Coral restoration in a changing world - a global synthesis of methods and techniques

Coral reef ecosystems have suffered an unprecedented loss of habitat-forming hard corals in recent decades, due to increased nutrient outputs from agriculture, elevated levels of suspended sediment caused by deforestation and development, destructive fishing practices, over-harvesting of reef species, outbreaks of corallivorous crown-of-thorns starfish (COTS, Acanthaster planci), coral disease and tropical storms. However, in recent years climate change has emerged as the primary threat to coral reefs. While reefs have a natural capacity for recovery, recurring events like mass coral bleaching and extreme weather events is increasing in frequency, intensity and severity, and are eroding the time for recovery between catastrophic events. Marine conservation has primarily focused on passive habitat protection over active restoration, in contrast to terrestrial ecosystems where active restoration is common practice. Further, active restoration is well accepted for wetlands and shellfish reefs however coral reef restoration has remained controversial both in academia and amongst marine managers. This is despite recent research suggesting that optimal conservation outcomes include both habitat protection and restoration. Critics often argue that coral restoration detracts focus from mitigating climate change and other threats to the marine environment, while proponents of coral restoration counter that interventions can serve to protect coral biodiversity and endangered species in the short-term, while mitigation of large-scale threats such as climate change and water quality take effect. Despite this disconnect between coral restoration practitioners, coral reef managers and scientists, active coral restoration is increasingly used as a tool to attempt to restore coral populations. The field has largely developed through independent work of isolated groups, and has fallen victim to ‘growing pains’ associated with ecological restoration in many other ecosystems. Partly this is due to a reluctance to share outcomes of projects, and in some cases a lack of monitoring or appropriate reporting of project outcomes. To mitigate this, we aimed to synthesise the available knowledge in a comprehensive global review of coral restoration methods, incorporating data from a traditional literature search of the scientific literature, complemented with information gathered from online sources and through a survey of coral restoration practitioners. We identified 329 case studies on coral restoration, of which 195 were from the scientific literature, 79 were sourced from the grey literature (i.e. reports and online descriptions), and 55 were responses to our survey of restoration practitioners. We identified ten coral restoration intervention types: coral gardening - transplantation phase (23% of records), direct transplantation (21%), artificial reefs (19%), coral gardening - nursery phase (17%), coral gardening (both phases, 7%), substrate enhancement with electricity (4%), substrate stabilisation (4%), algae removal (2%), larval enhancement (1%) and microfragmentation (<1%). The majority of interventions involve coral fragmentation or transplantation of coral fragments (70%). While 52 countries are represented in the dataset, the majority of projects were conducted in the USA, Philippines, Thailand and Indonesia (together representing 40% of projects). Coral restoration case studies are dominated by short-term projects, with 66% of all projects reporting less than 18 months of monitoring of the restored sites. Overall, the median length of projects was 12 months. Similarly, most projects are relatively small in spatial scale, with a median size of restored area of 500 m2. A diverse range of species are represented in the dataset, with 221 different species from 89 coral genera. Overall, coral restoration projects focused primarily (65% of studies) on fast-growing branching corals. Among all the published documents, the top five species (22% of studies) were Acropora cervicornis, Pocillopora damicornis, Stylophora pistillata, Porites cylindrica and Acropora palmata. Over a quarter of projects (26%) involved the coral genus Acropora, while 9% of studies included a single species - Acropora cervicornis. Much of the focus on Acropora cervicornis and Acropora palmata is likely to have resulted from these important reef-forming species being listed as threatened on the United States Endangered Species List and as Endangered on the International Union for Conservation of Nature Red List of Endangered Species (IUCN 2018). We have dedicated a section to each intervention type covered in this review, and describe the potential and limitations of each intervention type in detail there. However, collating this information has highlighted the following main points which apply to coral restoration in general. 1. On average, survival in restored corals is relatively high. All coral genera with sufficient replication from which to draw conclusions (>10 studies listing that genus) report an average survival between 60-70%. 2. Differences in survival and growth are largely species and/or location specific, so the selection of specific methods should be tailored to the local conditions, costs, availability of materials, and to the specific objectives of each project. 3. Projects are overall small and short, however substantial scaling up is required for restoration to be a useful tool in supporting the persistence of reefs in the future. While there is ample evidence detailing how to successfully grow corals at smaller scales, few interventions demonstrate a capacity to be scaled up much beyond one hectare. Notable exceptions include methods which propagate sexually derived coral larvae. 4. To date, coral restoration has been plagued by the same common problems as ecological restoration in other ecosystems. Mitigating these will be crucial to successfully scale up projects, and to retain public trust in restoration as a tool for resilience based management. a. Lack of clear objectives - There is a clear mismatch between the stated objectives of projects, and the design of projects and monitoring of outcomes. Poorly articulated or overinflated objectives risk alienating the general public and scientists, by over-promising and under-delivering. Social and economic objectives have inherent value and do not need to be disguised with ecological objectives. b. Lack of appropriate monitoring - A large proportion of projects do not monitor metrics relevant to their stated objectives, or do not continue monitoring for long enough to provide meaningful estimates of success. Further, there is a clear need for standardisation in the metrics that are used, to allow comparisons between projects. c. Lack of appropriate reporting - The outcomes of a large proportion of projects are not documented, which restricts knowledge-sharing and adaptive learning. While we attempted to access some of the unreported projects through our survey, it is clear we have only scratched the surface of existing knowledge. d. Poorly designed projects - An effect of inadequate monitoring and reporting is that projects are poorly suited to their specific area and conditions. Improved knowledge-sharing and development of best practice coral restoration guidelines aims to mitigate this problem

Coral restoration – a systematic review of current methods, successes, failures and future directions

Coral reef ecosystems have suffered an unprecedented loss of habitat-forming hard corals in recent decades. While marine conservation has historically focused on passive habitat protection, demand for and interest in active restoration has been growing in recent decades. However, a disconnect between coral restoration practitioners, coral reef managers and scientists has resulted in a disjointed field where it is difficult to gain an overview of existing knowledge. To address this, we aimed to synthesise the available knowledge in a comprehensive global review of coral restoration methods, incorporating data from the peer-reviewed scientific literature, complemented with grey literature and through a survey of coral restoration practitioners. We found that coral restoration case studies are dominated by short-term projects, with 60% of all projects reporting less than 18 months of monitoring of the restored sites. Similarly, most projects are relatively small in spatial scale, with a median size of restored area of 100 m2. A diverse range of species are represented in the dataset, with 229 different species from 72 coral genera. Overall, coral restoration projects focused primarily on fast-growing branching corals (59% of studies), and report survival between 60 and 70%. To date, the relatively young field of coral restoration has been plagued by similar 'growing pains' as ecological restoration in other ecosystems. These include 1) a lack of clear and achievable objectives, 2) a lack of appropriate and standardised monitoring and reporting and, 3) poorly designed projects in relation to stated objectives. Mitigating these will be crucial to successfully scale up projects, and to retain public trust in restoration as a tool for resilience based management. Finally, while it is clear that practitioners have developed effective methods to successfully grow corals at small scales, it is critical not to view restoration as a replacement for meaningful action on climate change

Deciphering mollusc shell production: the roles of genetic mechanisms through to ecology, aquaculture and biomimetics

Most molluscs possess shells, constructed from a vast array of microstructures and architectures. The fully formed shell is composed of calcite or aragonite. These CaCO3 crystals form complex biocomposites with proteins, which although typically less than 5% of total shell mass, play significant roles in determining shell microstructure. Despite much research effort, large knowledge gaps remain in how molluscs construct and maintain their shells, and how they produce such a great diversity of forms. Here we synthesize results on how shell shape, microstructure, composition and organic content vary among, and within, species in response to numerous biotic and abiotic factors. At the local level, temperature, food supply and predation cues significantly affect shell morphology, whilst salinity has a much stronger influence across latitudes. Moreover, we emphasize how advances in genomic technologies [e.g. restriction site-associated DNA sequencing (RAD-Seq) and epigenetics] allow detailed examinations of whether morphological changes result from phenotypic plasticity or genetic adaptation, or a combination of these. RAD-Seq has already identified single nucleotide polymorphisms associated with temperature and aquaculture practices, whilst epigenetic processes have been shown significantly to modify shell construction to local conditions in, for example, Antarctica and New Zealand. We also synthesize results on the costs of shell construction and explore how these affect energetic trade-offs in animal metabolism. The cellular costs are still debated, with CaCO3 precipitation estimates ranging from 1-2 J/mg to 17-55 J/mg depending on experimental and environmental conditions. However, organic components are more expensive (~29 J/mg) and recent data indicate transmembrane calcium ion transporters can involve considerable costs. This review emphasizes the role that molecular analyses have played in demonstrating multiple evolutionary origins of biomineralization genes. Although these are characterized by lineage-specific proteins and unique combinations of co-opted genes, a small set of protein domains have been identified as a conserved biomineralization tool box. We further highlight the use of sequence data sets in providing candidate genes for in situ localization and protein function studies. The former has elucidated gene expression modularity in mantle tissue, improving understanding of the diversity of shell morphology synthesis. RNA interference (RNAi) and clustered regularly interspersed short palindromic repeats - CRISPR-associated protein 9 (CRISPR-Cas9) experiments have provided proof of concept for use in the functional investigation of mollusc gene sequences, showing for example that Pif (aragonite-binding) protein plays a significant role in structured nacre crystal growth and that the Lsdia1 gene sets shell chirality in Lymnaea stagnalis. Much research has focused on the impacts of ocean acidification on molluscs. Initial studies were predominantly pessimistic for future molluscan biodiversity. However, more sophisticated experiments incorporating selective breeding and multiple generations are identifying subtle effects and that variability within mollusc genomes has potential for adaption to future conditions. Furthermore, we highlight recent historical studies based on museum collections that demonstrate a greater resilience of molluscs to climate change compared with experimental data. The future of mollusc research lies not solely with ecological investigations into biodiversity, and this review synthesizes knowledge across disciplines to understand biomineralization. It spans research ranging from evolution and development, through predictions of biodiversity prospects and future-proofing of aquaculture to identifying new biomimetic opportunities and societal benefits from recycling shell products.FCT: UID/Multi/04326/2019; European Marine Biological Research Infrastructure Cluster-EMBRIC (EU H2020 research and innovation program) 654008; European Union Seventh Framework Programme [FP7] ITN project 'CACHE: Calcium in a Changing Environment' under REA 60505; NERC Natural Environment Research Council NE/J500173/1info:eu-repo/semantics/publishedVersio

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

A global assessment of the vulnerability of shellfish aquaculture to climate change and ocean acidification

Human‐induced climate change and ocean acidification (CC‐OA) is changing the physical and biological processes occurring within the marine environment, with poorly understood implications for marine life. Within the aquaculture sector, molluskan culture is a relatively benign method of producing a high‐quality, healthy, and sustainable protein source for the expanding human population. We modeled the vulnerability of global bivalve mariculture to impacts of CC‐OA over the period 2020–2100, under RCP8.5. Vulnerability, assessed at the national level, was dependent on CC‐OA‐related exposure, taxon‐specific sensitivity and adaptive capacity in the sector. Exposure risk increased over time from 2020 to 2100, with ten nations predicted to experience very high exposure to CC‐OA in at least one decade during the period 2020–2100. Predicted high sensitivity in developing countries resulted, primarily, from the cultivation of species that have a narrow habitat tolerance, while in some European nations (France, Ireland, Italy, Portugal, and Spain) high sensitivity was attributable to the relatively high economic value of the shellfish production sector. Predicted adaptive capacity was low in developing countries primarily due to governance issues, while in some developed countries (Denmark, Germany, Iceland, Netherlands, Sweden, and the United Kingdom) it was linked to limited species diversity in the sector. Developing and least developed nations (n = 15) were predicted to have the highest overall vulnerability. Across all nations, 2060 was identified as a tipping point where predicted CC‐OA will be associated with the greatest challenge to shellfish production. However, rapid declines in mollusk production are predicted to occur in the next decade for some nations, notably North Korea. Shellfish culture offers human society a low‐impact source of sustainable protein. This research highlights, on a global scale, the likely extent and nature of the CC‐OA‐related threat to shellfish culture and this sector enabling early‐stage adaption and mitigation

Blue restoration – building confidence and overcoming barriers

Marine coastal (or “blue”) ecosystems provide valuable services to humanity and the environment, but global loss and degradation of blue ecosystems necessitates ecological restoration. However, blue restoration is an emerging field and is still relatively experimental and small-scale. Identification of the key barriers to scaling-up blue restoration will enable targeted problem solving and increase the likelihood of success. Here we describe the environmental, technical, social, economic, and political barriers to restoration of blue ecosystems, including saltmarsh, mangroves, seagrass, shellfish reefs, coral reefs, and kelp forests. We provide managers, practitioners, and decision-makers with solutions to construct barrier-informed blue restoration plans and illustrate these solutions through the use of case studies where barriers were overcome. We offer a way forward to build confidence in blue restoration for society, government, and restoration practitioners at larger and more ambitious scales

Coral reef restoration database

This database represents the core part of the synthesis review "Motivations, success and cost of coral reef restoration". It contains information on cost and success of restoration projects worldwide described by the published literature, some grey literature and a few personal communications. This database is an update of the coral reef section of the database "The cost and feasibility of marine coastal restoration" which captured information on the restoration of coral reefs, seagrass, mangroves, saltmarshes, and oyster reefs until November 2014. The update involves data extracted from the literature published until March 2018, data on motivations to carry out the restoration projects, information on whether the Standards for Ecological Restoration were followed by the projects, the category of the outcome reported and the variables measured to report on the project success. All economic values were updated with the newest data provided by The World Bank (March 2019). The coral reef restoration database contains the full reference, general information about the publication and project, the restoration action undertaken, species involved, location, a description on the type of cost reported, information on funding sources, project duration (in years), the area restored in hectare (ha), the converted restoration cost in 2010 US$ ha-1, feasibility information (including reasons for success or failure), and restoration success in terms of % survival of restored organisms. We accounted for pre-transplant (i.e. survival of coral spat/larvae in culture before rearing them in nursery or out-planting), transplant (i.e. survival of coral fragments during nursery period), post-transplant (i.e. survival of coral fragments after out-planting to the reef) survival as well as for the overall survival averaged over the former three categories. See ‘Methods’ of the publication for a detailed database description for a detailed summary of the database information

The potential for applying 'Nonviolent Communication' in conservation science

The role of a conservation scientist has never been more challenging. Amidst the rapid degradation occurring across Earth's natural ecosystems and the loss of biodiversity and ecosystem services, conservation scientists must learn new and effective ways to build trust and engage with the wider community. Here, we discuss the potential utility of a particular communication technique, Nonviolent Communication (also known as Compassionate Communication or Collaborative Communication), in conservation science. Nonviolent Communication is a structured form of communication, developed in the 1960s by Dr. Marshall Rosenberg, that seeks to foster interpersonal understanding and connection through communication of judgment-free observations, recognition of people's feelings, needs and values, and requests for specific actions to meet those needs. It has delivered positive outcomes in diverse fields such as prisoner reform, health science, and social work, and holds great promise for conservation applications. While there is no single communication strategy that resonates with all people, we argue that Nonviolent Communication could be used by conservation scientists and practitioners when communicating with colleagues, politicians, and the general public about important and sometimes contentious environmental issues.</p

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine