The addition of this feature to DBLR™ provides a tool to approach the long-accepted, but often impractical suggestion that propositions should be exhaustive within a case context.

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The findings from a bloodstain pattern analysis (BPA) may assist in formulating or falsifying scenarios that are considered in the investigative stages of a criminal investigation. When a case proceeds to trial the bloodstain pattern expert may be asked about the relevance of their findings given scenarios that are proposed by the prosecution and defense counsel. Such opinions provided by an expert are highly relevant to police investigation or legal proceedings, but the reasoning behind the opinion or implicit assumptions made by the expert may not be transparent. A proper framework for the evaluation of forensic findings has been developed since the late twentieth century, based on the hierarchy of propositions, Bayesian reasoning and a model for case assessment and interpretation. This framework, when implemented in casework, mitigates some of the risks of cognitive biases, and makes the reasoning and scientific basis for the opinion transparent. This framework is broadly used across forensic science disciplines. In this paper we describe its application to the field of BPA using a case example from the Netherlands Forensic Institute (NFI).

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Pain has proven to be a refractory problem in US healthcare. This paper argues that starting to address this requires viewing pain-assessment as a form of sense-making that occurs between patients and providers. Section I argues that two standard definitions of 'pain' that are thought to subtend pain assessment are not viable. Section II proffers a very different way to think about the meaning of 'pain'. Section III develops this novel account by pairing Rorty's account of hermeneutics with recent developments in the pain-assessment literature. Finally, section four moves beyond Rorty by linking sense-making to philosophical health. Should this prove persuasive, I will have shown an area in biomedicine where philosophy is not an 'optional add on', but a vitally important part of what should be clinical practice.

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Forensic laboratories often sample weapons and clip-seal plastic bags (CSPB) used to package illicit material for the purpose of identifying the handler(s). However, there may be other explanations as to how a person's DNA was transferred to such items. This may include an individual storing the item among their personal belongings for somebody else or the item being stored among their belongings without their knowledge. Here we investigate the direct transfer of DNA to knives and CSPB during handling and explore two feasible alternative explanations related to the indirect transfer of DNA to these items in residential environments. The handling of DNA-free items was performed by 10 individuals who were instructed, on separate occasions, to cut a foam board in half and fill a CSPB with a drug substitute. To explore indirect transfer, sets of these items were (a) placed on kitchen benches and coffee/dining tables for ∼1 min, or (b) stored for two days in kitchen and bedroom drawers within the homes of 10 individuals. After each of the three scenarios, samples were collected from the knife handle and blade, the body and seal of the CSPB, and the surface the items were placed on, the latter as a measure to gain insight into the presence of prevalent and/or background DNA. DNA transfer was observed under all three scenarios, though more frequently when items were handled or stored for 2 days, compared to when placed on a surface for ∼1 min. Under the latter scenario, DNA, if present, was below the level of detection in many samples and produced no profile, suggesting that detectable DNA transfer occurs to a lesser degree from static brief contacts. The study results and associated probabilities will assist forensic examiners with their interpretation of case circumstances regarding the transfer and recovery of DNA from these items.

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In a judiciary setting, questions regarding the mechanisms of transfer, persistence, and recovery of DNA are increasingly more common. The forensic expert is now asked to evaluate the strength of DNA trace evidence at activity level, thus assessing if a trace, given its qualitative and quantitative features, could be the result of an alleged activity. The present study is the reproduction of a real-life casework scenario of illicit credit card use by a co-worker (POI) of its owner (O). After assessing the shedding propensity of the participants, differences in DNA traces' qualitative and quantitative characteristics, given scenarios of primary and secondary transfer of touch DNA on a credit card, a non-porous plastic support, were investigated. A case-specific Bayesian Network to aid statistical evaluation was created and discrete observations, meaning the presence/absence of POI as a major contributor in both traces from direct and secondary transfer, were used to inform the probabilities of disputed activity events. Likelihood Ratios at activity level (LRα) were calculated for each possible outcome resulting from the DNA analysis. In instances where only POI and POI plus an unknown individual are retrieved, the values obtained show moderate to low support in favour of the prosecution proposition.

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Objective: To obtain and evaluate detailed descriptions of potential value propositions as seen by adults undergoing hearing rehabilitation with hearing aids. Design: Semi-structured interviews with patients and audiologists, a literature search, and the inclusion of domain knowledge from experts and scientists were used to derive value propositions. A two-alternative forced-choice paradigm and probabilistic choice models were used to investigate hearing aid users' preferences for the value propositions through an online platform. Study sample: Twelve hearing aid users (mean age 70, range 59-70) and eleven clinicians were interviewed. A total of 173 experienced hearing aid users evaluated the value propositions. Results: Twenty-nine value propositions as described by patients, clinicians, and hearing care experts where identified, from which twenty-one value propositions were evaluated. Results of the pair-wise evaluation method show that the value propositions judged to be the most important for the hearing aid users were: "13. To solve the hearing problem you have", "09. Thorough diagnosis of the hearing", and "16. The hearing aid solution is adapted to individual needs", which are related to finding the correct hearing solution and to be considered in the process. The value propositions judged to be least important were: "04 Next of kin and others involved in the process", "26. To be in the same room as the practitioner", and "29. The practitioner's human characteristics", related to the involvement of others in the process and the proximity and personal manner of the practitioners.

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Achieving the sustainable goals of the United Nations requires improving supply chain sustainability (SSC). Blockchain technology (BCT) has attracted attention on a global level with the ability to transform supply chain management and sustainability efforts. Recognizing this, this study investigates how BCT plays a role in SSC. The current study looks into the importance of BCT in order to move supply networks towards sustainability by performing bibliometric analysis, and network cluster analysis. Through the literature review, the current literature was analyzed and future research directions were concluded. We begin our study by selecting 297 papers on the relevant subjects by applying various filters to the Web of Science (WoS) database. Influential individuals, journals, and organizations in this field were identified using bibliometric analysis. A network analysis was performed to identify influential co-author, and keywords, and for page rank, and cluster analysis. The network analysis was revealed ten distinct study clusters, and ten propositions were suggested from the analysis of these clusters. Additionally, a conceptual framework for the research was proposed, which can advise managers, practitioners, and researcher communities on the key trends and topics in this emerging research domain. Furthermore, to guide research scholars in this field, 33 future research directions were suggested.

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Simple propositions are defined as those with one POI and the remaining contributors unknown under Hp and all unknown contributors under Ha. Conditional propositions are defined as those with one POI, one or more assumed contributors, and the remaining contributors (if any) unknown under Hp, and the assumed contributor(s) and N unknown contributors under Ha. In this study, compound propositions are those with multiple POI and the remaining contributors unknown under Hp and all unknown contributors under Ha. We study the performance of these three proposition sets on thirty-two samples (two laboratories × four NOCs × four mixtures) consisting of four mixtures, each with N = 2, N = 3, N = 4, and N = 5 contributors using the probabilistic genotyping software, STRmix™. In this study, it was found that conditional propositions have a much higher ability to differentiate true from false donors than simple propositions. Compound propositions can misstate the weight of evidence given the propositions strongly in either direction.

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OBJECTIVE: To estimate the prevalence of medical quackery, to identify the confounding factors of the rising trend, and suggest possible ways to eliminate the menace. METHODS: This empirical study was conducted from July 2019 to June 2020 in six divisions of the Sindh province of Pakistan, and comprised field inspection reports and data collection based on healthcare establishments' physical inspection, verification, and action on non-compliant units. Data was qualitatively and quantitatively analysed. RESULTS: Of the 3,063 healthcare establishments, 568(18%) were visited in Larkana, 641(21%) in Shaheed Benazirabad (SBA), 527(17%) in Mirpurkhas, 700(23%) in Hyderabad, 110(4%) in Sukkur, and 517(17%) in Karachi. Overall, 2,152(70%) outlets were shuttered and fined for violating anti-quackery laws, while 911(30%) were issued warning notices. CONCLUSIONS: The healthcare system in the Sindh province was found to be struggling, with quackery continuing to proliferate.

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INTRODUCTION: The challenge of territorial hospital groups is to develop coherent care pathways for optimal patient care. Following the creation of a territorial pharmaceutical team, a common prescription review process was initiated in our health area. The objective of this study is to analyze the uses of statins in the elderly. METHOD: The study included all statin-treated patients older than 75 years at the five participating institutions (including long-term nursing homes). In a prospective multicenter study, the benefit/risk ratio of statin prescription has been assessed up. Depending on the clinical situation, a proposal to stop or adjust the dosage could be made. RESULTS: Nine hundred and forty-seven patients were included. Among them, 184 were treated with a statin. Forty-seven patients (26%) are treated in primary prevention and 137 patients (74%) in secondary prevention. Dosages are lower for long stays. Fifteen treatments interruption were accepted out of 44 proposals, mostly for long stays. The reasons given to continue treatment are the need for a new evaluation by a cardiologist or a high cardiovascular risk. CONCLUSION: The variability of results according to the type healthcare institution makes territorial medical and pharmaceutical collaboration relevant. The challenge is to develop a coherent care pathway for optimal care of elderly patients, with congruent objectives.

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Evaluative conditioning (EC) research investigates changes in the evaluation of a stimulus after co-occurrence with an affective stimulus. To explain the motivation behind this research, this review begins with an overview of the history of EC research, followed by a summary of the state of the art with respect to three key questions. First, how should EC procedures be used to influence evaluation? We provide a guide based on evidence concerning the functional properties of EC effects. Second, how does the EC effect occur? We discuss the possible mediating cognitive processes and their automaticity. Third, are EC effects ubiquitous outside the lab? We discuss the evidence for the external validity of EC research. We conclude that the most important open questions pertain to the relevance of EC to everyday life and to the level of control that characterizes the processes that mediate the EC effect after people notice the stimulus co-occurrence.

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Several studies have demonstrated that DNA can be indirectly transferred from an individual onto a surface. Therefore, the presence of DNA that is compatible with a given person does not necessarily mean that this person has touched the surface on which the DNA was recovered. The present work simulates cases, where DNA is recovered on a door handle and compared to several reference DNA profiles. The DNA profile of the trace shares DNA components with a person of interest (POI). When asked about the DNA results, the POI says he has nothing to do with the incident and has never been at the scene. However, a possibility would be that the DNA came from his recently stolen gloves. Someone else, the alternative offender (AO), could have opened the door wearing his gloves (POI's gloves), and transferred his DNA (POI's DNA). Based on the above-mentioned scenario, 60 burglary simulations experiments were carried out to generate data to assess DNA results given these allegations. The quantity and quality of DNA profiles (NGM SElect) recovered when the POI opened/closed the door bare-handed or when someone else performed the same activity but using POI's gloves, were compared. The gloves were regularly worn during at least three months by their owner during the winter. On the contrary, the AO wore them only for two minutes. Among the traces collected on the door handles, less than 50% of the traces led to interpretable DNA profiles. In 30% of the cases (3/10), when the door was opened/closed with bare hands, the DNA found on the door handle led to a mixed DNA profile with the POI's DNA aligning with the major contributor. For the experiments where the AO opened/closed the door with the POI's gloves, the POI's DNA was compatible with 22% (11/50) of the mixed DNA profile, aligning with the major in 8% of the cases (4/50). The DNA profiles of the offices' occupants were observed on the door handles, but not the AO's. In addition to the results of the experiments, we show two examples of how one can assess results observed in casework. Given the possibility of indirect transfer of minute DNA quantities, this research emphasizes the need to evaluate DNA results given the activities when the POI has a legitimate reason that can explain the presence of their DNA.

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In cases where multiple questioned individuals are separately supported as contributors to a mixed DNA profile, guidance documents recommend performing a comparison to see if there is support for their joint contribution. Anecdotal observations suggest the summed log of the individual likelihood ratios (LR), termed the simple LR product, should be roughly equivalent to or less than the log(LR) for the joint likelihood ratio, termed the compound LR. To assist casework analysts in evaluating statistical weights applied to a case at hand, this study assessed how consistently compound LRs conform to an additive behavior when compared to the simple LR product counterparts. Two-, three-, and four-person DNA mixture data, of various mixture proportions and DNA inputs, were interpreted by STRmix® version 2.8 Probabilistic Genotyping Software. Relative magnitudes of LR increases were found to be dependent on both template level and mixture composition. The distribution of log(LR) differences between all compound/simple LR comparisons was ~-2.7 to ~28.3. This level of information gain was similar to that for compound LR comparisons, with and without interpretation conditioning (~-3.2 to ~27.7). In both scenarios, the probability density peaked at approximately 0.5, indicating the information gain from constrained genotype combinations has a comparable impact on the outcome of LR calculations whether the restriction is applied before or after interpretation.

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DNA samples recovered from items of clothing are often attributed to the wearer and one or more individuals who may have contacted the item during an alleged criminal activity. Another scenario often proposed by defence counsel is that DNA was transferred from a previously contacted item/surface unrelated to the activity of interest onto the item of clothing. Under such scenarios, DNA may also be transferred from the clothing to the item/surface with which it comes into contact. One such surface is flooring, upon which clothing may be placed while not being worn or may be contacted during wearing, such as falling or being forced to the ground. This study investigates the transfer of DNA to and from clothing and flooring when different contacts are applied between the two surfaces in an environment representative of what investigators would encounter in routine casework, a residential environment. Participants were provided with two sets of new and unused upper and lower garments to wash then wear for ~8 h inside their own home before storing them in paper evidence bags. The two sets of clothing were taken to a home occupied by unrelated individuals, where one set was placed on the floor ('passive') by the researcher while the other was worn by the participant who laid with their back on the floor, rolled to one side and back, then stood up ('active'). Within the houses sampled, the main bedroom was targeted as flooring types and histories of use were more consistent across houses and less variation in DNA profile composition was previously observed for samples collected in the same room. Samples were collected from predetermined areas of the clothing and flooring where contact did and did not occur. Reference profiles were obtained from wearers and individuals they lived with, as well as occupants of the home. DNA transfer was observed from clothing to flooring and from flooring to clothing in both 'active' and 'passive' situations, though greater where a situation involved the application of pressure and friction ('active'), and only where contact between clothing and flooring occurred. Results from this study inform on the composition of DNA profiles one is likely to obtain from an item of clothing or a flooring surface following a similar contact event between the two substrates and will aid investigators when interpreting DNA evidence recovered in a domestic environment and the activities leading to its transfer and subsequent recovery.

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The forensic community has devoted much effort over the last decades to the development of a logical framework for forensic interpretation, which is essential for the safe administration of justice. We review the research and guidelines that have been published and provide examples of how to implement them in casework. After a discussion on uncertainty in the criminal trial and the roles that the DNA scientist may take, we present the principles of interpretation for evaluative reporting. We show how their application helps to avoid a common fallacy and present strategies that DNA scientists can apply so that they do not transpose the conditional. We then discuss the hierarchy of propositions and explain why it is considered a fundamental concept for the evaluation of biological results and the differences between assessing results given propositions that are at the source level or the activity level. We show the importance of pre-assessment, especially when the questions relate to the alleged activities, and when transfer and persistence need to be considered by the scientists to guide the court. We conclude with a discussion on statement writing and testimony. This provides guidance on how DNA scientists can report in a balanced, transparent, and logical way.

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