Efficacy of an inflatable deterrent for reducing New World vulture human-wildlife conflict.

Increasing urbanization coupled with spatial expansion and numerical increase of New World vulture populations has engendered a rise in human-vulture conflict, creating a need for effective tools to mitigate vulture-related damage. Visual frightening devices that mimic the presence of human or other predators can be employed in human-vulture conflict scenarios to increase perceived risk by the pest species, thereby eliciting an antipredator behavioral response, such as fleeing. One visual frightening device, inflatable scarecrows, recently proved effective at reducing passerine attendance at feral swine feeders, but their effectiveness when directed at other species and conflict scenarios has varied. Our primary objective was to evaluate an inflatable deterrent for reducing the number of black (Coragyps atratus) and turkey vultures (Cathartes aura) present (hereafter abundance) at 13 human-vulture conflict sites throughout the southeastern United States. We predicted that vulture abundance would be substantially reduced when inflatable deterrents were deployed. Because we suspected other factors might also influence vulture site abundance, we also examined the exploratory variables of weather, site size (area), and vulture tolerance to human approach in relation to vulture site abundance using a model selection approach. Black vulture site abundance was more pervasive than turkey vultures, occurring at all sites and accounting for 85% of daily vulture counts (10.78 ± 0.52 vultures/site/day) whereas turkey vultures were only present at 62% of sites (2.12 ± 0.21). Across all sites, inflatable scarecrows were effective at reducing vulture abundance by 82% during the seventeen-day treatment period when deterrents were deployed (3.50 ± 0.20), but only a 48% reduction during the twenty-one-day post-treatment phase (15.34 ± 1.39) was observed. Site size and weather did not influence tool effectiveness. Human tolerance at sites, as determined by vulture flight initiation distance, was influential, with tool effectiveness being reduced at sites where local human tolerance was high. We recommend inflatable scarecrows as a tool to reduce vulture-wildlife conflict to private property and recreation at sites where the conflict is spatially restricted (e.g., parking lot or recreation area), conducive to scarecrow deployment (e.g., flat stable surfaces), and where vulture site human tolerance is low to moderate.

Association Between Type 2 Diabetes and Changes in Myocardial Structure, Contractile Function, Energetics, and Blood Flow Before and After Aortic Valve Replacement in Patients With Severe Aortic Stenosis.

BACKGROUND: Type 2 diabetes (T2D) is associated with an increased risk of left ventricular dysfunction after aortic valve replacement (AVR) in patients with severe aortic stenosis (AS). Persistent impairments in myocardial energetics and myocardial blood flow (MBF) may underpin this observation. Using phosphorus magnetic resonance spectroscopy and cardiovascular magnetic resonance, this study tested the hypothesis that patients with severe AS and T2D (AS-T2D) would have impaired myocardial energetics as reflected by the phosphocreatine to ATP ratio (PCr/ATP) and vasodilator stress MBF compared with patients with AS without T2D (AS-noT2D), and that these differences would persist after AVR. METHODS: Ninety-five patients with severe AS without coronary artery disease awaiting AVR (30 AS-T2D and 65 AS-noT2D) were recruited (mean, 71 years of age [95% CI, 69, 73]; 34 [37%] women). Thirty demographically matched healthy volunteers (HVs) and 30 patients with T2D without AS (T2D controls) were controls. One month before and 6 months after AVR, cardiac PCr/ATP, adenosine stress MBF, global longitudinal strain, NT-proBNP (N-terminal pro-B-type natriuretic peptide), and 6-minute walk distance were assessed in patients with AS. T2D controls underwent identical assessments at baseline and 6-month follow-up. HVs were assessed once and did not undergo 6-minute walk testing. RESULTS: Compared with HVs, patients with AS (AS-T2D and AS-noT2D combined) showed impairment in PCr/ATP (mean [95% CI]; HVs, 2.15 [1.89, 2.34]; AS, 1.66 [1.56, 1.75]; P<0.0001) and vasodilator stress MBF (HVs, 2.11 mL min g [1.89, 2.34]; AS, 1.54 mL min g [1.41, 1.66]; P<0.0001) before AVR. Before AVR, within the AS group, patients with AS-T2D had worse PCr/ATP (AS-noT2D, 1.74 [1.62, 1.86]; AS-T2D, 1.44 [1.32, 1.56]; P=0.002) and vasodilator stress MBF (AS-noT2D, 1.67 mL min g [1.5, 1.84]; AS-T2D, 1.25 mL min g [1.22, 1.38]; P=0.001) compared with patients with AS-noT2D. Before AVR, patients with AS-T2D also had worse PCr/ATP (AS-T2D, 1.44 [1.30, 1.60]; T2D controls, 1.66 [1.56, 1.75]; P=0.04) and vasodilator stress MBF (AS-T2D, 1.25 mL min g [1.10, 1.41]; T2D controls, 1.54 mL min g [1.41, 1.66]; P=0.001) compared with T2D controls at baseline. After AVR, PCr/ATP normalized in patients with AS-noT2D, whereas patients with AS-T2D showed no improvements (AS-noT2D, 2.11 [1.79, 2.43]; AS-T2D, 1.30 [1.07, 1.53]; P=0.0006). Vasodilator stress MBF improved in both AS groups after AVR, but this remained lower in patients with AS-T2D (AS-noT2D, 1.80 mL min g [1.59, 2.0]; AS-T2D, 1.48 mL min g [1.29, 1.66]; P=0.03). There were no longer differences in PCr/ATP (AS-T2D, 1.44 [1.30, 1.60]; T2D controls, 1.51 [1.34, 1.53]; P=0.12) or vasodilator stress MBF (AS-T2D, 1.48 mL min g [1.29, 1.66]; T2D controls, 1.60 mL min g [1.34, 1.86]; P=0.82) between patients with AS-T2D after AVR and T2D controls at follow-up. Whereas global longitudinal strain, 6-minute walk distance, and NT-proBNP all improved after AVR in patients with AS-noT2D, no improvement in these assessments was observed in patients with AS-T2D. CONCLUSIONS: Among patients with severe AS, those with T2D demonstrate persistent abnormalities in myocardial PCr/ATP, vasodilator stress MBF, and cardiac contractile function after AVR; AVR effectively normalizes myocardial PCr/ATP, vasodilator stress MBF, and cardiac contractile function in patients without T2D.

Redo aortic valve replacement versus valve-in-valve trans-catheter aortic valve implantation: a UK propensity-matched analysis.

This study sought to compare the morbidity and mortality of redo aortic valve replacement (redo-AVR) versus valve-in-valve trans-catheter aortic valve implantation (valve-in-valve TAVI) for patients with a failing bioprosthetic valve. A multicenter UK retrospective study of redo-AVR or valve-in-valve TAVI for patients referred for redo aortic valve intervention due to a degenerated aortic bioprosthesis. Propensity score matching was performed for confounding factors. From July 2005 to April 2021, 911 patients underwent redo-AVR and 411 patients underwent valve-in-valve TAVI. There were 125 pairs for analysis after propensity score matching. The mean age was 75.2±8.5 years. In-hospital mortality was 7.2% (n=9) for redo-AVR versus 0 for valve-in-valve TAVI, p=0.002. Surgical patients suffered more post-operative complications, including intra-aortic balloon pump support (p=0.02), early re-operation (p<0.001), arrhythmias (p<0.001), respiratory and neurological complications (p=0.02 and p=0.03) and multi-organ failure (p=0.01). The valve-in-valve TAVI group had a shorter intensive care unit and hospital stay (p<0.001 for both). However, moderate aortic regurgitation at discharge and higher post-procedural gradients were more common after valve-in-valve TAVI (p<0.001 for both). Survival probabilities in patients who were successfully discharged from the hospital were similar after valve-in-valve TAVI and redo-AVR over the 6-year follow-up (log-rank p=0.26). In elderly patients with a degenerated aortic bioprosthesis, valve-in-valve TAVI provides better early outcomes as opposed to redo-AVR, although there was no difference in mid-term survival in patients successfully discharged from the hospital.

Aortic arch surgery for type B aortic dissection: How far should we go? The value of a hybrid approach.

Traditionally, the management of type B aortic dissection has been the domain of the vascular surgeons. Timing and type of intervention still generate debate. We sought to review our early experience with the treatment of this condition based on a hybrid approach following an aortic multi-disciplinary team meeting involving close cooperation between cardiac surgeons, vascular surgeons, interventional radiologists, vascular anesthetists, and cardiac anesthetists. Four patients (age 41-56 years; 3 males; 1 female) with type B aortic dissection underwent aortic arch surgery through a hybrid approach: one elective procedure consisting of ascending aorta and hemi-arch replacement with debranching followed by thoracic endovascular aortic repair (TEVAR); one redo procedure requiring aortic arch replacement with hybrid frozen elephant trunk; two acute presentations (aortic arch replacement and debranching followed by TEVAR; AVR with ascending aorta, arch, and proximal descending thoracic aorta replacement with conventional elephant trunk and debranching). Deep hypothermic circulatory arrest was required in three patients. Despite respiratory complications and slightly prolonged postoperative course, all patients survived without onset of stroke, paraplegia, malperfusion, endoleak, or need for re-exploration. Follow-up remains satisfactory. Different factors may affect outcome following complex aortic procedures. Nevertheless, close cooperation between cardiac surgeons, vascular surgeons, and interventional radiologists may reduce potential for complications and address aspects that may not be completely within the domain of individual specialists.

Urban food subsidies reduce natural food limitations and reproductive costs for a wetland bird.

There is a strong conservation need to understand traits of species that adapt to urban environments, but results have been equivocal. Wetland birds exhibit a strong phylogenetic signal towards urban tolerance; however, they have largely been ignored in urban studies. In their historic ranges, wetland birds inhabit dynamic systems, traveling long distances to locate food. This ability to exploit dynamic resources may translate to success in urban environments, areas characterized by novel food opportunities. We used the Wood Stork (Mycteria americana), a species of conservation concern, to determine if the ability to exploit resources in natural environments translated to exploitation of urban resources. During optimal natural foraging conditions, storks nesting in both urban and natural wetlands had narrow diet breadths and high productivity. However, during suboptimal conditions, urban stork diet expanded to include anthropogenic items, leading to increased productivity. Our study provides a mechanistic understanding of how a wetland species persists, and even thrives, in urban environments. We demonstrated that species inhabiting dynamic systems can exploit urban areas resulting in increased reproductive performance during suboptimal conditions. Together, urban environments may support biodiversity in a variety of ways, but species-specific mechanistic understanding will help highlight how to best mitigate potential threats of urbanization.

Cardiffians' perceptions of English in the UK.

This Perceptual Dialectology (PD) study asked residents of Cardiff, Wales, about their perceptions of English in the United Kingdom (UK). In addition, because face to face exposure to dialect variation has rarely been included as a variable in PD studies, participants were asked about their travel experience to ascertain whether this might influence their responses to a PD map task. Participants' responses to the map task were analyzed using ArcGIS to create composite maps. Results show that these Cardiffians perceive "dialect or regional" speech boundaries to be located around major cities in England and Wales but also southwest Wales. Composite maps and polygon counts suggest that the more traveled respondents have a more nuanced perception of dialect regions than those who claim to travel less, suggesting that travel experience may influence PD participants' responses to map tasks.

Post-procedural myocardial infarction following surgical aortic valve replacement and transcatheter aortic valve implantation.

AIMS: Myocardial injury assessed using cardiac biomarker release is ubiquitous following surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI), preventing accurate discrimination between focal myocardial infarction (MI) and global injury. Cardiovascular magnetic resonance (CMR) late gadolinium enhancement (LGE) imaging was used to compare rates of new MI following SAVR and TAVI. METHODS AND RESULTS: Identical CMR scans were obtained at baseline and six months post procedure in ninety-six patients undergoing SAVR (n=39) and TAVI (n=57). The rate of new MI was greater following SAVR than TAVI (SAVR, n=10 [26%] vs. TAVI, n=3 [5%], p=0.004). Infarct mass was similar between groups (SAVR 1.1±0.6 vs. TAVI 2.0±1.4 g, p=0.395). New MI did not impact on change in LV ejection fraction (SAVR:LGE[+]2.2±4.7 vs. LGE[-]0.9±8.0%, p=0.437, TAVI:LGE[+]-0.9±6.0 vs. LGE[-]2.0±7.8%, p=0.420). Thirty-four patients (60%) in the TAVI group had non-revascularised coronary artery disease (CAD) at the time of TAVI, of whom three (9%) had new MI. CONCLUSIONS: MI is an infrequent complication of TAVI but is more common following SAVR. Infarct size is small following both procedures. The low new infarct rate in TAVI, especially in the context of high rates of non-revascularised CAD, strengthens data from previous studies suggesting that coronary revascularisation pre-TAVI may be unnecessary.

Evolution of the Macrophage CD163 Phenotype and Cytokine Profiles in a Human Model of Resolving Inflammation.

Cantharidin skin blisters were examined over two days to model the acute and resolving phases of inflammation in human skin. Four blisters were created by topical administration of cantharidin (0.1% v/v) to the forearm of healthy volunteers, with IRB approval. Duplicate skin blisters were aspirated at 16 and 40 hours to model the proinflammatory and resolving phases, respectively. There was a significant increase in leukocyte infiltrate at 40 h with appearance of a "resolving macrophage" phenotype CD14(+)CD163(+) by flow cytometry. Neutrophils acquired apoptotic markers at 40 h and were observed to be phagocytosed by macrophagic "Reiter's" cells. Multiplex cytokine analysis demonstrated that monocyte chemoattractant protein (MCP-1/CCL2), interleukin- (IL-) 6, IL-8/CXCL8, macrophage inflammatory protein (MIP1 α /CCL3), MIP-1 ß /CCL4, tumor necrosis factor- (TNF-) α , and eotaxin (CCL11) were all significantly upregulated at 16 h compared with 40 h. In contrast, immunoregulatory transforming growth factor- (TGF-) ß , macrophage-derived chemokine (MDC/CCL22), and interferon-inducible protein (IP-10/CXCL10) were significantly elevated at 40 h. Our results demonstrate that the phases of inflammation and resolution can be discriminated in a two-day model of dermal wound healing. This confirms and extends our understanding of wound repair in humans and provides a powerful research tool for use in clinical settings and to track the molecular benefits of therapeutic intervention.

"Everybody sounds the same": Otherwise Overlooked Ideology in Perceptual Dialectolgy.

When analyzing dialectology survey data, researchers usually exclude respondents who do not complete the survey as directed. It is argued here that such "unusable" responses can be considered "outlier" data and analyzed rather than be excluded, allowing otherwise overlooked language ideologies to emerge. Responses to a perceptual dialectology map survey in which 31 of the 229 respondents wrote comments on a map of Washington state, without drawing lines around perceived dialect areas as instructed, are described to illustrate this point. In the present data, ideologies such as the homogeneity of dialects and the importance of an urban/rural dichotomy surfaced. These themes are examined in terms outlined by Judith Irvine and Susan Gal in their discussion of how ideological processes are evident in language data. In addition, methodological issues regarding the presuppositions and orientation of respondents to the questionnaire itself are raised.

Seattle to Spokane: Mapping Perceptions of English in Washington State.

This research explores perceptions of linguistic variation in English in Washington state (WA). Respondents marked on a map of WA the places where they believe people's English sounds "different" and provided a label for that type of English. The analysis of the results used digital tools to create composite maps consisting of (1) respondents' spatial perceptions of English in WA, (2) spatial perceptions of English in WA according to different demographic groups, and (3) affective values associated with regions identified by respondents. The results suggest that Washingtonians perceive that urban areas and eastern WA are places where English is different. The results also demonstrate that when respondents are surveyed about variation within their own state rather than variation across the country, local types of organizational categories, such as an urban/rural dichotomy or belief in a regional standard, can emerge.

Successful salvage right upper lobectomy and flap repair of trachea-esophageal fistula due to severe necrotizing pneumonia.

A 55-year-old previously well man developed a severe pneumonia. Endoscopy found tracheal and esophageal fistulae communicating with the right lung and pleural space. Bilateral main bronchi intubation was required. Emergency surgery was performed with a latissimus dorsi and serratus anterior muscle flap to close the tracheal and esophageal fistulae. The right upper lobe was found to be destroyed and resected. It was possible to salvage the patient who was discharged home despite challenging anesthetic and surgical circumstances.

Cardiac papillary fibroelastoma presenting with recurrent ventricular tachycardia.

A 72-year-old man presented with multiple episodes of pulseless ventricular tachycardia, 10 days following an ST-segment elevation myocardial infarction. He had a 6-year cardiovascular history that included four neurological events and two myocardial infarctions. Transesophageal echocardiography revealed two mobile masses on the aortic valve. A transaortic surgical approach was successful in removing both masses. Histology confirmed papillary fibroelastoma. The patient subsequently received an implantable cardioverter defibrillator.

Shedding of lymphocyte function-associated antigen-1 (LFA-1) in a human inflammatory response.

Shedding of adhesion molecules has been described for members of the selectin and immunoglobulin superfamilies, but integrins are not known to be shed. Here, we describe shedding of the integrin lymphocyte function-associated antigen-1 (LFA-1; CD11a/CD18) from human leukocytes during the cutaneous inflammatory response to the blistering agent cantharidin. Expression of LFA-1 was significantly diminished on blister-infiltrated neutrophils (P < .001) and monocytes (P = .02) compared with cells in peripheral blood, but expression on lymphocytes remained unchanged. A capture enzyme-linked immunosorbent assay (ELISA) indicated that LFA-1 was shed into blister fluid as a heterodimer expressing an intact headpiece with I and I-like epitopes. However, a CD11a central region epitope, G25.2, was absent and this remained expressed as a "stub" on the cell surface of blister neutrophils. Western analysis of soluble LFA-1 revealed a truncated 110-kDa CD11a chain and a minimally truncated 86-kDa CD18 chain. However, LFA-1 was shed in a ligand-binding conformation, since it expressed KIM-127 and 24 activation epitopes and bound to solid-phase ICAM-1. Shed LFA-1 was also detected in a synovial effusion by ELISA and Western analysis. We hypothesize that LFA-1 shedding may play a role in leukocyte detachment after transendothelial migration and in regulating integrin-dependent outside-in signaling.

Macrophage release of transforming growth factor beta1 during resolution of monosodium urate monohydrate crystal-induced inflammation.

OBJECTIVE: It has previously been shown that as monocytes differentiate into macrophages, they lose the ability to secrete proinflammatory cytokines in response to monosodium urate monohydrate (MSU) crystals. The purpose of this study was to investigate whether MSU crystals induce macrophages to secrete antiinflammatory factor instead. METHODS: Human monocyte or macrophage isolates were prepared from samples obtained from healthy volunteer donors either by differentiation of blood monocytes in vitro or by collecting cells from skin blisters during the early or late phase of the dermal inflammatory response to cantharidin. Monocyte or macrophage isolates were then incubated with MSU crystals for 24 hours, and culture supernatants were assayed for candidate antiinflammatory mediators (by enzyme-linked immunosorbent assay) and for the capacity to activate or suppress endothelial cell E-selectin expression and secondary neutrophil recruitment under shear flow. RESULTS: Analysis of supernatants from in vitro-differentiated macrophages revealed that transforming growth factor beta1 (TGFbeta1) was induced following MSU crystal stimulation (mean +/- SEM 1.50 +/- 0.24 ng/ml/10(6) cells), but there was no evidence of interleukin-10 (IL-10), IL-1 receptor antagonist, or tumor necrosis factor (TNF) receptor p55 release. Macrophage TGFbeta1 significantly suppressed endothelial cell E-selectin expression and secondary neutrophil capture on endothelial monolayers stimulated with supernatants from MSU-treated monocytes. Leukocytes isolated from resolving (40-hour) skin blisters similarly elaborated TGFbeta1 when challenged with MSU crystals (0.66 +/- 1.3 ng/ml/10(5) CD14+ cells). In contrast, cells isolated from acute (16-hour) skin blisters secreted TNFalpha (0.49 +/- 0.08 ng/ml/10(5) CD14+ cells) but no detectable TGFbeta1. CONCLUSION: These data provide further support for the concept that differentiated macrophages play a protective role in the pathophysiology of gout, and they identify macrophage TGFbeta1 as a mediator of paracrine suppression during the resolution phase of inflammation.

Surgical clearance of invasive cardiac leiomyosarcoma with concomitant pneumonectomy.

The management of cardiac leiomyosarcoma is still controversial. Due to the rare occurrence and late presentation of such tumours the treatment is essentially palliative. We report on a case in a young female who presented with catastrophic haemodynamic instability and pulmonary venous obstruction by a large mass in her left atrium. Right pneumonectomy was performed as part of emergency surgery in this patient with a left atrial tumour of unknown histology. We feel that an attempt at complete clearance of these tumours is justified, as surgery remains the only chance of long-term survival. Postoperatively, adjuvant chemotherapy and/or radiotherapy may have a role.