Mapping the Spatio-temporal Distribution of Key Vegetation Cover Properties in Lowland River Reaches, Using Digital Photography

The presence of vegetation in stream ecosystems is highly dynamic in both space and time. A digital photography technique is developed to map aquatic vegetation cover at species level, which has a very-high spatial and a flexible temporal resolution. A digital single-lens-reflex (DSLR) camera mounted on a handheld telescopic pole is used. The low-altitude (5 m) orthogonal aerial images have a low spectral resolution (Red-Green-Blue), high spatial resolution (~1.9 pixels cm-2, ~1.3 cm length) and flexible temporal resolution (monthly). The method is successfully applied in two lowland rivers to quantify four key properties of vegetated rivers: vegetation cover, patch size distribution, biomass and hydraulic resistance. The main advantages are that the method is: (i) suitable for continuous and discontinuous vegetation covers (ii) of very-high spatial and flexible temporal resolution, (iii) relatively fast compared to conventional ground survey methods, (iv) non-destructive, (v) relatively cheap and easy to use, and (vi) the software is widely available and similar open source alternatives exist. The study area should be less than 10 m wide and the prevailing light conditions and water turbidity levels should be sufficient to look into the water. Further improvements of the images processing are expected in the automatic delineation and classification of the vegetation patches

Is surgical subspecialization associated with hand grip strength and manual dexterity?:A cross-sectional study

BACKGROUND: The aim of this study was to compare hand grip strength (HGS) and manual dexterity of academic, subspecialized surgeons. METHODS: A single-center cross-sectional study was performed among 61 surgeons. HGS was analysed with a hand dynamometer and manual dexterity was extensively analysed with a Purdue Pegboard Test. Correlations between HGS and manual dexterity and specific characteristics of the surgeons were analysed using Pearson's correlation coefficient (r). RESULTS: HGS and manual dexterity were comparable between surgeons from different specialities. HGS was positively correlated with male gender (r = 0.59, p < 0.001) and hand glove size (r = 0.61, p < 0.001), whereas manual dexterity was negatively correlated with male gender (r = −0.35, p = 0.006), age (r = −0.39, = 0.002), and hand glove size (r = −0.46, p < 0.001). CONCLUSIONS: Surgical subspecialization was not correlated with HGS or manual dexterity. Male surgeons have greater HGS, whereas female surgeons have better manual dexterity. Manual dexterity is also correlated with age, showing better scores for younger surgeons

A prospective cohort study evaluating screening and assessment of six modifiable risk factors in HPB cancer patients and compliance to recommended prehabilitation interventions

INTRODUCTION: Despite improvements in perioperative care, major abdominal surgery continues to be associated with significant perioperative morbidity. Accurate preoperative risk stratification and optimisation (prehabilitation) are necessary to reduce perioperative morbidity. This study evaluated the screening and assessment of modifiable risk factors amendable for prehabilitation interventions and measured the patient compliance rate with recommended interventions.METHOD: Between May 2019 and January 2020, patients referred to our hospital for HPB surgery were screened and assessed on six modifiable preoperative risk factors. The risk factors and screening tools used, with cutoff values, included (i) low physical fitness (a 6-min walk test &lt; 82% of patient's calculated norm and/or patient's activity level not meeting the global recommendations on physical activity for health). Patients who were unfit based on the screening were assessed with a cardiopulmonary exercise test (anaerobic threshold ≤ 11 mL/kg/min); (ii) malnutrition (patient-generated subjective global assessment ≥ 4); (iii) iron-deficiency anaemia (haemoglobin &lt; 12 g/dL for women, &lt; 13 g/dL for men and transferrin saturation ≤ 20%); (iv) frailty (Groningen frailty indicator/Robinson frailty score ≥ 4); (v) substance use (smoking and alcohol use of &gt; 5 units per week) and (vi) low psychological resilience (Hospital Anxiety and Depression Scale ≥ 8). Patients had a consultation with the surgeon on the same day as their screening. High-risk patients were referred for necessary interventions.RESULTS: One hundred consecutive patients were screened at our prehabilitation outpatient clinic. The prevalence of high-risk patients per risk factor was 64% for low physical fitness, 42% for malnutrition, 32% for anaemia (in 47% due to iron deficiency), 22% for frailty, 12% for smoking, 18% for alcohol use and 21% for low psychological resilience. Of the 77 patients who were eventually scheduled for surgery, 53 (68.8%) needed at least one intervention, of whom 28 (52.8%) complied with 100% of the necessary interventions. The median (IQR) number of interventions needed in the 77 patients was 1.0 (0-2).CONCLUSION: It is feasible to screen and assess all patients referred for HPB cancer surgery for six modifiable risk factors. Most of the patients had at least one risk factor that could be optimised. However, compliance with the suggested interventions remains challenging.</p

Flood routing in the river Aa using ’Femme’

The software ’Femme’, (a flexible environment for mathematically modelling the environment) is developed by the Netherlands Institute of Ecology (NIOO)(Soetaert et al., 2004) and is used for the modelling of ecological processes. Femme’s code is open source and works on a modular base. The implementation of a one dimensional hydrodynamic model into ’Femme’ to study the interaction between ecological processes and surface water flow as a driving force and the validation using field measurements is subject of this research. For example, the presence of macrophytes has an influence on the discharge by way of the entire roughness of the river, expressed by the Manning coefficient.River hydraulics is characterised by changing discharges and water levels due to rain fall, so studies have to take into account the non-permanent character of the flow. In a first phase, the river characteristics and the simplified Saint-Venant equations have been built into the model. The simplification to the parabolic and the kinematic equations allow a faster and easier solution. The parabolic model is known as the convection-diffusion equation and describes the translation, deformation and attenuation of a wave in open channels and is valid for stretches with mild slopes. The kinematic model doesn’t take into account the flattening of the wave and can only be applied in short stretches.Calculation results are presented by the variation of the discharge as a function of distance. Also the influence of the roughness coefficient is shown.The integrated study of ecological processes and surface water flow is situated in a multidisciplinary research were attention is paid to the interaction of groundwater, surface water and the ecological system in order to describe the transport of matter through river basins (Buis et al.,2005). An important study area is the river Aa near Poederlee (Belgium, Flanders, province of Antwerp), were discharge, grondwater and biomass measurements are carried out on a regular base, to perform studies in the field and to collect calibration data for the integrated hydraulics and ecology model

Actual postoperative protein and calorie intake in patients undergoing major open abdominal cancer surgery:A prospective, observational cohort study

Background Adequate nutritional protein and energy intake are required for optimal postoperative recovery. There are limited studies reporting the actual postoperative protein and energy intake within the first week after major abdominal cancer surgery. The main objective of this study was to quantify the protein and energy intake after major abdominal cancer surgery. Methods We conducted a prospective cohort study. Nutrition intake was assessed with a nutrition diary. The amount of protein and energy consumed through oral, enteral, and parenteral nutrition was recorded and calculated separately. Based on the recommendations of the European Society for Clinical Nutrition and Metabolism (ESPEN), protein and energy intake were considered insufficient when patients received Fifty patients were enrolled in this study. Mean daily protein and energy intake was 0.61 +/- 0.44 g/kg/day and 9.58 +/- 3.33 kcal/kg/day within the first postoperative week, respectively. Protein and energy intake were insufficient in 45 [90%] and 41 [82%] of the 50 patients, respectively. Patients with Clavien-Dindo grade >= III complications consumed less daily protein compared with the group of patients without complications and patients with grade I or II complications. Conclusion During the first week after major abdominal cancer surgery, the majority of patients do not consume an adequate amount of protein and energy. Incorporating a registered dietitian into postoperative care and adequate nutrition support after major abdominal cancer surgery should be a standard therapeutic goal to improve nutrition intake

Evaluating Active U: an Internet-mediated physical activity program.

Background: Engaging in regular physical activity can be challenging, particularly during the winter months. To promote physical activity at the University of Michigan during the winter months, an eight-week Internet-mediated program (Active U) was developed providing participants with an online physical activity log, goal setting, motivational emails, and optional team participation and competition. Methods: This study is a program evaluation of Active U. Approximately 47,000 faculty, staff, and graduate students were invited to participate in the online Active U intervention in the winter of 2007. Participants were assigned a physical activity goal and were asked to record each physical activity episode into the activity log for eight weeks. Statistics for program reach, effectiveness, adoption, and implementation were calculated using the Re-Aim framework. Multilevel regression analyses were used to assess the decline in rates of data entry and goal attainment during the program, to assess the likelihood of joining a team by demographic characteristics, to test the association between various predictors and the number of weeks an individual met his or her goal, and to analyze server load. Results: Overall, 7,483 individuals registered with the Active U website (≈16% of eligible), and 79% participated in the program by logging valid data at least once. Staff members, older participants, and those with a BMI < 25 were more likely to meet their weekly physical activity goals, and average rate of meeting goals was higher among participants who joined a competitive team compared to those who participated individually (IRR = 1.28, P < .001). Conclusion: Internet-mediated physical activity interventions that focus on physical activity logging and goal setting while incorporating team competition may help a significant percentage of the target population maintain their physical activity during the winter months

Selective serotonin reuptake inhibitors in the treatment of generalized anxiety disorder

Selective serotonin reuptake inhibitors have proven efficacy in the treatment of panic disorder, obsessive–compulsive disorder, post-traumatic stress disorder and social anxiety disorder. Accumulating data shows that selective serotonin reuptake inhibitor treatment can also be efficacious in patients with generalized anxiety disorder. This review summarizes the findings of randomized controlled trials of selective serotonin reuptake inhibitor treatment for generalized anxiety disorder, examines the strengths and weaknesses of other therapeutic approaches and considers potential new treatments for patients with this chronic and disabling anxiety disorder