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From the action potentials of neurons and cardiac cells to the amplification of calcium signals in oocytes, excitability is a hallmark of many biological signalling processes. In recent years, excitability in single cells has been related to multiple-timescale dynamics through canards, special solutions which determine the effective thresholds of the all-or-none responses. However, the emergence of excitability in large populations remains an open problem. Here, we show that the mechanism of excitability in large networks and mean-field descriptions of coupled quadratic integrate-and-fire (QIF) cells mirrors that of the individual components. We initially exploit the Ott-Antonsen ansatz to derive low-dimensional dynamics for the coupled network and use it to describe the structure of canards via slow periodic forcing. We demonstrate that the thresholds for onset and offset of population firing can be found in the same way as those of the single cell. We combine theoretical analysis and numerical computations to develop a novel and comprehensive framework for excitability in large populations, applicable not only to models amenable to Ott-Antonsen reduction, but also to networks without a closed-form mean-field limit, in particular sparse networks.

BackgroundThe COVID-19 pandemic has generated an infodemic, an overabundance of online and offline information. In this context, accurate information as well as misinformation and disinformation about the links between nutrition and COVID-19 have circulated on Twitter since the onset of the pandemic. ObjectiveThe purpose of this study was to compare tweets on nutrition in times of COVID-19 published by 2 groups, namely, a preidentified group of dietitians and a group of general users of Twitter, in terms of themes, content accuracy, use of behavior change factors, and user engagement, in order to contrast their information sharing behaviors during the pandemic. MethodsPublic English-language tweets published between December 31, 2019, and December 31, 2020, by 625 dietitians from Canada and the United States, and Twitter users were collected using hashtags and keywords related to nutrition and COVID-19. After filtration, tweets were coded against an original codebook of themes and the Theoretical Domains Framework (TDF) for identifying behavior change factors, and were compared to reliable nutritional recommendations pertaining to COVID-19. The numbers of likes, replies, and retweets per tweet were also collected to determine user engagement. ResultsIn total, 2886 tweets (dietitians, n=1417; public, n=1469) were included in the analyses. Differences in frequency between groups were found in 11 out of 15 themes. Grocery (271/1417, 19.1%), and diets and dietary patterns (n=507, 34.5%) were the most frequently addressed themes by dietitians and the public, respectively. For 9 out of 14 TDF domains, there were differences in the frequency of usage between groups. “Skills” was the most used domain by both groups, although they used it in different proportions (dietitians: 612/1417, 43.2% vs public: 529/1469, 36.0%; P

Acne-prone skin is associated with dysbiosis involving Cutibacterium acnes (C. acnes) and Staphylococcus epidermidis (S. epidermidis) causing increased seborrhea in sebaceous glands (SG) and inflammation. Human primary sebocytes were cultivated using 1.106 UFC/mL C. acnes Type IA (facial acne, ATCC6919) and/or 1.105 UFC/mL S. epidermidis (unknown origin, ATCC12228) for 48 h in our SEB4GLN-optimized media without antibiotics. Bacteria and sebocytes were enumerated and assessed to determine their viability. Lipid production was imaged and quantified via Nile Red staining. SG with hair follicles were microdissected from healthy skin and cultured using 1.105 UFC/mL C. acnes Type 1A and/or 1.104 UFC/mL S. epidermidis (wild-type facial skin strain) through prior fixation and immunostaining for MC5R, C. acnes and nuclei (DAPI) via Z-stack confocal microscopy bioimaging (Leica SP5X & FIJI software, Version 2.9.0). C. acnes growth was not impacted when co-cultivated with sebocytes (2D) or SG (3D) models. Phylotype IA stimulated sebocyte lipid production, which had no impact on viability. The S. epidermidis reference strain overproliferated, inducing sebocyte mortality. For 3D SG model, culture conditions were optimized using a wild-type facial skin strain at a lower concentration, 1:10 ratio to C. acnes, reduced contact time, sequential inoculation and rinsing step. Bioimaging revealed strong C. acnes labeling in the active areas of the pilosebaceous unit. S. epidermidis formed biofilm, which was distributed across the SG via non-specific fluorescence imaging. We developed an innovative model of a sebaceous gland that mimics acne-prone skin with lipid overproduction and virulent phylotype IA C. acnes inoculation.

The genus Ceutorhynchus Germar (Coleoptera: Curculionidae) is composed of canola pests, natural enemies of Brassicaceae, and other species associated with non-crop and non-weed plants. This study aimed to establish trophic associations of Ceutorhynchus with their host plants and with their parasitoids in the agricultural landscape, in order to assess the actual beneficial or noxious ecological roles of the insects. Trophic associations were established by identifying Ceutorhynchus species and their parasitoids emerging from collected Brassicaceae plants in areas adjacent to canola fields and other crops in 2019 and 2020. Five Ceutorhynchus species were collected and identified as hosts of parasitoids in the families Pteromalidae and Eulophidae. Two functional groups were characterized: natural enemies of weeds and agricultural pests. The exotic wormseed wallflower, Erysimum cheiranthoides was identified as a new host plant of the invasive canola pest Ceutorhynchus obstrictus (Marsham), and the native tower rockcress, Arabis glabra, as a new host plant of the native Ceutorhynchus neglectus Blatchley. Association between the exotic Ceutorhynchus typhae (Herbst) and a parasitoid of the genus Elachertodomyia is reported for the first time. Finally, Ceutorhynchus neglectus and C. typhae hosted the exotic parasitoid Trichomalus perfectus, an important natural enemy of C. obstrictus.

Abstract Background Alzheimer’s disease (AD) is the most common neurodegenerative disease ultimately manifesting as clinical dementia. Despite considerable effort and ample experimental data, the role of neuroinflammation related to systemic inflammation is still unsettled. While the implication of microglia is well recognized, the exact contribution of peripheral monocytes/macrophages is still largely unknown, especially concerning their role in the various stages of AD. Objectives AD develops over decades and its clinical manifestation is preceded by subjective memory complaints (SMC) and mild cognitive impairment (MCI); thus, the question arises how the peripheral innate immune response changes with the progression of the disease. Therefore, to further investigate the roles of monocytes/macrophages in the progression of AD we assessed their phenotypes and functions in patients at SMC, MCI and AD stages and compared them with cognitively healthy controls. We also conceptualised an idealised mathematical model to explain the functionality of monocytes/macrophages along the progression of the disease. Results We show that there are distinct phenotypic and functional changes in monocyte and macrophage populations as the disease progresses. Higher free radical production upon stimulation could already be observed for the monocytes of SMC patients. The most striking results show that activation of peripheral monocytes (hyperactivation) is the strongest in the MCI group, at the prodromal stage of the disease. Monocytes exhibit significantly increased chemotaxis, free radical production, and cytokine production in response to TLR2 and TLR4 stimulation. Conclusion Our data suggest that the peripheral innate immune system is activated during the progression from SMC through MCI to AD, with the highest levels of activation being in MCI subjects and the lowest in AD patients. Some of these parameters may be used as biomarkers, but more holistic immune studies are needed to find the best period of the disease for clinical intervention.

A subcritical pattern-forming system with nonlinear advection in a bounded domain is recast as a slow-fast system in space and studied using a combination of geometric singular perturbation theory and numerical continuation. Two types of solutions describing the possible location of stationary fronts are identified, whose origin is traced to the onset of convective and absolute instability when the system is unbounded. The former are present only for non-zero upstream boundary conditions and provide a quantitative understanding of noise-sustained structures in systems of this type. The latter correspond to the onset of a global mode and are present even with zero upstream boundary conditions. The role of canard trajectories in the nonlinear transition between these states is clarified and the stability properties of the resulting spatial structures are determined. Front location in the convective regime is highly sensitive to the upstream boundary condition, and its dependence on this boundary condition is studied using a combination of numerical continuation and Monte Carlo simulations of the partial differential equation. Statistical properties of the system subjected to random or stochastic boundary conditions at the inlet are interpreted using the deterministic slow-fast spatial dynamical system.

Servers’ field energy use remains poorly understood, given heterogeneous computing loads, configurable hardware and software, and operation over a wide range of management practices. This paper explores various characteristics of 1- and 2-socket volume servers that affect energy consumption, and quantifies the difference in power demand between higher-performing SPEC and ENERGY STAR servers and our best understanding of a typical server operating today. We first establish general characteristics of the U.S. installed base of volume servers from existing IDC data and the literature, before presenting information on server hardware configurations from data collection events at a major online retail website. We then compare cumulative distribution functions of server idle power across three separate datasets and explain the differences between them via examination of the hardware characteristics to which power draw is mostsensitive. We find that idle server power demand is significantly higher than ENERGY STAR benchmarks and the industry-released energy use documented in SPEC, and that SPEC server configurations—and likely theassociated power-scaling trends—are atypical of volume servers. Next, we examine recent trends in server power draw among high-performing servers across their full load range to consider how representative these trends are of all volume servers before inputting weighted average idle power load values into a recently published model of national server energy use. Finally, we present results from two surveys of IT managers (n=216) and IT vendors (n=178) that illustrate the prevalence of more-efficient equipment and operational practices in server rooms and closets; these findings highlight opportunities to improve the energy efficiency of the U.S. server stock.

Large data centers are well known for their high-energy intensity and have made dramatic efficiency improvements over the past decade. Small closet and room data centers have received much less attention, yet constitute a significant fraction of the total number of servers in the United States. The often makeshift, ad hoc nature of small data centers often results in little attention paid to energy efficiency and inadequate cooling equipment. The small physical footprint of these data centers, typically embedded within a larger building, makes it difficult to identify and target for efficiency measures. These conditions make small data centers notoriously inefficient relative to their larger counterparts. In this report, we present an analysis of small and midsize data centers in the US, drawing from surveys of commercial building stock. We find that servers in small data centers make up approximately 40% of installed server stock, with the vast majority of sites utilizing only 1-2 servers. We identify industries where small data centers are most prevalent, finding that the highest saturations are in medical, retail, office, and education sectors. Small data centers typically lack dedicated cooling equipment, often relying on building air conditioning and ventilation equipment for cooling. We further find that the type of cooling equipment used is highly correlated with the number of operational server racks, with less efficient cooling options used with fewer racks. We develop geospatial maps of small and midsize data centers to visually identify regions of high server concentration and calculate associated CO2 emissions. Small data centers consume 13 billion kWh of energy annually, emitting 7 million metric tons (MMT) of carbon dioxide–the equivalent emissions of approximately 2.3 coal-fired plants. We discuss efficiency measures that could be implemented and estimate potential energy and CO2 savings.

Tamas Fulop,1 Shreyansh Tripathi,2,3 Serafim Rodrigues,3,4 Mathieu Desroches,5,6 Ton Bunt,7 Arnold Eiser,8 Francois Bernier,9 Pascale B Beauregard,10 Annelise E Barron,11 Abdelouahed Khalil,1 Adam Plotka,12 Katsuiku Hirokawa,13 Anis Larbi,14 Christian Bocti,15 Benoit Laurent,16 Eric H Frost,17 Jacek M Witkowski12 1Research Center on Aging, Geriatric Division, Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada; 2Cluster Innovation Centre, North Campus, University of Delhi, Delhi, 110007, India; 3Ikerbasque, The Basque Foundation for Science, Bilbao, Spain; 4Mathematical Computational and Experimental Neuroscience (MCEN), BCAM - The Basque Center for Applied Mathematics, Bilbao, Spain; 5MathNeuro Team, Inria Sophia Antipolis Méditerranée, Sophia Antipolis, France; 6Department of Mathematics, Université Côte d’Azur, Nice, France; 7Izumi Biosciences, Inc., Lexington, MA, USA; 8Leonard Davis Institute, University of Pennsylvania, Drexel University College of Medicine, Philadelphia, PA, USA; 9Morinaga Milk Industry Co., Ltd, Next Generation Science Institute, Kanagawa, Japan; 10Department of Biology, Faculty of Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada; 11Department of Bioengineering, Stanford School of Medicine, Stanford, CA, USA; 12Department of Pathophysiology, Medical University of Gdansk, Gdansk, Poland; 13Institute of Health and Life Science, Tokyo Med. Dent. University, Tokyo and Nito-Memory Nakanosogo Hospital, Department of Pathology, Tokyo, Japan; 14Singapore Immunology Network (SIgN), Agency for Science Technology and Research (A*STAR), Immunos Building, Biopolis, Singapore, Singapore; 15Research Center on Aging, Department of Medicine, Division of Neurology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada; 16Research Center on Aging, Department of Biochemistry and Functional Genomics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada; 17Department of Microbiology and Infectious Diseases, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, CanadaCorrespondence: Tamas FulopResearch Center on Aging, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 3001, 12th Avenue North, Sherbrooke, Quebec, J1H 5N4, CanadaTel +1 819 780 2220Fax +1 819 829 7141Email tamas.fulop@usherbrooke.caSerafim RodriguesIkerbasque Prof. Dr., Ikerbasque, The Basque Foundation for Science Bilbao, Spain and BCAM - The Basque Center for Applied Mathematics, Mathematical, Computational and Experimental (MCEN) Research Group, Alameda de Mazarredo 14, Bilbao, Bizkaia, Basque-Country, 48009, SpainTel +34 946 567 842Email srodrigues@bcamath.orgAbstract: Alzheimer’s disease (AD) is the most common form of dementia and aging is the most common risk factor for developing the disease. The etiology of AD is not known but AD may be considered as a clinical syndrome with multiple causal pathways contributing to it. The amyloid cascade hypothesis, claiming that excess production or reduced clearance of amyloid-beta (Aβ) and its aggregation into amyloid plaques, was accepted for a long time as the main cause of AD. However, many studies showed that Aβ is a frequent consequence of many challenges/pathologic processes occurring in the brain for decades. A key factor, sustained by experimental data, is that low-grade infection leading to production and deposition of Aβ, which has antimicrobial activity, precedes the development of clinically apparent AD. This infection is chronic, low grade, largely clinically silent for decades because of a nearly efficient antimicrobial immune response in the brain. A chronic inflammatory state is induced that results in neurodegeneration. Interventions that appear to prevent, retard or mitigate the development of AD also appear to modify the disease. In this review, we conceptualize further that the changes in the brain antimicrobial immune response during aging and especially in AD sufferers serve as a foundation that could lead to improved treatment strategies for preventing or decreasing the progression of AD in a disease-modifying treatment.Keywords: Alzheimer’s disease, mild cognitive impairment, neuroinflammation, antimicrobial immunity, brain, treatment

The continental divide along the spine of the Canadian Rockies in southwestern Canada is a critical headwater region for hydrological drainages to the Pacific, Arctic, and Atlantic oceans. Major flooding events are typically attributed to heavy precipitation on its eastern side due to upslope (easterly) flows. Precipitation can also occur on the western side of the divide when moisture originating from the Pacific Ocean encounters the west-facing slopes of the Canadian Rockies. Often, storms propagating across the divide result in significant precipitation on both sides. Meteorological data over this critical region are sparse, with few stations located at high elevations. Given the importance of all these types of events, the Storms and Precipitation Across the continental Divide Experiment (SPADE) was initiated to enhance our knowledge of the atmospheric processes leading to storms and precipitation on either side of the continental divide. This was accomplished by installing specialized meteorological instrumentation on both sides of the continental divide and carrying out manual observations during an intensive field campaign from 24 April–26 June 2019. On the eastern side, there were two field sites: (i) at Fortress Mountain Powerline (2076 m a.s.l.) and (ii) at Fortress Junction Service, located in a high-elevation valley (1580 m a.s.l.). On the western side, Nipika Mountain Resort, also located in a valley (1087 m a.s.l.), was chosen as a field site. Various meteorological instruments were deployed including two Doppler light detection and ranging instruments (lidars), three vertically pointing micro rain radars, and three optical disdrometers. The three main sites were nearly identically instrumented, and observers were on site at Fortress Mountain Powerline and Nipika Mountain Resort during precipitation events to take manual observations of precipitation type and microphotographs of solid particles. The objective of the field campaign was to gather high-temporal-frequency meteorological data and to compare the different conditions on either side of the divide to study the precipitation processes that can lead to catastrophic flooding in the region. Details on field sites, instrumentation used, and collection methods are discussed. Data from the study are publicly accessible from the Federated Research Data Repository at https://doi.org/10.20383/101.0221 (Thériault et al., 2020). This dataset will be used to study atmospheric conditions associated with precipitation events documented simultaneously on either side of a continental divide. This paper also provides a sample of the data gathered during a precipitation event.

Background: Negative healthcare provider attitudes may contribute to healthcare disparities in adults with intellectual disabilities. This study identified predictors of nurses' attitudes and emotions toward caring for adults with intellectual disabilities in the United States. Method: A convenience sample of 248 nurses was used to collect nurses' attitudes and emotions toward caring for adults with intellectual disabilities (Adapted Caring for Adults with Disabilities Questionnaire) and quality of life beliefs (Prognostic Beliefs Scale). Results: Overall, nurses held less positive attitudes toward caring for an adult with intellectual disability versus a physical disability. Intellectual disability nurses held more positive attitudes and emotions and less negative emotions than non-intellectual disability nurses. Quality of life beliefs predicted nurse attitude, positive emotions and negative emotions. The number of adults with intellectual disabilities cared for during the nurse's career predicted negative emotions. Conclusions: Future interventions should focus on improving nurses' understanding of the quality of life of adults with intellectual disabilities.

Continuing education on dementia for health-care providers has been shown to have positive effects on diagnostic confidence, knowledge, and care management. Technological approaches to educational delivery have been found to have comparable effects in terms of quality and efficacy. The purpose of the systematic review was to compose and present an evidence base for technology-delivered dementia education for health-care providers. The review used PRISMA guidelines and Cochrane methods focusing on studies with a pre- and post-intervention evaluation. Technology-based delivery of dementia education was broadly defined as any technology-based medium delivered in real time or asynchronously. Ten studies were identified and analyzed using content analysis. The review revealed positive outcomes post-intervention, for dementia knowledge, readiness to change, receptiveness to training, communication skills, and self-efficacy. Studies were rated as medium to high quality on a scale for measurement of published data in research, and there was generally an unknown risk of bias due to a lack of a control group in most studies (N = 7). The findings revealed benefits of digitally-based, asynchronous continuing education for health-care providers, which allow schedule flexibility and the ability to deliver remotely. Findings also revealed benefits of presentations using a variety of interactive educational materials via videos, voice recordings, textual medium and online discussion groups. Suggestions for intervention improvements include tailoring training for the specific needs and knowledge levels of health-care practitioners and using validated scales to measure outcomes.

Background: Telehealth care is now a key element of mainstream health care since the COVID-19 pandemic, with all types of health care providers joining the digital revolution. As a population experiencing health care disparities, adults with developmental disabilities and their supporters have described variable experiences with telehealth care that contribute to overall care quality and health outcomes. Methods: This e-Delphi study established consensus on best practices in telehealth care for adults with developmental disabilities in the United States. Online surveys and videoconferencing interviews were conducted with 44 expert panelists with experience with telehealth care and developmental disabilities, including adults with developmental disabilities, family members, direct support professionals, nurses, and health care providers. Results: Three rounds of surveys resulted in a set of 9 guidelines consisting of 42 items. The guidelines addressed 1) appropriate situations for telehealth care, 2) communication needs and preferences, 3) support person collaboration, 4) education and anticipatory guidance, 5) reminders, 6) coordination of care, 7) equitable and fair access, 8) privacy and safety, and 9) evidence-based practice. Conclusion: Health care providers can adopt these best practice guidelines to ensure telehealth care is provided equitably and safely to adults with developmental disabilities. Policy advocacy is needed for the uptake of these guidelines and for health care providers and adults with developmental disabilities to access the resources needed for safe and effective telehealth care use. [ABSTRACT FROM AUTHOR]

In this article, we claim that recent developments in climate science and renewable energy should prompt a reframing of debates surrounding climate change mitigation. Taken together, we argue that these developments suggest (1) global climate collapse in this century is a non-negligible risk, (2) mitigation offers substantial benefits to current generations, and (3) mitigation by some can generate social tipping dynamics that could ultimately make renewables cheaper than fossil fuels. We explain how these claims undermine familiar framings of climate change, wherein mitigation is understood as self-sacrifice that individuals and governments must be morally persuaded or incentivized to undertake. [ABSTRACT FROM AUTHOR]

Aim Background Sources of evidence Discussion Conclusion Implications for nursing practice Implications for nursing policy This paper explains how we created the Global Intellectual Disability Nurse Research Collaboratory (GIDNRC), a transformative network. The GIDNRC aims to make improvements in the understanding, research, policy, clinical care, and support provided to people with an intellectual disability.In 2022, the World Health Organization (WHO) called upon healthcare leaders internationally to take actions to promote more equal healthcare for disabled persons. This paper promotes the GIDNRC as a way for professionals to work together to make more equal healthcare throughout the world for people with intellectual disabilities.We created this paper by reviewing peer‐reviewed literature and research, international policies, and nursing networking initiatives.This paper explores current policy, research, and practice issues that formed the basis of beginning the GIDNRC, including how the COVID‐19 pandemic changed care.Nurses are over 50% of the world's health workforce. Therefore, they have the potential to make a large impact in making care for people with intellectual disability much more equal than currently exists throughout the world. However, barriers exist. Forming the GIDNRC, as well as using the World Wide Web, offers an opportunity to address barriers to this goal.Nurses can address the needs of people with intellectual disability in their daily nursing practice. The GIDNRC aims to strengthen these clinical skills, understand how care may vary throughout the world, and share knowledge, good practices, and new ways to approach care for people with an intellectual disability worldwide.International nursing policy should actively focus on the needs of people with intellectual disabilities and the role nurses play in addressing these health needs. The GIDNRC may provide an important way to achieve developments in this policy. [ABSTRACT FROM AUTHOR]

Introduction: Consumer‐oriented health information technologies (CHIT) such as the patient portal have a growing role in care delivery redesign initiatives such as the Learning Health System. Care partners commonly navigate CHIT demands alongside persons with complex health and social needs, but their role is not well specified. Methods: We assemble evidence and concepts from the literature describing interpersonal communication, relational coordination theory, and systems‐thinking to develop an integrative framework describing the care partner's role in applied CHIT innovations. Our framework describes pathways through which systematic engagement of the care partner affects longitudinal work processes and multi‐level outcomes relevant to Learning Health Systems. Results: Our framework is grounded in relational coordination, an emerging theory for understanding the dynamics of coordinating work that emphasizes role‐based relationships and communication, and the Systems Engineering Initiative for Patient Safety (SEIPS) model. Cross‐cutting work systems geared toward explicit and purposeful support of the care partner role through CHIT may advance work processes by promoting frequent, timely, accurate, problem‐solving communication, reinforced by shared goals, shared knowledge, and mutual respect between patients, care partners, and care team. We further contend that systematic engagement of the care partner in longitudinal work processes exerts beneficial effects on care delivery experiences and efficiencies at both individual and organizational levels. We discuss the utility of our framework through the lens of an illustrative case study involving patient portal‐mediated pre‐visit agenda setting. Conclusions: Our framework can be used to guide applied embedded CHIT interventions that support the care partner role and bring value to Learning Health Systems through advancing digital health equity, improving user experiences, and driving efficiencies through improved coordination within complex work systems. [ABSTRACT FROM AUTHOR]

The future surface water and ocean topography (SWOT) satellite mission will provide images of surface water topography for inland water bodies and oceans. Over land, water surface elevation (WSE) will be retrieved at 10 cm accuracy for water bodies with areas > 250 m × 250 m and rivers with widths > 100 m, when averaging over 1 km2. Studies have shown that the Ka-band used by SWOT's main payload can be affected by aquatic and emergent riparian vegetation, which in turn could influence SWOT capacity to correctly observe water extent. The current study investigates effects of aquatic and emergent riparian vegetation on SWOT water extent and WSE detection capabilities through the use of NASA/JPL's SWOT simulator (HR). Data from the AirSWOT airborne campaign over Mamawi Lake (163 km2) in the Peace-Athabasca Delta (PAD, Alberta, Canada), are used to establish a land cover classification and backscattering values for simulation inputs. Simulation results have shown that aquatic vegetation has a negligible effect on the SWOT signal. Yet, simulations showed that water extent misclassification can occur for water with emergent riparian vegetation in the specific case of wetlands surrounding lakes (i.e., small differences in backscattering values between surrounding land and water with emergent riparian vegetation). Simulations featuring the smallest difference between emergent riparian vegetation and land (1.3 dB) showed a 32–35% lake extent reduction from true extent. As expected, this study reveals that estimating water extent from SWOT in very wet environments with emergent vegetation can be challenging.

Lakes are important sources of freshwater and provide essential ecosystem services. Monitoring their spatial and temporal variability, and their functions, is an important task within the development of sustainable water management strategies. The Surface Water and Ocean Topography (SWOT) mission will provide continuous information on the dynamics of continental (rivers, lakes, wetlands and reservoirs) and ocean water bodies. This work aims to contribute to the international effort evaluating the SWOT satellite (2022 launch) performance for water balance assessment over large lakes (e.g., >100 km2). For this purpose, a hydrodynamic model was set up over Mamawi Lake, Canada, and different wind scenarios on lake hydrodynamics were simulated. The derived water surface elevations (WSEs) were compared to synthetic elevations produced by the Jet Propulsion Laboratory (JPL) SWOT high resolution (SWOT-HR) simulator. Moreover, water storages and net flows were retrieved from different possible SWOT orbital configurations and synthetic gauge measurements. In general, a good agreement was found between the WSE simulated from the model and those mimicked by the SWOT-HR simulator. Depending on the wind scenario, errors ranged between approximately −2 and 5 cm for mean error and from 30 to 70 cm root mean square error. Low spatial coverage of the lake was found to generate important biases in the retrievals of water volume or net flow between two satellite passes in the presence of local heterogeneities in WSE. However, the precision of retrievals was found to increase as spatial coverage increases, becoming more reliable than the retrievals from three synthetic gauges when spatial coverage approaches 100 %, demonstrating the capabilities of the future SWOT mission in monitoring dynamic WSE for large lakes across Canada.

Growing reliance on the patient portal as a mainstream modality in health system interactions necessitates prioritizing digital health equity through systems-level strategies that acknowledge and support all persons. Older adults with physical, cognitive, sensory, and socioeconomic vulnerabilities often rely on the involvement of family and friends in managing their health, but the role of these care partners in health information technology is largely undefined and poorly understood. This viewpoint article discusses challenges and opportunities of systematic engagement of care partners through shared access to the patient portal that have been amplified in the context of the COVID-19 outbreak and recent implementation of federal information blocking rules to promote information transparency alongside broader shifts toward care delivery innovation and population aging. We describe implementation considerations and the promise of granular, role-based privacy controls in addressing the nuanced and dynamic nature of individual information sharing preferences and fostering person- and family-centered care delivery.

Objectives Assess the feasibility and impact of a continuous professional development (CPD) course on type 2 diabetes and depression on health professionals’ intention to include sex and gender considerations in patient care.Design and setting In collaboration with CPD organisations and patient-partners, we conducted a mixed-methods feasibility controlled trial with postintervention measures in three Canadian provinces.Participants Of 178 eligible health professionals, 127 completed questionnaires and 67 participated in semistructured group discussions.Intervention and comparator An interactive 1 hour CPD course, codesigned with patient-partners, on diabetes and depression that included sex and gender considerations (innovation) was compared with a similar course that did not include them (comparator).Outcomes Feasibility of recruitment and retention of CPD organisations and patient-partners throughout the study; adherence to planned activities; health professionals’ intention to include sex and gender considerations in patient care as measured by the CPD-Reaction questionnaire; and barriers and facilitators using the Theoretical Domains Framework.Results All recruited CPD organisations and patient-partners remained engaged throughout the study. All planned CPD courses occurred. Overall, 71% of eligible health professionals participated (63% under 44 years old; 79.5% women; 67.7% practising in French; 66.9% practising in Quebec; 78.8% in urban practice). After training, mean intention scores for the innovation (n=49) and control groups (n=78) were 5.65±0.19 and 5.19±0.15, respectively. Mean difference was −0.47 (CI −0.95 to 0.01; p=0.06). Adjusted for age, gender and practice settings, mean difference was −0.57 (CI −1.09 to −0.05; p=0.03). We identified eight theoretical domains related to barriers and six related to facilitators for providing sex-adapted and gender-adapted diabetes and depression care.Conclusions CPD training on diabetes and depression that includes sex and gender considerations is feasible and, compared with CPD training that does not, may prompt health professionals to modify their care. Addressing identified barriers and facilitators could increase intention.Trial registration number NCT03928132 with ClinicalTrials.gov; Post-results.

Communication between neurons at chemical synapses is regulated by hundreds of different proteins that control the release of neurotransmitter that is packaged in vesicles, transported to an active zone, and released when an input spike occurs. Neurotransmitter can also be released asynchronously, that is, after a delay following the spike, or spontaneously in the absence of a stimulus. The mechanisms underlying asynchronous and spontaneous neurotransmitter release remain elusive. Here, we describe a model of the exocytotic cycle of vesicles at excitatory and inhibitory synapses that accounts for all modes of vesicle release as well as short-term synaptic plasticity (STSP). For asynchronous release, the model predicts a delayed inertial protein unbinding associated with the SNARE complex assembly immediately after vesicle priming. Experiments are proposed to test the model's molecular predictions for differential exocytosis. The simplicity of the model will also facilitate large-scale simulations of neural circuits.