No abstract

Of 3,286 consecutive patients treated for acute myocardial infarction, electrophysiologic testing was performed in 1,209 survivors (37%) free of significant complications at the time of hospital discharge to determine their risk of spontaneous ventricular tachyarrhythmias during follow-up. Sustained monomorphic ventricular tachycardia was inducible by programmed electrical stimulation in 75 (6.2%). Antiarrhythmic therapy was not routinely prescribed regardless of the test results. During the 1st year of follow-up, 14 infarct survivors (19%) with inducible ventricular tachycardia experienced spontaneous ventricular tachycardia or fibrillation in the absence of new ischemia compared with 34 (2.9%) of those without inducible ventricular tachycardia (p less than 0.0005). During the extended follow-up period (median 28 months) of those with inducible ventricular tachycardia, 19 (25%) had a spontaneous electrical event; 37% of these first events were fatal. These results suggest that the most cost-effective strategy for predicting arrhythmia will be obtained by restricting electrophysiologic testing to infarct survivors whose left ventricular ejection fraction is less than 40% and using a stimulation protocol containing four extrastimuli. Electrophysiologic testing is the single best predictor of spontaneous ventricular tachyarrhythmias during follow-up in infarct survivors. The majority (94%) with a negative test benefit from the more reliable reassurance that all is well, whereas the 25% risk of electrical events in those with inducible ventricular tachycardia justifies a prospective trial of effective prophylactic antiarrhythmic interventions.

The ocean is a net source of N2O, a potent greenhouse gas and ozone-depleting agent. However, the removal of N2O via microbial N2O consumption is poorly constrained and rate measurements have been restricted to anoxic waters. Here we expand N2O consumption measurements from anoxic zones to the sharp oxygen gradient above them, and experimentally determine kinetic parameters in both oxic and anoxic seawater for the first time. We find that the substrate affinity, O2 tolerance, and community composition of N2O-consuming microbes in oxic waters differ from those in the underlying anoxic layers. Kinetic parameters determined here are used to model in situ N2O production and consumption rates. Estimated in situ rates differ from measured rates, confirming the necessity to consider kinetics when predicting N2O cycling. Microbes from the oxic layer consume N2O under anoxic conditions at a much faster rate than microbes from anoxic zones. These experimental results are in keeping with model results which indicate that N2O consumption likely takes place above the oxygen deficient zone (ODZ). Thus, the dynamic layer with steep O2 and N2O gradients right above the ODZ is a previously ignored potential gatekeeper of N2O and should be accounted for in the marine N2O budget.

No abstract

Despite expanding research on the popular recreational fishery, bonefish taxonomy remains murky. The genus Albula, comprising these iconic circumtropical marine sportfishes, has a complex taxonomic history driven by highly conserved morphology. Presently, 12 putative species are spread among 3 species complexes. The cryptic morphology hinders visual identification, requiring genetic species identification in some cases. Unclear nomenclature can have unintended consequences, including exacerbating taxonomic uncertainty and complicating resolution efforts. Further, ignoring this reality in publications may erode management and conservation efforts. In the Indian and Pacific oceans, ranges and areas of overlap are unclear, precluding certainty about which species support the fishery and hindering conservation efforts. Species overlap, at both broad and localized spatial scales, may mask population declines if one is targeted primarily (as demonstrated in the western Atlantic fishery). Additional work is necessary, especially to increase our understanding of spatiotemporal ecology across life history stages and taxa. If combined with increased capacity to discern between cryptic species, population structure may be ascertained, and fisheries stakeholders will be enabled to make informed decisions. To assist in such efforts, we have constructed new range maps for each species and species complex. For bonefishes, conservation genomic approaches may resolve lingering taxonomic uncertainties, supporting effective conservation and management efforts. These methods apply broadly to taxonomic groups with cryptic diversity, aiding species delimitation and taxonomic revisions.