Reduction of coastal lighting decreases seabird strandings.

Artificial light at night (ALAN) is negatively impacting numerous species of nocturnally active birds. Nocturnal positive phototaxis, the movement towards ALAN, is exhibited by many marine birds and can result in stranding on land. Seabird species facing major population declines may be most at risk. Leach's Storm-Petrels (Hydrobates leucorhous) are small, threatened seabirds with an extensive breeding range in the North Atlantic and North Pacific Oceans. The Atlantic population, which represents approximately 40-48% of the global population, is declining sharply. Nocturnal positive phototaxis is considered to be a key contributing factor. The Leach's Storm-Petrel is the seabird species most often found stranded around ALAN in the North Atlantic, though there is little experimental evidence that reduction of ALAN decreases the occurrence of stranded storm-petrels. During a two-year study at a large, brightly illuminated seafood processing plant adjacent to the Leach's Storm-Petrel's largest colony, we compared the number of birds that stranded when the lights at the plant were on versus significantly reduced. We recorded survival, counted carcasses of adults and juveniles, and released any rescued individuals. Daily morning surveys revealed that reducing ALAN decreased strandings by 57.11% (95% CI: 39.29% - 83.01%) per night and night surveys revealed that reducing ALAN decreased stranding of adult birds by 11.94% (95% CI: 3.47% - 41.13%) per night. The peak stranding period occurred from 25 September to 28 October, and 94.9% of the birds found during this period were fledglings. These results provide evidence to support the implementation of widespread reduction and modification of coastal artificial light as a conservation strategy, especially during avian fledging and migration periods.

Sociodemographic Factors are Associated with Care Delivery and Outcomes in Pediatric Severe Sepsis.

IMPORTANCE: Sepsis is a leading cause of morbidity and mortality in the United States and disparate outcomes exist between racial/ethnic groups despite improvements in sepsis management. These observed differences are often related to social determinants of health (SDoH). Little is known about the role of SDoH on outcomes in pediatric sepsis. OBJECTIVE: This study examined the differences in care delivery and outcomes in children with severe sepsis based on race/ethnicity and neighborhood context (as measured by the social vulnerability index). DESIGN SETTING AND PARTICIPANTS: This retrospective, cross-sectional study was completed in a quaternary care children's hospital. Patients 18 years old or younger who were admitted between May 1, 2018, and February 28, 2022, met the improving pediatric sepsis outcomes (IPSO) collaborative definition for severe sepsis. Composite measures of social vulnerability, care delivery, and clinical outcomes were stratified by race/ethnicity. MAIN OUTCOMES AND MEASURES: The primary outcome of interest was admission to the PICU. Secondary outcomes were sepsis recognition and early goal-directed therapy (EGDT). RESULTS: A total of 967 children met the criteria for IPSO-defined severe sepsis, of whom 53.4% were White/non-Hispanic. Nearly half of the cohort (48.7%) required PICU admission. There was no difference in illness severity at PICU admission by race (1.01 vs. 1.1, p = 0.18). Non-White race/Hispanic ethnicity was independently associated with PICU admission (odds ratio [OR] 1.35 [1.01-1.8], p = 0.04). Although social vulnerability was not independently associated with PICU admission (OR 0.95 [0.59-1.53], p = 0.83), non-White children were significantly more likely to reside in vulnerable neighborhoods (0.66 vs. 0.38, p < 0.001). Non-White race was associated with lower sepsis recognition (87.8% vs. 93.6%, p = 0.002) and less EGDT compliance (35.7% vs. 42.8%, p = 0.024). CONCLUSIONS AND RELEVANCE: Non-White race/ethnicity was independently associated with PICU admission. Differences in care delivery were also identified. Prospective studies are needed to further investigate these findings.