Trophic guilds of marine predators in the California Current Large Marine Ecosystem

Quantifying trophic relationships of marine species is fundamental to the construction and performance of ecosystem models, development of effective ecosystem-based fisheries management strategies, and support of trait-based approaches to ecological risk assessment. Accounting for food web dynamics in taxonomically diverse ecosystems, such as the California Current Large Marine Ecosystem (CCLME), is especially challenging because of the sheer number of trophic linkages and their inherent variability. Consequently, analyses that can inform the most appropriate means of aggregating species or other taxonomic groups into assemblages or guilds are critical to reducing system complexity for modeling and management, particularly when data are limited. To provide a methodological approach that is globally applicable in such cases, we define trophic guilds within biogeographic regions of the CCLME, compare results among these regions, and discuss ecological and management implications. Within each biogeographic region, predator guilds were clearly demarcated by foraging habitat (benthic, nearshore pelagic, offshore pelagic), scale of foraging movements, and trophic position. Furthermore, trophic guilds were distinctive for each region, with species composition and the noted ecological characteristics largely driving guild structure. Predator species that are reliant on continental slope and offshore foraging habitat, such as adult Pacific Hake, have diets that are representative of these areas and are similar throughout the CCLME. Generally, larger, more mobile predators that typically feed in deeper offshore waters, including swordfish, sea lions, and sharks clustered together in multiple bioregions along the coast; all reliant primarily on fishes and squids. Throughout bioregions, groundfishes preyed on benthic invertebrates (e.g., decapods, amphipods, polychaetes), while shelf-oriented pelagic predators, including smaller salmon, preyed on pelagic invertebrates (e.g., euphausiids, copepods, gelatinous zooplankton). A large number of forage taxa that are well represented in this study have dynamics largely dependent on oceanographic conditions at a regional scale (e.g., decapods), basin scale (e.g., copepods), or a combination of both (e.g., euphausiids, Northern Anchovy). Such distinctions indicate that spatial and temporal scales of coherence of predators and prey also must be considered in development of ecosystem models and evaluation of management strategies. Our study quantifies the spatial coherence of predator guilds integrated over decades within and across bioregions of the CCLME, providing an improved understanding of regional ecosystem functioning. The analytical approach we developed may be easily extended to address similar ecological and ecosystem based fisheries management priorities in other marine regions

Ten Years’ Experience with Alendronate for Osteoporosis in Postmenopausal Women

Background Antiresorptive agents are widely used to treat osteoporosis. We report the results of a multinational randomized, double-blind study, in which postmenopausal women with osteoporosis were treated with alendronate for up to 10 years. Methods The initial three-year phase of the study compared three daily doses of alendronate with placebo. Women in the original placebo group received alendronate in years 4 and 5 and then were discharged. Women in the original active-treatment groups continued to receive alendronate during the initial extension (years 4 and 5). In two further extensions (years 6 and 7, and 8 through 10), women who had received 5 mg or 10 mg of alendronate daily continued on the same treatment. Women in the discontinuation group received 20 mg of alendronate daily for two years and 5 mg daily in years 3, 4, and 5, followed by five years of placebo. Randomized group assignments and blinding were maintained throughout the 10 years. We report results for the 247 women who participated in all four phases of the study. Results Treatment with 10 mg of alendronate daily for 10 years produced mean increases in bone mineral density of 13.7 percent at the lumbar spine (95 percent confidence interval, 12.0 to 15.5 percent), 10.3 percent at the trochanter (95 percent confidence interval, 8.1 to 12.4 percent), 5.4 percent at the femoral neck (95 percent confidence interval, 3.5 to 7.4 percent), and 6.7 percent at the total proximal femur (95 percent confidence interval, 4.4 to 9.1 percent) as compared with base-line values; smaller gains occurred in the group given 5 mg daily. The discontinuation of alendronate resulted in a gradual loss of effect, as measured by bone density and biochemical markers of bone remodeling. Safety data, including fractures and stature, did not suggest that prolonged treatment resulted in any loss of benefit. Conclusions The therapeutic effects of alendronate were sustained, and the drug was well tolerated over a 10-year period. The discontinuation of alendronate resulted in the gradual loss of its effects

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

Personal Values and Executive Leadership: Global Comparisons and Practical Implications

This paper examines the value orientations of executives and their linkages to leadership behaviors. The 181 executives in this study were randomly selected from the top 500 Australian companies. Value orientations of Australian executives compared with their Russian, Japanese, and Chinese counterparts reveal as many similarities as there are differences. In general, transformational leadership styles were most closely related to personal values orientations. The implications of the findings are discussed, and practical suggestions for leadership development and research are proposed