Species-specific functional morphology of four US atlantic coast dune grasses: Biogeographic implications for dune shape and coastal protection

Coastal dunes arise from feedbacks between vegetation and sediment supply. Species-specific differences in plant functional morphology affect sand capture and dune shape. In this study, we build on research showing a relationship between dune grass species and dune geomorphology on the US central Atlantic Coast. This study seeks to determine the ways in which four co-occurring dune grass species (Ammophila breviligulata, Panicum amarum, Spartina patens, Uniola paniculata) differ in their functional morphology and sand accretion. We surveyed the biogeography, functional morphology, and associated change in sand elevation of the four dune grass species along a 320-kilometer distance across the Outer Banks. We found that A. breviligulata had dense and clumped shoots, which correlated with the greatest sand accretion. Coupled with fast lateral spread, it tends to build tall and wide foredunes. Uniola paniculata had fewer but taller shoots and was associated with ~ 42% lower sand accretion. Coupled with slow lateral spread, it tends to build steeper and narrower dunes. Panicum amarum had similar shoot densities and associated sand accretion to U. paniculata despite its shorter shoots, suggesting that shoot density is more important than morphology. Finally, we hypothesize, given the distributions of the grass species, that foredunes may be taller and wider and have better coastal protection properties in the north where A. breviligulata is dominant. If under a warming climate A. breviligulata experiences a range shift to the north, as appears to be occurring with U. paniculata, changes in grass dominance and foredune morphology could make for more vulnerable coastlines

Labeling poststorm coastal imagery for machine learning: measurement of interrater agreement

© The Author(s), 2021. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Goldstein, E. B., Buscombe, D., Lazarus, E. D., Mohanty, S. D., Rafique, S. N., Anarde, K. A., Ashton, A. D., Beuzen, T., Castagno, K. A., Cohn, N., Conlin, M. P., Ellenson, A., Gillen, M., Hovenga, P. A., Over, J.-S. R., Palermo, R., Ratliff, K. M., Reeves, I. R. B., Sanborn, L. H., Straub, J. A., Taylor, L. A., Wallace E. J., Warrick, J., Wernette, P., Williams, H. E. Labeling poststorm coastal imagery for machine learning: measurement of interrater agreement. Earth and Space Science, 8(9), (2021): e2021EA001896, https://doi.org/10.1029/2021EA001896.Classifying images using supervised machine learning (ML) relies on labeled training data—classes or text descriptions, for example, associated with each image. Data-driven models are only as good as the data used for training, and this points to the importance of high-quality labeled data for developing a ML model that has predictive skill. Labeling data is typically a time-consuming, manual process. Here, we investigate the process of labeling data, with a specific focus on coastal aerial imagery captured in the wake of hurricanes that affected the Atlantic and Gulf Coasts of the United States. The imagery data set is a rich observational record of storm impacts and coastal change, but the imagery requires labeling to render that information accessible. We created an online interface that served labelers a stream of images and a fixed set of questions. A total of 1,600 images were labeled by at least two or as many as seven coastal scientists. We used the resulting data set to investigate interrater agreement: the extent to which labelers labeled each image similarly. Interrater agreement scores, assessed with percent agreement and Krippendorff's alpha, are higher when the questions posed to labelers are relatively simple, when the labelers are provided with a user manual, and when images are smaller. Experiments in interrater agreement point toward the benefit of multiple labelers for understanding the uncertainty in labeling data for machine learning research.The authors gratefully acknowledge support from the U.S. Geological Survey (G20AC00403 to EBG and SDM), NSF (1953412 to EBG and SDM; 1939954 to EBG), Microsoft AI for Earth (to EBG and SDM), The Leverhulme Trust (RPG-2018-282 to EDL and EBG), and an Early Career Research Fellowship from the Gulf Research Program of the National Academies of Sciences, Engineering, and Medicine (to EBG). U.S. Geological Survey researchers (DB, J-SRO, JW, and PW) were supported by the U.S. Geological Survey Coastal and Marine Hazards and Resources Program as part of the response and recovery efforts under congressional appropriations through the Additional Supplemental Appropriations for Disaster Relief Act, 2019 (Public Law 116-20; 133 Stat. 871)

No outcome disparities in patients with diffuse large B-cell lymphoma and a low socioeconomic status

Introduction: In patients with diffuse large B-cell lymphoma (DLBCL) socioeconomic status (SES) is associated with outcome in several population-based studies. The aim of this study was to further investigate the existence of disparities in treatment and survival. Methods: A population-based cohort study was performed including 343 consecutive patients with DLBCL, diagnosed between 2005 and 2012, in the North-west of the Netherlands. SES was based on the socioeconomic position within the Netherlands by use of postal code and categorized as low, intermediate or high. With multivariable logistic regression and Cox proportional hazard models the association between SES and respectively treatment and overall survival (OS) was evaluated. Results: Two-third of patients was positioned in low SES. Irrespective of SES an equal proportion of patients received standard immunochemotherapy. SES was not a significant risk indicator for OS (intermediate versus low SES: hazard ratio (HR) 1.31 (95% CI 0.78-2.18); high versus low SES: HR 0.83 (95% CI 0.48-1.46)). The mortality risk remained significantly increased with higher age, advanced performance status, elevated LDH and presence of comorbidity. Conclusion: Within the setting of free access to health care, in this cohort of patients with DLBCL no disparities in treatment and survival were seen in those with lower SES. (C) 2017 Elsevier Ltd. All rights reserved

Biomedical informatics and translational medicine

Biomedical informatics involves a core set of methodologies that can provide a foundation for crossing the "translational barriers" associated with translational medicine. To this end, the fundamental aspects of biomedical informatics (e.g., bioinformatics, imaging informatics, clinical informatics, and public health informatics) may be essential in helping improve the ability to bring basic research findings to the bedside, evaluate the efficacy of interventions across communities, and enable the assessment of the eventual impact of translational medicine innovations on health policies. Here, a brief description is provided for a selection of key biomedical informatics topics (Decision Support, Natural Language Processing, Standards, Information Retrieval, and Electronic Health Records) and their relevance to translational medicine. Based on contributions and advancements in each of these topic areas, the article proposes that biomedical informatics practitioners ("biomedical informaticians") can be essential members of translational medicine teams

Moral lessons from residents. close relatives and volunteers about the COVID-19 restrictions in Dutch and Flemish nursing homes

BackgroundDuring the COVID-19 outbreak in 2020, national governments took restrictive measures, such as a visitors ban, prohibition of group activities and quarantine, to protect nursing home residents against infections. As ‘safety’ prevailed, residents and close relatives had no choice but to accept the restrictions. Their perspectives are relevant because the policies had a major impact on them, but they were excluded from the policy decisions. In this study we looked into the moral attitudes of residents, close relatives and volunteers regarding the restrictions in retrospect, and what moral lessons they considered important.MethodsWe conducted 30 semi-structured interviews with residents and close relatives and one focus group meeting with volunteers working in nursing homes. Data were transcribed verbatim and analyzed inductively. Subsequently, three Socratic dialogue meetings with residents, close relatives and volunteers were organized in which first analysis outcomes were discussed and dialogues were fostered into moral lessons for future pandemics. Outcomes were combined with moral theory following an empirical bioethics design.ResultsCritical perspectives regarding the COVID-19 restrictions grew in time. Various moral values were compromised and steered moral lessons for our future. The participants recognized three moral lessons as most important. First, constructing tailored (well-balanced) solutions in practice is desirable. Second, proper recognition is needed for the caring role that close relatives fulfill in practice. Third, a responsive power distribution should be in place that includes all stakeholder perspectives who are affected by the restrictions.DiscussionComparing the results with moral theory strengthens the plea for inclusion of all stakeholder groups in decision-making processes. To further concretize the moral lessons, tailored solutions can be realized with the use of moral case deliberations. Proper recognition includes actions addressing moral repair and including counter-stories in the debate. Responsive power distribution starts with providing clear and trustworthy information and including all perspectives

“You needed to accept the situation”:Resilience of nursing home residents in times of COVID-19

The restrictive measures taken by nursing homes during the COVID-19 outbreak in 2020 (e.g., quarantine) may have been important stressors for which residents needed resilience to safeguard their well-being. Based on 30 semi-structured interviews with nursing home residents and close relatives, this study explored the lived experiences with respect to the restrictive measures. The data were collected in psychogeriatric, somatic, and mixed wards in The Netherlands and Flanders, Belgium. The restrictive measures were important stressors for residents, indicated by feelings of loneliness, sadness, and powerlessness. To deal with these measures, residents used various resources, which were determined by factors in the individual (e.g., health), interactional (e.g., possibilities for social interactions) and contextual (e.g. nursing home policy) domains. Because the lived experiences with respect to the restrictive measures seemed to relate to the resilience of nursing home residents, it is crucial to reinforce resources in the individual, interactional, and contextual domains

Family involvement in dementia special care units in nursing homes:A qualitative care ethical study into family experiences

Aim: To explore the moral dimension of family experiences with being involved in the care of their loved one with dementia in the nursing home, using the care ethical framework of Tronto. Design: This qualitative study used a care ethical approach in which empirical data and care ethical theory were dialectically related and mutually informing. Methods: Fifteen close family members of nursing home residents with dementia were interviewed between February 2020 and October 2020. Forty-two interviews were conducted, based on a semi-structured open-ended design. A thematic narrative approach combined with the five phases of care as defined by Tronto was used to analyse the empirical data. Subsequently, Tronto's identified ethical qualities were used to identify the moral dimension of these empirical findings. Results: We found that in the care process (1) family can find it difficult to recognize their loved one's care needs; (2) both family and staff are reluctant to discuss the allocation of responsibilities with each other; (3) family sometimes feels insecure when it comes to connecting with their loved one; (4) family is often reluctant to provide feedback to staff when they are critical about the care that has been given; and (5) family is generally mild in judging staff, due to staff shortages. The care ethical interpretation of these findings showed that the moral qualities of attentiveness, responsibility, competence, responsiveness, and solidarity are under pressure to a certain extent. Conclusion: Family experiences moral distress during the care process, which hinders family involvement in nursing homes for people with dementia. Impact: Nursing home staff can look for and pilot strategies focused on supporting families to act more in accordance with the moral qualities that are under pressure. This can improve family involvement in practice. Patient or Public Contribution: No Patient/Public Contribution. Implications for Practice/Policy: Nursing home staff paying more attention to families' emotional struggles related to the decline of their loved one, could help families to be more attentive to noticing true care needs of the resident. Both family and nursing home staff should take more often initiatives to evaluate the division of care responsibilities with each other. Nursing home staff should help family connect with their loved one during their visits if they experience difficulties in doing so. Nursing home staff taking more often initiatives to contact family and ask them how they perceive the care for their loved one, can positively affect the responsiveness of both family and staff. It would be helpful if nursing home management could ensure the presence of sufficient and qualified staff so that the first four phases of the care process are not hindered by the lack of staff