The U.S. South Atlantic Region

This chapter describes the South Atlantic region and the major issues facing this marine fisheries ecosystem, and presents some summary statistics related to the 90 indicators of ecosystem-based fisheries management (EBFM) criteria. The South Atlantic contains the third-highest number of managed taxa of the eight regional U.S. marine ecosystems, including commercially and recreationally important reef fishes (snappers and groupers), penaeid shrimps, coastal migratory pelagic fishes (cobia, mackerels, dolphin/wahoo), and coral reef resources. The South Atlantic is a species-rich environment subject to several major stressors that include habitat loss, sea-level rise, ocean acidification, and intermittent high category hurricanes with increasing frequency over the past decades, along with the consequences of overfishing that continue to affect LMRs in this region. Overall, EBFM progress has been made in terms of implementing ecosystem-level planning, advancing knowledge of ecosystem principles, and in assessing risks and vulnerabilities to ecosystems through ongoing investigations into climate vulnerability and species prioritizations for stock and habitat assessments. Although the South Atlantic is progressing toward EBFM, little overall progress has been observed toward applying ecosystem-level emergent properties into management frameworks. While the South Atlantic is advancing in terms of its LMR management priorities and ecosystem efforts, some challenges remain to effectively implement formalized EBFM planning. Limited information regarding the status and biomass of fishery stocks and protected species in this region, and data gaps for many environmental factors have constrained EBFM implementation and prevented the application of ecosystem-level properties into management actions.

Geographic and Regional Variability in Racial and Ethnic Disparities in Stroke Thrombolysis in the United States

Background and Purpose: Intravenous thrombolysis (IVT) after ischemic stroke is underutilized in racially/ethnically minoritized groups. We aimed to determine the regional and geographic variability in racial/ethnic IVT disparities in the United States. Methods: Acute ischemic stroke admissions between 2012 and 2018 were identified in the National Inpatient Sample. Multivariable logistic regression was used to test the association between IVT and race/ethnicity, stratified by geographic region and controlling for demographic, clinical, and hospital characteristics. Results: Of the 545 509 included cases, 47 031 (8.6%) received IVT. Racially/ethnically minoritized groups had significantly lower adjusted odds of IVT compared with White people in the South Atlantic region (odds ratio [OR], 0.86 [95% CI, 0.82–0.91]), the East North Central region (OR, 0.91 [95% CI, 0.85–0.97]) and the Pacific region (OR, 0.90 [95% CI, 0.85–0.96]). In the South Atlantic region, IVT use in racial/ethnic minority groups was below the national average of all racial/ethnic minority patients ( P =0.002). Compared with White patients, Black patients had lower odds of IVT in the Middle Atlantic region (OR, 0.84 [95% CI, 0.78–0.91]), the South Atlantic region (OR, 0.78 [95% CI, 0.74–0.82]), and the East North Central region (OR, 0.86 [95% CI, 0.79–0.93]). In the South Atlantic region, this difference was below the national average for Black people ( P <0.001). Hispanic patients had significantly lower use of IVT only in the Pacific region (OR, 0.92 [95% CI, 0.85–0.99]), while Asian/Pacific Islander patients had lower odds of IVT in the Mountain (OR, 0.76 [95% CI, 0.59–0.98]) and Pacific region (OR, 0.89 [95% CI, 0.82–0.97]). Conclusions: Racial/ethnic disparities in IVT use in the United States vary by region. Geographic hotspots of lower IVT use in racially/ethnically minoritized groups are the South Atlantic region, driven predominantly by lower use of IVT in Black patients, and the East North Central and Pacific regions.

Estimated National and Regional Impact of COVID-19 on Elective Case Volume in Aesthetic Plastic Surgery

Background In efforts to help alleviate the strain placed on healthcare during the COVID-19 pandemic, the American Society of Plastic Surgery recommended suspending elective procedures on March 19, 2020. When this suspension was enacted, it was unknown when cases would resume. Objectives This analysis aimed to estimate the regional economic impact of the pandemic specifically with regards to elective, aesthetic surgical procedures. As knowledge regarding the effects of the pandemic has grown, the authors then evaluated the accuracy of the projected estimates compared with actual events. Methods Utilizing the American Society of Plastic Surgery 2018 Plastic Surgery Statistics Report, regional case volume and surgeons’ fees were obtained for the top 5 aesthetic procedures. Models developed by the Institute for Health Metrics and Evaluation were employed to estimate the anticipated duration of suspension by utilizing the date that no ventilators would be required for COVID-19 patients. This duration was utilized to calculate the volume of cases that would not occur. Results These estimates predict up to 1.3 billion fewer dollars will be collected in surgeons’ fees, representing a 20% loss compared with 2018. The South Atlantic region is predicted to have the greatest number of operating room days lost. However, the Mountain and Pacific regions are estimated to have the greatest loss in case volume and surgeons’ fees. Conclusions The cumulative impact of the pandemic on life, society, and the economy is tremendous. This analysis may help guide surgeons’ responses during and after the crisis.

Defense and Security policies for the South Atlantic region

This paper resulted from a contribution presented during an event promoted by the Nationalities Observatory research group. In this occasion, I tried to discuss prevalent ideas in the academic analysis on International Relations and Defense Studies. My starting argument was that the extremely conservative literary production on these matters do not signalize to a conception of an autonomous and sovereign performance of the Brazilian State.

Causes of interannual variability over the southern hemispheric tropospheric ozone maximum

We examine the relative contribution of processes controlling the interannual variability (IAV) of tropospheric ozone over four sub-regions of the southern hemispheric tropospheric ozone maximum (SHTOM) over a 20-year period. Our study is based on hindcast simulations from the National Aeronautics and Space Administration Global Modeling Initiative chemistry transport model (NASA GMI-CTM) of tropospheric and stratospheric chemistry, driven by assimilated Modern Era Retrospective Analysis for Research and Applications (MERRA) meteorological fields. Our analysis shows that over SHTOM region, the IAV of the stratospheric contribution is the most important factor driving the IAV of upper tropospheric ozone (270 hPa), where ozone has a strong radiative effect. Over the South Atlantic region, the contribution from surface emissions to the IAV of ozone exceeds that from stratospheric input at and below 430 hPa. Over the South Indian Ocean, the IAV of stratospheric ozone makes the largest contribution to the IAV of ozone with little or no influence from surface emissions at 270 and 430 hPa in austral winter. Over the tropical South Atlantic region, the contribution from IAV of stratospheric input dominates in austral winter at 270 hPa and drops to less than half but is still significant at 430 hPa. Emission contributions are not significant at these two levels. The IAV of lightning over this region also contributes to the IAV of ozone in September and December. Over the tropical southeastern Pacific, the contribution of the IAV of stratospheric input is significant at 270 and 430 hPa in austral winter, and emissions have little influence.

Causes of interannual variability of tropospheric ozone over the Southern Ocean

We examine the relative contribution of processes controlling the interannual variability (IAV) of tropospheric ozone over four sub-regions of the southern hemispheric tropospheric ozone maximum (SHTOM) over a twenty-year period. Our study is based on hindcast simulations from the National Aeronautics and Space Administration Global Modeling Initiative – Chemistry transport model (NASA GMI-CTM) of tropospheric and stratospheric chemistry, driven by assimilated Modern Era Retrospective-Analysis for Research and Applications (MERRA) meteorological fields. Our analysis shows that over SHTOM region, the IAV of the stratospheric contribution is the most important factor driving the IAV of upper tropospheric ozone (270 hPa), where ozone has a strong radiative effect. Over the south Atlantic region, the contribution from surface emissions to the IAV of ozone exceeds that from stratospheric input at and below 430 hPa. Over the south Indian Ocean, the IAV of stratospheric ozone makes the largest contribution to the IAV of ozone with little or no influence from surface emissions at 270 hPa and 430 hPa in austral winter. Over the tropical south Atlantic region, the contribution from IAV of stratospheric input dominates in austral winter at 270 hPa and drops to less than half but is still significant at 430 hPa. Emission contributions are not significant at these two levels, even during September. The IAV of lightning over this region also contributes to the IAV of ozone in September and December. Over the tropical southeastern Pacific, the contribution of the IAV of stratospheric input is significant at 270 hPa and 430 hPa in austral winter, and emissions have little influence.