Observed and projected functional reorganization of riverine fish assemblages from global change.

Climate and land-use/land-cover change ("global change") are restructuring biodiversity, globally. Broadly, environmental conditions are expected to become warmer, potentially drier (particularly in arid regions), and more anthropogenically developed in the future, with spatiotemporally complex effects on ecological communities. We used functional traits to inform Chesapeake Bay Watershed fish responses to future climate and land-use scenarios (2030, 2060, and 2090). We modeled the future habitat suitability of focal species representative of key trait axes (substrate, flow, temperature, reproduction, and trophic) and used functional and phylogenetic metrics to assess variable assemblage responses across physiographic regions and habitat sizes (headwaters through large rivers). Our focal species analysis projected future habitat suitability gains for carnivorous species with preferences for warm water, pool habitats, and fine or vegetated substrates. At the assemblage level, models projected decreasing habitat suitability for cold-water, rheophilic, and lithophilic individuals but increasing suitability for carnivores in the future across all regions. Projected responses of functional and phylogenetic diversity and redundancy differed among regions. Lowland regions were projected to become less functionally and phylogenetically diverse and more redundant while upland regions (and smaller habitat sizes) were projected to become more diverse and less redundant. Next, we assessed how these model-projected assemblage changes 2005-2030 related to observed time-series trends (1999-2016). Halfway through the initial projecting period (2005-2030), we found observed trends broadly followed modeled patterns of increasing proportions of carnivorous and lithophilic individuals in lowland regions but showed opposing patterns for functional and phylogenetic metrics. Leveraging observed and predicted analyses simultaneously helps elucidate the instances and causes of discrepancies between model predictions and ongoing observed changes. Collectively, results highlight the complexity of global change impacts across broad landscapes that likely relate to differences in assemblages' intrinsic sensitivities and external exposure to stressors.

Simple statistical models can be sufficient for testing hypotheses with population time-series data.

Time-series data offer wide-ranging opportunities to test hypotheses about the physical and biological factors that influence species abundances. Although sophisticated models have been developed and applied to analyze abundance time series, they require information about species detectability that is often unavailable. We propose that in many cases, simpler models are adequate for testing hypotheses. We consider three relatively simple regression models for time series, using simulated and empirical (fish and mammal) datasets. Model A is a conventional generalized linear model of abundance, model B adds a temporal autoregressive term, and model C uses an estimate of population growth rate as a response variable, with the option of including a term for density dependence. All models can be fit using Bayesian and non-Bayesian methods. Simulation results demonstrated that model C tended to have greater support for long-lived, lower-fecundity organisms (K life-history strategists), while model A, the simplest, tended to be supported for shorter-lived, high-fecundity organisms (r life-history strategists). Analysis of real-world fish and mammal datasets found that models A, B, and C each enjoyed support for at least some species, but sometimes yielded different insights. In particular, model C indicated effects of predictor variables that were not evident in analyses with models A and B. Bayesian and frequentist models yielded similar parameter estimates and performance. We conclude that relatively simple models are useful for testing hypotheses about the factors that influence abundance in time-series data, and can be appropriate choices for datasets that lack the information needed to fit more complicated models. When feasible, we advise fitting datasets with multiple models because they can provide complementary information.

Evaluating the impact of watershed development and climate change on stream ecosystems: A Bayesian network modeling approach.

A continuous-variable Bayesian network (cBN) model is used to link watershed development and climate change to stream ecosystem indicators. A graphical model, reflecting our understanding of the connections between climate change, weather condition, loss of natural land cover, stream flow characteristics, and stream ecosystem indicators is used as the basis for selecting flow metrics for predicting macroinvertebrate-based indicators. Selected flow metrics were then linked to variables representing watershed development and climate change. We fit the model to data from two river basins in southeast US and the resulting model was used to simulate future stream ecological conditions using projected future climate and development scenarios. The three climate models predicted varying ecological condition trajectories, but similar worst-case ecological conditions. The established modeling approach couples mechanistic understanding with field data to develop predictions of management-relevant variables across a heterogeneous landscape. We discussed the transferability of the modeling approach.

Euglycemic Ketoacidosis in a Patient with Metastatic Non-Small-Cell Lung Adenocarcinoma and Concomitant Pulmonary Embolism.

Euglycemic ketoacidosis is a recognised side effect secondary to sodium-glucose cotransporter 2 inhibitor use in the treatment of type 2 diabetes mellitus; however, there is scarce evidence to suggest whether preexisting comorbid conditions contribute to the development of this potentially life-threatening complication. We describe a case of euglycemic ketoacidosis in a patient with type 2 diabetes mellitus in the context of empagliflozin use after a recent diagnosis of metastatic lung adenocarcinoma. The diagnosis was complicated by a pulmonary embolism and hospital-acquired pneumonia, and was subsequently established after an anion-gap metabolic acidosis was identified on arterial blood gas and serum ketone measurement. The patient required admission to the intensive care unit for fluid resuscitation and regular intravenous insulin to ensure resolution of acidosis and maintenance of normoglycaemia. The patient was discharged to home for outpatient single-agent pembrolizumab for treatment of his lung adenocarcinoma. This article highlights the importance or awareness of oral hypoglycaemic medications and their side effects, along with providing further evidence for the potential contribution of malignancy to the development of euglycemic ketoacidosis in a patient with type 2 diabetes mellitus.

Action on neovascular age-related macular degeneration (nAMD): recommendations for management and service provision in the UK hospital eye service.

This report by a group of UK retina specialists and health professionals considers best practice recommendations for the management of sight-threatening neovascular age-related macular degeneration (nAMD), based on collective experience and expertise in routine clinical practice. The authors provide an update for ophthalmologists, allied healthcare professionals and commissioners on practice principles for optimal patient care and service provision standards. Refinement of care pathways for nAMD has improved access to intravitreal anti-vascular endothelial growth factor therapy but there are still variations in care and reported outcomes between clinic centres. Innovative organisational models of service provision allow providers to better match capacity with increasing demand. The authors review the recent NICE guideline for diagnosis and management of AMD, considerations for switching therapies and stopping treatment and need for regular monitoring of non-affected fellow eyes in patients with unilateral nAMD. Actions for delivery of high-quality care and to improve long-term patient outcomes are discussed. Local pathways need to detail nAMD target time to treat, maintenance of review intervals to ensure proactive treatment regimens are delivered on time and appropriate discharge for patients deemed low risk or no longer benefiting from treatment. Actual visual acuity outcomes achieved and maintenance of the level of vision when disease stability is achieved are considered good measures for judging the quality of care in the treatment of patients with nAMD. Robust community referral pathways must be in place for suspected reactivation of choroidal neovascularisation and rapid referral for second eye involvement. Practical considerations for intravitreal injection therapy are outlined.

CIB2 interacts with TMC1 and TMC2 and is essential for mechanotransduction in auditory hair cells.

Inner ear hair cells detect sound through deflection of stereocilia, the microvilli-like projections that are arranged in rows of graded heights. Calcium and integrin-binding protein 2 is essential for hearing and localizes to stereocilia, but its exact function is unknown. Here, we have characterized two mutant mouse lines, one lacking calcium and integrin-binding protein 2 and one carrying a human deafness-related Cib2 mutation, and show that both are deaf and exhibit no mechanotransduction in auditory hair cells, despite the presence of tip links that gate the mechanotransducer channels. In addition, mechanotransducing shorter row stereocilia overgrow in hair cell bundles of both Cib2 mutants. Furthermore, we report that calcium and integrin-binding protein 2 binds to the components of the hair cell mechanotransduction complex, TMC1 and TMC2, and these interactions are disrupted by deafness-causing Cib2 mutations. We conclude that calcium and integrin-binding protein 2 is required for normal operation of the mechanotransducer channels and is involved in limiting the growth of transducing stereocilia.Inner ear hair cells detect sound through deflection of stereocilia that harbor mechanically-gated channels. Here the authors show that protein responsible for Usher syndrome, CIB2, interacts with these channels and is essential for their function and hearing in mice.

Patterns of mortality in a montane mixed-conifer forest in San Diego County, California.

We examine spatial patterns of conifer tree mortality and their changes over time for the montane mixed-conifer forests of San Diego County. These forest areas have recently experienced extensive tree mortality due to multiple factors. A spatial contextual image processing approach was utilized with high spatial resolution digital airborne imagery to map dead trees for the years 1997, 2000, 2002, and 2005 for three study areas: Palomar, Volcan, and Laguna mountains. Plot-based fieldwork was conducted to further assess mortality patterns. Mean mortality remained static from 1997 to 2002 (4, 2.2, and 4.2 trees/ha for Palomar, Volcan, and Laguna) and then increased by 2005 to 10.3, 9.7, and 5.2 trees/ha, respectively. The increase in mortality between 2002 and 2005 represents the temporal pattern of a discrete disturbance event, attributable to the 2002-2003 drought. Dead trees are significantly clustered for all dates, based on spatial cluster analysis, indicating that they form distinct groups, as opposed to spatially random single dead trees. Other tests indicate no directional shift or spread of mortality over time, but rather an increase in density. While general temporal and spatial mortality processes are uniform across all study areas, the plot-based species and quantity distribution of mortality, and diameter distributions of dead vs. living trees, vary by study area. The results of this study improve our understanding of stand- to landscape-level forest structure and dynamics, particularly by examining them from the multiple perspectives of field and remotely sensed data.

Mechanotransduction current is essential for stability of the transducing stereocilia in mammalian auditory hair cells.

Mechanotransducer channels at the tips of sensory stereocilia of inner ear hair cells are gated by the tension of 'tip links' interconnecting stereocilia. To ensure maximal sensitivity, tip links are tensioned at rest, resulting in a continuous influx of Ca2+ into the cell. Here, we show that this constitutive Ca2+ influx, usually considered as potentially deleterious for hair cells, is in fact essential for stereocilia stability. In the auditory hair cells of young postnatal mice and rats, a reduction in mechanotransducer current, via pharmacological channel blockers or disruption of tip links, leads to stereocilia shape changes and shortening. These effects occur only in stereocilia that harbor mechanotransducer channels, recover upon blocker washout or tip link regeneration and can be replicated by manipulations of extracellular Ca2+ or intracellular Ca2+ buffering. Thus, our data provide the first experimental evidence for the dynamic control of stereocilia morphology by the mechanotransduction current.

Integrating modeling, monitoring, and management to reduce critical uncertainties in water resource decision making.

Stream ecosystems provide multiple, valued services to society, including water supply, waste assimilation, recreation, and habitat for diverse and productive biological communities. Managers striving to sustain these services in the face of changing climate, land uses, and water demands need tools to assess the potential effectiveness of alternative management actions, and often, the resulting tradeoffs between competing objectives. Integrating predictive modeling with monitoring data in an adaptive management framework provides a process by which managers can reduce model uncertainties and thus improve the scientific bases for subsequent decisions. We demonstrate an integration of monitoring data with a dynamic, metapopulation model developed to assess effects of streamflow alteration on fish occupancy in a southeastern US stream system. Although not extensive (collected over three years at nine sites), the monitoring data allowed us to assess and update support for alternative population dynamic models using model probabilities and Bayes rule. We then use the updated model weights to estimate the effects of water withdrawal on stream fish communities and demonstrate how feedback in the form of monitoring data can be used to improve water resource decision making. We conclude that investment in more strategic monitoring, guided by a priori model predictions under alternative hypotheses and an adaptive sampling design, could substantially improve the information available to guide decision-making and management for ecosystem services from lotic systems.

Application of Effective Discharge Analysis to Environmental Flow Decision-Making.

Well-informed river management decisions rely on an explicit statement of objectives, repeatable analyses, and a transparent system for assessing trade-offs. These components may then be applied to compare alternative operational regimes for water resource infrastructure (e.g., diversions, locks, and dams). Intra- and inter-annual hydrologic variability further complicates these already complex environmental flow decisions. Effective discharge analysis (developed in studies of geomorphology) is a powerful tool for integrating temporal variability of flow magnitude and associated ecological consequences. Here, we adapt the effectiveness framework to include multiple elements of the natural flow regime (i.e., timing, duration, and rate-of-change) as well as two flow variables. We demonstrate this analytical approach using a case study of environmental flow management based on long-term (60 years) daily discharge records in the Middle Oconee River near Athens, GA, USA. Specifically, we apply an existing model for estimating young-of-year fish recruitment based on flow-dependent metrics to an effective discharge analysis that incorporates hydrologic variability and multiple focal taxa. We then compare three alternative methods of environmental flow provision. Percentage-based withdrawal schemes outcompete other environmental flow methods across all levels of water withdrawal and ecological outcomes.

Personal attitudes, perceived social norms, and health-risk behavior among female adolescents with chronic medical conditions.

To examine whether perceived peer/parent norms or personal beliefs about adolescent substance use influence substance use among female adolescents with chronic medical conditions. Sixty-eight females reported on substance use, personal beliefs, and perceived peer/parent norms. Personal beliefs and perceived peer/parent norms were associated with adolescent's current and future substance use. Although perceived peer norms accounted for variance in current substance use, only personal beliefs accounted for variance in future alcohol use. Targeting perceived peer norms may be effective for intervention efforts among adolescents endorsing current substance use, whereas alcohol use prevention efforts should target personal beliefs.

Dealing with uncertainty when assessing fish passage through culvert road crossings.

Assessing the passage of aquatic organisms through culvert road crossings has become increasingly common in efforts to restore stream habitat. Several federal and state agencies and local stakeholders have adopted assessment approaches based on literature-derived criteria for culvert impassability. However, criteria differ and are typically specific to larger-bodied fishes. In an analysis to prioritize culverts for remediation to benefit imperiled, small-bodied fishes in the Upper Coosa River system in the southeastern United States, we assessed the sensitivity of prioritization to the use of differing but plausible criteria for culvert impassability. Using measurements at 256 road crossings, we assessed culvert impassability using four alternative criteria sets represented in Bayesian belief networks. Two criteria sets scored culverts as either passable or impassable based on alternative thresholds of culvert characteristics (outlet elevation, baseflow water velocity). Two additional criteria sets incorporated uncertainty concerning ability of small-bodied fishes to pass through culverts and estimated a probability of culvert impassability. To prioritize culverts for remediation, we combined estimated culvert impassability with culvert position in the stream network relative to other barriers to compute prospective gain in connected stream habitat for the target fish species. Although four culverts ranked highly for remediation regardless of which criteria were used to assess impassability, other culverts differed widely in priority depending on criteria. Our results emphasize the value of explicitly incorporating uncertainty into criteria underlying remediation decisions. Comparing outcomes among alternative, plausible criteria may also help to identify research most needed to narrow management uncertainty.

The effect of input data transformations on object-based image analysis.

The effect of using spectral transform images as input data on segmentation quality and its potential effect on products generated by object-based image analysis are explored in the context of land cover classification in Accra, Ghana. Five image data transformations are compared to untransformed spectral bands in terms of their effect on segmentation quality and final product accuracy. The relationship between segmentation quality and product accuracy is also briefly explored. Results suggest that input data transformations can aid in the delineation of landscape objects by image segmentation, but the effect is idiosyncratic to the transformation and object of interest.

Modeling the relations between flow regime components, species traits, and spawning success of fishes in warmwater streams.

Modifications to stream hydrologic regimes can have a profound influence on the dynamics of their fish populations. Using hierarchical linear models, we examined the relations between flow regime and young-of-year fish density using fish sampling and discharge data from three different warmwater streams in Illinois, Alabama, and Georgia. We used an information theoretic approach to evaluate the relative support for models describing hypothesized influences of five flow regime components representing: short-term high and low flows; short-term flow stability; and long-term mean flows and flow stability on fish reproductive success during fish spawning and rearing periods. We also evaluated the influence of ten fish species traits on fish reproductive success. Species traits included spawning duration, reproductive strategy, egg incubation rate, swimming locomotion morphology, general habitat preference, and food habits. Model selection results indicated that young-of-year fish density was positively related to short-term high flows during the spawning period and negatively related to flow variability during the rearing period. However, the effect of the flow regime components varied substantially among species, but was related to species traits. The effect of short-term high flows on the reproductive success was lower for species that broadcast their eggs during spawning. Species with cruiser swimming locomotion morphologies (e.g., Micropterus) also were more vulnerable to variable flows during the rearing period. Our models provide insight into the conditions and timing of flows that influence the reproductive success of warmwater stream fishes and may guide decisions related to stream regulation and management.

Estimating species occurrence, abundance, and detection probability using zero-inflated distributions.

Researchers have developed methods to account for imperfect detection of species with either occupancy (presence absence) or count data using replicated sampling. We show how these approaches can be combined to simultaneously estimate occurrence, abundance, and detection probability by specifying a zero-inflated distribution for abundance. This approach may be particularly appropriate when patterns of occurrence and abundance arise from distinct processes operating at differing spatial or temporal scales. We apply the model to two data sets: (1) previously published data for a species of duck, Anas platyrhynchos, and (2) data for a stream fish species, Etheostoma scotti. We show that in these cases, an incomplete-detection zero-inflated modeling approach yields a superior fit to the data than other models. We propose that zero-inflated abundance models accounting for incomplete detection be considered when replicate count data are available.

Newborn screening for cystic fibrosis: parents' preferences regarding counseling at the time of infants' sweat test.

Newborn screening (NBS) protocols for cystic fibrosis (CF) are the first regional population-based programs to incorporate DNA analysis into their procedures. Research about these programs can inform policy and practice regarding how best to counsel families with abnormal NBS results. The grounded theory method guided interviews with 33 families whose infants had abnormal CF NBS results. A dimensional analysis of these interviews provided a theoretical framework describing parents' preferences regarding counseling during their infant's sweat test appointment. This framework describes the contexts and characteristics of the two main dimensions of parents' preferences: factual information and emotional support. Factual information included learning about the probability of a CF diagnosis, CF disease facts, sweat test procedure, and CF genetics. Social support consisted of offering parents a choice about the timing and amount of CF information, showing empathy for their distress, instilling hope, personalizing counseling, and providing hospitality. This framework also explains the consequences of counseling that matched versus mismatched parental preferences in these domains. Counseling that matched parents preferences reduced parents' distress while mismatched counseling tended to increase parents' worry about their infant.

Fish assemblage responses to water withdrawals and water supply reservoirs in Piedmont streams.

Understanding effects of flow alteration on stream biota is essential to developing ecologically sustainable water supply strategies. We evaluated effects of altering flows via surface water withdrawals and instream reservoirs on stream fish assemblages, and compared effects with other hypothesized drivers of species richness and assemblage composition. We sampled fishes during three years in 28 streams used for municipal water supply in the Piedmont region of Georgia, U.S.A. Study sites had permitted average withdrawal rates that ranged from < 0.05 to > 13 times the stream's seven-day, ten-year recurrence low flow (7Q10), and were located directly downstream either from a water supply reservoir or from a withdrawal taken from an unimpounded stream. Ordination analysis of catch data showed a shift in assemblage composition at reservoir sites corresponding to dominance by habitat generalist species. Richness of fluvial specialists averaged about 3 fewer species downstream from reservoirs, and also declined as permitted withdrawal rate increased above about 0.5 to one 7Q10-equivalent of water. Reservoir presence and withdrawal rate, along with drainage area, accounted for 70% of the among-site variance in fluvial specialist richness and were better predictor variables than percent of the catchment in urban land use or average streambed sediment size. Increasing withdrawal rate also increased the odds that a site's Index of Biotic Integrity score fell below a regulatory threshold indicating biological impairment. Estimates of reservoir and withdrawal effects on stream biota could be used in predictive landscape models to support adaptive water supply planning intended to meet societal needs while conserving biological resources.

Importance of riparian forests in urban catchments contingent on sediment and hydrologic regimes.

Forested riparian corridors are thought to minimize impacts of landscape disturbance on stream ecosystems; yet, the effectiveness of streamside forests in mitigating disturbance in urbanizing catchments is unknown. We expected that riparian forests would provide minimal benefits for fish assemblages in streams that are highly impaired by sediment or hydrologic alteration. We tested this hypothesis in 30 small streams along a gradient of urban disturbance (1-65% urban land cover). Species expected to be sensitive to disturbance (i.e., fluvial specialists and "sensitive" species that respond negatively to urbanization) were best predicted by models including percent forest cover in the riparian corridor and a principal components axis describing sediment disturbance. Only sites with coarse bed sediment and low bed mobility (vs. sites with high amounts of fine sediment) had increased richness and abundances of sensitive species with higher percent riparian forests, supporting our hypothesis that response to riparian forests is contingent on the sediment regime. Abundances of Etheostoma scotti, the federally threatened Cherokee darter, were best predicted by models with single variables representing stormflow (r(2) = 0.34) and sediment (r(2) = 0.23) conditions. Lentic-tolerant species richness and abundance responded only to a variable representing prolonged duration of low-flow conditions. For these species, hydrologic alteration overwhelmed any influence of riparian forests on stream biota. These results suggest that, at a minimum, catchment management strategies must simultaneously address hydrologic, sediment, and riparian disturbance in order to protect all aspects of fish assemblage integrity.