Predicting long-term survival among patients with HCC.

Background: Prognosticating survival among patients with HCC and cirrhosis must account for both the tumor burden/stage, as well as the severity of the underlying liver disease. Although there are many staging systems used to guide therapy, they have not been widely adopted to predict patient-level survival after the diagnosis of HCC. We sought to develop a score to predict long-term survival among patients with early- to intermediate-stage HCC using purely objective criteria.

Improving the representation of forests in hydrological models.

Forests play a critical role in the hydrologic cycle, impacting the surface and groundwater dynamics of watersheds through transpiration, interception, shading, and modification of the atmospheric boundary layer. It is therefore critical that forest dynamics are adequately represented in watershed models, such as the widely applied Soil and Water Assessment Tool (SWAT). SWAT's default parameterization generally produces unrealistic forest growth predictions, which we address here through an improved representation of forest dynamics using species-specific re-parameterizations.

Connecting changes in Euphrates River flow to hydropattern of the Western Mesopotamian Marshes.

The Mesopotamian Marshlands are the largest wetland system in the Middle East. Historically, these marshes served as the floodplains of the Tigris and Euphrates rivers, and they are currently connected to these rivers via surface water feeder canals. Historically, the Mesopotamian marshes received consistent flood pulses during the spring season from March to May.

Venous Thromboembolism at High Altitude: Our Approach to Patients at Risk.

Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a prevalent disorder that confers substantial cardiovascular morbidity and, in serious cases, death. VTE has a complex and incompletely understood etiopathogenesis with genetic, acquired, and environmental risk factors. As the focus of this review, one environmental risk factor, which may interact with other risk factors such as hereditary and/or acquired thrombophilias, is travel to high altitude (HA), although current evidence is limited.

A casualty of climate change? Loss of freshwater forest islands on Florida's Gulf Coast.

Sea level rise elicits short- and long-term changes in coastal plant communities by altering the physical conditions that affect ecosystem processes and species distributions. While the effects of sea level rise on salt marshes and mangroves are well studied, we focus on its effects on coastal islands of freshwater forest in Florida's Big Bend region, extending a dataset initiated in 1992. In 2014-2015, we evaluated tree survival, regeneration, and understory composition in 13 previously established plots located along a tidal creek; 10 plots are on forest islands surrounded by salt marsh, and three are in continuous forest.

Freshwater Detention by Oyster Reefs: Quantifying a Keystone Ecosystem Service.

Oyster reefs provide myriad ecosystem services, including water quality improvement, fisheries and other faunal support, shoreline protection from erosion and storm surge, and economic productivity. However, their role in directing flow during non-storm conditions has been largely neglected. In regions where oyster reefs form near the mouth of estuarine rivers, they likely alter ocean-estuary exchange by acting as fresh water "dams".

Apixaban for the Secondary Prevention of Thrombosis Among Patients With Antiphospholipid Syndrome: Study Rationale and Design (ASTRO-APS).

Background: Antiphospholipid syndrome (APS) is an acquired thrombophilia characterized by thrombosis, pregnancy morbidity, and the presence of characteristic antibodies. Current therapy for patients having APS with a history of thrombosis necessitates anticoagulation with the vitamin K antagonist warfarin, a challenging drug to manage. Apixaban, approved for the treatment and prevention of venous thrombosis with a low rate of bleeding observed, has never been studied among patients with APS.

Beyond precipitation: physiographic gradients dictate the relative importance of environmental drivers on Savanna vegetation.

Background: Understanding the drivers of large-scale vegetation change is critical to managing landscapes and key to predicting how projected climate and land use changes will affect regional vegetation patterns. This study aimed to improve our understanding of the role, magnitude and spatial distribution of the key environmental factors driving vegetation change in southern African savanna, and how they vary across physiographic gradients.

Methodology/principal Findings: We applied Dynamic Factor Analysis (DFA), a multivariate times series dimension reduction technique to ten years of monthly remote sensing data (MODIS-derived normalized difference vegetation index, NDVI) and a suite of environmental covariates: precipitation, mean and maximum temperature, soil moisture, relative humidity, fire and potential evapotranspiration.