Life After Death in Lake Erie: Nutrient Controls Drive Fish Species Richness, Rehabilitation

We explored the recent (1969–1996) dynamics of fish communities within Lake Erie, a system formerly degraded by eutrophication and now undergoing oligotrophication owing to phosphorus abatement programs. By merging bottom trawl data from two lake basins of contrasting productivity with life-history information (i.e., tolerances to environmental degradation, diet and temperature preferences), we examined (1) the relationship between system productivity and species richness, (2) whether fish communities are resilient to eutrophication, and (3) whether oligotrophication necessarily leads to reduced sport and commercial fish production. Reduced phosphorus loading has led to fish community rehabilitation. In the productive west basin, six species tolerant of eutrophy (i.e., anoxia, turbidity) declined in abundance, whereas the abundance of three intolerant species increased through time. In the less productive central basin, although only one tolerant species declined, four species intolerant of eutrophic conditions recovered with oligotrophication. These differential responses appear to derive from dissimilar mechanisms by which reduced productivity alters habitat and resource availability for fishes. Specifically, enhanced bottom oxygen, combined with reduced biogenic turbidity and sedimentation, likely drove the loss of tolerant species in the west basin by reducing detrital mass or the ability of these species to compete with intolerant species under conditions of improved water clarity. In contrast, reduced bottom anoxia, which enhanced availability of cool- and cold-water habitat and benthic macroinvertebrate communities, appears important to the recovery of intolerant species in the central basin. Ultimately, these productivity-induced shifts caused species richness to decline in Lake Erie’s west basin and to increase in its central basin. Beyond confirming that unimodal models of productivity and species diversity can describe fish community change in a recovering system, our results provide optimism in an otherwise dismal state of affairs in fisheries management (e.g., overexploitation), given that many recovering intolerant species are desired sport or commercial fishes.Support for this work was provided by (1) Federal Aid in Sport Fish Restoration F-69-P (to R. A. Stein), administered jointly by the U.S. Fish and Wildlife Service and ODNR-ODW, (2) the Department of Evolution, Ecology, and Organismal Biology at The Ohio State University, and (3) a Presidential Fellowship awarded to S. A. Ludsin by The Ohio State University

Epigenetic regulation of transcription: a mechanism for inducing variations in phenotype (fetal programming) by differences in nutrition during early life?

There is considerable evidence for the induction of different phenotypes by variations in the early life environment, including nutrition, which in man is associated with a graded risk of metabolic disease; fetal programming. It is likely that the induction of persistent changes to tissue structure and function by differences in the early life environment involves life-long alterations to the regulation of gene transcription. This view is supported by both studies of human subjects and animal models. The mechanism which underlies such changes to gene expression is now beginning to be understood. In the present review we discuss the role of changes in the epigenetic regulation of transcription, specifically DNA methylation and covalent modification of histones, in the induction of an altered phenotype by nutritional constraint in early life. The demonstration of altered epigenetic regulation of genes in phenotype induction suggests the possibility of interventions to modify long-term disease risk associated with unbalanced nutrition in early life

Presenilin-Dependent Receptor Processing Is Required for Axon Guidance

SummaryThe Alzheimer's disease-linked gene presenilin is required for intramembrane proteolysis of amyloid-β precursor protein, contributing to the pathogenesis of neurodegeneration that is characterized by loss of neuronal connections, but the role of Presenilin in establishing neuronal connections is less clear. Through a forward genetic screen in mice for recessive genes affecting motor neurons, we identified the Columbus allele, which disrupts motor axon projections from the spinal cord. We mapped this mutation to the Presenilin-1 gene. Motor neurons and commissural interneurons in Columbus mutants lacking Presenilin-1 acquire an inappropriate attraction to Netrin produced by the floor plate because of an accumulation of DCC receptor fragments within the membrane that are insensitive to Slit/Robo silencing. Our findings reveal that Presenilin-dependent DCC receptor processing coordinates the interplay between Netrin/DCC and Slit/Robo signaling. Thus, Presenilin is a key neural circuit builder that gates the spatiotemporal pattern of guidance signaling, thereby ensuring neural projections occur with high fidelity

Agenda for Translating Physical Activity, Nutrition, and Weight Management Interventions for Cancer Survivors into Clinical and Community Practice.

Evidence supporting physical activity, diet, and weight management for cancer survivors has grown, leading to the development of guidelines and interventions. The next step is to identify necessary practice and policy changes and to develop a research agenda to inform how interventions can be delivered to survivors most effectively and efficiently in health care settings and by community-based organizations. Here, an agenda is proposed for research, practice, and policy that incorporates recommendations for a range of programming options, a patient-centered, tailored screening and referral approach, and training needs for survivorship care providers and providers of exercise, nutrition, and weight management services. Research needs to focus on sustainability, dissemination, and implementation. Needed policy changes are presented, as well as opportunities to leverage current health care policies

Supporting Practices to Adopt Registry-Based Care (SPARC): protocol for a randomized controlled trial

Background: Diabetes is predicted to increase in incidence by 42% from 1995 to 2025. Although most adults with diabetes seek care from primary care practices, adherence to treatment guidelines in these settings is not optimal. Many practices lack the infrastructure to monitor patient adherence to recommended treatment and are slow to implement changes critical for effective management of patients with chronic conditions. Supporting Practices to Adopt Registry-Based Care (SPARC) will evaluate effectiveness and sustainability of a low-cost intervention designed to support work process change in primary care practices and enhance focus on population-based care through implementation of a diabetes registry. Methods: SPARC is a two-armed randomized controlled trial (RCT) of 30 primary care practices in the Virginia Ambulatory Care Outcomes Research Network (ACORN). Participating practices (including control groups) will be introduced to population health concepts and tools for work process redesign and registry adoption at a meeting of practice-level implementation champions. Practices randomized to the intervention will be assigned study peer mentors, receive a list of specific milestones, and have access to a physician informaticist. Peer mentors are clinicians who successfully implemented registries in their practices and will help champions in the intervention practices throughout the implementation process. During the first year, peer mentors will contact intervention practices monthly and visit them quarterly. Control group practices will not receive support or guidance for registry implementation. We will use a mixed-methods explanatory sequential design to guide collection of medical record, participant observation, and semistructured interview data in control and intervention practices at baseline, 12 months, and 24 months. We will use grounded theory and a template-guided approach using the Consolidated Framework for Implementation Research to analyze qualitative data on contextual factors related to registry adoption. We will assess intervention effectiveness by comparing changes in patient-level hemoglobin A1c scores from baseline to year 1 between intervention and control practices. Discussion: Findings will enhance our understanding of how to leverage existing practice resources to improve diabetes care in primary care practices by implementing and using a registry. SPARC has the potential to validate the effectiveness of low-cost implementation strategies that target practice change in primary care

Risk of Human Immunodeficiency Virus Type 1-Related Neurologic Disease in a Cohort of Intravenous Drug Users

Background: Although the proportion of cases of acquired immunodeficiency syndrome related to intravenous drug use has increased dramatically over the past decade, there has been no longitudinal examination of primary neurologic disease in this group. Objective: To study the development of neurologic disease in human immunodeficiency virus (HIV)—negative and HIV-positive men and women who were intravenous drug users over a 3.5-year period. Design: Prospective observational cohort study. Setting: Subjects were recruited from an infectious disease clinic at a New York City Hospital or from a methadone maintenance program. Participants: Ninety-nine HIV-negative (62 men and 37 women) and 124 HIV-positive (85 men and 39 women) intravenous drug users volunteered. Main Outcome Measure: The development of clinically significant manifestations in six neurologic domains. Results: With multivariate adjustment for current and past substance abuse, age, education, and head injury, we examined the odds of developing HIV-related neurologic disease. Extrapyramidal signs and reduced motor ability became increasingly apparent over time in HIV-infected men as their CD4 cell count declined and as the subjects developed the acquired immunodeficiency syndrome. Fewer neurologic signs were seen in the women. Conclusions: The impact of HIV infection among intravenous drug users parallels that in homosexual men and is independent of alcohol and other drug use

Supporting Practices to Adopt Registry-Based Care (SPARC): protocol for a randomized controlled trial

Background: Diabetes is predicted to increase in incidence by 42% from 1995 to 2025. Although most adults with diabetes seek care from primary care practices, adherence to treatment guidelines in these settings is not optimal. Many practices lack the infrastructure to monitor patient adherence to recommended treatment and are slow to implement changes critical for effective management of patients with chronic conditions. Supporting Practices to Adopt Registry-Based Care (SPARC) will evaluate effectiveness and sustainability of a low-cost intervention designed to support work process change in primary care practices and enhance focus on population-based care through implementation of a diabetes registry. Methods: SPARC is a two-armed randomized controlled trial (RCT) of 30 primary care practices in the Virginia Ambulatory Care Outcomes Research Network (ACORN). Participating practices (including control groups) will be introduced to population health concepts and tools for work process redesign and registry adoption at a meeting of practice-level implementation champions. Practices randomized to the intervention will be assigned study peer mentors, receive a list of specific milestones, and have access to a physician informaticist. Peer mentors are clinicians who successfully implemented registries in their practices and will help champions in the intervention practices throughout the implementation process. During the first year, peer mentors will contact intervention practices monthly and visit them quarterly. Control group practices will not receive support or guidance for registry implementation. We will use a mixed-methods explanatory sequential design to guide collection of medical record, participant observation, and semistructured interview data in control and intervention practices at baseline, 12 months, and 24 months. We will use grounded theory and a template-guided approach using the Consolidated Framework for Implementation Research to analyze qualitative data on contextual factors related to registry adoption. We will assess intervention effectiveness by comparing changes in patient-level hemoglobin A1c scores from baseline to year 1 between intervention and control practices. Discussion: Findings will enhance our understanding of how to leverage existing practice resources to improve diabetes care in primary care practices by implementing and using a registry. SPARC has the potential to validate the effectiveness of low-cost implementation strategies that target practice change in primary care

Socioeconomic status and polycystic ovary syndrome

BACKGROUND: Polycystic ovary syndrome (PCOS) is a common metabolic-endocrine disorder in women and is associated with a number of metabolic morbidities. We examined the association of PCOS and its components with socioeconomic status (SES) over the life course to explore the role of the environment on the development of PCOS. METHODS: Participants included 1163 women, aged 34-39, from the Coronary Artery Risk Development in Young Adults (CARDIA) Women\u27s Study, examined at year 16 of the CARDIA study (2001). PCOS was defined according to the 1990 National Institutes of Health (NIH) criteria. RESULTS: Logistic regression models, adjusted for age, body mass index (BMI), waist circumference, and oral contraceptive (OC) use, demonstrated a statistically significant association between those women with low parental education/high personal education and PCOS (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.4-4.4). CONCLUSIONS: Our results indicate that women who experienced low childhood SES are at increased risk of PCOS, but this risk is limited to those who have personally attained a high level of education. More research is needed to determine the childhood socioeconomic factors that might influence this risk and whether conditions associated with upward life mobility play a role or if this group of at-risk women is simply more likely to recall the symptoms that define PCOS

Spatial variation in avian bill size is associated with humidity in summer among Australian passerines

Background: Climate imposes multiple selection pressures on animal morphology. Allen’s Rule proposes thatgeographic variation in the appendage size of endotherms, relative to body size, is linked to climatic variation,thereby facilitating heat exchange and body temperature regulation. Thus relatively larger appendages tend to befound in animals in warmer climates. Despite growing understanding of the role of the avian bill as an organ forheat exchange, few studies have tested the ecological significance of bill size for heat dissipation across speciesand environmental gradients. Amongst those that have, most have focused on the relationship with ambienttemperature, but there is growing evidence that humidity also has a strong influence on heat dissipation. Inparticular, increasing humidity reduces the potential for evaporative cooling, favouring radiative and convectiveheat loss via the bill, and hence potentially favouring larger bills in humid environments. Here, we usedphylogenetically-controlled analyses of the bill morphology of 36 species of Australian passerines to explore therelationship between bill size and multiple aspects of climate.Results: Humidity during the hot summer months (December-February) was positively associated with relative billsurface area across species. There was no overall association between bill size and summer temperatures per se, butthe association with humidity was mediated by temperature, with a significant interaction indicating strongerassociations with humidity at cooler summer temperatures. This is consistent with the idea that larger bills maybecome disadvantageous in humid conditions as ambient temperature approaches body temperature. Relative billsize was similar among closely related species, with phylogeny explaining 63.3% of the variance, and there wassignificant variation among species in their response to humidity. However, the relationship between relative billsize and humidity was not associated with phylogeny.Conclusions: Our results are consistent with the idea that body temperature regulation underlies continent-widepatterns of bill size variation in a broad range of Australian passerines, and suggests that Allen’s Rule may apply tohumidity gradients as well as temperature gradients. They add to growing evidence that a narrow focus ontemperature alone in studies of responses to climate change may limit our understanding of species’ sensitivities toclimatic variation, and of their capacity to adapt

Injectable and Oral Contraceptive Use and Cancers of the Breast, Cervix, Ovary, and Endometrium in Black South African Women: Case–Control Study

A case-control study conducted in South Africa provides new estimates of the risk of specific cancers of the female reproductive system associated with use of injectable and oral contraceptives