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Untreated sewage discharged increases the nutrient loads and changes ecosystem functions. It increases the values of the nitrogen isotopic signature (δ 15 N) of primary producers such as seagrasses. Itaparica Island (Bahia, Brazil) has undergone extensive urbanization over 50 years. Most of the island has no sewage treatment, and a bridge's construction could increase its population ten times. We evaluated the effects of sewage inputs on the δ 15 N of seagrass (Halodule wrightii) across Itaparica Island in 14 areas of the island with different degrees of urbanization. Average values of δ 15 N ranged from -3.95 ‰ (±1.04 SD) to 2.73 ‰ (±1.61). The highest human occupation site also has the highest mean value of δ 15 N, and seagrass shoot density. The significant correlation (p < 0.05) between δ 15 N values and shoot density may indicate a possible anthropogenic pressure impacting meadow abundance. Despite a positive correlation, increased anthropogenic nutrient supply can support algae growth and harm seagrass ecosystems., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Matheus Fernandes Andrade reports equipment, drugs, or supplies and travel were provided by National Council for Scientific and Technological Development. Matheus Fernandes Andrade reports financial support was provided by Foundation for Research Support of Bahia State. Ana Cecilia Rizzatti de Albergaria Barbosa reports financial support was provided by National Council for Scientific and Technological Development. Vinicius Faria Patire reports financial support was provided by Coordination of Higher Education Personnel Improvement., (Copyright © 2023. Published by Elsevier Ltd.)

Patients undergoing plastic surgery of the breasts often communicate their size expectations as a brassiere cup size. However, multiple factors may cause a miscommunication between the surgeon and patient when brassiere cup size is used as a measure of results. The aim of this study was to determine the degree of agreement between disclosed and estimated brassiere cup size and also interrater agreement., Methods: Three-dimensional (3D) scans of 32 subjects were evaluated by 10 plastic surgeons estimating cup size using the American brassiere system. The surgeons were blinded to all parameters, including the 3D surface software-derived volume measures of the Vectra scan. The 3D scans of the anterior torsos were viewed. The plastic surgeons' estimations were compared with the cup sizes stated by the subjects (disclosed cup size), using simple and weighted Kappa statistics., Results: Agreement between the estimated and disclosed brassiere sizes was only slight (0.1479 ± 0.0605) using a simple Kappa analysis. Even when a Fleiss-Cohen-weighted comparison was used, only moderate agreement (0.6231 ± 0.0589) was found. The interrater agreement intraclass correlation coefficient was 0.705. Rater accuracy varied. The percentage of time spent in cosmetic practice and gender were not significantly correlated with accuracy., Conclusions: Agreement between cup size disclosed by subjects and estimates by plastic surgeons was low. A miscommunication between the surgeon and patient may occur when using brassiere sizes to communicate wishes and estimates in procedures that involve changes in breast volume., Competing Interests: The authors have no disclosures or conflicts of interest., (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

The transport of passively dispersed organisms across tropical margins remains poorly understood. Hypotheses of oceanographic transportation potential lack testing with large scale empirical data. To address this gap, we used the seagrass species, Halodule wrightii, which is unique in spanning the entire tropical Atlantic. We tested the hypothesis that genetic differentiation estimated across its large-scale biogeographic range can be predicted by simulated oceanographic transport. The alternative hypothesis posits that dispersal is independent of ocean currents, such as transport by grazers. We compared empirical genetic estimates and modelled predictions of dispersal along the distribution of H. wrightii. We genotyped eight microsatellite loci on 19 populations distributed across Atlantic Africa, Gulf of Mexico, Caribbean, Brazil and developed a biophysical model with high-resolution ocean currents. Genetic data revealed low gene flow and highest differentiation between (1) the Gulf of Mexico and two other regions: (2) Caribbean-Brazil and (3) Atlantic Africa. These two were more genetically similar despite separation by an ocean. The biophysical model indicated low or no probability of passive dispersal among populations and did not match the empirical genetic data. The results support the alternative hypothesis of a role for active dispersal vectors like grazers., (© 2023. The Author(s).)

Biodiversity assessment is a mandatory task for sustainable and adaptive management for the next decade, and long-term ecological monitoring programs are a cornerstone for understanding changes in ecosystems. The Brazilian Long-Term Ecological Research Program (PELD) is an integrated effort model supported by public funds that finance ecological studies at 34 locations. By interviewing and compiling data from project coordinators, we assessed monitoring efforts, targeting biological groups and scientific production from nine PELD projects encompassing coastal lagoons to mesophotic reefs and oceanic islands. Reef environments and fish groups were the most often studied within the long-term projects. PELD projects covered priority areas for conservation but missed sensitive areas close to large cities, as well as underrepresenting ecosystems on the North and Northeast Brazilian coast. Long-term monitoring projects in marine and coastal environments in Brazil are recent (<5 years), not yet integrated as a network, but scientifically productive with considerable relevance for academic and human resources training. Scientific production increased exponentially with project age, despite interruption and shortage of funding during their history. From our diagnosis, we recommend some actions to fill in observed gaps, such as: enhancing projects' collaboration and integration; focusing on priority regions for new projects; broadening the scope of monitored variables; and, maintenance of funding for existing projects., Competing Interests: Juan P. Quimbayo is a PeerJ Academic Editor. The authors declare there are no competing interests., (©2022 Cordeiro et al.)

The role of seagrass meadows in the cycling and accumulation of rare earth elements and yttrium (REEY) is unknown. Here, we measured the concentration of REEY in the different compartments of Halodule wrightii (shoots, rhizomes, and roots) and soils in seagrass meadows near sandy beaches, mangroves, and coral reefs in the Todos os Santos Bay, Brazil. We provide data on the accumulation dynamics of REEY in seagrass compartments and demonstrate that plant compartments and soil properties determine accumulation patterns. The ∑REEY in soils were ~1.7-fold higher near coral reefs (93.0 ± 5.61 mg kg -1 ) than near mangrove sites (53.9 ± 31.5 mg kg -1 ) and were slightly higher than in sandy beaches (81.7 ± 49.1 mg kg -1 ). The ∑REEY in seagrasses varied between 35.4 ± 28.1 mg kg -1 near coral reefs to 59.2 ± 21.3 mg kg -1 near sandy beaches, respectively. The ∑REE bioaccumulation factor (BAF) was highest in seagrass roots near sandy beaches (BAF = 0.67 ± 0.48). All values of ∑REE translocation are <1, indicating inefficient translocation of REE from roots to rhizome to shoot. PAAS normalized REE was enriched in light REE (LREE) over heavy REE (HREE). The REEY accumulation in Halodule wrightii revealed a low potential of the seagrass to act as a sink for these elements. However, their bioavailability and potential uptake may change with soil properties. Our results serve as a basis for a better understanding of REE biogeochemical cycling and its fate in the marine environment. REE have experienced increased use as they are central to new technologies revealing an urgent need for further investigations of potential impacts on coastal ecosystems., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: The 21-cm notch-to-nipple distance has been accepted without academic scrutiny as a key measure in breast aesthetics. The Fibonacci sequence and phi ratio occur frequently in nature. They have previously been used to assess aesthetics of the face, but not the breast. This study aims to assess if the static 21-cm measure or the proportional phi ratio is associated with ideal breast aesthetics., Method: Subclavicular-breast height and breast width were used to calculate the aesthetic ratio. Subjects were subsequently aesthetically rated. A one-sample t-test was used to determine if the ratio for each breast differed from phi. Breast scores with one, both, or no breasts were compared with an optimal phi ratio. Analysis of variance was performed. Tukey-Kramer adjustment for multiple comparisons was used when pairwise comparisons were conducted., Results: Five subjects (14%) had bilateral optimal phi ratio breasts. Four subjects (11%) had one breast with an optimal phi ratio. Subjects with bilateral optimal phi ratios had significantly higher overall breast scores than those with only one optimal breast (Δ = 0.86, P = 0.025) or no optimal breast (Δ = 0.73, P = 0.008). Distance from optimal Fibonacci nipple position was moderately to strongly correlated with aesthetic score (-0.630, P = 0.016). No correlation was found between 21-cm notch-to-nipple distance and aesthetic score., Conclusion: The bilateral optimal phi ratio is correlated with high overall aesthetic scores, as is the optimal Fibonacci nipple position. No correlation was found between 21-cm notch-to-nipple distance and overall aesthetic score., Competing Interests: Disclosure: The authors have no financial interest to declare in relation to the content of this article., (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

Purpose: Financial burden caused by cancer treatment is associated with material loss, distress, and poorer outcomes. Financial resources exist to support patients but identification of need is difficult. We sought to develop and test a tool to accurately predict an individual's risk of financial toxicity based on clinical, demographic, and patient-reported data prior to initiation of breast cancer treatment., Patients and Methods: We surveyed 611 patients undergoing breast cancer therapy at MD Anderson Cancer Center. We collected data using the validated COmprehensive Score for financial Toxicity (COST) patient-reported outcome measure alongside other financial indicators (credit score, income, and insurance status). We also collected clinical and perioperative data. We trained and tested an ensemble of machine learning (ML) algorithms (neural network, regularized linear model, support vector machines, and a classification tree) to predict financial toxicity. Data were randomly partitioned into training and test samples (2:1 ratio). Predictive performance was assessed using area-under-the-receiver-operating-characteristics-curve (AUROC), accuracy, sensitivity, and specificity., Results: In our test sample (N = 203), 48 of 203 women (23.6%) reported significant financial burden. The algorithm ensemble performed well to predict financial burden with an AUROC of 0.85, accuracy of 0.82, sensitivity of 0.85, and specificity of 0.81. Key clinical predictors of financial burden from the linear model were neoadjuvant therapy (β regularized , .11) and autologous, rather than implant-based, reconstruction (β regularized , .06). Notably, radiation and clinical tumor stage had no effect on financial burden., Conclusion: ML models accurately predicted financial toxicity related to breast cancer treatment. These predictions may inform decision making and care planning to avoid financial distress during cancer treatment or enable targeted financial support. Further research is warranted to validate this tool and assess applicability for other types of cancer.

Aim: The introduction of aquatic non-indigenous species (ANS) has become a major driver for global changes in species biogeography. We examined spatial patterns and temporal trends of ANS detections since 1965 to inform conservation policy and management., Location: Global., Methods: We assembled an extensive dataset of first records of detection of ANS (1965-2015) across 49 aquatic ecosystems, including the (a) year of first collection, (b) population status and (c) potential pathway(s) of introduction. Data were analysed at global and regional levels to assess patterns of detection rate, richness and transport pathways., Results: An annual mean of 43 (±16 SD ) primary detections of ANS occurred-one new detection every 8.4 days for 50 years. The global rate of detections was relatively stable during 1965-1995, but increased rapidly after this time, peaking at roughly 66 primary detections per year during 2005-2010 and then declining marginally. Detection rates were variable within and across regions through time. Arthropods, molluscs and fishes were the most frequently reported ANS. Most ANS were likely introduced as stowaways in ships' ballast water or biofouling, although direct evidence is typically absent., Main Conclusions: This synthesis highlights the magnitude of recent ANS detections, yet almost certainly represents an underestimate as many ANS go unreported due to limited search effort and diminishing taxonomic expertise. Temporal rates of detection are also confounded by reporting lags, likely contributing to the lower detection rate observed in recent years. There is a critical need to implement standardized, repeated methods across regions and taxa to improve the quality of global-scale comparisons and sustain core measures over longer time-scales. It will be fundamental to fill in knowledge gaps given that invasion data representing broad regions of the world's oceans are not yet readily available and to maintain knowledge pipelines for adaptive management.

Tubastraea coccinea Lesson, 1830 and T. tagusensis Wells 1982 are azooxanthellate corals non-native to Brazil and introduced through fouling on oil platforms, the primary vector. They first invaded the tropical rocky reefs at Ilha Grande Bay (southwest Atlantic Ocean), during the early 1990s. Currently, at some Brazilian locations these species occupy 80% of the benthos of the shallow subtidal. They cause economic and environmental impacts by fouling shipping and modifying native communities. This study provides observations of an additional mechanism of secondary dispersal by T. coccinea and T. tagusensis that were seen attached to floating wood debris and marine litter, which are highly abundant in the region. Such rafting corals have been found adjacent to invaded reefs and stranded on beaches. These observations indicate that transport by rafting over long distances may be another mechanism of range expansion and secondary introduction of these invasive species within the region., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Ecological communities tend to be spatially structured due to environmental gradients and/or spatially contagious processes such as growth, dispersion and species interactions. Data transformation followed by usage of algorithms such as Redundancy Analysis (RDA) is a fairly common approach in studies searching for spatial structure in ecological communities, despite recent suggestions advocating the use of Generalized Linear Models (GLMs). Here, we compared the performance of GLMs and RDA in describing spatial structure in ecological community composition data. We simulated realistic presence/absence data typical of many β -diversity studies. For model selection we used standard methods commonly used in most studies involving RDA and GLMs., Methods: We simulated communities with known spatial structure, based on three real spatial community presence/absence datasets (one terrestrial, one marine and one freshwater). We used spatial eigenvectors as explanatory variables. We varied the number of non-zero coefficients of the spatial variables, and the spatial scales with which these coefficients were associated and then compared the performance of GLMs and RDA frameworks to correctly retrieve the spatial patterns contained in the simulated communities. We used two different methods for model selection, Forward Selection (FW) for RDA and the Akaike Information Criterion (AIC) for GLMs. The performance of each method was assessed by scoring overall accuracy as the proportion of variables whose inclusion/exclusion status was correct, and by distinguishing which kind of error was observed for each method. We also assessed whether errors in variable selection could affect the interpretation of spatial structure., Results: Overall GLM with AIC-based model selection (GLM/AIC) performed better than RDA/FW in selecting spatial explanatory variables, although under some simulations the methods performed similarly. In general, RDA/FW performed unpredictably, often retaining too many explanatory variables and selecting variables associated with incorrect spatial scales. The spatial scale of the pattern had a negligible effect on GLM/AIC performance but consistently affected RDA's error rates under almost all scenarios., Conclusion: We encourage the use of GLM/AIC for studies searching for spatial drivers of species presence/absence patterns, since this framework outperformed RDA/FW in situations most likely to be found in natural communities. It is likely that such recommendations might extend to other types of explanatory variables., Competing Interests: The authors declare there are no competing interests., (©2020 Carlos-Júnior et al.)

Background: There is little consensus about the relative determinative value of each individual factor in female breast aesthetics. When performing breast surgery with an aesthetic goal, certain factors will be more important than others. The purpose of this study was to make an aesthetic factor rank list to determine the relative contributions to overall breast aesthetics., Method: Volunteers were scanned using the 3-dimensional Vectra system. Ten Scandinavian plastic surgeons rated 37 subjects, using a validated scoring system with 49 scoring items. The correlation between specific aesthetic factors and overall breast aesthetic scores of the subjects were calculated using Pearson's r, Spearman's ρ, and Kendall's τ., Results: A very strong correlation was found between overall breast aesthetic score and lower pole shape (0.876, P < 0.0001). This was also true for upper pole shape (0.826, P < 0.0001) and breast height (0.821, P < 0.0001). A strong correlation was found between overall breast aesthetic score and nipple position (0.733, P < 0.0001), breast size (0.644, P < 0.0001), and breast width (0.632, P < 0.0001). Factors that were only moderately correlated with aesthetic score were intermammary distance (0.496, P = 0.002), nipple size and projection (0.588, P < 0.0001), areolar diameter (0.484, P < 0.0001), and areolar shape (0.403, P < 0.0001). Perceived symmetry was a weak factor (0.363, P = 0.027)., Conclusions: Aesthetic factors of the female breast can be ranked in a priority list. Shape of the lower pole and upper pole and breast height are primary factors of female breast aesthetics. These should be prioritized in any aesthetic breast surgery. Vertical dimensional factors seem to be more determinative than horizontal factors., Competing Interests: Disclosure: The authors have no financial interest to declare in relation to the content of this article., (Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

Objectives: The objective was to analyse the anti-inflammatory potential of the invasive coral species Tubastraea coccinea and Tubastraea tagusensis., Methods: Methanolic extracts, fractions and synthesized compounds were evaluated for their anti-inflammatory ability, and their composition was elucidated through chemical analysis., Key Findings: The genus Tubastraea (Order Scleractinia, Family Dendrophylliidae) (known as sun corals) presents compounds with pharmacological value. The introduction of these azooxanthellate hard corals into Brazil, initially in Rio de Janeiro state, occurred through their fouling of oil and gas platforms from the Campos oil Basin. The two invasive species have successfully expanded along the Brazilian coast and threaten endemic species and biodiversity. The HPLC-MS and GC-MS data suggest the presence of aplysinopsin analogues (alkaloids). Anti-inflammatory activity was observed in all samples tested in in-vivo assays, especially in T. coccinea. The ethyl acetate fraction from this sample was more effective in in-vitro assays for anti-inflammatory activity. Depending on the concentration, this fraction showed cytotoxic responses., Conclusions: These species have potential pharmacological use, and considering their invasive nature, this study presents a potential alternative use, which may enhance the management of this biological invasion., (© 2020 Royal Pharmaceutical Society.)

Atlantia is described as a new genus pertaining to the family Dendrophylliidae (Anthozoa, Scleractinia) based on specimens from Cape Verde, eastern Atlantic. This taxon was first recognized as Enallopsammia micranthus and later described as a new species, Tubastraea caboverdiana , which then changed the status of the genus Tubastraea as native to the Atlantic Ocean. Here, based on morphological and molecular analyses, we compare fresh material of T. caboverdiana to other dendrophylliid genera and describe it as a new genus named Atlantia in order to better accommodate this species. Evolutionary reconstruction based on two mitochondrial and one nuclear marker for 67 dendrophylliids and one poritid species recovered A. caboverdiana as an isolated clade not related to Tubastraea and more closely related to Dendrophyllia cornigera and Leptopsammia pruvoti . Atlantia differs from Tubastraea by having a phaceloid to dendroid growth form with new corallites budding at an acute angle from the theca of a parent corallite. The genus also has normally arranged septa (not Portualès Plan), poorly developed columella, and a shallow-water distribution all supporting the classification as a new genus. Our results corroborate the monophyly of the genus Tubastraea and reiterate the Atlantic non-indigenous status for the genus. In the light of the results presented herein, we recommend an extensive review of shallow-water dendrophylliids from the Eastern Atlantic., Competing Interests: Robert J. Toonen is an Academic Editor for PeerJ., (©2020 Capel et al.)

The high diversity of species in the marine environment gives rise to compounds with unique structural patterns not found as natural products in other systems and with great potential for pharmacological, cosmetic and nutritional use. The genus Tubastraea (Class Anthozoa, Order Scleractinia, Family Dendrophylliidae) is characterized as a hard coral without the presence of zooxanthellae. In species of this genus alkaloids derived from the compound aplysinopsin with pharmacological activity are known. In Brazil T. coccinea and T. tagusensis are characterized as non-indigenous and invasive and are currently found along the Brazilian coast, from Santa Catarina to Bahia states. This study aims to analyze the mutagenic, cytotoxic and genotoxic potential of methanolic and ethanolic extracts from T. coccinea and T. tagusensis collected in Ilha Grande Bay, Rio de Janeiro state, Brazil. Bacterial reverse mutation assay on the standard strains TA97, TA98, TA100, TA102 and TA104, in vitro micronucleus formation test and colorimetric assays for cytotoxic signals on the cell lines HepG2 and RAW264.7 were used. We also synthesized an oxoaplysinopsin derivate alkaloid (APL01) for comparative purposes. No mutagenic (250; 312.5; 375; 437.5 and 500 μg/plate) or genotoxic (0.05; 0.5; 5.0; 50 and 500 μg/mL) effects were observed in any sample tested for all measured concentrations. Cytotoxic responses were observed for eukaryotic cells in all tested samples at 500 and 5000 μg/mL concentrations. Cytotoxicity found in the WST-1 assay was independent of the metabolism of substances present in samples compositions. The cytotoxicity observed in the LDH release assay depended on metabolism., (© 2019 John Wiley & Sons, Ltd.)

The scleractinian corals Tubastraea coccinea Lesson, 1829 and T. tagusensis Wells, 1982 have invaded reefs along Brazil's coastline. Over the period 2011-2017 a standard, fast, easily repeatable semi-quantitative method was used to produce maps of distribution and a site (n = 77) specific Relative Abundance Index (RAI) to determine range expansion at Cabo Frio, an upwelling region. Invaded sites doubled from six to 12 over the period (one per year) and mean abundance increased tenfold from 0.2 to 2.6 RAI and 0.22 to 1.8 RAI (T. coccinea and T. tagusensis respectively). Site specific oceanographic conditions (temperature, salinity and water transparency) and distance from currently invaded sites (a proxy for propagule pressure) were chosen and used as determinants of invasion success in order to model the expansion. Model results compared favourably with empirical measurements and the simple, regional, and spatially explicit model predicted future range expansion under 10 and 20 year scenarios., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: As plants, algae and some sessile invertebrates may grow in nearly monospecific assemblies, their collective biomass increases and if they compete hard enough some die, freeing up space. The concurrent increase in biomass and decrease in density is called self-thinning, and its trajectory over time or maximum values represent a boundary condition. For a single stand developing over time the boundary defines the carrying capacity of the environment but the most extreme trajectories emulate the efficiency of species in packing biomass into space., Results: Here we present a meta-analysis of compiled data on biomass and density from 56 studies of 42 species of seaweeds from 8 orders within 3 phyla scattered through the world's oceans. Our analysis shows that, with respect to biomass, seaweeds are the most efficient space occupiers on Earth because they transgress previously fixed limits derived from land plants. This is probably because seaweeds are not limited by water and do not need structures for its transport or for transpiration; they photosynthesise and uptake nutrients over their entire surface; they are attached to the substrate by holdfasts that are small proportional to their volume or weight compared to roots; water provides them better support, reducing the need for tissues for rigidity. We also identified a biomass concentration common to plants and seaweeds which represents the threshold that no life on the planet can pass. Using each stand's distance to the biomass-density boundary, we determined that within the seaweeds the efficiency of space occupation differed amongst taxonomic and functional groups as well as with clonality and latitude., Conclusions: Algae occupy space more efficiently than plants, most likely because the watery environment facilitates the physical processes and integration of space occupation. The distance-to-the-boundary proves a good metric to discriminate among groups and may be useful for comparison of the most efficient biomass producing systems, or for the identification of systems impacted by pollution.

Background: Seagrasses are foundation species in estuarine and lagoon systems, providing a wide array of services for the ecosystem and the human population. Understanding the dynamics of their stands is essential in order to better assess natural and anthropogenic impacts. It is usually considered that healthy seagrasses aim to maximize their stand biomass (g DW m -2 ) which may be constrained by resource availability i.e., the local environment sets a carrying capacity. Recently, this paradigm has been tested and reassessed, and it is believed that seagrasses actually maximize their efficiency of space occupation-i.e., aim to reach an interspecific boundary line (IBL)-as quick as possible. This requires that they simultaneously grow in biomass and iterate new shoots to increase density. However, this strategy depresses their biomass potential., Results: to comply with this new paradigm, we developed a seagrass growth model that updates the carrying capacities for biomass and shoot density from the seagrass IBL at each time step. The use of a joint biomass and density growth rates enabled parameter estimation with twice the sample sizes and made the model less sensitive to episodic error in either of the variables. The use of instantaneous growth rates enabled the model to be calibrated with data sampled at widely different time intervals. We used data from 24 studies of six seagrass species scattered worldwide. The forecasted allometric biomass-density growth trajectories fit these observations well. Maximum growth and decay rates were found consistently for each species. The growth rates varied seasonally, matching previous observations., Conclusions: State-of-art models predicting both biomass and shoot density in seagrass have not previously incorporated our observation across many seagrass species that dynamics depend on current state relative to IBL. Our model better simulates the biomass-density dynamics of seagrass stands while shedding light on its intricacies. However, it is only valid for established patches where dynamics involve space-filling, not for colonization of new areas.

Background: Biomass-density relations have been at the centre of a search for an index which describes the health of seagrass meadows. However, this search has been complicated by the intricacy of seagrass demographics and their complex biomass-density relations, a consequence mainly of their modular growth and clonality. Concomitantly, biomass-density upper boundaries have been determined for terrestrial plants and algae, reflecting their asymptotic maximum efficiencies of space occupation. Each stand's distance to its respective biomass-density upper boundary reflects its effective efficiency in packing biomass, which has proved a reliable ecological indicator in order to discriminate between taxonomic groups, functional groups and clonal vs. non-clonal growth., Results: We gathered data from 32 studies on 10 seagrass species distributed worldwide and demonstrated that seagrasses are limited by their own boundary line, placed below the boundaries previously determined for algae and terrestrial plants. Then, we applied a new metric-d grass : each stand's perpendicular distance to the seagrass boundary-and used this parameter to review fundamental aspects such as clonal growth patterns, depth distribution, seasonality, interspecific competition, and the effects of light, temperature and nutrients., Conclusions: Seagrasses occupy space less efficiently than algae and terrestrial plants. Using only their biomass and density data we established a new and efficient tool to describe space occupation by seagrasses. This was used with success to evaluate their meadows as an ecological indicator for the health of coastal ecosystems.

Non-indigenous species (NIS) can cause substantial change in ecosystems and as marine invasives they can become a major threat to coastal and subtidal habitats. In September 2017 previously unknown and apparently NIS soft corals were detected on a shallow subtidal tropical rocky reef at Ilha Grande Bay, southeast Brazil. The present study aims to identify the species, quantify their distribution, abundance, and their interactions with native species. The most abundant NIS belonged to the recently described genus Sansibia (family Xeniidae) and the less common species was identified as Clavularia cf. viridis (family Clavulariidae). They were found along 170 m of shoreline at all depths where hard substrate was available. Sansibia sp. dominated deeper communities, associated positively with some macroalgal and negatively with the zoantharian Palythoa caribaeorum, which probably provided greater biotic resistance to invasion. Both species are of Indo-Pacific origin and typical of those ornamentals found in the aquarium trade., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Although the invasive azooxanthellate corals Tubastraea coccinea and T. tagusensis are spreading quickly and outcompeting native species in the Atlantic Ocean, there is little information regarding the genetic structure and path of introduction for these species. Here we present the first data on genetic diversity and clonal structure from these two species using a new set of microsatellite markers. High proportions of clones were observed, indicating that asexual reproduction has a major role in the local population dynamics and, therefore, represents one of the main reasons for the invasion success. Although no significant population structure was found, results suggest the occurrence of multiple invasions for T. coccinea and also that both species are being transported along the coast by vectors such as oil platforms and monobouys, spreading these invasive species. In addition to the description of novel microsatellite markers, this study sheds new light into the invasive process of Tubastraea ., Competing Interests: Robert J. Toonen is an Academic Editor for PeerJ.

Threats to and loss of seagrass ecosystems globally, impact not only natural resources but also the lives of people who directly or indirectly depend on these systems. Seagrass ecosystems play a multi-functional role in human well-being, e.g. food through fisheries, control of erosion and protection against floods. Quantifying these services reveals their contributions to human well-being and helps justify seagrass conservation. There has been no comprehensive assessment as to whether seagrass ecosystem services are perceived to vary over the globe or amongst genera. Our study compiles the most complete list of ecosystem services provided by seagrasses so far, including bioregional- and genus-specific information from expert opinion and published studies. Several seagrass ecosystem services vary considerably in their (known) provision across genera and over the globe. Seagrasses genera are clearly not all equal with regard to the ecosystem services they provide. As seagrass genera are not evenly distributed over all bioregions, the presence of an ecosystem service sometimes depends on the genera present. Larger sized seagrass genera (e.g. Posidonia, Enhalus) are perceived to provide more substantial and a wider variety of ecosystem services than smaller species (e.g. Halophila, Lepilaena). Nevertheless, smaller species provide important services. Our findings point out data gaps, provide new insight for more efficient management and recommend caution in economic valuation of seagrass services worldwide., Competing Interests: The authors have declared that no competing interests exist.

Phase shift phenomena are becoming increasingly common. However, they are also opportunities to better understand how communities are structured. In Southwest Atlantic coral reefs, a shift to the zoanthid Palythoa cf. variabilis dominance has been described. To test if competition drove this process, we carried out a manipulative experiment with three coral species. To estimate the natural frequency of encounters we assess the relationship between the proportion of encounters and this zoanthids coverage. The contact causes necrosis in 78% of coral colonies (6.47 ± SD 7.92 cm(2)) in 118 days. We found a logarithmic relationship between the proportion of these encounters and the cover of P. cf. variabilis, where 5.5% coverage of this zoanthid is enough to put 50% of coral colonies in contact, increasing their partial mortality. We demonstrate that zoanthid coverage increase followed by coral mortality increase will reduce coral cover and that competition drives the phase shift process., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Tubastraea tagusensis, a coral native to the Galapagos Archipelago, has successfully established and invaded the Brazilian coast where it modifies native tropical rocky shore and coral reef communities. In order to understand the processes underlying the establishment of T. tagusensis, we tested whether Maxent, a tool for species distribution modeling, based on the native range of T. tagusensis correctly forecasted the invasion range of this species in Brazil. The Maxent algorithm was unable to predict the Brazilian coast as a suitable environment for the establishment of T. tagusensis. A comparison between these models and a principal component analysis (PCA) allowed us to examine the environmental dissimilarity between the two occupied regions (native and invaded) and to assess the species' occupied niche breadth. According to the PCA results, lower levels of chlorophyll-a and nitrate on the Atlantic coast segregate the Brazilian and Galapagos environments, implying that T. tagusensis may have expanded its realized niche during the invasion process. We tested the possible realized niche expansion in T. tagusensis by assuming that Tubastraea spp. have similar fundamental niches, which was supported by exploring the environmental space of T. coccinea, a tropical-cosmopolitan congener of T. tagusensis. We believe that the usage of Maxent should be treated with caution, especially when applied to biological invasion (or climate change) scenarios where the target species has a highly localized native (original) distribution, which may represent only a small portion of its fundamental niche, and therefore a violation of a SDM assumption.

All organisms have a set of ecological conditions (or niche) which they depend on to survive and establish in a given habitat. The ecological niche of a species limits its geographical distribution. In the particular case of non-indigenous species (NIS), the ecological requirements of the species impose boundaries on the potential distribution of the organism in the new receptor regions. This is a theoretical assumption implicit when Ecological Niche Models (ENMs) are used to assess the potential distribution of NIS. This assumption has been questioned, given that in some cases niche shift may occur during the process of invasion. We used ENMs to investigate whether the model fit with data from the native range of the coral Tubastraea coccinea Lesson, 1829 successfully predicts its invasion in the Atlantic. We also identified which factors best explain the distribution of this NIS. The broad native distributional range of T. coccinea predicted the invaded sites well, especially along the Brazilian coast, the Caribbean Sea and Gulf of Mexico. The occurrence of T. coccinea was positively related to calcite levels and negatively to eutrophy, but was rather unaffected to other variables that often limit other marine organisms, suggesting that this NIS has wide ecological limits, a trait typical of invasive species., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Consequences of reef phase shifts on fish communities remain poorly understood. Studies on the causes, effects and consequences of phase shifts on reef fish communities have only been considered for coral-to-macroalgae shifts. Therefore, there is a large information gap regarding the consequences of novel phase shifts and how these kinds of phase shifts impact on fish assemblages. This study aimed to compare the fish assemblages on reefs under normal conditions (relatively high cover of corals) to those which have shifted to a dominance of the zoantharian Palythoa cf. variabilis on coral reefs in Todos os Santos Bay (TSB), Brazilian eastern coast. We examined eight reefs, where we estimated cover of corals and P. cf. variabilis and coral reef fish richness, abundance and body size. Fish richness differed significantly between normal reefs (48 species) and phase-shift reefs (38 species), a 20% reduction in species. However there was no difference in fish abundance between normal and phase shift reefs. One fish species, Chaetodon striatus, was significantly less abundant on normal reefs. The differences in fish assemblages between different reef phases was due to differences in trophic groups of fish; on normal reefs carnivorous fishes were more abundant, while on phase shift reefs mobile invertivores dominated.

Extensive degradation of coral reefs makes it imperative to create functional models that demonstrate ecological processes which occur in alternative states that persist over time. These models provide important information that can help in decision making regarding management measures for both the prevention of further degradation and the recovery of these ecosystems. Development of these models requires identifying and testing the ecological processes that will impose the reduction of coral cover and, preferably, identifying the disturbance that triggers this phenomenon. For this reason, research programs are a useful tool which allows a focus on the production of information for modeling. It should start with survey investigations and tests of hypotheses concerning the cause of the reduction of coral cover. Subsequently, projects should be guided by the most probable hypotheses, focusing on one guild or functional group at a time until the "trigger" process which unleashed the disturbance is identified. Even if incomplete, these models already provide information for focusing management steps., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

This study investigated the use of low salinity as a killing agent for the invasive pest corals Tubastraea coccinea and Tubastraea tagusensis (Dendrophylliidae). Experiments investigated the efficacy of different salinities, the effect of colony size on susceptibility and the influence of length of exposure. Experimental treatments of colonies were carried out in aquaria. Colonies were then fixed onto experimental plates and monitored in the field periodically over a period of four weeks. The killing effectiveness of low salinity depended on the test salinity and the target species, but was independent of colony size. Low salinity was fast acting and prejudicial to survival: discoloration, necrosis, fragmenting and sloughing, exposure of the skeleton and cover by biofoulers occurred post treatment. For T. tagusensis, 50% mortality (LC50) after three days occurred at eight practical salinity units (PSU); for T. coccinea the LC50 was 2 PSU. Exposure to freshwater for 45-120 min resulted in 100% mortality for T. tagusensis, but only the 120 min period was 100% effective in killing T. coccinea. Freshwater is now routinely used for the post-border management of Tubastraea spp. This study also provides insights as to how freshwater may be used as a routine biosecurity management tool when applied pre-border to shipping vectors potentially transporting non-indigenous marine biofouling species.

Minimally invasive harvest of the latissimus dorsi (LD) muscle is a desirable goal because of both the wide utility of this muscle and the length of incision required to harvest it. In this study, robotic harvest of the LD muscle was evaluated in a cadaver model and clinical series. Ten LD flaps were robotically harvested in eight cadavers. Positioning, port placement, procedural steps, instrumentation, and technical obstacles were all critically analyzed and reported. After modifying the technique based on experience gained in the cadaver study, eight LD muscles were robotically harvested and transferred in eight patients. Access included a short axillary incision and two additional port sites along the anterior border of the muscle. Insufflation was used to maintain the optical cavity. Indications included pedicled flaps for implant-based breast reconstruction and free flaps for scalp reconstruction. All flaps were successfully transferred without converting to open technique. In the clinical series, average time for setup and port placement was 23 minutes, and average robotic time was 1 hour and 51 minutes. There were no major complications. Robotic harvest of the LD is feasible and effective and permits full muscle harvest without a visible incision., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Background: When vascular compromise is detected, a free flap is immediately taken back to the operating room for attempted salvage. Which factors predict the success or failure of a take-back is currently unknown., Methods: A review of free flaps performed at a single institution over the last 10 years was performed. A total of 4965 flaps were identified, and an analysis of factors predicting salvage or failure of first, second, and third take-backs for microvascular complications was performed., Results: Of 4965 flaps, 517 (10.3 percent) required return to the operating room, 157 (3.34 percent) for vascular complications. There were 66 (1.41 percent) total flap failures. Of 157 take-backs, 102 required return once, 44 twice, and 11 three times, with salvage rates of 72, 34, and 27 percent, respectively (p < 0.01). Overall salvage rate was 58 percent. The probability of a flap going back for a second time was 35 percent. Risks for flap failure included thrombotic (35.1 percent) versus mechanical (8 percent) etiology (p = 0.01) and arterial (37.5 percent) or mixed (61.5 percent) versus venous only (25 percent) etiology (p = 0.06). Failure was more likely the greater number of days postoperatively the take-back occurred (p = 0.02)., Conclusions: The number of returns to the operating room is inversely proportional to flap salvage. Mechanical and venous etiologies tend to result in salvage and arterial and thrombotic etiologies in failure. Earlier take-backs are more likely to be successful. Knowledge of these predictors of salvage should guide clinical decision making and informed consent., Clinical Question/level of Evidence: Risk, II.

Many studies have assessed in unison specific biological attributes and certain environmental impacts but few studies have analyzed multiple biological variables and pressures from multiple sites at the same time. Our study's goal was to quantify the major potential human pressures in the shallow subtidal rocky reefs along a tropical Atlantic coast; propose a relative environmental pressure index and investigate the relationships between environmental pressures, the benthic community and coral population attributes. The analysis of human pressures suggests that one-third of sites were under high or very high proportional stress. Sites with high human pressure had lower live cover, higher percent of recent mortality and density of Siderastrea stellata. These relations were species specific. The coral species S. stellata seemed to be the best indicator of present environmental stress. These findings demonstrate the need to include multiple species and stressors in monitoring programs designed to contribute to coastal management initiatives., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Background: Fronto-orbital reconstruction is the standard of care for repair of unilateral coronal synostosis. This study examined the relationship between age at initial surgery and need for secondary surgery, to determine the optimal age for reconstruction., Methods: The series comprised 81 patients with unicoronal synostosis who underwent reconstruction over a 30-year period by a single surgeon. Measured outcomes included reoperation rate, relapse/defect rate, relapse interval, and problem rate., Results: Average age at surgery was 11.3 months (range, 1.5 to 71 months). The problem rate was 27.2 percent. Mean follow-up was 69 months (range, 6 to 234 months). The postoperative defect rate was 73 percent. Sixteen patients (20 percent) underwent reoperation to correct secondary deformities. Whitaker category I or II results were achieved in 90.1 percent. Problem rates for patients aged 0 to 6 months, 6 to 12 months, and older than 12 months were 13.3, 28, and 35, respectively. Secondary surgery was performed in 40 percent of patients whose first surgery was at 0 to 6 months, 7 percent aged 6 to 12 months, and 30.4 percent older than 12 months. After surgery, 87 percent of patients aged 0 to 6 months, 95 percent aged 6 to 12 months, and 87 percent older than 12 months had Whitaker category I or II results., Conclusions: Fronto-orbital advancement at younger than 6 months had the highest incidence of readvancement. Patients treated at 6 to 12 months had the least need for any secondary surgery; however, patients older than 12 months had the lowest incidence of readvancement. These results indicate that fronto-orbital advancement should be delayed until at least age 6 months to avoid relapse.

Orthognathic surgical planning should derive primarily from aesthetic considerations, and these should be based not on rigid cephalometric and anthropometric norms but on the surgeon's aesthetic sense. The historic goals of orthognathic surgery have addressed both stability and aesthetics. Stability relates to establishing a healthy, functional occlusion; aesthetic goals have focused on normalizing facial balance and proportions. With the advent of rigid fixation and bone graft substitutes, sacrificing facial aesthetics to attain stability and achieve a normal occlusion is no longer necessary. Orthognathic surgery now can be envisioned truly as aesthetic surgery.

The distribution and abundance of azooxanthellate coral Tubastraea Lesson, 1829 were examined at different depths and their slope preference was measured on rocky shores on Ilha Grande, Brazil. Tubastraea is an ahermatypic scleractinian nonindigenous to Brazil, which probably arrived on a ship's hull or oil platform in the late 1980's. The exotic coral was found along a great geographic range of the Canal Central of Ilha Grande, extending over a distance of 25 km. The abundance of Tubastraea was quantified by depth, using three different sampling methods: colony density, visual estimation and intercept points (100) for percentage of cover. Tubastraea showed ample tolerance to temperature and desiccation since it was found more abundantly in very shallow waters (0.1-0.5 m), despite the fact that hard substratum is available at greater depths at all the stations sampled. At most sites, 1 to 5 colonies per 0.25 m2 were found most frequently, but occasionally more than 50 colonies were found per 0.25 m2, indicating a somewhat gregarious spatial distribution for this coral. The coral Tubastraea was found to occupy slopes of every possible angle in the Canal Central of Ilha Grande, but more colonies were found occupying slopes of 80 to 100 degrees. Therefore, its insensitivity to angles of recruitment and its tolerance for different depths makes it an organism with great ecological tolerance, with a potential to colonize new areas and increase its current range in Brazil's coastal waters.

The DuraSoft 3 Colors cosmetic contact lens is manufactured with a pattern of opaque dots applied to its front surface in order to produce a change in apparent iris color. We fit ten subjects with the DuraSoft 3 Colors contact lens, and all were found to have pseudoexotropia. The deviation ranged from 10 to 22 delta (prism diopters) (average: 16 delta). The cause of the pseudoexotropia was creation of a pseudopositive angle kappa from lateral displacement of the contact lens. Physicians fitting the DuraSoft 3 Colors contact lens should pay special attention to centration characteristics during the fitting session in order to avoid creation of pseudostrabismus.