High-resolution global maps of tidal flat ecosystems from 1984 to 2019

Assessments of the status of tidal flats, one of the most extensive coastal ecosystems, have been hampered by a lack of data on their global distribution and change. Here we present globally consistent, spatially-explicit data of the occurrence of tidal flats, defined as sand, rock or mud flats that undergo regular tidal inundation. More than 1.3 million Landsat images were processed to 54 composite metrics for twelve 3-year periods, spanning four decades (1984–1986 to 2017–2019). The composite metrics were used as predictor variables in a machine-learning classification trained with more than 10,000 globally distributed training samples. We assessed accuracy of the classification with 1,348 stratified random samples across the mapped area, which indicated overall map accuracies of 82.2% (80.0–84.3%, 95% confidence interval) and 86.1% (84.2–86.8%, 95% CI) for version 1.1 and 1.2 of the data, respectively. We expect these maps will provide a means to measure and monitor a range of processes that are affecting coastal ecosystems, including the impacts of human population growth and sea level rise

Implementation of a hospital-wide multidisciplinary blunt chest injury care bundle (ChIP): Fidelity of delivery evaluation

BackgroundIneffective intervention for patients with blunt chest wall injury results in high rates of morbidity and mortality. To address this, a blunt chest injury care bundle protocol (ChIP) was developed, and a multifaceted plan was implemented using the Behaviour Change Wheel.ObjectiveThe purpose of this study was to evaluate the reach, fidelity, and dose of the ChIP intervention to discern if it was activated and delivered to patients as intended at two regional Australian hospitals.MethodsThis is a pretest and post-test implementation evaluation study. The proportion of ChIP activations and adherence to ChIP components received by eligible patients were compared before and after intervention over a 4-year period. Sample medians were compared using the nonparametric median test, with 95% confidence intervals. Differences in proportions for categorical data were compared using the two-sample z-test.Results/findingsOver the 19-month postimplementation period, 97.1% (n = 440) of eligible patients received ChIP (reach). The median activation time was 134 min; there was no difference in time to activation between business hours and after-hours; time to activation was not associated with comorbidities and injury severity score. Compared with the preimplementation group, the postimplementation group were more likely to receive evidence-based treatments (dose), including high-flow nasal cannula use (odds ratio [OR] = 6.8 [95% confidence interval {CI} = 4.8-9.6]), incentive spirometry in the emergency department (OR = 7.5, [95% CI = 3.2-17.6]), regular analgesia (OR = 2.4 [95% CI = 1.5-3.8]), regional analgesia (OR = 2.8 [95% CI = 1.5-5.3]), patient-controlled analgesia (OR = 1.8 [95% CI = 1.3-2.4]), and multiple specialist team reviews, e.g., surgical review (OR = 9.9 [95% CI = 6.1-16.1]).ConclusionsHigh fidelity of delivery was achieved and sustained over 19 months for implementation of a complex intervention in the acute context through a robust implementation plan based on theoretical frameworks. There were significant and sustained improvements in care practices known to result in better patient outcomes. Findings from this evaluation can inform future implementation programs such as ChIP and other multidisciplinary interventions in an emergency or acute care context

Reef Cover, a coral reef classification for global habitat mapping from remote sensing

Coral reef management and conservation stand to benefit from improved high-resolution global mapping. Yet classifications underpinning large-scale reef mapping to date are typically poorly defined, not shared or region-specific, limiting end-users’ ability to interpret outputs. Here we present Reef Cover, a coral reef geomorphic zone classification, developed to support both producers and end-users of global-scale coral reef habitat maps, in a transparent and version-based framework. Scalable classes were created by focusing on attributes that can be observed remotely, but whose membership rules also reflect deep knowledge of reef form and functioning. Bridging the divide between earth observation data and geo-ecological knowledge of reefs, Reef Cover maximises the trade-off between applicability at global scales, and relevance and accuracy at local scales. Two case studies demonstrate application of the Reef Cover classification scheme and its scientific and conservation benefits: 1) detailed mapping of the Cairns Management Region of the Great Barrier Reef to support management and 2) mapping of the Caroline and Mariana Island chains in the Pacific for conservation purposes

Unknowable bodies, unthinkable sexualities: lesbian and transgender legal invisibility in the Toronto women's bathhouse raid

Although litigation involving sexual orientation and gender identity discrimination claims has generated considerable public attention in recent years, lesbian and transgender bodies and sexualities still remain largely invisible in Anglo-American courts. While such invisibility is generally attributed to social norms that fail to recognize lesbian and transgender experiences, the capacity to 'not see' or 'not know' queer bodies and sexualities also involves wilful acts of ignorance. Drawing from R. v Hornick (2002) a Canadian case involving the police raid of a women's bathhouse, this article explores how lesbian and transgender bodies and sexualities are actively rendered invisible via legal knowledge practices, norms and rationalities. It argues that limited knowledge and limited thinking not only regulate the borders of visibility and belonging, but play an active part in shaping identities, governing conduct and producing subjectivity

Prostate cancer treated with brachytherapy; an exploratory study of dose-dependent biomarkers and quality of life

BACKGROUND: Low-dose-rate permanent prostate brachytherapy (PPB) is an attractive treatment option for patients with localised prostate cancer with excellent outcomes. As standard CT-based post-implant dosimetry often correlates poorly with late treatment-related toxicity, this exploratory (proof of concept) study was conducted to investigate correlations between radiation − induced DNA damage biomarker levels, and acute and late bowel, urinary, and sexual toxicity. METHODS: Twelve patients treated with (125)I PPB monotherapy (145Gy) for prostate cancer were included in this prospective study. Post-implant CT based dosimetry assessed the minimum dose encompassing 90% (D(90%)) of the whole prostate volume (global), sub-regions of the prostate (12 sectors) and the near maximum doses (D(0.1cc), D(2cc)) for the rectum and bladder. Six blood samples were collected from each patient; pre-treatment, 1 h (h), 4 h, 24 h post-implant, at 4 weeks (w) and at 3 months (m). DNA double strand breaks were investigated by staining the blood samples with immunofluorescence antibodies to γH2AX and 53BP1 proteins (γH2AX/53BP1). Patient self-scored quality of life from the Expanded Prostate Cancer Index Composite (EPIC) were obtained at baseline, 1 m, 3 m, 6 m, 9 m, 1 year (y), 2y and 3y post-treatment. Spearman’s correlation coefficients were used to evaluate correlations between temporal changes in γH2AX/53BP1, dose and toxicity. RESULTS: The minimum follow up was 2 years. Population mean prostate D(90%) was 144.6 ± 12.1 Gy and rectal near maximum dose D(0.1cc) = 153.0 ± 30.8 Gy and D(2cc) = 62.7 ± 12.1 Gy and for the bladder D(0.1cc) = 123.1 ± 27.0 Gy and D(2cc) = 70.9 ± 11.9 Gy. Changes in EPIC scores from baseline showed high positive correlation between acute toxicity and late toxicity for both urinary and bowel symptoms. Increased production of γH2AX/53BP1 at 24 h relative to baseline positively correlated with late bowel symptoms. Overall, no correlations were observed between dose metrics (prostate global or sector doses) and γH2AX/53BP1 foci counts. CONCLUSIONS: Our results show that a prompt increase in γH2AX/53BP1foci at 24 h post-implant relative to baseline may be a useful measure to assess elevated risk of late RT − related toxicities for PPB patients. A subsequent investigation recruiting a larger cohort of patients is warranted to verify our findings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13014-017-0792-1) contains supplementary material, which is available to authorized users

How Much Shallow Coral Habitat Is There on the Great Barrier Reef?

Australia’s Great Barrier Reef (GBR) is a globally unique and precious national resource; however, the geomorphic and benthic composition and the extent of coral habitat per reef are greatly understudied. However, this is critical to understand the spatial extent of disturbance impacts and recovery potential. This study characterizes and quantifies coral habitat based on depth, geomorphic and benthic composition maps of more than 2164 shallow offshore GBR reefs. The mapping approach combined a Sentinel-2 satellite surface reflectance image mosaic and derived depth, wave climate, reef slope and field data in a random-forest machine learning and object-based protocol. Area calculations, for the first time, incorporated the 3D characteristic of the reef surface above 20 m. Geomorphic zonation maps (0–20 m) provided a reef extent estimate of 28,261 km2 (a 31% increase to current estimates), while benthic composition maps (0–10 m) estimated that ~10,600 km2 of reef area (~57% of shallow offshore reef area) was covered by hard substrate suitable for coral growth, the first estimate of potential coral habitat based on substrate availability. Our high-resolution maps provide valuable information for future monitoring and ecological modeling studies and constitute key tools for supporting the management, conservation and restoration efforts of the GBR

Cyclotron Maser Emission from Blazar Jets?

We consider the production of electron cyclotron maser emission by low-density, highly magnetized plasmas in relativistic jets. The population inversion required to drive cyclotron maser instability could occur in localized, transient sites where hydromagnetic instabilities, shocks, and/or turbulence lead to magnetic mirroring along current-carrying flux tubes. The maser is pumped as electrons are accelerated by the parallel electric field that develops as a result of the mirror. We estimate the maximum brightness temperatures that can be obtained in a single maser site and in an array of many masers operating simultaneously, under conditions likely to apply in blazar jets. Synchrotron absorption, by relativistic electrons within the jet, presents the largest obstacle to the escape of the maser radiation, and may render most of it invisible. However, we argue that a high brightness temperature could be produced in a thin boundary layer outside the synchrotron photosphere, perhaps in the shear layer along the wall of the jet. Induced Compton scattering provides additional constraints on the maximum brightness temperature of a masing jet. We suggest that recent observations of diffractive scintillation in the blazar J1819+3845, indicating intrinsic brightness temperatures greater than 10^{14} K at 5 GHz, may be explained in terms of cyclotron maser emission. High brightness temperature maser emission from blazar jets may extend to frequencies as high as ~100 GHz, with the maximum possible T_B scaling roughly as 1/frequency. Less massive relativistic jet sources, such as microquasars, are even better candidates for producing cyclotron maser emission, primarily in the infrared and optical bands.Comment: 22 pages, 1 figure, accepted for publication in The Astrophysical Journa

Priority sites for wildfowl conservation in Mexico

A set of priority sites for wildfowl conservation in Mexico was determined using contemporary count data (1991–2000) from the U.S. Fish & Wildlife Service mid-winter surveys. We used a complementarity approach implemented through linear integer programming that addresses particular conservation concerns for every species included in the analysis and large fluctuations in numbers through time. A set of 31 priority sites was identified, which held more than 69% of the mid-winter count total in Mexico during all surveyed years. Six sites were in the northern highlands, 12 in the central highlands, six on the Gulf of Mexico coast and seven on the upper Pacific coast. Twenty-two sites from the priority set have previously been identified as qualifying for designation as wetlands of international importance under the Ramsar Convention and 20 sites are classified as Important Areas for Bird Conservation in Mexico. The information presented here provides an accountable, spatially-explicit, numerical basis for ongoing conservation planning efforts in Mexico, which can be used to improve existing wildfowl conservation networks in the country and can also be useful for conservation planning exercises elsewhere

The role and response of primary healthcare services in the delivery of palliative care in epidemics and pandemics : a rapid review to inform practice and service delivery during the COVID-19 pandemic

Background: The increased number of deaths in the community happening as a result of COVID-19 has caused primary healthcare services to change their traditional service delivery in a short timeframe. Services are quickly adapting to new challenges in the practical delivery of end-of-life care to patients in the community including through virtual consultations and in the provision of timely symptom control. Aim: To synthesise existing evidence related to the delivery of palliative and end-of-life care by primary healthcare professionals in epidemics and pandemics. Design: Rapid systematic review using modified systematic review methods, with narrative synthesis of the evidence. Data sources: Searches were carried out in Medline, Embase, PsychINFO, CINAHL and Web of Science on 7th March 2020. Results: Only five studies met the inclusion criteria, highlighting a striking lack of evidence base for the response of primary healthcare services in palliative care during epidemics and pandemics. All were observational studies. Findings were synthesised using a pandemic response framework according to ‘systems’ (community providers feeling disadvantaged in terms of receiving timely information and protocols), ‘space’ (recognised need for more care in the community), ‘staff’ (training needs and resilience) and ‘stuff’ (other aspects of managing care in pandemics including personal protective equipment, cleaning care settings and access to investigations). Conclusions: As the COVID-19 pandemic progresses, there is an urgent need for research to provide increased understanding of the role of primary care and community nursing services in palliative care, alongside hospices and community specialist palliative care providers