Belowground productivity varies by assessment technique, vegetation type, and nutrient availability in tidal freshwater forested wetlands transitioning to marsh.

Wetlands along upper estuaries are characterized by dynamic transitions between forested and herbaceous communities (marsh) as salinity, hydroperiod, and nutrients change. The importance of belowground net primary productivity (BNPP) associated with fine and coarse root growth also changes but remains the dominant component of overall productivity in these important blue carbon wetlands. Appropriate BNPP assessment techniques to use in various tidal wetlands are not well-defined, and could make a difference in BNPP estimation. We hypothesized that different BNPP techniques applied among tidal wetlands differ in estimation of BNPP and possibly also correlate differently with porewater nutrient concentrations. We compare 6-month and 12-month root ingrowth, serial soil coring techniques utilizing two different calculations, and a mass balance approach (TBCA, Total Belowground Carbon Allocation) among four tidal wetland types along each of two river systems transitioning from freshwater forest to marsh. Median values of BNPP were 266 to 2946 g/m2/year among all techniques used, with lower BNPP estimation from root ingrowth cores and TBCA (266-416 g/m2/year), and higher BNPP estimation from serial coring of standing crop root biomass (using Smalley and Max-Min calculation methods) (2336-2946 g/m2/year). Root turnover (or longevity) to a soil depth of 30 cm was 2.2/year (1.3 years), 2.7/year (1.1 years), 4.5/year (0.9 years), and 1.2/year (2.6 years), respectively, for Upper Forest, Middle Forest, Lower Forest, and Marsh. Marsh had greater root biomass and BNPP, with slower root turnover (greater root longevity) versus forested wetlands. Soil porewater concentrations of NH3 and reactive phosphorus stimulated BNPP in the marsh when assessed with short-deployment BNPP techniques, indicating that pulses of mineralized nutrients may stimulate BNPP to facilitate marsh replacement of forested wetlands. Overall, ingrowth techniques appeared to represent forested wetland BNPP adequately, while serial coring may be necessary to represent herbaceous plant BNPP from rhizomes as marshes replace forested wetlands.

Incorporating Stroke Severity Into Hospital Measures of 30-Day Mortality After Ischemic Stroke Hospitalization.

BACKGROUND AND PURPOSE: The Centers for Medicare & Medicaid Services publicly reports a hospital-level stroke mortality measure that lacks stroke severity risk adjustment. Our objective was to describe novel measures of stroke mortality suitable for public reporting that incorporate stroke severity into risk adjustment. METHODS: We linked data from the American Heart Association/American Stroke Association Get With The Guidelines-Stroke registry with Medicare fee-for-service claims data to develop the measures. We used logistic regression for variable selection in risk model development. We developed 3 risk-standardized mortality models for patients with acute ischemic stroke, all of which include the National Institutes of Health Stroke Scale score: one that includes other risk variables derived only from claims data (claims model); one that includes other risk variables derived from claims and clinical variables that could be obtained from electronic health record data (hybrid model); and one that includes other risk variables that could be derived only from electronic health record data (electronic health record model). RESULTS: The cohort used to develop and validate the risk models consisted of 188 975 hospital admissions at 1511 hospitals. The claims, hybrid, and electronic health record risk models included 20, 21, and 9 risk-adjustment variables, respectively; the C statistics were 0.81, 0.82, and 0.79, respectively (as compared with the current publicly reported model C statistic of 0.75); the risk-standardized mortality rates ranged from 10.7% to 19.0%, 10.7% to 19.1%, and 10.8% to 20.3%, respectively; the median risk-standardized mortality rate was 14.5% for all measures; and the odds of mortality for a high-mortality hospital (+1 SD) were 1.51, 1.52, and 1.52 times those for a low-mortality hospital (-1 SD), respectively. CONCLUSIONS: We developed 3 quality measures that demonstrate better discrimination than the Centers for Medicare & Medicaid Services' existing stroke mortality measure, adjust for stroke severity, and could be implemented in a variety of settings.

Assessing coastal wetland vulnerability to sea-level rise along the northern Gulf of Mexico coast: Gaps and opportunities for developing a coordinated regional sampling network.

Coastal wetland responses to sea-level rise are greatly influenced by biogeomorphic processes that affect wetland surface elevation. Small changes in elevation relative to sea level can lead to comparatively large changes in ecosystem structure, function, and stability. The surface elevation table-marker horizon (SET-MH) approach is being used globally to quantify the relative contributions of processes affecting wetland elevation change. Historically, SET-MH measurements have been obtained at local scales to address site-specific research questions. However, in the face of accelerated sea-level rise, there is an increasing need for elevation change network data that can be incorporated into regional ecological models and vulnerability assessments. In particular, there is a need for long-term, high-temporal resolution data that are strategically distributed across ecologically-relevant abiotic gradients. Here, we quantify the distribution of SET-MH stations along the northern Gulf of Mexico coast (USA) across political boundaries (states), wetland habitats, and ecologically-relevant abiotic gradients (i.e., gradients in temperature, precipitation, elevation, and relative sea-level rise). Our analyses identify areas with high SET-MH station densities as well as areas with notable gaps. Salt marshes, intermediate elevations, and colder areas with high rainfall have a high number of stations, while salt flat ecosystems, certain elevation zones, the mangrove-marsh ecotone, and hypersaline coastal areas with low rainfall have fewer stations. Due to rapid rates of wetland loss and relative sea-level rise, the state of Louisiana has the most extensive SET-MH station network in the region, and we provide several recent examples where data from Louisiana's network have been used to assess and compare wetland vulnerability to sea-level rise. Our findings represent the first attempt to examine spatial gaps in SET-MH coverage across abiotic gradients. Our analyses can be used to transform a broadly disseminated and unplanned collection of SET-MH stations into a coordinated and strategic regional network. This regional network would provide data for predicting and preparing for the responses of coastal wetlands to accelerated sea-level rise and other aspects of global change.

Propping up pharma's (natural) neoliberal phallic man: pharmaceutical representations of the ideal sexuopharmaceutical user.

Contemporary social theorists emphasise the cultural quest for authenticity under conditions of increasing artificiality. Within this context, the body is commonly treated as an 'unfinished' surface requiring ongoing transformation to fulfil identity obligations. In this paper, we examine one such identity authentication project in the form of marketing of men's sexuopharmaceuticals. We use online pharmaceutical advertising for four approved sexuopharmaceuticals (Viagra, Cialis, STAXYN and Stendra) to describe the ideal neoliberal consumer. These campaigns underscore the robust role of pharmaceuticals in sexual authentication projects undergirded by neoliberal consumerist and aspirationalist ideals. Penile dependability as a luxury consumerist project reinvigorates traditional sexual (masculine) authentication as yoked to phallic control, by repackaging sexual enhancement medication use as a neoliberal beacon of aspirational achievements. The ideal targeted user is increasingly younger, and consumption of sexuopharmaceuticals is represented as achieving elite status and exclusive pleasures; masculine authenticity and choice; progressive relationships and a contemporary urban, fast-paced life; and a prepared yet spontaneous romantic sexuality. Women are also increasingly used in promotional materials directed at men; their responsibility centres on coaching and coaxing potential users.