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Local adaptation to annually changing environments has evolved in numerous species. Seasonal coat colour change is an adaptation that has evolved in multiple mammal and bird species occupying areas that experience seasonal snow cover. It has a critical impact on fitness as predation risk may increase when an individual is mismatched against its habitat’s background colour. In this paper we investigate the impact of landscape covariates on moult timing in a native winter-adapted herbivore, the mountain hare (Lepus timidus), throughout Norway. Data was collected between 2011 and 2019 at 678 camera trap locations deployed across an environmental gradient. Based on this data, we created a Bayesian multinomial logistic regression model that quantified the correlations between landscape covariates and coat colour phenology and analysed among season and year moult timing variation. Our results demonstrate that mountain hare moult timing is strongly correlated with altitude and latitude with hares that live at higher latitudes and altitudes keeping their winter white coats for longer than their conspecifics that inhabit lower latitudes and altitudes. Moult timing was also weakly correlated with climate zone with hares that live in coastal climates keeping their winter white coats for longer than hares that live in continental climates. We found evidence of some among year moult timing variation in spring, but not in autumn. We conclude that mountain hare moult timing has adapted to local environmental conditions throughout Norway.

BACKGROUND Wellinks is a virtual disease management solution that provides a remote chronic obstructive pulmonary disease (COPD) care model. OBJECTIVE This study evaluated satisfaction and engagement, and explored clinical outcomes associated with participation with Wellinks. This study also sought to refine the cadence of health coaching for COPD patients. METHODS A 24-week interventional research study was conducted by Wellinks and the COPD Foundation in 2022. Adults with COPD were recruited by the COPD Foundation and determined to be eligible if they had phone and internet access and owned a smartphone. All study participants provided written informed consent. The Wellinks solution included virtual health coaching, virtual pulmonary rehabilitation, virtual group education, and access to the Wellinks app and Bluetooth-connected spirometer and pulse oximeter. All participants were offered six coaching sessions in the first 12 weeks. For the second 12-week period, by balanced assignment, participants either continued access to coaching at a reduced frequency or discontinued coaching; all other components of the Wellinks solution remained unchanged through the study duration. COPD Self-Efficacy Scale (CSES), Modified Medical Research Council (mMRC) Dyspnea Scale, pulmonary function, pulse oximetry and patient-reported healthcare resource utilization were the clinical outcome measures. Nonclinical outcomes included engagement and satisfaction with Wellinks as well as net promoter score. RESULTS 141 adults consented and completed Wellinks onboarding. Eighty-four percent completed the 24-week study. Participants had a mean age of 70 (range: 48-88), 81% were ≥65 years, and 56% were female. Most participants (84%) completed all six coaching sessions during the first 12-week period. Compliance with spirometer and pulse oximeter use was 66% to 75% early in the study in Weeks 2-4 but waned over time. Similar findings were observed with use of the Wellinks app. Regardless of group assignment, participants indicated a high degree of satisfaction with Wellinks, with ≥90% of participants indicating they agreed/strongly agreed that the educational content, health coaching, and devices were valuable. At the end of the study, the net promoter score was +64 and +55 in the coaching continuation and discontinuation arms, respectively. A statistically significant improvement from baseline to end of study was observed in the CSES total score (P < .001) and domain scores (P < .001 for each domain). 35% of participants improved their dyspnea score from baseline to week 24. CONCLUSIONS This study confirmed the feasibility of using a virtual model of care delivery to support people living with COPD. The insights gained in this study have allowed for further refinement and personalization of the Wellinks model of care. Findings related to the combined use of technology and personal care delivery should be considered by others developing remote disease management tools. CLINICALTRIAL ClinicalTrials.gov NCT05259280

DNA evidence is routinely used to identify individual predators responsible for attacks on people and livestock in terrestrial settings. However, the transfer of DNA techniques to aquatic environments for similar purposes is a recent development. To date, DNA barcoding has been used successfully to identify shark species depredating fish catches and biting surfboards and neoprene surfaces. In this study we demonstrate the successful DNA barcoding and fingerprinting of an individual tiger shark from transfer DNA collected directly from the wounds of two shark bite victims within two incidents that occurred 30 days and 85 km apart. This finding supports the existence of problem individuals among large shark species that target humans as potential prey. The successful use of DNA techniques to identify both species and specific individuals responsible for shark bites opens the door to selective removal of these individuals as an innovative shark bite risk management strategy. This selective approach would be a more effective, eco-responsible, cost-effective and ethical solution for vulnerable taxa than ongoing non-selective culling campaigns.

Background:Electronic medication monitors (EMMs) are associated with decreased rescue inhaler use, symptom burden, and increased medication adherence in asthma. However, the use of EMMs in people with chronic obstructive pulmonary disease (COPD) using the ELLIPTA dry powder inhaler has not been studied. Methods:This was an open-label, single-arm, prospective observational study of EMMs and associated application (app) use over 12 weeks and up to 24 weeks (April–October 2019) in people with self-reported COPD aged ≥40 years enrolled in the COPD Patient-Powered Research Network, using an ELLIPTA inhaler. The primary outcome was daily active use of the app over 12 weeks. Treatment adherence, rescue inhaler use, and participant satisfaction were assessed over the same period. Results:Among the 122 participants, mean (standard deviation [SD]) proportion of days participants opened the app was 59.5% (31.4), 51.1% (33.5) and 41.3% (34.2) for Days 1–30, 31–60 and 61–90, respectively. Mean (SD) adherence to maintenance medication remained stable: 80.2% (22.7) and 79.9% (26.7) for Days 1–30 and 61–90, respectively. In participants using a rescue inhaler and EMM, mean (SD) rescue-free days increased from 18.5 (10.0; Days 1–30, n=51) to 21.4 (9.6; Days 61–90, n=48). Participants reported high levels of confidence in using the EMM, valued app reminders highly, and reported high system satisfaction (mean [SD] scale: 1=low, 5=high; 4.6 [1.1], 4.3 [1.1] and 4.1 [1.1], respectively). Conclusions:Use of an ELLIPTA EMM with frequent app engagement, high participant satisfaction, and decreased rescue medication use may aid COPD management.

This article, co-authored by a patient affected by chronic obstructive pulmonary disease (COPD) and a respiratory specialist, discusses the patient’s experience of living with the disease and, in particular, the impact of COPD exacerbations on his life. The physician discusses the clinical approach to COPD exacerbations. Together, they provide a call to action to improve the management of COPD exacerbations. Funding AstraZeneca.

1. Recovering or threatened carnivore populations are often harvested to minimise their impact on human activities, such as livestock farming or game hunting. Increasingly, harvest quota decisions involve a set of scientific, administrative and political institutions operating at national and sub-national levels whose interactions and collective decision-making aim to increase the legitimacy of management and ensure population targets are met. In practice, however, assessments of how quota decisions change between these different actors and what consequences these changes have on population trends are rare. 2. We combine a state-space population modelling approach with an analysis of quota decisions taken at both regional and national levels between 2007 and 2018 to build a set of decision-making models that together predict annual harvest quota values for Eurasian lynx (Lynx lynx) in Norway. 3. We reveal a tendency for administrative decision-makers to compensate for consistent quota increases by political actors, particularly when the lynx population size estimate is above the regional target. Using population forecasts based on the ensemble of decision-making models, we show that such buffering of political biases ensures lynx population size remains close to regional and national targets in the long-term. 4. Our results go beyond the usual qualitative assessment of decentralised governance systems for carnivore management, revealing a system of checks and balances that, in the case of lynx in Norway, ensures both multi-stakeholder participation and sustainable harvest quotas. 5. Our work provides a predictive framework to evaluate co-participatory decision-making processes in wildlife management, paving the way for scientists and decision-makers to collaborate more widely in identifying where decision biases might lie and how institutional arrangements can be optimised to minimise them. We emphasise, however, that this is only possible if wildlife management decisions are documented and transparent.

Sustainable wildlife harvest is challenging due to the complexity of uncertain social-ecological systems, and diverse stakeholder perspectives of sustainability. In these systems, semi-complex stochastic simulation models can provide heuristics that bridge the gap between highly simplified theoretical models and highly context-specific case-studies. Such heuristics allow for more nuanced recommendations in low-knowledge contexts, and an improved understanding of model sensitivity and transferability to novel contexts. We develop semi-complex Management Strategy Evaluation (MSE) models capturing dynamics and variability in ecological processes, monitoring, decision-making, and harvest implementation, under a diverse range of contexts. Results reveal the fundamental challenges of achieving sustainability in wildlife harvest. Environmental contexts were important in determining optimal harvest parameters, but overall, evaluation contexts more strongly influenced perceived outcomes, optimal harvest parameters and optimal harvest strategies. Importantly, simple composite metrics popular in the theoretical literature (e.g. focusing on maximizing yield and population persistence only) often diverged from more holistic composite metrics that include a wider range of population and harvest objectives, and better reflect the trade-offs in real world applied contexts. While adaptive harvest strategies were most frequently preferred, particularly for more complex environmental contexts (e.g. high uncertainty or variability), our simulations map out cases where these heuristics may not hold. Despite not always being the optimal solution, overall adaptive harvest strategies resulted in the least value forgone, and are likely to give the best outcomes under future climatic variability and uncertainty. This demonstrates the potential value of heuristics for guiding applied management.

Clinical trials evaluating the management of acute exacerbations of COPD assess heterogeneous outcomes, often omitting those that are clinically relevant or more important to patients. We have developed a core outcome set, a consensus-based minimum set of important outcomes that we recommend are evaluated in all future clinical trials on exacerbations management, to improve their quality and comparability. COPD exacerbations outcomes were identified through methodological systematic reviews and qualitative interviews with 86 patients from 11 countries globally. The most critical outcomes were prioritised for inclusion in the core outcome set through a two-round Delphi survey completed by 1063 participants (256 patients, 488 health professionals and 319 clinical academics) from 88 countries in five continents. Two global, multi-stakeholder, virtual consensus meetings were conducted to 1) finalise the core outcome set and 2) prioritise a single measurement instrument to be used for evaluating each of the prioritised outcomes. Consensus was informed by rigorous methodological systematic reviews. The views of patients with COPD were accounted for at all stages of the project. Survival, treatment success, breathlessness, quality of life, activities of daily living, the need for a higher level of care, arterial blood gases, disease progression, future exacerbations and hospital admissions, treatment safety and adherence were all included in the core outcome set. Focused methodological research was recommended to further validate and optimise some of the selected measurement instruments. The panel did not consider the prioritised set of outcomes and associated measurement instruments to be burdensome for patients and health professionals to use.

1. Applied ecological research is increasingly inspired by the open science movement. However, new challenges about how we define our science when biodiversity data is being shared and re-used are not solved. Among these challenges is the risk associated with blurring the distinction between research that mainly seeks to explore patterns with no a-priori articulated hypotheses (exploratory research), and research that explicitly tests a-priori formulated hypotheses (confirmatory research). 2. A rapid screening of a random selection of the peer-reviewed literature suggests that neither experimental protocols nor hypothesis-testing sensu stricto are common in applied ecological research. In addition, most experiments are carried out on small spatial scales, which contrast with current global policy needs and research trends towards addressing large spatial and temporal scales. This latter trend makes it unfeasible for policy to rely mainly on insights gained from experimental research. 3. To solve fundamental local, regional and global societal challenges, we need both exploratory and confirmatory research. However, the fundamental role that confirmatory research testing a-priori hypothesis play for establishing causal relationships need to be revaluated in applied ecological research. 4. A clearer distinction between exploratory and confirmatory research is currently needed, and could be facilitated by allocating journal sections to different types of research; by embracing new tools offered by the open science era, such as pre-registration of hypothesis; by establishing new systems where post-hoc hypotheses emerging through exploration can also be registered for later testing; and by more broad adoption of causal inference methods that foster more structured testing of hypotheses about causal mechanisms from observational biodiversity data. 5. Synthesis and applications. To gain the full benefits from the open science era, researchers, funding bodies and journal editors should explicitly consider approaches and incentives that encourage openness about methods and approaches, as well as value the plurality of scientific approaches needed to address questions in applied ecology and conservation science.

Background Self-management support (SMS) for patients with COPD can improve health-related quality of life (HRQOL). However, it remains unclear what SMS strategies are most effective. Using peer support to advance self-management is promising, as peer supporters possess credibility and can serve as role models. Methods We conducted a single-blinded RCT comparing the effectiveness of two strategies to support patients with COPD. The strategies were ‘Health Care Professional (HCP)’ and ‘HCP Plus Peer’ support. Peer support was provided by patients with COPD who have stopped smoking, completed an acute pulmonary rehabilitation program, and met the requirements for becoming a peer supporter. We enrolled patients receiving treatment at inpatient and outpatient settings. Patients were encouraged to invite one family-caregiver to enroll with them. The primary outcome measure was the change in HRQOL at 6 months post enrollment. Secondary outcomes included COPD-related and all-cause hospitalizations and ED visits. Caregiver outcomes included preparedness for caregiving, caregiver stress, and coping. Results A total of 292 patients as well as 50 family-caregivers were enrolled. The average patient age was 67.3 yrs. (SD 9.4), 61% were female and 26% were African-Americans. The majority of caregivers were females (68%) and were a spouse/partner (58%). Discussion This study tested a dual strategy for providing support to patients with COPD that incorporates peer and health care professional support. The study had minimal exclusion criteria. If shown effective, the study offers a program of peer support that can be readily implemented in health care settings.

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