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The understanding of the Earth through global land monitoring from satellite images paves the way towards many applications including flight simulations, urban management and telecommunications. The twin satellites from the Sentinel-2 mission developed by the European Space Agency (ESA) provide 13 spectral bands with a high observation frequency worldwide. In this paper, we present a novel multi-temporal approach for land-cover classification of Sentinel-2 images whereby a time-series of images is classified using fully convolutional network U-Net models and then coupled by a developed probabilistic algorithm. The proposed pipeline further includes an automatic quality control and correction step whereby an external source can be introduced in order to validate and correct the deep learning classification. The final step consists of adjusting the combined predictions to the cloud-free mosaic built from Sentinel-2 L2A images in order for the classification to more closely match the reference mosaic image.

Clinical practice guidelines recommend using repeated wound surface area measurements to determine if a chronic ulcer is healing. This results in delays in determining the healing status. This study aimed to evaluate whether any of a panel of biomarkers can determine the healing status of chronic venous leg ulcers. Forty-two patients with chronic venous leg ulcers had their wound measured and wound fluid collected at weekly time points for 13 weeks. Wound fluid was analyzed using multiplex enzyme-linked immunosorbent assay to determine the concentration of biomarkers in the wound fluid at each weekly time point. Healing status was determined by examining the change in wound size at the previous and subsequent weeks. Predictive accuracy with 95% confidence intervals (CI) is reported. Of 42 patients, 105 evaluable weekly time points were obtained, with 32 classified as healing, 27 as nonhealing, and 46 as indeterminate. Thirteen biomarkers significantly differed between healing and nonhealing wounds (p < 0.1) and were included in a multivariate logistic regression model. Granulocyte macrophage-colony stimulating factor (p < 0.001) and matrix metalloprotease-13 (p = 0.004) were the best predictors of wound healing. Receiver operating characteristic curves indicated 92% accuracy (95% CI: 85%,100%) for granulocyte macrophage-colony stimulating factor, and 78% accuracy (95% CI: 65%,90%) for matrix metalloprotease-13 in discriminating between healing and nonhealing wounds. This study found that two biomarkers from wound fluid can predict healing status in chronic venous leg ulcers. These findings may lead to the ability to determine the future trajectory of a wound and the ability to modify treatment accordingly.

Global Earth observation from satellite images is an active research topic, driven by numerous applications, such as telecommunications, defence, natural hazard monitoring and urban management. The recently launched twin Sentinel-2 satellites acquire 13-band optical data with a 2–5 day revisit time, freely available for any use, and thus very valuable for global Earth observation. In this paper, we present a completely automatic operational chain for a global cloud-free mosaic and classification of Sentinel-2 images. The proposed pipeline enables producing the world 10-m cloud-free mosaic, and a 6-class landcover classification map.

Study design Systematic review. Objectives To examine use of theory and quality of reporting in skin care self-management interventions for people with SCI. Setting International. Methods The Theory Coding Scheme (TCS) and the Template for Intervention Description and Replication (TIDieR) checklist were applied by two independent researchers to 17 interventions identified in a systematic review of self-management interventions for skin care in people with SCI. Results Six (35%) of the 17 interventions reviewed were reported to have a theoretical basis. Theories used included three of the most commonly featured in health behavior research (the Health Belief Model, Social Cognitive Theory, and the Transtheoretical Model). In these six interventions, theory was used to design content but not to select participants or tailor strategies. None of the interventions were used to test theories in the SCI population, or to propose theoretical refinements. Reporting quality was found to vary by TIDieR item, with 6–100% of interventions including recommended information. Information on two intervention fidelity items was missing in 53 and 82% of descriptions. Conclusions Use of theory and reporting quality in SCI self-management research remains suboptimal, potentially slowing down advancements in this area of research. Rehabilitation researchers should direct their efforts toward improving these practices to help build a science of SCI self-management that is cumulative and reproducible by clinicians, scientists, and policy makers. Sponsorship This work was funded through a postdoctoral fellowship awarded to the first author by the Rick Hansen Institute.

Background High strain in soft tissues that overly bony prominences are considered a risk factor for pressure ulcers (PUs) following spinal cord impairment (SCI) and have been computed using Finite Element methods (FEM). The aim of this study was to translate a MRI protocol into ultrasound (US) and determine between-operator reliability of expert sonographers measuring diameter of the inferior curvature of the ischial tuberosity (IT) and the thickness of the overlying soft tissue layers on able-bodied (AB) and SCI using real-time ultrasound. Material and methods Part 1: Fourteen AB participants with a mean age of 36.7 ± 12.09 years with 7 males and 7 females had their 3 soft tissue layers in loaded and unloaded sitting measured independently by 2 sonographers: tendon/muscle, skin/fat and total soft tissue and the diameter of the IT in its short and long axis. Part 2: Nineteen participants with SCI were screened, three were excluded due to abnormal skin signs, and eight participants (42%) were excluded for abnormal US signs with normal skin. Eight SCI participants with a mean age of 31.6 ± 13.6 years and all male with 4 paraplegics and 4 tetraplegics were measured by the same sonographers for skin, fat, tendon, muscle and total. Skin/fat and tendon/muscle were computed. Results AB between-operator reliability was good (ICC = 0.81–0.90) for 3 soft tissues layers in unloaded and loaded sitting and poor for both IT short and long axis (ICC = −0.028 and −0.01). SCI between-operator reliability was good in unloaded and loaded for total, muscle, fat, skin/fat, tendon/muscle (ICC = 0.75–0.97) and poor for tendon (ICC = 0.26 unloaded and ICC = −0.71 loaded ) and skin (ICC = 0.37 unloaded and ICC = 0.10). Conclusion A MRI protocol was successfully adapted for a reliable 3 soft tissue layer model and could be used in a 2-D FEM model designed to estimate soft tissue strain as a novel risk factor for the development of a PU.

Area measurements of a chronic wound are the gold standard outcome measure to determine if a wound is on a healing or nonhealing trajectory. The use of digital planimetry can provide increased accuracy in measuring wound area however it is important to know the reliability and measurement error of these devices when used by multiple assessors. The aim of this study is to determine the within rater, between rater, and standard error of measurement of a digital planimetry device. Wound area in 42 patients was measured weekly for 12 weeks by two different raters, with each rater measuring the wound 10 times per visit. Intraclass correlation coefficients (ICC 1,k) and standard error of measurement were calculated for both within and between raters using 10 and the first three repeated measures to determine if using less measurements was as reliable. The true change in wound area was calculated by dividing stander error of measurements by mean wound areas. Within rater reliability for raters 1 and 2 were 0.995 and 0.992 for 10 measurements, and 0.996 and 0.992 for 3 measurements per time point. Between rater reliability was 0.979 for 10 measurements and 0.996 for 3 measurements per time point. The within rater standard error of measurement for raters 1 and 2 was 0.98 cm2 and 1.28 cm2 for 10 measurements and 0.895 cm2 and 1.29 cm2 for 3 measurements at each time point. The standard error of measurement for between raters was 2.07 cm2 for 10 measurements and 2.25 cm2 for 3 measurements per time point. The true change in wound size varied from 6.4% for within one rater to 15.7% for across different raters. This study found that both within and between rater reliability of the digital planimetry device was very high for three measurements per time point.

Clinical practice guidelines recommend using repeated wound surface area measurements to determine if a chronic ulcer is healing. This results in delays in determining the healing status. This study aimed to evaluate whether any of a panel of biomarkers can determine the healing status of chronic venous leg ulcers. Forty-two patients with chronic venous leg ulcers had their wound measured and wound fluid collected at weekly time points for 13 weeks. Wound fluid was analyzed using multiplex enzyme-linked immunosorbent assay to determine the concentration of biomarkers in the wound fluid at each weekly time point. Healing status was determined by examining the change in wound size at the previous and subsequent weeks. Predictive accuracy with 95% confidence intervals (CI) is reported. Of 42 patients, 105 evaluable weekly time points were obtained, with 32 classified as healing, 27 as nonhealing, and 46 as indeterminate. Thirteen biomarkers significantly differed between healing and nonhealing wounds (p < 0.1) and were included in a multivariate logistic regression model. Granulocyte macrophage-colony stimulating factor (p < 0.001) and matrix metalloprotease-13 (p = 0.004) were the best predictors of wound healing. Receiver operating characteristic curves indicated 92% accuracy (95% CI: 85%,100%) for granulocyte macrophage-colony stimulating factor, and 78% accuracy (95% CI: 65%,90%) for matrix metalloprotease-13 in discriminating between healing and nonhealing wounds. This study found that two biomarkers from wound fluid can predict healing status in chronic venous leg ulcers. These findings may lead to the ability to determine the future trajectory of a wound and the ability to modify treatment accordingly.

Background: Ultrasonography may have potential as an effective diagnostic tool for deep tissue injury (DTI) in tissues overlying bony prominences that are vulnerable when under sustained loading in sitting. Methods: Three cases of DTI in the fat and muscle layers overlying the ischial tuberosity of the pelvis in 3 persons with spinal cord injury (SCI) with different medical histories and abnormal tissue signs are described. Conclusion: There is a need for prospective studies using a reliable standardized ultrasonography protocol to diagnose DTI and to follow its natural history to determine its association with the development of pressure injuries.

Background Deep Tissue Pressure Injury (DTI) occurs in the tissues underlying the skin that may not have visible signs of skin breakdown and may be detected by ultrasound. The optimal position for ischial region ultrasound image acquisition to facilitate assessment of the tissue proximal to the ischias not been determined. Objective To evaluate the mean difference in geometric and grey scale measures of tissues overlying the ischial tuberosity (IT) acquired from ultrasound images in supine and lateral recumbent simulated sitting positions from adults with spinal cord impairment (SCI). Methods Nine individuals (3 acute and 6 chronic) with SCI or disease with neurological level of injury C4-T12 and AIS A-D and who used a wheelchair for mobility were recruited and underwent ultrasound acquisition in the supine and lateral recumbent positions. One participant was imaged twice on a separate day. Three images from the left (n = 8) and right (n = 2) IT were scanned using a 6 – 18 MHz linear ultrasound probe (Acuson S2000) with participants’ hips and knees flexed to 90° in both the supine and lateral recumbent positions using a single rater protocol. MATLAB Image Processing Toolbox with a customized script was used to obtain mean and maximal thickness, echogenicity and contrast of skin, subcutaneous tissue and muscle. Wilcoxon Signed Rank Test and Bland Altman analysis was used to determine if there were differences between the two image acquisition positions and to construct limits of agreement. Results Thickness and contrast measures were similar in the supine and lateral recumbent positions (p > 0.05). Muscle echogenicity was lower in the supine position (p = 0.04). Conclusion There is agreement in geometric and grey scale measures of tissues over the IT between the supine and lateral recumbent positions with the exception of muscle echogenicity, which was lower in the supine position. Since DTI is thought to originate in the muscle and echogenicity plays in a role in abnormal tissue imaging diagnosis, further studies are recommended to determine the impact of body position on muscle echogenicity prior to being used in prospective studies.

Study design Systematic review. Objectives To review the content and effectiveness of skin care self-management interventions for people with SCI. Setting International. Methods We searched electronic bibliographic databases, trial registers, and relevant reference lists. Eligibility criteria for the reviews of intervention content and effectiveness were identical with the exception of study design. The review of intervention content included non-randomized and randomized controlled trials (RCTs). The review of effectiveness included RCTs. A Behavior Change Technique (BCT) taxonomy of 93 BCTs was used to code intervention content. Intervention effects on outcomes of interest are summarized descriptively. Effect sizes were calculated, and the Cochrane risk of bias tool applied. Results In all, 15 studies testing 17 interventions were included in the review of intervention content. Interventions in these studies included 28 BCTs. The most common were “instructions on how to perform behavior” (16 interventions), “credible source” (12 interventions), and “social support (unspecified)” (9 interventions). Ten RCTs were included in the review of intervention effectiveness and they measured knowledge, self-efficacy, and skills relating to skin care/pressure ulcer (PU) prevention, skin care behaviors, skin status (PU prevalence, severity, and time to PU), and health-care utilization for skin problems. Evidence to support intervention effects on these outcomes was limited, particularly for clinical outcomes. Risk of bias assessments was often inconclusive due to poor reporting. Conclusions There is potential to design SCI skin care interventions that include currently untested BCTs. Further research and better consistency in outcome measurements and reporting are required to synthesize evidence on effectiveness.

Area measurements of a chronic wound are the gold standard outcome measure to determine if a wound is on a healing or nonhealing trajectory. The use of digital planimetry can provide increased accuracy in measuring wound area however it is important to know the reliability and measurement error of these devices when used by multiple assessors. The aim of this study is to determine the within rater, between rater, and standard error of measurement of a digital planimetry device. Wound area in 42 patients was measured weekly for 12 weeks by two different raters, with each rater measuring the wound 10 times per visit. Intraclass correlation coefficients (ICC 1,k) and standard error of measurement were calculated for both within and between raters using 10 and the first three repeated measures to determine if using less measurements was as reliable. The true change in wound area was calculated by dividing stander error of measurements by mean wound areas. Within rater reliability for raters 1 and 2 were 0.995 and 0.992 for 10 measurements, and 0.996 and 0.992 for 3 measurements per time point. Between rater reliability was 0.979 for 10 measurements and 0.996 for 3 measurements per time point. The within rater standard error of measurement for raters 1 and 2 was 0.98 cm

Background Pressure ulcers are a serious, common, lifelong, and costly secondary complication of spinal cord injury (SCI). Community-dwelling people with a SCI can prevent them with appropriate skin care (i.e. pressure relieving activities, skin checks). Adherence to skin care remains suboptimal however, and self-management interventions that focus on improving this have been designed. Little is known on their content, effectiveness, or theoretical basis. The aim of the proposed systematic review is to synthesize the literature on self-management interventions to improve skin care in people with a SCI. Specific objectives are to describe these interventions in relation to their content, effectiveness, theory base, and adherence to reporting guidelines for intervention description. Methods The search strategy will combine an electronic search of nine bibliographic databases (MEDLINE, Embase, PsycInfo, CENTRAL, CINAHL, Rehabdata, CIRRIE, PEDro, ERIC) and two trial registers with a manual search of relevant reference lists. Predefined eligibility criteria will be applied in a two-phase selection process involving title and abstract screening, followed by full-text screening. A data extraction spreadsheet will be applied to included papers. Intervention content will be coded using two taxonomies (behaviour change taxonomy; PRISMS self-management support taxonomy). A validated tool (Theory Coding Scheme) and the Template for Intervention Description and Replication (TIDieR) will be used to examine theoretical basis and assess adherence to reporting guidelines for intervention description. A small number of heterogeneous studies are likely to be included in this review therefore a narrative synthesis is planned. Discussion This systematic review will help identify the gaps and priorities to guide future research activities in this area. Systematic review registration PROSPERO CRD42016033191 Electronic supplementary material The online version of this article (doi:10.1186/s13643-016-0323-4) contains supplementary material, which is available to authorized users.

Sitting-acquired pressure ulcers (SAPUs) are serious secondary complications in individuals with spinal cord injury (SCI). The incidence of pressure ulcers in adults with SCI living in the community is more than 30% per year and up to 80% over a lifetime.1-3 They occur over the bony prominences of the pelvis, and multiple risk factors have been associated with their development and recurrence. One factor that has been associated with a higher rate of recurrence of SAPU is African American race,4 which suggests the possibility of a genetic predisposition to the development of ulceration. Studies on different types of chronic wounds, in particular venous leg ulcers, have found that there is an association between the development of the chronic wound and a number of genetic polymorphisms5-8 (Table 1). One of the polymorphisms has also been associated with impaired healing of chronic venous leg ulcers.9 Most of these polymorphisms are in genes that regulate the expression of different proteins. Table 1. Associations between genetic polymorphisms and venous leg ulcers Genetic polymorphisms are differences in the DNA sequences that occur between individuals, groups, or populations. The variation may occur in the coding region for a protein or may occur in a region that regulates protein expression. Single nucleotide polymorphism (SNP) is a source variance in a genome that is a single base mutation in DNA.10 SNPs are the most simple form and most common source of genetic polymorphism in the human genome (90% of all human DNA polymorphisms). The association of genetic polymorphisms with other types of chronic wounds raises the possibility that the same factors may be associated with the development of SAPUs following SCI. This concept is supported by the clinical observation that some individuals with the similar risk profile develop SAPUs while others are pressure ulcer free, suggesting an inherent predisposition. The association between race and ulcer recurrence after controlling for socioeconomic status strongly suggests a role for genetic factors. The objectives of this work within our research group have been to further examine associations between genetic polymorphisms and venous leg ulcers and more recently to assess associations with SAPUs following SCI.

This study is undertaken to develop a simplified, rapid method to determine both immediate and potential off odors due to 4-vinyl guaiacol and its odorless precursor, ferulic acid, from a single sample preparation and chromatographic analysis. Orange juice sample preparation consists of a simple, C18 solid phase extraction. Utilizing a 5-microns, 25-cm, C18 column, both compounds can be separated within 40 min using a one-step, linear gradient beginning with an aqueous 12% tetrahydrofuran (THF)-5% acetonitrile mixture and ending with 35% aqueous THF. Hesperidin and nariutin have been identified as the compounds that interfered with the ultraviolet (UV) determination of sinapic and caffeic acids. Fluorescence detection with wavelength programming offers optimal sensitivity and selectivity. Recoveries of 4-vinyl guaiacol and ferulic acid range from 90 to 103%. Detection limits are 1 ppm and 5 ppm for ferulic acid and 4-vinyl guaiacol, respectively. Other hydroxycinnamic acids such as coumaric, sinapic, and caffeic acids may also be determined from the same chromatogram.

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During the course of an investigation carried out some years ago by the writer in the Gaspe peninsula of Quebec, it was discovered that adults of Dendroctonus piceaperda Hopk., Polygraphus rufipennis Kby., Ips perturbatus Eichh., and Ips borealis Sw., cut two sets of tunnels the same season and in some cases hibernated and cut tunnels in the following season. Subsequently, a series of detailed studies on the biology of Canadian barkbeetles has been in progress in field laboratories at Fredericton, N. B., Frater, Ont., Vernon, B.C., and Pender Harbour, B. C.

Length 2.5 mm., width 1.1 mm. Pronotum and elytra equal in width, sides straight and parallel, elytra arcuately narrowed on the caudal third, very broadly obtuse behind; dark reddish brown; pubescence sparse, erect and yellow, more evident about the apex of the pronotum and on the elytral declivity.The head has the frons broadly, feebly convex, the median line feebly carinate with a narrow, transverse epistomal impression, the entire surface subopaque from minute reticulations, marked with sparse, coarse, shallow punctures with minute setae on the caudal half, more finely and closely granulatepunctate in front, the punctures bearing long yellow hairs erect on the frons, longer and recumbent from the transverse impression, forming the epistomal fringe, the epistomal margin smooth, narrow and feebly elevated; the eyes with a deep triangular emargination.

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The purpose of this study was to explore the relationships between mechanical power, thrust power, propelling efficiency and sprint performance in elite swimmers. Mechanical power was measured in 12 elite sprint male swimmers: (1) in the laboratory, by using a whole-body swimming ergometer (W'TOT) and (2) in the pool, by measuring full tethered swimming force (FT) and maximal swimming velocity (Vmax): W'T = FT · Vmax. Propelling efficiency (ηP) was estimated based on the “paddle wheel model” at Vmax. Vmax was 2.17 ± 0.06 m · s−1, ηP was 0.39 ± 0.02, W'T was 374 ± 62 W and W'TOT was 941 ± 92 W. Vmax was better related to W'T (useful power output: R = 0.943, P < 0.001) than to W'TOT (total power output: R = 0.744, P < 0.01) and this confirms the use of the full tethered test as a valid test to assess power propulsion in sprinters and to estimate swimming performance. The ratio W'T/W'TOT (0.40 ± 0.04) represents the fraction of total mechanical power that can be utilised in water (e.g., ηP) and was indeed the same as that estimated based on the “paddle wheel model”; this supports the use of this model to estimate ηP in swimming. © 2017 Informa UK Limited, trading as Taylor & Francis Group.