Reefscapes of fear assess tradeoffs of risk and reward on coral reefs

Degradation of coral reef habitats changes the abundance and community composition of fishes due in part to changes in the ecology of fear. The ecology of fear sees the predator-prey system as a dynamic game of behavioral responses to perceived risk with population and community level consequences. We measure spatial variation in predation risk as landscapes of fear. We consider changes in predation risk with habitat quality and examine the effects of fear on coral reefs in Kāne‘ohe Bay, O‘ahu, Hawai‘i. First, we associate fish and benthic communities on patch reefs with varying degradation due to invasive algae (Euchema spp. and Kappaphycus spp.). Next, we quantify the spatio-temporal variation of risk (reefscape of fear) of a common Hawaiian fish (saddle wrasse, hīnālea lau wili, Thalassoma duperrey) across reefs of varying degradation. Finally, we assess the tradeoffs in resource availability and predation risk on these reefs. At the scale of whole reefs, saddle wrasse responded to perceived risk. Intensity of patch use (measured by giving-up densities) by wrasse indicated risky reefs. Such reefs differed in benthic and fish community composition. We demonstrated the impact of an altered reefscape of fear due to habitat degradation. Habitat degradation seems to influence the tradeoff between resource availability and safety. From wrasse abundances and their patch use behavior we can classify the reefs into categories based on risk and resource availability. Allowing fish to reveal their perceptions of habitat qualities through their behaviors provides critical information for assessing and monitoring reefs.

Bovine xenograft pericardial patch use for definitive single stage repair of a large esophageal defect: a case report

Background Large esophageal perforations are challenging and often treated with exclusion or resection. This case demonstrates the feasibility of definitive surgical repair of a large esophageal perforation using large bovine pericardial patch. Case A patient with missed Boerhaave Syndrome underwent transesophageal echocardiography causing worsening perforation and sepsis. At thoracotomy and faced with a large esophageal defect, a large Bovine pericardial patch was used for repair with omentopexy. The patient recovered promptly and at 8 months was asymptomatic with satisfactory studies. Conclusion Xenograft pericardium is available and widely used for vascular reconstructions. It’s use for primary repair of large esophageal perforations should be considered.

Findings from the patch augmented rotator cuff surgery (PARCS) feasibility study

Background A rotator cuff tear is a common disabling shoulder problem. Symptoms include pain, weakness, lack of mobility and sleep disturbance. Many patients require surgery to repair the tear; however, there is a high failure rate. There is a pressing need to improve the outcome of rotator cuff surgery. The use of patch augmentation to provide support to the healing process and improve patient outcomes holds new promise. Different materials (e.g. human/animal skin or intestine tissue, and completely synthetic materials) and processes (e.g. woven or a mesh) have been used to produce patches. However, clinical evidence on their use is limited. The patch augmented rotator cuff surgery (PARCS) feasibility study aimed to determine the design of a definitive randomised controlled trial (RCT) assessing the effectiveness and cost-effectiveness of a patch to augment surgical repair of the rotator cuff that is both acceptable to stakeholders and feasible. Methods A mixed methods feasibility study of conducing a subsequent RCT. The project involved six stages: a systematic review of clinical evidence; a survey of the British Elbow and Shoulder Society’s (BESS) surgical membership; a survey of surgeon trialists; focus groups and interviews with stakeholders; a two-round Delphi study administered via online questionnaires and a 2-day consensus meeting. Results The BESS surgeons’ survey identified a variety of patches in use (105 (21%) responses received). Twenty-four surgeons (77%) completed the trialist survey relating to trial design. Four focus groups were conducted involving 24 stakeholders. Twenty-nine (67% of invited) individuals took part in the Delphi. Differing views were held on a number of aspects including the appropriate patient population for trial participation. Agreement on the key research questions and the outline of two potential RCTs were achieved through the Delphi study and the consensus meeting. Conclusions Randomised comparisons of on-lay patch use for completed rotator cuff repairs, and bridging patch use for partial rotator cuff repairs were identified as areas for further research. The value of an observational study to assess safety concerns of patch use was also highlighted. The main limitation was that the findings were influenced by the participants, who might not necessarily reflect all stakeholders.

Real-world Utilisation of the Rivastigmine Transdermal Patches Accompanying the use of Risk Minimisation Tools in Patients with Dementia

Background: Transdermal patches are convenient to use, especially in patients with Alzheimer’s disease (AD)-associated dementia. However, various identified risks of errors in ad- ministering the patches cannot be disregarded. Patient Reminder Cards (PRCs, included a Medica- tion record sheet [MRS]) have been recently introduced as a risk minimisation tool to prevent incor- rect patch use (IU). Objectives: This study aimed to assess the effectiveness of PRCs to prevent IU and to investigate the dose titration pattern of rivastigmine patches in a real-world setting. Methods: This multinational, observational, 11-month study included patients with AD currently using rivastigmine patches (4.6 mg/day, 9.5 mg/day, 13.3 mg/day) accompanied by a caregiver. Study outcomes were IU, including multiple patch use (MPU), incorrect patch placement, other IUs, perceived usefulness of the PRCs, and titration patterns of the patches. Results: Of the total 614 patients included, most were aged ≥65 years and had mild-to-moderate AD. Before and during the study, 27.7% and 18.0% of patients reported IU, respectively. Most pa- tients used MRS, and 73.5% rated it ‘helpful’ and reported lower rates of IU than those who report- ed it ‘not helpful’ (13.9%–16.5% vs. 20.2%). Overall, 141 patients had dose titrations, with 75.8% being up-titrated from 4.6 mg/day to 9.5 mg/day after a mean duration of 58 days. Safety findings were consistent with the established profile for the rivastigmine patch. Conclusion: PRC was effective as a risk minimisation tool in limiting the inappropriate use of ri- vastigmine patches. The majority of patients requiring dose-change were up-titrated to 9.5 mg/day patches.

Patch use and departure rules by gull-billed tern Gelochelidon nilotica

The gull-billed tern Gelochelidon nilotica feeds on the fiddler crab Leptuca uruguayensis, which settles forming patches in south-eastern temperate mudflats of Argentina. Through field observations, we evaluated whether gull-billed terns used patches following the marginal value theorem (MVT). Gull-billed tern residence time in a patch was not related to crab density or travel times. The number of captures was also unrelated to crab density. Most of the times (44.6%) terns captured only one crab from each patch, and 35% of the times they left without a capture. However, crab density was lower when terns left the patches than when they arrived. This suggests that following several capture attempts by terns, crabs hide, producing a temporary decrease in their availability, forcing tern departure from the patches, which are no longer profitable. Thus, when prey availability is affected more by predator activity than by consumption, the MVT may not necessarily apply.

Does a bacterial infection lead to a nutritional deficiency in foraging Allenby’s gerbils?

Bacterial infections can have both direct (physiological) and indirect (ecological) costs for their hosts. The direct costs of infection may include nutritional deficiencies, which reduce body condition over time, and result in the hosts modifying their foraging behaviour to compensate for any losses. Allenby’s gerbils are commonly infected with the Mycoplasma haemomuris-like bacteria, which may induce choline (essential vitamin) and arginine (amino acid) deficiencies. Gerbils should therefore alter their behaviour to make up for any shortfalls in nutrient production and retention. We tested two predictions. 1) infected gerbils would compensate for nutrient losses by spending more time foraging in patches, including, during riskier periods of owl presence, and in riskier open microhabitats. Furthermore, infected gerbils would preferentially forage from patches supplemented with choline and arginine enriched food over control food. 2) Alternatively, if infection did not create a nutrient deficiency, then infected individuals would display a similar pattern of patch use to uninfected individuals, and harvest similar amounts of food from supplemented and control patches. Our findings supported the second prediction. There was no observed difference in foraging behaviour between infected and uninfected individuals. Moreover, infected gerbils did not selectively forage more intensively from food patches enriched with either choline or arginine seed over the control patches. These results suggest that this bacteria-gerbil interaction does not result in a nutrient deficiency as observed for other Mycoplasma-rodent systems.

Findings from the Patch Augmented Rotator Cuff Surgery (PARCS) Feasibility Study

BackgroundA rotator cuff tear is a common disabling shoulder problem. Symptoms include pain, weakness, lack of mobility and sleep disturbance. Many patients require surgery to repair the tear; however, there is a high failure rate. There is a pressing need to improve the outcome of rotator cuff surgery. The use of patch augmentation to provide support to the healing process and improve patient outcomes holds new promise. Different materials (e.g. human/animal skin or intestine tissue, and completely synthetic materials) and processes (e.g. woven or a mesh) have been used to produce patches. However, clinical evidence on their use is limited. The Patch Augmented Rotator Cuff Surgery (PARCS) feasibility study aimed to determine the design of a definitive randomised controlled trial (RCT) assessing the effectiveness and cost-effectiveness of a patch to augment surgical repair of the rotator cuff that is both acceptable to stakeholders and feasible.MethodsA mixed methods feasibility study of a RCT. The project involved six stages: a systematic review of clinical evidence; a survey of the British Elbow and Shoulder (BESS) society’s surgical membership; a survey of surgeon trialists; focus groups and interviews with stakeholders; a two-round Delphi study administered via online questionnaires; and a two-day Consensus Meeting. ResultsThe BESS surgeons’ survey identified a variety of patches in use (105 (21%) responses received). Twenty-four surgeons (77%) completed the trialist survey relating to trial design. Four focus groups were conducted involving 24 stakeholders. Twenty-nine (67% of invited) individuals took part in the Delphi. Differing views were held on a number of aspects including the appropriate patient population for trial participation. Agreement on the key research questions and the outline of two potential RCTs were achieved through the Delphi study and the consensus meeting). ConclusionsRandomised comparisons of on-lay patch use for completed rotator cuff repairs, and bridging patch use for partial rotator cuff repairs were identified as areas for further research. The value of an observational study to assess safety concerns of patch use was also highlighted. The main limitation was that the findings were influenced by the participants, who might not necessarily reflect all stakeholders.

Host Patch Use and Potential Competitive Interactions Between Two Egg Parasitoids From the Family Scelionidae, Candidate Biological Control Agents of Bagrada hilaris (Hemiptera: Pentatomidae)

Two egg parasitoids from Pakistan, Gryon sp. nr. gonikopalense Sharma (Hymenoptera: Scelionidae) and Trissolcus hyalinipennis Rajmohana & Narendran (Hymenoptera: Scelionidae), are currently being investigated as potential classical biocontrol agents for Bagrada hilaris Burmeister. The former is the most promising because of its ability to attack B. hilaris eggs in soil, but the latter was recently discovered in California. This study detailed the patch use and oviposition behavior of both species and assessed their relative foraging efficiency. We also investigated possible competitive interactions by assessing 1) the occurrence of intra- and interspecific host discrimination, 2) mutual interference between females (extrinsic competition), 3) the outcome of multiparasitism (intrinsic competition), and 4) the effect of competition on host suppression. Our results showed that T. hyalinipennis females tended to probe repeatedly in the same hosts leading to longer host patch time and lower foraging efficiency. Both species avoided conspecific superparasitism, but not multiparasitism. When the two species foraged simultaneously, G. sp. nr. gonikopalense seemed to be slightly superior in extrinsic competition, while neither species seemed to have an advantage in intrinsic competition. Also, neither species could develop as a facultative hyperparasitoid, but they inflicted non-reproductive mortality on eggs containing 4-d-old larvae of their competitor. Lastly, host mortality inflicted by G. sp. nr. gonikopalense and T. hyalinipennis when acting together appeared to be additive. These results suggest that the presence of T. hyalinipennis in California is unlikely to reduce G. sp. nr. gonikopalense efficiency, but will instead improve the biological control of B. hilaris.