Search

BACKGROUND Electronic Health Records (EHRs) play an increasingly important role in the delivery of HIV care in low-and-middle-income countries. The data collected is used for direct clinical care, quality improvement activities, reporting and clinical research. Despite widespread EHR use for HIV care in East Africa, and countries like Nigeria, Mozambique and Haiti, challenges remain especially with achieving and maintaining high quality data. OBJECTIVE To determine factors influencing data quality in a large scale EHR deployment and potential strategies to improve quality. METHODS We carried out a data quality evaluation in 50 health facilities in Rwanda using the OpenMRS EHR systems for HIV care. The sites were part of a larger randomized controlled trial and half of the sites had an enhanced version of the EHR with clinical decision support alerts. Trained data collectors visited 50 health facilities to collect 28 variables from both paper charts and the EHR system using the ODK app. We measured the data completeness, timeliness, the degree of matching of paper and EHR data including use of concordance scores. Factors potentially effecting data quality were drawn from a previous survey of users in the 50 sites. RESULTS We randomly selected 3467 records, reviewed from the paper charts and EHR, collecting a total of 194,152 data items. Data completeness was above the 85% threshold for all variables except viral load (VL) results and second and third line drug regimens. Matching scores for data values were close to or above 85%, but lower for dates particularly for drug pickups and VL. Data concordance had a mean of 10.2/15 (68%) for the 15 variables. Site and user factors (years of EHR use, technology experience, EHR availability/uptime, intervention status) were tested for correlation with data quality measures. EHR system availability/uptime was positively correlated with concordance, and users experiences of technology was negatively correlated. The alerts for missing viral load results implemented in 11 intervention sites showed clear evidence of improving timeliness and completeness of initially low matching of VL results in the EHR and paper records (11.9% to 26.7%, P CONCLUSIONS The EHR records in the 50 health facilities generally had a high level of completeness. Matching results were within 3% of the 85% threshold or above for non-date variables, but lower for dates. Higher EHR stability and uptime was associated with better data quality. Alerts and reminders for entering VL were shown to have a strong effect in improving data quality. Overall, most data was considered fit for purpose, but more regular data quality assessments, training, mentoring and technical improvements in forms and data reports would be beneficial particularly for dates and key lab data. CLINICALTRIAL N/A

This dataset contains the teaching resources that were used in the outreach activity described in the publication "ChemDiverse: A Chemistry Careers Activity Showcasing Diversity". It includes, a series of career profiles showcasing a diverse array of chemistry careers and people in those jobs. Additionally, there is a file containing the set of questions used to construct the profiles, and a set of questions provided to teachers to use as a reflective activity in their classes. The ReadMe file proves a more detailed description of each of the files in the data set.

The broad sharing of research data is widely viewed as critical for the speed, quality, accessibility, and integrity of science. Despite increasing efforts to encourage data sharing, both the quality of shared data and the frequency of data reuse remain stubbornly low. We argue here that a significant reason for this unfortunate state of affairs is that the organization of research results in the findable, accessible, interoperable, and reusable (FAIR) form required for reuse is too often deferred to the end of a research project when preparing publications–by which time essential details are no longer accessible. Thus, we propose an approach to research informatics in which FAIR principles are applied continuously, from the inception of a research project and ubiquitously, to every data asset produced by experiment or computation. We suggest that this seemingly challenging task can be made feasible by the adoption of simple tools, such as lightweight identifiers (to ensure that every data asset is findable), packaging methods (to facilitate understanding of data contents), data access methods, and metadata organization and structuring tools (to support schema development and evolution). We use an example from experimental neuroscience to illustrate how these methods can work in practice.

BACKGROUND Symptom checkers (SCs) are diagnostic decision support apps for patients, used by tens of millions of people annually. They are designed to provide diagnosis and triage advice and assist users in seeking the appropriate level of care. Little evidence is available on their diagnostic and triage accuracy with direct use by patients for urgent conditions. OBJECTIVE To determine the diagnostic and triage accuracy and usability of a symptom checker in use by for patients presenting to an emergency department METHODS We recruited a convenience sample of English-speaking patients presenting for care in an urban emergency department. Each consenting patient used a leading SC from Ada Health prior to ED evaluation. Diagnostic accuracy was evaluated, comparing (1) the SC’s diagnoses and (2) those of 3 independent emergency physicians viewing the patient-entered symptom data, to (3) the final diagnoses from the ED evaluation. The Ada diagnoses and triage were also critiqued by the independent physicians. Patients completed a usability survey based on the Technology Acceptance Model. RESULTS Forty participants (80% of those approached, mean age 40.1 years (range 18 – 76); 65% female, 68% White, 48% Hispanic or Latino, completed the SC assessment and usability survey. Sensitivity for at least one of the ED final diagnoses by Ada (based on it’s top 5 diagnoses) was 70.0% (95% CI 54% – 86%) close to the mean sensitivity for the 3 physicians (on their top 3 diagnoses) of 68.9%. The physicians rated Ada triage decisions as 62% fully agree, and 24% safe but too cautious. It was rated unsafe and too risky in 22% by at least one physician, 14% by two and 5% by all 3, although none of the under-triaged patients suffered an adverse event in the ED. Some cases only had symptoms recorded for their ED diagnosis, limiting analysis. Usability was rated highly, participants agreed or strongly agreed a mean of 84.6% with the 7 TAM usability questions, although “satisfaction” and “enjoyment” were rated low. CONCLUSIONS This study provides preliminary evidence that a SC can provide acceptable usability and diagnostic accuracy for patients with a variety of urgent conditions. 14% of SC triage recommendations were deemed unsafe and too risky by at least 2 physicians based on the symptoms recorded. Larger studies are needed of diagnosis and triage performance with direct patient use in different clinical environments.

This work honors the work of the Mental Research Institute (MRI) in Palo Alto, California, upon the sale of the building it long occupied, and particularly the closing of the MRI Brief Therapy Center as a research and training center. The major position of the article is that the MRI was much more than a place, a name, or the people who have been part of it. Instead, the ideas and practices of those who have been part of the MRI are what endure and thrive. As a case in point, the author follows his own professional journey from his first contact with the MRI ideas as a “difference that made a difference” through his present day work.

The avian egg is a closed system that protects the growing embryo from external factors but prevents direct observation of embryo development. Various culture systems exist in the literature to study the development of the embryo for short periods of incubation (from 12 h up to a maximum of 60 h of egg incubation). A common flaw to these culture techniques is the inability to culture the unincubated avian blastoderm with intact tissue tensions on its native yolk. The goal of this work is to create a unique novel egg-in-cube system that can be used for long-term quail embryo culture initiated from its unincubated blastoderm stage. The egg-in-cube acts as an artificial transparent eggshell system that holds the growing embryo, making it amenable to microscopy. With the egg-in-cube system, quail embryos can be grown up to 9 days from the unincubated blastoderm (incubated in air, 20.9% O2), which improves to 15 days on switching to a hyperoxic environment of 60% O2. Using transgenic fluorescent quail embryos in the egg-in-cube system, cell movements in the unincubated blastoderm are imaged dynamically using inverted confocal microscopy, which has been challenging to achieve with other culture systems. Apart from these observations, several other imaging applications of the system are described in this work using transgenic fluorescent quail embryos with upright confocal or epifluorescence microscopy. To demonstrate the usefulness of the egg-in-cube system in perturbation experiments, the quail neural tube is electroporated with fluorescent mRNA “in cubo”, followed by the incubation of the electroporated embryo and microscopy of the electroporated region with the embryo in the cube. The egg-in-cube culture system in combination with the “in cubo” electroporation and dynamic imaging capabilities described here will enable researchers to investigate several fundamental questions in early embryogenesis with the avian (quail) embryo on its native yolk.

We know that students often struggle to build cause and effect rationales while explaining mechanistic problems. Researchers have investigated whether these issues might stem from how their instructors explain causal relationships. Senior lecturer in pure and applied chemistry at the University of Strathclyde, Fraser Scott considers how the research findings can help secondary school chemistry teachers tailor their approach.

The expanded application of fluorescence imaging in biomedical and biological research towards more complex systems and geometries requires tools that can analyze a multitude of components at widely varying time- and length-scales. The major challenge in such complex imaging experiments is to cleanly separate multiple fluorescent labels with overlapping spectra from one another and background autofluorescence, without perturbing the sample with high levels of light. Thus, there is a requirement for efficient and robust analysis tools capable of quantitatively separating these signals. In response, we have combined multispectral fluorescence microscopy with hyperspectral phasors and linear unmixing to create Hybrid Unmixing (HyU). Here we demonstrate its capabilities in the dynamic imaging of multiple fluorescent labels in live, developing zebrafish embryos. HyU is more sensitive to low light levels of fluorescence compared to conventional linear unmixing approaches, permitting better multiplexed volumetric imaging over time, with less bleaching. HyU can also simultaneously image both bright exogenous and dim endogenous labels because of its high dynamic range. This allows studies of cellular behaviors, tagged components, and cell metabolism within the same specimen, offering a powerful window into the orchestrated complexity of biological systems.

Supplemental material, sj-docx-1-jop-10.1177_02698811221104058 for Systematic review and meta-analysis of augmentation and combination treatments for early-stage treatment-resistant depression by Fraser Scott, Elliot Hampsey, Sam Gnanapragasam, Ben Carter, Lindsey Marwood, Rachael W Taylor, Cansu Emre, Lora Korotkova, Jonatan Martín-Dombrowski, Anthony J Cleare, Allan H Young and Rebecca Strawbridge in Journal of Psychopharmacology

In the Acknowledgments, the following text should be added at the end, as it was missed through oversight in the original submission: "This work is based on research funded in part by the Bill & Melinda Gates Foundation (Investment ID OPP1093639) and with UK aid from the UK Government (Project 300504) through GALVmed. The findings and conclusions contained within are those of the authors and do not necessarily reflect positions or policies of the Bill & Melinda Gates Foundation or the UK Government."

In this chapter, the authors explore the entrepreneurial nature of craft brewing. The authors find growth in the microbrewery sector has been supported through a cooperative approach between competing artisanal small firms. This has helped build competitive advantage in resistance to the dominant market forces of large brewers. Data were gathered using semi-structured interviews with 12 craft brewers in the North East of Scotland. Analysed findings are used in the design of a conceptual model on the nature of collaboration in the craft beer sector. An artisanal scene is presented, where community benefit and continued development of the craft beer movement is prioritised, over commercial and strategic growth. The typically small firms in this area share resources and support each other in a drive to wean customers away from the large mainstream producers. The authors argue that the nature of the craft beer sector seeks to actively resist market dominance, not only through product quality and marketing, but also in the entrepreneurial behaviours enacted to sustain the movement. The findings suggest a co-existence of both collaboration and competition in the strategic decisions of craft brewers. The focus is on the locally embedded connections these firms develop in the maintenance of their craft roots, with a range of complex interconnected factors linking brewer, community, and the broader industry.

A study investigating students' self-assessed understanding has implications for your practice. Students need to know how well they are performing in classroom tasks. This ability is very helpful, for example, when deciding what topic to focus on during study time or how long to spend studying each topic. A recent study investigated the factors that most greatly affect students' self-assessments of their understanding in a chemistry classroom. This article takes a look at what strategies are useful and what approaches do not improve a student’s understanding of their performance.

Fresh insight offers tips for teaching the mathematics of moles, volume and molarity. A group of researchers has provided new insight into students' misconceptions about concentration in a recent study. Previous research has focused on students' ideas about the nature of solutions and the process of dissolution. This study, led by Andrés Raviolo, investigated quantitative aspects.

Research-based tips for improving your students' sub-microscopic understanding of particle models. Johnstone's triangle summarises levels of representation regularly used when thinking about chemical concepts. Of the three levels, the sub-microscopic is probably the most important for understanding or explaining how chemical processes occur. A student's understanding of how the sub-microscopic level is visually represented, for example in diagrams, is directly linked to their understanding of the underlying chemistry concepts.

Anti-infective and anticancer drugs share the serious problem that over time resistance develops to their effects leading to clinical obsolescence. Research at the University of Strathclyde has discovered a platform of anti-infective drugs based upon minor groove binders for DNA that have exceptional resilience to the development of resistance in their target organisms (bacteria, fungi, and parasites). This property is associated with the fact that the Strathclyde minor groove binders (S-MGBs) act at more than one discrete molecular target. One of the compounds has successfully completed a phase IIa clinical trial for the treatment of Clostridioides difficile infections. Several other compounds have shown activity against a number of cancer cell lines in vitro with indications of in vivo activity in a mouse model of lung cancer. This paper places these discoveries in the context of previous studies of minor groove binders as anticancer agents and considers whether the benefits of multitargeting successfully demonstrated in anti-infective applications can be translated to anticancer applications.

What to look out for graphically when teaching reaction kinetics. Chemists often represent the underlying models of chemical kinetics graphically, such as when plotting concentration v time or rate v time. Studies have shown that students have difficulties understanding rate and rate constant, and that graphical representations often make it more challenging. A recent study from researchers in the US investigated the relationship between students' models of reaction rate, and the graphical representations they use to describe them.

Microbubbles acting as lenses are interesting for optical and photonic applications such as volumetric displays, optical resonators, integration of photonic components onto chips, high-resolution spectroscopy, lithography, and imaging. However, stable, rationally designed, and uniform microbubbles on substrates such as silicon chips are challenging because of the random nature of microbubble formation. We describe the fabrication of elastic microbubbles with a precise control of volume and curvature based on femtosecond laser irradiated graphene oxide. We demonstrate that the graphene microbubbles possess a near-perfect curvature that allows them to function as reflective microlenses for focusing broadband white light into an ultrahigh aspect ratio diffraction-limited photonic jet without chromatic aberration. Our results provide a pathway for integration of graphene microbubbles as lenses for nanophotonic components for miniaturized lab-on-a-chip devices along with applications in high-resolution spectroscopy and imaging.

Researchers put their new scaffolding method for argumentation to the test. A recent study helped students to construct clear, logical arguments by scaffolding the argumentation process. Scientific practice involves justifying claims based on empirical or theoretical evidence, and argumentation is a key aspect of this. However, students often find justifying their claims with evidence and rebutting counterarguments difficult.

Tech helps students think differently in acid—base reactions exercises. Acid—base theory guides our understanding of chemical reactivity and reaction pathways. Students begin their understanding of reaction mechanisms with acid—base reactions because they are simple and ubiquitous. They form some of the simplest steps in reaction mechanisms, like proton-transfer, for example. Researchers at the University of Michigan in the US studied how two groups of first-year undergraduates reason through acid—base reaction mechanisms. One group used an app and the other was given a more traditional pencil-and-paper task. The researchers asked students to think aloud to capture their reasoning.

Try these tools and tips for teaching electron pushing. Educators at the University of Ottawa in Canada developed an open access, online module called 'Organic mechanisms: mastering the arrows' to support students with the concept of electron pushing. A recent piece of research by Carle et al (2020) shows that students who used this online module had significant learning gains. Discover how you can use their findings in your classroom to help your students master organic mechanisms.

Get students to leave behind troublesome techniques when solving algebraic equations. Algebra is the branch of maths where letters, and other symbols, are used to represent numbers in order to construct equations and formulas. We find it many times in our chemistry curriculums: from solving PVT calculations, interpreting chemical properties graphically, through to investigating chemical kinetics.

This is the collection of resources and reports from our Royal Society of Chemistry-funded schools outreach project.

Irrigation has been used for millennia to increase the quantity and reliability of food and fibre production in areas where lack of precipitation limits plant growth. Despite the importance of irrigation, our understanding of the impact of irrigation on soil carbon (C) and nitrogen (N) stocks is still limited, particularly for grazed grasslands. In this study, we analysed soil profile C and N data collected to 0.6 m depth from 124 paired irrigated and unirrigated grassland sites across different regions and soils in New Zealand. Averaged across all sites, soil C and N stocks were significantly lower in irrigated than adjacent unirrigated soils. Cumulative differences increased with depth in the profile to a maximum at 0.5 m, where irrigated soils had 5.21 Mg ha−1 less C (P 575 mm or aridity index >0.85) there were increasingly significant C losses from irrigated soils relative to adjacent unirrigated soils. There was evidence that the effect of irrigation increased with irrigation duration – from no significant effect at any depth for sites irrigated for

Submitted to Digestive Disease Week 2020 and American College of Gastroenterology's 2021 Annual Scientific Meeting

School reports are an enduring feature of the education landscape. They form part of our personal history, fondly retained by parents well beyond a child’s school leaving age. The Department for Education requires schools in England to report to parents annually(Department for Education, 2015). There is widespread variation in reporting practice and many schools are doing more than is legally required of them(Power and Clark, 2000).While frequent, data focused reports are commonly used, many schools continue to write comment-based reports as part of their reporting regime. As students move into secondary school, reports of their day to day learning become less forthcoming from the students themselves and reports become one of very few channels of home-school communication.

The development of ultrathin flat lenses has revolutionized the lens technologies and holds great promise for miniaturizing the conventional lens system in integrated photonic applications. In certain applications, the lenses are required to operate in harsh and/or extreme environments, for example aerospace, chemical, and biological environments. Under such circumstances, it is critical that the ultrathin flat lenses can be resilient and preserve their outstanding performance. However, the majority of the demonstrated ultrathin flat lenses are based on metal or semiconductor materials that have poor chemical, thermal, and UV stability, which limit their applications. Herein, we experimentally demonstrate a graphene ultrathin flat lens that can be applied in harsh environments for different applications, including a low Earth orbit space environment, strong corrosive chemical environments (pH = 0 and pH = 14), and biochemical environment. The graphene lenses have extraordinary environmental stability and can maintain a high level of structural integrity and outstanding focusing performance under different test conditions. Thus, it opens tremendous practical application opportunities for ultrathin flat lenses.

Acanthamoeba is a free-living amoeba widely distributed in the environment which exists as two stages in their life cycle: a motile and trophic replicating trophozoite and a resistant cyst stage. In recent years, the incidence of infections due to Acanthamoeba spp. has shown a remarkable increase. This parasite is the causative agent of a sight-threatening infection of the cornea known as Acanthamoeba keratitis (AK) and a fatal disease of the central nervous system known as Granulomatous Amebic Encephalitis (GAE) mainly in immunocompromised patients. Although the trophozoite form is much more readily eliminated, at present there are not harmless effective treatments or a single drug that can eliminate both cystic and trophozoite forms. A particular set of compounds known as Minor Grove Binders (MGBs) have the characteristic of binding specifically to minor groove region of double-stranded DNA. The main effects of these MGBs are their ability to interfere with biological functions of DNA such as transcription machinery, also induction of apoptosis, hence cell death. These molecules have received great attention since they can be empirically screened and iteratively refined via chemical synthesis to target various entities such as tumors, bacteria, viruses and parasites. MGBs have been tested in vitrousing a colorimetric alamar Blue viability cell assayagainst Acanthamoeba castellanii Neff strain. To date, 2 hit compounds were able to inhibit trophozoites producing IC50s of 1.56 µM and 12.5 µM.

Coral reefs are spectacular ecosystems found along tropical coastlines where they provide goods and services to hundreds of millions of people. While under threat from local factors, coral reefs are increasingly susceptible to ocean warming from anthropogenic climate change. One of the signature disturbances is the large-scale, and often deadly, breakdown of the symbiosis between corals and dinoflagellates. This is referred to as mass coral bleaching and often causes mass mortality. The first scientific records of mass bleaching date to the early 1980s (Hoegh-Guldberg et al., 2017). Kamenos and Hennige (2018, hereafter KH18), however, claim to show that mass coral bleaching is not a recent phenomenon, and has occurred regularly over the past four centuries (1572–2001) on the Great Barrier Reef (GBR), Australia. They support their claim by developing a putative proxy for coral bleaching that uses the suggested relationship between elevated sea surface temperatures (SSTs) and reduced linear extension rates of 44 Porites spp. coral cores from 28 GBR reefs. If their results are correct, then mass coral bleaching events have been a frequent feature for hundreds of years in sharp contrast to the vast majority of scientific evidence. There are, however, major flaws in the KH18 methodology. Their use of the Extended Reconstructed Sea Surface Temperature (ERSST) dataset (based on ship and buoy observations) for reef temperatures from 1854 to 2001, ignores the increasing unreliability of these data which become sparse, less rigorous, and more interpolated going back in time. To demonstrate how the quality of these data degrades, we plot the average number of SST observations per month that contribute to each 200 x 200 km ERSST pixel (Figure 1A, black line). Note that from 1854 to 1900 the four ERSST pixels used by KH18 averaged only 0.85 observations per month, and 82% of these months had no observations at all. Given the heterogeneous nature of SST at local and regional levels, using such broad-scale data as ERSST, is likely to produce substantial errors at reef scales (Figure 1A, red line prior to 1900).

Soil carbon (C) plays a central role in the global biogeochemical cycles of most major nutrients, but the degree to which the quality versus quantity of C controls microbial abundance and function across land uses is still somewhat uncertain. We measured soil organic matter (SOM) concentration and composition as well as nutrient ratios and other soil characteristics on two contrasting soil types across three land uses (forest, pasture, maize cropping), to determine their relationships to microbial abundance and specific measures of microbial activity (e.g. qCO2, the ratio of respiration rate to microbial biomass, and net laboratory N mineralization). Although there was significant variability in bulk SOM composition (by 13C NMR spectroscopy), we could detect differences between broad-leaved forest and pasture/maize systems on a landscape scale, primarily attributable to differences in aryl C content. Variability in O-alkyl C between sites correlated strongly with the soil C:N ratio, but variability in alkyl C (which was particularly evident in pasture sites) could not be adequately explained by measured environmental or soil characteristics. Soil C:P and N:P ratios followed similar patterns with forest > pasture > maize. Bulk soil C:N, hot-water extractable C:N and particulate C:N all followed similar patterns with forest > pasture ≈ maize cropping. Microbial biomass C:N followed a different pattern, however, with forest ≈ pasture > maize. Despite the differences in SOM composition and nutrient ratios, anaerobically mineralizable N and hot-water extractable C (as a measures of available C) best explained the variation in microbial biomass and function across sites. Anaerobically mineralizable N generally explained the most variation for microbial biomass and qCO2 and had the smallest soil or land use effect. Hot-water extractable C explained the most variance for net N mineralization. Addition of stoichiometric measures and other soil attributes (e.g. soil C:N, C:P, δ15N) in a multiple regression model explained more of the variation than a single factor plus the land use effect (though soil order still explained a small, but significant amount of variance for measures of microbial biomass). A measure of available C, however, was needed to explain the maximum amount of variance in microbial biomass and function across sites (i.e. total C plus nutrient status and other soil attributes could not explain as much of the variance). Our data suggest that nutrient content/stoichiometry does assist in defining the quality of SOM, but a measure of available C (similar to the “active” pool in C models) is also needed. Anaerobically mineralizable N and/or hot water–water extractable C appear to be adequate measures of available C that relate to “active” C, but C functional groups (from 13C NMR spectroscopy) were not particularly useful for this purpose.

Two-dimensional (2D) black phosphorus (BP) displays unique anisotropic properties in its linear optical responses, but its third-order nonlinearity (Kerr effect) has remained relatively unexplored. Here we measured the third-order nonlinear optical responses in exfoliated BP and in lithium hydride intercalated BP (LiH-BP) flakes using polarization-resolved microscopic femtosecond Z-scan techniques. Strong optical Kerr nonlinearities were measured for single flakes of BP and LiH-BP, with third-order nonlinear susceptibilities that are larger than those for many 2D materials. The nonlinear coefficients of LiH-BP are higher than those of BP, indicating that lithium hydride intercalation enhances not only the ambient stability of BP but also its nonlinear optical response. Highly anisotropic polarization-dependent Kerr nonlinearities of both BP and LiH-BP flakes were observed. The strong nonlinear and anisotropic optical responses of BP and LiH-BP indicate the great potential of these materials in nonlinear p...

Selling is integral to entrepreneurship, yet it has rarely been a focal topic of analysis for entrepreneurship scholars. To address this, we undertake a broad-ranging systematic literature review of research that in some way explores selling within entrepreneurial contexts. We inductively develop a framework that orders extant research into selling antecedents, activities, contexts, and outcomes. Then, drawing on these entrepreneurship-selling intersections, we suggest opportunity theory can be extended by integrating critical insights from selling literatures. In particular, we address ego-centric views of entrepreneurship which prioritize entrepreneurial agency, and advocate for the incorporation of customer agency into synchronized processes of opportunity identification, refinement, and exploitation. The article concludes that a promising avenue for future theory development resides in the study of situated sales interactions, which can serve as an empirical vista to the underexplored entrepreneur-customer nexus.

Coral reef resilience is the capacity of a reef to resist or recover from degradation and maintain provision of ecosystem goods and services. Resilience-based management (RBM) has been developed to overcome the challenges of supporting ecosystem resilience in this era of rapid change. RBM involves the application of resilience theory and tools to deliver ecosystem-based management outcomes into the future. RBM of coral reefs can include assessing spatial variation in resilience potential and then targeting and tailoring appropriate actions to preserve or restore the resilience of reefs. Resilience assessments involve measuring or assessing resilience indicators (e.g., coral disease, coral recruitment and herbivorous fish biomass) and producing an aggregate score that expresses resilience potential for all sites as relative to the site with the highest (assessed) resilience potential. The Marine Fisheries Management Plan of Guam explains that understanding the resilience of reef fisheries and the coral reefs upon which they depend is needed for future assessments of yield. This project was designed to meet this need.