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Coastal Surveillance Through Observation of Ocean Color (COASTℓOOC) oceanographic expeditions were conducted in 1997 and 1998 to examine the relationship between the optical properties of seawater and related biological and chemical properties across the coastal to open-ocean gradient in various European seas. A total of 379 stations were visited along the coasts of the Gulf of Lion in the Mediterranean Sea (n=61), the Adriatic Sea (n=39), the Baltic Sea (n=57), the North Sea (n=99), the English Channel (n=85), and the Atlantic Ocean (n=38). Particular emphasis was placed on the collection of a comprehensive set of apparent and inherent optical properties (AOPs and IOPs) to support the development of ocean color remote-sensing algorithms. The data were collected in situ using traditional ship-based sampling but also from a helicopter, which is a very efficient means for that type of coastal sampling. The dataset collected during the COASTℓOOC campaigns is unique in that it is fully consistent in terms of operators, protocols, and instrumentation. This rich and historical dataset is still today frequently requested and used by other researchers. Therefore, we present the result of an effort to compile and standardize a dataset which will facilitate its reuse in future development and evaluation of new bio-optical models adapted for optically complex waters. The dataset is available at https://doi.org/10.17882/93570 (Massicotte et al., 2023).

Climate warming and related drivers of soil thermal change in the Arctic are expected to modify the distribution and dynamics of carbon contained in perennially frozen grounds. Thawing of permafrost in the Mackenzie River watershed of northwestern Canada, coupled with increases in river discharge and coastal erosion, triggers the release of terrestrial organic matter (OMt) from the largest Arctic drainage basin in North America into the Arctic Ocean. While this process is ongoing and its rate is accelerating, the fate of the newly mobilized organic matter as it transits from the watershed through the delta and into the marine system remains poorly understood. In the framework of the European Horizon 2020 Nunataryuk programme, and as part of the Work Package 4 (WP4) Coastal Waters theme, four field expeditions were conducted in the Mackenzie Delta region and southern Beaufort Sea from April to September 2019. The temporal sampling design allowed the survey of ambient conditions in the coastal waters under full ice cover prior to the spring freshet, during ice breakup in summer, and anterior to the freeze-up period in fall. To capture the fluvial–marine transition zone, and with distinct challenges related to shallow waters and changing seasonal and meteorological conditions, the field sampling was conducted in close partnership with members of the communities of Aklavik, Inuvik and Tuktoyaktuk, using several platforms, namely helicopters, snowmobiles, and small boats. Water column profiles of physical and optical variables were measured in situ, while surface water, groundwater, and sediment samples were collected and preserved for the determination of the composition and sources of OMt, including particulate and dissolved organic carbon (POC and DOC), and colored dissolved organic matter (CDOM), as well as a suite of physical, chemical, and biological variables. Here we present an overview of the standardized datasets, including hydrographic profiles, remote sensing reflectance, temperature and salinity, particle absorption, nutrients, dissolved organic carbon, particulate organic carbon, particulate organic nitrogen, CDOM absorption, fluorescent dissolved organic matter intensity, suspended particulate matter, total particulate carbon, total particulate nitrogen, stable water isotopes, radon in water, bacterial abundance, and a string of phytoplankton pigments including total chlorophyll. Datasets and related metadata can be found in Juhls et al. (2021) (https://doi.org/10.1594/PANGAEA.937587).

The Green Edge project was designed to investigate the onset, life, and fate of a phytoplankton spring bloom (PSB) in the Arctic Ocean. The lengthening of the ice-free period and the warming of seawater, amongst other factors, have induced major changes in Arctic Ocean biology over the last decades. Because the PSB is at the base of the Arctic Ocean food chain, it is crucial to understand how changes in the Arctic environment will affect it. Green Edge was a large multidisciplinary, collaborative project bringing researchers and technicians from 28 different institutions in seven countries together, aiming at understanding these changes and their impacts on the future. The fieldwork for the Green Edge project took place over two years (2015 and 2016) and was carried out from both an ice camp and a research vessel in Baffin Bay, in the Canadian Arctic. This paper describes the sampling strategy and the dataset obtained from the research cruise, which took place aboard the Canadian Coast Guard ship (CCGS) Amundsen in late spring and early summer 2016. The sampling strategy was designed around the repetitive, perpendicular crossing of the marginal ice zone (MIZ), using not only ship-based station discrete sampling but also high-resolution measurements from autonomous platforms (Gliders, BGC-Argo floats …) and under-way monitoring systems. The dataset is available at https://doi.org/10.17882/86417 (Bruyant et al., 2022).

The MALINA oceanographic campaign was conducted during summer 2009 to investigate the carbon stocks and the processes controlling the carbon fluxes in the Mackenzie River estuary and the Beaufort Sea. During the campaign, an extensive suite of physical, chemical and biological variables were measured across seven shelf–basin transects (south–north) to capture the meridional gradient between the estuary and the open ocean. Key variables such as temperature, absolute salinity, radiance, irradiance, nutrient concentrations, chlorophyll a concentration, bacteria, phytoplankton and zooplankton abundance and taxonomy, and carbon stocks and fluxes were routinely measured onboard the Canadian research icebreaker CCGS Amundsen and from a barge in shallow coastal areas or for sampling within broken ice fields. Here, we present the results of a joint effort to compile and standardize the collected data sets that will facilitate their reuse in further studies of the changing Arctic Ocean. The data set is available at https://doi.org/10.17882/75345 (Massicotte et al., 2020).

Study designRetrospective cohort study of prospectively accrued data.ObjectiveTo evaluate a large, prospective, multicentre dataset of surgically treated degenerative cervical myelopathy (DCM) cases on the contemporary risk of C5 palsy with surgical approach.Summary of background dataThe influence of surgical technique on postoperative C5 palsy after decompression for DCM is intensely debated. Comprehensive, covariate-adjusted analyses are needed using contemporary data.MethodsPatients with moderate to severe DCM were prospectively enrolled in the multicenter, randomized, Phase III CSM-Protect clinical trial and underwent either anterior or posterior decompression between Jan 31, 2012 and May 16, 2017. The primary outcome was the incidence of postoperative C5 palsy, defined as the onset of muscle weakness by at least one grade in manual muscle test at the C5 myotome with slight or absent sensory disruption after cervical surgery. Two comparative cohorts were made based on the anterior or posterior surgical approach. Multivariate hierarchical mixed-effects logistic regression was used to estimate odds ratios (OR) with 95% confidence intervals (CI) for C5 palsy.ResultsA total of 283 patients were included, and 53.4% underwent posterior decompression. The total incidence of postoperative C5 palsy was 7.4% and was significantly higher in patients who underwent posterior decompression compared with anterior decompression (11.26% vs. 3.03%, P =0.008). After multivariable regression, the posterior approach was independently associated with greater than four times the likelihood of postoperative C5 palsy ( P =0.017). Rates of C5 palsy recovery were comparable between the two surgical approaches.ConclusionThe odds of postoperative C5 palsy are significantly higher after posterior decompression compared to anterior decompression for DCM. This may influence surgical decision-making when there is equipoise in deciding between anterior and posterior treatment options for DCM.Level of evidenceTherapeutic Level-II.

The North Atlantic current has been suspected to trigger intrusions of temperate marine species in the Arctic. Here, Oziel and colleagues reveal the link between the poleward intrusion of the temperate coccolithophore Emiliania huxleyi and the North Atlantic current, showing evidence for bio-advection as an important mechanism.

The Green Edge initiative was developed to investigate the processes controlling the primary productivity and fate of organic matter produced during the Arctic phytoplankton spring bloom (PSB) and to determine its role in the ecosystem. Two field campaigns were conducted in 2015 and 2016 at an ice camp located on landfast sea ice southeast of Qikiqtarjuaq Island in Baffin Bay (67.4797∘ N, 63.7895∘ W). During both expeditions, a large suite of physical, chemical and biological variables was measured beneath a consolidated sea-ice cover from the surface to the bottom (at 360 m depth) to better understand the factors driving the PSB. Key variables, such as conservative temperature, absolute salinity, radiance, irradiance, nutrient concentrations, chlorophyll a concentration, bacteria, phytoplankton and zooplankton abundance and taxonomy, and carbon stocks and fluxes were routinely measured at the ice camp. Meteorological and snow-relevant variables were also monitored. Here, we present the results of a joint effort to tidy and standardize the collected datasets, which will facilitate their reuse in other Arctic studies. The dataset is available at https://doi.org/10.17882/59892 (Massicotte et al., 2019a).

Dissolved organic carbon (DOC) concentration in the Pearl River estuary (PRE) of China was measured in May, August, and October 2015 and January 2016. Chromophoric and fluorescent dissolved organic matter (CDOM and FDOM) in the latter three seasons were characterized by absorption and fluorescence spectroscopy. CDOM and FDOM exhibited negligible seasonal variations, while DOC displayed a significant seasonality, with the average concentration being highest in May (156 µmol L−1), lowest in November (87 µmol L−1), and comparable between January (118 µmol L−1) and August (112 µmol L−1). Although DOC, CDOM, and FDOM in surface water were generally higher than in bottom water, the difference between the two layers was statistically insignificant. DOC showed little cross-estuary variations in all seasons, while CDOM and FDOM in January were higher on the west side of the estuary than on the east side. All three variables showed rapid drawdowns in the head region of the estuary (salinity ); their dynamics in the main estuary were primarily controlled by conservative mixing, leading to linearly declining or relatively constant (for DOC in May and November only) contents with increasing salinity. The decrease in FDOM with salinity was 5 %–35 % faster than that of CDOM, which in turn was 2–3 times quicker than that of DOC. Salinity and CDOM absorption coefficients could serve as indicators of DOC in August and January. Freshwater endmembers in all seasons mainly contained fresh, protein-rich DOM of microbial origin, a large part of it likely being pollution-derived. Protein-like materials were preferentially consumed in the head region but the dominance of the protein signature was maintained throughout the estuary. Exports of DOC and CDOM (in terms of the absorption coefficient at 330 nm) into the South China Sea were estimated as 195×109 g and 266×109 m2 for the PRE and 362×109 g and 493×109 m2 for the entire Pearl River Delta. The PRE presents the lowest concentrations and export fluxes of DOC and CDOM among the world's major estuaries. DOM delivered from the PRE is, however, protein-rich and thus may enhance heterotrophs in the adjacent coastal waters. Overall, the PRE manifests lower abundance and smaller spatiotemporal variability of DOM than expected for a sizable estuary with a marked seasonality of river runoff due supposedly to the poorly forested watershed of the Pearl River, the rapid degradation of the pollution-derived DOM in the upper reach, and the short residence time of freshwater.

Despite the increasing understanding about differences in carbon cycling between temperate and tropical freshwater systems, our knowledge on the importance of organic matter (OM) pools on light absorption properties in tropical lakes is very scarce. We performed a factorial mesocosm experiment in a tropical lake (Minas Gerais, Brazil) to evaluate the effects of increased concentrations of allochthonous and autochthonous OM, and differences in light availability on the light absorption characteristics of chromophoric dissolved organic matter (CDOM). Autochthonous OM deriving from phytoplankton ( ∼ Chl a) was stimulated by addition of nutrients, while OM from degradation of terrestrial leaves increased allochthonous OM, and neutral shading was used to manipulate light availability. Effects of the additions and shading on DOC, Chl a, nutrients, total suspended solid concentrations (TSM) and spectral CDOM absorption were monitored every 3 days. CDOM quality was characterized by spectral indices (S250–450, S275–295, S350–450, SR and SUVA254). Effects of carbon sources and shading on the spectral CDOM absorption was investigated through principal component (PCA) and redundancy (RDA) analyses. The two different OM sources affected CDOM quality very differently and shading had minor effects on OM levels, but significant effects on OM quality, especially in combination with nutrient additions. Spectral indices (S250–450 and SR) were mostly affected by allochthonous OM addition. The PCA showed that enrichment by allochthonous carbon had a strong effect on the CDOM spectra in the range between 300 and 400 nm, while the increase in autochthonous carbon increased absorption at wavelengths below 350 nm. Our study shows that small inputs of allochthonous OM can have large effects on the spectral light absorption compared to large production of autochthonous OM, with important implications for carbon cycling in tropical lakes.

Groundwater-borne contaminants such as nutrients, dissolved organic carbon (DOC), coloured dissolved organic matter (CDOM) and pesticides can have an impact the biological quality of lakes. The sources of pollutants can, however, be difficult to identify due to high heterogeneity in groundwater flow patterns. This study presents a novel approach for fast hydrological surveys of small groundwater-fed lakes using multiple groundwater-borne tracers. Water samples were collected from the lake and temporary groundwater wells, installed every 50 m within a distance of 5–45 m to the shore, were analysed for tracer concentrations of CDOM, DOC, total dissolved nitrogen (TDN, groundwater only), total nitrogen (TN, lake only), total dissolved phosphorus (TDP, groundwater only), total phosphorus (TP, lake only), δ18O ∕ δ16O isotope ratios and fluorescent dissolved organic matter (FDOM) components derived from parallel factor analysis (PARAFAC). The isolation of groundwater recharge areas was based on δ18O measurements and areas with a high groundwater recharge rate were identified using a microbially influenced FDOM component. Groundwater discharge sites and the fractions of water delivered from the individual sites were isolated with the Community Assembly via Trait Selection model (CATS). The CATS model utilized tracer measurements of TDP, TDN, DOC and CDOM from the groundwater samples and related these to the tracer measurements of TN, TP, DOC and CDOM in the lake. A direct comparison between the lake and the inflowing groundwater was possible as degradation rates of the tracers in the lake were taken into account and related to a range of water retention times (WRTs) of the lake (0.25–3.5 years in 0.25-year increments). These estimations showed that WRTs above 2 years required a higher tracer concentration of inflowing water than found in any of the groundwater wells around the lake. From the estimations of inflowing tracer concentration, the CATS model isolated groundwater discharge sites located mainly in the eastern part of the lake with a single site in the southern part. Observations from the eastern part of the lake revealed an impermeable clay layer that promotes discharge during heavy precipitation events, which would otherwise be difficult to identify using traditional hydrological methods. In comparison to the lake concentrations, high tracer concentrations in the southern part showed that only a smaller fraction of water could originate from this area, thereby confirming the model results. A Euclidean cluster analysis of δ18O isotopes identified recharge sites corresponding to areas adjacent to drainage channels, and a cluster analysis of the microbially influenced FDOM component C4 further identified five sites that showed a tendency towards high groundwater recharge rate. In conclusion, it was found that this methodology can be applied to smaller lakes within a short time frame, providing useful information regarding the WRT of the lake and more importantly the groundwater recharge and discharge sites around the lake. Thus, it is a tool for specific management of the catchment.

Arctic sea ice is experiencing a shorter growth season and an earlier ice melt onset. The significance of spring microalgal blooms taking place prior to sea ice breakup is the subject of ongoing scientific debate. During the Green Edge project, unique time-series data were collected during two field campaigns held in spring 2015 and 2016, which documented for the first time the concomitant temporal evolution of the sea ice algal and phytoplankton blooms in and beneath the landfast sea ice in western Baffin Bay. Sea ice algal and phytoplankton blooms were negatively correlated and respectively reached 26 (6) and 152 (182) mg of chlorophyll 'a' per m2 in 2015 (2016). Here, we describe and compare the seasonal evolutions of a wide variety of physical forcings, particularly key components of the atmosphere–snow–ice–ocean system, that influenced microalgal growth during both years. Ice algal growth was observed under low-light conditions before the snow melt period and was much higher in 2015 due to less snowfall. By increasing light availability and water column stratification, the snow melt onset marked the initiation of the phytoplankton bloom and, concomitantly, the termination of the ice algal bloom. This study therefore underlines the major role of snow on the seasonal dynamics of microalgae in western Baffin Bay. The under-ice water column was dominated by Arctic Waters. Just before the sea ice broke up, phytoplankton had consumed most of the nutrients in the surface layer. A subsurface chlorophyll maximum appeared and deepened, favored by spring tide-induced mixing, reaching the best compromise between light and nutrient availability. This deepening evidenced the importance of upper ocean tidal dynamics for shaping vertical development of the under-ice phytoplankton bloom, a major biological event along the western coast of Baffin Bay, which reached similar magnitude to the offshore ice-edge bloom.

The processing of terrestrially derived dissolved organic matter (DOM) during downstream transport in fluvial networks is poorly understood. Here, we report a dataset of dissolved organic carbon (DOC) concentrations and DOM composition (stable carbon isotope ratios, absorption and fluorescence properties) acquired along a 1700 km transect in the middle reach of the Congo River basin. Samples were collected in the mainstem and its tributaries during high-water (HW) and falling-water (FW) periods. DOC concentrations and DOM composition along the mainstem were found to differ between the two periods because of a reduced lateral mixing between the central water masses of the Congo River and DOM-rich waters from tributaries and also likely because of a greater photodegradation during FW as water residence time (WRT) increased. Although the Cuvette Centrale wetland (one of the world's largest flooded forests) continuously releases highly aromatic DOM in streams and rivers of the Congo Basin, the downstream transport of DOM was found to result in an along-stream gradient from aromatic to aliphatic compounds. The characterization of DOM through parallel factor analysis (PARAFAC) suggests that this transition results from (1) the losses of aromatic compounds by photodegradation and (2) the production of aliphatic compounds by biological reworking of terrestrial DOM. Finally, this study highlights the critical importance of the river–floodplain connectivity in tropical rivers in controlling DOM biogeochemistry at a large spatial scale and suggests that the degree of DOM processing during downstream transport is a function of landscape characteristics and WRT.

Large rivers transport considerable amounts of terrestrial dissolved organic matter (DOM) to the ocean. However, downstream gradients and temporal variability in DOM fluxes and characteristics are poorly studied at the scale of large river basins, especially in tropical areas. Here, we report longitudinal patterns in DOM content and composition based on absorbance and fluorescence measurements along the Zambezi River and its main tributary, the Kafue River, during two hydrological seasons. During high-flow periods, a greater proportion of aromatic and humic DOM was mobilized along rivers due to the hydrological connectivity with wetlands, while low-flow periods were characterized by lower DOM content of less aromaticity resulting from loss of connectivity with wetlands, more efficient degradation of terrestrial DOM and enhanced autochthonous productivity. Changes in water residence time due to contrasting water discharge were found to modulate the fate of DOM along the river continuum. Thus, high water discharge promotes the transport of terrestrial DOM downstream relative to its degradation, while low water discharge enhances the degradation of DOM during its transport. The longitudinal evolution of DOM was also strongly impacted by a hydrological buffering effect in large reservoirs in which the seasonal variability of DOM fluxes and composition was strongly reduced.<

Abstract This study aimed to progress the understanding of idiopathic hypersomnia (IH) by assessing the moderating influence of individual characteristics, such as age, sex, and body mass index (BMI) on sleep architecture. In this retrospective study, 76 IH participants (38.1 ± 11.3 years; 40 women) underwent a clinical interview, an in-laboratory polysomnography with a maximal 9-h time in bed and a multiple sleep latency test (MSLT). They were compared to 106 healthy controls (38.1 ± 14.1 years; 60 women). Multiple regressions were used to assess moderating influence of age, sex, and BMI on sleep variables. We used correlations to assess whether sleep variables were associated with Epworth Sleepiness Scale scores and mean sleep onset latency on the MSLT in IH participants. Compared to controls, IH participants had shorter sleep latency (p = 0.002), longer total sleep time (p

Most follicular cell-derived differentiated thyroid carcinomas are regarded as low-risk neoplasms prompting conservative therapeutic management. Here, we provide consensus recommendations reached by a multidisciplinary group of endocrinologists, medical oncologists, pathologists, radiation oncology specialists, a surgeon and a medication reimbursement specialist, addressing more challenging forms of this malignancy, focused on radioactive iodine (RAI)-resistant or -refractory differentiated thyroid carcinoma (RAIRTC). In this document we highlight clinical, radiographic, and molecular features providing the basis for these management plans. We distinguish differentiated thyroid cancers associated with more aggressive behavior from thyroid cancers manifesting as poorly differentiated and/or anaplastic carcinomas. Treatment algorithms based on risk-benefit assessments of different multimodal therapy approaches are also discussed. Given the scarcity of data supporting management of this rare yet aggressive disease entity, these consensus recommendations provide much needed guidance for multidisciplinary teams to optimally manage RAIRTC.

Rationale & Objective: Research in anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) has focused on reducing treatment toxicities, notably through reduction of exposure to glucocorticoids. Glucocorticoid-sparing therapies such as avacopan are not widely available in many countries, and patients are exposed to high glucocorticoid doses. There is little data concerning what clinicians should accept as the lowest glucocorticoid dosing that can be used in induction therapy for AAV. Study Design: International, online survey. Setting & Participants: Clinicians in various countries with experience in managing vasculitis. Exposure and Outcomes: Survey questions to gauge interest and preferences in studying an induction of remission regimen for severe AAV using only 2 or 4 weeks of glucocorticoids without avacopan. Data collected included general opinions about standard of care for induction agents, glucocorticoids, and avacopan. Respondents were presented with 3 candidate trial designs, 2 of which proposed a combination of cyclophosphamide and rituximab induction. Analytical Approach: Using a 10-point Likert scale, respondents ranked each candidate trial on its usefulness in demonstrating whether a minimal glucocorticoid regimen would be safe and effective and their willingness to randomize into the trial. Results: There were 210 respondents to the survey. The candidate trials were rated moderate-to-high for usefulness to demonstrate safety and efficacy (scores 6-7/10), and moderate (scores 5-6/10) for willingness to randomize. Four-week glucocorticoid duration was preferred to 2 weeks, and combination cyclophosphamide-rituximab with 4-week glucocorticoids was the most preferred design. Forty-two percent of respondents felt avacopan had to be incorporated into a minimal GC trial design to want to recruit patients. Limitations: Representativeness of survey sample and generalizability of findings. Conclusions: Combination cyclophosphamide-rituximab may be the ideal way of studying minimal glucocorticoid use in severe AAV. Given its increasing uptake, incorporating avacopan into a potential trial design is important. Plain Language Summary: Research in anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) has focused on using less glucocorticoids to limit side effects. New drugs that drastically limit glucocorticoid use are not available in many countries. Studies are needed to find other ways of reducing glucocorticoid exposure to treat AAV, but it is unclear how best to achieve this. We administered a survey to doctors with experience in treating AAV and had them grade different combinations of widely available treatments with 2 or 4 weeks of glucocorticoids. We found that a combination of 2 doses cyclophosphamide with 2 doses rituximab and 4 weeks of glucocorticoids was the preferred treatment. The results will guide the development of a trial studying minimal use of glucocorticoids for the treatment of AAV.

Background: In patients with anterior ST-elevation myocardial infarction (STEMI) and new-onset antero-apical wall motion abnormalities (WMAs), whether the rate of prophylaxis against left ventricular thrombus and outcomes differ between men and women is unknown. Methods: A multicentre retrospective cohort study of patients with STEMI and new-onset antero-apical WMAs treated with primary percutaneous coronary intervention was conducted. Patients with an established indication of oral anticoagulation (OAC) were excluded. The rates of triple therapy (double antiplatelet therapy + OAC) at discharge were compared for women vs men. The rates of net adverse clinical events, a composite of mortality, myocardial infarction, stroke or transient ischemic attack, systemic thromboembolism or Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding at 6 months were compared across sex using a multivariate logistic regression model. Results: A total of 1664 patients were included in the primary analysis, of whom 402 (24.2%) were women and 1262 (75.8%) were men. A total of 138 women (34.3%) and 489 men (38.7%) received a triple therapy prescription at discharge (P = 0.11). At 6 months, 33 women (8.2%) and 96 men (7.6%) experienced a net adverse clinical event (adjusted odds ratio 0.82; 95% confidence interval 0.49-1.37). No difference occurred in the risk of bleeding events and ischemic events between men and women, when these were analyzed separately. Conclusions: The rates of OAC prescription for left ventricular thrombus prophylaxis and clinical outcomes at 6 months were similar in women and men following anterior STEMI with new-onset antero-apical WMAs. Résumé: Contexte: On ignore si le taux de prophylaxie contre le thrombus ventriculaire gauche et les résultats thérapeutiques diffèrent entre les hommes et les femmes qui ont subi un infarctus du myocarde avec élévation du segment ST (STEMI) antérieur et ont des anomalies du mouvement pariétal (AMP) antéroapical d’apparition récente. Méthodes: Nous avons mené une étude de cohorte rétrospective multicentrique auprès de patients qui ont subi un STEMI et ont des AMP d’apparition récente traitées par une intervention coronarienne percutanée primaire. Nous avons exclu les patients chez lesquels il existait une indication établie à l’anticoagulation orale (ACO). Nous avons comparé les taux de trithérapie (bithérapie antiplaquettaire + ACO) à la sortie de l’hôpital entre les femmes et les hommes. Nous avons comparé les taux d’événements indésirables cliniques nets, le critère composite de mortalité, d’infarctus du myocarde, d’accident vasculaire cérébral ou d’accident ischémique transitoire, la thromboembolie systémique ou l’hémorragie de type 3 ou 5 selon le Bleeding Academic Research Consortium (BARC) après 6 mois entre les sexes au moyen du modèle de régression logistique multivariée. Résultats: Au sein des 1 664 patients de l’analyse principale, 402 (24,2 %) étaient des femmes et 1262 (75,8 %) étaient des hommes. Un total de 138 femmes (34,3 %) et de 489 hommes (38,7 %) ont reçu une ordonnance de trithérapie à la sortie de l’hôpital (P = 0,11). Après 6 mois, 33 femmes (8,2 %) et 96 hommes (7,6 %) ont subi un événement indésirable net (rapport de cotes ajusté 0,82 ; intervalle de confiance à 95 % 0,49-1,37). Aucune différence n’a été notée dans le risque d’événements hémorragiques et d’événements ischémiques entre les hommes et les femmes lorsque ces événements étaient analysés séparément. Conclusions: Les taux d’ordonnances d’ACO en prophylaxie du thrombus ventriculaire gauche et les résultats cliniques après 6 mois étaient similaires entre les femmes et les hommes à la suite du STEMI antérieur et des AMP antéroapicale d’apparition récente.

Many sexuality educators in the United States have noted that current sex education models do not meet the needs of an increasingly diverse student body, and they have begun advocating for anti-racist sex education. Many sexuality instructors, however, work in public schools that require the use of prevention-focused, evidence-based sexuality curricula. This article explores the unique challenges for sexuality instructors in incorporating anti-racist content into the public school classroom. It outlines the intersections of racism and sexuality to manifest the need for anti-racist sex education and offers five strategies for sexuality instructors wishing to incorporate anti-racist frameworks into the evidence-based sex education classroom.

À ce jour, on a surtout étudié la contre-culture d’un point de vue occidentalocentriste et colonialiste, et ce sans reconnaître l’appropriation culturelle qui la caractérise pourtant, qu’il s’agisse des nombreux emprunts superficiels aux spiritualités orientales (Roszak 1995 [1969]) ou encore de l’adoption artificielle de modes de vie autochtones, que l’on a qualifiée, à tort, de « retour à la nature » (Deloria 2013). La contre-culture, dans sa signification véritable de remise en question des structures oppressives de la vie (le Blanc 2014), est intrinsèquement liée aux prises de parole autochtones des années 1970 et 1980. Pour Emma LaRocque (Crie/Métisse), puisque les littératures autochtones, en tant que forme d’expression collective, n’étaient pas possibles avant les années 1970 (2010 : 19), les écritures autochtones seraient l’histoire d’une contestation stratégique (2010 : 24). Plus encore, la littérature contestataire serait le canon des littératures autochtones (LaRocque 2010 : 25). C’est la dévalorisation colonialiste des cultures autochtones qui a généré une réponse contre-culturelle, un contre-discours autochtone qui, porté par la colère et la polémique, invite à une révision de plusieurs sources de savoir eurocentrées (LaRocque 2010 : 70 et 108). Avec cette contribution, j’espère parvenir à déconstruire la contre-culture settler et à esquisser les contours de ce que sont les contre-cultures littéraires autochtones.

The field of interior home design has witnessed a growing utilization of machine learning. However, the subjective nature of aesthetics poses a significant challenge due to its variability among individuals and cultures. This paper proposes an applied machine learning method to enhance manufactured custom doors in a proper and aesthetic home design environment. Since there are millions of possible custom door models based on door types, wood species, dyeing, paint, and glass types, it is impossible to foresee a home design model fitting every custom door. To generate the classification data, a home design expert has to label thousands of door/home design combinations with the different colors and shades utilized in home designs. These data train a random forest classifier in a supervised learning context. The classifier predicts a home design according to a particular custom door. This method is applied in the following context: A web page displays a choice of doors to a customer. The customer selects the desired door properties, which are sent to a server that returns an aesthetic home design model for this door. This door configuration generates a series of images through the Unity 3D engine module, which are returned to the web client. The customer finally visualizes their door in an aesthetic home design context. The results show the random forest classifier’s good performance, with an accuracy level of 86.8%, in predicting suitable home design, marking the way for future developments requiring subjective evaluations. The results are also explained using a feature importance graphic, a decision tree, a confusion matrix, and text.

Chlorophyll a concentration (Chl) is a key variable for estimating primary production (PP) through ocean-color remote sensing (OCRS). Accurate Chl estimates are crucial for better understanding of the spatio-temporal trends in PP in recent decades as a consequence of climate change. However, a number of studies have reported that currently operational chlorophyll a algorithms perform poorly in the Arctic Ocean (AO), largely due to the interference of colored and detrital material (CDM) with the phytoplankton signal in the visible part of the spectrum. To determine how and to what extent CDM biases the estimation of Chl, we evaluated the performances of eight currently available ocean-color algorithms: OC4v6, OC3Mv6, OC3V, OC4L, OC4P, AO.emp, GSM01 and AO.GSM. Our results suggest that the empirical AO.emp algorithm performs the best overall, but, for waters with high CDM acdm(443) > 0.067 m−1), a common scenario in the Arctic, the two semi-analytical GSM models yield better performance. In addition, sensitivity analyses using a spectrally and vertically resolved Arctic primary-production model show that errors in Chl mostly propagate proportionally to PP estimates, with amplification of up to 7%. We also demonstrate that, the higher level of CDM in relation to Chl in the water column, the larger the bias in both Chl and PP estimates. Lastly, although the AO.GSM is the best overall performer among the algorithms tested, it tends to fail for a significant number of pixels (16.2% according to the present study), particularly for waters with high CDM. Our results therefore suggest the ongoing need to develop an algorithm that provides reasonable Chl estimates for a wide range of optically complex Arctic waters.

It is challenging to discriminate the early presentation of Degenerative Cervical Myelopathy (DCM) as well as sensitively and accurately distinguishing between mild, moderate, and severe levels of impairment. As gait dysfunction is one of the cardinal symptoms of DCM, we hypothesized that spatiotemporal gait parameters, including the enhanced gait variability index (eGVI), could be used to sensitively discriminate between different severities of DCM. A total of 153 patients recently diagnosed with DCM were recruited and stratified on the basis of DCM severity grades, as measured using the modified Japanese Orthopedic Association (mJOA) scale. Demographic information and neurological status were collected. Gait assessments were performed using an 8 m walkway. Spearman rank correlation was used to identify relationships between gait parameters and mJOA values as well as the mJOA lower extremity (LE) subscore. Kruskal-Wallis H test was performed to evaluate differences between severity groups, as defined by mJOA classification. A significant and relatively strong correlation was found between the mJOA score and eGVI, as well as between the LE subscore of the mJOA and eGVI. Significant differences in the eGVI (X2(2, N = 153) = 55.04, p < 0.0001, ε2 = 0.36) were found between all groups of DCM severity, with a significant increase in the eGVI as DCM progressed from mild to moderate. The eGVI was the most discriminative gait parameter, which facilitated objective differentiation between varying severities of DCM. Quantitative gait assessments show promise as an accurate and objective tool to diagnose and classify DCM, as well as to potentially evaluate the impact of therapeutic interventions.

BackgroundDegenerative cervical myelopathy (DCM) involves spinal cord compression, which causes neurological decline. Neurological impairment in DCM is variable and can involve complex upper limb dysfunction including loss of manual dexterity, hyperreflexia, focal weakness, and sensory impairment. The modified Japanese Orthopaedic Association (mJOA) score relies on the patients' subjective perceptions, whereas existing objective measures such as strength and sensory testing do not capture subtle changes in dexterity and function.Objective1) To characterize arm and hand function in DCM; and 2) To develop and validate Graded Redefined Assessment of Strength, Sensibility, and Prehension Version-Myelopathy (GRASSP-M), a clinical assessment that quantifies upper limb impairment.MethodsA total of 148 DCM patients (categorized into mild, moderate, and severe based on mJOA grade) and 21 healthy subjects were enrolled. A complete neurological exam, the mJOA, the QuickDASH, grip dynamometry, and the GRASSP-M were administered.ResultsStrength, sensation, and manual dexterity significantly declined with increasing DCM severity (P ≤ .05). Impairment in hand dexterity showed better discrimination between mild, moderate, and severe DCM categories than strength or sensation. The GRASSP-M was found to be both a reliable (intraclass correlation coefficient >0.75 for intra- and inter-rater reliability) and valid (with both concurrent and construct validity) tool.ConclusionThese results demonstrate that patients' subjective reporting of functional status, especially in the mild DCM category, may underrepresent the extent of functional impairment. The GRASSP-M is an objective tool designed to characterize patients' functional impairment related to the upper limb, which proves useful to diagnose and quantify mild dysfunction, monitor patients for deterioration, and help determine when patients should be treated surgically.

In this paper, we demonstrate how machine learning could be used to quickly assess a student's multimodal representational thinking. Multimodal representational thinking is the complex construct that encodes how students form conceptual, perceptual, graphical, or mathematical symbols in their mind. The augmented reality (AR) technology is adopted to diversify student's representations. The AR technology utilized a low-cost, high-resolution thermal camera attached to a smartphone which allows students to explore the unseen world of thermodynamics. Ninth-grade students (N = 314) engaged in a prediction-observation-explanation (POE) inquiry cycle scaffolded to leverage the augmented observation provided by the aforementioned device. The objective is to investigate how machine learning could expedite the automated assessment of multimodal representational thinking of heat energy. Two automated text classification methods were adopted to decode different mental representations students used to explain their haptic perception, thermal imaging, and graph data collected in the lab. Since current automated assessment in science education rarely considers multilabel classification, we resorted to the help of the state-of-the-art deep learning technique-bidirectional encoder representations from transformers (BERT). The BERT model classified open-ended responses into appropriate categories with higher precision than the traditional machine learning method. The satisfactory accuracy of deep learning in assigning multiple labels is revolutionary in processing qualitative data. The complex student construct, such as multimodal representational thinking, is rarely mutually exclusive. The study avails a convenient technique to analyze qualitative data that does not satisfy the mutual-exclusiveness assumption. Implications and future studies are discussed.