Extent and reproduction of coastal species on plastic debris in the North Pacific Subtropical Gyre.

We show that the high seas are colonized by a diverse array of coastal species, which survive and reproduce in the open ocean, contributing strongly to its floating community composition. Analysis of rafting plastic debris in the eastern North Pacific Subtropical Gyre revealed 37 coastal invertebrate taxa, largely of Western Pacific origin, exceeding pelagic taxa richness by threefold. Coastal taxa, including diverse taxonomic groups and life history traits, occurred on 70.5% of debris items. Most coastal taxa possessed either direct development or asexual reproduction, possibly facilitating long-term persistence on rafts. Our results suggest that the historical lack of available substrate limited the colonization of the open ocean by coastal species, rather than physiological or ecological constraints as previously assumed. It appears that coastal species persist now in the open ocean as a substantial component of a neopelagic community sustained by the vast and expanding sea of plastic debris.

Investigating microcrystalline cellulose crystallinity using Raman spectroscopy.

Microcrystalline cellulose (MCC) is a semi-crystalline material with inherent variable crystallinity due to raw material source and variable manufacturing conditions. MCC crystallinity variability can result in downstream process variability. The aim of this study was to develop models to determine MCC crystallinity index (%CI) from Raman spectra of 30 commercial batches using Raman probes with spot sizes of 100 µm (MR probe) and 6 mm (PhAT probe). A principal component analysis model separated Raman spectra of the same samples captured using the different probes. The %CI was determined using a previously reported univariate model based on the ratio of the peaks at 380 and 1096 cm-1. The univariate model was adjusted for each probe. The %CI was also predicted from spectral data from each probe using partial least squares regression models (where Raman spectra and univariate %CI were the dependent and independent variables, respectively). Both models showed adequate predictive power. For these models a general reference amorphous spectrum was proposed for each instrument. The development of the PLS model substantially reduced the analysis time as it eliminates the need for spectral deconvolution. A web application containing all the models was developed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10570-021-04093-1.

Evidence for a role of arginine vasotocin receptors in the gill during salinity acclimation by a euryhaline teleost fish.

The nonapeptide arginine vasotocin (AVT) regulates osmotic balance in teleost fishes, but its mechanisms of action are not fully understood. Recently, it was discovered that nonapeptide receptors in teleost fishes are differentiated into two V1a-type, several V2-type, and two isotocin (IT) receptors, but it remains unclear which receptors mediate AVT's effects on gill osmoregulation. Here, we examined the role of nonapeptide receptors in the gill of the euryhaline Amargosa pupfish (Cyprinodon nevadensis amargosae) during osmotic acclimation. Transcripts for the teleost V1a-type receptor v1a2 were upregulated over fourfold in gill 24 h after transferring pupfish from 7.5 ppt to seawater (35 ppt) or hypersaline (55 ppt) conditions and downregulated after transfer to freshwater (0.3 ppt). Gill transcripts for the nonapeptide degradation enzyme leucyl-cystinyl aminopeptidase (LNPEP) also increased in fish acclimating to 35 ppt. To test whether the effects of AVT on the gill might be mediated by a V1a-type receptor, we administered AVT or a V1-type receptor antagonist (Manning compound) intraperitoneally to pupfish before transfer to 0.4 ppt or 35 ppt. Pupfish transferred to 35 ppt exhibited elevated gill mRNA abundance for cystic fibrosis transmembrane conductance regulator (cftr), but that upregulation diminished under V1-receptor inhibition. AVT inhibited the increase in gill Na+/Cl- cotransporter 2 (ncc2) transcript abundance that occurs following transfer to hypoosmotic environments, whereas V1-type receptor antagonism increased ncc2 mRNAs even without a change in salinity. These findings indicate that AVT acts via a V1-type receptor to regulate gill Cl- transport by inhibiting Cl- uptake and facilitating Cl- secretion during seawater acclimation.

Near-infrared monitoring of roller compacted ribbon density: Investigating sources of variation contributing to noisy spectral data.

The aim of this study was to highlight how variability in roller compacted ribbon quality can impact on NIR spectral measurement and to propose a simple method of data selection to remove erroneous spectra. The use of NIR spectroscopy for monitoring ribbon envelope density has been previously demonstrated, however to date there has been limited discussion as to how spectral data sets can contain erroneous outliers due to poor sample presentation to the NIR probes. In this study compacted ribbon of variable quality was produced from three separate blends of microcrystalline cellulose (MCC)/lactose/magnesium stearate at 8 Roll Force settings (2-16kN/cm). The three blends differed only in the storage conditions of MCC prior to blending and compaction. MCC sublots were stored at ambient (41% RH/20°C), low humidity (11% RH/20°C) and high humidity (75% RH/40°C) conditions prior to blending. Ribbon envelope density was measured and ribbon NIR spectral data was acquired at line using a multi-probe spectrometer (MultiEye™ NIR). Initial inspection of the at-line NIR spectral data set showed a large degree of variability which indicated that some form of data cleaning was required. The source of variability in spectral measurements was investigated by subjective visual examination and by statistical analysis. Spectral variability was noted due to the storage conditions of MCC prior to compaction, Roll Force settings and between individual ribbon samples sampled at a set Roll Force/Blend combination. Variability was also caused by ribbon presentation to probes, such as differences in the presentation of broken, curved and flat intact ribbons. Based on the subjective visual examination of data, a Visual Discard method was applied and was found to be particularly successful for blends containing MCC stored at ambient and low humidity. However the Visual Discard method of spectra cleaning is subjective and therefore a non-subjective method capable of screening for erroneous probe readings was developed. For this data set a Trimmed Mean method was applied to set a limit on how data is cleaned from the data set allowing for the removal of a faulty probe reading (25% of data) or a poor sample (33% of data). The 33% Trimmed Mean reduced the impact of spectral variation or misreads between samples or probes and was found to be as successful as the Visual Discard method at cleaning the data set prior to development of the calibration equation.

Therapist facilitative interpersonal skills and training status: A randomized clinical trial on alliance and outcome.

OBJECTIVES: Therapist effects, independent of the treatment provided, have emerged as a contributor to psychotherapy outcomes. However, past research largely has not identified which therapist factors might be contributing to these effects, though research on psychotherapy implicates relational characteristics. The present Randomized Clinical Trial tested the efficacy of therapists who were selected by their facilitative interpersonal skills (FIS) and training status. METHOD: Sixty-five clients were selected from 2713 undergraduates using a screening and clinical interview procedure. Twenty-three therapists met with 2 clients for 7 sessions and 20 participants served in a no-treatment control group. RESULTS: Outcome and alliance differences for Training Status were negligible. High FIS therapists had greater pre-post client outcome, and higher rates of change across sessions, than low FIS therapists. All clients treated by therapists improved more than the silent control, but effects were greater with high FIS than low FIS therapists. From the first session, high FIS therapists also had higher alliances than low FIS therapists as well as significant improvements on client-rated alliance. CONCLUSIONS: Results were consistent with the hypothesis that therapists' common relational skills are independent contributors to therapeutic alliance and outcome.

Demographic and work-related correlates of job burnout in professional eating disorder treatment providers.

Patients with eating disorders present unique challenges to treatment providers that may contribute to job burnout. This study examined demographic and work-related correlates of three primary components of burnout (i.e., emotional exhaustion, cynicism, and lack of personal accomplishment) in a sample of 296 professional eating disorder treatment providers. Participants completed the Maslach Burnout Inventory-Human Services Survey (MBI-HSS; Maslach, Jackson, & Leiter, 1996), demographics, and a questionnaire developed by the authors measuring eating disorder-specific factors theorized to be relevant to burnout. Overall, participants reported comparable levels of emotional exhaustion but significantly less cynicism and lack of personal accomplishment relative to established norms for mental health care providers on the MBI-HSS. Analyses of variance and backward regression analyses suggested that higher levels of burnout were associated with being younger, female, and overweight; working longer hours; having less experience; and experiencing a patient's death. Conversely, working in a private practice setting, having children, and having a personal history of an eating disorder were associated with lower burnout levels. Furthermore, over 45% of participants reported that treatment resistance, ego-syntonicity, high relapse rates, worry about patient survival, emotional drain, lack of appropriate financial reimbursement, and extra hours spent working contributed to feelings burned out somewhat to very much. Overall, these data suggest that emotional exhaustion is the most common aspect of burnout experienced by eating disorder treatment providers and highlight some of the key correlates of burnout for this population, which can be used to inform prevention and intervention efforts.

Treatment providers with a personal history of eating pathology: a qualitative examination of common experiences.

Using qualitative methodology, this study examined the experiences of treatment providers with a personal history of eating pathology. A total of 139 eating disorder treatment providers completed a questionnaire designed by the authors that (a) asked whether and how their personal history influences treatment of patients with eating disorders and (b) elicited feedback for other therapists. Results indicated that the large majority of participants (94%) believed that their eating disorder history positively influenced their treatment of patients (e.g., increased empathy, greater understanding of the disorder, more positive personal outlook). Conversely, only 8% identified ways in which it can negatively influence treatment (e.g., feeling personally triggered, over-identifying with patients). Feedback for other professionals included the importance of personally recovering before treating this population and monitoring one's experiences in session (e.g., notice countertransference). Continued discourse regarding the benefits and challenges of a personal history of eating pathology in treatment providers is warranted.

What makes a Catholic hospital "Catholic" in an age of religious-secular collaboration? The case of the Saint Marys hospital and the Mayo Clinic.

Mayo Clinic is recognized as a worldwide leader in innovative, high-quality health care. However, the Catholic mission and ideals from which this organization was formed are not widely recognized or known. From partnership with the Sisters of St. Francis in 1883, through restructuring of the Sponsorship Agreement in 1986 and current advancements, this Catholic mission remains vital today at Saint Marys Hospital. This manuscript explores the evolution and growth of sponsorship at Mayo Clinic, defined as "a collaboration between the Sisters of St. Francis and Mayo Clinic to preserve and promote key values that the founding Franciscan sisters and Mayo physicians embrace as basic to their mission, and to assure the Catholic identity of Saint Marys Hospital." Historical context will be used to frame the evolution and preservation of Catholic identity at Saint Marys Hospital; and the shift from a "sponsorship-by-governance" to a "sponsorship-by-influence" model will be highlighted. Lastly, using the externally-developed Catholic Identity Matrix (developed by Ascension Health and the University of St. Thomas, Minnesota), specific examples of Catholic identity will be explored in this joint venture of Catholic health care institution and a secular, nonprofit corporation (Mayo Clinic).

The influence of supervision on manual adherence and therapeutic processes.

OBJECTIVES: To identify the effectiveness of psychotherapy supervision on therapists' immediate (next session) and long-term (1 year) adherence to time-limited dynamic psychotherapy (TLDP). METHOD: Sixteen therapists from the Vanderbilt II psychotherapy project were assigned new cases in pretraining, training, and booster/posttraining year-long cohorts. Technical adherence to the manual, as well as general therapeutic relational processes, were rated for clinical supervisory sessions in which the third therapy session was discussed. The therapy sessions immediately before and after the supervisory sessions were also rated for technical adherence and relational processes. RESULTS: Postsupervision adherence increased from the presupervision session during the training cohort. In supervision, therapists' discussion of techniques and strategies from the manual in supervision was significantly related to technical adherence in the session prior to (but not after) supervision. However, supervisors' discussion of specific techniques predicted therapists' total technical adherence in the therapy session after (but not before) supervision. In terms of the type of techniques, supervisors' influenced postsupervision therapy adherence on TLDP's unique approach to formulation, the cyclical maladaptive pattern, but did not influence technical adherence on the therapeutic relationship. CONCLUSIONS: In supervision, therapists tend to focus on how they adhered to techniques from the previous session, whereas supervisors' comments about specific techniques predicted how the therapist would adhere to techniques in the next therapy session. The findings provide support for the immediate effects of supervision in shaping therapist techniques as well as highlighting the challenges of altering common relational processes through technical training.

A qualitative analysis of job burnout in eating disorder treatment providers.

Although job burnout is common in mental health care settings, almost no research has examined burnout in eating disorder treatment providers. Using qualitative methodology, this study examined a) perceived contributors of burnout, b) efforts to manage burnout, and c) recommendations for avoiding burnout in a sample of professional eating disorder treatment providers. Recruited via professional organizations, 298 participants completed an online questionnaire designed by the authors. Qualitative responses were coded and grouped into themes. Results indicated that almost all participants worried about their patients' health, which frequently resulted in negative affect (e.g., anxiety, sadness). The most frequently cited contributors to burnout were common characteristics of eating pathology (e.g., chronicity, relapse, symptom severity); patient characteristics (e.g., personality conflict); work-related factors (e.g., time demands); and, financial issues (e.g., inadequate compensation). To avoid burnout, over 90% of participants engaged in self-care behaviors (e.g., exercise, social support). Early-career practitioners were encouraged to utilize supervision, create a work/life balance, engage in self-care, and limit caseloads. These results suggest that supervision and training of eating disorder treatment providers should include burnout management.

Ethical analysis of withdrawing ventricular assist device support.

OBJECTIVE: To describe a series of patients with heart failure supported with a ventricular assist device (VAD) who requested (or whose surrogates requested) withdrawal of VAD support and the legal and ethical aspects pertaining to these requests. PATIENTS AND METHODS: We retrospectively reviewed the medical records of patients at Mayo Clinic, Rochester, MN, from March 1, 2003, through January 31, 2009, who requested (or whose surrogates requested) withdrawal of VAD support and for whom the requests were fulfilled. We then explored the legal and ethical permissibility of carrying out such requests. RESULTS: The median age of the 14 patients identified (13 men, 1 woman) was 57 years. Requests were made by 2 patients and 12 surrogates. None of the patients' available advance directives mentioned the VAD. For 11 patients, multidisciplinary care conferences were held before withdrawal of VAD support. Only 1 patient had an ethics consultation. All 14 patients died within 1 day of withdrawal of VAD support. CONCLUSION: Patients have the right to refuse or request the withdrawal of any unwanted treatment, and we argue that this right extends to VAD support. We also argue that the cause of death in these cases is the underlying heart disease, not assisted suicide or euthanasia. Therefore, patients with heart failure supported with VADs or their surrogates may request withdrawal of this treatment. In our view, carrying out such requests is permissible in accordance with the principles that apply to withdrawing other life-sustaining treatments.

Treating patients with eating disorders: an examination of treatment providers' experiences.

Patients with eating disorders bring unique challenges to treatment providers. The purpose of this study was to explore treatment providers' experiences working with patients with eating disorders. Specifically, we investigated 1) the frequency and management of commentary about the treatment providers' appearance from patients, 2) personal changes in affect, vigilance around appearance, and eating behaviors in treatment providers, and 3) feedback and suggestions about effectively working with these patients. Using quantitative and qualitative methods, 43 professional eating disorder treatment providers attending the Multiservice Eating Disorder Association (MEDA) annual conference completed a questionnaire created for this study. Results suggest that most treatment providers experienced direct and indirect commentary about their appearance from patients and experienced notable changes in their view of food, eating behaviors, and vigilance of their own and others' appearance while working with these patients. Recommendations and suggestions from treatment providers about effectively treating these patients and managing personal changes are explored.

Patients who complete advance directives and what they prefer.

OBJECTIVE: To determine health care preferences expressed by patients in advance directives (ADs) and to identify characteristics of patients who completed them. PATIENTS AND METHODS: A computer-generated random sample of 500 patients was selected from the 25,865 (margin of error, +/- 4.34%) unique patients who submitted ADs to Mayo Clinic Rochester between January 1, 2004, and July 1, 2005. After excluding 24 (4.8%) patients who had submitted documents related to financial and property matters instead of ADs, we analyzed the contents of the 476 ADs and the demographic features of the patients to whom the documents belonged. RESULTS: The median (range) age of the patients at the time they signed their respective ADs was 67 (19-97) years. Of the 476 study patients, 409 (91.3%) were high school graduates; 339 (71.2%) had submitted a combined AD, which has features of a living will and a health care power of attorney; 434 (91.2%) had designated a health care agent; and most had granted the agent powers to consent for procedures (340 [78.3%]), to access information (327 [75.3%]), and to withhold and withdraw life-sustaining treatments (337 [77.6%]). Most patients expressed a desire for pain control (308 [64.7%]). For the clinical situations of dying or permanent unconsciousness, most patients explicitly expressed a preference to avoid "general life support" (371 [77.9%]) but did not explicitly address common life-sustaining treatments, including cardiopulmonary resuscitation, mechanical ventilation, hemodialysis, blood transfusion, and artificial nutrition and hydration (if they did, nearly all expressed a preference to avoid the treatments). CONCLUSION: In ADs submitted to our institution, most patients designated a health care agent and granted the agent broad decision-making powers. Although most expressed a desire to avoid "general life support" if dying or permanently unconscious, few expressed preferences regarding specific life-sustaining treatments. Patients, clinicians, and others who use ADs, and investigators contemplating research involving ADs, might find these results informative.