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1.
PLoS One ; 17(11): e0273325, 2022.
Article in English | MEDLINE | ID: mdl-36449458

ABSTRACT

While coral reefs in Australia have historically been a showcase of conventional management informed by research, recent declines in coral cover have triggered efforts to innovate and integrate intervention and restoration actions into management frameworks. Here we outline the multi-faceted intervention approaches that have developed in Australia since 2017, from newly implemented in-water programs, research to enhance coral resilience and investigations into socio-economic perspectives on restoration goals. We describe in-water projects using coral gardening, substrate stabilisation, coral repositioning, macro-algae removal, and larval-based restoration techniques. Three areas of research focus are also presented to illustrate the breadth of Australian research on coral restoration, (1) the transdisciplinary Reef Restoration and Adaptation Program (RRAP), one of the world's largest research and development programs focused on coral reefs, (2) interventions to enhance coral performance under climate change, and (3) research into socio-cultural perspectives. Together, these projects and the recent research focus reflect an increasing urgency for action to confront the coral reef crisis, develop new and additional tools to manage coral reefs, and the consequent increase in funding opportunities and management appetite for implementation. The rapid progress in trialling and deploying coral restoration in Australia builds on decades of overseas experience, and advances in research and development are showing positive signs that coral restoration can be a valuable tool to improve resilience at local scales (i.e., high early survival rates across a variety of methods and coral species, strong community engagement with local stakeholders). RRAP is focused on creating interventions to help coral reefs at multiple scales, from micro scales (i.e., interventions targeting small areas within a specific reef site) to large scales (i.e., interventions targeting core ecosystem function and social-economic values at multiple select sites across the Great Barrier Reef) to resist, adapt to and recover from the impacts of climate change. None of these interventions aim to single-handedly restore the entirety of the Great Barrier Reef, nor do they negate the importance of urgent climate change mitigation action.


Subject(s)
Anthozoa , Animals , Ecosystem , Australia , Acclimatization , Water
2.
Mar Environ Res ; 179: 105675, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35696878

ABSTRACT

Interest in oyster reef conservation and restoration is growing globally, but particularly in Australia, it is unclear the extent to which oyster reefs complement (versus replicate) habitat provisioning by other structured habitats in the seascape. Remote underwater video surveys of two east Australian estuaries revealed that at high tide, oyster reefs not only supported distinct fish communities to bare sediments but also to adjacent seagrass beds and mangrove forests. Fish observations in oyster reefs were close to double that of mangroves and seagrass, with species richness, abundance, feeding and wandering behaviours similar. Several species of blenny and goby were unique to oyster reefs and oyster-containing mangroves, whilst recreationally fished species such as bream and mullet were more abundant on oyster reefs than in other habitats. Resolving the association between oyster reefs and fish species within the broader seascape will assist in developing restoration and management strategies that maximise fisheries benefit.


Subject(s)
Ecosystem , Ostreidae , Animals , Australia , Coral Reefs , Estuaries , Fisheries , Fishes
3.
Conserv Biol ; 36(6): e13958, 2022 12.
Article in English | MEDLINE | ID: mdl-35621094

ABSTRACT

Achieving a sustainable socioecological future now requires large-scale environmental repair across legislative borders. Yet, enabling large-scale conservation is complicated by policy-making processes that are disconnected from socioeconomic interests, multiple sources of knowledge, and differing applications of policy. We considered how a multidisciplinary approach to marine habitat restoration generated the scientific evidence base, community support, and funding needed to begin the restoration of a forgotten, functionally extinct shellfish reef ecosystem. The key actors came together as a multidisciplinary community of researchers, conservation practitioners, recreational fisher communities, and government bodies that collaborated across sectors to rediscover Australia's lost shellfish reefs and communicate the value of its restoration. Actions undertaken to build a case for large-scale marine restoration included synthesizing current knowledge on Australian shellfish reefs and their historical decline, using this history to tell a compelling story to spark public and political interest, integrating restoration into government policy, and rallying local support through community engagement. Clearly articulating the social, economic, and environmental business case for restoration led to state and national funding for reef restoration to meet diverse sustainability goals (e.g., enhanced biodiversity and fisheries productivity) and socioeconomic goals (e.g., job creation and recreational opportunities). A key lesson learned was the importance of aligning project goals with public and industry interests so that projects could address multiple political obligations. This process culminated in Australia's largest marine restoration initiative and shows that solutions for large-scale ecosystem repair can rapidly occur when socially valued science acts on political opportunities.


Transformación de un Ecosistema Arrecifal Perdido en un Programa Nacional de Restauración Resumen Actualmente se requiere una reparación ambiental a gran escala que atraviese fronteras legislativas para lograr un futuro socio-ecológico sustentable. Aun así, habilitar la conservación a gran escala es complicado debido a los procesos de elaboración de políticas que están desconectadas de los intereses socio-económicos, las múltiples fuentes de conocimiento y las diferentes aplicaciones de las políticas. Consideramos cómo una estrategia multidisciplinaria para la restauración de hábitats marinos generó una base de evidencia científica, apoyo comunitario y el financiamiento necesario para así iniciar la restauración de un ecosistema arrecifal de conchas funcionalmente extinto. Los actores clave formaron una comunidad multidisciplinaria de investigadores, practicantes de la conservación, comunidades de pescadores recreativos y órganos gubernamentales que colaboró con varios sectores para redescubrir los arrecifes perdidos de Australia y comunicó el valor de su restauración. Las acciones realizadas para armar el caso para la restauración marina a gran escala incluyeron la síntesis del conocimiento actual sobre los arrecifes de conchas en Australia y su declinación histórica, el uso de esta historia para contar una narración convincente que active el interés público y político, la integración de la restauración a la política gubernamental y la movilización del apoyo local por medio de la participación comunitaria. Claramente, la articulación del caso del negocio social, económico y ambiental para la restauración llevó al financiamiento estatal y nacional para la restauración arrecifal a cumplir diversos objetivos socio-económicos (p. ej.: creación de empleos, oportunidades recreativas) y de restauración (p. ej.: una productividad realzada de la biodiversidad y las pesquerías). Una lección clave que aprendimos fue lo importante que es alinear los objetivos del proyecto con los intereses públicos y de la industria, de tal manera que los proyectos aborden las múltiples obligaciones políticas. Este proceso culminó con la iniciativa de restauración marina más grande en Australia y demuestra que las soluciones para la reparación de los ecosistemas a gran escala pueden ocurrir rápidamente cuando la ciencia con valor social actúa sobre las oportunidades políticas.


Subject(s)
Conservation of Natural Resources , Ecosystem , Australia , Fisheries , Biodiversity , Coral Reefs
4.
Glob Chang Biol ; 28(16): 4751-4764, 2022 08.
Article in English | MEDLINE | ID: mdl-35451154

ABSTRACT

Recent warm temperatures driven by climate change have caused mass coral bleaching and mortality across the world, prompting managers, policymakers, and conservation practitioners to embrace restoration as a strategy to sustain coral reefs. Despite a proliferation of new coral reef restoration efforts globally and increasing scientific recognition and research on interventions aimed at supporting reef resilience to climate impacts, few restoration programs are currently incorporating climate change and resilience in project design. As climate change will continue to degrade coral reefs for decades to come, guidance is needed to support managers and restoration practitioners to conduct restoration that promotes resilience through enhanced coral reef recovery, resistance, and adaptation. Here, we address this critical implementation gap by providing recommendations that integrate resilience principles into restoration design and practice, including for project planning and design, coral selection, site selection, and broader ecosystem context. We also discuss future opportunities to improve restoration methods to support enhanced outcomes for coral reefs in response to climate change. As coral reefs are one of the most vulnerable ecosystems to climate change, interventions that enhance reef resilience will help to ensure restoration efforts have a greater chance of success in a warming world. They are also more likely to provide essential contributions to global targets to protect natural biodiversity and the human communities that rely on reefs.


Subject(s)
Anthozoa , Coral Reefs , Animals , Anthozoa/physiology , Climate Change , Conservation of Natural Resources , Ecosystem , Humans
5.
Front Cell Dev Biol ; 9: 709398, 2021.
Article in English | MEDLINE | ID: mdl-34458267

ABSTRACT

Autophagy, a highly conserved intracellular process, has been identified as a novel mechanism regulating T lymphocyte homeostasis. Herein, we demonstrate that both starvation- and T cell receptor-mediated autophagy induction requires class I phosphatidylinositol-3 kinases to produce PI(3)P. In contrast, common gamma chain cytokines are suppressors of autophagy despite their ability to activate the PI3K pathway. T cells lacking the PI3KI regulatory subunits, p85 and p55, were almost completely unable to activate TCR-mediated autophagy and had concurrent defects in PI(3)P production. Additionally, T lymphocytes upregulate polyinositol phosphatases in response to autophagic stimuli, and the activity of the inositol phosphatases Inpp4 and SHIP are required for TCR-mediated autophagy induction. Addition of exogenous PI(3,4)P2 can supplement cellular PI(3)P and accelerate the outcome of activation-induced autophagy. TCR-mediated autophagy also requires internalization of the TCR complex, suggesting that this kinase/phosphatase activity is localized in internalized vesicles. Finally, HIV-induced bystander CD4+ T cell autophagy is dependent upon PI3KI. Overall, our data elucidate an important pathway linking TCR activation to autophagy, via induction of PI3KI activity and inositol phosphatase upregulation to produce PI(3)P.

6.
PLoS One ; 15(10): e0240846, 2020.
Article in English | MEDLINE | ID: mdl-33108387

ABSTRACT

Coral reef ecosystems are under increasing pressure from local and regional stressors and a changing climate. Current management focuses on reducing stressors to allow for natural recovery, but in many areas where coral reefs are damaged, natural recovery can be restricted, delayed or interrupted because of unstable, unconsolidated coral fragments, or rubble. Rubble fields are a natural component of coral reefs, but repeated or high-magnitude disturbances can prevent natural cementation and consolidation processes, so that coral recruits fail to survive. A suite of interventions have been used to target this issue globally, such as using mesh to stabilise rubble, removing the rubble to reveal hard substrate and deploying rocks or other hard substrates over the rubble to facilitate recruit survival. Small, modular structures can be used at multiple scales, with or without attached coral fragments, to create structural complexity and settlement surfaces. However, these can introduce foreign materials to the reef, and a limited understanding of natural recovery processes exists for the potential of this type of active intervention to successfully restore local coral reef structure. This review synthesises available knowledge about the ecological role of coral rubble, natural coral recolonisation and recovery rates and the potential benefits and risks associated with active interventions in this rapidly evolving field. Fundamental knowledge gaps include baseline levels of rubble, the structural complexity of reef habitats in space and time, natural rubble consolidation processes and the risks associated with each intervention method. Any restoration intervention needs to be underpinned by risk assessment, and the decision to repair rubble fields must arise from an understanding of when and where unconsolidated substrate and lack of structure impair natural reef recovery and ecological function. Monitoring is necessary to ascertain the success or failure of the intervention and impacts of potential risks, but there is a strong need to specify desired outcomes, the spatial and temporal context and indicators to be measured. With a focus on the Great Barrier Reef, we synthesise the techniques, successes and failures associated with rubble stabilisation and the use of small structures, review monitoring methods and indicators, and provide recommendations to ensure that we learn from past projects.


Subject(s)
Conservation of Natural Resources , Coral Reefs , Animals , Anthozoa , Biodiversity , Conservation of Natural Resources/methods , Ecological Parameter Monitoring/methods , Ecosystem , Environmental Restoration and Remediation/methods , Geologic Sediments
7.
PLoS One ; 15(8): e0236399, 2020.
Article in English | MEDLINE | ID: mdl-32845878

ABSTRACT

Climate change is impacting coral reefs now. Recent pan-tropical bleaching events driven by unprecedented global heat waves have shifted the playing field for coral reef management and policy. While best-practice conventional management remains essential, it may no longer be enough to sustain coral reefs under continued climate change. Nor will climate change mitigation be sufficient on its own. Committed warming and projected reef decline means solutions must involve a portfolio of mitigation, best-practice conventional management and coordinated restoration and adaptation measures involving new and perhaps radical interventions, including local and regional cooling and shading, assisted coral evolution, assisted gene flow, and measures to support and enhance coral recruitment. We propose that proactive research and development to expand the reef management toolbox fast but safely, combined with expedient trialling of promising interventions is now urgently needed, whatever emissions trajectory the world follows. We discuss the challenges and opportunities of embracing new interventions in a race against time, including their risks and uncertainties. Ultimately, solutions to the climate challenge for coral reefs will require consideration of what society wants, what can be achieved technically and economically, and what opportunities we have for action in a rapidly closing window. Finding solutions that work for coral reefs and people will require exceptional levels of coordination of science, management and policy, and open engagement with society. It will also require compromise, because reefs will change under climate change despite our best interventions. We argue that being clear about society's priorities, and understanding both the opportunities and risks that come with an expanded toolset, can help us make the most of a challenging situation. We offer a conceptual model to help reef managers frame decision problems and objectives, and to guide effective strategy choices in the face of complexity and uncertainty.


Subject(s)
Anthozoa/growth & development , Climate Change , Conservation of Natural Resources , Ecosystem , Acclimatization/physiology , Animals , Coral Reefs , Models, Theoretical
9.
PLoS One ; 15(1): e0226631, 2020.
Article in English | MEDLINE | ID: mdl-31999709

ABSTRACT

Coral reef ecosystems have suffered an unprecedented loss of habitat-forming hard corals in recent decades. While marine conservation has historically focused on passive habitat protection, demand for and interest in active restoration has been growing in recent decades. However, a disconnect between coral restoration practitioners, coral reef managers and scientists has resulted in a disjointed field where it is difficult to gain an overview of existing knowledge. To address this, we aimed to synthesise the available knowledge in a comprehensive global review of coral restoration methods, incorporating data from the peer-reviewed scientific literature, complemented with grey literature and through a survey of coral restoration practitioners. We found that coral restoration case studies are dominated by short-term projects, with 60% of all projects reporting less than 18 months of monitoring of the restored sites. Similarly, most projects are relatively small in spatial scale, with a median size of restored area of 100 m2. A diverse range of species are represented in the dataset, with 229 different species from 72 coral genera. Overall, coral restoration projects focused primarily on fast-growing branching corals (59% of studies), and report survival between 60 and 70%. To date, the relatively young field of coral restoration has been plagued by similar 'growing pains' as ecological restoration in other ecosystems. These include 1) a lack of clear and achievable objectives, 2) a lack of appropriate and standardised monitoring and reporting and, 3) poorly designed projects in relation to stated objectives. Mitigating these will be crucial to successfully scale up projects, and to retain public trust in restoration as a tool for resilience based management. Finally, while it is clear that practitioners have developed effective methods to successfully grow corals at small scales, it is critical not to view restoration as a replacement for meaningful action on climate change.


Subject(s)
Anthozoa/growth & development , Conservation of Natural Resources/methods , Conservation of Natural Resources/trends , Ecosystem , Animals , Climate Change
10.
PLoS One ; 13(2): e0190914, 2018.
Article in English | MEDLINE | ID: mdl-29444143

ABSTRACT

We review the status of marine shellfish ecosystems formed primarily by bivalves in Australia, including: identifying ecosystem-forming species, assessing their historical and current extent, causes for decline and past and present management. Fourteen species of bivalves were identified as developing complex, three-dimensional reef or bed ecosystems in intertidal and subtidal areas across tropical, subtropical and temperate Australia. A dramatic decline in the extent and condition of Australia's two most common shellfish ecosystems, developed by Saccostrea glomerata and Ostrea angasi oysters, occurred during the mid-1800s to early 1900s in concurrence with extensive harvesting for food and lime production, ecosystem modification, disease outbreaks and a decline in water quality. Out of 118 historical locations containing O. angasi-developed ecosystems, only one location still contains the ecosystem whilst only six locations are known to still contain S. glomerata-developed ecosystems out of 60 historical locations. Ecosystems developed by the introduced oyster Crasostrea gigas are likely to be increasing in extent, whilst data on the remaining 11 ecosystem-forming species are limited, preventing a detailed assessment of their current ecosystem-forming status. Our analysis identifies that current knowledge on extent, physical characteristics, biodiversity and ecosystem services of Australian shellfish ecosystems is extremely limited. Despite the limited information on shellfish ecosystems, a number of restoration projects have recently been initiated across Australia and we propose a number of existing government policies and conservation mechanisms, if enacted, would readily serve to support the future conservation and recovery of Australia's shellfish ecosystems.


Subject(s)
Ecosystem , Shellfish , Animals , Australia , Biodiversity , Ostrea , Water Quality
11.
Health Commun ; 32(10): 1210-1216, 2017 10.
Article in English | MEDLINE | ID: mdl-27612878

ABSTRACT

In the relationship between patients and health care providers, few communicative features are as significant as the providers' ability to express empathy. A robust empirical literature describes the importance of physician communication skills-particularly those that convey empathy-yet few studies have examined empathic communication by physician assistants, who provide primary care for an increasing number of Americans. The present study examines the empathic communication of physician assistant students in interactions with standardized patients. Over a 6-month period, each student conducted three clinical interviews, each of which was evaluated for empathic communication by the patients, the students' clinical instructors, and third-party observers. Students also provided saliva samples for genotyping six single-nucleotide polymorphisms on the oxytocin receptor gene (OXTR) that are linked empirically to empathic behavior. Consistent with recent research, this study adopted a cumulative risk approach wherein students were scored for their number of risky alleles on the single-nucleotide polymorphisms. Results indicated that cumulative risk on OXTR receptor gene predicted lower patient empathy scores as rated by instructors and observers, but not by standardized patients.


Subject(s)
Communication , Empathy , Physician Assistants/education , Receptors, Oxytocin/genetics , Genotype , Health Personnel/psychology , Health Personnel/statistics & numerical data , Humans , Patient Simulation , Physician-Patient Relations , Polymorphism, Single Nucleotide/genetics , Risk , Students
12.
Mil Med ; 181(9): e1180-4, 2016 09.
Article in English | MEDLINE | ID: mdl-27612380

ABSTRACT

Chyle leaks are a rare but potentially fatal complication of head and neck surgery carrying an incidence as high as 8.3%. The development of a chyle leak carries significant morbidity ranging from delayed wound healing to oropharyngeal fistulas. Presented here is a case of a chyle leak that developed following a left posterolateral neck dissection that was successfully managed with a combination of drain suction, pressure dressing, and a fat-restricted diet. However, the patient's course was complicated by repeated chyle leak recurrences that may have been associated with the initiation of medium-chain triglyceride supplementation. Although further research is required to establish a causal relationship, these findings support the concerns of other investigators about the possible counterproductive role of medium-chain triglyceride supplementation in the management of chyle leaks.


Subject(s)
Anastomotic Leak/therapy , Chyle , Conservative Treatment/methods , Dissection/adverse effects , Postoperative Complications/surgery , Dissection/methods , Humans , Male , Melanoma/surgery , Middle Aged , Neck/abnormalities , Surgical Procedures, Operative/adverse effects
13.
PLoS One ; 11(5): e0155360, 2016.
Article in English | MEDLINE | ID: mdl-27191721

ABSTRACT

The prevalence of extreme, short-term temperature spikes in coastal regions during summer months is predicted to increase with ongoing climate change. In tropical systems, these changes are predicted to increase the metabolic demand of coral reef fish larvae while also altering the plankton communities upon which the larvae feed during their pelagic phase. The consequences of these predictions remain speculative in the absence of empirical data on the interactive effects of warm temperatures on the metabolism, postprandial processes and growth responses of coral reef fish larvae. Here, we tested the effect of increased temperature on the metabolism, postprandial performance and fine-scale growth patterns of a coral reef fish (Amphiprion percula) in the latter half of its ~11-d larval phase. First, we measured the length and weight of fed versus fasted larvae (N = 340; mean body mass 4.1±0.05 mg) across fine temporal scales at a typical current summer temperature (28.5°C) and a temperature that is likely be encountered during warm summer periods later this century (31.5°C). Second, we measured routine metabolic rate (Mo2 routine) and the energetics of the postprandial processes (i.e., digestion, absorption and assimilation of a meal; termed specific dynamic action (SDA)) at both temperatures. Larvae fed voraciously when provided with food for a 12-hour period and displayed a temperature-independent increase in mass of 40.1% (28.5°C) and 42.6% (31.5°C), which was largely associated with the mass of prey in the gut. A subsequent 12-h fasting period revealed that the larvae had grown 21.2±4.8% (28.5°C) and 22.8±8.8% (31.5°C) in mass and 10.3±2.0% (28.5°C) and 7.8±2.6% (31.5°C) in length compared with pre-feeding values (no significant temperature effect). Mo2 routine was 55±16% higher at 31.5°C and peak Mo2 during the postprandial period was 28±11% higher at 31.5°C, yet elevated temperature had no significant effect on SDA (0.51±0.06 J at 28.5°C vs. 0.53±0.07 J at 31.5°C), SDA duration (6.0±0.6 h vs. 6.5±0.5 h), or the percent of total meal energy used for SDA (SDA coefficient: 10.1±1.3% vs. 13.0±1.7%). Our findings of higher Mo2 routine but similar SDA coefficient at high temperature provide the first empirical evidence that coral reef fish larvae may have to secure more food to attain similar growth rates during warm summer periods, and perhaps with chronically warmer conditions associated with climate change.


Subject(s)
Coral Reefs , Digestion , Fishes/physiology , Hot Temperature , Animals , Climate Change , Energy Metabolism , Fishes/growth & development , Intestines/physiology , Larva/physiology
14.
Autophagy ; 11(12): 2335-45, 2015.
Article in English | MEDLINE | ID: mdl-26569626

ABSTRACT

The highly conserved cellular degradation pathway, macroautophagy, regulates the homeostasis of organelles and promotes the survival of T lymphocytes. Previous results indicate that Atg3-, Atg5-, or Pik3c3/Vps34-deficient T cells cannot proliferate efficiently. Here we demonstrate that the proliferation of Atg7-deficient T cells is defective. By using an adoptive transfer and Listeria monocytogenes (LM) mouse infection model, we found that the primary immune response against LM is intrinsically impaired in autophagy-deficient CD8(+) T cells because the cell population cannot expand after infection. Autophagy-deficient T cells fail to enter into S-phase after TCR stimulation. The major negative regulator of the cell cycle in T lymphocytes, CDKN1B, is accumulated in autophagy-deficient naïve T cells and CDKN1B cannot be degraded after TCR stimulation. Furthermore, our results indicate that genetic deletion of one allele of CDKN1B in autophagy-deficient T cells restores proliferative capability and the cells can enter into S-phase after TCR stimulation. Finally, we found that natural CDKN1B forms polymers and is physiologically associated with the autophagy receptor protein SQSTM1/p62 (sequestosome 1). Collectively, autophagy is required for maintaining the expression level of CDKN1B in naïve T cells and selectively degrades CDKN1B after TCR stimulation.


Subject(s)
Autophagy/physiology , Cell Cycle Checkpoints/physiology , Cell Proliferation/physiology , Cyclin-Dependent Kinase Inhibitor p27/metabolism , Lymphocyte Activation/immunology , T-Lymphocytes/cytology , Animals , Cyclin-Dependent Kinase Inhibitor p27/genetics , Homeostasis/physiology , Mice , Mice, Transgenic , Microtubule-Associated Proteins/metabolism , Mitochondria/metabolism , T-Lymphocytes/immunology
16.
J Physician Assist Educ ; 26(2): 93-8, 2015 Jun.
Article in English | MEDLINE | ID: mdl-26211032

ABSTRACT

PURPOSE: Empathic communication with patients is an essential component of quality primary care. This study examines the ability of physician assistant (PA) students to communicate empathically in clinical interviews with standardized patients. METHODS: In their first year of training, PA students conducted 3 clinical interviews with standardized patients over a 6-month period in 2014, during the second half of their didactic year. Each interview was evaluated for empathy by 4 individuals: the students themselves, their standardized patients, their clinical instructors, and third-party observers. RESULTS: Students consistently rated their empathic abilities more favorably than did patients, clinical instructors, or observers, with mean differences ranging from 0.56 to 1.92 and averaging 1.09 on a 9-point scale. Students' evaluations were most dissimilar from those of patients (difference M = 1.12) and most similar to those of observers (difference M = 1.06). The assessments of all 4 raters varied over time: students rated themselves as significantly more empathic in April (time 2) than in July (time 3) of their didactic year. Patients rated students as significantly less empathic in January of the didactic year (time 1) than at time 2 and as significantly more empathic at time 2 than time 3. Instructors rated students as significantly less empathic at time 1 than at either time 2 or time 3. Finally, observers rated students as significantly more empathic at time 1 than at either time 2 or time 3. CONCLUSIONS: PA students consistently overestimate their empathic abilities during their first year of training. Given the importance of empathy in clinical care, increased didactic efforts focused on developing and conveying empathy may be warranted in PA education.


Subject(s)
Communication , Empathy , Physician Assistants/education , Adult , Attitude of Health Personnel , Female , Humans , Male , Middle Aged , Patient Simulation , Professional-Patient Relations , Self Efficacy , Self Report
17.
Eur J Orthop Surg Traumatol ; 24(4): 615-9, 2014 May.
Article in English | MEDLINE | ID: mdl-24158742

ABSTRACT

The posterolateral approach to ankle joint is well suited for ORIF of posterior malleolar fractures. There are no major neurovascular structures endangering this approach other than the sural nerve. The sural nerve is often used as an autologous peripheral nerve graft and provides sensation to the lateral aspect of the foot. The aim of this paper is to measure the precise distance of the sural nerve from surrounding soft tissue structures so as to enable safe placement of skin incision in posterolateral approach. This is a retrospective image review study involving 64 MRI scans. All measurements were made from Axial T1 slices. The key findings of the paper is the safety window for the sural nerve from the lateral border of tendoachilles (TA) is 7 mm, 1.3 cm and 2 cm at 3 cm above ankle joint, at the ankle joint and at the distal tip of fibula respectively. Our study demonstrates the close relationship of the nerve in relation to TA and fibula in terms of exact measurements. The safety margins established in this study should enable the surgeon in preventing endangerment of the sural nerve encountered in this approach.


Subject(s)
Ankle Fractures/pathology , Ankle Fractures/surgery , Ankle Joint/surgery , Magnetic Resonance Imaging/methods , Orthopedic Procedures/methods , Sural Nerve/anatomy & histology , Adult , Aged , Aged, 80 and over , Anatomic Landmarks , Ankle Joint/blood supply , Ankle Joint/pathology , Female , Humans , Male , Middle Aged , Orthopedic Procedures/standards , Retrospective Studies , Saphenous Vein/anatomy & histology , Saphenous Vein/surgery , Subcutaneous Fat/anatomy & histology , Subcutaneous Fat/surgery , Sural Nerve/surgery , Young Adult
18.
J Exp Biol ; 217(Pt 7): 1122-8, 2014 Apr 01.
Article in English | MEDLINE | ID: mdl-24311818

ABSTRACT

Increasing sediment input into coastal environments is having a profound influence on shallow marine habitats and associated species. Coral reef ecosystems appear to be particularly sensitive, with increased sediment deposition and re-suspension being associated with declines in the abundance and diversity of coral reef fishes. While recent research has demonstrated that suspended sediment can have negative impacts on post-settlement coral reef fishes, its effect on larval development has not been investigated. In this study, we tested the effects of different levels of suspended sediment on larval growth and development time in Amphiprion percula, a coral reef damselfish. Larvae were subjected to four experimental concentrations of suspended sediment spanning the range found around coastal coral reefs (0-45 mg l(-1)). Larval duration was significantly longer in all sediment treatments (12 days) compared with the average larval duration in the control treatment (11 days). Approximately 75% of the fish in the control had settled by day 11, compared with only 40-46% among the sediment treatments. In the highest sediment treatment, some individuals had a larval duration twice that of the median duration in the control treatment. Unexpectedly, in the low sediment treatment, fish at settlement were significantly longer and heavier compared with fish in the other treatments, suggesting delayed development was independent of individual condition. A sediment-induced extension of the pelagic larval stage could significantly reduce numbers of larvae competent to settle and, in turn, have major effects on adult population dynamics.


Subject(s)
Perciformes/growth & development , Water Pollutants/adverse effects , Age Distribution , Animals , Bentonite , Coral Reefs , Female , Geologic Sediments , Larva/growth & development , Male , Metamorphosis, Biological
19.
Article in English | MEDLINE | ID: mdl-24174886

ABSTRACT

INTRODUCTION: Hypocalcemia after thyroidectomy results in prolongation of hospitalization and patient discomfort but can be predicted by PTH assays. However, there is considerable variation in their use. METHODS: This study was undertaken to document current US and European practice patterns regarding the use of this assay. Anonymous surveys were collected in 2009-2011 from members of the American Academies of Otolaryngology-Head and Neck Surgery and Endocrine Surgery and the European, Italian, French, Spanish and British Societies of Endocrine Surgery. RESULTS: There were 356 American (3% response) and 61 European (10% response) respondents. 105 (29.8%) American and 25 (41%) European respondents reported routine PTH assay use. Fellowship trained surgeons reported increased use of the PTH assay (P = 0.004). Shorter reported average post-operative hospital stay was associated with American physicians (P = 0.0001), community practice location (P = 0.0002) and routine calcium supplementation (P = 0.0015). CONCLUSIONS: Surgical training was associated with routine use of the PTH assay. Average reported hospital stay was lower for American and community practice physicians and correlated with post-operative oral calcium use.

20.
PLoS One ; 8(9): e72864, 2013.
Article in English | MEDLINE | ID: mdl-24069162

ABSTRACT

The determination of cell fate and the establishment of polarity axes during Drosophila oogenesis depend upon pathways that localize mRNAs within the egg chamber and control their on-site translation. One factor that plays a central role in regulating on-site translation of mRNAs is Orb. Orb is a founding member of the conserved CPEB family of RNA-binding proteins. These proteins bind to target sequences in 3' UTRs and regulate mRNA translation by modulating poly(A) tail length. In addition to controlling the translation of axis-determining mRNAs like grk, fs(1)K10, and osk, Orb protein autoregulates its own synthesis by binding to orb mRNA and activating its translation. We have previously shown that Rasputin (Rin), the Drosophila homologue of Ras-GAP SH3 Binding Protein (G3BP), associates with Orb in a messenger ribonucleoprotein (mRNP) complex. Rin is an evolutionarily conserved RNA-binding protein believed to function as a link between Ras signaling and RNA metabolism. Here we show that Orb and Rin form a complex in the female germline. Characterization of a new rin allele shows that rin is essential for oogenesis. Co-localization studies suggest that Orb and Rin form a complex in the oocyte at different stages of oogenesis. This is supported by genetic and biochemical analyses showing that rin functions as a positive regulator in the orb autoregulatory pathway by increasing Orb protein expression. Tandem Mass Spectrometry analysis shows that several canonical stress granule proteins are associated with the Orb-Rin complex suggesting that a conserved mRNP complex regulates localized translation during oogenesis in Drosophila.


Subject(s)
Carrier Proteins/metabolism , Drosophila Proteins/metabolism , Oogenesis/physiology , RNA-Binding Proteins/metabolism , Animals , Carrier Proteins/genetics , Drosophila , Drosophila Proteins/genetics , Female , Oogenesis/genetics , Protein Binding , RNA-Binding Proteins/genetics , Tandem Mass Spectrometry
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