Criteria for Patient Selection and Multidisciplinary Evaluation and Treatment of the Weight Loss Surgery Patient

Objective: To provide evidence‐based guidelines for patient selection and to recommend the medical and nutritional aspects of multidisciplinary care required to minimize perioperative and postoperative risks in patients with severe obesity who undergo weight loss surgery (WLS). Research Methods and Procedures: Members of the Multidisciplinary Care Task Group conducted searches of MEDLINE and PubMed for articles related to WLS in general and medical and nutritional care in particular. Pertinent abstracts and literature were reviewed for references. Multiple searches were carried out for various aspects of multidisciplinary care published between 1980 and 2004. A total of 3000 abstracts were identified; 242 were reviewed in detail. Results: We recommended multidisciplinary screening of WLS patients to ensure appropriate selection; preoperative assessment for cardiovascular, pulmonary, gastrointestinal, endocrine, and other obesity‐related diseases associated with increased risk for complications or mortality; preoperative weight loss and cessation of smoking; perioperative prophylaxis for deep vein thrombosis and pulmonary embolism (PE); preoperative and postoperative education and counseling by a registered dietitian; and a well‐defined postsurgical diet progression. Discussion: Obesity‐related diseases are often undiagnosed before WLS, putting patients at increased risk for complications and/or early mortality. Multidisciplinary assessment and care to minimize short‐ and long‐term risks include: comprehensive medical screening; appropriate pre‐, peri‐, and postoperative preparation; collaboration with multiple patient care disciplines (e.g., anesthesiology, pulmonary medicine, cardiology, and psychology); and long‐term nutrition education/counseling.     

Herbivore responses to nutrient enrichment and landscape heterogeneity in a mangrove ecosystem

Complex gradients in forest structure across the landscape of offshore mangrove islands in Belize are associated with nutrient deficiency and flooding. While nutrient availability can affect many ecological processes, here we investigate how N and P enrichment interact with forest structure in three distinct zones (fringe, transition, dwarf) to alter patterns of herbivory as a function of folivory, loss of yield, and tissue mining. The effects of nutrient addition and zone varied by functional feeding group or specific herbivore. Folivory ranged from 0 to 0.4% leaf area damaged per month, but rates did not vary by either nutrient enrichment or zone. Leaf lifetime damage ranged from 3 to 10% of the total leaf area and was caused primarily by the omnivorous tree crab Aratus pisonii. We detected two distinct spatial scales of response by A. pisonii that were unrelated to nutrient treatment, i.e., most feeding damage occurred in the fringe zone and crabs fed primarily on the oldest leaves in the canopy. Loss of yield caused by the bud moth Ecdytolopha sp. varied by zone but not by nutrient treatment. A periderm-mining Marmara sp. responded positively to nutrient enrichment and closely mirrored the growth response by Rhizophora mangle across the tree height gradient. In contrast, a leaf-mining Marmara sp. was controlled by parasitoids and predators that killed >89% of its larvae. Thus, nutrient availability altered patterns of herbivory of some but not all mangrove herbivores. These findings support the hypothesis that landscape heterogeneity of the biotic and abiotic environment has species-specific effects on community structure and trophic interactions. Predicting how herbivores respond to nutrient over-enrichment in mangrove ecosystems also requires an assessment of habitat heterogeneity coupled with feeding strategies and species-specific behavior measured on multiple scales of response.     

Role of honey bees (Hymenoptera: Apidae) in the pollination biology of a California native plant, Triteleia laxa (Asparagales: Themidaceae)

A central focus of pollination biology is to document the relative effectiveness of different flower visitors as pollinators. Ongoing research seeks to determine the role that introduced honey bees (Apis mellifera L.) play in the pollination of both invasive and native plants. Here we report on the importance of A. mellifera as pollinators of a California native plant, Triteleia laxa Bentham. In observation plots and transect censuses, A. mellifera overwhelmingly dominated the T. laxa flower visitor assemblage. We believe the proximity to agriculture, where A. mellifera density is higher relative to areas far from agriculture, contributes to the discrepancy between A. mellifera abundance at the two sites. Although A. mellifera were inferior flower visitors qualitatively (visited less flowers per minute), they were the most frequent interactors with flowers. Furthermore, the proportion of visits to flowers on the same plant among flower visitor species did not differ, suggesting a general mechanism by which insects forage at T. laxa flowers and that A. mellifera do not cause more deleterious geitonogamy than do native pollinators. Flower visitation rates as a function of floral display size did not differ between A. mellifera and other flower visitors. The difference in the magnitude of flower visitation (largely by A. mellifera) between sites is consistent with a difference in seed set between sites. These results suggest that non-native A. mellifera bees can play an important role in the pollination of native plant species.     

Carbon isotopes reveal soil organic matter dynamics following arid land shrub expansion

 Over the past century, overgrazing and drought in New Mexico’s Jornada Basin has promoted the replacement of native black grama (Bouteloua eriopoda Torr.) grass communities by shrubs, primarily mesquite (Prosopis glandulosa Torr.). We investigated the effects of shrub expansion on the distribution, origin, turnover, and quality of light (LFC) and heavy (HFC) soil organic matter (SOM) fractions using δ¹³C natural abundance to partition SOM into C₄ (grass) and C₃ (shrub) sources. Soil organic matter beneath grasses and mesquite was isotopically distinct from associated plant litter, providing evidence of both recent shrub expansion and Holocene plant community changes. Our δ¹³C analyses indicated that SOM derived from mesquite was greatest beneath shrub canopies, but extended at least 3 m beyond canopy margins, similar to the distribution of fine roots. Specific ¹⁴C activities of LFC indicated that root litter is an important source of SOM at depth. Comparison of turnover rates for surface LFC pools in grass (7 or 40 years) and mesquite (11 or 28 years) soils and for HFC pools by soil depth (∼150–280 years), suggest that mesquite may enhance soil C storage relative to grasses. We conclude that the replacement of semiarid grasslands by woody shrubs will effect changes in root biomass, litter production, and SOM cycling that influence nutrient availability and long-term soil C sequestration at the ecosystem level. Received: 17 May 1996 / Accepted: 12 November 1996     

A study of tolerance of ingested tannin in Schistocerca gregaria

A study has been made on the effects of ingestion of tannic acid on growth and development of Schistocerca gregaria. No deleterious effects were found on digestion or utilisation of food, even when food protein levels were very low. At high concentrations consumption rates were relatively low over the first day, but this effect was not sustained. The lack of ‘antidigestive’ effects is shown to be due partly to the hydrolysis of tannic acid to gallic acid and glucose, and partly to the adsorptive properties of the peritrophic membrane. Insects reared on food with high levels of tannic acid took a longer time to reach sexual maturity than did the controls, although fecundity was not affected thereafter.     

Robust assessment of associations between weather and eastern wild turkey nest success

Temperature and precipitation have been identified as factors that potentially influence eastern wild turkey (Meleagris gallopavo silvestris) reproduction, but robust analyses testing the relationship between weather parameters and turkey nest success are lacking. Therefore, we assessed how weather influenced turkey daily nest survival using 8 years of data collected from 715 nests across the southeastern United States. We also conducted exploratory analyses investigating if weather conditions during or prior to nesting best predicted nest success. We then assessed the possible implications of climate change through 2041–2060 for future eastern wild turkey daily nest survival and nest success for variables determined significant in analyses. During incubation, positive anomalies of minimum daily temperature were associated with greater daily nest survival. Precipitation during nesting was not a good predictor of daily nest survival. Exploratory analyses unexpectedly indicated that weather conditions in January prior to incubation were more important to nest success than weather conditions during incubation. In January, negative anomalies of minimum temperature and greater average daily precipitation were associated with greater nest success. Projections of future nest success or daily nest survival based on these relationships with the predictive covariates, and informed by climate models, suggest that nest success may increase as January precipitation increases and that daily nest survival may increase as temperature during incubation increases. These positive associations could be offset by a negative association between nest success and the expected increases in January minimum average temperature. Additional research is needed to investigate causes of these relationships and assess the implications of climate change for eastern wild turkey poult survival.     

Ultrastructural organization of amyloid fibrils by atomic force microscopy

Atomic force microscopy has been employed to investigate the structural organization of amyloid fibrils produced in vitro from three very different polypeptide sequences. The systems investigated are a 10-residue peptide derived from the sequence of transthyretin, the 90-residue SH3 domain of bovine phosphatidylinositol-3'-kinase, and human wild-type lysozyme, a 130-residue protein containing four disulfide bridges. The results demonstrate distinct similarities between the structures formed by the different classes of fibrils despite the contrasting nature of the polypeptide species involved. SH3 and lysozyme fibrils consist typically of four protofilaments, exhibiting a left-handed twist along the fibril axis. The substructure of TTR(10-19) fibrils is not resolved by atomic force microscopy and their uniform appearance is suggestive of a regular self-association of very thin filaments. We propose that the exact number and orientation of protofilaments within amyloid fibrils is dictated by packing of the regions of the polypeptide chains that are not directly involved in formation of the cross-beta core of the fibrils. The results obtained for these proteins, none of which is directly associated with any human disease, are closely similar to those of disease-related amyloid fibrils, supporting the concept that amyloid is a generic structure of polypeptide chains. The detailed architecture of an individual fibril, however, depends on the manner in which the protofilaments assemble into the fibrillar structure, which in turn is dependent on the sequence of the polypeptide and the conditions under which the fibril is formed.