9 research outputs found

    Using Unoccupied Aerial Vehicles to Map and Monitor Changes in Emergent Kelp Canopy after an Ecological Regime Shift

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    Kelp forests are complex underwater habitats that form the foundation of many nearshore marine environments and provide valuable services for coastal communities. Despite their ecological and economic importance, increasingly severe stressors have resulted in declines in kelp abundance in many regions over the past few decades, including the North Coast of California, USA. Given the significant and sustained loss of kelp in this region, management intervention is likely a necessary tool to reset the ecosystem and geospatial data on kelp dynamics are needed to strategically implement restoration projects. Because canopy-forming kelp forests are distinguishable in aerial imagery, remote sensing is an important tool for documenting changes in canopy area and abundance to meet these data needs. We used small unoccupied aerial vehicles (UAVs) to survey emergent kelp canopy in priority sites along the North Coast in 2019 and 2020 to fill a key data gap for kelp restoration practitioners working at local scales. With over 4,300 hectares surveyed between 2019 and 2020, these surveys represent the two largest marine resource-focused UAV surveys conducted in California to our knowledge. We present remote sensing methods using UAVs and a repeatable workflow for conducting consistent surveys, creating orthomosaics, georeferencing data, classifying emergent kelp and creating kelp canopy maps that can be used to assess trends in kelp canopy dynamics over space and time. We illustrate the impacts of spatial resolution on emergent kelp canopy classification between different sensors to help practitioners decide which data stream to select when asking restoration and management questions at varying spatial scales. Our results suggest that high spatial resolution data of emergent kelp canopy from UAVs have the potential to advance strategic kelp restoration and adaptive management

    Acceptability, feasibility and preliminary efficacy of low-moderate intensity Constraint Induced Aphasia Therapy and Multi-Modality Aphasia Therapy in chronic aphasia after stroke

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    Background: High-intensity Constraint-Induced Aphasia Therapy Plus (CIAT-Plus) and Multi-Modality Aphasia Therapy (M-MAT) are effective interventions for chronic post-stroke aphasia but challenging to provide in clinical practice. Providing these interventions may be more feasible at lower intensities, but comparative evidence is lacking. We therefore explored feasibility, acceptability, and preliminary efficacy of the treatments at a lower intensity. Methods: A multisite, single-blinded, randomized Phase II trial was conducted within the Phase III COMPARE trial. Groups of participants with chronic aphasia from the usual care arm of the COMPARE trial were randomized to M-MAT or CIAT-Plus, delivered at the same dose as the COMPARE trial but at lower intensity (6 hours/week × 5 weeks rather than 15 hours/week × 2 weeks). Blinded assessors measured aphasia severity (Western Aphasia Battery-Revised Aphasia Quotient), word retrieval, connected speech, multimodal communication, functional communication, and quality of life immediately post interventions and after 12 weeks. Feasibility and acceptability were explored. Results: Of 70 eligible participants, 77% consented to the trial; 78% of randomized participants completed intervention and 98% of assessment visits were conducted. Fatigue and distress ratings were low with no related withdrawals. Adverse events related to the trial (n = 4) were mild in severity. Statistically significant treatment effects were demonstrated on word retrieval and functional communication and both interventions were equally effective. Conclusions: Low–moderateintensity CIAT-Plus and M-MAT were feasible and acceptable. Both interventions show preliminary efficacy at a low–moderate intensity. These results support a powered trial investigating these interventions at a low–moderate intensity

    Constraint-induced or multi-modal personalized aphasia rehabilitation (COMPARE): A randomized controlled trial for stroke-related chronic aphasia

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    Rationale: The comparative efficacy and cost-effectiveness of constraint-induced and multi-modality aphasia therapy in chronic stroke are unknown. Aims and hypotheses: In the COMPARE trial, we aim to determine whether Multi-Modal Aphasia Treatment (M-MAT) and Constraint-Induced Aphasia Therapy Plus (CIAT-Plus) are superior to usual care (UC) for chronic post-stroke aphasia. Primary hypothesis: CIAT-Plus and M-MAT will reduce aphasia severity (Western Aphasia Battery-Revised Aphasia Quotient (WAB-R-AQ)) compared with UC: CIAT-Plus superior for moderate aphasia; M-MAT superior for mild and severe aphasia. Sample size estimates: A total of 216 participants (72 per arm) will provide 90% power to detect a 5-point difference on the WAB-R-AQ between CIAT-Plus or M-MAT and UC at α = 0.05. Methods and design: Prospective, randomized, parallel group, open-label, assessor blinded trial. Participants: Stroke \u3e6 months; aphasia severity categorized using WAB-R-AQ. Computer-generated blocked and stratified randomization by aphasia severity (mild, moderate, and severe), to 3 arms: CIAT-Plus, M-MAT (both 30 h therapy over two weeks); UC (self-reported usual community care). Study outcomes: WAB-R-AQ immediately post-intervention. Secondary outcomes: WAB-R-AQ at 12-week follow-up; naming scores, discourse measures, Communicative Effectiveness Index, Scenario Test, and Stroke and Aphasia Quality of Life Scale-39 g immediately and at 12 weeks post-intervention; incremental cost-effectiveness ratios compared with UC at 12 weeks. Discussion: This trial will determine whether CIAT-Plus and M-MAT are superior and more cost-effective than UC in chronic aphasia. Participant subgroups with the greatest response to CIAT-Plus and M-MAT will be described

    Using unoccupied aerial vehicles to map and monitor changes in emergent kelp canopy after an ecological regime shift

    No full text
    Abstract Kelp forests are complex underwater habitats that form the foundation of many nearshore marine environments and provide valuable services for coastal communities. Despite their ecological and economic importance, increasingly severe stressors have resulted in declines in kelp abundance in many regions over the past few decades, including the North Coast of California, USA. Given the significant and sustained loss of kelp in this region, management intervention is likely a necessary tool to reset the ecosystem and geospatial data on kelp dynamics are needed to strategically implement restoration projects. Because canopy‐forming kelp forests are distinguishable in aerial imagery, remote sensing is an important tool for documenting changes in canopy area and abundance to meet these data needs. We used small unoccupied aerial vehicles (UAVs) to survey emergent kelp canopy in priority sites along the North Coast in 2019 and 2020 to fill a key data gap for kelp restoration practitioners working at local scales. With over 4,300 hectares surveyed between 2019 and 2020, these surveys represent the two largest marine resource‐focused UAV surveys conducted in California to our knowledge. We present remote sensing methods using UAVs and a repeatable workflow for conducting consistent surveys, creating orthomosaics, georeferencing data, classifying emergent kelp and creating kelp canopy maps that can be used to assess trends in kelp canopy dynamics over space and time. We illustrate the impacts of spatial resolution on emergent kelp canopy classification between different sensors to help practitioners decide which data stream to select when asking restoration and management questions at varying spatial scales. Our results suggest that high spatial resolution data of emergent kelp canopy from UAVs have the potential to advance strategic kelp restoration and adaptive management

    Results of the COMPARE trial of Constraint-induced or Multimodality Aphasia Therapy compared with usual care in chronic post-stroke aphasia

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    BackgroundWhile meta-analyses confirm treatment for chronic post-stroke aphasia is effective, a lack of comparative evidence for different interventions limits prescription accuracy. We investigated whether Constraint-Induced Aphasia Therapy Plus (CIAT-plus) and/or Multimodality Aphasia Therapy (M-MAT) provided greater therapeutic benefit compared with usual community care and were differentially effective according to baseline aphasia severity.MethodsWe conducted a three-arm, multicentre, parallel group, open-label, blinded endpoint, phase III, randomised-controlled trial. We stratified eligible participants by baseline aphasia on the Western Aphasia Battery-Revised Aphasia Quotient (WAB-R-AQ). Groups of three participants were randomly assigned (1:1:1) to 30 hours of CIAT-Plus or M-MAT or to usual care (UC). Primary outcome was change in aphasia severity (WAB-R-AQ) from baseline to therapy completion analysed in the intention-to-treat population. Secondary outcomes included word retrieval, connected speech, functional communication, multimodal communication, quality of life and costs.ResultsWe analysed 201 participants (70 in CIAT-Plus, 70 in M-MAT and 61 in UC). Aphasia severity was not significantly different between groups at postintervention: 1.05 points (95% CI −0.78 to 2.88; p=0.36) UC group vs CIAT-Plus; 1.06 points (95% CI −0.78 to 2.89; p=0.36) UC group vs M-MAT; 0.004 points (95% CI −1.76 to 1.77; p=1.00) CIAT-Plus vs M-MAT. Word retrieval, functional communication and communication-related quality of life were significantly improved following CIAT-Plus and M-MAT. Word retrieval benefits were maintained at 12-week follow-up.ConclusionsCIAT-Plus and M-MAT were effective for word retrieval, functional communication, and quality of life, while UC was not. Future studies should explore predictive characteristics of responders and impacts of maintenance doses.Trial registration numberACTRN 2615000618550

    Results of the COMPARE trial of constraint-induced or multimodality aphasia therapy compared with usual care in chronic post-stroke aphasia

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    Background: While meta-analyses confirm treatment for chronic post-stroke aphasia is effective, a lack of comparative evidence for different interventions limits prescription accuracy. We investigated whether Constraint-Induced Aphasia Therapy Plus (CIAT-plus) and/or Multimodality Aphasia Therapy (M-MAT) provided greater therapeutic benefit compared with usual community care and were differentially effective according to baseline aphasia severity. Methods: We conducted a three-arm, multicentre, parallel group, open-label, blinded endpoint, phase III, randomised-controlled trial. We stratified eligible participants by baseline aphasia on the Western Aphasia Battery-Revised Aphasia Quotient (WAB-R-AQ). Groups of three participants were randomly assigned (1:1:1) to 30 hours of CIAT-Plus or M-MAT or to usual care (UC). Primary outcome was change in aphasia severity (WAB-R-AQ) from baseline to therapy completion analysed in the intention-to-treat population. Secondary outcomes included word retrieval, connected speech, functional communication, multimodal communication, quality of life and costs. Results: We analysed 201 participants (70 in CIAT-Plus, 70 in M-MAT and 61 in UC). Aphasia severity was not significantly different between groups at postintervention: 1.05 points (95% CI -0.78 to 2.88; p=0.36) UC group vs CIAT-Plus; 1.06 points (95% CI -0.78 to 2.89; p=0.36) UC group vs M-MAT; 0.004 points (95% CI -1.76 to 1.77; p=1.00) CIAT-Plus vs M-MAT. Word retrieval, functional communication and communication-related quality of life were significantly improved following CIAT-Plus and M-MAT. Word retrieval benefits were maintained at 12-week follow-up. Conclusions: CIAT-Plus and M-MAT were effective for word retrieval, functional communication, and quality of life, while UC was not. Future studies should explore predictive characteristics of responders and impacts of maintenance doses. Trial registration number: ACTRN 2615000618550
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