Canadian Estimate of Bird Mortality Due to Collisions and Direct Habitat Loss Associated with Wind Turbine Developments

We estimated impacts on birds from the development and operation of wind turbines in Canada considering both mortality due to collisions and loss of nesting habitat. We estimated collision mortality using data from carcass searches for 43 wind farms, incorporating correction factors for scavenger removal, searcher efficiency, and carcasses that fell beyond the area searched. On average, 8.2 ± 1.4 birds (95% C.I.) were killed per turbine per year at these sites, although the numbers at individual wind farms varied from 0 - 26.9 birds per turbine per year. Based on 2955 installed turbines (the number installed in Canada by December 2011), an estimated 23,300 birds (95% C.I. 20,000 - 28,300) would be killed from collisions with turbines each year. We estimated direct habitat loss based on data from 32 wind farms in Canada. On average, total habitat loss per turbine was 1.23 ha, which corresponds to an estimated total habitat loss due to wind farms nationwide of 3635 ha. Based on published estimates of nest density, this could represent habitat for ~5700 nests of all species. Assuming nearby habitats are saturated, and 2 adults displaced per nest site, effects of direct habitat loss are less than that of direct mortality. Installed wind capacity is growing rapidly, and is predicted to increase more than 10-fold over the next 10-15 years, which could lead to direct mortality of approximately 233,000 birds / year, and displacement of 57,000 pairs. Despite concerns about the impacts of biased correction factors on the accuracy of mortality estimates, these values are likely much lower than those from collisions with some other anthropogenic sources such as windows, vehicles, or towers, or habitat loss due to many other forms of development. Species composition data suggest that < 0.2% of the population of any species is currently affected by mortality or displacement from wind turbine development. Therefore, population level impacts are unlikely, provided that highly sensitive or rare habitats, as well as concentration areas for species at risk, are avoided

Genome Sequencing of SHH Medulloblastoma Predicts Genotype-Related Response to Smoothened Inhibition

SummarySmoothened (SMO) inhibitors recently entered clinical trials for sonic-hedgehog-driven medulloblastoma (SHH-MB). Clinical response is highly variable. To understand the mechanism(s) of primary resistance and identify pathways cooperating with aberrant SHH signaling, we sequenced and profiled a large cohort of SHH-MBs (n = 133). SHH pathway mutations involved PTCH1 (across all age groups), SUFU (infants, including germline), and SMO (adults). Children >3 years old harbored an excess of downstream MYCN and GLI2 amplifications and frequent TP53 mutations, often in the germline, all of which were rare in infants and adults. Functional assays in different SHH-MB xenograft models demonstrated that SHH-MBs harboring a PTCH1 mutation were responsive to SMO inhibition, whereas tumors harboring an SUFU mutation or MYCN amplification were primarily resistant

Development of the Preferred Components for Co-Design in Research Guideline and Checklist: Protocol for a Scoping Review and a Modified Delphi Process

Background: There is increasing evidence that co-design can lead to more engaging, acceptable, relevant, feasible, and even effective interventions. However, no guidance is provided on the specific designs and associated methods or methodologies involved in the process. We propose the development of the Preferred Components for Co-design in Research (PRECISE) guideline to enhance the consistency, transparency, and quality of reporting co-design studies used to develop complex health interventions. Objective: The aim is to develop the first iteration of the PRECISE guideline. The purpose of the PRECISE guideline is to improve the consistency, transparency, and quality of reporting on studies that use co-design to develop complex health interventions. Methods: The aim will be achieved by addressing the following objectives: to review and synthesize the literature on the models, theories, and frameworks used in the co-design of complex health interventions to identify their common elements (components, values or principles, associated methods and methodologies, and outcomes); and by using the results of the scoping review, prioritize the co-design components, values or principles, associated methods and methodologies, and outcomes to be included in the PRECISE guideline. Results: The project has been funded by the Canadian Institutes of Health Research. Conclusions: The collective results of this project will lead to a ready-to-implement PRECISE guideline that outlines a minimum set of items to include when reporting the co-design of complex health interventions. The PRECISE guideline will improve the consistency, transparency, and quality of reports of studies. Additionally, it will include guidance on how to enact or enable the values or principles of co-design for meaningful and collaborative solutions (interventions). PRECISE might also be used by peer reviewers and editors to improve the review of manuscripts involving co-design. Ultimately, the PRECISE guideline will facilitate more efficient use of new results about complex health intervention development and bring better returns on research investments

Relative sea-level change in northeastern Florida (USA) during the last ~8.0 ka

An existing database of relative sea-level (RSL) reconstructions from the U.S. Atlantic coast lacked valid sea-level index points from Georgia and Florida. This region lies on the edge of the collapsing forebulge of the former Laurentide Ice Sheet making it an important location for understanding glacio-isostatic adjustment and the history of ice-sheet melt. To address the paucity of data, we reconstruct RSL in northeastern Florida (St. Marys) over the last ∼8.0 ka from samples of basal salt-marsh sediment that minimize the influence of compaction. The analogy between modern salt-marsh foraminifera and their fossil counterparts preserved in the sedimentary record was used to estimate paleomarsh surface elevation. Sample ages were determined by radiocarbon dating of identifiable and in-situ plant macrofossils. This approach yielded 25 new sea-level index points that constrain a ∼5.7 m rise in RSL during the last ∼8.0 ka. The record shows that no highstand in sea level occurred in this region over the period of the reconstruction. We compared the new reconstruction to Earth-ice models ICE 6G-C VM5a and ICE 6G-C VM6. There is good fit in the later part of the Holocene with VM5a and for a brief time in the earlier Holocene with VM6. However, there are discrepancies in model-reconstruction fit in the early to mid Holocene in northeastern Florida and elsewhere along the Atlantic coast at locations with early Holocene RSL reconstructions. The most pronounced feature of the new reconstruction is a slow down in the rate of RSL rise from approximately 5.0 to 3.0 ka. This trend may reflect a significant contribution from local-scale processes such as tidal-range change and/or change in base flow of the St. Marys River in response to paleoclimate changes. However, the spatial expression (local vs. regional) of this slow down is undetermined and corroborative records are needed to establish its geographical extent

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

K (2013) Flight paths of migrating golden eagles and the risk associated with wind energy development in the Rocky Mountains. Avian Conservation and Ecology 8: 12

ABSTRACT. In recent years, the eastern foothills of the Rocky Mountains in northeastern British Columbia have received interest as a site of industrial wind energy development but, simultaneously, have been the subject of concern about wind development coinciding with a known migratory corridor of Golden Eagles (Aquila chrysaetos). We tracked and quantified eagle flights that crossed or followed ridgelines slated for one such wind development. We found that hourly passage rates during fall migration peaked at midday and increased by 17% with each 1 km/h increase in wind speed and by 11% with each 1°C increase in temperature. The propensity to cross the ridge tops where turbines would be situated differed between age classes, with juvenile eagles almost twice as likely to traverse the ridge-top area as adults or subadults. During fall migration, Golden Eagles were more likely to cross ridges at turbine heights (risk zone, &lt; 150 m above ground) under headwinds or tailwinds, but this likelihood decreased with increasing temperature. Conversely, during spring migration, eagles were more likely to move within the ridge-top area under eastern crosswinds. Identifying Golden Eagle flight routes and altitudes with respect to major weather systems and local topography in the Rockies may help identify scenarios in which the potential for collisions is greatest at this and other installations. RÉSUMÉ. Récemment, les contreforts des Rocheuses dans le nord-est de la Colombie-Britannique ont attiré l&apos;attention comme site potentiel d&apos;un développement éolien industriel, tout en faisant simultanément l&apos;objet de préoccupations puisque ce projet coïnciderait avec un corridor de migration connu d&apos;Aigles royaux (Aquila chrysaetos). Nous avons suivi et quantifié les vols d&apos;aigles qui ont traversé ou longé les lignes de crêtes visées par un projet éolien de ce genre. Nous avons constaté que le taux de passage horaire durant la migration automnale atteignait un maximum à midi et augmentait de 17 % pour chaque km/h d&apos;augmentation de la vitesse du vent, et de 11 % pour chaque °C d&apos;augmentation de la température. La propension à traverser les sommets des crêtes où seraient installées les éoliennes différait selon les classes d&apos;âge, les jeunes aigles de l&apos;année ayant deux fois plus de chance de le faire que les adultes ou les jeunes plus âgés. Durant la migration automnale, les aigles traversaient davantage les crêtes à hauteur d&apos;éoliennes (zone de risque, &lt; 150 m au-dessus du niveau du sol) sous un vent de face ou arrière, mais cette tendance diminuait avec l&apos;augmentation de la température. En revanche, durant la migration printanière, les aigles étaient plus susceptibles de survoler la région des sommets sous un vent latéral de l&apos;est. La détermination des trajectoires et des altitudes de vol des Aigles royaux, selon les systèmes météorologiques prédominants et la topographie locale des Rocheuses, peut contribuer à identifier les scénarios dans lesquels les risques de collision sont les plus élevés, que ce soit pour ce projet éolien ou d&apos;autres

Feeding-Danger Trade-Offs Underlie Stopover Site Selection by Migrants

To migrate successfully, birds need to store adequate fat reserves to fuel each leg of the journey. Migrants acquire their fuel reserves at stopover sites; this often entails exposure to predators. Therefore, the safety attributes of sites may be as important as the feeding opportunities. Furthermore, site choice might depend on fuel load, with lean birds more willing to accept danger to obtain good feeding. Here, we evaluate the factors underlying stopover-site usage by migrant Western Sandpipers (Calidris mauri) on a landscape scale. We measured the food and danger attributes of 17 potential stopover sites in the Strait of Georgia and Puget Sound region. We used logistic regression models to test whether food, safety, or both were best able to predict usage of these sites by Western Sandpipers. Eight of the 17 sites were used by sandpipers on migration. Generally, sites that were high in food and safety were used, whereas sites that were low in food and safety were not. However, dangerous sites were used if there was ample food abundance, and sites with low food abundance were used if they were safe. The model including both food and safety best-predicted site usage by sandpipers. Furthermore, lean sandpipers used the most dangerous sites, whereas heavier birds (which do not need to risk feeding in dangerous locations) used safer sites. This study demonstrates that both food and danger attributes are considered by migrant birds when selecting stopover sites, thus both these attributes should be considered to prioritize and manage stopover sites for conservation

Simple anthropometrics are more correlated with health variables than are estimates of body composition in Yup'ik people.

ObjectivesTo (1) evaluate the relationships between several indices of obesity with obesity-related risk factors; (2) compare the accuracy of body composition estimates derived from anthropometry and bioimpedance analysis (BIA) to estimates of body composition assessed by doubly-labeled water (DLW); and (3) establish equations for estimating fat mass (FM), fat-free mass (FFM), and percent body fat (PBF) in Yup'ik people.Design and methodsParticipants included 1,056 adult Yup'ik people from 11 communities in Southwestern Alaska. In a sub-study of 30 participants, we developed population-specific linear regression models for estimating FM, FFM, and PBF from anthropometrics, age, sex, and BIA against criterion measures derived from total body water assessed with DLW. These models were then used with the population cohort and we analyzed the relationships between obesity indices and several health-related and disease status variables: (1) fasting plasma lipids, (2) glucose, (3) HbA1c, (4) adiponectin, (5) blood pressure, (6) diabetes (DM), and (7) cerebrocoronary vascular disease (CCVD) which includes stroke and heart disease.ResultsThe best model for estimating FM in the sub-study used only three variables-sex, waist circumference (WC), and hip circumference and had multiple R(2) = 0.9730. FFM and PBF were calculated from FM and body weight.ConclusionWC and other anthropometrics were more highly correlated with a number of obesity-related risk factors than were direct estimates of body composition. Body composition in Yup'ik people can be accurately estimated from simple anthropometrics