Ecosystem-size relationships of river populations and communities.

Knowledge of ecosystem-size influences on river populations and communities is integral to the balancing of human and environmental needs for water. The multiple dimensions of dendritic river networks complicate understanding of ecosystem-size influences, but could be resolved by the development of scaling relationships. We highlight the importance of physical constraints limiting predator body sizes, movements, and population sizes in small rivers, and where river contraction limits space or creates stressful conditions affecting community stability and food webs.

Consequences of climate-induced range expansions on multiple ecosystem functions.

Climate-driven species range shifts and expansions are changing community composition, yet the functional consequences in natural systems are mostly unknown. By combining a 30-year survey of subalpine pond larval caddisfly assemblages with species-specific functional traits (nitrogen and phosphorus excretion, and detritus processing rates), we tested how three upslope range expansions affected species' relative contributions to caddisfly-driven nutrient supply and detritus processing. A subdominant resident species (Ag.

Species-specific traits predict whole-assemblage detritus processing by pond invertebrates.

Functional trait diversity determines if ecosystem processes are sensitive to shifts in species abundances or composition. For example, trait variation suggests detritivores process detritus at different rates and make different contributions to whole-assemblage processing, which could be sensitive to compositional shifts. Here, we used a series of microcosm experiments to quantify species-specific coarse and fine particulate organic matter (CPOM and FPOM) processing for ten larval caddisfly species and three non-caddisfly species in high-elevation wetlands.

Regulation of open populations of a stream insect through larval density dependence.

In organisms with complex life cycles, the various stages occupy different habitats creating demographically open populations. The dynamics of these populations will depend on the occurrence and timing of stochastic influences relative to demographic density dependence, but understanding of these fundamentals, especially in the face of climate warming, has been hampered by the difficulty of empirical studies. Using a logically feasible organism, we conducted a replicated density-perturbation experiment to manipulate late-instar larvae of nine populations of a stream caddisfly, Zelandopsyche ingens, and measured the resulting abundance over 2 years covering the complete life cycle of one cohort to evaluate influences on dynamics.

Predators balance consequences of climate-change-induced habitat shifts for range-shifting and resident species.

While many species distributions are shifting poleward or up in elevation in response to a changing climate, others are shifting their habitats along localized gradients in environmental conditions as abiotic conditions become more stressful. Whether species are moving across regional or local environmental gradients in response to climate change, range-shifting species become embedded in established communities of competitors and predators. The consequences of these shifts for both resident and shifting species are often unknown, as it can be difficult to isolate the effects of multiple species interactions.

Habitat size influences community stability.

Mechanisms linked to demographic, biogeographic, and food-web processes thought to underpin community stability could be affected by habitat size, but the effects of habitat size on community stability remain relatively unknown. We investigated whether those habitat-size-dependent properties influenced community instability and vulnerability to perturbations caused by disturbance. This is particularly important given that human exploitation is contracting ecosystems, and abiotic perturbations are becoming more severe and frequent.

A Taxonomic Review of Patient Complaints in Adult Hospital Medicine.

Previous studies show that patient complaints can identify gaps in quality of care, but it is difficult to identify trends without categorization. We conducted a review of complaints relating to admissions on hospital internal medicine (HIM) services over a 26-month period. Data were collected on person characteristics and key features of the complaint.

Does taxonomic and numerical resolution affect the assessment of invertebrate community structure in New World freshwater wetlands?

The efficiency of biodiversity assessments and biomonitoring studies is commonly challenged by limitations in taxonomic identification and quantification approaches. In this study, we assessed the effects of different taxonomic and numerical resolutions on a range of community structure metrics in invertebrate compositional data sets from six regions distributed across North and South America. We specifically assessed the degree of similarity in the metrics (richness, equitability, beta diversity, heterogeneity in community composition and congruence) for data sets identified to a coarse resolution (usually family level) and the finest taxonomic resolution practical (usually genus level, sometimes species or morphospecies) and by presence-absence and relative abundance numerical resolutions.

Elevation alters outcome of competition between resident and range-shifting species.

Species' geographic range shifts toward higher latitudes and elevations are among the most frequently reported consequences of climate change. However, the role of species interactions in setting range margins remains poorly understood. We used cage experiments in ponds to test competing hypotheses about the role of abiotic and biotic mechanisms for structuring range boundaries of an upslope range-shifting caddisfly Limnephilus picturatus.

A retrospective review of breast reconstruction outcomes comparing AlloDerm and DermaCELL.

Acellular dermal matrix (ADM) has become an accepted and advantageous adjunct to alloplastic breast reconstruction. The increase in demand has led to an upsurge of dermal-based products, both human and animal derived. There are few direct ADM comparative studies, but it is unclear whether there are any differences in complication rates.

'Taking the wheels off': young people with cognitive impairment in out-of-home care.

Children with cognitive impairment in out-of-home care (OOHC) are significantly over-represented in the criminal justice system. Little attention has been given to the connection between those with cognitive impairment who also have a care background and how these combined factors are linked to their criminal behaviour. A qualitative study utilising semi-structured interviews with 11 senior strategic officers and service providers to this cohort was conducted with the aim of investigating the views of these professionals and gaining insight into factors contributing to the criminalisation of children with cognitive impairment in OOHC.

"No Waiting" in the "Waiting Room": The Self-rooming Patient Pilot Study.

Introduction: Although patient timeliness and appointment flow are highly important for patients and practices, the impact of technology on improving these aspects of healthcare delivery are not widely studied. We evaluated the satisfaction and acceptability of using a handheld internet-enabled tablet computer (the Mobile Patient Communicator (MPC)) that uses interactive maps, and visual and written instructions to direct patients from waiting rooms to exam rooms independently of medical personnel.

Methods: At the time of appointment check-in, eligible patients attending their healthcare appointments at a family medicine practice received the MPC that provided them an online orientation about its use and function.

Repeat disturbances have cumulative impacts on stream communities.

Climate change has altered disturbance regimes in many ecosystems, and predictions show that these trends are likely to continue. The frequency of disturbance events plays a particularly important role in communities by selecting for disturbance-tolerant taxa.However, ecologists have yet to disentangle the influence of disturbance frequency per se and time since last disturbance, because more frequently disturbed systems have also usually been disturbed more recently.

Landscape heterogeneity strengthens the relationship between β-diversity and ecosystem function.

Consensus has emerged in the literature that increased biodiversity enhances the capacity of ecosystems to perform multiple functions. However, most biodiversity/ecosystem function studies focus on a single ecosystem, or on landscapes of homogenous ecosystems. Here, we investigate how increased landscape-level environmental dissimilarity may affect the relationship between different metrics of diversity (α, β, or γ) and ecosystem function.

Capacity to support predators scales with habitat size.

Habitat reduction could drive biodiversity loss if the capacity of food webs to support predators is undermined by habitat-size constraints on predator body size. Assuming that (i) available space restricts predator body size, (ii) mass-specific energy needs of predators scale with their body size, and (iii) energy availability scales with prey biomass, we predicted that predator biomass per unit area would scale with habitat size (quarter-power exponent) and prey biomass (three-quarter-power exponent). We found that total predator biomass scaled with habitat size and prey resources as expected across 29 New Zealand rivers, such that a unit of habitat in a small ecosystem supported less predator biomass than an equivalent unit in a large ecosystem.

Patient portal use and hospital outcomes.

Objectives: To determine whether use of a patient portal during hospitalization is associated with improvement in hospital outcomes, 30-day readmissions, inpatient mortality, and 30-day mortality.

Materials And Methods: We performed a retrospective propensity score-matched study that included all adult patients admitted to Mayo Clinic Hospital in Jacksonville, Florida, from August 1, 2012, to July 31, 2014, who had signed up for a patient portal account prior to hospitalization (N = 7538).

Results: Out of the admitted patients with a portal account, 1566 (20.

Structural and electrical cardiac abnormalities are prevalent in asymptomatic adults with myotonic dystrophy.

Objective: Cardiac disease accounts for a large burden of premature mortality and morbidity in patients with type 1 myotonic dystrophy (MD). However, little is known about structural cardiac abnormalities particularly in asymptomatic patients with MD. We sought to describe the prevalence and extent of structural cardiac abnormalities in patients with MD and to assess their association with functional, electrical, biochemical and genetic disturbances.

Warming alters food web-driven changes in the CO2 flux of experimental pond ecosystems.

Evidence shows the important role biota play in the carbon cycle, and strategic management of plant and animal populations could enhance CO2 uptake in aquatic ecosystems. However, it is currently unknown how management-driven changes to community structure may interact with climate warming and other anthropogenic perturbations to alter CO2 fluxes. Here we showed that under ambient water temperatures, predators (three-spined stickleback) and nutrient enrichment synergistically increased primary producer biomass, resulting in increased CO2 uptake by mesocosms in early dawn.

A new framework for selecting environmental surrogates.

Surrogate concepts are used in all sub-disciplines of environmental science. However, controversy remains regarding the extent to which surrogates are useful for resolving environmental problems. Here, we argue that conflicts about the utility of surrogates (and the related concepts of indicators and proxies) often reflect context-specific differences in trade-offs between measurement accuracy and practical constraints.

Measures of satisfaction for providers and patients using same day teledermoscopy consultation.

Background: We aimed to determine whether patients and providers were satisfied with teledermoscopy consultation for skin lesions.

Methods: From 2010 to 2011, patients with clinically suspicious lesions were referred for teledermoscopy by internal medicine physicians. Lesions were digitally photographed using a dermatoscope accessory lens.

Residents' knowledge of quality improvement: the impact of using a group project curriculum.

Background: The Accreditation Council for Graduate Medical Education requires residents to learn and demonstrate proficiency in practice improvement. Quality improvement (QI) projects are a way to improve patient care as well as facilitate education on this core competency. There are inherent barriers to completing these goals in the structure of residency training including rigorous resident schedules and a limited number of projects and resources.

The body size dependence of trophic cascades.

Trophic cascades are indirect positive effects of predators on resources via control of intermediate consumers. Larger-bodied predators appear to induce stronger trophic cascades (a greater rebound of resource density toward carrying capacity), but how this happens is unknown because we lack a clear depiction of how the strength of trophic cascades is determined. Using consumer resource models, we first show that the strength of a trophic cascade has an upper limit set by the interaction strength between the basal trophic group and its consumer and that this limit is approached as the interaction strength between the consumer and its predator increases.

A bioenergetic framework for the temperature dependence of trophic interactions.

Changing temperature can substantially shift ecological communities by altering the strength and stability of trophic interactions. Because many ecological rates are constrained by temperature, new approaches are required to understand how simultaneous changes in multiple rates alter the relative performance of species and their trophic interactions. We develop an energetic approach to identify the relationship between biomass fluxes and standing biomass across trophic levels.

Increased temperature variation poses a greater risk to species than climate warming.

Increases in the frequency, severity and duration of temperature extremes are anticipated in the near future. Although recent work suggests that changes in temperature variation will have disproportionately greater effects on species than changes to the mean, much of climate change research in ecology has focused on the impacts of mean temperature change. Here, we couple fine-grained climate projections (2050-2059) to thermal performance data from 38 ectothermic invertebrate species and contrast projections with those of a simple model.