In natural systems, animal‐mediated nutrient transport can be a major driver of primary productivity, but the role of marine megafauna such as cetaceans in mediating the transfer and recycling of nutrients has been overlooked. Here, we developed a spatially resolved, stochastic, nutrient‐transport model for cetaceans in the oceanic Gulf of Mexico using species−specific foraging depths, distributions, and diets. An estimated 6.4 × 10 ⁸ mmol N d ⁻¹ , or 0.06 mt N yr ⁻¹ ind ⁻¹ , is transported to the surface from depths below 100 m by the 19 cetacean species that occur in the oceanic Gulf of Mexico; 75% of this transport occurs seaward of the continental slope, but the per area transported nitrogen is greater on the continental slope (200–1000 m) than in the ocean basin. Benthos to surface transport comprised 6.0 × 10 ⁷ mmol N d ⁻¹ and was much more common on the continental slope than the open basin. Compared to an existing physical‐biogeochemical model, the transported nutrients add 8% N d ⁻¹ to the estimated ammonium concentration above the nutricline and could add 16% N d ⁻¹ to the surface ammonium concentration if expelled nutrients remain at the surface. Through feeding on diel vertical migrants, cetaceans retain an additional 2.7 × 10 ⁷ mmol N d ⁻¹ in the surface waters that would otherwise return to depth via downward diel vertical migration. Cetaceans contribute to nutrient movements and recycling in the oceanic Gulf of Mexico, and may provide one of the few allochthonous sources of nutrients for primary producers in oligotrophic ecosystems.
Objectives The aim of Working Group 4 was to address patient benefits associated with implant dentistry. Focused questions on (a) dental patient‐reported outcomes (dPROs), (b) improvement in orofacial function, and (c) preservation of orofacial tissues in partially and fully edentulous patients following provision of implant‐retained/supported dental prostheses were addressed. Materials and Methods Three systematic reviews formed the basis for discussion. Participants developed statements and recommendations determined by group consensus based on the findings of the systematic reviews. These were then presented and accepted following further discussion and modifications as required by the plenary of the 7th ITI Consensus Conference, taking place in 2023 in Lisbon, Portugal. Results Edentulous patients wearing complete dentures (CD) experience substantial improvements in overall dPROs and orofacial function following treatment with either complete implant‐supported fixed dental prostheses (CIFDP) or implant overdentures (IODs). With respect to dPROs, mandibular IODs retained by two implants are superior to IODs retained by one implant. However, increasing the number of implants beyond two, does not further improve dPROs. In fully edentulous patients, rehabilitation with CIFDP or IOD is recommended to benefit the preservation of alveolar bone and masseter muscle thickness. Conclusions Completely edentulous patients benefit substantially when at least the mandible is restored using an CIFDP or an IOD compared to CD. In fully edentulous patients, implant prostheses are the best option for tooth replacement. The availability of this treatment modality should be actively promoted in all edentulous communities, including those with limited access and means.
Many marine species can regulate the intensity of bioluminescence from their ventral photophores in order to counterilluminate, a camouflage technique whereby animals closely match the intensity of the downwelling illumination blocked by their bodies, thereby hiding their silhouettes. Recent studies on autogenic cuticular photophores in deep-sea shrimps indicate that the photophores themselves are light sensitive. Here, our results suggest photosensitivity in a second type of autogenic photophore, the internal organs of Pesta, found in deep-sea sergestid shrimps. Experiments were conducted onboard ship on live specimens, exposing the animals to bright light, which resulted in ultrastructural changes that matched those seen in crustacean eyes during the photoreceptor membrane turnover, a process that is crucial for the proper functioning of photosensitive components. In addition, RNA-seq studies demonstrated the expression of visual opsins and phototransduction genes in photophore tissue that are known to play a role in light detection, and electrophysiological measurements indicated that the light organs are responding to light received by the eyes. The long sought after mechanism of counterillumination remains unknown, but evidence of photosensitivity in photophores may indicate a dual functionality of light detection and emission.
High-elevation neotropical environments of the Andes include the Páramo, a biodiversity hotspot with fast speciation rates. The genus Espeletia is distinctive of this ecosystem in the northern Andes. Its southern distribution limit lies in Ecuador, with the endemic E. pycnophylla subsp. llanganatensis being the only known representative south of the equator. This study presents the distribution, population structure and co-occurring flora of the subspecies llanganatensis in the Valle de los Frailejones (VFL), Cordillera de los Llanganates. Four clusters totalling ~ 20 ha could be identified at elevations of 3400–3550 m above sea level. Espelatia pycnophylla subsp. llanganatensis occurred amidst the sub-Páramo upper elevational limits of montane forests and within transitional areas between forest margins and waterlogged terrains. This habitat preference was a distinguishing ecological difference to the nearest (200 km) congener, E. pycnophylla subsp. angelensis. Plants (N = 781 measured) were skewed towards the smallest size classes ≤ 20 cm (28% of the population, including 17% recruits ≤ 10 cm) and reaching a total plant height of 900 cm. Synflorescences were observed in specimens ≥ 110 cm and in 51% of the mature population. The oldest specimens grew on terrains with higher edaphic stability. While local recruitment appears healthy, geographic distribution is limited suggesting vulnerability to local extinction. Co-occurring vegetation encompassed ~ 70 species, with grasses (Poaceae) and mosses (Bryophyta) dominating the ground cover, resulting in homogenous vegetation. Although E. pycnophylla subsp. llanganatensis is currently not exposed to direct human disturbance, clandestine mining activities intruding the region pose a potential threat to the survival of this Ecuadorian endemic.
G protein-coupled receptors (GPCRs) play pivotal roles in regulation of cardiac function and homeostasis. To function properly, every cell needs these receptors to be stimulated only when a specific extracellular stimulus is present, and to be silenced the moment that stimulus is removed. The regulator of G protein signaling (RGS) proteins are crucial for the latter to occur at the cell membrane, where the GPCR normally resides. Perturbations in both activation and termination of G protein signaling underlie numerous heart pathologies. Although more than 30 mammalian RGS proteins have been identified, each RGS protein seems to interact only with a specific set of G protein subunits and GPCR types/subtypes in any given tissue or cell type, and this applies to the myocardium as well. A large number of studies have provided substantial evidence for the roles various RGS proteins expressed in cardiomyocytes play in cardiac physiology and heart disease pathophysiology. This review summarizes the current understanding of the functional roles of cardiac RGS proteins and their implications for the treatment of specific heart diseases, such as heart failure and atrial fibrillation. We focus on cardiac RGS4 in particular, since this isoform appears to be selectively (among the RGS protein family) upregulated in human heart failure and is also the target of ongoing drug discovery efforts for the treatment of a variety of diseases.
Over the past several decades, the use of punishment as a strategy to discipline children has fallen into disfavor in popular books and among many parenting researchers. Other well-respected researchers point out important instances where punishment can be beneficial if implemented appropriately together with positive reinforcement. In this chapter, we summarize the research on punishment, ranging from parental use of timeout to the clinical use of mild electric shocks to treat severe self-destructive behaviors that are otherwise resistant to change. We find that the bifurcation of research into causally informative studies of clinical child cases and correlational studies of more representative samples have prevented progress on how consistent mild punishment can enhance positive parenting techniques such as reasoning and negotiation, especially in children with oppositional defiance. We need better punishment research to help parents, because most of them will use some kind of punishment sometimes.
Cardiac injury, such as myocardial infarction and heart failure, remains a significant global health burden. The limited regenerative capacity of the adult heart poses a challenge for restoring its function after injury. Mesenchymal stem cells (MSCs) have emerged as promising candidates for cardiac regeneration due to their ability to differentiate into various cell types and secrete bioactive molecules. In recent years, attention has been given to noncoding RNAs derived from MSCs, particularly long noncoding RNAs (lncRNAs), and their potential role in cardiac injury and repair. LncRNAs are RNA molecules that do not encode proteins but play critical roles in gene regulation and cellular responses including cardiac repair and regeneration. This review focused on MSC-derived lncRNAs and their implications in cardiac regeneration, including their effects on cardiac function, myocardial remodeling, cardiomyocyte injury, and angiogenesis. Understanding the molecular mechanisms of MSC-derived lncRNAs in cardiac injury and repair may contribute to the development of novel therapeutic strategies for treating cardiovascular diseases. However, further research is needed to fully elucidate the potential of MSC-derived lncRNAs and address the challenges in this field.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), could affect brain structure and function. SARS-CoV-2 can enter the brain through different routes, including the olfactory, trigeminal, and vagus nerves, and through blood and immunocytes. SARS-CoV-2 may also enter the brain from the peripheral blood through a disrupted blood-brain barrier (BBB). The neurovascular unit in the brain, composed of neurons, astrocytes, endothelial cells, and pericytes, protects brain parenchyma by regulating the entry of substances from the blood. The endothelial cells, pericytes, and astrocytes highly express angiotensin converting enzyme 2 (ACE2), indicating that the BBB can be disturbed by SARS-CoV-2 and lead to derangements of tight junction and adherens junction proteins. This leads to increased BBB permeability, leakage of blood components, and movement of immune cells into the brain parenchyma. SARS-CoV-2 may also cross microvascular endothelial cells through an ACE2 receptor-associated pathway. The exact mechanism of BBB dysregulation in COVID-19/neuro-COVID is not clearly known, nor is the development of long COVID. Various blood biomarkers could indicate disease severity and neurologic complications in COVID-19 and help objectively diagnose those developing long COVID. This review highlights the importance of neurovascular and BBB disruption, as well as some potentially useful biomarkers in COVID-19, and long COVID/neuro-COVID.
Background: Hospitalized COVID-19 patients with hypoxemic respiratory failure may deteriorate despite invasive mechanical ventilation and thus require extracorporeal membrane oxygenation (ECMO) support. Unfractionated heparin (UFH) is the antithrombotic of choice, however, bivalirudin may offer more predictable pharmacokinetics resulting in consistent anticoagulant effects with lower bleeding and thrombotic occurrences. The aim of this study was to evaluate efficacy and safety outcomes in patients undergoing venovenous (VV) ECMO receiving bivalirudin or UFH-based anticoagulation. Methods: This retrospective, single-center, observational cohort study included patients with confirmed COVID-19 infection requiring VV ECMO support receiving anticoagulation with UFH or bivalirudin. Primary endpoints were time to reach therapeutic aPTT, percent time spent in aPTT range, and the occurrence of thrombotic events over the entire course of ECMO support. Secondary endpoints included the incidence of major/minor bleeding, the ability to wean off ECMO support, in-hospital mortality, and length of stay. Results: Twenty-two patients were included in the study (n = 10 UFH, n = 12 bivalirudin). Time to therapeutic aPTT was achieved faster with UFH (10 h vs. 20 h). The percentage time spent within the goal aPTT range was similar between UFH and bivalirudin (50% vs. 52%). Thrombotic events were significantly higher in the UFH group (40% DVT, 40% PE, 80% oxygenator thrombus in ECMO machine, 10% ischemic stroke) versus bivalirudin (8% DVT, 17% PE, 33% oxygenator thrombus, no ischemic strokes) (CI 95%, p = 0.04). The overall bleeding incidence was higher in the UFH arm (90% vs. 75%). The mortality rate was 90% in the UFH group and 58% in the bivalirudin group. The length of stay was similar between the two study arms. Conclusion: In hospitalized patients with COVID-19-associated acute respiratory distress syndrome (ARDS) on VV ECMO support, the use of bivalirudin showed to be a viable anticoagulation alternative in terms of efficacy compared to UFH and resulted in a favorable safety profile with lower rates of bleeding and thrombotic events.
In 1861, the Confederate States of America authorized the establishment of a “Court of Admiralty and Maritime Jurisdiction” at Key West. Although a judge was appointed, the court never sat because the island remained in Union hands throughout the Civil War. After first describing the court's creation and staffing, this article highlights the various procedural and practical problems the court would have faced if it had been able to operate.
In 1859, Key West found itself transfixed by a sensational criminal trial. Styled United States v. Carcer, Eloy, and Davis, and presided over by William Marvin, the island's legendary federal judge, the case involved a mutiny-murder aboard the slave ship Enterprise. Although famous in its day, the tale has been all but forgotten due to the Great Key West Fire of 1886, which destroyed nearly every record of the affair.
In 1845, lawyer-turned-physician Daniel W. Whitehurst, originally from Virginia, moved to Key West. By the time of his death in 1872, Whitehurst had served as the city's mayor, state senator, and captain of its rebel guard. Nevertheless, Whitehurst now is an unknown figure. Buried with him is his cause of death, which may have been suicide.
Objective: Mixed methods research (MMR) integrates quantitative and qualitative methods throughout the research process to answer complex research questions. Mixed methods research designs align with the guiding frameworks of patient-centered care and social determinants of health by effectively examining the role of contextual factors and human experiences in influencing health and rehabilitation outcomes. Reporting standards and critical appraisal tools ensure quality and transparency of the research process. Mixed methods research standards exist yet there is a need for reporting guidelines and an appraisal tool that meets field standards, is applicable across rehabilitation fields of study, and can accommodate the range of possibilities for combining research approaches and methods. Methods: The Mixed Methods Reporting in Rehabilitation & Health Science (MMR-RHS) was developed using a systematic consensus-building process in accordance with published guidance and was preregistered with the Equator Network. MMR-RHS evolved through a sequence of steps including extensive literature review, expert consultation, stakeholder feedback, pilot testing, and tool refinement. Results: MMR-RHS consists of 20 criteria that align with field standards for rigor and transparency with emphasis on integration throughout the research process, a key component of mixed methods research. Conclusions: A systematic process was utilized to develop reporting standards and an appraisal tool for mixed methods research in rehabilitation and health science. The tool is comprehensive, includes a set of criteria grounded in mixed methods research literature, and is flexible for application to a range of mixed methods research designs commonly seen in rehabilitation research. Impact: The MMR-RHS may improve quality and transparency of mixed methods research by supporting investigators, authors, reviewers, and editors during project development, manuscript preparation, and critical review. The tool may assist readers in critical appraisal, knowledge translation, and application of published mixed methods research findings. Ultimately, the MMR-RHS may help legitimize mixed methods in rehabilitation and health research, an important step toward understanding the complexities of healthcare, patient outcomes, and evolving societal health needs.
Background Youth with ADHD are at risk of academic impairments, dropping out of high school, and dysfunction in young adulthood. Interventions delivered early in high school could prevent these harmful outcomes, yet few high school students with ADHD receive treatment due to limited access to intervention providers. This study will test a peer-delivered intervention (STRIPES) for general education 9th grade students with impairing ADHD symptoms. Methods A type 1 hybrid effectiveness-implementation design will be used to evaluate the effectiveness of STRIPES and explore the intervention’s implementability. Analyses will test the impact of STRIPES vs. enhanced school services control on target mechanisms and determine whether differences in basic cognitive profiles moderate intervention response. The acceptability and feasibility of STRIPES and treatment moderators will also be examined. Discussion This study will generate knowledge about the effectiveness and implementability of STRIPES, which will inform dissemination efforts in the future. A peer-delivered high school intervention for organization, time management, and planning skills can provide accessible and feasible treatment targeting declines in academic motivation, grades, and attendance during the ninth-grade year. Trial registration This study is registered on OSF Registries (10.17605/OSF.IO/Q8V6S).
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