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Background and Purpose: The canonical Kir6.2/SUR2A ventricular KATP channel is highly ATP‐sensitive and remains closed under normal physiological conditions. These channels activate only when prolonged metabolic compromise causes significant ATP depletion and then shortens the action potential to reduce contractile activity. Pharmacological activation of KATP channels is cardioprotective, but physiologically, it is difficult to understand how these channels protect the heart if they only open under extreme metabolic stress. The presence of a second KATP channel population could help explain this. Here, we characterise the biophysical and pharmacological behaviours of a constitutively active Kir6.1‐containing KATP channel in ventricular cardiomyocytes. Experimental Approach: Patch‐clamp recordings from rat ventricular myocytes in combination with well‐defined pharmacological modulators was used to characterise these newly identified K+ channels. Action potential recording, calcium (Fluo‐4) fluorescence measurements and video edge detection of contractile function were used to assess functional consequences of channel modulation. Key Results: Our data show a ventricular K+ conductance whose biophysical characteristics and response to pharmacological modulation were consistent with Kir6.1‐containing channels. These Kir6.1‐containing channels lack the ATP‐sensitivity of the canonical channels and are constitutively active. Conclusion and Implications: We conclude there are two functionally distinct populations of ventricular KATP channels: constitutively active Kir6.1‐containing channels that play an important role in fine‐tuning the action potential and Kir6.2/SUR2A channels that activate with prolonged ischaemia to impart late‐stage protection against catastrophic ATP depletion. Further research is required to determine whether Kir6.1 is an overlooked target in Comprehensive in vitro Proarrhythmia Assay (CiPA) cardiac safety screens. [ABSTRACT FROM AUTHOR]

The Undiagnosed Disease Network (UDN) is comprised of clinical and research experts collaborating to diagnose rare disease. The UDN is funded by the National Institutes of Health and includes 12 different clinical sites (About Us, 2022). Here we highlight the success of collaborative efforts within the UDN Clinical Site at Vanderbilt University Medical Center (VUMC) in utilizing a cohort of experts in bioinformatics, structural biology, and genetics specialists in diagnosing rare disease. Our UDN team identified a de novo mosaic CACNA1D variant c.2299T>C in a 5‐year‐old female with a history of global developmental delay, dystonia, dyskinesis, and seizures. Using a collaborative multidisciplinary approach, our VUMC UDN team diagnosed the participant with Primary Aldosteronism, Seizures, and Neurologic abnormalities (PASNA) OMIM: 615474 due to a rare mosaic CACNA1D variant (O'Neill, 2013). Interestingly, this patient was mosaic, a phenotypic trait previously unreported in PASNA cases. This report highlights the importance of a multidisciplinary approach in diagnosing rare disease. [ABSTRACT FROM AUTHOR]

Disease specific cohort studies have reported details on X linked (XL) disorders affecting females. We investigated the spectrum and penetrance of XL disorders seen in electronic health records (EHR). We generated a cohort of individuals diagnosed with XL disorders at Vanderbilt University Medical Center over 20 years. Our cohort included 477 males and 203 females diagnosed with 108 different XL genetic disorders. We found large differences between the female/male (F/M) ratios for various XL disorders regardless of their OMIM annotated mode of inheritance. We identified four XL recessive disorders affecting women previously only described in men. Biomarkers for XL disease had unique gender‐specific patterns differing between modes of inheritance. EHRs provide large cohorts of XL genetic disorders that give new insights compared to the literature. Differences in the F/M ratios and biomarkers of XL disorders observed likely result from disease specific and sex dependent penetrance. We conclude that observed gender ratios associated with specific XL disorders may be more useful than those predicted by Mendelian genetics provided by OMIM. Our findings of a gender specific penetrance and severity for XL disorders show unexpected differences from Mendelian predictions. Further work is required to validate our findings in larger combined EHR cohorts. [ABSTRACT FROM AUTHOR]

A 26‐year‐old female proband with a clinical diagnosis and consistent phenotype of Diamond–Blackfan anemia (DBA, OMIM 105650) without an identified genotype was referred to the Undiagnosed Diseases Network. DBA is classically associated with monoallelic variants that have an autosomal‐dominant or ‐recessive mode of inheritance. Intriguingly, her case was solved by a detection of a digenic interaction between non‐allelic RPS19 and RPL27 variants. This was confirmed with a machine learning structural model, co‐segregation analysis, and RNA sequencing. This is the first report of DBA caused by a digenic effect of two non‐allelic variants demonstrated by machine learning structural model. This case suggests that atypical phenotypic presentations of DBA may be caused by digenic inheritance in some individuals. We also conclude that a machine learning structural model can be useful in detecting digenic models of possible interactions between products encoded by alleles of different genes inherited from non‐affected carrier parents that can result in DBA with an unrealized 25% recurrence risk. [ABSTRACT FROM AUTHOR]

Introduction: Older people represent a growing proportion of the population in most high‐income countries. The impact of oral diseases on health and well‐being is far‐reaching, and future graduates should be able to meet their needs in this phase of life. This research tested the feasibility of involving dental students in direct community engagement to explore older peoples' oral health concerns and information needs. Materials and Methods: Seventeen older people were recruited locally to attend workshops with eight dental students in a health and well‐being centre. First, older people selected oral health‐related topics important to them, raising relevant questions and concerns. Students provided evidence‐informed feedback on these selected topics at a subsequent workshop. Participants (students and older people) reflected on their involvement (via questionnaires, discussions and personal reflections). Qualitative data were analysed using thematic analysis. The structure, process and outcome of the study were explored. Results: Structure: Both students and older people were willing to participate in workshops. Workshops in the community facilitated active engagement between both groups without the constraints of clinics. Process: Students considered pre‐workshop preparations adequate but raised issues about their ability to manage 'strong characters' within discussion groups. Outcome: Older people welcomed the initiative. Important topics raised by them were addressed by students giving them advice on maintaining their oral health. Students reported an improved understanding of how older people can be supported and expected a significant impact on future practice. Conclusion: Student involvement in direct community engagement was welcomed by all, demonstrating the feasibility and positive impact of the design whilst highlighting issues of importance for older people's oral health. [ABSTRACT FROM AUTHOR]

Fe‐based potassium Prussian blue analogs (K‐PBAs) are commonly used as K‐ion battery (KIB) cathodes. Interestingly, K‐PBAs are appealing cathodes for Na‐ion batteries (NIBs). In a hybrid NIB cell, where Na‐ion is in the electrolyte and K‐ion is in the PBA cathode, cation intercalation and electrochemical performance of the cathode can be significantly affected by [Fe(CN)6]4− anion vacancy. This work studies the effect of anion vacancy in K‐PBAs on regulating K‐ion/Na‐ion intercalation mechanism in hybrid NIB cells, by comparing two K‐PBA cathodes with different vacancy contents. The results demonstrate that introducing a level of anion vacancy can maximize the number of K‐ion intercalation sites and enhance K‐ion diffusion in the PBA framework. This facilitates K‐ion intercalation and suppresses Na‐ion intercalation, resulting in a K‐ion‐dominated and high‐discharge‐voltage ion storage process in the hybrid NIB cell. The K‐PBA cathode with 20% anion vacancy delivers 128 mAh g−1 at 25 mA g−1 and 67 mAh g−1 at 1000 mA g−1, as well as retains 89% and 81% capacity after 100 and 300 cycles, respectively. It completely outperforms the counterpart with 7% anion vacancy, which exhibits increased Na‐ion intercalation but overall deteriorated ion storage. [ABSTRACT FROM AUTHOR]

The article offers information on the potential synergy between storytelling and peacebuilding, envisioning a better world through their collaborative efforts. Topics discussed include the role of storytelling in fostering harmony and healing; the significance of oral traditions in challenging dominant narratives; and the need for inclusive storytelling spaces at various levels of society to address ignorance and promote a more peaceful future.

Background: Dermatology residents gain exposure to dermatopathology through a variety of educational modalities. While virtual pathology applications have risen dramatically, resident utilization of digital libraries, slide scanner availability, and comfort with virtual slides are not well‐known. This study aims to assess the current landscape of educational resources used by dermatology residents. Methods: A 17‐question survey was sent to dermatology residents through a national email database. The survey was a self‐assessment of their experience in dermatopathology education and the use of departmental slide scanners. Results: The use of digital dermatopathology is high among trainees, despite only half of respondents reporting slide scanner access. Residents report using virtual images more often in non‐clinical dermatopathology didactics and independent studies compared to clinical dermatopathology rotations. Public slide set use was common, while professional society and departmental slide sets may be underutilized. Over half of respondents report being extremely or very comfortable navigating interactive scanned slides. Conclusions: Survey data suggests digital slides are currently predominantly used in non‐clinical dermatopathology rotations and independent studies. Incorporation of slide scanners into departments may benefit resident education through the development of high‐quality, curated departmental slide sets. [ABSTRACT FROM AUTHOR]

A 72‐year‐old man was referred to the Undiagnosed Diseases Network (UDN) because of gradual progressive weakness in both lower extremities for the past 45 years. He was initially diagnosed as having Charcot–Marie–Tooth disease type 2 (CMT2) without a defined molecular genetic cause. Exome sequencing (ES) failed to detect deleterious neuromuscular variants. Very recently, biallelic variants in sorbitol dehydrogenase (SORD) were discovered to be a novel cause of inherited neuropathies including CMT2 or distal hereditary motor neuropathy (dHMN) referred to as Sorbitol Dehydrogenase Deficiency with Peripheral Neuropathy (SORDD, OMIM 618912). The most common variant identified was c.757delG; p.A253Qfs*27. Through the Vanderbilt UDN clinical site, this patient was formally diagnosed with SORDD after the identification of homozygosity for the above SORD frameshift through UDN Genome Sequencing (GS). His medical odyssey was solved by GS and detection of extremely high levels of sorbitol. The diagnosis provided him the opportunity to receive potential treatment with an investigational drug in a clinical trial for SORDD. We suggest that similar studies be considered in other individuals thought to possibly have CMT2 or dHMN. [ABSTRACT FROM AUTHOR]

Background: Intensive care settings have high rates of medication administration errors. Medications are often administered by nurses and midwives using a specified process (the '5 rights'). Understanding where medication errors occur, the contributing factors and how best practice is delivered may assist in developing interventions to improve medication safety. Aims: To identify medication administration errors and context specific barriers and enablers for best practice in an adult and a neonatal intensive care unit. Secondary aims were to identify intervention functions (through the Behaviour Change Wheel). Study Design: A dual methods exploratory descriptive study was conducted (May to June 2021) in a mixed 56‐bedded adult intensive care unit and a 6‐bedded neonatal intensive care unit in Sydney, Australia. Incident monitoring data were examined. Direct semi‐covert observational medication administration audits using the 5 rights (n = 39) were conducted. Brief interviews with patients, parents and nurses were conducted. Data were mapped to the Behaviour Change Wheel. Results: No medication administration incidents were recorded. Audits (n = 3) for the neonatal intensive care unit revealed no areas for improvement. Adult intensive care unit nurses (n = 36) performed checks for the right medication 35 times (97%) and patient identity 25 times (69%). Sixteen administrations (44%) were interrupted. Four themes were synthesized from the interview data: Trust in the nursing profession; Availability of policies and procedures; Adherence to the '5 rights' and departmental culture; and Adequate staffing. The interventional functions most likely to bring about behaviour change were environmental restructuring, enablement, restrictions, education, persuasion and modelling. Conclusions: This study reveals insights about the medication administration practices of nurses in intensive care. Although there were areas for improvement there was widespread awareness among nurses regarding their responsibilities to safely administer medications. Interview data indicated high levels of trust among patients and parents in the nurses. Relevance to clinical practice: This novel study indicated that nurses in intensive care are aware of their responsibilities to safely administer medications. Mapping of contextual data to the Behaviour Change Wheel resulted in the identification of Intervention functions most likely to change medication administration practices in the adult intensive care setting that is environmental restructuring, enablement, restrictions, education, persuasion and modelling. [ABSTRACT FROM AUTHOR]

The contribution of mosaicism to diagnosed genetic disease and presumed de novo variants (DNV) is under investigated. We determined the contribution of mosaic genetic disease (MGD) and diagnosed parental mosaicism (PM) in parents of offspring with reported DNV (in the same variant) in the (1) Undiagnosed Diseases Network (UDN) (N = 1946) and (2) in 12,472 individuals electronic health records (EHR) who underwent genetic testing at an academic medical center. In the UDN, we found 4.51% of diagnosed probands had MGD, and 2.86% of parents of those with DNV exhibited PM. In the EHR, we found 6.03% and 2.99% and (of diagnosed probands) had MGD detected on chromosomal microarray and exome/genome sequencing, respectively. We found 2.34% (of those with a presumed pathogenic DNV) had a parent with PM for the variant. We detected mosaicism (regardless of pathogenicity) in 4.49% of genetic tests performed. We found a broad phenotypic spectrum of MGD with previously unknown phenotypic phenomena. MGD is highly heterogeneous and provides a significant contribution to genetic diseases. Further work is required to improve the diagnosis of MGD and investigate how PM contributes to DNV risk. [ABSTRACT FROM AUTHOR]

Metapopulations are often managed as a single contiguous population despite the spatial structure underlying their local and regional dynamics. Disturbances from human activities can also be spatially structured with mortality impacts concentrated to just a few local populations among the aggregate. Scale transitions between local and regional processes can generate emergent properties whereby the whole system can fail to recover as quickly as expected for an equivalent single population. Here, we draw on theory and empirical case studies to ask: what is the consequence of spatially structured ecological and disturbance processes on metapopulation recoveries? We suggest that exploring this question could help address knowledge gaps for managing metapopulations including: Why do some metapopulations recover quickly while others remain collapsed? And, what risks are unaccounted for when metapopulations are managed at aggregate scales? First, we used model simulations to examine how scale transitions among ecological and disturbance conditions interact to generate emergent metapopulation recovery outcomes. In general, we found that the spatial structure of disturbance was a strong determinant of recovery outcomes. Specifically, disturbances that unevenly impacted local populations consistently generated the slowest recoveries and highest conservation risks. Ecological conditions that dampened metapopulation recoveries included low dispersal, variable local demography, sparsely connected habitat networks, and spatially and temporally correlated stochastic processes. Second, we illustrate the unexpected challenges of managing metapopulations by examining the recoveries of three USA federally listed endangered species: Florida Everglade snail kites, California and Alaska sea otters, and Snake River Chinook salmon. Overall, our results show the pivotal role of spatial structure in metapopulation recoveries whereby the interplay between local and regional processes shapes the resilience of the whole system. With this understanding, we provide guidelines for resource managers tasked with conserving and managing metapopulations and identify opportunities for research to support the application of metapopulation theory to real‐world challenges. [ABSTRACT FROM AUTHOR]

Under future climate change, modification of temperature and salinity are expected to result in distribution shifts of marine organisms, including commercial fish and shellfish. Changes are anticipated everywhere, including in the seas of many important fishing nations. Species turnover will in turn result in both opportunities and threats to fishing industries. To determine the impacts for northwest European shelf fisheries, we project changes for 49 commercially important fish and shellfish species using an ensemble of five ecological niche models and three different downscaled climate change projections. The habitat suitability and latitudinal shifts projected from the recent past (1997–2016) to two futures (2030–2050; 2050–2070) were calculated for waters around the United Kingdom. Of the species examined, around half were projected to have consistently more suitable habitat in the future, including European seabass (Dicentrarchus labrax, Moronidae), sardine (Sardina pilchardus, Alosidae) and anchovy (Engraulis encrasicolus, Engraulidae). Conversely, it is suggested that UK waters will become less suitable for species including Atlantic cod (Gadus morhua, Gadidae) and saithe (Pollachius virens, Gadidae). Our comprehensive approach using a number of models and climate change scenarios shows that while there are differences in the magnitude of change between models, and while some models perform better for certain species compared with others, overall, the general trends in habitat suitability and abundance are robust across models and climate scenarios. This emphasises the value in using more than one modelling technique with different climate scenarios (i.e., an ensemble approach) to capture the uncertainty or agreement around climate change projections. [ABSTRACT FROM AUTHOR]

Background: Studies evaluating the association between prenatal ultrasounds and autism spectrum disorder (ASD) have largely produced negative results. Concern remains due to the rising identification of children with ASD and ultrasound use. Objective: To evaluate the association between prenatal ultrasound use and ASD. Methods: We used data from the Study to Explore Early Development, a multisite case‐control study of preschool‐aged children with ASD implemented during 2007–2012. We recruited cases from children receiving developmental disability services and randomly selected population controls from birth records. ASD case status was based on in‐person standardised assessments. We stratified analyses by pre‐existing maternal medical conditions and pregnancy complications associated with increased ultrasound use (ultrasound indications) and used logistic regression to model case status by increasing ultrasound counts. For pregnancies with medical record data on ultrasound timing, we conducted supplementary tests to model associations by trimester of exposure. Results: Among 1524 singleton pregnancies, ultrasound indications were more common for ASD cases than controls; respectively, for each group, no indications were reported for 45.1% and 54.2% of pregnancies, while ≥2 indications were reported for 26.1% and 18.4% of pregnancies. The percentage of pregnancies with multiple ultrasounds varied by case status and the presence of ultrasound indications. However, stratified regression models showed no association between increasing ultrasound counts and case status, either for pregnancies without (aOR 1.01, 95% CI 0.92, 1.11) or with ultrasound indications (aOR 1.01, 95% CI 0.95, 1.08). Trimester‐specific analyses using medical record data showed no association in any individual trimester. Conclusions: We found no evidence that prenatal ultrasound use increases ASD risk. Study strengths included gold‐standard assessments for ASD case classification, comparison of cases with controls, and a stratified sample to account for conditions associated both with increased prenatal ultrasound use and ASD. [ABSTRACT FROM AUTHOR]

The field of printed electronics strives for lower processing temperatures to move toward flexible substrates that have vast potential: from wearable medical devices to animal tagging. Typically, ink formulations are optimized using mass screening and elimination of failures; as such, there are no comprehensive studies on the fundamental chemistry at play. Herein, findings which describe the steric link to decomposition profile: combining density functional theory, crystallography, thermal decomposition, mass spectrometry, and inkjet printing, are reported. Through the reaction of copper(II) formate with excess alkanolamines of varying steric bulk, tris‐co‐ordinated copper precursor ions: "[CuL3]," each with a formate counter‐ion (1–3) are isolated and their thermal decomposition mass spectrometry profiles are collected to assess their suitability for use in inks (I1–3). Spin coating and inkjet printing of I1,2 provides an easily up‐scalable method toward the deposition of highly conductive copper device interconnects (ρ = 4.7–5.3 × 10−7 Ω m; ≈30% bulk) onto paper and polyimide substrates and forms functioning circuits that can power light‐emitting diodes. The connection among ligand bulk, coordination number, and improved decomposition profile supports fundamental understanding which will direct future design. [ABSTRACT FROM AUTHOR]

Background: Previous studies found consistent associations between pregestational diabetes and birth defects. Given the different biological mechanisms for type 1 (PGD1) and type 2 (PGD2) diabetes, we used National Birth Defects Prevention Study (NBDPS) data to estimate associations by diabetes type. Methods: The NBDPS was a study of major birth defects that included pregnancies with estimated delivery dates from October 1997 to December 2011. We compared self‐reported PGD1 and PGD2 for 29,024 birth defect cases and 10,898 live‐born controls. For case groups with ≥5 exposed cases, we estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association between specific defects and each diabetes type. We calculated crude ORs (cORs) and 95% CIs with Firth's penalized likelihood for case groups with 3–4 exposed cases. Results: Overall, 252 (0.9%) cases and 24 (0.2%) control mothers reported PGD1, and 357 (1.2%) cases and 34 (0.3%) control mothers reported PGD2. PGD1 was associated with 22/26 defects examined and PGD2 was associated with 29/39 defects examined. Adjusted ORs ranged from 1.6 to 70.4 for PGD1 and from 1.6 to 59.9 for PGD2. We observed the strongest aORs for sacral agenesis (PGD1: 70.4, 32.3–147; PGD2: 59.9, 25.4–135). For both PGD1 and PGD2, we observed elevated aORs in every body system we evaluated, including central nervous system, orofacial, eye, genitourinary, gastrointestinal, musculoskeletal, and cardiac defects. Conclusions: We observed positive associations between both PGD1 and PGD2 and birth defects across multiple body systems. Future studies should focus on the role of glycemic control in birth defect risk to inform prevention efforts. [ABSTRACT FROM AUTHOR]

Background: A de novo, pathogenic, missense variant in UBTF, c.628G>A p.Glu210Lys, has been described as the cause of an emerging neurodegenerative disorder, Childhood‐Onset Neurodegeneration with Brain Atrophy (CONDBA). The p.Glu210Lys alteration yields a positively charged stretch of three lysine residues. Functional studies confirmed this change results in a stronger interaction with negatively charged DNA and gain‐of‐function activity when compared to the wild‐type sequence. The CONDBA phenotype reported in association with p.Glu210Lys consists of normal early‐neurodevelopment followed by progressive motor, cognitive, and behavioral regression in early‐to‐middle childhood. Methods and Results: The current proband presented at 9 months of age with baseline developmental delay and more extensive neuroradiological findings, including pontine hypoplasia, thalamic volume loss and signal abnormality, and hypomyelination. Like the recurrent CONDBA p.Glu210Lys variant, this novel variant, c.608A>G p.(Gln203Arg) lies within the highly conserved second HMG‐box homology domain and involves the replacement of the wild‐type residue with a positively charged residue, arginine. Computational structural modeling demonstrates that this amino acid substitution potentiates the interaction between UBTF and DNA, likely resulting in a gain‐of‐function effect for the UBTF protein, UBF. Conclusion: Here we present a new divergent phenotype associated with a novel, likely pathogenic, missense variant at a different position in the UBTF gene, c.608A>G p.(Gln203Arg). [ABSTRACT FROM AUTHOR]

Aims: The rate of unplanned reattendances is used as an indicator of the quality of care delivered in a paediatric emergency department (PED). With early reattendance in the UK well above the national target of 1–5%, we aimed to identify the factors which predict unplanned early reattendance to the PED. Methods: This is a prospective, single‐centre cohort study undertaken over 12 months. Data were collected on all patients who reattended the PED within 7 days of their initial visit as well as for a comparative cohort of patients with no visit in the preceding or subsequent 7 days. Multiple patient and departmental variables were recorded and analysed using a multivariate regression model. Results: There were a total of 19 420 index visits to the PED, of which 1461 patients had an unscheduled reattendance within 7 days – a rate of 7.5%. Factors associated with unplanned but related reattendance include young age and diagnosis with a respiratory or other medical illness. Interestingly, the grade of clinician appeared to be relevant with patients seen by junior members of the medical team less likely to reattend. Acuity of illness was not a significant factor. A substantial number of unplanned early reattenders (36.3%) would have been missed had a time period of 72 h been used rather than 7 days. Conclusions: This study identifies the typical patient who will have an unplanned, related early reattendance to a PED. This study also supports the use of a 7‐day time period when using early reattendance as a performance indicator. [ABSTRACT FROM AUTHOR]

Background: Associations between birth defects and fevers attributed to colds, influenza, and urinary tract infections (UTIs) have been observed in previous studies. Our aim was to study associations between birth defects and fevers attributed to other causes. Methods: We analyzed data from 34,862 participants in the National Birth Defects Prevention Study, a multistate case–control study of major structural birth defects. Using multivariable logistic regression, we assessed the association between maternal report of fever during early pregnancy due to causes other than colds, influenza, or UTI and 36 categories of birth defects. Results: Maternal reports of fever due to other causes were associated with significantly elevated odds ratios ranging from 1.93 to 10.60 for 8 of 36 birth defects, primarily involving the spine, limbs, and heart (spina bifida, intestinal atresia, intercalary limb deficiency, transverse limb deficiency, congenital heart defect with heterotaxy, tetralogy of Fallot, pulmonary atresia and atrial septal defect, not otherwise specified). Conclusion: Our data suggests fever itself or other physiologic changes associated with many infections are associated with some birth defects. Women who are pregnant or planning to become pregnant may want to consider speaking with their healthcare provider about the best ways to avoid infections that may cause fever and for guidance on how to treat fevers during pregnancy. [ABSTRACT FROM AUTHOR]

Understanding the role of animal behaviour in linking individuals to ecosystems is central to advancing knowledge surrounding community structure, stability and transition dynamics. Using 22 years of long‐term subtidal monitoring, we show that an abrupt outbreak of purple sea urchins (Strongylocentrotus purpuratus), which occurred in 2014 in southern Monterey Bay, California, USA, was primarily driven by a behavioural shift, not by a demographic response (i.e. survival or recruitment). We then tracked the foraging behaviour of sea urchins for 3 years following the 2014 outbreak and found that behaviour is strongly associated with patch state (forest or barren) transition dynamics. Finally, in 2019, we observed a remarkable recovery of kelp forests at a deep rocky reef. We show that this recovery was associated with sea urchin movement from the deep reef to shallow water. These results demonstrate how changes in grazer behaviour can facilitate patch dynamics and dramatically restructure communities and ecosystems. [ABSTRACT FROM AUTHOR]

Data collection Sunderland clinicians prospectively captured data about the needs of children with CP since 1990, in collaboration with the North of England Collaborative Cerebral Palsy Survey until 2016 when Public Health England withdrew funding. Abbreviation MRICS Magnetic Resonance Imaging Classification System When new information about a child having cerebral palsy (CP) is shared with families, parents want to know what this will mean for them and what to expect for the future. Of the 11 out of 95 (11.6%) children with CP who had no admissions and MRICS category E (normal), all had motor function in GMFCS levels I or II, other than one in GMFCS level IV. Definitions The internationally agreed definition of CP was used.11 The classification system of the Surveillance of Cerebral Palsy in Europe described CP subtypes.12 The GMFCS1 described gross motor function. [Extracted from the article]

Sea otters (Enhydra lutris kenyoni) historically occurred in Washington State, USA, until their local extinction in the early 1900s as a result of the maritime fur trade. Following their extirpation, 59 sea otters were translocated from Amchitka Island, Alaska, USA, to the coast of Washington, with 29 released at Point Grenville in 1969 and 30 released at La Push in 1970. The Washington Department of Fish and Wildlife has outlined 2 main objectives for sea otter recovery: a target population level and a target geographic distribution. Recovery criteria are based on estimates of population abundance, equilibrium abundance (K), and geographic distribution; therefore, estimates of these parameters have important management implications. We compiled available survey data for sea otters in Washington State since their translocation (1977–2019) and fit a Bayesian state‐space model to estimate past and current abundance, and equilibrium abundance at multiple spatial scales. We then used forward projections of population dynamics to explore potential scenarios of range recolonization and as the basis of a sensitivity analysis to evaluate the relative influence of movement behavior, frontal wave speed, intrinsic growth, and equilibrium density on future population recovery potential. Our model improves upon previous analyses of sea otter population dynamics in Washington by partitioning and quantifying sources of estimation error to estimate population dynamics, by providing robust estimates of K, and by simulating long‐term population growth and range expansion under a range of realistic parameter values. Our model resulted in predictions of population abundance that closely matched observed counts. At the range‐wide scale, the population size in our model increased from an average of 21 independent sea otters (95% CI = 13–29) in 1977 to 2,336 independent sea otters (95% CI = 1,467–3,359) in 2019. The average estimated annual growth rate was 12.42% and varied at a sub‐regional scale from 6.42–14.92%. The overall estimated mean K density of sea otters in Washington was 1.71 ± 0.90 (SD) independent sea otters/km2 of habitat (1.96 ± 1.04 sea otters/km2, including pups), and estimated densities within the current range correspond on average to 87% of mean sub‐regional equilibrium values (range = 66–111%). The projected value of K for all of Washington was 5,287 independent sea otters (95% CI = 2,488–8,086) and 6,080 sea otters including pups (95% CI = 2,861–9,300), assuming a similar range of equilibrium densities in currently un‐occupied habitats. Sensitivity analysis of simulations of sea otter population growth and range expansion suggested that mean K density estimates in currently occupied sub‐regions had the largest impact on predicted future population growth (r2 = 0.52), followed by the rate of southward range expansion (r2 = 0.26) and the mean K density estimate of currently unoccupied sub‐regions to the south of the current range (r2 = 0.04). Our estimates of abundance and sensitivity analysis of simulations of future population abundance and geographic range help determine population status in relation to population recovery targets and identify the most influential parameters affecting future population growth and range expansion for sea otters in Washington State. [ABSTRACT FROM AUTHOR]

The southern sea otter (Enhydra lutris nereis) is a threatened sub‐species in coastal ecosystems. To understand better the role of diet, monitor health, and enhance management of this and other marine mammal species, we characterized the oral (gingival) and distal gut (rectal and fecal) microbiota of 158 wild southern sea otters living off the coast of central California, USA, and 12 captive sea otters, some of which were included in a diet shift experiment. We found that the sea otter fecal microbiota was distinct from that of three other otter species, and that captivity does not significantly alter the community structure of the sea otter gingival or distal gut microbiota. Metagenomic analysis unexpectedly revealed that the majority of sea otter fecal DNA is derived from prey, rather than from indigenous bacteria or host cells as with most other mammals. We speculate that a reduced bacterial biomass in the sea otter gut reflects rapid gut transit time and a particular strategy for foraging and energy harvest. This study establishes a reference for the healthy sea otter microbiota, highlights how a marine lifestyle may shape the mammalian microbiota, and may inform future health assessments and conservation management of sea otter populations. The southern sea otter (Enhydra lutris nereis) is a threatened sub‐species in coastal ecosystems. To understand better the role of diet, monitor health, and enhance management of this and other marine mammal species, we characterized the oral and distal gut microbiota of 158 wild southern sea otters living off the coast of central California, USA, and 12 captive sea otters, some of which participated in a diet shift experiment. We found that the sea otter microbiota is distinct, that captivity does not significantly alter the structure of its microbiota, and that the sea otter gut appears to have reduced bacterial biomass, suggesting rapid gut transit and a particular strategy for foraging and energy harvest. [ABSTRACT FROM AUTHOR]

Aims: The response of understory plants is an important, yet understudied element of forest dynamics associated with mountain pine beetle (MPB) disturbance. Here, we provide a detailed assessment of both the changes in understory species and communities over a 5‐year period following severe MPB‐induced lodgepole pine mortality. Specifically, we examine species turnover, rarity and mobility over time, and evaluate shifts in community composition, including the potential for post‐outbreak community homogenization or differentiation. Location: Western Rocky Mountain National Park in the southern Rocky Mountains, Colorado. Methods: We collected species occurrence data across lodgepole pine‐dominated forest understories using repeated sampling of the same study sites (during the peak of MPB activity and 5 years after). Results: More species appeared than disappeared 5 years after the peak of the outbreak. New species were comprised of both early‐ and late‐successional species, suggesting the presence of rather high microhabitat heterogeneity. Although most species remained relatively rare, the number of exceedingly rare species decreased, and the number of highly common species increased. Several species were able to take advantage of the new stand conditions and expand throughout the study area. Some species appeared to spread locally over short distances mainly via vegetative reproduction, others expanded primarily upwards in elevation, probably through long‐distance dispersal and some spread over both short and long distances. Non‐native species doubled in occurrence and tended to spread upslope, towards the interior of the park, yet remained a small component of the understory overall. Shifts in community composition were minimal, but a slight convergence of plant community groups suggests a trend towards community homogenization. Conclusions: Our results demonstrate that even relatively sparse and depauperate lodgepole pine forest understories may be altered in diverse ways following MPB‐induced overstory mortality, depending on the unique ability of species to respond to changes in site conditions and resource availability. [ABSTRACT FROM AUTHOR]

A variety of fluid models are proposed, due to the uncertain flow diversity and rheological features of non‐Newtonian fluids, out of which, viscoelastic Oldroyd‐B nanofluid is considered here with a nonuniform heat source over a Riga plate using an nth‐order chemical reaction. The ever increasing demand for chemical reactions in hydrometallurgical, chemical, and biomedical industries necessitates studying the behavior of heat and mass transfer in the presence of chemical reaction; a few of its applications are manufacturing of glassware or ceramics, food processing, polymer production, particulate water inflows, dehydration and drying operations in the chemical industry, and numerous applications in agricultural fields and many branches of engineering and sciences. To solve the set of nonlinear DEs, which are found after applying a suitable transformation on the governing nonlinear PDEs, a robust numerical technique, such as the fourth‐order Runge–Kutta method, is employed in the current motion problem. Also, the influences of all substantial thermophysical parameters are discussed graphically and analytically. Furthermore, the major outcomes of the results are: attenuation in the relaxation time leads to a rise in the fluid momentum significantly near the wall and the solutal profile retards with an enhanced Brownian motion that results in the retardation in the bounding surface thickness of the profile. [ABSTRACT FROM AUTHOR]

Background: The estimated prevalence of neural tube defects (NTDs) in Africa is 11.7 per 10,000 live births; however, data on the impact of antiretroviral therapy (ART) during pregnancy and the risk for birth defects in Africa are limited. Methods: Data from a hospital‐based surveillance program at four hospitals in Kampala, Uganda were used to estimate the baseline prevalence of NTDs and assess potential associations with HIV status and ART use. All live births, stillbirths, and spontaneous abortions delivered at the participating hospitals affected with selected birth defects between August 2015 and December 2018 were included. Trained midwives collected data from hospital records, maternal interviews, photographs, and narrative descriptions of birth defects. We estimated NTD prevalence per 10,000 births (live, stillbirths, spontaneous abortions), prevalence ratios, and 95% confidence intervals (CIs). Results: A total of 110,752 births from 107,133 women were included in the analysis; 9,394 (8.8%) women were HIV‐infected and among those with HIV infection, 95.6% (n = 8,977) were on ART at delivery. Overall, 109 births were affected with NTDs, giving a prevalence of 9.8 (95% CI [8.2, 11.9]). Spina bifida (n = 63) was the most common type of NTD, with a prevalence of 5.7 (95% CI [4.4, 7.3]), followed by anencephaly (n = 31), with a prevalence of 2.8 (95% CI [2.0, 4.0]). Conclusion: The prevalence of NTDs among births in Kampala, Uganda is consistent with current estimates for Africa. With the continued introduction of new medications that may be taken during pregnancy, sustainable birth defect surveillance systems and pharmacovigilance are indicated. [ABSTRACT FROM AUTHOR]

An analysis is built up for the exploration of radiative heat transport on the magnetohydrodynamic flow of rotating fluid over a vertical sheet. The inclusion of thermal radiation in conjunction with the reacting species enhances the energy as well as the solutal profiles respectively. In an advance, external heat source and applied magnetic field effects are considered for further improvement. As the magnetic Reynolds number is low, the influence of the induced magnetic field is neglected. The transformation of governing nonlinear partial differential equations into coupled nonlinear ordinary differential equations is attained with a proper supposition of similarity variables. Moreover, the solution of these transformed equations is scheduled using the "Runge-Kutta fourth-order" method numerically in association with the "shooting technique." The simulation or various illustrating parameters affecting the flow phenomena are obtained and displayed through graphs and for numerical validation with earlier published work shows the convergence process of the methodology applied. The main findings of the study are; the Dufour number is favorable to enhance the fluid temperature throughout the domain and the destructive chemical reaction also encourages the solutal profile significantly. [ABSTRACT FROM AUTHOR]

The purpose of the current investigation is to discuss the varying physical properties, that is, thermal conductivity and viscosity of a viscous time-independent flow past a slandering stretching surface. The heat transfer phenomenon is enhanced by the inclusion of an external heat source under the action of dissipative heat energy and thermal radiation. The implementation of convective boundary conditions affects the heat and solutal transfer phenomena with the inclusion of chemical reactions. The flow characteristic is directed by the system of differential equations that are converted to nonlinear ordinary type by appropriate assumptions of similarity variables and stream function. Furthermore, the "homotopy analysis method" is deployed to simplify the system. The convergence of the methodology is also discussed with their various order of approximations. The conformity of the solution is presented along with validation in tabular form. Moreover, the effect of the parameters on flow profiles is explained graphically, and the major contribution of few important parameters is laid down. The rate of shear stress along with the longitudinal velocity profile augments with the enhanced variable viscosity. Furthermore, the reverse impact is rendered for the augmented values of the variable viscosity. [ABSTRACT FROM AUTHOR]

Sea otter (Enhydra lutris) populations in southwest Alaska declined substantially between about 1990 and the most recent set of surveys in 2015. Here we report changes in the distribution and abundance of sea otters, and covarying patterns in reproduction, mortality, body size and condition, diet and foraging behavior, food availability, health profiles, and exposure to environmental contaminants over this 25‐yr period. The population decline, which resulted in densities on the order of 5% of environmental carrying capacity, ranged from Attu Island in the west to about Castle Cape (on the south side of the Alaska Peninsula) in the east. Remaining sea otters moved closer to shore and into shallow, protected habitats. Reproductive rates appeared unchanged with the decline. Although the demographic cause of the decline was clearly elevated mortality, stranded carcasses were rare or absent. The net rate of energy gain by foraging sea otters, body length and condition, and prey biomass density, all increased after the decline and varied inversely with sea otter population density beyond the area of decline. Sea otters within the area of decline showed no increases in health anomalies, disease, contaminant exposure, or abnormal gene transcription patterns as compared to animals outside the area of decline. These collective findings are inconsistent with nutritional limitation, disease, or environmental contaminants, and consistent with predation (or possibly some other density‐independent factor) as the reason for the sea otter population decline. Our approach and analyses provide a broad conceptual template for thinking about and assessing the causes of wildlife population declines. [ABSTRACT FROM AUTHOR]

Measurement error arises commonly in clinical research settings that rely on data from electronic health records or large observational cohorts. In particular, self‐reported outcomes are typical in cohort studies for chronic diseases such as diabetes in order to avoid the burden of expensive diagnostic tests. Dietary intake, which is also commonly collected by self‐report and subject to measurement error, is a major factor linked to diabetes and other chronic diseases. These errors can bias exposure‐disease associations that ultimately can mislead clinical decision‐making. We have extended an existing semiparametric likelihood‐based method for handling error‐prone, discrete failure time outcomes to also address covariate error. We conduct an extensive numerical study to compare the proposed method to the naive approach that ignores measurement error in terms of bias and efficiency in the estimation of the regression parameter of interest. In all settings considered, the proposed method showed minimal bias and maintained coverage probability, thus outperforming the naive analysis which showed extreme bias and low coverage. This method is applied to data from the Women's Health Initiative to assess the association between energy and protein intake and the risk of incident diabetes mellitus. Our results show that correcting for errors in both the self‐reported outcome and dietary exposures leads to considerably different hazard ratio estimates than those from analyses that ignore measurement error, which demonstrates the importance of correcting for both outcome and covariate error. [ABSTRACT FROM AUTHOR]

Background: Use of nonsteroidal anti‐inflammatory drugs (NSAIDs) during pregnancy may increase risk for neural tube defects (NTDs), including spina bifida. Folic acid intake can prevent NTDs, but it is not known whether it modifies any risks associated with NSAID use. Objectives: To assess the impact of periconceptional NSAID use on the risk of spina bifida overall and stratified by folic acid intake. Study Design: We analyzed 1998–2015 data from the Slone Epidemiology Center Birth Defects Study, a multi‐site, case–control study. Mothers were interviewed to identify sociodemographic factors, behaviors, and exposures during pregnancy. Periconceptional NSAID use was defined as use of aspirin, ibuprofen, naproxen, or COX2 inhibitors within the month before or after the last menstrual period. Logistic regression models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for NSAID use, adjusted for study center and race/ethnicity stratified by average daily folic acid intake above ("high FA") or below ("low FA") 400 mcg/day. Results: We compared mothers of 267 infants with spina bifida to mothers of 6,233 nonmalformed controls. Among control mothers, 20% used NSAIDS periconceptionally (16% ibuprofen, 4% aspirin, 3% naproxen, and <1% COX‐2 inhibitors). For any NSAID use, the aORs among low FA and high FA women were 1.70 (95% CI [1.13, 2.57]) and 1.09 (95% CI [0.69, 1.71]), respectively. Conclusions: We observed a small increase in the risk for spina bifida among infants born to women who used NSAIDs periconceptionally, but this risk was limited to those who had inadequate folic acid intake. [ABSTRACT FROM AUTHOR]

Sea otters, Enhydra lutris, were once abundant along the nearshore areas of the North Pacific. The international maritime fur trade that ended in 1911 left 13 small remnant populations with low genetic diversity. Subsequent translocations into previously occupied habitat resulted in several reintroduced populations along the coast of North America. We sampled sea otters between 2008 and 2011 throughout much of their current range and used 19 nuclear microsatellite markers to evaluate genetic diversity, population structure, and connectivity between remnant and reintroduced populations. Average genetic diversity within populations was similar: observed heterozygosity 0.55 and 0.53, expected heterozygosity 0.56 and 0.52, unbiased expected heterozygosity 0.57 and 0.52, for reintroduced and remnant populations, respectively. Sea otter population structure was greatest between the Northern and Southern sea otters with further structuring in Northern sea otters into Western, Central, and Southeast populations (including the reintroduced populations). Migrant analyses suggest the successful reintroductions and growth of remnant groups have enhanced connectivity and gene flow between populations throughout many of the sampled Northern populations. We recommend that future management actions for the Southern sea otter focus on future reintroductions to fill the gap between the California and Washington populations ultimately restoring gene flow to the isolated California population. [ABSTRACT FROM AUTHOR]

Background: Maternal pregestational diabetes and obesity are risk factors for birth defects. Diabetes and obesity often occur together; it is unclear whether their co‐occurrence compounds birth defect risk. Methods: We analyzed 1997–2011 data on 29,671 cases and 10,963 controls from the National Birth Defects Prevention Study, a multisite case‐control study. Mothers self‐reported height, pregestational weight, and diabetes (pregestational and gestational; analyzed separately). We created four exposure groups: no obesity or diabetes (referent), obesity only, diabetes only, and both obesity and diabetes. We estimated odds ratios (ORs) using logistic regression and the relative excess risk due to interaction (RERI). Results: Among mothers with pregestational obesity without diabetes, modest associations (OR range: 1.1–1.5) were observed for neural tube defects, small intestinal atresia, anorectal atresia, renal agenesis/hypoplasia, omphalocele, and several congenital heart defects. Pregestational diabetes, regardless of obesity, was strongly associated with most birth defects (OR range: 2.0–75.9). Gestational diabetes and obesity had a stronger association than for obesity alone and the RERI (in parentheses) suggested additive interaction for hydrocephaly (1.2; 95% confidence interval [CI]: −0.1, 2.5), tetralogy of Fallot (0.9; 95% CI: −0.01, 1.8), atrioventricular septal defect (1.1; 95% CI: −0.1, 2.3), hypoplastic left heart syndrome (1.1; 95% CI: −0.2, 2.4), and atrial septal defect secundum or not otherwise specified (1.0; 95% CI: 0.3, 1.6; only statistically significant RERI). Conclusions: Our results do not support a synergistic relationship between obesity and diabetes for most birth defects examined. However, there are opportunities for prevention by reducing obesity and improving glycemic control among women with pregestational diabetes before conception. [ABSTRACT FROM AUTHOR]

Fine‐scale (submillimeter to centimeter) depositional and diagenetic features encountered during the Curiosity rover's traverse in Gale crater provide a means to understand the geologic history of Vera Rubin ridge (VRR). VRR is a topographically high feature on the lower north slope of Aeolis Mons, a 5‐km high stratified mound within Gale crater. We use high‐spatial resolution images from the Mars Hand Lens Imager (MAHLI) as well as grain sizes estimated with the Gini index mean score technique that uses ChemCam Laser‐Induced Breakdown Spectroscopy (LIBS) chemical data to constrain the postdepositional history of the strata exposed on this ridge. MAHLI images were used to examine the color, grain size, and style of lamination of the host rocks, as well as to explore the occurrence of nodules, diagenetic crystals, pits, and a variety of dark‐gray iron‐rich features. This survey revealed abundant and widespread diagenetic features within the rocks exposed on VRR and demonstrated that rock targets estimated to be coarser generally contain more diagenetic features than those estimated to have finer grains, which indicate that grain size may have influenced the degree and type of diagenesis. A subset of rocks within VRR are gray in color and exhibit the highest proportion of diagenetic features. We suggest that these targets experienced a different diagenetic history than the other rocks on VRR and hypothesize that redistribution and recrystallization of iron within specific intervals may have resulted in both the gray color and the abundance of dark‐gray iron‐rich diagenetic features. Plain Language Summary: We use high resolution images to identify submillimeter‐to‐centimeter scale features that resulted from either primary deposition or alteration of the rocks after the sediment was deposited at Vera Rubin ridge (VRR). VRR is located on the flank of Aeolis Mons, the 5‐km high mound that occupies the center of Gale crater on Mars. We find that the majority of these fine‐scale features were created after the initial deposition of sediment, when water existed in the subsurface and interacted with and altered the rocks. A subset of these features is dark gray in color and have iron‐rich compositions that suggest iron remobilization and recrystallization within the host rock. We find that rocks with larger grain sizes also show more postdepositional alteration features, suggesting that grain size influenced where water moved and interacted with rocks in the subsurface. Key Points: We investigate depositional and diagenetic features on Vera Rubin ridge using high‐spatial resolution imagesObservations of submillimeter‐to‐centimeter scale features indicate extensive diagenesis occurred in this areaSubtle deviations in grain size likely contributed to the distribution and variability of diagenesis [ABSTRACT FROM AUTHOR]

The recovery of large carnivore species from over‐exploitation can have socioecological effects; thus, reliable estimates of potential abundance and distribution represent a valuable tool for developing management objectives and recovery criteria. For sea otters (Enhydra lutris), as with many apex predators, equilibrium abundance is not constant across space but rather varies as a function of local habitat quality and resource dynamics, thereby complicating the extrapolation of carrying capacity (K) from one location to another. To overcome this challenge, we developed a state‐space model of density‐dependent population dynamics in southern sea otters (E. l. nereis), in which K is estimated as a continuously varying function of a suite of physical, biotic, and oceanographic variables, all described at fine spatial scales. We used a theta‐logistic process model that included environmental stochasticity and allowed for density‐independent mortality associated with shark bites. We used Bayesian methods to fit the model to time series of survey data, augmented by auxiliary data on cause of death in stranded otters. Our model results showed that the expected density at K for a given area can be predicted based on local bathymetry (depth and distance from shore), benthic substrate composition (rocky vs. soft sediments), presence of kelp canopy, net primary productivity, and whether or not the area is inside an estuary. In addition to density‐dependent reductions in growth, increased levels of shark‐bite mortality over the last decade have also acted to limit population expansion. We used the functional relationships between habitat variables and equilibrium density to project estimated values of K for the entire historical range of southern sea otters in California, USA, accounting for spatial variation in habitat quality. Our results suggest that California could eventually support 17,226 otters (95% CrI = 9,739–30,087). We also used the fitted model to compute candidate values of optimal sustainable population abundance (OSP) for all of California and for regions within California. We employed a simulation‐based approach to determine the abundance associated with the maximum net productivity level (MNPL) and propose that the upper quartile of the distribution of MNPL estimates (accounting for parameter uncertainty) represents an appropriate threshold value for OSP. Based on this analysis, we suggest a candidate value for OSP (for all of California) of 10,236, which represents 59.4% of projected K. © 2021 The Authors. The Journal of Wildlife Management published by Wiley Periodicals LLC on behalf of The Wildlife Society. We use a spatially explicit population model to explore the functional relationships between biotic and abiotic habitat variables and carrying capacity (K) of southern sea otters in California, USA, 1983–2018. We estimate that California could support 17,226 sea otters at K, with local densities varying from <1 to >10 otters/km2 based on habitat quality, and we suggest a candidate value for optimal sustainable population abundance of 10,236. [ABSTRACT FROM AUTHOR]

We recently contributed to the description of eight individuals with a novel condition caused by 16p13.3 microdeletions encompassing TBC1D24, ATP6V0C, and PDPK1 and resulting in epilepsy, microcephaly and neurodevelopmental problems. The phenotypic spectrum, the minimum overlapping region and the underlying disease mechanism for this disorder remain to be clarified. Here we report a 3.5‐year‐old male, with microcephaly, autism spectrum disorder and a de novo 16p13.3 microdeletion. We performed detailed in silico analysis to show that the minimum overlapping region for the condition is ~80Kb encompassing five protein coding genes. Analysis of loss of function constraint metrics, transcript‐aware evaluation of the population variants, GeVIR scores, analysis of reported pathogenic point variants, detailed review of the known functions of gene products and their animal models showed that the haploinsufficiency of ATP6V0C likely underlies the phenotype of this condition. Protein–protein interaction network, gene phenology and analysis of topologically associating domain showed that it was unlikely that the disorder has an epistatic or regulatory basis. 16p13.3 deletions encompassing ATP6V0C cause a neurodevelopmental disorder. Our results broaden the phenotypic spectrum of this disorder and clarify the likely underlying disease mechanism for the condition. [ABSTRACT FROM AUTHOR]

Background: Strain analysis with speckle‐tracking echocardiography shows promise as a screening tool for silent myocardial dysfunction in pediatric‐onset systemic lupus erythematosus (pSLE). We compared left ventricular (LV) systolic deformation (measured by strain) in children and adolescents with pSLE to controls, and assessed the relationship between strain, disease activity, and other noninvasive measures of cardiovascular health. Methods: Twenty pSLE subjects ages 9–21 underwent comprehensive cardiovascular testing, including 2D speckle‐tracking echocardiography, ambulatory blood pressure monitoring (ABPM), peripheral endothelial function testing, pulse wave velocity and analysis, and carotid ultrasound. Longitudinal apical‐4 chamber (LSA4C) and midpoint circumferential strain (CSmid) were compared to that of 70 healthy controls using multivariable linear regression. Among pSLE subjects, Pearson correlation coefficients were calculated to evaluate relationships between global longitudinal or circumferential strain and other measures of cardiovascular health. Results: Average SLE disease duration was 3.2 years (standard deviation [SD] 2.1). 2/20 pSLE subjects had persistent disease activity, and only one met criteria for hypertension by ABPM. LSA4C was significantly reduced in pSLE subjects compared to controls (mean −18.3 [SD 3.2] vs −21.8% [SD 2.2], P‐value <.001). There was no significant difference in CSmid (−24.8 [SD 3.7] vs −25.7% [SD 3.4], P =.29). Among pSLE subjects, decreased nocturnal blood pressure dipping on ABPM was associated with reduced global circumferential strain (r −0.59, P =.01). Conclusions: Longitudinal myocardial deformation is impaired in pSLE patients despite clinical remission and may represent early myocardial damage. Strain analysis should be considered in addition to standard echocardiographic assessment during follow‐up of patients with pSLE. [ABSTRACT FROM AUTHOR]

Background: Maternal folic acid (FA) intake before and during early pregnancy reduces the risk for neural tube defects (NTDs); evidence suggests it may also reduce the risk for oral clefts, urinary defects, and cardiac defects. We sought to re‐examine the use of drugs, which affect folate metabolism, dihydrofolate reductase inhibiting (DHFRI) medications, and anti‐epileptic drugs (AEDs), in data collected in the post‐FA fortification era (1998+) in the Slone Birth Defects Study. Methods: We assessed maternal DHFRI and AED use and risk for NTDs, oral clefts, and urinary and cardiac defects. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression. We assessed daily average FA intake of ≥400 mcg as a potential effect modifier. Results: We analyzed data from 10,209 control and 9,625 case mothers. Among controls, the prevalence of exposure to DHFRI medications was 0.3% and to AEDs was 0.5%. Maternal use of AEDs was associated with increased risks for NTDs (OR: 3.4; 95% CI: 1.5, 7.5), oral clefts (OR: 2.3; 95% CI: 1.3, 4.0), urinary defects (OR: 1.6; 95% CI: 1.0, 2.7), and cardiac defects (OR: 1.6; 95% CI: 1.1, 2.3); similar or further increased risks were found among those with FA intake ≥400 mcg per day. DHFRI use was rare and relative risk estimates were imprecise and consistent with the null. Conclusions: Similar to our previous analyses, we observed associations between AED use and these defects. For DHFRI exposure, we found no evidence for increased risk of these defects. Though statistical power to examine FA effect modification was low, we found no evidence of further protection among those with FA intake ≥400 mcg, with some associations somewhat stronger in this group. [ABSTRACT FROM AUTHOR]

Projecting the future effects of climate change on marine fished populations can help prepare the fishing industry and management systems for resulting ecological, social and economic changes. Generating projections using multiple climate scenarios can provide valuable insights for fisheries stakeholders regarding uncertainty arising from future climate data.Using a range of climate projections based on the Intergovernmental Panel on Climate Change A1B, RCP4.5 and RCP8.5 climate scenarios, we modelled abundance of eight commercially important bottom dwelling fish species across the Celtic Sea, English Channel and southern North Sea through the 21st century. This region spans a faunal boundary between cooler northern waters and warmer southern waters, where mean sea surface temperatures are projected to rise by 2 to 4°C by 2098.For each species, Generalized Additive Models were trained on spatially explicit abundance data from six surveys between 2001 and 2010. Annual and seasonal temperatures were key drivers of species abundance patterns. Models were used to project species abundance for each decade through to 2090.Projections suggest important future changes in the availability and catchability of fish species, with projected increases in abundance of red mullet Mullus surmuletus L., Dover sole Solea solea L., John dory Zeus faber L. and lemon sole Microstomus kitt L. and decreases in abundance of Atlantic cod Gadus morhua L., anglerfish Lophius piscatorius L. and megrim Lepidorhombus whiffiagonis L. European plaice Pleuronectes platessa L. appeared less affected by projected temperature changes. Most projected abundance responses were comparable among climate projections, but uncertainty in the rate and magnitude of changes often increased substantially beyond 2040.Synthesis and applications. These results indicate potential risks as well as some opportunities for demersal fisheries under climate change. These changes will challenge current management systems, with implications for decisions on target fishing mortality rates, fishing effort and allowable catches. Increasingly flexible and adaptive approaches that reduce climate impacts on species while also supporting industry adaptation are required. [ABSTRACT FROM AUTHOR]

Sea level on the northwestern European shelf (NWES) varies substantially from year to year. Removing explained parts of interannual sea level variability from observations helps to improve estimates of long‐term sea level trends. To this end, the contributions of different drivers to interannual sea level variability need to be understood and quantified. We quantified these contributions for the entire NWES by performing sensitivity experiments with a high‐resolution configuration of the Regional Ocean Modeling System (ROMS). The lateral and atmospheric boundary conditions were derived from reanalyses. We compared our model results with satellite altimetry data and used our sensitivity experiments to show that nonlinear feedbacks cause only minor interannual sea level variability on the shelf. This indicates that our experiments can be used to separate the effects of different drivers. We find that wind dominates the variability of annual mean sea level in the southern and eastern North Sea (up to 4.7‐cm standard deviation), whereas the inverse barometer effect dominates elsewhere on the NWES (up to 1.7‐cm standard deviation). In contrast, forcing at the lateral ocean boundaries results in small and coherent variability on the shelf (0.5‐cm standard deviation). Variability driven by buoyancy fluxes ranges from 0.5‐ to 1.3‐cm standard deviation. The results of our sensitivity experiments explain the (anti)correlation between interannual sea level variability at different locations on the NWES and can be used to estimate sea level rise from observations in this region with higher accuracy.Plain Language Summary: Sea level on the continental shelf northwest of Europe is rising in the long term but is also varying strongly from year to year. This makes it difficult to determine the rate of sea level rise from observations. To improve long‐term trends computed from sea level observations, the causes of short‐term sea level variability need to be understood. Therefore, we test the influences of different components of the atmosphere and ocean on year‐to‐year sea level variability, using a numerical ocean model for northwestern Europe. We find that the varying strength and direction of winds causes large variability of sea level in the southern and eastern North Sea. In other places on the continental shelf, sea level variability is mainly influenced by the variability of atmospheric pressure. We also find that the ocean outside our model domain drives small and uniform sea level variability on the continental shelf and that there is a moderate influence of solar radiation, precipitation, and evaporation. Our results help to understand how sea level varies at different locations in northwestern Europe and to obtain better estimates of the rate of long‐term sea level rise.Key Points: We use a ROMS setup to quantify the contributions of different drivers to interannual sea level variability on the NWES for 1995–2018Atmospheric variability is the main driver, whereas ocean variability drives small and uniform sea level variability on the shelfWind drives large variability in the North Sea, north of the United Kingdom and around Norway, while the inverse barometer effect dominates elsewhere [ABSTRACT FROM AUTHOR]

Reliable age estimation is an essential tool to assess the status of wildlife populations and inform successful management. Aging methods, however, are often limited by too few data, skewed demographic representation, and by single or uncertain morphometric relationships. In this study, we synthesize age estimates in southern sea otters Enhydra lutris nereis from 761 individuals across 34 years of study, using multiple noninvasive techniques and capturing all life stages from 0 to 17 years of age. From wild, stranded, and captive individuals, we describe tooth eruptions, tooth wear, body length, nose scarring, and pelage coloration across ontogeny and fit sexbased growth functions to the data. Dental eruption schedules provided reliable and identifiable metrics spanning 0.3-9 months. Tooth wear was the most reliable predictor of age of individuals aged 1-15 years, which when combined with total length, explained >93% of observed age. Beyond age estimation, dental attrition also indicated the maximum lifespan of adult teeth is 13-17 years, corresponding with previous estimates of life expectancy. Von Bertalanffy growth function model simulations of length at age gave consistent estimates of asymptotic lengths (male Loo = 126.0-126.8 cm, female Loo = 115.3-115.7 cm), biologically realistic gestation periods (t0 = 115 days, SD = 10.2), and somatic growth (male k = 1.8, SD = 0.1; female k = 2.1, SD = 0.1). Though exploratory, we describe how field radiographic imaging of epiphyseal plate development or fusions may improve aging of immature sea otters. Together, our results highlight the value of integrating information from multiple and diverse datasets to help resolve conservation problems. [ABSTRACT FROM AUTHOR]

The sea otter (Enhydra lutris) is a marine mammal hunted to near extinction during the 1800s. Despite their well‐known modern importance as a keystone species, we know little about historical sea otter ecology. Here, we characterize the ecological niche of ancient southern sea otters (E. lutris nereis) using δ13C analysis and δ15N analysis of bones recovered from archaeological sites spanning ~7,000 to 350 years before present (N = 112 individuals) at five regions along the coast of California. These data are compared with previously published data on modern animals (N = 165) and potential modern prey items. In addition, we analyze the δ15N of individual amino acids for 23 individuals to test for differences in sea otter trophic ecology through time. After correcting for tissue‐specific and temporal isotopic effects, we employ nonparametric statistics and Bayesian niche models to quantify differences among ancient and modern animals. We find ancient otters occupied a larger isotopic niche than nearly all modern localities; likely reflecting broader habitat and prey use in prefur trade populations. In addition, ancient sea otters at the most southerly sites occupied an isotopic niche that was more than twice as large as ancient otters from northerly regions. This likely reflects greater invertebrate prey diversity in southern California relative to northern California. Thus, we suggest the potential dietary niche of sea otters in southern California could be larger than in central and northern California. At two sites, Año Nuevo and Monterey Bay, ancient otters had significantly higher δ15N values than modern populations. Amino acid δ15N data indicated this resulted from shifting baseline isotope values, rather than a change in sea otter trophic ecology. Our results help in better understanding the contemporary ecological role of sea otters and exemplify the strength of combing zooarchaeological and biological information to provide baseline data for conservation efforts. [ABSTRACT FROM AUTHOR]

The persistence and fall rate of snags (standing dead trees) generated during bark beetle outbreaks have consequences for the behavior, effects, and suppression of potential wildfires, hazard tree and timber salvage operations, wildlife habitat, and numerous ecosystem processes. However, post‐beetle snagfall dynamics are poorly understood in most forest types. We tagged standing live and dead lodgepole pine (Pinus contorta), subalpine fir (Abies lasiocarpa), and Engelmann spruce (Picea engelmannii), including beetle‐killed pine snags following the peak of a recent mountain pine bark beetle outbreak in watersheds at the Fraser Experimental Forest in northcentral Colorado and sampled snagfall 10 and 12 years later. Bark beetle attacks began in 2003, peaked by 2006, and killed 78% of overstory lodgepole pine in 133 plots distributed across a range of stand and site conditions. Of those snags, only 17% fell between 2007 and 2018. Most snags broke at ground level, due to butt rot, and were oriented downhill. In contrast, snags that tipped up or snapped off above the ground were oriented with the prevailing winds. Equal numbers of snags fell singly and in multiple‐tree groups, and equal numbers remained elevated rather than in contact with the ground. Lodgepole pine snagfall was 1.6‐times higher on steep slopes (>40%) where dead pine density was higher, compared to flatter sites. Based on our findings and previous research, we estimate that one‐half the beetle‐killed lodgepole pine in high‐elevation forests such as those at Fraser may fall within 15–20 yr of beetle infestation, but that some pine snags are likely to persist for decades longer. Post‐outbreak snagfall dynamics create a multiple‐decade legacy of bark beetle outbreaks that will persist longer in high‐elevation compared to lower‐elevation forests. [ABSTRACT FROM AUTHOR]

Background: Women with a previous neural tube defect (NTD)‐affected pregnancy are recommended to consume 4,000 μg daily folic acid (FA) for prevention (10 times the general‐population recommendation). Protection from doses between 400 and 4,000 μg for this and other higher risk groups is unclear. Methods: In the case–control Slone Birth Defects Study (1988–2015), we examined the associations between periconceptional FA doses and NTDs among four higher risk groups: NTD family history, periconceptional antiepileptic drug exposure (AED), pregestational diabetes, and prepregnancy obesity. Mothers completed standardized interviews about pregnancy events and exposures. FA categorizations were based on (a) supplements only and (b) supplements and diet ("total folate"). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) (adjusted for age and study center) using logistic regression. Results: Cases and controls included: 45 and 119 with family history, 25 and 108 with AED exposure, 12 and 63 with pregestational diabetes, 111 and 1,243 with obesity. Daily FA supplementation was associated with lower NTD risk compared to no supplementation (adjusted ORs were 0.33 [95% CI 0.13, 0.76] for family history, 0.31 [0.09, 0.95] for AED exposure, 0.25 [0.04, 1.05] for pregestational diabetes, 0.65 [0.40, 1.04] for obesity). Though estimates were imprecise, as total folate increased stronger point estimates were observed, notably among family history. No mothers with a prior NTD‐affected pregnancy supplemented with 4,000 μg. Conclusions: Our findings reinforce that all women of childbearing potential should consume at least 400 μg FA/day to protect against NTDs. Higher risk groups may benefit from higher doses. [ABSTRACT FROM AUTHOR]

Habitat characteristics are primary determinants of nearshore marine communities. However, biological drivers like predation can also be important for community composition. Sea otters (Enhydra lutris ssp.) are a salient example of a keystone species exerting top‐down control on ecosystem community structure. The translocation and subsequent population growth and range expansion of the northern sea otter (Enhydra lutris kenyoni) in Washington State over the last five decades has created a spatio‐temporal gradient in sea otter occupation time and density, and acts as a natural experiment to quantify how sea otter population status and habitat type influence sea otter diet. We collected focal observations of sea otters foraging at sites across the gradient in varying habitat types between 2010 and 2017. We quantified sea otter diet composition and diversity, and long‐term rates of energy gain across the gradient. We found that sea otter diet diversity was positively correlated with cumulative sea otter density, while rate of energy gain was negatively correlated with cumulative density. Additionally, we found that habitat type explained 1.77 times more variance in sea otter diet composition than sea otter cumulative density. Long‐term diet studies can provide a broader picture of sea otter population status in Washington State. [ABSTRACT FROM AUTHOR]

Objective: To investigate first‐year survival of infants born with spina bifida, and examine the association of maternal prepregnancy body mass index (BMI) with infant mortality. Methods: This is a retrospective cohort study of 1,533 liveborn infants with nonsyndromic spina bifida with estimated dates of delivery from 1998 to 2011 whose mothers were eligible for the National Birth Defects Prevention Study (NBDPS). NBDPS data were linked to death records to conduct survival analyses. Kaplan–Meier survival functions estimated mortality risk over the first year of life. Cox proportional hazards models estimated hazard ratios (HRs) for maternal prepregnancy BMI categorized as underweight (<18.5), normal (18.5–24.9), overweight (25–29.9), and obese (≥30). Results: Infant mortality risk among infants with spina bifida was (4.4% [3.52, 5.60%]). Infants with multiple co‐occurring defects, very preterm delivery, multiple gestation, high‐level spina bifida lesions, or non‐Hispanic Black mothers had an elevated risk of infant mortality. Maternal prepregnancy underweight and obesity were associated with higher infant mortality (15.7% [7.20, 32.30%] and 5.82% [3.60, 9.35%], respectively). Adjusted HR estimates showed underweight and obese mothers had greater hazard of infant mortality compared to normal weight mothers (HR: 4.5 [1.08, 16.72] and 2.6 [1.36, 8.02], respectively). Conclusion: The overall risk of infant mortality for infants born with spina bifida was lower than most previously reported estimates. Infants born with spina bifida to mothers who were underweight or obese prepregnancy were at higher risk of infant mortality. This study provides additional evidence of the importance of healthy maternal weight prior to pregnancy. [ABSTRACT FROM AUTHOR]

Sea otter populations in Southeast Alaska, USA, have increased dramatically from just over 400 translocated animals in the late 1960s to >8,000 by 2003. The recovery of sea otters to ecosystems from which they had been absent has affected coastal food webs, including commercially important fisheries, and thus information on expected growth and equilibrium abundances can help inform resource management. We compile available survey data for Southeast Alaska and fit a Bayesian state‐space model to estimate past trends and current abundance. Our model improves upon previous analyses by partitioning and quantifying sources of estimation error, accounting for over‐dispersion of aerial count data, and providing realistic measurements of uncertainty around point estimates of abundance at multiple spatial scales. We also provide estimates of carrying capacity (K) for Southeast Alaska, at regional and sub‐regional scales, and analyze growth rates, current population status and expected future trends. At the regional scale, the population increased from 13,221 otters in 2003 to 25,584 otters in 2011. The average annual growth rate in southern Southeast Alaska (7.8%) was higher than northern Southeast Alaska (2.7%); however, growth varied at the sub‐regional scale and there was a negative relationship between growth rates and the number of years sea otters were present in an area. Local populations vary in terms of current densities and expected future growth; the mean estimated density at K was 4.2 ± 1.58 sea otters/km2 of habitat (i.e., the sub‐tidal benthos between 0 m and 40 m depth) and current densities correspond on average to 50% of projected equilibrium values (range = 1–97%) with the earliest‐colonized sub‐regions tending to be closer to K. Assuming a similar range of equilibrium densities for currently un‐occupied habitats, the projected value of K for all of Southeast Alaska is 74,650 sea otters. Future analyses can improve upon the precision of K estimates by employing more frequent surveys at index sites and incorporating environmental covariates into the process model to generate more accurate, location‐specific estimates of equilibrium density. © 2019 The Authors. The Journal of Wildlife Management Published by Wiley Periodicals, Inc. We used a Bayesian state‐space model to estimate abundance and trends of sea otters in southeast Alaska and generated the first estimates of carrying capacity at regional and sub‐regional scales. Our results show spatial variation in status with respect to carrying capacity and help identify areas with potential for future population growth. [ABSTRACT FROM AUTHOR]