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Information on cetacean distribution plays an important role in the identification of suitable boundaries for marine protected areas, but is also crucial for developing management and monitoring programmes. In response to the European ‘Habitats Directive’, a candidate Special Area of Conservation (cSAC) has been established in the Moray Firth, northeast Scotland to protect a small and isolated population of common bottlenose dolphins (Tursiops truncatus). Limited data on the distribution of bottlenose dolphins and on temporal changes in distribution have recently constrained attempts to mitigate against the impacts of new developments upon this population. In response to the need for current information on the distribution of dolphins throughout the cSAC, this study aims to provide data on the distribution of dolphins and other small cetaceans throughout the Moray Firth. Changes in the distribution patterns of dolphins in the inner Moray Firth were examined using data collected between 1990 and 2000. In addition, combined passive acoustic and visual survey techniques were used to determine the distribution of dolphins and harbour porpoises (Phocoena phocoena) on a broader scale across the whole Moray Firth. Dolphin schools were distributed throughout the inner Moray Firth, but there were concentrations of sightings around three deep, narrow channels that were consistent over the ten year study period. Results from surveys across the whole of the Moray Firth showed that all sightings and acoustic detections of dolphins were made within the area of the cSAC. In contrast, porpoise sightings were widely distributed throughout the Moray Firth. The median encounter rate of porpoises across the whole Moray Firth was 1.69 per 100km. Encounter rates of porpoises were similar in the outer Moray Firth and the cSAC. This combination of distribution studies at differing spatial scales provides a valuable tool for monitoring the distribution of animals and identifying important habitats, and the results of this study have directly supported efforts to manage the cSAC.

An EU-funded Life project was initiated off southern Spain in 2002, with the objective of developing a Conservation Plan for bottlenose dolphins in the area. Baseline information and monitoring of abundance and distribution is needed to determine if the conservation objectives are met in the long-term. To estimate abundance, 12,568km of non-systematic line transects conducted from 2000 to 2003, with 72 sightings, were analysed using spatial modelling methods. Transects were divided into 4,575 small segments (average 2.8km) with similar values for sightability conditions and environmental variables. The point estimate of bottlenose dolphin abundance in the area was 584 dolphins (95% CI=278-744). The same method was applied to investigate changes in abundance since 1992 in the eastern section of the research area, where most dolphins were concentrated, stratifying by three groups of years. Point estimates were 111 dolphins for 1992-97, 537 for 1998-2000 and 279 for 2001-03. The higher abundance between 1998 and 2000 corresponded with the observation of an ‘immigrant’ group of dolphins in these years. These results highlight the importance of long-term studies to understand natural variation in abundance in a specific area subject to conservation activities.

During the middle Pliocene (∼3.8–3.2 Ma), both Australopithecus afarensis and Kenyanthropus platyops are known from the Turkana Basin, but between 3.60 and 3.44 Ma, most hominin fossils are found on the west side of Lake Turkana. Here, we describe a new hominin locality (ET03-166/168, Area 129) from the east side of the lake, in the Lokochot Member of the Koobi Fora Formation (3.60–3.44 Ma). To reconstruct the paleoecology of the locality and its surroundings, we combine information from sedimentology, the relative abundance of associated mammalian fauna, phytoliths, and stable isotopes from plant wax biomarkers, pedogenic carbonates, and fossil tooth enamel. The combined evidence provides a detailed view of the local paleoenvironment occupied by these Pliocene hominins, where a biodiverse community of primates, including hominins, and other mammals inhabited humid, grassy woodlands in a fluvial floodplain setting. Between

SummaryBackgroundPulse oximeters are widely used to monitor blood oxygen saturations, although concerns exist that they are less accurate in individuals with pigmented skin.AimsThis study aimed to determine if patients with pigmented skin were more severely unwell at the period of transfer to intensive care units (ICUs) than individuals with White skin.MethodsUsing data from a large teaching hospital, measures of clinical severity at the time of transfer of patients with COVID-19 infection to ICUs were assessed, and how this varied by ethnic group.ResultsData were available on 748 adults. Median pulse oximetry demonstrated similar oxygen saturations at the time of transfer to ICUs (Kruskal–Wallis test, P = 0.51), although median oxygen saturation measurements from arterial blood gases at this time demonstrated lower oxygen saturations in patients classified as Indian/Pakistani ethnicity (91.6%) and Black/Mixed ethnicity (93.0%), compared to those classified as a White ethnicity (94.4%, Kruskal–Wallis test, P = 0.005). There were significant differences in mean respiratory rates in these patients (P ConclusionsThese data are consistent with the hypothesis that differential measurement error for pulse oximeter readings negatively impact on the escalation of clinical care in individuals from other than White ethnic groups. This has implications for healthcare in Africa and South-East Asia and may contribute to differences in health outcomes across ethnic groups globally.

Psychosocial treatments for opioid use disorder represent an important component of the opioid treatment infrastructure. This chapter briefly reviews the early history of psychosocial treatment of OUD in the United States to place the more recent history of empirical research into an appropriate context. It reviews the most common psychosocial interventions, categorized into atheoretical (e.g., peer support or mutual help groups) and theoretically driven strategies (e.g., cognitive behavioral therapy, relapse prevention, motivational interviewing, behavior therapy, and mindfulness-based therapy) before describing the current state of OUD treatment from both a research and clinical perspective. Finally, several gaps in the field will be discussed, as well as recommendations to address them.

Ionic liquids (ILs) are becoming a revolutionary synthesis medium for inorganic nanomaterials, permitting more efficient, safer and environmentally benign preparation of high quality products. A smart combination of ILs and unconventional synthesis methods allows added value to be drawn from the broad matrix of available property combinations. Mixed systems such as Deep Eutectic Solvents (DES) offer a similarly broad combinatorial playground, which is also beginning to translate into applications. Approached holistically, these liquids therefore enable new universal manufacturing techniques that provide solutions to the existing problems of nanomanufacturing, and beyond that will open completely new horizons and possibilities for controlling the growth and assembly of nanostructures. Examples that illustrate the power of ILs in the improved manufacturing of nanomaterials are explored, such as the synthesis of light phosphors with exceptional quantum yields, record-figure-of merit thermoelectrics, and efficient photocatalysts, alongside developments in DES nanostructure and deep eutectic-solvothermal and ionothermal techniques.

This pilot outcome evaluation assesses the effectiveness of an online curriculum, the Keystones of Development, aimed at improving residents' knowledge, attitudes, and reported behaviors around promoting positive parenting and childhood development in well-child visits.We used an explanatory mixed-methods approach, including a single-arm pre-posttest of intervention effects on self-reported behavioral outcomes (discussing, modeling, and praising) and secondary outcomes (knowledge, perceived barriers, attitudes, and self-efficacy). Following this, a subset of residents participated in in-depth interviews to describe participant responses to the intervention.The study was conducted at 8 pediatric residency programs across the United States with 67 pediatric residents (mean age = 29; 79% female; 57% PGY1). Within one month postintervention, there was a statistically significant increase in the behaviors that promote positive parenting: discussing (P.01;d = 0.73) and modeling (P.01;d = 0.61) but not praising (P = .05; d = 0.3). Significant changes in the secondary outcomes: knowledge (P.01), perceived barriers, (P.01), and retrospective self-efficacy (P.01) were seen. Interviews revealed that integration of curriculum content into clinical practice was due to the relevance of the material to primary care and the modeling of how to apply in the clinical setting. Curriculum format, content, and clinical application helped participants weave recommendations into the well-child visit.In this study, we demonstrated that the online curriculum, Keystones of Development, increased resident behaviors, knowledge, and self-efficacy, and decreased perceived barriers to promote parenting behaviors associated with improved child development outcomes in well-child visits. These findings were observed across participants demonstrating equal success regardless of demographic characteristics or study site.

Quantifying consumption and prey choice for marine predator species is key to understanding their interaction with prey species, fisheries, and the ecosystem as a whole. However, parameterizing a functional response for large predators can be challenging because of the difficulty in obtaining the required data on predator diet and on the availability of multiple prey species.This study modeled a multi‐species functional response (MSFR) to describe the relationship between consumption by harbour porpoises (Phocoena phocoena) and the availability of multiple prey species in the southern North Sea. Bayesian methodology was employed to estimate MSFR parameters and to incorporate uncertainties in diet and prey availability estimates. Prey consumption was estimated from stomach content data from stranded harbour porpoises. Prey availability to harbour porpoises was estimated based on the spatial overlap between prey distributions, estimated from fish survey data, and porpoise foraging range in the days prior to stranding predicted from telemetry data.Results indicated a preference for sandeels in the study area. Prey switching behavior (change in preference dependent on prey abundance) was confirmed by the favored type III functional response model. Variation in the size of the foraging range (estimated area where harbour porpoises could have foraged prior to stranding) did not alter the overall pattern of the results or conclusions.Integrating datasets on prey consumption from strandings, predator foraging distribution using telemetry, and prey availability from fish surveys into the modeling approach provides a methodological framework that may be appropriate for fitting MSFRs for other predators., A multi‐species functional response (MSFR) was modeled to describe the relationship between consumption by harbour porpoises and the availability of multiple prey species in the southern North Sea. Bayesian methodology was employed to estimate MSFR parameters and to incorporate uncertainties in diet and prey availability estimates. Results indicated a strong preference for sandeel in the study area and prey switching behavior was confirmed by the favored type III functional response model.

This study was made possible with financial support from Earthwatch Institute, Atlantis Blue Project Foundation, with permission to conduct research granted by the Bahamas Department of Marine Resources. Little Bahama Bank in the northern Bahamas supports several populations of bottlenose dolphins (Tursiops truncatus). We provide the first estimates of birth rate and age-class-specific apparent survival rates for the local South Abaco population using data from a long-term (1997–2014) photo-identification (photo-ID) study and use the estimated life history parameters in a population viability analysis (PVA) to predict future population trends. Hurricane events are predicted to become more intense due to climate change but knowledge of how hurricanes may impact cetacean populations is limited. Little Bahama Bank is subject to hurricane activity, so we also investigate the potential impact of hurricanes on calf, juvenile and adult survival. Photo-ID data confirmed the existence of a core adult population with relatively high site fidelity in South Abaco, but also evidence of transient animals. Estimated annual birth rate was 0.278 (95% CI: 0.241–0.337). We found strong support for a decline in apparent survival for all age-classes. Estimated survival declined by 9% in adults (0.941 in 1998, to 0.855 in 2013), 5% in juveniles (0.820 in 2000, to 0.767 in 2013) and 36% in calves (0.970 in 1997, to 0.606 in 2013). Evidence that survival was influenced by repeated hurricane activity leading to increased mortality and/or emigration was stronger for calves and juveniles than for adults. PVA simulations of an assumed isolated South Abaco population showed that declines would lead to extinction within decades, even under the most optimistic scenario. Future work should focus on establishing if South Abaco is part of natural source–sink metapopulation dynamics on Little Bahama Bank by assessing trends in abundance in local populations and establishing how they interact; this will be important for assessing their conservation status in a potentially increasingly changing environment. Publisher PDF

Symptomatic umbilical hernias are a common cause of morbidity and mortality in patients with cirrhosis and end-stage liver disease (ESLD). This study set out to characterise the factors predicting outcome following repair of symptomatic umbilical hernias in ESLD at a single institution.A retrospective review was performed of all patients with ESLD who underwent repair of a symptomatic umbilical hernia between 1998 and 2020. Overall survival was predicted using the Kaplan-Meier method. Logistic regression was used to determine predictors of decompensation and 30-day, 90-day and 1-year mortality.One-hundred-and-eight patients with ESLD underwent umbilical hernia repair (emergency n = 78, 72.2%). Transjugular shunting was performed in 29 patients (26.9%). Decompensation occurred in 44 patients (40.7%) and was predicted by emergency surgery (OR, 13.29; P = 0.001). Length of stay was shorter in elective patients compared to emergency patients (3-days vs. 7-days; P = 0.003). Thirty-day, 90-day and 1-year survival was 95.2, 93.2 and 85.4%, respectively. Model for ESLD score15 predicted 90-day mortality (OR, 18.48; P = 0.030) and hyponatraemia predicted 1-year mortality (OR, 5.31; P = 0.047). Transjugular shunting predicted survival at 1 year (OR, 0.15; P = 0.038).Repair of symptomatic umbilical hernias in patients with ESLD can be undertaken with acceptable outcomes in a specialist centre, however, this remains a high-risk intervention. Patients undergoing emergency repair are more likely to decompensate postoperatively, develop wound-related problems and have a longer length of stay. Transjugular shunting may confer a benefit to survival, but further prospective trials are warranted.

1. Historical abundance estimates are important for establishing baselines fromwhich trends can be determined using more recent data. Long-term studies basedon photo-identification were merged and used to estimate population size,survival rate and sex ratio (biopsy sampling) of fin whales in the North-westernMediterranean.2. Merging four existing photo-id catalogues yielded a Mediterranean cataloguewith 507 individually identified fin whales. Ninety-five (18.7%) individuals wereresighted at least once during the study period (1990–2007): 71 whales wereresighted in different years, 24 within the same season and 13 both in the sameseason and in different years. The number of resightings within-season rangedfrom one to four, over periods from 1 to 90 days.3. Capture histories from these individuals were used in the capture–recaptureanalyses. Estimates of the animals present in the area each year between 1991and 1995 through different modelling approaches were consistent: 900–1,000from a POPAN open population model; 1,200 from a multi-sample closedpopulation model; and 900–1,100 from simple two-sample closed populationmodels for pairs of consecutive years, all with heavily overlapping 95%confidence intervals.4. The estimated apparent survival rate of 0.916 (95% CI=0.773–0.972) was lowerthan expected, which may be linked to temporary or permanent emigration, ormortality possibly owing to ship strikes.5. Conservation and mitigation measures such as Important Marine Mammal Areasand Particularly Sensitive Sea Areas are presented and discussed.

Increased orexin/hypocretin signaling is implicated in opioid withdrawal, sleep disturbances, and drug-seeking behaviors. This study examined whether a dual-orexin receptor antagonist would improve sleep and withdrawal outcomes when compared with placebo during a buprenorphine/naloxone taper. Thirty-eight participants with opioid use disorder were recruited to a clinical research unit and maintained on 8/2 to 16/4 mg of buprenorphine/naloxone treatment for 3 days before being randomized to 20 mg of suvorexant ( n = 14), 40 mg of suvorexant ( n = 12), or placebo ( n = 12); 26 individuals completed the study. After randomization, participants underwent a 4-day buprenorphine/naloxone taper and 4-day post-taper observation period. Total sleep time (TST) was collected nightly with a wireless electroencephalography device and wrist-worn actigraphy; opioid withdrawal symptoms were assessed via the Subjective Opiate Withdrawal Scale (SOWS); and abuse potential was assessed on a 0- to 100-point visual analog scale of “High” every morning. A priori outcomes included two-group (collapsing suvorexant doses versus placebo) and three-group comparisons of area-under-the-curve (AUC) scores for TST, SOWS, and High. In two-group comparisons, participants receiving suvorexant displayed increased TST during the buprenorphine/naloxone taper and decreased SOWS during the post-taper period. In three-group comparisons, participants receiving 20 mg of suvorexant versus placebo displayed increased AUC for TST during the buprenorphine/naloxone taper, but there was no difference in SOWS among groups. There was no evidence of abuse potential in two- or three-group analyses. The results suggest that suvorexant might be a promising treatment for sleep and opioid withdrawal in individuals undergoing a buprenorphine/naloxone taper.

Fieldwork was supported by grants from the Sea World and Busch Gardens Conservation fund and Sea World and Parks Entertainment. This study used multisensory data tags with integrated 4K video to investigate feeding behavior and prey profitability in five adult male killer whales (Orcinus orca) at herring wintering grounds in Norway, in 2016 and 2017. Video recorded two killer whales engaged in carousel feeding, and two engaged in seiner feeding (i.e., feeding on herring discards around purse seiner vessels). The feeding behaviors identified from the video data allowed for determination of associated kinematic signatures, which were used to further identify and characterize carousel feeding and deep feeding dives over the entire logger duration. Prey consumption during on camera feeding bouts was also measured to calculate profitability of feeding bouts for the different behaviors. Average number of prey consumed per minute was 1.08±0.43 for carousel feeding and 0.43±0.07 for seiner feeding (n = 122 prey capture events). Using kinematic data, a total of 18 carousel feeding bouts and 206 deep feeding dives were identified. Whales spent at least 37%-65% of time over 24-hr feeding. Using field metabolic rate estimates from the literature and the energetic content of herring caught locally, killer whales required an estimated 285-578 herring/day to balance daily energy requirements. Postprint

An assessment of the total number, demographics and geographic distribution of new entrants to the optometry profession in Australia can assist planning for workforce requirements.Over the past decade, the number of registered optometrists in Australia has increased by 30.1 per cent, a rate that is greater than the population growth of the country (12.1 per cent). Concerns have been expressed about the size of the optometry workforce in a context of increasing numbers of graduating optometrists. This paper analyses data obtained from the Australian Health Practitioner Regulation Agency (AHPRA) about new entrants to the profession and their initial practice location during the period 1 July 2010 to 30 June 2018.A de-identified dataset was obtained from AHPRA that revealed the following characteristics of new entrants: qualification, gender, year of birth (in five-year bands), registration type, registration endorsement and principal place of practice including its Remoteness Area classification.Data for 1,680 entrants were eligible for analysis; 80 per cent graduated from an Australian university, 12 per cent graduated from the optometry program in New Zealand, and seven per cent were graduates of an overseas university. The remaining two per cent registered via the Trans-Tasman Mutual Recognition Agreement, although the dataset did not include the qualification. The United Kingdom and Republic of Ireland provided the majority of overseas entrants (60 per cent). Most (75 per cent) entrants commenced practice in a major Australian city. Graduates of Australian universities tended to commence practice in the state in which they trained or an adjacent state or territory. Juxtaposed on the data outlined above is the high proportion (42 per cent) of overseas-trained optometrists commencing practice in Western Australia.Coincident with the newer optometry programs producing graduates is the increased number of optometrists entering the Australian workforce over the past decade, with the majority commencing practice in major cities. Australia-trained optometrists tend to commence practice in the state where their training was undertaken. New entrants to the optometry profession can be generalised as graduates of an Australian optometry program, female, aged in their early-mid 20s and qualified for therapeutic practice.

The survey was funded by Falklands Conservation, the Royal Society for the Protection of Birds, and the Falkland Islands Government Environmental Studies Budget. Little information exists on the current status of Southern Hemisphere sei whales (Balaenoptera borealis). We assessed their distribution and abundance along the west coast of the Falkland Islands (southwest Atlantic) during February and March 2018, using line transect and nonsystematic surveys. Abundance estimates were generated for a single survey stratum using design- and model-based approaches. Sightings of sei whales and unidentified baleen whales (most, if not all, likely to be sei whales) occurred from the coast to the 100 m depth isobath that marked the offshore boundary of the stratum. The modeled distribution predicted highest whale densities in King George Bay and in the waters between Weddell Island and the Passage Islands. Sei whale abundance was estimated as 716 animals (CV = 0.22; 95% CI [448, 1,144]; density = 0.20 whales/km2) using the design-based approach, and 707 animals (CV = 0.11; 95% CI [566, 877]; density = 0.20 whales/km2) using the model-based approach. For sei whales and unidentified baleen whales combined, the equivalent estimates were 916 animals (CV = 0.19; 95% CI [606, 1,384]; density = 0.26 whales/km2) and 895 animals (CV = 0.074; 95% CI [777, 1,032]; density = 0.25 whales/km2). The data indicate that the Falkland Islands inner shelf region may support globally important seasonal feeding aggregations of sei whales, and potentially qualify as a Key Biodiversity Area. Postprint

Genetic and environmental factors have been observed to influence risks for birth defects, though few studies have investigated gene-environment interactions. Our aim was to examine the interaction terms of gene variants in biotransformation enzyme pathways and air pollution exposures in relation to risk of several structural birth defects. We evaluated the role of ambient air pollutant exposure (nitrogen dioxide [NO2 ], nitrogen oxide, carbon monoxide, particulate matter

Embaràs i malaltia cardíaca; Resultats de l’embaràs; Transposició de les grans artèries Embarazo y enfermedad cardíaca; Resultados del embarazo; Transposición de las grandes arterias Pregnancy and cardiac disease; Pregnancy outcomes, Transposition of the great arteries Background In the past 3 decades, the arterial switch procedure has replaced the atrial switch procedure as treatment of choice for transposition of the great arteries. Although survival is superior after the arterial switch procedure, data on pregnancy outcomes are scarce and transposition of the great arteries after arterial switch is not yet included in the modified World Health Organization classification of maternal cardiovascular risk. Methods and Results The ROPAC (Registry of Pregnancy and Cardiac disease) is an international prospective registry of pregnant women with cardiac disease, part of the European Society of Cardiology EURObservational Research Programme. Pregnancy outcomes in all women after an arterial switch procedure for transposition of the great arteries are described. The primary end point was a major adverse cardiovascular event, defined as combined end point of maternal death, supraventricular or ventricular arrhythmias requiring treatment, heart failure, aortic dissection, endocarditis, ischemic coronary events, and thromboembolic events. Altogether, 41 pregnant women (mean age, 26.7±3.9 years) were included, and there was no maternal mortality. A major adverse cardiovascular event occurred in 2 women (4.9%): heart failure in one (2.4%) and ventricular tachycardia in another (2.4%). One woman experienced fetal loss, whereas no neonatal mortality was observed. Conclusions Women after an arterial switch procedure for transposition of the great arteries tolerate pregnancy well, with a favorable maternal and fetal outcome. During counseling, most women should be reassured that the risk of pregnancy is low. Classification as modified World Health Organization risk class II seems appropriate. Funding from “Zabawas Foundation” and “De Hoop Foundation” in addition to the support from EURObservational Research Programme (EORP) is greatly acknowledged. Since the start of EORP, the following companies have supported the program: Abbott Vascular Int (2011–2021), Amgen Cardiovascular (2009–2018), AstraZeneca (2014–2021), Bayer AG (2009–2018), Boehringer Ingelheim (2009–2019), Boston Scientific (2009–2012), The Bristol Myers Squibb and Pfizer Alliance (2011–2019), Daiichi Sankyo Europe GmbH (2011–2020), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2014–2017), Edwards (2016–2019), Gedeon Richter Plc (2014–2016), Menarini Int Op (2009–2012), MSD‐Merck & Co (2011–2014), Novartis Pharma AG (2014–2020), ResMed (2014–2016), Sanofi (2009–2011), SERVIER (2009–2021), and Vifor (2019–2022).

Funding: Support for this project was provided by the Lenfest Ocean Program. 1. Determining acceptable rates of human‐caused mortality in low‐data situations is a concern for many taxa world‐wide. An established approach for determining acceptable levels of human‐caused mortality of marine mammals and other species of conservation concern is the Potential Biological Removal (PBR) framework, but PBR requires near‐unbiased estimates of absolute abundance, constraining its use in systems with limited data. 2. We develop three alternative methods for identifying acceptable levels of human‐caused mortality for long‐lived, slowly reproducing species, using indices of relative abundance combined with estimates of bycatch mortality in fisheries, and evaluate these methods using simulations similar to those used to develop PBR. 3. Across a variety of scenarios, the parameters of the three methods can be tuned to achieve conservation performance similar to that of PBR in scenarios that represent nearly ideal conditions. However, these methods produce lower and more variable bycatch mortality limits, depend upon reasonably accurate estimates of bycatch mortality and are more sensitive to uncertainties. 4. Synthesis and applications. Here we develop three alternative methods that expand the toolbox of approaches available for use in determining marine mammal conservation reference points for human‐caused mortality when it is not possible to apply the more standard, data‐hungry PBR approach. These approaches may be useful in supporting the establishment of new bycatch management programmes, or until estimates of absolute abundance become available. Publisher PDF