An assessment of long-term bluff recession rates in the Puget Sound and Salish Sea: implications for the prioritization and design of restoration projects

This oral presentation focuses on extensive recent work documenting long-term coastal bluff recession rates along the shores of the Puget Sound region of the Salish Sea. Coastal bluffs are the most prevalent coastal landform type in this region, accounting for over 1,000 miles (42.6% by length) of the region’s shore (CGS 2017). Coastal bluff recession supplies the overwhelming majority of sediment to Puget Sound beaches, which comprise valued nearshore habitats for salmon, shellfish, and other fish and wildlife (Finlayson 2006; Johannessen and MacLennan 2007; Keuler 1988). Little research has documented the range of bluff recession rates in the region (less than 25 published sites; Shipman 2004, 1995) or how those rates are influenced by changes in bluff form, geology, stratigraphy, or wave exposure. Understanding the range and dominant drivers of long-term (23–101 years for this project) coastal bluff recession rates is critical in informing coastal management and the prioritization and design of restoration and conservation projects. These data may be also used to identify future risk. CGS compiled existing historical change rates into a database, which was then augmented with additional field (direct measurement) and remote (using aerial photography) measurements, totaling 185 sites across the region. Variables describing various bluff characteristics were compiled for all measurement locations and further explored. Variables included: bluff height, surface geology, toe geology, maximum fetch, shore orientation, geomorphic shoretype, beach substrate, tidal range, latitude, permeable over impermeable stratigraphy, location within the drift cell (percent down‐drift of the littoral drift cell origin), and vertical land movement. This presentation will showcase the database of coastal bluff recession rates throughout the U.S. Salish Sea, including the project methods, analysis, and results. Future work includes refining existing datasets and adding new bluff sites for a more spatially distributed and representative picture of long-term shoreline change in the region

Feeder Bluffs on Puget Sound: Tools for Improved Management

Much of Puget Sound’s shoreline consists of mixed sand and gravel beaches, dominated by longshore sediment transport and organized into hundreds of discrete littoral cells. Sediment supply within these cells is often provided by erosion of the steep coastal bluffs, which are composed of abundant, coarse-grained Pleistocene sediment. Bluffs that provide beach sediment are referred to as feeder bluffs and are important to the long-term maintenance of Puget Sound beaches. At the same time, development of Puget Sound’s shoreline has led to widespread construction of seawalls and revetments to control bluff erosion, with the unintended consequence of reducing natural sources of beach sediment. Coastal managers are concerned that this will adversely impact beach conditions. Impair nearshore ecological functions, and reduce resilience to rising sea level. Until recently, regional mapping of feeder bluffs existed. In 2012-2013, we combined existing information with new data and completed a sound-wide coverage of eroding bluffs, along with related beach and coastal landforms. Mapping was conducted using detailed field observations, supplemented with geologic information and aerial photographs. Bluffs were categorized based on their potential ability to deliver beach sediment. We found that of Puget Sound’s 4000 km of shoreline, about 2200 km are beaches. Of these about 600 km are feeder bluffs and about 50 km were mapped as exceptional. About 35% of the region’s beaches were mapped as modified or armored. The maps of feeder bluffs will be provided on Ecology’s online Coastal Atlas, allowing access and integration with other nearshore data. In addition, web-based material provides background information on geology and beaches and guidance on how to interpret and apply his information. This will assist planners and resource managers in improving shoreline management, assessing Puget Sound nearshore health, and identifying coastal restoration priorities

Soft shore protection: lessons learned from 20 years of project design and implementation

Hard armor structures, including bulkheads, seawalls, soldier piles, and other structures are present at 29% of Washington shores of the Salish Sea, as documented in mapping conducted by CGS for the ESRP Beach Strategies project . Hard armor adversely affects nearshore ecosystems by disrupting natural processes of sediment input and transport, reducing resiliency of down-drift coastal areas to impacts of sea level rise, and impairing essential forage fish spawning and other habitats. Soft shore protection, also referred to as sustainable shorelines or nature based solutions, allows for slowing erosion while maintaining natural processes. Soft sure protection design and implementation have received increasing attention and acceptance in the Salish Sea in recent decades. This has stemmed from increasing documentation of negative impacts of hard armor, dramatically stricter regulations, the increasing rigor applied to the design process, and expanded information and outreach. Lessons learned on design and implementation will be presented based on continuously advancing soft shore protection approaches over the past 20 years and the design and implementation of more than 120 of these projects throughout Puget Sound and in the central Salish Sea. Project approaches successfully applied to both residential and larger reaches of shore will be highlighted, organized around different short types (barrier beaches, bluffs, artificial shores), relative wave energy, and by property extent. Principles featured in the 2014 Marine Shoreline Design Guidelines will be distilled, along with data and examples not included in the MSDG. Soft shore protection has been shown to work in all wave energy environments of the Puget Sound region, depending on other factors such as shore orientation, project length, backshore with, and other site characteristics. Case studies will be provided to illustrate points, and site selection implementation pointers will be included as lessons learned. Additional references will be provided for further information

The beach strategies geodatabase

This oral presentation will highlight methods, results, and utility of the Beach Strategies geospatial database, recently completed by Coastal Geologic Services as part of the ESRP Learning Program. Making nearshore geospatial data accessible and reliable for use by professionals presents unique challenges. Many coastal datasets in the Puget Sound region of the Salish Sea were mapped by many different scientists over many years, some using inconsistent or outdated methods. Improved remote and field-based mapping methods used in the project have greatly expanded the resolution and reliability of data from previous records. This geodatabase has immense value and implications for nearshore prioritization and restoration. Geospatial products of the Beach Strategies project consist of three major data elements: a shoreline feature class, comprehensive shoreline parcels polygons, and linear referencing routes that convey locations and context for littoral drift mapping (referred heretofore as net shore-drift cells). The shoreline feature class includes best-available mapping of shore armor, geomorphic shoretype (current and historical), fetch, divergence zones, and net shore-drift cells in Puget Sound. The parcel polygons include a compilation of Sound-wide residential and non-residential real estate parcels, which each contain a summary of adjacent, intersecting shoreline data. The linear referencing component treats net shore-drift cells as routes, which allows for examination of up-drift and down-drift relationships between areas of interest, such as identifying the feeder bluffs that supply a down-drift beach with sediment. Together these data can enable improve planning and prioritization of restoration and preservation of coastal processes from a Sound-wide scale to individual real estate parcels. All data included in the Beach Strategies geodatabase conforms to the WDNR ShoreZone Shoreline (2001), making it compatible with many existing coastal datasets. This presentation will focus on geodatabase components, structure, and applications for use by nearshore professionals around the region

Multi-national survey on the methods, efficacy, and safety on the post-approval clinical use of pulsed field ablation (MANIFEST-PF).

AIMS Pulsed field ablation (PFA) is a novel atrial fibrillation (AF) ablation modality that has demonstrated preferential tissue ablation, including no oesophageal damage, in first-in-human clinical trials. In the MANIFEST-PF survey, we investigated the 'real world' performance of the only approved PFA catheter, including acute effectiveness and safety-in particular, rare oesophageal effects and other unforeseen PFA-related complications. METHODS AND RESULTS This retrospective survey included all 24 clinical centres using the pentaspline PFA catheter after regulatory approval. Institution-level data were obtained on patient characteristics, procedure parameters, acute efficacy, and adverse events. With an average of 73 patients treated per centre (range 7-291), full cohort included 1758 patients: mean age 61.6 years (range 19-92), female 34%, first-time ablation 94%, paroxysmal/persistent AF 58/35%. Most procedures employed deep sedation without intubation (82.1%), and 15.1% were discharged same day. Pulmonary vein isolation (PVI) was successful in 99.9% (range 98.9-100%). Procedure time was 65 min (38-215). There were no oesophageal complications or phrenic nerve injuries persisting past hospital discharge. Major complications (1.6%) were pericardial tamponade (0.97%) and stroke (0.4%); one stroke resulted in death (0.06%). Minor complications (3.9%) were primarily vascular (3.3%), but also included transient phrenic nerve paresis (0.46%), and TIA (0.11%). Rare complications included coronary artery spasm, haemoptysis, and dry cough persistent for 6 weeks (0.06% each). CONCLUSION In a large cohort of unselected patients, PFA was efficacious for PVI, and expressed a safety profile consistent with preferential tissue ablation. However, the frequency of 'generic' catheter complications (tamponade, stroke) underscores the need for improvement

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe