Modelling and mapping regional-scale patterns of fishing impact and fish stocks to support coral-reef management in Micronesia

Aim: Use a fishery‐independent metric to model and map regional‐scale fishing impact, and demonstrate how this metric assists with modelling current and potential fish biomass to support coral‐reef management. We also examine the relative importance of anthropogenic and natural factors on fishes at biogeographical scales. Location: Reefs of five jurisdictions in Micronesia. Methods: A subset of 1,127 fish surveys (470 surveys) was used to calculate site‐specific mean parrotfish lengths (a proxy for cumulative fishing impact), which were modelled against 20 biophysical and anthropogenic variables. The resulting model was extrapolated to each 1 ha reef cell in the region to generate a fishing impact map. The remaining data (657 surveys) were then used to model fish biomass using 15 response variables, including fishing impact. This model was used to map estimated current regional fish standing stocks and, by setting fishing impact to 0, potential standing stocks. Results: Human population pressure and distance to port were key anthropogenic variables predicting fishing impact. Total fish biomass was negatively correlated with fishing, but the influence of natural gradients of primary productivity, sea surface temperature, habitat quality and larval supply was regionally more important. Main conclusions: Mean parrotfish length appears to be a useful fishery‐independent metric for modelling Pacific fishing impact, but considering environmental covariates is critical. Explicitly modelling fishing impact has multiple benefits, including generation of the first large‐scale map of tropical fishing impacts that can inform conservation planning. Using fishing impact data to map current and potential fish stocks provides further benefits, including highlighting the relative importance of fishing on fish biomass and identifying key biophysical variables that cause maximum potential biomass to vary significantly across the region. Regional‐scale maps of fishing, fish standing stocks and the potential benefits of protection are likely to lead to improved conservation outcomes during reserve network planning

What should an ideal spinal injury classification system consist of? A methodological review and conceptual proposal for future classifications

Since Böhler published the first categorization of spinal injuries based on plain radiographic examinations in 1929, numerous classifications have been proposed. Despite all these efforts, however, only a few have been tested for reliability and validity. This methodological, conceptual review summarizes that a spinal injury classification system should be clinically relevant, reliable and accurate. The clinical relevance of a classification is directly related to its content validity. The ideal content of a spinal injury classification should only include injury characteristics of the vertebral column, is primarily based on the increasingly routinely performed CT imaging, and is clearly distinctive from severity scales and treatment algorithms. Clearly defined observation and conversion criteria are crucial determinants of classification systems’ reliability and accuracy. Ideally, two principle spinal injury characteristics should be easy to discern on diagnostic images: the specific location and morphology of the injured spinal structure. Given the current evidence and diagnostic imaging technology, descriptions of the mechanisms of injury and ligamentous injury should not be included in a spinal injury classification. The presence of concomitant neurologic deficits can be integrated in a spinal injury severity scale, which in turn can be considered in a spinal injury treatment algorithm. Ideally, a validation pathway of a spinal injury classification system should be completed prior to its clinical and scientific implementation. This review provides a methodological concept which might be considered prior to the synthesis of new or modified spinal injury classifications

Is there a way to diagnose spinal instability in acute burst fractures by performing ultrasound?

The aim of this study is to examine the predictive value of ultrasound diagnostics for the assessment of traumatic lesions of the posterior ligament complex (PLC) in burst fractures of the thoracolumbar spine. This was a prospective validating cohort study. Judgment about instability and treatment of burst fractures depends on the condition of the PLC. There have been some studies describing underdiagnosis of PLC injuries due to classification problems in ligamentary distraction type fractures. The gold standard for assessing these lesions is magnetic resonance imaging (MRI). Even then, there are often limits in contemporary operational availability and technical limitations of MRI. Ultrasound was described being an alternative. In a prospective study, 54 levels of 18 patients with acute burst fractures of the thoracic and lumbar spine have been examined by ultrasound and additional MRI scans preoperatively. The condition (intact vs. ruptured) of supraspinous ligament (SSL) and the interspinous ligament has been assessed for the ligaments separately. Hematoma below the SSL has also been evaluated as an indirect sign of an injured PLC. In all the patients the primary performed operative treatment was a posterior spinal instrumentation. Postoperatively the blinded results of the ultrasound procedures have been matched against intraoperative and MRI findings. Assessments of all target structures have been contributed to the calculation of the sensitivity and specificity of ultrasound. A total of 18 patients, 14 males and 4 females, with acute burst fractures have been qualified for inclusion in the study. The patients’ mean age was 43.4 years. Comparing intraoperative findings with preoperatively performed investigations, ultrasound archived a sensitivity of 0.99 and a specificity of 0.75 (P < 0.05) to detect traumatic lesions to the PLC. As hypothesized the obtained predictive value using ultrasound correlates closely with intraoperative findings. Anyway MRI still seems to be the superior diagnostic method for examining the PLC. However, ultrasound can be considered to be an adequate alternative method in cases with contraindications for MRI such as ferromagnetic side effects, claustrophobia, availability or emergency diagnostics in multiple injuries