A diverse portfolio of marine protected areas can better advance global conservation and equity

Marine protected areas (MPAs) are widely used for ocean conservation, yet the relative impacts of various types of MPAs are poorly understood. We estimated impacts on fish biomass from no-take and multiple-use (fished) MPAs, employing a rigorous matched counterfactual design with a global dataset of >14,000 surveys in and around 216 MPAs. Both no-take and multiple-use MPAs generated positive conservation outcomes relative to no protection (58.2% and 12.6% fish biomass increases, respectively), with smaller estimated differences between the two MPA types when controlling for additional confounding factors (8.3% increase). Relative performance depended on context and management: no-take MPAs performed better in areas of high human pressure but similar to multiple-use in remote locations. Multiple-use MPA performance was low in high-pressure areas but improved significantly with better management, producing similar outcomes to no-take MPAs when adequately staffed and appropriate use regulations were applied. For priority conservation areas where no-take restrictions are not possible or ethical, our findings show that a portfolio of well-designed and well-managed multiple-use MPAs represents a viable and potentially equitable pathway to advance local and global conservation.

Piecing together the data of the U.S. marine aquaculture puzzle

Aquaculture recently became the main source of global seafood production and many countries, including the United States, see potential in marine aquaculture to sustainably fill growing demand. The U.S. supports the majority of its seafood consumption through imports, and therefore identifying bottlenecks to domestic aquaculture growth is a priority at the federal and state level. Yet, one critical aspect that appears not yet addressed is the quality and accessibility of marine aquaculture data. In this study we conducted the first multi-state synthesis and comparison of the most comprehensive suite of species, volume, and value information on U.S. marine aquaculture over time, across the 23 marine coastal states. Using publicly available data sources from the U.S. Department of Agriculture (USDA), state-level solicited data that we aggregated, and data from the National Oceanic and Atmospheric Administration (NOAA), we found strong evidence that marine aquaculture has played an increasingly important role in marine coastal states, but also uncovered numerous data gaps and discrepancies between and within these sources. In particular, we found a dearth of volumetric data and millions in missing value (USD$). We found U.S. marine aquaculture is likely much more diverse, abundant and valuable than is currently reported, but the main sources of error in any given state remain unclear. We recommend U.S. state governments adopt a standardized, digital and annual data collection program, such as the NOAA Fisheries Information Networks. Better strategic aquaculture planning, management, and research depend on accurate data, and existing digital data infrastructures provide strong opportunities for improvement.

Spatial covariation in nutrient enrichment and fishing of herbivores in an oceanic coral reef ecosystem

Both natural and anthropogenic stressors are increasing on coral reefs, resulting in large-scale loss of coral and potential shifts from coral- to macroalgae-dominated community states. Two factors implicated in shifts to macroalgae are nutrient enrichment and fishing of reef herbivores. Although either of these factors alone could facilitate establishment of macroalgae, reefs may be particularly vulnerable to coral-to-algae phase shifts in which strong bottom-up forcing from nutrient enrichment is accompanied by a weakening of herbivore control of macroalgae via intense fishing. We explored spatial heterogeneity and covariance in these drivers on reefs in the lagoons of Moorea, French Polynesia, where the local fishery heavily targets herbivorous fishes and there are spatially variable inputs of nutrients from agricultural fertilizers and wastewater systems. Spatial patterns of fishing and nutrient enrichment were not correlated at the two landscape scales we examined: among the 11 interconnected lagoons around the island or among major habitats (fringing reef, mid-lagoon, back reef) within a lagoon. This decoupling at the landscape scale resulted from patterns of covariation between enrichment and fishing that differed qualitatively between cross-shore and long-shore directions. At the cross-shore scale, nutrient enrichment declined but fishing increased from shore to the crest of the barrier reef. By contrast, nutrient enrichment and fishing were positively correlated in the long-shore direction, with both increasing with proximity to a pass in the barrier reef. Contrary to widespread assumptions in the scientific literature that human coastal population density correlates with impact on marine ecosystems and that fishing effort declines linearly with distance from the shore, these local stressors produced a complex spatial mosaic of reef vulnerabilities. Our findings support spatially explicit management involving the control of anthropogenic nutrients and strategic reductions in fishing pressure on herbivores by highlighting specific areas to target for management actions.

An experimental evaluation of the effect of escape gaps on the quantity, diversity, and size of fish caught in traps in Montserrat

Coral reef fisheries are vital to the livelihoods of millions of people worldwide but are challenging to manage due to the high diversity of fish species that are harvested and the multiple types of fishing gear that are used. Fish traps are a commonly used gear in reef fisheries in the Caribbean and other regions, but they have poor selectivity and frequently capture juvenile fish, impacting the sustainability of the fishery. One option for managing trap fisheries is the addition of escape gaps, which allow small fish to escape. We compared catches of traps with and without two 2.5 cm (1 inch) escape gaps on the Caribbean island of Montserrat. No significant differences were found in the mean fish length, total fish biomass, number of fish, fish species richness, and Shannon diversity index between hauls of the two trap designs, though traps with escape gaps did catch larger proportions of wider-bodied fish and smaller proportions of narrow-bodied fish. Furthermore, traps with gaps caught a smaller proportion of small-sized fish and fewer immature fish (though differences were not statistically significant). Linear mixed effect models predict that soak time (the length of time between trap hauls) increases the mean catch length, total catch biomass and total number of species in the catch. The relatively modest evidence for the effect of the gaps on catch may be explained by the long soak times used, which could have allowed most smaller-sized fish to escape or be consumed by larger individuals before hauling in both traps with and without escape gaps. Despite the small differences detected in this study, escape gaps may still offer one of the best options for improving sustainability of catches from fish traps, but larger escape gaps should be tested with varying soak times to determine optimum escape gap size.

The MPA Guide: A framework to achieve global goals for the ocean

[Figure: see text].

Caribbean reefs of the Anthropocene: Variance in ecosystem metrics indicates bright spots on coral depauperate reefs

Dramatic coral loss has significantly altered many Caribbean reefs, with potentially important consequences for the ecological functions and ecosystem services provided by reef systems. Many studies examine coral loss and its causes-and often presume a universal decline of ecosystem services with coral loss-rather than evaluating the range of possible outcomes for a diversity of ecosystem functions and services at reefs varying in coral cover. We evaluate 10 key ecosystem metrics, relating to a variety of different reef ecosystem functions and services, on 328 Caribbean reefs varying in coral cover. We focus on the range and variability of these metrics rather than on mean responses. In contrast to a prevailing paradigm, we document high variability for a variety of metrics, and for many the range of outcomes is not related to coral cover. We find numerous "bright spots," where herbivorous fish biomass, density of large fishes, fishery value, and/or fish species richness are high, despite low coral cover. Although it remains critical to protect and restore corals, understanding variability in ecosystem metrics among low-coral reefs can facilitate the maintenance of reefs with sustained functions and services as we work to restore degraded systems. This framework can be applied to other ecosystems in the Anthropocene to better understand variance in ecosystem service outcomes and identify where and why bright spots exist.

Perceptions and responses of Pacific Island fishers to changing coral reefs

The transformation of coral reefs has profound implications for millions of people. However, the interactive effects of changing reefs and fishing remain poorly resolved. We combine underwater surveys (271 000 fishes), catch data (18 000 fishes), and household surveys (351 households) to evaluate how reef fishes and fishers in Moorea, French Polynesia responded to a landscape-scale loss of coral caused by sequential disturbances (a crown-of-thorns sea star outbreak followed by a category 4 cyclone). Although local communities were aware of the disturbances, less than 20% of households reported altering what fishes they caught or ate. This contrasts with substantial changes in the taxonomic composition in the catch data that mirrored changes in fish communities observed on the reef. Our findings highlight that resource users and scientists may have very different interpretations of what constitutes 'change' in these highly dynamic social-ecological systems, with broad implications for successful co-management of coral reef fisheries.

Projecting marine species range shifts from only temperature can mask climate vulnerability

Climate change is causing range shifts in many marine species, with implications for biodiversity and fisheries. Previous research has mainly focused on how species' ranges will respond to changing ocean temperatures, without accounting for other environmental covariates that could affect future distribution patterns. Here, we integrate habitat suitability modeling approaches, a high-resolution global climate model projection, and detailed fishery-independent and -dependent faunal datasets from one of the most extensively monitored marine ecosystems-the U.S. Northeast Shelf. We project the responses of 125 species in this region to climate-driven changes in multiple oceanographic factors (e.g., ocean temperature, salinity, sea surface height) and seabed characteristics (i.e., rugosity and depth). Comparing model outputs based on ocean temperature and seabed characteristics to those that also incorporated salinity and sea surface height (proxies for primary productivity and ocean circulation features), we explored how an emphasis on ocean temperature in projecting species' range shifts can impact assessments of species' climate vulnerability. We found that multifactor habitat suitability models performed better in explaining and predicting species historical distribution patterns than temperature-based models. We also found that multifactor models provided more concerning assessments of species' future distribution patterns than temperature-based models, projecting that species' ranges will largely shift northward and become more contracted and fragmented over time. Our results suggest that using ocean temperature as a primary determinant of range shifts can significantly alter projections, masking species' climate vulnerability, and potentially forestalling proactive management.

Sovereign states in the Caribbean have lower social-ecological vulnerability to coral bleaching than overseas territories

Coral reef social-ecological systems worldwide face major impacts from climate change, and spatial variation in vulnerability is driven by differential exposure to climatic threats, ecological and socio-economic sensitivity to those threats, ecological recovery potential, and socio-economic adaptive capacity. We assess variation in social-ecological vulnerability to climate change-induced coral bleaching, specifically for reef-based fisheries and tourism, of islands throughout the insular Caribbean, thus providing the first region-wide quantitative analysis of island-scale social-ecological vulnerability to coral bleaching. We show that different components of vulnerability have distinct spatial patterns and that variability in overall vulnerability is driven more by socio-economic than ecological components. Importantly, we find that sovereign islands are less vulnerable on average than overseas territories and that the presence of fisheries management regulations is a significant predictor of adaptive capacity and socio-economic sensitivity, with important implications for island-level governance and policies to reduce climate vulnerability.

Marine spatial planning makes room for offshore aquaculture in crowded coastal waters

Marine spatial planning (MSP) seeks to reduce conflicts and environmental impacts, and promote sustainable use of marine ecosystems. Existing MSP approaches have successfully determined how to achieve target levels of ocean area for particular uses while minimizing costs and impacts, but they do not provide a framework that derives analytical solutions in order to co-ordinate siting of multiple uses while balancing the effects of planning on each sector in the system. We develop such a framework for guiding offshore aquaculture (bivalve, finfish, and kelp farming) development in relation to existing sectors and environmental concerns (wild-capture fisheries, viewshed quality, benthic pollution, and disease spread) in California, USA. We identify > 250,000 MSP solutions that generate significant seafood supply and billions of dollars in revenue with minimal impacts (often < 1%) on existing sectors and the environment. We filter solutions to identify candidate locations for high-value, low-impact aquaculture development. Finally, we confirm the expectation of substantial value of our framework over conventional planning focused on maximizing individual objectives.

Marine spatial planning is used to co-ordinate multiple ocean uses, and is frequently informed by tradeoffs and composite metrics. Here, Lester et al. introduce an approach that plans for multiple uses simultaneously whilst balancing individual objectives, using a case study of aquaculture development in California.

Functional diversity of catch mitigates negative effects of temperature variability on fisheries yields

Temperature variation within a year can impact biological processes driving population abundances. The implications for the ecosystem services these populations provide, including food production from marine fisheries, are poorly understood. Whether and how temperature variability impacts fishery yields may depend on the number of harvested species and differences in their responses to varying temperatures. Drawing from previous theoretical and empirical studies, we predict that greater temperature variability within years will reduce yields, but harvesting a larger number of species, especially a more functionally diverse set, will decrease this impact. Using a global marine fisheries dataset, we find that within-year temperature variability reduces yields, but current levels of functional diversity (FD) of targeted species, measured using traits related to species' responses to temperature, largely offset this effect. Globally, high FD of catch could avoid annual losses in yield of 6.8% relative to projections if FD were degraded to the lowest level observed in the data. By contrast, species richness in the catch and in the ecosystem did not provide a similar mitigating effect. This work provides novel empirical evidence that short-term temperature variability can negatively impact the provisioning of ecosystem services, but that FD can buffer these negative impacts.

A novel framework for analyzing conservation impacts: evaluation, theory, and marine protected areas

Environmental conservation initiatives, including marine protected areas (MPAs), have proliferated in recent decades. Designed to conserve marine biodiversity, many MPAs also seek to foster sustainable development. As is the case for many other environmental policies and programs, the impacts of MPAs are poorly understood. Social-ecological systems, impact evaluation, and common-pool resource governance are three complementary scientific frameworks for documenting and explaining the ecological and social impacts of conservation interventions. We review key components of these three frameworks and their implications for the study of conservation policy, program, and project outcomes. Using MPAs as an illustrative example, we then draw upon these three frameworks to describe an integrated approach for rigorous empirical documentation and causal explanation of conservation impacts. This integrated three-framework approach for impact evaluation of governance in social-ecological systems (3FIGS) accounts for alternative explanations, builds upon and advances social theory, and provides novel policy insights in ways that no single approach affords. Despite the inherent complexity of social-ecological systems and the difficulty of causal inference, the 3FIGS approach can dramatically advance our understanding of, and the evidentiary basis for, effective MPAs and other conservation initiatives.

Fisheries regulatory regimes and resilience to climate change

Climate change is already producing ecological, social, and economic impacts on fisheries, and these effects are expected to increase in frequency and magnitude in the future. Fisheries governance and regulations can alter socio-ecological resilience to climate change impacts via harvest control rules and incentives driving fisher behavior, yet there are no syntheses or conceptual frameworks for examining how institutions and their regulatory approaches can alter fisheries resilience to climate change. We identify nine key climate resilience criteria for fisheries socio-ecological systems (SES), defining resilience as the ability of the coupled system of interacting social and ecological components (i.e., the SES) to absorb change while avoiding transformation into a different undesirable state. We then evaluate the capacity of four fisheries regulatory systems that vary in their degree of property rights, including open access, limited entry, and two types of rights-based management, to increase or inhibit resilience. Our exploratory assessment of evidence in the literature suggests that these regulatory regimes vary widely in their ability to promote resilient fisheries, with rights-based approaches appearing to offer more resilience benefits in many cases, but detailed characteristics of the regulatory instruments are fundamental.

Offshore aquaculture: Spatial planning principles for sustainable development

Marine aquaculture is expanding into deeper offshore environments in response to growing consumer demand for seafood, improved technology, and limited potential to increase wild fisheries catches. Sustainable development of aquaculture will require quantification and minimization of its impacts on other ocean-based activities and the environment through scientifically informed spatial planning. However, the scientific literature currently provides limited direct guidance for such planning. Here, we employ an ecological lens and synthesize a broad multidisciplinary literature to provide insight into the interactions between offshore aquaculture and the surrounding environment across a spectrum of spatial scales. While important information gaps remain, we find that there is sufficient research for informed decisions about the effects of aquaculture siting to achieve a sustainable offshore aquaculture industry that complements other uses of the marine environment.

Marine protected area networks: assessing whether the whole is greater than the sum of its parts

Anthropogenic impacts are increasingly affecting the world's oceans. Networks of marine protected areas (MPAs) provide an option for increasing the ecological and economic benefits often provided by single MPAs. It is vital to empirically assess the effects of MPA networks and to prioritize the monitoring data necessary to explain those effects. We summarize the types of MPA networks based on their intended management outcomes and illustrate a framework for evaluating whether a connectivity network is providing an outcome greater than the sum of individual MPA effects. We use an analysis of an MPA network in Hawai'i to compare networked MPAs to non-networked MPAs to demonstrate results consistent with a network effect. We assert that planning processes for MPA networks should identify their intended outcomes while also employing coupled field monitoring-simulation modeling approaches, a powerful way to prioritize the most relevant monitoring data for empirically assessing MPA network performance.

Encourage sustainability by giving credit for marine protected areas in seafood certification

Sarah Lester et al. argue that sustainable seafood certification programs are missing a critical opportunity by failing to provide credit for marine protected areas. Fixing this oversight will improve the leverage of certification programs to drive sustainable fishing, with significant benefits to fish and fisheries.

An index to assess the health and benefits of the global ocean

The ocean plays a critical role in supporting human well-being, from providing food, livelihoods and recreational opportunities to regulating the global climate. Sustainable management aimed at maintaining the flow of a broad range of benefits from the ocean requires a comprehensive and quantitative method to measure and monitor the health of coupled human–ocean systems. We created an index comprising ten diverse public goals for a healthy coupled human–ocean system and calculated the index for every coastal country. Globally, the overall index score was 60 out of 100 (range 36–86), with developed countries generally performing better than developing countries, but with notable exceptions. Only 5% of countries scored higher than 70, whereas 32% scored lower than 50. The index provides a powerful tool to raise public awareness, direct resource management, improve policy and prioritize scientific research.

Treatment-induced stable, moderate reduction in blood cell counts correlate to disease control in early rheumatoid arthritis

BACKGROUND

Treatment of rheumatoid arthritis (RA) has become more intensive, thereby raising concerns regarding toxicities, including leucopenia. The objective was to analyse cell counts obtained as routine surveillance for adverse effects to assess the effect of intensive treatment and treatment dosage and to examine correlations to disease activity scores.

METHODS

Patients with early RA were treated with combinations of disease-modifying anti-inflammatory drugs according to pre-defined rules, with dose adjustments contingent on residual disease activity and tolerance.

RESULTS

Mean leucocyte, neutrophil and platelet counts fell with levels that correlated to disease activity scores. The strongest correlation was between platelets and disease activity scores. There was a modest, inverse correlation between methotrexate dose and monocyte and lymphocyte counts. No serious toxicity associated with the therapy was seen.

CONCLUSION

Moderate reductions in cell counts are well tolerated in RA and appear to contribute to disease control.

The relationship between dispersal ability and geographic range size

There are a variety of proposed evolutionary and ecological explanations for why some species have more extensive geographical ranges than others. One of the most common explanations is variation in species' dispersal ability. However, the purported relationship between dispersal distance and range size has been subjected to few theoretical investigations, and empirical tests reach conflicting conclusions. We attempt to reconcile the equivocal results of previous studies by reviewing and synthesizing quantitative dispersal data, examining the relationship between average dispersal ability and range size for different spatial scales, regions and taxonomic groups. We use extensive data from marine taxa whose average dispersal varies by seven orders of magnitude. Our results suggest dispersal is not a general determinant of range size, but can play an important role in some circumstances. We also review the mechanistic theories proposed to explain a positive relationship between range size and dispersal and explore their underlying rationales and supporting or refuting evidence. Despite numerous studies assuming a priori that dispersal influences range size, this is the first comprehensive conceptual evaluation of these ideas. Overall, our results indicate that although dispersal can be an important process moderating species' distributions, increased attention should be paid to other processes responsible for range size variation.

Reproduction on the edge: large-scale patterns of individual performance in a marine invertebrate

Reproductive output is a central attribute of life history, providing a measure of individual and population performance. The fields of ecology, biogeography, and evolutionary biology take disparate approaches in addressing spatial variation in reproduction, and thus we lack clear predictions for how reproductive output should vary geographically. We empirically investigate these contrasting theoretical approaches by determining geographic patterns in reproductive output for intertidal populations of the purple sea urchin, Strongylocentrotus purpuratus, at 15 sites spanning a large geographic distance (9 degrees span of latitude) from central California, USA, to Baja California, Mexico. Contrary to predictions from biogeography, some of the highest values of reproductive output are at sites near the species' southern range boundary. Additionally, sea urchins do not exhibit a latitudinal gradient in reproduction, but rather show considerable mesoscale variation in reproductive output. Spatial analyses reveal that this variation is correlated with coastal topographic features that are known to influence the pattern of nearshore nutrient flux and circulation. We hypothesize that urchins' reproductive output may be driven by the spatial distribution of their food supply, drift macroalgae, the abundance of which is influenced by both nutrient supply and alongshore transport processes that are coupled to topographic features. Large-scale studies such as this provide valuable insight into the causes of species' range limits, population connectivity, habitat reserve design, and forecasting the effects of climate change on species' distributions.

Lesson plans in surgical training

Lesson plans in surgery enable trainers and trainees to agree on goals that balance training needs with service commitments. Lesson plans are individualised to the trainee and encourage ownership of learning. They are based on SMART criteria and therefore have a sound educational footing. Most of the work in creating a lesson plan falls to the trainee. The total time for creation of each plan is approximately 20 min. Our use of lesson plans for surgical training has been met with favourable response from both trainer and trainees.

Temperature control of larval dispersal and the implications for marine ecology, evolution, and conservation

Temperature controls the rate of fundamental biochemical processes and thereby regulates organismal attributes including development rate and survival. The increase in metabolic rate with temperature explains substantial among-species variation in life-history traits, population dynamics, and ecosystem processes. Temperature can also cause variability in metabolic rate within species. Here, we compare the effect of temperature on a key component of marine life cycles among a geographically and taxonomically diverse group of marine fish and invertebrates. Although innumerable lab studies document the negative effect of temperature on larval development time, little is known about the generality versus taxon-dependence of this relationship. We present a unified, parameterized model for the temperature dependence of larval development in marine animals. Because the duration of the larval period is known to influence larval dispersal distance and survival, changes in ocean temperature could have a direct and predictable influence on population connectivity, community structure, and regional-to-global scale patterns of biodiversity.

Silencing the snorers: no gain without pain?

Objective: To compare the estimated effects of conservative surgery to those of a mandibular advancement splint (MAS) in the treatment of habitual snoring.

Method: Prospective, observational, non-randomized cohort study.

Results: Adequate follow-up data were available for 88 participants (23 following coblation, 65 after provision of an MAS). The mean reduction in snoring symptoms inventory (SSI) score for the 23 subjects undergoing coblation was 9.83 (± standard deviation 11.43). Reported pain duration was greatest with uvula amputation, but uvula coblation did not always adequately reduce its bulk. Of the 65 MAS patients, 39 (60 per cent) used the device regularly, with a mean fall in SSI of 12 (±16.4, p = 0.001). Approximately one in four patients in both groups achieved a significant fall in SSI (>15 points), and the measured effect sizes were close to 0.75 for both treatments.

Conclusions: Mandibular advancement splints and coblation have similar efficacies. However, their efficacy does not match that of radical surgery.

The relationship between pelagic larval duration and range size in tropical reef fishes: a synthetic analysis

We address the conflict in earlier results regarding the relationship between dispersal potential and range size. We examine all published pelagic larval duration data for tropical reef fishes. Larval duration is a convenient surrogate for dispersal potential in marine species that are sedentary as adults and that therefore only experience significant dispersal during their larval phase. Such extensive quantitative dispersal data are only available for fishes and thus we use a unique dataset to examine the relationship between dispersal potential and range size. We find that dispersal potential and range size are positively correlated only in the largest ocean basin, the Indo-Pacific, and that this pattern is driven primarily by the spatial distribution of habitat and dispersal barriers. Furthermore, the relationship strengthens at higher taxonomic levels, suggesting an evolutionary mechanism. We document a negative correlation between species richness and larval duration at the family level in the Indo-Pacific, implying that speciation rate may be negatively related to dispersal potential. If increased speciation rate within a taxonomic group results in smaller range sizes within that group, speciation rate could regulate the association between range size and dispersal potential.

Spontaneous growth hormone release in term infants: changes during the first four days of life

Healthy term infants have higher umbilical cord GH levels compared to older infants and children. In the sheep, GH concentrations rapidly fall within an hour of birth; the physiology of GH release after parturition in the human term infant is less well known. The purpose of this study was to investigate spontaneous 12-h GH release in male and female term infants of varying postnatal ages. We studied 14 infants (7 males and 7 females). Subjects were divided into those studied earlier following delivery (28.2 +/- 3.4 h of age, mean +/- SE) and into those studied at a later time (74.8 +/- 3.5 h, P < 0.0005). The age at study was defined as the age (hours) when blood sampling began. There were eight infants studied at an early age (four males and four females) and six studied at a later age (three males and three females). Subjects were comparable with respect to gestational age, birth weight, and length; all were biochemically euthyroid. One infant was large for gestational age although his head circumference was in the normal range. Blood (0.1 mL) was taken every 30 min over a 12-h period from an indwelling umbilical catheter; no stress occurred during the blood withdrawal. GH was determined by a double-antibody RIA using 0.01 mL plasma. GH pulse detection was undertaken using Cluster, a computerized pulse detection algorithm. Total insulin-like growth factor I (IGF-I) was measured following separation of the IGFs from the serum binding proteins. Spontaneous pulsatile GH release was observed in all infants studied. No differences in GH characteristics were found between male and female subgroups in the early or late study groups. In subsequent analysis, the data for the males and females are combined. The GH pulse frequency per 12 h was greater in the earlier studied group, 5.1 +/- 0.9 (mean +/- SE) vs. 2.5 +/- 0.7 in the later group (P < 0.05). The maximal pulse amplitude was 47.1 +/- 7.9 micrograms/L in the early and 27.1 +/- 4.1 in the later studied group (P < 0.06). The incremental pulse amplitude was 26.4 +/- 3.4 micrograms/L in the early and 12.8 +/- 2.7 in the later group (P = 0.01). The pulse width was greater in the later studied group (202.8 +/- 71.1 min vs. 84.1 +/- 21.6, P < 0.06).(ABSTRACT TRUNCATED AT 400 WORDS)

Spontaneous and stimulated growth hormone release in adolescents with type I diabetes mellitus: effects of metabolic control

Abnormalities in GH release have been found in adults with poorly controlled type I diabetes mellitus. During puberty, circulating GH concentrations transiently increase. To investigate in pubertal diabetic adolescents, the physiological relationship between metabolic control and GH release, we compared spontaneous and GH-releasing hormone (GHRH)-stimulated GH release in six pubertal subjects during poor (study A) and improved (study B) metabolic control. The subjects included two females and four males (mean age +/- SE, 15.5 +/- 1 yr; duration of diabetes, 8.6 +/- 0.9 yr; Tanner stages II-V). Serum samples for glucose and GH determinations were obtained at 20-min intervals over a 24-h period. Significant pulses of GH release were identified using a pulse detection algorithm (Cluster). Fourier expansion time series was used to document the occurrence of significant periodicities in the GH concentration-time data series. All subjects received 1.0 microgram/kg GHRH-44, iv, at 0800 h on the day after the 24-h monitoring for GH. After GHRH administration, samples were taken for glucose and GH determinations over 90 min. The overall mean glucose level (+/- SE) during the 24-h monitoring was 11.5 +/- 0.2 mmol/L during study A and 7.2 +/- 0.2 during study B (P = 0.0001). During the 4 weeks of improved control, glycated hemoglobin fell from 13.9 +/- 1.4% to 11.7 +/- 0.8% (mean +/- SE; P < 0.025). All subjects had significant pulses of GH release during poor or improved metabolic control. Relative to that at night, the daytime pulse frequency was higher in study A (P < 0.025). The overnight pulse frequency increased during study B (P < 0.01). Other pulse parameters, including maximal and incremental pulse amplitudes, pulse width, and interpulse valley mean, did not change during improved control. The mean +/- SE 24-h GH concentration was 4.1 +/- 0.7 micrograms/L during study A and 4.3 +/- 0.8 during study B. The amplitude of the circadian GH rhythm was not different by Fourier analysis. The overall mean glucose +/- SE after GHRH administration was 15.3 +/- 0.2 mmol/L in study A and 6.8 +/- 0.1 in study B. In spite of the marked hyperglycemia during study A, the GH responses were similar during studies A and B. Maximal GH levels were obtained at 15-30 min (mean +/- SE) and were 36.0 +/- 16.9 micrograms/L in study A and 38.7 +/- 18.9 in study B.(ABSTRACT TRUNCATED AT 400 WORDS)