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Intrauterine growth restriction (IUGR) and exposure to a high-fat diet (HFD) independently increase the risk of cardiovascular disease (CVD) and hyperlipidemia. In our previous studies, IUGR increased blood pressure and promoted vascular remodeling and stiffness in early life, a finding that persisted and was augmented by a maternal HFD through postnatal day (PND) 60. The impact of these findings with aging and the development of hyperlipidemia and atherosclerosis remain unknown. We hypothesized that the previously noted impact of IUGR on hypertension, vascular remodeling, and hyperlipidemia would persist. Adult female rats were fed either a regular diet (RD) or high fat diet (HFD) prior to conception through lactation. IUGR was induced by uterine artery ligation. Offspring were weaned to either RD or HFD through PND 365. For both control (C) and IUGR (I) and rats, this resulted in the following six groups per sex: offspring from RD dams weaned to an RD (CRR and IRR), or offspring from HFD dams weaned to either an RD (CHR and IHR) or to an HFD (CHH and IHH). IHH male and female rats had increased large artery stiffness, a suggestion of fatty streaks in the aorta, and persistent decreased elastin and increased collagen in the aorta and carotid arteries. Post-weaning HFD intake increased blood lipids regardless of IUGR status. IUGR increased HFD-induced mortality. We speculate that HFD-induced risk of CVD and mortality is potentiated by developmental programming of the ECM.

Landing biomechanics provide important information pertaining to second anterior cruciate ligament (ACL) injury risk in patients following ACL reconstruction (ACLR). While traditional motion analysis technologies are often impractical for use in non-laboratory settings, methods to assess landing biomechanics which are inexpensive, portable, and user-friendly have recently been developed and validated. The purpose of this study was to compare landing kinematics and kinetics between ACLR patients and uninjured controls in a non-laboratory setting. Sixteen ACLR patients (7 male/9 female, 6-12 months post-ACLR) and 16 gender-matched controls completed seven bilateral drop vertical jumps and seven unilateral drop landings on each limb. Plantar force was measured bilaterally using force sensing insoles and frontal and sagittal-plane knee kinematics were measured using two tablets, six reflective markers, and automated point tracking software. Plantar force impulse normalized symmetry index (NSI) and knee frontal plane projection angle (FPPA) range of motion were computed during bilateral landing, and knee flexion range of motion NSI was computed during unilateral landing and compared between groups using independent samples t tests. ACLR patients had larger NSIs (reflecting less symmetry) for plantar force impulse during bilateral landing (p < 0.001) and knee flexion range of motion during unilateral landing (p = 0.004). No between-group differences were observed for knee FPPA range of motion (p = 0.111). This study is an important step towards assessing landing biomechanics in non-research settings with the goal of providing quantitative injury risk metrics in a clinical setting that can be used for return to sport decision making.

Understanding the effects of climate on the vital rates (e.g., survival, development, reproduction) and dynamics of natural populations is a long-standing quest in ecology, with ever-increasing relevance in the face of climate change. However, linking climate drivers to demographic processes requires identifying the appropriate time windows during which climate influences vital rates. Researchers often do not have access to the long-term data required to test a large number of windows, and are thus forced to make a priori choices. In this study, we first synthesize the literature to assess current a priori choices employed in studies performed on 104 plant species that link climate drivers with demographic responses. Second, we use a sliding-window approach to investigate which combination of climate drivers and temporal window have the best predictive ability for vital rates of four perennial plant species that each have over a decade of demographic data (Helianthella quinquenervis, Frasera speciosa, Cylindriopuntia imbricata, and Cryptantha flava). Our literature review shows that most studies consider time windows in only the year preceding the measurement of the vital rate(s) of interest, and focus on annual or growing season temporal scales. In contrast, our sliding-window analysis shows that in only four out of 13 vital rates the selected climate drivers have time windows that align with, or are similar to, the growing season. For many vital rates, the best window lagged more than 1 year and up to 4 years before the measurement of the vital rate. Our results demonstrate that for the vital rates of these four species, climate drivers that are lagged or outside of the growing season are the norm. Our study suggests that considering climatic predictors that fall outside of the most recent growing season will improve our understanding of how climate affects population dynamics.

We summarize the current debate surrounding four small‐dollar credit products: pawn loans, vehicle title loans, payday loans, and cash installment loans from finance companies. We review the contributions of scholars that inform this debate. We underscore that users of these products fit the description of those whom consumer credit models predict benefit from these products. Many studies find that, on average, consumer use of small‐dollar credit products is, at worst, innocuous. There are, however, findings of heterogeneity in borrowers' experiences. The disagreements surrounding these credit products and the difficulty in crafting the proper policy response stems from this heterogeneity. (JEL D18, G23)

Atomically dispersed transition metal-nitrogen-carbon catalysts are emerging as low-cost electrocatalysts for the oxygen reduction reaction in fuel cells. However, a cost-effective and scalable synthesis strategy for these catalysts is still required, as well as a greater understanding of their mechanisms. Herein, iron, nitrogen co-doped carbon spheres (Fe@NCS) have been prepared via hydrothermal carbonization and high-temperature post carbonization. It is determined that FeN4 is the main form of iron existing in the obtained Fe@NCS. Two different precursors containing Fe2+ and Fe3+ are compared. Both chemical and structural differences have been observed in catalysts starting from Fe2+ and Fe3+ precursors. Fe2+@NCS-A (starting with Fe2+ precursor) shows better catalytic activity for the oxygen reduction reaction. This catalyst is studied in an anion exchange membrane fuel cell. The high open-circuit voltage demonstrates the potential approach for developing high-performance, low-cost fuel cell catalysts.

Although rarely experimentally tested, biotic interactions have long been hypothesised to limit low-elevation range boundaries of species. We tested the effects of herbivory on three alpine-restricted plant species by transplanting plants below (novel), at the edge (limit), or in the centre (core) of their current elevational range and factorially fencing-out above- and belowground mammals. Herbivore damage was greater in range limit and novel habitats than in range cores. Exclosures increased plant biomass and reproduction more in novel habitats than in range cores, suggesting demographic costs of novel interactions with herbivores. We then used demographic models to project population growth rates, which increased 5–20% more under herbivore exclosure at range limit and novel sites than in core habitats. Our results identify mammalian herbivores as key drivers of the low-elevation range limits of alpine plants and indicate that upward encroachment of herbivores could trigger local extinctions by depressing plant population growth. publishedVersion

The sensitivity of tropical Atlantic precipitation patterns to the mean position of the Intertropical Convergence Zone (ITCZ) at different time scales is well‐known. However, recent research suggests a more complex behavior of the northern hemispheric tropical rain belt related to the ITCZ in the western tropical Atlantic. Here we present a precisely dated speleothem multi‐proxy record from a well‐monitored cave in Puerto Rico, covering the period between 46.2 and 15.3 ka. The stable isotope and trace element records document a pronounced response of regional rainfall to abrupt climatic excursions in the North Atlantic across the Last Glacial such as Heinrich stadials and Dansgaard/Oeschger events. The annual to multidecadal resolution of the proxy time series allows substructural investigations of the recorded events. Spectral analysis suggests that multidecadal to centennial variability persisted in the regional hydroclimate mainly during interstadial conditions but also during the Last Glacial Maximum. In particular, we observe a strong agreement between the speleothem proxy data and the strength of the Atlantic meridional overturning circulation, supporting a persistent link of oceanic forcing to regional precipitation. Comparison to other paleo‐precipitation records enables the reconstruction of past changes in position, strength, and extent of the ITCZ in the western tropical Atlantic in response to millennial‐ and orbital‐scale global climate change., Plain Language Summary: It is important to understand the climatic circumstances of how rainfall in the western tropical Atlantic varies under a changing climate to better manage the water supply for millions of people. However, it is not well understood how rainfall varied in the past, especially during the Last Glacial period, a time of strong climate variability and abrupt climate changes. Here, we use a stalagmite from Puerto Rico to create a new record of past changes in rainfall in this region. For this purpose, we analyzed proxy data that reveal a series of wet and dry periods during the Last Glacial corresponding to rapid global climate shifts. Our rainfall‐sensitive stalagmite record captured changes of the tropical rain belt on various timescales and shows that this variability in rainfall is closely connected to changes in the strength of the ocean circulation. This suggests that the link between the ocean and the atmosphere is more robust than previously assumed. The comparison of our record with other rainfall‐sensitive records from Central America and the northern Caribbean allows for a detailed reconstruction of the spatial and temporal changes of the western tropical Atlantic rain belt., Key Points: Puerto Rican speleothem record documents multidecadal to millennial‐scale precipitation variability between 46.2 and 15.3 ka. Climate proxies show a distinct rainfall response to abrupt North Atlantic climate change including Heinrich and Dansgaard/Oeschger events. Compilation of regional precipitation records allows to reconstruct past changes in ITCZ patterns in the western tropical Atlantic., National Science Foundation (NSF) http://dx.doi.org/10.13039/501100000930, Deutsche Forschungsgemeinschaft (DFG) http://dx.doi.org/10.13039/501100001659

AIM To describe neurobehavioral patterns in neonates with congenital heart disease (CHD). METHOD A cohort study describing neurobehavioral performance of neonates with CHD requiring cardiac surgery. The neonates were evaluated preoperatively and postoperatively with the Neonatal Intensive Care Unit Network Neurobehavioral Scale (NNNS) and scores were compared with published normative values. Clinical factors were obtained by chart review to assess their association with behavior. The CHD NNNS score pattern was compared with previously reported profiles in other high-risk populations. RESULTS NNNS evaluations were completed on 67 neonates with CHD, resulting in 97 evaluations (50 preoperative, 47 postoperative). Compared with normative values, the cohort with CHD demonstrated decreased attention, regulation, asymmetry, stress, arousal, and excitability, along with increased non-optimal reflexes, lethargy, and need for handling (p

Objective To evaluate the efficacy of diamond burr debridement (DBD) vs a combination of diamond burr debridement with superficial grid keratotomy (DBD+SGK) for the treatment of spontaneous chronic corneal epithelial defects (SCCEDs) in dogs. Procedure Medical records of dogs diagnosed with SCCEDs from three different institutions that received a DBD or DBD+SGK between 2003 and 2015 were reviewed. Age, breed, sex, history of a previous SCCED, procedures performed, time to healing, and complications were statistically analyzed. Results One hundred and ninety-four dogs met the inclusion criteria. Eighty-two of 106 eyes (77.4%) received a DBD and healed following the first treatment (13.3 ± 4.9 days to recheck, range 2-27). Sixty-eight of 88 eyes (77.3%) received a DBD+SGK and healed following the first treatment (15.4 ± 5.0 days to recheck, range 5-45). No significant difference in healing outcome was found between the two treatments (P = 1). For SCCEDs that healed after a single treatment (n = 150), complications occurred in 13.3% (n = 20) of eyes with no difference in complications between the DBD and DBD+SGK groups (P = .86). Thirty-five of 44 eyes (80.0%) healed after the second treatment (16 ± 8.2 days from second treatment to third visit, range 5-47); nine of 44 eyes (20.0%) were not healed (12 ± 6.2 days from second treatment to third visit, range 5-25). The second treatment method did not influence healing rates (P = .64). Conclusions DBD and DBD+SGK are equally effective treatment methods for canine SCCEDs. No differences in complication rates after one treatment were observed between DBD and DBD+SGK.

There is limited literature that follows a population of Anterior Cruciate Ligament Reconstruction (ACLR) patients through recovery. Our aim was to examine differences in movement and loading patterns across time and between limbs over four visits during 12 months post-ACLR. We hypothesized that kinematic and kinetic data during a stop-jump would have time- and limb-dependent differences through 12 months post-surgery. Twenty-three ACLR athletes performed five vertical stop-jumps at 4, 5, 6, and 12 months post-op with motion capture and force plate data collection. The peak knee flexion (PKF) was different between the 4 and 12, 5 and 6, and the 5 and 12 month visits with earlier months exhibiting higher PKF. The peak vertical ground reaction force (vGRF) was lower at 4 than at 5 and 6 months. The peak posterior ground reaction force (pGRF) was lower at 4 months than all other visits. Frontal knee and sagittal hip range of motion (ROM) were different between 12 months and each previous visit. Asymmetries were present in peak vGRF, peak knee extension moment and impulse up to 12 months. The loading rate and peak pGRF demonstrated between limb differences up to 6 months; limb stiffness demonstrated differences up to 5 months post-ACLR. PKF was only asymmetric at the 4 month visit. While some variables improved in the 12 months post-ACLR, limb asymmetries in peak knee extension moment, peak vGRF and impulse persisted up to 12 months. Additionally, frontal plane knee and sagittal hip ROM had not normalized at 12 months. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1887-1893, 2018.

The importance of predators in influencing community structure is a well-studied area of ecology. However, few studies test ecological hypotheses of predation in multi-predator microbial communities. The phytotelmic community found within the water-filled leaves of the pitcher plant, Sarracenia purpurea, exhibits a simple trophic structure that includes multiple protozoan predators and microbial prey. Using this system, we sought to determine whether different predators target distinct microorganisms, how interactions among protozoans affect resource (microorganism) use, and how predator diversity affects prey community diversity. In particular, we endeavored to determine if protozoa followed known ecological patterns such as keystone predation or generalist predation. For these experiments, replicate inquiline microbial communities were maintained for seven days with five protozoan species. Microbial community structure was determined by 16S rRNA gene amplicon sequencing (iTag) and analysis. Compared to the control (no protozoa), two ciliates followed patterns of keystone predation by increasing microbial evenness. In pairwise competition treatments with a generalist flagellate, prey communities resembled the microbial communities of the respective keystone predator in monoculture. The relative abundance of the most common bacterial Operational Taxonomic Unit (OTU) in our system decreased compared to the control in the presence of these ciliates. This OTU was 98% similar to a known chitin degrader and nitrate reducer, important functions for the microbial community and the plant host. Collectively, the data demonstrated that predator identity had a greater effect on prey diversity and composition than overall predator diversity.

Poly(ethylene oxide) (PEO) is a promising solid electrolyte material for solid-state lithium–sulfur (Li–S) batteries, but low intrinsic ionic conductivity, poor mechanical properties, and failure to hinder the polysulfide shuttle effect limits its application. Herein, a polymer of intrinsic microporosity (PIM) is synthesized and applied as an organic framework to comprehensively enhance the performance of PEO by forming a composite electrolyte (PEO-PIM). The unique structure of PIM-1 not only enhances the mechanical strength and hardness over the PEO electrolyte by an order of magnitude, increasing stability toward the metallic lithium anode but also increases its ionic conductivity by lowering the degree of crystallinity. Furthermore, the PIM-1 is shown to effectively trap lithium polysulfide species to mitigate against the detrimental polysulfide shuttle effect, as electrophilic 1,4-dicyanooxanthrene functional groups possess higher binding energy to polysulfides. Benefiting from these properties, the use of PEO-PIM composite electrolyte has achieved greatly improved rate performance, long-cycling stability, and excellent safety features for solid-state Li-S batteries. This methodology offers a new direction for the optimization of solid polymer electrolytes.

The combustion of mercury(II) thiocyanate to form "Pharaoh's serpents" is a spectacular reaction first described nearly two centuries ago. The large volume of distinctive yellow branches that grow from a tiny quantity of flaming reactants makes this an enchanting demonstration, often used to depict the magic of chemistry. In recent years several videos of this bizarre process have "gone viral" online. Formally, the reaction should yield a carbon nitride with the ideal formula C 3 N 4 along with HgS. However, since early characterization attempts there has been little further study of the materials produced. Herein we apply modern characterization techniques to reinvestigate the nature of the carbon nitride and its intimate relationship to the HgS produced. The HgS phase forms nanoparticles that decorate the surfaces of a C 3 N 4 foam matrix. Both of these compounds are important wide-gap semiconductors and we propose that the "Pharaoh's serpents reaction" could be used to produce a potentially important heterojunction nanocomposite materials that could be useful optoelectronic and photocatalytic applications.

The invasive Red Palm Weevil (RPW), Rhynchophorus ferrugineus (Olivier) (Coleoptera: Curculionidae), is one of the most destructive pests of ornamental and economically important palms globally. It has been found in 50 % of date-growing and 15 % of coconut-producing countries in the world. Synthetic organic insecticides have been the default method to combat this pest, but they are clearly inefficient due to the secretive nature of the insect and there is concern about non-target effects from blanket spraying. For this reason, there is increasing interest in biological control methods such as the possible use of microbial entomopathogens, which might be incorporated into IPM approaches. In this review we summarize research work on microbial control agents, their effectiveness against RPW and their integration with other control measures.

There is currently much debate about whether the precise role of the hippocampus in scene processing is predominantly constructive, perceptual, or mnemonic. Here, we developed a novel experimental paradigm designed to control for general perceptual and mnemonic demands, thus enabling us to specifically vary the requirement for constructive processing. We tested the ability of patients with selective bilateral hippocampal damage and matched control participants to detect either semantic (e.g., an elephant with butterflies for ears) or constructive (e.g., an endless staircase) violations in realistic images of scenes. Thus, scenes could be semantically or constructively 'possible' or 'impossible'. Importantly, general perceptual and memory requirements were similar for both types of scene. We found that the patients performed comparably to control participants when deciding whether scenes were semantically possible or impossible, but were selectively impaired at judging if scenes were constructively possible or impossible. Post-task debriefing indicated that control participants constructed flexible mental representations of the scenes in order to make constructive judgements, whereas the patients were more constrained and typically focused on specific fragments of the scenes, with little indication of having constructed internal scene models. These results suggest that one contribution the hippocampus makes to scene processing is to construct internal representations of spatially coherent scenes, which may be vital for modelling the world during both perception and memory recall. © 2016 The Authors. Hippocampus Published by Wiley Periodicals, Inc.

Implementation of an ecosystem approach to fisheries management (EAFM) for forage fish requires methods to evaluate tradeoffs associated with competing management objectives that focus on supporting fishery yields or providing food for predators. We developed an Ecopath with Ecosim ecosystem model of the U.S. Northwest Atlantic continental shelf (NWACS) for the period 1982–2013 to inform an EAFM for Atlantic Menhaden Brevoortia tyrannus. The model (with 61 trophic groups and 8 fishing fleets) was parameterized and fitted to time series using data from stock assessments, surveys, and literature. Fifty-year simulations evaluated how Atlantic Menhaden fishing mortality rates (F) influenced different ecosystem indicators, including population biomasses, fishery yields, prey-to-predator ratios, and the proportion of trophic groups that were positively or negatively affected. We quantified tradeoffs associated with a range of alternative ecosystem-based reference points for Atlantic Menhaden F and bioma...

Two-dimensional (2D) layered graphitic carbon nitride (gCN) nanosheets offer intriguing electronic and chemical properties. However, the exfoliation and functionalisation of gCN for specific applications remain challenging. We report a scalable one-pot reductive method to produce solutions of single- and few-layer 2D gCN nanosheets with excellent stability in a high mass yield (35 %) from polytriazine imide. High-resolution imaging confirmed the intact crystalline structure and identified an AB stacking for gCN layers. The charge allows deliberate organic functionalisation of dissolved gCN, providing a general route to adjust their properties.

Sperm limitation has been a concern for several crustacean species around the world. It may be of particular concern for blue crabs Callinectes sapidus in Chesapeake Bay due to the species’ reproductive biology and the sex-specific fishery regulations in place. Our objectives were to characterize the differences in sperm counts in mated females from six tributaries of the Chesapeake Bay and to determine whether sperm quantity was affected by the ratio of males to females in each system. Mature females were sampled 1–4 times in each tributary on a biweekly schedule from September to November 2011. We quantified sperm storage for each crab by microscopic examination and compared the sperm counts of females among river systems with the adult male : female sex ratios using ANOVA and linear regression. Total sperm quantity per female varied 16-fold (0.9–13.0 × 108) among tributaries. The sex ratio was also variable among tributaries. Total sperm quantity per female was not significantly related to sex ...

Temperature is known to influence ecosystem processes through its direct effect on biological rates such as respiration and nutrient cycling. These changes can then indirectly affect ecologically processes by altering trophic dynamics, the persistence of a species in a given environment, and, consequently, its distribution. However, it is not known if this direct effect of temperature on biological rates is singularly the most important factor for the functioning of ecosystems, or if trophic structure and the adaptation of a species to the local environment also play an essential role. Understanding the relative importance of these factors is crucial for predicting the impact that climate change will have on species and ecosystems. To achieve a more complete understanding of the impact of changing temperatures, it is necessary to integrate perspectives from biogeography, such as the influences of species distribution and local adaptation, with ecosystem and community ecology. By using the microbial community inhabiting the water-filled leaves of Sarracenia purpurea, we tested the importance of temperature, trophic structure, and local adaptation on ecosystem functioning. We accomplished this by collecting communities along a natural temperature gradient and maintaining these communities in a common garden, factorial experiment. To test for the importance of local adaptation and temperature, the origin of each community was crossed with the temperature from each site. Additionally, to test the importance of top-down trophic regulation for ecosystem functioning, the presence of the mosquito larvae top predator was manipulated. We found that temperature has a greater effect on ecosystem functioning than origin, and that top-down trophic regulation increased with temperature. Our results emphasize the synergistic effects of temperature and biotic interactions when predicting the consequences of global warming on ecosystem functioning.

Graphitic carbon nitride (gCN) is shown to undergo lithium insertion reactions applicable with lithium-ion battery anodes. Lithium capacity was found to be substantially lower than theoretically expected, so the properties of gCN composited with conducting graphite (CG), which was added to improve the performance, were investigated. The electrodes exhibited a systematic increase in lithium uptake with CG content, but the capacity never exceeded that of graphite. It is shown that electron transport via conducting pathways was limiting. Li+ uptake for 10 % gCN was similar to a graphite electrode, indicating that gCN does play a role in determining the storage capacity.

The objectives of this work were to quantify the spatial and temporal distribution of the occurrence of anadromous fishes (alewife Alosa pseudoharengus, blueback herring Alosa aestivalis and American shad Alosa sapidissima) in the stomachs of demersal fishes in coastal waters of the north-west Atlantic Ocean. Results show that anadromous fishes were detectable and quantifiable in the diets of common marine piscivores for every season sampled. Even though anadromous fishes were not the most abundant prey, they accounted for c. 5-10% of the diet by mass for several marine piscivores. Statistical comparisons of these data with fish diet data from a broad-scale survey of the north-west Atlantic Ocean indicate that the frequency of this trophic interaction was significantly higher within spatially and temporally focused sampling areas of this study than in the broad-scale survey. Odds ratios of anadromous predation were as much as 460 times higher in the targeted sampling as compared with the broad-scale sampling. Analyses indicate that anadromous prey consumption was more concentrated in the near-coastal waters compared with consumption of a similar, but more widely distributed species, the Atlantic herring Clupea harengus. In the context of ecosystem-based fisheries management, the results suggest that even low-frequency feeding events may be locally important, and should be incorporated into ecosystem models.

Summary 1. A potential driver of species abundance that remains understudied is the interaction between host species and their microbial symbionts. Beneficial symbionts could promote the dominance of common host species by increasing their population growth rates more than they do for rare species, and symbiont benefits could be important for maintaining rare species in communities. Alternatively, intrinsic differences in demography, independent of interactions with symbionts, could be the main driver of species’ relative abundances. 2. Here, we used demographic modelling with 5 years of data from experimental host populations to compare how symbiotic fungal endophytes, which are vertically transmitted from parent plant to offspring, influenced the population dynamics of one pair of co-occurring, congeneric rare versus common host grasses (genus Poa). 3. The common plant species achieved higher population growth than the rare species. Endophyte symbiosis increased the geometric population growth rate (k) of rare and common species by 18% and 32%, respectively, but only the rare species was predicted to decline (k < 1) in the absence of the endophyte, demonstrating that symbiosis was essential to maintain this species in the community. 4. Endophyte symbiosis differentially affected the demographic transitions of the two hosts, increasing survival and growth for the common host, Poa sylvestris, and increasing survival but decreasing the probability of flowering for the rare host, Poa alsodes. The total contribution of the endophyte effects on host demographic rates to the overall difference in population growth between host species was small compared to the plants’ intrinsic differences in demography. However, low rates of vertical transmission in P. sylvestris lessened its advantage in intrinsic demography over P. alsodes and thus decreased the projected difference in population growth between host plants. 5. Synthesis. Our results highlight the importance of plant–symbiont interactions in the persistence of a rare plant population, as well as the utility of demographic models in teasing apart the relative importance of plant demographic rates versus host–symbiont interactions on the regional abundance of rare and common host plant species.

The United States spends about $180 billion per year on inpatient surgical procedures in nonfederal hospitals alone.1 The average cost of surgery continues to climb—from $13,000 per hospitalization in 2000 to $18,000 (inflation adjusted) in 2010—and patient safety, outcomes, and readmissions are ongoing concerns.1 Is the perioperative surgical home (PSH) a part of the solution? The concept of a more rigorously coordinated and integrated perioperative patient management system has been implemented, studied, and reported primarily in Canada, Europe, Australia, and the United States within the last 40 years, but the evolution of the PSH concept in the United States seems to be more recent. Earlier, surgical care in the United States followed a general trend of surgical specialties and capabilities moving toward same-day surgery admissions2; market expectations for high-quality surgical outcomes while controlling cost of surgeries by pursuing service-line strategies3; and value-based payment programs launched as a result of the Patient Protection and Affordable Care Act, which could yield significant savings for payers.4 The PSH continues to be defined in both the literature and clinical practice. One of its most recent definitions is based on the PSH model adopted by the University of Alabama at Birmingham, which describes the PSH model as “an innovative, patient-centered, surgical continuity of care model that incorporates shared decision making.”5 PSH programs in the United States have a variety of names, such as “center for perioperative services,” “reengineered perioperative services,” and “perioperative care pathways.” An initial examination of the literature suggests that most definitions feature 2 points of emphasis: stronger continuity, coordination, and integration of surgical care; and greater patient-focused and shared decision making. Because the terminology used to describe the PSH varies widely, we looked at the most recent comprehensive reviews and definitions of this new concept of perioperative medicine and surgical care. In one, Lee and colleagues broadly use the umbrella term “perioperative system” to encompass all the PSH's activities and developments.6 Consistently emerging evidence in the health care literature supports care coordination models like the well-established patient-centered medical home (PCMH), with its underlying principle of a single physician who coordinates the patient's care and engages a team of health care providers and their patient in an individualized treatment and management plan.7 The PCMH embodies principles laid out by the Institute of Medicine intended to improve care coordination and patient satisfaction.8 The PCMH and the PSH share a vision of higher quality and lower cost while at the same time incorporating similar elements of patient engagement and care coordination.5 Unfortunately, surgical care often is not standardized or coordinated, resulting in duplicative or unnecessary preoperative testing and procedures, which cost an estimated $18 billion annually in the United States alone.9 The PSH concept provides a model that addresses this need for perioperative care standardization and coordination, and its impact on both clinical outcomes and cost has recently been evaluated.10

The Atlantic Menhaden Brevoortia tyrannus is an important component of the estuarine and nearshore fish assemblages in the mid-Atlantic region. It serves as a forage species for many piscivorous fish, birds, and marine mammals as well as being subject to an important commercial fishery. Currently there is concern over low standing stocks and recruitment, yet few studies have addressed those concerns. We evaluated the effectiveness of using an otolith chemistry approach to identify juvenile menhaden nursery areas throughout the Chesapeake Bay over 2 years. If successful, an otolith chemistry approach is capable of addressing a number of hypotheses regarding the source and fate of recruits in a stock. We found multiple unique otolith chemistry signatures in menhaden collected in the Chesapeake Bay. Overall correct classification was 85% for the 2005 cohort and 95% for the 2006 cohort. The ratios of most trace element: Ca and stable isotope ratios were different among areas. In addition to spatial di...

Variable survival outcomes are seen following treatment for aggressive non-Hodgkin lymphoma (NHL). This study examined whether outcomes for aggressive B-cell NHL are associated with single nucleotide polymorphisms (SNPs) in oxidative stress-related genes, which can alter drug metabolism and immune responses. Genotypes for 53 SNPs in 29 genes were determined for 337 patients given anthracycline-based therapies. Their associations with progression-free survival (PFS) and overall survival (OS) were estimated by Cox proportional hazard regression; associations with hematologic toxicity were estimated by logistic regression. To validate the findings, the top three SNPs were tested in an independent cohort of 572 DLBCL patients. The top SNPs associated with PFS in the discovery cohort were the rare homozygotes for MPO rs2243828 (hazard ratio [HR] = 1.87, 95% confidence interval [CI] = 1.14–3.06, P = 0.013), AKR1C3 rs10508293 (HR = 2.09, 95% CI = 1.28–3.41, P = 0.0032) and NCF4 rs1883112 (HR = 0.66, 95% CI = 0.43–1.02, P = 0.06). The association of the NCF4 SNP with PFS was replicated in the validation dataset (HR = 0.66, 95% CI = 0.44–1.01, P = 0.05) and the meta-analysis was significant (HR = 0.66, 95% CI = 0.49–0.89, P

Accumulating evidence indicates that as global temperatures rise, reproductive behaviors, including migrations, are occurring earlier across a range of taxa. Alone, these changes are ecologically important; however, for some fish populations, management practices may unknowingly interact with climate-induced changes in reproductive phenology, leading to unanticipated changes in fishing mortality. The potential for such an interaction exists for the Chesapeake Bay Striped Bass Morone saxatilis fishery, which opens on the same week each year during the spawning season. Earlier migrants spawn before the fishery opens; however, later migrants are vulnerable to fishing before they reach the spawning grounds. Consequently, if there are climate-induced changes in Striped Bass spawning phenology, unexpected levels of fishing mortality may occur for egg-bearing, prespawn females. To evaluate the potential consequences of this temporally fixed fishing season, we analyzed a time series of gill-net catch data...

Objective Despite standardization in care, heterogeneity in outcomes persists for infants with hypoplastic left heart syndrome (HLHS). One potential factor is in utero stressors. Uteroplacental insufficiency (UPI) induces systemic vascular and myocardial adaptations in the absence of structural heart disease. The effect of UPI in HLHS is unknown. Methods We retrospectively analyzed infants undergoing Norwood palliation for HLHS from 2007 to 2012. We compared the umbilical artery systolic to diastolic (SD) ratio to growth outcomes and postoperative right ventricular function. Results Forty three infants met our inclusion criteria. Fetuses without a declining SD ratio with advancing gestational age had asymmetric birth biometry, defined as birth weight minus head circumference z scores (−0.9 vs −0.05, p

Harvesting for food or sport is often non-random with respect to demographic state, such as size or life stage. The population-level consequences of such selective harvesting depend upon which states are harvested and how those states contribute to population dynamics. We focused on a form of selective harvesting that has not previously been investigated in an experimental context: sex-selective harvesting, a common feature of exploited, dioecious populations. Using simple metapopulations (two patches connect by dispersal) of sexually dimorphic Bruchid beetles in the laboratory, we contrasted the effects of female-selective, male-selective, and non-selective harvesting over six generation of population dynamics. We also tested the ability of a harvest refuge (one patch of the metapopulation free from harvesting) to mitigate the effects of harvesting, and whether refuge effects interacted with sex selectivity. Sex-selective harvesting significantly perturbed operational sex ratios and harvest refuges dampened these perturbations. Metapopulations assigned to male-selective and non-selective treatments were able to fully compensate for harvesting, such that their dynamics did not differ from non-harvested controls. Only female-selective harvesting led to significant reductions in population size and this effect was completely offset by dispersal from a harvest refuge. A two-sex model confirmed that population dynamics are more sensitive to female vs. male harvesting, but suggested that higher levels of male harvest than included in our experiment would cause population decline. We discuss the roles of density-dependent competition and frequency-dependent sexual processes in the population response to sex-selective harvesting.

For federally managed fisheries in the USA, National Standard 1 requires that an acceptable biological catch be set for all fisheries and that this catch avoid overfishing. Achieving this goal for data-poor stocks, for which stock assessments are not possible, is particularly challenging. A number of harvest control rules have very recently been developed to set sustainable catches in data-poor fisheries, but the ability of most of these rules to avoid overfishing has not been tested. We conducted a management strategy evaluation to assess several control rules proposed for data-poor situations. We examined three general life histories (“slow,” “medium,” and “fast”) and three exploitation histories (under-, fully, and overexploited) to identify control rules that balance the competing objectives of avoiding overfishing and maintaining high levels of harvest. Many of the control rules require information on species life history and relative abundance, so we explored a scenario in which unbiased kn...

During the past century, the field of fisheries oceanography has dominated the study of population connectivity in marine environments. The influence of physical and biological processes and their relationship to transport and retention of early life history stages has been central in providing insight into population structuring and connectivity. However, the focus on dispersive early life history stages has meant that the role of adults has received less attention and is not fully understood or appreciated. We argue that adults play a vital role in population connectivity for a wide range of marine taxa and hypothesize that adult-mediated population connectivity commonly results in a diverse array of population structuring. Two case-studies on winter skate, Leucoraja ocellata, and winter flounder, Pseudopleuronectes americanus, are presented to illustrate the role adults play in marine connectivity at both broad and fine scales, respectively. Indeed, if adults are important for population connectivity, we argue that the role of larval processes is conditional on adult choice and only management and research pursuits that integrate the full life cycle of species will capture the full dynamics of metapopulation connectivity. Failure to include the roles of adults can lead to misinterpretation of the causes and consequences of changes in ecosystem structure and fisheries productivity.

BACKGROUND: Patients with peripheral T-cell lymphomas (PTCLs) have inferior progression-free survival (PFS) and overall survival (OS) compared with patients who have aggressive B-cell non-Hodgkin lymphoma. Because PTCLs over express multidrug resistance gene 1/P-glycoprotein (MDR-1/P-gp), we devised platinum, etoposide, gemcitabine, and methylprednisolone (PEGS) with agents that are not substrates of the efflux pump. Gemcitabine was included because of its excellent single-agent activity in PTCL. METHODS: Patients who had PTCL with stage II bulky disease, stage III or IV disease with extra-nodal, nodal, and transformed cutaneous presentations were eligible. Patients received intravenous cisplatin 25 mg/m2 on days 1 through 4, etoposide 40 mg/m2 on days 1 through 4, gemcitabine 1000 mg/m2 on day 1, and methylprednisolone 250 mg on days 1 through 4 of a 21-day cycle for 6 cycles. RESULTS: In total, 34 patients were enrolled, 33 were eligible, and 79% were newly diagnosed. Histologic types were PTCL not otherwise specified (n = 15), anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma (n = 4), angioimmunoblastic T-cell lymphoma (n = 6), or other T-cell non-Hodgkin lymphomas (n = 8). Adverse events included 1 grade 5 infection with grade 3 or 4 neutropenia and 9 grade 4 hematologic toxicities. The overall response rate was 39% (47% in PTCL not otherwise specified, 33% in angioimmunoblastic T-cell lymphoma, 25% in ALK-negative and 38% in other T-cell non-Hodgkin lymphomas). The PFS rate at 2 years was 12% (95% confidence interval, 0.1%-31%), and the median PFS was 7 months. The OS rate at 2 years was 30% (95% confidence interval, 8%-54%), and the median OS was 17 months. Immunohistochemical analysis of P-gp expression revealed strong positivity in a subset of lymphoma cells (n = 6) and tumor endothelium (n = 25). CONCLUSIONS: Overall, PEGS was well tolerated, but OS was not considered promising given the design-specified targets. These results may serve as a benchmark for future comparisons for non-CHOP regimens. Cancer 2013. © 2012 American Cancer Society.

Objective Quantification of fetal right ventricular (RV) function by 2D-echocardiography is challenging. Velocity vector imaging (VVI) is an angle independent speckle tracking technique that assesses regional myocardial mechanics. Alteration in the deformation of the fetal RV in hypoplastic left heart syndrome (HLHS) is unknown. This study aimed to evaluate the regional mechanics of the fetal RV in HLHS. Methods We retrospectively analyzed HLHS fetuses imaged at our center. Velocity, strain and strain rate were obtained using VVI. Global and regional parameters of RV deformation were compared between HLHS fetuses and gestational age matched controls. Results A total of 30 HLHS fetuses and 30 gestational age matched controls were analyzed. The mean gestational age was 30.5 ±3.5 weeks. Global myocardial strain was significantly decreased in HLHS RVs compared to controls (−1.9% vs. -4.1%, p = 0.003). The volume of the hypoplastic left ventricle did not affect RV deformation in HLHS. Conclusions Compared to controls, the RV in HLHS fetuses has decreased systolic strain. Prenatal abnormalities in RV myocardial deformation may be responsible for inefficient cardiac performance and output. RV myocardial performance in HLHS can be measured prenatally and may be predictive of post-natal RV dysfunction. © 2012 John Wiley & Sons, Ltd.

Determining and understanding patterns in the reproductive status of fishes are essential for assessing individual and population reproductive potential. The least biased method for determining reproductive stage is through the use of ovarian histology; however, this method can be time consuming and expensive. To overcome these restrictions, we developed models to predict the reproductive stage of female striped bass Morone saxatilis by using ovary color and other female characteristics. We provide a standardized and calibrated method for quantifying ovary color, and we outline an analytical approach that utilizes binary and ordinal logistic regression. Our results indicated that binary models had high accuracy (