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Traditional methods of collecting, sorting, and identifying benthic macroinvertebrate samples are useful for stream biomonitoring and ecological studies, however, these methods are time consuming, expensive, and require taxonomic expertise. Estimating larval densities through collection of post-emergent exuvia can be a practical and time efficient alternative. We evaluated the use of multiple pass depletion techniques of the post-emergent exuvia of Pteronarcys californica to estimate larval densities at ten sites in three Colorado rivers. Exuvia density was highly correlated with both final-instar larval density (R2 = 0.90) and total larval density (R2 = 0.88) and the multiple pass removal technique performed well. Exuvia surveys found P. californica at three low density sites where benthic sampling failed to detect it. At moderate and high density sites the exuvia surveys always produced lower density estimates than benthic surveys. Multiple pass depletion estimates of exuvia proved to be an accurate and efficient technique at estimating larval densities and provided an effective alternative for traditional benthic sampling when objectives are detecting and monitoring P. californica, especially at low density sites.

Climate change will bring about changes in meteorological and ecological factors that are currently used in global-scale models to calculate biogenic emissions. By comparing long-term datasets of biogenic compounds to modeled emissions, this work seeks to improve understanding of these models and their driving factors. We compare speciated biogenic volatile organic compound (BVOC) measurements at the Virginia Forest Research Laboratory located in Fluvanna County, VA, USA, for the year 2020 with emissions estimated by the Model of Emissions of Gases and Aerosols from Nature version 3.2 (MEGANv3.2). The emissions were subjected to oxidation in a 0-D box model (F0AM v4.3) to generate time series of modeled concentrations. We find that default light-dependent fractions (LDFs) in the emissions model do not accurately represent observed temporal variability in regional observations. Some monoterpenes with a default light dependence are better represented using light-independent emissions throughout the year (LDFα-pinene=0, as opposed to 0.6), while others are best represented using a seasonally or temporally dependent light dependence. For example, limonene has the highest correlation between modeled and measured concentrations using an LDF =0 for January through April and roughly 0.74–0.97 in the summer months, in contrast to the default value of 0.4. The monoterpenes β-thujene, sabinene, and γ-terpinene similarly have an LDF that varies throughout the year, with light-dependent behavior in summer, while camphene and α-fenchene follow light-independent behavior throughout the year. Simulations of most compounds are consistently underpredicted in the winter months compared to observed concentrations. In contrast, day-to-day variability in the concentrations during summer months are relatively well captured using the coupled emissions–chemistry model constrained by regional concentrations of NOX and O3.

Background The effect of angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARBs) on major adverse cardiovascular events (MACE) in patients who undergo coronary artery bypass graft surgery is equivocal. This retrospective, population‐based cohort study evaluated effect of exposure to an ACEI/ARB on MACE using linked administrative databases that included all cardiac revascularization procedures, hospitalizations, and prescriptions for the population of British Columbia, Canada. Methods and Results All adults who underwent coronary artery bypass graft surgery between 2002 and 2020 were eligible. The primary outcome was time to MACE, defined as a composite of all‐cause death, myocardial infarction, and ischemic stroke using Cox proportional hazards models with inverse probability treatment weighting. Included were 15 439 patients and 6191 (40%) were prescribed an ACEI/ARB. Mean age was 66 years, 83% were men, and 16% had heart failure (HF). Median exposure time was 40 months. Over the 5‐year follow‐up, 1623 MACE occurred. Impact of exposure was different for patients with and without HF (P

Rapid Arctic climate warming, amplified relative to lower-latitude regions, has led to permafrost thaw and associated thermokarst processes. Recent work has shown permafrost is a rich source of ice-nucleating particles (INPs) that can initiate ice formation in supercooled liquid clouds. Since the phase of Arctic clouds strongly affects the surface energy budget, especially over ice-laden surfaces, characterizing INP sources in this region is critical. For the first time, we provide a large-scale survey of potential INP sources in tundra terrain where thermokarst processes are active and relate to INPs in the air. Permafrost, seasonally thawed active layer, ice wedge, vegetation, water, and aerosol samples were collected near Utqiaġvik, Alaska, in late summer and analyzed for their INP contents. Permafrost was confirmed as a rich source of INPs that was enhanced near the coast. Sensitivity to heating revealed differences in INPs from similar sources, such as the permafrost and active layer. Water, vegetation, and ice wedge INPs had the highest heat-labile percentage. The aerosol likely contained a mixture of known and unsurveyed INP types that were inferred as biological. Arctic water bodies were shown to be potential important links of sources to the atmosphere in thermokarst regions. Therefore, a positive relationship found with total organic carbon considering all water bodies gives a mechanism for future parameterization as permafrost continues to thaw and drive regional landscape shifts.

Background: Guideline-directed medical therapy (GDMT) reduces morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF). Use of GDMT is recommended in all adults with HFrEF, but it is potentially underutilized in patients with advanced age. This study sought to characterize use of GDMT in octogenarians and nonagenarians with HFrEF and identify barriers to initiation and uptitration. Methods: This retrospective cohort study included patients aged 80-99 years at 3 heart failure clinics in the Lower Mainland region of British Columbia, Canada. Patients with a left ventricular ejection fraction ≤ 40% and heart failure hospitalization < 12 months were included. Data were collected between September 2019 and August 2021, for up to 24 months from the initial clinic visit. Results: A total of 91 patients were included. The mean age was 85 years, and the mean left ventricular ejection fraction was 30%. About 50% of patients had New York Heart Association class II symptoms. Throughout the study follow-up period, approximately 91% of patients were on a beta-blocker, 72% were on a renin-angiotensin system (RAS) inhibitor, 31% were on a mineralocorticoid receptor antagonist (MRA), and 4% were on a sodium-glucose cotransporter 2 (SGLT2) inhibitor. The target dose was achieved in 19% of patients on a beta-blocker, 7% on an RAS inhibitor, 11% on an MRA, and 100% on an SGLT2 inhibitor. Frequent barriers to GDMT initiation and/or uptitration were renal dysfunction, hypotension, and hyperkalemia. Conclusions: The levels of use of RAS inhibitors and beta-blockers in patients aged 80-99 years with HFrEF were reasonable, whereas the levels of use of MRAs and SGLT2 inhibitors were low. Achievement of target doses of GDMT was rare, owing to common adverse effects. Résumé: Contexte: Le traitement médical recommandé dans les lignes directrices réduit la morbidité et la mortalité chez les patients atteints d’insuffisance cardiaque à fraction d’éjection réduite (ICFER). Ce traitement est préconisé chez tous les adultes atteints d’ICFER, mais pourrait être sous-employé chez les patients d’âge avancé. Cette étude visait à caractériser son utilisation chez les octogénaires et les nonagénaires atteints d’ICFER et à repérer les obstacles à l’initiation d’un tel traitement et à l’augmentation de la dose. Méthodologie: Cette étude de cohorte rétrospective regroupait des patients âgés de 80 à 99 ans de trois cliniques traitant l’insuffisance cardiaque dans la région du Lower Mainland, en Colombie-Britannique, au Canada. Des patients présentant une fraction d’éjection ventriculaire gauche (FEVG) ≤40 % et hospitalisés en raison d’une insuffisance cardiaque dans les 12 derniers mois ont été inclus dans l’étude. Les données ont été recueillies entre septembre 2019 et août 2021, jusqu’à 24 mois après la visite initiale à la clinique. Résultats: Au total, 91 patients ont été inclus dans l’étude. Leur âge moyen était de 85 ans, et la FEVG moyenne, de 30 %. Environ 50 % des patients présentaient des symptômes de la classe II de la New York Heart Association. Pendant toute la période de suivi de l’étude, environ 91 % des patients étaient traités par un bêtabloquant, 72 % par un inhibiteur du système rénine-angiotensine (SRA), 31 % par un antagoniste des récepteurs minéralocorticoïdes (ARM) et 4 % par un inhibiteur du cotransporteur du glucose-sodium de type 2 (SGLT2). La dose cible a été atteinte chez 19 % des patients traités par un bêtabloquant, 7 % de ceux traités par un inhibiteur du SRA, 11 % de ceux recevant un ARM et 100 % des sujets recevant un inhibiteur du SGLT2. Les obstacles fréquents à l’instauration du traitement médical recommandé dans les lignes directrices ou à l’augmentation de la dose étaient la dysfonction rénale, l’hypotension et l’hyperkaliémie. Conclusions: Les taux d’utilisation des inhibiteurs du SRA et des bêtabloquants chez les patients âgés de 80 à 99 ans présentant une ICFER étaient raisonnables, tandis que les taux d’utilisation des ARM et des inhibiteurs du SGLT2 étaient faibles. L’atteinte des doses cibles préconisées dans le traitement médical recommandé dans les lignes directrices était rare en raison des effets secondaires courants.

Background: Pharmacologic management of heart failure with reduced ejection fraction (HFrEF) involves several medications. Decision aids informed by patient decisional needs and treatment preferences could assist in making HFrEF medication choices; however, these are largely unknown. Methods: We searched MEDLINE, Embase, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), without language restriction, for qualitative, quantitative, and mixed-method studies that included patients with HFrEF or clinicians providing HFrEF care, and reported data on decisional needs or treatment preferences applicable to HFrEF medications. We classified decisional needs using a modified version of the Ottawa Decision Support Framework (ODSF). Results: From 3996 records, we included 16 reports describing 13 studies (n = 854). No study explicitly assessed ODSF decisional needs; however, 11 studies reported ODSF-classifiable data. Patients commonly reported having inadequate knowledge or information, and difficult decisional roles. No study systematically assessed treatment preferences, but 6 studies reported on attribute preferences. Reducing mortality and improving symptoms frequently were ranked as being important, whereas cost importance rankings varied, and adverse events generally were ranked as being less important. Conclusion: This scoping review identified key decisional needs regarding HFrEF medications, notably inadequate knowledge or information, and difficult decisional roles, which can readily be addressed by decision aids. Future studies should systematically explore the full scope of ODSF-based decisional needs in patients with HFrEF, along with relative preferences among treatment attributes to further inform development of individualized decision aids. Résumé: Contexte: La prise en charge pharmacologique de l’insuffisance cardiaque avec fraction d’éjection réduite (ICFER) peut être réalisée à l’aide de plusieurs médicaments. Des outils d’aide à la décision reposant sur les besoins décisionnels et les préférences thérapeutiques des patients pourraient faciliter le choix des médicaments dans les cas d’ICFER. Malheureusement, ce type d’outils demeure largement inconnu. Méthodologie: Nous avons interrogé les bases de données MEDLINE, Embase et Cumulative Index to Nursing and Allied Health Literature (CINAHL), sans restriction quant à la langue, pour trouver des études qualitatives, quantitatives et mixtes incluant des patients atteints d’ICFER ou des cliniciens prodiguant des soins aux personnes atteintes d’ICFER. Nous avons recueilli les données sur les besoins décisionnels ou les préférences thérapeutiques qui s’appliquaient aux médicaments contre l’ICFER, puis avons classé les besoins décisionnels à l’aide d’une version modifiée du Modèle d’aide à la décision d’Ottawa (MADO). Résultats: Sur un total de 3996 résultats, nous avons retenu 16 rapports décrivant 13 études (n = 854). Aucune étude n’évaluait explicitement les besoins décisionnels selon le MADO, mais 11 études faisaient état de données qu’il était possible de classer selon ce modèle. Les patients ont fréquemment mentionné avoir des connaissances ou des informations inadéquates et un rôle décisionnel difficile. Aucune étude n’évaluait systématiquement les préférences de traitement, mais six études ont rapporté des préférences quant aux attributs du traitement. La réduction de la mortalité et l’atténuation des symptômes étaient souvent classées comme importantes, les coûts faisaient l’objet d’un classement variable et les événements indésirables étaient généralement classés comme étant peu importants. Conclusion: Cette revue exploratoire a permis de relever des besoins décisionnels clés concernant les médicaments contre l’ICFER, notamment des connaissances et des informations inadéquates, et un rôle décisionnel difficile, besoins qui peuvent facilement être comblés par des outils d’aide à la décision. De futures études devraient explorer de manière systématique la portée complète des besoins décisionnels des patients atteints d’ICFER selon le MADO, ainsi que les préférences relatives quant aux attributs du traitement pour orienter l’élaboration d’outils personnalisés d’aide à la décision.

Emissions from natural sources are driven by various external stimuli such as sunlight, temperature, and soil moisture. Once biogenic volatile organic compounds (BVOCs) are emitted into the atmosphere, they rapidly react with atmospheric oxidants, which has significant impacts on ozone and aerosol budgets. However, diurnal, seasonal, and interannual variability in these species are poorly captured in emissions models due to a lack of long-term, chemically speciated measurements. Therefore, increasing the monitoring of these emissions will improve the modeling of ozone and secondary organic aerosol concentrations. Using 2 years of speciated hourly BVOC data collected at the Virginia Forest Research Lab (VFRL) in Fluvanna County, Virginia, USA, we examine how minor changes in the composition of monoterpenes between seasons are found to have profound impacts on ozone and OH reactivity. The concentrations of a range of BVOCs in the summer were found to have two different diurnal profiles, which, we demonstrate, appear to be driven by light-dependent versus light-independent emissions. Factor analysis was used to separate the two observed diurnal profiles and determine the contribution from each emission type. Highly reactive BVOCs were found to have a large influence on atmospheric reactivity in the summer, particularly during the daytime. These findings reveal the need to monitor species with high atmospheric reactivity, even though they have low concentrations, to more accurately capture their emission trends in models.

As a consequence of the COVID-19 pandemic crisis, farmers across the country are plowing under their fields and laying off workers. Plant biomass has been shown by the DARPA "Blue Angel" project in 2010 to be an efficient way to rapidly make vaccines and diagnostics. This technology could pivot some areas of agriculture toward biomedical products to aid in the COVID-19 pandemic response.

Patients with heart failure with reduced ejection fraction (HFrEF) often have concurrent chronic kidney disease (CKD), which can make initiating and titrating the 4 standard pharmacologic therapies a challenge. Drug dosing is often based on a calculation of the patient’s creatine clearance or estimated glomerular filtration rate (eGFR), but it should also incorporate the trend in their renal function over time and the risk of toxicity of the drug. The presence of CKD in a patient should not preclude the use of a renin-angiotensin system inhibitor, although patients should be monitored frequently for worsening renal function and hyperkalemia. Sacubitril/valsartan is not recommended in patients with an eGFR < 30 mL/min per 1.73 m2. Of the 3 ß-blockers recommended in the management of HFrEF, only bisoprolol may accumulate in patients with renal impairment; however, patients should still be titrated to the target dose (10 mg daily) or the maximally tolerated dose, depending on their clinical response. The sodium-glucose cotransporter 2 inhibitors are effective at reducing adverse cardiovascular and renal outcomes in patients with HFrEF and CKD (eGFR ≥ 25 mL/min per 1.73 m2 with dapagliflozin or ≥ 20 mL/min per 1.73 m2 with empagliflozin), although declining kidney function is a risk, due to the osmotic diuretic effect. Finally, mineralocorticoid receptor antagonist therapy should be considered in all patients with HFrEF and an eGFR ≥ 30 mL/min per 1.73 m2. The starting dose should be low (eg, 6.25-12.5 mg daily or 12.5 mg every other day) and can be uptitrated based on the patient’s renal function and serum potassium. Résumé: Les patients atteints d’insuffisance cardiaque avec fraction d’éjection réduite (ICFER) présentent souvent une néphropathie chronique (NC) concomitante, ce qui peut compliquer l’instauration et l’ajustement du traitement par les quatre types de médicaments principaux. La posologie repose souvent sur le calcul de la clairance de la créatine ou du débit de filtration glomérulaire estimé (DFGe), mais l’évolution de la fonction rénale du patient et le risque de toxicité du médicament devraient également être pris en compte. Une NC chez un patient ne devrait pas empêcher l’utilisation d’un inhibiteur du système rénine-angiotensine, mais il convient alors d’effectuer un suivi fréquent de ces patients pour détecter un éventuel déclin de la fonction rénale ou une hyperkaliémie. L’association sacubitril-valsartan n’est pas recommandée chez les patients ayant un DFGe < 30 ml/min/1,73 m2. Parmi les trois ß-bloqueurs recommandés pour la prise en charge de l’ICFER, seul le bisoprolol pourrait se bioaccumuler chez les patients souffrant d’une dysfonction rénale; il convient toutefois d’ajuster progressivement la posologie jusqu’à l’atteinte de la dose cible (10 mg par jour) ou de la dose maximale tolérée, selon la réponse clinique. Les inhibiteurs du cotransporteur sodium-glucose de type 2 permettent de réduire l’incidence des manifestations cliniques cardiovasculaires et rénales indésirables chez les patients atteints d’ICFER et de NC (DFGe ≥ 25 ml/min/1,73 m2 pour le traitement par la dapagliflozine ou ≥ 20 ml/min/1,73 m2 pour le traitement par l'empagliflozine), mais leur effet diurétique osmotique peut entraîner un risque de déclin de la fonction rénale. Enfin, le traitement par les antagonistes des récepteurs mi-néralocorticoïdes devrait être envisagé pour tous les patients atteints d’ICEFR ayant un DFGe ≥ 30 ml/min/1,73 m2. Il convient d’instaurer le traitement avec une dose faible (p. ex., de 6,25 à 12,5 mg par jour ou 12,5 mg tous les deux jours) et d’ajuster la dose à la hausse selon la fonction rénale du patient et son taux de potassium sérique.

In forested systems, woodpecker species richness has been linked with songbird diversity, and identifying woodpecker biodiversity hotspots may contribute important information for conservation planning. The availability of global forest structure data via the Global Ecosystem Dynamics Investigation (GEDI) instrument provides a new tool for examining broad extent relationships amongst environmental variables, forest structure, and woodpecker diversity hotspots. Within the Marine West Coast Forest ecoregion, USA, we used eBird data for 7 woodpecker species to model encounter rates based on bioclimatic variables, process data (e.g. duration and timing of survey), MODIS forest land cover data, and GEDI-fusion metrics. The GEDI-fusion metrics included foliage height diversity (fhd), rh98 (a representation of canopy height), and canopy cover, which were created by combining GEDI data with Landsat, Sentinel-1, topographic, and climatic information within a random forest modeling framework. AUCs for the species-specific models ranged from 0.77–0.98, where bioclimatic and process predictors were amongst the most important variables for all species. GEDI-fusion forest structure metrics were highly ranked for all species, with fhd included as a highly ranked predictor for all species. The structural metrics included as top predictors for each species were reflective of known species-specific habitat associations. Hotspots in this ecoregion tended to be inland and occurred most often on privately-owned lands. Identification of hotspots is the first step towards management plans focused on biodiversity, and understanding ownership patterns is important for future conservation efforts. The near-global extent of GEDI data, along with recent studies that recommend woodpeckers as indicators of biodiversity across multiple forest types at local and global scales, suggest that synthesis of GEDI-derived data applied to woodpecker detection information might be a powerful approach to identifying biodiversity hotspots.

We provide the first documented case of whirling disease (WD) impacts to wild, self-sustaining rainbow trout (RNTR, Oncorynchus mykiss) populations in Canada. Myxobolus cerebralis (Mc), the causative agent of WD, was first confirmed in Alberta in 2016. However, evidence of disease in local fish populations was unknown. Using a weight-of-evidence approach, we examined multiple parasite life cycle stages in the Crowsnest River, Alberta. Percentage of infected Tubifex tubifex worms actively shedding triactinomyxons (TAMs) exceeded known thresholds of Mc establishment and TAM densities instream exceeded thresholds known to cause [greater than or equal to]90% declines in RNTR populations. Mc was detected at 5 of 6 study sites in water, fish, and worms. Disease severity was highest in the lower watershed where 100% of sentinel fish tested positive for Mc 7 to 14 days post-exposure; up to 85% of wild fingerling RNTR showed clinical signs of disease and yearling trout were largely absent from the river suggesting reduced survival. Our findings indicate conditions necessary for outbreak of WD exist in Alberta, highlighting the need to consider this disease as an emerging threat to wild salmonid populations. Nous faisons etat du premier cas documente d'impacts du tournis des truites sur des populations sauvages autosuffisantes de truites arc-en-ciel (Oncorynchus mykiss) au Canada. La presence de Myxobolus cerebralis (Mc), l'agent etiologique du tournis, a ete confirmee pour la premiere fois en Alberta en 2016. Aucune preuve de la presence de la maladie dans des populations locales de poissons n'avait toutefois ete rapportee a ce jour. En utilisant une approche basee sur le poids de la preuve, nous avons examine plusieurs etapes de cycles de vie de parasites dans la riviere Crowsnest (Alberta). Le pourcentage de vers de vase Tubifex tubifex infectes qui rejetaient activement des triactinomyxons (TAM) depassait les seuils connus au-dela desquels Mc peut s'etablir et la densite de TAM dans le cours d'eau depassait les seuils dont il est etabli que le depassement cause des baisses de [greater than or equal to]90% des populations de truites arc-en-ciel. Mc a ete detecte dans cinq des six sites d'etude dans l'eau, des poissons et des vers. La severite de la maladie etait la plus elevee dans le bassin inferieur, oU 100 % des poissons sentinelles ont produit un resultat positif au depistage du Mc de 7 a 14 jours apres l'exposition; jusqu'a 85 % des alevins d'un an sauvages de truite arc-en-ciel presentaient des signes cliniques de la maladie et les truites de l'annee etaient en bonne partie absentes de la riviere, ce qui indiquerait une survie reduite. Nos constatations indiquent que les conditions necessaires a des eclosions de tournis des truites existent en Alberta, ce qui souligne la necessite de considerer cette maladie comme constituant une nouvelle menace pour les populations de salmonides sauvages. [Traduit par la Redaction], 1. Introduction Aquatic invasive species are a globally significant threat to freshwater fish (Dudgeon et al. 2006; Jelks et al. 2008). Globalization has led to the increased movement of people [...]