Caregiver health-related quality of life, burden, and patient outcomes in ambulatory advanced heart failure: A report from REVIVAL

Background Heart failure (HF) imposes significant burden on patients and caregivers. Longitudinal data on caregiver health-related quality of life (HRQOL) and burden in ambulatory advanced HF are limited. Methods and Results Ambulatory patients with advanced HF (n=400) and their participating caregivers (n=95) enrolled in REVIVAL (Registry Evaluation of Vital Information for VADs [Ventricular Assist Devices] in Ambulatory Life) were followed up for 24 months, or until patient death, left ventricular assist device implantation, heart transplantation, or loss to follow-up. Caregiver HRQOL (EuroQol Visual Analog Scale) and burden (Oberst Caregiving Burden Scale) did not change significantly from baseline to follow-up. At time of caregiver enrollment, better patient HRQOL by Kansas City Cardiomyopathy Questionnaire was associated with better caregiver HRQOL

Scanning Electron Microscopic Aids For Identification Of Larval And Post-Larval Bivalves

The identification of bivalve larvae and early postlarvae in plankton and benthic samples has long been a challenge, hampering both basic and applied research efforts in marine, estuarine, and freshwater environments. The usefulness of published optical micrographs of the early life-history stages of bivalves is limited because of the great morphological similarity of the imaged articulated shells, particularly at the early (straight-hinge) developmental stages. While a number of techniques have been refined in recent years and show promise for use in routine identifications of larval and post-larval bivalves (e.g., single-step nested multiplex polymerase chain reaction; in situ hybridization protocols through color coding with taxon-specific, dye-labeled DNA probes; coupled fluorescence in situ hybridization and cell sorting; and image analysis techniques using species-specific shell birefringence patterns under polarized light), no adequate comprehensive reference source exists that accurately depicts the morphology and morphometry of the shells of larval and post-larval stages of target bivalve species in a consistent format to assist in identification of such stages. To this end, scanning electron micrograph (SEM) sequences are presented of the disarticulated shell valves of laboratory-reared larval and post-larval stages of 56 species of bivalve molluscs from a wide spectrum of marine, estuarine, and freshwater habitats. Emphasis is placed on the usefulness of the morphology and morphometrics of consistently-oriented, disarticulated shell valves and associated hinge structures in discriminating the early life-history stages of these various bivalve species. Although the scanning electron micrograph sequences presented accurately depict the gross morphologies/morphometrics and hinge structures of the disarticulated shell valves of the larvae and/or postlarvae of the 56 species of bivalves, it is important to emphasize that a scanning electron microscope is not necessary to observe even fine hinge structures associated with the early ontogenetic stages of these species. Such structures are readily visible using a wide range of optical compound microscopes equipped with high-intensity reflected light sources, although the disarticulated shell valves must be viewed in several planes of focus to discern the often subtle details seen clearly in the scanning electron micrographs. These morphological characters provide researchers with invaluable aids for the routine identification of the early life-history stages of these species isolated from plankton and benthic samples

How consistent is the advice from stock assessments? Empirical estimates of inter-assessment bias and uncertainty for marine fish and invertebrate stocks

Fishery management frequently involves precautionary buffering for scientific uncertainty. For example, a precautionary buffer that scales with scientific uncertainty is used to calculate the acceptable biological catch downward from the overfishing limit in the US federal fishery management system. However, there is little empirical guidance to suggest how large buffers for scientific uncertainty should be. One important component of uncertainty is variation among different assessments of the same stock in estimates of management-relevant quantities. We analysed commercially exploited marine fish and invertebrate stocks around the world and developed Bayesian hierarchical models to quantify inter-assessment variation in terminal year biomass and fishing mortality estimates, reference points, relative biomass and fishing mortality estimates, and overfishing limits. There was little evidence of inter-assessment bias; stock assessment estimates in the terminal year of the assessment were not consistently higher or lower than estimates of the same quantities in future years. However, there was a tendency for extreme values from the terminal year to be pulled closer to the mean in future years. Inter-assessment variation in all estimates differed across regions, and a longer inter-assessment interval generally resulted in greater variation. Inter-assessment uncertainty was greatest for estimates of the overfishing limit, with coefficients of variation ranging from 17% in Europe (non-EU) to 107% for Pacific Ocean pelagic stocks. Because inter-assessment variation is only one component of scientific uncertainty, we suggest that these uncertainty estimates may provide a basis for determining the minimum size of precautionary buffers

Fishing and bottom water temperature as drivers of change in maximum shell length in Atlantic surfclams (Spisula solidissima)

Maximum shell length of Atlantic surfclams (Spisula solidissima) on the Middle Atlantic Bight (MAB) continental shelf, obtained from federal fishery survey data from 1982-present, has decreased by 15-20 mm. Two potential causes of this decreasing trend, fishery removal of large animals and stress due to warming bottom temperatures, were investigated using an individual-based model for post-settlement surfclams and a fifty-year hindcast of bottom water temperatures on the MAB. Simulations showed that fishing and/or warming bottom water temperature can cause decreases in maximum surfclam shell length (body size) equivalent to those observed in the fished stock. Independently, either localized fishing rates of 20% or sustained bottom temperatures that are 2 degrees C warmer than average conditions generate the observed decrease in maximum shell length. However, these independent conditions represent extremes and are not sustained in the MAB. The combined effects of fishing and warmer temperatures can generate simulated length decreases that are similar to observed decreases. Interannual variability in bottom water temperatures can also generate fluctuations in simulated shell length of up to 20 mm over a period of 10-15 years. If the change in maximum size is not genotypic, simulations also suggest that shell size composition of surfclam populations can recover if conditions change; however, that recovery could take a decade to become evident

An Overview Of Factors Affecting Distribution Of The Atlantic Surfclam (Spisula solidissima), A Continental Shelf Biomass Dominant, During A Period Of Climate Change

The Atlantic surfclam (Spisula solidissitna) is a dominant member of the biological community of the Middle Atlantic Bight continental shelf and a commercially harvested species. Climate warming is affecting the biology and distribution of this species, which provides an opportunity to investigate the processes and conditions that are restructuring this fishery and the implications for ecological and socioeconomic systems. A Management Strategy Evaluation (MSE) developed for the surfclam fishery provides a mechanistic description of the surfclam\u27s response to climate change and understanding of the cascade of effects initiated by changes in oceanographic conditions that ultimately appear as social and economic effects. This understanding in turn informs development of management policies for the resource. This overview considers the components of the surfclam MSE, relevant results, and implications for management and policy. The lessons learned from the surfclam MSE provide a basis for applying similar approaches to other ecologically important species that are also commercially exploitable resources