High‐resolution satellite measurements of ocean color and surface winds, along with historical in situ data, are used to explore interannual variability in the annual migration of the transition zone ...chlorophyll front (TZCF) in the central North Pacific Ocean. Significant variations in frontal position and annual range were observed, including a significant southerly displacement during El Niño events. This displacement, apparently forced by enhanced surface convergence and vertical mixing in the transition zone, creates vast regions of anomalously high wintertime surface chlorophyll in the North Pacific Subtropical Gyre. A remarkably close correspondence between the positions of the TZCF and the 18°C surface isotherm over a portion of the central North Pacific allows historical temperature data to be used as a proxy for TZCF position. This surface temperature proxy has revealed decadal‐scale variability in frontal position, with greater (lesser) annual range and southerly extent following the large‐scale 1976–77 (1998–99) climate shifts. Interannual variations in TZCF position could have important implications for the distribution and survival of a number of apex predators that utilize the TZCF as a migratory and foraging habitat.
National Oceanic and Atmospheric Administration’s Coral Reef Conservation Program supports the National Coral Reef Monitoring Program (NCRMP) in the United States Pacific, Atlantic, Caribbean, and ...Gulf of Mexico. NCRMP conducts standardized observations of biological, climatic, and socioeconomic indicators across American Samoa, Guam, the Main Hawaiian Islands, the Northwestern Hawaiian Islands, the Northern Mariana Islands, the Pacific Remote Islands, Florida, the Flower Garden Banks, Puerto Rico, and the United States Virgin Islands. NCRMP provides periodic, national-level assessments of the status of United States coral reef ecosystems and communities connected to them. In 2014, NCRMP partnered with the University of Maryland Center for Environmental Science on an unprecedented collaboration between federal and jurisdictional/state agencies, academia, and non-governmental organizations to synthesize NCRMP data into a reporting format designed to be accessible and relevant to the public and policy makers. The process involved multi-year data analyses of key benthic, fish, and climate indicators. In populated jurisdictions, socioeconomic data were integrated to assess public support for management actions, participation in pro-environmental behaviors, and awareness of threats to coral reefs. Jurisdictions were scored using a report-card scale (0–100%) by establishing references for each indicator using best-available historical data or expert opinion where historical data did not exist or were not statistically comparable. Despite overall ecosystem scores of Fair for all combined Atlantic (70%) and Pacific (74%) jurisdictions, the current trend is downward with a majority of United States coral reefs declining and vulnerable to further degradation. Remote, uninhabited reefs had an advantage with respect to reef fish population scores, i.e., Flower Garden Banks (85%) and Pacific Remote Islands (93%), when compared to populated location scores, i.e., Puerto Rico (63%) and Main Hawaiian Islands (66%). All coral reefs are highly impacted by climate change, and climate impacts were more pronounced than expected on remote reefs, i.e., the Northwestern Hawaiian Islands (58%). Presenting results in a report-card style facilitates communication to the public and policy makers, and provides a useful mechanism to garner support for management actions such as expanding protected areas; enforcing existing regulations; increasing climate change education; reducing land-based sources of pollution; and other actions to improve the trajectory of coral reef ecosystem conditions.
Hemorrhage is a major concern in patients undergoing hepatic surgery or in those with hepatic trauma. In these cases, employing traditional hemostatic strategies can be problematic due to the diffuse ...nature of hepatic hemorrhage and limited opportunities for direct hemostasis. This study assessed the efficacy of a bovine-derived thrombin solution, (BT), as a topical liquid agent to augment hemostasis and survival following severe hepatic hemorrhage in a rat model. Heart rate (HR), arterial blood pressure (ABP), packed cell volume (PCV), and overall survival were evaluated in 54 rats randomly assigned to receive topical application of BT, saline, or suture ligation applied immediately to a liver lobe following controlled laceration. Six additional rats received liver laceration with no applied treatment. Intravenous fluid resuscitation was initiated and HR and ABP were recorded for 60 min, after which survivors were recovered from anesthesia. Rats were then monitored for 72 h, after which survivors were euthanized. There was no significant difference in survival time, percentage survival, intra-operative ABP or HR, or post-operative PCV between treatment groups. There is insufficient evidence to recommend BT as the sole therapy using this delivery method for mitigating severe hemorrhage from liver injury.
Introduction: Anterior uveal melanocytoma (AUM) pose a diagnostic challenge as they can mimic growing melanomas. Establishing a definitive diagnosis of melanocytoma necessitates cytologic or ...histopathologic confirmation. We describe the clinical presentation and characteristics of fifteen pathologically proven AUM cases and assess the role of fine needle aspiration biopsy (FNAB) as a safe and effective tool for diagnosis. Methods: Retrospective review of pathologically confirmed AUM cases was performed. Demographic data, presenting symptoms, clinical features, diagnostic approach, cytological and histological features, and clinical outcomes were collected. Results: Fifteen patients with pathologically confirmed AUM were identified. The mean and median age of diagnosis were 50 and 53 years, respectively (range 3–77 years). The melanocytoma was localized to the iris (5, 33%) or ciliary body (7, 47%), and 3 patients had iridociliary involvement (20%). Presentation was due to concern for growth in 4 (29%), visual symptoms in 1 (7%), and was an incidental finding in 10 (64%) patients. Pigmentation of the tumor varied with 9 (60%) appearing brown and 3 (20%) black in color. The color of 3 (20%) ciliary body tumors could not be assessed. The diagnosis was confirmed with FNAB in 6 (40%), excisional biopsy in 7 (47%), and incisional biopsy in 2 (13%). Cytologic and histologic preparations demonstrated predominance of round to polygonal cells with heavily pigmented cytoplasm and small round nuclei. One patient who underwent excisional biopsy had prior FNAB that was interpreted as suspicious for melanoma (false-positive). Instances of false-negative cytology were not observed as demonstrated by the subsequent stable clinical course during the mean follow-up of 21.2 months (range = 1.0–63.0 months). FNAB-related complications were not observed in any case. Conclusion: FNAB offers a minimally invasive and safe diagnostic approach for pathologic confirmation of AUM. However, limitations of FNAB including false-negative and false-positive biopsies must be considered when excluding underlying malignancy. Continued observation to document tumor stability should be considered.
OBJECTIVE: To describe the indications, duration of ventilation, underlying cardiac diseases, and outcome of dogs and cats undergoing positive‐pressure ventilation (PPV) for treatment of congestive ...heart failure (CHF). DESIGN: Two‐site retrospective study (1992–2012). SETTING: Two university small animal teaching hospitals. ANIMALS: Six cats and 10 dogs undergoing PPV for CHF. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Medical records were searched to identify patients requiring PPV for treatment of pulmonary edema secondary to CHF. Sixteen animals fulfilled these criteria. Patient signalment, duration of PPV, underlying cardiac disease, arterial or venous blood gas values, pharmacologic therapy before, during, and after PPV, anesthetic drugs, complications, and outcome were recorded. Overall survival to discharge was 62.5% (10/16). Mean (±SD) duration of PPV was 30.8 ± 21.3 hours and average time from presentation for CHF to initiation of PPV was 5.9 ± 6.4 hours. Azotemia at the time of initiation of ventilation, development of anuria or oliguria, and use of pentobarbital for anesthesia were negatively associated with survival (P = 0.011, P = 0.036, and P = 0.036, respectively). Survival‐to‐discharge rate was 77% (10/13) for patients treated after 2005 and those not receiving pentobarbital. There was no significant effect attributed to age, sex, weight, species, nature of heart disease, furosemide dose, length of ventilation, use of vasopressors, first‐time CHF events, or plasma lactate concentration on survival to discharge. CONCLUSIONS: Dogs and cats requiring PPV for CHF have a good overall prognosis for hospital discharge and require PPV for a relatively short duration. Azotemia, oliguria or anuria, and the use of pentobarbital are negatively associated with outcome.
Objective
To systematically examine the evidence on patient monitoring before, during, and following veterinary CPR and to identify scientific knowledge gaps.
Design
Standardized, systematic ...evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice. Relevant questions were answered on a worksheet template and reviewed by the Reassessment Campaign on Veterinary Resuscitation (RECOVER) monitoring domain members, by the RECOVER committee and opened for comments by veterinary professionals for 3 months.
Setting
Academia, referral practice, and general practice.
Results
Eighteen worksheets evaluated monitoring practices relevant for diagnosing cardiopulmonary arrest (CPA), monitoring CPR efforts, identifying return of spontaneous circulation (ROSC), and post‐ROSC monitoring.
Conclusions
Although veterinary clinical trials are lacking, experimental literature using canine models and human clinical trials provided relevant data. The major conclusions from this analysis of the literature highlight the utility of end‐tidal carbon dioxide (EtCO2) monitoring to identify ROSC and possibly to evaluate quality of CPR. In addition, recommendations for ECG analysis during CPR were addressed. Unless the patient is instrumented at the time of CPA, other monitoring devices (eg, Doppler flow probe) are likely not useful for diagnosis of CPA, and the possibility of pulseless electrical activity makes ECG inappropriate as a sole diagnostic tool. Optimal monitoring of the intra‐ and postcardiac arrest patient remains to be determined in clinical veterinary medicine, and further evaluation of the prognostic and prescriptive utility of EtCO2 monitoring will provide material for future studies in veterinary CPR.
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