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2022 marked the third consecutive La Niña and extended the longest consecutive stretch of negative Oceanic Niño Index since 1998-2001. While physical and biological conditions in winter and spring largely adhered to prior La Niña conditions, summer and fall were very different. Similar to past La Niña events, in winter and spring coastal upwelling was either average or above average, temperature average or below average, salinity generally above average. In summer and fall, however, upwelling and temperature were generally average or slightly below average, salinity was close to average and chlorophyll a was close to average. Again, as during prior La Niña events, biomass of northern/southern copepods was above/below average off Oregon in winter, and body size of North Pacific krill in northern California was above average in winter. By contrast, later in the year the abundance of northern krill dropped off Oregon while southern copepods increased and body sizes of North Pacific krill fell in northern California. Off Oregon and Washington abundances of market squid and Pacific pompano (indicators of warm, non-typical La Niña conditions) were high. In the 20th century, Northern anchovy recruitment tended to be high during cold conditions, but despite mostly warm conditions from 2015-2021 anchovy populations boomed and remained high in 2022. Resident seabird reproductive success, which tended in the past to increase during productive La Niña conditions was highly variable throughout the system as common murre and pelagic cormorant, experienced complete reproductive failure at Yaquina Head, Oregon while Brandt’s cormorant reproduction was average. At three sampling locations off central California, however, common murre reproduction was close to or above average while both pelagic and Brandt’s cormorant were above average. California sealion reproduction has been above average each year since 2016, and pup weight was also above average in 2022, likely in response not to La Niña or El Niño but continuous high abundance of anchovy. The highly variable and often unpredictable physical and biological conditions in 2022 highlight a growing recognition of disconnects between basin-scale indices and local conditions in the CCE. “July-December 2022 is the biggest outlier from individual “strong” La Niña (events) ever going back to the 50s.” – Nate Mantua

Eclipse Sound, in the northeastern Canadian Arctic, has experienced a substantial increase in ship traffic due to growing tourism and industrial development in the region. This study aims to describe the natural soundscape as well as to assess the noise levels associated with shipping. Underwater sound recordings were collected at two locations: Eastern Eclipse Sound (72° 43.730 N, 76° 13.519 W, 670 m) leading to Baffin Bay, and Milne Inlet (72° 15.260 N, 80° 34.205 W, 313 m) situated near the southwest end of Eclipse Sound. To capture the dynamic nature of the soundscape, the data from these two locations were divided into three seasons: late spring, summer, and early fall. These periods were selected to account for the changing contribution of sea ice to the soundscape during the sea ice break-up, two months of open water, and the sea ice freeze-up. By analyzing ship tracks and underwater acoustic recordings, we identified patterns of ship traffic and estimated underwater noise levels due to ships. Noise emitted by ships is quantified by vessel type, including three cargo ship types, passenger ships, pleasure craft, and icebreakers. Individual ship transits through the region introduce transient noise at frequencies from 20 kHz, with durations lasting from a few minutes to >6 h. The impact of ship noise on the soundscape is significant, resulting in increases in sound levels by 15 to >30 dB when ships are within 10 km and measurable ship noise below 200 Hz at distances of >50 km.

BACKGROUND: Prognostic disclosure is essential to informed decision making in oncology, yet many oncologists are unsure how to successfully facilitate this discussion. This scoping review determines what prognostic communication models exist, compares and contrasts these models, and explores the supporting evidence. METHOD: A protocol was created for this study using the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols extension for Scoping Reviews. Comprehensive literature searches of electronic databases MEDLINE, EMBASE, PsycINFO and Cochrane CENTRAL were executed to identify relevant publications between 1971 and 2020. RESULTS: In total, 1532 articles were identified, of which 78 met inclusion criteria and contained 5 communication models. Three of these have been validated in randomised controlled trials (the Serious Illness Conversation Guide, the Four Habits Model and the ADAPT acronym) and have demonstrated improved objective communication measures and patient reported outcomes. All three models emphasise the importance of exploring patients illness understanding and treatment preferences, communicating prognosis and responding to emotion. CONCLUSION: Communicating prognostic estimates is a core competency skill in advanced cancer care. This scoping review highlights available communication models and identifies areas in need of further assessment. Such areas include how to maintain learnt communication skills for lifelong practice, how to assess patient and caregiver understanding during and after these conversations, and how to best scale these protocols at the institutional and national levels.

Sperm whales (Physeter macrocephalus) are a cosmopolitan species but are only found in ice-free regions of the ocean. It is unknown how their distribution might change in regions undergoing rapid loss of sea ice and ocean warming like Baffin Bay in the eastern Canadian Arctic. In 2014 and 2018, sperm whales were sighted near Eclipse Sound, Baffin Bay: the first recorded uses of this region by sperm whales. In this study, we investigate the spatiotemporal distribution of sperm whales near Eclipse Sound using visual and acoustic data. We combine several published open-source, data sets to create a map of historical sperm whale presence in the region. We use passive acoustic data from two recording sites between 2015 and 2019 to investigate more recent presence in the region. We also analyze regional trends in sea ice concentration (SIC) dating back to 1901 and relate acoustic presence of sperm whales to the mean SIC near the recording sites. We found no records of sperm whale sightings near Eclipse Sound outside of the 2014/2018 observations. Our acoustic data told a different story, with sperm whales recorded yearly from 2015 to 2019 with presence in the late summer and fall months. Sperm whale acoustic presence increased over the 5-year study duration and was closely related to the minimum SIC each year. Sperm whales, like other cetaceans, are ecosystem sentinels, or indicators of ecosystem change. Increasing number of days with sperm whale presence in the Eclipse Sound region could indicate range expansion of sperm whales as a result of changes in sea ice. Monitoring climate change-induced range expansion in this region is important to understand how increasing presence of a top-predator might impact the Arctic food web.

To be literate in a society where the information shared online is often exploited, learners should be exposed to multiple aspects of contemporary predictive modeling. This article explores an activity in which grade 10 students learned how a famous AI algorithm (the Apriori algorithm) uses conditional probability to automate the process of recommending content. Then, in the conclusion, the author offers ways to extend that knowledge by teaching students that when they use social media to sign up to various websites (e.g., using Facebook to sign up for Amazon), they often give both platforms permission to exchange their personal information (e.g., shopping patterns and browser histories). Therefore, social media sites such as Facebook can exploit the information from other sites to perform tailored ad campaigns. This lesson is not designed to introduce the concept of conditional probability; rather, these activities offer students opportunities to apply their skills to real-life situations. Students should have a working knowledge of probability before attempting these activities.

In late 2020, models predicted that a strong La Niña would take place for the first time since 2013, and we assessed whether physical and biological indicators in 2021 were similar to past La Niñas in the California Current Ecosystem (CCE). The Pacific Decadal Oscillation and Oceanic Niño Index indeed remained negative throughout 2021; the North Pacific Gyre Oscillation Index, however, remained strongly negative. The seventh largest marine heatwave on record was unexpectedly present from April to the end of 2021; however, similar to past La Niñas, this mass of warm water mostly remained seaward of the continental shelf. As expected from past La Niñas, upwelling and chlorophyll were mostly high and sea surface temperature was low throughout the CCE; however, values were close to average south of Point Conception. Similar to past La Niñas, abundances of lipid-rich, northern copepods off Oregon increased. In northern California, unlike past La Niñas, the body size of North Pacific krill (Euphausia pacifica) was close to average. Predictably, overall krill abundance was above average in far northern California but, unexpectedly, below average south of Cape Mendocino. Off Oregon, similar to past La Niñas, larval abundances of three of six coastal species rose, while five of six southern/offshore taxa decreased in 2021. Off California, as expected based on 2020, Northern Anchovy (Engraulis mordax) were very abundant, while Pacific Sardine (Sardinops sagax) were low. Similar to past La Niñas, market squid (Doryteuthis opalescens) and young of the year (YOY) Pacific Hake (Merluccius pacificus), YOY sanddabs (Citharichthys spp.), and YOY rockfishes (Sebastes spp.) increased. Southern mesopelagic (e.g., Panama lightfish Vinciguerria lucetia, Mexican lampfish Triphoturus mexicanus) larvae decreased as expected but were still well above average, while northern mesopelagic (e.g., northern lampfish Stenobrachius leucopsarus) larvae increased but were still below average. In line with predictions, most monitored bird species had above-average reproduction in Oregon and California. California sea lion (Zalophus californianus) pup count, growth, and weight were high given the abundant Anchovy forage. The CCE entered an enduring La Niña in 2021, and assessing the responses of various ecosystem components helped articulate aspects of the system that are well understood and those that need further study.

Bowhead whales (Balaena mysticetus) face threats from diminishing sea ice and increasing anthropogenic activities in the Arctic. Passive acoustic monitoring is the most effective means for monitoring their distribution and population trends, based on the detection of their calls. Passive acoustic monitoring, however, is influenced by the sound propagation environment and ambient noise levels, which impact call detection probability. Modeling and simulations were used to estimate detection probability for bowhead whale frequency-modulated calls in the 80-180 Hz frequency band with and without sea ice cover and under various noise conditions. Sound transmission loss for bowhead calls is substantially greater during ice-covered conditions than during open-water conditions, making call detection ~ 3 times more likely in open-water. Estimates of daily acoustic detection probability were used to compensate acoustic detections for sound propagation and noise effects in two recording datasets in the northeast Chukchi Sea, on the outer shelf and continental slope, collected between 2012 and 2013. The compensated acoustic density suggests a decrease in whale presence with the retreat of sea ice at these recording sites. These results highlight the importance of accounting for effects of the environment on ambient noise and acoustic propagation when interpreting results of passive acoustic monitoring.

The current coronavirus pandemic has forced a dramatic shift in the way clinicians practice medicine, including the way we communicate with our patients. The pandemic has both facilitated and challenged serious illness conversations between providers and patients. Furthermore, telemedicine has emerged as a major practice across the globe. Benefits of which include greater involvement of supporting family members while drawbacks involve socioeconomic barriers that limit high quality interactions between provider and patient. This commentary aims to highlight the evolution of communication strategies over this unique time in hopes of promoting reflection and change to improve our communication strategies at the individual and institutional level.

Palliative care has evolved to be an integral part of comprehensive cancer care with the goal of early intervention to improve quality of life and patient outcomes. The NCCN Guidelines for Palliative Care provide recommendations to help the primary oncology team promote the best quality of life possible throughout the illness trajectory for each patient with cancer. The NCCN Palliative Care Panel meets annually to evaluate and update recommendations based on panel members' clinical expertise and emerging scientific data. These NCCN Guidelines Insights summarize the panel's recent discussions and highlights updates on the importance of fostering adaptive coping strategies for patients and families, and on the role of pharmacologic and nonpharmacologic interventions to optimize symptom management.

Aside from being culturally relevant, artificial intelligence is also supporting companies in making business decisions. Consequently, "workforce needs have shifted rapidly," resulting in a demand for applicants who are skilled in "data, analytics, machine learning, and artificial intelligence" (Miller and Hughes 2017). This article contributes to filling that need by exploring a lesson in which students learned how conditional probability is the crux of many machine learning algorithms, including predictive text applications. Prior to this lesson, students learned how to calculate conditional probability. Most students had also demonstrated that they were able to calculate experimental probabilities on the basis of a Venn diagram, on a word problem, and on a two-way table. The activity described in this article satisfies Common Core State Standard CCSS.MATH.CONTENT.HSS. CP.A.5.

RNA viruses are a major human health threat. The life cycles of many highly pathogenic RNA viruses like influenza A virus (IAV) and Lassa virus depends on host mRNA, because viral polymerases cleave 5'-m7G-capped host transcripts to prime viral mRNA synthesis ("cap-snatching"). We hypothesized that start codons within cap-snatched host transcripts could generate chimeric human-viral mRNAs with coding potential. We report the existence of this mechanism of gene origination, which we named "start-snatching." Depending on the reading frame, start-snatching allows the translation of host and viral "untranslated regions" (UTRs) to create N-terminally extended viral proteins or entirely novel polypeptides by genetic overprinting. We show that both types of chimeric proteins are made in IAV-infected cells, generate T cell responses, and contribute to virulence. Our results indicate that during infection with IAV, and likely a multitude of other human, animal and plant viruses, a host-dependent mechanism allows the genesis of hybrid genes.

Despite the importance of artificial intelligence in our daily lives, it has yet to be integrated into K-12 classrooms in a meaningful way. This article explores a lesson in which geometry students use Euclidean distance to implement a functional machine learning algorithm in Google Sheets™. The assignment requires students to apply the distance formula to a machine learning context, break a data set into parts to establish relationships among its components, synthesize the analysis to implement an algorithm in Google Sheets, and use test data to evaluate the systems' accuracy.