Wildfire Smoke Particle Properties and Evolution, from Space-Based Multi-Angle Imaging

Emitted smoke composition is determined by properties of the biomass burning source and ambient ecosystem. However, conditions that mediate the partitioning of black carbon (BC) and brown carbon (BrC) formation, as well as the spatial and temporal factors that drive particle evolution, are not understood adequately for many climate and air-quality related modeling applications. In situ observations provide considerable detail about aerosol microphysical and chemical properties, although sampling is extremely limited. Satellites offer the frequent global coverage that would allow for statistical characterization of emitted and evolved smoke, but generally lack microphysical detail. However, once properly validated, data from the National Aeronautics and Space Administration (NASA) Earth Observing Systems Multi-Angle Imaging Spectroradiometer (MISR) instrument can create at least a partial picture of smoke particle properties and plume evolution. We use in situ data from the Department of Energys Biomass Burning Observation Project (BBOP) field campaign to assess the strengths and limitations of smoke particle retrieval results from the MISR Research Aerosol (RA) retrieval algorithm. We then use MISR to characterize wildfire smoke particle properties and to identify the relevant aging factors in several cases, to the extent possible. The RA successfully maps qualitative changes in effective particle size, light absorption, and its spectral dependence, when compared to in situ observations. By observing the entire plume uniformly, the satellite data can be interpreted in terms of smoke plume evolution, including size-selective deposition, new-particle formation, and locations within the plume where BC or BrC dominates

Untethered Lecture Capture: A Qualitative Investigation of College Student Experiences

Untethered Lecture Capture (ULC), a technology-enhanced teaching strategy, permits faculty to be freely mobile in the classroom (untethered) while simultaneously teaching and creating audiovisual media assets (lecture capture). Faculty, representing nine disciplines, implemented ULC in undergraduate courses. Qualitative content analysis resulted in three themes. Undergraduate participants (n¼23) reported ULC supports accessibility and education affordances, enhancing personalized, self-paced learning, and equal opportunities for academic success. Untethered faculty teach on our turf, teaching among rather than talking at students, enhancing time-on-task, in-class focus, and learner socialization. Understanding and retention were perceived as improved when multimedia instruction principles were integrated in the classroom

Adjuvant Chemotherapy Use and Adverse Events Among Older Patients With Stage III Colon Cancer

Randomized trials suggest adjuvant chemotherapy is effective for elderly patients with stage III colon cancer. However, the elderly are less likely to receive this therapy than younger patients, perhaps because of concern about adverse effects

PKD1 Inhibits AMPK2 through Phosphorylation of Serine 491 and Impairs Insulin Signaling in Skeletal Muscle Cells

Background: Diminished activity of the enzyme AMP-activated protein kinase (AMPK) is associated with impaired insulin signaling. Results: Protein Kinase (PK)C/D1 activation inhibits AMPK2 via Ser491 phosphorylation; PKD1 inhibition prevents this in skeletal muscle cells. Conclusion: PKD1 is a novel upstream AMPK-kinase that phosphorylates AMPK on Ser491 and regulates insulin signaling. Significance: PKD1 inhibition may be a novel strategy for improving insulin sensitivity

Oncologists' perspectives on post-cancer treatment communication and care coordination with primary care physicians

Post-treatment cancer care is often fragmented and of suboptimal quality. We explored factors that may affect cancer survivors' post-treatment care coordination, including oncologists' use of electronic technologies such as e-mail and integrated electronic health records (EHRs) to communicate with primary care physicians (PCPs). We used data from a survey (357 respondents; participation rate 52.9%) conducted in 2012-2013 among medical oncologists caring for patients in a large US study of cancer care delivery and outcomes. Oncologists reported their frequency and mode of communication with PCPs, and role in providing post-treatment care. Seventy-five per cent said that they directly communicated with PCPs about post-treatment status and care recommendations for all/most patients. Among those directly communicating with PCPs, 70% always/usually used written correspondence, while 36% always/usually used integrated EHRs; telephone and e-mail were less used. Eighty per cent reported co-managing with PCPs at least one post-treatment general medical care need. In multivariate-adjusted analyses, neither communication mode nor intensity were associated with co-managing survivors' care. Oncologists' reliance on written correspondence to communicate with PCPs may be a barrier to care coordination. We discuss new research directions for enhancing communication and care coordination between oncologists and PCPs, and to better meet the needs of cancer survivors post-treatment

Evaluation of a flipped classroom approach to learning introductory epidemiology

Background Although the flipped classroom model has been widely adopted in medical education, reports on its use in graduate-level public health programs are limited. This study describes the design, implementation, and evaluation of a flipped classroom redesign of an introductory epidemiology course and compares it to a traditional model. Methods One hundred fifty Masters-level students enrolled in an introductory epidemiology course with a traditional format (in-person lecture and discussion section, at-home assignment; 2015, N = 72) and a flipped classroom format (at-home lecture, in-person discussion section and assignment; 2016, N = 78). Using mixed methods, we compared student characteristics, examination scores, and end-of-course evaluations of the 2016 flipped classroom format and the 2015 traditional format. Data on the flipped classroom format, including pre- and post-course surveys, open-ended questions, self-reports of section leader teaching practices, and classroom observations, were evaluated. Results There were no statistically significant differences in examination scores or students’ assessment of the course between 2015 (traditional) and 2016 (flipped). In 2016, 57.1% (36) of respondents to the end-of-course evaluation found watching video lectures at home to have a positive impact on their time management. Open-ended survey responses indicated a number of strengths of the flipped classroom approach, including the freedom to watch pre-recorded lectures at any time and the ability of section leaders to clarify targeted concepts. Suggestions for improvement focused on ways to increase regular interaction with lecturers. Conclusions There was no significant difference in students’ performance on quantitative assessments comparing the traditional format to the flipped classroom format. The flipped format did allow for greater flexibility and applied learning opportunities at home and during discussion sections

Linking Ecology and Economics for Ecosystem Management

This article outlines an approach, based on ecosystem services, for assessing the trade-offs inherent in managing humans embedded in ecological systems. Evaluating these trade-offs requires an understanding of the biophysical magnitudes of the changes in ecosystem services that result from human actions, and of the impact of these changes on human welfare.We summarize the state of the art of ecosystem services?based management and the information needs for applying it. Three case studies of Long Term Ecological Research (LTER) sites?coastal, urban, and agricultural? illustrate the usefulness, information needs, quantification possibilities, and methods for this approach. One example of the application of this approach, with rigorously established service changes and valuations taken from the literature, is used to illustrate the potential for full economic valuation of several agricultural landscape management options, including managing for water quality, biodiversity, and crop productivity

Performance of verbal autopsy methods in estimating HIV-associated mortality among adults in South Africa

Aaron S. Karat - ORCID 0000-0001-9643-664X https://orcid.org/0000-0001-9643-664XIntroduction Verbal autopsy (VA) can be integrated into civil registration and vital statistics systems, but its accuracy in determining HIV-associated causes of death (CoD) is uncertain. We assessed the sensitivity and specificity of VA questions in determining HIV status and antiretroviral therapy (ART) initiation and compared HIV-associated mortality fractions assigned by different VA interpretation methods.Methods Using the WHO 2012 instrument with added ART questions, VA was conducted for deaths among adults with known HIV status (356 HIV positive and 103 HIV negative) in South Africa. CoD were assigned using physiciancertified VA (PCVA) and computer-coded VA (CCVA) methods and compared with documented HIV statusResults The sensitivity of VA questions in detecting HIV status and ART initiation was 84.3% (95% CI 80 to 88) and 91.0% (95% CI 86 to 95); 283/356 (79.5%) HIV-positive individuals were assigned HIV-associated CoD by PCVA, 166 (46.6%) by InterVA-4.03, 201 (56.5%) by InterVA-5, and 80 (22.5%) and 289 (81.2%) by SmartVA-Analyze V.1.1.1 and V.1.2.1. Agreement between PCVA and older CCVA methods was poor (chance-corrected concordance [CCC] <0; cause-specific mortality fraction [CSMF] accuracy ≤56%) but better between PCVA and updated methods (CCC 0.21–0.75; CSMF accuracy 65%–98%). All methods were specific (specificity 87% to 96%) in assigning HIV-associated CoD.Conclusion All CCVA interpretation methods underestimated the HIV-associated mortality fraction compared with PCVA; InterVA-5 and SmartVA-Analyze V.1.2.1 performed better than earlier versions. Changes to VA methods and classification systems are needed to track progress towards targets for reducing HIV-associated mortality,This study was funded by a grant from the Bill & Melinda Gates Foundation (OPP1083118).http://dx.doi.org/10.1136/bmjgh-2018-0008333pubpub

Reengineering the clinical research enterprise to involve more community clinicians

<p>Abstract</p> <p>Background</p> <p>The National Institutes of Health has called for expansion of practice-based research to improve the clinical research enterprise.</p> <p>Methods</p> <p>This paper presents a model for the reorganization of clinical research to foster long-term participation by community clinicians.</p> <p>Based on the literature and interviews with clinicians and other stakeholders, we posited a model, conducted further interviews to test the viability of the model, and further adapted it.</p> <p>Results</p> <p>We propose a three-dimensional system of checks and balances to support community clinicians using research support organizations, community outreach, a web-based registry of clinicians and studies, web-based training services, quality audits, and a feedback mechanism for clinicians engaged in research.</p> <p>Conclusions</p> <p>The proposed model is designed to offer a systemic mechanism to address current barriers that prevent clinicians from participation in research. Transparent mechanisms to guarantee the safety of patients and the integrity of the research enterprise paired with efficiencies and economies of scale are maintained by centralizing some of the functions. Assigning other responsibilities to more local levels assures flexibility with respect to the size of the clinician networks and the changing needs of researchers.</p