Data integration reveals dynamic and systematic patterns of breeding habitat use by a threatened shorebird.

Incorporating species distributions into conservation planning has traditionally involved long-term representations of habitat use where temporal variation is averaged to reveal habitats that are most suitable across time. Advances in remote sensing and analytical tools have allowed for the integration of dynamic processes into species distribution modeling. Our objective was to develop a spatiotemporal model of breeding habitat use for a federally threatened shorebird (piping plover, Charadrius melodus). Piping plovers are an ideal candidate species for dynamic habitat models because they depend on habitat created and maintained by variable hydrological processes and disturbance. We integrated a 20-year (2000-2019) nesting dataset with volunteer-collected sightings (eBird) using point process modeling. Our analysis incorporated spatiotemporal autocorrelation, differential observation processes within data streams, and dynamic environmental covariates. We evaluated the transferability of this model in space and time and the contribution of the eBird dataset. eBird data provided more complete spatial coverage in our study system than nest monitoring data. Patterns of observed breeding density depended on both dynamic (e.g., surface water levels) and long-term (e.g., proximity to permanent wetland basins) environmental processes. Our study provides a framework for quantifying dynamic spatiotemporal patterns of breeding density. This assessment can be iteratively updated with additional data to improve conservation and management efforts, because reducing temporal variability to average patterns of use may cause a loss in precision for such actions.

Dispersal distance is driven by habitat availability and reproductive success in Northern Great Plains piping plovers.

BACKGROUND: Dispersal is a critical life history strategy that has important conservation implications, particularly for at-risk species with active recovery efforts and migratory species. Both natal and breeding dispersal are driven by numerous selection pressures, including conspecific competition, individual characteristics, reproductive success, and spatiotemporal variation in habitat. Most studies focus on dispersal probabilities, but the distance traveled can affect survival, fitness, and even metapopulation dynamics. METHODS: We examined sources of variation in dispersal distances with 275 natal dispersal and 1335 interannual breeding events for piping plovers (Charadrius melodus) breeding in the Northern Great Plains between 2014 and 2019. RESULTS: Natal dispersal was on average longer (mean: 81.0 km, median: 53 km) than adult breeding movements (mean: 23.7 km, median: 1 km). Individuals moved the shortest distances when hatched, previously nested, or settling on river habitats. When more habitat was available on their natal area than in the year prior, hatch-year birds moved shorter distances to their first breeding location. Similarly, adults also moved shorter distances when more habitat was available at the settling site and when in closer proximity to other known nesting areas. Additionally, adult movement distance was shorter when successfully hatching a nest the year prior, retaining a mate, or initiating a current nest earlier. CONCLUSION: Habitat availability appears to be associated with dispersal distance for both hatch-year and adult piping plovers. Conservation efforts that integrate dispersal distances may benefit from maintaining nesting habitat within close proximity to other areas for adults and a network of clustered sites spread out across a larger landscape for natal dispersal.

Antiretroviral Laboratory Monitoring and Implications for HIV Clinical Care in the Era of COVID-19 and Beyond.

In the era of COVID-19, providers are delaying laboratory testing in people with HIV (PWH). The purpose of this study was to examine the clinical significance of renal, liver, and lipid testing. We reviewed the charts of 261 PWH who initiated care at an academic HIV clinic between January 1, 2016 and December 21, 2018. Analysis included one-sided binomial exact tests and multiple linear, Poisson, and Beta regression models. The most common abnormality was a glomerular filtration rate (GFR) <60 mL/min (10%). Age <40 years [estimated relative rate (rr) 0.017, 95% confidence interval (CI) 0.207 to 0.494], cobicistat (rr 0.284, 95% CI 0.128 to 0.63), and tenofovir alafenamide (rr 0.295 95% CI 0.151 to 0.573) were associated with a decreased risk of GFR <60 mL/min. An increased AST and ALT ≥2 × upper limit of normal (ULN) was found in 5% and 3%, respectively. Hepatitis C and use of darunavir and lopinavir were associated with increased AST or ALT. When a GFR was <60 mL/min or an AST or ALT was ≥2 × ULN, no action was taken in 53% of cases. In 18% of cases the only intervention was repeat testing. The most common interventions after lipid results were calculation of a 10-year cardiovascular risk score (31%) and addition of a statin (18%). Taking action after lipid results was strongly associated with age ≥40 (rr 7.37, 95% CI 3.0 to 18.3). Young PWH without hepatitis C rarely have renal, liver, or lipid test results that alter clinical care. Decreased testing should be considered.

Behavioral differences at scent stations between two exploited species of desert canids.

Coyotes (Canis latrans) and kit foxes (Vulpes macrotis) are desert canids that share ecological similarities, but have disparate histories with anthropogenic pressure that may influence their responses towards novel stimuli. We used remote cameras to investigate response to novel stimuli for these two species. We predicted that coyotes (heavily pressured species) would be more wary towards novel stimuli on unprotected land (canid harvest activities are permitted) than in protected areas (canid harvest activities are not permitted), whereas kit foxes (less pressured species) would exhibit no difference. We examined differences in the investigative behaviors at 660 scent stations in both protected and unprotected areas. Coyotes showed no differences between protected and unprotected land and were generally more wary than kit foxes, supporting our prediction. Kit foxes were more investigative on protected land, contrary to our expectations. Our study provides evidence that anthropogenic pressure can alter the behaviors of wildlife species.

Clinical Outcomes Following the Use of Archived Proviral HIV-1 DNA Genotype to Guide Antiretroviral Therapy Adjustment.

BACKGROUND: Evidence regarding the safety of using proviral HIV-1 DNA genotype (DNA GT) to guide antiretroviral therapy (ART) is limited. We hypothesized that HIV RNA would not increase following ART adjustment guided by DNA GT in a university HIV clinic. METHODS: Data were obtained from electronic medical records of adult persons living with HIV-1 (PWH) who underwent DNA GT testing and changed ART between October 2014 and November 2017. Logistic regression was used to evaluate the effect of ART switch on HIV RNA over time. RESULTS: Eighty-three PWH had DNA GT performed, 66 (80%) switched ART, and 59 had postswitch follow-up. Data were analyzed pre-/postswitch for these 59 PWH (median age, 54 years; 71% LWH ≥10 years; 46% ≥2 previous regimens; 36% recent low-level viremia; 34% unknown medication history). On DNA GT, 58% had ≥1-class ART resistance, 34% ≥2-class, and 10% 3-class. Median follow-up (range) was 337 (34-647) days. There was no change in probability of HIV RNA ≥50 copies/mL over time (P > .05). At baseline, 76% had HIV RNA <50 vs 88% at last postswitch follow-up (P = .092). Protease inhibitor use decreased from 58% to 24% (P < .001). Average daily pills and dosing frequency decreased from 3.48 to 2.05 (P < .001) and 1.39 to 1.09 (P < .001), respectively; ART cost did not change. CONCLUSIONS: DNA GT facilitated changes in ART in a treatment-experienced population without increases in HIV RNA. Decreased pill burden occurred without increased ART cost. Further studies to identify optimal use of DNA GT are needed.

Antimicrobial Stewardship for a Geriatric Behavioral Health Population.

Antimicrobial resistance is a growing public health concern. Antimicrobial stewardship and multi-disciplinary intervention can prevent inappropriate antimicrobial use and improve patient care. Special populations, especially older adults and patients with mental health disorders, can be particularly in need of such intervention. The purpose of this project was to assess the impact of pharmacist intervention on appropriateness of antimicrobial prescribing on a geriatric psychiatric unit (GPU). Patients ≥18 years old prescribed oral antibiotics during GPU admission were included. Antimicrobial appropriateness was assessed pre- and post-pharmacist intervention. During the six-month pre- and post-intervention phase, 63 and 70 patients prescribed antibiotics were identified, respectively. Subjects in the post-intervention group had significantly less inappropriate doses for indication compared to the pre-intervention group (10.6% vs. 23.9%, p = 0.02), and significantly less antibiotics prescribed for an inappropriate duration (15.8% vs. 32.4%, p < 0.01). There were no significant differences for use of appropriate drug for indication or appropriate dose for renal function between groups. Significantly more patients in the post intervention group had medications prescribed with appropriate dose, duration, and indication (51% vs. 66%, p = 0.04). Pharmacist intervention was associated with decreased rates of inappropriate antimicrobial prescribing on a geriatric psychiatric unit.