Cross-shelf and seasonal variation in larval fish assemblages on the southeast United States continental shelf off the coast of Georgia

Seasonal and cross-shelf patterns were investigated in larval fish assemblages on the continental shelf off the coast of Georgia. The influence of environmental factors on larval distributions also was examined, and larval transport processes on the shelf were considered. Ichthyoplankton and environmental data were collected approximately every other month from spring 2000 to winter 2002. Ten stations were repeatedly sampled along a 110-km cross-shelf transect, including four stations in the vicinity of Gray’s Reef National Marine Sanctuary. Correspondence analysis (CA) on untransformed community data identified two seasonal (warm weather [spring, summer, and fall] and winter) and three cross-shelf larval assemblages (inner-, mid-, and outer-shelf ). Five environmental factors (temperature, salinity, density, depth of the water column, and stratification) were related to larval cross-shelf distribution. Specifically, increased water column stratification was associated with the outer-shelf assemblage in spring, summer, and fall. The inner shelf assemblage was associated with generally lower temperatures and lower salinities in the spring and summer and higher salinities in the winter. The three cross-shelf regions indicated by the three assemblages coincided with the location of three primary water masses on the shelf. However, taxa occurring together within an assemblage were transported to different parts of the shelf; thus, transport across the continental shelf off the coast of Georgia cannot be explained solely by twodimensional physical factors

Implementation and early experience of a pediatric electrophysiology telehealth program

BACKGROUND: Telehealth (TH) visits have been growing with exponential increased utilization during the COVID-19 pandemic. The aim of this manuscript is to describe the implementation and early experience of a pediatric electrophysiology (EP) TH program implemented during the pandemic, assessing patient satisfaction, patient equity and inclusion (measured by geographical outreach), and sustainability. METHODS: A retrospective chart review study was performed and data were collected from the medical record, including demographic, testing, and billing data from scheduled TH encounters between March and August 2020 of a single pediatric EP group in the Midwest. Patients were called to complete satisfaction surveys. RESULTS: Patients with diverse pathologies were seen in TH, with supraventricular/atrial tachycardias (n = 41, 35%) and inherited arrhythmia syndromes (n = 23, 20%) being most common. The mean distance from clinic was 95 miles (range 2.8-320 miles), with 43% of patients living more than 100 miles away from clinic. A total of 172 tests were performed previsit (n = 102, 59%), during the visit (n = 17, 10%), or postvisit (n = 53, 31%), including 15 EP studies. Time-based Current Procedural Terminology codes were predominantly used for billing purposes (n = 92, 78%). There was generation of work relative value units (wRVU) for visits (220.5 wRVU) and testing (325.1 wRVU). Survey data demonstrated that 98% of patients were satisfied with their telehealth appointment and 99% had a clear understanding of their diagnosis. CONCLUSION: Pediatric EP TH clinics can provide care for a geographically and pathologically heterogeneous group of patients who had positive attitudes toward TH. Our study shows significant downstream testing and subsequent wRVU generation, suggesting financial sustainability

Assessment of Apple Watch Series 6 pulse oximetry and electrocardiograms in a pediatric population

BACKGROUND: Recent technologic advances have resulted in increased development and utilization of direct-to-consumer cardiac wearable devices with various functionality. This study aimed to assess Apple Watch Series 6 (AW6) pulse oximetry and electrocardiography (ECG) in a cohort of pediatric patients. METHODS: This single-center, prospective study enrolled pediatric patients ≥ 3kg and having an ECG and/or pulse oximetry (SpO2) as part of their planned evaluation. Exclusion criteria: 1) non-English speaking patients and 2) patients in state custody. Simultaneous tracings were obtained for SpO2 and ECG with concurrent standard pulse oximeter and 12-lead ECG. AW6 automated rhythm interpretations were compared to physician over-read and categorized as accurate, accurate with missed findings, inconclusive (automated interpretation: inconclusive ), or inaccurate. RESULTS: A total of 84 patients were enrolled over a 5-week period. 68 patients (81%) were placed into the SpO2 and ECG arm, with 16 patients (19%) placed into the SpO2 only arm. Pulse oximetry data was successfully collected in 71/84 (85%) patients and ECG data in 61/68 (90%). ΔSpO2 between modalities was 2.0±2.6% (r = 0.76). ΔRR was 43±44msec (r = 0.96), ΔPR 19±23msec (r = 0.79), ΔQRS 12±13msec (r = 0.78), and ΔQT 20±19msec (r = 0.9). The AW6 automated rhythm analysis yielded a 75% specificity and found: 1) 40/61 (65.6%) accurate , 2) 6/61 (9.8%) accurate with missed findings , 3) 14/61 (23%) inconclusive , and 4) 1/61 (1.6%) incorrect. CONCLUSION: The AW6 can accurately measure oxygen saturation when compared to hospital pulse oximeters in pediatric patients and provide good quality single lead ECGs that allow for accurate measurement of RR, PR, QRS, and QT intervals with manual interpretation. The AW6-automated rhythm interpretation algorithm has limitations for smaller pediatric patients and patients with abnormal ECGs

Type 2-diabetes i fastlegepraksis – en fokusgruppestudie

BAKGRUNN Nasjonal diabetesplan 2017–21 har iverksatt tiltak for å bedre diagnostisering og oppfølging av personer med type 2-diabetes i primærhelsetjenesten. Formålet med denne studien var å undersøke norske fastlegers erfaringer og tanker rundt diagnostisering og oppfølging av pasientgruppen. MATERIALE OG METODE I denne kvalitative studien ble det gjennomført tre fokusgruppeintervjuer med totalt 17 fastleger. Intervjuene ble tatt opp på bånd, transkribert og analysert med systematisk tekstkondensering. RESULTATER Fastlegene fortalte om en travel arbeidshverdag der målrettet identifikasjon av pasienter i risikosonen for sykdommen sjelden ble prioritert. De beskrev en pasientsentrert diabetesomsorg, hvor motivering til livsstilsendring ble ansett som en nødvendig, men krevende arbeidsoppgave. Legene problematiserte balansegangen mellom å følge generelle kliniske retningslinjer og det å individtilpasse oppfølging til den enkelte pasient. Samtidig uttrykte deltakerne at de var mindre faglig oppdatert enn de ønsket, grunnet tidspress. FORTOLKNING Fastlegene i studien beskrev en pasientsentrert diabetesomsorg som drives av klinisk erfaring. Retningslinjer har en veiledende, men ikke førende funksjon. En slik tilpasning muliggjør individualisert og tilpasset behandling, men kan også være en medvirkende årsak til mangelfull oppfølging i henhold til nasjonale retningslinjer.publishedVersio

Myoclonus and hypercalcemia in a dog with poorly differentiated lymphoproliferative neoplasia.

A 1-year, 8-month-old Rhodesian Ridgeback was presented with obtundation, ambulatory tetraparesis, and myoclonus. Initial clinical findings included ionized hypercalcemia with an apparent marked increase in parathyroid hormone, thrombocytopenia, and nonregenerative anemia. Low numbers of circulating atypical cells were noted on blood film evaluation. Brain magnetic resonance imaging identified an extra-axial contrast enhancing subtentorial lesion, and cerebrospinal fluid (CSF) analysis documented a marked atypical lymphocytic pleocytosis. Flow cytometry performed on the CSF demonstrated expression of only CD45, CD90, and MHC class II, with Pax5 positivity on subsequent immunohistochemistry. The final diagnosis was of B-cell lymphoblastic lymphoma or acute leukemia, given the distribution of disease and the presence of significant bone marrow infiltration alongside an aggressive clinical course. The unusual immunophenotype of the neoplastic cells and hypercalcemia presented antemortem diagnostic challenges, highlighting the need for a multidisciplinary approach and caution in the interpretation of clinical abnormalities in cases with multiple comorbidities

Maximizing the value of Solar System data through Planetary Spatial Data Infrastructures

Planetary spatial data returned by spacecraft, including images and higher-order products such as mosaics, controlled basemaps, and digital elevation models (DEMs), are of critical importance to NASA, its commercial partners and other space agencies. Planetary spatial data are an essential component of basic scientific research and sustained planetary exploration and operations. The Planetary Data System (PDS) is performing the essential job of archiving and serving these data, mostly in raw or calibrated form, with less support for higher-order, more ready-to-use products. However, many planetary spatial data remain not readily accessible to and/or usable by the general science user because particular skills and tools are necessary to process and interpret them from the raw initial state. There is a critical need for planetary spatial data to be more accessible and usable to researchers and stakeholders. A Planetary Spatial Data Infrastructure (PSDI) is a collection of data, tools, standards, policies, and the people that use and engage with them. A PSDI comprises an overarching support system for planetary spatial data. PSDIs (1) establish effective plans for data acquisition; (2) create and make available higher-order products; and (3) consider long-term planning for correct data acquisition, processing and serving (including funding). We recommend that Planetary Spatial Data Infrastructures be created for all bodies and key regions in the Solar System. NASA, with guidance from the planetary science community, should follow established data format standards to build foundational and framework products and use those to build and apply PDSIs to all bodies. Establishment of PSDIs is critical in the coming decade for several locations under active or imminent exploration, and for all others for future planning and current scientific analysis.Comment: 8 pages, 0 figures. White paper submitted to the Planetary Science and Astrobiology Decadal Survey 2023-203

Mercury in the marine environment of the Canadian Arctic: Review of recent findings

AbstractThis review summarizes data and information which have been generated on mercury (Hg) in the marine environment of the Canadian Arctic since the previous Canadian Arctic Contaminants Assessment Report (CACAR) was released in 2003. Much new information has been collected on Hg concentrations in marine water, snow and ice in the Canadian Arctic. The first measurements of methylation rates in Arctic seawater indicate that the water column is an important site for Hg methylation. Arctic marine waters were also found to be a substantial source of gaseous Hg to the atmosphere during the ice-free season. High Hg concentrations have been found in marine snow as a result of deposition following atmospheric mercury depletion events, although much of this Hg is photoreduced and re-emitted back to the atmosphere. The most extensive sampling of marine sediments in the Canadian Arctic was carried out in Hudson Bay where sediment total Hg (THg) concentrations were low compared with other marine regions in the circumpolar Arctic. Mass balance models have been developed to provide quantitative estimates of THg fluxes into and out of the Arctic Ocean and Hudson Bay.Several recent studies on Hg biomagnification have improved our understanding of trophic transfer of Hg through marine food webs. Over the past several decades, Hg concentrations have increased in some marine biota, while other populations showed no temporal change. Marine biota also exhibited considerable geographic variation in Hg concentrations with ringed seals, beluga and polar bears from the Beaufort Sea region having higher Hg concentrations compared with other parts of the Canadian Arctic. The drivers of these variable patterns of Hg bioaccumulation, both regionally and temporally, within the Canadian Arctic remain unclear. Further research is needed to identify the underlying processes including the interplay between biogeochemical and food web processes and climate change

Introductory programming: a systematic literature review

As computing becomes a mainstream discipline embedded in the school curriculum and acts as an enabler for an increasing range of academic disciplines in higher education, the literature on introductory programming is growing. Although there have been several reviews that focus on specific aspects of introductory programming, there has been no broad overview of the literature exploring recent trends across the breadth of introductory programming. This paper is the report of an ITiCSE working group that conducted a systematic review in order to gain an overview of the introductory programming literature. Partitioning the literature into papers addressing the student, teaching, the curriculum, and assessment, we explore trends, highlight advances in knowledge over the past 15 years, and indicate possible directions for future research

A Vulnerability Assessment of Fish and Invertebrates to Climate Change on the Northeast U.S. Continental Shelf

Climate change and decadal variability are impacting marine fish and invertebrate species worldwide and these impacts will continue for the foreseeable future. Quantitative approaches have been developed to examine climate impacts on productivity, abundance, and distribution of various marine fish and invertebrate species. However, it is difficult to apply these approaches to large numbers of species owing to the lack of mechanistic understanding sufficient for quantitative analyses, as well as the lack of scientific infrastructure to support these more detailed studies. Vulnerability assessments provide a framework for evaluating climate impacts over a broad range of species with existing information. These methods combine the exposure of a species to a stressor (climate change and decadal variability) and the sensitivity of species to the stressor. These two components are then combined to estimate an overall vulnerability. Quantitative data are used when available, but qualitative information and expert opinion are used when quantitative data is lacking. Here we conduct a climate vulnerability assessment on 82 fish and invertebrate species in the Northeast U.S. Shelf including exploited, forage, and protected species. We define climate vulnerability as the extent to which abundance or productivity of a species in the region could be impacted by climate change and decadal variability. We find that the overall climate vulnerability is high to very high for approximately half the species assessed; diadromous and benthic invertebrate species exhibit the greatest vulnerability. In addition, the majority of species included in the assessment have a high potential for a change in distribution in response to projected changes in climate. Negative effects of climate change are expected for approximately half of the species assessed, but some species are expected to be positively affected (e.g., increase in productivity or move into the region). These results will inform research and management activities related to understanding and adapting marine fisheries management and conservation to climate change and decadal variability