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Introduction Isometric resistance training has repeatedly shown to be an effective exercise modality in lowering resting blood pressure (BP), yet associated mechanisms and sex differences in the response to training remain unclear. Exploration into potential sex differences in the response to isometric resistance training is necessary, as it may allow for more optimal and sex-based exercise prescription, thereby maximizing the efficacy of the training intervention. Purpose Therefore, we investigated, in normotensives, whether sex differences exist in the response to isometric handgrip (IHG) training. Methods Resting BP and endothelium-dependent vasodilation (brachial artery flow-mediated dilation; FMD) were assessed in 11 women (23 ± 4 years) and 9 men (21 ± 2 years) prior to and following 8 weeks of IHG training (four, 2-min unilateral contractions at 30 % of maximal voluntary contraction; 3 days per week). Results Main effects of time were observed (all P  < 0.05), whereby IHG training reduced systolic BP (Δ 8 ± 6 mmHg), diastolic BP (Δ 2 ± 3 mmHg), mean arterial pressure (Δ 4 ± 3 mmHg), and pulse pressure (Δ 5 ± 7 mmHg), accompanied by increases in absolute (Δ 0.09 ± 0.15 mm) and relative (Δ 2.4 ± 4.1 %) brachial artery FMD; however, no significant sex differences were observed in the magnitude of post-training change in any variable assessed (all P  > 0.05). Conclusion IHG training effectively lowers resting BP and improves endothelium-dependent vasodilation in men and women, without significant sex differences in the magnitude of response.

Fever during chemotherapy is a common and potentially severe complication being increasingly evaluated in emergency departments to minimize morbidity and mortality. Streamlining triage of these patients may improve health outcomes and wait times in the health care system. A retrospective chart review of febrile patients undergoing chemotherapy was conducted at a local emergency department to assess the impact of nurse-initiated protocols on wait times. We identified 315 patients undergoing current chemotherapy presenting with fever. Of these, 140 (44%) and 87 (28%) were initiated on the sepsis and febrile neutropenia nurse-initiated protocols, respectively. In total, 197 (63%) were admitted. The febrile neutropenia protocol had a shorter wait time from triage to disposition than the sepsis protocol (403 minutes [SD = 23] vs 329 minutes [SD = 19], t = 1.71, P = 0.01). Furthermore, the febrile neutropenia protocol demonstrated shorter times from both triage to lab results reported, in addition to the physician initial assessment in the admitted patient subgroup. Decreased wait times from triage associated with the use of a febrile neutropenia protocol could be accounted for by a lower number of lab results required through this protocol in addition to shorter physician assessment times in the admitted population. This study shows that nurse-initiated protocols may influence door-to-antibiotic time for patients undergoing chemotherapy. By having a targeted protocol for the cancer population, health care centers may be able to demonstrate decreased health care expenditure and increased resource availability. Furthermore, as the current population of patients undergoing chemotherapy is at a high risk for neutropenia, prompt management is crucial to minimize mortality.

To support ongoing marine spatial planning in New Zealand, a numerical environmental classification using Gradient Forest models was developed using a broad suite of biotic and high-resolution environmental predictor variables. Gradient Forest modeling uses species distribution data to control the selection, weighting and transformation of environmental predictors to maximise their correlation with species compositional turnover. A total of 630,997 records (39,766 unique locations) of 1,716 taxa living on or near the seafloor were used to inform the transformation of 20 gridded environmental variables to represent spatial patterns of compositional turnover in four biotic groups and the overall seafloor community. Compositional turnover of the overall community was classified using a hierarchical procedure to define groups at different levels of classification detail. The 75-group level classification was assessed as representing the highest number of groups that captured the majority of the variation across the New Zealand marine environment. We refer to this classification as the New Zealand “Seafloor Community Classification” (SCC). Associated uncertainty estimates of compositional turnover for each of the biotic groups and overall community were also produced, and an added measure of uncertainty – coverage of the environmental space – was developed to further highlight geographic areas where predictions may be less certain owing to low sampling effort. Environmental differences among the deep-water New Zealand SCC groups were relatively muted, but greater environmental differences were evident among groups at intermediate depths in line with well-defined oceanographic patterns observed in New Zealand’s oceans. Environmental differences became even more pronounced at shallow depths, where variation in more localised environmental conditions such as productivity, seafloor topography, seabed disturbance and tidal currents were important differentiating factors. Environmental similarities in New Zealand SCC groups were mirrored by their biological compositions. The New Zealand SCC is a significant advance on previous numerical classifications and includes a substantially wider range of biological and environmental data than has been attempted previously. The classification is critically appraised and considerations for use in spatial management are discussed.

Patients with heart failure (HF) have evidence of chronic systemic inflammation. Whether inflammation contributes to the exercise intolerance in patients with HF is, however, not well established. We hypothesized that the levels of C-reactive protein (CRP), an established inflammatory biomarker, predict impaired cardiopulmonary exercise performance, in patients with chronic systolic HF. We measured CRP using high-sensitivity particle-enhanced immunonephelometry in 16 patients with ischemic heart disease (previous myocardial infarction) and chronic systolic HF, defined as a left ventricular ejection fraction ≤50% and New York Heart Association class II-III symptoms. All subjects with CRP >2 mg/L, reflecting systemic inflammation, underwent cardiopulmonary exercise testing using a symptom-limited ramp protocol. CRP levels predicted shorter exercise times (R = −0.65, p = 0.006), lower oxygen consumption (VO2) at the anaerobic threshold (R = −0.66, p = 0.005), and lower peak VO2 (R = −0.70, p = 0.002), reflecting worse cardiovascular performance. CRP levels also significantly correlated with an elevated ventilation/carbon dioxide production slope (R = +0.64, p = 0.008), a reduced oxygen uptake efficiency slope (R = −0.55, p = 0.026), and reduced end-tidal CO2 level at rest and with exercise (R = −0.759, p = 0.001 and R = −0.739, p = 0.001, respectively), reflecting impaired gas exchange. In conclusion, the intensity of systemic inflammation, measured as CRP plasma levels, is associated with cardiopulmonary exercise performance, in patients with ischemic heart disease and chronic systolic HF. These data provide the rationale for targeted anti-inflammatory treatments in HF.

Monitoring species’ response in marine protected areas is important for informing both the management of those areas and the establishment of additional protected areas. Populations of spiny lobsters Jasus edwardsii were monitored in eight New Zealand marine reserves for up to 34 years. The populations displayed highly variable responses to protection. While a few showed rapid (within 1–2 years of protection) increases in abundance, others showed little response even after a decade of protection. Some reserves displayed little initial recovery, then a sudden increase following several years of protection, while others displayed significant declines in abundance following initial recovery. Marine reserves located in areas with initially high densities of juveniles tended to have rapid recovery, but aspects of reserve design had no significant influence on the recovery rate. Variability among recovery trajectories also suggests that supply-side dynamics may be a key driver of lobster recovery. Densities of legal-sized lobsters were positively correlated with reserve age, but the abundance of juvenile lobsters increased in all but one reserve, indicating enhanced recruitment, survival and/or movement of juvenile lobsters into reserves. It is important to consider the placement of reserves, with respect to potential levels of larval supply, when establishing marine reserves for either conservation or fisheries management purposes and for evaluating their effectiveness.

Anti-protective antigen (PA) immunoglobulin (Ig) G, toxin neutralization, and PA-specific IgG memory B cell responses were studied in patients with bioterrorism-related cutaneous or inhalation anthrax and in a patient with laboratory-acquired cutaneous anthrax. Responses were determined for >1 year after the onset of symptoms. Eleven days after the onset of symptoms (15 days after likely exposure), anti-PA IgG was detected in 16 of 17 patients with confirmed or suspected clinical anthrax who were tested. Anti-PA IgG remained detectable 8–16 months after the onset of symptoms in all 6 survivors of inhalation anthrax and in 7 of 11 survivors of cutaneous anthrax who were tested. Anti-PA IgG levels and serum toxin neutralizing activity were strongly associated (R2 = 0.83). PA-specific IgG memory B cells were detectable in all 6 survivors of inhalation anthrax but in only 2 of 7 patients with cutaneous anthrax who were tested. Anti-PA IgG is an important diagnostic marker of anthrax, a predictor of serum anti-toxin activity, and a marker of immunological memory against anthrax.

Size and abundance data were compiled and collated for blue codParapercis coliasand rock lobsterJasus edwardsiifrom New Zealand marine reserve (MR) studies for a meta-analysis to test the null hypotheses that reserve status does not affect the size or abundance of either species. Calculation of meta-analysis effect sizes revealed that significant differences in effect size existed among studies, meaning that the biological response to MR status of both species in terms of their changes in size and/or abundance differed significantly among the MRs. Analysis revealed that blue cod were bigger inside compared with outside MRs in 9 of 10 studies and were more abundant inside MRs in 8 of 11 studies, and that rock lobster were bigger inside the MRs in 12 of 13 studies and more abundant inside the MRs in 11 of 14 studies. These findings indicate that MR protection can result in more and bigger individuals soon after the establishment of the MR (mean of 6.5 yr for blue cod, 8.5 yr for rock lobster) despite small sample sizes of studies (≤10 for blue cod, ≤14 for rock lobster). Focused comparison tests did not reveal any relationship between rock lobster or blue cod size or abundance and either age or area of MRs. Our results demonstrate that no-take MRs are valuable conservation tools for species such as blue cod and rock lobster (and probably also for other exploited species with similar life history characteristics and habitat requirements) and that statistically detectable conservation benefits are apparent after only a few years of protection.

Monitoring species' response inmarine protected areas is important for informing both the management of those areas and the establishment of additional protected areas. Populations of spiny lobstersJasus edwardsiiwere monitored in eight New Zealand marine reserves for up to 34 years. The populations displayed highly variable responses to protection. While a few showed rapid (within 1–2 years of protection) increases in abundance, others showed little response even after a decade of protection. Some reserves displayed little initial recovery, then a sudden increase following several years of protection, while others displayed significant declines in abundance following initial recovery. Marine reserves located in areas with initially high densities of juveniles tended to have rapid recovery, but aspects of reserve design had no significant influence on the recovery rate. Variability among recovery trajectories also suggests that supply-side dynamics may be a key driver of lobster recovery. Densities of legal-sized lobsters were positively correlated with reserve age, but the abundance of juvenile lobsters increased in all but one reserve, indicating enhanced recruitment, survival and/or movement of juvenile lobsters into reserves. It is important to consider the placement of reserves, with respect to potential levels of larval supply, when establishing marine reserves for either conservation or fisheries management purposes and for evaluating their effectiveness.

Structural variants (SVs) contribute substantially to genomic variation and disease, but detecting somatic SVs (sSVs) remains difficult due to reference bias, mosaicism, and enrichment in repetitive regions. Linear reference genomes, like GRCh38 and CHM13, do not fully capture individual genomic structure, which can obscure true somatic variation. Donor-specific assemblies (DSAs) generated from the same genome where sSVs are being assayed provide a personalized alternative, yet their performance for sSV detection has not been systematically assessed. As part of the Somatic Mosaicism across Human Tissues (SMaHT) Network, we benchmark a DSA for sSV discovery in the COLO829 melanoma cell line with a matched normal sample from the same individual. We compare sSV detection across GRCh38, CHM13, and the COLO829BL_DSA using three different sSV callers (Delly, Severus, and Sniffles2) and sequence data from multiple long-read platforms. The COLO829BL_DSA identifies 1.8-fold more manually validated sSVs than linear references, in regions both shared with GRCh38 and CHM13 and unique to the COLO829BL_DSA. Variants detected only with the COLO829BL_DSA are often found in satellite and other repeat-rich regions that are difficult to resolve using standard references. In addition, several COLO829BL_DSA-specific sSVs are located in genes, some of which are associated with cancer. Overall, these results underscore the utility of DSAs in improving sSV detection.