A collaborative and near-comprehensive North Pacific humpback whale photo-ID dataset.

We present an ocean-basin-scale dataset that includes tail fluke photographic identification (photo-ID) and encounter data for most living individual humpback whales (Megaptera novaeangliae) in the North Pacific Ocean. The dataset was built through a broad collaboration combining 39 separate curated photo-ID catalogs, supplemented with community science data. Data from throughout the North Pacific were aggregated into 13 regions, including six breeding regions, six feeding regions, and one migratory corridor. All images were compared with minimal pre-processing using a recently developed image recognition algorithm based on machine learning through artificial intelligence; this system is capable of rapidly detecting matches between individuals with an estimated 97-99% accuracy. For the 2001-2021 study period, a total of 27,956 unique individuals were documented in 157,350 encounters. Each individual was encountered, on average, in 5.6 sampling periods (i.e., breeding and feeding seasons), with an annual average of 87% of whales encountered in more than one season. The combined dataset and image recognition tool represents a living and accessible resource for collaborative, basin-wide studies of a keystone marine mammal in a time of rapid ecological change.

Macronutrient composition of sea otter diet with respect to recolonization, life history, and season in southern Southeast Alaska.

The sea otter (Enhydra lutris) population of Southeast Alaska has been growing at a higher rate than other regions along the Pacific coast. While good for the recovery of this endangered species, rapid population growth of this apex predator can create a human-wildlife conflict, negatively impacting commercial and subsistence fishing. Previous foraging studies throughout the sea otter range have shown they will reduce invertebrate prey biomass when recolonizing an area. The goal of this study was to examine and quantify the energy content of sea otter diets through direct foraging observations and prey collection. Our study area, Prince of Wales Island in southern Southeast Alaska, exhibits a gradient of sea otter recolonization, thus providing a natural experiment to test diet change in regions with different recolonization histories. Sea otter prey items were collected in three seasons (spring, summer, and winter) to measure caloric value and lipid and protein content. We observed 3523 sea otter dives during the spring and summer. A majority of the sea otter diet consisted of clams. Sea otters in newly recolonized areas had lower diet diversity, higher energetic intake rates (EIR, kcal/min), and prey had higher energy content (kcal/g). Females with pups had the highest diet diversity and the lowest EIR. Sea otter EIR were higher in the fall and winter vs. spring and summer. Sea cucumber energy and lipid content appeared to correspond with times when sea otters consumed the highest proportion of sea cucumbers. These caloric variations are an important component of understanding ecosystem-level effects sea otters have in the nearshore environment.

Whales in the carbon cycle: can recovery remove carbon dioxide?

The great whales (baleen and sperm whales), through their massive size and wide distribution, influence ecosystem and carbon dynamics. Whales directly store carbon in their biomass and contribute to carbon export through sinking carcasses. Whale excreta may stimulate phytoplankton growth and capture atmospheric CO2; such indirect pathways represent the greatest potential for whale-carbon sequestration but are poorly understood. We quantify the carbon values of whales while recognizing the numerous ecosystem, cultural, and moral motivations to protect them. We also propose a framework to quantify the economic value of whale carbon as populations change over time. Finally, we suggest research to address key unknowns (e.g., bioavailability of whale-derived nutrients to phytoplankton, species- and region-specific variability in whale carbon contributions).

Skeletal muscle thermogenesis enables aquatic life in the smallest marine mammal.

Basal metabolic rate generally scales with body mass in mammals, and variation from predicted levels indicates adaptive metabolic remodeling. As a thermogenic adaptation for living in cool water, sea otters have a basal metabolic rate approximately three times that of the predicted rate; however, the tissue-level source of this hypermetabolism is unknown. Because skeletal muscle is a major determinant of whole-body metabolism, we characterized respiratory capacity and thermogenic leak in sea otter muscle. Compared with that of previously sampled mammals, thermogenic muscle leak capacity was elevated and could account for sea otter hypermetabolism. Muscle respiratory capacity was modestly elevated and reached adult levels in neonates. Premature metabolic development and high leak rate indicate that sea otter muscle metabolism is regulated by thermogenic demand and is the source of basal hypermetabolism.

Effective arteriovenous fistula alternative for hemodialysis access.

BACKGROUND: The use of autologous arteriovenous fistulae (AVF) for hemodialysis (HD) is the gold standard; however, for many patients at tertiary referral centers, this is not an option. METHODS: We conducted a four year retrospective cohort study to evaluate HD access outcomes with AVF, bovine carotid artery (BCA), and polytetrafluoroethylene arteriovenous graft (PTFE). RESULTS: The study contained 416 AVF, 175 BCA, and 58 PTFE, N = 649. There was statistical difference between rates of infection (AVF 3.4%, BCA 2.9%, PTFE 11.9%), P = 0.02. Maturation failed in 7.5% of AVF but in none of the BCA or PTFE (P = 0.001). Accesses were abandoned with AVF (1.9%), BCA (1.5%), and PTFE (9.5%), P = 0.01. CONCLUSION: Bovine carotid artery can be an effective alternative form of HD access with lower infection, abandonment, and failure to maturation rates when autologous arteriovenous fistula is not an option.

Household waste behaviours among a community sample in Iran: an application of the theory of planned behaviour.

Understanding the factors influencing recycling behaviour can lead to better and more effective recycling programs in a community. The goal of this study was to examine factors associated with household waste behaviours in the context of the theory of planned behaviour (TPB) among a community sample of Iranians that included data collection at time 1 and at follow-up one year later at time 2. Study participants were sampled from households under the coverage of eight urban health centers in the city of Qazvin. Of 2000 invited households, 1782 agreed to participate in the study. A self-reported questionnaire was used for assessing socio-demographic factors and the TPB constructs (i.e. attitude, subjective norms, perceived behavioural control, and intention). Furthermore, questions regarding moral obligation, self-identity, action planning, and past recycling behaviour were asked, creating an extended TPB. At time 2, participants were asked to complete a follow-up questionnaire on self-reported recycling behaviours. All TPB constructs had positive and significant correlations with each other. Recycling behaviour at time 1 (past behaviour) significantly related to household waste behaviour at time 2. The extended TPB explained 47% of the variance in household waste behaviour at time 2. Attitude, perceived behavioural control, intention, moral obligation, self-identity, action planning, and past recycling behaviour were significant predictors of household waste behaviour at time 2 in all models. The fact that the expanded TPB constructs significantly predicted household waste behaviours holds great promise for developing effective public campaigns and behaviour-changing interventions in a region where overall rates of household waste reduction behaviours are low. Our results indicate that educational materials which target moral obligation and action planning may be particularly effective.

Recycling attitudes and behavior among a clinic-based sample of low-income Hispanic women in southeast Texas.

We examined attitudes and behavior surrounding voluntary recycling in a population of low-income Hispanic women. Participants (N = 1,512) 18-55 years of age completed a self-report survey and responded to questions regarding household recycling behavior, recycling knowledge, recycling beliefs, potential barriers to recycling (transportation mode, time), acculturation, demographic characteristics (age, income, employment, marital status, education, number of children, birth country), and social desirability. Forty-six percent of participants (n = 810) indicated that they or someone else in their household recycled. In a logistic regression model controlling for social desirability, recycling behavior was related to increased age (P<0.05), lower acculturation (P<0.01), knowing what to recycle (P<0.01), knowing that recycling saves landfill space (P<0.05), and disagreeing that recycling takes too much time (P<0.001). A Sobel test revealed that acculturation mediated the relationship between recycling knowledge and recycling behavior (P<0.05). We offer new information on recycling behavior among Hispanic women and highlight the need for educational outreach and intervention strategies to increase recycling behavior within this understudied population.

Sociability of female bottlenose dolphins (Tursiops spp.) and chimpanzees (Pan troglodytes): Understanding evolutionary pathways toward social convergence.

On the northern tip of New Zealand's South Island, bottlenose dolphins (Tursiops truncatus) occasionally pass through Admiralty Bay in large, fast-traveling groups of 100 or so individuals. Watching such a group race and splash through the water is reminiscent of a stampeding herd of ungulates, cetaceans' closest terrestrial ancestors. At other times, smaller social groups of bottlenose dolphins appear in the bay and provide a glimpse of the behavioral complexity that dolphins share with their distant relatives, the primates (Fig. 1). Despite being evolutionarily separated for 95 million years and evolving in vastly different environments, cetaceans and primates share striking similarities in behavior, socioecological problem-solving, life-history patterns, and cognitive capacity. By comparing attributes shared by primates and cetaceans, distraction from phylogenetic "noise" is minimized and our understanding of evolutionary pathways is enhanced. In particular, cetaceans provide a powerful outgroup for studying the evolution of primate social organization.

Human papillomavirus vaccine decision-making in Da Nang, Vietnam: perceived spousal and adolescent-parent concordance.

This descriptive study examined parents' perceptions of the role of mothers, fathers, and daughters in the decision to have their daughter receive the human papillomavirus (HPV) vaccine; perceived concordance between spouses and between parents and daughters; and the relationships between vaccine decision-making and (1) who takes the daughter to the doctor, and (2) the daughter's age. Health care workers (N=139) with a daughter 9-21 years old completed a self-administered questionnaire including demographic and HPV vaccine-related questions. Health care workers were employed by Da Nang General Hospital or the Da Nang Center for Reproductive Health Care in Vietnam. Most (73%) parents favored having their daughter receive the HPV vaccine and 84% would consult their spouse about having their daughter vaccinated. Sixty-six percent of parents believed that HPV vaccination should be a joint decision involving both parents and the daughter. Parents perceived concordance between themselves and their spouse, with 91% agreement between their own decision and what they thought their spouse would decide; less concordance (77%) was observed between themselves and what they thought their daughter would want. Most (87% of mothers and 62% of fathers) would consider his/her spouse's opinion in the decision regarding HPV vaccination when accompanying the daughter to a health care visit in the absence of the spouse. Perceived spousal concordance was 94% for parents of daughters under the age of consent in Vietnam (16 years). Decisions regarding HPV vaccination will likely be made jointly by parents and adolescents. Educating fathers about HPV vaccination may be important.

A theory-based approach to understanding follow-up of abnormal Pap tests.

We applied a general theoretical framework to understand intentions to attend recommended follow-up for abnormal Pap results. Participants were 338 women attending university-affiliated clinics. Intention was associated with favorable attitudes toward follow-up (OR = 5.3); perceiving attending follow-up as consistent with one's self-concept (OR = 3.0); self-efficacy (OR = 1.8); and believing one would be told exactly what is wrong (OR = 1.3). Intention was negatively associated with believing the problem could be avoided by not returning for follow-up (OR = 0.75). Beliefs, affect and attitudes differed by race and ethnicity (all p < .05). Attendance at follow-up was related to attitude and self-concept (both p < .05). Results have implications for theory development and patient education.

Demographic, behavioral, and physical correlates of body esteem among low-income female adolescents.

PURPOSE: To examine demographic, behavioral, and physical correlates of body esteem among female adolescents of lower socioeconomic background. METHODS: Data were collected in a women's health clinic in southeast Texas as part of a larger investigation. A total of 271 female individuals aged 16-21 years completed the Body Esteem Scale (BES), which yields scores for total body esteem, sexual attractiveness, weight concern, and physical condition. Participants answered questions regarding smoking and the presence of acne. Height and weight were measured by a nurse using standard instrumentation and technique. Of the participants, 35% were African-American, 31% white, and 34% Hispanic; and 48% reported an annual household income less than $20,000. The mean body mass index (BMI) was 26.1 (SD = 6.5). RESULTS: Race/ethnicity was associated with total body esteem, sexual attractiveness, weight esteem, and physical condition (all p < .01). African-American participants demonstrated greater body esteem on all scales relative to white participants. Adolescents reporting annual household incomes less than $20,000 (vs. greater) demonstrated higher overall body esteem, sexual attractiveness, and physical condition (all p < .01). Current smokers (vs. non-smokers) reported lower physical condition (p < .01), lower weight concern (p < .05), and lower overall body esteem (p < .02). BMI was associated with weight concern (p < .001) and total body esteem (p = .05). Adolescents reporting acne (vs. not) reported lower scores for total body esteem, sexual attractiveness, and weight concern (all p < .05). CONCLUSIONS: Body esteem among adolescent females is affected by demographic, physical, and behavioral variables. Results highlight the importance of measuring multiple dimensions of body esteem.

Satisfaction with care among low-income female outpatients.

Patient satisfaction correlates with important health behaviors and outcomes. Little is known about satisfaction in disadvantaged populations of different racial/ethnic backgrounds. The current study evaluated demographic and psychological correlates of patient satisfaction among a low-income, multiethnic sample of female outpatients attending cervical cancer screening. Participants included 338 African American, Latina, and white women ages 18 - 49 years attending University of Texas Medical Branch Regional Maternal & Child Health Clinics. Data were obtained via self-report and chart review. Patient satisfaction was assessed using the Patient Satisfaction Questionnaire (PSQ). Total PSQ scores reflected two distinct underlying subscales (satisfaction and dissatisfaction), which differed from the original factor structure of the PSQ. Satisfaction was predicted by patient beliefs that their health is self-determined, beliefs that doctors control their health, self-esteem, and education. Dissatisfaction was predicted by patient beliefs that good health is a matter of chance/luck, self-esteem, social desirability, and income. Higher self-esteem, education, and beliefs that health is controlled by oneself or doctors correlated with higher satisfaction with care in the clinic setting. Understanding the influence of patient characteristics on perceptions of care is important for physicians to foster relationships with patients that increase feelings of satisfaction, decrease dissatisfaction, and ultimately, improve health outcomes.

Are women ready for the HPV vaccine?

OBJECTIVE: An HPV (human papillomavirus) vaccine will be available soon. Because vaccination for both boys and girls will be critical to reduce the incidence of this disease, we evaluated the willingness of women to accept the HPV vaccine and to consent to having their children vaccinated. METHODS: A 20-item questionnaire was distributed to women who had children between the ages of 8 and 14 years, the likely age range of the children who will be targeted to receive the vaccine. RESULTS: 200 women completed surveys. The median age for the respondents was 34.4 years (range, 23-53 years). 77% of the women surveyed would be willing to accept an HPV vaccine for themselves. 67% who had a daughter (n = 156) and 66% who had a son (n = 137) would consent to have their child vaccinated. Those not accepting the vaccine cited the risk of unknown adverse effects or their current lack of sexual activity. Women who would not consent to have their children vaccinated cited the risk of unknown adverse effects and their belief that their children are not sexually active. Male children not directly benefiting from the vaccine were also a reason for not considering the vaccine for sons. A history of an abnormal Papanicolaou smear was not associated with willingness to accept the vaccine. CONCLUSIONS: This pilot study demonstrated a willingness of women to accept the HPV vaccine for themselves and their children. Gynecologists and gynecologic oncologists must focus not only on the diagnosis and treatment of cervical cancer but also on its prevention.

Poor knowledge regarding the Pap test among low-income women undergoing routine screening.

CONTEXT: Many women undergoing cervical cancer screening lack appropriate understanding of the Pap test. It is important to evaluate knowledge and informational needs about Pap testing among groups who may have difficulty accessing care or a relatively low likelihood of obtaining follow-up for an abnormal result, such as minority and low-income women. METHODS: A sample of 338 women undergoing cervical screening at two clinics in Texas completed a questionnaire measuring their knowledge of Pap testing and asking what specific information they would like to know about the test. Group comparisons and qualitative analyses were conducted. RESULTS: Women correctly answered an average of 8.7 out of 20 questions; the range was 0-17. Mean scores were higher among white women (10.2) than among blacks (8.4) and Hispanics (7.4), among women with more than a high school education than among their less educated counterparts (10.0 vs. 7.9) and among women with an annual household income of at least $10,000 than among those with a lower income (9.3 vs. 8.4). Knowledge scores did not differ according to Pap history. Open-ended questioning identified a need for information on the purpose of the test, exam procedures, abnormal test results and prognosis. CONCLUSIONS: Minority women and those of low socioeconomic status had poor understanding of Pap testing. Identifying misunderstandings in this vulnerable population and improving patient education on the most basic aspects of Pap testing may increase adherence to follow-up when abnormalities are detected.

In-continuity hepatic resection for advanced hilar cholangiocarcinoma.

BACKGROUND: The purpose of this study was to examine outcomes of patients undergoing concomitant hepatectomy and bile duct excision for advanced Klatskin tumors. METHODS: Thirty-one patients, 16 men and 15 women, with an average age of 64 years, underwent concomitant biliary and hepatic resections for Klatskin tumors. Outcomes, including complications and survival, are reported. RESULTS: Fifteen patients had postoperative courses free of complications. Sixteen patients experienced a total of 50 complications; 13 patients experienced 1 or more major complications (including hemorrhage [n = 1], pneumonia [n = 5], intra-abdominal abscess [n = 8], hepatic failure [n = 3], and myocardial infarction [n = 2]). Five patients died perioperatively, 1 from adult respiratory distress syndrome and 4 from multisystem organ failure precipitated by hepatic failure. One-, 3-, and 5-year survival after resection was 69%, 33%, and 26%, respectively. American Joint Committee on Cancer stage and margin status did not impact long-term survival after resection. CONCLUSIONS: Concomitant hepatic and biliary resections for Klatskin tumors carry relatively high risk but offer hope for long-term survival. This study supports in-continuity hepatectomy and extrahepatic biliary resection for advanced Klatskin tumors even when microscopically negative margins cannot be obtained.