Trends in utilisation of ultrasound by older Australians (2010-2019)

Background: Older people have increasingly complex healthcare needs, often requiring appropriate access to diagnostic imaging, an essential component of their health and disease management planning. Ultrasound is a safe imaging tool used to diagnose several conditions commonly experienced by older people such as deep vein thrombosis. Purpose To evaluate the utilisation of major ultrasound services by Australians≥65 years old between 2009- and 2019. Methods: This population-based and yearly cross-sectional study of ultrasound utilisation per 1,000 Australians≥65 years old was conducted using publicly available data sources. Overall, examination site and age- and sexspecifc incidence rate (IR) of ultrasound per 1,000 people, adjusted incidence rate ratios (IRRs) and 95% confdence intervals (CIs) were calculated using negative binomial regression models. Results: Over the study period, the crude utilisation of ultrasound increased by 83% in older Australians. Most ultrasound examinations were conducted on extremities (39%) and the chest (21%), with 25% of all ultrasounds investigating the vascular system. More men than women use ultrasounds of the chest (184/1,000 vs 268/1,000 people), particularly echocardiograms (177/1,000 vs 261/1,000 people), and abdomen (88/1,000 vs 92/1,000 people), especially in those≥85 years old. Hip and pelvic ultrasound were used more by women than men (212/1,000 vs 182/1,000 people). There were increases in vascular abdominal (IRR:1.07, 95%CI:1.06–1.08) and extremeties (IRR:1.06, 95%CI:1.05– 1.07) ultrasounds over the study period, particularly in≥75 years old men. Conclusions: Ultrasound is a common and increasingly used diagnostic tool for conditions commonly experienced by older Australians.Virginie Gaget, Maria C. Inacio, David R. Tivey, Robert N. Jorissen, Wendy J. Babidge, Renuka Visvanathan, and Guy J. Madder

Stakeholders' perspectives of mobile x-ray services in support of healthcare-in-place in residential aged care facilities: a qualitative study

Background: There is interest in reducing avoidable emergency department presentations from residential aged care facilities (RACF). Mobile x-ray services may enable the delivery of healthcare in residential aged care facilities. Accordingly, the Australian Government in November 2019 introduced a Medicare Benefit Schedule rebate providing for a ‘call-out’ fee payable to radiology service providers. This study aims to understand stakeholder perspectives on the benefits of mobile x-ray services and the factors influencing their adoption by RACFs. Design, setting, participants: Twenty-two semi-structured interviews were conducted between October 2020 and February 2021 with a range of stakeholders involved in healthcare delivery to residents: a) general practitioners; b) emergency department clinicians; c) paramedic clinicians; d) a hospital avoidance clinician; e) radiology clinicians and managers; and f ) aged care clinicians and managers. Thematic analysis was conducted. Results: Mobile x-ray services were considered valuable for RACF residents. Lack of timely general practitioner in person assessment and referral, as well as staffing deficits in residential aged care facilities, reduces optimal use of mobile x-ray services and results in potentially unnecessary hospital transfers. Conclusions: The use of mobile x-ray services, as a hospital avoidance strategy, depends on the capacity of RACFs to provide more complex healthcare-in-place. However, this requires greater access to general practitioners for in-person assessment and referral, adequate staffing numbers and appropriately skilled nursing staff within residential aged care facilities.Joanne Dollard, Jane Edwards, Lalit Yadav, Virginie Gaget, David Tivey, Maria Inacio, Guy Maddern, and Renuka Visvanatha

Assessing the effectiveness of the Ramsar Convention in preserving wintering waterbirds in the Mediterranean

lthough biological conservation is based on international agreements, its effectiveness depends on how countries implement such recommendations as effective conservation tools. The Ramsar Convention is the oldest international treaty for wetland and waterbird conservation, establishing the world's largest network of protected areas. However, since it does not constitute any binding measure, its effectiveness in protecting wintering waterbird populations at an international scale has been questioned. Here, we use long-term (1991–2012) count data to assess the effectiveness of the Ramsar Convention in the Mediterranean Basin. We compared abundance and temporal trends of 114 waterbird species between 251 Ramsar wetlands and 3486 non-Ramsar wetlands. We found that the Ramsar network is critical for wintering waterbirds, concentrating nearly half of all waterbirds counted in the Mediterranean Basin in only 7% of monitored wetlands. Waterbird trends followed a northwestsoutheast gradient, with a population decrease in the East. A significant and positive Ramsar effect on population trends was only found for the species of higher conservation concern in the Maghreb, particularly when a management plan was implemented. The Ramsar Convention was previously used on very important wetlands for waterbirds in Southern Europe, but is now an underused conservation tool. Our study suggests weaknesses in the use of Ramsar as an effective conservation tool in most of the Mediterranean Basin. However, the Ramsar Convention effectiveness to enhance waterbird populations in the Maghreb should encourage strengthening the Ramsar Convention. It should be done particularly in countries with limited environmental agreements and by systematic implementation of management plans. Conservation measures International conventions Protected areas Protection status Monitoring WetlandsacceptedVersio

The future distribution of wetland birds breeding in Europe validated against observed changes in distribution

Wetland bird species have been declining in population size worldwide as climate warming and land-use change affect their suitable habitats. We used species distribution models (SDMs) to predict changes in range dynamics for 64 non-passerine wetland birds breeding in Europe, including range size, position of centroid, and margins. We fitted the SDMs with data collected for the first European Breeding Bird Atlas and climate and land-use data to predict distributional changes over a century (the 1970s-2070s). The predicted annual changes were then compared to observed annual changes in range size and range centroid over a time period of 30 years using data from the second European Breeding Bird Atlas. Our models successfully predicted ca. 75% of the 64 bird species to contract their breeding range in the future, while the remaining species (mostly southerly breeding species) were predicted to expand their breeding ranges northward. The northern margins of southerly species and southern margins of northerly species, both, predicted to shift northward. Predicted changes in range size and shifts in range centroids were broadly positively associated with the observed changes, although some species deviated markedly from the predictions. The predicted average shift in core distributions was ca. 5 km yr(-1) towards the north (5% northeast, 45% north, and 40% northwest), compared to a slower observed average shift of ca. 3.9 km yr(-1). Predicted changes in range centroids were generally larger than observed changes, which suggests that bird distribution changes may lag behind environmental changes leading to 'climate debt'. We suggest that predictions of SDMs should be viewed as qualitative rather than quantitative outcomes, indicating that care should be taken concerning single species. Still, our results highlight the urgent need for management actions such as wetland creation and restoration to improve wetland birds' resilience to the expected environmental changes in the future

A Comparison of rpoB and 16S rRNA as Markers in Pyrosequencing Studies of Bacterial Diversity

Background: The 16S rRNA gene is the gold standard in molecular surveys of bacterial and archaeal diversity, but it has the disadvantages that it is often multiple-copy, has little resolution below the species level and cannot be readily interpreted in an evolutionary framework. We compared the 16S rRNA marker with the single-copy, protein-coding rpoB marker by amplifying and sequencing both from a single soil sample. Because the higher genetic resolution of the rpoB gene prohibits its use as a universal marker, we employed consensus-degenerate primers targeting the Proteobacteria. <p/>Methodology/Principal Findings: Pyrosequencing can be problematic because of the poor resolution of homopolymer runs. As these erroneous runs disrupt the reading frame of protein-coding sequences, removal of sequences containing nonsense mutations was found to be a valuable filter in addition to flowgram-based denoising. Although both markers gave similar estimates of total diversity, the rpoB marker revealed more species, requiring an order of magnitude fewer reads to obtain 90% of the true diversity. The application of population genetic methods was demonstrated on a particularly abundant sequence cluster. <p/>Conclusions/Significance: The rpoB marker can be a complement to the 16S rRNA marker for high throughput microbial diversity studies focusing on specific taxonomic groups. Additional error filtering is possible and tests for recombination or selection can be employed

The future distribution of wetland birds breeding in Europe validated against observed changes in distribution

Publisher Copyright: © 2022 The Author(s). Published by IOP Publishing Ltd.Wetland bird species have been declining in population size worldwide as climate warming and land-use change affect their suitable habitats. We used species distribution models (SDMs) to predict changes in range dynamics for 64 non-passerine wetland birds breeding in Europe, including range size, position of centroid, and margins. We fitted the SDMs with data collected for the first European Breeding Bird Atlas and climate and land-use data to predict distributional changes over a century (the 1970s-2070s). The predicted annual changes were then compared to observed annual changes in range size and range centroid over a time period of 30 years using data from the second European Breeding Bird Atlas. Our models successfully predicted ca. 75% of the 64 bird species to contract their breeding range in the future, while the remaining species (mostly southerly breeding species) were predicted to expand their breeding ranges northward. The northern margins of southerly species and southern margins of northerly species, both, predicted to shift northward. Predicted changes in range size and shifts in range centroids were broadly positively associated with the observed changes, although some species deviated markedly from the predictions. The predicted average shift in core distributions was ca. 5 km yr-1 towards the north (5% northeast, 45% north, and 40% northwest), compared to a slower observed average shift of ca. 3.9 km yr-1. Predicted changes in range centroids were generally larger than observed changes, which suggests that bird distribution changes may lag behind environmental changes leading to 'climate debt'. We suggest that predictions of SDMs should be viewed as qualitative rather than quantitative outcomes, indicating that care should be taken concerning single species. Still, our results highlight the urgent need for management actions such as wetland creation and restoration to improve wetland birds' resilience to the expected environmental changes in the future.Peer reviewe

OPA1 links human mitochondrial genome maintenance to mtDNA replication and distribution

Eukaryotic cells harbor a small multiploid mitochondrial genome, organized in nucleoids spread within the mitochondrial network. Maintenance and distribution of mitochondrial DNA (mtDNA) are essential for energy metabolism, mitochondrial lineage in primordial germ cells, and to prevent mtDNA instability, which leads to many debilitating human diseases. Mounting evidence suggests that the actors of the mitochondrial network dynamics, among which is the intramitochondrial dynamin OPA1, might be involved in these processes. Here, using siRNAs specific to OPA1 alternate spliced exons, we evidenced that silencing of the OPA1 variants including exon 4b leads to mtDNA depletion, secondary to inhibition of mtDNA replication, and to marked alteration of mtDNA distribution in nucleoid and nucleoid distribution throughout the mitochondrial network. We demonstrate that a small hydrophobic 10-kDa peptide generated by cleavage of the OPA1-exon4b isoform is responsible for this process and show that this peptide is embedded in the inner membrane and colocalizes and coimmunoprecipitates with nucleoid components. We propose a novel synthetic model in which a peptide, including two trans-membrane domains derived from the N terminus of the OPA1-exon4b isoform in vertebrates or from its ortholog in lower eukaryotes, might contribute to nucleoid attachment to the inner mitochondrial membrane and promotes mtDNA replication and distribution. Thus, this study places OPA1 as a direct actor in the maintenance of mitochondrial genome integrity

Post Genome-Wide Association Studies of Novel Genes Associated with Type 2 Diabetes Show Gene-Gene Interaction and High Predictive Value

Recently, several Genome Wide Association (GWA) studies in populations of European descent have identified and validated novel single nucleotide polymorphisms (SNPs), highly associated with type 2 diabetes (T2D). Our aims were to validate these markers in other European and non-European populations, then to assess their combined effect in a large French study comparing T2D and normal glucose tolerant (NGT) individuals. rs7903146 SNP, were combined (8.68-fold for the 14% of French individuals carrying 18 to 30 risk alleles with an allelic OR of 1.24). With an area under the ROC curve of 0.86, only 15 novel loci were necessary to discriminate French individuals susceptible to develop T2D. strongly associate with T2D in French individuals, and mostly in populations of Central European descent but not in Moroccan subjects. Genes expressed in the pancreas interact together and their combined effect dramatically increases the risk for T2D, opening avenues for the development of genetic prediction tests

Climate Change in the Baltic Sea Region: A Summary

Based on the Baltic Earth Assessment Reports of this thematic issue in Earth System Dynamics and recent peer-reviewed literature, current knowledge about the effects of global warming on past and future changes in climate of the Baltic Sea region is summarized and assessed. The study is an update of the Second Assessment of Climate Change (BACC II) published in 2015 and focusses on the atmosphere, land, cryosphere, ocean, sediments and the terrestrial and marine biosphere. Based on the summaries of the recent knowledge gained in paleo-, historical and future regional climate research, we find that the main conclusions from earlier assessments remain still valid. However, new long-term, homogenous observational records, e.g. for Scandinavian glacier inventories, sea-level driven saltwater inflows, so-called Major Baltic Inflows, and phytoplankton species distribution and new scenario simulations with improved models, e.g. for glaciers, lake ice and marine food web, have become available. In many cases, uncertainties can now be better estimated than before, because more models can be included in the ensembles, especially for the Baltic Sea. With the help of coupled models, feedbacks between several components of the Earth System have been studied and multiple driver studies were performed, e.g. projections of the food web that include fisheries, eutrophication and climate change. New data sets and projections have led to a revised understanding of changes in some variables such as salinity. Furthermore, it has become evident that natural variability, in particular for the ocean on multidecadal time scales, is greater than previously estimated, challenging our ability to detect observed and projected changes in climate. In this context, the first paleoclimate simulations regionalized for the Baltic Sea region are instructive. Hence, estimated uncertainties for the projections of many variables increased. In addition to the well-known influence of the North Atlantic Oscillation, it was found that also other low-frequency modes of internal variability, such as the Atlantic Multidecadal Variability, have profound effects on the climate of the Baltic Sea region. Challenges were also identified, such as the systematic discrepancy between future cloudiness trends in global and regional models and the difficulty of confidently attributing large observed changes in marine ecosystems to climate change. Finally, we compare our results with other coastal sea assessments, such as the North Sea Region Climate Change Assessment (NOSCCA) and find that the effects of climate change on the Baltic Sea differ from those on the North Sea, since Baltic Sea oceanography and ecosystems are very different from other coastal seas such as the North Sea. While the North Sea dynamics is dominated by tides, the Baltic Sea is characterized by brackish water, a perennial vertical stratification in the southern sub-basins and a seasonal sea ice cover in the northern sub-basins</p