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The hawksbill sea turtle Eretmochelys imbricata is categorized as Critically Endangered on the IUCN Red List and its population has declined by over 80% in the last century. The Eastern Pacific population is one of the most threatened hawksbill populations globally. Western Mexico is the northern distribution limit for hawksbill sea turtles in the Eastern Pacific and recent research indicates that the Mexican Pacific portion of the population is a separate management unit because of the restricted movements of these turtles. Here we use the most complete database of sighting records in the north-west Pacific of Mexico to identify sites where hawksbill turtles are present. We also develop a conservation index to determine the conservation status of hawksbill turtle sites. Our results demonstrate the importance of this region for juveniles and the relevance of rocky reefs and mangrove estuaries as habitats for hawksbill turtles. We identified 52 sites with records of hawksbill turtles. Most of these sites (71%) are not protected; however, sites with high conservation value included islands and coastal sites along the Baja California peninsula that are established as marine protected areas. Reefs and mangrove estuaries relevant for hawksbill turtles are probably also significant fish nursery areas that are important for local fishing communities, creating opportunities for conservation strategies that combine science, local engagement and policy to benefit both local fishing communities and hawksbill sea turtle conservation.
This paper describes the results of a multi-country survey of governance approaches for the use of digital contact tracing (DCT) in response to the COVID-19 pandemic. We argue that the countries in our survey represent two distinct models of DCT governance, both of which are flawed. The “data protection model” emphasizes privacy protections at the expense of public health benefit, while the “emergency response model” sacrifices transparency and accountability, prompting concerns about excessive governance surveillance. The ethical and effective use of DCT in the future requires a new governance approach that is better suited to this novel use of mobile phone data to promote public health.”
Vector-borne parasites are important ecological drivers influencing life-history evolution in birds by increasing host mortality or susceptibility to new diseases. Therefore, understanding why vulnerability to infection varies within a host clade is a crucial task for conservation biology and for understanding macroecological life-history patterns. Here, we studied the relationship of avian life-history traits and climate on the prevalence of Plasmodium and Parahaemoproteus parasites. We sampled 3569 individual birds belonging to 53 species of the family Thraupidae. Individuals were captured from 2007 to 2018 at 92 locations. We created 2 phylogenetic generalized least-squares models with Plasmodium and Parahaemoproteus prevalence as our response variables, and with the following predictor variables: climate PC1, climate PC2, body size, mixed-species flock participation, incubation period, migration, nest height, foraging height, forest cover, and diet. We found that Parahaemoproteus and Plasmodium prevalence was higher in species inhabiting open habitats. Tanager species with longer incubation periods had higher Parahaemoproteus prevalence as well, and we hypothesize that these longer incubation periods overlap with maximum vector abundances, resulting in a higher probability of infection among adult hosts during their incubation period and among chicks. Lastly, we found that Plasmodium prevalence was higher in species without migratory behaviour, with mixed-species flock participation, and with an omnivorous or animal-derived diet. We discuss the consequences of higher infection prevalence in relation to life-history traits in tanagers.
Migratory birds are implicated in dispersing haemosporidian parasites over great geographic distances. However, their role in sharing these vector-transmitted blood parasites with resident avian host species along their migration flyway is not well understood. We studied avian haemosporidian parasites in 10 localities where Chilean Elaenia, a long-distance Neotropical austral migrant species, spends part of its annual cycle to determine local parasite transmission among resident sympatric host species in the elaenia's distributional range across South America. We sampled 371 Chilean Elaenias and 1,818 birds representing 243 additional sympatric species from Brazilian wintering grounds to Argentinian breeding grounds. The 23 haemosporidian lineages found in Chilean Elaenias exhibited considerable variation in distribution, specialization, and turnover across the 10 avian communities in South America. Parasite lineage dissimilarity increased with geographic distance, and infection probability by Parahaemoproteus decreased in localities harbouring a more diverse haemosporidian fauna. Furthermore, blood smears from migrating Chilean Elaenias and local resident avian host species did not contain infective stages of Leucocytozoon, suggesting that transmission did not take place in the Brazilian stopover site. Our analyses confirm that this Neotropical austral migrant connects avian host communities and transports haemosporidian parasites along its distributional range in South America. However, the lack of transmissive stages at stopover site and the infrequent parasite lineage sharing between migratory host populations and residents at breeding and wintering grounds suggest that Chilean Elaenias do not play a significant role in dispersing haemosporidian parasites, nor do they influence local transmission across South America.
The loggerhead turtle (Caretta caretta) is a circumglobal species and is listed as vulnerable globally. The North Pacific population nests in Japan and migrates to the Central North Pacific and Pacific coast of North America to feed. In the Mexican Pacific, records of loggerhead presence are largely restricted to the Gulf of Ulloa along the Baja California Peninsula, where very high fisheries by-catch mortality has been reported. Records of loggerhead turtles within the Sea of Cortez also known as the Gulf of California (GC) exist; however, their ecology in this region is poorly understood. We used satellite tracking and an environmental variable analysis (chlorophyll-a (Chl-a) and sea surface temperature (SST)) to determine movements and habitat use of five juvenile loggerhead turtles ranging in straight carapace length from 62.7–68.3 cm (mean: 66.7 ± 2.3 cm). Satellite tracking durations ranged from 73–293 days (mean: 149 ± 62.5 days), transmissions per turtle from 14–1006 (mean: 462 ± 379.5 transmissions) and total travel distance from 1237–5222 km (mean: 3118 ± 1490.7 km). We used travel rate analyses to identify five foraging areas in the GC, which occurred mainly in waters from 10–80 m deep, with mean Chl-a concentrations ranging from 0.28–13.14 mg m−3 and SST ranging from 27.8–34.4°C. This is the first study to describe loggerhead movements in the Gulf of California and our data suggest that loggerhead foraging movements are performed in areas with eutrophic levels of Chl-a.
During the COVID-19 pandemic, the antimicrobial stewardship module in our electronic medical record was reconfigured for the management of COVID-19 patients. This change allowed our subspecialist providers to review charts quickly to optimize potential therapy and management during the patient surge.
Few studies have investigated the patterns of posttraumatic stress disorder (PTSD) symptom change in prolonged exposure (PE) therapy. In this study, we aimed to understand the patterns of PTSD symptom change in both PE and present-centered therapy (PCT).
Methods
Participants were active duty military personnel (N = 326, 89.3% male, 61.2% white, 32.5 years old) randomized to spaced-PE (S-PE; 10 sessions over 8 weeks), PCT (10 sessions over 8 weeks), or massed-PE (M-PE; 10 sessions over 2 weeks). Using latent profile analysis, we determined the optimal number of PTSD symptom change classes over time and analyzed whether baseline and follow-up variables were associated with class membership.
Results
Five classes, namely rapid responder (7–17%), steep linear responder (14–22%), gradual responder (30–34%), non-responder (27–33%), and symptom exacerbation (7–13%) classes, characterized each treatment. No baseline clinical characteristics predicted class membership for S-PE and M-PE; in PCT, more negative baseline trauma cognitions predicted membership in the non-responder v. gradual responder class. Class membership was robustly associated with PTSD, trauma cognitions, and depression up to 6 months after treatment for both S-PE and M-PE but not for PCT.
Conclusions
Distinct profiles of treatment response emerged that were similar across interventions. By and large, no baseline variables predicted responder class. Responder status was a strong predictor of future symptom severity for PE, whereas response to PCT was not as strongly associated with future symptoms.
Terrorism and natural catastrophes have made disaster preparedness a critical issue. Despite the documented vulnerabilities of children during and following disasters, gaps remain in health care systems regarding pediatric disaster preparedness. This research study examined changes in knowledge acquisition of pediatric disaster preparedness among medical and non-medical personnel at a children’s hospital who completed an online training course of five modules: planning, triage, age-specific care, disaster management, and hospital emergency code response.
Methods
A multi-disciplinary team within the Pediatric Disaster Resource and Training Center at Children’s Hospital Los Angeles (Los Angeles, California USA) developed an online training course. Available archival course data from July 2009 to August 2012 were analyzed through linear growth curve multi-level modeling, with module total score as the outcome (0 to 100 points), attempt as the Level 1 variable (any module could be repeated), role in the hospital (medical or non-medical) as the Level 2 variable, and attempt by role as the cross-level effect.
Results
A total of 44,115 module attempts by 5,773 course participants (3,686 medical personnel and 2,087 non-medical personnel) were analyzed. The average module total score upon first attempt across all participants ranged from 60.28 to 80.11 points, and participants significantly varied in how they initially scored. On average in the planning, triage, and age-specific care modules: total scores significantly increased per attempt across all participants (average rate of change ranged from 0.59 to 1.84 points) and medical personnel had higher total scores initially and through additional attempts (average difference ranged from 13.25 to 16.24 points). Cross-level effects were significant in the disaster management and hospital emergency code response modules: on average, total scores were initially lower among non-medical personnel compared to medical personnel, but non-medical personnel increased their total scores per attempt by 3.77 points in the disaster management module and 6.40 points in the hospital emergency code response module, while medical personnel did not improve their total scores through additional attempts.
Conclusion:
Medical and non-medical hospital personnel alike can acquire knowledge of pediatric disaster preparedness. Key content can be reinforced or improved through successive training in an online course.
PhamPK, BeharSM, BergBM, UppermanJS, NagerAL. Pediatric Online Disaster Preparedness Training for Medical and Non-Medical Personnel: A Multi-Level Modeling AnalysisPrehosp Disaster Med.2018;33(4):349–354.
Simulation is used in many aspects of medical training but less so for echocardiography instruction in paediatric cardiology. We report our experience with the introduction of simulator-based echocardiography training at Weill Cornell Medicine for paediatric cardiology fellows of the New York–Presbyterian Hospital of Columbia University and Weill Cornell Medicine. Knowledge of CHD and echocardiographic performance improved following simulation-based training. Simulator training in echocardiography can be an effective addition to standard training for paediatric cardiology trainees.
Doveweed is a problematic weed of lawns and sod production, as well as golf course roughs, fairways, and tees. End-user reports of selective POST control options are inconsistent and control is often short-lived. In addition, inconsistent control with non-selective herbicides such as glyphosate is common. The goals of this research were: (1) evaluate selective POST doveweed control options in ‘Tifway’ hybrid bermudagrass turf; (2) compare efficacy of single vs. sequential applications of selective POST herbicides; (3) quantify doveweed tolerance to glyphosate; and (4) quantify recovery of foliar applied glyphosate following treatment with a C14-glyphosate solution. A single application of sulfentrazone+metsulfuron; thiencarbazone+iodosulfuron+dicamba or 2,4-D+MCPP+dicamba+carfentrazone; or thiencarbazone+foramsulfuron+halosulfuron provided >60% control 2 weeks after initial treatment (WAIT). A second application of these treatments 3 WAIT improved control 6 WAIT. Two applications of 2,4-D+MCPP+dicamba+carfentrazone or thiencarbazone+foramsulfuron+halosulfuron provided ~80% control 6 WAIT. Doveweed was tolerant to glyphosate application up to 5.68 kgaeha-1. Absorption of 14C-glyphosate was compared between doveweed with cuticle intact, doveweed with a disturbed cuticle, and smooth crabgrass. 14C-glyphosate recovery from the leaf surface of doveweed plants with an intact cuticle was 93.6%. In comparison, 14C-glyphosate recovery from the leaf surface of doveweed plants with a disrupted cuticle and the leaf surface of crabgrass plants was 79.1 and 70.5%, respectively.
Gorgona National Park (GNP) protects the only known feeding aggregation of juvenile green turtles Chelonia mydas on the Pacific coast of Colombia. This study was undertaken to compare the diet of the two known C. mydas morphotypes (black and yellow), and to determine availability, selectivity, and quality of food resources at GNP. Oesophageal lavages and isotopic analysis of epidermal tissue were performed on turtles captured between February and December 2012. Food quantity was estimated by determining per cent cover in quadrats randomly placed on the reefs. Food quality of algae species was estimated by proximate analysis. Food selection was estimated using Ivlev's electivity index, and the trophic level of sea turtles at GNP was calculated. A total of 30 black (mean = 63.9 cm SCL) and 47 yellow (mean = 54.3 cm SCL) morphotype turtles were lavaged. Eight invertebrate and nine algae food items were identified in oesophageal contents. The most frequently found and abundant items in lavages were terrestrial plants, plastic fibres, invertebrates and algae. A total of 27 items, including 15 algae species, were identified on the reefs, of which Cladophora sp. was selected by black turtles, and Hypnea pannosa and Dictyota sp. were selected by both morphotypes; the latter species had the highest protein and lipid content, and low lignin content. A trophic level of 3.5 for black and 3.4 for yellow turtles was calculated. No significant difference in diet between the two morphotypes could be determined through lavage or isotopic analysis.
Following release by emergency department (ED) for acute heart failure (AHF), returns to ED represent important adverse health outcomes. The objective of this study was to document relapse events and factors associated with return to ED in the 14-day period following release by ED for patients with AHF.
Methods
The primary outcome was the number of return to ED for patients who were release by ED after the initial visit, for any related medical problem within 14 days of this initial ED visit.
Results
Return visits to the EDs occurred in 166 (20%) patients. Of all patients who returned to ED within the 14-day period, 77 (47%) were secondarily admitted to the hospital. The following factors were associated with return visits to ED: past medical history of percutaneous coronary intervention or coronary artery bypass graft (aOR=1.51; 95% CIs [1.01-2.24]), current use of antiarrhythmics medications (1.96 [1.05-3.55]), heart rate above 80 /min (1.89 [1.28-2.80]), systolic blood pressure below 140 mm Hg (1.67[1.14-2.47]), oxygen saturation (SaO2) above 96% (1.58 [1.08-2.31]), troponin above the upper reference limit of normal (1.68 [1.15-2.45]), and chest X-ray with pleural effusion (1.52 [1.04-2.23]).
Conclusions
Many heart failure patients (i.e. 1 in 5 patients) are released from the ED and then suffer return to ED. Patients with multiple medical comorbidities, and those with abnormal initial vital signs are at increased risk for return to ED and should be identified.
Avian malaria is a vector transmitted disease caused by Plasmodium and recent studies suggest that variation in its prevalence across avian hosts is correlated with a variety of ecological traits. Here we examine the relationship between prevalence and diversity of Plasmodium lineages in southeastern Amazonia and: (1) host ecological traits (nest location, nest type, flocking behaviour and diet); (2) density and diversity of avian hosts; (3) abundance and diversity of mosquitoes; and (4) season. We used molecular methods to detect Plasmodium in blood samples from 675 individual birds of 120 species. Based on cytochrome b sequences, we recovered 89 lineages of Plasmodium from 136 infected individuals sampled across seven localities. Plasmodium prevalence was homogeneous over time (dry season and flooding season) and space, but heterogeneous among 51 avian host species. Variation in prevalence among bird species was not explained by avian ecological traits, density of avian hosts, or mosquito abundance. However, Plasmodium lineage diversity was positively correlated with mosquito abundance. Interestingly, our results suggest that avian host traits are less important determinants of Plasmodium prevalence and diversity in southeastern Amazonia than in other regions in which they have been investigated.
Parasites of the genera Plasmodium and Haemoproteus (Apicomplexa: Haemosporida) are a diverse group of pathogens that infect birds nearly worldwide. Despite their ubiquity, the ecological and evolutionary factors that shape the diversity and distribution of these protozoan parasites among avian communities and geographic regions are poorly understood. Based on a survey throughout the Neotropics of the haemosporidian parasites infecting manakins (Pipridae), a family of Passerine birds endemic to this region, we asked whether host relatedness, ecological similarity and geographic proximity structure parasite turnover between manakin species and local manakin assemblages. We used molecular methods to screen 1343 individuals of 30 manakin species for the presence of parasites. We found no significant correlations between manakin parasite lineage turnover and both manakin species turnover and geographic distance. Climate differences, species turnover in the larger bird community and parasite lineage turnover in non-manakin hosts did not correlate with manakin parasite lineage turnover. We also found no evidence that manakin parasite lineage turnover among host species correlates with range overlap and genetic divergence among hosts. Our analyses indicate that host switching (turnover among host species) and dispersal (turnover among locations) of haemosporidian parasites in manakins are not constrained at this scale.
American burnweed is an early successional summer annual species in the Asteraceae. This weed is a poor competitor; however, it rapidly colonizes disturbed and low-maintenance areas, especially following an environmental disturbance. Recently, turfgrass managers have made adjustments to maintenance practices to satisfy budget requirements and address environmental concerns. This has resulted in reduced mowing frequency in some golf course rough and out-of-play turf areas, and has allowed establishment of broadleaf weed species such as American burnweed which would otherwise be controlled by frequent mowing. The purpose of this study was to evaluate PRE and POST herbicide treatments for American burnweed control in an unmown bermudagrass golf course rough. Single PRE applications of simazine at 2.24 kg ai ha−1 and indaziflam at 0.06 kg ai ha−1 provided > 80% American burnweed control 24 wk after treatment (WAT) in 2012 and 2013. Sequential combination applications of liquid formulations of dimethenamid-p + pendimethalin (2.24 + 1.68 kg ai ha−1) provided 95% American burnweed control 24 wk after initial treatment in 2012 and 2013. Other PRE treatments did not provide consistent control of American burnweed across rating dates and years. Regardless of year, four POST treatments provided ≥ 87% control at 8 and 16 WAT. These included thiencarbazone + foramsulfuron + halosulfuron (0.02 + 0.044 + 0.07 kg ai ha−1), thiencarbazone + iodosulfuron + dicamba (0.02 + 0.15 + 0.005 kg ai ha−1), triclopyr + clopyralid (0.88 + 0.32 kg ai ha−1), and sulfentrazone + metsulfuron (0.4 + 0.04 kg ai ha−1). Several PRE and POST American burnweed control solutions exist for low maintenance bermudagrass areas. Future research should continue to screen other herbicides for control efficacy and focus on application timing to balance season-long control with minimal chemical inputs.