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Limited research on diabetes education and support implementation in Appalachia, which is a critical knowledge gap considering barriers to care, and high prevalence rates. The aim was to understand what each facility is providing regarding diabetes education and services within West Virginia. This study reports cognitive interview qualitative findings from a multi-methods study. Individuals were recruited through an online search to identify clinics, organizations, and hospital staff that provided diabetes education in the state of West Virginia. Eligible participants were individuals who facilitated and managed diabetes education and support in counties of West Virginia. The interviews followed an 11-item interview guide, approved, and reviewed by a practicing Registered Dietitian and Certified Diabetes Care Education Specialist in West Virginia. All qualitative data from the interviews were hand-coded using grounded theory, by two researchers. 15 participating organizations from the state of West Virginia were included and described three phenomena: Diabetes Education Implementation (differences in: evaluation measures, modality, delivery format, topical areas); Barriers to Care (staffing, lack of training, evaluation, loss of research partnerships and funding); and Facilitators to Care (community-based involvement, interdisciplinary collaboration, capacity building (trainings). There are concerns with program drift and "risky" adaptations such as inconsistent evaluative measures, lack of training for program facilitators, variety of delivery formats, and content material. Findings recommend more alignment in program delivery to better implementation. Further studies should assess patient experiences with implemented diabetes education programs in West Virginia to further support the current research findings.

Abstract Where and when alien organisms are successfully introduced are central questions to elucidate biotic and abiotic conditions favorable to the introduction, establishment and spread of invasive species. We propose a modelling framework to analyze multiple introductions by several invasive genotypes or genetic variants, in competition with a resident population, when observations provide knowledge on the relative proportions of each variant at some dates and places. This framework is based on a mechanistic-statistical model coupling a reaction–diffusion model with a probabilistic observation model. We apply it to a spatio-temporal dataset reporting the relative proportions of five genetic variants of watermelon mosaic virus (WMV, genus Potyvirus, family Potyviridae) in infections of commercial cucurbit fields. Despite the parsimonious nature of the model, it succeeds in fitting the data well and provides an estimation of the dates and places of successful introduction of each emerging variant as well as a reconstruction of the dynamics of each variant since its introduction.

Introduction Area-level residential instability (ARI), an index of social fragmentation, has been shown to explain the association between urbanicity and psychosis. Urban upbringing has been shown to be associated with decreased gray matter volumes (GMV)s of brain regions corresponding to the right caudal middle frontal gyrus (CMFG) and rostral anterior cingulate cortex (rACC). Objectives We hypothesize that greater ARI will be associated with reduced right posterior CMFG and rACC GMVs. Methods Data were collected at baseline as part of the North American Prodrome Longitudinal Study. Counties where participants resided during childhood were geographically coded using the US Censuses to area-level factors. ARI was defined as the percentage of residents living in a different house five years ago. Generalized linear mixed models tested associations between ARI and GMVs. Results This study included 29 HC and 64 CHR-P individuals who were aged 12 to 24 years, had remained in their baseline residential area, and had magnetic resonance imaging scans. ARI was associated with reduced right CMFG (adjusted β = -0.258; 95% CI = -0.502 – -0.015) and right rACC volumes (adjusted β = -0.318; 95% CI = -0.612 – -0.023). The interaction terms (ARI X diagnostic group) in the prediction of both brain regions were not significant, indicating that the relationships between ARI and regional brain volumes held for both CHR-P and HCs. Conclusions Like urban upbringing, ARI may be an important social environmental characteristic that adversely impacts brain regions related to schizophrenia. Disclosure No significant relationships.

La sequía es un fenómeno que genera grandes pérdidas económicas para la sociedad y se están observando más frecuentemente debido al cambio climático. En Centroamérica este fenómeno se relaciona con la distribución anómala de la precipitación (P) en un período corto, dentro de la estación lluviosa. Específicamente, en El Salvador, el fenómeno denominado “canícula”, está asociado a una disminución importante de la P cuya duración es de pocos días, por lo que es difícil de monitorearlo sólo con la P, como se hace actualmente. En el presente se han desarrollado muchos indicadores para caracterizar las sequías; en particular, se destacan la precipitación estandarizada y los índices de condición propuestos por Kogan (1995), que admiten diversas fuentes de información. En este trabajo se aplicaron cinco indicadores de déficit hídrico - la P estandarizada, la evapotranspiración (ET), el índice de condición de la humedad del suelo (HSCI), el índice de condición de la vegetación (VCI) y estrés hídrico (EH) - para evaluar las sequías en El Salvador. Para ello se utilizó información satelital, bases de datos climáticas y la interface de programación disponible en la plataforma Google Earth Engine. Se analizó el comportamiento de los indicadores en el periodo 2015-2019 y en particular, el año extremadamente seco 2015, para determinar la capacidad de monitoreo de los indicadores utilizados. Los resultados obtenidos sugieren que el conjunto de índices propuesto permite monitorear la sequía, identificando el inicio, el impacto y la extensión territorial en El Salvador.

Recent criticisms of large-scale summative assessments have claimed that the assessments are biased against historically excluded groups because of the assessments' lack of cultural representation. Accompanying these criticisms is a call for more culturally responsive assessments--assessments that take into account the background characteristics of the students; their beliefs, values, and ethics; their lived experiences; and everything that affects how they learn and behave and communicate. In this paper, we present provisional principles, based on a review of research, that we deem necessary for fostering cultural responsiveness in assessment. We believe the application of these principles can address the criticisms of current assessments.

Context: Simulations and standardized patient encounters (SPEs) have been increasingly used in professional athletic training programs. Recently they also have been identified as a mechanism to assess curricular content standards. Objective: To investigate how professional athletic training programs use simulations and SPEs for teaching and assessment, and barriers preventing use of these techniques. Design: Cross-sectional survey. Setting: Electronic survey. Patients or Other Participants: Forty-three professional program directors completed the survey, representing programs for doctoral, master's, and baccalaureate institutions. Data Collection and Analysis: The survey consisted of 8 demographic questions, 3 items regarding the frequency of using simulations and SPEs, 2 items regarding barriers to use, 1 item examining faculty collaborators and administrative release time, and 4 open-ended questions regarding additional uses and barriers. Cronbach [alpha] determined internal consistency, [alpha] = 0.891 to 0.911. Descriptive statistics were computed for all items. Results: Most respondents used simulations and SPEs for teaching and assessment. Simulation use occurred most in the curricular content areas of nonorthopaedic evaluation (n = 40, 97.6%), emergency care and life-threatening injuries (n = 38, 95.0%), and orthopaedic evaluation (n = 36, 87.8%). Regarding SPEs, use occurred most in the curricular content areas of orthopaedic evaluation (n = 32, 76.2%), nonorthopaedic evaluation (n = 32, 76.2%), and emergency care and life-threatening injuries (n = 28, 66.7%). Overall, a lack of faculty knowledge (4.40 ± 0.989), faculty time (4.36 ± 0.727), and financial resources for implementation (4.24 ± 1.100) were identified as barriers to use. Conclusions: Though simulations and standardized patients provide opportunities for engagement in real-time patient encounters in a safe learning environment, many educators still perceive a lack of evidence to support their use for teaching and assessment. Athletic training educators should seek mechanisms to increase the use of these techniques, as their use is important for preparing students for professional practice.

Introduction: Prostate and breast cancer are the most prevalent primary malignant human tumors globally. Prostatectomy and breast conservative surgery remain the most common definitive treatment option for the >500,000 men and women newly diagnosed with localized prostate and breast cancer each year only in the US. Morphological examination is the mainstay of diagnosis but margin under-sampling of the excised cancer tissue may lead to local recurrence. In despite of the progress of non-invasive optical imaging, there is still a clinical need for targeted optical imaging probes that could rapidly and globally visualize cancerous tissues. Methods: Elevated expression of junctional adhesion molecule-A (JAM-A) on tumor cells and its multiple pro-tumorigenic activity make the JAM-A a candidate for molecular imaging. Near-infrared imaging probe, which employed anti-JAM-A monoclonal antibody (mAb) phthalocyanine dye IR700 conjugates (JAM-A mAb/IR700), was synthesized and used to identify and visualize heterotopic human prostate and breast tumor mouse xenografts in vivo. Results: The intravenously injected JAM-A mAb/IR700 conjugates enabled the non-invasive detection of prostate and breast cancerous tissue by fluorescence imaging. A single dose of JAM-A mAb/IR700 reduced number of mitotic cancer cells in vivo, indicating theranostic ability of this imaging agent. The JAM-A mAb/IR700 conjugates allowed us to image a specific receptor expression in prostate and breast tumors without post-image processing. Conclusion: This agent demonstrates promise as a method to image the extent of prostate and breast cancer in vivo and could assist with real-time visualization of extracapsular extension of cancerous tissue.

La evapotranspiración (ET) es un proceso importante en el ciclo hidrológico y en el balance energético de la superficie terrestre. En las últimas décadas, la teledetección ha aportado información muy valiosa a la hora de cuantificar la ET. Sin embargo, recién en los últimos años se han desarrollado metodologías que utilizan datos de sensores pasivos de microondas, como los de la misión “Soil Moisture Active Passive” (SMAP). En este trabajo, se presenta una formulación para determinar la evapotranspiración relativa y ET con datos in situ y de microondas. La metodología se basa en una modificación de la ecuación original de Komatsu (2003) en la que se introdujo un parámetro de calibración que representa el efecto de la velocidad del viento y la vegetación y permite estimar la evapotranspiración relativa. Esta nueva ecuación es utilizada en la relación complementaria de Bouchet junto a la ecuación de Priestley y Taylor, para estimar la ET a escala regional. Los resultados obtenidos fueron comparados con datos observados en el área de Southern Great Plains - USA (SGP), indicando que el nuevo modelo estima la ET con un error medio cuadrático (RMSE) de 0,88 mm d–1 y un coeficiente de determinación (R2) superior a 0,8. El modelo calibrado fue aplicado en un período extremadamente húmedo en la Región Pampeana de Argentina arrojando resultados que se aproximaron a tasas potenciales.

The first five centimeters of soil form an interface where the main heat fluxes exchanges between the land surface and the atmosphere occur. Besides ground measurements, remote sensing has proven to be an excellent tool for the monitoring of spatial and temporal distributed data of the most relevant Earth surface parameters including soil’s parameters. Indeed, active microwave sensors (Synthetic Aperture Radar - SAR) offer the opportunity to monitor soil moisture (HS) at global, regional and local scales by monitoring involved processes. Several inversion algorithms, that derive geophysical information as HS from SAR data, were developed. Many of them use electromagnetic models for simulating the backscattering coefficient and are based on statistical techniques, such as neural networks, inversion methods and regression models. Recent studies have shown that simple multiple regression techniques yield satisfactory results. The involved geophysical variables in these methodologies are descriptive of the soil structure, microwave characteristics and land use. Therefore, in this paper we aim at developing a multiple linear regression model to estimate HS on flat agricultural regions using TerraSAR-X satellite data and data from a ground weather station. The results show that the backscatter, the precipitation and the relative humidity are the explanatory variables of HS. The results obtained presented a RMSE of 5.4 and a R2 of about 0.6

In situ observation of the marine environment has traditionally relied on ship-based platforms. The obvious consequence is that physical and biogeochemical properties have been dramatically undersampled, especially in the remote Southern Ocean (SO). The difficulty in obtaining in situ data represents the major limitations to our understanding, and interpretation of the coupling between physical forcing and the biogeochemical response. Southern elephant seals (Mirounga leonina) equipped with a new generation of oceanographic sensors can measure ocean structure in regions and seasons rarely observed with traditional oceanographic platforms. Over the last few years, seals have allowed for a considerable increase in temperature and salinity profiles from the SO, but we were still lacking information on the spatiotemporal variation of phytoplankton concentration. This information is critical to assess how the biological productivity of the SO, with direct consequences on the amount of CO2 "fixed'' by the biological pump, will respond to global warming. In this research programme, we use an innovative sampling fluorescence approach to quantify phytoplankton concentration at sea. For the first time, a low energy consumption fluorometer was added to Argos CTD-SRDL tags, and these novel instruments were deployed on 27 southern elephant seals between 25 December 2007 and the 4 February 2011. As many as 3388 fluorescence profiles associated with temperature and salinity measurements were thereby collected from a vast sector of the Southern Indian Ocean. This paper addresses the calibration issue of the fluorometer before being deployed on elephant seals and presents the first results obtained for the Indian sector of the Southern Ocean. This in situ system is implemented in synergy with satellite ocean colour radiometry. Satellite-derived data is limited to the surface layer and is restricted over the SO by extensive cloud cover. However, with the addition of these new tags, we are able to assess the 3-dimension distribution of phytoplankton concentration by foraging southern elephant seals. This approach reveals that for the Indian sector of the SO, the surface chlorophyll a (chl a) concentrations provided by MODIS were underestimated by a factor 2 compared to chl a concentrations estimated from HPLC corrected in situ fluorescence measurements. The scientific outcomes of this programme include an improved understanding of both the present state and variability in ocean biology, and the accompanying biogeochemistry, as well as the delivery of real-time and open-access data to scientists (doi:10.7491/MEMO.1).

Ground based remote sensing systems for future observation operations will allow continuous monitoring of the lower troposphere at temporal resolutions much better than every 30 min. Observations which may be considered spurious from an individual instrument can be validated or eliminated when considered in conjunction with measurements from other instruments observing at the same location. Thus, improved quality control of atmospheric profiles from microwave radiometers and wind profilers should be sought by considering the measurements from different systems together rather than individually. In future test bed deployments for future operational observing systems, this should be aided by observations from laser ceilometers and cloud radars. Observations of changes in atmospheric profiles at high temporal resolution in the lower troposphere are presented from a 12 channel microwave radiometer and 1290 MHz UHF wind profiler deployed in southern England during the CSIP field experiment in July/August 2005. The observations chosen were from days when thunderstorms occurred in southern England. Rapid changes near the surface in dry layers are considered, both when rain/hail may be falling from above and where the dry air is associated with cold pools behind organised thunderstorms. Also, short term variations in atmospheric profiles and vertical stability are presented on a day with occasional low cloud, when thunderstorms triggered 50 km down wind of the observing site Improved quality control of the individual remote sensing systems need to be implemented, examining the basic quality of the underlying observations as well as the final outputs, and so for instance eliminating ground clutter as far as possible from the basic Doppler spectra measurements of the wind profiler. In this study, this was performed manually. The potential of incorporating these types of instruments in future upper air observational networks leads to the challenge to improve the observing systems and also to exploit measurements at high temporal resolution in numerical weather prediction. These examples are intended to inform potential operational users of the changes in atmospheric structure that can be observed with the new types of observing system.

Electrokinetic phenomena link fluid flow and electrical flow in porous and fractured media such that a hydraulic flow will generate an electrical current and vice versa. Such a link is likely to be extremely useful, especially in the development of the electroseismic method. However, surprisingly few experimental measurements have been carried out, particularly as a function of frequency because of their difficulty. Here we have considered six different approaches to make laboratory determinations of the frequency-dependent streaming potential coefficient. In each case, we have analyzed the mechanical, electrical, and other technical difficulties involved in each method. We conclude that the electromagnetic drive is currently the only approach that is practicable, while the piezoelectric drive may be useful for low permeability samples and at specified high frequencies. We have used the electro-magnetic drive approach to design, build, and test an apparatus for measuring the streaming potential coefficient of unconsolidated and disaggregated samples such as sands, gravels, and soils with a diameter of 25.4 mm and lengths between 50 mm and 300 mm.

Frequency-dependent streaming potential coefficient measurements have been made upon Ottawa sand and glass bead packs using a new apparatus that is based on an electromagnetic drive. The apparatus operates in the range 1 Hz to 1 kHz with samples of 25.4 mm diameter up to 150 mm long. The results have been analysed using theoretical models that are either (i) based upon vibrational mechanics, (ii) treat the geological material as a bundle of capillary tubes, or (iii) treat the material as a porous medium. The best fit was provided by the Pride model and its simplification, which is satisfying as this model was conceived for porous media rather than capillary tube bundles. Values for the transition frequency were derived from each of the models for each sample and were found to be in good agreement with those expected from the independently measured effective pore radius of each material. The fit to the Pride model for all four samples was also found to be consistent with the independently measured steady-state permeability, while the value of the streaming potential coefficient in the low-frequency limit was found to be in good agreement with other steady-state streaming potential coefficient data.