Objectives Feline arterial thromboembolism (ATE), an often devastating outcome, was recently shown to affect 11.3% of cats with hypertrophic cardiomyopathy over 10 years. Current American College of Veterinary Internal Medicine guidelines recommend the use of clopidogrel in cats at risk for ATE, with addition of a factor Xa inhibitor in very high risk or post-ATE cases. To date, no studies have examined the safety or efficacy of this combined antithrombotic therapy. This retrospective case series aimed to assess the frequency and type of adverse events that occurred in cats prescribed dual clopidogrel and rivaroxaban therapy. Secondary aims were to evaluate indications for dual therapy and clinical outcome. Methods The study included 32 cats prescribed clopidogrel (18.75 mg PO q24h) and rivaroxaban (2.5 mg PO q24h) on an outpatient basis over a 5-year period. Results Cats were prescribed dual therapy for at least one of the following: ATE event (n = 18), presence of an intracardiac thrombi (n = 17) or presence of spontaneous echocardiographic contrast (SEC) (n = 16). Five cats experienced adverse effects that could be attributed to medications, a median of 13 days from initiation (epistaxis, hematemesis, hematochezia or hematuria). No cat required hospitalization as a result of these events. Median survival time from onset of therapy was 257 days (interquartile range [IQR] = 38–497) for all cats, 502 days (IQR = 171–663) for ATE cats, 725 days (IQR = 133–856) for cats with an ATE to two or more limbs and 301 days (IQR = 221–431) for cats with only one limb affected. Recurrence rate of ATE while on dual therapy was 16.7%; no cat newly developed an ATE while on dual therapy. Conclusions and relevance Dual antithrombotic therapy with clopidogrel and rivaroxaban resulted in a low reported incidence of adverse events. Cats placed on dual therapy for an ATE event experienced a low rate of recurrence and effective thromboprophylaxis was achieved in cats with intracardiac thrombi or SEC.

Age and body size can influence predation risk and hence habitat use. Many species undergo ontogenetic shifts in habitat use as individuals grow larger and have different age-specific predation pressures. On coral reefs, a number of fish species are more tolerant of threats in structurally complex habitats that contain more refuges than in less structurally complex habitats. However, we do not know how risk perception varies with age, and whether age interacts with habitat complexity. Adults and juveniles, because of their size, may face different risks in structurally simple versus complex habitats. We used flight initiation distance as a metric to analyze perceptions of risk in a species of damselfish Stegastes nigricans. All else being equal, fish fleeing at greater distances are inferred to perceive higher risk. We targeted juvenile and adult damselfish to assess whether there are ontogenetic shifts in perceptions of safety in relation to structural complexity, inferred based on percent coral cover and rugosity. We found that adult damselfish tolerated closer approach in more complex habitats as measured by percent coral cover, but not rugosity, whereas juvenile fish always allowed closer approach than adult fish regardless of complexity. This ontogenetic shift in habitat use may result from juvenile fish taking bigger risks to maximize growth, whereas older animals, who are closer to their maximum body size, can afford to take fewer risks and protect their assets.

Aurelia Dimas had been sent to investigate the various properties being offered by the State of California in the form of a sale-leaseback agreement. The opportunity was perfect for her firm, Orrington Financial Partners, which had recently expanded its fixed-income portfolio to include real estate. The wide range of offerings in the Golden State Portfolio provided both diversification and stability over a period of decades. She had spent the last week walking the halls of each and every building to see the offering first hand. Now the task of valuing the portfolio rested on her shoulders.By reading and analyzing this case, students will be exposed to real estate valuation and understand the issues with a sale-leaseback investment. The objectives are obtained by requiring students to justify how and why they make adjustments to the cash flow forecasts provided to them by a real estate advisory firm, explain their methodology for arriving at a specific value for a piece (or a portfolio) of commercial property, and debate the pros and cons of a sale-leaseback structure.

Paul Hamann was senior vice president of The Night Ministry, a Chicago-based not-for-profit organization. In October 2003 he received a phone call from the wife of the Reverend Tom Behrens, the founding president and the public face of the organization. She told Hamann that Behrens had suffered a massive stroke and that doctors were unsure of his prognosis. Behrens had been walking the streets of run-down Chicago neighborhoods since 1976, looking for people in despair, listening to their needs, and offering them a helping hand and a consoling presence. In the intervening twenty-seven years, he had built The Night Ministry into a well-known organization that helped thousands of adults and youth every year. No succession plan, if one existed, had ever been conveyed to senior management. Now Hamann was unsure when or even if Behrens would be able to work again. If Behrens returned to work, would he be able to continue to lead the organization? If not, who would lead The Night Ministry going forward, even if it were just for the near term, and who would make that decision? How would the community and major donors react to a new leader?Understand Founder's Syndrome and why it is unique to the nonprofit industry