Avian diversity and abundance across years: consistent patterns in forests but not grasslands on Viti Levu, Fiji

Context. Habitat loss is a global problem and in Fiji >50% of the land area once covered by forests has been converted to grasslands and agricultural land. About 99% of Fiji’s endemic biodiversity and 80% of the land bird species have been identified as forest species. Aims. In this study, we compare forest and grassland sites and test for consistency in avian diversity, abundance, foraging guild, and distribution status (endemic, native, introduced to Fiji) over a 5-year period (2016–2020). Methods. We surveyed bird communities using the point count method with a 100 m radius and 7-min observation period per site. Key results. A one-way analysis of similarities (ANOSIM) analysis showed significant differences in species composition and bird abundance between the forested habitats and grassland habitats. A general linear model test showed significant differences in foraging guild composition and distribution status between forested and grassland habitats. There were no significant differences between the three forested sites (primary montane forest, secondary old-growth forest, old-growth mahogany plantations with regenerating native species), while grassland sites had stronger annual change in species composition. Implications. Forest cover, irrespective of whether these forests are of primary or secondary nature, therefore plays an important role in maintaining the native and endemic land bird species and other biodiversity in oceanic island ecosystems such as Viti Levu Island, Fiji

Interspecific competition and vertical niche partitioning in Fiji’s forest birds

Charles Darwin proposed his ‘principle of divergence’ to account for changes in traits that could promote speciation and coexistence of diverse forms through occupation of different niches to reduce interspecific competition. We explore interspecific foraging behaviour overlap in Fiji’s forest birds, and address two main questions: (1) Is there vertical stratification of foraging behavior? and (2) Is there evidence of interspecific competition driving the differences in foraging behaviour? We explore these questions across three foraging guilds, nectarivores (three species), insectivores (two species), and omnivores (two species), and find vertical portioning of foraging in each group. To investigate the effect of interspecific competition, we compared foraging heights of the Orange-breasted Myzomela (Myzomela jugularis) honeyeater on Viti Levu Island (where it coexists with two other honeyeater species) and Leleuvia Island (no other honeyeater species). On the main island Viti Levu, we found evidence for vertical niche partitioning within each foraging guild. On Leleuvia, with the ‘one-species only foraging guild’, Orange-breasted Myzomela occupied broader vertical foraging niche than on Viti Levu with two other competitor honeyeater species. This result supports the idea that vertical foraging height can be shaped by interspecific competition. The findings of this study support Darwin’s principle of divergence in Fiji’s forest birds for every foraging guild measured and adds to our understanding of the significance of interspecific competition and niche divergence for patterns of ecological speciation on islands

Optimizing robust PID control of propofol anesthesia for children; design and clinical evaluation

Objective: The goal of this study was to optimize robust PID control for propofol anesthesia in children aged 5-10 years to improve performance, particularly to decrease the time of induction of anesthesia while maintaining robustness.Methods: We analyzed results of a previous study conducted by our group to identify opportunities for system improvement. Allometric scaling was introduced to reduce the interpatient variability and a new robust PID controller was designed using an optimization based method. We evaluated this optimized design in a clinical study involving 16 new cases.Results: The optimized controller design achieved the performance predicted in simulation studies in the design stage. Time of induction of anesthesia was median [Q1, Q3] 3.7 [2.3, 4.1] minutes and the achieved global score was 13.4 [9.9, 16.8]. Conclusion: Allometric scaling reduces the interpatient variability in this age group, and allows for improved closed-loop performance. The uncertainty described by the model set, the predicted closedloop responses and the predicted robustness margins are realistic. The system meets the design objectives of improved speed of induction of anesthesia while maintaining robustness, improving clinically relevant system behavior.Significance: Control system optimization and ongoing system improvement are essential to the development of a clinically relevant commercial device. This paper demonstrates the validity of our approach, including system modeling, controller optimization and pre-clinical testing in simulation

Brain vital sign monitoring of sleep deprivation detects situational cognitive impairment

Objective, rapid evaluation of cognitive function is critical for identifying situational impairment due to sleep deprivation. The present study used brain vital sign monitoring to evaluate acute changes in cognitive function for healthy adults. Thirty (30) participants were scanned using portable electroencephalography before and after either a night of regular sleep or a night of total sleep deprivation. Brain vital signs were extracted from three established event-related potential components: (1) the N100 (Auditory sensation); (2) the P300 (Basic attention); and (3) the N400 (Cognitive processing) for all time points. As predicted, the P300 amplitude was significantly reduced in the sleep deprivation group. The findings indicate that it is possible to detect situational cognitive impairment due to sleep deprivation using objective, rapid brain vital sign monitoring

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Exploring self-determined solutions to service and system challenges to promote social and emotional wellbeing in Aboriginal and Torres Strait Islander people: a qualitative study

IntroductionMany Aboriginal and Torres Strait Islander people living on Kaurna Country in northern Adelaide experience adverse health and social circumstances. The Taingiwilta Pirku Kawantila study sought to understand challenges facing Aboriginal and Torres Strait Islander communities and identify solutions for the health and social service system to promote social and emotional wellbeing.MethodsThis qualitative study applied Indigenous methodologies undertaken with Aboriginal and Torres Strait Islander governance and leadership. A respected local Aboriginal person engaged with Aboriginal and Torres Strait Islander community members and service providers through semi-structured interviews and yarning circles that explored community needs and challenges, service gaps, access barriers, success stories, proposed strategies to address service and system challenges, and principles and values for service design. A content analysis identified the breadth of challenges in addition to describing key targets to empower and connect communities and optimize health and social services to strengthen individual and collective social and emotional wellbeing.ResultsEighty-three participants contributed to interviews and yarning circles including 17 Aboriginal community members, 38 Aboriginal and Torres Strait Islander service providers, and 28 non-Indigenous service providers. They expressed the need for codesigned, strengths-based, accessible and flexible services delivered by Aboriginal and Torres Strait Islander workers with lived experience employed in organisations with Aboriginal and Torres Strait Islander leadership and governance. Community hubs and cultural events in addition to one-stop-shop service centres and pre-crisis mental health, drug and alcohol and homelessness services were among many strategies identified.ConclusionHolistic approaches to the promotion of social and emotional wellbeing are critical. Aboriginal and Torres Strait Islander people are calling for places in the community to connect and practice culture. They seek culturally safe systems that enable equitable access to and navigation of health and social services. Aboriginal and Torres Strait Islander workforce leading engagement with clients is seen to safeguard against judgement and discrimination, rebuild community trust in the service system and promote streamlined access to crucial services

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

BACKGROUND: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. METHODS: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). FINDINGS: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29-146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0- 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25-1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39-1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65-1·60]; p=0·92). INTERPRETATION: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention. FUNDING: British Heart Foundation

Looking beyond the motor cortex : examining the potential of the primary sensory cortex as a target for repetitive transcranial magnetic stimulation after stroke

Stroke is the leading cause of chronic adult disability, and standard post-stroke therapies may not be sufficient for individuals to reach their full recovery potential. When paired with skilled motor practice, non-invasive brain stimulation techniques such as repetitive transcranial magnetic stimulation (rTMS) may enhance motor recovery by transiently modulating cortical excitability, effectively priming the brain to facilitate mechanisms of motor learning. Depending on the pulse frequency, rTMS may be used to increase cortical excitability in the damaged hemisphere, or decrease it in the undamaged hemisphere, with the goal of re-establishing a normal interhemispheric balance. While theoretically promising, the majority of studies considering the effects of rTMS over the primary motor cortex (M1) have shown relatively small effect sizes and high inter-individual variability. Improved effect sizes may be produced by 1) finding the optimal cortical target for stimulation, rather than defaulting to M1, and 2) choosing an appropriate sample that will optimally benefit from the intervention. In the following thesis, we will explore the potential of the primary sensory cortex (S1) as an alternative target for rTMS intervention, and the anatomical and physiological variables that may help to identify who may best benefit from this intervention. First, we describe a randomized, single blind experiment comparing the impact of active versus sham rTMS over S1 paired with practice of a skilled visuomotor reaching task in individuals with chronic stroke. Second, we describe a retrospective analysis of the participants from the first experiment, to determine whether individual differences in morphology of the underlying sensory cortex might be predictive of rTMS responsiveness. Third, we describe an exploratory study using a paired median nerve somatosensory evoked potential paradigm using electroencephalography in healthy individuals, to elucidate the neurophysiological mechanism of interhemispheric inhibition between S1s. We conclude that S1 should be considered as a viable target for future rTMS trials as an adjunct therapy to rehabilitation after stroke.Medicine, Faculty ofGraduat