We conducted a study to determine the demographic traits, trainingcharacteristics, andgeographic distribution of otolaryngologists in the United States usingpublicly available data. We then correlated ourfindings with U.S. census data. Univariate analysis wasperformed toanalyze results, with a p valueof <0.05 determinedassignificant. Weuseddatafrom theAmerican BoardofOtolaryngology's listof 18,587 board-certified allopathic otolaryngologists through 2013 and the American Osteopathic Colleges of Ophthalmology & Otolaryngology-Head & Neck Surgery's list of 428 osteopathic otolaryngologists. From these two databases, 9,642 otolaryngologists met inclusion criteria, which includedan activepractice in the United States and an age of 70yearsand younger. This group was made up of8,185 men (84.9%) and 1,449women(15.0%); wewere not ableto identify the sex of8 otolaryngologists (0.1%). The medianage ofthewomen wassignificantly lower than that of the men (54 vs. 48 yr. p < 0.001). A total of 8,510 otolaryngologists (88.3%) graduatedfrom a u.s. allopathic medical school, and 8,520(88.4%) graduatedfrom a u.s. allopathic residency program. Wedeterminedthat 25.9% of otolaryngologists established theirpractice in thesame metropolitan statistical area where they completed their residency training. Olderpractitioners (p < 0.001) and women(p < 0.001) were significantly morelikelytostayin thesamearea thanyoungerphysicians and men. In terms ofpopulation, 61.8% of the otolaryngologists practiced in metropolitan areas with more than 1 million residents; by comparison, these areas represent only 55.3% of the total U.S. population, indicating that otolaryngologists are over-represented in larger U.S. cities.

1. Invasive alien species and climate change are two of the most serious global environmental threats. In particular, it is of great interest to understand how changing climates could impact the distribution of invaders that pose serious threats to ecosystems and human activities.2. In this study, we developed ensemble species distribution models for predicting the current and future global distribution of the signal crayfish Pacifastacus leniusculus and the red swamp crayfish Procambarus clarkii, two of the most highly problematic invaders of freshwater ecosystems worldwide. We collected occurrence records of the species, from native and alien established ranges worldwide.These records in combination with averaged observations of current climatic conditions were used to calibrate a set of 10 distinct correlative models for estimating the climatic niche of each species. We next projected the estimated niches into the geographical space for the current climate conditions and for the 2050s and 2070s under representative concentration pathway 2.6 and 8.5 scenarios.3. Our species distribution models had high predictive abilities and suggest that annual mean temperature is the main driver of the distribution of both species.Model predictions indicated that the two crayfish species have not fully occupied their suitable climates and will respond differently to future climate scenarios in different geographic regions. Suitable climate for P. leniusculus was predicted to shift poleward and to increase in extent in North America and Europe but decrease in Asia. Regions with suitable climate for P. clarkii are predicted to widen in Europe but contract in North America and Asia.4. This study highlights that invasive species with different thermal preference are likely to respond differently to future climate changes. Our results provide important information for policy makers to design and implement anticipated measures for the prevention and control of these two problematic species. K E Y W O R D Sclimate change, habitat suitability, Pacifastacus leniusculus, Procambarus clarkii, species distribution modelling

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Obstetricians and gynecologists receive a substantial amount of payments from industry. Most of these payments were for honoraria, faculty compensation, or consulting and totaled less than $400 per health care provider. Although this total amount is less than typically received by surgical providers, including orthopedic surgeons who account for the highest compensated group in total and mean industry payments, the median payment value for obstetrics and gynecology subspecialists surpasses the median payment to orthopedic surgeons. These financial relationships warrant further exploration with future research.