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ABSTRACT The implementation of deep learning algorithms has brought new perspectives to plankton ecology. Emerging as an alternative approach to established methods, deep learning offers objective schemes to investigate plankton organisms in diverse environments. We provide an overview of deep‐learning‐based methods including detection and classification of phytoplankton and zooplankton images, foraging and swimming behavior analysis, and finally ecological modeling. Deep learning has the potential to speed up the analysis and reduce the human experimental bias, thus enabling data acquisition at relevant temporal and spatial scales with improved reproducibility. We also discuss shortcomings and show how deep learning architectures have evolved to mitigate imprecise readouts. Finally, we suggest opportunities where deep learning is particularly likely to catalyze plankton research. The examples are accompanied by detailed tutorials and code samples that allow readers to apply the methods described in this review to their own data.

Abstract Actinic keratoses (AKs) are common pre‐malignant lesions. There are numerous management options including active surveillance, multiple topical therapies, cryotherapy, curettage and cautery, and photodynamic therapy, each with their own risks, benefits and efficacy. Best practice currently involves shared decision‐making between patient and clinician, particularly in the setting of multiple management options. Patient decision aids have been shown to be beneficial in the shared decision‐making process. In view of this, we have developed and validated a decision aid for the management of AKs, in concordance with the International Patient Decision Aids Standards.

Abstract Sea lamprey Petromyzon marinus is an anadromous and semelparous fish without homing behaviors. Despite being a freshwater, free‐living organism for a large part of their life cycle, its adulthood is spent as a parasite of marine vertebrates. In their native European range, while it is well‐established that sea lampreys comprise a single nearly‐panmictic population, few studies have further explored the evolutionary history of natural populations. Here, we performed the first genome‐wide characterization of sea lamprey's genetic diversity in their European natural range. The objectives were to investigate the connectivity among river basins and explore evolutionary processes mediating dispersal during the marine phase, with the sequencing of 186 individuals from 8 locations spanning the North Eastern Atlantic coast and the North Sea with double‐digest RAD‐sequencing, obtaining a total of 30,910 bi‐allelic SNPs. Population genetic analyses reinforced the existence of a single metapopulation encompassing freshwater spawning sites within the North Eastern Atlantic and the North Sea, though the prevalence of private alleles at northern latitudes suggested some limits to the species' dispersal. Seascape genomics suggested a scenario where oxygen concentration and river runoffs impose spatially varying selection across their distribution range. Exploring associations with the abundance of potential hosts further suggested that hake and cod could also impose selective pressures, although the nature of such putative biotic interactions was unresolved. Overall, the identification of adaptive seascapes in a panmictic anadromous species could contribute to conservation practices by providing information for restoration activities to mitigate local extinctions on freshwater sites.

Abstract While medical education has traditionally been designed, led and delivered exclusively by clinicians and academics, there has been an increasing shift towards diversifying actors involved in training future generations of health professionals. Public and patient involvement in learning increases the likelihood that learning is relevant to the communities we purport to serve. This article explores the experiences of medical students who were partnered with a community‐based organisation (CBOs) as part of the intercalated Global Health BSc at Imperial College London. Students involved in this programme highlight opportunities to understand the needs of communities they were placed with, beyond what is possible to understand in clinical practice; this is essential to support them in becoming holistic, patient‐centred practitioners. Students also found this opportunity helpful to gain insight into the role and value of the voluntary sector in healthcare and develop transferrable skills in project leadership and management. It is hypothesised that the benefits of this partnership extend to community‐organisations; they gain experience working with students, who provide an external view of their services and may be helpful in the delivery of quality‐improvement projects. Communities could also benefit from interactions with students by sharing insight into their needs and priorities, and in turn, shaping students’ priorities as future health professionals and co‐designers of voluntary‐sector initiatives within the community. Whilst the establishment of these partnerships does not come without its challenges, this article also highlights lessons for students and institutions undergoing similar programmes, including clarification of goals, stakeholder consultation, sustainability of interventions, voicing the community, timetable flexibility and funding.

Abstract Livestock farming in Great Britain (GB) faces multiple pressures. Yet, grassland managed for livestock is the most extensive habitat in GB and is key to cultural landscapes and their biodiversity and soil health. This study analysed a nationally representative dataset of over 940 large (200 m2) Neutral (agriculturally semi‐improved) and (agriculturally) Improved Grassland plots from the GB Countryside Survey (CS) to assess relationships between key grassland sward and soil variables. Analysis also looked at how these variables changed over time as plots switched between these grassland types. Data from grassland plots managed by Pasture‐Fed Livestock Association (PFLA) farmers were compared to CS plot data to assess the impacts of their practices on these variables. Plant species richness in Neutral grassland types in CS plots was positively associated with total soil invertebrate abundance (total taxa) and soil N and C and negatively associated with soil P. There were negative relationships between the covers of Lolium sp. (Neutral only), legumes and forbs and soil C and moisture variables. Grassland swards on PFLA member farms were characteristic of Neutral grassland. PFLA plots were more species rich and contained more legume and forb species and lower proportions of Lolium perenne than those on Improved Grassland. Vegetation height was greater in PFLA plots than in CS plots of either Improved or Neutral Grassland. Unlike CS Neutral Grassland plots, soil properties in PFLA plots were not significantly different from those for Improved Grassland for any measured variable (soil carbon concentration [C], bulk density, pH, nitrogen [N], phosphorus [P]). Higher species richness in grasslands is associated with positive measures of soil health. PFLA plant communities contain relatively high species richness and tall vegetation, which is positive for biodiversity. Lack of positive measures of soil health associated with higher species richness recorded in PFLA grassland (as opposed to CS grassland) may reflect time lags in soil responses to management, as evidenced through an analysis of the impacts of land‐use change over time on CS plot characteristics. Our findings indicate that pasture‐fed livestock approaches may be beneficial for grassland and wider ecosystems.

Abstract Women with pulmonary arterial hypertension (PAH) experience multiple symptoms, including dyspnea, fatigue, and sleep disturbance, that impair their health‐related quality of life (HRQOL). However, we know little about phenotypic subgroups of patients with PAH with similar, concurrent, multiple symptoms. The objectives of this study were to define the “symptome” by symptom cluster phenotypes and compare characteristics such as biomarkers, cardiac structure and function (echocardiography), functional capacity (6‐min walk distance), and HRQOL between the groups. This cross‐sectional study included 60 women with PAH. Subjects completed an assessment battery: Pulmonary Arterial Hypertension Symptom Scale, Pittsburgh Sleep Quality Index, Multidimensional Dyspnea Profile, Patient‐Reported Outcomes Measurement Information System (PROMIS®) Physical Function, PROMIS® Sleep‐Related Impairment, and the emPHasis‐10. Subjects also underwent transthoracic echocardiography, phlebotomy, 6‐min walk distance, and actigraphy. The three symptoms of dyspnea, fatigue, and sleep disturbance were used to define the symptom clusters. Other PAH symptoms, plasma and serum biomarkers, cardiac structure and function (echocardiography), exercise capacity (6‐min walk distance), sleep (actigraphy), and HRQOL were compared across phenotypes. The mean age was 50 ± 18 years, 51% were non‐Hispanic white, 32% were non‐Hispanic Black and 40% had idiopathic PAH. Cluster analysis identified Mild (n = 28, 47%), Moderate (n = 20, 33%), and Severe Symptom Cluster Phenotypes (n = 12, 20%). There were no differences for age, race, or PAH etiology between the phenotypes. WHO functional class (p

Abstract The prognostic value of cytonuclear grade in ductal carcinoma in situ (DCIS) is debated, partly due to high interobserver variability and the use of multiple guidelines. The aim of this study was to evaluate interobserver agreement in grading DCIS between Dutch, British, and American pathologists. Haematoxylin and eosin‐stained slides of 425 women with primary DCIS were independently reviewed by nine breast pathologists based in the Netherlands, the UK, and the USA. Chance‐corrected kappa (κma) for association between pathologists was calculated based on a generalised linear mixed model using the ordinal package in R. Overall κma for grade of DCIS (low, intermediate, or high) was estimated to be 0.50 (95% confidence interval [CI] 0.44–0.56), indicating a moderate association between pathologists. When the model was adjusted for national guidelines, the association for grade did not change (κma = 0.53; 95% CI 0.48–0.57); subgroup analysis for pathologists using the UK pathology guidelines only had significantly higher association (κma = 0.58; 95% CI 0.56–0.61). To assess if concordance of grading relates to the expression of the oestrogen receptor (ER) and HER2, archived immunohistochemistry was analysed on a subgroup (n = 106). This showed that non‐high grade according to the majority opinion was associated with ER positivity and HER2 negativity (100 and 89% of non‐high grade cases, respectively). In conclusion, DCIS grade showed only moderate association using whole slide images scored by nine breast pathologists. As therapeutic decisions and inclusion in ongoing clinical trials are guided by DCIS grade, there is a pressing need to reduce interobserver variability in grading. ER and HER2 might be supportive to prevent the accidental and unwanted inclusion of high‐grade DCIS in such trials.

Abstract Fostering widespread concern for conservation problems requires a robust understanding of the life experiences that positively contribute to an individual's conservation attitudes and behaviours. However, few studies have assessed a comprehensive range of social and experiential predictors of conservation concern. Using survey responses from 391 undergraduate students enrolled in various course disciplines across Australia, we describe the relationships between five major constructs of early‐life experiences and two measures of conservation concern: a preference for a conservation career and positive conservation attitudes. We find that conservation career preferences are positively associated with childhood preferences for nature‐related books, movies and school subjects, biospheric family value orientations and environmental volunteering. Conservation attitudes were positively associated with biospheric family value orientations and environmental volunteering. Both constructs were negatively associated with egoistic family values and childhood experiences of nature were not a significant factor in either of our models. This suggests that limited nature experiences do not necessarily impede the development of conservation concern in young Australians, and that family values and experiences with environmental organizations, nature‐related storylines and school subjects may help to foster greater conservation concern. A free Plain Language Summary can be found within the Supporting Information of this article.

Abstract With mounting scientific evidence demonstrating adverse global climate change (GCC) impacts to water quality, water quality policies, such as the Total Maximum Daily Loads (TMDLs) under the U.S. Clean Water Act, have begun accounting for GCC effects in setting nutrient load‐reduction policy targets. These targets generally require nutrient reductions for attaining prescribed water quality standards (WQS) by setting safe levels of nutrient concentrations that curtail potentially harmful cyanobacteria blooms (CyanoHABs). While some governments require WQS to consider climate change, few tools are available to model the complex interactions between climate change and benthic legacy nutrients. We present a novel process‐based integrated assessment model (IAM) that examines the extent to which synergistic relationships between GCC and legacy Phosphorus release could compromise the ability of water quality policies to attain established WQS. The IAM is calibrated for simulating the eutrophic Missisquoi Bay and watershed in Lake Champlain (2001–2050). Water quality impacts of seven P‐reduction scenarios, including the 64.3% reduction specified under the current TMDL, were examined under 17 GCC scenarios. The TMDL WQS of 0.025 mg/L total phosphorus is unlikely to be met by 2035 under the mandated 64.3% reduction for all GCC scenarios. IAM simulations show that the frequency and severity of summer CyanoHABs increased or minimally decreased under most climate and nutrient reduction scenarios. By harnessing IAMs that couple complex process‐based simulation models, the management of water quality in freshwater lakes can become more adaptive through explicit accounting of GCC effects on both the external and internal sources of nutrients.

Ultraviolet radiation‐induced DNA mutations are a primary environmental driver of melanoma. The reason for this very high level of unrepaired DNA lesions leading to these mutations is still poorly understood. The primary DNA repair mechanism for UV‐induced lesions, that is, the nucleotide excision repair pathway, appears intact in most melanomas. We have previously reported a postreplication repair mechanism that is commonly defective in melanoma cell lines. Here we have used a genome‐wide approach to identify the components of this postreplication repair mechanism. We have used differential transcript polysome loading to identify transcripts that are associated with UV response, and then functionally assessed these to identify novel components of this repair and cell cycle checkpoint network. We have identified multiple interaction nodes, including global genomic nucleotide excision repair and homologous recombination repair, and previously unexpected MASTL pathway, as components of the response. Finally, we have used bioinformatics to assess the contribution of dysregulated expression of these pathways to the UV signature mutation load of a large melanoma cohort. We show that dysregulation of the pathway, especially the DNA damage repair components, are significant contributors to UV mutation load, and that dysregulation of the MASTL pathway appears to be a significant contributor to high UV signature mutation load.