High mortality rates in a juvenile free-ranging marine predator and links to dive and forage ability.

Blood was collected for haematological, red cell enzyme and red cell metabolic intermediate studies from 20 Southern elephant seals Mirounga leonina. Mean haematological values were: haemoglobin (Hb) 22.4 ± 1.4 g/dl, packed cell volume (PCV) 54.2 ± 3.8%, mean cell volume (MCV) 213.0 ± 5.0 fl and red cell count (RCC) 2.5 × 1012/l. Red cell morphology was unremarkable. Most of the red cell enzymes showed low activity in comparison with human red cells. Haemoglobin electrophoresis showed a typical pinniped pattern, i.e. two major components. Total leucocyte counts, platelet counts, and coagulation studies were within expected mammalian limits. Eosinophil counts varied from 0.5 × 109/l to 7.7 × 109/l(5%–49%), and there was a very wide variation in erythrocyte sedimentation rates, from 3 to 60 mm/h.

Higher trophic-level species are an integral component of any marine ecosystem. Despite their importance, methods for representing these species in end-to-end ecosystem models often have limited representation of life histories, energetics and behaviour. We built an individual-based model coupled with a dynamic energy budget for female southern elephant seals Mirounga leonina to demonstrate a method for detailed representation of marine mammals. We aimed to develop a model which could i) simulate energy use and life histories, as well as breeding traits of southern elephant seals in an emergent manner, ii) project a stable population over time, and iii) have realistic population dynamics and structure based on emergent life history features (such as age at first breeding, lifespan, fecundity and (yearling) survival). We evaluated the model’s ability to represent a stable population over long time periods (>10 generations), including the sensitivity of the emergent properties to variations in key parameters. Analyses indicated that the model is sensitive to changes in resource availability and energy requirements for the transition from pup to juvenile, and juvenile to adult stage. This was particularly the case for breeding success and yearling survival. This model is suitable for use as a standalone tool for investigating the impacts of changes to behaviour and population responses of southern elephant seals.

Recently, a number of Antarctic marine environmental studies have used oceanographic parameters collected from instrumented top predators for ecological and physical information. Phytoplankton concentration is generally quantified through active measurement of chlorophyll fluorescence. In this study, light absorption coefficient (K0.75) was used as an indicator of phytoplankton concentration. This measurement, easy to obtain and requiring low electric power, allows for assessing of the fine scale horizontal structuring of phytoplankton. As part of this study, Southern elephant seals (SES) were simultaneously equipped with a fluorometer and a light logger. Along the SES tracks, variations in K0.75 were strongly correlated with chlorophyll, a concentration measured by the fluorometer within the euphotic layer. With regards to SES foraging behaviour, bottom depth of the seal’s dive was highly dependent on light intensity at 150 m, indicating that the vertical distribution of SES’s prey such as myctophids is tightly related to light level. Therefore, change in phytoplankton concentration may not only have a direct effect on SES’s prey abundance but may also determine their vertical accessibility with likely consequences on SES foraging efficiency.

The period between the Franco-Prussian War (1871) and the beginning of World War I (1914), rich in scientific discoveries and filled with artistic creation, opened a new era in medicine. A high infant mortality rate, which was fueled by lack of basic hygiene, curtailed population growth in various European countries. Governments were worried, especially in France, (1)(2)(3) where industrialization and colonization were in progress. The “European Empires” needed men for industry, the military, and the colonies. Influential political men such as Dr Bourneville, a senator of the French Republic, (4) turned to obstetricians to solve the acute problem of infant mortality and address the depopulation issue. This powerful physician facilitated the creation of modern maternity units managed by certified obstetricians instead of surgeons. Maternal mortality had decreased markedly, starting in 1890, thanks to the introduction of antisepsis. A participant in this effort was the young doctor Pierre Budin, a senior resident of Stephane Tarnier, the leader of French obstetrics. (5) In 1874, he was sent to study with Joseph Lister in Edinburgh (6) to learn the preventive treatment of surgical infections. Puerperal fever had decimated maternity units to such an extent that some were closed intermittently. This serious issue absorbed so much of Dr Tarnier's energy that he was forced to take a leave of absence to prevent his health from deteriorating. A friend of Budin, Lucas Championniere, (7) a young surgeon, had preceded him on this path by working for a few months with Lister at the Royal Infirmary in Edinburgh. In Paris, he already was applying the antiseptic method of Lister with extremely good results. (7) Shortly after Championniere, Budin made the trip to Scotland and learned all the details of the antiseptic method. He also benefited from the teaching of Duncan, the chief …

#### Summary points Community cohort studies report that a fifth of parents say that their otherwise healthy baby has cry-fuss problems at two months of age.1 2 Excessive crying is...

Monitoring marine top predators is fundamental for assessing the health and functioning of open ocean ecosystems. Although recently tracking observations have substantially increased, factors determining the horizontal exploration of the ocean by marine predators are still largely unknown, especially at the scale of behavioral switches (1–100 km, days-weeks). It is commonly assumed that the influence of water movement can be neglected for animals capable of swimming faster than the current. Here, we challenge this assumption by combining the use of biologging (GPS and accelerometry), satellite altimetry and in-situ oceanographic data (ADCP and drifting buoys) to investigate the effect of the mesoscale ocean dynamics on a marine predator, the southern elephant seal. A Lagrangian approach reveals that trajectories of elephant seals are characterized by quasi-planktonic bouts where the animals are horizontally drifting. These bouts correspond to periods of increased foraging effort, indicating that in the quasi-planktonic conditions energy is allocated to diving and chasing, rather than in horizontal search of favourable grounds. These results suggest that mesoscale features like eddies and fronts may act as a focal points for trophic interactions not only by bottom-up modulation of nutrient injection, but also by directly entraining horizontal displacements of the upper trophic levels.

The potential effects of ocean warming on marine predators are largely unknown,
\nthough the impact on the distribution of prey in vertical space may have far reaching impacts on
\ndiving predators such as southern elephant seals. We used data from satellite-tracked southern
\nelephant seals from Marion Island to investigate the relationship between their dive characteristics
\n(dive depths, dive durations and time-at-depth index values) and environmental variables
\n(temperature at depth, depth of maximum temperature below 100 m, frontal zone and bathymetry)
\nas well as other demographic and behavioural variables (migration stage, age-class, track day
\nand vertical diel strategy). While other variables, such as bathymetry and vertical diel strategy
\nalso influenced dive depth, our results consistently indicated a significant influence of temperature
\nat depth on dive depths. This relationship was positive for all groups of animals, indicating
\nthat seals dived to deeper depths when foraging in warmer waters. Female seals adjusted their
\ndive depths proportionally more than males in warmer water. Dive durations were also influenced
\nby temperature at depth, though to a lesser extent. Results from time-at-depth indices showed that
\nboth male and female seals spent less time at targeted dive depths in warmer water, and were presumably
\nless successful foragers when diving in warmer water. Continued warming of the Southern
\nOcean may result in the distribution of prey for southern elephant seals shifting either poleward
\nand/or to increasing depths. Marion Island elephant seals are expected to adapt their
\nranging and diving behaviour accordingly, though such changes may result in greater physiological
\ncosts associated with foraging.

BackgroundPercutaneous coronary intervention (PCI) had become the major therapeutic procedure for coronary artery disease (CAD), but the high rate of in-stent restenosis (ISR) still remained an unsolved clinical problem in clinical practice. Increasing evidences suggested that diabetes mellitus (DM) was a major risk factor for ISR, but the risk predictors of ISR in CAD patients with DM had not been well characterized. The aim of this study was to investigate the clinical and angiographic characteristic predictors significantly associated with the occurrence of ISR in diabetic patients following coronary stenting with drug-eluting stent (DES).MethodsA total of 920 patients with diabetes who diagnosed CAD and underwent coronary DES implantation at Beijing Anzhen Hospital in China were consecutively enrolled from January 2012 to December 2012. Of these, 440 patients underwent the second angiography within ≥ 6 months due to the progression of treated target lesions. Finally, 368 of these patients who met the inclusion and exclusion criteria were followed up by angiography after baseline PCI. According to whether ISR was detected at follow-up angiography, patients were divided into the ISR group (n = 74) and the non-ISR group (n = 294). The independent predictors of ISR in patients with DM were explored by multivariate Cox's proportional hazards regression models.ResultsA total of 368 patients (260 women and 108 men) with a mean ages of 58.71 ± 10.25 years were finally enrolled in this study. Of these, ISR occurred in 74/368 diabetic patients (20.11%) by follow-up angiography. Univariate analysis showed that most baseline characteristics of the ISR and non-ISR group were similar. Patients in the ISR group had significantly higher serum very low density lipoprotein cholesterol (VLDL-C), triglyceride (TG) and uric acid (UA) levels, more numbers of target vessel lesions, higher prevalence of multi-vessel disease, higher SYNTAX score, higher rate of previous but lower rate of drinking compared with patients in the non-ISR group. The independent predictors of ISR in patients with DM after DES implantation included VLDL-C (HR = 1.85, 95% CI: 1.24–2.77, P = 0.002), UA (per 50 µmol/L increments, HR = 1.19, 95% CI: 1.05–1.34, P = 0.006), SYNTAX score (per 5 increments, HR = 1.34, 95% CI: 1.03–1.74, P = 0.031) and the history of PCI (HR = 3.43, 95% CI: 1.57–7.80, P = 0.003) by the multivariate Cox's proportional hazards regression analysis.ConclusionsThe increased serum VLDL-C and UA level, higher SYNTAX score and the history of previous PCI were independent predictors of ISR in patients with DM after coronary DES implantation. It provided new evidence for physicians to take measures to lower the risk of ISR for the better management of diabetic patients after PCI.

Our study makes use of a fortuitous oceanographic data set collected around the remote sub-Antarctic island of Bouvetoya by a conductivity–temperature–depth recorder (CTD) integrated with a satellite-relayed data logger deployed on an adult female southern elephant seal ( Mirounga leonina ) to describe the seasonal evolution of the western shelf waters. The instrumented seal remained in waters over the shelf for 259 days, collecting an average of 2.6 (±0.06) CTD profiles per day, providing hydrographic data encompassing the late austral summer and the entire winter. These data document the thermal stratification of the upper water layer due to summer surface heating of the previous year’s Antarctic Surface Water, giving way to a cold subsurface layer at about 100 m as the austral winter progressed, with a concomitant increase in salinity of the upper layer. Upper Circumpolar Deep Water was detected at a depth of approximately 200 m along the western shelf of Bouvetoya throughout the year. These oceanographic data represent the only seasonal time series for this region and the second such animal–instrument oceanographic time series in the sub-Antarctic domain of the Southern Ocean. Keywords: Biotelemetry; diving; elephant seal; oceanography; marine predators; CTD-SRDL. (Published: 27 October 2016) To access the supplementary material for this article, please see supplementary files in the column to the right (under Article Tools). Citation: Polar Research 2016, 35 , 28278, http://dx.doi.org/10.3402/polar.v35.28278

Body growth of 137 female southern elephant seals (Mirounga leonina) over 1 year of age was investigated at subantarctic Macquarie Island. An asymptotic straight line, snout–tail body length of 2.57±0.03 m was estimated to be attained at 9 years of age, using a three-parameter Gompertz equation. A significant increase of approximately 0.1 m (5%) in mean body length of females between 1 and 10 years of age was estimated to have occurred between the 1950–1960s and 1990s at Macquarie Island. This is consistent with a reduction in both the rate of population decline and the age of onset of sexual maturity. Age determination using dental cementum layers and the importance of standardised measurements in pinniped growth studies are discussed.

Mass transfer from mother to pup during the lactation period, and mass recovery for the same females during the foraging period were measured in the southern elephant seal at King George Island, Antarctica. During the 19.2 ± 0.9-day lactation period measured (which represented 87% of the entire nursing), females lost a mean mass of 10.56 ± 1.76 kg/day (n = 27), while their pups gained a mean mass of 5.27 ± 1.1 kg/day. There was a correlation between daily body weight gain in pups and daily weight loss by their mothers. Pup weaning mass was positively related to maternal post-partum mass. Serial samples showed that weight losses by females and gains by their pups were not linear over lactation, but showed lower values at the beginning and at the end of lactation. During the 60.5 ± 6.2-day foraging phase between the end of lactation and molt, females gained 2.21 ± 0.65 kg/day (n = 12), or 54% of the mass lost during nursing. Growth rates reported here are higher than those reported in other breeding sites. However, the ratio of body mass loss by females to gain by their pups was similar, suggesting that higher growth rates and greater weaning mass at South Shetland are due to a higher mean weight of females on arrival at this breeding site. The foraging period was shorter and the mass gained greater than those measured at South Georgia; this could be related to relatively shorter distances to foraging areas.

The neutrophil-lymphocyte ratio (NLR) has been proposed as a prognostic biomarker for cirrhosis and non-liver malignancies. We aimed to evaluate the prognostic value of NLR in a diverse cohort of patients with hepatocellular carcinoma (HCC). We performed a retrospective study of patients diagnosed with HCC between 2008 and 2017 at two large US health systems. We used Cox proportional hazard and multivariable ordinal logistic regression models to identify factors associated with overall survival and response to first HCC treatment, respectively. Primary variables of interest were baseline NLR and delta NLR, defined as the difference between pre- and post-treatment NLR. Among 1019 HCC patients, baseline NLR was < 5 in 815 (80.0%) and ≥ 5 in 204 (20.0%). Patients with NLR ≥ 5 had a higher proportion of infiltrative tumors (36.2% vs 22.3%), macrovascular invasion (39.6% vs 25.5%), metastatic disease (20.6% vs 11.4%), and AFP > 200ng/mL (45.6% vs 33.8%). Baseline NLR ≥ 5 was independently associated with higher mortality (median survival 4.3 vs 15.1months; adjusted HR 1.70, 95%CI 1.41-2.06), with differences in survival consistent across BCLC stages. After adjusting for baseline covariates including NLR, delta NLR > 0.26 was also independently associated with increased mortality (HR 1.42, 95%CI 1.14-1.78). In a secondary analysis, high NLR was associated with lower odds of response to HCC treatment (20.2% vs 31.6%; adjusted OR 0.55, 95%CI 0.32-0.95). In a large Western cohort of patients with HCC, high baseline NLR and delta NLR were independent predictors of mortality. NLR is an inexpensive test that may be a useful component of future HCC prognostic models.

IntroductionSingle-nucleotide polymorphisms (SNPs) in codon 72 of the TP53 (also known as p53) gene (rs1042522) and in the promoter region of the MDM2 gene (SNP309; rs2279744) have been suggested to play roles in many cancers. We investigated whether these SNPs were associated with patient outcome and the effect of adjuvant systemic therapy.MethodsThe genotypes of TP53 codon 72 and MDM2 SNP309 were defined among 557 primary Japanese breast cancer patients (median follow-up, 61.7 months). The effects of several variables on survival were tested by Cox's proportional hazards regression analysis.ResultsWe showed that the Pro/Pro genotype of TP53 codon 72 was associated with poorer disease-free survival (DFS) than other genotypes by Kaplan-Meier analysis (P = 0.049) and multivariate Cox's proportional hazards regression analysis (P = 0.047, risk ratio of recurrence = 1.67), whereas MDM2 SNP309 status was not associated with DFS. The association of the Pro/Pro TP53 genotype with poorer DFS was especially significant in patients who received adjuvant chemotherapy (P = 0.009). In contrast, among the patients who had received adjuvant hormonal therapy or no adjuvant systemic therapy, TP53 codon 72 genotype was not associated with DFS.ConclusionThe Pro/Pro genotype of TP53 codon 72 appears to be an independent prognostic marker in breast cancer patients.

The patient, a 15-year-old girl, is the second oldest known survivor with 18-trisomy. Mosaicism seems unlikely as no normal cells were found in blood and skin cultures. The physical appearance of individuals with 18-trisomy may become less characteristic with survival past the first few months of life.

Four-month-old infants from Boston, Dublin, and Beijing were administered the same battery of visual, auditory, and olfactory stimuli to evaluate differences in level of reactivity. The Chinese infants were significantly less active, irritable, and vocal than the Boston and Dublin samples, with American infants showing the highest level of reactivity. The data suggest the possibility of temperamental differences between Caucasian and Asian infants in reactivity to stimulation. Most developmentalists agree that ease and intensity of behavioral arousal to external stimulation is a salient temperamental quality of infants. Rothbart (1989), who calls this characteristic reactivity, regards it as one of the two basic temperamental dimensions, along with self-regulation. However, because ease of arousal is a general term, several issues arise. The first of these is the need to specify response mode and class of incentive. Infants differ with respect to the behaviors that reflect their level of arousal (e.g., motor activity, vocalization, smiling, fretting, or crying) as well as the type of incentive that most often elicits arousal (e.g., visual, auditory, or olfactory stimulation). Most infants show more vigorous motor activity to moving objects than to sounds or speech, but they smile more often to speech than to visual stimuli during the first few months of life (Kagan & Snidman, 1991a). A second issue is whether the early variation in arousal, specified by incentive and behavioral modality, predicts variation in other psychological qualities displayed in later infancy or childhood. A third, related question asks whether infants of different nationalities, differing in genetic or cultural backgrounds or both, differ in ease of arousal. This article reports a difference between Chinese and Caucasian 4-month-old infants in the level of reactivity to stimulation. Anticipation of the major result can be found in earlier reports that suggested that Asian infants are at a lower level of arousal than Caucasian infants (Caudill & Weinstein, 1969; Freedman, 1974; Freedman & Freedman, 1969; Kagan, Kearsley, & Zelazo, 1978; Lewis, 1989). Over 20 years ago, Freedman and Freedman (1969) reported that newborn Asian-American infants, compared with European-Americans, were calmer, less labile, less likely to remove a cloth placed on their face, and