Vulnerability to climate change of United States marine mammal stocks in the western North Atlantic, Gulf of Mexico, and Caribbean.

Climate change and climate variability are affecting marine mammal species and these impacts are projected to continue in the coming decades. Vulnerability assessments provide a framework for evaluating climate impacts over a broad range of species using currently available information. We conducted a trait-based climate vulnerability assessment using expert elicitation for 108 marine mammal stocks and stock groups in the western North Atlantic, Gulf of Mexico, and Caribbean Sea. Our approach combined the exposure (projected change in environmental conditions) and sensitivity (ability to tolerate and adapt to changing conditions) of marine mammal stocks to estimate vulnerability to climate change, and categorize stocks with a vulnerability index. The climate vulnerability score was very high for 44% (n = 47) of these stocks, high for 29% (n = 31), moderate for 20% (n = 22), and low for 7% (n = 8). The majority of stocks (n = 78; 72%) scored very high exposure, whereas 24% (n = 26) scored high, and 4% (n = 4) scored moderate. The sensitivity score was very high for 33% (n = 36) of these stocks, high for 18% (n = 19), moderate for 34% (n = 37), and low for 15% (n = 16). Vulnerability results were summarized for stocks in five taxonomic groups: pinnipeds (n = 4; 25% high, 75% moderate), mysticetes (n = 7; 29% very high, 57% high, 14% moderate), ziphiids (n = 8; 13% very high, 50% high, 38% moderate), delphinids (n = 84; 52% very high, 23% high, 15% moderate, 10% low), and other odontocetes (n = 5; 60% high, 40% moderate). Factors including temperature, ocean pH, and dissolved oxygen were the primary drivers of high climate exposure, with effects mediated through prey and habitat parameters. We quantified sources of uncertainty by bootstrapping vulnerability scores, conducting leave-one-out analyses of individual attributes and individual scorers, and through scoring data quality for each attribute. These results provide information for researchers, managers, and the public on marine mammal responses to climate change to enhance the development of more effective marine mammal management, restoration, and conservation activities that address current and future environmental variation and biological responses due to climate change.

The distribution of manta rays in the western North Atlantic Ocean off the eastern United States.

In 2018, the giant manta ray was listed as threatened under the U.S. Endangered Species Act. We integrated decades of sightings and survey effort data from multiple sources in a comprehensive species distribution modeling (SDM) framework to evaluate the distribution of giant manta rays off the eastern United States, including the Gulf of Mexico. Manta rays were most commonly detected at productive nearshore and shelf-edge upwelling zones at surface thermal frontal boundaries within a temperature range of approximately 20-30 °C. SDMs predicted highest nearshore occurrence off northeastern Florida during April, with the distribution extending northward along the shelf-edge as temperatures warm, leading to higher occurrences north of Cape Hatteras, North Carolina from June to October, and then south of Savannah, Georgia from November to March as temperatures cool. In the Gulf of Mexico, the highest nearshore occurrence was predicted around the Mississippi River delta from April to June and again from October to November. SDM predictions will allow resource managers to more effectively protect manta rays from fisheries bycatch, boat strikes, oil and gas activities, contaminants and pollutants, and other threats.

Using hierarchical bayes to understand movement, health, and survival in the endangered north atlantic right whale.

Body condition is an indicator of health, and it plays a key role in many vital processes for mammalian species. While evidence of individual body condition can be obtained, these observations provide just brief glimpses into the health state of the animal. An analytical framework is needed for understanding how health of animals changes over space and time.Through knowledge of individual health we can better understand the status of populations. This is particularly important in endangered species, where the consequences of disruption of critical biological functions can push groups of animals rapidly toward extinction. Here we built a state-space model that provides estimates of movement, health, and survival. We assimilated 30+ years of photographic evidence of body condition and three additional visual health parameters in individual North Atlantic right whales, together with survey data, to infer the true health status as it changes over space and time. We also included the effect of reproductive status and entanglement status on health. At the population level, we estimated differential movement patterns in males and females. At the individual level, we estimated the likely animal locations each month. We estimated the relationship between observed and latent health status. Observations of body condition, skin condition, cyamid infestation on the blowholes, and rake marks all provided measures of the true underlying health. The resulting time series of individual health highlight both normal variations in health status and how anthropogenic stressors can affect the health and, ultimately, the survival of individuals. This modeling approach provides information for monitoring of health in right whales, as well as a framework for integrating observational data at the level of individuals up through the health status of the population. This framework can be broadly applied to a variety of systems - terrestrial and marine - where sporadic observations of individuals exist.

Swim speed, behavior, and movement of North Atlantic right whales (Eubalaena glacialis) in coastal waters of northeastern Florida, USA.

In a portion of the coastal waters of northeastern Florida, North Atlantic right whales (Eubalaena glacialis) occur close to shore from December through March. These waters are included within the designated critical habitat for right whales. Data on swim speed, behavior, and direction of movement--with photo-identification of individual whales--were gathered by a volunteer sighting network working alongside experienced scientists and supplemented by aerial observations. In seven years (2001-2007), 109 tracking periods or "follows" were conducted on right whales during 600 hours of observation from shore-based observers. The whales were categorized as mother-calf pairs, singles and non-mother-calf pairs, and groups of 3 or more individuals. Sample size and amount of information obtained was largest for mother-calf pairs. Swim speeds varied within and across observation periods, individuals, and categories. One category, singles and non mother-calf pairs, was significantly different from the other two--and had the largest variability and the fastest swim speeds. Median swim speed for all categories was 1.3 km/h (0.7 kn), with examples that suggest swim speeds differ between within-habitat movement and migration-mode travel. Within-habitat right whales often travel back-and-forth in a north-south, along-coast, direction, which may cause an individual to pass by a given point on several occasions, potentially increasing anthropogenic risk exposure (e.g., vessel collision, fishing gear entanglement, harassment). At times, mothers and calves engaged in lengthy stationary periods (up to 7.5 h) that included rest, nursing, and play. These mother-calf interactions have implications for communication, learning, and survival. Overall, these behaviors are relevant to population status, distribution, calving success, correlation to environmental parameters, survey efficacy, and human-impacts mitigation. These observations contribute important parameters to conservation biology, predictive modeling, and management. However, while we often search for predictions, patterns, and means, the message here is also about variability and the behavioral characteristics of individual whales.

Applying science and strategy to operating room workforce management.

The traditional means of planning nurse staffing for operating rooms are either poorly translated to the setting or do not provide decision makers with a platform to defend their needs, especially in an era of health care reform. The surgical operations department of the Cleveland Clinic initiated a quality improvement project aimed at applying a scientific method to operating room staffing. One goal was to provide a defensible plan for allocating direct caregiver positions. A second goal was to provide a quick and easy way for nurse managers and directors to track positions and graphically depict the effect of vacancies and orientation on their staffing budgets. Using an objective, scientific method allows position requests to be approved quickly and allows managers to feel much more comfortable functioning in a "lean" mode because they know needed positions will be approved quickly. Managers and directors also have found that graphically depicting numbers of vacant positions, as well as staff in orientation, could quickly relate a story visually rather than getting "bogged down" in narrative (often losing finance administrators along the way).

An adaptive framework for selecting environmental monitoring protocols to support ocean renewable energy development.

Offshore renewable energy developments (OREDs) are projected to become common in the United States over the next two decades. There are both a need and an opportunity to guide efforts to identify and track impacts to the marine ecosystem resulting from these installations. A monitoring framework and standardized protocols that can be applied to multiple types of ORED would streamline scientific study, management, and permitting at these sites. We propose an adaptive and reactive framework based on indicators of the likely changes to the marine ecosystem due to ORED. We developed decision trees to identify suites of impacts at two scales (demonstration and commercial) depending on energy (wind, tidal, and wave), structure (e.g., turbine), and foundation type (e.g., monopile). Impacts were categorized by ecosystem component (benthic habitat and resources, fish and fisheries, avian species, marine mammals, and sea turtles) and monitoring objectives were developed for each. We present a case study at a commercial-scale wind farm and develop a monitoring plan for this development that addresses both local and national environmental concerns. In addition, framework has provided a starting point for identifying global research needs and objectives for understanding of the potential effects of ORED on the marine environment.

Soft tissue sarcomas: current management and future directions.

This article reviews the current state of diagnosis and treatment of soft tissue sarcomas. Etiology, staging, imaging, tissue sampling, and current treatment are all reviewed using updated references. Current standards for surgical treatment are emphasized and the future directions of treatment addressed.

The effects of race and age on axillary lymph node involvement in breast cancer patients at a Midwestern safety-net hospital.

BACKGROUND: Black and premenopausal patients have been shown to have poorer stage for stage survival than the overall population. The purpose of this study was to define the effects of age and race on axillary lymph node involvement at a Midwestern safety-net hospital. The hypothesis was that black patients under the age of 50 would be found to have increased rates of axillary involvement in breast cancer. METHODS: A retrospective case review was performed of 184 breast cancer patients from 2000 to 2005. Statistical analysis was performed by race and age. Patients under 50 years of age were defined as premenopausal. RESULTS: The overall rate of axillary involvement was 47.8%. Black patients had an overall rate of axillary involvement of 52.9%. However, premenopausal black patients had a 70.8% rate of axillary involvement (P < .05). Premenopausal white patients had a 46.3% rate of axillary involvement. Logistic regression analysis was performed, and premenopausal age and tumor size were found to be independent predictors of positive lymph node status in black patients. CONCLUSION: In our study, premenopausal black patients had a much higher rate of axillary lymph node involvement than any other group. This finding was consistent even when tumor size was taken into account. More research needs to be done to better define this difference and to detect this disease at an earlier stage.

Hemorrhagic shock in the rat: comparison of carotid and femoral cannulation.

BACKGROUND: The reservoir model of rat hemorrhagic shock is widely used. In this model, either the carotid or femoral artery can be cannulated to withdraw blood and measure pressure. In animals undergoing hemorrhage using the carotid approach, we observed seizure activity during the post-shock period, suggesting some degree of brain damage. The hypothesis of the present study is that survival in a model of severe hemorrhagic shock would be higher with femoral cannulation than with carotid cannulation. MATERIALS AND METHODS: All animals (n = 90) were anesthetized with isoflurane using an anesthesia vaporizer while breathing spontaneously. In group 1, the left carotid artery and jugular vein were cannulated; in group 2, the left femoral artery and vein were cannulated. Following a period of hemorrhagic shock (20 to 30 mmHg for 30, 60, or 50-90 min), resuscitation was performed through the venous cannula by giving L-lactated Ringer's (21 mL/kg) and returning the shed blood. RESULTS: In the carotid cannulation group, nearly 50% of the animals had seizures after resuscitation, and most of those animals died following the seizures. The 24-h survival rate in the femoral artery cannulation group was significantly higher than in the carotid artery cannulation group. Femoral cannulated animals had no seizures following reperfusion. CONCLUSIONS: Femoral artery cannulation was associated with considerably better survival than carotid artery cannulation in this rodent model of hemorrhagic shock. The occurrence of seizures in animals undergoing carotid cannulation suggests brain damage from inadequate cerebral perfusion or subsequent reperfusion damage.

Kidney patient care in disasters: emergency planning for patients and dialysis facilities.

The catastrophic 2005 hurricane season alerted Americans to the need for a more effective response to mass casualty incidents. To address the needs of the nephrology community, the Kidney Community Emergency Response Coalition (KCERC) was formed, with representatives from more than 50 governmental agencies and private organizations. After completing phase 1 of its work, the KCERC issued recommendations for patients, dialysis units, and providers. During phase 2, the KCERC will promote implementation of those recommendations. During a disaster, the KCERC will host a daily conference call on which dialysis facilities, the End-Stage Renal Disease Networks, and emergency response officials will coordinate disaster response. Predisaster preparation for kidney patients should stress identification of alternative dialysis facilities, education about the renal emergency diet, and plans for early evacuation from the disaster area and for evacuating with medical documents and medications. Dialysis facilities are required to have a disaster plan; regular revision and rehearsal are essential. Critical issues for dialysis facilities include identification of partner facilities, a robust communications plan that takes into account the limitations of telephones and broadband access, staff shortages in the face of a possible influx of new patients, the delivery of service in the face of compromised utilities (water, power), and the recovery of a dialysis facility that experiences flooding or structural damage. A timeline to safety for dialysis patients can be visualized; if specific tasks are accomplished at each disaster stage, then it is likely that the health of these vulnerable patients can be protected.

Kidney patient care in disasters: lessons from the hurricanes and earthquake of 2005.

The active 2005 hurricane season alerted Americans to the pressing need for a more effective response to mass casualty incidents. The kidney patient community was particularly affected. Ninety-four dialysis facilities in the Gulf Coast states closed for at least 1 wk in the aftermath of Hurricane Katrina, and additional units were affected by evacuation of dialysis patients. Dialysis units along the Gulf Coast were also affected by Hurricanes Rita and Wilma. Existing emergency response plans were inadequate in providing continuity of care for kidney patients. The Kashmir, South Asia, earthquake of October 2005 killed 97,000 individuals. Building collapse was associated with widespread crush injury, and many patients required temporary hemodialysis. Several regions of the United States have the potential for catastrophic earthquakes. The Kidney Community Emergency Response Coalition has recently issued recommendations for patients, dialysis facilities, and providers, with a goal to improve care of kidney patients in future domestic disasters. With suitable planning, the nephrology community can do much to ensure the continuity of medical care for kidney patients in the face of a wide range of possible natural and human-made disasters.

Gestational ethanol exposure disrupts the expression of FGF8 and Sonic hedgehog during limb patterning.

BACKGROUND: Ethanol is known to induce a wide variety of gestational anomalies, including skeletal malformations. Gestational ethanol exposure in mice has been shown to induce postaxial digit loss (ectrodactyly). How ethanol induces limb malformations is not understood. To better understand how ethanol effects limb development, we have utilized a transgenic line of mice that expresses beta-galactosidase in the apical ectodermal ridge (AER) of the limbs throughout gestation. METHODS: Pregnant female mice were injected with 2.9, 3.4, or 3.9 gm/kg ethanol at E9.3 and E9.5; embryos were isolated at E11.25, stained for beta-galactosidase activity, and evaluated for AER defects. Based upon the pattern of defects seen, expression of FGF8 in the AER and Sonic hedgehog in the postaxial mesoderm was evaluated by in situ hybridization. RESULTS: Two distinct phenotypes were seen in response to ethanol that were dose dependent. At 2.9 gm/kg ethanol, the most prevalent phenotype was a mislocalization of the AER to regions both dorsal and ventral to the midline. A higher dosage of 3.4 gm/kg ethanol did not increase the mislocalization phenotype, but resulted in a higher frequency of postaxial loss of the AER and associated mesenchymal tissue. The highest dosage utilized (3.9 gm/kg) resulted in a high frequency of both preaxial and postaxial loss of the AER. Through in situ hybridization, we found that ethanol exposure resulted in a concomitant reduction in FGF8 expression in the AER and Sonic hedgehog expression from the zone of polarizing activity (ZPA). CONCLUSIONS: We propose a model where ethanol disrupts the AER/ZPA positive feedback loop to induce postaxial malformations. Preaxial malformations seen at higher ethanol dosage suggest FGF8 as a critical target of ethanol in producing limb defects.

Nearly 4 years after an event: children's eyewitness memory and adults' perceptions of children's accuracy.

OBJECTIVE: The current study examined children's eyewitness memory nearly 4 years after an event and the ability of adults to evaluate such memory. METHOD: In Phase 1, 7- and 10-year olds were interviewed about a past event after a nearly 4-year delay. The interview included leading questions relevant to child abuse as well as statements designed to implicate the original confederate. In Phase 2, laypersons and professionals watched a videotaped interview (from Phase 1) that they were misled to believe was from an ongoing abuse investigation. Respondents then rated the child's accuracy and credibility, and the probability that the child had been abused. RESULTS: In Phase 1, few significant age differences in memory accuracy were found, perhaps owing in part to small sample size. Although children made a variety of commission errors, none claimed outright to have been abused. Nevertheless, some of the children's answers (e.g., saying that their picture had been taken, or that they had been in a bathtub) might cause concern in a forensic setting. In Phase 2, professional and nonprofessional respondents were unable to reliably estimate the overall accuracy of children's statements. However, respondents were able to reasonably estimate the accuracy of children's answers to abuse questions. Respondents were also more likely to think that 7-year olds compared to 10-year olds had been abused. Professionals were significantly less likely than nonprofessionals to believe that credible evidence of abuse existed. Professionals who indicated personal experience with child abuse or a close relationship with an abuse victim were more likely to rate children as abused. A gender bias to rate boys as more accurate than girls was apparent among laypersons but not professionals. CONCLUSIONS: Children were generally resistant to suggestions that abuse occurred during a long-ago generally forgotten event, but some potentially concerning errors were made. Both professionals and non-professionals had difficulty estimating the accuracy of children's reports, but adults were more likely to rate children as accurate if the children answered abuse-related questions correctly. Training and personal experience were associated with adults' ratings of children's reports. Implications for evaluations of child abuse reports are discussed.

Protamine P1 sequences in equids: comparison with even-toed animals.

Protamine P1 amino acid sequences were determined from semen samples of the Przewalski horse, donkey, Somali wild ass, Grevy's zebra, and Grant's zebra (odd-toed perissodactyls), and compared with those of the domestic horse. Although the rate of amino acid variation of protamine P1 is known to be among the most rapidly diverging polypeptides, the equid sequences revealed only little variation. The sequence from the Przewalski horse was identical with that from the domestic horse. The other sequences differed from the corresponding sequences of the domestic and Przewalski horses in two positions-Ser29 was replaced by Cys and Gln32 was replaced by Arg. The presence of the Cys residue at position 29 in the protamine P1 from the zebras, the donkey, and the Somali wild ass may allow formation of one extra protamine disulfide bridge during chromosome condensation in these species. Comparison with protamines from various even-toed animals (artiodactyls) indicated amino acid changes specific for those but different from the equid sequences.