High Recruitment Rates Research Articles

Multiple abiotic and biotic pathways shape biomass demographic processes in temperate forests.

Forests play a key role in regulating the global carbon cycle, and yet the abiotic and biotic conditions that drive the demographic processes that underpin forest carbon dynamics remain poorly understood in natural ecosystems. To address this knowledge gap, we used repeat forest inventory data from 92,285 trees across four large permanent plots (4–25 ha in size) in temperate mixed forests in northeast China to ask the following questions: (1) How do soil conditions and stand age drive biomass demographic processes? (2) How do vegetation quality (i.e., functional trait diversity and composition) and quantity (i.e., initial biomass stocks) influence biomass demographic processes independently from soil conditions and stand age? (3) What is the relative contribution of growth, recruitment, and mortality to net biomass change? Using structural equation modeling, we showed that all three demographic processes were jointly constrained by multiple abiotic and biotic factors and that mortality was the strongest determinant on net biomass change over time. Growth and mortality, as well as functional trait diversity and the community‐weighted mean of specific leaf area (CWMSLA), declined with stand age. By contrast, high soil phosphorous concentrations were associated with greater functional diversity and faster dynamics (i.e., high growth and mortality rates), but associated with lower CWMSLA and initial biomass stock. More functionally diverse communities also had higher recruitment rates, but did not exhibit faster growth and mortality. Instead, initial biomass stocks and CWMSLA were stronger predictors of biomass growth and mortality, respectively. By integrating the full spectrum of abiotic and biotic drivers of forest biomass dynamics, our study provides critical system‐level insights needed to predict the possible consequences of regional changes in forest diversity, composition, structure and function in the context of global change.

Transversus thoracis muscle plane block in cardiac surgery: a pilot feasibility study

IntroductionCardiac surgery patients often experience significant pain after median sternotomy. The transversus thoracis muscle plane (TTP) block is a newly developed, single-shot nerve block technique that provides analgesia for the...

Upper mesophotic depths in the coral reefs of Eilat, Red Sea, offer suitable refuge grounds for coral settlement

Due to increasing frequency of disturbances to shallow reefs, it has been suggested that Mesophotic Coral Ecosystems (MCEs, 30–150 m depth) may serve as a refuge for corals and a source of larvae that can facilitate the recovery of shallow degraded reefs. As such, they have received increased attention in the past decade, yet remained understudied regarding recruitment dynamics. Here we describe coral recruitment dynamics on settlement tiles and their adjacent natural habitats (10 m vs. 50 m depths) in Eilat, over a period of 5.5 years. The tiles were deployed along three sites onto 18 racks (3 at each depth and at each site). Recruitment patterns varied both temporally and spatially, ending up to two-fold higher juvenile density and higher recruitment rates at mesophotic sites. Settlement surface preference changed with depth, favoring exposed surfaces in mesophotic waters and cryptic surfaces in shallow waters. Juvenile assemblages differed between depths and were distinct from adjacent natural habitats. Over half of the recruited genera overlapped between depths. We suggest that Eilat MCEs serve as a larval sink, providing settlement grounds for shallow-reef propagules. In view of their significance, we call for the protection of these unique and distinct deep-reef habitats.

Exploring the genetic diversity and the population structure of the mesophotic Paramuricea macrospina in the Menorca Channel

Gorgonians play an important structural and functional role promoting high diversity and biomass of associated fauna. Up to now, studies on gorgonian ecology in the Mediterranean Sea have been focused mainly on the SCUBA diving depth range. Although increased availability of remotely operated vehicles allowed access to the deeper areas, gorgonian assemblages located on continental shelf and slopes are still barely known. Gorgonian assemblages on continental shelves are extremely vulnerable to anthropogenic impacts, especially bottom trawling and longline fishing. To implement effective management and conservation policies it is crucial to understand patterns of genetic structure among populations since connectivity enhances the resilience of populations. Paramuricea macrospina is a key structuring gorgonian in the Menorca Channel's (Balearic Archipelago) outer continental shelf where it covers vast extensions, reaching very high densities. Combining two mitochondrial makers and 10 microsatellites, this study gives the first insight into the genetic diversity and population structure of P. macrospina between 60 and 100 m depth in the Menorca Channel and at a horizontal spatial scale of about 60 Km. Overall, we demonstrate a low genetic diversity and a lack of genetic structure among populations, which may be explained by the geomorphology and hydrodynamic features of the Menorca Channel (e.g. internal waves, high currents). Our study suggests some connectivity among P. macrospina populations in accordance with the high recruitment rates observed. This connectivity may increase the resilience and foster the recovery of impacted populations since the study area will become a Marine Protected Area of the Natura 2000 network in the near future. Nevertheless, complementary studies based on a larger sample size should be conducted to complement our results. In addition, temporal genetic monitoring of these populations should be envisaged to monitor the potential reduction of genetic diversity of this mesophotic species.

MyHealth: specialist nurse-led follow-up in breast cancer. A randomized controlled trial – development and feasibility

Background: Traditionally, women treated for breast cancer (BC) have been followed up through regular oncologist-led visits in outpatient clinics, focusing on detection of recurrences, new primary BC, symptom management, and psychological support. However, this follow-up routine is expensive and its effectiveness has been questioned. Consequently, alternative follow-up programs have been tested. The Guided Self-Determination method (GSD), which facilitates partnership between health-care provider and patient, has been shown to improve self-management in patients with chronic conditions, including cancer. Patient-reported outcomes (PRO) is another increasingly used tool to improve patient–provider communication, symptom monitoring and control. In combination, GSD and PRO may have the potential to meet the objectives of BC follow-up. To test this, we developed the MyHealth study, a randomized controlled trial comparing a nurse-led follow-up program based on GSD, collection of PRO, and patient navigation with routine oncologist-led follow-up. Here we describe how we developed the intervention and are currently testing the feasibility of the MyHealth protocol in terms of recruitment, adherence to the intervention, collection of PRO, and patient navigation.Material and methods: We have invited the first 25 consecutively enrolled patients to test the MyHealth intervention. This consists of (1) 3–5 initial GSD appointments with a nurse, (2) collection of PRO, and (3) symptom management and patient navigation. The randomized trial was launched in January 2017 and is still recruiting.Results of the feasibility study: Of 32 patients invited, 25 accepted participation. At 18-month follow-up, two patients have withdrawn, 143 PRO questionnaires have been completed (mean 5.7/patient) resulting in 59 nurse contacts (mean 2.4 per patient) and 14 project physician contacts (mean 0.6 per patient).Conclusion: A high recruitment rate and response rate to PRO indicate that follow-up led by specialist nurses, based on collection of PRO is feasible and acceptable for patients treated for early stage BC.Trial registration: ClinicalTrials.gov identifier: NCT02949167.

BIOLAP: biological versus synthetic mesh in laparo-endoscopic inguinal hernia repair: study protocol for a randomized, multicenter, self-controlled clinical trial

BackgroundInguinal hernia repair is one of the most common surgical operations globally; more than 20 million groin herniae are repaired annually worldwide. Recurrence after an inguinal hernia operation is a considerable clinical problem. Another remaining problem after hernia surgery is the occurrence of chronic pain. Up to now, the use of synthetic meshes is the standard procedure, but there is increasing evidence that biological meshes could be advantageous concerning the occurrence of chronic pain due to different postoperative remodeling, without the disadvantages of a life-long implant.We hypothesize that the use of a biological mesh reduces postoperative pain without being inferior in terms of recurrence rate compared with a synthetic mesh.Methods/designThe trial compares possible the advantages of biological matrices to synthetic meshes in laparo-endoscopic inguinal hernia repair. Four hundred and ninety-six patients with primary bilateral inguinal herniae in 20 German hernia centers will be enrolled. Biological mesh is used for one of the bilateral herniae, the other side will be operated on with a synthetic mesh. Randomization will preset which side is repaired with which material and trial participants will not be informed about the location of each mesh type. The primary endpoints will be intensity of postoperative local pain and the incidence of recurrent hernia after 2 years.DiscussionThere is no reasonably sized trial that assesses the use of biological meshes in laparo-endoscopic inguinal hernia repair.Our self-controlled trial design allows a direct comparison of the two meshes with very few confounding factors as well as minimizing the exclusion criteria. As we compare CE-certified medical devices in their designated indication the medical risk is not different compared to routine clinical care. Due to the common nature of bilateral inguinal hernia, a high recruitment rate is achievable. Because guidelines for hernia repair have stressed the need for reliable data on the already frequent use of biological meshes, we can expect our trial to have a direct implication on hernia-repair standards.Trial registrationGerman Clinical Trials Register, ID: DRKS00010178. Registered on 16.June.2016. BIOLAP underwent full external peer review as part of the funding process with the German Research Foundation.

Adult Survival of Common Eiders in Maine

Although most species of sea ducks are poorly studied, much is known about the population dynamics of the American race of Somateria mollissma dresseri (Common Eider). Although Common Eiders typically have high adult survival and low recruitment rates, their populations in Maine have declined since the early 1990s. Wildlife managers hypothesized this decline was due to reduced adult survival; therefore, they decreased daily bag limits in Maine in 1999 and 2009 to increase local populations. The goals of this project were to assess (a) whether survival rates of adult females captured while nesting varied between historical estimates (1943–1993) and recent estimates (2000–2012), (b) whether survival rates increased from 2000–2009 after the initial harvest restrictions were implemented in 1999, and (c) determine if estimates of survival rates of adult males and females captured while molting differed from estimates of adult females captured while nesting. We used mark–recapture models to estimate survival rates of Common Eiders we banded in Maine (nesting females [n = 2340] from 2000 to 2012; molting males [ n = 4366] and molting females [n = 4952] from 2000 to 2009). We found no difference in survival of nesting females based on historical (mean ± SE = 0.9003 ± 0.0841) and recent estimates (0.90 ± 0.015). Although we observed annual fluctuations in survival, survival rates did not increase following the implementation of harvest restrictions. Mean annual survival rates were similarly high for molting females (0.894 ± 0.0205) and nesting females, but lower for molting males (0.855 ± 0.0128). Lower survival rates of adult males may reflect the preference by US hunters to selectively harvest adult males. Overall mean recovery rates of banded birds were low (females: 0.037 ± 0.00043, males: 0.0226 ± 0.0006). We hypothesize that current harvest rates may be influencing decreased survival of adult males to some extent.

Comparisons of life-history traits of the alien invasive Semimytilus algosus and three other mytilid mussels on the West Coast of South Africa

MEPS Marine Ecology Progress Series Contact the journal Facebook Twitter RSS Mailing List Subscribe to our mailing list via Mailchimp HomeLatest VolumeAbout the JournalEditorsTheme Sections MEPS 607:113-127 (2018) - DOI: https://doi.org/10.3354/meps12794 Comparisons of life-history traits of the alien invasive Semimytilus algosus and three other mytilid mussels on the West Coast of South Africa Zannè Zeeman*, George M Branch, Deena Pillay Department of Biological Sciences and Marine Research Institute, University of Cape Town, Rondebosch 7700, South Africa *Corresponding author: zannezeeman@gmail.com ABSTRACT: The invasive mytilid mussel Semimytilus algosus was first recorded on South African shores in 2009 and rapidly spread to occupy 500 km of the West Coast, where it dominates lower portions of the rocky shore. To identify mechanisms underlying the invasive success of S. algosus, the life-history parameters survivorship, reproductive output, recruitment, growth rate and shell and byssus strength were compared among S. algosus and another alien, Mytilus galloprovincialis, and the indigenous mussels Aulacomya atra and Choromytilus meridionalis. To standardise the effects of wave exposure and shore height on life history patterns, all observations and sampling were limited to the low shore at the research site, Bloubergstrand. The 4 mussel species employed very different means of maximising survival and/or space occupancy. S. algosus proved to be a typical r-selected species, with low survival due to its weak shell and byssal strength. Unexpectedly, it grew relatively slowly but had a high reproductive output and exceptionally high recruitment rate that largely account for its invasive success. This study therefore demonstrates how life-history traits influence the invasive success of alien species and allows predictions about their relative impacts on intertidal rocky shores. KEY WORDS: Invasive species · Competition · Rocky shores · Recruitment · Growth · Reproduction Full text in pdf format Supplementary material PreviousNextCite this article as: Zeeman Z, Branch GM, Pillay D (2018) Comparisons of life-history traits of the alien invasive Semimytilus algosus and three other mytilid mussels on the West Coast of South Africa. Mar Ecol Prog Ser 607:113-127. https://doi.org/10.3354/meps12794 Export citation RSS - Facebook - Tweet - linkedIn Cited by Published in MEPS Vol. 607. Online publication date: December 06, 2018 Print ISSN: 0171-8630; Online ISSN: 1616-1599 Copyright © 2018 Inter-Research.

Implications of high rates of sexual recruitment in driving rapid reef recovery in Mo\u2019orea, French Polynesia

Coral abundance continues to decline on tropical reefs around the world, and this trend suggests that coral reefs may not persist beyond the current century. In contrast, this study describes the near-complete mortality of corals on the outer reef (10 m and 17 m depth) of the north shore of Mo’orea, French Polynesia, from 2005 to 2010, followed by unprecedented recovery from 2011 to 2017. Intense corallivory and a cyclone drove coral cover from 33–48% to <3% by 2010, but over the following seven years, recovery occurred through rapid population growth (up to 12% cover y−1) to 25–74% cover by 2017. The thirteen-year, U-shape trajectory of coral cover over time created by the loss and replacement of millions of corals through sexual reproduction underscores the potential for beneficial genetic responses to environmental conditions for at least one genus, Pocillopora. The high ecological resilience of this coral community appears to have been enhanced by variation among genera in the susceptibility to declining cover, and the capacity for population growth (i.e., response diversity). These results suggest that the outer coral communities of Mo’orea may be poised for genetic changes that could affect their capacity to persistence.

A Feasibility Study of a Multifaceted Walking Intervention to Maintain the Functional Mobility, Activities of Daily Living, and Quality of Life of Nursing Home Residents With Dementia.

The aim of the study was to evaluate the feasibility, acceptability, and efficacy of a multifaceted walking intervention (MWI) aimed to maintain the functional mobility, activities of daily living function, and quality of life of long-term care home residents with dementia. A quasiexperimental time-series design was used. The 4-month intervention provided one-on-one walking 2-4 days a week, guided by an individualized communication care plan and interviews with collaterals and staff. The MWI was feasible based on high recruitment and adherence rates (86% and 94%, respectively) and highly acceptable to stakeholders. Residents (n = 25) showed significant improvements after the intervention: Timed Up-and-Go (-8.85 seconds, p = .00), Two-Minute Walk Test (27.47 m, p = .00), Functional Independence Measure (0.72, p = .00), and Alzheimer's Disease-Related Quality of Life (2.44, p = .05). The MWI was feasible and improved functional mobility compared to usual care. Physical activity delivered with a person-centered care was feasible and may be beneficial to mitigate decline in long-term care home residents with dementia.

Distribution pattern prediction of an invasive alien species largemouth bass using a maximum entropy model (MaxEnt) in the Korean peninsula

Largemouth bass (Micropterus salmoides) is one of the world’s most notorious fish species, rapidly invaded in the aquatic ecosystems because of high fecundity and recruitment rate across the world, including South Korea, and is a major threat to native fish biodiversity and ecosystems. Knowledge about invasion range of largemouth bass has immense importance for conservation and management of native fish species. This study was conducted to predict a potential spatial spread in the future for the national-level risk assessments and successful management of largemouth bass in Korea. Using the MaxEnt (Maximum Entropy) model, 1109 streams and rivers of largemouth bass along with 24 climatic environmental variables of Korea were used to predict the future spatial distribution patterns and habitat suitability area. The precision of the MaxEnt model was highly significant, with an area under the curve value of 0.854 and 0.829 in 2050 and 2100, respectively. Overall, our study suggested that the output of MaxEnt model is useful for understanding how climatic variables affect the distribution range of invasive alien fish species and generating a map of potential risk.

Changes in Parent Psychological Flexibility after a One-Time Mindfulness-Based Intervention for Parents of Adolescents with Persistent Pain Conditions.

Parenting a child with chronic pain can be stressful and impact parent functioning in a variety of areas. Several studies have examined mindfulness-based interventions (MBIs) for parents of children with different health and mental health conditions. However, no studies to date have examined MBIs for parents of children with pain conditions. This study aimed to: (1) determine the feasibility and acceptability of a one-time MBI workshop for parents (n = 34) of adolescents with painful conditions (chronic pain and inflammatory bowel disease) who were participating in a concurrent mindfulness group for adolescents with pain, and (2) examine changes in parent mindfulness and psychological flexibility following the intervention. A mixed-method design was used. In terms of feasibility and acceptability, high recruitment and retention rates were observed, and parents reported high satisfaction scores with the workshop. Changes pre to post intervention showed that dimensions of parent psychological flexibility, but not parent mindfulness, improved following participation in the workshop. Qualitative analyses based on parent responses on a questionnaire uncovered seven themes of parent “takeaways” following participation in the workshop: Mindfulness Skills, Not Alone, Psychological Flexibility, Parent–Child Interactions, Self-Efficacy, Optimism/Positivity/Hope, and Awareness of Values. Taken together, these findings suggest that a one-time MBI workshop offered to parents whose teen was participating in a concurrent mindfulness group for pain is a feasible and promising intervention for parents of children with pain conditions.

Culturally adapted Family Intervention (CaFI) for African-Caribbean people diagnosed with schizophrenia and their families: a mixed-methods feasibility study of development, implementation and acceptability

BackgroundAfrican-Caribbean people in the UK experience the highest incidence of schizophrenia and the greatest inequity in mental health care. There is an urgent need to improve their access to evidence-based care and outcomes. Family intervention (FI) is a National Institute for Health and Care Excellence-approved psychosocial intervention. Although clinically effective and cost-effective for schizophrenia, it is rarely offered. Evidence for any research into FI is lacking for ethnic minority people generally and for African-Caribbean people specifically.Aims(1) To assess the feasibility of delivering a novel, culturally appropriate psychosocial intervention within a ‘high-risk’ population to improve engagement and access to evidence-based care. (2) To test the feasibility and acceptability of delivering FI via ‘proxy families’.DesignA mixed-methods, feasibility cohort study, incorporating focus groups and an expert consensus conference.SettingTwo mental health trusts in north-west England.ParticipantsWe recruited a convenience sample of 31 African-Caribbean service users. Twenty-six family units [service users, relatives/family support members (FSMs) or both] commenced therapy. Half of the service users (n = 13, 50%), who did not have access to their biological families, participated by working with FSMs.InterventionsAn extant FI model was culturally adapted with key stakeholders using a literature-derived framework [Culturally adapted Family Intervention (CaFI)]. Ten CaFI sessions were offered to each service user and associated family.Main outcome measuresRecruitment (number approached vs. number consented), attendance (number of sessions attended), attrition (number of dropouts at each time point), retention (proportion of participants who completed therapy sessions), and completeness of outcome measurement.ResultsOf 74 eligible service users, 31 (42%) consented to take part in the feasibility trial. The majority (n = 21, 67.7%) were recruited from community settings, seven (22.6%) were recruited from rehabilitation settings and three (9.7%) were recruited from acute wards. Twenty-four family units (92%) completed all 10 therapy sessions. The proportion who completed treatment was 77.42% (24/31). The mean number of sessions attended was 7.90 (standard deviation 3.96 sessions) out of 10. It proved feasible to collect a range of outcome data at baseline, post intervention and at the 3-month follow-up. The rating of sessions and the qualitative findings indicated that CaFI was acceptable to service users, families, FSMs and health-care professionals.LimitationsThe lack of a control group and the limited sample size mean that there is insufficient power to assess efficacy. The findings are not generalisable beyond this population.ConclusionsIt proved feasible to culturally adapt and test FI with a sample of African-Caribbean service users and their families. Our study yielded high rates of recruitment, attendance, retention and data completion. We delivered CaFI via FSMs in the absence of biological families. This novel aspect of the study has implications for other groups who do not have access to their biological families. We also demonstrated the feasibility of collecting a range of outcomes to inform future trials and confirmed CaFI’s acceptability to key stakeholders. These are important findings. If CaFI can be delivered to the group of service users with the most serious and persistent disparities in schizophrenia care, it has the potential to be modified for and delivered to other underserved groups.Future workA fully powered, multicentre trial, comparing CaFI with usual care, is planned.Trial registrationCurrent Controlled Trials ISRCTN94393315.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full inHealth Services and Delivery Research; Vol. 6, No. 32. See the NIHR Journals Library website for further project information.

Decadal erosion of coral assemblages by multiple disturbances in the Palm Islands, central Great Barrier Reef

Increases in the frequency of perturbations that drive coral community structure, such as severe thermal anomalies and high intensity storms, highlight the need to understand how coral communities recover following multiple disturbances. We describe the dynamics of cover and assemblage composition of corals on exposed inshore reefs in the Palm Islands, central Great Barrier Reef, over 19 years encapsulating major disturbance events such as the severe bleaching event in 1998 and Cyclone Yasi in 2011, along with other minor storm and heat stress events. Over this time, 47.8% of hard coral cover was lost, with a concomitant shift in coral assemblage composition due to taxon-specific rates of mortality during the disturbances, and asymmetric recovery in the aftermath thereof. High recruitment rates of some broadcast-spawning corals, particularly corymbose Acropora spp., even in the absence of adult colonies, indicate that a strong external larval supply replenished the stocks. Conversely, the time required for recovery of slow-growing coral morphologies and life histories was longer than the recurrence times of major disturbances. With interludes between bleaching and cyclones predicted to decrease, the probability of another severe disturbance event before coral cover and assemblage composition approximates historical levels suggests that reefs will continue to erode.

Evaluating the Feasibility of a Pilot Exercise Intervention Implemented Within a Residential Rehabilitation Unit for People With Severe Mental Illness: GO HEART: (Group Occupational Health Exercise and Rehabilitation Treatment).

Purpose: People with severe mental illness are sedentary, have high cardio-metabolic risks and significantly reduced life expectancy. Despite considerable data regarding positive physical and mental health outcomes following exercise interventions, implementation and evaluation of real-world programs is lacking. The primary aim of this study was to assess the feasibility of an exercise intervention implemented by exercise physiology (EP) students within a residential rehabilitation unit for residents with severe mental illness, together with assessment of a range of secondary physical and mental health outcomes pre- and post- the intervention.Design: Single arm, prospective pilot study evaluating outcomes pre- and post- a 10 week intervention.Method: Inactive people with severe mental illness participated in a mixed aerobic and resistance exercise intervention, three times per week for 10 weeks. Data was obtained from a sample of 16 residents with severe mental illness; primary diagnosis schizophrenia (n = 12). Primary outcomes were feasibility as assessed using recruitment, retention and participation rates, as well as reasons for withdrawal and amount of exercise achieved. Secondary outcomes included: functional exercise capacity was measured by the 6-min walk test; metabolic data obtained from anthropometric measurements; blood pressure; fasting cholesterol and blood sugar levels; and physical activity levels and mental health as assessed by self- administered questionnaires measured before and after the intervention.Results: Broad level acceptance of the program: high recruitment (81%), retention (77%), and participation (78%) rates were observed. Promising improvements in functional exercise capacity, volume of exercise, and negative symptoms was demonstrated in those who completed.Conclusions: Exercise interventions delivered by EP students in a residential rehabilitation setting for people with SMI are feasible; group setting, supervision and choice for engagement are important considerations. Evaluation of longitudinal, multi site studies, with the addition of dietary interventions within residential rehabilitation units are warranted. Addressing cost feasibility and cost effectiveness of such programs is recommended.The trial was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) number, Unique Identifier: ACTRN 12618000478213, http://www.anzctr.org.au Universal trial number (UTN) – U1111-1211-4009.

A pilot study to determine the feasibility of a cluster randomised controlled trial of an intervention to change peer attitudes towards children who stutter.

BackgroundWhile randomised controlled trials (RCTs) are considered the gold standard of research, prior study is needed to determine the feasibility of a future large-scale RCT study.ObjectivesThis pilot study, therefore, aimed to determine feasibility of an RCT by exploring: (1) procedural issues and (2) treatment effect of the Classroom Communication Resource (CCR), an intervention for changing peer attitudes towards children who stutter.MethodA pilot cluster stratified RCT design was employed whereby the recruitment took place first at school-level and then at individual level. The dropout rate was reported at baseline, 1 and 6 months post-intervention. For treatment effect, schools were the unit of randomisation and were randomised to receive either the CCR intervention administered by teachers or usual practice, using a 1:1 allocation ratio. The stuttering resource outcomes measure (SROM) measured treatment effect at baseline, 1 and 6 months post-intervention overall and within the constructs (positive social distance, social pressure and verbal interaction).ResultsFor school recruitment, 11 schools were invited to participate and 82% (n = 9) were recruited. Based on the school recruitment, N = 610 participants were eligible for this study while only n = 449 were recruited, where there was n = 183 in the intervention group and n = 266 in the control group. The dropout rate from recruitment to baseline was as follows: intervention, 23% (n = 34), and control, 6% (n = 15). At 1 month a dropout rate of 7% (n = 10) was noted in the intervention and 6% (n = 15) in the control group, whereas at 6 months, dropout rates of 7% (n = 10) and 17% (n = 44) were found in the intervention and control groups, respectively. For treatment effect on the SROM, the estimated mean differences between intervention and control groups were (95% Confidence Interval (CI): -1.07, 5.11) at 1 month and 3.01 (95% CI: -0.69, 6.69) at 6 months. A statistically significant difference was observed at 6 months on the VI subscale of the SROM, with 1.35 (95% CI: 0.58, 2.13).ConclusionA high recruitment rate of schools and participants was observed with a high dropout rate of participants. Significant differences were only noted at 6 months post-intervention within one of the constructs of the SROM. These findings suggest that a future RCT study is warranted and feasible.

Abstract A27: Diversity in multiple myeloma clinical trials

Abstract Background: Multiple myeloma (MM) accounts for approximately 1% of all cancers and 10% of hematologic malignancies in the United States (U.S.). MM occurs in all races, but the incidence in African Americans is two to three times higher than in non-Hispanic whites. MM is also slightly more frequent in men than women (1.4:1). Many clinical trials lack appropriate representation of specific patient populations, limiting the generalizability of the evidence obtained. Therefore, we determined the representation of ethnic minorities, the elderly, and women in MM clinical trials. Methods: Enrollment data from all therapeutic trials reported as completed in clinicaltrial.gov from 2000 to 2016 were analyzed. Clinical trials including other hematologic malignancies and with recruitment outside of the U.S. were excluded. Enrollment fraction (EF) was defined as the number of enrollees divided by the 2013 SEER database MM complete prevalence. Chi-square test was used to estimate differences in categorical data. Results: Out of 177 MM clinical trials (CT), 78 (44%) reported ethnicity with a total of 12,055 enrollees. Regarding enrollees' ethnic composition, 84% were non-Hispanic White (NHW), 8.6% African American (AA), 2.8% Asian, 1.8% Hispanic, and 0.1% Native American/Alaskan Indian. Out of those 78 CT, 52 (66%) were phase II, 15 (19%) phase III, and 11 (14%) phase I. Most of the results were published from 2012 to 2016 (74%). Forty-six (59%) trials were sponsored by industry, 7 (9%) by NCI, and 25 (32%) were investigator initiated. Participation in CT varied significantly across ethnic groups, NHW were more likely to be enrolled in CT (EF of 0.23) than AA (EF of 0.08, p &amp;lt; 0.0001) and Hispanics (EF of 0.05, p&amp;lt; 0.0001). Males had a higher recruitment rate than females (58% vs. 42%), but this could be explained by the higher incidence of MM in males. Enrollees' median age was 62 years. Younger patients (&amp;lt; 65 years) were more likely to be enrolled in CT than the elderly (66% vs. 34%, p&amp;lt;0.0001). Industry-sponsored trials were less likely to recruit AA compared with investigator-initiated trials (7.6% vs. 12%, p&amp;lt;0.01). Conclusions: Despite the higher incidence of MM in African Americans and the elderly, the former only represented 8.6% of the study participants and 66% of these were less than 65 years of age; therefore, we are lacking data in the tolerability of these new agents in our aging MM population. We also observed that industry studies were less likely to recruit AA patients. Collaborations between investigators, sponsors, and the community are necessary to increase our minority and elderly patients' access to clinical trials. Citation Format: Narjust Duma, Miguel Gonzalez Velez, Jesus Vera-Aguilera, Richardo Parrondo, Veronica Mariotti, Jonas Paludo, Yucai Wang, Ronald Go, Alex Adjei. Diversity in multiple myeloma clinical trials [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A27.

The role of larval supply and competition in controlling recruitment of the temperate coral Oculina arbuscula

Recruitment success in sessile benthic invertebrates that produce pelagic larvae is an emergent property of larval supply, settlement rates, and post-settlement survival. While intuitive that larval supply and settlement rates should be positively correlated, previous studies have demonstrated that many factors, such as competition for limited space on hard substrata, may decouple this relationship. Oculina arbuscula is a temperate, broadcast spawning coral and is the only structurally complex Scleractinian occurring on hard bottom reefs of the South Atlantic Bight (SAB), a region located in the North Atlantic Ocean off the southeastern coast of the U.S.A. Planula larvae of this species must settle on hard-bottom substrate that is densely colonized by a diversity of sessile benthic invertebrates, including sponges, bryozoans, and ascidians. To investigate the relative roles of larval supply and competition for space on the recruitment dynamics of O. arbuscula, settlement to and survival on 30 × 30 cm plots was monitored over 5 years on a reef off the coast of Georgia, U.S.A. Treatments consisted of 10 replicates of each of the following: 1) unmanipulated natural substrate, 2) natural substrate initially cleared of encrusting competitors such as sponges and tunicates, and 3) artificial substrate composed of concrete paving tiles. These plots were photographed 3–5 times per year between July 2004 and June 2009. These images showed that O. arbuscula recruits throughout the year in the SAB with a peak in September/October. While recruitment rates were higher than death rates in all treatments and resulted in a net gain of O. arbuscula colonies, recruitment to artificial substrate far-exceeded that found on natural surfaces. The high recruitment rates observed on artificial substrate ruled out the possibility that maintenance of O. arbuscula populations on natural surfaces is limited by larval supply. Competition with other sessile invertebrates, such as ascidians and sponges, also appeared to contribute to differences in recruitment among treatments, however, comparisons between cleared and unmanipulated control plots on natural substrate suggested that the competition effect was small. Based on these findings as well as anecdotal observations suggesting that sediment accumulates less on the artificial substrate, the alternative hypothesis that O. arbuscula populations in this system are controlled by physical factors, especially sedimentation, is proposed and warrants further investigation.

Quantifying population-level effects of water temperature, flow velocity and chemical-induced reproduction depression: A simulation study with smallmouth bass

Evaluating stochastic abiotic factors and their combined effects on fish and wildlife populations have been challenging in environmental sciences. Contributing to this challenge is the paucity of data describing how observations made on individuals related to exposure to chemical compounds ultimately effect population vital rates, and how this exposure interacts with other abiotic drivers. Using three smallmouth bass populations in Pennsylvania as a case study, we explored both single-factor and combined effects of water temperature, flow velocity and chemical exposure on populations through a model simulation. Although there are many pathways through which chemicals can affect population vital rates, we focused on one where chemical exposure leads to reduced reproduction. Among the three populations considered, two (the Juniata and Susquehanna populations) have experienced adverse health, including the potential adverse effects of environmental stress and chemical contamination that may cause disease and mortality of young-of-year (YOY), various skin lesions and a high prevalence of intersex or testicular oocytes in adults. The third population (The Alleghany population) has not encountered mortality events of YOY and intersex prevalence is much lower. The simulation involved projecting populations using a length-based model under different environmental conditions. In the simulations, abiotic factors influenced population dynamics through their impacts on growth, survival and recruitment. Response to the same environmental stress varied by population and life-stage of the species. Factors affecting young adult and adult life-stages had great influence on proportional stock density (PSD) and the probability of having PSD within the suggested range (PSD probability). Increases in water temperature had a negative effect and dominant role in the combined effect on population size structure (e.g., PSD and PSD probability) – increases in flow velocity during the spring season also had a negative effect on abundance. Populations with high recruitment rates sustained relatively large population size, even under high water temperature and/or high flow velocity, which suggests that factors and management strategies that benefit recruitment (such as reduced chemical contaminants) may compensate for the negative effects of warming water temperatures and high spring flow velocity on population size.

Use of a web-based app to improve postoperative outcomes for patients receiving gynecological oncology care: A randomized controlled feasibility trial

ObjectiveNearly 1 in 5 patients hospitalized for ovarian cancer surgery are readmitted for complications that may have been prevented with monitoring. We conducted a randomized controlled feasibility trial to evaluate a postoperative web-based app intervention to provide real-time symptom monitoring among patients diagnosed or with suspected gynecological cancer who had open bilateral salpingo-oophorectomy surgery. MethodsParticipants were randomized into two groups: (1) App + Reminder: had access to the app, and use was encouraged with daily and/or weekly reminders; (2) app: had access to the app but received no reminders. The app displayed discharge instructions and queried symptoms. Patients' self-reported health information was integrated into their electronic health records. Outcomes above a predetermined threshold triggered alerts that indicated a patient may need medical intervention. Participants completed a questionnaire at baseline and 30-day follow-up. They were also invited to provide qualitative, post-intervention feedback. ResultsWe screened 35 patients, with high rates of recruitment (74%, N = 26) and completion (93%, N = 24). Participants in the App + Reminder group had more frequent app use relative to the app group (p = 0.05). Using differences-in-differences (DID) analysis for quality of life, the App + Reminder group had relative increase in the mental health score (DID = 7.51, p = 0.15) but decrease in the physical health score (DID = −7.49, p = 0.13). Participant feedback suggested the relative decrease in physical quality of life was attributable to the app activating patients' focus on physical symptoms, not the intervention. ConclusionThe pilot established feasibility, acceptability, and some potential benefits of a new web-based app intervention for gynecological oncology postoperative care.