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This article provides the first systematic interpretation of the moral theory developed in Newcome's Enquiry into the Evidence of the Christian Religion (1728, revised 1732). More importantly, it shows that Newcome's views constitute a valuable but overlooked contribution to the development of utilitarianism. Indeed, she is arguably the first utilitarian. Her ethical views are considered in two stages. The article first explores her hedonist approach to the good and then turns to her consequentialist account of right action. The article then situates Newcome's work within the context of the pre-Bentham utilitarian movement. Strikingly, Newcome lived and worked in close proximity to other prominent early utilitarians and was well positioned to have exerted an influence on the development of their views. Newcome has never been discussed in connection with the history of ethics. This article constitutes an argument for her inclusion in our narratives about the development of a major moral theory.

This paper analyzes the metaphysical system developed in Cheyne’s Philosophical Principles of Religion. Cheyne was an early proponent of Newtonianism and tackled several philosophical questions raised by Newton’s work. The most pressing of these concerned the causal origin of gravitational attraction. Cheyne rejected the occasionalist explanations offered by several of his contemporaries in favor of a model on which God delegated special causal powers to bodies. Additionally, he developed an innovative approach to divine conservation. This allowed him to argue that Newton’s findings provided evidence for God’s existence and providence without the need for continuous divine intervention in the universe.

OBJECTIVEAlthough it is known that intersurgeon variability in offering elective surgery can have major consequences for patient morbidity and healthcare spending, data addressing variability within neurosurgery are scarce. The authors performed a prospective peer review study of randomly selected neurosurgery cases in order to assess the extent of consensus regarding the decision to offer elective surgery among attending neurosurgeons across one large academic institution.METHODSAll consecutive patients who had undergone standard inpatient surgical interventions of 1 of 4 types (craniotomy for tumor [CFT], nonacute redo CFT, first-time spine surgery with/without instrumentation, and nonacute redo spine surgery with/without instrumentation) during the period 2015–2017 were retrospectively enrolled (n = 9156 patient surgeries, n = 80 randomly selected individual cases, n = 20 index cases of each type randomly selected for review). The selected cases were scored by attending neurosurgeons using a need for surgery (NFS) score based on clinical data (patient demographics, preoperative notes, radiology reports, and operative notes; n = 616 independent case reviews). Attending neurosurgeon reviewers were blinded as to performing provider and surgical outcome. Aggregate NFS scores across various categories were measured. The authors employed a repeated-measures mixed ANOVA model with autoregressive variance structure to compute omnibus statistical tests across the various surgery types. Interrater reliability (IRR) was measured using Cohen’s kappa based on binary NFS scores.RESULTSOverall, the authors found that most of the neurosurgical procedures studied were rated as “indicated” by blinded attending neurosurgeons (mean NFS = 88.3, all p values < 0.001) with greater agreement among neurosurgeon raters than expected by chance (IRR = 81.78%, p = 0.016). Redo surgery had lower NFS scores and IRR scores than first-time surgery, both for craniotomy and spine surgery (ANOVA, all p values < 0.01). Spine surgeries with fusion had lower NFS scores than spine surgeries without fusion procedures (p < 0.01).CONCLUSIONSThere was general agreement among neurosurgeons in terms of indication for surgery; however, revision surgery of all types and spine surgery with fusion procedures had the lowest amount of decision consensus. These results should guide efforts aimed at reducing unnecessary variability in surgical practice with the goal of effective allocation of healthcare resources to advance the value paradigm in neurosurgery.

This chapter revisits three key disagreements between Locke and Berkeley. The disagreements relate to abstraction, the idea of substance, and the status of the primary/secondary quality distinction. The goal of the chapter is to show that these disagreements are rooted in a more fundamental disagreement over the nature of ideas. For Berkeley, ideas are tied very closely to perceptual content. Locke adopts a less restrictive account of the nature of ideas. On his view, ideas are responsible for both perceptual content and non-perceptual mental content. Recognizing this allows for the following analysis of their disputes. Berkeley often appeals to introspection to suggest that we do not have some particular idea. But Locke’s arguments that we have a particular idea often appeal to the functional role the idea has in our cognitive economy rather than to facts about our immediate phenomenology.

Cellular viral reservoirs are rapidly established in tissues upon HIV‐1/SIV infection, which persist throughout viral infection, even under long‐term antiretroviral therapy (ART). Specific integrins are involved in the homing of cells to gut‐associated lymphoid tissues (GALT) and inflamed tissues, which may promote the seeding and dissemination of HIV‐1/SIV to these tissue sites. In this study, we investigated the efficacy of prophylactic integrin blockade (α4β7 antibody or α4β7/α4β1 dual antagonist TR‐14035) on viral infection, as well as dissemination and seeding of viral reservoirs in systemic and lymphoid compartments post‐SIV inoculation. The results showed that blockade of α4β7/α4β1 did not decrease viral infection, replication, or reduce viral reservoir size in tissues of rhesus macaques after SIV infection, as indicated by equivalent levels of plasma viremia and cell‐associated SIV RNA/DNA to controls. Surprisingly, TR‐14035 administration in acute SIV infection resulted in consistently higher viremia and more rapid disease progression. These findings suggest that integrin blockade alone fails to effectively control viral infection, replication, dissemination, and reservoir establishment in HIV‐1/SIV infection. The use of integrin blockade for prevention or/and therapeutic strategies requires further investigation.

STUDY DESIGN Clinical case series. OBJECTIVE The aim of this study was to determine the effectiveness of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) surgical risk calculator in the prediction of complications after anterior lumbar interbody fusion (ALIF). SUMMARY OF BACKGROUND DATA Identifying at-risk patients may aid in the prevention of complications after spine procedures. The ACS NSQIP surgical risk calculator was developed to predict 30-day postoperative complications for a variety of operative procedures. METHODS Medical records of patients undergoing ALIF at our institution from 2009 to 2019 were retrospectively reviewed. Demographic and comorbidity variables were entered into the ACS NSQIP surgical risk calculator to generate percentage predictions for complication incidence within 30 days postoperatively. The observed incidences of these complications were also abstracted from the medical record. The predictive ability of the ACS NSQIP surgical risk calculator was assessed in comparison to the observed incidence of complications using area under the curve (AUC) analyses. RESULTS Two hundred fifty-three (253) patients were analyzed. The ACS NSQIP surgical risk calculator was a fair predictor of discharge to non-home facility (AUC 0.71) and surgical site infection (AUC 0.70). The ACS NSQIP surgical risk calculator was a good predictor of acute kidney injury/progressive renal insufficiency (AUC 0.81). The ACS NSQIP surgical risk calculator was not an adequate predictive tool for any other category, including: pneumonia, urinary tract infections, venous thromboembolism, readmission, reoperations, and aggregate complications (AUC

A number of commentators have recently suggested that there is a puzzle surrounding Locke’s acceptance of Newton’s Principia. On their view, Locke understood natural history as the primary methodology for natural philosophy and this commitment was at odds with an embrace of mathematical physics. This article considers various attempts to address this puzzle and finds them wanting. It then proposes a more synoptic view of Locke’s attitude towards natural philosophy. Features of Locke’s biography show that he was deeply interested in mathematical physics long before the publication of the Principia. This interest was in line with important developments in the Royal Society. It is argued that Locke endorsed a two-stage approach to natural philosophy which was consistent with an embrace of both natural history and mathematical physics. The Principia can be understood as consistent with this approach.

Commentators almost universally agree that Locke denies the possibility of thinking matter in Book IV Chapter 10 of the Essay. This article develops an alternative interpretation according to which Locke allows for the possibility that a system of matter could think (even prior to any act of superaddition on God’s part). In addition, it contends that this does not destroy Locke’s argument in the chapter, instead it helps to illuminate the nature of it. The article proceeds in two main stages. First, a distinction between two senses of ‘production’ is made to clarify Locke’s claim that matter cannot produce thought. Second, Locke’s claim that God could not be a system of randomly moving particles is interpreted as a claim about God’s wisdom and knowledge and not as a claim about thinking matter.

Despite its philosophical interest, Susanna Newcome's Enquiry into the Evidence of the Christian Religion (1728, revised 1732) has received little attention from commentators. This paper seeks to r...

Dam removal is widely used as an approach for river restoration in the United States. The increase in dam removals—particularly large dams—and associated dam-removal studies over the last few decades motivated a working group at the USGS John Wesley Powell Center for Analysis and Synthesis to review and synthesize available studies of dam removals and their findings. Based on dam removals thus far, some general conclusions have emerged: (1) physical responses are typically fast, with the rate of sediment erosion largely dependent on sediment characteristics and dam-removal strategy; (2) ecological responses to dam removal differ among the affected upstream, downstream, and reservoir reaches; (3) dam removal tends to quickly reestablish connectivity, restoring the movement of material and organisms between upstream and downstream river reaches; (4) geographic context, river history, and land use significantly influence river restoration trajectories and recovery potential because they control broader physical and ecological processes and conditions; and (5) quantitative modeling capability is improving, particularly for physical and broad-scale ecological effects, and gives managers information needed to understand and predict long-term effects of dam removal on riverine ecosystems. Although these studies collectively enhance our understanding of how riverine ecosystems respond to dam removal, knowledge gaps remain because most studies have been short (< 5 years) and do not adequately represent the diversity of dam types, watershed conditions, and dam-removal methods in the U.S.

BACKGROUND CONTEXT Degenerative cervical myelopathy (DCM) is caused by narrowing of the cervical spinal canal resulting in compression of the spinal cord. The diagnosis of DCM is confirmed by history, physical exam findings, and advanced imaging showing cord compression. Radcliff et al reported the incidence of undiagnosed DCM in hip fracture patients (18%) and elective hip replacement patients (0%) based on history, modified Japanese Orthopedic Association (mJOA) score, and physical exam. Other investigators have studied the specificity and sensitivity of physical exam findings for diagnosing DCM and found it to be imperfect, with 21% of patients diagnosed with DCM lacking obvious clinical signs. PURPOSE The purpose of this study was to determine the prevalence of undiagnosed DCM in patients over 60 years by combining history, physical exam, and MRI. STUDY DESIGN/SETTING Prospective case series. PATIENT SAMPLE Patients aged 60 years or older without history or current symptoms of DCM. OUTCOME MEASURES Central canal stenosis as measured by MRI, myelopathic symptoms on neurologic exam, and patient-reported outcomes (mJOA and neck disability index [NDI]). METHODS Patients 60 years and older were prospectively enrolled from primary care practices. Patients were excluded if they had a history of debilitating neck pain, inability to have a cervical MRI, neurologic disease, cognitive impairment, or prior cervical spine surgery. A cervical MRI was performed using a 3.0 Tesla imaging system and a cervical coil. NDI and mJOA scores were collected for all patients, as well as a thorough history and physical exam. MRI results were reviewed independently by an orthopedic spine surgeon and neuroradiologist. Central cervical canal stenosis was graded 0-3, with 0 indicating no canal stenosis and 3 indicating spinal cord compression with myelomalacia. Patients were diagnosed with DCM if they had myelopathic history (mJOA RESULTS Eighty patients were included in the study: 39 Males (48.8%) and 41 Females (51.2%). The average age was 68.6 years-old (range 60–90 years). The mean NDI was 2.5%, range 0-24%. The mean mJOA score for the cohort was 17.5 (range 14-18). Two patients (3.8%) had an mJOA score of 16. Two (2.5%) patients had myelomalacia on MRI but were asymptomatic. CONCLUSIONS In our study, the prevalence of cervical spinal cord compression in patients 60 years and older with minimal neck pain was found by MRI to be 37.5%. Among these patients, one was diagnosed with DCM, while two others had myelomalacia with a normal physical exam. Our data support the work of other researchers and show that patients may have MRI findings of myelomalacia but remain asymptomatic. This study confirms a small but important prevalence of spinal stenosis and spinal cord compression in patients over 60 who have minimal or no symptoms. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

Managers make decisions regarding if and how to remove dams in spite of uncertainty surrounding physical and ecological responses, and stakeholders often raise concerns about certain negative effects, regardless of whether these concerns are warranted at a particular site. We used a dam-removal science database supplemented with other information sources to explore seven frequently raised concerns, herein Common Management Concerns (CMCs). We investigate the occurrence of these concerns and the contributing biophysical controls. The CMCs addressed are the following: degree and rate of reservoir sediment erosion, excessive channel incision upstream of reservoirs, downstream sediment aggradation, elevated downstream turbidity, drawdown impacts on local water infrastructure, colonization of reservoir sediments by nonnative plants, and expansion of invasive fish. Biophysical controls emerged for some of the concerns, providing managers with information to assess whether a given concern is likely to occur at a site. To fully assess CMC risk, managers should concurrently evaluate site conditions and identify the ecosystem or human uses that will be negatively affected if the biophysical phenomenon producing the CMC occurs. We show how many CMCs have one or more controls in common, facilitating the identification of multiple risks at a site, and demonstrate why CMC risks should be considered in the context of other factors such as natural watershed variability and disturbance history.

Condit Dam, at river kilometer 5.3 on the White Salmon River, Washington, was breached in 2011 and completely removed in 2012. This action opened habitat to migratory fish for the first time in 100 years. The White Salmon Working Group was formed to create plans for fish salvage in preparation for fish recolonization and to prescribe the actions necessary to restore anadromous salmonid populations in the White Salmon River after Condit Dam removal. Studies conducted by work group members and others served to inform management decisions. Management options for individual species were considered, including natural recolonization, introduction of a neighboring stock, hatchery supplementation, and monitoring natural recolonization for some time period to assess the need for hatchery supplementation. Monitoring to date indicates that multiple species and stocks of anadromous salmonids are finding and spawning in the now accessible and recovering habitat.

Locke's account of the idea of power is thought to be seriously problematic. Commentators allege (1) that the idea of power causes problems for Locke's taxonomy of ideas, (2) that it is defined circularly, and (3) that, contrary to Locke's claims, it cannot be acquired in experience. This paper defends Locke's account. Previous commentators have assumed that there is only one idea of power. But close attention to Locke's text, combined with background features of his theory of ideas, supports the drawing of a distinction between four different ideas of power. The paper describes each idea and its role in the Essay. It then argues that this distinction can help Locke to avoid the traditional criticisms.

In a recent article Fred Ablondi compares the different approaches to occasionalism put forward by two eighteenth-century Newtonians, Colin Maclaurin and Andrew Baxter. The goal of this short essay is to respond to Ablondi by clarifying some key features of Maclaurin's views on occasionalism and the cause of gravitational attraction. In particular, I explore Maclaurin's matter theory, his views on the explanatory limits of mechanism, and his appeals to the authority of Newton. This leads to a clearer picture of the way in which Maclaurin understood gravitational attraction and the workings of nature.

Biotic and abiotic factors influence fish populations and distributions. Concerns have been raised about the influence of hatchery fish on wild populations. Carson National Fish Hatchery produces spring Chinook salmon Oncorhynchus tshawytscha in the Wind River, Washington, and some spawn in the river. Managers were concerned that Chinook salmon could negatively affect wild steelhead O. mykiss and that a self-sustaining population of Chinook salmon may develop. Our objectives were to assess: 1) the distribution and populations of juvenile spring Chinook salmon and juvenile steelhead in the upper Wind River; 2) the influence of stream flow and of each population on the other; and 3) if Chinook salmon populations were self-sustaining. We snorkeled to determine distribution and abundance. Flow in the fall influenced upstream distribution and abundance of juvenile Chinook salmon. Juvenile Chinook salmon densities were consistently low (range 0.0 to 5.7 fish 100 m-2) and not influenced by number of spa...

Theory states that both the spatial complexity of landscapes and the strength of interactions between consumers and their resources are important for maintaining biodiversity and the balance of nature. Spatial complexity is hypothesized to promote biodiversity by reducing the potential for competitive exclusion; whereas, models show that weak trophic interactions can enhance stability and maintain biodiversity by dampening destabilizing oscillations associated with strong interactions. Here, we show that spatial complexity can reduce the strength of consumer-resource interactions in natural food webs. By sequentially aggregating food webs of individual aquatic habitat patches across a floodplain mosaic, we found that increasing spatial complexity resulted in decreases in the strength of interactions between predators and prey, owing to a greater proportion of weak interactions and a reduced proportion of strong interactions in the meta-food web. The main mechanism behind this pattern was that some patches provided predation refugia for species that were often strongly preyed upon in other patches. If weak trophic interactions do indeed promote stability, then our findings may signal an additional mechanism by which complexity and stability are linked in nature. In turn, this may have implications for how the values of landscape complexity, and the costs of biophysical homogenization, are assessed.

The primary purpose of this paper is to elucidate two interesting parallels between views discussed in John Wilkins’s Of the Principles and Duties of Natural Religion (hereafter Principles) and positions developed by John Locke in his Essay concerning Human Understanding (hereafter Essay). The first parallel pertains to a faculty of inner sense. Both authors carve out a central role for this introspective perceptual modality. The second parallel pertains to volition and free will. Both authors employ an investigative methodology which privileges first-personal experiences of choosing and willing.

Many commentators have argued that Locke understood laws of nature as causally efficacious. On this view the laws are causally responsible for the production of natural phenomena. This paper argues that this interpretation faces serious difficulties. First, I argue that it will be very difficult to specify the ontological status of these laws. Proponents of the view suggest that these laws are divine volitions. But I argue that this will be difficult or impossible to square with Locke’s nominalism. Second, I argue that it will be difficult to specify the manner in which these laws operate. The view runs the risk of collapsing into occasionalism and Locke has measured critiques of the occasionalist position. The only way to maintain that laws are causally efficacious divine volitions while avoiding occasionalism is to have God engage in what I call ‘brute fact-making’. But brute fact-making is difficult to square with Locke’s remarks on God’s action in the world and with his standards for explanation in natural philosophy.

Dams have been a fundamental part of the U.S. national agenda over the past two hundred years. Recently, however, dam removal has emerged as a strategy for addressing aging, obsolete infrastructure and more than 1,100 dams have been removed since the 1970s. However, only 130 of these removals had any ecological or geomorphic assessments, and fewer than half of those included before- and after-removal (BAR) studies. In addition, this growing, but limited collection of dam-removal studies is limited to distinct landscape settings. We conducted a meta-analysis to compare the landscape context of existing and removed dams and assessed the biophysical responses to dam removal for 63 BAR studies. The highest concentration of removed dams was in the Northeast and Upper Midwest, and most have been removed from 3rd and 4th order streams, in low-elevation (< 500 m) and low-slope (< 5%) watersheds that have small to moderate upstream watershed areas (10–1000 km2) with a low risk of habitat degradation. Many of the BAR-studied removals also have these characteristics, suggesting that our understanding of responses to dam removals is based on a limited range of landscape settings, which limits predictive capacity in other environmental settings. Biophysical responses to dam removal varied by landscape cluster, indicating that landscape features are likely to affect biophysical responses to dam removal. However, biophysical data were not equally distributed across variables or clusters, making it difficult to determine which landscape features have the strongest effect on dam-removal response. To address the inconsistencies across dam-removal studies, we provide suggestions for prioritizing and standardizing data collection associated with dam removal activities.

My goal in this paper is to elucidate a problematic feature of Newton's metaphysics of absolute space. Specifically, I argue that Newton's theory has the untenable consequence that God depends on space for His existence and is therefore not an independent entity. I argue for this conclusion in stages. First, I show that Newton believed that space was an entity and that God and space were ontologically distinct entities. Part of this involves arguing that Newton denies that space is a divine attribute. I then show that Newton endorsed a principle according to which the existence of space is a necessary condition for the existence of any other entity. Following this, I discuss the ways in which this makes God depend on space for His existence and the reasons why this is unacceptable for traditional conceptions of God. Specifically, I show that it is incompatible with the orthodox position that God be entirely independent and self-determining. Finally, I offer two considerations which, I hope, make the problem seem less serious than it first appears. The first consideration has to do with Newton's polemical context and the second has to do with the nature of his theological thought.

Object Ventriculitis related to external ventricular drain (EVD) placement is a significant source of morbidity in neurological intensive care patients. Current rates of EVD-related infections range from 2% to 45% in the literature. The authors sought to determine if a 2-octyl cyanoacrylate adhesive would result in lower infection rate than standard semiocclusive dressings. Methods The authors tracked ventriculitis rates via CSF cultures among 259 patients whose EVD sites were dressed with sterile semiocclusive dressings and underwent routine sterile dressing exchanges every 48 hours. They analyzed data obtained in an additional 113 patients whose EVD sites were dressed one time with a surgical adhesive, 2-octyl cyanoacrylate. Results Ventriculitis rate in patients with standard bioocclusive dressings and wound care was 15.1%, whereas that in patients with a 2-octyl cyanoacrylate dressing was 3.54% (p = 0.002). Staphylococcus genus accounted for 79.5% of instances of ventriculitis among patients with bioocclusive dressings and routine wound care, whereas it accounted for 25.0% of the instances of ventriculitis among patients with a liquid polymer sealant dressing. A 90% reduction in Staphylococcus infection completely accounts for the observed effect (p = 0.04). Conclusions The one-time application of 2-octyl cyanoacrylate to EVD wounds and exit sites provided superior protection against EVD-related ventriculitis compared to conventional EVD-site wound care. Likely this protection results from a barrier to the entry of gram-positive skin flora along the EVD exit tract. The results should be validated in a randomized trial.

We examined the contribution of three types of side channels based on their hydrologic connectivity (seasonally disconnected, partially connected, and connected) to production of juvenile anadromous salmonids. Juvenile steelhead Oncorhynchus mykiss and Chinook Salmon O. tshawytscha were found in all three of these side channel types and in each year of the study. Upon connection with the main stem at high flows, the seasonally disconnected side channels experienced an emptying out of the previous year's fish while filling with young-of-year fish during the 2- to 4-month period of hydrologic connection. There were no differences between the densities of juvenile steelhead and Chinook Salmon and the rate of smolts produced among the three types of side channels. Recently reintroduced Coho Salmon O. kisutch had sporadic presence and abundance in partially and connected side channels, but the smolt production rate was over two times that of steelhead and Chinook Salmon in seasonally disconnected side ...

The primary purpose of this paper is to provide an interpretation of a claim made by Isaac Newton in the Queries appended to his Opticks. Specifically, my goal is to provide an analysis of Newton's...

Connectivity of river networks and the movements among habitats can be critical for the life history of many fish species, and understanding of the patterns of movement is central to managing populations, communities, and the landscapes they use. We combined passive integrated transponder tagging over 4 years and strontium isotopes in otoliths to demonstrate that 25% of the mountain whitefish (Prosopium williamsoni) sampled moved between the Methow and Columbia rivers, Washington, USA. Seasonal migrations downstream from the Methow River to the Columbia River to overwinter occurred in autumn and upstream movements in the spring. We observed migration was common during the first year of life, with migrants being larger than nonmigrants. However, growth between migrants and nonmigrants was similar. Water temperature was positively related to the proportion of migrants and negatively related to the timing of migration, but neither was related to discharge. The broad spatio-temporal movements we observed suggest mountain whitefish, and likely other nonanadromous fish, require distant habitats and also suggests that management and conservation strategies to keep connectivity of large river networks are imperative.

Life history polymorphisms provide ecologi- cal and genetic diversity important to the long term persistence of species responding to stochastic environ- ments. Oncorhynchus mykiss have complex and over- lapping life history strategies that are also sympatric with hatchery populations. Passive integrated transpon- der (PIT) tags and parentage analysis were used to identify the life history, origin (hatchery or wild) and reproductivesuccess of migratory rainbow/steelhead for two brood years after barriers were removed from a small stream. The fluvial rainbow trout provided a source of wild genotypes to the colonizing population boosting the number of successful spawners. Signifi- cantly more parr offspring were produced by anadro- mousparentsthanexpectedinbroodyear2005,whereas significantly more parr offspring were produced by flu- vial parents thanexpected in brood year 2006. Although hatchery steelhead were prevalent in the Methow Basin, they produced only 2 parr and no returning adults in Beaver Creek. On average, individual wild steelhead produced more parr offspring than the fluvial or hatch- ery groups. Yet, the offspring that returned as adult steelhead were from parents that produced few parr offspring, indicating that high production of parr off- spring may not be related to greater returns of adult offspring. These data in combination with other studies of sympatric life histories of O. mykiss indicate that fluvial rainbow trout are important to the conservation and recovery of steelhead and should be included in the management and recovery efforts.

We evaluated the potential effects of two climate change scenarios on salmonid habitats in the Yakima River by linking the outputs from a watershed model, a river operations model, a two-dimensional (2D) hydrodynamic model, and a geographic information system (GIS). The watershed model produced a discharge time series (hydrograph) in two study reaches under three climate scenarios: a baseline (1981-2005), a 1-°C increase in mean air temperature (plus one scenario), and a 2-°C increase (plus two scenario). A river operations model modified the discharge time series with Yakima River operational rules, a 2D model provided spatially explicit depth and velocity grids for two floodplain reaches, while an expert panel provided habitat criteria for four life stages of coho and fall Chinook salmon. We generated discharge-habitat functions for each salmonid life stage (e.g., spawning, rearing) in main stem and side channels, and habitat time series for baseline, plus one (P1) and plus two (P2) scenarios. The spatial and temporal patterns in salmonid habitats differed by reach, life stage, and climate scenario. Seventy-five percent of the 28 discharge- habitat responses exhibited a decrease in habitat quantity, with the P2 scenario producing the largest changes, followed by P1. Fry and spring/summer rearing habitats were the most sensitive to warming and flow modification for both species. Side channels generally produced more habitat than main stem and were more responsive to flow changes, demonstrating the importance of lateral connectivity in the floodplain. A discharge-habitat sensitivity analysis revealed that proactive management of regulated surface waters (i.e., increasing or decreasing flows) might lessen the impacts of climate change on salmonid habitats.

Big Spring spinedace (Lepidomeda mollispinis pratensis) is a cyprinid whose entire population occurs within a section of Meadow Valley Wash, Nevada. Other spinedace species have suffered population and range declines (one species is extinct). Managers, concerned about the vulnerability of Big Spring spinedace, have considered habitat restoration actions or translocation, but they have lacked data on distribution or habitat use. Our study occurred in an 8.2-km section of Meadow Valley Wash, including about 7.2 km in Condor Canyon and 0.8 km upstream of the canyon. Big Spring spinedace were present upstream of the currently listed critical habitat, including in the tributary Kill Wash. We found no Big Spring spinedace in the lower 3.3 km of Condor Canyon. We tagged Big Spring spinedace ≥70 mm fork length (range 70–103 mm) with passive integrated transponder tags during October 2008 (n = 100) and March 2009 (n = 103) to document movement. At least 47 of these individuals moved from their release location (up to 2 km). Thirty-nine individuals moved to Kill Wash or the confluence area with Meadow Valley Wash. Ninety-three percent of movement occurred in spring 2009. Fish moved both upstream and downstream. We found no movement downstream over a small waterfall at river km 7.9 and recorded only one fish that moved downstream over Delmue Falls (a 12-m drop) at river km 6.1. At the time of tagging, there was no significant difference in fork length or condition between Big Spring Spinedace that were later detected moving and those not detected moving. We found no significant difference in fork length or condition at time of tagging of Big Spring spinedace ≥70 mm fork length that were detected moving and those not detected moving. Kill Wash and its confluence area appeared important to Big Spring spinedace; connectivity with these areas may be key to species persistence. These areas may provide a habitat template for restoration or translocation. The lower 3.3 km of Meadow Valley Wash in Condor Canyon may be a good candidate section for habitat restoration actions.

Barriers to migration are numerous in stream environments and can occur from anthropogenic activities (such as dams and culverts) or natural processes (such as log jams or dams constructed by beaver (Castor canadensis)). Identification of barriers can be difficult when obstructions are temporary or incomplete providing passage periodically. We examine the effect of several small irrigation diversion dams on the recent migration rates of steelhead (Oncorhynchus mykiss) in three tributaries to the Methow River, Washington. The three basins had different recent migration patterns: Beaver Creek did not have any recent migration between sites, Libby Creek had two-way migration between sites and Gold Creek had downstream migration between sites. Sites with migration were significantly different from sites without migration in distance, number of obstructions, obstruction height to depth ratio and maximum stream gradient. When comparing the sites without migration in Beaver Creek to the sites with migration in Libby and Gold creeks, the number of obstructions was the only significant variable. Multinomial logistic regression identified obstruction height to depth ratio and maximum stream gradient as the best fitting model to predict the level of migration among sites. Small irrigation diversion dams were limiting population interactions in Beaver Creek and collectively blocking steelhead migration into the stream. Variables related to stream resistance (gradient, obstruction number and obstruction height to depth ratio) were better predictors of recent migration rates than distance, and can provide important insight into migration and population demographic processes in lotic species.

Colonization of vacant habitats is an important process for supporting the long-term persistence of populations and species. We used a before-after experimental design to follow the process of colonization by steelhead Oncorhynchus mykiss (anadromous Rainbow Trout) at six monitoring sites in a natal stream, Beaver Creek, after the modification or removal of numerous stream passage barriers. Juvenile O. mykiss were collected at monitoring sites by using a back- pack electrofisher. Passive integrated transponder tags and instream tag reading stations were used in combination with 16 microsatellite markers to determine the source, extent, and success of migrant O. mykiss after implementation of the barrier removal projects. Steelhead migrated into the study area during the first spawning season after passage was established. Hatchery steelhead, although comprising more than 80% of the adult returns to the Methow River basin, constituted a small proportion (23%) of the adult O. mykiss colonizing the study area. Adult steelhead and fluvial Rainbow Trout entered the stream during the first spawning season after barrier removal and were passing the uppermost tag reader (12 km upstream from the mouth) 3-4 years later. Parr that were tagged in Beaver Creek returned as adults, indicating establishment of the anadromous life history in the study area. Population genetic measures at the lower two monitoring sites (lower 4 km of Beaver Creek) significantly changed within one generation (4-5 years). Colonization and expansion of steelhead occurred more slowly than expected due to the low number of adults migrating into the study area.

Although numerous studies have attempted to place species of interest within the context of food webs, such efforts have generally occurred at small scales or disregard potentially important spatial heterogeneity. If food web approaches are to be employed to manage species, studies are needed that evaluate the multiple habitats and associated webs of interactions in which these species participate. Here, we quantify the food webs that sustain rearing salmon and steelhead within a floodplain landscape of the Methow River, Washington, USA, a location where restoration has been proposed to restore side channels in an attempt to recover anadromous fishes. We combined year-long measures of production, food demand, and diet composition for the fish assemblage with estimates of invertebrate prey productivity to quantify food webs within the main channel and five different, intact, side channels; ranging from channels that remained connected to the main channel at low flow to those reduced to floodplain ponds. Although we found that habitats within the floodplain had similar invertebrate prey production, these habitats hosted different local food webs. In the main channel, 95% of total prey consumption flowed to fishes that are not the target of proposed restoration. These fishes consumed 64% and 47% of the prey resources that were found to be important to fueling chinook and steelhead production in the main channel, respectively. Conversely, in side channels, a greater proportion of prey was consumed by anadromous salmonids. As a result, carrying capacity estimates based on food were 251% higher, on average, for anadromous salmonids in side channels than the main channel. However, salmon and steelhead production was generally well below estimated capacity in both the main and side channels, suggesting these habitats are under-seeded with respect to food, and that much larger populations could be supported. Overall, this study demonstrates that floodplain heterogeneity is associated with the occurrence of a mosaic of food webs, all of which were utilized by anadromous salmonids, and all of which may be important to their recovery and persistence. In the long term, these and other fishes would'likely benefit from restoring the processes that maintain floodplain complexity.

Increasing temperatures and changes in food resources owing to climate change may alter the growth and migratory behavior of organisms. This is particularly important for salmonid species like Oncorhynchus mykiss, where some individuals remain in freshwater to mature (nonanadromous Rainbow Trout) and others migrate to sea (anadromous Steelhead). Whether one strategy is adopted over the other may depend on the individual's growth and size. In this study, we explored (1) how water temperature in Beaver Creek, a tributary to the Methow River, Washington, may increase under four climate scenarios, (2) how these thermal changes may alter the life history trajectory followed by O. mykiss (i.e., when and if to smolt), and (3) how changes in food quality or quantity might interact with increasing temperatures. We combined bioenergetic and state-dependent life history models parameterized for O. mykiss in Beaver Creek to mimic baseline life history trajectories. Based on our simulations, when mean water t...

Purpose Bone Morphogenetic Protein-2 (BMP-2) may offer the potential to enhance allograft-host osseous union in limb-salvage surgery following osteosarcoma resection. However, there is concern regarding the effect of locally applied BMP-2 on tumor recurrence and metastasis. The purpose of this project was to evaluate the effect of exogenous BMP-2 on osteosarcoma migration and invasion across a panel of tumor cell lines in vitro and to characterize the effect of BMP-2 on pulmonary osteosarcoma metastasis within a xenograft model. Experimental design The effect of BMP-2 on in vitro tumor growth and development was assessed across multiple standard and patient-derived xenograft osteosarcoma cell lines. Tumor migration capacity, invasion, and cell proliferation were characterized. In addition, the effect on metastasis was measured using a xenograft model following tail-vein injection. The effect of exogenous BMP-2 on the development of metastases was measured following both single and multiple BMP-2 administrations. Results There was no significant difference in migration capacity, invasion, or cell proliferation between the BMP-2 treated and the untreated osteosarcoma cell lines. There was no significant difference in pulmonary metastases between either the single-dose or multi-dose BMP-2 treated animals and the untreated control animals. Conclusions In the model systems tested, the addition of BMP-2 does not increase osteosarcoma proliferation, migration, invasion, or metastasis to the lungs.

Incisional cerebrospinal fluid (CSF) leakage after cranial surgery is a significant cause of morbidity due to poor wound healing and infection, meningitis, and pseudomeningocele formation. Many common dural closure techniques, such as sutures, autologous grafts, gelatin or collagen sponges, and fibrin glues, are used to achieve watertight closure, although none are US Food and Drug Administration approved for this use. DuraSeal Dural Sealant System is a polyethylene glycol (PEG) hydrogel approved by the U.S. Food and Drug Administration for obtaining watertight dural closure when applied after standard dural suturing. This multicenter, prospective randomized study further evaluated the safety of a PEG hydrogel compared with common dural sealing techniques.A total of 237 patients undergoing elective cranial surgery at 17 institutions were randomized to dural closure augmented with the PEG hydrogel or a control "standard of care" dural sealing technique after Valsalva maneuver demonstrated an intraoperative nonwatertight dural closure. Data were collected on complications resulting in unplanned postoperative interventions or reoperations, surgical site infections, CSF leaks, and other neurological complications within 30 days. Surgeons also provided data on the ease of use of the dural sealing techniques, as well as preparation and application times.The incidences of neurosurgical complications, surgical site infections, and CSF leaks were similar between treatment and control groups, with no statistically significant difference between the measures. In the PEG hydrogel group (n = 120), the incidence of neurosurgical complications was 5.8% (n = 7), the incidence of surgical site infections was 1.7% (n = 2), and the incidence of CSF leak was 0.8% (n = 1). In the control group (n = 117), the incidence of neurosurgical complications was 7.7% (n = 9), the incidence of surgical site infection was 2.6% (n = 3), and the incidence of CSF leak was 1.7% (n = 2). Sealant preparation time was less than 5 minutes in 96.6% of the PEG hydrogel group compared with 66.4% of controls (P

There is strong and growing interest in estimating the proportion of hatchery fish that are in a natural population (the hatchery fraction). In a sample of fish from the relevant population, some are observed to be marked, indicating their origin as hatchery fish. The observed proportion of marked fish is usually less than the actual hatchery fraction, since the observed proportion is determined by the proportion originally marked, differential survival (usually lower) of marked fish relative to unmarked hatchery fish, and rates of mark retention and detection. Bayesian methods can work well in a setting such as this, in which empirical data are limited but for which there may be considerable expert judgment regarding these values. We explored a Bayesian estimation of the hatchery fraction using Monte Carlo–Markov chain methods. Based on our findings, we created an interactive Excel tool to implement the algorithm, which we have made available for free. Received March 30, 2011; accepted June 21, 2011

Study design We evaluated 43 patients diagnosed with tandem spinal stenosis (TSS) from 1999 to 2005 in an academic hospital. Objective The purpose of this study is to compare outcomes after simultaneous decompression of the cervical and lumbar spine versus staged operations. Summary of background data TSS is a rare degenerative disease affecting multiple spinal levels with limited research describing operative management. Methods Of our patients, 21 underwent simultaneous decompression of both the cervical and lumbar spine and 22 underwent staged decompression of the cervical spine followed by the lumbar spine at a later date. Medical records were reviewed for patient demographics, type and duration of symptoms, operative time, combined blood loss, cervical myelopathy modified Japan Orthopaedic Association Score, Oswestry Disability Index (ODI), major and minor complications, and average length of follow up. Each category was evaluated by Pearson correlations and unpaired Student t tests. Results With a mean follow-up of 7 years, both groups improved in JOA and ODI without a significant difference between the 2 operative groups in terms of major or minor complications, JOA, or ODI. Independent of the surgical algorithm, age above 68 years, estimated blood loss ≥400 mL, and operative time ≥150 minutes significantly increased the number of complications. Conclusions These results indicate that TSS can be effectively managed by either surgical intervention, simultaneous, or staged decompressions. However, patient age, blood loss, and operative time do significantly impact outcomes. Therefore, operative management should be tailored to the patient's age and the option which will limit blood loss and operative time, whether that is by simultaneous or staged procedures.

COMMENTARY ON Singh K, Nandyala SV, Marquez-Lara A, et al. A perioperative cost analysis comparing single-level minimally invasive and open transforaminal lumbar interbody fusion. Spine J 2014;14:1694–701 ( in this issue ).