Objectives/Goals: Engaging interest holders in research is increasingly common, and guidelines include creating engagement plans. A detailed plan may be especially helpful when researchers perceive engagement as difficult or less relevant. We tested whether a study’s translational stage or an investigator’s years of research experience affect their perceptions. Methods/Study Population: Since 2019, the Tufts Clinical and Translational Science Institute Pilot Studies Program required applicants to submit plans to engage interest holders. Applicants in three cohorts responded to a survey about this requirement, including perceived difficulty developing an engagement plan, perceived relevance of engagement, and self-reported years of research experience (≤5, 6–10, and ≥10 years). Two raters assigned translational stage(s) of proposed studies: T0 (basic science), T.5 (pre-clinical to initial human studies), and T1 through T4. Separate analyses were conducted when multistage studies were coded as the earliest vs. latest stage and for individual stage vs. groups of stages (T0/T.5/T1 vs. T2/T3/T4). The Fisher’s exact statistical test was used to assess associations between variables. Results/Anticipated Results: Analyses included 67 participants. Developing an engagement plan was perceived as more difficult for studies at earlier translational stages when those studies were coded as the earliest applicable stage. This significant association held both when stages were grouped as T0/T.5/T1 and T2/T3/T4 (P  =  .03) and when analyzed as a single stage (P  =  .01); however, when studies were coded as the latest applicable stage, there were no significant associations. Similarly, when multistage studies were coded as the earliest applicable stage, engagement was perceived as less relevant for early-stage studies when grouped (P  =  .04), but not for individual stages or when studies were coded as the latest applicable stage. No significant association between years of research experience and perceived difficulty was identified. Discussion/Significance of Impact: Results show that investigators conducting early-stage research perceive more difficulty engaging interest holders, aligning with prior qualitative studies. These investigators may need more evidence of the value added to early-stage studies, targeted and practical training, and funder requirements to establish a culture of engagement.

Cotton producers need residual herbicides that can safely and practically be applied postemergence. Herbicide-coated fertilizers could allow for simultaneous application of residual herbicides and a bulk fertilizer blend. Therefore, a study was conducted in 2022 and 2023 in Fayetteville, AR, to evaluate cotton tolerance to 12 herbicide treatments coated onto a fertilizer blend and applied over cotton. Herbicides and rates evaluated included diuron at 840 g ai ha−1, florpyrauxifen-benzyl at 29 g ai ha−1, flumioxazin at 105 g ai ha−1, flumioxazin + pyroxasulfone at 70 + 90 g ai ha−1, fluridone at 168 g ai ha−1, fluometuron at 840 g ai ha−1, fomesafen at 280 g ai ha−1, pyroxasulfone at 128 g ai ha−1, saflufenacil at 66 g ai ha−1, saflufenacil + dimethenamid-P at 25 + 219 g ai ha−1, saflufenacil + pyroxasulfone at 44 + 91 g ai ha−1, and S-metolachlor at 1,388 g ai ha−1. In both years, fluridone, fluometuron, diuron, and S-metolachlor caused less than 10% injury at 7 d after treatment (DAT). Higher injury levels were observed in 2022 (19% to 30%) compared with 2023 (4% to 12%) for flumioxazin, fomesafen, saflufenacil, saflufenacil plus dimethenamid-P, and saflufenacil + pyroxasulfone. The elevated injury in one of two years was attributed to the presence of dew when the herbicide-coated fertilizer was applied. The initial injury was transient, as the cotton generally had recovered by 28 DAT for all herbicides. No differences in seed cotton yield or groundcover among the herbicide treatments occurred either year. These results highlight the potential of using several postemergence-applied, residual herbicides coated onto fertilizer that are not currently registered for over-the-top use in cotton.

Weeds belonging to the Amaranthus family are most problematic for soybean producers. With Palmer amaranth evolving resistance to multiple herbicides labeled for use in soybean, producers seek new sites of action to integrate into season-long herbicide programs. Bayer CropScience plans to launch a Convintro™ brand of herbicides, one being a premixture that will include diflufenican (categorized as a Group 12 herbicide by the Weed Science Society of America [WSSA]), metribuzin (WSSA Group 5), and flufenacet (WSSA Group 15), for use preemergence in soybean. Research trials were conducted in Fayetteville and Keiser, AR, and Holt, MI, in 2022 and 2023, to evaluate the premixture in a season-long program in a dicamba-resistant soybean system. A 0.17:0.35:0.48 ratio of a premixture of diflufenican:metribuzin:flufenacet (DFF-containing premixture) was applied preemergence with different combinations of glyphosate, glufosinate, dicamba, and acetochlor at 28 (early postemergence) and 42 (late postermergence) days after planting (DAP). At the early postemergence timing, the DFF-containing premixture provided >90% control of Palmer amaranth and prickly sida. However, common ragweed, common lambsquarters, morningglory ssp., and annual grass control was ≤80% at this timing. When the late postemergence applications occurred, treatments that had already received an early postemergence application controlled prickly sida, morningglory ssp., Palmer amaranth, and annual grasses to a greater extent than those that had not, indicating the preemergence application of the DFF-containing premixture was not sufficient to provide control of the weed spectrum through 42 DAP. By 70 DAP, all programs provided ≥93% control of all weeds evaluated. Herbicide programs that included the DFF-containing premixture preemergence followed by (fb) EPOST fb LPOST common ragweed, common lambsquarters, morningglory ssp., and annual grasses to a greater than the one-pass postemergence systems. In addition, all herbicide programs evaluated in this study reduced Palmer amaranth seed production by >99%. However, producers who plan to use the DFF-containing premixture may need two postemergence herbicide applications to obtain high levels of weed control throughout the growing season.

With Palmer amaranth and waterhemp evolving resistance to nine and six different sites of action (SOAs) globally, soybean producers continue to search for new options to control these problematic weeds. Bayer CropScience has announced its intentions to launch a Convintro™ brand of herbicides, one being a three-way premixture for preemergence use in soybean. The premixture will contain diflufenican (WSSA Group 12), metribuzin (WSSA Group 5), and flufenacet (WSSA Group 15), adding a new SOA for soybean producers throughout the United States. With the anticipated launch of the premixture, research is needed to evaluate the length of residual control provided by the new herbicide. Research trials were conducted in Fayetteville and Keiser, AR, and Morrice, MI, in 2022 and 2023. A 0.17:0.35:0.48 ratio of a diflufenican:metribuzin:flufenacet (DFF)-containing premixture was applied alone and in combination with additional metribuzin and dicamba. Also, metribuzin, acetochlor, a S-metolachlor:metribuzin premixture, and a flumioxazin:pyroxasulfone:metribuzin premixture were applied preemergence. The DFF-containing premixture was more effective in reducing Palmer amaranth/waterhemp emergence than acetochlor in four of six trials at 28 d after treatment (DAT). Palmer amaranth and waterhemp densities in plots treated with the DFF-containing premixture exhibited similar results to plots treated with the S-metolachlor:metribuzin premixture and the flumioxazin:pyroxasulfone:metribuzin premixture at 28 DAT. By 56 DAT, Palmer amaranth and waterhemp densities were comparable or superior in plots with the DFF-containing premixture than in those treated with acetochlor and metribuzin, and the S-metolachlor:metribuzin premixture at five of six sites. The addition of dicamba or metribuzin to the DFF-containing premixture did not reduce Palmer amaranth or waterhemp density compared to the DFF-containing premixture at 28 or 56 DAT. Overall, the DFF-containing premixture generally provided greater or comparable control over several standard herbicides, providing growers a new product for preemergence control of Amaranthus species in soybean fields.

An array of information about the Antarctic ice sheet can be extracted from ice-sheet internal architecture imaged by airborne ice-penetrating radar surveys. We identify, trace and date three key internal reflection horizons (IRHs) across multiple radar surveys from South Pole to Dome A, East Antarctica. Ages of ~38 ± 2.2, ~90 ± 3.6 and ~162 ± 6.7 ka are assigned to the three IRHs, with verification of the upper IRH age from the South Pole ice core. The resultant englacial stratigraphy is used to identify the locations of the oldest ice, specifically in the upper Byrd Glacier catchment and the Gamburtsev Subglacial Mountains. The distinct glaciological conditions of the Gamburtsev Mountains, including slower ice flow, low geothermal heat flux and frozen base, make it the more likely to host the oldest ice. We also observe a distinct drawdown of IRH geometry around South Pole, indicative of melting from enhanced geothermal heat flux or the removal of deeper, older ice under a previous faster ice flow regime. Our traced IRHs underpin the wider objective to develop a continental-scale database of IRHs which will constrain and validate future ice-sheet modelling and the history of the Antarctic ice sheet.

Bayer Crop Science anticipates launching several premixtures for use in soybean, targeted at control of Palmer amaranth. One of the premixtures will contain diflufenican (Weed Science Society of America [WSSA] Group 12), metribuzin (WSSA Group 5), and flufenacet (WSSA Group 15) (DFF-containing premixture), offering an alternative site of action for soybean producers. Field experiments were conducted in Arkansas and Michigan to evaluate application timings of the DFF-containing premixture for soybean tolerance and weed control and possible cultivar tolerance differences to diflufenican and the DFF-containing premixture. Soybean injury from the 1X and 2X rates of the DFF-containing premixture ranged from 0% to 60% 14 d after planting (DAP), with injury increasing the closer the herbicide was applied to soybean emergence. Excluding the 2X rate applied 3 DAP in Arkansas in 2023, soybean injury was <20% regardless of location, site-year, application timing, and rate. For weed control experiments, only a 1X rate of the DFF-containing premixture was applied at the various application timings. Control of five weed species, encompassing broadleafs and grasses, ranged from 81% to 98%, regardless of application timing, by 28 DAP. By 42 DAP, weed control ranged from 71% to 97%, with the 14-d preplant application timing typically being the least effective. The DFF-containing premixture and diflufenican alone were applied PRE at 1X and 2X rates for the soybean cultivar study. Soybean metribuzin sensitivity did not affect the degree of crop response, even in a high-pH soil, and injury to soybean never exceeded 20%. Overall, the DFF-containing premixture will be a tool that soybean producers can integrate into a season-long herbicide program for use across the United States regardless of soybean cultivar.

After St James the Apostle, Bishop Teodomiro of Iria-Flavia is the most important figure associated with the pilgrimage to Santiago de Compostela. He supposedly discovered the apostolic tomb after a divine revelation between AD 820 and 830 yet, until the discovery, in 1955, of a tombstone inscribed with his name, his very existence was a matter of some debate. Here, the authors employ a multi-stranded analytical approach, combining osteoarchaeology, radiocarbon dating, stable isotope and ancient DNA analyses to demonstrate that human bones associated with the tombstone, in all likelihood, represent the earthly remains of Bishop Teodomiro.

The reactivity of colloidal particles is regulated by their surface properties. These properties affect the wettability, flocculation-dispersion characteristics, ion exchange, sorption capacities and transport of inorganic colloids. Most studies have focused on hydrophilic, charged-particle surfaces, often ignoring the alterations in surface properties produced by the adsorption of natural organic matter, surfactants and other compounds. Adsorption of these substances can potentially render a surface substantially more hydrophobic. Nevertheless, comparatively little is known about changes in surface properties and reactivity of minerals upon sorption of hydrophobic organic compounds. In this study, the properties of four minerals (kaolinite, pyrophyllite, montmorillonite and Min-U-Sil®) and two inorganic materials (X-ray amorphous Al hydroxide and X-ray amorphous Si oxide) were compared before and after treatment with the common silylating agent, trimethylchlorosilane (TMCS). The samples were characterized by measurements of total carbon, cation exchange capacity (CEC), particle size, specific surface area (SSA), electrophoretic mobility, contact angle, particle aggregation, and by X-ray diffraction and diffuse reflectance infrared spectroscopy. For the layer silicates, surface coverage was limited to ∼2% trimethyl silane (TMSi). TMSi covered 7.5% of the Min-U-Sil® surface and 33% of the X-ray amorphous Si oxide. Treatment did not affect the structure of the minerals but reduced the CEC, SSA and electrophoretic mobilities. Water contact angles increased to between 18 and 114° with treatment. While the apolar characteristic of the surfaces decreased minimally with treatment, the Lewis acid/base properties were substantially reduced and interfacial free energy shifted from positive to negative values indicating a more hydrophobic surface character. For all the samples except kaolinite, these changes affected the stability of the colloids in suspension depending upon solution pH. Although the grafting of TMSi altered colloidal mineral surface properties and increased their hydrophobicity, these changes were not sufficient to predict colloid aggregation behavior.

Investigations of the relevance of low-tunnel methodology and air sampling concerning the off-target movement of dicamba were conducted from 2018 to 2022, focused primarily on volatility. This research, divided into three experiments, evaluated the impact of herbicides and adjuvants added to dicamba and the type of surface treated on dicamba volatility. Treatment combinations included glyphosate and glufosinate, the presence of a simulated contamination rate of ammonium sulfate (AMS), the benefit of a volatility reduction agent (VRA), and a vegetated (dicamba-resistant cotton) or soil surface treated with dicamba. Volatility assessments included air sampling collected over 48 h. Dicamba treatments were applied four times to each of two bare soil or cotton trays and placed inside the tunnels. Dicamba from air samples was extracted and quantified. Field assessments included the maximum and average visible injury in bioindicator soybean and the lateral movement of dicamba damage expressed by the farthest distance from the center of the plots to the position in which plants exhibited 5% injury. Adding glufosinate and glyphosate to dicamba increased the dicamba amount in air samples. A simulated tank contamination rate of AMS (0.005% v/v) did not affect dicamba emissions compared to a treatment lacking AMS. Adding a VRA reduced dicamba in air samples by 70% compared to treatment without the adjuvant. Dicamba treatments applied on vegetation generally produced greater detectable amounts of dicamba than treatments applied to bare soil. Field assessment results usually followed differences in dicamba concentration by treatments tested. Results showed that low-tunnel methodology allowed simultaneous comparisons of several treatment combinations concerning dicamba volatility.

The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery (WCPCCS) will be held in Washington DC, USA, from Saturday, 26 August, 2023 to Friday, 1 September, 2023, inclusive. The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery will be the largest and most comprehensive scientific meeting dedicated to paediatric and congenital cardiac care ever held. At the time of the writing of this manuscript, The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery has 5,037 registered attendees (and rising) from 117 countries, a truly diverse and international faculty of over 925 individuals from 89 countries, over 2,000 individual abstracts and poster presenters from 101 countries, and a Best Abstract Competition featuring 153 oral abstracts from 34 countries. For information about the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery, please visit the following website: [www.WCPCCS2023.org]. The purpose of this manuscript is to review the activities related to global health and advocacy that will occur at the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery.

Acknowledging the need for urgent change, we wanted to take the opportunity to bring a common voice to the global community and issue the Washington DC WCPCCS Call to Action on Addressing the Global Burden of Pediatric and Congenital Heart Diseases. A copy of this Washington DC WCPCCS Call to Action is provided in the Appendix of this manuscript. This Washington DC WCPCCS Call to Action is an initiative aimed at increasing awareness of the global burden, promoting the development of sustainable care systems, and improving access to high quality and equitable healthcare for children with heart disease as well as adults with congenital heart disease worldwide.

Damage to non–dicamba resistant (non-DR) soybean [Glycine max (L.) Merr.] has been frequent in geographies where dicamba-resistant (DR) soybean and cotton (Gossypium hirsutum L.) have been grown and sprayed with the herbicide in recent years. Off-target movement field trials were conducted in northwest Arkansas to determine the relationship between dicamba concentration in the air and the extent of symptomology on non-DR soybean. Additionally, the frequency and concentration of dicamba in air samples at two locations in eastern Arkansas and environmental conditions that impacted the detection of the herbicide in air samples were evaluated. Treatment applications included dicamba at 560 g ae ha−1 (1X rate), glyphosate at 860 g ae ha−1, and particle drift retardant at 1% v/v applied to 0.37-ha fields with varying degrees of vegetation. The relationship between dicamba concentration in air samples and non-DR soybean response to the herbicide was more predictive with visible injury (generalized R 2 = 0.82) than height reduction (generalized R 2 = 0.43). The predicted dicamba air concentration resulting in 10% injury to soybean was 1.60 ng m−3 d−1 for a single exposure. The predicted concentration from a single exposure to dicamba resulting in a 10% height reduction was 3.78 ng m−3 d−1. Dicamba was frequently detected in eastern Arkansas, and daily detections above 1.60 ng m−3 occurred 17 times in the period sampled. The maximum concentration of dicamba recorded was 7.96 ng m−3 d−1, while dicamba concentrations at Marianna and Keiser, AR, were ≥1 ng m−3 d−1 in six samples collected in 2020 and 22 samples in 2021. Dicamba was detected consistently in air samples collected, indicating high usage in the region and the potential for soybean damage over an extended period. More research is needed to quantify the plant absorption rate of volatile dicamba and to evaluate the impact of multiple exposures of gaseous dicamba on non-targeted plant species.

We introduce two concepts—social certainty and social doubt—that help to articulate a variety of experiences of the social world, such as shyness, self-consciousness, culture shock, and anxiety. Following Carel's (2013) analysis of bodily doubt, which explores how a person's tacit confidence in the workings of their body can be disrupted and undermined in illness, we consider how an individual's faith in themselves as a social agent, too, can be compromised or lost, thus altering their experience of what is afforded by the social environment. We highlight how a loss of bodily or social certainty can be shaped and sustained by the environments in which one finds oneself. As such, we show how certain individuals might be more vulnerable to experiences of bodily and social doubt than others.

The threat of herbicide-resistant weed species, such as Palmer amaranth, has driven the development of robust weed management programs that rely on more than chemicals for weed control. Previous research has shown that zero-tolerance weed thresholds, cover crops, deep tillage, and diverse herbicide programs are effective strategies for controlling Palmer amaranth. Unfortunately, research investigating the integration of all four of these weed management strategies in a system is lacking. To better leverage these integrated weed management strategies in cotton production systems, a long-term study was initiated in fall 2018 near Marianna, AR, with zero tolerance, deep tillage, a cereal rye cover crop, and either a dicamba or non-dicamba in-crop herbicide program as factors. Results found that total Palmer amaranth emergence was reduced 76% as the result of deep tillage in 2019 and, in the absence of a zero-tolerance strategy, 73% in 2020. In the absence of a zero-tolerance strategy, the combination of a non–cover crop strategy and dicamba herbicide program decreased total Palmer amaranth emergence by 73%, while the combination of a cover crop strategy and dicamba herbicide program decreased total Palmer amaranth emergence by 78% compared to the combination of a cover crop and non-dicamba herbicide program. Under a zero-tolerance strategy in 2019, tillage reduced cotton yield by 12% and partial returns by US$370 ha−1. In 2020, tillage reduced cotton yield by 14% and partial returns of US$371 ha−1 under a non-zero-tolerance strategy, while a 12% yield reduction and a US$260 ha−1 decrease in partial returns were observed under a zero-tolerance strategy. In 2019, the non-dicamba program resulted in greater partial returns than the dicamba in-crop program because of greater yield and lower program costs. However, in 2020, partial returns were greater for the dicamba in-crop herbicide program owing to greater yields achieved by this program.

Double-cropping winter rye cover crops (CC) with soybean in the North Central US could help with the global effort to sustainably intensify agriculture. Studies addressing the management of these systems are limited. Therefore, a field study was conducted from 2017 to 2019 in Central Iowa, US to evaluate winter rye CC biomass production, aboveground N accumulation, estimated economics, estimated within-field energy balance and estimated greenhouse gas (GHG) emissions under three N application rates (0, 60, 120 kg N ha−1) and three planting methods (pre- and post-harvest broadcast and post-harvest drilling). Averaged over N rates, all planting methods resulted in >5.0 Mg ha−1 year−1 rye aboveground biomass dry matter. Averaged over the 2-year study and compared with unfertilized treatments, applying 60 kg N ha−1 produced 1.1 Mg ha−1 more aboveground biomass (6.1 vs 5.0 Mg ha−1), accumulated 30 kg ha−1 more N in aboveground biomass (88 vs 58 kg N ha−1), and led to 20 GJ ha−1 more net energy. Biomass production was not significantly higher with 120 kg N ha−1 compared with the 60 kg N ha−1 rate. Even when accounting for an estimated 0.75 Mg ha−1 of above ground rye biomass left in the field after harvesting, more N was removed than applied at the 60 kg N ha−1 rate. The minimum rye prices over the 2-year study needed for double-cropping winter rye CC to be profitable (breakeven prices) averaged $117 and $104 Mg−1 for the 0 and 60 kg N ha−1 rates, which factors in estimated soybean yield reductions in 2019 compared with local averages but not off-site transportation. GHG emissions were estimated to increase approximately threefold between the unfertilized and 60 kg N ha−1 rates without considering bioenergy offsets. While environmental tradeoffs need further study, results suggest harvesting fertilized rye CC biomass before planting soybean is a promising practice for the North Central US to maximize total crop and net energy production.

The ability of weed populations to evolve resistance to herbicides affects management strategies and the profitability of crop production. The objective of this research was to screen Palmer amaranth accessions from Arkansas for glufosinate resistance. Additional efforts focused on the effectiveness of various herbicides, across multiple sites of action (SOAs), on each putative-resistant accession. The three putative accessions were selected from 60 Palmer amaranth accessions collected in 2019 and 2020 and screened with to 0.5× and 1× rates of glufosinate. A dose-response experiment was conducted for glufosinate on accessions A2019, A2020, and B2020. The effectiveness of various preemergence- and postemergence-applied herbicides were evaluated on each accession. Resistance ratios of A2019, A2020, and B2020 to glufosinate ranged from 5.1 to 27.4 when comparing LD50 values to two susceptible accessions, thus all three accessions were resistant to glufosinate. All three accessions (A2019, A2020, and B2020) were found to have a reduction equal to or greater than 20 percentage points in mortality to at least one herbicide from five different SOAs equal to or greater than five sites of action. Herbicides from nine different SOAs controlled A2019 at least 20 percentage points less than the susceptible accessions, which points to a need for additional research to characterize the response of this accession.

When followed, there is evidence that social distancing measures play a major role in reducing the transmission of viruses such as COVID-19. However, not all individuals follow the guidance. We explored barriers and facilitators to compliance with UK social distancing guidelines during the COVID-19 pandemic through semi-structured interviews with 116 adults. Data were analysed using reflexive thematic analysis and themes mapped to the Capability, Opportunity and Motivation Model of Behaviour (COM-B). Barriers to compliance included inconsistent rules, caring responsibilities, fatigue, unintended consequences of control measures, and the need for emotional support. Facilitators were informational support and social responsibility. Six themes were both a barrier and a facilitator: lived environment, beliefs about consequences of non-compliance, influence of others, practical support, and trust in government. Reflective motivation, psychological capability, and social opportunity were important drivers for compliance. Measures that enable social support alongside strategies to maintain motivation to comply, provide clear guidance and optimise social cohesion should be promoted.

Palmer amaranth has developed resistance to at least seven herbicide sites of action in the Cotton Belt of the United States, leaving producers with fewer options to manage this weed. Previous research with corn and newly commercially released soybean systems have found the use of 4-hydroxyphenylpyruvate dioxygenase (HPPD)-inhibiting herbicides such as isoxaflutole (IFT) to be effective at managing Palmer amaranth. Consequently, a new transgenic cultivar of cotton is being developed with tolerance to IFT, allowing for in-crop applications of the herbicide. Two separate studies were conducted near Marianna, AR, in 2019 and replicated in 2020, to investigate the crop safety and utility of IFT when added to cotton herbicide programs. Herbicide programs featured IFT as a preemergence or early-postemergence option, residual herbicides in subsequent postemergence applications, and the presence or absence of a layby application. The use of IFT did not significantly impact cotton injury or yield, whereas the use of layered residual herbicides, including IFT, increased Palmer amaranth control compared to those without. Regardless of earlier use of IFT, layby applications were needed for season-long control of Palmer amaranth, entireleaf morningglory, broadleaf signalgrass, and johnsongrass, as evidenced by greater than a 20 percentage point improvement in control of all weeds when a layby application was made. Overall, findings from these studies indicate IFT to be a suitable tool for managing Palmer amaranth and will provide an additional site of action for cotton herbicide programs. Sequential herbicide applications and overlaying residuals were found to be paramount for managing Palmer amaranth throughout the season.

We describe the incidence of suicidality (2007–2017) in people with depression treated by secondary mental healthcare services at South London and Maudsley NHS Trust (n = 26 412). We estimated yearly incidence of ‘suicidal ideation’ and ‘high risk of suicide’ from structured and free-text fields of the Clinical Record Interactive Search system. The incidence of suicidal ideation increased from 0.6 (2007) to 1 cases (2017) per 1000 population. The incidence of high risk of suicide, based on risk forms, varied between 0.06 and 0.50 cases per 1000 adult population (2008–2017). Electronic health records provide the opportunity to examine suicidality on a large scale, but the impact of service-related changes in the use of structured risk assessment should be considered.