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Using matched micro-data on the spending of households and their macroeconomic expectations, we study the link between the realized inflation of households in their daily shopping and their perceived and expected levels of inflation both before and during the pandemic. As the pandemic spread across the USA, disagreement among US households about inflation expectations surged along with the average perceived and expected level of inflation. Simultaneously, realized inflation at the household level became more dispersed. During the pandemic, low income, low education, and Black households experienced a larger increase in realized inflation than other households. Dispersion in realized and perceived inflation explains a large share of the rise in dispersion in inflation expectations. Finally, households jointly revised their inflation and unemployment expectations during the pandemic, consistent with a supply-side view of the pandemic. JEL Classification E02 * E03, 1 Introduction When the COVID19 pandemic spread across the US and economic activity ground to a halt in many sectors, a basic question that policymakers faced was whether to think [...]

The COVID-19 vaccination drive raises questions about the trajectory of the economic recovery and the pandemic's impact on consumers' longer-term behaviors. In this Commentary, we examine the evolution of consumers' expectations for their post-crisis spending on services that have been dramatically curtailed by the pandemic: visiting restaurants, bars, and hotels, using public transportation, and attending crowded events. We document a U-shaped pattern of expected future use of these services, with growing pessimism in summer 2020 that had largely reversed by fall 2020--for most groups. More recently, higher-income individuals have indicated that they expect to sharply increase their use of these services compared with their pre-pandemic behaviors, but there has been a notable scarring of expectations among older Americans., The distribution of multiple COVID-19 vaccines provides hope that the virus will be brought under better control in the not-too-distant future, potentially allowing for a broadening recovery in economic activity. [...]

To provide insights into the processes that drive inflationary dynamics, the Federal Reserve Bank of Cleveland holds an annual conference on the topic of inflation: the Inflation: Drivers and Dynamics series. The 2020 installment of the conference was held on May 21-22, 2020. This Commentary summarizes the papers at the conference, which broadly fell into four categories: (1) empirical Phillips curves, (2) networks and Phillips curves, (3) expectations formation, and (4) price-setting behavior and inflation., Inflation is a topic of considerable interest and importance to the public, policymakers, and academics. Researchers continue to investigate new--and, sometimes, old--aspects of the inflation process in an ongoing attempt [...]

Walleye Sander vitreusare important sport fish that are commonly stocked to supplement populations. Increases in Smallmouth Bass Micropterus dolomieuabundance have prompted concerns regarding potential predation by these and other piscivores on stocked Walleye. Our objectives were to assess the timing and duration of predation on stocked Walleye, the frequency of occurrence and percent composition of Walleye in predator diets, and the percentage of stocked Walleye consumed. We collected Smallmouth Bass, adult Walleye, Largemouth Bass M. nigricans, and Northern Pike Esox luciusdiets in May (prestocking) and June–September (poststocking) 2019 and 2021 from three bays in Lake Oahe, South Dakota. We stocked two bays with Walleye (30–32 mm; 255–1649 Walleye/ha), whereas one bay was unstocked and served as a reference. We estimated Smallmouth Bass population abundance using Schnabel capture–recapture models, and we used bioenergetics to estimate the percentage of stocked age‐0 Walleye consumed. We found age‐0 Walleye in up to 11.4% of Smallmouth Bass diets and 14.6% of adult Walleye diets during the poststocking period. A single Largemouth Bass consumed one Walleye at 3 days poststocking (DPS), whereas we did not identify Walleye in Northern Pike diets. Daily mean percent composition by weight (±95% confidence interval) of age‐0 Walleye in diets peaked at 43.2 ± 35.1% at 3 DPS for Smallmouth Bass and 49.8 ± 97.7% at 14 DPS for adult Walleye. Following the peaks, age‐0 Walleye percent composition by weight rapidly declined and was generally 0% after 25 DPS. Smallmouth Bass abundance was 0.4–5.6 fish/ha, whereas recaptures of other predator species were insufficient for reliable population estimates. We estimated that Smallmouth Bass consumed 29,930 age‐0 Walleye in 2019 and 12,535 age‐0 Walleye in 2021 (up to 14.7 ± 4.7% of stocked fish), potentially representing an important source of stocking mortality. Our research provides insights into the effects of poststocking predation on age‐0 Walleye by Smallmouth Bass and, to a lesser extent, Walleye, Largemouth Bass, and Northern Pike. Managers should consider predation on stocked fingerling Walleye from resident predators and should contemplate alternative stocking locations or timing to reduce potential predation. Impact statementPredation may influence poststocking survival. We found that Smallmouth Bass were the most common predators of stocked age‐0 Walleye, predation generally occurred within 14 days poststocking, and up to 14.7% of stocked fish were consumed. Our results can guide management decisions for improving Walleye stocking success. Predation may influence poststocking survival. We found that Smallmouth Bass were the most common predators of stocked age‐0 Walleye, predation generally occurred within 14 days poststocking, and up to 14.7% of stocked fish were consumed. Our results can guide management decisions for improving Walleye stocking success.

Barriers can be an effective method for reducing escapement of reservoir sport fish; however, whether the financial benefits of a barrier outweigh the costs of a barrier is unknown. We sought to quantify the costs and benefits associated with constructing barriers to reduce fish escapement while explicitly accounting for variability and uncertainty. We developed a framework using simulation modeling and discounted cash flow techniques to quantify the costs and benefits of barrier construction on Brushy Creek Lake, Iowa, where a barrier was constructed in 2020 to reduce escapement of stocked Walleye Sander vitreusand Muskellunge Esox masquinongy.We then incorporated this framework into an interactive Shiny application to enable cost–benefit evaluations across a wide range of barrier types, system types, species, and escapement rates. The present value of the parallel‐bar barrier on Brushy Creek Lake, Iowa, over 10 years was US$69,576 (range = $64,484–$73,976), whereas the present value of escaped fish was $316,416 ($253,459–$378,823), indicating a net benefit of $246,840 ($188,975–$304,847) associated with barrier construction. The benefit–cost ratio of barrier construction was 4.55 after 10 years, indicating that for every $1 in present value spent on barrier construction, we saved $4.55 by preventing fish escapement. There was a 99% probability of a positive mean net benefit of the barrier after 3 years. Our results indicate that barriers can be a cost‐effective option to minimize fish escapement, and barrier costs are more predictable compared with the cost of escapement. Quantifying the value of escaped fish and barrier construction on an economic scale enables the use of formal decision‐making tools to address complicated and multifaceted issues associated with reservoir fisheries management. Impact statementWe developed a framework to enable the costs and benefits of barrier construction to minimize reservoir sport fish escapement to be quantified on an economic scale and subsequently applied this framework to a barrier construction project in Iowa. We then integrated this framework into a flexible application to enable the costs and benefits of barrier construction to be assessed across a variety of systems. We developed a framework to enable the costs and benefits of barrier construction to minimize reservoir sport fish escapement to be quantified on an economic scale and subsequently applied this framework to a barrier construction project in Iowa. We then integrated this framework into a flexible application to enable the costs and benefits of barrier construction to be assessed across a variety of systems.

Study design Cross-sectional studyObjectives To examine the relationship between morphological changes of the deep extensor neck muscles in patients with degenerative cervical myelopathy (DCM) and the level of maximum spinal cord compression (MSCC) and canal compromise (MCC). A secondary objective was to examine the relationship between muscle morphological changes with neck pain and functional scores related to neck pain and interference.Methods A total of 171 patients with DCM were included. Total cross-sectional area (CSA), functional CSA (fat free area, FCSA), ratio of FCSA/CSA (fatty infiltration) and asymmetry of the multifidus (MF) and semispinalis cervicis (SCer) together, and cervical muscle as a group (eg, MF, SCer, semispinalis capitis, splenius capitis) were obtained from T2-weighted axial MR images at mid-disc, at the level of maximum cord compression and the level below. The relationship between the muscle parameters of interest, MSCC, MCC and functional scores including the Neck Disability Index (NDI) was assessed using multivariate linear regression models, adjusting for age, body mass index and sex.Results Greater MF + Scer fatty infiltration was associated with greater MCC (P= .032) and MSCC (P= .049) at the same level. Greater asymmetry in MF + SCer CSA was also associated with greater MCC (P= .006). Similarly, greater asymmetry in FCSA and FCSA/CSA of the entire extensor muscle was associated with greater MCC (P= .011, P= .013). There was a negative association between asymmetry in FCSA MF + SCer, FCSA/CSA MF + SCer and FCSA/CSA group muscles with NDI score at the level below.Conclusion Greater MCC is associated with increased fatty infiltration and greater asymmetry of the deep cervical muscles in patients with DCM. A negative association between muscle asymmetry and NDI scores was also observed which has implications for clinical prediction around axial neck pain.

AbstractWe study the role of heterogeneity in nominal price rigidity for aggregate fluctuations in a model with sectoral productivity shocks. Theoretically, sectoral heterogeneity in the pricing friction has an ambiguous effect on GDP and aggregate price volatility. Quantitatively, (i) GDP volatility is amplified when the friction is heterogeneous rather than homogeneous; (ii) sectoral shocks can jointly rationalize the volatility of sectoral prices, aggregate prices, and GDP, unlike aggregate shocks; and (iii) shocks to the largest or most central sectors may not matter in the aggregate as heterogeneous pricing frictions may alter the identity of the most important sectors for aggregate fluctuations. (JEL E12, E23, E31, E32)

The diagnosis of cardiac amyloidosis can be established non-invasively by scintigraphy using bone-avid tracers, but visual assessment is subjective and can lead to misdiagnosis. We aimed to develop and validate an artificial intelligence (AI) system for standardised and reliable screening of cardiac amyloidosis-suggestive uptake and assess its prognostic value, using a multinational database of 99mTc-scintigraphy data across multiple tracers and scanners.

Masks or cloth face coverings have the potential to help reduce the spread of COVID-19 without greatly disrupting economic activity if they are widely used. To assess the state of mask wearing, we surveyed US consumers about their recent and prospective mask-wearing behavior. We find that most respondents are wearing masks in public but that some respondents are less likely to follow social-distancing guidelines while doing so, indicating a potential tradeoff between two of the recommended methods that jointly reduce coronavirus transmission. While most respondents indicated that they were extremely likely to wear a mask if required by public authorities, the reported likelihood is strongly dependent on age and perceived mask efficacy., The novel coronavirus that causes COVIDT9 continues to spread in the United States. After an initial burst of confirmed or probable cases of COVID-19 in late March and early April [...]

Study Design Retrospective analysis was performed of a multi-center Canadian Spine Outcomes and Research Network (CSORN) surgical database.Objective To determine the rate and time to return to work (RTW) based on workload intensity after elective degenerative lumbar spine surgery.Methods Patients working pre-operatively, aged greater than 18, who underwent a primary one- or two-level elective lumbar spine surgery for degenerative conditions between January 2015 and October 2020 were evaluated. The percentage of patients who returned to work at 1 year and the time to RTW post-operatively were analyzed based on workload intensity.Results Of the 1290 patients included in the analysis, the overall rate of RTW was 82% at 1 year. Based on workload there was no significant difference in time to RTW after a fusion procedure, with median time to RTW being 10 weeks. For non-fusion procedure, the sedentary group had a statistically significantly quicker time to RTW than the light-moderate (P< .005) and heavy-very heavy (<.027) groups.Conclusions The rate of RTW ranged between 84% for patients with sedentary work to 77% for patient with a heavy-very heavy workload. Median time to resumption of work was about 10 weeks following a fusion regardless of work intensity. There was more variability following non-fusion surgeries such as laminectomy and discectomy reflecting the patient’s job demands.

CDK2 is a critical regulator of the cell cycle. For a variety of human cancers, the dysregulation of CDK2/cyclin E1 can lead to tumor growth and proliferation. Historically, early efforts to develop CDK2 inhibitors with clinical applications proved unsuccessful due to challenges in achieving selectivity over off-target CDK isoforms with associated toxicity. In this report, we describe the discovery of (4-pyrazolyl)-2-aminopyrimidines as a potent class of CDK2 inhibitors that display selectivity over CDKs 1, 4, 6, 7, and 9. SAR studies led to the identification of compound 17, a kinase selective and highly potent CDK2 inhibitor (IC50= 0.29 nM). The evaluation of 17in CCNE1-amplified mouse models shows the pharmacodynamic inhibition of CDK2, measured by reduced Rb phosphorylation, and antitumor activity.

Objectives: This study evaluated whether the Reasoning and Rehabilitation (R&R2) program was effective in reducing recidivism, minimizing dropout rates, and improving outcomes related to attitudes, behaviors, and personality among people living in detention. Methods: Data were collected in eight Swiss German-speaking prisons among males detained for violent offenses using a quasi-experimental controlled design (R&R2: n= 129, treatment as usual [TAU]: n= 84). Measures included recidivism, dropout rate, and self-report questionnaires (hostile attribution bias, aggressiveness, interpersonal problems, and willingness to accept responsibility). Data were analyzed using mixed-effect models. Results: Participants in the R&R2 group were less likely to reoffend in comparison with the TAU group in the intention-to-treat (n= 51, odds ratio = 0.75, p= .060) and the per-protocol (excluding dropouts; n= 38, odds ratio = 0.65, p= .068) analyses. They also had lower self-reported scores of spontaneous and reactive aggressiveness (p= .047 and p= .070) and excitability (p= .086). Conclusions: The findings of this pilot project were promising, with the R&R2 program leading to reduced recidivism and dropout rate. Even though these results should be considered preliminary, the R&R2 program appeared to be a relevant approach in reducing recidivism after prison.

Here we show that MINSTED localization, a method whereby the position of a fluorophore is identified with precisely controlled beams of a STED microscope, tracks fluorophores and hence labeled biomolecules with nanometer/millisecond spatiotemporal precision. By updating the position for each detected photon, MINSTED recognizes fluorophore steps of 16 nm within <250 μs using about 13 photons. The power of MINSTED tracking is demonstrated by resolving the stepping of the motor protein kinesin-1 walking on microtubules and switching protofilaments.

Multiresistente Keime stellen die westliche Medizin vor immer neue Herausforderungen bei bakteriellen Infektionen.

Mean Sortable Silt (SS) size records in the hemipelagic deposits at Site U1452 (IODP 354) in the lower Bengal Fan are presented here to reconstruct the bottom water circulation strengths in the Bay of Bengal (BoB) during the last 200 ka (Marine Isotopic Stage 1 to 6). To eliminate possible amplitude shifts in SS size due to terrestrial sediment flux or turbiditic interventions, sedimentation history at the site is decomposed using End Member Analysis (EMA). SS size record in the BoB is mostly unimpacted by the terrestrial sediment flux and turbidity current deposition; hence the size sorting signature in SS records is best described to have arisen from benthic boundary layer current intensity. SS size record in the BoB indicates reduced bottom water flow speed during glacials (MIS 2 and 6), concomitant with the greater import of Antarctic/ Southern Ocean (SO) derived deep waters and increased speed during interglacials (MIS 1, 3 and 5) corresponding to an increased proportion of Northern Atlantic derived deep water mass in the northern Indian Ocean. Glacial and stadial decline in flow speed reflects on the density reversal between two deep water mass end members in the SO and a shoaled Atlantic meridional overturning circulation (AMOC). On the other hand, faster flow speed during the climate optima at MIS 5.5 and other warm substages of MIS 5 as well as during the Holocene present a deep and strong AMOC. Reduced bottom water circulation strength in the BoB during the MIS 5.5 to 5.4 transition might have contributed to atmospheric CO2 drawdown and global cooling during the early stages of glacial inception along with deep circulation changes in the SO. Also, millennial-scale variability in circulation strength in the BoB is linked to oceanic frontal shift in high northern latitudes and deepwater formation manifesting in reduced flow strength associated with local cold anomalies (C28–C23), successively culminating into glacial inception at MIS 5.4. Reduced flow speed is also observed during some of the Heinrich events indicating a strong teleconnection between deep North Atlantic and BoB. Productivity changes in the BoB might as well have been influenced by variable fluxes of northern and southern sourced water mass during the last 200 ka.

Neurodegenerative Erkrankungen wie Demenz, Parkinson-Krankheit (PD) und Multiple Sklerose (MS) verzeichnen in den meisten Ländern der Welt einen deutlichen Anstieg. Für keine dieser Krankheiten gibt es ein etabliertes erfolgreiches Behandlungsprotokoll. Alle diese scheinbar unterschiedlichen klinischen Entitäten sind mit einer beeinträchtigten Mitochondrienfunktion und Anzeichen von chronischen Entzündungen verbunden. Die Diagnose und der Ausgleich von oxidativem Stress können das Fortschreiten einer Neuroentzündung verlangsamen, möglicherweise sogar in Remission schicken.

We investigated foraging success, diet composition, and the abundances of various prey taxa in the diets of larval Freshwater Drum Aplodinotus grunniensacross a gradient of bigheaded carp (Bighead Carp Hypophthalmichthys nobilisand Silver Carp H. molitrix) relative abundance and in relation to zooplankton density, temperature, discharge, and larval fish densities in the upper Mississippi River (UMR). We sampled fish larvae and zooplankton every 10 days (May–August 2017 and 2018) from UMR Pools 14, 16, and 18–20; collected environmental data from nearby gauging stations; and assessed bigheaded carp relative abundance. Crustacean zooplankton abundance was positively related to larval foraging success. Copepods were the dominant prey, but larvae also consumed large proportions of rotifer eggs and benthic insect larvae. Bigheaded carp presence and catch per unit effort were positively associated with increased larval consumption of atypical prey (rotifer eggs and aquatic insect larvae) and cyclopoid copepods. Cladocerans were the rarest prey consumed by larvae in pools where bigheaded carp were present, but they were more frequently consumed in pools where bigheaded carp were absent. In addition to bigheaded carp abundance, river discharge was negatively associated with larval consumption of cladocerans, aquatic insect larvae, and rotifers; water temperature was negatively associated with the consumption of copepods and cladocerans; and rotifer abundance was positively associated with their consumption. We suggest that bigheaded carp alter larval fish diets to prey that may be less energetically beneficial, which can have implications for larval growth and survival. Impact StatementEffects of invasive bigheaded carp on native fishes in North America remain poorly understood. We assessed the effect of adult bigheaded carp abundance on diets of larval Freshwater Drum in the upper Mississippi River. We observed changes in larval fish diets in the presence of bigheaded carp, suggesting competition that may affect larval growth and survival. Effects of invasive bigheaded carp on native fishes in North America remain poorly understood. We assessed the effect of adult bigheaded carp abundance on diets of larval Freshwater Drum in the upper Mississippi River. We observed changes in larval fish diets in the presence of bigheaded carp, suggesting competition that may affect larval growth and survival.

ABSTRACT:Objective:To examine differences in surgical practices between salaried and fee-for-service (FFS) surgeons for two common degenerative spine conditions. Surgeons may offer different treatments for similar conditions on the basis of their compensation mechanism.Methods:The study assessed the practices of 63 spine surgeons across eight Canadian provinces (39 FFS surgeons and 24 salaried) who performed surgery for two lumbar conditions: stable spinal stenosis and degenerative spondylolisthesis. The study included a multicenter, ambispective review of consecutive spine surgery patients enrolled in the Canadian Spine Outcomes and Research Network registry between October 2012 and July 2018. The primary outcome was the difference in type of procedures performed between the two groups. Secondary study variables included surgical characteristics, baseline patient factors, and patient-reported outcome.Results:For stable spinal stenosis (n= 2234), salaried surgeons performed statistically fewer uninstrumented fusion (p< 0.05) than FFS surgeons. For degenerative spondylolisthesis (n= 1292), salaried surgeons performed significantly more instrumentation plus interbody fusions (p< 0.05). There were no statistical differences in patient-reported outcomes between the two groups.Conclusions:Surgeon compensation was associated with different approaches to stable lumbar spinal stenosis and degenerative lumbar spondylolisthesis. Salaried surgeons chose a more conservative approach to spinal stenosis and a more aggressive approach to degenerative spondylolisthesis, which highlights that remuneration is likely a minor determinant in the differences in practice of spinal surgery in Canada. Further research is needed to further elucidate which variables, other than patient demographics and financial incentives, influence surgical decision-making.

Study Design Retrospective cohort.Objectives To compare outcomes of minimally invasive surgery (MIS) vs open surgery (OPEN) for lumbar spinal stenosis (LSS) in patients with diabetes.Methods Patients with diabetes who underwent spinal decompression alone or with fusion for LSS within the Canadian Spine Outcomes and Research Network (CSORN) database were included. MIS vs OPEN outcomes were compared for 2 cohorts: (1) patients with diabetes who underwent decompression alone (N = 116; MIS n = 58 and OPEN n = 58), (2) patients with diabetes who underwent decompression with fusion (N = 108; MIS n = 54 and OPEN n = 54). Modified Oswestry Disability Index (mODI) and back and leg pain were compared at baseline, 6–18 weeks, and 1-year post-operation. The number of patients meeting minimum clinically important difference (MCID) or minimum pain/disability at 1-year was compared.Results MIS approaches had less blood loss (decompression alone difference 100 mL, P= .002; with fusion difference 244 mL, P< .001) and shorter length of stay (LOS) (decompression alone difference 1.2 days, P= .008; with fusion difference 1.2 days, P= .026). MIS compared to OPEN decompression with fusion had less patients experiencing adverse events (AEs) (difference 13 patients, P= .007). The MIS decompression with fusion group had lower 1-year mODI (difference 14.5, 95% CI [7.5, 21.0], P< .001) and back pain (difference 1.6, 95% CI [.6, 2.7], P= .002) compared to OPEN. More patients in the MIS decompression with fusion group exceeded MCID at 1-year for mODI (MIS 75.9% vs OPEN 53.7%, P= .028) and back pain (MIS 85.2% vs OPEN 70.4%, P= .017).Conclusions MIS approaches were associated with more favorable outcomes for patients with diabetes undergoing decompression with fusion for LSS.

The Bigmouth Buffalo Ictiobus cyprinellusis a long‐lived catostomid with ecological and commercial harvest value. Management of Bigmouth Buffalo relies on accurate age data for population dynamic assessments (recruitment, growth, and mortality), but between‐reader precision of nonlethal aging structures compared to otoliths has not been assessed. We analyzed age bias and between‐reader precision of ages estimated from pectoral and dorsal fin rays relative to lapillus otoliths for Bigmouth Buffalo (n= 115) captured from shallow natural lakes in Iowa. Maximum agreed age was 21 years for otoliths, 15 years for pectoral fin rays, and 14 years for dorsal fin rays. Ages estimated from pectoral fin rays were the most precise (CV = 12.6%; average percent error [APE] = 8.9%), followed by dorsal fin rays (CV = 16.1%; APE = 11.4%) and otoliths (CV = 21.5%; APE = 16.5%). Pectoral fin rays also had higher exact agreement between readers (37%) and higher agreement within 1 year (77%) compared to dorsal fin rays (35% exact; 69% within 1 year) and lapillus otoliths (17% exact; 61% within 1 year). Both dorsal fin rays and pectoral fin rays underestimated age relative to otoliths, which resulted in younger population age structures and larger mean length‐at‐age estimates. Our results suggest that biologists can use dorsal and pectoral fin rays as viable nonlethal structures for younger fish (up to 10 years for dorsal fin rays; up to 13 years for pectoral fin rays), whereas otoliths can be difficult to age but are necessary to accurately determine age for older individuals.

Background: A mere 25% of patients who need treatment for osteoporosis receive appropriate therapy, partly due to the time-consuming and stressful diagnostic workup for older patients with functional decline. Aims: The purpose of the present study was to investigate the accuracy of pulse-echo ultrasound measurement of the lower leg for the detection of osteoporosis in older patients, and evaluate the effect of a proposed diagnostic algorithm. Methods: Cortical thickness and the so-called density index (DI) were measured prospectively on the lower leg with a pulse-echo ultrasound (PEUS) device. The accuracy of the device was compared with dual-energy X-ray absorptiometry (DXA) of the hip. We calculated algorithms combining FRAX® scores and PEUS measures as a guide for specific treatment of osteoporosis. Results: Three hundred and thirty-three patients aged on average 81 years (82.1% women, 275/333) were included in the study. The sensitivity of the ultrasound device versus DXA for the detection of osteoporosis was 94.4% (84/89), and the specificity was 59% (144/247). The gender-specific sensitivity was 96.2% (75/78) for women and 81.8% (9/11) for men. Discussion: Clinical decisions for the specific treatment of osteoporosis could be based on the proposed algorithm, without additional DXA measurements, in 90.9% (303/333) of the patients. Conclusion: Older patients with a similar risk profile as in our study population may benefit from PEUS, as it is a non-invasive, cost-effective, and efficient diagnostic tool with high accuracy in screening patients for osteoporosis and the risk of fractures.

Study Design: International multicenter prospective observational cohort study on patients undergoing radiation +/− surgical intervention for the treatment of symptomatic spinal metastases.Objectives: To investigate the association between the total Spinal Instability Neoplastic Score (SINS), individual SINS components and PROs.Methods: Data regarding patient demographics, diagnostics, treatment, and PROs (SF-36, SOSGOQ, EQ-5D) was collected at baseline, 6 weeks, and 12 weeks post-treatment. The SINS was assessed using routine diagnostic imaging. The association between SINS, PRO at baseline and change in PROs was examined with the Spearmans rank test.Results: A total of 307 patients, including 174 patients who underwent surgery+/− radiotherapy and 133 patients who underwent radiotherapy were eligible for analyses. In the surgery+/− radiotherapy group, 18 (10.3%) patients with SINS score between 0-6, 118 (67.8%) with a SINS between 7-12 and 38 (21.8%) with a SINS between 13-18, as compared to 55 (41.4%) SINS 0-6, 71(53.4%) SINS 7-12 and 7 (5.2%) SINS 13-18 in the radiotherapy alone group. At baseline, the total SINS and the presence of mechanical pain was significantly associated with the SOSGOQ pain domain (r = −0.519, P< 0.001) and the NRS pain score (r = 0.445, P< 0.001) for all patients. The presence of mechanical pain demonstrated to be moderately associated with a positive change in PROs at 12 weeks post-treatment.Conclusion: Spinal instability, as defined by the SINS, was significantly correlated with PROs at baseline and change in PROs post-treatment. Mechanical pain, as a single SINS component, showed the highest correlations with PROs.

Study Design: Retrospective cohort study.Objective: We evaluated the effectiveness of minimally invasive (MIS) tubular discectomy in comparison to conventional open surgery among patients enrolled in the Canadian Spine Outcomes and Research Network (CSORN).Methods: We performed an observational analysis of data that was prospectively collected. We implemented Minimum Clinically Important Differences (MCIDs), and we adjusted for potential confounders with multiple logistic regression. Adverse events were collected according to the Spinal Adverse Events Severity (SAVES) protocol.Results: Three hundred thirty-nine (62%) patients underwent MIS tubular discectomy and 211 (38%) underwent conventional open discectomy. There were no significant differences between groups for improvement of leg pain and disability, but the MIS technique was associated with reduced odds of achieving the MCID for back pain (OR 0.66, 95% CI 0.44 to 0.99, P< 0.05). We identified statistically significant differences in favor of MIS for each of operating time (MIS mean (SD) 72.2 minutes (30.0) vs open 93.5 (40.9)), estimated blood loss (MIS 37.9 mL (36.7) vs open 76.8 (71.4)), length of stay in hospital (MIS 73% same-day discharge vs open 40%), rates of incidental durotomy (MIS 4% vs open 8%), and wound-related complications (MIS 3% vs open 9%); but not for overall rates of reoperation.Conclusions: Open and MIS techniques yielded similar improvements of leg pain and disability at up to 12 months of follow-up, but MIS patients were less likely to experience improvement of associated back pain. Small differences favored MIS for operating time, blood loss, and adverse events but may have limited clinical importance.

IMPORTANCE: Ultrasound renal denervation (uRDN) was shown to lower blood pressure (BP) in patients with uncontrolled hypertension (HTN). Establishing the magnitude and consistency of the uRDN effect across the HTN spectrum is clinically important. OBJECTIVE: To characterize the effectiveness and safety of uRDN vs a sham procedure from individual patient-level pooled data across uRDN trials including either patients with mild to moderate HTN on a background of no medications or with HTN resistant to standardized triple-combination therapy. DATA SOURCES: A Study of the ReCor Medical Paradise System in Clinical Hypertension (RADIANCE-HTN SOLO and TRIO) and A Study of the ReCor Medical Paradise System in Stage II Hypertension (RADIANCE II) trials. STUDY SELECTION: Trials with similar designs, standardized operational implementation (medication standardization and blinding of both patients and physicians to treatment assignment), and follow-up. DATA EXTRACTION AND SYNTHESIS: Pooled analysis using individual patient-level data using linear regression models to compare uRDN with sham across the trials. MAIN OUTCOMES AND MEASURES: The primary outcome was baseline-adjusted change in 2-month daytime ambulatory systolic BP (dASBP) between groups. RESULTS: A total of 506 patients were randomized in the 3 studies (uRDN, 293; sham, 213; mean [SD] age, 54.1 [9.3]; 354 male [70.0%]). After a 1-month medication stabilization period, dASBP was similar between the groups (mean [SD], uRDN, 150.3 [9.2] mm Hg; sham, 150.8 [10.5] mm Hg). At 2 months, dASBP decreased by 8.5 mm Hg to mean (SD) 141.8 (13.8) mm Hg among patients treated with uRDN and by 2.9 mm Hg to 147.9 (14.6) mm Hg among patients treated with a sham procedure (mean difference, −5.9; 95% CI, −8.1 to −3.8 mm Hg; P &lt; .001 in favor of uRDN). BP decreases from baseline with uRDN vs sham were consistent across trials and across BP parameters (office SBP: −10.4 mm Hg vs −3.4 mm Hg; mean difference, −6.4 mm Hg; 95% CI, −9.1 to –3.6 mm Hg; home SBP: −8.4 mm Hg vs −1.4 mm Hg; mean difference, −6.8 mm Hg; 95% CI, −8.7 to −4.9 mm Hg, respectively). The BP reductions with uRDN vs sham were consistent across prespecified subgroups. Independent predictors of a larger BP response to uRDN were higher baseline BP and heart rate and the presence of orthostatic hypertension. No differences in early safety end points were observed between groups. CONCLUSIONS AND RELEVANCE: Results of this patient-level pooled analysis suggest that BP reductions with uRDN were consistent across HTN severity in sham-controlled trials designed with a 2-month primary end point to standardize medications across randomized groups. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02649426 and NCT03614260

AbstractMartin A. Simonson, Michael J. Weber, Grace M. Wilkinson and Andrew R. Annear. 2023. Annual changes in water quality and sportfish community structure following commercial harvest of common carp and bigmouth buffalo. Lake Reserv Manage. 39:174–189.Commercial harvest of common carp (Cyprinus carpio; hereafter carp) and bigmouth buffalo (Ictiobus cyprinellus; hereafter buffalo) populations had little detectable effect on shallow lake ecosystems. We tested whether carp and buffalo biomass removal affects limnological variables and fish community metrics across 6 shallow, natural lakes of northwestern Iowa using mixed effects models. Annual commercial harvest of carp ranged from 0 to 71 kg/ha; annual harvest of buffalo ranged from 0 to 356 kg/ha. Biomanipulation (i.e., commercial harvest) of carp was associated with decreases in soluble phosphorus and nitrogen concentrations, but not total phosphorus or nitrogen. Buffalo harvest was unrelated to annual changes in nutrient concentrations but was associated with reductions in chlorophyll aand phycocyanin concentrations. Secchi disk transparency and total suspended solids were unrelated to carp and buffalo harvest. Carp harvest was associated with reduced biomass of large cladocerans but no other zooplankton biomass densities; buffalo harvest was unrelated to zooplankton biomass. Species richness and rake density of aquatic macrophytes were unrelated to carp and buffalo harvest. Carp and buffalo harvest was unrelated to changes in most indices of sportfish abundance, condition, and size distribution. Our results suggest harvest of carp and buffalo <71 kg/ha has little effect on abiotic and biotic ecosystem components on short time scales and highlights the challenges associated with shallow lake restoration.

Common Carp Cyprinus carpioand Bigmouth Buffalo Ictiobus cyprinellusare widespread across the Midwest, where they can achieve high population densities in shallow lakes. Despite their contrasting statuses as invasive and native fishes, these species are commonly managed together due to their capacity to have deleterious effects on water quality. However, intra‐annual sampling variability is poorly understood for both species, making it difficult to track population changes. We compared boat electrofishing CPUE and proportional size distribution (PSD) of Common Carp and Bigmouth Buffalo during May–October 2018–2020 in seven shallow northwestern Iowa lakes. We also estimated sampling effort necessary to reach targets of fish captured (100) and precision (relative standard error < 25%) and to detect 25% and 50% differences in CPUE between samples. Common Carp CPUE peaked in June (29 fish/h), declined across the summer, and was lowest in October (9 fish/h). Bigmouth Buffalo CPUE exhibited bimodal peaks in May (16 fish/h) and October (12 fish/h), with low catches during August (2 fish/h). Common Carp size structure was largest during October (PSD of preferred‐size fish [PSD‐P] = 92) and smallest in July (PSD‐P = 58). Bigmouth Buffalo size structure was smaller in June (PSD‐P = 20) than in all other months (PSD‐P = 34). Our targets for number of fish captured and precision were typically reached within twenty‐five 15‐min electrofishing transects for Common Carp during periods of high catch rates but were not reached after 100 transects for Bigmouth Buffalo in most cases. Our results suggest that timing of sampling is important for reliably and efficiently assessing Common Carp and Bigmouth Buffalo populations. We recommend the sampling of Common Carp with electrofishing during June and the sampling of Bigmouth Buffalo during May in Midwestern shallow lakes to maximize catch rates while minimizing the influence of seasonal sampling variability.

Downstream escapement of fishes from reservoirs via release structures can represent a loss to populations that is comparable to natural and harvest mortality. Consequently, quantifying and managing fish escapement constitute a critical component of sustainable reservoir fish management. We reviewed existing literature to assess the state of knowledge of reservoir fish escapement and found 57 unique papers published from 1942 through 2021. Early studies sought to evaluate escapement by directly capturing fish below release structures. More recently, advances in technology have enabled more detailed studies on factors influencing escapement and the influence it has on regulating reservoir fisheries. Evaluations have occurred throughout North America, assessing escapement of 49 species through a number of different outlet structures. Annual escapement estimates ranged from 0% to 100%, and escapement tended to be higher from spillways and surface release outlets compared to other outlets. Further, smaller‐bodied individuals tended to escape at higher rates than larger fish and escapement was generally positively related to reservoir discharge metrics. Sixteen papers assessed benefits of physical and nonphysical barriers for reducing reservoir fish escapement and determined that the barriers were effective for retaining fish in reservoirs. We conclude by describing management options to address escapement as well as three pressing research needs that will broaden the existing knowledge base regarding fish escapement. In light of predicted changes in precipitation events and subsequent adaptations to reservoir management, quantifying and mitigating fish escapement will be a critical component of sustainable reservoir fish management in the future.

Understanding and predicting recruitment, longstanding goals in fisheries science and ecology, are complicated by variation in the importance of environmental drivers coupled with the dynamic nature of individual ecosystems. Developing an understanding of recruitment from well‐monitored stocks offers an opportunity to overcome these complexities. We used a systematic literature review, a survey, and a workshop attended by professionals with expertise in recruitment of Walleye Sander vitreusto identify common environmental drivers of Walleye recruitment and additional sources of variation (i.e., context dependencies) among populations. The importance of individual environmental drivers, as well as the direction of their influence, differed as a function of geographic region, lake surface area, and Walleye life stage. The literature suggested abiotic conditions (e.g., temperature) during the first year of life were influential in determining recruitment. Professional opinion noted the importance of biotic factors, with prey availability and predation risk having the most consistent relationships with recruitment. We synthesized this information to propose a conceptual model that illustrates the suite of characteristics that shape Walleye recruitment over large spatial and temporal scales. Our findings emphasize the importance of first‐year growth and system‐specific contextual factors, which can alter the relative importance of the environmental drivers of recruitment.

Study Design Narrative Review. The spine remains the most common site for bony metastasis. It is estimated that up to 70% of cancer patients harbor secondary spinal disease. And up to 10% will develop a clinically significant lesion. The last two decades have seen a substantial leap forward in the advancements of the management of spinal metastases. What once was a death sentence is now a manageable, even potentially treatable condition. With marked advancements in the surgical treatment and post-operative radiotherapy, a standardized approach to stratify and manage these patients is both prudent and now feasible.Objectives This article looks to examine the best available evidence in the stratification and surgical management of patients with spinal metastases. So the aim of this review is to offer a standardized approach for surgical management and surgical planning of patients with spinal metastases.

Three species of invasive carp—Grass Carp Ctenopharyngodon idella, Silver Carp Hypophthalmichthys molitrix, and Bighead Carp H. nobilis—are rapidly spreading throughout North America. Monitoring their reproduction can help to determine establishment in new areas but is difficult due to challenges associated with identifying fish eggs. Recently, random forest models provided accurate identification of eggs based on morphological traits, but the models have not been validated using independent data. Our objective was to evaluate the predictive performance of egg identification models developed by Camacho et al. (2019) for classifying invasive carp eggs by using an independent data set. When invasive carp were grouped as one category, predictive accuracy was high at the following levels: family (89%), genus (90%), species (91%), and species with reduced predictor variables (94%). Invasive carp predictive accuracy decreased when we only considered observations from newly sampled locations (family: 9%; genus: 22%; species: 30%; species with reduced predictor variables: 70%), suggesting potential differences in egg characteristics among locations. Random forest models using a combination of previous and new data resulted in high predictive accuracy for invasive carp (96–98%) when invasive carp were grouped as one class for all models at the family, genus, and species levels. The two most influential predictor variables were average membrane diameter and average embryo diameter; the probability of predicting an invasive carp egg increased with these metrics. High predictive accuracy metrics suggest that these trained and validated random forest models can be used to identify invasive carp eggs based on morphometric variables. However, decreased performance at new locations suggests that more research would be beneficial to determine the models’ applicability to a larger spatial region.

Invasive carp are expanding throughout the upper Mississippi River basin and are of great concern due to their potential economic and ecological impacts. Identification of spawning locations provides critical information on recruitment sources to evaluate potential management strategies. Our objective was to create and validate a spawning habitat suitability model of the Des Moines River, Iowa, during low‐, average‐, and high‐water‐level conditions. Backwater availability, abundance of hardpoints (structures that create turbulence), river gradient and sinuosity, water temperature, and continuously free‐flowing river lengths were used as model parameters. The model was compared to back‐calculated spawning locations from invasive carp eggs collected in 2014–2015. Turbulent hardpoints, river sinuosity, and gradient were not significant predictors of invasive carp spawning locations, and backwater availability in the 25 river kilometers downstream of each reach was inversely correlated with invasive carp spawning locations. Invasive carp eggs were not caught in 2014 despite optimal spawning conditions, revealing that spawning may have high interannual variation. This study suggests that predicting invasive carp reproduction may require variables in addition to those currently proposed.

Intervertebral disc (IVD) degeneration and herniation often necessitate surgical interventions including a discectomy with or without a nucleotomy, which results in a loss of the normal nucleus pulposus (NP) and a defect in the annulus fibrosus (AF). Due to the limited regenerative capacity of the IVD tissue, the annular tear may remain a persistent defect and result in recurrent herniation post-surgery. Bioadhesives are promising alternatives but show limited adhesion performance, low regenerative capacity, and inability to prevent re-herniation. Here, we report hybrid bioadhesives that combine an injectable glue and a tough sealant to simultaneously repair and regenerate IVD post-nucleotomy. The glue fills the NP cavity while the sealant seals the AF defect. Strong adhesion occurs with the IVD tissues and survives extreme disc loading. Furthermore, the glue can match native NP mechanically, and support the viability and matrix deposition of encapsulated cells, serving as a suitable cell delivery vehicle to promote NP regeneration. Besides, biomechanical tests with bovine IVD motion segments demonstrate the capacity of the hybrid bioadhesives to restore the biomechanics of bovine discs under cyclic loading and to prevent permanent herniation under extreme loading. This work highlights the synergy of bioadhesive and tissue-engineering approaches. Future works are expected to further improve the tissue specificity of bioadhesives and prove their efficacy for tissue repair and regeneration.

More attention is being paid to blood pressure (BP) effects in new chemical entities under development for non-hypertension indications, especially when these are not anticipated and not thoroughly defined during [...]

Since the approval of anti-amyloid therapies, there has been increased focus on recognizing early cognitive changes and treating patients in this stage.

Resistant hypertension is associated with increased cardiovascular risk. The endothelin pathway has been implicated in the pathogenesis of hypertension, but it is currently not targeted therapeutically, thereby leaving this relevant pathophysiological pathway unopposed with currently available drugs. The aim of the study was to assess the blood pressure lowering efficacy of the dual endothelin antagonist aprocitentan in patients with resistant hypertension.

Tournament mortality of Largemouth Bass Micropterus salmoidescan be a major source of population mortality. Tournament captures and mortality may be reduced through restrictive harvest regulations (bag and length limits), but these approaches for mitigating tournament mortality have not been assessed. We assessed the effects of bass tournament angler bag and minimum length limits on the number of bass weighed in, bass tournament weigh‐in probability, and the reduction in tournament mortality. We tagged nearly 4,000 Largemouth Bass during 205 tournaments and electrofishing events at Brushy Creek Lake, Iowa, from 2015 to 2019. We then used a before–after–control–impact analysis to evaluate the effect of tournament regulations (bag limit: either three or five bass; minimum length limit: no minimum or 305, 330, 356, or 381 mm) on bass monthly catch rates and a capture–recapture model to assess tournament weigh‐in probability among regulation types. Number of bass per tournament angler‐hour was similar among a three‐bass, ≥381‐mm length limit and more liberalized regulations (mean = 0.26 bass/angler/h). Length and bag limits had little effect on bass weigh‐in probability. We estimated that reducing the bag limit from five to three bass would have little effect, while a reduction from three to two bass would reduce the number of bass weighed in by 35% and a bag limit of one bass would result in a 62% reduction. Alternatively, a minimum length limit of ≥381 mm could reduce the number of bass weighed in by over 40%. Tournament mortality was greatest in July and August, but low catch rates during these months resulted in little mortality. Although current length and bag limits did not affect bass weigh‐in probability, the number of bass weighed in and associated tournament mortality may be reduced if bag and length limits are very restrictive (≤2 bass/angler or minimum length ≥381 mm). However, restrictive tournament regulations may not be biologically necessary or socially acceptable.

IMPORTANCE: Although early trials of endovascular renal denervation (RDN) for patients with resistant hypertension (RHTN) reported inconsistent results, ultrasound RDN (uRDN) was found to decrease blood pressure (BP) vs sham at 2 months in patients with RHTN taking stable background medications in the Study of the ReCor Medical Paradise System in Clinical Hypertension (RADIANCE-HTN TRIO) trial. OBJECTIVES: To report the prespecified analysis of the persistence of the BP effects and safety of uRDN vs sham at 6 months in conjunction with escalating antihypertensive medications. DESIGN, SETTING, AND PARTICIPANTS: This randomized, sham-controlled, clinical trial with outcome assessors and patients blinded to treatment assignment, enrolled patients from March 11, 2016, to March 13, 2020. This was an international, multicenter study conducted in the US and Europe. Participants with daytime ambulatory BP of 135/85 mm Hg or higher after 4 weeks of single-pill triple-combination treatment (angiotensin-receptor blocker, calcium channel blocker, and thiazide diuretic) with estimated glomerular filtration rate (eGFR) of 40 mL/min/1.73 m2 or greater were randomly assigned to uRDN or sham with medications unchanged through 2 months. From 2 to 5 months, if monthly home BP was 135/85 mm Hg or higher, standardized stepped-care antihypertensive treatment starting with aldosterone antagonists was initiated under blinding to treatment assignment. INTERVENTIONS: uRDN vs sham procedure in conjunction with added medications to target BP control. MAIN OUTCOMES AND MEASURES: Six-month change in medications, change in daytime ambulatory systolic BP, change in home systolic BP adjusted for baseline BP and medications, and safety. RESULTS: A total of 65 of 69 participants in the uRDN group and 64 of 67 participants in the sham group (mean [SD] age, 52.4 [8.3] years; 104 male [80.6%]) with a mean (SD) eGFR of 81.5 (22.8) mL/min/1.73 m2 had 6-month daytime ambulatory BP measurements. Fewer medications were added in the uRDN group (mean [SD], 0.7 [1.0] medications) vs sham (mean [SD], 1.1 [1.1] medications; P = .045) and fewer patients in the uRDN group received aldosterone antagonists at 6 months (26 of 65 [40.0%] vs 39 of 64 [60.9%]; P = .02). Despite less intensive standardized stepped-care antihypertensive treatment, mean (SD) daytime ambulatory BP at 6 months was 138.3 (15.1) mm Hg with uRDN vs 139.0 (14.3) mm Hg with sham (additional decreases of −2.4 [16.6] vs −7.0 [16.7] mm Hg from month 2, respectively), whereas home SBP was lowered to a greater extent with uRDN by 4.3 mm Hg (95% CI, 0.5-8.1 mm Hg; P = .03) in a mixed model adjusting for baseline and number of medications. Adverse events were infrequent and similar between groups. CONCLUSIONS AND RELEVANCE: In this study, in patients with RHTN initially randomly assigned to uRDN or a sham procedure and who had persistent elevation of BP at 2 months after the procedure, standardized stepped-care antihypertensive treatment escalation resulted in similar BP reduction in both groups at 6 months, with fewer additional medications required in the uRDN group. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02649426

As black bass Micropterusspp. tournaments continue to grow in popularity, so too must evaluations on the population‐level effects of live‐release angling events. Although factors influencing the tournament mortality of individuals are well studied, assessments at the population level are lacking. We evaluated differences in tournament capture probability and survival of two size‐classes of Largemouth Bass M. salmoides(medium: 381–457 mm; large: >457 mm) using a multistate mark–recapture model. Changes in estimated capture and survival rates of medium and large bass were then simulated to assess potential effects on population size structure. Tournament capture probabilities for medium bass were approximately three times higher than those for large bass, and tournament capture probabilities for both size‐classes increased with air temperature. Medium bass also experienced higher survival rates than large bass after tournaments, and survival rates of both groups declined with increasing water temperature. Our simulations indicated that both increases in tournament capture probability and reductions in posttournament survival of large bass resulted in some reductions in population size structure. However, increases in tournament capture probability or reductions in tournament survival of medium bass or medium and large bass alone had little to no effect. Our results suggest that under the observed tournament conditions, tournaments have little effect on bass population size structure, but size structure could be reduced with higher capture probabilities and lower posttournament survival; this information is useful for managing the fishery effects of tournament angling. Our modeling approach also provides a framework for understanding population‐level effects of tournaments on other populations under alternative conditions.