Climatologically forced coherence between diverse juvenile populations in the Virginia tributaries to the Chesapeake Bay

Long term trends in juvenile recruitment of oyster, bluecrab, and 24 species of finfish in a large temperate estuary (lower Chesapeake Bay, USA) are coherent across the three major tributaries (the Virginia rivers James, York, and Rappahannock). The driving force for these long term trends is geographically large in scale. Anomalous winters in the mid 1970\u27s, with the warmest years on record followed immediately by the coldest, caused a severe perturbation in population dynamics. The extreme conditions caused the system to shift, with recruitment patterns following temperatures by a one year lag. Following this anomalous episode, smoothed mean winter water temperatures have increased steadily from 1979 until 1995 &\rm (3.9{lcub}-{rcub}5.7\sp\circ C,& long-term T = &\rm 4.6\sp\circ C),& closely followed (with zero lag) by the first principal component (PC) from each set of smoothed biological indices. Annual indices of juvenile abundance (means of log-transformed catch per unit effort) were calculated by river for the James, York and Rappahannock Rivers. Two collections of different temporal lengths are analysed, oyster, bluecrab and 14 species of finfish (1965-1995) and 17 species of finfish (1980-1995), with an overlap of seven species of finfish. The indices are smoothed by loess (locally weighted scatterplot smoother), and analyses are performed on the indices, the loess-smoothed indices, and the residuals. Principal components analysis (PCA) on the indices indicates coherence in the population fluctuations by a relatively small number of PC\u27s. Weak relationships are found in the unsmoothed indices and the residuals. Smoothed long-term trends eliminate much of the noise, thus exposing the underlying behavior of populations. PCA on the loess-smoothed indices were remarkably cohesive, with only three or four PC\u27s significant in each of the six treatments, accounting for 93 to 98% of total variance, with 44 to 70% in PC#1. Correlations on the first PC\u27s of the loess-smoothed indices, between rivers, within and between surveys, yielded 87-99% agreement; such coherence indicates the underlying causal factor is geographically broad. Cross correlations and scatterplots of smoothed winter water temperature and PC#1 identify the lag during the perturbation years

Evidence for a Relation Between a White Perch Young-of-the-Year Index and Indices of Later Life Stages

Juvenile indices are employed in fisheries management to predict the future relative abundance of harvestable adults and to monitor the success of management efforts. Frequently, regulations controlling utilization of the resource, and a lack of fishery independent abundance data, make verification of the prediction impossible. In the case of white perch (Morone americana) in Virginia, this is not so. Using the weighting system developed for a Chesapeake Bay-wide index of juvenile striped bass abundance based on summertime beach seine data collected in nursery ground waters, we developed a similar index for white perch in the Virginia portion of the Bay. Regressions against Virginia Institute of Marine Science otter trawl survey indices (taken in deep, mesohaline water during winter months) for young-of-the-year (r2 = 0.597, p = 0.003) and age 1 + (r2 = 0.703, p \u3c 0.001) white perch were significant and positive. These results lend support for the continued use of juvenile indices for finfish management

Do Striped Bass and Blue Crab Abundances Correlate in Chesapeake Bay?

We examined a corollary to the hypothesis that striped bass regulate the blue crab population in Chesapeake Bay by preying on juveniles, an expected inverse correlation between striped bass and blue crab abundance. Abundance indices based on Virginia striped bass young-of-the-year beach seine data (1980-1992) were constructed for fish ages 1 - 8, and for the Virginia resident stock component, ages 1 - 5. Fishery-independent, pound net data for fall and spring were also used to construct indices of striped bass abundance in Rappahannock River (1986-1993). Juvenile blue crab abundance indices were constructed based on trawl survey data from the James, York and Rappahannock Rivers. Fall crab abundance correlated positively with predicted Virginia resident striped bass abundance. Crab abundance in the spring did not correlate with any measure of striped bass abundance, nor did fall Rappahannock River crab abundance correlate with the fall Rappahannock River pound net index. Thus, these data do not support the hypothesis that striped bass abundance and blue crab abundance are inversely related. Striped bass populations do not appear to have regulated blue crab population dynamics in the Virginia portion of Chesapeake Bay from 1980 to 1992

Methods for specifying the target difference in a randomised controlled trial : the Difference ELicitation in TriAls (DELTA) systematic review

Peer reviewedPublisher PD

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

Quality of Cardiovascular Disease Preventive Care and Physician/Practice Characteristics

BACKGROUND: Quality of cardiovascular disease (CVD) preventive care is suboptimal. Recent data correlated increasing years in practice for physicians with lower-quality health care. OBJECTIVE: The purpose of this study was to assess physician awareness/adherence to national blood pressure, cholesterol, and CVD prevention guidelines for women according to physician/practice characteristics. DESIGN: Standardized online survey and experimental case studies were administered to 500 randomly selected U.S. physicians. Multivariable regression models tested physician age, gender, specialty, and practice type as independent predictors of guideline awareness/adherence. RESULTS: Compared with older physicians (50+ years), younger physicians (<50 years) reported a lower level of awareness of cholesterol guidelines (P=.04) and lower incorporation of women's guidelines (P=.02). Yet, older physicians were less likely to recommend weight management for high-risk cases (P=.03) and less confident in helping patients manage weight (P=.045) than younger physicians. Older physicians were also less likely to identify a low-density lipoprotein<100 mg/dL as optimal versus younger physicians (P=.01), as were solo versus nonsolo practitioners (P=.02). Solo practitioners were less aware of cholesterol guidelines (P=.04) and were more likely to prescribe aspirin for low-risk female patients than nonsolo practitioners (P<.01). Solo practitioners rated their clinical judgment as more effective than guidelines in improving patient health outcomes (P<.01) and more frequently rated the patient as the greatest barrier to CVD prevention versus nonsolo practitioners (P<.01). CONCLUSIONS: Though guideline awareness is high, efforts to promote their utilization are needed and may improve quality outcomes. Targeted education and support for CVD prevention may be helpful to older and solo physicians