Survey effort and targeted landbird community metrics at Indiana lowland forest restoration sites.

Many sampling and analytical methods can estimate the abundance, distributions, and diversity of birds and other wildlife. However, challenges with sample size and analytical capacity can make these methods difficult to implement for resource-limited monitoring programs. To apprise efficient and attainable sampling designs for landbird monitoring programs with limited observational data, we used breeding season bird point survey data collected in 2016 at four forest restoration sites in Indiana, USA. We evaluated three subsets of observed species richness, total possibly breeding landbirds, Partners in Flight Regional Conservation Concern (PIF RCC) landbirds, and interior forest specialists (IFSs). Simulated surveys based on field data were used to conduct Bayesian Michaelis-Menten curve analyses estimating observed species as a function of sampling effort. On comparing simulated survey sets with multiple habitat types versus those with one habitat, we found that those with multiple habitat types had estimated 39%-83% greater observed PIF RCC species richness and required 41%-55% fewer visits per point to observe an equivalent proportion of PIF RCC species. Even with multiple habitats in a survey set, the number of visits per point required to detect 50% of observable species was 30% higher for PIF RCC species than for total breeding landbird species. Low detection rates of IFS species at two field sites made precise estimation of required effort to observe these species difficult. However, qualitatively, we found that only sites containing mature forest fragments had detections of several bird species designated as high-confidence IFS species. Our results suggest that deriving specialized species diversity metrics from point survey data can add value when interpreting those data. Additionally, designing studies to collect these metrics may require explicitly planning to visit multiple habitat types at a monitoring site and increasing the number of visits per survey point. Integr Environ Assess Manag 2024;00:1-15. © 2024 The Author(s). Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC). This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.

Studies to assess natural resource recovery and evaluate monitoring methods for restored bottomland hardwood forests.

The Natural Resource Damage Assessment and Restoration process assesses natural resource injury due to oil or chemical spills and calculates the damages to compensate the public for those injuries. Ecological restoration provides a means for recovering resources injured or lost due to contamination from oil or chemical spills by restoring the injured site after remediation, or acquiring or reconstructing equivalent resources off site to replace those lost due to the spill. In the case of restored forests, once restoration is implemented, monitoring of forest ecology helps keep recovery on track, with the maturation of forest vegetation, recovered soil conditions, and development of microbial, fungal, and faunal communities, necessary for ecologically functioning forests. This series of papers focuses on applying methods for monitoring restoration progress in forest vegetation and soils, and amphibian, avian, and mammalian communities, assessing strengths and weaknesses of different methods, and evaluating levels of effort needed to obtain accurate indications of forest ecological condition. Integr Environ Assess Manag 2024;00:1-5. © 2024 The Author(s). Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Continental Scale Hydrostratigraphy: Basin-Scale Testing of Alternative Data-Driven Approaches.

Integrated hydrological modeling is an effective method for understanding interactions between parts of the hydrologic cycle, quantifying water resources, and furthering knowledge of hydrologic processes. However, these models are dependent on robust and accurate datasets that physically represent spatial characteristics as model inputs. This study evaluates multiple data-driven approaches for estimating hydraulic conductivity and subsurface properties at the continental-scale, constructed from existing subsurface dataset components. Each subsurface configuration represents upper (unconfined) hydrogeology, lower (confined) hydrogeology, and the presence of a vertical flow barrier. Configurations are tested in two large-scale U.S. watersheds using an integrated model. Model results are compared to observed streamflow and steady state water table depth (WTD). We provide model results for a range of configurations and show that both WTD and surface water partitioning are important indicators of performance. We also show that geology data source, total subsurface depth, anisotropy, and inclusion of a vertical flow barrier are the most important considerations for subsurface configurations. While a range of configurations proved viable, we provide a recommended Selected National Configuration 1 km resolution subsurface dataset for use in distributed large-and continental-scale hydrologic modeling.

Cutaneous angiosarcoma presenting as bilateral periorbital edema.

A 66-year-old man presented with chronic bilateral periorbital edema with associated yellowish hue, scattered violaceous smooth macules and contracture of the forehead. He had undergone dental surgery 3 months prior to symptom onset. Laboratory workup for common causes of eyelid edema was unremarkable and MRI of the orbits was unrevealing. The patient did not respond to oral corticosteroids or antibiotics. Punch biopsies were obtained which revealed atypical lymphatic endothelial cells consistent with a diagnosis of cutaneous angiosarcoma.The patient was deemed not to be a surgical candidate and underwent 3 cycles of immunotherapy with limited response. He declined further treatment and transitioned to hospice care. Although cutaneous angiosarcoma uncommonly involves the periorbital region, it should be considered in the differential diagnosis of eyelid edema as early recognition and treatment are critical to prevent rapid intradermal spread and metastases.

Frailty Severity and Hospitalization After Dialysis Initiation.

BACKGROUND: Frailty is associated with hospitalization and mortality among dialysis patients. To now, few studies have considered the degree of frailty as a predictor of hospitalization. OBJECTIVE: We evaluated whether frailty severity was associated with hospitalization after dialysis initiation. DESIGN: Retrolective cohort study. SETTING: Nova Scotia, Canada. PATIENTS: Consecutive adult, chronic dialysis patients who initiated dialysis from January 1, 2009 to June 30, 2014, (last follow-up June, 2015). METHODS: Frailty Severity, as determined by the 7-point Clinical Frailty Scale (CFS, ranging from 1 = very fit to 7 = severely frail), was measured at dialysis initiation and treated as continuous and in categories (CFS scores of 1-3, 4/5, and 6/7). Hospitalization was characterized by cumulative time admitted to hospital (proportion of days admitted/time at risk) and by the joint risk of hospitalization and death. Time at risk included time in hospital after dialysis initiation and patients were followed until transplantation or death. RESULTS: Of 647 patients (mean age: 62 ± 15), 564 (87%) had CFS scores. The mean CFS score was 4 ("corresponding to "vulnerable") ± 2 ("well" to "moderately frail"). In an adjusted negative binomial regression model, moderate-severely frail patients (CFS 6/7) had a >2-fold increased risk of cumulative time admitted to hospital compared to the lowest CFS category (IRR = 2.18, 95% confidence interval [CI] = 1.31-3.63). In the joint model, moderate-severely frail patients had a 61% increase in the relative hazard for hospitalization (hazard ratio [HR] = 1.61, 95% CI = 1.29-2.02) and a 93% increase in the relative hazard for death compared to the lowest CFS category (HR = 1.93, 95% CI = 1.16-3.22). LIMITATIONS: Potential unknown confounders may have affected the association between frailty severity and hospitalization given observational study design. The CFS is subjective and different clinicians may grade frailty severity differently or misclassify patients on the basis of limited availability. CONCLUSIONS: Among incident dialysis patients, a higher frailty severity as defined by the CFS is associated with both an increased risk of cumulative time admitted to hospital and joint risk of hospitalization and death.

CONTEXTE: La fragilité est associée à davantage d'hospitalisations et de mortalité chez les patients qui suivent des traitements de dialyze. À l'heure actuelle, peu d'études se sont penchées sur le degré de fragilité comme facteur prédictif d'hospitalization. OBJECTIFS: Nous avons évalué l'existence d'un lien entre la gravité de la fragilité et le risque d'hospitalization après l'amorce d'un traitement de dialyze. TYPE D'ÉTUDE: Étude de cohorte rétrospective. CADRE: Nouvelle-Écosse, Canada. SUJETS: L'étude porte sur des patients adultes consécutifs sous dialyze chronique et ayant entrepris leur traitement entre le 1er janvier 2009 et le 30 juin 2014 (dernier suivi en juin 2015). MÉTHODOLOGIE: L'échelle CFS (Clinical Frailty Scale) en 7 points (1 = très bonne forme physique; 7= gravement fragile) a été employée pour déterminer le niveau de gravité de la fragilité. Cette dernière a été évaluée à l'amorce de la dialyze et traitée en tant que mesure continue et selon trois niveaux d'atteinte (scores CFS de 1-3, de 4-5 et de 6-7). L'hospitalization a été caractérisée par la durée cumulative des hospitalisations (proportion de jours d'hospitalization/l'intervalle de risque) et par un risque conjoint d'hospitalization et de décès. L'intervalle de risque comprend le temps passé à l'hôpital depuis le début du traitement. Les patients ont été suivis jusqu'à la transplantation ou jusqu'au décès. RÉSULTATS: Parmi les 647 patients admissibles (âge moyen: 62 ans ± 15), 564 patients (87 %) disposaient d'un score CFS. Le score CFS moyen était de 4 (correspondant à « apparence de vulnérabilité ¼) ± 2 (« bonne forme physique ¼ à « modérément fragile ¼). Dans un modèle corrigé de régression binomiale négative, les patients jugés modérément à gravement fragiles (CFS 6/7) présentaient un risque cumulatif plus de 2 fois plus élevé d'être hospitalisés comparativement aux patients du groupe avec le score CFS le plus faible (RTI: 2,18; IC 95 %: 1,31 à 3,63). Dans le modèle conjoint, les patients jugés modérément à gravement fragiles ont présenté une augmentation de 61 % du risque relatif d'hospitalization (RR:1,61; IC 95 %: 1,29 à 2,02) et une augmentation de 93 % du risque relatif de décès comparativement aux patients avec le score CFS le plus faible (RR: 1,93; IC 95 %: 1,16 à 3,22). LIMITES: La méthodologie de l'étude (observationnelle) laisse supposer que de possibles facteurs confusionnels inconnus pourraient avoir eu une incidence sur le lien entre les hospitalisations et la gravité de la fragilité. Le score CFS est une mesure subjective. Il est possible que les cliniciens évaluent différemment la gravité de la fragilité ou classent les patients de façon erronée en raison d'une disponibilité limitée. CONCLUSION: Chez les patients dialysés, une plus grande fragilité, telle que définie par le score CFS, a été associée à la fois à un risque accru d'être hospitalisé sur une plus longue durée cumulative et à un risque conjoint d'hospitalization et de décès.

Modeling the Effects of Calcium Overload on Mitochondrial Ultrastructural Remodeling.

Mitochondrial cristae are dynamic invaginations of the inner membrane and play a key role in its metabolic capacity to produce ATP. Structural alterations caused by either genetic abnormalities or detrimental environmental factors impede mitochondrial metabolic fluxes and lead to a decrease in their ability to meet metabolic energy requirements. While some of the key proteins associated with mitochondrial cristae are known, very little is known about how the inner membrane dynamics are involved in energy metabolism. In this study, we present a computational strategy to understand how cristae are formed using a phase-based separation approach of both the inner membrane space and matrix space, which are explicitly modeled using the Cahn-Hilliard equation. We show that cristae are formed as a consequence of minimizing an energy function associated with phase interactions which are subject to geometric boundary constraints. We then extended the model to explore how the presence of calcium phosphate granules, entities that form in calcium overload conditions, exert a devastating inner membrane remodeling response that reduces the capacity for mitochondria to produce ATP. This modeling approach can be extended to include arbitrary geometrical constraints, the spatial heterogeneity of enzymes, and electrostatic effects to mechanize the impact of ultrastructural changes on energy metabolism.

The very low number of calcium-induced permeability transition pores in the single mitochondrion.

Mitochondrial permeability transition (PT) is a phenomenon of stress-induced increase in nonspecific permeability of the mitochondrial inner membrane that leads to disruption of oxidative phosphorylation and cell death. Quantitative measurement of the membrane permeability increase during PT is critically important for understanding the PT's impact on mitochondrial function. The elementary unit of PT is a PT pore (PTP), a single channel presumably formed by either ATP synthase or adenine nucleotide translocator (ANT). It is not known how many channels are open in a single mitochondrion during PT, which makes it difficult to quantitatively estimate the overall degree of membrane permeability. Here, we used wide-field microscopy to record mitochondrial swelling and quantitatively measure rates of single-mitochondrion volume increase during PT-induced high-amplitude swelling. PT was quantified by calculating the rates of water flux responsible for measured volume changes. The total water flux through the mitochondrial membrane of a single mitochondrion during PT was in the range of (2.5 ± 0.4) × 10-17 kg/s for swelling in 2 mM Ca2+ and (1.1 ± 0.2) × 10-17 kg/s for swelling in 200 µM Ca2+. Under these experimental conditions, a single PTP channel with ionic conductance of 1.5 nS could allow passage of water at the rate of 0.65 × 10-17 kg/s. Thus, we estimate the integral ionic conductance of the whole mitochondrion during PT to be 5.9 ± 0.9 nS for 2 mM concentration of Ca2+ and 2.6 ± 0.4 nS for 200 µM of Ca2+. The number of PTPs per mitochondrion ranged from one to nine. Due to the uncertainties in PTP structure and model parameters, PTP count results may be slightly underestimated. However, taking into account that each mitochondrion has ∼15,000 copies of ATP synthases and ANTs, our data imply that PTP activation is a rare event that occurs only in a small subpopulation of these proteins.

Should donors who have used marijuana be considered candidates for living kidney donation?

BACKGROUND: The use of marijuana in the USA has been steadily increasing over the last 10 years. This study is the first to investigate the effect of marijuana use by live kidney donors upon outcomes in both donors and recipients. METHODS: Living kidney donor transplants performed between January 2000 and May 2016 in a single academic institution were retrospectively reviewed. Donor and recipient groups were each divided into two groups by donor marijuana usage. Outcomes in donor and recipient groups were compared using t-test, Chi-square and mixed linear analysis (P < 0.05 considered significant). RESULTS: This was 294 living renal donor medical records were reviewed including 31 marijuana-using donors (MUD) and 263 non-MUDs (NMUD). It was 230 living kidney recipient records were reviewed including 27 marijuana kidney recipients (MKRs) and 203 non-MKRs (NMKR). There was no difference in donor or recipient perioperative characteristics or postoperative outcomes based upon donor marijuana use (P > 0.05 for all comparisons). There was no difference in renal function between NMUD and MUD groups and no long-term difference in kidney allograft function between NMKR and MKR groups. CONCLUSIONS: Considering individuals with a history of marijuana use for living kidney donation could increase the donor pool and yield acceptable outcomes.

Impact of a Wireless System Upon Verbal Communication in a Simulated Robotic Operating Theater.

OBJECTIVE: To compare the efficacy of communication via the standard Da Vinci Si speaker system with a wireless, hands-free audio system in a prospective blinded study. METHODS: Nine hundred and sixty surgical phrases were spoken in a simulated robotic operating room (OR), including 480 phrases expressed via the Da Vinci Si speakers and 480 phrases expressed through a wireless, hands-free system. Using a dual console robotic system, communication was evaluated. Wireless headsets were given to the console and assistant robotic console surgeons, bedside assistant, anesthesiologist, and circulating nurse. An accurate response was defined as hearing the phrase correctly and transcribing it on a data sheet. The primary outcome was the number of correct phrases recorded during the study and secondary outcomes included subjective clarity and effectiveness of communication reported using a Likert scale. RESULTS: Overall, the wireless, hands-free system increased the accuracy of communication (390/480 [81.3%]) compared to the conventional robotic system (310/480 [64.4%]; P <.001). The bedside assistant, anesthesiologist, and circulating nurse had significantly fewer correct phrases recorded than the assistant robotic console surgeon when using the robotic speakers (P <.05 for all). In contrast, there were no significant differences in the number of correct phrases recorded between different positions when using the wireless system. Subjectively, the wireless system resulted in improved clarity and effectiveness of communication (P = .021; P <.001, respectively). CONCLUSION: Robotic operating systems have intrinsic barriers to effective communication between the surgeon and the rest of the operating room team. Improved communication could reduce surgical errors and improve patient safety.