Summer Residency of Pacific Halibut in Glacier Bay National Park

Glacier Bay National Park (Fig.1), as a Marine Protected Area (MPA), is phasing out commercial fishing of Pacific halibut (Hippoglossus stenolepis) within the park. The species continues to be commercially harvested outside of the bay

Apatite: a U-Pb thermochronometer or geochronometer?

Apatite is an accessory mineral that is frequently found in both igneous and clastic sedimentary rocks. It is conventionally considered to be characterized by a closure temperature range between 375 and 600 °C and hence has been employed to address mid-temperature thermochronology questions relevant to the reconstruction of thermal events in the middle to lower crust. However, questions remain as to whether apatite faithfully records thermally-activated volume diffusion profiles, or rather is influenced by recrystallization and new growth processes. We present a case study of two apatite samples from the Akia Terrane in Greenland that help chart some of the post magmatic history of this region. Apatite in a tonalitic gneiss has distinct U-enriched rims and its U-Pb apparent ages correlate with Mn chemistry, with a high Mn group yielding an age of c. 2813 Ma. The U-Pb and trace element chemistry and morphology support an interpretation in which these apatite crystals are originally igneous and record cooling after metamorphism, with subsequent generation of discrete new rims. Epidote observed in the sample implies a <600 °C fluid infiltration event associated with apatite rims. The second sample, from a granitic leucosome, contains apparently homogeneous apatite, however U-Pb analyses define two distinct discordia arrays with different common Pb components. An older, c. 2490 Ma, component is associated with elevated Sr, whereas a younger, c. 1800 Ma, component has lower Sr concentration. A depth profile reveals an older core with progressively younger ages towards a compositionally discrete late Paleoproterozoic rim. The chemical and age profiles do not directly correspond, implying different diffusion rates between trace elements and U and Pb. The variation in core ages is interpreted to reflect radiogenic-Pb loss from a metamorphic population during new rim growth. The younger, c. 1800 Ma U-Pb age is interpreted to date new apatite growth from a compositionally distinct reservoir driven by tectonothermal and fluid activity, consistent with regional mica Ar-Ar ages. Results from these two samples show that recrystallization, dissolution and regrowth processes likely formed the younger rim overgrowths, and at temperatures below those often considered to be closure temperatures for Pb diffusion in apatite. The results from these samples imply many apatite grains may not record simple thermally activated Pb diffusion profiles and cautions against inversion of apatite U-Pb data to thermal histories without detailed knowledge of the grain growth/alteration processes

Guest editorial: Promoting cultural competency in the nursing care of LGBT patients

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.none- editoria

Relationships between Clinician-Level Attributes and Fidelity-Consistent and Fidelity-Inconsistent Modifications to an Evidence-Based Psychotherapy

Background: Clinicians often modify evidence-based psychotherapies (EBPs) when delivering them in routine care settings. There has been little study of factors associated with or implications of modifications to EBP protocols. This paper differentiates between fidelity-consistent and fidelity-inconsistent modifications and it examines the potential influence of two clinician characteristics, training outcomes, and attitudes toward EBPs on fidelity-consistent and fidelity-inconsistent modifications of cognitive behavioral therapy in a sample of clinicians who had been trained to deliver these treatments for children or adults. Methods: Survey and coded interview data collected 2 years after completion of training programs in cognitive behavioral therapy were used to examine associations between successful or unsuccessful completion of training, clinician attitudes, and modifications. Modifications endorsed by clinicians were categorized as fidelity-consistent or fidelity-inconsistent and entered as outcomes into separate regression models, with training success and attitudes entered as independent variables. Results: Successful completion of a training program was associated with subsequent fidelity-inconsistent modifications but not fidelity-consistent modifications. Therapists who reported greater openness to using EBPs prior to training reported more fidelity-consistent modifications at follow-up, and those who reported greater willingness to adopt EBPs if they found them appealing were more likely to make fidelity-inconsistent modifications. Conclusions: Implications of these findings for training, implementation, EBP sustainment, and future studies are discussed. Research on contextual and protocol-related factors that may impact decisions to modify EBPs will be an important future direction of study to complement to this research

Mechanisms of Fetal Programming in Hypertension

Events that occur in the early fetal environment have been linked to long-term health and lifespan consequences in the adult. Intrauterine growth restriction (IUGR), which may occur as a result of nutrient insufficiency, exposure to hormones, or disruptions in placental structure or function, may induce the fetus to alter its developmental program in order to adapt to the new conditions. IUGR may result in a decrease in the expression of genes that are responsible for nephrogenesis as nutrients are rerouted to the development of more essential organs. Fetal survival under these conditions often results in low birth weight and a deficit in nephron endowment, which are associated with hypertension in adults. Interestingly, male IUGR offspring appear to be more severely affected than females, suggesting that sex hormones may be involved. The processes of fetal programming of hypertension are complex, and we are only beginning to understand the underlying mechanisms

Black patients referred to a lung cancer screening program experience lower rates of screening and longer time to follow-up.

BACKGROUND: Racial disparities are well-documented in preventive cancer care, but they have not been fully explored in the context of lung cancer screening. We sought to explore racial differences in lung cancer screening outcomes within a lung cancer screening program (LCSP) at our urban academic medical center including differences in baseline low-dose computed tomography (LDCT) results, time to follow-up, adherence, as well as return to annual screening after additional imaging, loss to follow-up, and cancer diagnoses in patients with positive baseline scans. METHODS: A historical cohort study of patients referred to our LCSP was conducted to extract demographic and clinical characteristics, smoking history, and lung cancer screening outcomes. RESULTS: After referral to the LCSP, blacks had significantly lower odds of receiving LDCT compared to whites, even while controlling for individual lung cancer risk factors and neighborhood-level factors. Blacks also demonstrated a trend toward delayed follow-up, decreased adherence, and loss to follow-up across all Lung-RADS categories. CONCLUSIONS: Overall, lung cancer screening annual adherence rates were low, regardless of race, highlighting the need for increased patient education and outreach. Furthermore, the disparities in race we identified encourage further research with the purpose of creating culturally competent and inclusive LCSPs

Detection of lung carcinoma arising from ground glass opacities (GGO) after 5 years - A retrospective review

Pure ground glass opacities (GGO) may indicate pre-invasive subtypes of lung carcinoma. These neoplasms typically demonstrate indolent patterns of growth; Fleischner Society guidelines recommend up to five years of serial imaging. Our aim was to determine the frequency of diagnosed carcinoma arising from GGO detected beyond 5 years of surveillance. We reviewed pathologic diagnoses of lung carcinoma (n = 442) between 2016 and 2018 of a tertiary academic hospital and National Cancer Institute-designated cancer center to identify all cancers that arose from ground glass opacities detected on CT scan. Of the 442 cases of lung carcinoma, 32 (7%) were found that arose from pure GGOs and were ultimately diagnosed as cancer. Among the subgroup of GGOs, 78% (n = 25) were diagnosed within five years of surveillance, but up to 22% (n = 7) required between five and twelve years of serial follow up prior to definitive diagnosis. In order to detect 95% of cancers, GGOs would need to be followed for 7.9–12.7 years based upon a Kaplan-Meier estimate (p = 0.05). No patients who had lung carcinoma arising from GGOs died (0/32) within a follow-up time of one to three years. These data suggest that a greater number of lung carcinomas would be detected upon routine follow up of GGOs that extended beyond the current recommendation of five years. The overall survival of the cohort was 100%, consistent with existing data that these cancers are indolent. It is unknown whether a higher detection rate from longer interval follow up would impact overall survival