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There is a growing agreement that conservation needs to be proactive and pay increased attention to common species and to the threats they face. The blue sheep (Pseudois nayaur) plays a key ecological role in sensitive high‐altitude ecosystems of Central Asia and is among the main prey species for the globally vulnerable snow leopard (Panthera uncia). As the blue sheep has been increasingly exposed to human pressures, it is vital to estimate its population dynamics, protect the key populations, identify important habitats, and secure a balance between conservation and local livelihoods. We conducted a study in Manang, Annapurna Conservation Area (Nepal), to survey blue sheep on 60 transects in spring (127.9 km) and 61 transects in autumn (134.7 km) of 2019, estimate their minimum densities from total counts, compare these densities with previous estimates, and assess blue sheep habitat selection by the application of generalized additive models (GAMs). Total counts yielded minimum density estimates of 6.0–7.7 and 6.9–7.8 individuals/km2 in spring and autumn, respectively, which are relatively high compared to other areas. Elevation and, to a lesser extent, land cover indicated by the normalized difference vegetation index (NDVI) strongly affected habitat selection by blue sheep, whereas the effects of anthropogenic variables were insignificant. Animals were found mainly in habitats associated with grasslands and shrublands at elevations between 4,200 and 4,700 m. We show that the blue sheep population size in Manang has been largely maintained over the past three decades, indicating the success of the integrated conservation and development efforts in this area. Considering a strong dependence of snow leopards on blue sheep, these findings give hope for the long‐term conservation of this big cat in Manang. We suggest that long‐term population monitoring and a better understanding of blue sheep–livestock interactions are crucial to maintain healthy populations of blue sheep and, as a consequence, of snow leopards. Blue sheep play a key ecological role in high‐altitude ecosystems and represent the staple prey for the globally threatened snow leopard. We show that the Manang area, Annapurna Conservation Area, Nepal, still maintains a relatively high density of these ungulates. Elevation and land cover are the main local determinants of blue sheep habitats.

The greatest threat to the protected Eurasian lynx (Lynx lynx) in Central Europe is human‐induced mortality. As the availability of lynx prey often peaks in human‐modified areas, lynx have to balance successful prey hunting with the risk of encounters with humans. We hypothesized that lynx minimize this risk by adjusting habitat choices to the phases of the day and over seasons. We predicted that (1) due to avoidance of human‐dominated areas during daytime, lynx range use is higher at nighttime, that (2) prey availability drives lynx habitat selection at night, whereas high cover, terrain inaccessibility, and distance to human infrastructure drive habitat selection during the day, and that (3) habitat selection also differs between seasons, with altitude being a dominant factor in winter. To test these hypotheses, we analyzed telemetry data (GPS, VHF) of 10 lynx in the Bohemian Forest Ecosystem (Germany, Czech Republic) between 2005 and 2013 using generalized additive mixed models and considering various predictor variables. Night ranges exceeded day ranges by more than 10%. At night, lynx selected open habitats, such as meadows, which are associated with high ungulate abundance. By contrast, during the day, lynx selected habitats offering dense understorey cover and rugged terrain away from human infrastructure. In summer, land‐cover type greatly shaped lynx habitats, whereas in winter, lynx selected lower altitudes. We concluded that open habitats need to be considered for more realistic habitat models and contribute to future management and conservation (habitat suitability, carrying capacity) of Eurasian lynx in Central Europe. The distribution of Eurasian lynx (Lynx lynx) populations in Central Europe overlaps with human‐dominated landscapes and we expected lynx to modify range use and habitat selection between the phases of the day and over seasons. Lynx used larger areas and selected open habitats at nighttime, while they preferred dense understorey cover and rugged terrain away from human infrastructure during the day with land‐cover type and altitude greatly shaping lynx habitats in summer and winter, respectively. These findings provide new insights into habitat selection by lynx, reveal behavioral adaptations of lynx to human‐modified landscapes and can contribute to improved management and conservation of lynx in Central Europe.

Illegal hunting of ungulates can reduce the prey base of carnivores, which can increase human–carnivore conflict (HCC) through livestock depredation. However, the relationship between ungulate poaching, wild prey abundance and livestock depredation has rarely been empirically studied. We surveyed 18 sites across the Hyrcanian forest in northern Iran; a global biodiversity hotspot under pressure from illegal hunting of ungulates, prey depletion, livestock grazing and HCC. We conducted three field surveys across 1,204 km in 93 4 × 4 km cells to count signs of ungulate poaching as well as encounters with livestock and prey species of the Persian leopard Panthera pardus saxicolor and the grey wolf Canis lupus. We documented sheep/goat and cattle depredation from interviews with 201 herders and analysed the effects of illegal hunting of ungulates, forest cover, IUCN categories of reserves, elevation, distance to villages, and wild prey and livestock encounter rates on carnivore depredation rates using generalized linear models. Illegal hunting of ungulates was the most influential depredation predictor. An increase in the illegal hunting of ungulates by one sign/km significantly increased depredation by up to four times. We also found significantly lower levels of ungulate poaching in national parks (IUCN category II) compared to protected areas (V), wildlife refuges (IV) and no‐hunting areas, though poaching signs were frequently found in most cells (58%). Encounters with livestock was inversely linked to wild prey species, but positively coupled with signs of ungulate poaching. Synthesis and applications. Our study reveals that: (a) an increase in the intensity of illegal hunting of ungulates can intensify livestock depredation by carnivores; (b) future efforts in reducing human‐carnivore conflict to acceptable levels require a combination of law enforcement, prey recovery approaches and mitigation measures; (c) it is essential to understand the root causes of poaching to help minimize human‐carnivore conflict (HCC). Our study reveals that: (a) an increase in the intensity of illegal hunting of ungulates can intensify livestock depredation by carnivores; (b) future efforts in reducing human‐carnivore conflict to acceptable levels require a combination of law enforcement, prey recovery approaches and mitigation measures; (c) it is essential to understand the root causes of poaching to help minimize human‐carnivore conflict (HCC).

Background and aims - Blakea austin-smithii, B. chlorantha and B. aff. penduliflora from Costa Rican cloud forests share floral traits with rodent-pollinated plants, e.g. cryptic, inconspicuous, green flowers, and are known to be visited and probably pollinated by rodents. However, contrasting records indicate birds as pollen vectors for B. chlorantha. Previously, three Costa Rican Blakea species were described to have flowers lacking scent discernible to humans which is typical for bird-pollinated but not for rodent-pollinated flowers. This study aims at evaluating the role of rodents and birds as pollinators of B. austin-smithii and B. chlorantha in Costa Rica as well as the yet unstudied B. gregii in Panama. Therefore, additional diurnal observation data as well as data on floral traits were collected. Methods - In addition to floral visitor observations during the day and measurements of nectar properties, floral colour and morphology, floral scent was analysed by means of coupled gas chromatography - mass spectrometry. Two bee-pollinated Blakea species were chosen as methodological standards. Key results - We observed three passerine bird species, Chlorospingus flavopectus, C. pileatus, Myioborus torquatus, and the hummingbird Lampornis calolaemus visiting B. austin-smithii as well as the hummingbird Panterpe insignis visiting the similar Panamanian B. gregii. Whereas no scent was detected in B. austin-smithii, B. chlorantha and B. gregii, strong odours of B. maurofernandeziana (rose-like) and B. anomala (lemon-like) could be confirmed with the finding of > 70% phenylethyl alcohol, and monoterpenes, respectively. Conclusions - The bird observations together with lacking olfactory signals point to birds as main pollinators. However, to clearly evaluate pollinator importance of the different vertebrates, further observations and proof of pollen transfer are needed.

Spatial and foraging ecology of the Eurasian lynx (Lynx lynx) has been well recognized, however due to the distinct taxonomic position and geographic isolation of its Balkan population, it is important to learn and compare its ecology to other populations of this felid. Therefore, the paper offers the first ever investigation into the spatial and foraging ecology of this predator. To that aim, we used modern GPS/GSM telemetry methods, allowing proper research of animal spatial requirements and diet preferences. Individuals were captured using walk-through, double-door box-traps and foot-snares placed on fresh lynx kills. Average home range size of males is 373 km2 (95\\% MCP) and 400 km2 (0.7 Kernel), while the female’s home range is 119 km2 (95\\% MCP) and 108 km2 (0.7 Kernel). GPS clusters showed prey remains of 153 kills from five different species: roe deer, chamois, brown hare, red fox and marten. Data collected for the Balkan lynx suggest lower kill rates, probably associated with lower ungulate densities in the study area compared to most of Central Europe, also indicated by the relatively long search time. Although Eurasian lynx can adapt to lower ungulate prey densities by increasing hunting effort, changing spatial organization or switching to smaller prey, this, in turn, can have adverse demographic effects on the critically endangered Balkan population. Using GPS telemetry, we provided first insight into the space use of this small population, and show that the spatial and foraging ecology of the Balkan lynx appear similar to other European populations of this species, especially those from Central Europe with similar home range size and principal prey preference.

Background Niemann-Pick disease type C (NP-C) is a rare neurovisceral disease characterised by progressive neurological degeneration, where the rate of neurological disease progression varies depending on age at neurological onset. We report longitudinal data on functional disease progression and safety observations in patients in the international NPC Registry who received continuous treatment with miglustat. Methods The NPC Registry is a prospective observational cohort of NP-C patients. Enrolled patients who received ≥1 year of continuous miglustat therapy (for ≥90 % of the observation period, with no single treatment interruption >28 days) were included in this analysis. Disability was measured using a scale rating the four domains, ambulation, manipulation, language and swallowing from 0 (normal) to 1 (worst). Neurological disease progression was analysed in all patients based on: 1) annual progression rates between enrolment and last follow up, and; 2) categorical analysis with patients categorised as ‘improved/stable’ if ≥3/4 domain scores were lower/unchanged, and as ‘progressed’ if <3 scores were lower/unchanged between enrolment and last follow-up visit. Results In total, 283 patients were enrolled from 28 centers in 13 European countries, Canada and Australia between September 2009 and October 2013; 92 patients received continuous miglustat therapy. The mean (SD) miglustat exposure during the observation period (enrolment to last follow-up) was 2.0 (0.7) years. Among 84 evaluable patients, 9 (11 %) had early-infantile (<2 years), 27 (32 %) had late-infantile (2 to <6 years), 30 (36 %) had juvenile (6 to <15 years) and 18 (21 %) had adolescent/adult (≥15 years) onset of neurological manifestations. The mean (95%CI) composite disability score among all patients was 0.37 (0.32,0.42) at enrolment and 0.44 (0.38,0.50) at last follow-up visit, and the mean annual progression rate was 0.038 (0.018,0.059). Progression of composite disability scores appeared highest among patients with neurological onset during infancy or childhood and lowest in those with adolescent/adult-onset. Overall, 59/86 evaluable patients (69 %) were categorized as improved/stable and the proportion of improved/stable patients increased with age at neurological onset. Safety findings were consistent with previous data. Conclusions Disability status was improved/stable in the majority of patients who received continuous miglustat therapy for an average period of 2 years.

Background Drowning is a global threat and one of the leading causes of injury around the world. The impact of drowning conditions including water salinity on patients’ prognosis remains poorly explored in Intensive Care Units (ICUs) patients. Methods We conducted a retrospective multicenter study on patients admitted to 14 ICUs in the west of France from January 2013 to January 2020. We first compared demographic and clinical characteristics at admission as well as clinical courses of these patients according to the salinity of drowning water. Then, we aimed to identify variables associated with 28-day survival using a Cox proportional hazard model. Results Of the 270 consecutive included patients, drowning occurred in seawater in 199 patients (73.7%) and in freshwater in 71 patients (26.3%). Day-28 mortality was observed in 55 patients (20.4%). Freshwater was independently associated with 28-day mortality (Adjusted Hazard Ratio (aHR) 1.84 [95% Confidence Interval (CI) 1.03–3.29], p  = 0.04). A higher proportion of freshwater patients presented psychiatric comorbidities (47.9 vs. 19.1%; p  < 0.0001) and the etiology of drowning appeared more frequently to be a suicide attempt in this population (25.7 vs. 4.2%; p  < 0.0001). The other factors independently associated with 28-day mortality were the occurrence of a drowning-related cardiac arrest (aHR 11.5 [95% CI 2.51–52.43], p  = 0.0017), duration of cardiopulmonary resuscitation (aHR 1.05 [95% CI 1.03–1.07], p  < 0.0001) and SOFA score at day 1 (aHR 1.2 [95% CI 1.11–1.3], p  < 0.0001). Conclusions In this large multicenter cohort, freshwater drowning patients had a poorer prognosis than saltwater drowning patients. Reasons for such discrepancies include differences in underlying psychiatric comorbidity, drowning circumstances and severities. Patients with initial cardiac arrest secondary to drowning remain with a very poor prognosis.

Background Both critically ill patients with coronavirus disease 2019 (COVID-19) and patients receiving extracorporeal membrane oxygenation (ECMO) support exhibit a high incidence of healthcare-associated infections (HAI). However, data on incidence, microbiology, resistance patterns, and the impact of HAI on outcomes in patients receiving ECMO for severe COVID-19 remain limited. We aimed to report HAI incidence and microbiology in patients receiving ECMO for severe COVID-19 and to evaluate the impact of ECMO-associated infections (ECMO-AI) on in-hospital mortality. Methods For this study, we analyzed data from 701 patients included in the ECMOSARS registry which included COVID-19 patients supported by ECMO in France. Results Among 602 analyzed patients for whom HAI and hospital mortality data were available, 214 (36%) had ECMO-AI, resulting in an incidence rate of 27 ECMO-AI per 1000 ECMO days at risk. Of these, 154 patients had bloodstream infection (BSI) and 117 patients had ventilator-associated pneumonia (VAP). The responsible microorganisms were Enterobacteriaceae (34% for BSI and 48% for VAP), Enterococcus species (25% and 6%, respectively) and non-fermenting Gram-negative bacilli (13% and 20%, respectively). Fungal infections were also observed (10% for BSI and 3% for VAP), as were multidrug-resistant organisms (21% and 15%, respectively). Using a Cox multistate model, ECMO-AI were not found associated with hospital death (HR = 1.00 95% CI [0.79–1.26], p = 0.986). Conclusions In a nationwide cohort of COVID-19 patients receiving ECMO support, we observed a high incidence of ECMO-AI. ECMO-AI were not found associated with hospital death. Trial registration number NCT04397588 (May 21, 2020).