What are contraindications to IUDs?

Based on limited evidence, use of intrauterine devices (IUDs) is not contraindicated for women with HIV/AIDS (strength of recommendation [SOR]: C), multiple sexual partners (SOR: C), previous actinomyces colonization (SOR: C), most types of fibroids (SOR: C), or previous ectopic pregnancy (SOR: C). The risk to IUD users of pelvic inflammatory disease (PID) is similar to women using no contraception (SOR: B). Nulliparous women may experience increased insertion discomfort and higher rates of expulsion (SOR: B). IUD use of <3.5 years is not associated with decreased fertility (SOR: B)

What are the risks to the fetus associated with diagnostic radiation exposure during pregnancy?

There is no evidence of significant risk to the developing fetus from any single diagnostic x-ray exposure (strength of recommendation: C, based on non-homogenous case-control studies). No studies were found on fetal exposure risks from other forms of diagnostic radiation such as computed tomography (CT) scans, fluoroscopy, or mammography. Prudent clinicians should order only those studies that result in clinically important information and efforts should be made to minimize fetal exposure

A Multidisciplinary Approach to Investigate Deep-Pelagic Ecosystem Dynamics in the Gulf of Mexico Following Deepwater Horizon

The pelagic Gulf of Mexico (GoM) is a complex system of dynamic physical oceanography (western boundary current, mesoscale eddies), high biological diversity, and community integration via diel vertical migration and lateral advection. Humans also heavily utilize this system, including its deep-sea components, for resource extraction, shipping, tourism, and other commercial activity. This utilization has had impacts, some with disastrous consequences. The Deepwater Horizon oil spill (DWHOS) occurred at a depth of ∼1500 m (Macondo wellhead), creating a persistent and toxic mixture of hydrocarbons and dispersant in the deep-pelagic (water column below 200 m depth) habitat. In order to assess the impacts of the DWHOS on this habitat, two large-scale research programs, described herein, were designed and executed. These programs, ONSAP and DEEPEND, aimed to quantitatively characterize the oceanic ecosystem of the northern GoM and to establish a time-series with which natural and anthropogenic changes could be detected. The approach was multi-disciplinary in nature and included in situ sampling, acoustic sensing, water column profiling and sampling, satellite remote sensing, AUV sensing, numerical modeling, genetic sequencing, and biogeochemical analyses. The synergy of these methodologies has provided new and unprecedented perspectives of an oceanic ecosystem with respect to composition, connectivity, drivers, and variability

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Cephalopods of the Broad Caribbean: Distribution, Abundance, and Ecological Importance

The Broad Caribbean region is defined as the Gulf of Mexico, and the coastal and marine areas of the Caribbean Sea, including the chain of islands forming the Greater and Lesser Antilles, Turks and Caicos, the Bahamas, and the gulf coasts of the United States, Central and South America (Stanley, 1995). The cephalopods of the Broad Caribbean were examined in terms of distribution, abundance, and ecological importance. A suite of 5190 preserved cephalopod specimens were identified and catalogued to produce regional maps of cephalopod distribution within the Broad Caribbean. Eighteen range extensions were noted for known species. Regional species richness was examined with respect to Rapoport\u27s Rule with an eye toward possible cephalopod hotspots in the region. Cephalopods of the Broad Caribbean within the latitudinal bands of 8°N and 30°N do not support Rapoport\u27s Rule as they exhibit increasing species richness with increasing latitude. Eight subareas were chosen to compare species richness. Regionally, species richness is patchy, with the largest concentration of cephalopods off the eastern Florida coast. Areas of the southern Caribbean Sea are in need of more samples for accurate assemblage counts and more meaningful comparisons with other Caribbean regions. Rarefaction curves were used to normalize the variously sized samples throughout the Broad Caribbean. A checklist of the Gulf of Mexico based on literature developed a picture for the northern regions of the Broad Caribbean. This checklist provided an updated account of cephalopod species that were reported from smaller literature works. Lastly, the first observation in the North Atlantic Ocean of the deep-sea squid Asperoteuthis acanthoderma (family Chiroteuthidae) was described. The description is based on two nearly intact, but damaged, specimens that were found floating at the surface in the waters off Key West and Marathon, Florida in 2007. All previously known records are recorded from a few specimens scattered in the western Pacific Ocean. There is a need for increased sampling throughout the Broad Caribbean to explore the systematics, life histories, distribution patterns, and potential fisheries for this group of organisms

Cephalopods of the Broad Caribbean: Distribution, Abundance, and Ecological Importance

The Broad Caribbean region is defined as the Gulf of Mexico, and the coastal and marine areas of the Caribbean Sea, including the chain of islands forming the Greater and Lesser Antilles, Turks and Caicos, the Bahamas, and the gulf coasts of the United States, Central and South America (Stanley, 1995). The cephalopods of the Broad Caribbean were examined in terms of distribution, abundance, and ecological importance. A suite of 5190 preserved cephalopod specimens were identified and catalogued to produce regional maps of cephalopod distribution within the Broad Caribbean. Eighteen range extensions were noted for known species. Regional species richness was examined with respect to Rapoport\u27s Rule with an eye toward possible cephalopod hotspots in the region. Cephalopods of the Broad Caribbean within the latitudinal bands of 8°N and 30°N do not support Rapoport\u27s Rule as they exhibit increasing species richness with increasing latitude. Eight subareas were chosen to compare species richness. Regionally, species richness is patchy, with the largest concentration of cephalopods off the eastern Florida coast. Areas of the southern Caribbean Sea are in need of more samples for accurate assemblage counts and more meaningful comparisons with other Caribbean regions. Rarefaction curves were used to normalize the variously sized samples throughout the Broad Caribbean. A checklist of the Gulf of Mexico based on literature developed a picture for the northern regions of the Broad Caribbean. This checklist provided an updated account of cephalopod species that were reported from smaller literature works. Lastly, the first observation in the North Atlantic Ocean of the deep-sea squid Asperoteuthis acanthoderma (family Chiroteuthidae) was described. The description is based on two nearly intact, but damaged, specimens that were found floating at the surface in the waters off Key West and Marathon, Florida in 2007. All previously known records are recorded from a few specimens scattered in the western Pacific Ocean. There is a need for increased sampling throughout the Broad Caribbean to explore the systematics, life histories, distribution patterns, and potential fisheries for this group of organisms

Doryteuthis plei (Blainville, 1823), slender inshore squid.

The loliginid squid species Doryteuthis plei is widely distributed in warm, tropical and subtropical waters from 36°N to 35° S in the western Atlantic Ocean, Caribbean Sea, and the Gulf of Mexico. This muscular species reaches 370 mm mantle length and shares many traits with the other abundant loliginid species in this area, Doryteuthis pealeii. Doryteuthis plei is abundant in parts of its range, with seasonal peaks in population sizes. This species is an important link in ecosystem dynamics as both predator and prey. Fisheries for D. plei center in the southeastern United States and the southern Caribbean and include artisanal and larger-scale commercial catches

Morphological and molecular evidence of heteroteuthis dagamensis in the Gulf of Mexico

Published records indicate that Heteroteuthis dispar (Ruppell, 1844) is found in the North Atlantic Ocean and that Heteroteuthis dagamensis Robson, 1924 inhabits the South Atlantic Ocean. However, specimens recently collected in the northern Gulf of Mexico (n = 123) show that H. dagamensis is the only species of the genus common in the Gulf of Mexico based on identification of male specimens. Also, comparison of DNA barcodes for three morphologically similar species of Heteroteuthis, H. dispar, H. dagamensis, and Heteroteuthis hawaiiensis (Berry, 1909) confirm that all are distinct species and indicate that H. dagamensis and H. hawaiiensis are closer genetically than either is to H. dispar

Vertical Migration Patterns of Cephalopods in the Northern Gulf of Mexico

Cephalopods are important in midwater ecosystems of the Gulf of Mexico (GOM) as both predator and prey. Vertical distribution and diel migration patterns are not known for the majority of deep-water cephalopods. These varying patterns are of interest as they have the potential to contribute to the movement of large amounts of nutrients and contaminants through the water column during diel migrations. Two large-scale programs (the Offshore Nekton Sampling and Analysis Program [ONSAP] and the Deep Pelagic Nekton Dynamics of the Gulf of Mexico [DEEPEND]) focused on the deep water column (0-1500 m) between the years 2010-16 to produce a combined dataset of over 12,500 midwater-cephalopod records for the region. Cephalopod vertical distribution patterns will be highlighted from the ONSAP and DEEPEND cruises, which utilized a Multiple Opening/Closing Net and Environmental Sensing System to acquire discrete-depth data. Species accounts include those with synchronous (e.g. Pterygioteuthis sp.) and asynchronous (e.g. Stigmatoteuthis arcturi) vertical migration. Non-migration patterns of various midwater cephalopods (e.g. Vampyroteuthis infernalis) are also highlighted. http://www.deependconsortium.or