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Coastal and ocean management in the United States is a complex issue requiring an equally complex management policy. Federal policy has historically been carried out in a siloed (sector-by-sector) fashion causing inefficient and bureaucratic management by federal agencies. The Obama administration took a novel approach to coastal and ocean management by signing an executive order that brought together federal agencies and empowered regional stakeholders, creating a first of its kind comprehensive National Ocean Policy. In 2018, former President Donald Trump rescinded the Obama-era policy and enacted his own version of National Ocean Policy that shifted authority to the states and focused on the economic potential of American waters. This research addresses a significant challenge in federal management of a complex natural resource. Here we identify common management strategies between different administrations to provide insights for future attempts at National Ocean Policy. We collect policy documents, press releases, and congressional testimony from high-level stakeholders and identified the most common themes over a 12-year period from 2009-2021. We find three common themes between the administrations even though their policies varied in strategy and scope: 1) the importance of a strong and enduring marine economy, 2) creating a strategic and efficient ocean policy, and 3) devolving authority from the federal government to state and regional decision-makers. We argue that coastal and ocean management via executive order is too easily rescinded to have a lasting impact. These novel findings highlight potential strategies for bipartisan cooperation in future attempts at National Ocean Policy.

Tropical forests store more than half of the world's terrestrial carbon (C) pool and account for one-third of global net primary productivity (NPP). Many terrestrial biosphere models (TBMs) estimate increased productivity in tropical forests throughout the 21st century due to CO2 fertilization. However, phosphorus (P) limitations on vegetation photosynthesis and productivity could significantly reduce the CO2 fertilization effect. Here, we used a carbon-nitrogen-phosphorus coupled model (Dynamic Land Ecosystem Model; DLEM-CNP) with heterogeneous maximum carboxylation rates to examine how P limitation has affected C fluxes in tropical forests during 1860–2018. Our model results showed that the inclusion of the P processes enhanced model performance in simulating ecosystem productivity. We further compared the simulations from DLEM-CNP, DLEM-CN, and DLEM-C and the results showed that the inclusion of P processes reduced the CO2 fertilization effect on gross primary production (GPP) by 25% and 45%, and net ecosystem production (NEP) by 28% and 41%, respectively, relative to CN-only and C-only models. From the 1860s to the 2010s, the DLEM-CNP estimated that in tropical forests GPP increased by 17%, plant respiration (Ra) increased by 18%, ecosystem respiration (Rh) increased by 13%, NEP increased by 121% per unit area, respectively. Additionally, factorial experiments with DLEM-CNP showed that the enhanced NPP benefiting from the CO2 fertilization effect had been offset by 135% due to deforestation from the 1860s to the 2010s. Our study highlights the importance of P limitation on the C cycle and the weakened CO2 fertilization effect resulting from P limitation in tropical forests.

Abstract Background While prior Micra trials demonstrated a high implant success rate and favorable safety and efficacy results, changes in implant populations and safety over time is not well studied. The objective of this analysis was to report the performance of Micra in European and Middle Eastern patients and compare to the Micra Investigational Device Exemption (IDE) and Micra Post Approval Registry (PAR) studies. Methods The prospective, single‐arm Micra Acute Performance European and Middle Eastern (MAP EMEA) registry was designed to further study the performance of Micra in patients from EMEA. The primary endpoint was to characterize acute (30‐day) major complications. Electrical performance was analyzed. The major complication rate through 12 months was compared with the IDE and PAR studies. Results The MAP EMEA cohort (n = 928 patients) had an implant success rate of 99.9% and were followed for an average of 9.7 ± 6.5 months. Compared to prior studies, MAP EMEA patients were more likely to have undergone dialysis and have a condition which precluded the use of a transvenous pacemaker (p

IntroductionFor drug resistant epilepsy patients who are either not candidates for resective surgery or have already failed resective surgery, neuromodulation is a promising option. Neuromodulatory approaches include responsive neurostimulation (RNS), deep brain stimulation (DBS), and vagal nerve stimulation (VNS). Thalamocortical circuits are involved in both generalized and focal onset seizures. This paper explores the use of RNS in the centromedian nucleus of the thalamus (CMN) and in the anterior thalamic nucleus (ANT) of patients with drug resistant epilepsy.MethodsThis is a retrospective multicenter study from seven different epilepsy centers in the United States. Patients that had unilateral or bilateral thalamic RNS leads implanted in the CMN or ANT for at least 6 months were included. Primary objectives were to describe the implant location and determine changes in the frequency of disabling seizures at 6 months, 1 year, 2 years, and > 2 years. Secondary objectives included documenting seizure free periods, anti-seizure medication regimen changes, stimulation side effects, and serious adverse events. In addition, the global clinical impression scale was completed.ResultsTwelve patients had at least one lead placed in the CMN, and 13 had at least one lead placed in the ANT. The median baseline seizure frequency was 15 per month. Overall, the median seizure reduction was 33% at 6 months, 55% at 1 year, 65% at 2 years, and 74% at >2 years. Seizure free intervals of at least 3 months occurred in nine patients. Most patients (60%, 15/25) did not have a change in anti-seizure medications post RNS placement. Two serious adverse events were recorded, one related to RNS implantation. Lastly, overall functioning seemed to improve with 88% showing improvement on the global clinical impression scale.DiscussionMeaningful seizure reduction was observed in patients who suffer from drug resistant epilepsy with unilateral or bilateral RNS in either the ANT or CMN of the thalamus. Most patients remained on their pre-operative anti-seizure medication regimen. The device was well tolerated with few side effects. There were rare serious adverse events. Most patients showed an improvement in global clinical impression scores.

Abstract Background and aims Many patients with intracerebral hemorrhage (ICH) develop intraventricular hemorrhage (IVH), which is associated with higher mortality and worse clinical outcome. External ventricular drains (EVDs) are often placed, but there is little data on how much patients benefit from this intervention. We explored the use, timing, and location of EVD in ICH patients and any association with clinical outcome. Results During the study period, 2870 patients presented with primary ICH, and 2486 were included in analyses. Overall, patients were 73 (± 13) years old; 54% were male, and 46% had associated IVH. An EVD was placed in 29% of patients with IVH and 4% of those without. IVH patients with EVD were younger (67 ± 13 vs 74 ± 13, p

Abstract Background and aim Early diagnosis and treatment of intracerebral hemorrhage (ICH) is thought to be critical for improving outcomes. We examined whether racial or ethnic disparities exist in acute care processes in the first hours after ICH. Methods We performed a retrospective review of a prospectively collected cohort of consecutive patients with spontaneous primary ICH presenting to a single urban tertiary care center. Acute care processes studied included time to computerized tomography (CT) scan, time from CT to inpatient bed request, and time from bed request to hospital admission. Clinical outcomes included mortality, Glasgow Outcome Scale, and modified Rankin Scale. Results Four hundred fifty-nine patients presented with ICH between 2006 and 2018 and met inclusion criteria (55% male; 75% non-Hispanic White [NHW]; mean age of 73). In minutes, median time to CT was 43 (interquartile range [IQR] 28, 83), time to bed request was 62 (IQR 33, 114), and time to admission was 142 (IQR 95, 232). In a multivariable analysis controlling for demographic factors, clinical factors, and disease severity, race/ethnicity had no effect on acute care processes. English language, however, was independently associated with slower times to CT (β = 30.7 min, 95% CI 9.9 to 51.4, p = 0.004) and to bed request (β = 32.8 min, 95% CI 5.5 to 60.0, p = 0.02). Race/ethnicity and English language were not independently associated with worse outcome. Conclusions We found no evidence of racial/ethnic disparities in acute care processes or outcomes in ICH. English as first language, however, was associated with slower care processes.

Mycoplasma bovis is 1 of several bacterial pathogens associated with pneumonia in cattle. Its role in pneumonia of free-ranging ungulates has not been established. Over a 3-month period in early 2019, »60 free-ranging pronghorn with signs of respiratory disease died in northeast Wyoming, USA. A consistent finding in submitted carcasses was severe fibrinosuppurative pleuropneumonia and detection of M. bovis by PCR and immunohistochemical analysis. Multilocus sequence typing of isolates from 4 animals revealed that all have a deletion in 1 of the target genes, adh-1. A retrospective survey by PCR and immunohistochemical analysis of paraffin-embedded lung from 20 pronghorn that died with and without pneumonia during 2007–2018 yielded negative results. These findings indicate that a distinct strain of M. bovis was associated with fatal pneumonia in this group of pronghorn.

Abstract Phytomining is suggested as a technology to obtain platinum group metals (PGMs) nanoparticles from plants grown on the mineralized soils or tailings. Samples from North American Palladium (Canada) and gossans from Broken Hill (BH) (Australia) were studied to assess the possibility of using these PGM-rich samples as substrates for phytomining. The bioavailability of PGMs was indirectly assessed using geochemical procedures. The selective extractions showed that the highest available concentration of Pd is 5.38 ppm in BH gossan 1. The extraction of PGMs by ammonium acetate, fulvic acid or citrate-dithionite indicates natural availability to plants. The BH gossan 1 was the best of the five studied samples for phytomining of Pd due to available Pd concentration (> 2 mg/kg), low Electric Conductivity (< 2dS/m), high CEC (Cation Exchange Capacity) (38.8 meq/100g), and proper pH (6.5). Cu-tolerant plant species should be chosen to grow on BH gossan 1. A criterium for choosing substrates for phytomining of Pd was developed comprising various classical soil parameters plus selective extraction procedures.

This article explores the concept of generating a porous anodic layer on the surface of a metallic component to host a phase change material (PCM) aiming to reduce the peak temperatures that the host structure will experience. The conditions to fabricate a porous anodic layer on top of an aluminum substrate were determined through varying anodization conditions: solution concentration, voltage employed, and anodization times. Pore sizes were characterized using scanning electron microscopy. The alkane n-eicosane was selected as PCM, introduced within the porous anodic annealed layer using vacuum impregnation and the thin film composite structure sealed. Epoxy resin and a metallic paste were tested as sealants. Thermal tests were performed to compare the behavior of aluminum alloy substrates anodized and sealed with and without PCM. The results showed pores with diameters in the 5–85 nm range, with average values that increased as the time of anodization was extended. The aluminum alloy impregnated with n-eicosane presents lowered surface peak temperatures during heating cycles than the samples that were only anodized or than the base alloy, demonstrating the potential of PCM incorporated in the superficial microstructure of anodic structures to manage, to a certain extent, peak transient thermal loads.

Background. The primary environmental risk associated with artisanal small-scale gold mining (ASGM) activities in Sekotong and Taliwang is waste discharged directly into the environment. This waste contains variable concentrations of heavy metals and a high level of mercury. When these elements are released into the environment, plants and animals can be contaminated. If mercury is methylated to methylmercury, levels can increase in concentration at each level of the food chain (biomagnify). Fish are a primary risk vector for methylmercury poisoning in humans, and represent a significant source of protein for the Sekotong and Taliwang communities. Objectives. The present study aimed to identify the concentration of mercury in fish from ASGM sites in Sekotong and Taliwang. Methods. Descriptive research was used to describe the mercury concentrations of fish in the present study. The fish species collected for the samples represented commercially available fish most commonly consumed by the community on a daily basis. Results. In Sekotong's ASGM area, the mercury concentration in Pilsbryoconcha exilis tissue was 596 ppb, 721 ppb for Sephia officinalis and 50% of the Euthynnus affinis samples had a high level of mercury, above the World Health Organization (WHO) maximum permissable limit for the sale of fish for human consumption of 0.5 ppb. Conclusions. Some fish species from the studied ASGM sites had high mercury concentrations above the maximum permissible mercury concentration in edible fish tissue. The risks associated with mercury exposure from fish consumption threaten community health. Ethics Approval. All experiments were performed in accordance with relevant local guidelines and regulations. Competing Interests. The authors declare no competing financial interests.

Along the U.S. West Coast, sustainable manage­ment has rebuilt fish stocks, providing an oppor­tunity to supply nutrient-rich food to adjacent coastal communities where food insecurity and diet-based diseases are common. However, the market has not successfully supplied locally sourced seafood to nutritionally vulnerable people. Rather, a few organizations make this connection on a limited scale. We used a “positive deviant” approach to learn how these organizations’ efforts developed, how they overcame challenges, and what conditions enabled their interventions. We found that organizations in these positive deviant cases provided fish from a wide variety of species and sources, and distributed them through different channels to a diversity of end consumers. A key factor facilitating success was the ability to negotiate a price point that was both profitable and reasonable for organizations supplying nutritionally vulnerable or low-income consumers. Further­more, securing access to grants overcame initial costs of establishing new supply channels. All cases highlighted the importance of individual cham­pi­ons who encouraged development and cultural connections between the initiative and the nearby community. Organizations overcame key chal­lenges by establishing regulations governing these new channels and either using partnerships or vertically integrating to reduce costs associated with processing and transport. Oftentimes training and education were also critical to instruct workers on how to process unfamiliar fish and to increase consumer awareness of local fish and how to pre­pare them. These lessons illuminate pathways to improve the contribution of local seafood to the healthy food system.

This article describes the radiation facilities and associated sample preparation, management, and analysis equipment currently in place at the Dalton Cumbrian Facility, a facility which opened in 2011 to support the UK’s nuclear industry. Examples of measurements performed using these facilities are presented to illustrate their versatility and the breadth of research they make possible. Results are presented from research which furthers our understanding of radiation damage to polymeric materials, radiolytic yield of gaseous products in situations relevant to nuclear materials, radiation chemistry in light water reactor cooling systems, material chemistry relevant to immobilization of nuclear waste, and radiation-induced corrosion of fuel cladding elements. Applications of radiation chemistry relevant to health care are also described. Research concerning the mechanisms of radioprotection by dietary carotenoids is reported. An ongoing open-labware project to develop a suite of modular sample handling components suited to radiation research is described, as is the development of a new neutron source able to provide directional beams of neutrons.

As debates over the value and effectiveness of online courses continue, more research is needed to assist in identifying predictors of positive student outcomes in online courses. Building from previous research in Feedback Intervention Theory (Kluger & DeNisi, 1996) and the Community of Inquiry framework (Anderson, Rourke, Garrison, & Archer, 2001; Garrison, Anderson, & Archer, 1999), this study sought to identify predictors of student motivation toward online courses. Results from a hierarchical multiple regression, using data from 170 online undergraduate students, suggest that student predisposition to receiving instructor feedback and student perceptions of teaching presence provide strong prediction of student motivation toward online courses.

DOI: 10.17014/ijog.v1i1.171New technology is needed to protect the safety and health of communities and the environment at ASGM locations in Indonesia. This technology must be simple, cheap, easy to operate, and financially rewarding. A proven option that should be promoted is phytoextraction, a farming activity that could develop agriculture as an alternative livelihood in ASGM areas. This is a technology where plants are used to extract metals from waste rock, soil, or water. These metals can be recovered from the plant in its pure form, then be sold or recycled. Gold phytoextraction is a commercially available technology, while an international research has shown that phytoextraction will also work for mercury. In the context of this idea, tailings would be contained in ‘farming areas’ and cropped using phytoextraction technology. Gold and mercury would be extracted in the crops, with the remaining mercury burden of the tailings becoming adsorbed to soil constituents. The system would be financially rewarding to ‘gold farmers’. The economic value of this scenario could facilitate the clean-up and management of mercury pollution, reducing the movement of mercury from tailings into soil, water, and plants, thereby mitigating environmental and human risk in the mining areas. The goal of the described research is to promote agriculture as an alternative livelihood in ASGM areas. The gold value of the phytoremediation crop should provide a cash incentive to artisanal farmers who develop this new agricultural enterprise. The benefits will be social, environmental, and economic, as opportunities for education, employment, new business, the containment of toxic mercury, food safety and security, and revenue are all realized.

The rumen microbial community in dairy cows plays a critical role in efficient milk production. However, there is a lack of data comparing the composition of the rumen bacterial community of the main dairy breeds. This study utilizes 16S rRNA gene sequencing to describe the rumen bacterial community composition in Holstein and Jersey cows fed the same diet by sampling the rumen microbiota via the rumen cannula (Holstein cows) or esophageal tubing (both Holstein and Jersey cows). After collection of the rumen sample via esophageal tubing, particles attached to the strainer were added to the sample to ensure representative sampling of both the liquid and solid fraction of the rumen contents. Alpha diversity metrics, Chao1 and observed OTUs estimates, displayed higher (P = 0.02) bacterial richness in Holstein compared to Jersey cows and no difference (P > 0.70) in bacterial community richness due to sampling method. The principal coordinate analysis displayed distinct clustering of bacterial communities by breed suggesting that Holstein and Jersey cows harbor different rumen bacterial communities. Family level classification of most abundant (> 1%) differential OTUs displayed that OTUs from the bacterial families Lachnospiraceae and p-2534-18B5 to be predominant in Holstein cows compared to Jersey cows. Additionally, OTUs belonging to family Prevotellaceae were deferentially abundant in the two breeds. Overall, the results from this study suggest that the bacterial community between Holstein and Jersey cows differ and that esophageal tubing with collection of feed particles associated with the strainer provides a representative rumen sample similar to a sample collected via the rumen cannula. Thus, in future studies esophageal tubing with addition of retained particles can be used to collect rumen samples reducing the cost of cannulation and increasing the number of animals used in microbiome investigations, thus increasing the statistical power of rumen microbial community evaluations.

In Indonesia, amount of biodiversity could be found including soil microorganism which were useful for sustainable agriculture. Everything lives in agricultural land were interacts and influences each others. Many factors of biotic and a-biotic environment such as land and climate fluctuation influences microbial expansion within the soils. For example arbuscular mycorrhiza (AM) which was formed by myches (fungus) and root of higher plant maybe fluctuated in the expansion due to the soil tillage. Land management and the present higher plant affected its growth and expansion. Mycorrhizae spores as one of the important generative form of various species in the difference host plant. The implication of different host plant often close related to the soil management and properties. Soil sample that was collected from various host plant in the fields or bare land have been found varied spores. Andisols and its properties conserve higher organic matter relatively and developed in the cold temperature, therefore very suitable for AM expansion and also as natural resources stock of AM potentially.

The authors explore the uncertainty implied in the estimation of changes in flood frequency due to climate change at the basins of the Cedar River and Skunk River in Iowa, United States. The study focuses on the influence of climate change on the 100-year flood, used broadly as a reference flow for civil engineering design. Downscaled rainfall projections between 1960–2099 were used as forcing into a hydrological model for producing discharge projections at locations intersecting vulnerable transportation infrastructure. The annual maxima of the discharge projections were used to conduct flood frequency analyses over the periods 1960–2009 and 1960–2099. The analysis of the period 1960–2009 is a good predictor of the observed flood values for return periods between 2 and 200 years in the studied basins. The findings show that projected flood values could increase significantly in both basins. Between 2009 and 2099, 100-year flood could increase between 47% and 52% in Cedar River, and between 25% and 34% in South Skunk River. The study supports a recommendation for assessing vulnerability of infrastructure to climate change, and implementation of better resiliency and hydraulic design practices. It is recommended that engineers update existing design standards to account for climate change by using the upper-limit confidence interval of the flood frequency analyses that are currently in place.

A hydride-generation atomic absorption spectroscopy (AAS) method was developed for the analysis of total Hg in liquid matrices of mercury-rich plants and mine tailings samples. The detection limit for this method was as low as 11.4 ng/mL. The reproducibility of the mercury signals (in terms of relative standard deviation) was 4.6%. Accuracy of the method was verified by analyses of deionised water samples spiked with HgCl2 and HgNO3. Recovery values for total mercury ranged from 88.5 to 94.3% for both mercury species added. An external certified laboratory validated the analytical method with a maximum discrepancy of 15 %. Optimal analytical response of the equipment for Hg analysis of plant samples was achieved when the sample volume added to the reaction vessel was 0.25 mL.Um protocolo para análise do mercúrio (Hg) em amostras líquidas de solo e tecidos vegetais enriquecidos com Hg foi desenvolvido com base na técnica de geração de hidretos. O limite de detecção para este método foi de 11.4 ng/mL. A reproducibilidade do método (calculado com base no desvio padrão relativo) foi de 4.6%. A precisão do método foi verificada pela análise de amostras de água deionizada contendo HgCl2 and HgNO3. Os valores de mercúrio total recuperados variaram de 88.5 a 94.3% para ambas as espécies testadas. O método analítico foi validado por um laboratório externo certificado com discrepância máxima de 15 %. O desempenho analítico do equipamento para análise do mercúrio em tecidos vegetais foi considerado ótimo para volumes de amostra de até 0.25 mL.

Abstract Introduction At the Medical College of Wisconsin, geriatricians, nephrologists, and medical educators worked together to create and implement a geriatric nephrology objective structured clinical examination (OSCE) for nephrology fellows. Key curriculum content gaps (pathophysiology of the aging kidney, medication and renal dosing, and renal toxicity in elderly patients) were identified through a needs assessment including ACGME nephrology requirements, nephrology fellows' in-service exam scores, survey of fellows and faculty to identify areas of perceived weakness, literature review, and brief multiple-choice questions of basic science linked to clinical case questions. Methods Curriculum content was delivered using the OSCE educational method. The curriculum session highlighted kidney injury and pharmacology topics: drug toxicity and underlying science through an OSCE session with postsession debriefing provided by faculty. Fellows were evaluated by faculty using a checklist, and fellows evaluated the session prior to the end. Results The OSCE curriculum session (N = 6) showed strong learner evaluations (1 = poor, 7 = excellent), including “Session objectives were clearly stated and accomplished” = 6.8, “Feedback provided in debriefing will improve my ability to care for geriatric patients” = 5.8, and “Overall effectiveness of session in improving my ability to care for geriatric patients” = 6.5. Discussion Fellow performance from the OSCE rater checklists completed by faculty and standardized patients showed the fellows' extent of completion/inclusion of OSCE elements to range between 69% and 80% complete. The program director identified a discrepancy between fellows' knowledge and some communication skills in summarizing the information and providing closure to the session. The ability of the OSCE to provide direct observation of the fellows' performance was highly valued by the program director and has led to further adjustments in teaching and assessment over time.

Tropical forests store large amounts of carbon in tree biomass, although the environmental controls on forest carbon stocks remain poorly resolved. Emerging airborne remote sensing techniques offer a powerful approach to understand how aboveground carbon density (ACD) varies across tropical landscapes. In this study, we evaluate the accuracy of the Carnegie Airborne Observatory (CAO) Light Detection and Ranging (LiDAR) system to detect top-of-canopy tree height (TCH) and ACD across the Osa Peninsula, Costa Rica. LiDAR and field-estimated TCH and ACD were highly correlated across a wide range of forest ages and types. Top-of-canopy height (TCH) reached 67 m, and ACD surpassed 225 Mg C ha-1, indicating both that airborne CAO LiDAR-based estimates of ACD are accurate in tall, high-biomass forests and that the Osa Peninsula harbors some of the most carbon-rich forests in the Neotropics. We also examined the relative influence of lithologic, topoedaphic and climatic factors on regional patterns in ACD, which are known to influence ACD by regulating forest productivity and turnover. Analyses revealed a spatially nested set of factors controlling ACD patterns, with geologic variation explaining up to 16% of the mapped ACD variation at the regional scale, while local variation in topographic slope explained an additional 18%. Lithologic and topoedaphic factors also explained more ACD variation at 30-m than at 100-m spatial resolution, suggesting that environmental filtering depends on the spatial scale of terrain variation. Our result indicate that patterns in ACD are partially controlled by spatial variation in geologic history and geomorphic processes underpinning topographic diversity across landscapes. ACD also exhibited spatial autocorrelation, which may reflect biological processes that influence ACD, such as the assembly of species or phenotypes across the landscape, but additional research is needed to resolve how abiotic and biotic factors contribute to ACD variation across high biomass, high diversity tropical landscapes.

This article presents an annotated English translation of the composer-theologian Dieter Schnebel’s seminal essay exploring music’s spiritual capacities. Speaking explicitly from his time and place, Schnebel considers compositional questions arising from the most advanced new music of European modernism. The approach is driven by insights derived from Marxist critical theory and the “new theology” associated with Bonhoeffer, Bultmann, and others. Acknowledging the secularized, religionless society Bonhoeffer had predicted in 1944, Schnebel argues that an authentic geistliche Musik has always been one driven by a secularizing dynamic, pressing beyond the walls of the church to engage a broken world of injustice and suffering. For him, the experimental avant-garde is fertile ground, since a music of the Spirit is a new, non-conformist music engaged in renewal. A translator’s introduction analyzes briefly the major components of Schnebel’s thought.

As the proportion of adults with obesity continues to climb, so too does the need for total knee arthroplasty. Unfortunately, total knee replacement patients often experience post-operative weight gain, despite improved joint function. The purposes of this study were: 1) To execute a literature meta-analysis in order quantify the changes in body mass that are typically observed following TKA, and 2) Evaluate data from a prospective, multicenter study to assess any trends towards weight loss in a group of “balanced”, sensor-assisted TKA patients. The literature review found that average proportion of patients who had weight gain after TKA is 47% to 66%. In literature, the average post-operative weight gain was 9.5 lbs. (1.6 kg/m2 BMI increase), up to 14 lbs. (2.3 kg/m2). In the multicenter study, only 30.4% of patients and 36.9% of patients exhibited weight gain at 6 months and 1 year, respectively. At the 1-year interval, this indicates an 11% decrease from reported averages (p=0.049), up to 29% as reported by the NIH (p

Accurate and spatially-explicit maps of tropical forest carbon stocks are needed to implement carbon offset mechanisms such as REDD+ (Reduced Deforestation and Degradation Plus). The Random Forest machine learning algorithm may aid carbon mapping applications using remotely-sensed data. However, Random Forest has never been compared to traditional and potentially more reliable techniques such as regionally stratified sampling and upscaling, and it has rarely been employed with spatial data. Here, we evaluated the performance of Random Forest in upscaling airborne LiDAR (Light Detection and Ranging)-based carbon estimates compared to the stratification approach over a 16-million hectare focal area of the Western Amazon. We considered two runs of Random Forest, both with and without spatial contextual modeling by including--in the latter case--x, and y position directly in the model. In each case, we set aside 8 million hectares (i.e., half of the focal area) for validation; this rigorous test of Random Forest went above and beyond the internal validation normally compiled by the algorithm (i.e., called "out-of-bag"), which proved insufficient for this spatial application. In this heterogeneous region of Northern Peru, the model with spatial context was the best preforming run of Random Forest, and explained 59% of LiDAR-based carbon estimates within the validation area, compared to 37% for stratification or 43% by Random Forest without spatial context. With the 60% improvement in explained variation, RMSE against validation LiDAR samples improved from 33 to 26 Mg C ha(-1) when using Random Forest with spatial context. Our results suggest that spatial context should be considered when using Random Forest, and that doing so may result in substantially improved carbon stock modeling for purposes of climate change mitigation.

The muscular anatomy of the athecate hydroid Podocoryna carnea hydrorhiza is elucidated. The polyp-stolon junction is characterized by an opening, here called the chloe, in the otherwise continuous hydrorhizal perisarc. The chloe is elliptical when the polyp first arises, but takes on a more complex outline as multiple stolons anastomose to communicate with that polyp. Surrounding the polyp base are spots, here called anchors, which autofluoresce at the same wavelengths as perisarc and which, like perisarc, contain chitin as assessed by Calcofluor White, Congo Red and wheat germ agglutinin staining. Anchors remain after living tissues are digested using KOH. Collagen IV staining indicates that the mesoglea is pegged to the anchors and rhodamine phallodin staining detects cytoskeletal F-actin fibers of the basal epidermis surrounding the anchors. Longitudinal muscle fibers of the polyp broaden at the polyp base and are inserted into the mesoglea of the underlying stolon, but were neither observed to extend along the stolonal axis nor to attach to the anchors. Circular muscular fibers of the polyp extend into stolons as a dense collection of strands running along the proximal-distal axis of the stolon. These gastrodermal axial muscular fibers extend to the stolon tip. Epidermal cells at the stolon tip and the polyp bud display a regular apical latticework of F-actin staining. A similar meshwork of F-actin staining was found in the extreme basal epidermis of all stolons. Immunohistochemical staining for tubulin revealed nerves at stolon tips, but at no other hydrorhizal locations. These studies bear on the mechanisms by which the stolon tip and polyp bud pulsate, the manner in which the stolon lumen closes, and on the developmental origin of the basal epidermis of the hydrorhiza.

Canopy gaps express the time-integrated effects of tree failure and mortality as well as regrowth and succession in tropical forests. Quantifying the size and spatial distribution of canopy gaps is requisite to modeling forest functional processes ranging from carbon fluxes to species interactions and biological diversity. Using high-resolution airborne Light Detection and Ranging (LiDAR), we mapped and analyzed 5,877,937 static canopy gaps throughout 125,581 ha of lowland Amazonian forest in Peru. Our LiDAR sampling covered a wide range of forest physiognomies across contrasting geologic and topographic conditions, and on depositional floodplain and erosional terra firme substrates. We used the scaling exponent of the Zeta distribution (λ) as a metric to quantify and compare the negative relationship between canopy gap frequency and size across sites. Despite variable canopy height and forest type, values of λ were highly conservative (λ mean = 1.83, s = 0.09), and little variation was observed regionally among geologic substrates and forest types, or at the landscape level comparing depositional-floodplain and erosional terra firme landscapes. λ-values less than 2.0 indicate that these forests are subjected to large gaps that reset carbon stocks when they occur. Consistency of λ-values strongly suggests similarity in the mechanisms of canopy failure across a diverse array of lowland forests in southwestern Amazonia.

BACKGROUND: A multicenter study was conducted to evaluate the diagnostic accuracy (sensitivity and specificity) of the Verigene Gram-Positive Blood Culture Test (BC-GP) test to identify 12 Gram-positive bacterial gene targets and three genetic resistance determinants directly from positive blood culture broths containing Gram-positive bacteria. METHODS AND FINDINGS: 1,252 blood cultures containing Gram-positive bacteria were prospectively collected and tested at five clinical centers between April, 2011 and January, 2012. An additional 387 contrived blood cultures containing uncommon targets (e.g., Listeria spp., S. lugdunensis, vanB-positive Enterococci) were included to fully evaluate the performance of the BC-GP test. Sensitivity and specificity for the 12 specific genus or species targets identified by the BC-GP test ranged from 92.6%-100% and 95.4%-100%, respectively. Identification of the mecA gene in 599 cultures containing S. aureus or S. epidermidis was 98.6% sensitive and 94.3% specific compared to cefoxitin disk method. Identification of the vanA gene in 81 cultures containing Enterococcus faecium or E. faecalis was 100% sensitive and specific. Approximately 7.5% (87/1,157) of single-organism cultures contained Gram-positive bacteria not present on the BC-GP test panel. In 95 cultures containing multiple organisms the BC-GP test was in 71.6% (68/95) agreement with culture results. Retrospective analysis of 107 separate blood cultures demonstrated that identification of methicillin resistant S. aureus and vancomycin resistant Enterococcus spp. was completed an average of 41.8 to 42.4 h earlier using the BC-GP test compared to routine culture methods. The BC-GP test was unable to assign mecA to a specific organism in cultures containing more than one Staphylococcus isolate and does not identify common blood culture contaminants such as Micrococcus, Corynebacterium, and Bacillus. CONCLUSIONS: The BC-GP test is a multiplex test capable of detecting most leading causes of Gram-positive bacterial blood stream infections as well as genetic markers of methicillin and vancomycin resistance directly from positive blood cultures.

Transitory fusion is an allorecognition phenotype displayed by the colonial hydroid Hydractinia symbiolongicarpus when interacting colonies share some, but not all, loci within the allorecognition gene complex (ARC). The phenotype is characterized by an initial fusion followed by subsequent cell death resulting in separation of the two incompatible colonies. We here characterize this cell death process using scanning electron microscopy (SEM), transmission electron microscopy (TEM), and continuous in vivo digital microscopy. These techniques reveal widespread autophagy and subsequent necrosis in both colony and grafted polyp assays. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assays and ultrastructural observations revealed no evidence of apoptosis. Pharmacological inhibition of autophagy using 3-methyladenine (3-MA) completely suppressed transitory fusion in vivo in colony assays. Rapamycin did not have a significant effect in the same assays. These results establish the hydroid allorecognition system as a novel model for the study of cell death.

Does information improve deliberation? Proponents of online deliberation argue that the availability of the Internet can solve two longstanding problems of citizen decisionmaking: that preexisting inequalities tend to be reproduced rather than minimized in deliberative forums and that citizen decisionmaking sacrifices the benefits of expertise. Because all deliberators online can access information during their discussion, deliberation should be more informed and more equal. We put those claims to the test by analyzing URL-link posting in an online deliberative forum composed of 25 deliberating groups. On the positive side of the ledger, we show that participants did take advantage of the informational capacities of the web. URL-link posting not only generated more interaction than did opinions posted without links but it also responded to what we call the scale and uptake problems of public deliberation. On the negative side of the ledger, far from equalizing deliberation, the availability of online information may have given additional advantages to already advantaged groups. This was true even in groups that were actively facilitated. The availability of online information may also have fostered discussions, in some instances, that were more opinionated than informed. Information in the Internet age is newly accessible, we conclude, but is also politicized in unfamiliar ways.