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Rationale: Propofol is one of the first-line sedative-hypnotic agents for critically ill adults requiring mechanical ventilation. Although propofol can elevate triglyceride levels, and the latter is a risk factor for pancreatitis, the association between propofol and acute pancreatitis is unclear. Objectives: We sought to determine the clinical impact and potential associations between propofol infusion, hypertriglyceridemia, and acute pancreatitis. Methods: This is an observational multicenter study of adults (⩾18 yr old) who were admitted to an intensive care unit, who required mechanical ventilation and received continuous propofol infusion for at least 24 hours. The primary outcomes were the frequency of hypertriglyceridemia (>400 mg/dl) and acute pancreatitis. Further analyses were done to determine the clinical impact of elevated triglyceride levels (i.e., sedation changes) and risk factors for pancreatitis development. Results: Of 11,828 patients included, 33.2% (n = 3,922) had triglyceride levels measured, of whom 21.7% (n = 851) had hypertriglyceridemia at 4.5 days (SD = 6.8) after propofol initiation. Of those still requiring sedation, 70.4% (n = 576/818) received alternative sedatives after developing hypertriglyceridemia. Pancreatitis occurred in 1.2% of patients (n = 47/3,922) and was more frequent in those with hypertriglyceridemia (3.2%, 27/851; vs. 0.7%, 20/3,071; P < 0.001). After adjustment for potential confounding variables, each 100 mg/dl increase in triglyceride levels was associated with an 11% increase in risk of pancreatitis. Propofol dose was not associated with pancreatitis development. Conclusions: Acute pancreatitis is uncommon in patients receiving propofol infusion, and it occurs over a wide range of triglyceride levels, indicating a multifactorial pathophysiology. Hypertriglyceridemia frequently prompts the use of alternative sedatives. Further study is needed to determine how to best monitor and treat hypertriglyceridemia in critically ill patients receiving propofol infusion. [ABSTRACT FROM AUTHOR]

Background: Delirium or an acute confusional state (ACS) is characterised as being a frequent and complex hospital complication in older adult patients, which can affect their level of independence and increase patient morbidity and mortality. Critically ill patients in the intensive care unit (ICU) frequently develop ICU delirium, leading to longer hospital and ICU stays, increased mortality and long-term impairment. Objectives: This review aims to assess existing evidence of interventions that can be considered effective for the management and prevention of delirium in ICUs, reducing short-term morbidity and mortality, ICU and hospital admission times and the occurrence of other long-term complications. Methodology: For this systematic review, we searched Medline, PubMed, Cochrane Library, CINHAL, LILACS, SciELO and Dialnet from January 2018 to August 2024, in English, Spanish and French. MeSH descriptors were adjusted to search the different databases. We also checked Prospero for ongoing systematic reviews. Main results: The electronic search yielded a total of 2656 studies, of which 14 trials met the eligibility criteria, with a total of 14,711 participants. We included eight randomised clinical trial (RCTs), four cohort analyses, one systematic review and one observational trial, including participants over 65 years admitted to the ICU. Ten of these studies were based on pharmacological interventions, three of them examined non-pharmacological interventions and the remaining study examined mixed (pharmacological and non-pharmacological) interventions. Six placebo RCTs were included, plus four reported comparisons between different drugs. Regarding non-pharmacological interventions, nursing programmes focused on optimising modifiable risk factors or the use of therapies such as bright light are emerging. Regarding mixed interventions, we found the combination of invasive techniques and with sedoanalgesia. Conclusions: Due to its satisfactory level of sedation, dexmedetomidine is presented as a viable option because, although olanzapine offers safer results, postoperative administration angiotensin inhibitor systems significantly reduced the incidence of delirium. As for propofol, no significant differences were found. Among the non-pharmacological and mixed therapies, bright light therapy was able to reduce the incidence of delirium, and the combination of epidural/general anaesthesia was effective in all subtypes of delirium. Concerning the remaining interventions, the scientific evidence is still insufficient to provide a definitive recommendation. [ABSTRACT FROM AUTHOR]

Context: Microplastics are a concern for maritime nations such as Fiji, which rely heavily on seafood, such as bivalves, which can transfer pollutants through the food chain. The lack of biomonitoring studies in the Pacific region highlights the necessity of researching microplastic pollution in seafood. Aims: This study quantifies microplastics in Anadara antiquata , a commonly consumed shellfish in Fiji, and evaluates its general biochemical responses. As a baseline, this study is not to draw an association between the two endpoints (microplastics and biochemical responses), rather present these as baselines for future studies. Methods: A total of 58 specimens from Ba River Delta, Rakiraki Bay and Vueti Navakavu were examined, where differences in potential sources or pathways for microplastics, including anthropogenic pollutants with the potential to induce stress on marine animals, were considered (rivers, industrial zones, stormwater outlets, sewerage outfalls and mining area). Specific hepatopancreatic enzyme activities associated with detoxification (glutathione-S transferase, GST) and oxidative stress (glutathione peroxidase, GPX, and glutathione reductase, GR) were measured. Key results: Microplastics were extracted, classified by morphology and quantified. The study found that 64% of specimens had microplastics, <1.0 mm being more prevalent. Ba River Delta showed significant biochemical stress (Kruskal–Wallis test; P < 0.05) with GST (χ 2 = 40.28, d.f. = 2, P -value < 0.001), GPX (χ 2 = 38.38, d.f. = 2, P -value < 0.001) and GR χ 2 = 45.14, d.f. = 2, P -value < 0.001) being considered as likely to be responding to pollution. Conclusion: As a baseline, the study underlines the need for biomonitoring as a result of varying and concerning levels of pollution and biochemical stress responses found across the study areas. Integrating biomonitoring methods into risk-assessment protocols in Fiji may support establishment of opportunities or considerations for health guidelines and policy interventions to minimise human exposure to microplastics, and regulate environmental pollution. Implications: These measures are crucial for protecting public health and monitoring pollution impacts. Researchers in Fiji found microplastics in 64% of local edible cockles, with higher levels of microplastics and associated biological stress signs in the edible cockles from more polluted areas. The findings highlighted the need for continuous environmental and biomonitoring of pollution effects in seafood. This scientific contribution will inform and shape future policy on regulating pollution and promoting human-health needs in seafood quality. [ABSTRACT FROM AUTHOR]

Coral reef ecosystems are facing severe degradation due to anthropogenic activities at both local and global scales. In response, extensive restoration efforts are underway, aiming to bolster coral cover and enhance reef fish communities to foster facilitation between fish and corals. This reciprocal relationship is anticipated to improve overall restoration efficacy and enhance coral reef resilience in the face of global warming. Here, we investigate the impact of coral restoration using out-planted Acropora cervicornis colonies attached to raised domes on the associated fish community on the isolated, well-protected reef of Little Cayman Island in the Central Caribbean. Surveys were conducted immediately preceding out-planting, five days later, and 85 days later to capture temporal changes in the fish community. After 85 days of out-planting, there were no changes in fish biomass, abundance, or species richness for the entire fish community. This pattern was consistent for selected fish functional groups. Additionally, no significant differences were observed in the fish community before outplanting, five days after out-planting, or 85 days after out-planting of restoration domes. Our results underscore the limited impact of coral restoration for influencing fish communities in the isolated and highly protected reef of Little Cayman over an 85-day period. Consequently, our findings have implications for using coral restoration as a mechanism to enhance fish populations, particularly in marginally disturbed regions where structural complexity has not been lost. Future restoration programs should therefore incorporate local knowledge of environmental history and restoration needs along with an increased data-driven understanding of the intricate interaction between fish and coral populations to be successful. [ABSTRACT FROM AUTHOR]

Background: Agitation is a common clinical problem encountered in the intensive care unit (ICU). Treatment options are based on clinical experience and sparse quality literature. Aim: The aim of this study was to describe the effect of valproic acid (VPA) as adjuvant treatment for agitation in the ICU, identify predictors of response to VPA and evaluate the independent effect of VPA on agitation compared to standard of care (SOC). Method: This retrospective single center observational study evaluated adult patients admitted to the ICU for whom a psychiatric consultation was requested for agitation management, with agitation defined as a Richmond Agitation Sedation Score of 2 or greater. A descriptive analysis of the proportion of agitation-free patients per day of follow-up, the incidence of agitation-related-events, as well as the evolution of co-medications use over time are presented. A logistic regression model was used to assess predictors of VPA response, defined as being agitation-free on Day 7 and generalized estimating equations were used to evaluate the independent effect of VPA as adjuvant therapy for agitation in the critically ill. Results: One hundred seventy-five patients were included in the study with 78 receiving VPA. The percentage of agitation-free patients on VPA was 6.5% (5/77) on Day 1, 14.1% (11/78) on Day 3 and 39.5% (30/76) on Day 7. Multivariate regression model for clinical and demographic variables identified female gender as predictor of response on Day 7 (OR 6.10 [1.18–31.64], p = 0.03). The independent effect of VPA was non-significant when compared to SOC. Conclusion: Although VPA used as adjuvant treatment was associated with a decrease in agitation, its effect when compared to SOC did not yield significant results. [ABSTRACT FROM AUTHOR]

Purpose: Assess the efficacy and safety of valproic acid (VPA) for delirium and agitation in the intensive care unit (ICU) as compared to the use of other antipsychotics. Materials and Methods: This was a retrospective cohort study of patients treated for delirium and agitation in the ICU. Patients were included if they had a Richmond Agitation-Sedation Scale ≥2 and Confusion Assessment Method for the ICU positive. Patients were split into two groups based on their VPA exposure. The primary outcome was delirium free days. Secondary outcomes included agitation free days, ICU length of stay (LOS), mechanical ventilation duration, and mortality. Results: One hundred eight patients were included, 49 patients in the VPA group and 59 patients in the control group. Baseline characteristics were similar between groups. There was no significant difference in the primary outcome (difference −.15, 95% CI: 0.63-.93, P =.70). There were no significant differences in agitation-free days, mortality, mechanical ventilation duration, or ICU LOS. Conclusions: Our findings suggest that VPA is associated with similar delirium and agitation-free days compared to other non-VPA medications, with some adverse effects. Larger prospective studies are needed to validate the routine use of VPA in this setting. [ABSTRACT FROM AUTHOR]

Purpose: To assess the in vitro activity of ceftaroline and a panel of comparator agents against isolates of Gram-positive bacteria, including Staphylococcus aureus, Streptococcus pneumoniae, β-hemolytic streptococci, and coagulase-negative staphylococci (CoNS) from blood collected in Africa and Middle East (AfME), Asia Pacific (APAC), Europe, Latin America (LATAM), and North America from 2017 to 2020 as a part of the Antimicrobial Testing Leadership and Surveillance (ATLAS) program.Methods: Susceptibility and minimum inhibitory concentration were determined using broth microdilution for all antimicrobial agents by a central reference laboratory according to the Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines.Results: Ceftaroline showed good activity (susceptibility ≥ 89.8%, MIC90 0.008– 2 mg/L) against all Gram-positive isolates tested. All isolates of methicillin-susceptible S. aureus, penicillin-susceptible S. pneumoniae, S. agalactiae, S. dysgalactiae, and S. pyogenes were susceptible to ceftaroline (MIC90 0.008– 0.25 mg/L). Ceftaroline susceptibility for MRSA isolates was 89.8% globally (MIC90 2 mg/L). Among the comparator agents, all isolates were susceptible to vancomycin, except S. epidermis (susceptibility, 99.9%). Among other agents, daptomycin, linezolid, and tigecycline showed potent activity (susceptibility ≥ 97.9%, MIC90 0.03– 2 mg/L) against all isolates tested.Conclusion: Ceftaroline showed potent in vitro activity against global bloodstream isolates of Gram-positive bacteria collected between 2017 and 2020. Monitoring and surveillance of global as well as regional longitudinal trends of resistance rates among Gram-positive isolates causing bloodstream infections are important to limit the spread of AMR, establish stewardship measures, and manage and appropriately treat infections. [ABSTRACT FROM AUTHOR]

Coastal river systems provide essential habitats for a diversity of fish species that transition marine, estuarine, and freshwater environments to complete their lifecycles. Movement among and within these environments is important to access resources that optimise growth, survival, and reproduction. Knowledge on the movements, including the drivers, underpins management strategies, although this information is often lacking for many species. We used acoustic telemetry to quantify the relative importance of a range of abiotic stimuli in relation to seasonal movement patterns in blue salmon catfish Neoarius graeffei throughout an unregulated coastal river catchment, the Clarence River in northern New South Wales, Australia. Neoarius graeffei continuously occupied the Clarence River system for the duration of the 1-year study and were mostly confined to estuarine reaches, with occasional movement into freshwater habitats. Seasonal differences in habitat occupation were observed, with N. graeffei using habitats close to the river mouth in winter and upstream estuary habitats in spring. Broad-scale movement patterns were influenced by both water temperature and river flow, and high-flow events (> 1.5 m) resulted in short-term changes (~ 10 days) in habitat use. Sex-specific differences in seasonal habitat use were also observed which we hypothesise is linked to contrasting energetic investment in reproduction. The response of N. graeffei to changes in river flow highlights the need for assessment on these impacts for estuarine-dependent species more broadly, in the face of climate change and increased river regulation. [ABSTRACT FROM AUTHOR]

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Coral-eating crown-of-thorns seastars (CoTS, Acanthaster spp.) are major contributors to the coral reef crises across the Indo-Pacific region. Until recently, CoTS throughout the Indo-Pacific were regarded to be a single species, Acanthaster planci. However, genetic and morphological analyses demonstrated that there are at least four distinct species: Acanthaster benziei in the Red Sea, Acanthaster mauritiensis and A. planci in the Indian Ocean, and Acanthaster cf. solaris in the western Pacific. Acanthaster cf. ellisii in the eastern Pacific needs more taxonomic attention. Here, we review the biological knowledge for each species adapting a pragmatic geographical species definition and using a systematic literature review complemented with more focused searches for individual species. The vast majority of CoTS research (88%) was conducted on A. cf. solaris, with much of this research undertaken on the Great Barrier Reef or in Japan. Many studies of A. cf. solaris are focused on monitoring or documenting incidences of outbreaks, though there is a solid base of knowledge on larval, juvenile and adult ecology derived from field and laboratory experiments. By contrast, most of the published studies on the four remaining species simply document cases of population outbreaks. The major taxonomic bias in CoTS research constitutes a significant limitation for understanding and managing these species for two reasons. First, even for A. cf. solaris, which is the most studied species, limited fundamental knowledge of their biology and ecology constrains understanding of the drivers of outbreaks and hinders corresponding management actions for prevention and control of these events. Second, understanding and management of other species are predicated on the assumption that all CoTS species have similar biology and behaviour, an unsatisfying assumption for ecosystem management. [ABSTRACT FROM AUTHOR]

Octopuses present a difficult resource to manage because of their relatively short life spans, rapid growth rates, high natural mortality and seasonal fluctuations in abundance. With exploitation efforts increasing worldwide, particularly in the Pacific Island region, substantial knowledge gaps in their biology, exploitation and management remain. We conducted a literature review to summarise their species distribution, abundance, ecological attributes, utilization, importance and management within the Pacific Island Countries and Territories (PICTs) of Fiji, Vanuatu, the Solomon Islands, New Caledonia, Tonga, Samoa and American Samoa. We found that 23 species of octopuses within 11 genera were recorded from these PICTs, belonging to the families Amphitretidae and Octopodidae. Overall, Tonga was the most speciose country with 11 occurrence records and Samoa recorded the least with just a single species. All other countries recorded between 2 and 8 taxa. The day octopus (Octopus cyanea) was recorded from all PICTs except Samoa. There are no specific national regulations on octopus fisheries within the PICTs and management is largely dependent on overarching national fisheries legislation. However, community-based management efforts can be an effective platform in sustaining octopus stocks. Octopuses also play an important role in the folklore and customs of many Pacific Islanders, and we provide a summary of these for the specific PICTs assessed. This review highlights areas for further research and development for the Pacific Island region and the urgent need to address specific knowledge gaps on octopus taxonomy, stock assessment and fishery management. [ABSTRACT FROM AUTHOR]

Indo-Pacific corals predominantly reproduce using synchronous mass spawning events to maximise fertilisation. However, as disturbances continue to thin population densities, the quantities of gametes released declines and colonies become more isolated, reducing the likelihood of cross-fertilisation. Local hydrodynamic conditions can promote or inhibit gamete contact; thus, the interaction between the abiotic environment and sperm density will determine the amount of time gametes interact. In this study, we investigated the sensitivity of reproduction to manipulations of two key limiting factors of fertilisation: sperm concentration and contact time between gametes. We explored fertilisation kinetics of phylogenetically and functionally similar and diverse coral taxa on the Great Barrier Reef and Western Australia (Acropora digitifera, A. tenuis; Coelastrea aspera, Platygyra daedalea). Results indicate that fertilisation is optimised at sperm concentrations > 103 sperm mL−1 and contact times > 30 s, but the extent of these relationships is species-specific. All species showed clear differences in fertilisation success across contact times, although these differences were less distinct for A. tenuis and P. daedalea at very high sperm concentrations. Acropora digitifera and P. daedalea exhibited nonlinear trends with steep slopes of increased fertilisation success once sperm concentration surpassed values of 104 sperm mL−1 and 102 sperm mL−1, respectively, followed by slight declines. Acropora tenuis and A. digitifera had the highest maximum fertilisation success, likely owing to beneficial evolved functional traits like large egg sizes. The present analysis underpins studies of fertilisation kinetics in natural reef populations to help inform management and restoration practices that assist population resilience and recovery. [ABSTRACT FROM AUTHOR]

The editorial discusses propofol-associated hypertriglyceridemia, a condition where elevated triglyceride levels are linked to propofol sedation in critically ill patients. Heybati and colleagues conducted a study involving 11,828 adult patients on mechanical ventilation, finding that hypertriglyceridemia was more common in patients receiving higher doses of propofol. The study highlights the need for further research on when to measure triglyceride levels, the risks of continuing propofol, and the role of triglyceride-lowering therapies in managing this condition. The findings underscore the importance of understanding and addressing propofol-associated hypertriglyceridemia in intensive care settings to improve patient outcomes. [Extracted from the article]

Background: Long Covid is a widely recognised consequence of COVID-19 infection, but little is known about the burden of symptoms that patients present with in primary care, as these are typically recorded only in free text clinical notes. Aims: To compare symptoms in patients with and without a history of COVID-19, and investigate symptoms associated with a Long Covid diagnosis. Methods: We used primary care electronic health record data until the end of December 2020 from The Health Improvement Network (THIN), a Cegedim database. We included adults registered with participating practices in England, Scotland or Wales. We extracted information about 89 symptoms and 'Long Covid' diagnoses from free text using natural language processing. We calculated hazard ratios (adjusted for age, sex, baseline medical conditions and prior symptoms) for each symptom from 12 weeks after the COVID-19 diagnosis. Results: We compared 11,015 patients with confirmed COVID-19 and 18,098 unexposed controls. Only 20% of symptom records were coded, with 80% in free text. A wide range of symptoms were associated with COVID-19 at least 12 weeks post-infection, with strongest associations for fatigue (adjusted hazard ratio (aHR) 3.46, 95% confidence interval (CI) 2.87, 4.17), shortness of breath (aHR 2.89, 95% CI 2.48, 3.36), palpitations (aHR 2.59, 95% CI 1.86, 3.60), and phlegm (aHR 2.43, 95% CI 1.65, 3.59). However, a limited subset of symptoms were recorded within 7 days prior to a Long Covid diagnosis in more than 20% of cases: shortness of breath, chest pain, pain, fatigue, cough, and anxiety / depression. Conclusions: Numerous symptoms are reported to primary care at least 12 weeks after COVID-19 infection, but only a subset are commonly associated with a GP diagnosis of Long Covid. [ABSTRACT FROM AUTHOR]

Introduction: Vancomycin is used in intensive care unit (ICU) patients for the treatment of infections caused by gram-positive bacteria. The vancomycin pharmacokinetic/pharmacodynamic index is a ratio of the area under the concentration to the minimum inhibitory concentration ≥400–600 h*mg/L. This target can generally be achieved by a plasma concentration of 20–25 mg/L. Together with the pathophysiological alterations and pharmacokinetic variability associated with critical illness, the use of continuous renal replacement therapy (CRRT) may complicate the attainment of adequate vancomycin concentrations. The primary objective was the prevalence of attainment of vancomycin concentrations 20–25 mg/L after 24 h in adult ICU patients receiving CRRT. Secondary outcomes were to evaluate target attainment at days 2 and 3 and to calculate vancomycin clearance (CL) by CRRT and residual diuresis. Methods: We performed a prospective observational study in adult ICU patients on CRRT, which received at least 24 h continuous infusion of vancomycin. Between May 2020 and February 2021, daily vancomycin residual blood gas and dialysate samples were collected from 20 patients, every 6 h and if possible vancomycin urine samples. Vancomycin was analysed with an immunoassay method. The CL by CRRT was calculated by a different approach correcting for the downtime and providing insight into the degree of filter patency. Results: The proportion of patients with vancomycin concentrations <20 mg/L was 50% 24 h after starting vancomycin (n = 10). No differences were observed in patient characteristics. The target vancomycin concentration 20–25 mg/L was only achieved in 30% of the patients. On days 2 and 3, despite the use of TDM and albeit in lower percentages, sub- and supratherapeutic levels were still observed. Taking downtime and filter patency into account resulted in lower vancomycin CL. Conclusions: 50% of the studied ICU patients on CRRT showed subtherapeutic vancomycin concentrations 24 h after starting therapy. The results reveal that optimization of vancomycin dosage during CRRT therapy is needed. [ABSTRACT FROM AUTHOR]

Purpose of Review: Patients with acute neurologic injury require a specialized approach to critical care, particularly with regard to sedation and analgesia. This article reviews the most recent advances in methodology, pharmacology, and best practices of sedation and analgesia for the neurocritical care population. Recent Findings: In addition to established agents such as propofol and midazolam, dexmedetomidine and ketamine are two sedative agents that play an increasingly central role, as they have a favorable side effect profile on cerebral hemodynamics and rapid offset can facilitate repeated neurologic exams. Recent evidence suggests that dexmedetomidine is also an effective component when managing delirium. Combined analgo-sedation with low doses of short-acting opiates is a preferred sedation strategy to facilitate neurologic exams as well as patient-ventilator synchrony. Summary: Optimal care for patients in the neurocritical care population requires an adaptation of general ICU strategies that incorporates understanding of neurophysiology and the need for close neuromonitoring. Recent data continues to improve care tailored to this population. [ABSTRACT FROM AUTHOR]

Purpose. To summarize the most highly esteemed, peer-reviewed, infectious diseases (ID) pharmacotherapy articles published in 2020. Summary. Members of the Houston Infectious Diseases Network (HIDN) nominated articles that were deemed to have noteworthy contributions to ID pharmacotherapy in 2020, including those on coronavirus disease 2019 (COVID-19) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). To select the most significant articles of 2020, a survey was created and distributed to members of the Society of Infectious Diseases Pharmacists (SIDP) to vote on their top 10 articles of general ID and COVID-19 pharmacotherapy and one noteworthy HIV/AIDS publication. A total of 40 articles were nominated by HIDN: 35 articles pertaining to general ID/COVID-19 pharmacotherapy and 5 articles with HIV/AIDS involvement. Of the 247 SIDP members who responded to the survey, 205 and 42 members voted for general ID/COVID-19 pharmacotherapy articles and HIV/AIDS related articles, respectively. The top publications are summarized. Conclusion. In a taxing year of a global pandemic, the abundant and rapid distribution of ID literature has made it challenging for clinicians to stay informed of significant publications across the ID spectrum. This review summarizes significant ID-related publications in 2020 with the goal of aiding clinicians in staying up to date on the most relevant publications in ID pharmacotherapy. [ABSTRACT FROM AUTHOR]

Bloodstream infections (BSIs) due to Gram‐positive organisms have traditionally been treated with prolonged courses of intravenous antimicrobials. However, this dogma is associated with substantial burden to the patient and health care system. Consequently, there is growing interest in the utilization of oral stepdown therapy, defined as the transition of intravenous therapy to an active oral agent, for this indication. This review highlights available literature examining oral stepdown in adult patients with BSI due to commonly encountered Gram‐positive pathogens, including Staphylococcus aureus, Streptococcus spp., and Enterococcus spp. Support for oral stepdown in this setting is primarily derived from observational studies subject to selection bias. Nevertheless, this treatment strategy exhibits promising potential in carefully selected patients as it is consistently associated with reductions in hospital length of stay without jeopardizing clinical cure or survivability. Prospective, randomized trials are needed for validation of oral stepdown in Gram‐positive BSI and to identify the optimal patient population and regimen. [ABSTRACT FROM AUTHOR]

Background: The recent SARS‐CoV‐2 pandemic has resulted in significant morbidity and mortality worldwide. The healthcare systems, including pharmacies, faced unique challenges, such as managing an overwhelming patient influx, clinical workforce management, transitioning to remote or online work, medication procurement and several others. The purpose of this study is to describe our hospital pharmacy's experience dealing with the COVID-19 pandemic and to present solutions to the challenges that arose. Methodology: We retrospectively reviewed and consolidated strategies, interventions, and solutions that were implemented by our pharmaceutical institute in response to the challenges that arose during the COVID-19 pandemic. The study period was from March 1 to September 30, 2020. Results: We reviewed and organized our hospital pharmacy response to the COVID-19 pandemic into different categories. In inpatient and outpatient satisfaction surveys, physicians and patients expressed a high level of satisfaction with pharmacy services. The close collaboration between the pharmacy team and other clinicians was demonstrated through the number of pharmacist interventions, participation in the COVID-19 guidelines reviews, involvement in local and international research, and innovative solutions to inpatient and outpatient pharmacy medication management challenges. Conclusions: This study highlights the crucial role that our pharmacists and pharmaceutical institute played in ensuring continuity of care during the COVID-19 pandemic. We implemented several key initiatives, innovations, and collaborations with other clinical disciplines to successfully overcome the challenges faced. [ABSTRACT FROM AUTHOR]

Coastal cities are under severe threat from the impacts of climate change, such as sea-level rise, extreme weather events, coastal inundation, and ecosystem degradation. It is well known that the ocean, and in particular coastal environments, have been changing at an unprecedented rate, which poses increasing risks to people in small island developing states, such as Fiji. The Greater Suva Urban Area, the capital and largest metropolitan area of Fiji, is expected to be largely impacted by climate-related risks to its socio-economic, cultural, and political positions. In the face of these threats, creating a resilient city that can withstand and adapt to the impacts of climate change and promote sustainable development should be guided by a holistic approach, encompassing stakeholders from the government, the private sector, civil society organizations, and international institutions. This study assesses the risk profile of Suva city using an innovative risk information tool, the climate and ocean risk vulnerability index (CORVI), which applies structured expert judgment to quantify climate-related risks in data-sparse environments. Through comparative quantification of diverse risk factors and narrative analysis, this study identifies three priority areas for Suva's future climate-resilient actions: development of climate risk-informed urban planning, harmonized urban development and natural restoration, and enhancing the climate resilience to the tourism sector. [ABSTRACT FROM AUTHOR]

Background: Non-motor symptoms (NMS) are compulsory clinical features for the clinical diagnosis of multiple system atrophy (MSA), some of which precede motor symptoms onset. To date, few studies have systematically investigated NMS in MSA and the timing of presenting NMS as the disease progresses. Clinically, MSA is difficult to be differentiated from Parkinson's disease (PD) and progressive supranuclear palsy (PSP), and the differences in NMS between MSA and PD/PSP remain unclear. The aim of this study was to compare the burden of NMS between MSA and PD/PSP and to delineate the timing of NMS presentation relative to the onset of motor symptoms in MSA. Methods: A total of 61, 87, and 30 patients with MSA, PD, and PSP, respectively, were enrolled in this study. NMS was systematically assessed in all patients using the NMS scale (NMSS), and the onset of NMS relative to the onset of motor symptoms in MSA was investigated. Results: MSA group had higher total NMSS scores (82.15 ± 46.10) than the PD (36.14 ± 30.78) and PSP (50.30 ± 55.05) groups (p < 0.001 overall). The number distribution pattern of the NMS was significantly different among the three parkinsonian disorders (p < 0.001 overall). In total, 85.2% of patients with MSA had more than 10 NMS, which was significantly higher than PD (28.7%) and PSP (33.3%). The frequency and scores of many NMSS subdomains and symptoms were higher in MSA than in PD and PSP (all p < 0.05). Multivariate logistic regression analysis revealed that patients with fainting, lack of motivation, swallowing, and loss of sexual interest could be attributed to MSA rather than PD or PSP, while patients with loss of concentration and forgetfulness were characteristic features of PD or PSP rather than MSA. REM-sleep behavior disorder (RBD), constipation, problems having sex, and loss of sexual interest preceded the motor symptoms onset of MSA by 2.81 ± 4.51, 1.54 ± 6.32, 1.35 ± 4.70, and 0.45 ± 3.61 years, respectively. Conclusion: The NMS spectrum in MSA differs from that of PD and PSP. Patients with MSA have a higher NMS burden than patients with PD or PSP. RBD, constipation, problems having sex, and loss of sexual interest may become early diagnostic clinical markers of MSA. [ABSTRACT FROM AUTHOR]

Evidence supporting intravenous‐to‐oral (IV‐to‐PO) antibiotic deescalation for uncomplicated streptococcal bloodstream infections (BSIs) are limited. The objective of this study was to compare clinical outcomes of patients treated with IV‐only versus IV‐to‐PO antibiotic therapy for uncomplicated streptococcal BSIs. This was a single‐center, retrospective study of patients aged ≥18 years who received treatment for uncomplicated streptococcal BSIs from January 2017 to December 2019. Patients were excluded if they had a polymicrobial BSI, endocarditis, osteomyelitis, septic arthritis, or received antibiotic therapy for >14 days. The primary outcome was clinical failure, defined as persistent bacteremia, recurrence of bacteremia, or mortality at 30 days. Secondary outcomes included length of hospital stay, all‐cause readmissions, development of Clostridioides difficile infection, and adverse antibiotic reactions. There were 98 patients who met the inclusion criteria: 51 patients in the IV‐to‐PO therapy group and 47 patients who received IV‐only antibiotics. Streptococcus pneumoniae and beta‐hemolytic streptococci were the most common pathogens. Patients received an average of 4.4 days of IV antibiotics before being stepped down to an oral agent. Hospital length of stay (6.3 vs 12.6 days; P <.001) and total antibiotic duration of therapy (11.8 vs 13.9 days; P =.002) were significantly shorter in patients receiving IV‐to‐PO therapy. There were no clinical failures observed in patients who received IV‐to‐PO antibiotic therapy. IV‐to‐PO step‐down therapy for uncomplicated streptococcal BSIs was not associated with worse clinical outcomes compared to patients receiving IV‐only antibiotic therapy. [ABSTRACT FROM AUTHOR]

Objectives Pharmacy practice journals are considered the main player in promoting pharmacy practice research and the pharmacy profession globally. The current study aimed to explore and analyze literature on the COVID-19 pandemic published in pharmacy practice journals. Methods COVID-19 research articles were extracted from 32 pharmacy practice journals indexed in Scopus for the study period from 01 January 2020, up until 31 December 2021 Key findings A total of 581 documents were found with an average of 4.5 authors per article and 4.8 citations per document. The retrieved documents were published in 28 pharmacy practice-related journals with the Research in Social and Administrative Pharmacy and the American Journal of Health System Pharmacy journals being the leaders in this field. The major findings of the analysis indicated (1) a limited number of contributing countries with limited author-author interactions and cross country collaboration; (2) specific topics were encountered, mainly hospital pharmacy services, survey studies on knowledge, and pharmacy education; (3) several contributing countries in the Middle East, mainly Saudi Arabia; Egypt, and Jordan contributed to the retrieved documents, and (4) the highly-cited documents discussed issues related to pharmacy services and role of the community pharmacists during the pandemic. Conclusion Research activity on COVID-19 in pharmacy practice journals represents the commitment of researchers and professionals to transform and promote the profession of pharmacy. Research on pharmacy practice and pharmacists in low- and middle-income countries during pandemics needs to be prioritized by scholars and journal editors. [ABSTRACT FROM AUTHOR]

Background: Court Mental Health Liaison and Diversion Services (CMHLDS) have developed in some countries as a response to the over-representation of mental illness and other vulnerabilities amongst defendants presenting to criminal justice (or correctional) systems. This study examined the characteristics and rates of mental disorder of 9088 defendants referred to CMHLDS. Method: The study analysed service level data, obtained from the National Health Service's mental health data set, to examine characteristics relating to gender, ethnicity and comorbidity of common mental and neurodevelopmental disorders at five CMHLDS across London between September 2015 and April 2017. Results: The sample included 7186 males (79.1%) and 1719 females (18.9%), the gender of 183 (2%) were not recorded. Of those referred, 6616 (72.8%) presented with an identifiable mental disorder and 503 (5.5%) with a neurodevelopmental disorder (NDD). Significantly higher rates of schizophrenia were reported amongst Black defendants (n = 681; 37.2%) and Asian defendants (n = 315; 29%), while higher rates of depression were found amongst White defendants (n = 1007; 22.1%). Substance misuse was reported amongst 2813 defendants (31%), and alcohol misuse amongst 2111 (23.2%), with significantly high rates of substance and alcohol misuse amongst defendants presenting with schizophrenia or personality disorder. Conclusions: This is one of the largest studies to examine mental health needs and vulnerabilities amongst defendants presenting to CMHLDS. It will enable an improved understanding of the required service designs and resources required to manage the healthcare pathways for people attending CMHLDS. [ABSTRACT FROM AUTHOR]

Purpose: Early clinical failure criteria (ECFC) were recently introduced to predict unfavorable outcomes in patients with Gram-negative bloodstream infections (BSI). ECFC include hypotension, tachycardia, tachypnea or mechanical ventilation, altered mental status, and leukocytosis evaluated at 72–96 h after BSI. The aim of this retrospective cohort study was to assess performance of ECFC in predicting 28-day mortality in Enterococcus species BSI. Methods: Hospitalized adults with Enterococcus species BSI at Prisma Health hospitals from 1 January 2015 to 31 July 2018 were identified. Multivariate logistic regression was used to determine the association between ECFC and 28-day mortality. Area under the receiver operating characteristic (AUROC) curve was used to measure model discrimination. Results: Among 157 patients, 28 (18%) died within 28 days of BSI. After adjustments in multivariate model, the risk of 28-day mortality increased in the presence of each additional ECFC (OR 1.6, 95% CI 1.2–2.3, p = 0.005). Infective endocarditis (OR 3.9, 95% CI 1.4–10.7, p = 0.01) was independently associated with 28-day mortality. AUROC curve of ECFC model in predicting 28-day mortality was 0.74 with ECFC of 2 identified as the best breakpoint. Mortality was 8% in patients with ECFC < 2 compared to 33% in those with ECFC ≥ 2 (p < 0.001). Conclusion: ECFC had good discrimination in predicting 28-day mortality in patients with Enterococcus species BSI. These criteria may have utility in future clinical investigations. [ABSTRACT FROM AUTHOR]

The global decline of coral reefs has driven considerable interest in active coral restoration. Despite their importance and dominance on mature reefs, relatively few coral restoration projects use slower growth forms like massive and encrusting coral species. Micro-fragmentation can increase coral cover by orders of magnitude faster than natural growth, which now allows cultivation of slow growing massive forms and shows promise and flexibility for active reef restoration. However, the major causes of variation in growth and survival of outplanted colonies remain poorly understood. Here, we report simple outplanting assays to aid in active reef restoration of slower growing species and increase the likelihood of restoration success. We used two different micro-fragmentation assays. Pyramid assays were used to examine variation associated with fragment size (ranging from ≈1-9 cm2), nursery residence time (for both in-situ and ex-situ nurseries), and 2D vs. 3D measurements of growth. Block assays were used to examine spatial variation among individual performance at outplanting sites in the field. We found 2D and 3D measurements correlated well, so measured survivorship and growth using top-down planar images for two of the main Hawaiian reef building corals, the plating Montipora capitata and the massive Porites compressa. Pyramid assays housed and outplanted from the in-situ nursery showed no effect of residence time or size on overall survivorship or growth for either species. Results from the ex-situ nursery, however, varied by species, with P. compressa again showing no effect of nursery residence time or size on survivorship or growth. In contrast, nursery culture resulted in improved survivorship of small M. capitata fragments, but net growth showed a weak positive effect of nursery time for medium fragments. Small fragments still suffered higher mortality than either medium or large fragments. Due to their lower mortality, medium fragments (≈3 cm2) appear to be the best compromise between growth and survivorship for outplanting. Likewise, given weak positive gains relative to the investment, our results suggest that it could be more cost-effective to simply outplant medium fragments as soon as possible, without intermediate culture in a nursery. Furthermore, the block assay revealed significant differences in survivorship and growth among sites for individuals of both species, emphasizing the importance of considering spatial variation in coral survival and growth following outplanting. These results highlight the value of using short-term micro-fragmentation assays prior to outplanting to assess size, and location specific performance, optimizing the efficiency of active reef restoration activities and maximizing the probability of success for active coral restoration projects. [ABSTRACT FROM AUTHOR]

Context: Antipsychotics and benzodiazepines do not improve delirium. Valproic acid (VPA) has been used recently to treat agitation in delirium. Objectives: To review the evidence for VPA in the management of Delirium. Methods: Systematic review. English language, age 19 and above, from 1946 to January 12, 2021. Mesh Terms: "Valproic acid", "valproate", "sodium valproate", "delirium", "acute mania with delirium" in PubMed and Ovid. Exclusion: Studies of VPA used for diagnoses other than delirium. Results: 21 abstracts were identified and 10 studies were included in the review (252 patients): One prospective open label study (n: 7), 2 case series (n: 22), 4 retrospective studies (n: 219) and 3 case reports (n: 4). No randomized controlled trial (RCT) evaluates the effect of VPA in delirium. 237/250 (94.8%) patients were in the ICU. Mean age was 59.7 (27-87). 153/204 (74%) were male. The mean starting dose was 733 mg/day in 148 patients and the mean dose at follow up was 1061 mg/day in 205 patients. CAM ICU was used to diagnose delirium in 6 reviews. Delirium improved in case series in 19/22 patients. Delirium improved in retrospective studies at day 3 compared to day 1. VPA levels were not consistently reported. Hyperammonemia (12-19%) and thrombocytopenia (9-13%) were the most common side effects. No deaths were attributed to VPA. Conclusion: VPA is being used more frequently for delirium. The evidence is limited to retrospective studies and case series. There is a need for RCT to evaluate the effect of VPA in delirium compared to other alternatives and placebo. [ABSTRACT FROM AUTHOR]

The cushion seastar Culcita schmideliana has gained major attention in the last few years because of its selective predation on juvenile corals, as well as its ability to generate large demographic assemblages, causing delays in coral recovery after large mortality events in the Republic of Maldives. However, a lack of data regarding the factors affecting its distribution and habitat selection still persists in this area. Here, we adopted a novel approach in the study of corallivorous seastar habitat selection that combined ecological and digital photogrammetry data. In this regard, we tested 3 different parameters as factors influencing seastar habitat choice in the South-East region of Faafu Atoll, Republic of Maldives, namely prey abundance, Linear Rugosity Index (LRI), and Average Slope (AS). The analysis of selectivity coefficient (Ei) of seastars for different habitat types showed a preference for reefs characterized by medium AS values (Ei = 0.268), a LRI included between 2 and 2.5 (Ei = 0.180), and a juvenile coral density ranging between 10 and 20 colonies m−2 (Ei = 0.154). A multiple linear regression analysis showed that different AS and LRI values explained the 43.1% (R2 = 0.431, P = 0.007) and the 48.1% (R2 = 0.481, P = 0.024) of variance in seastars abundance, respectively, while juvenile coral densities did not significantly affect this (R2 = 0.132, P = 0.202). These results provide new information on the distribution and behaviour of an important corallivore of Maldivian reefs, such as C. schmideliana. [ABSTRACT FROM AUTHOR]

Rationale: The use of intravenous valproate is not approved for clinical practice in psychiatry. Literature data pointed out for a potential usefulness of this route of administration for valproate, but there is no actual consensus. Objectives: The aim of the present systematic review is to assess the effectiveness of intravenous valproate in agitation as well as general safety. Methods: A systematic review of studies evaluating the use of intravenous valproate in agitation was conducted. Additionally, safety was evaluated in all randomized trials involving the use of intravenous valproate in all medical conditions (epilepsy, migraine and psychiatric conditions). Results: For the systematic review on effectiveness in agitation, the search yielded 965 articles overall. After removing duplicates, 9411 articles were screened by title and abstract, and 39 of these were evaluated at a full-text level. Six studies were considered eligible for qualitative synthesis: one RCT and case report (n = 3), followed by cohort studies (n = 2). For the systematic review on safety, twenty-two RCTs were considered eligible for quantitative synthesis. Conclusion: Intravenous valproate seems efficacious in reducing agitation in psychiatric patients; it generally appears safe compared to other neuroleptics or antiepileptics. However, the evidence is still not strong as it relies mainly on open-label studies or case series. [ABSTRACT FROM AUTHOR]

Hard-shell-mating is the typical way that semi-terrestrial and terrestrial crabs copulate, when females reproduce with a hard carapace during the intermoult period and the couples have a brief or absent pre- and post-copulatory behaviour. For Gecarcinidae crabs there are few studies on reproductive behaviour, and are especially rare for isolated species, as in the genus Johngarthia. Here, we describe the mating behaviour of the endangered insular crab J. lagostoma endemic of the South Atlantic Ocean, with a focus on pre-, copulatory, and post-copulatory behaviours. Observations were made on 20 pairs in the field, with every female in intermoult. Accessory behaviours were absent, with copulation beginning after sexual recognition. After mating, there were no records of males guarding or embracing females. All couples had the female in an upper position and passive males, which do not react when other males are near the mating site. The size of the chelipeds and males were random and not determinant to mating. However, yellow crabs predominated (95%) in mating pairs and the linkage of colouration to sexual selection needs to be more elucidated because purple crabs are less frequent in the population and the lower representation in the couples can be an effect of this. Experimental studies are required to investigate sexual selection and the occurrence of the behaviour described herein at other locations. [ABSTRACT FROM AUTHOR]

Tropical cyclones can dramatically reduce coral cover, coral diversity and structural complexity, which can all cause flow-on effects to fish communities. In 2016, Fiji sustained extensive damage from one of the most severe cyclones recorded in the southern hemisphere (Category 5 cyclone Winston). We assessed the impacts of cyclone Winston on the coral reef habitat and fish assemblages in Kubulau and Levuka districts in Fiji. Wave modelling showed that cyclone-generated waves were substantially larger and persisted longer in Levuka than Kubulau. Damage to live corals was spatially variable and highest in Levuka, with the extent of damage highly correlated to the exposure, height and duration of waves at each site. We recorded increases in macroalgae directly after the cyclone and increases in encrusting coralline algae two years after the cyclone. We did not detect many changes in the fish assemblage caused by cyclone Winston. Obligate corallivores, and species within this group, Chaetodon baronessa and Labrichthys unilineatus, were the only fish to show a decline post-cyclone, most likely caused by declines in coral cover. We found that the modelling of cyclone wave dynamics (wave height, duration and exposure) explained the variation and damage to live corals better than proximity to the cyclone path, providing a useful tool to predict cyclone damage. Future climate models predict that more cyclones will reach the highest intensities. Understanding the impact this will have on vulnerable coastal communities that are dependent on marine resources and are protected from wave energy by reefs is essential for effective mitigation and adaptive management plans. [ABSTRACT FROM AUTHOR]

Background: Malaria transmission is currently resurging in Papua New Guinea (PNG). In addition to intervention coverage, social and cultural factors influence changes in epidemiology of malaria in PNG. This study aimed to better understand the role of human behavior in relation to current malaria control efforts.Methods: A mixed-method design was used in 2 sites in PNG. In-depth interviews, focus group discussions, cross-sectional malaria indicator survey, and population census were implemented.Results: We identified 7 population groups based on demographics and behavioral patterns with potential relevance to Anopheles exposure. People spend a substantial amount of time outdoors or in semiopen structures. Between 4 pm and 8 am, all types of activities across all groups in both study sites may be exposing individuals to mosquito bites; sleeping under a long-lasting insecticidal net was the exception. The later in the night, the more outdoor presence was concentrated in adult men.Conclusions: Our findings highlight the potential of outdoor exposure to hamper malaria control as people spend a remarkable amount of time outdoors without protection from mosquitoes. To prevent ongoing transmission, targeting of groups, places, and activities with complementary interventions should consider setting-specific human behaviors in addition to epidemiological and entomological data. [ABSTRACT FROM AUTHOR]

Princess parrotfish Scarus taeniopterus is one of the top three parrotfish species landed in the Caribbean, and the top Scarus species targeted in commercial fishing efforts; however, a paucity of information exists concerning basic life history information for Caribbean parrotfish species. Prior to this work, no comprehensive life history information existed in the literature for princess parrotfish. This study provides the first comprehensive documentation of age, growth, size/age at sexual maturity, and size/age at transition for a Caribbean Scarus species. Sampling of 759 fish occurred in Puerto Rico and the US Virgin Islands from October 2015 to February 2020. Females ranged from 50 to 250 mm total length (TL) and 0 to 7 years of age, males ranged from 159 to 314 mm TL and 2 to 11 years, and transitional fish ranged from 140 to 292 mm TL and 2 to 6 years. Previously unknown von Bertalanffy parameters (L∞ = 301 and k = 0.316) and length at median sexual maturity (LM50 = 119 mm TL), age at median sexual maturity (AM50 = 1.5 years), length at median sexual transition (LS50 = 223 mm TL), and age at median sexual transition (AS50 = 4.2 years) will enable stock assessments and informed management for this Caribbean parrotfish. [ABSTRACT FROM AUTHOR]

Background: The movement ecology of mutton snapper Lutjanus analis is poorly understood despite their ecological and economic importance in the Caribbean. Passive acoustic telemetry was used to determine home ranges of six adult L. analis, including diel patterns, in Brewers Bay, St. Thomas, US Virgin Islands. Understanding long-term space use, including site fidelity and habitat usage, is necessary to implement effective and appropriate management actions for a species with extensive space and resource needs. Results: Individual L. analis were tracked over an average period of 316 days (range 125–509 days) and showed high site fidelity to relatively small home ranges (mean ± SD: 0.103 ± 0.028 km2, range 0.019–0.190 km2) and core use areas with low overlap among individuals. Most home ranges had a habitat composition dominated by seagrass and to a lesser degree, coral reef and/or pavement. Nighttime activity spaces were distinct from but contained within daytime areas. Conclusions: Mutton snapper showed strong site fidelity to home ranges in Brewers Bay. Two individuals that were absent from the array for more than a few hours were detected at separate arrays at spawning aggregation sites. This study expands upon knowledge of mutton snapper home range characteristics, highlights the importance of maintaining adjacent high-quality habitat types in any spatial management plan, and encourages the adoption of other types of management strategies, particularly for transient-aggregating species. [ABSTRACT FROM AUTHOR]

This cross sectional study examines how patient characteristics, doctor characteristics, and doctors' education and attitudes affect the extent to which doctors link progress notes to clinical problems. The independent effects of patient characteristics on the linking of notes was examined with a mixed model logistic regression. The effects of doctor characteristics and doctors' education and attitudes on the link ratio was analyzed with univariate analysis of variance. A survey was used to obtain arguments and attitudes on linking notes. For "patient characteristics", the odds of linking increased with an increase in the number of problems or hospital days, decreased, with an increase in the number of involved doctors, medical specialties or the number of notes. For "doctor characteristics", the link ratio increased with more work experience. For "doctors' education and attitudes", the link ratio increased with more familiarity in linking notes and belief in the added value of problem oriented charting. "Overview" was the most cited reason for linking; "I don't know how" the most cited reason for not linking. There is a huge variation within and between all disciplines. Important arguments, for and against, are found. Recommendations for policymakers and medical leadership are given to maximize the benefits. [ABSTRACT FROM AUTHOR]

General practice in the United Kingdom has been using electronic health records for over two decades, but coding clinical information remains poor. Lack of interest and training are considerable barriers preventing code use levels improvement. Tailored training could be the way forward, to break barriers in the uptake of coding; to do so it is paramount to understand coding use of the particular clinicians, to recognise their needs. It should be possible to easily assess text quantity and quality in medical consultations. A tool to measure these parameters, which could be used to tailor training needs and assess change, is demonstrated. The tool is presented and a preliminary study using a randomised sample of five recent consultations from thirteen different clinicians is used as an example. The tool, based on using a word processor and a spread-sheet, allowed quantitative analysis among clinicians while word clouds permitted a qualitative comparison between coded and free text. The average amount of free text per consultation was 68.2 words, (ranging from 25.4 and 130.2 among clinicians); an average of 6% of the text was coded (ranging from 0 to 13%). Patterns among clinicians could be identified. Using Word cloud, a different text use was demonstrated depending on its purpose. Some free text could be turned into code but nomenclature probably prevented some of the codings, like the expression of time. This proof of concept demonstrated that it is possible to calculate what percentage of consultations are coded and what codes are used. This allowed understanding clinicians' preferences; training needs and gaps in nomenclature. [ABSTRACT FROM AUTHOR]

The discovery of multi-species synchronous spawning of scleractinian corals on the Great Barrier Reef in the 1980s stimulated an extraordinary effort to document spawning times in other parts of the globe. Unfortunately, most of these data remain unpublished which limits our understanding of regional and global reproductive patterns. The Coral Spawning Database (CSD) collates much of these disparate data into a single place. The CSD includes 6178 observations (3085 of which were unpublished) of the time or day of spawning for over 300 scleractinian species in 61 genera from 101 sites in the Indo-Pacific. The goal of the CSD is to provide open access to coral spawning data to accelerate our understanding of coral reproductive biology and to provide a baseline against which to evaluate any future changes in reproductive phenology. Measurement(s) Point in Time Date and Time Data Type • Spawning Technology Type(s) Observation • digital curation Sample Characteristic - Organism Scleractinia Sample Characteristic - Environment ocean Sample Characteristic - Location Pacific Ocean • Indian Ocean region Machine-accessible metadata file describing the reported data: https://doi.org/10.6084/m9.figshare.13100552 [ABSTRACT FROM AUTHOR]

Modern-day Indo-Pacific coral reefs are characterized by rapid recovery driven by pulses of coral recruitment, but Caribbean reefs exhibit low rates of recruitment and poor recovery following a wide range of disturbance events. The contrasting evolutionary history of coral taxa offers key insight into biogeographic patterns of coral resilience. Following the closure of the Isthmus of Panama approximately 2.8 million years ago, widespread extinction of Caribbean corals led to an evolutionary bottleneck that favored large and long-lived species with a relatively high reliance on asexual versus sexual reproduction. In contrast, adaptive radiation led to the evolution of superrecruiting tabular, digitate, and corymbose corals that drive the rapid recovery of modern-day Indo-Pacific reefs following disturbance. The dominance of branching growth forms and evolutionary absence of superrecruiting growth forms throughout the entire evolutionary history of the Caribbean (approximately 38 million years ago to present) may explain the exceptionally high recruitment rates on modern-day Indo-Pacific reefs and low historical recruitment on Caribbean reefs. The evolutionary history of the Caribbean coral reef-building taxa implies that, even with a reversal of ecosystem state, widespread recovery of Caribbean reefs may be limited. [ABSTRACT FROM AUTHOR]

A greater understanding of gendered roles in fisheries is necessary to value the often-hidden roles that women play in fisheries and households. We examine women's contributions to household food and income using focus group discussions, market surveys, and landings data in six communities in Timor-Leste. Women were actively fishing more days per month than men. Gleaning was the most frequent activity and 100% of trips returned with catch for food and/or income. Mollusc and crab catches were common and exploitation appeared targeted on a dynamic reappraisal of changing food values and changing estimates of group needs. With as many as 80% of households in coastal areas involved in fishing, and at least 50% of women fishing, this highlights the current lack of women's engagement as a critical gap in fisheries management approaches. The current androcentric dialogue limits social-ecological understanding of these systems and the potential for their effective stewardship. [ABSTRACT FROM AUTHOR]

Spatial patterns of coral reef benthic communities vary across a range of broad-scale biogeographical levels to fine-scale local habitat conditions. This study described spatial patterns of coral reef benthic communities spanning across the 536-km coast of Kenya. Thirty-eight reef sites representing different geographical zones within an array of habitats and management levels were assessed by benthic cover, coral genera and coral colony size classes. Three geographical zones were identified along the latitudinal gradient based on their benthic community composition. Hard coral dominated the three zones with highest cover in the south and Porites being the most abundant genus. Almost all 15 benthic variables differed significantly between geographical zones. The interaction of habitat factors and management levels created a localised pattern within each zone. Four habitats were identified based on their similarity in benthic community composition; 1. Deep-Exposed Patch reef in Reserve areas (DEPR), 2. Deep-Exposed Fringing reefs in Unprotected areas (DEFU), 3. Shallow Fringing and Lagoon reefs in Protected and Reserve areas (SFLPR) and 4. Shallow Patch and Channel reefs (SPC). DEPR was found in the north zone only and its benthic community was predominantly crustose coralline algae. DEFU was found in central and south zones mainly dominated by soft corals, Acropora, Montipora, juvenile corals and small colonies of adult corals. SFLPR was dominated by macroalgae and turf algae and was found in north and central zones. SPC was found across all geographical zones with a benthic community dominated by hard corals of mostly large colonies of Porites and Echinopora. The north zone exhibits habitat types that support resistance properties, the south supports recovery processes and central zone acts as an ecological corridor between zones. Identifying habitats with different roles in reef resilience is useful information for marine spatial planning and supports the process of designing effective marine protected areas. [ABSTRACT FROM AUTHOR]

Scleractinian corals often reproduce in synchronized spawning events to maximize gamete fertilization and coral larval production. The extent of spawning synchrony and its timing vary among coral taxa and among biogeographic regions. Information is, however, limited, especially for equatorial reefs, hindering the identification of environmental cues that influence gametogenic cycles and spawning. To investigate the timing of gamete maturation and spawning in Palau and their association with environmental cues, we monitored tagged colonies from 11 common coral species within three families over 21 months. We then combined our findings with previous available information to more broadly summarize the known coral spawning patterns in Palau. In combination with previous observations, our data confirmed the occurrence of an extended coral spawning season in Palau, spreading over 9 months. Some coral taxa participated in synchronous multispecific spawning events, with the largest occurring throughout April and May. Other coral taxa, including Montipora corals, displayed inter- and intra-specific spawning asynchrony. Consequently, environmental cues associated with spawning patterns differed among species. The largest Acropora spawning event of the year (March–April) was associated with the lowest yearly high tides and a monthly mean sea surface temperature around 29 °C. Massive Porites spawned predominantly in April and May, associated with increased monthly levels of solar insolation. Porites rus spawned in June–August and was associated with longest monthly day length. Our study demonstrates that Palauan coral assemblages have complex patterns of multispecific spawning events throughout most of the year, which may have important implications for larval dispersal, supply and recruitment patterns, influencing the resilience of coral reefs in this region. [ABSTRACT FROM AUTHOR]

Egg size and fecundity are often used as proxies for coral reproductive success and health. The amount of energy a coral invests in reproduction reflects its environmental conditions during gametogenesis. Additionally, assuming resources for reproduction are limited, it is thought that an increase in egg size should result in a decrease in the number of eggs produced i.e. investing in many small eggs or fewer larger eggs. The biannually spawning populations of Scott Reef offer a unique opportunity to compare the egg size and polyp fecundity of corals exposed to different environmental conditions during gametogenesis, prior to spawning in autumn (March) and spring (October). In this study, we investigated the relationship between egg size and polyp fecundity within and between seven Acropora species from 2008 to 2010. We also quantified the fecundity and egg size of four Acropora species that spawn during both autumn and spring (2008–2010). We found no seasonal variability in egg size and fecundity in the species studied here, possibly as a result of a summer light regime being impacted by high cloud cover in cyclone season. There was high natural variability and no apparent trade-off between egg size and fecundity, both within and between each species. These findings challenge the assumption that egg size and fecundity are negatively correlated, or that a simple, energetically constrained trade-off exists between the two. [ABSTRACT FROM AUTHOR]

Acropora cervicornis is a structurally and functionally important Caribbean coral species. Since the 1980s, it has suffered drastic population losses with no signs of recovery and has been classified as a critically endangered species. Its rapid growth rate makes it an excellent candidate for coral restoration programs. In 2011, the Fundación Dominicana de Estudios Marinos (Dominican Marine Studies Foundation, FUNDEMAR) began an A. cervicornis restoration program in Bayahibe, southeast Dominican Republic. In this study, we present the methodology and results of this program from its conception through 2017, a preliminary analysis of the strong 2016 and 2017 cyclonic seasons in the greater Caribbean, and a genetic characterization of the “main nursery”. The mean survival of the fragments over 12 months was 87.45 ± 4.85% and the mean productivity was 4.01 ± 1.88 cm year−1 for the eight nurseries. The mean survival of six outplanted sites over 12 months was 71.55 ± 10.4%, and the mean productivity was 3.03 ± 1.30 cm year−1. The most common cause of mortality during the first 12 months, in both nurseries and outplanted sites, was predation by the fireworm, Hermodice carunculata. We identified 32 multilocus genotypes from 145 total analyzed individuals. The results and techniques described here will aid in the development of current and future nursery and outplanted site restoration programs. [ABSTRACT FROM AUTHOR]

Coral reef restoration is not the same as forest restoration as its success is not always guaranteed because of insufficient knowledge of coral biology. The technology of active restoration has a history of only 40 years or less. In spite of many devices and efforts, restoration is often hampered by low survivorship of colonies, fragments or sexual propagules. In order to enhance coral resilience and adaptation in a changing world, many new approaches to coral reef restoration are being suggested. However, we wouldn't be able to succeed or achieve expected result, i.e. recovery and thriving of the coral reefs, if outplanted coral recruits do not grow well and spawn and successfully fertilize in the sea. The cost to restore a few hectares of reef is often considerable. More studies are needed to improve the methodology. Contractors and practitioners of coral reef restoration projects must have advanced techniques supported by strong science for successful propagation, rearing, and transplantation/outplantation of corals. This review describes what we have learned so far from research on active coral reef restoration and discusses seven topics that may facilitate successful restoration projects. [ABSTRACT FROM AUTHOR]