Search

The Florida bay scallop (Argopeclen irradiuns concentricus Say, 1822) is a relatively short-lived species that resides in dynamic marine systems and is subject to multiple stressors, although the environmental drivers of bay scallop abundance along the Florida Gulf Coast are not well understood. The use of an ecosystem approach to fisheries management may be particularly relevant for short-lived species that are highly susceptible to environmental changes, but this approach requires an understanding of how environmental variables, such as salinity and temperature, may influence bay scallops throughout their range. This study was designed to identify the relationships between environmental variables and bay scallop abundance and to evaluate the relative effect of these relationships. Scallop surveys conducted in the spring and fall along the Florida Gulf Coast from 1992 to 2019 were compared with seasonal water quality parameters, streamfiow discharge, precipitation, wind speed, and climate indices. The size and spawning success of the fall scallop population were negatively affected by relatively high Karenia brevis counts, low dissolved oxygen, and low phosphorus availability. During the period of early postsettlement growth in the winter, scallops were negatively impacted by salinities outside the range of 22-27 due to increased rainfall and low nitrogen availability. Finally, the factors that negatively affected juvenile scallop growth and survival in the spring included increased rainfall and wind speed resulting in relatively high turbidity and comparatively low chlorophyll a. KEY WORDS: Argopecten irradians, abundance, Florida, Karenia brevis, salinity, GAMLSS, INTRODUCTION The Florida bay scallop (Argopecten irradians concentricus Say, 1822) is a relatively short-lived species with a lifespan of approximately 12-18 mo (Barber & Blake 1981). Bay scallop spawning typically [...]

Bay scallops (Argopecten irradiuns conemtricus Say. 1822) exhibit a strong association with seagrass habitat from the time of larval settlement, but alternative habitats, such as macroalgae species, may also serve as important habitats for this species. The association of Florida bay scallops with the percent cover of observed seagrass, macroalgal species, and several substrate types (e.g., mud, shell, and rocks) was examined to determine whether a variety of seagrass and macroalgal species significantly influences the abundance of bay scallops in Florida. Sampling occurred at eight study sites along the Gulf coast of Florida, from Tampa Bay in the south to St. Andrew Bay in the north. SCUBA divers used a point-intercept approach along a transect to assess habitat type and percent cover, in addition to recording bay scallop abundance. Generalized additive models for location, scale, and shape were used to model bay scallop abundance as a function of habitat type. Across all sites, bay scallop abundance was positively correlated with percent cover of seagrass and negatively correlated with bare substrate, such as mud and sand. Five out of the 13 habitat types observed in association with bay scallops in this study were significant factors in models of bay scallop abundance including Acetabularia spp. (J.V. Lamouroux. 1812), Cmderpa spp. (J.V. Lamouroux, 1809), Gracilaria spp. (Greville, 1830), Syringadium filiforme (Kiitz, 1860), and Thalassia testudinum (Koenig. 1805). The two most important habitat variables were T. testudinum and Gracilaria spp., and there was an observed threshold response of bay scallop abundance to these habitat variables at low to medium percent cover. This is the first study to identify the importance of both seagrass and several macroalgal species for Florida bay scallops and suggests that bay scallop restoration efforts may benefit from restoring seagrass and macroalgae. KEY WORDS: Argopecten irradians concentricus, bay scallop, Florida, habitat, macroalgae, Thalassia. seagrass, GAMLSS, INTRODUCTION Bay scallops (Argopecten irradians Say. 1822) are found in coastal, benthic habitats ranging from Cape Cod, Massachusetts to Laguna Madre, Texas (Fay et al. 1983). Commercial bay scallop fisheries [...]

BackgroundIn 2011, the FDA approved telaprevir (TVR) and boceprevir (BOC) for use with pegylated interferon and ribavirin to treat hepatitis C virus (HCV) genotype 1. We aimed to evaluate the real-world application, tolerability, and effectiveness of TVR- and BOC-based HCV treatment in a large integrated care setting.MethodsWe utilized Northern California Kaiser Permanente Medical Care Program (KPNC) electronic databases and medical records to study the experience of all KPNC patients who initiated TVR or BOC from June 2011 to March 2012.ResultsCompared with the pool of 5,194 treatment-eligible patients, the 352 treatment initiators were more likely to be cirrhotic (24 vs. 10%, p < 0.001) and treatment-experienced (44 vs. 22%, p < 0.001). Among the treatment initiators, 211 received TVR and 141 BOC. Overall, 31% discontinued treatment prematurely; 16% of patients stopped treatment early because of side effects. One patient with cirrhosis died of sepsis during treatment. Premature discontinuation was highest among TVR-treated cirrhotic patients (58%). Sustained virologic response (SVR) was achieved in 55% overall and was similar comparing the TVR (56%)- and BOC (53%)-treated groups. The only independent predictors of treatment failure were cirrhosis at baseline [odds ratio (OR) for SVR 0.44, p = 0.004] and prior partial or null response (OR for SVR 0.57, p = 0.02).ConclusionsIn the initial application of TVR and BOC, patients with cirrhosis and prior treatment failure were prioritized for treatment. In this real-world experience, most patients successfully completed a full treatment course. However, side effect-related premature discontinuations were common, and SVR rates were lower than reported in clinical trials.

When Creative Problem Solving (CPS) was introduced into social studies programs, the students' participation in the classrooms began to change. They began to assume leadership roles and take on a sense of responsibility; they asked questions and worked cooperatively to decide on social action. In this article, the authors argue that CPS has the potential to support the development of many citizenship skills, especially problem-solving, communicating, critical-thinking, and information skills. The authors describe how CPS was used to solve problems by students in grades 2 and 6 of a primary school in a small New Zealand farming community. The case studies show how ordinary classrooms can be transformed so that learning is embedded in purposeful and authentic participation, which fosters a community of learners responsible for the direction of their learning. (Contains 2 figures.)

The number of school-associated deaths appears to be higher than originally estimated. Researchers used newspaper clipping services and online newspaper databases to identify 105 deaths of elementary and secondary school students that occurred at 101 schools in 25 states between July, 1992 and June, 1994. Additional data were provided by local police, medical examiners and school officials. Twenty of the deaths (19%) were suicides. Forty-three percent occurred during an activity sponsored by the school. However, only 29% occurred inside the school building, indicating that metal detectors and security cameras may have little effect on reducing student violence. Sixty percent of the deaths occurred in urban schools and 77% involved firearms. Most of the firearms used were handguns and many were automatic or semiautomatic. One-third of the incidents involved personal disputes and 31% were gang-related. Most of the victims were younger than 20, 83% were male and almost half were non-Hispanic blacks. Twenty-one percent had a criminal background., Objectives. - To conduct the first nationwide investigation of violent deaths associated with schools in the United States, to quantify the risk of school-associated violent death, and to identify epidemiologic features of these deaths. Design. - Descriptive case series. Setting. - United States, July 1, 1992, through June 30, 1994. Methods. - School-associated violent deaths were identified by study collaborators and through 2 online news databases. Police reports, medical examiners&apos; records, and interviews with police and school officials provided detailed information about each case. Results. - In a 2-year period, 105 school-associated violent deaths were identified. The estimated incidence of school-associated violent death was 0.09 per 100 000 student-years. Students in secondary schools, students of minority racial and ethnic backgrounds, and students in urban school districts had higher levels of risk. The deaths occurred in communities of all sizes in 25 different states. Homicide was the predominant cause of death (n=85 [80.90%]), and firearms were responsible for a majority (n=81 [77.1%]) of the deaths. Most victims were students (n=76 [72.4%]). Both victims and offenders tended to be young (median ages, 16 and 17 years, respectively) and male (82.90% and 95.60%, respectively). Approximately equal numbers of deaths occurred inside school buildings (n=31 [29.5%]), outdoors but on school property (n=37 [35.2%]), and at off-campus locations while the victim was in transit to or from school (n=37 [35.21%]). Equal numbers of deaths occurred during classes or other school activities (n=46 [43.80%]) and before or after official school activities (n=46 [43.8%]). Conclusions. - School-associated violent deaths were more common than previously estimated. The epidemiologic features of these deaths were similar to those of homicides and suicides that occur elsewhere. A comprehensive approach that addresses violent injury and death among young people at school and elsewhere in the community is suggested.

Fibroadenomas (FA) are the most common benign tumor in the female breast. Most are managed conservatively provided there is clinical, radiologic, and pathologic concordance. However, surgical excision is typically recommended for cellular fibroepithelial lesions or those lesions with clinical, radiologic, or pathologic features concerning for phyllodes tumor (PT). Some studies have suggested surgical excision in all FA >30 mm to reduce core needle biopsy (CNB) sampling errors. The aim of our study was to evaluate, in the absence of any other concerning clinicopathologic features, whether surgical excision of FA was warranted based on size criteria alone. Cork University Hospital is a large academic center in Southern Ireland. Its breast cancer center provides both a screening and symptomatic service and diagnoses approximately 600 cancers per year. The breast histopathological data base was reviewed for all CNBs from January 1, 2010, to June 30, 2015, with a diagnosis of FA that went on to have excision at our institution. We excluded all cellular fibroepithelial lesions and those cases with co‐existent lobular neoplasia, ductal carcinoma in situ, invasive carcinoma, atypical ductal hyperplasia, or lesions which would require excision in their own right. Cases in which the radiologic targeted mass was discordant with a diagnosis of FA were also excluded. Patient demographics and preoperative radiologic size and the radiologic target were recorded in each case. All radiology was reviewed by a breast radiologist prior to inclusion in the study, and there was histologic radiologic concordance with a diagnosis of FA in all cases. A total of 12,109 consecutive radiologically guided CNB were performed January 2010‐June 2015; 3438 with a diagnosis of FA were identified of which 290 cases went on to have surgical excision. Of those 290 cases; 98.28% (n = 285) were confirmed as FA on excision. The remaining 1.72% (n = 5) had atypical features—FA with LCIS (n = 1), benign PT (n = 3), and invasive ductal carcinoma (n = 1). Our study suggests that, excision based solely on size is not warranted in clinical and radiologically concordant cases with a diagnosis of FA on CNB. [ABSTRACT FROM AUTHOR]

Aim: Corporate risk management observed a trend of increasing numbers of serious safety events related to hospital-acquired pressure injuries across a multi-hospital system. A Common Cause Analysis identified gaps in patient care and documentation, related to inconsistencies in product availability and knowledge deficits. The aim of this project was to design and implement a system-wide pressure injury prevention (PIP) program. Method: The strategy for change involved multi-disciplinary collaboration and consistency in education, tools, resources, product availability, documentation, and tracking and trending of pressure injury outcomes across the multi- hospital system. Results / Discussion: One hospital's journey resulted in a 70% decrease in Stage 2, 3, 4, unstageable and DTIs over the first three quarters of 2022, as compared to Quarters 1, 2, 3 in 2021, with an estimated treatment cost savings of $2.5M. There was an 80% decrease in Stage 3, 4 and unstageable pressure injuries over the first three quarters of 2022, as compared to Quarters 1, 2, 3 in 2021, with an estimated treatment cost savings of $522,408. Conclusion: A collaborative approach to system-wide PIP resulted in clinical and financial outcomes. The success of the program will be sustained through continued monitoring of practice, addressing identified gaps, and focus on long-term goals of risk reduction, patient safety, and improved hospital value-based purchasing, Leapfrog and CMS star ratings, in addition to the patient experience. [ABSTRACT FROM AUTHOR]