A Phenology Model for Asian Gypsy Moth Egg Hatch.

Phenology models are useful tools in pest management interventions, biosecurity operations targeting alien invaders, and answering questions regarding the potential for range expansion/shift. The Gypsy Moth Life Stage model (GLS) has been used to predict the invasive range of the North American gypsy moth (Lymantria dispar dispar Linnaeus [Lepidoptera: Erebidae]) in North America and New Zealand. It has been used to examine the role of supra-optimal temperatures in range expansion/stasis/retraction. However, GLS has also been used where the target organism is the Asian subspecies L. d. asiatica Vnukovskij, despite observed differences between the predominant phenotypes of the two subspecies in the temperature requirements for egg hatch and the absence of egg phenology model parameters specific to the Asian phenotype. Here we describe the results of temperature and exposure duration on the timing of Asian gypsy moth egg hatch, and we present phenology model parameters for the Asian phenotype. Sum of squared differences (observed minus predicted day of median egg hatch) was reduced from 7,818 d2 (North American parameters) to 178 d2. Days of simulated median egg hatch differed from the observed days by 0-7 d (x¯=0.2; SD=3.1). The pattern of simulated egg hatch closely mimicked the irregular pattern of observed egg hatch from the temperature regimes of our experiment. Egg hatch is arguably the most important life cycle event in gypsy moth population suppression/eradication interventions and in estimating their potential invasive range. The model parameters described here produce accurate predictions of Asian gypsy moth egg hatch.

Age-Dependent Developmental Response to Temperature: An Examination of the Rarely Tested Phenomenon in Two Species (Gypsy Moth (Lymantria dispar) and Winter Moth (Operophtera brumata)).

The pervading paradigm in insect phenology models is that the response to a given temperature does not vary within a life stage. The developmental rate functions that have been developed for general use, or for specific insects, have for the most part been temperature-dependent but not age-dependent, except where age is an ordinal variable designating the larval instar. Age dependence, where age is a continuous variable, is not often reported (or investigated), and is rarely included in phenology models. I provide a short review of the seldom-investigated phenomenon of age dependence in developmental response to temperature, and compare the derivation of the winter moth egg phenology model by Salis et al. to the derivation of another egg phenology model with age-dependent responses to temperature I discuss some probable reasons for the discrepancies (acknowledged by Salis et al. between modelled and observed developmental rates of the winter moth, and discuss the contribution that geographically robust phenology models can make to estimates of species distributions.

Model-specification uncertainty in future forest pest outbreak.

Climate change will modify forest pest outbreak characteristics, although there are disagreements regarding the specifics of these changes. A large part of this variability may be attributed to model specifications. As a case study, we developed a consensus model predicting spruce budworm (SBW, Choristoneura fumiferana [Clem.]) outbreak duration using two different predictor data sets and six different correlative methods. The model was used to project outbreak duration and the uncertainty associated with using different data sets and correlative methods (=model-specification uncertainty) for 2011-2040, 2041-2070 and 2071-2100, according to three forcing scenarios (RCP 2.6, RCP 4.5 and RCP 8.5). The consensus model showed very high explanatory power and low bias. The model projected a more important northward shift and decrease in outbreak duration under the RCP 8.5 scenario. However, variation in single-model projections increases with time, making future projections highly uncertain. Notably, the magnitude of the shifts in northward expansion, overall outbreak duration and the patterns of outbreaks duration at the southern edge were highly variable according to the predictor data set and correlative method used. We also demonstrated that variation in forcing scenarios contributed only slightly to the uncertainty of model projections compared with the two sources of model-specification uncertainty. Our approach helped to quantify model-specification uncertainty in future forest pest outbreak characteristics. It may contribute to sounder decision-making by acknowledging the limits of the projections and help to identify areas where model-specification uncertainty is high. As such, we further stress that this uncertainty should be strongly considered when making forest management plans, notably by adopting adaptive management strategies so as to reduce future risks.

Risk Reduction of an Invasive Insect by Targeting Surveillance Efforts with the Assistance of a Phenology Model and International Maritime Shipping Routes and Schedules.

Reducing the risk of introduction to North America of the invasive Asian gypsy moth (Lymantria dispar asiatica Vnukovskij and L. d. japonica [Motschulsky]) on international maritime vessels involves two tactics: (1) vessels that wish to arrive in Canada or the United States and have visited any Asian port that is subject to regulation during designated times must obtain a predeparture inspection certificate from an approved entity; and (2) vessels with a certificate may be subjected to an additional inspection upon arrival. A decision support tool is described here with which the allocation of inspection resources at North American ports can be partitioned among multiple vessels according to estimates of the potential onboard Asian gypsy moth population and estimates of the onboard larval emergence pattern. The decision support tool assumes that port inspection is uniformly imperfect at the Asian ports and that each visit to a regulated port has potential for the vessel to be contaminated with gypsy moth egg masses. The decision support tool uses a multigenerational phenology model to estimate the potential onboard population of egg masses by calculating the temporal intersection between the dates of port visits to regulated ports and the simulated oviposition pattern in each port. The phenological development of the onboard population is simulated each day of the vessel log until the vessel arrives at the port being protected from introduction. Multiple independent simulations are used to create a probability distribution of the size and timing of larval emergence.

Unwanted spatial bias in predicting establishment of an invasive insect based on simulated demographics.

A strategy to estimate the probability of successful establishment of the invasive gypsy moth (given an introduction) is growing in popularity. The strategy calls for an examination of the demographic output of a phenology model of the complete life-cycle to estimate the generational success under the climate of the location under consideration. The probability is maximal where the climate satisfies the life-cycle requirements of all life-stages of 100% of the population every year. The probability decreases where a smaller proportion of the population has its requirements satisfied every year, or where the frequency of unsatisfactory years increases. The strategy can give an unbiased and objective estimate of the probability. However, implementation of the strategy has most often forced unnatural and overly simplistic modifications onto the demographic structure that is simulated by the phenology model, and used an inappropriate and arbitrary calendar date to estimate demographic changes from winter mortality. This produces pronounced spatial bias in the estimates of generational success, and therefore in the estimates of climate-mediated establishment probability. In an examination of the strategy, as implemented in New Zealand, one demographic simplification caused an overestimate of 21% in a southern location; a second simplification caused an overestimate of 17% in a northern location. One hundred percent of the generations were incorrectly considered to have failed in a northern location because of the arbitrary calendar date that was used; and 78% of the generations were incorrectly considered successful in a southern location because of the arbitrary date.

Fire regime zonation under current and future climate over eastern Canada.

Fire is a major disturbance in Canadian forests. Along with fuel and ignition characteristics, climatic conditions are seen as one of the main drivers of fire regimes. Projected changes in climate are expected to significantly influence fire regimes in Canada. As fire regime greatly shapes large-scale patterns in biodiversity, carbon, and vegetation, as well as forest and fire management strategies, it becomes necessary to define regions where current and future fire regimes are homogeneous. Random Forests (RF) modeling was used to relate fire regime attributes prevailing between 1961 and 1990 in eastern Canada with climatic/fire-weather and environmental variables. Using climatic normals outputs from the Canadian Regional Climate Model (CRCM), we delineated current (1961-1990) and future (2011-2040, 2040-2070, 2071 2100) homogeneous fire regime (HFR) zones. Heterogeneous response of fire regime to climate changes is projected for eastern Canada with some areas (e.g., western Quebec) experiencing very small alterations while others (e.g., southeastern Ontario) are facing great shifts. Overall, models predicted a 2.2- and 2.4-fold increase in the number of fires and the annual area burned respectively mostly as a result of an increase in extreme fire-weather normals and mean drought code. As extreme fire danger would occur later in the fire season on average, the fire season would shift slightly later (5-20 days) in the summer for much of the study area while remaining relatively stable elsewhere. Although fire regime values would change significantly over time, most zone boundaries would remain relatively stable. The information resulting from HFR zonations is clearly of interest for forest and fire management agencies as it reveals zones with peculiar fire regimes that would have been hidden otherwise using predefined administrative or ecological stratifications.

Prepupal diapause and instar IV developmental rates of the spruce beetle, Dendroctonus rufipennis (Coleoptera: Curculionidae, Scolytinae).

The spruce beetle, Dendroctonus rufipennis (Kirby), is an important mortality agent of native spruces throughout North America. The life-cycle duration of this species varies from 1 to 3 years depending temperature. The univoltine cycle (one generation per year) is thought to maximize outbreak risk and accelerate host mortality in established outbreaks. Prepupal diapause is associated with the semivoltine cycle (one generation per 2 years) and we investigated thermal conditions that result in diapause induction. Preliminary experiments used respirometry in an attempt to distinguish the diapause state of experimental insects but the technique was apparently confounded by low respiration before and during pupation, regardless of diapause status. Therefore, diapause induction was deduced using developmental delays. The observed developmental response was not a "switch", with developmental delay either present or absent, but instead varied continuously. We found that temperatures <15°C from instar III through mid-instar IV were associated with developmental delays beyond that expected from cool temperatures. Moreover, the duration of exposure to cool temperatures was important in determining the degree of developmental delay. Small, if any, delays were observed if the cumulative exposure to <15°C was <20 d whereas >40 d cumulative exposure was associated with distinct developmental suppression. Intermediate exposure to cool temperatures resulted in minor developmental delays. We used our results to parameterize a maximum likelihood estimation model of temperature-dependent instar IV developmental rates, including the effect of diapause. This model can be included as part of a spruce beetle phenology model for predicting population dynamics.

Role for PROMs data to support quality improvement across the healthcare system: an informed exchange with senior health system leaders.

The Institute for Healthcare Improvement's Triple Aim (initiated in 2007) and several high-level Canadian studies have made general calls to improve health system performance. Managers and administrators have been urged to tackle the challenges of quality improvement and cost control. In the lead essay, McGrail et al. point to patient-reported outcome measures (PROMs) as something worth doing, and this has been welcomed as an appropriate response to long-standing calls for action. A recent gathering of senior health system leaders explored the prospect of routinely collecting PROMs data to drive quality improvement. The symposium, Measures of Health Outcomes to Improve Performance, Value and Productivity, was held in Victoria, British Columbia, on December 9, 2010. The symposium delegates considered the challenges and issues involved in moving forward with PROMs, looking closely at the potential for enhancing the quality of data resources available for managing our healthcare system. Senior leaders and administrators from the publicly funded healthcare systems of British Columbia and western and northern Canada participated in a frank discussion of challenges and requirements for moving forward with a PROMs initiative.

Hitchhikers on trade routes: A phenology model estimates the probabilities of gypsy moth introduction and establishment.

As global trade increases so too does the probability of introduction of alien species to new locations. Estimating the probability of an alien species introduction and establishment following introduction is a necessary step in risk estimation (probability of an event times the consequences, in the currency of choice, of the event should it occur); risk estimation is a valuable tool for reducing the risk of biological invasion with limited resources. The Asian gypsy moth, Lymantria dispar (L.), is a pest species whose consequence of introduction and establishment in North America and New Zealand warrants over US$2 million per year in surveillance expenditure. This work describes the development of a two-dimensional phenology model (GLS-2d) that simulates insect development from source to destination and estimates: (1) the probability of introduction from the proportion of the source population that would achieve the next developmental stage at the destination and (2) the probability of establishment from the proportion of the introduced population that survives until a stable life cycle is reached at the destination. The effect of shipping schedule on the probabilities of introduction and establishment was examined by varying the departure date from 1 January to 25 December by weekly increments. The effect of port efficiency was examined by varying the length of time that invasion vectors (shipping containers and ship) were available for infection. The application of GLS-2d is demonstrated using three common marine trade routes (to Auckland, New Zealand, from Kobe, Japan, and to Vancouver, Canada, from Kobe and from Vladivostok, Russia).

Age-dependent postdiapause development in the gypsy moth (Lepidoptera: Lymantriidae) life stage model.

For the last approximately 10 yr, the Gypsy Moth Life Stage (GLS) model has been used by pest managers to predict when important events in the gypsy moth, Lymantria dispar L., life cycle will occur (e.g., peak second larval instar population and male moth flight). Although the GLS model has been shown to outperform other gypsy moth phenology models, its predictions have not always been as accurate as desired. Differences between predicted and observed egg hatch phenology prompted a re-examination of the original experimental data that were used in the construction of the egg hatch submodels of the original GLS model, and a data processing error was discovered to have truncated the postdiapause experimental data. Analysis of the complete data set confirmed that developmental rates in the postdiapause phase were age and temperature dependent but that the developmental response to temperature is distinctly nonlinear at postdiapause initiation, in contrast to the indeterminate response previously reported. By incorporating the new estimates of developmental rate patterns and parameters into the GLS model, errors in the GLS-simulated egg hatch period were reduced by 33-71% and error in date of 50% cumulative egg hatch by 25-100%.

Cost-justification of a clinical pharmacist-managed anticoagulation clinic.

A cost-benefit evaluation of a clinical pharmacist-managed anticoagulation clinic (AC) was performed. Outpatient and hospital records were examined for 26 patients in the treatment group with an AC clinic and 26 patients in the control group. Therapeutic prothrombin times were maintained within the treatment group to a significantly greater extent than within the control group (p<0.001). The AC was successful in preventing hospitalizations resulting from hemorrhage or thromboembolic admissions (p<0.05, p<0.005, respectively). Patients were hospitalized 3.22 days and .048 days per patient-treatment-year in the control and treatment groups, respectively. The net savings in reduced hospitalization costs per year in the treatment group was $211,776. The benefit:cost ratio (B:C) was 6.55, suggesting the program is socially valuable. This clinical pharmacist-managed AC was effective in maintaining therapeutic prothrombin times, and reducing the incidence of hospitalizations resulting from anticoagulation complications, and can be cost-justified based on a cost-benefit analysis.

New perspectives on the pharmacotherapy of ischemic stroke.

OBJECTIVE: To provide an overview of the impact of ischemic stroke and the steps that can be taken to reduce its burden through greater awareness of the disease, improved diagnosis and better treatment, with emphasis on the use of antiplatelet agents. DATA SOURCES: Recent (1995-2003) published scientific literature, as identified by the authors through Medline searches, using the terms stroke, transient ischemic attack, cerebrovascular disease, atherothrombosis, risk factors, pharmacotherapy, prevention, and reviews on treatment. STUDY SELECTION: Recent systematic English-language review articles and reports of controlled randomized clinical trials were screened for inclusion. DATA SYNTHESIS: Ischemic stroke is generally the result of an atherothrombotic process leading to vessel obstruction or narrowing. Of the two types of ischemic stroke, thrombotic stroke is caused by a thrombus that develops within the cerebral vasculature, while embolic stroke arises from a distant embolus that lodges in a cerebral artery. The neurologic manifestations of stroke depend on the location of injury in the brain and the degree of ischemia or infarction. Symptoms may be reversible or irreversible and range from sensory deficits to hemiplegia. Risk factors for development of ischemic stroke include hypertension, diabetes, dyslipidemia, smoking, atrial fibrillation, prior stroke, and transient ischemic attack. Tissue plasminogen activator is currently the only available drug treatment for acute ischemic stroke. Stroke recurrence rates are high (about 40% over 5 years), and all ischemic stroke patients should receive antithrombotic therapy (unless contraindicated) for secondary prevention. Of the oral antiplatelet therapies, aspirin, clopidogrel (Plavix--Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership), and the extended-release dipyridamole plus aspirin combination are acceptable first-line agents, while anticoagulants (warfarin) are preferred in patients with atrial fibrillation. CONCLUSION: Lifestyle changes and drug therapy are important components of primary and secondary prevention strategies in ischemic stroke. Risk factors such as elevated blood pressure and high cholesterol should be aggressively treated. Antiplatelet agents, antihypertensive agents, and cholesterol-lowering agents are therapeutic cornerstones for secondary prevention.