An Agent Based Model of the Diel Vertical Migration Patterns of Mysis diluviana

Recent work indicates that the macro-invertebrate Mysis diluviana exhibits partial diel vertical migration (DVM), whereby one part of the population remains on the lake bottom at night while the other migrates up the water column. The drivers underlying the decision to migrate remain unknown. We developed an agent-based model that can simulate thousands of individual mysids decision-making processes at an hourly time step throughout a year. The model takes into account a daily and seasonally changing environment, including light, temperature, food availability across habitats and body con- dition. We found that the simulated Mysis population is highly sensitive to changes in the energy cost of performing migration. We have also devel- oped a graphical user interface to help disseminate the results and testing of hypotheses without the need for the researcher to edit code. In addition to testing hypotheses about migration drivers, the model, once parameters have been calibrated with real data, will help facilitate more efficient field sampling and prediction of resource availability for mysivorous fishes by evaluating the potential for seasonality in Mysis migration patterns

Computer-Facilitated 5A’s for Smoking Cessation: A Randomized Trial of Technology to Promote Provider Adherence

IntroductionAlthough evidence-based, the 5A's (Ask, Advise, Assess, Assist, and Arrange) for smoking cessation are often incompletely delivered by primary care providers. This study examines whether a computer tablet 5A's intervention improves primary care provider adherence to the 5A's.Study designCluster RCT.Setting/participantsAll primary care providers in three urban, adult primary care clinics were randomized for participation. Any English- or Spanish-speaking patient with a primary care appointment who had smoked >100 lifetime cigarettes and at least one cigarette in the past week was eligible.InterventionA cluster RCT comparing computer-facilitated 5A's with usual care assessed effects on provider adherence to each of the 5A's as determined by patient report. Intervention subjects used a computer tablet to complete the 5A's immediately before a primary care appointment. A tailored, patient handout and a structured, clinician guide were generated. Data were collected in 2014-2015 and analyzed in 2016-2017.Main outcome measuresProvider adherence to the 5A's.ResultsProviders (N=221) saw 961 patients (n=412 intervention, n=549 control) for a total of n=1,340 encounters with n=1,011 completed post-visit interviews (75.4% completion). Intervention providers had significantly higher odds of completing Assess (AOR=1.32, 95% CI=1.02, 1.73) and Assist (AOR=1.45, 95% CI=1.08, 1.94). When looking at first study visits only, intervention providers had higher odds for Arrange (AOR=1.72, 95% CI=1.23, 2.40) and all 5A's (AOR=2.04, 95% CI=1.35, 3.07) but study visit did not influence receipt of the other 5A's.ConclusionsA computer-facilitated 5A's delivery model was effective in improving the fidelity of provider-delivered 5A's to diverse primary care patients. This relatively low-cost, time-saving intervention has great potential for smoking cessation and other health behaviors. Future studies should identify ways to promote and sustain technology implementation.Trial registrationThis study is registered at www.clinicaltrials.gov NCT02046408