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Age-based stock assessments are sometimes rejected by review panels due to large retrospective patterns. When this occurs, data-limited approaches are often used to set catch advice, under the assumption that these simpler methods will not be impacted by the problems causing retrospective patterns in the age-based assessment. This assumption has never been formally evaluated. Closed-loop simulations were conducted where a known source of error caused a retrospective pattern in an age-based assessment. Twelve data-limited methods, an ensemble of a subset of these methods, and a statistical catch-at-age model with retrospective adjustment were all evaluated to examine their ability to prevent overfishing and rebuild overfished stocks. Overall, none of the methods evaluated performed best across the scenarios. A number of methods performed consistently poorly, resulting in frequent and intense overfishing and low stock sizes. The retrospective adjusted statistical catch-at-age assessment performed better than a number of the alternatives explored. Thus, using a data-limited approach to set catch advice will not necessarily result in better performance than relying on the age-based assessment with a retrospective adjustment.

Weighting data appropriately in stock assessment models is necessary to diagnose model mis-specification, estimate uncertainty, and when combining data sets. Age- and length-composition data are often fitted using a multinomial distribution and then reweighted iteratively, and the Dirichlet-multinomial (“DM”) likelihood provides a model-based alternative that estimates an additional parameter and thereby “self-weights” data. However, the DM likelihood requires specifying an input sample size (ninput), which is often unavailable and results are sensitive to ninput. We therefore introduce the multivariate-Tweedie (MVTW) as alternative with three benefits: (1) it can identify both overdispersion (downweighting) or underdispersion (upweighting) relative to the ninput; (2) proportional changes in ninput are exactly offset by parameters; and (3) it arises naturally when expanding data arising from a hierarchical sampling design. We use an age-structured simulation to show that the MVTW (1) can be more precise than the DM in estimating data weights, and (2) can appropriately upweight data when needed. We then use a real-world state-space assessment to show that the MVTW can easily be adapted to other software. We recommend that stock assessments explore the sensitivity to specifying DM, MVTW, and logistic-normal likelihoods, particularly when the DM estimates an effective sample size approaching ninput.

The productivity of many fish populations is influenced by the environment, but developing environment-linked stock assessments remain challenging and current management of most commercial species assumes that stock productivity is time-invariant. In the Northeast United States, previous studies suggest that the recruitment of Southern New England-Mid Atlantic yellowtail flounder is closely related to the strength of the Cold Pool, a seasonally formed cold water mass on the continental shelf. Here, we developed three new indices that enhance the characterization of Cold Pool interannual variations using bottom temperature from a regional hindcast ocean model and a global ocean data assimilated hindcast. We associated these new indices to yellowtail flounder recruitment in a state–space, age-structured stock assessment framework using the Woods Hole Assessment Model. We demonstrate that incorporating Cold Pool effects on yellowtail flounder recruitment reduces the retrospective patterns and may improve the predictive skill of recruitment and, to a lesser extent, spawning stock biomass. We also show that the performance of the assessment models that incorporated ocean model-based indices is improved compared to the model using only the observation-based index. Instead of relying on limited subsurface observations, using validated ocean model products as environmental covariates in stock assessments may both improve predictions and facilitate operationalization.

Fisheries managers use biological reference points (BRPs) as targets or limits on fishing and biomass to maintain productive levels of fish stock biomass. There are multiple ways to calculate BRPs when biological parameters are time varying. Using summer flounder (Paralichthys dentatus) as a case study, we investigated time-varying approaches in concert with climate-linked population models to understand the impact of environmentally driven variability in natural mortality, recruitment, and size-at-age on two commonly used BRPs [B0(t) and F35%(t)]. We used the following two approaches to calculate time-varying BRPs: dynamic-BRP and moving-average-BRP. We quantified the variability and uncertainty of different climate dependencies and estimation approaches, attributed BRP variation to variation in life-history processes, and evaluated how using different approaches impacts estimates of stock status. Results indicate that the dynamic-BRP approach using the climate-linked natural mortality model produced the least variable reference points compared to others calculated. Summer flounder stock status depended on the estimation approach and climate model used. These results emphasize that understanding climate dependencies is important for summer flounder reference points and perhaps other species, and careful consideration is warranted when considering what time-varying approach to use, ideally based upon simulation studies within a proposed set of management procedures.

Climate can impact fish population dynamics through changes in productivity and shifts in distribution, and both responses have been observed for many fish species. However, few studies have incorporated climate into population dynamics or stock assessment models. This study aimed to uncover how past variations in population vital rates and fishing pressure account for observed abundance variation in summer flounder (Paralichthys dentatus). The influences of the Gulf Stream Index, an index of climate variability in the Northwest Atlantic, on abundance were explored through natural mortality and stock–recruitment relationships in age-structured hierarchical Bayesian models. Posterior predictive loss and deviance information criterion indicated that out of tested models, the best estimates of summer flounder abundances resulted from the climate-dependent natural mortality model that included log-quadratic responses to the Gulf Stream Index. This climate-linked population model demonstrates the role of climate responses in observed abundance patterns and emphasizes the complexities of environmental effects on populations beyond simple correlations. This approach highlights the importance of modeling the combined effect of fishing and climate simultaneously to understand population dynamics.

The efficiency of survey gear is an important measure that can be used to estimate the absolute scale of populations in assessment models. We develop a general hierarchical model for estimating the efficiency of a New Bedford-style sea scallop (Placopecten magellanicus) survey dredge from paired dredge and Habcam camera system tows. Habcam data for each tow consist of multiple images that give information on within-tow variability of scallop density. The model accounts for these multiple observations as well as the possibility of differences between the true densities in dredge and Habcam pairs due to the pairs not covering exactly the same ground. We fit several models with alternative assumptions to observations on Atlantic sea scallops and compare the relative performance using Akaike’s information criterion. The best performing model estimated higher dredge efficiency on fine substrates than on coarse ones (approximately 0.40 and 0.27, respectively). Our results inform the scale of annual abundance estimates from dredge surveys and reduce uncertainty in the sea scallop stock assessments.

Regenerative medicine is a resource to restore structure and function to damaged tissues and organs, and to support the body’s own healing mechanisms. For surgeons, intraoperative cell therapies that integrate autologous cell-based therapy with surgical interventions are aiding patients in their own recovery. Intraoperative cell therapy includes tissue harvesting and processing in combination with surgical techniques and the cell-derivative application. The purpose of this paper is to provide the technique for obtaining bone marrow aspirate during surgery, and it’s applications in surgical interventions that include bone lengthening and arthrodesis, muscular transpositions, and micro peripheral nerve reconstruction.

Temporal variation in demographic rates has been observed in various fish populations and environmental influences are likely to be a key factor. Here we show how it can be important to combine state-space models for environmental covariates and demographic rates when evaluating effects of the former on the latter. In an application to Georges Bank Atlantic cod (Gadus morhua), we show how estimates of the environmental covariate can be aliased with unknown temporal variation in growth rates and that stronger and opposite effects of the environment can incorrectly be found when the autocorrelation in the growth rate is not separately modeled. The perception of effects on maturity also depends on whether an appropriate distribution is considered for the maturity observations. Bottom temperature did not improve prediction of maturity parameters, but temporal variation driven by other sources did. Both bottom temperature and temporal variation improved performance of growth models. Finally, we found growth and maturity estimation to be important contributors to uncertainty of spawning biomass and biological reference points when incorporated into a state-space assessment model.

Decadal-scale climate variability and change can cause trends in oceanographic conditions that impact demographic rates. Rebuilding scenarios, therefore, developed assuming constant demographic rates may not be realistic. Winter flounder (Pseudopleuronectes americanus) is an important commercial and recreational species that has declined in the southern portion of its range despite reduced exploitation. Laboratory and mesocosm studies suggest that stock productivity is reduced under warmer conditions and that rebuilding to historical levels may not be possible. Our goal was to examine the rebuilding potential of winter flounder in the face of regional warming. We integrated winter temperature into a population model to estimate environmentally driven stock–recruitment parameters and projected the stock into the future under different climate and fishing scenarios. The inclusion of winter temperature had minor impacts on the estimates of current abundance, but provided greater understanding of the drivers of recruitment. Projections that included the environment suggest that rebuilding the stock to historical levels is unlikely. The integration of both fishing and the environment has the potential to provide more realistic expectations of future stock status.

Copyright © 2018 by the American Society of Plastic Surgeons. Background: Soft-tissue complications often dictate the success of limb salvage and the overall outcome of open fractures. Based on prior work at the R Adams Cowley Shock Trauma Center, the authors hypothesize that wounds larger than 200 cm2 are associated with a greater likelihood of both flap-related reoperation and wound complications among patients requiring soft-tissue reconstruction with a rotational flap or free tissue transfer. Methods: This study was a secondary analysis of Fluid Lavage in Open Wounds trial data that included all patients who received a rotational or free tissue flap transfer for an open fracture. The primary outcome was flap-related reoperation within 12 months of injury. The secondary outcome was wound complication, which included events treated operatively or nonoperatively. Multivariable logistic regression was used to assess the association between wound size and outcomes, adjusting for confounders. Results: Seventeen percent of the 112 patients required a flap-related reoperation. A wound size greater than 200 cm2 was not associated with reoperation in an unadjusted model (p = 0.64) or adjusting for Gustilo type (p = 0.70). The sample had an overall wound complication rate of 47.3 percent. Patients with a wound size of greater than 200 cm2 were three times more likely to experience wound complications (OR, 3.05; 95 percent CI, 1.08 to 8.62; p = 0.04) when adjusting for moderate to severe wound contamination and wound closure in the operating room. Conclusion: The findings of this study demonstrate that wound surface area is an integral determinant for wound complication following soft-tissue flap treatment, but found no association between wound surface area and flap-related reoperation rates.

State-space models explicitly separate uncertainty associated with unobserved, time-varying parameters from that which arises from sampling the population. The statistical aspects of formal state-space models are appealing and these models are becoming more widely used for assessments. However, treating natural mortality as known and constant across ages continues to be common practice. We developed a state-space, age-structured assessment model that allowed different assumptions for natural mortality and the degree of temporal stochasticity in abundance. We fit a suite of models where natural mortality was either age-invariant or an allometric function of mass and interannual transitions of abundance were deterministic or stochastic to observations on Gulf of Maine – Georges Bank Acadian redfish (Sebastes fasciatus). We found that allowing stochasticity in the interannual transition in abundance was important and estimating age-invariant natural mortality was sufficient. A simulation study showed low bias in annual biomass estimation when the estimation and simulation model matched and the Akaike imformation criterion accurately measured relative model performance, but it was important to allow simulated data sets to include the stochasticity in interannual transitions of abundance-at-age.

The northeast US fishing industry and other stakeholders have considerable interest in the quality of bottom trawl survey results because of their importance in the setting of quotas, especially those directly derived from bottom trawl indices measured in catch per area swept by the survey net. Net spread (also referred to as wing spread) impacts catches and thus indices and, for the federal northeast bottom trawl survey, it is correlated with the depth at which a tow is performed. As part of an ongoing partnership between the Northeast Fisheries Science Center, the New England and Mid-Atlantic Fisheries Management Councils, members of the fishing industry, and academics in the region, an experiment to evaluate the impact of wing spread on the catchability of a number of species was conducted in the Fall of 2019 on the F/V Karen Elizabeth. The experiment targeted four species of flatfishes using a twin trawl rigging to collect simultaneous observations of catch and wing spread relative to a controlled optimal net spread. We analyzed these data to estimate the effect of net spread on relative catch efficiency and to evaluate the hypothesis that relative catch efficiency decreases as net spread departs from the optimal configuration. We found that, while the total catch was impacted by net wing spread (catches increased with increasing swept-area), there was no evidence of a wing spread effect on relative catch efficiency for any of the flatfish species. These results suggest that bottom trawl surveys should account for swept-area of individual tows, but that it is not necessary to incorporate species- or length-specific efficiency conversions based on the width of the net.

The rapid changes observed in many marine ecosystems that support fisheries pose a challenge to stock assessment and management predicated on time-invariant productivity and considering species in isolation. In single-species assessments, two main approaches have been used to account for productivity changes: allowing biological parameters to vary stochastically over time (empirical), or explicitly linking population processes such as recruitment (R) or natural mortality (M) to environmental covariates (mechanistic). Here, we describe the Woods Hole Assessment Model (WHAM) framework and software package, which combines these two approaches. WHAM can estimate time- and age-varying random effects on annual transitions in numbers at age (NAA), M, and selectivity, as well as fit environmental time-series with process and observation errors, missing data, and nonlinear links to R and M. WHAM can also be configured as a traditional statistical catch-at-age (SCAA) model in order to easily bridge from status quo models and test them against models with state-space and environmental effects, all within a single framework. We fit models with and without (independent or autocorrelated) random effects on NAA, M, and selectivity to data from five stocks with a broad range of life history, fishing pressure, number of ages, and time-series length. Models that included random effects performed well across stocks and processes, especially random effects models with a two dimensional (2D) first-order autoregressive, AR(1), covariance structure over age and year. We conducted simulation tests and found negligible or no bias in estimation of important assessment outputs (SSB, F, stock status, and catch) when the operating and estimation models matched. However, bias in SSB and F was often non-trivial when the estimation model was less complex than the operating model, especially when models without random effects were fit to data simulated from models with random effects. Bias of the variance and correlation parameters controlling random effects was also negligible or slightly negative as expected. Our results suggest that WHAM can be a useful tool for stock assessment when environmental effects on R or M, or stochastic variation in NAA transitions, M, or selectivity are of interest. In the U.S. Northeast, where the productivity of several groundfish stocks has declined, conducting assessments in WHAM with time-varying processes via random effects or environment-productivity links may account for these trends and potentially reduce retrospective bias.

The presence of retrospective patterns in stock assessments is problematic for determining stock and harvest status because current estimates of stock size or fishing mortality are consistently lower or higher than those when the assessment model is updated with new data. A statistical measure of evidence for retrospective patterns is needed, but a requisite method to estimate variance of retrospective patterns is lacking. We evaluated the statistical behavior of a parametric bootstrap-based variance estimator for retrospective patterns that arise due to a change in natural mortality using a simulation experiment patterned after an assessment of yellowtail flounder on Georges Bank. We also evaluated effects of retrospective patterns on accuracy of stock assessment results and adjustments to terminal stock attributes intended to correct for retrospective patterns. We focused our analyses on Mohn's ρ, but the bootstrap approach could be used with any measure of retrospective pattern. We found that coverage for confidence intervals of Mohn's ρ were adequate, particularly for commonly specified percentage levels near 95%. We also found increased statistical efficiency of terminal year stock attributes that are adjusted for estimated retrospective patterns when the model structures used to simulate observations and estimate the parameters were inconsistent. Furthermore, this increase in efficiency was generally greater than the decrease in efficiency of adjusted stock attributes when models for simulated data and parameter estimation were consistent. However, the utility of adjustments for estimating stock and harvest status depended on our expectation for future productivity of the stock and using confidence interval coverage of Mohn's ρ to determine whether to adjust terminal stock attributes provided no greater benefit than simply always adjusting.

Rebuilding of some U.S. West Coast rockfish ( Sebastes spp.) stocks relies heavily on mandatory fishery discard, however the long-term condition of discarded fish experiencing capture-related barotrauma is unknown. We conducted two studies designed to evaluate delayed mortality, physical condition, and behavioral competency of yelloweye rockfish, Sebastes ruberrimus , experiencing barotrauma during capture followed by recompression (assisted return to depth of capture). First, we used sea-cage and laboratory holding to evaluate fish condition at 2, 15, and 30 days post-capture from 140 to 150 m depth. All external barotrauma signs resolved following 2 days of recompression, but fish that survived (10/12) had compromised buoyancy regulation, swim bladder injuries, and coelomic and visceral hemorrhages at both 15 and 30 days post-capture. For the second study, we used a video-equipped sea-cage to observe fish behavior for one hour following capture and return to the sea floor. Trials were conducted with 24 fish captured from 54 to 199 m water depth. All fish survived, but 50% of fish from the deepest depth ranges showed impairment in their ability to vertically orient ( P P

Survival is an important population process in fisheries stock assessment models and is typically treated as deterministic. Recently developed state-space assessment models can estimate stochastic deviations in survival, which represent variability in some ambiguous combination of natural mortality (M), fishing mortality (F), and migration. These survival deviations are generally treated as independent by age and year, despite our understanding that many population processes can be autocorrelated and that not accounting for autocorrelation can result in notable bias. We address these concerns, as well as the strong retrospective pattern found in the last assessment of Southern New England yellowtail flounder (Limanda ferruginea), by incorporating two-dimensional (2D, age and year) first-order autocorrelation in survival and M. We found that deviations were autocorrelated among both years (0.53 ± 0.09, 0.63 ± 0.16) and ages (0.33 ± 0.12, 0.40 ± 0.16) when estimated for survival or M, respectively. Models with 2D autocorrelation on survival or M fit the data better and had reduced retrospective pattern than models without autocorrelation. The best fit model included 2D autocorrelated deviations in survival as well as independent deviations in M and altered estimates of spawning stock biomass by 18 % and F by 21 % in model years. In short-term projections with F = 0, including 2D autocorrelation in survival or M reduced spawning stock biomass by 48 %. We conclude that incorporating 2D autocorrelated variation in survival or M could improve the assessment of Southern New England yellowtail flounder in terms of model fit and consistency of biomass projections.

The state-space model framework provides a natural, probabilistic approach to stock assessment by modeling the stochastic nature of population survival and recruitment separately from sampling uncertainty inherent in observations on the population. We propose a state-space assessment model that is expanded to simultaneously treat environmental covariates as stochastic processes and estimate their effects on recruitment. We apply the model to southern New England yellowtail flounder (Limanda ferruginea) using data from the most recent benchmark assessment to evaluate evidence for effects of the mid-Atlantic cold pool and spawning stock biomass on recruitment. Based on Akaike’s information criterion, both the cold pool and spawning stock biomass were important predictors of recruitment and led to annual variation in estimated biomass reference points and associated yield. We also demonstrate the effect of the stochasticity of the mid-Atlantic cold pool on short-term forecasts of the stock size, biomass reference point, and stock status.

Penalties are widely used for a range of parameters while fitting fish stock assessment models. Penalizing annual recruitments for deviating from an underlying mean recruitment is probably the most common. Assuming that recruits are log-normally distributed for the purposes of this penalty is theoretically justifiable. In practice, however, bias may be induced because this distributional assumption includes a term equal to the summation of the log observed data, which in the case of recruitment equals the summation of the log recruitment parameters that are not data. Using simulation, the potential for bias caused by assuming that recruits were log-normally distributed was explored, and results were contrasted with the assumption that log-recruitment was normally distributed, an alternative that avoids the potentially troublesome summation term. Spawning stock biomass ( SSB ) and recruitment were negatively biased, while fishing mortality ( F ) was positively biased under the assumption of log-normally distributed recruitments, and the bias worsened closer to the terminal year. The bias also worsened when the true underlying F was low relative to natural mortality, and with domed fishery selectivity. Bias in SSB , recruitment, and F was nonexistent or relatively small under the assumption that log-recruitment was normally distributed. Distributional assumptions for penalties used in assessment models should be reviewed to reduce the potential for biased estimation. These results also provide further support for simulation testing to evaluate statistical behavior of assessment models.

Plasma doping (PLAD) has long been a mainstay in semiconductor manufacturing, specifically memory devices for poly gate and contact doping applications. PLAD is also an attractive technology for fabricating shallow junctions with low implant energies as well as high aspect ratio structures, which are critical for continued device scaling. Traditionally, PLAD implant process (Process A) using B 2 H 6 chemistry results in surface deposition, which can be a challenge for photoresist (PR) removal and to some extent limits the control of the dopant profile in the near surface region. Thus, controlling the deposition during the implant step is of paramount importance for improving the process for current technology nodes and for enabling some of the new aforementioned applications. In this paper we have systematically studied the boron deposition characteristics during the B 2 H 6 implant process using several different techniques. Quartz crystal microbalance (QCM) was used extensively to understand the deposition process and good correlation of QCM was observed with other metrologies. Based on the findings in this work, we have developed a new process (Process B) that yields minimal deposition with similar boron dopant profile. The new process provides better tunability of the profile and greatly simplifies the integration scheme by alleviating the clean requirements post implant step. Work is in progress to further optimize the dopant profile using the new process and to evaluate the effect on contact resistance.

PREMISE OF THE STUDY Wildfire changes the demography, morphology, and behavior of plants, and may alter the pollinator community. Such trait changes may drastically alter the outcome of pollination mutualisms on plants; however, the direct role of fire on these mutualisms is poorly known. METHODS Following a pair of fires in the northern California coast range chaparral, we censused floral visitor communities of Trichostema laxum (Lamiaceae), quantified visiting bee behavior, and estimated outcrossing rates using a widespread Mendelian recessive floral polymorphism across a matrix of populations in burned and unburned sites. We also compared pre- and postfire floral visitation in two populations. RESULTS Outcrossing rates were significantly lower in burned areas; however, our data suggest that the much larger size of plants in burned areas, not burn status itself, drove this pattern. Large-bodied bees dominated floral visitor communities after fire, likely recruiting to the abundant postfire floral resources. These bees visited more flowers per plant than did the smaller bees prevalent before fire and in unburned areas, likely increasing selfing through geitonogamy (within-plant pollination), an effect made possible by the far larger size of plants in burned areas. CONCLUSIONS Outcrossing rates dropped substantially after wildfires because of changes in the pollinators, plant display size, and their interactions. Reductions in outcrossing following fire may have important implications for population resilience and evolution in a changing climate with more frequent fires.

Juvenile Neuronal Ceroid Lipofuscinosis (JNCL) is a lysosomal storage disease caused by an autosomal recessively inherited mutation in the CLN3 gene. JNCL is a progressive neurodegenerative disorder in which the central nervous system (CNS) is greatly affected resulting in behavioral issues, vision loss, and other cognitive disabilities. We developed a novel AAV capsid with enhanced tropism for CNS tissue after systemic administration and optimized the CLN3 transgene cassette to improve biodistribution and expression in CNS and somatic tissues. AAV9 was used as a benchmark to assess the gene biodistribution in the Cln3Δex7/8 mice model. AAV9-CLN3 and AAV214-CLN3 were compared in mice that received 2.0 x 1013 vg/kg via intravenous administration. After 30 days the animals were sacrificed and tissues were harvested for biodistribution analysis. We evaluated capsid delivery in the primary regions of the CNS and the spinal cord (cervical and lumbar). In those tissues AAV214-CLN3 showed greater biodistribution efficacy when compared to AAV9-CLN3 (brain=160% of AAV9, Cervical SC=158% of AAV9 and lumbar SC=184% off AAV9). The sciatic nerve also demonstrated higher AAV214-CLN3 (744%) biodistribution compared to AAV9. The optimization of the CLN3 gene and expression cassette along with a novel AAV vector was able to show greater tropism into the CNS via systemic administration. Current studies assessing expression and dose response over a longer duration suggest AAV-214 can be used for effective systemic delivery and the ability to correct CLN3 in CNS tissues and peripheral tissues.

BackgroundImplementation of highly active antiretroviral therapy (HAART) significantly increased the life expectancy of those living with human immunodeficiency virus (HIV). Except for prevalence, scientific reports regarding clinical manifestations of plantar verrucae in the post-HAART era are lacking. The objective of this study was to compare clinical manifestations of plantar verrucae between HIV-infected and noninfected individuals and then to compare these findings with those observed before the implementation of HAART.MethodsNineteen patients with plantar verrucae (ten with HIV and nine without HIV) were examined to determine the size, number, and clinical type of verrucae present. The two groups were first compared with each other and then with previously collected data from a similar analysis conducted in 1995, before the implementation of HAART. Statistical significance was determined using the Fisher exact test or the Wilcoxon rank sum test.ResultsNo significant differences were observed in the size, number, or clinical type of verrucae between HIV-negative and HIV-positive patients. Compared with the 1995 data, there was a significant decrease in the number of verrucae lesions per individual and a nonsignificant decrease in the average size of verrucae in HIV-positive patients.ConclusionsStudy results indicate that the implementation of HAART has impacted the clinical manifestations of plantar verrucae in HIV-positive individuals. Further analyses with a larger number of patients are required to confirm and substantiate these findings.

Background:Patients with calcaneus fractures often exhibit settling of the posterior facet with a corresponding decrease in Bohler’s angle (BA) following either operative or nonoperative treatment. Both injury BA and postoperative BA have been shown to be prognostic for outcomes; however, the demographic and surgeon-specific factors that may contribute to settling have not been critically examined in the literature. The purpose of this study was to identify these causative factors.Methods:234 patients with intra-articular calcaneus fractures were analyzed. All patients had preoperative plain radiographs, at least 5 months of orthopedic follow-up, and computed tomography scanning performed. BA was measured on the injury radiographs for all patients. For operatively treated patients, BA was measured on the immediate postoperative radiographs and compared with the last available radiograph. For nonoperatively treated patients, BA was measured on the last available radiograph. All patients were fully weightbearing at the time of final follow-up but not on initial radiographs due to their recent injury. Demographic data including age, gender, energy of injury mechanism, tobacco use, diabetes, osteoporosis, rheumatoid arthritis, and substance/alcohol abuse were retrospectively collected. Fractures were classified using the Essex-Lopresti and Sanders classifications. Time to full weightbearing was documented, as were any reports of noncompliance with weightbearing restrictions. For patients treated operatively, type of fixation (calcaneal-specific perimeter plate, nonperimeter plate, screw fixation), use of locking screws, use of bone graft or graft substitutes, and the number of screws supporting the posterior facet were documented.Results:There was a statistically significant amount of settling within the operative and nonoperative groups, but there was no statistically significant difference in settling of BA between the groups. The average settling of BA for the operative and nonoperative group was 8 degrees. Age greater than 50 years, diabetes, and alcohol abuse were all statistically significant and independent predictors of BA settling irrespective of treatment.Conclusion:The amount of BA settling between the operative and nonoperative group was not significant and showed an average decrease of 8 degrees in each group. However, the amount of settling that we found, irrespective of treatment, increased with patient age, alcohol abuse, and diabetes.Level of Evidence:Level III, retrospective comparative study.

Background: The study by Lauge-Hansen published in the Archives of Surgery in 1950 still stands as the seminal work for our understanding of the pathomechanics of ankle fractures. The purpose of the present study was to recreate Lauge-Hansen’s experiments for the supination-external rotation (SER) fracture mechanism and to determine whether the predicted sequence of osseous and soft-tissue injury is reproducible on the basis of his originally described methodology. Methods: Ten fresh-frozen cadaver specimens amputated above the knee were utilized. The foot was axially loaded in a position of neutral dorsiflexion and supination. External rotation was applied manually in accordance with Lauge-Hansen’s description until osseous and/or soft-tissue injury occurred. Fluoroscopic images were made and anatomic dissection was performed. Results: Although several specimens exhibited findings consistent with certain stages of the SER injury pattern, no specimen demonstrated the complete sequence of predicted osseous and soft-tissue injury. Conclusions: Loading cadaver specimens with an SER mechanism utilizing a methodology similar to that in the original experiments by Lauge-Hansen does not reliably produce the sequence of osseous and soft-tissue injury predicted by Lauge-Hansen.

A foot-and-mouth disease (FMD) recombinant subunit vaccine formulated with a lipid/polymer adjuvant was evaluated in two vaccine efficacy challenge studies in steers. The vaccine active ingredient is a replication-deficient human adenovirus serotype 5 vector encoding the FMD virus (FMDV) A24/Cruzeiro/BRA/55 capsid (AdtA24). In the first study, AdtA24 formulated in ENABL® adjuvant was compared to a fourfold higher dose of AdtA24 without adjuvant. Steers vaccinated with AdtA24 + ENABL® adjuvant developed a significantly higher virus neutralizing test (VNT) antibody titer and an improved clinical response following FMDV A24/Cruzeiro/BRA/55 intradermal lingual challenge at 14 days post-vaccination (dpv) than steers vaccinated with the active ingredient alone. In the second study, vaccination with AdtA24 formulated in ENABL® at the same dose used in the first study, followed by FMDV A24/Cruzeiro/BRA/55 challenge on 7 or 14 dpv, prevented clinical FMD in all steers and conferred 90% protection against viremia. In addition, post-challenge FMDV titers in nasal samples from vaccinated steers compared to unvaccinated steers were significantly reduced. In both studies, none of the AdtA24 vaccinated steers developed antibodies to the FMDV non-structural proteins prior to challenge with FMDV, indicative of the capacity to differentiate infected from vaccinated animals (DIVA). These results demonstrate that administration of AdtA24 formulated in ENABL® adjuvant lowered the protective dose and prevented clinical FMD following exposure of vaccinated steers to virulent FMDV at 7 or 14 dpv.

Recent developments in global dynamical climate prediction systems have allowed for skillful predictions of climate variables relevant to living marine resources (LMRs) at a scale useful to understanding and managing LMRs. Such predictions present opportunities for improved LMR management and industry operations, as well as new research avenues in fisheries science. LMRs respond to climate variability via changes in physiology and behavior. For species and systems where climate-fisheries links are well established, forecasted LMR responses can lead to anticipatory and more effective decisions, benefitting both managers and stakeholders. Here, we provide an overview of climate prediction systems and advances in seasonal to decadal prediction of marine-resource relevant environmental variables. We then describe a range of climate-sensitive LMR decisions that can be taken at lead-times of months to decades, before highlighting a range of pioneering case studies using climate predictions to inform LMR decisions. The success of these case studies suggests that many additional applications are possible. Progress, however, is limited by observational and modeling challenges. Priority developments include strengthening of the mechanistic linkages between climate and marine resource responses, development of LMR models able to explicitly represent such responses, integration of climate driven LMR dynamics in the multi-driver context within which marine resources exist, and improved prediction of ecosystem-relevant variables at the fine regional scales at which most marine resource decisions are made. While there are fundamental limits to predictability, continued advances in these areas have considerable potential to make LMR managers and industry decision more resilient to climate variability and help sustain valuable resources. Concerted dialog between scientists, LMR managers and industry is essential to realizing this potential.

© 2017 Elsevier Ltd Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between March 3, 2008, and March 31, 2014, we randomly assigned 1108 patients to receive a sliding hip screw (n=557) or cancellous screws (n=551). Reoperations within 24 months did not differ by type of surgical fixation in those included in the primary analysis: 107 (20%) of 542 patients in the sliding hip screw group versus 117 (22%) of 537 patients in the cancellous screws group (hazard ratio [HR] 0·83, 95% CI 0·63–1·09; p=0·18). Avascular necrosis was more common in the sliding hip screw group than in the cancellous screws group (50 patients [9%] vs 28 patients [5%]; HR 1·91, 1·06–3·44; p=0·0319). However, no significant difference was found between the number of medically related adverse events between groups (p=0·82; appendix); these events included pulmonary embolism (two patients [

Digital image correlation (DIC) uses images from a camera and lens system to make quantitative measurements of the shape, displacement, and strain of test objects. This increasingly popular method has had little research on the influence of the imaging system resolution on the DIC results. This paper investigates the entire imaging system and studies how both the camera and lens resolution influence the DIC results as a function of the system Modulation Transfer Function (MTF). It will show that when making spatial resolution decisions (including speckle size) the resolution limiting component should be considered. A consequence of the loss of spatial resolution is that the DIC uncertainties will be increased. This is demonstrated using both synthetic and experimental images with varying resolution. The loss of image resolution and DIC accuracy can be compensated for by increasing the subset size, or better, by increasing the speckle size. The speckle-size and spatial resolution are now a function of the lens resolution rather than the more typical assumption of the pixel size. The paper will demonstrate the tradeoffs associated with limited lens resolution.

Calcaneus fractures are the most commonly fractured tarsal bone with approximately 75% being intra-articular in nature. Böhler’s angle has been found to be reliable and prognostic, and it has been used as a proxy for joint depression and articular involvement. It often guides the need for advanced imaging and/or operative intervention. We describe a rare variant of intra-articular calcaneus fracture-dislocation that results in elevation of a portion of the posterior facet above the posterior talus and a seemingly normal or increased Böhler’s angle, which we call the “joint-elevation” calcaneus fracture. Orthopaedic surgeons should be aware of this previously undescribed variant in order to avoid inappropriate treatment or misdiagnosis. Level of Evidence: Therapeutic Level IV: Case Series

Multispecies stock assessment models require predator diet data, e.g. stomach samples. Diet data can be unavailable, sparse, of small sample size, or very noisy. It is unclear if multispecies interactions can be estimated without bias when interactions are weak. Research is needed about how model performance is affected by the availability or quality of diet data and by the method for fitting it. We developed seven age-structured operating models that simulate trophic interactions for two fish species and different scenarios of diet data availability or quality. The simulated data sets were fitted using four statistical catch-at-age models that estimated fishing, predation and residual natural mortality and differed in the way the diet data was fitted. Fitting the models to diet data averaged over time should be avoided since it resulted in estimation bias. Fitting annual diet composition per stomach produced bias estimates due to the occurrence of zeros in the observed proportions and the statistical assumptions for the diet model. Fitting to annual stomach proportions averaged across stomachs led to unbiased results even if the number of stomachs was small, the interactions were weak or some sampled years and ages were missing. These methods should be preferred when fitting multispecies models.

Fabry disease is an X-linked lysosomal storage disorder caused by a deficiency in alpha-galactosidase A (GLA) activity that results in the accumulation of the glycolipid products, globotriaosylceramide (Gb3) and lyso-Gb3 in the lysosome. Disease manifestations include frequent bouts of peripheral neurotrophic pain, angiokeratomas, reduced sweat production, corneal dystrophy, cardiomyopathy, renal insufficiency and cerebrovascular disease, which result in reduced lifespan in Fabry patients. While males are affected more severely due to the mutations in the GLA gene, female patients are also frequently symptomatic and are often misdiagnosed. Enzyme replacement therapy (ERT) is currently the only FDA-approved therapy to treat Fabry and requires bi-weekly injections of relatively large quantities of recombinant protein. While ERT reduces the accumulation of Gb3 in the heart, kidney and vasculature it fails to completely treat all symptoms of Fabry, primarily due to its inability to efficiently enter the CNS. Gene therapy strategies have been investigated and while many show great promise in correcting the glycolipid accumulation, most have failed to efficiently enter the CNS and also suffered from an immune response often seen during GLA replacement. Previous work has demonstrated that hepatic-specific expression can tolerize animals to the GLA protein and significantly reduce the humoral response but suffer from the same limitations as ERT. We have identified novel adeno-associated virus (AAV) capsids with improved tissue specificity and expression in the target tissues, namely CNS, heart, and kidney after intravenous administration. After identifying a lead AAV candidate, we have developed a novel, codon-optimized transgene and enhanced promoter to provide supraphysiological expression levels in target tissues as well as increased secretion for cross-correction to non-transduced cells. Proof of concept studies demonstrate significant improvements and enzymatic activity to facilitate IND-enabling studies.

The life history of North American Atlantic salmon (Salmo salar) is characterized by extensive round-trip migrations between freshwater rearing habitats and marine feeding grounds off the coasts of Canada and Greenland. Growth is rapid during the marine migration, and growth rate and condition factor may be indicators of salmon health during this period. Growth data were evaluated from a tag-recovery program conducted from 1969 to 1991 using hatchery-reared Atlantic salmon smolts released in the Penobscot River, Maine, U.S.A. Information from recaptures of 3167 salmon that were at large in the marine environment for 1 month to 3 yr was analyzed. Length–weight measurements coupled with time-at-large data were used to estimate von Bertalanffy and allometric growth parameters specific to the marine phase. Variations in growth and condition factor in relation to smolt age, release date, and temperature conditions in the northwest Atlantic were also examined. The von Bertalanffy k parameter declined with ordinal release date, indicating faster growth rates during the first year of smolts released earlier in the spring. The 2-yr-old smolts had a larger k than 1-yr-old smolts, although 1-yr-old smolts grew to a larger asymptotic size. Sea surface temperature had variable effects on growth parameters and condition factor, with temperature at the beginning of the migration and in overwintering habitat during the first year at sea having the greatest influence on length–weight relationships. Determining the mechanisms that influence growth of individuals during the marine phase will help elucidate the factors responsible for historic growth trends, establishing a baseline for current research.

A1 Effects of enhanced recovery pathways on renal function Charles R. Horres, Mohamed A. Adam, Zhifei Sun, Julie K. Thacker, Timothy J. Miller, Stuart A. Grant A2 Economic outcomes of enhanced recovery after surgery (ERAS) Jeffrey Huang A3 What does eating, drinking and mobilizing after enhanced recovery surgery really mean? Kirstie McPherson, Sanjiv Patel, Su Cheen Ng, Denise Veelo, Bart Geerts, Monty Mythen A4 Intra-operative fluid monitoring practices Su Cheen Ng, Mark Foulger, Tim Collins, Kirstie McPherson, Michael Mythen A5 Development of an integrated perioperative medicine care pathway Mark Edwards, Denny Levett, Tristan Chapman, Imogen Fecher – Jones, Julian Smith, John Knight, Michael Grocott A6 Cardiopulmonary exercise testing for collaborative decision making prior to major hepatobiliary surgery Mark Edwards, Thomas Sharp, Sandy Jack, Tom Armstrong, John Primrose, Michael Grocott, Denny Levett A7 Effect of an enhanced recovery program on length of stay for microvascular breast reconstruction patients Adam B. King, Kye Higdon, Melissa Bellomy, Sandy An, Paul St. Jacques, Jon Wanderer, Matthew McEvoy A8 Addressing readmissions associated with an enhanced recovery pathway for colorectal surgery Anne C. Fabrizio, Michael C. Grant, Deborah Hobson, Jonathan Efron, Susan Gearhart, Bashar Safar, Sandy Fang, Christopher Wu, Elizabeth Wick A9 The Manchester surgical outcomes project: prevalence of pre operative anaemia and peri operative red cell transfusion rates Leanne Darwin, John Moore A10 Preliminary results from a pilot study utilizing ears protocol in living donor nephrectomy Aparna Rege, Jayanth Reddy, William Irish, Ahmad Zaaroura, Elizabeth Flores Vera, Deepak Vikraman, Todd Brennan, Debra Sudan, Kadiyala Ravindra A11 Enhanced recovery after surgery: the role of the pathway coordinator Deborah Watson A12 Hospitalization costs for patients undergoing orthopedic surgery treated with intravenous acetaminophen (IV-APAP) + IV opioids or IV opioids alone for postoperative pain Manasee V. Shah, Brett A. Maiese, Michael T. Eaddy, Orsolya Lunacsek, An Pham, George J. Wan A13 Development of an app for quality improvement in enhanced recovery Kirstie McPherson, Thomas Keen, Monty Mythen A14 A clinical rotation in enhanced recovery pathways and evidence based perioperative medicine for medical students Alexander B Stone, Christopher L. Wu, Elizabeth C. Wick A15 Enhanced recovery after surgery (ERAS) implementation in abdominal based free flap breast reconstruction Rachel A. Anolik, Adam Glener, Thomas J. Hopkins, Scott T. Hollenbeck, Julie K. Marosky Thacker A16 How the implementation of an enhanced recovery after surgery (ERAS) protocol can improve outcomes for patients undergoing cystectomy Tracey Hong, Andrea Bisaillon, Peter Black, Alan So, Associate Professor, Kelly Mayson A17 Use of an app to improve patient engagement with enhanced recovery pathways Kirstie McPherson, Thomas Keen, Monty Mythen A18 Effect of an enhanced recovery after surgery pathway for living donor nephrectomy patients Adam B. King, Rachel Forbes, Brad Koss, Tracy McGrane, Warren S. Sandberg, Jonathan Wanderer, Matthew McEvoy A19 Introduction and implementation of an enhanced recovery program to a general surgery practice in a community hospital Patrick Shanahan, John Rohan, Desiree Chappell, Carrie Chesher A20 “Get fit” for surgery: benefits of a prehabilitation clinic for an enhanced recovery program for colorectal surgical patients Susan VanderBeek, Rebekah Kelly A21 Evaluation of gastrointestinal complications following radical cystectomy using enhanced recovery protocol Siamak Daneshmand, Soroush T. Bazargani, Hamed Ahmadi, Gus Miranda, Jie Cai, Anne K. Schuckman, Hooman Djaladat A22 Impact of a novel diabetic management protocol for carbohydrate loaded patients within an orthopedic ERAS protocol Volz L, Milby J A23 Institution of a patient blood management program to decrease blood transfusions in elective knee and hip arthroplasty Opeyemi Popoola, Tanisha Reid, Luciana Mullan, Mehrdad Rafizadeh, Richard Pitera

Surveys of bumble bees and the plants they visit, carried out in 1974 near the Rocky Mountain Biological Laboratory in Colorado, were repeated in 2007, thus permitting the testing of hypotheses arising from observed climate change over the intervening 33‐yr period. As expected, given an increase in average air temperature with climate warming and a declining temperature with increasing elevation, there have been significant shifts toward higher elevation for queens or workers or both, for most bumble bee species, for bumble bee queens when species are combined, and for two focal plant species, with no significant downward shifts. However, contrary to our hypotheses, we failed to observe significant altitudinal changes for some bumble bee species and most plant species, and observed changes in elevation were often less than the upward shift of 317 m required to maintain average temperature. As expected, community flowering phenology shifted toward earlier in the season throughout our study area, but bumble bee phenology generally did not change, resulting in decreased synchrony between bees and plants. However, we were unable to confirm the narrower expectation that phenologies of bumble bee workers and community flowering coincided in 1974 but not in 2007. As expected, because of reduced synchrony between bumble bees and community flowering, bumble bee abundance was reduced in 2007 compared with 1974. Hence, climate change in our study area has apparently resulted primarily in reduced abundance and upward shift in distribution for bumble bees and shift toward earlier seasonality for plant flowering. Quantitative disagreements between climate change expectations and our observations warrant further investigation.

The hold-up problem is central to the theory of incomplete contracts. It shows how the difficulty to write complete contracts and the resulting need to renegotiate can lead to underinvestment. We describe the design of a simple teaching experiment that illustrates the hold-up problem. The model used is a simple perfect information game. The experiment can hence also be used to illustrate the concept of subgame perfect equilibrium and the problem of making non-binding commitments.

Potency testing of most human and veterinary rabies vaccines requires vaccination of mice followed by a challenge test using an intracerebral injection of live rabies virus. NICEATM, ICCVAM, and their international partners organized a workshop to review the availability and validation status of alternative methods that might reduce, refine, or replace the use of animals for rabies vaccine potency testing, and to identify research and development efforts to further advance alternative methods. Workshop participants agreed that general anesthesia should be used for intracerebral virus injections and that humane endpoints should be used routinely as the basis for euthanizing animals when conducting the mouse rabies challenge test. Workshop participants recommended as a near-term priority replacement of the mouse challenge with a test validated to ensure potency, such as the mouse antibody serum neutralization test for adjuvanted veterinary rabies vaccines for which an international collaborative study was recently completed. The workshop recommended that an in vitro antigen quantification test should be a high priority for product-specific validation of human and non-adjuvanted veterinary rabies vaccines. Finally, workshop participants recommended greater international cooperation to expedite development, validation, regulatory acceptance, and implementation of alternative test methods for rabies vaccine potency testing.

Miller, A. S., Sheehan, T. F., Renkawitz, M. D., Meister, A. L., and Miller, T. J. 2012. Revisiting the marine migration of US Atlantic salmon using historical Carlin tag data. – ICES Journal of Marine Science, 69: 1609–1615. The development of a fishery for Atlantic salmon (Salmo salar) in the sea at West Greenland in the early 1960s prompted the start of a US tagging programme in 1962. Between 1962 and 1996, more than 1.5 million salmon from New England rivers, primarily hatchery-reared smolts, were tagged and released. Overall, the rate of tag recovery was 0.55%, with 23.2% of the tags recovered from Canada, 26.0% from Greenland, and 50.8% from the United States. A generalized additive model was used to analyse marine survival based on returns of tagged salmon to the Penobscot River. The month and year of release, sea age, smolt age, and environmental variables, such as the North Atlantic Oscillation (NAO) and Atlantic Multidecadal Oscillation (AMO) indices and local sea surface temperatures (SSTs), were assessed to explain the variability in the return rate. The AMO and NAO indices, SST, sea age, and time across years all affected survival assessed in terms of returns to the Penobscot River. The results provide information to support the management of Atlantic salmon stocks on a spatial and temporal scale in US rivers and the fishery at West Greenland.

Previous neuroimaging studies of scenarios such as the prisoner’s dilemma and ultimatum game show how brain systems which evolved to process rewarding and aversive stimuli are activated differentially during adherence to and breaches of norms. One theory of how shared social norms evolve is that they arise from mutually rewarding conventions which, through repeated execution, acquire a normative value that sustains social cohesion even when individual self-interest is not served. The authors report an fMRI study of a 2-player coordination game in which players must coordinate on an arbitrary convention (a left or right button press) to obtain monetary rewards. Once this convention has been established, one of the participants is incentivized to deviate from the equilibrium with the offer of extra reward. During the period prior to decisions to violate the convention, activity was observed in regions associated with reward processing, such as the midbrain, caudate, and orbitofrontal cortex. Activations in advance of decisions to continue coordinating included the amygdala and anterior insula–inferior frontal gyrus. The data are discussed in the light of theories which propose the existence of multiple interacting value-based decision-making systems in the human brain.