Many large-bodied marine fishes that form spawning aggregations, such as the Nassau grouper (Epinephelus striatus), have suffered regional overfishing due to exploitation during spawning. In response, marine resource managers in many locations have established marine protected areas or seasonal closures to recover these overfished stocks. The challenge in assessing management effectiveness lies largely in the development of accurate estimates to track stock size through time. For the past 15 y, the Cayman Islands government has taken a series of management actions aimed at recovering collapsed stocks of Nassau grouper. Importantly, the government also partnered with academic and nonprofit organizations to establish a research and monitoring program (Grouper Moon) aimed at documenting the impacts of conservation action. Here, we develop an integrated population model of 2 Cayman Nassau grouper stocks based on both diver-collected mark-resight observations and video censuses. Using both data types across multiple years, we fit parameters for a state-space model for population growth. We show that over the last 15 y the Nassau grouper population on Little Cayman has more than tripled in response to conservation efforts. Census data from Cayman Brac, while more sparse, show a similar pattern. These findings demonstrate that spatial and seasonal closures aimed at rebuilding aggregationbased fisheries can foster conservation success.fish-spawning aggregation | Nassau grouper | integrated population model | mark-resight | tagging

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Attacks by the isopod Excorallana tricornis tricornis on Nassau grouper Epinephelus striatus caught in Antillean fish traps around Little Cayman Island, Cayman Islands, are recorded. Divers reported heavily parasitized fish during the study period, suggesting that trapping did not exclusively precipitate parasitism. Parasitic infestations were reported to be common in Nassau grouper immediately following their spawning season in mid-winter. #

Nassau grouper Epinephelus striatus are a large bodied, top level predator that is ecologically important throughout the Caribbean. Although typically solitary, Nassau grouper form large annual spawning aggregations at predictable times in specific locations. In 2003, The Cayman Islands Marine Conservation Board established protection for a newly rediscovered Nassau grouper spawning aggregation on Little Cayman, British West Indies. The large size of this aggregation provides a unique opportunity to study the behavior of Nassau grouper on a relatively intact spawning aggregation. During non-spawning periods Nassau grouper display a reddish-brown-and-white barred coloration. However, while aggregating they exhibit three additional color phases: “bicolor”, “dark”, and “white belly”. We video sampled the population on multiple days leading up to spawning across five spawning years. Divers focused a laser caliper equipped video camera on individual fish at the aggregation. We later analyzed the video to determine the length of the fish and record the color phase. Our observations show that the relative proportion of fish in the bicolor color phase increases significantly on the day leading up to the primary night of spawning. The increase in the proportion of the bicolor color phase from 0.05 early in the aggregation to 0.40 on the day of spawning suggests that this color phase conveys that a fish is behaviorally and physiologically prepared to spawn. Additionally, 82.7% of fish exhibiting dark or white belly coloration early in the aggregation period suggests that these color phases are not only shown by female fish as was previously posited.

Study Design. Retrospective cohort study. Objective. To evaluate the ability of patient reported outcome measurement information system (PROMIS) assessments to capture disability related to cervical sagittal alignment and secondarily to compare these findings to legacy outcome measures. Summary of Background Data. PROMIS is a validated patient-reported outcome metric that is increasing in popularity due to its speed of administration relative to legacy metrics. The ability of PROMIS to capture disability from sagittal alignment and baseline health status in patients with neck pain has not been investigated. Methods. Patients presenting with a chief complaint of neck pain from December 2016 to July 2017 were included. Demographics and comorbidities were retrospectively collected. All patients prospectively completed the neck disability index (NDI), EQ-5D, visual analog scale (VAS) neck, VAS arm, PROMIS physical function, PROMIS pain intensity, and PROMIS pain interference metrics. Cervical sagittal alignment parameters were measured on standing X-rays. The correlations between outcome measures, health status indexes, psychiatric diagnoses, and sagittal alignment were analyzed. Results. Two hundred twenty-six patients were included. The sample was 58.4% female with a mean age of 55.1 years. In patients with neck pain, PROMIS physical function correlated strongly with the NDI (r = −0.763, P < 0.01), EQ-5D (r = 0.616, P < 0.01), VAS neck pain (−0.466, P < 0.01), and VAS arm pain (r = −0.388, P < 0.01). One hundred seventy-seven patients (69.96%) were included in the radiographic analysis. 20.3% of the radiographic cohort had cervical deformity and in this group, less cervical lordosis correlated with PROMIS pain intensity and EQ-5D but not NDI. In patients without cervical deformity, no outcome metric was found to correlate significantly with cervical alignment parameters. Conclusion. PROMIS domains correlated strongly with legacy outcome metrics. For the whole cohort, sagittal alignment was not correlated with outcomes. In patients with sagittal cervical deformity, worsening alignment correlated with PROMIS pain intensity and EQ-5D but not NDI. Level of Evidence: 3

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Introduction: This study assessed the incidence and risk factors for pseudarthrosis among primary spine fusion patients. Methods: Retrospective review of ACS-NSQIP (2005-2013. Differences in comorbidities between spine fusion patients with and without pseudarthrosis (Pseud, N-Pseud) were assessed using chi-squared tests and Independent Samples t-tests. Binary logistic regression assessed patient-related and procedure-related predictors for pseudarthrosis. Results: 52,402 patients (57yrs, 53%F, 0.4% w/pseudarthrosis). Alcohol consumption (OR:2.6[1.2-5.7]) and prior history of surgical revision (OR:1.6[1.4-1.8]) were risk factors for pseudarthrosis operation. Pseud patients at higher risk for deep incisional SSI (at 30-days:OR:6.6[2.0-21.8]). Pseud patients had more perioperative complications (avg:0.24 ± 0.43v0.18 ± 0.39,p=0.026). Conclusions: Alcoholism and surgical revision are major risk factors for pseudarthrosis in patients undergoing spine fusion.

Characterizing the behavior of coral reef fishes at home reef sites can provide insight into the mechanisms of spatial ecology and provide a framework for spatial resource management. In the Caribbean, populations of Nassau grouper Epinephelus striatus have declined due to fishing impacts on spawning aggregations. Despite local and regional efforts by fisheries managers to implement regulations protecting spawning aggregations, few Nassau grouper populations appear to be recovering. In order to improve management strategies for this critically endangered species, it is necessary to understand the spatial ecology of the species across seasons and years. In the Cayman Islands, we used a multi-year, presence/absence, depth-coded acoustic tagging dataset of Nassau grouper to characterize patterns in the species’ behavior and vertical habitat use at home reef sites. Twenty acoustically tagged individuals (56-84 cm, 70.01 ± 7.40 cm; total length, mean ± SD) maintained consistent home reef sites, although some fish regularly shifted activity centers within the home site, often following a seasonal spawning migration. Seven fish with depth-coded tags showed a higher probability of vertical movement in the hours immediately following dawn and preceding dusk. We found evidence of a positive relationship between the fish condition factor and depth of home reef site. The finding of persistent home reef sites across years suggests that properly sized spatial reserves at home reef sites can be a useful complement to spawning aggregation protection when considering management strategies for Nassau grouper.