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Ecological resilience is a powerful heuristic for ecosystem management in the context of rapid environmental change. Significant efforts are underway to improve the resilience of biodiversity and ecological function to extreme events and directional change across all types of landscapes, from intact natural systems to highly modified landscapes such as cities and agricultural regions. However, identifying management strategies likely to promote ecological resilience remains a challenge. In this article, we present seven core dimensions to guide long-term and large-scale resilience planning in highly modified landscapes, with the objective of providing a structure and shared vocabulary for recognizing opportunities and actions likely to increase resilience across the whole landscape. We illustrate application of our approach to landscape-scale ecosystem management through case studies from two highly modified California landscapes, Silicon Valley and the Sacramento–San Joaquin Delta. We propose that resilience-based management is best implemented at large spatial scales and through collaborative, cross-sector partnerships.

Humans are changing the Earth's surface at an accelerating pace, with significant consequences for ecosystems and their biodiversity. Landscape transformation has far-reaching implications including reduced net primary production (NPP) available to support ecosystems, reduced energy supplies to consumers, and disruption of ecosystem services such as carbon storage. Anthropogenic activities have reduced global NPP available to terrestrial ecosystems by nearly 25%, but the loss of NPP from wetland ecosystems is unknown. We used a simple approach to estimate aquatic NPP from measured habitat areas and habitat-specific areal productivity in the largest wetland complex on the USA west coast, comparing historical and modern landscapes and a scenario of wetland restoration. Results show that a 77% loss of wetland habitats (primarily marshes) has reduced ecosystem NPP by 94%, C (energy) flow to herbivores by 89%, and detritus production by 94%. Our results also show that attainment of habitat restoration goals could recover 12% of lost NPP and measurably increase carbon flow to consumers, including at-risk species and their food resources. This case study illustrates how a simple approach for quantifying the loss of NPP from measured habitat losses can guide wetland conservation plans by establishing historical baselines, projecting functional outcomes of different restoration scenarios, and establishing performance metrics to gauge success.

Background and purpose To determine if traditional didactic lecture or the jigsaw learning method is more effective to teach the medication therapy management (MTM) core elements in a first year pharmacy course. Educational activity and setting Traditional didactic lecture and a pre-class reading assignment were used in the fall semester cohort, and the jigsaw method was used in the spring semester cohort. Jigsaw is a cooperative learning strategy requiring students to assume responsibility for learning, and subsequently teaching peers. The students were responsible for reading specific sections of the pre-class reading, and then teaching other students in small groups about their specific reading assignments. To assess potential differences, identical pre- and post-tests were administered before and after the MTM section. Additionally, grade performance on an in-class project and final exam questions were compared, and students were surveyed on perceptions of teaching method used. Findings A total of 45 and 43 students completed both the pre- and post-test in the fall and spring (96% and 93% response rate), respectively. Improvement in post-test scores favored the traditional method (p = 0.001). No statistical differences were noted between groups with grade performance on the in-class project and final exam questions. However, students favored the jigsaw method over traditional lecture and perceived improvements in problem solving skills, listening/communication skills and encouragement of cooperative learning (p = 0.018, 0.025 and 0.031). Summary Although students favored the jigsaw learning method, traditional didactic lecture was more effective for the pre- and post-knowledge test performance. This may indicate that traditional didactic lecture is more effective for more foundational content.

Acute coronary syndrome (ACS) is a cardiovascular condition with a multifactorial pathophysiology that includes atherosclerotic plaques, platelet activation and thrombin production, among others. Thrombin production and the prothrombotic state of ACS patients have provided a role for anticoagulants to treat patients during the acute event and has led to subsequent research for the post-acute state. Warfarin has an indication for ACS, however, it is restricted to specific patients and many factors limit its use. Therefore, novel oral anticoagulants (NOACs) are being explored for ACS. Limitations for the use of NOACs in ACS are centered on the increased risk of bleeding that occurs when these agents are added to the current standard of care with dual antiplatelet therapy. Rivaroxaban is the only NOAC that has achieved approval in Europe for this indication with none of the NOAC currently approved in the US for use in ACS. Ongoing studies for rivaroxaban and apixaban may provide evidence to further clarify the place in therapy for NOAC agents in ACS management.

Objective To determine if a more objective and descriptive evaluation tool more closely aligned faculty and peer grades than a previous rubric in a seminar course. Additional objectives were to evaluate grade changes between the tools, determine the association of student characteristics on grades, and to assess faculty and student perceptions of the effectiveness of the new tool. Methods Faculty and peer grades were compared to each other in 2013 and 2014. Total combined grades for 2013 were compared to those of 2014. Students and presentation evaluators who participated in the 2014 course were surveyed for demographics and perceptions of the tool. Statistical analyses were performed for grade comparisons, demographic data, and perception data. Results Faculty and peer grades were not more closely aligned using the new tool ( p p = 0.222). From the demographic data collected, only female gender and a desire to pursue postgraduate education or training had a significant effect on grades ( p p = 0.003, respectively). Overall perception responses for faculty and students were positive as they relate to rubric helpfulness. Conclusions The new evaluation tool was positively perceived to be more objective among faculty and students; however, it did not result in more closely aligned faculty and peer grades. Lastly, the data from this study indicate that few known modifiable predictors of student success in a seminar course exist currently.

Atrial fibrillation is the most common cause of stroke. Treatment with anticoagulants in patients with atrial fibrillation reduces embolic complications of the disease including stroke. However, the commonly used anticoagulant has a narrow therapeutic index, requires routine monitoring, and has numerous drug and food interactions leading to less than optimal rates of adherence. Inhibition of clotting factor Xa has been evaluated as a potential target for anticoagulation therapy with the hypothesis that using target-specific therapy will alleviate some of the dosing variability observed with the vitamin K antagonist. Three factor Xa inhibitors are currently indicated for use in nonvalvular atrial fibrillation. Similar to the vitamin K antagonist, warfarin, all of the factor Xa inhibitors are administered orally. Rivaroxaban and edoxaban are dosed once daily while apixaban is dosed twice daily. All three agents have demonstrated noninferiority when compared with current standard treatment with warfarin for efficacy and safety outcomes. The therapeutic dose of factor Xa inhibitors vary based on renal function. Unlike warfarin, there are no currently available antidotes for the factor Xa inhibitors although this is an area of interest for current and future studies. In the event of a life-threatening bleed there are established management strategies to reverse the bleeding effects of the factor Xa inhibitors.

The mainstay of rheumatoid arthritis (RA) treatment involves the use of medications that slow disease progression and reduce inflammation. Inadequate treatment responses and intolerances to conventional RA treatment have led to the development of biologic agents for the management of moderate-to-severe disease activity. Interleukin-6 (IL-6) inhibition is one of the targets for biologic activity in RA treatment. IL-6 is found in excess in the synovial fluid and contributes to joint erosion through its action on osteoclast cells. Sarilumab is a new IL-6 inhibitor indicated for the treatment of moderate-to-severe RA as monotherapy or in combination with conventional therapies in patients with an inadequate response to previous RA treatment.

Author(s): Cloern, James E.; Robinson, April; Richey, Amy; Grenier, Letitia; Grossinger, Robin; Boyer, Katharyn E.; Burau, Jon; Canuel, Elizabeth A.; DeGeorge, John F.; Drexler, Judith Z.; Enright, Chris; Howe, Emily R.; Kneib, Ronald; Mueller–Solger, Anke; Naiman, Robert J.; Pinckney, James L.; Safran, Samuel M.; Schoellhamer, David; Simenstad, Charles | Abstract: To evaluate the role of restoration in the recovery of the Delta ecosystem, we need to have clear targets and performance measures that directly assess ecosystem function. Primary production is a crucial ecosystem process, which directly limits the quality and quantity of food available for secondary consumers such as invertebrates and fish. The Delta has a low rate of primary production, but it is unclear whether this was always the case. Recent analyses from the Historical Ecology Team and Delta Landscapes Project provide quantitative comparisons of the areal extent of 14 habitat types in the modern Delta versus the historical Delta (pre-1850). Here we describe an approach for using these metrics of land use change to: (1) produce the first quantitative estimates of how Delta primary production and the relative contributions from five different producer groups have been altered by large-scale drainage and conversion to agriculture; (2) convert these production estimates into a common currency so the contributions of each producer group reflect their food quality and efficiency of transfer to consumers; and (3) use simple models to discover how tidal exchange between marshes and open water influences primary production and its consumption. Application of this approach could inform Delta management in two ways. First, it would provide a quantitative estimate of how large-scale conversion to agriculture has altered the Delta's capacity to produce food for native biota. Second, it would provide restoration practitioners with a new approach—based on ecosystem function—to evaluate the success of restoration projects and gauge the trajectory of ecological recovery in the Delta region.

The distribution of macroinvertebrates across a tidal gradient is described from a study of invertebrate distribution across tidal marsh sub-habitats, a non-quantitative survey of epifauna on intertidal rocky substrate, and a few additional observations and records from China Camp State Park, Marin County, California. In the tidal marsh study, invertebrates were sampled from distinct sub-habitat types: high-order channels, low-order channels, vegetated marsh plain, and natural levees adjacent to channels. Invertebrates were collected using a variety of trapping methods to account for capture biases associated with any one method. All common invertebrate taxa were significantly more abundant in a particular sub-habitat, and within each trapping method a few species accounted for most of the biomass. On intertidal rocks, 79% of the taxa identified to species or genus were exotic, but a few native species were common.

We report on the results of a synchrotron calibration of two identical microchannel plate (MCP) detectors carried out at the CCL Daresbury synchrotron radiation source (SRS). The SRS was run with low ring current to allow operation of the detectors in photon-counting mode. Both detectors were half coated with KBr and half with CsI. Detector 1 was calibrated, for both photocathodes, in 1 eV steps over the energy range 50 - 350 eV, on SRS beamline 6.1. We present measurements of edge-related absolute quantum efficiency features arising from both the photocathodes and the underlying lead silicate glass. We also describe the results of charge abstraction lifetests of Detector 1, made possible by the small cross section and relatively high peak count rate of the line 6.1 x-ray beam. A preliminary analysis of the calibration of detector 2 in 3 eV steps over the energy range 2000 - 6000 eV (on IRC beamline 4.2) is also presented.© (1995) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.