bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low‐Temperature Tolerance of Juvenile Spotted Seatrout in South Carolina
Authors: Anweiler Katie V. , Arnott Stephen A. , Denson Michael R. 
Published: October 2017

AbstractSpotted Seatrout Cynoscion nebulosus are vulnerable to mortality in winter when water temperature decreases rapidly. Temporary fishery closures in response to population declines should be based on a thorough understanding of the magnitude of winter mortality. We used three methods to estimate the low‐temperature tolerance of Spotted Seatrout: the chronic lethal method (CLM) and the acclimated chronic exposure (ACE) method using both static and fluctuating temperatures. All three methods use an environmentally realistic temperature change of 1°C/d. Fish acclimated to 14°C (n = 24) for 10 d and subsequently exposed to constantly declining temperatures using the CLM experienced loss of equilibrium at a temperature of 3.57 ± 0.24°C (mean ± SD) and mortality at a temperature of 3.08 ± 0.31°C. The ACE method, which uses changing temperatures until a base temperature is reached, was used to evaluate how Spotted Seatrout are affected by prolonged, sublethal temperatures. The ACE method was performed with static and fluctuating temperatures at two base temperatures (5.25°C and 4.25°C). Fish exposed to static temperatures of 5.25°C (n = 46) and 4.25°C (n = 46) had significantly different survival rates (P < 0.001) and 4% and 91% mortality, respectively. Temperature fluctuations around a 5.25°C base temperature did not significantly affect loss of equilibrium or mortality compared with the static treatment at 5.25°C. Temperature fluctuations at the 4.25°C base temperature did not cause greater mortality, but did cause fish to lose equilibrium significantly faster than in the static treatment (P < 0.001). Results of this study suggest that temperatures below 5°C should be cause for concern for this species, though the duration of cold temperatures and the spatial distribution of temperature conditions will determine the severity of a winter mortality event. These data can be used to develop predictive mortality estimates for juvenile Spotted Seatrout (175–220 mm).Received April 29, 2013; accepted March 4, 2014
Prevalence of External Skin Lesions and Polycyclic Aromatic Hydrocarbon Concentrations in Gulf of Mexico Fishes, Post‐Deepwater Horizon
Authors: Murawski Steven A. , Hogarth William T. , Peebles Ernst B. , Barbeiri Luiz 
Published: October 2017

AbstractWe surveyed offshore fish populations in the Gulf of Mexico in 2011 and 2012, following persistent reports of abnormal skin lesions and other pathologies in the aftermath of the Deepwater Horizon oil spill. The incidence of skin lesions in 2011 sampling was most frequent in some bottom‐dwelling species along the continental shelf edge north of the Deepwater Horizon site. Longline surveys revealed that by 2012 the overall frequency of lesions in northern Gulf of Mexico (NGM) fishes in the vicinity of the Deepwater Horizon had declined 53%, with severity also declining. Relatively high concentrations of polycyclic aromatic hydrocarbon (PAH) metabolites (up to 470,000 ng naphthalene equivalents/g bile wet weight), indicative of oil‐related pollution, were found in fish bile in 2011; concentrations of summed PAHs measured in fish liver and muscle were relatively low (<35 ng/g) due to the efficient metabolism of these compounds by teleost fish. Significant declines in bile concentrations of naphthalene and phenanthrene metabolites in Red Snapper Lutjanus campechanus between 2011 and 2012 indicate an episodic exposure to elevated levels of hydrocarbons of petrogenic origin. The composition of PAH parent compounds and alkylated homologs in Red Snapper liver samples was highly correlated with oil collected at the Deepwater Horizon wellhead but was less coherent with other PAH sources in the NGM. The elevated 2011 prevalence of skin lesions in some NGM species was unrelated to surface salinity or temperature anomalies and was not the result of an epizootic observable in our histopathology samples but was positively correlated with PAH concentration. Thus, we fail to reject the null hypothesis that elevated skin lesion frequency is unrelated to PAH exposure from the Deepwater Horizon oil spill.Received August 14, 2013; accepted March 26, 2014
Thermal Tolerance, Survival, and Recruitment of Cyprinids Exposed to Competition and Chronic Heat Stress in Experimental Streams
Authors: Dekar Matthew P. , McCauley Cagney , Ray Jesse W. , King Ryan S. 
Published: October 2017

AbstractWe examined survival, competition, and recruitment among cyprinids that were subjected to interspecific and intraspecific competition and chronic heat stress in large, outdoor experimental streams. The study was conducted in 2011 during the hottest summer (also one of the driest summers) recorded in Texas. We measured survival of Red Shiners Cyprinella lutrensis, Blacktail Shiners Cyprinella venusta, and Central Stonerollers Campostoma anomalum stocked at varying densities to examine competitive interactions. Trophic interactions among Blacktail Shiner density treatments were assessed with stable isotope analysis (SIA), and mitochondrial markers were used to examine the lineage of young‐of‐the‐year shiners spawned during the study. Stocking survival was significantly greater for Red Shiners, and both shiner species demonstrated higher overall survival rates than Central Stonerollers. Although SIA results were variable among replicate streams, more generalist foraging patterns were observed for Blacktail Shiners in the high‐density treatment (intraspecific competition; no Red Shiners present) relative to the low‐density Blacktail Shiner treatment. Less trophic redundancy was observed in the interspecific competition treatment (Blacktail Shiners and Red Shiners co‐occurring) compared with the same density of Blacktail Shiners only (high‐density treatment). Despite the potentially lethal water temperatures, including 4 d on which water temperatures exceeded 37°C, mitochondrial sequences showed that both Red Shiners and Blacktail Shiners were able to spawn during the study. These results collectively highlight potential mechanisms for explaining fish assemblage responses at local and landscape scales, such as the Red Shiner's recent range expansion and increased abundance in some areas of Texas. Our findings are relevant for forecasting regional changes in fish species distributions in response to more frequent droughts and warmer summers due to climate change.Received March 1, 2013; accepted March 11, 2014
Fish Assemblages of Shoal‐ and Shoreline‐Associated Seagrass Beds in Eastern Gulf of Mexico Estuaries
Authors: De Angelo Jacquelyn A. , Stevens Philip W. , Blewett David A. , Switzer Theodore S. 
Published: October 2017

AbstractAssemblage structure of fishes associated with seagrasses (order Alismatales) is affected by factors such as depth, seagrass coverage, location of seagrass beds, and proximity of seagrass beds to adjacent habitats. Although these relationships have been well explored for small‐bodied fishes, few studies have examined seagrass habitat use by large‐bodied fishes (>100 mm SL). To examine the effects of habitat characteristics on assemblages of large‐bodied fishes, two seagrass habitat types were sampled in three eastern Gulf of Mexico estuaries (2008–2010) with a 183‐m haul seine: (1) seagrasses immediately adjacent to shorelines and (2) seagrasses associated with shoals (seagrass beds >100 m from shoreline). Within each estuary, fish density was greater (as much as two times greater) in shoal seagrass beds than in those along shorelines. Fish assemblage structure also differed significantly between the two habitat types. Species that distinguished the seagrass shoreline (e.g., Spot Leiostomus xanthurus, Redfin Needlefish Strongylura notata) had affinities for habitats that were relatively shallow, gently sloped, less saline, and muddy with less seagrass coverage. Species that distinguished seagrass shoals (e.g., Pigfish Orthopristis chrysoptera, Silver Perch Bairdiella chrysoura) had affinities for habitats that were deeper, steeply sloped, sandy, and more saline, with greater seagrass coverage. Among economically important fishes, some were more abundant along shorelines (e.g., Common Snook Centropomus undecimalis, Sheepshead Archosargus probatocephalus, and Striped Mullet Mugil cephalus), while others were more abundant on shoals (e.g., Gag Mycteroperca microlepis, Spotted Seatrout Cynoscion nebulosus, and Scaled Sardine Harengula jaguana). This study demonstrates that seagrass shoals, which are being lost in some estuaries, provide different environmental conditions than those along shorelines, support unique fish assemblages, and host greater densities of several economically important species.Received November 12, 2013; accepted March 18, 2014
Sociodemographic and Clinical Factors Associated With Increasing Bacterial Sexually Transmitted Infection Diagnoses in Men Who Have Sex With Men Accessing Care at a Boston Community Health Center (2005–2015)
Authors: Mayer Kenneth H , Maloney Kevin M , Levine Kenneth , King Dana , Grasso Chris , Krakower Douglas S , Rosenberg Eli S , Boswell Stephen L 
Published: October 2017

Abstract

Background
The reasons why bacterial sexually transmitted infections (BSTIs) are increasing in US men who have sex with men (MSM) have not been fully characterized.

Methods
An open cohort of MSM accessing medical care at a Boston community health center was used to assess secular trends in BSTI diagnoses. Frequency of infection and the estimated population size were used to calculate diagnosis rates. Poisson models were fit for multivariable analyses.

Results
Between 2005 and 2015, 19 232 men had at least 1 clinic visit. Most (72.4%) were white; 6.0% were black, and 6.1% were Latino. Almost half had documented self-report of identifying as gay (42.6%) or bisexual (3.2%). Most had private health insurance (61.7%); 5.4% had Medicare, 4.6% had Medicaid, and 8.4% reported no insurance. Between 2005 and 2015, BSTI diagnoses increased more than 8-fold. In 2015, of 1319 men who were diagnosed with at least 1 BSTI; 291 were diagnosed with syphilis, 554 with gonorrhea (51.4% rectal, 31.0% urogenital), and 679 with chlamydia (69.1% rectal, 34.3% urogenital). In 2015, 22.7% of BSTIs were diagnosed among HIV-infected patients (15.4% of the clinic population), and 32.8% of BSTIs were diagnosed among HIV-uninfected patients using pre-exposure prophylaxis (PrEP; 10.1% of all men in care). In multivariable analyses, age 18 to 24 years, being HIV-infected, using PrEP, being nonwhite, or reporting Medicaid or not reporting having private insurance or Medicare were independently associated with being diagnosed with a new BSTI.

Conclusions
Over the past decade, BSTI diagnosis rates increased in HIV-infected and uninfected MSM, with disproportionate increases in PrEP users, racial and ethnic minority MSM, those aged 25 to 34 years, and those without stable health insurance, warranting focused education, screening, and accessible services for these key subpopulations.
Outpatient Macrolide Antibiotic Prescribing in the United States, 2008–2011
Authors: Sanchez Guillermo V , Shapiro Daniel J , Hersh Adam L , Hicks Lauri A , Fleming-Dutra Katherine E 
Published: October 2017

Abstract
National Ambulatory Medical Care Survey data were used to assess outpatient macrolide prescribing and selection. Conditions for which macrolides are firstline therapy represented 5% of macrolide prescribing. Family practitioners selected macrolides for children more frequently than pediatricians. Macrolides are an important antibiotic stewardship target.
Implementation and Evaluation of the Z-Score System for Normalizing Residency Evaluations
Authors: Wanderer Jonathan P. , de Oliveira Filho Getulio R. , Rothman Brian S. , Sandberg Warren S. , McEvoy Matthew D. 
Published: October 2017

Abstract

Background
Assessment of clinical competence is essential for residency programs and should be guided by valid, reliable measurements. We implemented Baker’s Z-score system, which produces measures of traditional core competency assessments and clinical performance summative scores. Our goal was to validate use of summative scores and estimate the number of evaluations needed for reliable measures.

Methods
We performed generalizability studies to estimate the variance components of raw and Z-transformed absolute and peer-relative scores and decision studies to estimate the evaluations needed to produce at least 90% reliable measures for classification and for high-stakes decisions. A subset of evaluations was selected representing residents who were evaluated frequently by faculty who provided the majority of evaluations. Variance components were estimated using ANOVA.

Results
Principal component extraction from 8,754 complete evaluations demonstrated that a single factor explained 91 and 85% of variance for absolute and peer-relative scores, respectively. In total, 1,200 evaluations were selected for generalizability and decision studies. The major variance component for all scores was resident interaction with measurement occasions. Variance due to the resident component was strongest with raw scores, where 30 evaluation occasions produced 90% reliable measurements with absolute scores and 58 for peer-relative scores. For Z-transformed scores, 57 evaluation occasions produced 90% reliable measurements with absolute scores and 55 for peer-relative scores. The results were similar for high-stakes decisions.

Conclusions
The Baker system produced moderately reliable measures at our institution, suggesting that it may be generalizable to other training programs. Raw absolute scores required few assessment occasions to achieve 90% reliable measurements.
The SPOT GRADE
Authors: Spotnitz William D. , Zielske Dirk , Centis Valerie , Hoffman Rachel , Gillen Daniel L. , Wittmann Catherine , Guyot Vincent , Campos Doris M. , Forest Patricia , Pearson Alan , McAfee Paul C. 
Published: October 2017

Study Design.Benchtop model with prospective surgeon video testing.Objective.To create a surface bleeding severity scale, the SPOT GRADE (SG), for quantitative assessment of target bleeding site (TBS) blood loss. This is of particular interest for spinal surgery due to epidural bleeding and an inability to use diathermy and radiofrequency cautery close to nerve roots.Summary of Background Data.A novel apparatus perfusable at known flow rates and simulating different sized wounds was used to create movies to educate surgeons on specific degrees of bleeding.Methods.Training (36) and testing (108) videos were created using a benchtop apparatus employing different bleeding severities based on the six-level SG (none, minimal, mild, moderate, severe, and extreme) and TBS sizes (1, 10, and 50 cm2). Fourteen surgeons in four specialties (cardiothoracic, abdominal, spine, and orthopedic lower extremity) were trained and tested to evaluate SG characteristics including inter-rater and intrarater reliability.Results.The interclass correlation coefficient was estimated to be 0.89840 (95% confidence interval [CI]: 0.85771, 1), whereas the intraclass correlation coefficient was estimated to be 0.93673 (95% CI: 0.89603, 1). In 98% of cases (95% CI: 0.9736, 0.9927), surgeons correctly identified eligible bleeds for a future clinical trial (scores = 1, 2, or 3) and in 91% of cases (95% CI: 0.8895, 0.9344), surgeons correctly identified noneligible bleeds (scores = 4 or 5). In 98.6% of cases (95% CI: 0.9777, 0.9945), physicians correctly identified true hemostasis (score = 0). Based upon these data the probability of a physician rating a bleed incorrectly as hemostasis (score = 0) is estimated to be 1.51% (95% CI: 0.0061, 0.0363).Conclusion.This SG is reproducible and reliable providing a basis for educating surgeons on TBS blood loss. It appears to be a new standard for evaluating wound blood loss.Level of Evidence:2
Syncope Episodes and Blood Flow Restriction Training
Authors: Martín-Hernández Juan , Santos-Lozano Alejandro , Foster Carl , Lucia Alejandro 
Published: October 2017

Abstract:
The combination of low-load resistance training [or more recently, neuromuscular electrical stimulation (NMES)] with a moderate local blood flow restriction (BFR) is becoming a widespread training and rehabilitation method. Scientific data indicate the overall safety of BFR, at least in healthy young people. However, it has been associated with side effects, usually minor, and further research is warranted regarding the safety and efficacy of this technique, especially in clinical populations. We found 3 syncope/presyncopal episodes among 21 healthy people (9 men), all occurring in men and during familiarization sessions (in which BFR was applied alone) but not thereafter (BFR sessions combined with NMES): 1 subject experienced a brief syncope and 2 other subjects exhibited presyncopal symptoms (sweating, lightheadedness, and pallor). Our cases are evidence that cardiovascular complications may emerge during BFR. Caution is thus needed in the application of BFR, and gentle familiarization with this training modality is also recommended.
Septic shock resuscitation in the first hour
Authors: Simpson Nicholas , Lamontagne Francois , Shankar-Hari Manu 
Published: October 2017

Purpose of review
We reviewed the recent advances in the initial approach to resuscitation of sepsis and septic shock patients.

Recent findings
Sepsis and septic shock are life-threatening emergencies. Two key interventions in the first hour include timely antibiotic therapy and resuscitation. Before any laboratory results, the need for resuscitation is considered if a patient with suspected infection has low blood pressure (BP) or impaired peripheral circulation found at clinical examination. Until now, this early resuscitation in sepsis and septic shock was supported by improvements in outcome seen with goal-directed therapy. However, three recent, goal-directed therapy trials failed to replicate the originally reported mortality reductions, prompting a debate on how this early resuscitation should be performed. As resuscitation is often focussed on macrociculatory goals such as optimizing central venous pressure, the discordance between microcirculatory and macrocirculatory optimization during resuscitation is a potential argument for the lack of outcome benefit in the newer trials. Vasoactive drug dose and large volume resuscitation-associated-positive fluid balance, are independently associated with worse clinical outcomes in critically ill sepsis and septic shock patients. As lower BP targets and restricted volume resuscitation are feasible and well tolerated, should we consider a lower BP target to reduce the adverse effects of catecholamine’ and excess resuscitation fluids. Evidence guiding fluids, vasopressor, and inotrope selection remains limited.

Summary
Though the early resuscitation of sepsis and septic shock is key to improving outcomes, ideal resuscitation targets are elusive. Distinction should be drawn between microcirculatory and macrocirculatory changes, and corresponding targets. Common components of resuscitation bundles such as large volume resuscitation and high-dose vasopressors may not be universally beneficial. Microcirculatory targets, individualized resuscitation goals, and reassessment of completed trials using the updated septic shock criteria should be focus areas for future research.
Comparison of fenofibrate and pioglitazone effects on patients with nonalcoholic fatty liver disease
Authors: Yaghoubi Malek , Jafari Sattar , Sajedi Behnam , Gohari Sepehr , Akbarieh Samira , Heydari Amir H. , Jameshoorani Maryam 
Published: October 2017

Introduction
Nonalcoholic fatty liver disease (NAFLD) is known to be a health-related problem; there is no proven treatment for NAFLD. However, a wide range of possible therapies have been proposed and studied. In the current study, we aimed to compare the therapeutic effects of fenofibrate and pioglitazone on NAFLD.

Patients and methods
In this randomized clinical trial study (ethic number: ZUMS.REC.1393.133), patients with NAFLD and alanine aminotransferase in range of 1–1.5 folds of normal and BMI (25–35) were studied. Blood lipids and liver enzymes were measured. The patients were divided randomly into three groups (recipient of fenofibrate, pioglitazone, and exercise). After the patients completed the course of treatment, liver enzymes were measured.

Results
According to the results of this study, 90 patients with NAFLD were divided into three groups of 30 patients. All variables at the beginning of the study showed no significant difference among the three groups, but after the treatment period, the results showed that the levels of alanine aminotransferase, aspartate transaminase, systolic blood pressure, diastolic blood pressure, and BMI changed significantly: the levels decreased in all groups.

Conclusion
This study showed beneficial effects of fenofibrate and pioglitazone in patients with fatty liver. Further studies with larger study populations on the effects of these drugs on fatty liver, lipid profile, blood glucose, and insulin are suggested.
Outcomes after Phalloplasty: Do Transgender Patients and Multiple Urethral Procedures Carry a Higher Rate of Complication?
Authors: Remington Austin C. , Morrison Shane D. , Massie Jonathan P. , Crowe Christopher S. , Shakir Afaaf , Wilson Stelios C. , Vyas Krishna S. , Lee Gordon K. , Friedrich Jeffrey B. 
Published: October 2017

Background:
Phalloplasty is associated with improved quality-of-life in those with penile defects, and in female-to-male transgender (transmale) patients seeking gender-confirming surgery. However, aggregate complication and outcome data are sparse. This study compares phalloplasty outcomes between transmale and cismale patients and between those with primary versus staged urethroplasty.

Methods:
A comprehensive literature search of PubMed, MEDLINE, and Google Scholar databases was conducted for studies relating to phalloplasty. Data on techniques, complications, outcomes, and patient demographics were collected. Analysis using the random-effects model with subgroup analyses was performed.

Results:
A total of 50 studies (1351 patients) were included: 19 studies (869 patients) for transmale patients and 31 studies (482 patients) for cismale patients. The urethral complication rate in the transmale group was 39.4 percent (95 percent CI, 30.6 to 48.9 percent; p = 0.028) compared to 24.8 percent (95 percent CI, 16.5 to 35.4 percent; p < 0.001) in the cismale group. The overall flap complication rates for transmale and cismale patients were 10.8 percent (95 percent CI, 7.0 to 16.2 percent; p < 0.001) and 8.1 percent (95 percent CI, 5.5 to 11.7 percent; p < 0.001), respectively. Twenty-three studies (723 patients) used primary urethroplasty and 13 studies (210 patients) performed staged urethroplasty procedures. Flap complication rates of primary and staged urethroplasty were 8.6 percent (95 percent CI, 5.3 to 13.8 percent; p < 0.001) and 16.7 percent (95 percent CI, 10.7 to 24.9 percent; p < 0.001), respectively. Primary urethroplasty had superior outcomes of voiding while standing, sexual function, and patient satisfaction compared with staged urethroplasty.

Conclusions:
Cismale patients undergoing phalloplasty had lower urethral and flap complication rates compared with transmale patients. Staged urethroplasty had more flap complications, and worse outcomes and patient satisfaction compared with primary urethroplasty.