Recreational Shark Fishing in Florida: How Research and Strategic Science Communication Helped to Change Policy

Sharks are taxa of significant conservation concern, and while commercial overfishing is the leading cause of population declines, recreational angling poses an increasing threat to some coastal shark populations. Here, I present a detailed case study of my role in a multi-stakeholder process to improve policy surrounding recreational fishing for threatened sharks in Florida. While many other people including other scientists, concerned citizens, responsible conservation-minded anglers, and environmental activists played key roles throughout this process, my scientific research and public engagement contributed significantly, and is the focus of this case study. Over the course of several years, my research documented the scope of several unnecessary angler practices that were harmful to threatened shark species. As a result of my research and stakeholder interactions, I was able to propose science-based politically feasible policy solutions, and I strategically communicated the problem and possible solutions to policymakers, journalists, environmental activists, scientific professional societies, and the public. In July of 2019, the Florida Fish and Wildlife Conservation Commission enacted new rules for land-based shark fishing in Florida waters, incorporating several of my proposed solutions. This case study demonstrates that through careful planning, understanding policy, developing a strategic communication plan, and networking with key stakeholders, even early career researchers can successfully help to change policy and help protect threatened species. Supplementary materials (Data S1) contain detailed background information, a timeline of events, and a diverse set of examples of my science communication

Analysis of 17,576 Potentially Functional SNPs in Three Case–Control Studies of Myocardial Infarction

Myocardial infarction (MI) is a common complex disease with a genetic component. While several single nucleotide polymorphisms (SNPs) have been reported to be associated with risk of MI, they do not fully explain the observed genetic component of MI. We have been investigating the association between MI and SNPs that are located in genes and have the potential to affect gene function or expression. We have previously published studies that tested about 12,000 SNPs for association with risk of MI, early-onset MI, or coronary stenosis. In the current study we tested 17,576 SNPs that could affect gene function or expression. In order to use genotyping resources efficiently, we staged the testing of these SNPs in three case–control studies of MI. In the first study (762 cases, 857 controls) we tested 17,576 SNPs and found 1,949 SNPs that were associated with MI (P<0.05). We tested these 1,949 SNPs in a second study (579 cases and 1159 controls) and found that 24 SNPs were associated with MI (1-sided P<0.05) and had the same risk alleles in the first and second study. Finally, we tested these 24 SNPs in a third study (475 cases and 619 controls) and found that 5 SNPs in 4 genes (ENO1, FXN (2 SNPs), HLA-DPB2, and LPA) were associated with MI in the third study (1-sided P<0.05), and had the same risk alleles in all three studies. The false discovery rate for this group of 5 SNPs was 0.23. Thus, we have identified 5 SNPs that merit further examination for their potential association with MI. One of these SNPs (in LPA), has been previously shown to be associated with risk of cardiovascular disease in other studies

The Role and Value of Science in Shark Conservation Advocacy

Many species of sharks are threatened with extinction, and there has been a longstanding debate in scientific and environmental circles over the most effective and appropriate strategy to conserve and protect them. Should we allow for sustainable fisheries exploitation of species which can withstand fishing pressure, or ban all fisheries for sharks and trade in shark products? In the developing world, exploitation of fisheries resources can be essential to food security and poverty alleviation, and global management efforts are typically focused on sustainably maximizing economic benefits. This approach aligns with traditional fisheries management and the perspectives of most surveyed scientific researchers who study sharks. However, in Europe and North America, sharks are increasingly venerated as wildlife to be preserved irrespective of conservation status, resulting in growing pressure to prohibit exploitation of sharks and trade in shark products. To understand the causes and significance of this divergence in goals, we surveyed 155 shark conservation focused environmental advocates from 78 environmental non-profits, and asked three key questions: (1) where do advocates get scientific information? (2) Does all policy-relevant scientific information reach advocates? and (3) Do advocates work towards the same policy goals identified by scientific researchers? Findings suggest many environmental advocates are aware of key scientific results and use science-based arguments in their advocacy, but a small but vocal subset of advocates report that they never read the scientific literature or speak to scientists. Engagement with science appears to be a key predictor of whether advocates support sustainable management of shark fisheries or bans on shark fishing and trade in shark products. Conservation is a normative discipline, and this analysis more clearly articulates two distinct perspectives in shark conservation. Most advocates support the same evidence-based policies as academic and government scientists, while a smaller percentage are driven more by moral and ethical beliefs and may not find scientific research relevant or persuasive. We also find possible evidence that a small group of non-profits may be misrepresenting the state of the science while claiming to use science-based arguments, a concern that has been raised by surveyed scientists about the environmental community. This analysis suggests possible alternative avenues for engaging diverse stakeholders in productive discussions about shark conservation

Diversity and inclusion in conservation: A proposal for a marine diversity network

Low diversity among scientists and practitioners is rampant in conservation. Currently, conservation professionals do not reflect the same diversity of perspectives and experiences of the world as the communities who bear the largest burden for implementing—or adverse consequences for failing to implement—conservation action. Acknowledging and describing the problem is important. But policies and programmes must also be put in place to correct it. Here, we highlight some measurable benefits of workforce diversity, and give an overview of some of the barriers to inclusion in marine conservation that help perpetuate low workforce diversity. Importantly, we underscore actions that both individuals and groups can take to alleviate such barriers. In particular, we describe the establishment of an online Marine Diversity Network, which conference participants proposed during a focus group meeting at the 4th International Marine Conservation Congress. The network will serve to bring together people from across the globe, from a variety of backgrounds, and from all career stages, to share knowledge, experiences and ideas, to provide and receive mentorship in marine conservation, and to forge new collaborations. Removing barriers to diverse participation requires coordinated, mindful actions by individuals and organizations. We hope that the proposed network and other actions presented in this paper find widespread support, and that they might serve both as inspiration and guide to other groups concerned with increasing diversity and inclusivity

Effectiveness of Ledipasvir-Sofosbuvir Combination in Patients With Hepatitis C Virus Infection and Factors Associated With Sustained Virologic Response

The combination of ledipasvir and sofosbuvir has been approved for treatment of genotype 1 hepatitis C virus (HCV) infection, including an 8-week regimen for treatment-naïve patients without cirrhosis and a baseline level of HCV RNA <6 million IU/mL. We analyzed data from a multicenter, prospective, observational study to determine real-world sustained virologic responses 12 weeks after treatment (SVR12) with regimens containing ledipasvir and sofosbuvir and identify factors associated with treatment failure

Designing an automated clinical decision support system to match clinical practice guidelines for opioid therapy for chronic pain

Abstract Background Opioid prescribing for chronic pain is common and controversial, but recommended clinical practices are followed inconsistently in many clinical settings. Strategies for increasing adherence to clinical practice guideline recommendations are needed to increase effectiveness and reduce negative consequences of opioid prescribing in chronic pain patients. Methods Here we describe the process and outcomes of a project to operationalize the 2003 VA/DOD Clinical Practice Guideline for Opioid Therapy for Chronic Non-Cancer Pain into a computerized decision support system (DSS) to encourage good opioid prescribing practices during primary care visits. We based the DSS on the existing ATHENA-DSS. We used an iterative process of design, testing, and revision of the DSS by a diverse team including guideline authors, medical informatics experts, clinical content experts, and end-users to convert the written clinical practice guideline into a computable algorithm to generate patient-specific recommendations for care based upon existing information in the electronic medical record (EMR), and a set of clinical tools. Results The iterative revision process identified numerous and varied problems with the initially designed system despite diverse expert participation in the design process. The process of operationalizing the guideline identified areas in which the guideline was vague, left decisions to clinical judgment, or required clarification of detail to insure safe clinical implementation. The revisions led to workable solutions to problems, defined the limits of the DSS and its utility in clinical practice, improved integration into clinical workflow, and improved the clarity and accuracy of system recommendations and tools. Conclusions Use of this iterative process led to development of a multifunctional DSS that met the approval of the clinical practice guideline authors, content experts, and clinicians involved in testing. The process and experiences described provide a model for development of other DSSs that translate written guidelines into actionable, real-time clinical recommendations.http://deepblue.lib.umich.edu/bitstream/2027.42/78267/1/1748-5908-5-26.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/2/1748-5908-5-26.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/3/1748-5908-5-26-S3.TIFFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/4/1748-5908-5-26-S2.TIFFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78267/5/1748-5908-5-26-S1.TIFFPeer Reviewe

Effect on Adherence to Nicotine Replacement Therapy of Informing Smokers Their Dose Is Determined by Their Genotype: A Randomised Controlled Trial

BACKGROUND: The behavioural impact of pharmacogenomics is untested. We tested two hypotheses concerning the behavioural impact of informing smokers their oral dose of NRT is tailored to analysis of DNA. METHODS AND FINDINGS: We conducted an RCT with smokers in smoking cessation clinics (N = 633). In combination with NRT patch, participants were informed that their doses of oral NRT were based either on their mu-opioid receptor (OPRM1) genotype, or their nicotine dependence questionnaire score (phenotype). The proportion of prescribed NRT consumed in the first 28 days following quitting was not significantly different between groups: (68.5% of prescribed NRT consumed in genotype vs 63.6%, phenotype group, difference = 5.0%, 95% CI -0.9,10.8, p = 0.098). Motivation to make another quit attempt among those (n = 331) not abstinent at six months was not significantly different between groups (p = 0.23). Abstinence at 28 days was not different between groups (p = 0.67); at six months was greater in genotype than phenotype group (13.7% vs 7.9%, difference = 5.8%, 95% CI 1.0,10.7, p = 0.018). CONCLUSIONS: Informing smokers their oral dose of NRT was tailored to genotype not phenotype had a small, statistically non-significant effect on 28-day adherence to NRT. Among those still smoking at six months, there was no evidence that saying NRT was tailored to genotype adversely affected motivation to make another quit attempt. Higher abstinence rate at six months in the genotype arm requires investigation. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN14352545.</p

Genome-Wide Study of Gene Variants Associated with Differential Cardiovascular Event Reduction by Pravastatin Therapy

Statin therapy reduces the risk of coronary heart disease (CHD), however, the person-to-person variability in response to statin therapy is not well understood. We have investigated the effect of genetic variation on the reduction of CHD events by pravastatin. First, we conducted a genome-wide association study of 682 CHD cases from the Cholesterol and Recurrent Events (CARE) trial and 383 CHD cases from the West of Scotland Coronary Prevention Study (WOSCOPS), two randomized, placebo-controlled studies of pravastatin. In a combined case-only analysis, 79 single nucleotide polymorphisms (SNPs) were associated with differential CHD event reduction by pravastatin according to genotype (P<0.0001), and these SNPs were analyzed in a second stage that included cases as well as non-cases from CARE and WOSCOPS and patients from the PROspective Study of Pravastatin in the Elderly at Risk/PHArmacogenomic study of Statins in the Elderly at risk for cardiovascular disease (PROSPER/PHASE), a randomized placebo controlled study of pravastatin in the elderly. We found that one of these SNPs (rs13279522) was associated with differential CHD event reduction by pravastatin therapy in all 3 studies: P = 0.002 in CARE, P = 0.01 in WOSCOPS, P = 0.002 in PROSPER/PHASE. In a combined analysis of CARE, WOSCOPS, and PROSPER/PHASE, the hazard ratio for CHD when comparing pravastatin with placebo decreased by a factor of 0.63 (95% CI: 0.52 to 0.75) for each extra copy of the minor allele (P = 4.8×10−7). This SNP is located in DnaJ homolog subfamily C member 5B (DNAJC5B) and merits investigation in additional randomized studies of pravastatin and other statins