A semi-automated spectral approach to analyzing cyclical growth patterns using fish scales

We introduce a new semi-automated approach to analyzing growth patterns recorded on fish scales. After manually specifying the center of the scale, the algorithm radially unwraps the scale patterns along a series of transects from the center to the edge of the scale. A sliding window Fourier transform is used to produce a spectrogram for each sampled transect of the scale image. The maximum frequency over all sampled transects of the average spectrogram yields a well-discriminated peak frequency trace that can then serve as a growth template for that fish. The spectrogram patterns of individual fish scales can be adjusted to a common period accounting for differences in date of return or size of fish at return without biasing the growth profile of the scale. We apply the method to 147 Atlantic salmon scale images sampled from 3 years and contrast the information derived with this automated approach to what is obtained using classical human operator measurements. The spectrogram analysis quantifies growth patterns using the entire scale image rather than just a single transect and provides the possibility of more robustly analyzing individual scale growth patterns. This semi-automated approach that removes essentially all the human operator interventions provides an opportunity to process large datasets of fish scale images and combined with advanced analyses such as deep learning methods could lead to a greater understanding of salmon marine migration patterns and responses to variations in ecosystem conditions.

Cancer-related lymphedema: clinical pearls for providers

Lymphedema is a chronic inflammatory condition that results from damage to the lymphatic system. Lymphedema is classified as either primary or secondary, the former being caused by a malformation of lymph vessels or nodes, and the latter resulting from trauma, chronic lymphatic system overload, or the sequelae of cancer treatments. In the present article, we focus on secondary cancer-related lymphedema (crl), a potential survivorship treatment-related effect. Treatments for breast, gynecologic, prostate, and head-and-neck cancers, and melanoma and other skin cancers are most frequently associated with crl. The incidence of crl varies widely based on cancer location and treatment modalities, with estimates ranging from 5% to 83% in various cancers. Given the lack of a universal definition and diagnostic criteria, the prevalence of crl is difficult to ascertain; current estimates suggest that more than 300,000 Canadians are affected by crl. Here, we present an overview of crl, divided into 5 subtopics: lymphedema risk factors; early identification and intervention; diagnosis and staging; management, with emphasis on the volume reduction and maintenance phases, plus patient support and education; and clinical pearls to help providers integrate knowledge about crl into their practice.

Radiotherapy side effects: integrating a survivorship clinical lens to better serve patients

The Canadian Cancer Society estimated that 220,400 new cases of cancer would be diagnosed in 2019. Of the affected patients, more than 60% will survive for 5 years or longer after their cancer diagnosis. Furthermore, nearly 40% will receive at least 1 course of radiotherapy (rt). Radiotherapy is used with both curative and palliative intent: to treat early-stage or locally advanced tumours (curative) and for symptom management in advanced disease (palliative). It can be delivered systemically (external-beam rt) or internally (brachytherapy). Although technique improvements have drastically reduced the occurrence of rt-related toxicity, most patients still experience burdensome rt side effects (seffs). Radiotherapy seffs are local or locoregional, and manifest in tissues or organs that were irradiated. Side effects manifesting within weeks after rt completion are termed "early seffs," and those occurring months or years after treatment are termed "late seffs." In addition to radiation oncologists, general practitioners in oncology and primary care providers are involved in survivorship care and management of rt seffs. Here, we present an overview of common seffs and their respective management: anxiety, depression, fatigue, and effects related to the head-and-neck, thoracic, and pelvic treatment sites.

Spatial synchrony in the response of a long range migratory species (Salmo salar) to climate change in the North Atlantic Ocean

A major challenge in understanding the response of populations to climate change is to separate the effects of local drivers acting independently on specific populations, from the effects of global drivers that impact multiple populations simultaneously and thereby synchronize their dynamics. We investigated the environmental drivers and the demographic mechanisms of the widespread decline in marine survival rates of Atlantic salmon (Salmo salar) over the last four decades. We developed a hierarchical Bayesian life cycle model to quantify the spatial synchrony in the marine survival of 13 large groups of populations (called stock units, SU) from two continental stock groups (CSG) in North America (NA) and Southern Europe (SE) over the period 1971-2014. We found strong coherence in the temporal variation in postsmolt marine survival among the 13 SU of NA and SE. A common North Atlantic trend explains 37% of the temporal variability of the survivals for the 13 SU and declines by a factor of 1.8 over the 1971-2014 time series. Synchrony in survival trends is stronger between SU within each CSG. The common trends at the scale of NA and SE capture 60% and 42% of the total variance of temporal variations, respectively. Temporal variations of the postsmolt survival are best explained by the temporal variations of sea surface temperature (SST, negative correlation) and net primary production indices (PP, positive correlation) encountered by salmon in common domains during their marine migration. Specifically, in the Labrador Sea/Grand Banks for populations from NA, 26% and 24% of variance is captured by SST and PP, respectively and in the Norwegian Sea for populations from SE, 21% and 12% of variance is captured by SST and PP, respectively. The findings support the hypothesis of a response of salmon populations to large climate-induced changes in the North Atlantic simultaneously impacting populations from distant continental habitats.

Oncologists and General Practitioners in Oncology: Allies in Cancer Care Delivery

The number of cancer cases in Canada is projected to be 79% higher in 2028–2032 than it was in 2003–2007[...].

Integrating primary care providers through the seasons of survivorship

Traditionally, the role of primary care providers (pcps) across the cancer care trajectory has focused on prevention and early detection. In combination with screening initiatives, new and evolving treatment approaches have contributed to significant improvements in survival in a number of cancer types. For Canadian cancer survivors, the 5-year survival rate is now better than it was a decade ago, and the survivor population is expected to reach 2 million by 2031. Notwithstanding those improvements, many cancer survivors experience late and long-term effects, and comorbid conditions have been noted to be increasing in prevalence for this vulnerable population. In view of those observations, and considering the anticipated shortage of oncology providers, increasing reliance is being placed on the primary care workforce for the provision of survivorship care. Despite the willingness of pcps to engage in that role, further substantial efforts to elucidate the landscape of high-quality, sustainable, and comprehensive survivorship care delivery within primary care are required. The present article offers an overview of the integration of pcps into survivorship care provision. More specifically, it outlines known barriers and potential solutions in five categories: ■ Survivorship care coordination■ Knowledge of survivorship■ pcp-led clinical environments■ Models of survivorship care■ Health policy and organizational advocacy.

Patients with advanced cancer: when, why, and how to refer to palliative care services

Palliative care (pc) is a fundamental component of the cancer care trajectory. Its primary focus is on "the quality of life of people who have a life-threatening illness, and includes pain and symptom management, skilled psychosocial, emotional and spiritual support" to patients and loved ones. Palliative care includes, but is not limited to, end-of-life care. The benefits of early introduction of pc services in the care trajectory of patients with advanced cancer are well known, as indicated by improved quality of life, satisfaction with care, and a potential for increased survival. In turn, early referral of patients with advanced cancer to pc services is strongly recommended. So when, how, and why should patients with advanced cancer be referred to pc services? In this article, we summarize evidence to address these questions about early pc referral: ▪ What are the known benefits?▪ What is the "ideal" pc referral timing?▪ What are the barriers?▪ Which strategies can optimize integration of pc into oncology care?▪ Which communication tools can facilitate skillful introduction of pc to patients?

General practitioners in oncology: their valuable role throughout the cancer care trajectory

In the past decade, evidence has emerged to demonstrate a growing trend throughout Canada: family physicians choosing to tailor their clinical practice to include focused practices such as cancer care [...]

The Survivorship Care Plan: A Valuable Tool for Primary Care Providers?

The era of immunotherapy and improved cancer treatments has led to current trends in health care [...]