Citizen science and online data: Opportunities and challenges for snake ecology and action against snakebite

The secretive behavior and life history of snakes makes studying their biology, distribution, and the epidemiology of venomous snakebite challenging. One of the most useful, most versatile, and easiest to collect types of biological data are photographs, particularly those that are connected with geographic location and date-time metadata. Photos verify occurrence records, provide data on phenotypes and ecology, and are often used to illustrate new species descriptions, field guides and identification keys, as well as in training humans and computer vision algorithms to identify snakes. We scoured eleven online and two offline sources of snake photos in an attempt to collect as many photos of as many snake species as possible, and attempt to explain some of the inter-species variation in photograph quantity among global regions and taxonomic groups, and with regard to medical importance, human population density, and range size. We collected a total of 725,565 photos—between 1 and 48,696 photos of 3098 of the world's 3879 snake species (79.9%), leaving 781 “most wanted” species with no photos (20.1% of all currently-described species as of the December 2020 release of The Reptile Database). We provide a list of most wanted species sortable by family, continent, authority, and medical importance, and encourage snake photographers worldwide to submit photos and associated metadata, particularly of “missing” species, to the most permanent and useful online archives: The Reptile Database, iNaturalist, and HerpMapper.ISSN:2590-171

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

The small pelagic fishery of the Pemba Channel, Tanzania: what we know and what we need to know for management under climate change

Small pelagic fish, including anchovies, sardines and sardinellas, mackerels, capelin, hilsa, sprats and herrings, are distributed widely, from the tropics to the far north Atlantic Ocean and to the southern oceans off Chile and South Africa. They are most abundant in the highly productive major eastern boundary upwelling systems and are characterised by significant natural variations in biomass. Overall, small pelagic fisheries represent about one third of global fish landings although a large proportion of the catch is processed into animal feeds. Nonetheless, in some developing countries in addition to their economic value, small pelagic fisheries also make an important contribution to human diets and the food security of many low-income households. Such is the case for many communities in the Zanzibar Archipelago and on mainland Tanzania in the Western Indian Ocean. Of great concern in this region, as elsewhere, is the potential impact of climate change on marine and coastal ecosystems in general, and on small pelagic fisheries in particular. This paper describes data and information available on Tanzania's small pelagic fisheries, including catch and effort, management protocols and socio-economic significance

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease

Lake Tanganyika : status, challenges, and opportunities for research collaborations

Abstract: Lake Tanganyika is one of the most important lakes in the world because it supports millions of people who rely on its resources and its exceptional biodiversity. However, the lake currently suffers from a range of anthropogenic stressors, including water pollution and sedimentation, resource, biodiversity decline, habitat loss (both physical and functional) and climate change. Past and current research has been limited and disparate, only allowing the scientific community to gather inadequate data required to make informed policy and management plans for this lake. Based on data and knowledge derived from scientific studies and field experiences by scientists and experts working in the Lake Tanganyika basin, this paper outlines past research, present gaps, and the opportunities for collaboration to generate scientific knowledge to inform positive policy and management strategies leading to the protection of Lake Tanganyika's ecological integrity. The results of this paper draw from independent short surveys, freshwater expert meetings, and formal and informal discussions carried out to identify and prioritize specific issues and threats that need to be addressed for the conservation of biodiversity and sustainable management of the Lake Tanganyika basin. After highlighting each issue or threat, the authors propose possible management interventions; the results of this work focus heavily on the need for enhanced specific research on many issues and a larger, multi-disciplinary, long-term monitoring program to collect comprehensive information on a host of variables that will ultimately assist relevant stakeholders and key agencies in addressing these issues and threats

Need for harmonized long-term multi-lake monitoring of African Great Lakes

To ensure the long-term sustainable use of African Great Lakes (AGL), and to better understand the functioning of these ecosystems, authorities, managers and scientists need regularly collected scientific data and information of key environmental indicators over multi-years to make informed decisions. Monitoring is regularly conducted at some sites across AGL; while at others sites, it is rare or conducted irregularly in response to sporadic funding or short-term projects/studies. Managers and scientists working on the AGL thus often lack critical long-term data to evaluate and gauge ongoing changes. Hence, we propose a multi-lake approach to harmonize data collection modalities for better understanding of regional and global environmental impacts on AGL. Climate variability has had strong impacts on all AGL in the recent past. Although these lakes have specific characteristics, their limnological cycles show many similarities. Because different anthropogenic pressures take place at the different AGL, harmonized multi-lake monitoring will provide comparable data to address the main drivers of concern (climate versus regional anthropogenic impact). To realize harmonized long-term multi-lake monitoring, the approach will need: (1) support of a wide community of researchers and managers; (2) political goodwill towards a common goal for such monitoring; and (3) sufficient capacity (e.g., institutional, financial, human and logistic resources) for its implementation. This paper presents an assessment of the state of monitoring the AGL and possible approaches to realize a long-term, multi-lake harmonized monitoring strategy. Key parameters are proposed. The support of national and regional authorities is necessary as each AGL crosses international boundaries

Need for harmonized long-term multi-lake monitoring of African Great Lakes

To ensure the long-term sustainable use of African Great Lakes (AGL), and to better understand the functioning of these ecosystems, authorities, managers and scientists need regularly collected scientific data and information of key environmental indicators over multi-years to make informed decisions. Monitoring is regularly conducted at some sites across AGL; while at others sites, it is rare or conducted irregularly in response to sporadic funding or short-term projects/studies. Managers and scientists working on the AGL thus often lack critical long-term data to evaluate and gauge ongoing changes. Hence, we propose a multi-lake approach to harmonize data collection modalities for better understanding of regional and global environmental impacts on AGL. Climate variability has had strong impacts on all AGL in the recent past. Although these lakes have specific characteristics, their limnological cycles show many similarities. Because different anthropogenic pressures take place at the different AGL, harmonized multi-lake monitoring will provide comparable data to address the main drivers of concern (climate versus regional anthropogenic impact). To realize harmonized long-term multi-lake monitoring, the approach will need: (1) support of a wide community of researchers and managers; (2) political goodwill towards a common goal for such monitoring; and (3) sufficient capacity (e.g., institutional, financial, human and logistic resources) for its implementation. This paper presents an assessment of the state of monitoring the AGL and possible approaches to realize a long-term, multi-lake harmonized monitoring strategy. Key parameters are proposed. The support of national and regional authorities is necessary as each AGL crosses international boundaries

Global Retinoblastoma Presentation and Analysis by National Income Level

This cross-sectional analysis reports the retinoblastoma stage at diagnosis across the world during a single year, investigates associations between clinical variables and national income level, and investigates risk factors for advanced disease at diagnosis. Key PointsQuestionIs the income level of a country of residence associated with the clinical stage of presentation of patients with retinoblastoma? FindingsIn this cross-sectional analysis that included 4351 patients with newly diagnosed retinoblastoma, approximately half of all new retinoblastoma cases worldwide in 2017, 49.1\% of patients from low-income countries had extraocular tumor at time of diagnosis compared with 1.5\% of patients from high-income countries. MeaningThe clinical stage of presentation of retinoblastoma, which has a major influence on survival, significantly differs among patients from low-income and high-income countries, which may warrant intervention on national and international levels. ImportanceEarly diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. ObjectivesTo report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and ParticipantsA total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and MeasuresAge at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. ResultsThe cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4\%) were female. Most patients (n=3685 {[}84.7\%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n=2638 {[}62.8\%]), followed by strabismus (n=429 {[}10.2\%]) and proptosis (n=309 {[}7.4\%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5\%) patients having intraocular retinoblastoma and 2 (0.3\%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1\%) having extraocular retinoblastoma and 94 of 498 (18.9\%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 {[}95\% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 {[}95\% CI, 4.30-7.68]). Conclusions and RelevanceThis study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs