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The mammalian target of rapamycin (mTOR) is a serinethreonine kinase that acts as a central mediator of translation and plays important roles in cell growth, synaptic plasticity, cancer, and a wide range of developmental disorders. The signaling cascade linking lipid kinases (phosphoinositide 3- kinases), protein kinases (AKT), and translation initiation complexes (EIFs) to mTOR has been extensively modeled, but does not fully describe mTOR system behavior. Here, we use quantitative multiplex coimmunoprecipitation to monitor a protein interaction network (PIN) composed of 300+ binary interactions among mTOR-related proteins. Using a simple model system of serum-deprived or fresh-media-fed mouse 3T3 fibroblasts, we observed extensive PIN remodeling involving 27+ individual protein interactions after 1 h, despite phosphorylation changes observed after only 5 min. Using small molecule inhibitors of phosphoinositide 3-kinase, AKT, mTOR, MEK and ERK, we define subsets of the PIN, termed “modules”, that respond differently to each inhibitor. Using primary fibroblasts from individuals with overgrowth disorders caused by pathogenic PIK3CA or MTOR variants, we find that hyperactivation of mTOR pathway components is reflected in a hyperactive PIN. Our data define a “modular” organization of the mTOR PIN in which coordinated groups of interactions respond to the activation or inhibition of distinct nodes, and demonstrate that kinase inhibitors affect the modular network architecture in a complex manner, inconsistent with simple linear models of signal transduction. [ABSTRACT FROM AUTHOR]

• Past hurricane damage was a strong predictor of damage during Hurricane Matthew. • Homes with bulkheads experienced more damage than homes with natural shorelines. • Homes with bulkheads were closer to the water than homes with natural shorelines. Hurricanes and tropical storms are among the most frequent and costly natural disasters in the United States, and their impacts are expected to intensify in the future. Understanding the best predictors of hurricane damage in coastal areas is of paramount importance for reducing recovery costs and protecting coastal infrastructure and human lives. This project used surveys of 295 homeowners in coastal North Carolina to evaluate damage to estuarine shorelines and homes caused by Hurricane Matthew in 2016. Specifically, we were interested in the following questions: 1) did homes with hardened shorelines (e.g. bulkheads and riprap revetments) experience more or less damage than homes with natural shorelines during the storm; and, 2) what were the strongest predictors of hurricane damage to shorelines and homes. Overall, we found that past hurricane damage to shorelines was the strongest predictor of shoreline damage during Hurricane Matthew and that flood zone and past hurricane damage to homes were the strongest predictors of home damage. However, homes with bulkheads also sustained more hurricane damage than homes with natural shorelines, perhaps because homes with bulkheads were on average 2 times closer to the shoreline than homes with natural shorelines. Our results show patterns of repeated shoreline and home damage during hurricanes and indicate that environmental context and vulnerability can outweigh individual residents' shoreline management decisions. [ABSTRACT FROM AUTHOR]

Species occupying similar habitat and functional niches will necessarily have some external force driving differentiation between them, thus creating complementarity, or otherwise face high competition for resources. In order to fully understand the role of each species in an ecosystem and their contributions to ecosystem function, it is important to understand the nature of these interactions. However, for species that occur in the same spatial niche and appear to occupy redundant functional niches, it is often difficult to distinguish between complementarity and redundancy and therefore to designate the functional role each species plays. We used two co-occurring fiddler crab species that are presumed to be functionally similar, Leptuca pugilator (sand fiddler crab) and Minuca pugnax (mud fiddler crab), to explore how species interactions may influence burrowing behavior. We ran manipulative mesocosm experiments to assess potential effects of species interactions on the number and location of burrows as well as the burrowing behavior of the crabs. Overall, sand fiddler crabs dug more burrows on average than mud fiddlers across all experiments while mud fiddlers were choosier about the location and sediment type of their burrows, suggesting complementarity in burrowing between the two species. Burrow counts in heterospecific treatments suggest that neither species interfered with nor enhanced burrow creation by the other species. However, increased burrow occupancy by mud fiddlers in the presence of sand fiddlers and aggressive behavior by mud fiddlers toward sand fiddlers suggest that mud fiddler crabs may receive refuge benefits from sand fiddler crabs through antagonistic rather than facilitative interactions. Thus, species-specific habitat use and interspecific interactions are likely influencing the role each species plays as a burrower and marsh ecosystem engineer. • We conducted experiments to test the effects of species interactions on burrowing. • Sand fiddler dug more burrows than mud fiddler implying functional complementarity. • The mud fiddler was choosier about where it burrowed and stole sand fiddler burrows. • The species are complementary but also evidence for competition and niche overlap. [ABSTRACT FROM AUTHOR]

Background and Aims: Overweight and obesity increase risk for diabetes and cardiovascular disease, largely through development of insulin resistance. Benefits of dietary weight loss are documented for obese individuals with insulin resistance. Similar benefits have not been shown in overweight individuals. We sought to quantify whether dietary weight loss improves metabolic risk profile in overweight insulin-resistant individuals, and evaluated potential mediators between weight loss and metabolic response.Methods and Results: Healthy volunteers with BMI 25-29.9 kg/m2 underwent detailed metabolic phenotyping including insulin-mediated-glucose disposal, fasting/daylong glucose, insulin, triglycerides, FFA, and cholesterol. Subcutaneous fat biopsies were performed for measurement of adipose cell size. After 14 weeks of hypocaloric diet and 2 weeks of weight maintenance, cardiometabolic measures and biopsies were repeated. Changes in weight, % body fat, waist circumference, adipose cell size and FFA were evaluated as predictors of change in insulin resistance. Weight loss (4.3 kg) yielded significant improvements in insulin resistance and all cardiovascular risk markers except glucose, HDL-C, and LDL-C. Improvement in insulin sensitivity was greater among those with <2 vs >2 cardiovascular risk factors at baseline. Decrease in adipose cell size and waist circumference, but not weight or body fat, independently predicted improvement in insulin resistance.Conclusions: Weight loss yields metabolic health benefits in insulin-resistant overweight adults, even in the absence of classic cardiovascular risk factors. Weight loss-related improvement in insulin sensitivity may be mediated through changes in adipose cell size and/or central distribution of body fat. The insulin-resistant subgroup of overweight individuals should be identified and targeted for dietary weight loss.Clinical Trials Identifier: NCT00186459. [ABSTRACT FROM AUTHOR]

Growing coastal populations, rising sea levels, and likely increases in the frequency of major storm events will intensify coastal vulnerability in coming decades. Decisions regarding how and when to fortify estuarine shorelines against coastal hazards, such as erosion, flooding, and attendant property damages, rest largely in the hands of waterfront-property owners. Traditionally, hard engineered structures (e.g. bulkheads, revetments, seawalls) have been used to protect coastal properties, based on the assumption that these structures are durable and effective at preventing erosion. This study evaluates the validity of these assumptions by merging results from 689 surveys of waterfront-property owners in NC with empirical shoreline damage data collected along estuarine shorelines after Hurricanes Irene (2011) and Arthur (2014). The data show: 1) homeowners perceive bulkheads to be the most durable and effective at preventing erosion, but also the most costly; 2) compared to residents with revetments and natural shorelines, property owners with bulkheads reported double the price to repair hurricane damage to their property and four times the cost for annual shoreline maintenance; 3) 93% of evident post-hurricane shoreline damage was attributable to bulkheads or bulkhead hybrids and a higher proportion of surveyed homeowners with bulkheads reported having property damage from hurricanes; and, 4) shoreline hardening increased by 3.5% from 2011 to 2016 along 39 km of the Outer Banks. These results suggest that bulkheads are not meeting waterfront property-owner expectations despite continued use, and that nature-based coastal protection schemes may be able to more effectively align with homeowner needs. [ABSTRACT FROM AUTHOR]

We reviewed the oncological and functional outcomes of patients treated for a primary sarcoma possibly involving the knee joint and present an algorithm to guide treatment. The records of 76 patients who had a primary bone or soft tissue sarcoma possibly invading the knee between 1996 and 2012 were identified. Mean age and follow-up was 32 years (9–74) and 64 months (12–195), respectively. Patients were grouped according to the resection (Intra-articular [IAR] vs. Extra-articular [EAR] vs. Amputation/rotationplasty) for survival and functional outcomes. Overall 5 and 10 year survival was 61% and 53%, respectively. No differences in survival were found between the 3 groups (p = 0.55). Sixteen patients developed local recurrence with no difference between the groups. Mean MSTS score was 24.5 (12–30). Mean flexion at final follow-up was 106° (70–130°). We conclude that EAR of the knee allows for good oncologic and functional outcomes but with an increased risk of complications compared to IAR. Intra-operative assessment of joint involvement can be done in patients where joint infiltration by the tumour is not clear to avoid an unnecessary EAR. For chondrosarcoma patients with joint involvement, an EAR should be carefully considered because they present a significantly higher local recurrence risk. [ABSTRACT FROM AUTHOR]

The aim of this systematic review was to synthesise the study findings on whether GLP-1 secretion in response to a meal tolerance test is affected by the presence of type 2 diabetes (T2D). The influence of putative moderators such as age, sex, meal type, meal form, and assay type were also explored. A literature search identified 32 relevant studies. The sample mean and SD for fasting GLP-1 TOTAL and GLP-1 TOTAL iAUC were extracted and used to calculate between-group standardised mean differences (SMD), which were meta-analysed using a random-effects model to derive pooled estimates of Hedges' g and 95 % prediction intervals (PI). Pooled across 18 studies, the overall SMD in GLP-1 TOTAL iAUC between individuals with T2D (n = 270, 1047 ± 930 pmol·L−1·min) and individuals without T2D (n = 402, 1204 ± 937 pmol·L−1·min) was very small, not statistically significant and heterogenous across studies (g = −0.15, p = 0.43, PI: −1.53, 1.23). Subgroup analyses demonstrated an effect of assay type whereby Hedges' g for GLP-1 iAUC was greater in individuals with, versus those without T2D when using ELISA or Mesoscale (g = 0.67 [moderate], p = 0.009), but not when using RIA (g = −0.30 [small], p = 0.10). Pooled across 30 studies, the SMD in fasting GLP-1 TOTAL between individuals with T2D (n = 580, 16.2 ± 6.9 pmol·L−1) versus individuals without T2D (n = 1363, 12.4 ± 5.7 pmol·L−1) was small and heterogenous between studies (g = 0.24, p = 0.21, PI: −1.55, 2.02). Differences in fasting GLP-1 TOTAL and GLP-1 TOTAL iAUC between individuals with, versus those without T2D were generally small and inconsistent between studies. Factors influencing study heterogeneity such as small sample sizes and poor matching of groups may help to explain the wide prediction intervals observed. Considerations to improve comparisons of GLP-1 secretion in T2D and potential mediating factors more important than T2D diagnosis per se are outlined. PROSPERO ID: CRD42020195612. [Display omitted] • Small and inconsistent differences in fasting GLP-1 and GLP-1 iAUC were observed between individuals with and without T2D • GLP-1 iAUC was higher in T2D when using enzyme-linked immunoassays, but not radioimmunoassay • There was high heterogeneity between studies measuring GLP-1 secretion in individuals with, versus without T2D • Potential mediators (e.g. fat mass/intracellular fat) should be explored to understand the pathophysiology of the impaired T2D incretin response [ABSTRACT FROM AUTHOR]

Aims: Weight loss improves glycaemic control in type 2 diabetes mellitus (T2DM). However, as achieving and maintaining weight loss is difficult, alternative strategies are needed. Our primary aim was to investigate the effects of intermittent energy restriction (IER) compared to continuous energy restriction (CER) on glycated haemoglobin A1c (HbA1c). Secondary aims were to assess effects on weight loss, body composition, medication changes and subjective measures of appetite. Using a 2-day IER method, we expected equal improvements to HbA1c and weight in both groups.Method: Sixty-three overweight or obese participants (BMI 35.2±5kg/m2) with T2DM (HbA1c 7.4±1.3%) (57mmol/mol) were randomised to a 2-day severe energy restriction (1670-2500kJ/day) with 5days of habitual eating, compared to a moderate CER diet (5000-6500kJ/day) for 12weeks.Results: At 12weeks HbA1c (-0.7±0.9% P<0.001) and percent body weight reduction (-5.9±4% P<0.001) was similar in both groups with no group by time interaction. Similar reductions were also seen for medication dosages, all measures of body composition and subjective reports of appetite.Conclusions: In this pilot trial, 2days of IER compared with CER resulted in similar improvements in glycaemic control and weight reduction offering a suitable alternative treatment strategy. [ABSTRACT FROM AUTHOR]

Objectives: 'Nanny-state' accusations can function as powerful rhetorical weapons against interventions intended to promote public health. Public health advocates often lack effective rebuttals to these criticisms. Nanny-state accusations are largely accusations of paternalism. They conjure up emotive concern about undue governmental interference undermining peoples' autonomy. But autonomy can be understood in various ways. We outline three main conceptions of autonomy, argue that these that can underpin three different conceptions of paternalism, and consider implications for responses to nannystate accusations and the assessment of public health interventions. Study design and methods: Detailed conceptual analysis. Results: The conceptions of paternalism implicit in nanny-state accusations generally depend on libertarian conceptions of autonomy. These reflect unrealistic views of personal independence and do not discriminate sufficiently between trivial and important freedoms. Decisional conceptions of paternalism, like their underlying decisional conceptions of autonomy, have limited applicability in public health contexts. Relational conceptions of paternalism incorporate relational conceptions of autonomy, so recognize that personal autonomy depends on socially shaped skills, self-identities and self-evaluations as well as externally structured opportunities. They encourage attention to the various ways that social interactions and relationships, including disrespect, stigmatization and oppression, can undermine potential for autonomy. While nanny-state accusations target any interference with negative freedom, however trivial, relational conceptions direct concerns to those infringements of negative freedom, or absences of positive freedom, serious enough to undermine self-determination, self-governance and/or self-authorization. Conclusion: Relational conceptions of autonomy and paternalism offer public health policymakers and practitioners a means for rebutting nanny-state accusations, and can support more nuanced and more appropriately demanding appraisals of public health interventions. [ABSTRACT FROM AUTHOR]

Improvements in survival for patients with renal cell carcinoma have resulted in an increase in the burden of disease due to skeletal metastases, which are often solitary and resistant to radiotherapy. Surgical intervention remains a valid treatment to improve function and relieve pain, and replacement is able to achieve this and improve disease free implant survival. The aim of this study was identify prognostic factors for reconstruction survival of skeletal metastases in renal cell carcinoma and to characterise the nature of the reconstruction related complications. A retrospective analysis of all patients treated for metastatic renal cell carcinoma in three international bone tumour units between 2000 and 2014 identified 268 surgical interventions suitable for inclusion. Reconstruction survivorship was calculated using the Kaplan–Meier method whilst factors affecting reconstruction survival were assessed using Cox-regression multivariate analysis. Differences in proportions were assessed using Fisher's exact test. The overall rate of complications was 17%, which were classified as structural failure (7.1%), infection (4.9%) and tumour progression (3.7%). Endoprosthetic replacement when performed as the primary procedure demonstrate the best survivorship whilst factors associated with compromised reconstruction survival included previous surgical intervention and pre operative radiotherapy, and intralesional resection margins. We conclude that endoprosthetic replacement be considered as the index surgical intervention for skeletal metastases from renal cell carcinoma in certain locations as this carries the lowest incidence of complications. Revision of previous skeletal stabilisation, especially when combined with radiotherapy carries a high risk of complication, including infection, which often necessitates amputation. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: The local treatment option for pelvic Ewing sarcoma (ES) remains uncertain and challenging as surgery is often disabling while radiotherapy alone has a higher risk of local recurrence but not necessarily a worse survival. The aim is to analyse the outcome of patients with pelvic ES after radiotherapy as the primary local treatment in combination with a temporary intrapelvic surgically placed tissue expander (TE) to reduce bowel complications. Materials and methods: 20 patients were retrospectively analysed. All patients had neoadjuvant and adjuvant chemotherapy. We identified survival, time to develop local recurrence and metastasis, dose of radiotherapy administered, local complications related to the use of the tissue expander and bowel effects of radiotherapy. Results: The median follow-up was 41 months. 14 patients were stage IIb and six stage III. There were no problems after insertion of the TE and only one patient who developed mild diarrhoea. Local recurrence occurred in six patients. At the last follow-up 12 patients have died from sarcoma, five are disease free and three have had recurrent disease. Conclusions: In this paper we reviewed pelvic Ewing sarcoma with all the special considerations that this entails. We think that tissue expander can be safely used when radiotherapy is chosen to treat pelvic ES. It does appear to prevent bowel problems and is a low morbidity procedure. New treatment approaches should be considered to give a chance of cure to those patients with “bad prognostic” pelvic ES. [Copyright &y& Elsevier]

Cardiac allograft vasculopathy (CAV) is common in patients who have undergone orthotopic heart transplant (OHT) and is associated with significant morbidity and mortality. Non-invasive methods for identifying CAV are an appealing alternative to standard clinical practice of routine invasive angiography. We explored the association of CAV with incidental coronary artery calcium (CAC) from non-ECG gated, clinically indicated chest CT scans. This is a single-center, retrospective, observational study of OHT patients >1 year from transplant who underwent left heart catheterization between 2015 and 2019 and had a clinically indicated, non-ECG gated chest CT obtained for a variety of indications within 6 months of the catheterization. CAC was graded by a blinded reviewer in a semi-quantitative manner based on extent and distribution across the coronary tree. Angiographically significant CAV was obtained from left heart catheterizations results obtained per standard institutional protocol. 73 patients were included, 56 (77%) were male, mean age was 60±12 years and median time from heart transplant was 4 years [IQR 2, 8]. 34 patients (47%) were found to have CAC, of which 7 (21%) were found to have moderate or severe CAC. 38 patients (52%) were found to have CAV on angiography. In the CAC group, 25 were found to have CAV (74%). Of those with moderate to severe CAC, 7 (100%) were found to have CAV. In the no CAC group, 13 (33%) were found to have CAV. The presence of CAC had a sensitivity, specificity, positive predictive value and negative predictive value of 66%, 74%, 73%, and 67% respectively for the diagnosis of CAV. The absence of CAC on non-ECG gated CT demonstrated a moderate ability to rule out CAV, while moderate to severe CAC was strongly associated with CAV. As chest CT scans are common in this population, informing clinical decision making with this "free" information is potentially beneficial. [ABSTRACT FROM AUTHOR]

Abstract: We first used semipermeable membrane devices as samplers to evaluate concentrations of organochlorines and PAHs in the Brisbane River in 1998. Here we revisit this work and repeat the study a decade later in the same season (summer), also taking account of results from a similar study involving PAHs in the summer of 2001–2002. The accumulation of organochlorines and most PAHs in the samplers in the recent assessment was substantially less than in the 1998 deployment, suggesting that the ambient concentrations of these chemicals have decreased considerably over the last decade. In all cases there was high reproducibility of the mass of chemicals accumulated in the sampler. We used performance reference compounds in the later deployment, and assuming that the kinetics were similar in both deployment periods, we estimate that the concentration of dieldrin, the organochlorine found at highest concentrations, decreased from approximately 3.9ng/L to about 1.4ng/L. The decrease of most other analytes of interest including DDE and DDD was greater, potentially indicating that dieldrin is still entering the Brisbane River through run-off from urban areas where it was used widely for treatment of termites until 1995. DDT use in Australia ceased in the mid 1980s. [Copyright &y& Elsevier]

Teaching is, by its very nature, a scholarly activity. However, in the seventeen years since Boyer articulated teaching as a key domain of nursing scholarship, its full scholarly value has yet to be realized. The inherent nature of teaching scholarship is evidenced through mechanisms designed to build 'bridges of understanding'. Teaching scholarship then advances nursing scholarship by its impact on nursing practice. Recognizing teaching practices as scholarship also demonstrates pride in teaching. This article demonstrates the scholarship of daily educational practice by describing how reflections on the teaching-learning relationship, associated role changes, and time impact the 'bridges of understanding'. Theoretical frameworks of learning partnerships, learner-centered teaching, and critical inquiry are brought to life when described in terms of actual course activities. This, in turn, demonstrates how teaching advances nursing scholarship. [ABSTRACT FROM AUTHOR]

To investigate the associations between indices of bone health in childhood and corresponding parental measures. The Southampton Women's Survey characterised 12,583 non-pregnant women aged 20–34 years; 3158 subsequently had singleton live births. In a subset, dual-energy X-ray absorptiometry (DXA) measurements of bone area (BA), bone mineral content (BMC) and areal bone mineral density (aBMD) lumbar spine and total hip were obtained in the parent/offspring (aged 8–9 years) trios. Another subset of children (aged 6–7 years), and their parents, had peripheral quantitative computed tomography (pQCT; 4% and 38% tibia) measures. Using multivariable linear regression we examined relationships between mother/father and offspring, adjusting for parental age, habitual walking speed and education; offspring age and sex; and the corresponding bone measure in the other parent (β-coefficients (95%CI) unit/unit for each bone measure). Data were available for 260 trios with DXA and 99 with pQCT. There were positive associations for BA, BMC and aBMD between either parent and offspring. Mother-child associations were of greater magnitude than father-child; for example, mother-child aBMD (β = 0.26 g·cm−2/g·cm−2 (0.21,0.32)) and father-child aBMD (β = 0.16 g·cm−2/g·cm−2 (0.11,0.21)), P-difference in β = 0.007. In the subset with pQCT there was a positive association for mother-offspring 4% tibial total area (β = 0.33 mm2/mm2 (0.17,0.48)), but little evidence of a father-offspring association (β = −0.06 mm2/mm2 (−0.17,0.06)). In contrast offspring 38% cortical density was more strongly associated with this measure in fathers (β = 0.48 mg·cm−3/mg·cm−3 (0.15,0.82)) than mothers (β = 0.27 mg·cm−3/mg·cm−3 (−0.03,0.56)). In general mother-father differences were attenuated by adjustment for height. Whilst offspring bone measures are independently associated with those of either parent, the magnitude of the association is often greater for maternal than paternal relationships. These findings are consistent with an in utero influence on offspring growth but might also reflect genetic and/or epigenetic parent of origin effects. In an established parent-offspring cohort, associations between parent and offspring bone indices were generally greater in magnitude for mother-offspring than father-offspring relationships. • In the UK Southampton Women's Survey, we investigated parent-offspring associations for DXA and pQCT bone measures. • Offspring bone measures were independently associated with those from either parent with little difference by offspring sex. • The magnitude of parent-offspring DXA bone associations were often greater for mother-offspring than father-offspring. • Our findings are consistent with an in utero influence on offspring growth but might also reflect genetic/epigenetic effects. [ABSTRACT FROM AUTHOR]

Abstract: The eastern red bat (Lasiurus borealis) is a common, widespread species that occurs throughout eastern North America; however, information on potential differences in roost selection between sexes is limited. We studied summer diurnal roosting of adult red bats in a diverse forested landscape to: (1) characterize roosts of adult males and females, (2) determine habitat relationships for both sexes, and (3) compare roost selection between the sexes. We radiotracked 21 male and 20 female red bats to 142 roost locations and quantified roost characteristics. Both sexes roosted mostly in overstory hardwoods (82% of male and 81% of female roosts), but males occasionally (8% of roosts) roosted in sapling (<5cm diameter at breast height; dbh) whereas females did not. Females roosted at greater heights than males but, mean diameter and height of roost trees ≥5cm dbh did not differ between sexes; roosts trees used by both sexes were greater in diameter and height than random trees. We found no difference between sexes in tree species used for roosting; both sexes preferred to roost in white oaks (Quercus alba) and hickories (Carya spp.) but avoided Pines (Pinus spp.). Sex-specific habitat models created using an information-theoretic approach indicated males were more likely to roosts at sites with more midstory (5–10cm dbh) and small overstory (10–25cm dbh) hardwoods, taller hardwoods, shorter pines, and further from the nearest tree than random. Females were more likely to roost at sites with more midstory hardwoods, fewer small overstory pines (10–25cm dbh), and fewer understory (<5cm dbh) woody stems than random. Comparisons of mean habitat parameters surrounding roost sites indicated only distance to nearest tree differed (P <0.05) between sexes; females roosted further from the nearest tree than males. Ninety-five percent of male roosts and 92% of female roosts were in stands dominated by mature (≥50 years old) trees, and 45% of male roosts and 40% of female roosts were in stands that had been partially harvested 1–5 years earlier but retained mature overstory hardwoods. Retaining minimum basal areas of 1.1–2.3m2/ha of overstory hardwoods and retaining unharvested buffers along stream drains in harvested areas would likely provide adequate roosting habitat for both sexes of red bats in managed landscapes during summer. [Copyright &y& Elsevier]

Summary: Objective: This study examined the risk factors associated with middle ear disease in a cohort of Pacific 2-year-old children residing in New Zealand. Methods: The data were gathered as part of the Pacific Island Families: first 2 years of life (PIF) study in which 656 2-year-old were screened using tympanometry to identify children at risk for otitis media with effusion (OME) and other otological disorders. Results: Within this 2-year-old cohort of Pacific children, one set of factors significantly associated with OME was clustered around the respiratory and auditory health of the child over the past year. OME was more likely for children who were regularly suffering from fluid/pus discharge from ears (OR=2.10, 95% CI: 1.01–4.35), children with five or more coughs/colds in the last year (OR=1.90, 95% CI: 1.22–3.00), and children who frequently/constantly snored (OR=2.60, 95% CI: 1.09–6.23) to have OME. Those children who were treated at home for breathing problems were more that two times more likely to have OME (OR=2.61, 95% CI: 1.55–4.42). A second set of factors was clustered around environmental risks that exposed children to a large number of other children. Children who attended a day care centre for more than 20h were five times more likely (OR=5.21, 95% CI: 2.90–9.35) and those who regularly attended church (OR=2.78, 95% CI: 1.05–7.40) were almost three times more likely to have OME. Conclusions: These findings portray a child compromised by persistent ear infections and general coughs and colds as being at increased risk of contracting OME. In line with international research these findings raise questions about the negative child health effects associated with the day care environment for young children. [Copyright &y& Elsevier]

Summary: Objective: The aim of this study was to determine the prevalence of chronic middle ear disease in 2-year-old Pacific children living in New Zealand. Methods: The data were gathered as part of the Pacific Islands Families: First Two Years of Life (PIF) Study in which 1001 two year olds were screened using tympanometry to identify children at risk for otitis media with effusion (OME) and other otological disorders. Those failing the screening tests were referred to Manukau Superclinic where they had a further tympanometry test, and if they failed this test, were followed up with a comprehensive otological examination by an otolaryngologist using otomicroscopy and pneumatic otoscopy. Results: Bilateral otitis media with effusion (OME) was the most common abnormality detected (N =102) with further cases of unilateral OME (N =8), and unilateral OME resolving (N =2). Other cases of OME were associated with acute otitis media (AOM), impacted wax (N =1), perforation (N =1), and mild retraction (N =2). Overall there were 118 children with unilateral or bilateral OME. AOM of any form was seen in nine cases. Retraction of the tympanic membrane was seen in 26 cases. The population prevalence among Pacific 2-year-old children was estimated as 25.4% for OME, 1.9% for AOM, and 26.9% for OME or AOM. Conclusions: These findings reveal that over 25% of Pacific Island 2-year-old were affected by OME and recommend the consideration of national screening for OME and other otological disorders at this earlier age. [Copyright &y& Elsevier]

Rapid human development in coastal areas is introducing significant amounts of novel habitat and leading to widespread habitat simplification. To predict how species will respond to these changes, it is important to understand how organisms interact with novel habitats versus naturally existing habitats. In this study, we used traditional fish sampling gear (fyke nets and minnow traps) and a Dual-Frequency Identification Sonar (DIDSON) to conduct fish surveys along natural and modified estuarine shorelines in North Carolina, USA. The overall objective of our study was to investigate how fish abundance and other community metrics change as a function of shoreline type (natural marsh, living shoreline, or bulkhead), sampling location (marsh platform or the shallow subtidal area offshore of the structure), and time of day (day or night). Using fyke nets, we caught significantly more fish and recorded higher species richness on the marsh platform at living shorelines versus natural marsh shorelines. However, we found no significant differences in fish abundance in the shallow unvegetated habitats seaward of the different shoreline types, which may have been affected by low sampling efficiency and replication when sampled using minnow traps and the DIDSON. Our findings, in conjunction with similar studies, may reflect a localized shoreline effect where the nursery enhancement observed at living shoreline sites is restricted to the living component of the shoreline (i.e., the marsh). Additionally, the preliminary results from our limited daytime versus nighttime DIDSON sampling show no significant differences in fish detections. This contrasts with many previous studies using traditional fish sampling techniques that report substantially higher fish catches at night. This unexpected finding is worthy of additional research as it may suggest that traditional fish sampling techniques are underestimating fish abundances during the day, perhaps due to visual gear avoidance. Ultimately, a careful consideration of the social and ecological goals of any shoreline stabilization project is needed before choosing a final design; however, maximizing habitat restoration and limiting the use of artificial materials is likely to confer the greatest ecological benefit. • Living shorelines have high fish abundances and species richness. • Fish abundances are enhanced behind the sill structure but not in front of the sill. • Preliminary DIDSON surveys reveal no differences in fish detections between day and night. • DIDSON may be a powerful tool for investigating diel patterns in fish use. [ABSTRACT FROM AUTHOR]

The article offers information on Teen Cuisine, a cooking-based curriculum designed by Virginia youth development program 4-H and Family and Nutrition Program which aim to promote healthy eating habit youth. Topics discussed include the requirement to teach cooking skills and food preparation from 8th-10th grade to prevent obesity, the aspects of the lessons included in the curriculum, and the various skill-building activities associated with the program.