GLACIER NATIONAL PARK BAT INVENTORY AND MONITORING Project

Prior to 2011, no formal bat surveys had been conducted in Glacier National Park (GNP). Given concerns about high bat mortalities due to the continual spread of white-nose syndrome (WNS) and placement of wind energy facilities, it was critical to learn about GNP’s bat diversity, abundance, and distributions before these risks could potentially impact our populations. Of the 11 potential species in GNP, six are Montana (or potential) species of concern. Three years of surveys have now been completed. Survey techniques included mist-netting, acoustic surveys, bridge, building, and cave inspections. To date, we have mist-netted bats over 44 nights in 24 sample units (grid cells-each unit 10 km2) in GNP, processing a total of 700 individuals. Results indicated no sign of WNS. In addition, we conducted nighttime acoustic surveys at 97 different locations within 31 grid cells. Thus far, we have confirmed nine different bat species throughout the park and added three new bat species to the mammals list for GNP. Acoustic surveys have also confirmed the presence of hibernating bats in the winter. The two most commonly captured bats were the little brown myotis (Myotis lucifugus) and the hoary bat (Lasiurus cinereus). GNP may be one of the most substantial migratory routes for hoary bats across North America. Plans include continuing with the inventory phase by surveying additional grid cells using both acoustic and visual techniques, and focusing on long-term monitoring using acoustic sampling and systematic and repeatable counts of little brown bat maternity roosts

Bats in Buildings: Assessing Human Structures as Roost Sites in Glacier National Park (Poster)

Many bat populations are declining due to factors such as spread of white-nose syndrome (WNS) and changes in land use, increasing the need for information to prevent further declines. The little brown bat (Myotis lucifugus) is a species of concern in Montana, is susceptible to WNS, is the most common bat in Glacier National Park (GNP) and is frequently found roosting in buildings. We sought to document the locations and types of bat roosts in human structures throughout GNP. We conducted daytime inspections of 579 of the >900 buildings in GNP during summer 2015. When we detected a roost, we determined whether it was a day or night roost and recorded characteristics of the building and roost. In total we found 451 roost sites; most were night roosts. Buildings with tin siding were less likely to be used as night roosts, whereas buildings with masonry were more likely to be used as night roosts. Buildings with a bat house were more likely to be used as day roosts. We also found some evidence that bats preferred to day roost in buildings with tin roofs or logs. These baseline data on locations and numbers of bat roosts will allow biologists to better assess potential impacts of WNS should it arrive in Montana. These data also will provide GNP staff with the necessary information to develop mitigation measures to protect bats

Timing, Duration, and Pathways of Harlequin Duck Migration to Pacific Molting and Wintering Areas

The core breeding range for Harlequin Ducks (Histrionicus histrionicus) in western North America extends from Alaska, and south through the Yukon, Northwest Territories, and British Columbia. Smaller breeding populations exist in southwestern Alberta, Washington, Oregon, Idaho, Wyoming, and Montana. Each state and province in these areas has identified the Harlequin Duck as a species of conservation priority, given its small and isolated populations, its specific nesting requirements, and changes in abundance or distribution. Conservation objectives for all areas have identified the importance of mapping migration routes that connect breeding sites to Pacific coast molting and wintering locations, as well as determining migration timing, duration, habitat use, and stopover sites. In spring 2016, we captured Harlequin Duck pairs on breeding streams and surgically implanted satellite transmitters in the males and attached geolocators to the leg bands of females. We marked 18 harlequin pairs (Alberta = 10 (minus one female), Montana = 5, Wyoming = 2, Washington = 1). Migration initiation dates varied by breeding areas and occurred from June 3 to July 10. Male migration lasted between 1-17 days and stopovers occurred approximately half-way to the coast and included rivers, mountain streams, and lakes. They arrived at their molting areas between June 5-July 24 and these areas ranged from southeast Alaska to northwestern Washington. The majority (71%) of harlequins departed molt locations to differing winter locations. Efforts will be made to retrieve the geolocators from females in spring 2017 to compare locations between males and females from different devices

Editor's Choice - Bypass versus Angioplasty for Severe Ischaemia of the Leg (BASIL) Prospective Cohort Study and the Generalisability of the BASIL-2 Randomised Controlled Trial

OBJECTIVE: The Bypass versus Angioplasty in Severe Ischaemia of the Leg-2 (BASIL-2) randomised controlled trial has shown that, for patients with chronic limb threatening ischaemia (CLTI) who require an infrapopliteal (IP) revascularisation a vein bypass (VB) first revascularisation strategy led to a 35% increased risk of major amputation or death when compared with a best endovascular treatment (BET) first revascularisation strategy. The study aims are to place the BASIL-2 trial within the context of the CLTI patient population as a whole and to investigate the generalisability of the BASIL-2 outcome data.METHODS: This was an observational, single centre prospective cohort study. Between 24 June 2014 and 31 July 2018, the BASIL Prospective Cohort Study (PCS) was performed which used BASIL-2 trial case record forms to document the characteristics, initial and subsequent management, and outcomes of 471 consecutive CLTI patients admitted to an academic vascular centre. Ethical approval was obtained, and all patients provided fully informed written consent. Follow up data were censored on 14 December 2022.RESULTS: Of the 238 patients who required an infrainguinal revascularisation, 75 (32%) had either IP bypass (39 patients) or IP BET (36 patients) outside BASIL-2. Seventeen patients were initially randomised to BASIL-2. A further three patients who did not have an IP revascularisation as their initial management were later randomised in BASIL-2. Therefore, 95/471 (20%) of patients had IP revascularisation (16% outside, 4% inside BASIL-2). Differences in amputation free survival, overall survival, and limb salvage between IP bypass and IP BET performed outside BASIL-2 were not subject to hypothesis testing due to the small sample size. Reasons for non-randomisation into the trial were numerous, but often due to anatomical and technical considerations.CONCLUSION: CLTI patients who required an IP revascularisation procedure and were subsequently randomised into BASIL-2 accounted for a small subset of the CLTI population as a whole. For a wide range of patient, limb, anatomical and operational reasons, most patients in this cohort were deemed unsuitable for randomisation in BASIL-2. The results of BASIL-2 should be interpreted in this context.</p

Drug Adverse Event Detection in Health Plan Data Using the Gamma Poisson Shrinker and Comparison to the Tree-based Scan Statistic

Background: Drug adverse event (AE) signal detection using the Gamma Poisson Shrinker (GPS) is commonly applied in spontaneous reporting. AE signal detection using large observational health plan databases can expand medication safety surveillance. Methods: Using data from nine health plans, we conducted a pilot study to evaluate the implementation and findings of the GPS approach for two antifungal drugs, terbinafine and itraconazole, and two diabetes drugs, pioglitazone and rosiglitazone. We evaluated 1676 diagnosis codes grouped into 183 different clinical concepts and four levels of granularity. Several signaling thresholds were assessed. GPS results were compared to findings from a companion study using the identical analytic dataset but an alternative statistical method—the tree-based scan statistic (TreeScan). Results: We identified 71 statistical signals across two signaling thresholds and two methods, including closely-related signals of overlapping diagnosis definitions. Initial review found that most signals represented known adverse drug reactions or confounding. About 31% of signals met the highest signaling threshold. Conclusions: The GPS method was successfully applied to observational health plan data in a distributed data environment as a drug safety data mining method. There was substantial concordance between the GPS and TreeScan approaches. Key method implementation decisions relate to defining exposures and outcomes and informed choice of signaling thresholds

ΔFlucs: brighter photinus pyralis firefly luciferases identified by surveying consecutive single amino acid deletion mutations in a thermostable variant

The bright bioluminescence catalyzed by Photinus pyralis firefly luciferase (Fluc) enables a vast array of life science research such as bio imaging in live animals and sensitive in vitro diagnostics. The effectiveness of such applications is improved using engineered enzymes that to date have been constructed using amino acid substitutions. We describe ΔFlucs: consecutive single amino acid deletion mutants within six loop structures of the bright and thermostable ×11 Fluc. Deletion mutations are a promising avenue to explore new sequence and functional space and isolate novel mutant phenotypes. However, this method is often overlooked and to date there have been no surveys of the effects of consecutive single amino acid deletions in Fluc. We constructed a large semi-rational ΔFluc library and isolated significantly brighter enzymes after finding ×11 Fluc activity was largely tolerant to deletions. Targeting an “omega-loop” motif (T352-G360) significantly enhanced activity, altered kinetics, reduced Km for D-luciferin, altered emission colors, and altered substrate specificity for redshifted analog DL-infraluciferin. Experimental and in silico analyses suggested remodeling of the Ω-loop impacts on active site hydrophobicity to increase light yields. This work demonstrates the further potential of deletion mutations, which can generate useful Fluc mutants and broaden the palette of the biomedical and biotechnological bioluminescence enzyme toolbox

Achieving integrated treatment: a realist synthesis of service models and systems for co-existing serious mental health and substance use conditions.

Approximately 30-50% of people with serious mental illness have co-existing drug or alcohol problems (COSMHAD), associated with adverse health and social care outcomes. UK guidelines advocate both co-occurring needs being met within mental health services, but uncertainty remains about how to operationalise this to improve outcomes. Various unevaluated service configurations exist in the UK. A realist synthesis was done to identify, test, and refine programme theories of how context shapes the mechanisms through which UK service models for COSMHAD work, for whom, and in what circumstances. Structured and iterative realist searches of seven databases identified 5099 records. A two-stage screening process identified 132 papers. Three broad contextual factors shaped COSMHAD services across 11 programme theories: committed leadership, clear expectations regarding COSMHAD from mental health and substance use workforces, and clear care-coordination processes. These contextual factors led to increased staff empathy, confidence, legitimisation, and multidisciplinary ethos, which improved care coordination and increased the motivation of people with COSMHAD to work towards their goals. Our synthesis highlights that integrating COSMHAD care is complex, and both individual and cultural behavioural shifts in leadership, workforce, and service delivery are essential to ensure people with COSMHAD receive compassionate, trauma-informed care that meets their needs

Achieving integrated treatment: a realist synthesis of service models and systems for co-existing serious mental health and substance use conditions

Approximately 30–50% of people with serious mental illness have co-existing drug or alcohol problems (COSMHAD), associated with adverse health and social care outcomes. UK guidelines advocate both co-occurring needs being met within mental health services, but uncertainty remains about how to operationalise this to improve outcomes. Various unevaluated service configurations exist in the UK. A realist synthesis was done to identify, test, and refine programme theories of how context shapes the mechanisms through which UK service models for COSMHAD work, for whom, and in what circumstances. Structured and iterative realist searches of seven databases identified 5099 records. A two-stage screening process identified 132 papers. Three broad contextual factors shaped COSMHAD services across 11 programme theories: committed leadership, clear expectations regarding COSMHAD from mental health and substance use workforces, and clear care-coordination processes. These contextual factors led to increased staff empathy, confidence, legitimisation, and multidisciplinary ethos, which improved care coordination and increased the motivation of people with COSMHAD to work towards their goals. Our synthesis highlights that integrating COSMHAD care is complex, and both individual and cultural behavioural shifts in leadership, workforce, and service delivery are essential to ensure people with COSMHAD receive compassionate, trauma-informed care that meets their needs

Guidelines for Field Surveys of the Quality of Medicines: A Proposal

Paul Newton and colleagues propose guidelines for conducting and reporting field surveys of the quality of medicines

Human malarial disease: a consequence of inflammatory cytokine release

Malaria causes an acute systemic human disease that bears many similarities, both clinically and mechanistically, to those caused by bacteria, rickettsia, and viruses. Over the past few decades, a literature has emerged that argues for most of the pathology seen in all of these infectious diseases being explained by activation of the inflammatory system, with the balance between the pro and anti-inflammatory cytokines being tipped towards the onset of systemic inflammation. Although not often expressed in energy terms, there is, when reduced to biochemical essentials, wide agreement that infection with falciparum malaria is often fatal because mitochondria are unable to generate enough ATP to maintain normal cellular function. Most, however, would contend that this largely occurs because sequestered parasitized red cells prevent sufficient oxygen getting to where it is needed. This review considers the evidence that an equally or more important way ATP deficency arises in malaria, as well as these other infectious diseases, is an inability of mitochondria, through the effects of inflammatory cytokines on their function, to utilise available oxygen. This activity of these cytokines, plus their capacity to control the pathways through which oxygen supply to mitochondria are restricted (particularly through directing sequestration and driving anaemia), combine to make falciparum malaria primarily an inflammatory cytokine-driven disease