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Background: Reverse total shoulder arthroplasty (rTSA) is an increasingly common procedure for proximal humerus fractures (PHFs), but postoperative complications have not been well characterized. The purpose of this systematic review is to assess complications and revision rates following rTSA in the management of PHFs as documented in current literature. Methods: A systematic review was performed on primary rTSA for PHFs. In adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search was conducted between September and December of 2023, utilizing the databases PubMed, Scopus, and the Cochrane Library to include relevant articles from any period. A total of 102 studies were identified for inclusion after initial screening of 3800 query results. Extracted data from each article included the publishing journal, level of evidence, study design, number of patients, mean age, age range, percent female, mean follow-up, specific postoperative complications, total complications, complication rate, number of revisions, and revision rate. Overall complication rates were determined by dividing total complications by total patients and multiplying by 100, which also applied to revision rates. Results: Among 10,797 primary rTSA cases for PHFs identified from 102 studies, the mean age of patients was 75.6 ± 3.6 years, and 82.6% of patients were female. The average follow-up was 38.9 ± 21.0 months. The overall complication rate was 7.0% (754/10,797) with a range of 0% to 46.9%. The most common postoperative complications were prosthetic instability/dislocation (2.3%, 244/10,797; range: 0%-7%) and infection (1.2%, 131/10,797; range: 0%-2.5%). Periprosthetic fracture (0.8%), nerve injury (0.3%), and other complications were also documented. The overall revision rate was 3.3% (355/10,797; range: 0%-28%). Conclusion: This systematic review summarizes the most common postoperative complications of rTSA for PHFs. The most frequent complication was prosthetic instability/dislocation, followed by infection. While the average total complication and revision rates were relatively low, there was wide variability, with some studies reporting rates as high as 46% and 28%, respectively.

The unique electromagnetic properties of rare earth elements (REEs) have led to rapid technological advances, creating a sharp increase in demand for these materials. The inherent challenges of separating REEs and the significant drawbacks of existing processes have driven the development of a new method known as field-effect separation (FES). This technology leverages electrical and magnetic fields to achieve separation by exploiting the differences in magnetic moments or effective charges of REEs in solution. Experiments on REEs were conducted using a microchannel based separation device, which confines fluid flow to facilitate separation within a field, with metal cations in solution being transported based on their respective electrostatic or magnetic properties. The results demonstrate that separation based on effective charge or paramagnetic properties is achievable. The confinement of fluid flow to microchannels allowed advective and osmotic forces to be suppressed sufficiently such that a reasonable separation of ions was achieved, though the impact of these forces were not completely removed. This innovative approach promises to improve the efficiency and effectiveness of REE separation, addressing both the growing demand and the limitations of current methods.

Objective: As the number of individuals diagnosed with dementia increases, so does the need to understand the preferences of persons living with dementia (PLWD) and caregivers for how clinicians can deliver a dementia diagnosis effectively, which can be a difficult process. This study describes the diagnostic communication preferences of PLWD and caregivers. Methods: We conducted semi-structured individual phone interviews with two groups: PLWD who were diagnosed in the past two years (n = 11) and family caregivers of PLWD (n = 19) living in Florida. PLWD and caregivers were not recruited/enrolled as dyads. Results: The groups' communication preferences were largely similar. Data were analyzed thematically into five themes: communicate the diagnosis clearly, meet information needs, discuss PLWD/caregiver resources, prepare for continued care, and communicate to establish and maintain relationships. Conclusion: Participants wanted clear communication, information, and support, but differed in some details (e.g. the language used to describe the diagnosis and the amount/type of desired information). Clinicians can apply general principles but will need to tailor them to individual preferences of PLWD and caregivers. Innovation: Limited research has elicited PLWD and caregivers' communication preferences for receiving dementia diagnoses, particularly through an individualized data collection method allowing for richer descriptions and deeper understanding.

Abstract Marine turtles are a group of imperiled marine megafauna particularly vulnerable to anthropogenic stressors. Most long‐term studies of marine turtles are based on nesting surveys which focus on numbers of eggs, hatchlings, and nesting females. However, we know less about long‐term abundance trends of immature and adult turtles in the marine environment. To address this data gap, we examined records from 35,000 underwater visual census (UVC) dives (1993–2019) and short‐term in‐water turtle survey data (2009–2014) at Cocos Island, Costa Rica. During UVCs, trained divemasters from UnderSea Hunter recorded observations of two species of marine turtles—green Chelonia mydas and hawksbill Eretmochelys imbricata. Our short‐term in‐water surveys revealed that most turtles at Cocos are greens, but both immature and mature greens occur at Cocos. We analyzed long‐term UVC data using a hierarchical modeling approach and we modeled a 26% decrease in the relative abundance of turtles observed on dives each year. Our model also revealed potential interactions between tiger sharks and turtles, finding that for each additional tiger shark present during a dive, the predicted relative abundance of turtles decreased by 43%. Lastly, our model suggested the influence of environmental variation on marine turtle relative abundance; a 1°C increase in sea surface temperature (SST) decreased the predicted relative abundance of turtles by 7%. Our results suggest that marine turtles are sensitive to long‐term environmental and oceanographic changes, and potentially avoid certain areas to reduce exposure to tiger sharks. Given our study area is already protected, there needs to be more focus on protecting adult turtles during their movements across the Eastern Tropical Pacific. Our work also highlights the importance of long‐term underwater surveys to monitor adult turtles.

Objectives Only 5–8% of adults with cancer participate in cancer clinical trials (CCTs), with even lower rates among underrepresented groups. Improving oncologists’ communication skills may enhance the frequency and quality of their discussions with patients about CCTs, consequently increasing participation. However, little is known about interest in or presence of CCT-related communication training during Hematology-Oncology (Hem-Onc) fellowships. This study aimed to describe, from the perspective of Hem-Onc fellowship program directors (PDs): (1) the current landscape of CCT education for Hem-Onc fellows; (2) the acceptability and feasibility of implementing a CCT communication skills workshop for Hem-Onc fellows. Methods We used an explanatory sequential mixed-methods approach. PDs were surveyed and interviewed about their graduate medical education (GME) programs’ current CCT curriculum, training challenges, fellows’ CCT knowledge and CCT communication skills, and preferences for a CCT communication workshop. Results PDs were surveyed (n = 40) and interviewed (n = 12). PDs reported that their institutions prioritize CCT accrual (M = 4.58, SD = .78; 1-5 scale, 5 = “Strongly Agree”) and clinical research training (M = 4.20, SD = .85). CCT skills that programs least often addressed were how to (1) discuss CCTs with newly diagnosed patients, (2) talk to patients about CCTs when none are available, and (3) help patients find CCTs at other institutions. PDs were interested in a CCT communication workshop for fellows (“yes” = 67.5%, “maybe” = 32.5%) and said training would be feasible (M = 4.28, SD = .78) and useful (M = 4.47, SD = .78). Qualitative results described programs’ current approaches to CCT education and insights about developing and implementing CCT communication training. Conclusions There is a clear need to improve CCT communication skills training in Hem-Onc fellowship programs and to implement and scale such training to increase CCT participation, especially among diverse patient populations. Furthermore, Hem-Onc GME PDs view such training as feasible and useful.

The Gulf of Maine (GoM) is one of the fastest-warming parts of the world’s oceans. Some species’ distributional shifts have already been documented, especially for commercially-important species. Less is known about species that are not currently exploited but may become so in the future. As a case study into these issues, we focus on lumpfish (Cyclopterus lumpus) because of the recognized and timely need to understand wild lumpfish population dynamics to support sustainable fisheries and aquaculture developments. Using occurrence data from five different fisheries-dependent and independent surveys, we examined lumpfish distribution over time in the GoM. We found that lumpfish presence was more likely in Fall and correlated with deeper waters and colder bottom temperatures. Since 1980, lumpfish presence has increased over time and shifted north. Given a limited set of data, these findings should be interpreted with caution as additional work is needed to assess if the actual distribution of lumpfish is changing. Nevertheless, our work provides preliminary information for resource managers to ensure that lumpfish are harvested sustainably for use in emergent lumpfish aquaculture facilities.

Abstract Background Despite a clear appreciation of the impact of human pathogens on community health, efforts to understand pathogen dynamics within populations often follow a narrow-targeted approach and rely on the deployment of specific molecular probes for quantitative detection or rely on clinical detection and reporting. Main text Genomic analysis of wastewater samples for the broad detection of viruses, bacteria, fungi, and antibiotic resistance genes of interest/concern is inherently difficult, and while deep sequencing of wastewater provides a wealth of information, a robust and cooperative foundation is needed to support healthier communities. In addition to furthering the capacity of high-throughput sequencing wastewater-based epidemiology to detect human pathogens in an unbiased and agnostic manner, it is critical that collaborative networks among public health agencies, researchers, and community stakeholders be fostered to prepare communities for future public health emergencies or for the next pandemic. A more inclusive public health infrastructure must be built for better data reporting where there is a global human health risk burden. Conclusions As wastewater platforms continue to be developed and refined, high-throughput sequencing of human pathogens in wastewater samples will emerge as a gold standard for understanding community health.

Operative fixation for acute displaced midshaft clavicle fractures provides improved functional outcomes and patient satisfaction over nonoperative treatment. Although open reduction and plate fixation is most commonly used, intramedullary fixation produces similar patient outcomes with fewer symptomatic hardware or scar complications. The purpose of this Technical Note is to detail a straightforward and cost-efficient method of intramedullary clavicle fracture fixation using a headless cannulated screw.

Abstract Background Recruitment of cancer clinical trial (CCT) participants, especially participants representing the diversity of the US population, is necessary to create successful medications and a continual challenge. These challenges are amplified in Phase I cancer trials that focus on evaluating the safety of new treatments and are the gateway to treatment development. In preparation for recruitment to a Phase I recurrent head and neck cancer (HNC) trial, we assessed perceived barriers to participation or referral and suggestions for recruitment among people with HNC and community physicians (oncologist, otolaryngologist or surgeon). Methods Between December 2020 and February 2022, we conducted a qualitative needs assessment via semistructured interviews with a race and ethnicity‐stratified sample of people with HNC (n = 30: 12 non‐Hispanic White, 9 non‐Hispanic African American, 8 Hispanic and 1 non‐Hispanic Pacific Islander) and community physicians (n = 16) within the University of Florida Health Cancer Center catchment area. Interviews were analyzed using a qualitative content analysis approach to describe perspectives and identify relevant themes. Results People with HNC reported thematic barriers included: concerns about side effects, safety and efficacy; lack of knowledge and systemic and environmental obstacles. Physicians identified thematic barriers of limited physician knowledge; clinic and physician barriers and structural barriers. People with HNC and physicians recommended themes included: improved patient education, dissemination of trial information and interpersonal communication between community physicians and CCT staff. Conclusions The themes identified by people with HNC and community physicians are consistent with research efforts and recommendations on how to increase the participation of people from minoritized populations in CCTs. This community needs assessment provides direction on the selection of strategies to increase CCT participation and referral. Patient or Public Contribution This study focused on people with HNC and community physicians' lived experience and their interpretations of how they would consider a future Phase I clinical trial. In addition to our qualitative data reflecting community voices, a community member reviewed the draft interview guide before data collection and both people with HNC and physicians aided interpretation of the findings.

BackgroundDementia with Lewy bodies (DLB) is one of the most common degenerative dementias, but research on end-of-life experiences for people with DLB and their caregivers is limited.MethodDyads of individuals with moderate-advanced DLB and their primary informal caregivers were recruited from specialty clinics, advocacy organizations, and research registries and followed prospectively every 6 months. The current study examines results of caregiver study visits 3 months after the death of the person with DLB. These visits included the Last Month of Life survey, study-specific questions, and a semi-structured interview querying end-of-life experiences.ResultsIndividuals with DLB (n = 50) died 3.24 ± 1.81 years after diagnosis, typically of disease-related complications. Only 44% of caregivers reported a helpful conversation with clinicians regarding what to expect at the end of life in DLB. Symptoms commonly worsening prior to death included: cognition and motor function, ADL dependence, behavioral features, daytime sleepiness, communication, appetite, and weight loss. Almost 90% of participants received hospice care, but 20% used hospice for ConclusionMost caregivers of individuals who died with DLB reported positive end-of-life experiences. However, the study identified multiple opportunities for improvement relating to clinician counseling of patients/families, support/hospice referrals, and monitoring individuals with DLB to identify approaching end of life. Future research should quantitatively identify changes that herald end of life in DLB and develop tools that can assist clinicians in evaluating disease stage to better inform counseling and timely hospice referrals.Trial registrationTrial registration information: NCT04829656.

Objective: By analyzing Objective Structured Clinical Examination (OSCE) evaluations of first-year interns’ communication with standardized patients (SP), our study aimed to examine the differences between ratings of SPs and a set of outside observers with training in healthcare communication. Methods: Immediately following completion of OSCEs, SPs evaluated interns’ communication skills using 30 items. Later, two observers independently coded video recordings using the same items. We conducted two-tailed t-tests to examine differences between SP and observers’ ratings. Results: Rater scores differed significantly on 21 items (p < .05), with 20 of the 21 differences due to higher SP in-person evaluation scores. Items most divergent between SPs and observers included items related to empathic communication and nonverbal communication. Conclusion: Differences between SP and observer ratings should be further investigated to determine if additional rater training is needed or if a revised evaluation measure is needed. Educators may benefit from adjusting evaluation criteria to decrease the number of items raters must complete and may do so by encompassing more global questions regarding various criteria. Furthermore, evaluation measures may be strengthened by undergoing reliability and validity testing. Innovation: This study highlights the strengths and limitations to rater types (observers or SPs), as well as evaluation methods (recorded or in-person).

Rationale: Parents of a child or adolescent (CA) or young adult (YA) diagnosed with a hematologic cancer often face uncertainty. Managing uncertainty is critical to reduce the psychosocial burden of illness-related stressors. Objective: This study sought to identify: 1) sources of uncertainty among parents of a child diagnosed with a hematologic cancer, 2) strategies used by parents to manage uncertainty, and 3) clinicians' responses to parents' online information-seeking approach to managing uncertainty. Methods: Parents of CAs/YAs diagnosed with a hematologic cancer within the past 1–18 months and living in the U.S. participated in an in-depth, semi-structured phone interview (n = 20). Data were analyzed thematically. Results: Parents reported uncertainty about treatment (options, efficacy, and side effects or risks) and uncertainty about the future (recurrence, whether worry would subside, and how to approach the child's future). Parents managed uncertainty by seeking information online, talking to clinicians, and joining support groups. Clinicians' responses to online information-seeking were described as supportive and unsupportive. Conclusion: Parents described struggling with uncertainty across the cancer continuum (from primary treatment to survivorship). Parents' psychosocial health may benefit from individual and systems level interventions that help address and manage uncertainty, especially interventions focusing on parent caregiver-clinician communication.

Titles of scientific papers play a key role in their discovery, and “good” titles engage and recruit readers. Humour is a particularly interesting aspect of title construction, but little is known about whether funny titles boost or limit paper impact. We used a panel of scorers to assess title humour for 2439 papers in ecology and evolution, and measured associations between humour and subsequent citation (self-citation and citation by others). Papers with funnier titles were cited less, but this appears to reflect confounding with paper importance: self-citation data suggest that authors give funnier titles to papers they consider less important. After correction for this, papers with funny titles have significantly higher citation rates (P

Abstract Myasthenia gravis (MG) is an autoantibody-mediated autoimmune disorder of the neuromuscular junction. A small subset of patients (

Abstract Background A greater understanding of the county-level differences in human papillomavirus (HPV) vaccination rates could aid targeting of interventions to reduce HPV-related cancer disparities. Methods We conducted a mixed-methods study to compare the stakeholder-reported barriers and efforts to increase HPV vaccination rates between counties within the highest, middle, and lowest HPV vaccine initiation (receipt of the first dose) rates among 22 northern Florida counties. Between August 2018 and April 2019, we recruited stakeholders (n = 68) through purposeful and snowball sampling to identify potential participants who were most knowledgeable about the HPV vaccination activities within their county and would represent a variety of viewpoints to create a diverse picture of each county, and completed semi-structured interviews. County-level HPV vaccine initiation rates for 2018 were estimated from the Florida Department of Health’s immunization registry and population counts. Implementation strategies were categorized by level of importance and feasibility using the Expert Recommendations for Implementing Change (ERIC) taxonomy. We compared the barriers and implementation strategies for HPV vaccination between tercile groups of counties by HPV vaccine initiation rates: highest (18 stakeholders), middle (27 stakeholders), and lowest (23 stakeholders). Results The majority of the 68 stakeholders were female (89.7%), non-Hispanic white (73.5%), and represented a variety of clinical and non-clinical occupations. The mentioned barriers represented five themes: healthcare access, clinician practices, community partnerships, targeted populations, and cultural barriers. Within themes, differences emerged between county terciles. Within healthcare access, the highest rate county stakeholders focused on transportation, lowest rate county stakeholders focused on lack of clinicians, and middle county stakeholders mentioned both. The number of ERIC quadrant I strategies, higher feasibility, and importance described decreased with the tercile for HPV vaccination: highest = 6, middle = 5, and lowest =3 strategies. Conclusions The differing barriers and strategies between the highest, middle, and lowest vaccination rate counties suggest that a tailored and targeted effort within the lowest and middle counties to adopt strategies of the highest rate counties may reduce disparities.

Traditionally, financial risk management is examined with cartesian and interpretivist frameworks. However, the emergence of complexity science provides a different perspective. Using a structured questionnaire completed by 120 Risk Managers, this paper pioneers a comparative analysis of cartesian and complexity science theoretical frameworks adoption in sixteen Zimbabwean banks, in unique settings of a developing country. Data are analysed with descriptive statistics. The paper finds that overally banks in Zimbabwe are adopting cartesian and complexity science theories regardless of bank size, in the same direction and trajectory. However, adoption of cartesian modeling is more comprehensive and deeper than complexity science. Furthermore, due to information asymmetries, there is diverging modeling priorities between the regulator and supervisor. The regulator places strategic thrust on Knightian risks modeling whereas banks prioritise ontological, ambiguous and Knightian uncertainty measurement. Finally, it is found that complexity science and cartesianism intersect on market discipline. From these findings, it is concluded that complexity science provides an additional dimension to quantitative risk management, hence an integration of these two perspectives is beneficial. This paper makes three contributions to knowledge. First, it adds valuable insights to theoretical perspectives on Quantitative Risk Management. Second, it provides empirical evidence on adoption of two theories from developing country perspective. Third, it offers recommendations to improve Quantitative Risk Management policy formulation and practice.

Abstract Background Heart failure with preserved ejection fraction (HFpEF) is a syndrome with a heterogeneous cluster of causes, including non-resolving inflammation, endothelial dysfunction, and multi-organ defects. The present study’s objective was to identify novel predictors of HFpEF. Methods The study analyzed the Multi-Ethnic Study of Atherosclerosis (MESA) to assess the association of specific markers of inflammation with new onset of HFpEF (interleukin-2 [IL-2], matrix metalloproteinase 3 [MMP3], large low-density lipoprotein cholesterol [LDL-C], and medium high-density lipoprotein cholesterol [HDL-C]). The study included men and women 45 to 84 years of age without cardiovascular disease at baseline. The primary outcome was the multivariate association of the hypothesized markers of inflammation with new-onset of HFpEF versus participants without new-onset heart failure. Participants with missing data were excluded. Results The present analysis included 6814 participants, 53% female, with a mean age of 62 years. Among the entire cohort, HFpEF was diagnosed in 151 (2.2%) participants and heart failure with reduced ejection fraction (HFrEF) was diagnosed in 146 (2.1%) participants. Participants were followed for the outcome of heart failure for a median 13.9 years. Baseline IL-2 was available for 2861 participants. The multivariate analysis included 2792 participants. Of these, 2668 did not develop heart failure, 62 developed HFpEF, 47 developed HFrEF, and 15 developed unclassified heart failure. In the multivariate regression model, IL-2 was associated with new-onset HFpEF (OR, 1.00058; 95% confidence interval, 1.00014 to 1.00102, p = 0.009) but not new-onset HFrEF. In multivariate analysis, MMP3, large LDL-C, and medium HDL-C were not associated with HFpEF or HFrEF. Conclusion These findings portend IL-2 as an important component of suboptimal inflammation in the pathogenesis of HFpEF.

Due to their short timescale, stellar flares are a challenging target for the most modern synoptic sky surveys. The upcoming Vera C. Rubin Legacy Survey of Space and Time (LSST), a project designed to collect more data than any precursor survey, is unlikely to detect flares with more than one data point in its main survey. We developed a methodology to enable LSST studies of stellar flares, with a focus on flare temperature and temperature evolution, which remain poorly constrained compared to flare morphology. By leveraging the sensitivity expected from the Rubin system, differential chromatic refraction (DCR) can be used to constrain flare temperature from a single-epoch detection, which will enable statistical studies of flare temperatures and constrain models of the physical processes behind flare emission using the unprecedentedly high volume of data produced by Rubin over the 10 yr LSST. We model the refraction effect as a function of the atmospheric column density, photometric filter, and temperature of the flare, and show that flare temperatures at or above ∼4000 K can be constrained by a single g -band observation at air mass X ≳ 1.2, given the minimum specified requirement on the single-visit relative astrometric accuracy of LSST, and that a surprisingly large number of LSST observations are in fact likely be conducted at X ≳ 1.2, in spite of image quality requirements pushing the survey to preferentially low X . Having failed to measure flare DCR in LSST precursor surveys, we make recommendations on survey design and data products that enable these studies in LSST and other future surveys.

The growing interest in electrochemistry over recent years has sparked an increase in the popularity of various electrochemical techniques, including more advanced methods, that have previously been overlooked in academia and industry. This makes comprehensive hands-on experience in electrochemistry a highly demanded addition to chemistry graduates. However, many students do not receive sufficient training in the theory and experimental design to confidently use and apply various electrochemical techniques throughout their undergraduate, and sometimes even in graduate studies. Here we summarize the theory and practical applications for both rotating disk electrode (RDE) and rotating ring disk electrode (RRDE) techniques. The different modes of operation of rotating ring disk voltammetry, methodologies of data analysis and interpretation as well as the scope of the information that can be extracted from the RDE/RRDE are discussed. Proposed modifications of the laboratory curriculum will allow students to examine and learn valuable information about the reactions on the surface of the electrode/liquid interface. This information will allow chemists to confidently use RDE and RRDE techniques for a wide range of research and development targets. Furthermore, incorporating these techniques into existing chemistry laboratories will help chemistry educators to enrich the undergraduate chemistry curriculum and improve students’ learning outcomes.

The vast majority of individuals with dementia want to receive a diagnosis. Research suggests, however, that only a fraction of individuals with dementia receive a diagnosis and patients and families often feel the information is poorly explained. We thus aimed to assess clinician-reported barriers to dementia disclosure and recommendations for giving a dementia diagnosis. To accomplish this, we performed telephone interviews with 15 clinicians from different specialties using a semi-structured interview guide. Transcripts were analyzed thematically. Clinician-reported barriers fit 3 categories: patient and caregiver-related barriers, clinician-related barriers, and barriers related to the triadic interaction. Patient and caregiver-related barriers included lack of social support, misunderstanding the diagnosis , and denial. Clinician barriers included difficulty giving bad news, difficulty communicating uncertainty , and lack of time. Triadic interaction barriers included c hallenges meeting multiple goals or needs and family requests for non-disclosure. Recommendations for best practice included for clinicians to foster relationships, educate patients and family, and take a family-centered approach. Clinicians described recommendations for fostering relationships such as using empathic communication and developing and maintaining connection . Educating patients and families included tailoring communication , explaining how the diagnosis was reached , and following up . Family approaches included meeting with family members prior to delivering the diagnosis and involving the caregiver in the discussion. Findings may inform updated recommendations for best practices when communicating a dementia diagnosis.

Monitoring population size and dynamics of threatened or low-density species is often both logistically difficult and costly. Recently, social media has emerged as a new tool for species monitoring. In this study, we expand on the use of social media posts as a tool to monitor the spatial and temporal distribution and public perceptions toward the smalltooth sawfish Pristis pectinata. We recorded 442 encounters with smalltooth sawfish from 2018 to 2021 in the form of Instagram posts. We identified locations of encounters within the following regions: Florida Keys, Everglades, South Florida (Miami/Fort Lauderdale), Caloosahatchee River, Bahamas, Upper Charlotte Harbor, Port St. Lucie, Ten Thousand Islands, Tampa, Naples, and Cape Canaveral. We found the greatest number of encounters occurred in the Florida Keys. In addition to spatiotemporal analysis, we used the captions of the posts to assess public attitudes and behaviors toward this charismatic species. This revealed individuals who encounter sawfish feel in general positive about their experience (over half described their encounter using positive language). We also found that sawfish were frequently caught as bycatch when other species (e.g., shark, tarpon, bonefish) were being targeted. Notably, in 12.6% of cases where sawfish were caught, they were being directly targeted. We also identified specific problematic or illegal handling behaviors from image and caption analysis. In addition to captured sawfish, we found sawfish are also frequently observed by beachgoers, boaters, and divers— however, in many cases these encounters may not be reported.

BackgroundAdult child caregivers of parents with cancer may face challenges when communicating with the patient and other family members, communicating during clinical interactions, and navigating web-based information seeking. ObjectiveWe developed and pilot-tested the Healthy Communication Practice program for adult child caregivers of parents with a blood cancer, which aims to help participants learn and implement communication skills central to caregiving. We assessed the feasibility and acceptability of the training. MethodsEligible participants completed a preprogram survey. We assessed the feasibility of participants completing the intervention in the allotted time. Participants had 2 weeks to complete the 2-part, 90-minute online program and completed a postprogram survey that included program evaluation items and the Acceptability of Intervention Measure (AIM) using a 1-5 rating scale (5=strongly agree). ResultsOf 50 caregivers who initially expressed interest, 34 consented, and 30 completed the program and both surveys (88% completion rate). Caregivers had a mean age of 45.07 (SD 11.96) years and provided care for parents who had a mean age of 73.31 (SD 9.38) years. Caregivers were primarily daughters (n=22, 73%). Overall, scores on the AIM scale were high (mean 4.48, SD 0.67). Specifically, caregivers felt the content met their communication needs (mean 4.58, SD 0.62) and their own needs as a caregiver of a parent with a blood cancer (mean 4.39, SD 0.72). ConclusionsWe demonstrated the feasibility and acceptability of the Healthy Communication Practice program, which aims to enhance family and clinical communication skills among caregivers of a parent with a blood cancer. Future studies will examine the efficacy of the program and its impact on both caregiver and patient communication and health outcomes.

Abstract Trend analysis can provide valuable information about marine mammal population dynamics, potentially revealing the influence of environmental factors and inform conservation and management decisions. We reviewed the marine mammal stock assessment reports (SARs) published by the US National Marine Fisheries Service and found that 80% of the selected 244 marine mammal stocks with SARs lack assessment for trends in population abundance. We compared trend analysis with another common management tool, potential biological removal (PBR), a measure of the maximum human‐caused mortality that can still result in positive population growth. We found that, generally, estimates of PBR were lower for declining stocks than for increasing or stable stocks and varied by life history characteristics. As a case study, we used a resampling approach on three well‐studied stocks, killer whale (Orcinus orca—Northern Resident), beluga (Delphinapterus leucas—Cook Inlet), and humpback whale (Megaptera novaeangliae—CA/OR/WA), to test the minimal amount of time and sampling necessary to detect population trends with high statistical power. We found seven sampling events over more than 10 years were needed for a high statistical power level for all three stocks. Altogether, these findings suggest that well‐studied stocks can provide crucial information on the statistical requirements for detecting trends. Furthermore, our proposed resampling approach might enable more frequent trend analysis, even with limited time series available for many stocks.

The United States’ fishing and seafood industries experienced major shifts in consumer demand and social-distancing restrictions starting in March 2020, when the early stages of the COVID-19 pandemic were unfolding. However, the specific effects on fishers and seafood processors are less well known. Fishermen and seafood workers are potentially at risk during a pandemic given existing tight working quarters, seasonal work, and long hours. To address these concerns, and given a lack of data on the sector, we reviewed news articles, scientific articles, and white papers to assess the various effects of COVID-19 on US seafood workers. Here, we show that most COVID-19 cases among seafood workers occurred during summer 2020 and during the beginning of 2021. These cases were documented across coastal areas, with Alaska experiencing the largest number of cases and outbreaks. Seafood workers were about twice as likely to contract COVID-19 as workers in other parts of the overall US food system. We also documented a number of indirect effects of the pandemic. New social-distancing restrictions and policies limited crew size, resulting in longer hours and more physical taxation. Because of changes in demand and the closure of some processing plants because of COVID-19 outbreaks, economic consequences of the pandemic were a primary concern for fishers and seafood workers, and safety measures allowed for seafood price variation and losses throughout the pandemic. We also highlight a number of inequities in COVID-19 responses within the seafood sector, both along racial and gender lines. All of these conditions point to the diverse direct and indirect effects of the COVID-19 pandemic on fishers and seafood workers. We hope this work sets the foundation for future work on the seafood sector in relation to the COVID-19 pandemic, improving the overall workplace, and collecting systematic social and economic data on workers.