A multi-targeted treatment approch to cancer cachexia: Auckland's Cancer Cachexia evaluating Resistance Training (ACCeRT) trial

Abstract Background Cancer cachexia is a condition often seen at diagnosis, throughout anti-cancer treatments and in end-stage nonsmall- cell lung cancer patients. Methods and results Participants with late-stage non-small-cell lung cancer and cachexia (defined as ≥5% weight loss within 12 months) were randomly assigned 1:2 to 2.09 g of eicosapentaenoic acid (EPA) and 300 mg of cyclo-oxygenase-2 inhibitor celecoxib orally once daily vs. same dosing of EPA, celecoxib, plus two sessions per week of progressive resistance training and 20 g of oral essential amino acids high in leucine in a split dose over 3 days, after each session. Primary endpoint was the acceptability of the earlier multi-targeted approach. Main secondary endpoints included change in body weight and fat-free mass, by bioelectric impedance analysis and total quadriceps muscle volume by magnetic resonance imaging over 20 weeks. Sixty-nine patients were screened resulting in 20 patients being enrolled. Acceptability scored high, with 4.5/5 (Arm A) and 5/5 (Arm B) for EPA and 5/5 for celecoxib within both arms and 4.8/5 for progressive resistance training sessions and 4.5/5 for essential amino acids within Arm B, all at Week 20. Results showed a net gain in bioelectric impedance analysis fat-free mass of +1.3 kg, n = 2 (Arm A), compared with +0.7 kg, n = 7 (Arm B) at Week 12, and —1.5 kg, n = 2 (Arm A), compared with —1.7 kg, n = 4 (Arm B) at Week 20. Trends in efficacy in terms of improvement and/or stability in cachexia markers were seen within magnetic resonance imaging muscle volume, albumin, and C-reactive protein levels within both arms. There were no exercise-related adverse events, with one possible related adverse event of asymptomatic atrial fibrillation in one participant within Arm A. Conclusions Non-small-cell lung cancer cachectic patients are willing to be enrolled onto a multi-targeted treatment regimen and may benefit from cachexia symptom management even during the late/refractory stage

Updated protocol and guest participant results from the ACCeRT clinical study

Introduction Cancer cachexia is a condition often seen at diagnosis, throughout chemotherapeutic treatments and in end stage Non-Small Cell Lung Cancer patients. These patients often experience a shorter life-expectancy and deterioration in performance status and reduced quality of life. New multi˗targeted regimens are required to be tested in this population to address these issues. Materials and methods The ACCeRT study is an open label, prospective, randomised controlled feasibility study investigating the use of eicosapentaenoic acid and COX-2 inhibitor (celecoxib) versus eicosapentaenoic acid, COX-2 inhibitor (celecoxib), progressive resistance training followed by ingestion of essential amino acids high in leucine in Non-Small Cell Lung Cancer cachectic patients. The study protocol was published in November 2011. Due to study participants and study team preferences a number of changes were made. Firstly, a change from a bolus drink containing 20 g of essential amino acids to an encapsulated form in divided doses over three days. Secondly, a change in leg strength analysis from utilising a leg/back dynamometry to a customised chair with a load cell testing extension isometric force. Thirdly, study drug dose reductions were now permitted. Fourthly, addition of two study sites which allowed participants to attend progressive resistance training sessions in their local area. Finally, a change in inclusion criteria to include participants that had received any first-line anti-cancer treatment. A guest participant was invited onto the study in April 2012, followed by the first study participant in June 2012. Results The guest participant showed trends in efficacy in a number of outcomes; stable fat free mass in the context of decreasing total body weight, with stable FAACT˗PWB, MFSI-SF physical, and WHOQOL-BREF QOL scores at week 20, all during documented disease progression now termed refractory cachexia. There were no treatment or exercise-related adverse events. Conclusion Publishing feasibility study protocols allows transparency in study interventions and assessments. The above ACCeRT regimen stabilised fat free mass and a number of physical/performance indicators and QOL in the guest participant

Translating Marine Animal Tracking Data into Conservation Policy and Management

There have been efforts around the globe to track individuals of many marine species and assess their movements and distribution with the putative goal of supporting their conservation and management. Determining whether, and how, tracking data have been successfully applied to address real-world conservation issues is however difficult. Here, we compile a broad range of case studies from diverse marine taxa to show how tracking data have helped inform conservation policy and management, including reductions in fisheries bycatch and vessel strikes, and the design and administration of marine protected areas and important habitats. Using these examples, we highlight pathways through which the past and future investment in collecting animal tracking data might be better used to achieve tangible conservation benefits

Convergence of marine megafauna movement patterns in coastal and open oceans

Author Posting. © The Author(s), 2017. This is the author's version of the work. It is posted here for personal use, not for redistribution. The definitive version was published in Proceedings of the National Academy of Sciences of the United States of America 115 (2018): 3072-3077, doi:10.1073/pnas.1716137115.The extent of increasing anthropogenic impacts on large marine vertebrates partly depends on the animals’ movement patterns. Effective conservation requires identification of the key drivers of movement including intrinsic properties and extrinsic constraints associated with the dynamic nature of the environments the animals inhabit. However, the relative importance of intrinsic versus extrinsic factors remains elusive. We analyse a global dataset of 2.8 million locations from > 2,600 tracked individuals across 50 marine vertebrates evolutionarily separated by millions of years and using different locomotion modes (fly, swim, walk/paddle). Strikingly, movement patterns show a remarkable convergence, being strongly conserved across species and independent of body length and mass, despite these traits ranging over 10 orders of magnitude among the species studied. This represents a fundamental difference between marine and terrestrial vertebrates not previously identified, likely linked to the reduced costs of locomotion in water. Movement patterns were primarily explained by the interaction between species-specific traits and the habitat(s) they move through, resulting in complex movement patterns when moving close to coasts compared to more predictable patterns when moving in open oceans. This distinct difference may be associated with greater complexity within coastal micro-habitats, highlighting a critical role of preferred habitat in shaping marine vertebrate global movements. Efforts to develop understanding of the characteristics of vertebrate movement should consider the habitat(s) through which they move to identify how movement patterns will alter with forecasted severe ocean changes, such as reduced Arctic sea ice cover, sea level rise and declining oxygen content.Workshops funding granted by the UWA Oceans Institute, AIMS, and KAUST. AMMS was supported by an ARC Grant DE170100841 and an IOMRC (UWA, AIMS, CSIRO) fellowship; JPR by MEDC (FPU program, Spain); DWS by UK NERC and Save Our Seas Foundation; NQ by FCT (Portugal); MMCM by a CAPES fellowship (Ministry of Education)

Global Spatial Risk Assessment of Sharks Under the Footprint of Fisheries

Effective ocean management and conservation of highly migratory species depends on resolving overlap between animal movements and distributions and fishing effort. Yet, this information is lacking at a global scale. Here we show, using a big-data approach combining satellite-tracked movements of pelagic sharks and global fishing fleets, that 24% of the mean monthly space used by sharks falls under the footprint of pelagic longline fisheries. Space use hotspots of commercially valuable sharks and of internationally protected species had the highest overlap with longlines (up to 76% and 64%, respectively) and were also associated with significant increases in fishing effort. We conclude that pelagic sharks have limited spatial refuge from current levels of high-seas fishing effort. Results demonstrate an urgent need for conservation and management measures at high-seas shark hotspots and highlight the potential of simultaneous satellite surveillance of megafauna and fishers as a tool for near-real time, dynamic management

Key Questions in Marine Megafauna Movement Ecology

It is a golden age for animal movement studies and so an opportune time to assess priorities for future work. We assembled 40 experts to identify key questions in this field, focussing on marine megafauna, which include a broad range of birds, mammals, reptiles, and fish. Research on these taxa has both underpinned many of the recent technical developments and led to fundamental discoveries in the field. We show that the questions have broad applicability to other taxa, including terrestrial animals, flying insects, and swimming invertebrates, and, as such, this exercise provides a useful roadmap for targeted deployments and data syntheses that should advance the field of movement ecolog

Key Questions in Marine Megafauna Movement Ecology

It is a golden age for animal movement studies and so an opportune time to assess priorities for future work. We assembled 40 experts to identify key questions in this field, focussing on marine megafauna, which include a broad range of birds, mammals, reptiles, and fish. Research on these taxa has both underpinned many of the recent technical developments and led to fundamental discoveries in the field. We show that the questions have broad applicability to other taxa, including terrestrial animals, flying insects, and swimming invertebrates, and, as such, this exercise provides a useful roadmap for targeted deployments and data syntheses that should advance the field of movement ecology

Distribution and Cconnection to other Plant-Communities of Genista radiata (L.) Scop in the South Tyrol (Italy)

Es werden die Genista radiata-Bestände an der Mendel in Südtirol (Italien) beschrieben und ihr Gesellschaftsanschluß diskutiert. Das Genisto-Festucetum alpestris Peer 83 besidelt steile südexponierte Kalkhänge der hochmontanen und subalpinen Stufe und ersetzt z.T. den Zwergstrauchgürtel mit Pinus mugo. Ähnlich zusammengesetzt ist das Genisto-Festucetum alpestris pinetosum Peer 83, das in den ¡lockeren Erika-Kiefernwäldern auftritt und bis in die tiefmontane Stufe hinunterreicht. Keinerlei syntaxonomische Bedeutung besitzt Genista radiata in den thermophilen Buschwaldgesellschaften, in denen die Pflanze lediglich eine Variante zum Orno-Ostryetum seslerietosum Peer 81 darstellt und speziell in der Saumzone anzutreffen ist. Auch in den Lärchenwiesen der Kammlagen kommt Genista radiata nur sporadisch vor. Sie ist hier mit dem Festucetum nigrescentis laricetosum subass. prov. verzahnt.Istražene su vegetacijske sastojine vrste Genista radiata u južnom Tirolu i razmatrana njihova fitocenološka pripadnost. Asocijacija Genisto-Festucetum alpestris Peer 83 nastava strme, južne vapnenačke obronke visokobrdskog i subalpskog pojasa. Subasocijacija Genisto-Festucetum alpestris pinetosum Peer 83 dolazi u rijetkim borovim šumama s crnjušom i spušta se do u niži brdski pojas. Termofilne niske šume, u kojima Genista radiata nema posebno sintaksonomsko značenje, označene su samo kao varijanta zajednice Orno-Ostryetum seslerietosum Peer 81. Genista radiata dolazi također na travnjacima s arišem, ali samo sporadično i to u mješavini sa zajednicom Festucetum nigrescentis laricetosnm subass. prov.The Genista radiata-communities of the Mendel in the South Tyrol (Italy) are described and their connection to other plant-communities is discussed. Genisto-Festucetum alpestris Peer 83 settles on steep, south- exposed colcareous slopes of high-mountain and subalpine altitudes and replaces particularly the dwarf-shrub-belt with Firms mugo. Similar contents aire found in Genisto-F estucetum alpestris pinetasum Peer 83, which occurs in undensed Erico-Pinetum-communities and reaches down to the low-mountain-altitude. In the thermophilic bush-communities, in which Genista radiata is found only as a variant of Orneto-Ostryetum seslerie- tosum (Peer 81), the plant has no syntaxonomic importance. Genista radiata especially is found in the edge-zone. In the grassland of the larch- communities of the ridges Genista radiata appears only sporadically. Here the plant appeals in Festucetum nigrescentis laricetosum subass. prov