Habituation responses in wild reindeer exposed to recreational activities

Displacement is the effect most often predicted when recreational activities in wild reindeer (Rangifer tarandus tarandus) areas are discussed. Wild reindeer in Blefjell (225 km2) are exposed to humans more frequently than in Hardangervidda (8200 km2), from which the Blefjell herd originate. We recorded fright and flight response distances of groups of reindeer in both herds to a person directly approaching them on foot or skis during winter, summer, and autumn post-hunting and rutting season in 2004-2006. The response distances sight, alert, flight initiation and escape were shorter in Blefjell than in Hardangervidda while the probability of assessing the observer before flight tended to be greater in Blefjell. To test whether these results could be due to habituation or genetic influence of semi-domestic reindeer previously released in the Blefjell region, we compared the genetic variation of the Blefjell reindeer with previously reported variation in semi-domestic reindeer and in the wild reindeer from Hardangervidda. Microsatellite analyses revealed closer genetic ancestry of the Blefjell reindeer to the wild Hardangervidda reindeer and not to the semi-domestic reindeer at both the herd and the individual level. We conclude that the decreased flight responses in Blefjell reindeer appear to be a habituation response to frequent human encounters rather than traits inherited from a semi-domestic origin

Implementing precision cancer medicine in the public health services of Norway: the diagnostic infrastructure and a cost estimate

Objective Through the conduct of an individual-based intervention study, the main purpose of this project was to build and evaluate the required infrastructure that may enable routine practice of precision cancer medicine in the public health services of Norway, including modelling of costs. Methods An eligible patient had end-stage metastatic disease from a solid tumour. Metastatic tissue was analysed by DNA sequencing, using a 50-gene panel and a study-generated pipeline for analysis of sequence data, supplemented with fluorescence in situ hybridisation to cover relevant biomarkers. Cost estimations compared best supportive care, biomarker-agnostic treatment with a molecularly targeted agent and biomarker-based treatment with such a drug. These included costs for medication, outpatient clinic visits, admission from adverse events and the biomarker-based procedures. Results The diagnostic procedures, which comprised sampling of metastatic tissue, mutation analysis and data interpretation at the Molecular Tumor Board before integration with clinical data at the Clinical Tumor Board, were completed in median 18 (8-39) days for the 22 study patients. The 23 invasive procedures (12 from liver, 6 from lung, 5 from other sites) caused a single adverse event (pneumothorax). Per patient, 0–5 mutations were detected in metastatic tumours; however, no actionable target case was identified for the current single-agent therapy approach. Based on the cost modelling, the biomarker-based approach was 2.5-fold more costly than best supportive care and 2.5-fold less costly than the biomarker-agnostic option. Conclusions The first project phase established a comprehensive diagnostic infrastructure for precision cancer medicine, which enabled expedite and safe mutation profiling of metastatic tumours and data interpretation at multidisciplinary tumour boards for patients with end-stage cancer. Furthermore, it prepared for protocol amendments, recently approved by the designated authorities for the second study phase, allowing more comprehensive mutation analysis and opportunities to define therapy targets