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Objective: To examine the effect of enrollee switching from a broad‐network accountable care organization (ACO) health maintenance organization (HMO) to a "high performance" ACO‐HMO with a selective narrow network and comprehensive patient navigation system on access, utilization, expenditures, and enrollee experiences. Data Sources: Secondary administrative data were obtained for 2016–2020, and primary interview and survey data in 2021. Study Design: Fixed‐effects instrumental variable analyses of administrative data and regression analyses of survey data. Outcomes included access, utilization, expenditures, and enrollee experience. Background information was gathered via interviews. Data Collection/Extraction Methods: We obtained medical expenditure/enrollment and access data on continuously enrolled members in a broad‐network ACO‐HMO (n = 24,555), a subset of those who switched to a high‐performance ACO‐HMO in 2018 (n = 7664); interviews of organizational leaders (n = 13); and an enrollee survey (n = 512). Principal Findings: Health care effectiveness data and information Set (HEDIS) access measures were not different across plans. However, annual utilization dropped by 15.5 percentage points (95% CI: 18.1, 12.9) more in the high‐performance ACO‐HMO, with relative annual expenditures declining by $1251 (95% CI: $1461, $1042) per person per year. High‐performance ACO‐HMO enrollees were 10.1 percentage points (95% CI 0.001, 0.201) more likely to access primary care usually or always as soon as needed and 11.2 percentage points (95% CI 0.007, 0.217) more likely to access specialty care usually or always as soon as needed. Plan satisfaction was 7.1 percentage points (95% CI: −0.001, 0.138) higher in the high‐performance ACO‐HMO. Interviewees noted the comprehensive patient navigation system was designed to ensure patients remained in the narrow network to receive care. Conclusions: ACO and HMO contracts with selective narrow networks supported by comprehensive patient navigation can reduce expenditures and improve specialty access and patient satisfaction compared to broad‐network plans that lack these features. Payers should consider implementing narrow networks with comprehensive support systems. [ABSTRACT FROM AUTHOR]

The article describes the first documented observation of placental expulsion by a long-finned pilot whale, which was captured on video by an unmanned aerial system (UAS) in coastal waters of the Shetland Isles, Scotland, United Kingdom. Topics include examines the advent and development of UAS technology provides novel opportunities to observe and document biologically significant events that are challenging to observe via boat or from land.

The article focuses on an opportunistic observation of a dyadic interaction between a harbor seal and a Eurasian otter within the southern remit of Aith Voe, Shetland, Scotland, United Kingdom on April 2, 2022. Topics include examines the interaction occurred both on and within several meter of Aith Pier, a man-made public pier consisting mainly of rock armour which juts northeast into the sheltered waters of Aith Voe.

The rapid emergence of new marine developments (e.g., marine renewables, port infrastructure) alongside the substantial growth of existing industries has ultimately resulted in an unprecedented increase in anthropogenic structures within the marine environment over the previous century. Knowledge of whether marine species interact with, avoid, or accommodate and adapt to such structures is essential to ensure that further development of marine environments do not compromise conservation objectives of marine species. This article documents one such interaction. Herein, we describe the observation of a harbour seal (Phoca vitulina) seeking refuge from a group of foraging killer whales (Orcinus orca) within a blue (aka common) mussel (Mytilus edulis) farm. Aerial video footage (38 min 27 s) was collected using an unmanned aerial system during an encounter at an aquaculture site in Dury Voe, Shetland, UK. Analysis of the footage showed the killer whale group spent 73.7% of the total encounter time exhibiting predatory associated behaviours and that they were observed interacting with the mussel farm infrastructure only during "predation activity" for a total of 26 min 52 s (72.8%). The harbour seal interacted with the mussel farm infrastructure during re- and proactive anti-predator behaviour and when exhibiting fatigue for 27 min 59 s, 94.4% of the total time the seal was observed. It is clear that both marine and terrestrial predator-prey interactions are increasingly occurring in settings that are in some way defined by the Anthropocene. The implications of this are discussed, including potential entanglement risk and human-altered "landscapes of fear." As comprehension of the potential effects of human-altered risk grows, such knowledge should be taken into consideration prior to further modification of marine habitats. [ABSTRACT FROM AUTHOR]

International sailing regattas are major sporting events often held within coastal marine environments which overlap with the habitats of marine species. Although races are confined to courses, the popularity of these events can attract large spectator flotillas, sometimes composed of hundreds of motorized vessels. Underwater noise from these flotillas can potentially alter soundscapes experienced by marine species. To understand how these flotillas may alter soundscapes, acoustic recordings were taken around racecourses during the 36th America's Cup in the Hauraki Gulf, New Zealand in 2021. Sustained increases in broadband underwater sound levels during the regatta (up to 17 dB re 1 μPa rms; 0.01–24 kHz) that extended beyond racecourse boundaries (>8.5 km) and racing hours were observed; very likely attributable to the increase in regatta-related vessel activity. Underwater noise pollution from spectator flotillas attending larger regattas should be considered during event planning stages, particularly when events occur in ecologically significance areas. • International regattas can attract a large number of spectators in motorized vessels. • Spectator vessels increase underwater noise well beyond course boundaries and racing hours. • Underwater noise from spectator flotillas should be considered during event planning. [ABSTRACT FROM AUTHOR]

Photographic identification (photo ID) is a well-established, non-invasive, and relatively cost-effective technique to collect longitudinal data from species that can be individually recognised based on natural markings. This method has been improved by computer-assisted pattern recognition software which speed up the processing of large numbers of images. Freely available algorithms exist for a wide range of species, but the choice of software can have significant effects on the accuracy of individual capture histories and derived demographic parameter estimates. We tested the performance of three open source, semi-automated pattern recognition software algorithms for harbour seal (Phoca vitulina vitulina) photo ID: ExtractCompare, I3S Pattern and Wild-ID. Performance was measured as the ability of the software to successfully score matching images higher than non-matching images using the cumulative density function (CDF). The CDF for the top ranked potential match was highest for Wild-ID (CDF1 = 0.34–0.58), followed by ExtractCompare (CDF1 = 0.24–0.36) and I3S pattern (CDF1 = 0.02–0.3). This trend emerged regardless of how many potential matches were inspected. The highest performing aspects in ExtractCompare were left heads, whereas in I3S Pattern and Wild-ID these were front heads. Within each aspect, images collected using a camera and lens performed higher than images taken by a camera and scope. Data processing within ExtractCompare took  > 4 × longer than Wild-ID, and  > 3 × longer than I3S Pattern. We found that overall, Wild-ID outperformed both ExtractCompare and I3S Pattern under tested scenarios, and we therefore recommend its assistance in harbour seal photo ID. [ABSTRACT FROM AUTHOR]