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El Niño-Southern Oscillation (ENSO) events activate long-distance teleconnections through the atmosphere and ocean that can dramatically impact marine ecosystems along the West Coast of NorthAmerica, affecting diverse organisms ranging from plankton to exploitable and protected species. Such ENSO-related changes to marine ecosystems can ultimately affect humans in many ways, including via depressed plankton and fish production, dramatic range shifts formany protected and exploited species, inaccessibility of traditionally fished resources, more prevalent harmful algal blooms, altered oxygen and pH of waters used in mariculture, and proliferation of pathogens. Theprincipal objective of the Forecasting ENSO Impacts on Marine Ecosystems of the US West Coast workshop was to develop a scientific framework for building an ENSO-related forecast system of ecosystem indicators along the West Coast of North America, including major biological and biogeochemical responses. Attendees realized thata quantitative, biologically-focused forecast system is a much more challenging objective than forecasting the physical system alone; it requires an understanding of the ocean-atmospheric physical system and of diverse organism-level, population-level, and geochemicalresponses that, in aggregate, lead to altered ecosystem states.

BACKGROUND AND OBJECTIVES: Cognitive benefits of longitudinal curricula and interleaving have been demonstrated in several disciplines. However, most residency curricula are structured in a block format. There is no consensus definition as to what constitutes a longitudinal program, making comparative research on curricular efficacy a challenge. The objective of our study was to arrive at a consensus definition of Longitudinal Interleaved Residency Training (LIRT) in family medicine. METHODS: A national workgroup was convened and utilized a Delphi method between October 2021 and March 2022 to arrive at a consensus definition. RESULTS: Twenty-four invitations were sent, and 18 participants initially accepted. The final workgroup (n=13) was representative of the nationwide diversity of family medicine residency programs in terms of geographic location (P=.977) and population density (P=.123). The following definition was approved: LIRT is a curricular design and program structure that offers graduated, concurrent clinical experiences in the core competencies of the specialty. LIRT models the comprehensive scope of practice and continuity that defines the specialty; applies training methods that enhance long-term retention of knowledge, skills, and attitudes across all dimensions and locations of care delivery; and accomplishes program objectives through employment of longitudinal curricular scheduling and interleaving with spaced repetition. Additional technical criteria and definitions of terms are elucidated in the body of this article. CONCLUSIONS: A representative national workgroup crafted a consensus definition of Longitudinal Interleaved Residency Training (LIRT) in family medicine, a program structure with a basis in emerging evidence-based cognitive science.

Summary: During DNA repair, ATM-induced H2AX histone phosphorylation and MDC1 recruitment spread megabases beyond the damage site. While loop extrusion has been suggested to drive this spread, the underlying mechanism remains unclear. Herein, we provide two lines of evidence that loop extrusion is not the only driver of damage-induced γH2AX spread. First, cohesin loader NIPBL and cohesin subunit RAD21 accumulate considerably later than the phosphorylation of H2AX and MDC1 recruitment at micro-IR-induced damage. Second, auxin-induced RAD21 depletion does not affect γH2AX/MDC1 spread following micro-irradiation or DSB induction by zeocin. To determine if diffusion of activated ATM could account for the observed behavior, we measured the exchange rate and diffusion constants of ATM and MDC1 within damaged and unperturbed chromatin. Using these measurements, we introduced a quantitative model in which the freely diffusing activated ATM phosphorylates H2AX. This model faithfully describes the dynamics of ATM and subsequent γH2AX/MDC1 spread at complex DNA lesions.

Preclinical models of large‐vessel occlusion (LVO) stroke play an important role in testing novel thrombolytic and neuroprotective agents, as well as assessing endovascular devices for endovascular thrombectomy. Depending on the modality used to model LVO stroke, different aspects of human stroke pathophysiology can be recapitulated. Thus, variables including size and region of the occlusion, composition of the clot, and degree of reperfusion can be controlled. We conducted a thorough literature review of all the preclinical models of stroke used currently. We searched for studies using the PubMed database and included original studies, reviews, systematic reviews, and meta‐analyses. In this review, we describe the considerations in choosing a preclinical model of LVO stroke. We provide an overview of available small‐ and large‐animal LVO stroke models that can be used in stroke research as well as the benefits and limitations of each. We then discuss the current outcome measures that can be evaluated through these models, in terms of both tissue damage and behavioral outcome. We also discuss the advantages and disadvantages of each animal model. Finally, based on this summary, we propose that mice represent the most versatile small‐animal LVO model and dogs are the most appropriate large‐animal LVO stroke model to translate candidate drugs and devices into clinical trials.

Zooplankton and ichthyoplankton community assessments depend on species diagnostics, yet morphological identifications are time-consuming, require taxonomic expertise, and are hampered by a lack of diagnostic characters, particularly for larval stages. Metabarcoding can identify multiple species in communities from short DNA sequences in comparison to reference databases. To evaluate species resolution across phylogenetic groups and food webs of zooplankton and ichthyoplankton, we compare five metabarcode mitochondrial (mt)DNA markers from gene regions of (a) cytochrome c oxidase subunit I, (b) cytochrome b, (c) 16S ribosomal RNA, and (d) 12S ribosomal RNA for DNA extracted from net tows in the Northeastern Pacific Ocean’s Salish Sea across seven sites and two seasons. Species resolved by metabarcoding are compared to invertebrate morphological identifications and biomass estimates. Results indicate that species resolution for different zooplankton and ichthyoplankton taxa can markedly vary among gene regions and markers in comparison to morphological identifications. Thus, researchers seeking “universal” metabarcoding should take caution that several markers and gene regions likely will be needed; all will miss some taxa and yield incomplete overlap. Species resolution requires careful attention to taxon marker selection and coverage in reference sequence repositories. In summary, combined multi-marker metabarcoding and morphological approaches improve broadscale zooplankton diagnostics.

The amphipod Cyphocaris challengeri is a globally distributed, highly abundant species of zooplankton. Here, we report the complete mitochondrial genome of C. challengeri obtained using the Illumina sequencing platform from a specimen collected from Puget Sound, Washington. The mitogenome is a circular DNA molecule with a size of 14,338 bp and 26.7% GC content, with 13 protein-encoding genes, 2 rRNAs, and 22 tRNAs annotated. A maximum likelihood phylogenetic analysis including C. challengeri and all other available mitogenomes from Amphipoda places our mitogenome firmly within the Lysianassoidea superfamily, as expected. The newly described mitochondrial genome of C. challengeri fills a gap in valuable reference data for detecting this organism using molecular methods such as environmental DNA.

Abstract Previous work demonstrated inactivation of influenza virus by GHz frequency electromagnetic fields. Despite theoretical and experimental results, the underlying mechanism driving this inactivation remains unknown. One hypothesis is that the electromagnetic field is causing damage to the virion membrane (and therefore changing spike protein orientation) rendering the virus unable to attach and infect host cells. Towards examining this hypothesis, our group employed nanosecond pulsed electric fields (nsPEFs) as a surrogate to radiofrequency (RF) exposure to enable exploration of dose response thresholds of electric field-induced viral membrane damage. In summary, Bovine coronavirus (BCoV) was exposed, in suspension, to mono and bipolar 600-ns pulsed electric fields (nsPEFs) at two amplitudes (12.5 and 25 kV/cm) and pulse numbers [0 (sham), 1, 5, 10, 100, and 1000] at a 1 Hz (Hz) repetition rate. The temperature rise immediately after exposure(s) was measured using thermocouples to differentiate effects of the electric field (E-field) and heating (i.e., the thermal gradient). Inactivation of BCoV was evaluated by infecting HRT-18G host cells and assessing differences in virus infectivity days after exposure. Our results show that 600 nsPEFs, both bipolar and monopolar, can reduce the infectivity of coronaviruses at various amplitudes, pulse numbers, and pulse polarity. Interestingly, we observed that bipolar exposures appeared to be more efficient at lower exposure intensities than monopolar pulses. Future work should focus on experiments to identify the mechanism underlying nsPEF-induced viral inactivation.

Background: Percutaneous approaches to the spine have been explored recently for various procedures, including transforaminal lumbar interbody fusion. It is known that facet decortication leads to higher rates of fusion, but effective percutaneous approaches have not been well documented. There are a set of instruments used in the cervical spine for percutaneous decortication, the CORUS™ Spinal System-X (DI# 00852776006508), which may be useful in this setting. Our aim was to investigate the feasibility of decorticating the lumbar facet joints with these instruments in cadavers to aid in minimally invasive lumbar fusion. Methods: We performed percutaneous facet joint decortication at each facet joint in the lumbar spine in two adult cadavers. We tested varying degrees of laterality for entry points and angulation for access at each level to optimize the innovative procedure. Results: When using the CORUS™ Spinal System-X to obtain percutaneous access for facet decortication in the lumbar spine, we successfully dissected down to the facet joint without neurovascular injury. At the L1-L2 and L2-L3 levels, access was best obtained at 4 cm from midline with an angulation of 10°. At the L3-L4 and L4-L5 level, access was best obtained at 4 cm from midline with an angulation of 20°. Conclusions: This study demonstrates that percutaneous lumbar facet joint decortication is feasible with the CORUS™ Spinal System-X instruments, and warrants further, comparative study in the clinical setting

El Niño-Southern Oscillation (ENSO) events activate long-distance teleconnections through the atmosphere and ocean that can dramatically impact marine ecosystems along the West Coast of NorthAmerica, affecting diverse organisms ranging from plankton to exploitable and protected species. Such ENSO-related changes to marine ecosystems can ultimately affect humans in many ways, including via depressed plankton and fish production, dramatic range shifts formany protected and exploited species, inaccessibility of traditionally fished resources, more prevalent harmful algal blooms, altered oxygen and pH of waters used in mariculture, and proliferation of pathogens. Theprincipal objective of the Forecasting ENSO Impacts on Marine Ecosystems of the US West Coast workshop was to develop a scientific framework for building an ENSO-related forecast system of ecosystem indicators along the West Coast of North America, including major biological and biogeochemical responses. Attendees realized thata quantitative, biologically-focused forecast system is a much more challenging objective than forecasting the physical system alone; it requires an understanding of the ocean-atmospheric physical system and of diverse organism-level, population-level, and geochemicalresponses that, in aggregate, lead to altered ecosystem states.

Abstract The iconic and threatened Caribbean coral, Acropora palmata, is an essential reef-ecosystem engineer. Understanding the processes underpinning this coral’s survival and growth is essential to restoring this foundational species. Here, we compared replicate A. palmata colonies transplanted along 350 km of Florida’s offshore coral reef to determine holobiont and/or environmental variables that predict transplant success. We found a west-to-east gradient in coral physiology coupled with site-specific coral-associated microbiomes. Interestingly, no variables were linked to coral genet. Our results suggest that the unique oceanographic conditions with periodic upwelling events in the Dry Tortugas provide corals with greater opportunity for heterotrophy that in turn enhances coral growth and survivorship, and positively influences the microbiome. Our findings indicate that restoration efforts in the Dry Tortugas, and other places exhibiting higher food availability, could be most effective for A. palmata.

The global increase in anthropogenic CO2 is leading to ocean warming and acidification, which is threatening corals. In Ischia, Italy, two species of Mediterranean scleractinian corals-the symbiotic Cladocora caespitosa and the asymbiotic Astroides calycularis-were collected from ambient pH sites (average pHT = 8.05) and adjacent CO2 vent sites (average pHT = 7.8) to evaluate their response to ocean acidification. Coral colonies from both sites were reared in a laboratory setting for six months at present day pH (pHT ~ 8.08) or low pH (pHT ~7.72). Previous work showed that these corals were tolerant of low pH and maintained positive calcification rates throughout the experiment. We hypothesized that these corals cope with low pH by increasing their heterotrophic capacity (i.e., feeding and/or proportion of heterotrophically derived compounds incorporated in their tissues), irrespective of site of origin, which was quantified indirectly by measuring δ13C, δ15N, and sterols. To further characterize coral health, we quantified energy reserves by measuring biomass, total lipids, and lipid classes. Additional analysis for C. caespitosa included carbohydrates (an energy reserve) and chlorophyll a (an indicator of photosynthetic capacity). Isotopic evidence shows that ambient-sourced Mediterranean corals, of both species, decreased heterotrophy in response to six months of low pH. Despite maintaining energy reserves, lower net photosynthesis (C. caespitosa) and a trend of declining calcification (A. calycularis) suggest a long-term cost to low heterotrophy under ocean acidification conditions. Conversely, vent-sourced corals maintained moderate (C. caespitosa) or high (A. calycularis) heterotrophic capacity and increased photosynthesis rates (C. caespitosa) in response to six months at low pH, allowing them to sustain themselves physiologically. Provided there is sufficient zooplankton and/or organic matter to meet their heterotrophic needs, vent-sourced corals are more likely to persist this century and potentially be a source for new corals in the Mediterranean.

Abstract Coral reefs are declining worldwide, yet some coral populations are better adapted to withstand reductions in pH and the rising frequency of marine heatwaves. The nearshore reef habitats of Palau, Micronesia are a proxy for a future of warmer, more acidic oceans. Coral populations in these habitats can resist, and recover from, episodes of thermal stress better than offshore conspecifics. To explore the physiological basis of this tolerance, we compared tissue biomass (ash-free dry weight cm−2), energy reserves (i.e., protein, total lipid, carbohydrate content), and several important lipid classes in six coral species living in both offshore and nearshore environments. In contrast to expectations, a trend emerged of many nearshore colonies exhibiting lower biomass and energy reserves than colonies from offshore sites, which may be explained by the increased metabolic demand of living in a warmer, acidic, environment. Despite hosting different dinoflagellate symbiont species and having access to contrasting prey abundances, total lipid and lipid class compositions were similar in colonies from each habitat. Ultimately, while the regulation of colony biomass and energy reserves may be influenced by factors, including the identity of the resident symbiont, kind of food consumed, and host genetic attributes, these independent processes converged to a similar homeostatic set point under different environmental conditions.

IMPORTANCE:. Initial Society of Critical Care Medicine Discovery Viral Infection and Respiratory illness Universal Study (VIRUS) Registry analysis suggested that improvements in critical care processes offered the greatest modifiable opportunity to improve critically ill COVID-19 patient outcomes. OBJECTIVES:. The Structured Team-based Optimal Patient-Centered Care for Virus COVID-19 ICU Collaborative was created to identify and speed implementation of best evidence based COVID-19 practices. DESIGN, SETTING, AND PARTICIPANTS:. This 6-month project included volunteer interprofessional teams from VIRUS Registry sites, who received online training on the Checklist for Early Recognition and Treatment of Acute Illness and iNjury approach, a structured and systematic method for delivering evidence based critical care. Collaborators participated in weekly 1-hour videoconference sessions on high impact topics, monthly quality improvement (QI) coaching sessions, and received extensive additional resources for asynchronous learning. MAIN OUTCOMES AND MEASURES:. Outcomes included learner engagement, satisfaction, and number of QI projects initiated by participating teams. RESULTS:. Eleven of 13 initial sites participated in the Collaborative from March 2, 2021, to September 29, 2021. A total of 67 learners participated in the Collaborative, including 23 nurses, 22 physicians, 10 pharmacists, nine respiratory therapists, and three nonclinicians. Site attendance among the 11 sites in the 25 videoconference sessions ranged between 82% and 100%, with three sites providing at least one team member for 100% of sessions. The majority reported that topics matched their scope of practice (69%) and would highly recommend the program to colleagues (77%). A total of nine QI projects were initiated across three clinical domains and focused on improving adherence to established critical care practice bundles, reducing nosocomial complications, and strengthening patient- and family-centered care in the ICU. Major factors impacting successful Collaborative engagement included an engaged interprofessional team; an established culture of engagement; opportunities to benchmark performance and accelerate institutional innovation, networking, and acclaim; and ready access to data that could be leveraged for QI purposes. CONCLUSIONS AND RELEVANCE:. Use of a virtual platform to establish a learning collaborative to accelerate the identification, dissemination, and implementation of critical care best practices for COVID-19 is feasible. Our experience offers important lessons for future collaborative efforts focused on improving ICU processes of care.

Wealth ownership is a critical component of economic well-being, and wealth in early adulthood provides important clues about the trajectories along which individuals move throughout their lives. Using data from the National Longitudinal Study of Adolescent Health (Add Health), we find an association between growing up rural and adult wealth that varies across the components of wealth. We also find that growing up rural has unique implications for young adult wealth ownership that differ from growing up in other geographic regions, particularly in urban areas. Our results highlight an important outcome that is conditioned by growing up rural and underscores the importance of context for understanding how families save and accumulate wealth.

Global decline of coral reefs shows varied responses to environmental stress, highlighting the need to understand these differences. The physiological plasticity of coral hosts and their microalgal symbionts can allow the coral holobiont to thrive in diverse marine environments, suggesting new strategies for effective restoration. To investigate local environmental influence on the physiology of two Caribbean coral species (Acropora palmata and Orbicella faveolata), clonal colonies from a land‐based nursery were transferred to nearshore and offshore reefs for one year. After transfer to coral reef habitats, both coral species shifted in photopigmentation and host energy reserves. Acropora palmata also shifted dominant symbionts and altered growth. Stable isotopes identified higher autotrophic proportions of metabolic carbon and higher photosynthesis rates in transplanted colonies compared to those in the land‐based nursery. Synthesis and applications. These findings improve our understanding of coral acclimatization and physiological plasticity, highlighting potential side effects of domestication. As coral restoration accelerates globally, this knowledge is crucial for guiding efforts and conserving endangered ecosystems by supplying considerations for improving coral‐rearing systems and providing information on genera‐specific acclimatization to transplant sites. [ABSTRACT FROM AUTHOR]