Low net carbonate accretion characterizes Florida's coral reef.

Coral reef habitat is created when calcium carbonate production by calcifiers exceeds removal by physical and biological erosion. Carbonate budget surveys provide a means of quantifying the framework-altering actions of diverse assemblages of marine species to determine net carbonate production, a single metric that encapsulates reef habitat persistence. In this study, carbonate budgets were calculated for 723 sites across the Florida Reef Tract (FRT) using benthic cover and parrotfish demographic data from NOAA's National Coral Reef Monitoring Program, as well as high-resolution LiDAR topobathymetry. Results highlight the erosional state of the majority of the study sites, with a trend towards more vulnerable habitat in the northern FRT, especially in the Southeast Florida region (- 0.51 kg CaCO3 m-2 year-1), which is in close proximity to urban centers. Detailed comparison of reef types reveals that mid-channel reefs in the Florida Keys have the highest net carbonate production (0.84 kg CaCO3 m-2 year-1) and indicates that these reefs may be hold-outs for reef development throughout the region. This study reports that Florida reefs, specifically their physical structure, are in a net erosional state. As these reefs lose structure, the ecosystem services they provide will be diminished, signifying the importance of increased protections and management efforts to offset these trends.

Implementation of a Mobile Technology-Supported Diaphragmatic Breathing Intervention in Military mTBI With PTSD.

BACKGROUND: Diaphragmatic breathing is an evidence-based intervention for managing stress and anxiety; however, some military veterans with mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) report challenges to learning and practicing the technique. BreatheWell Wear assists performance of breathing exercises through reminders, biofeedback, and visual, tactile, and auditory guidance. OBJECTIVE: To evaluate feasibility of implementing BreatheWell Wear, a mobile smartwatch application with companion smartphone app, as an intervention for stress management in military veterans with mTBI and PTSD. METHODS: Thirty veterans with chronic symptoms of mTBI and PTSD recruited from an interdisciplinary, intensive outpatient program participated in this pilot pragmatic clinical trial. Participants were randomly assigned to the experimental (BreatheWell Wear and conventional care) and control (conventional care) groups for 4 weeks. Conventional care included instruction on relaxation breathing and participation in behavioral health therapy. Effects on goal attainment, treatment adherence, diaphragmatic breathing technique knowledge, and stress were measured through surveys and diaries. Changes in symptoms, mood, and well-being were measured pre/postintervention via the Posttraumatic Checklist for DSM-5, Beck Anxiety Inventory, Beck Depression Inventory, and Flourishing Scale. RESULTS: Person-centered goal attainment (t = 4.009, P < .001), treatment adherence (t = 2.742, P = .001), diaphragmatic breathing technique knowledge (t = 1.637, P < .001), and reported ease of remembering to practice (t = -3.075, P = .005) were significantly greater in the experimental group. As expected, measures of PTSD, anxiety, depression, and psychological well-being showed clinically meaningful change in both groups, and both groups demonstrated reduced stress following diaphragmatic breathing. CONCLUSION: These preliminary findings indicate that BreatheWell Wear may be a clinically feasible tool for supporting diaphragmatic breathing as an intervention in veterans with mTBI and PTSD, and a future effectiveness trial is warranted.

Peritoneal Dialysis Following Left Ventricular Assist Device Placement and Kidney Recovery: A Case Report.

Acute kidney injury (AKI) complicates up to 50% of left ventricular assist device (LVAD) placements and up to 30% of these patients require dialysis. Despite advances in LVAD technology since the first-generation devices, the risk for AKI remains high. We present a case of a woman in her 50s with previously stable stage C heart failure who developed critical cardiogenic shock and resultant AKI. She required continuous kidney replacement therapy both before and after placement of an LVAD. Following multiple inpatient and outpatient hemodialysis sessions complicated by hypotension, she was transitioned to peritoneal dialysis (PD). She tolerated PD well, and her kidney function continued to improve during the following weeks. After 6 weeks of outpatient PD, she recovered kidney function, allowing for cessation of dialysis. PD is a good option for patients with advanced heart failure who receive an LVAD due to gentler ultrafiltration, decreased risk for bacteremia, and better preservation of kidney function as compared with hemodialysis.

Regulating hearing aid compatibility of cell phones: results from a national survey.

Accessibility of telecommunication technologies by people who are deaf or hard of hearing has been a critical issue since the invention of the telephone. As both telephone and hearing-aid technologies have evolved, finding compatible solutions has been an ongoing challenge. This paper uses the findings of a longitudinal study to examine the impact of Federal hearing-aid compatibility (HAC) regulations in resolving this problem. The study ran concurrently with the phase-in of Federal Communications Commission regulations requiring that mobile handset manufacturers and wireless service providers make available minimum numbers of cell phones with shielding to reduce electromagnetic interference when cell phones are positioned close to a hearing aid user's ear. These regulations also require package labeling and printed information to assist buyers in selecting a hearing-aid compatible phone. The survey presented here focused on changes in satisfaction with sound quality and ease of finding a hearing-aid compatible mobile handset. Data analysis suggests that the regulations have had limited success, and problems persist for consumers in locating a hearing aid compatible phone. The FCC has requested input on more stringent hearing-aid compatibility requirements; study findings suggest that these changes are not likely to remedy the problem.

Use of social media during public emergencies by people with disabilities.

INTRODUCTION: People with disabilities are generally more vulnerable during disasters and public emergencies than the general population. Physical, sensory and cognitive impairments may result in greater difficulty in receiving and understanding emergency alert information, and greater difficulty in taking appropriate action. The use of social media in the United States has grown considerably in recent years. This has generated increasing interest on the part of national, state and local jurisdictions in leveraging these channels to communicate public health and safety information. How and to what extent people with disabilities use social and other communications media during public emergencies can help public safety organizations understand the communication needs of the citizens in their jurisdictions, and plan their social media and other communications strategies accordingly. METHODS: This article presents data from a survey on the use of social media and other communications media during public emergencies by people with disabilities conducted from November 1, 2012 through March 30, 2013. RESULTS: The data presented here show four key results. First, levels of use of social media in general are high for people with disabilities, as well as for the general population. Second, use of social media during emergencies is still low for both groups. Third, levels of use of social media are not associated with income levels, but are significantly and strongly associated with age: younger people use social media at higher rates than older people in both groups (p<0.001). Fourth, differences in the use of social media during emergencies across disability types are slight, with the exception of deaf and hard-of-hearing respondents, the former more likely to have used social media to receive (p=0.002), verify (p=0.092) and share (p=0.007) emergency information. CONCLUSION: These last two results suggest that effective emergency communications strategies need to rely on multiple media types and channels to reach the entire community.

Three isolated superior mesenteric artery dissections: update of previous case reports, diagnostics, and treatment options.

Isolated superior mesenteric artery dissection is a relatively rare vascular pathology. However, the number of recent case reports has shown an increasing incidence with the widespread use of computed tomography imaging for abdominal pain. Here we report three cases of isolated superior mesenteric artery dissection. The unique surgical option of small bowel transplantation along with successful medical management is described. A treatment algorithm for isolated superior mesenteric artery dissection is also proposed.