Multispectral Classification of Gulf of Maine Surface Waters: Seasonal and Interannual Variability

Bio-optically, surface waters of the northeastern US continental shelf are strongly heterogeneous, exhibiting highly variable distributions in both time and space of suspended sediment, colored dissolved organic matter (CDOM), and phytoplankton concentration and community structure. These render the standard global NASA satellite chlorophyll algorithm suspect. However, spectral signatures of the water are well quantified by the actual satellite-based multispectral reflectance (Rrs) measurements. Here, we use 6 bands of Rrs measurements from 19 years (1998-2016) of monthly composite SeaWiFS and MODIS data to identify the spectral signatures of dominant water types present over the northeast shelf. A merged multivariate clustering approach that incorporates neural network-based Self-Organizing Maps and agglomerative hierarchical clustering is used to group similar spectral signatures across the entire time and space domain. These sort the surface water into 8 dominant groups. Remapped results provide a climatological view of seasonal cycles of these bio-optical groups and their spatial geography and then quantify their interannual variability over 19 years. Results indicate the same 2-3 spectral groups dominate the study area each year. Several less spatially predominant groups are present mainly along the coast and over George’s Bank. Spectral signatures of the water groups suggest that three groups represent the clearest waters and two groups the most particle and absorption dominated waters, with other groups representing varying concentrations of CDOM and phytoplankton. These descriptions are consistent with both the geographic position of the groups and calculated inherent optical properties of the groups. Interannual variability of the groups at each location effectively captures boundaries between ecological regions, reflecting frontal zones reported in the literature. Quantified trends in the spatial coverage of the groups over the 19 years shows a significant decline in the time/space coverage of the clearest water groups. These trends are strongest and significant in summer months, consistent with strong summer trends in sea surface temperature. There are also systematic trends in water groups in March and May on either side of the April spring bloom, suggesting phenology shifts in bloom characteristics. Over interannual time scales, the more turbid coastal water groups have correlations to wind strength and river discharge. These results provide new satellite-based ocean color measurements of shelf variability over seasonal and interannual time scales and present managers with new tools to monitor biologically important change over this economically critical and rapidly changing ecosystem

Effects of Art from the Heart on Nurse Satisfaction and Patient Well-Being

Introduction. Art programs have been shown to positively affect unit culture, quality of care, and nursing practices. Art interventions improve well-being, reduce stress, and enhance nurse-patient communication. Art from the Heart (AFTH) is an art program that provides art supplies, visual art, and patient About Me pages to patients, families and employees at University of Vermont Medical Center (UVMMC).Objective. Assess the efficacy of AFTH through nursing staff perceptions, understanding, and attitudes toward the program.Methods. Structured interviews were conducted on Baird 4, an adult inpatient ward, at UVMMC. A 19-question survey using Likert scales and short answer formats was administered to nursing staff. Questions assessed perceptions of effects of art on patient anxiety and pain, communication, and job satisfaction. Surveys were analyzed to extract major and minor themes.Results. Twenty-eight interviews were obtained and two major themes emerged: nurse satisfaction and patient well-being. Nursing staff satisfaction minor themes included improved productivity, promoting conversation, and creating a positive influence on the unit. Respondents reported that AFTH helped initiate conversations with patients (100% of respondents) and reduced workday stress (68%). The second major theme, patient well-being, included benefits to patients with dementia, providing comfort, and serving as an outlet or distraction. Utilizing AFTH improved perceived patient mood (100%), health (78.5%), and reduced patient anxiety (89.3%).Conclusions. AFTH provides positive benefits by reducing nursing staff stress and perceived patient anxiety; improving communication, perceived patient mood and health; and creating a sense of community. AFTH should be expanded to the entire 6 Community Agency: Burlington City Arts, Art from the Hearthttps://scholarworks.uvm.edu/comphp_gallery/1240/thumbnail.jp

Family-Focused Public Health: Supporting Homes and Families in Policy and Practice

Life expectancy in the US is on the decline. Mental health issues associated with opioid abuse and suicide have been implicated for this decline necessitating new approaches and procedures. While Public Health 3.0 provides a call to action for stakeholders to work closely together to address such complex problems as these, less attention has been given to engaging and supporting the most important stakeholders and primary producers of health within the US: families and households. The idea that health begins at home is discussed from the perspective of primary, secondary, and tertiary prevention levels. Primary prevention where research provides evidence for the role of the family in healthy child development. Secondary and tertiary prevention where research offers evidence for the role of the family in caregiving. Despite this evidence, greater focus and attention must be placed on the family at all prevention levels as an often overlooked setting of public health practice and level of influence. Prevention across all levels is enhanced as public health practitioners think family when designing and implementing public health policy. Four family impact principles are presented to help guide planning and implementation decisions to nourish family engagement

Nutritional Ketosis Alters Fuel Preference and Thereby Endurance Performance in Athletes.

Ketosis, the metabolic response to energy crisis, is a mechanism to sustain life by altering oxidative fuel selection. Often overlooked for its metabolic potential, ketosis is poorly understood outside of starvation or diabetic crisis. Thus, we studied the biochemical advantages of ketosis in humans using a ketone ester-based form of nutrition without the unwanted milieu of endogenous ketone body production by caloric or carbohydrate restriction. In five separate studies of 39 high-performance athletes, we show how this unique metabolic state improves physical endurance by altering fuel competition for oxidative respiration. Ketosis decreased muscle glycolysis and plasma lactate concentrations, while providing an alternative substrate for oxidative phosphorylation. Ketosis increased intramuscular triacylglycerol oxidation during exercise, even in the presence of normal muscle glycogen, co-ingested carbohydrate and elevated insulin. These findings may hold clues to greater human potential and a better understanding of fuel metabolism in health and disease

Research trends in forensic science:A scientometric approach to analyze the content of the INTERPOL reviews

The use of forensic evidence has become indispensable in many countries and jurisdictions around the world, however the dissemination of research advancements does not necessarily directly or easily reach the forensic science community. Reports from the INTERPOL International Forensic Science Managers Symposium outline major areas that are of interest to forensic practitioners across the INTERPOL member countries. The information contained in the INTERPOL reports is extensive but can be challenging to process. The purpose of this research is to provide a comprehensive overview of the evolution of trends within the INTERPOL reports over an 18 year period. References relating to 10 evidence types retrieved from the 14th to 19th INTERPOL IFSMS reports (2004-2019) were processed and compared with data exports from the citation database Scopus covering the same evidence types. The results from this work are summarised by investigating the relationships between the 10 evidence types. To explore the outputs a user-friendly R-Shiny application was developed and is freely available at: https://uod.ac.uk/lrcfsinterpolreportsexplorer

Dabrafenib plus trametinib is effective in the treatment of BRAF V600-mutated metastatic melanoma patients:analysis of patients from the dabrafenib plus trametinib Named Patient Program (DESCRIBE II)

In clinical trials, dabrafenib plus trametinib improved overall survival (OS) compared with single-agent BRAF inhibitors (BRAFi) in patients with BRAF V600-mutant unresectable or metastatic melanoma. We investigated dabrafenib plus trametinib therapy in a compassionate-use setting [Named Patient Program (NPP); DESCRIBE II]. A retrospective chart review of patients with BRAF V600-mutated unresectable stage III/IV melanoma receiving dabrafenib plus trametinib as compassionate use was conducted. Treatment patterns and duration, clinical outcomes, and tolerability were evaluated. Of 271 patients, 92.6% had stage IV melanoma, including 36.5% with brain metastases. Overall, 162 patients (59.8%) were BRAFi naive and 171 (63.1%) received first-line dabrafenib plus trametinib. Among BRAFi-naive patients, the overall response rate (ORR) was 67.3%, median OS (mOS) was 20.0 months, and median progression-free survival (mPFS) was 7.5 months. In BRAFi-naive patients with known brain metastases (n = 62), ORR was 61.3%, mOS was 15.5 months, and mPFS was 6.2 months. Eighty-four patients received BRAFi monotherapy for >30 days and switched to dabrafenib plus trametinib prior to progression. Of these 84 patients, 63 had known disease status at the time of switch, and 22 improved with the combination therapy. No new safety signals were identified, and dabrafenib plus trametinib was well tolerated. Dabrafenib plus trametinib showed substantial clinical activity in NPP patients with BRAF V600-mutated unresectable or metastatic melanoma. Analysis of treatment patterns demonstrated the effectiveness of the combination in patients with brain metastases and across lines of therapy with a well tolerated and manageable safety profile

Characteristics of control group participants who increased their physical activity in a cluster-randomized lifestyle intervention trial

<p>Abstract</p> <p>Background</p> <p>Meaningful improvement in physical activity among control group participants in lifestyle intervention trials is not an uncommon finding, and may be partly explained by participant characteristics. This study investigated which baseline demographic, health and behavioural characteristics were predictive of successful improvement in physical activity in usual care group participants recruited into a telephone-delivered physical activity and diet intervention trial, and descriptively compared these characteristics with those that were predictive of improvement among intervention group participants.</p> <p>Methods</p> <p>Data come from the Logan Healthy Living Program, a primary care-based, cluster-randomized controlled trial of a physical activity and diet intervention. Multivariable logistic regression models examined variables predictive of an improvement of at least 60 minutes per week of moderate-to-vigorous intensity physical activity among usual care (n = 166) and intervention group (n = 175) participants.</p> <p>Results</p> <p>Baseline variables predictive of a meaningful change in physical activity were different for the usual care and intervention groups. Being retired and completing secondary school (but no further education) were predictive of physical activity improvement for usual care group participants, whereas only baseline level of physical activity was predictive of improvement for intervention group participants. Higher body mass index and being unmarried may also be predictors of physical activity improvement for usual care participants.</p> <p>Conclusion</p> <p>This is the first study to examine differences in predictors of physical activity improvement between intervention group and control group participants enrolled in a physical activity intervention trial. While further empirical research is necessary to confirm findings, results suggest that participants with certain socio-demographic characteristics may respond favourably to minimal intensity interventions akin to the treatment delivered to participants in a usual care group. In future physical activity intervention trials, it may be possible to screen participants for baseline characteristics in order to target minimal-intensity interventions to those most likely to benefit. (Australian Clinical Trials Registry, <url>http://www.anzctr.org.au/default.aspx</url>, ACTRN012607000195459)</p