Long-Term Monitoring Of A High-Latitude Coral Reef System Off Southeast Florida, Usa: A Partnership Between Academia And Resource Management

Significant coral reef community development exists along the eastern shelf of the United States from the Dry Tortugas through the Florida Keys (Monroe County) and Southeast (SE) Florida (Miami-Dade, Broward, Palm Beach, and Martin Counties). State and county resource managers have partnered with academia to monitor the health of the SE Florida reef system. Since 2000, more than 20 sites have been monitored annually offshore Broward County. Quantitative data includes stony coral species cover, colony size, density, and condition (bleaching, disease, etc.) and gorgonian and sponge density. The SE Florida Coral Reef Evaluation and Monitoring Project (SECREMP) was established in 2003 as an expansion of the Florida Keys Coral Reef Evaluation and Monitoring Project (CREMP). Thirteen SECREMP sites are monitored annually across the 4 SE Florida counties. The stony coral, gorgonian, sponge, and other functional group cover data collected within the SECREMP sites and the Keys CREMP sites provides status and trend information for the entire Florida reef tract. The SE Florida reef system typically has 2-4% stony coral cover with more than 30 stony coral species and a diverse assemblage of octocoral, sponges, and fishes. Since their inception, monitoring efforts have shown relatively stable levels in stony coral cover and density. However, there have been many impacts to the SE Florida ecosystem resulting from its proximity to the highly developed and urbanized SE Florida coast. These reefs are influenced by many factors including commercial and recreational fishing and diving, major shipping ports, sewer outfalls, ship groundings, and coastal construction activities. SE Florida’s coral reef ecosystems generate $1.1 billion in annual income and support 36,000 jobs in the region. The uniqueness and value of these resources to the community demands sustained cooperative monitoring efforts and increased investigations into limiting environmental/ecological processes

Rapid Response and Restoration for Coral Reef Injuries in Southeast Florida: Guidelines and Recommendations

From the time an injury to coral reef resources is reported, a well-coordinated and implemented plan is critical to the success of response and restoration efforts. There are three major plan components, each of which is equally important: (1) the Initial Response period immediately following notification of the incident; (2) the Response period, during which the Responsible Party (RP) is identified, the Trustees and RP carry out their respective responsibilities, a Primary Restoration plan is developed, authorizations and contractors to conduct restoration activities are sought and obtained, and primary restoration activities are conducted; and (3) the Post-Response period, which is largely a monitoring, compensatory restoration/mitigation, and penalty assessment phase that takes place after primary restoration activities are carried out. The guidelines and recommendations presented in this docuemnt were developed to examine reef injury response processes and to facilitate a rapid response to, and the successful restoration of, southeast Florida reefs. The document was developed as part of a Local Action Strategy (LAS) of the Southeast Florida Coral Reef Initiative (SEFCRI) to develop guidelines and recommendations for a rapid response and restoration process for reef injuries in the SEFCRI region. In February 2006, a two day workshop was held in Fort Lauderdale, Florida, to compile information on existing emergency response processes, identify deficiencies and develop solutions for those processes, and compile information on existing technologies and procedures for triage and the restoration of reef injuries. The first day of the workshop focused on process and policy issues. The second day addressed response, injury and mitigation assessment, restoration and repair, and monitoring. Workshop panelists and attendees included respresentatives from local, state, and federal agencies with proprietary or regulatory authority or jurisdiction over sovereign submerged lands and reef resources located within Florida\u27s waters. Also in attendance were technical and academic experts in the fields of coral reef research, injury assessment, and restoration, as well as marine contractors, private and public attorneys, nongovernmental organizations, and other interested parties. These guidelines and recommendations incorporate information from the combined experience of the workshop attendees, workshop outcomes, published documents, and numerous state and federal regulations, policies, and procedures

The State of Coral Reef Ecosystems of Southeast Florida

The northern extension of the Florida reef tract and a complex of limestone ridges run parallel to the subtropical Atlantic coastline of southeast Florida. Spanning 170 km from the northern border of Biscayne National Park (BNP) in Miami-Dade County to the St. Lucie Inlet in Martin County, the reefs and hardbottom areas in this region support a rich and diverse biological community (Figure 5.1). Nearshore reef habitats in southeast Florida include hardbottom areas, patch reefs and worm reefs (Phragmatopoma spp.) exhibiting abundant octocoral, macroalgae, stony coral and sponge assemblages. Offshore, coral reef associated biotic assemblages occur on linear Holocene Acropora palmata mid-shelf and shelf margin reefs that extend from Miami Dade County to Palm Beach County (Lighty, 1977; Figure 5.2). Anastasia Formation limestone ridges and terraces colonized by reef biota characterize the reefs from Palm Beach County to Martin County (Cooke and Mossom, 1929). The coastal region of southeast Florida is highly developed, containing one third of Florida’s population of 16 million people (U.S. Census Bureau, 2006). Many southeast Florida reefs are located just 1.5 km from this urbanized shoreline. Despite their unique position as the highest latitude reefs along the western Atlantic seaboard, the reefs of southeast Florida have only recently received limited scientific and resource management attention. Andrews et al. (2005) discussed the reefs of southeast Florida and the critical need to implement actions that fill resource knowledge gaps and address conservation and threats to reef health. This report further examines and updates the list of stressors imperiling the health of southeast Florida’s reefs, and presents information gained from new research, monitoring and management efforts to determine the extent and condition of reef resources in this distinctive region

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Leadership and Uncertainty Management in Politics: Leaders, Followers and Constraints in Western Democracies

International audienceThrough a range of international case studies from the USA, UK, France, Germany and Italy, this engaging new text examines political leadership and considers the rise in the Executive powers of Western democracies in the last few decades.Unlike earlier assessments of the subject, which have emphasized the importance of a unified force of followers rallying behind a public figure, this volume argues that leadership can also be understood as a risk-taking venture which takes advantage of uncertainty among voters.Assessing the conditions necessary for effective leadership, it emphasizes the part played by indecision and division amongst followers and shows that political leadership can be a cause in itself, which cannot be reduced to a mere consequence of a chain of previous events

Preventive Medication Patterns in Bipolar Disorder and Their Relationship With Comorbid Substance Use Disorders in a Cross-National Observational Study

International audienceObjective The potential role of sub-optimal pharmacological treatment in the poorer outcomes observed in bipolar disorder (BD) with vs. without comorbid substance use disorders (SUDs) is not known. Thus, we investigated whether patients with BD and comorbid SUD had different medication regimens than those with BD alone, in samples from France and Norway, focusing on compliance to international guidelines. Methods Seven hundred and seventy patients from France and Norway with reliably ascertained BD I or II (68% BD-I) were included. Medication information was obtained from patients and hospital records, and preventive treatment was categorized according to compliance to guidelines. We used Bayesian and regression analyses to investigate associations between SUD comorbidity and medication. In the Norwegian subsample, we also investigated association with lack of medication. Results Comorbid SUDs were as follows: current tobacco smoking, 26%, alcohol use disorder (AUD), 16%; cannabis use disorder (CUD), 10%; other SUDs, 5%. Compliance to guidelines for preventive medication was lacking in 8%, partial in 44%, and complete in 48% of the sample. Compliance to guidelines was not different in BD with and without SUD comorbidity, as was supported by Bayesian analyses (highest Bayes Factor = 0.16). Cross national differences in treatment regimens led us to conduct country-specific adjusted regression analyses, showing that (1) CUD was associated with increased antipsychotics use in France (OR = 2.4, 95% CI = 1.4–3.9, p = 0.001), (2) current tobacco smoking was associated with increased anti-epileptics use in Norway (OR = 4.4, 95% CI = 1.9–11, p < 0.001), and (3) AUD was associated with decreased likelihood of being medicated in Norway (OR = 1.2, 95% CI = 1.04–1.3, p = 0.038). Conclusion SUD comorbidity in BD was overall not associated with different pharmacological treatment in our sample, and not related to the level of compliance to guidelines. We found country-specific associations between comorbid SUDs and specific medications that warrant further studies