Effectiveness of the European Natura 2000 network to sustain a specialist wintering waterbird population in the face of climate change.

Analysis of coordinated Greater Scaup (Aythya marila) count data from the last 30 years showed a 38.1% decrease in wintering numbers in North-West Europe, from 309,000 during 1988-1991 to c.192,300 individuals during 2015-2018. Annual trends in wintering numbers differed throughout the range. Numbers decreased in the UK, Ireland, and in the Netherlands, while numbers were stable in Denmark. Germany, Poland, Sweden, and Estonia showed increasing numbers, suggesting a shift in the distribution of the species within its wintering grounds towards the east and north. Higher temperatures in northern and eastern areas were correlated with the range shift of the wintering distribution. Deaths from bycatch drowning of Scaup in fishing gear have significantly decreased in recent decades in the Netherlands, where currently the greatest threat is considered the deterioration of food resources. The increasing concentration of wintering Scaup in coastal Poland and Germany (where lack of effective implementation of conservation measures fail to protect the species from the impacts of bycatch and declining food quality) pose major threats to the entire population.

Contralateral effect of systemic absorption of low dose bevacizumab (Avastin) after unilateral intravitreal injection in severe retinopathy of prematurity (ROP).

An extremely premature baby boy born at 23 weeks' gestational age was treated with unilateral low dose of 0.16 mg/0.025 mL intravitreal bevacizumab in the left eye for aggressive retinopathy of prematurity (ROP). He developed photographically documented changes in his contralateral right eye on imaging 5 days later. Second eye treatment was at 12 days. He has development assessment and ophthalmic review beyond age 2, which is normal. Systemic absorption of the drug caused an end organ effect to slow down and reverse ROP in his untreated right eye. Both eyes vascularised fully. His normal Bayley III developmental score at age 2 is uncommon for a 23-week gestation baby. Even at a low dose, bevacizumab has the potential for end organ effect on the second eye, and therefore other organs. In this case, there are no medium-term measurable neurodevelopmental side-effects. We suggest longer term follow-up is required before excluding unwanted side-effects.

Time series analysis reveals synchrony and asynchrony between conflict management effort and increasing large grazing bird populations in northern Europe.

The management of conflicts between wildlife conservation and agricultural practices often involves the implementation of strategies aimed at reducing the cost of wildlife impacts on crops. Vital to the success of these strategies is the perception that changes in management efforts are synchronized relative to changes in impact levels, yet this expectation is never evaluated. We assess the level of synchrony between time series of population counts and management effort in the context of conflicts between agriculture and five populations of large grazing birds in northern Europe. We reveal inconsistent patterns of synchrony and asynchrony between changes in population counts and impact management effort relating to population harvesting, monetary payments, or scaring practices. This variation is likely due to differing management aims, the existence of lags between management decisions and population monitoring, and the inconsistent use of predictive models across case studies. Overall, our findings highlight the need for more adaptive and timely responses of management to changes in target species numbers so as not to unexpectedly increase social conflicts and jeopardize the status of wildlife populations.

Outcome of babies with no detectable heart rate before 10†minutes of age, and the effect of gestation.

OBJECTIVE: Current resuscitation guidelines suggest that it is reasonable to consider stopping resuscitation where no heart rate (cardiac activity) has been detected for 10 min in a newborn baby from birth. We aimed to determine the mortality rate and 2-year neurodevelopmental outcome of all babies born with no heart rate before 10 min of age where resuscitation was attempted in a tertiary referral centre over a 5-year period. DESIGN: To identify all babies with no heart rate before age 10 min we examined two groups:▸ All babies classified as live born who received cardiac massage at birth between January 2009 and December 2013.▸ All babies classified as stillborn between January 2009 and December 2013 where attempts were made at resuscitation beyond 10 min. RESULTS: 87 babies received cardiac massage. 81 babies were live born and 6 were classified as stillborn. Twenty-two babies had no heart rate before 10 min of age. Eight babies survived to 2-year follow-up. 6/11 term babies survived, 2/4 babies born between 32 weeks and 37 weeks survived, and no infants born less than 32 weeks survived (n=7). Of the survivors, 5/8 had a normal neurodevelopmental outcome at 2 years' age. One patient was lost to follow-up, while the other two patients had hemiplegia. CONCLUSIONS: Our results add to the body of evidence suggesting that having no heart rate before 10 min of age, in term babies, may not be an appropriate prompt to discontinue resuscitation.

Proportionate reduction in uncertainty of late onset infection in pre-term infants by neutrophil CD64 measurement.

OBJECTIVE: Establish how neutrophil CD64 performs as a marker of definite infection in pre-term infants in comparison to C reactive protein (CRP) and procalcitonin (PCT). METHODS: A total of 38 pre-term infants with suspected late onset infection had CD64 measured by flow cytometry. Proportionate reduction in uncertainty (PRU) curves were generated for CD64 counts at various threshold values. RESULTS: PRU curves reduced the residual uncertainty of the presence of infection by up to 64%. CONCLUSIONS: The CD64 appears to be a useful point of care test (POCT) for further defining the likelihood of infection and performs better than CRP or PCT at helping to rule in infection.

Rapid climate driven shifts in wintering distributions of three common waterbird species.

Climate change is predicted to cause changes in species distributions and several studies report margin range shifts in some species. However, the reported changes rarely concern a species' entire distribution and are not always linked to climate change. Here, we demonstrate strong north-eastwards shifts in the centres of gravity of the entire wintering range of three common waterbird species along the North-West Europe flyway during the past three decades. These shifts correlate with an increase of 3.8 °C in early winter temperature in the north-eastern part of the wintering areas, where bird abundance increased exponentially, corresponding with decreases in abundance at the south-western margin of the wintering ranges. This confirms the need to re-evaluate conservation site safeguard networks and associated biodiversity monitoring along the flyway, as new important wintering areas are established further north and east, and highlights the general urgency of conservation planning in a changing world. Range shifts in wintering waterbirds may also affect hunting pressure, which may alter bag sizes and lead to population-level consequences.

Deaths in preterm infants: changing pathology over 2 decades.

OBJECTIVE: To establish how cause of death for live-born preterm infants (24-31 weeks gestation) has changed in a single large UK population over 2 decades. STUDY DESIGN: This was an interrogation of a population-based survey of >680, 000 live births (between 1988 and 2008) for deaths in the first postnatal year. We collected cause of death grouped into major etiologies: respiratory, infection, malformation, necrotizing enterocolitis (NEC), and other. Data were analyzed in three 7-year epochs and 2 gestational groups (<27 and 28-31 weeks). Numbers, rates per 1000 live births, and proportional contributions to each epoch were analyzed. RESULTS: A total of 1504 deaths occurred. The infants who died had a median gestational age of 26 weeks (IQR, 25-28 weeks) and a median birth weight of 880 g (IQR, 700-1170 g). The number of deaths decreased with each later epoch (from 671 to 473 and then to 360), as did the proportion of deaths from respiratory causes (64% to 62% and then to 49%). The proportion of deaths occurring after 40 weeks postmenstrual age remained stable across the 3 epochs (8.8%, 8%, and 8%). Deaths from infection and NEC increased with time (from 11% to 13% and then to 21%), as did median time to death (from 2.7 to 3.8 days). CONCLUSION: Infection and NEC are increasingly prevalent causes of death in preterm infants.

Wintering French mallard and teal are heavier and in better body condition than 30 years ago: effects of a changing environment?

Animal populations are exposed to large-scale anthropogenic impact from, e.g., climate change, habitat alteration and supplemental stocking. All of these may affect body condition in wintering dabbling ducks, which in turn may affect an individual's survival and reproductive success. The aim of this study was to assess whether there have been morphometric changes in Mallard (Anas platyrhynchos) and Teal (Anas crecca) over the last 30 years at a major wintering site. Body mass and condition increased from the 1950s-1960s to the 2000s in both species. The increase in body mass amounted to as much as 11.7%, with no corresponding change in body size. Improved body condition was maintained from early to mid-winter, but then converged with historical values for late winter. Our interpretation is that increasingly benign ambient winter conditions permit ducks to maintain better energetic "safety margins" throughout winter, and that converging spring departure values may be related to evolutionary flight energetic optima. The observed changes are consistent with large-scale climate amelioration and local/regional habitat improvement (both anthropogenic).

Analysis of parental and nurse weight estimates of children in the pediatric emergency department.

OBJECTIVE: To evaluate the accuracy of parent and triage nurse estimates of children's weights in the pediatric emergency department. METHODS: A convenience sample of parents was surveyed before triage regarding their child's chief complaint, when and where the child was last weighed, and an estimate of their child's weight. Children unable to be weighed or with possible dehydration or external orthopedic devices were excluded. Nurses also estimated children's weights before weighing them and were blinded to parent estimates. All nurses were experienced in the department, had participated in a triage course, and had completed a background survey. RESULTS: Nine hundred forty-two patients presenting to pediatric emergency department triage were enrolled, resulting in 812 surveys. Parents were more accurate at weight estimation than nurses, with 79% of parents and 83% of legal guardians estimating weights within 10%. Only 55% of nurse estimates were within 10%. Parents and nurses tended to underestimate patients' weights (P < 0.0001). Parent estimates were not affected by a child's age or sex or the location the child was last weighed (P > 0.05). Accuracy of nurse estimates was not related to nurse education or experience (P > 0.05). Parent estimates of weight were more accurate than nurse estimates 74.6% of the time. CONCLUSIONS: Parents were more accurate at estimating children's weights than triage nurses but were within 10% of the children's actual weights only 79% of the time. Nurse estimates were highly inaccurate. Other methods to estimate patient weights should be used when actual patient weights are unobtainable.