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Complex histories of chronic and acute sea surface temperature (SST) stresses are expected to trigger taxon- and location-specific responses that will ultimately lead to novel coral communities. The 2016 El Niño-Southern Oscillation provided an opportunity to examine large-scale and recent environmental histories on emerging patterns in 226 coral communities distributed across 12 countries from East Africa to Fiji. Six main coral communities were identified that largely varied across a gradient of Acropora to massive Porites dominance. Bleaching intensity was taxon-specific and was associated with complex interactions among the 20 environmental variables that we examined. Coral community structure was better aligned with the historical temperature patterns between 1985 and 2015 than the 2016 extreme temperature event. Additionally, bleaching responses observed during 2016 differed from historical reports during past warm years. Consequently, coral communities present in 2016 are likely to have been reorganized by both long-term community change and acclimation mechanisms. For example, less disturbed sites with cooler baseline temperatures, higher mean historical SST background variability, and infrequent extreme warm temperature stresses were associated with Acropora-dominated communities, while more disturbed sites with lower historical SST background variability and frequent acute warm stress were dominated by stress-resistant massive Porites corals. Overall, the combination of taxon-specific responses, community-level reorganization over time, geographic variation, and multiple environmental stressors suggest complex responses and a diversity of future coral communities that can help contextualize management priorities and activities.

Under extreme heat stress, corals expel their symbiotic algae and colour (that is, ‘bleaching’), which often leads to widespread mortality. Predicting the large-scale environmental conditions that reinforce or mitigate coral bleaching remains unresolved and limits strategic conservation actions1,2. Here we assessed coral bleaching at 226 sites and 26 environmental variables that represent different mechanisms of stress responses from East Africa to Fiji through a coordinated effort to evaluate the coral response to the 2014–2016 El Niño/Southern Oscillation thermal anomaly. We applied common time-series methods to study the temporal patterning of acute thermal stress and evaluated the effectiveness of conventional and new sea surface temperature metrics and mechanisms in predicting bleaching severity. The best models indicated the importance of peak hot temperatures, the duration of cool temperatures and temperature bimodality, which explained ~50% of the variance, compared to the common degree-heating week temperature index that explained only 9%. Our findings suggest that the threshold concept as a mechanism to explain bleaching alone was not as powerful as the multidimensional interactions of stresses, which include the duration and temporal patterning of hot and cold temperature extremes relative to average local conditions.

IntroductionCoral reefs as key ecosystems in Zanzibar are exposed to several anthropogenic and natural stressors.MethodsThe benthic composition and coverage of coral reefs were investigated on three data sets involving ten coral reefs monitored from 1992 to 2016. Firstly, we investigated differences in the reef composition using data from seven reefs in 2015. Secondly, we analyzed communities on three distinctive reefs (2010 to 2012) to understand the importance of seasons and reef zones (slope, crest and flat) on species abundance. Finally, we investigated long-term changes (1992 to 2016) of five reefs.ResultsBranching Porites and Acropora, and soft coral order Corallimorpharia, characterized sheltered reef communities. Soft corals and algal species characterized the reef communities exposed to strong hydrodynamic conditions, which also displayed greater cover of rocks and rubbles. The average dissimilarity between reefs ranged between 60% and 75%. The seasonal changes in community structure for reefs near Stone Town were mostly associated with soft coral Corallimorpharia. Indeed, the bare rock and algae distinguished the northern exposed reef from more sheltered reefs. Acropora was a key genus for the sheltered Chumbe reef, which explained between 14% and 18% of the dissimilarities among the three reefs. Hard corals covered between 40% and 70% in most years, with severe declines following El Niño events in 1998 and 2016. The dominating genus Acropora showed a strong decline from the late 1990s’ with signs of recovery at remote reefs compared to reefs closer to human residence.DiscussionOur results highlight the importance of seasonality and spatial differences, reflecting differences in human impact and physical exposure and significant long-term changes in coral communities. Continued monitoring of reef health is essential to evaluate the success of ongoing management to sustain the reef services.

Background Personalised medicine is a medical model that aims to provide tailor-made prevention and treatment strategies for defined groups of individuals. The concept brings new challenges to the translational step, both in clinical relevance and validity of models. We have developed a set of recommendations aimed at improving the robustness of preclinical methods in translational research for personalised medicine. Methods These recommendations have been developed following four main steps: (1) a scoping review of the literature with a gap analysis, (2) working sessions with a wide range of experts in the field, (3) a consensus workshop, and (4) preparation of the final set of recommendations. Results Despite the progress in developing innovative and complex preclinical model systems, to date there are fundamental deficits in translational methods that prevent the further development of personalised medicine. The literature review highlighted five main gaps, relating to the relevance of experimental models, quality assessment practices, reporting, regulation, and a gap between preclinical and clinical research. We identified five points of focus for the recommendations, based on the consensus reached during the consultation meetings: (1) clinically relevant translational research, (2) robust model development, (3) transparency and education, (4) revised regulation, and (5) interaction with clinical research and patient engagement. Here, we present a set of 15 recommendations aimed at improving the robustness of preclinical methods in translational research for personalised medicine. Conclusions Appropriate preclinical models should be an integral contributor to interventional clinical trial success rates, and predictive translational models are a fundamental requirement to realise the dream of personalised medicine. The implementation of these guidelines is ambitious, and it is only through the active involvement of all relevant stakeholders in this field that we will be able to make an impact and effectuate a change which will facilitate improved translation of personalised medicine in the future.

Background. Low-income settings challenge the level of protection provided by live attenuated oral rotavirus vaccines. Rotarix (RV1) was introduced in the United Republic of Tanzania in early 2013, with 2 doses given at the World Health Organization–recommended schedule of ages 6 and 10 weeks, along with oral poliovirus vaccine. Methods. We performed active surveillance for rotavirus hospitalizations at the largest hospital in Zanzibar, Tanzania, from 2010 through 2015. Using a case–test-negative control design, we estimated the vaccine effectiveness (VE) of 2 RV1 doses in preventing rotavirus hospitalizations. Results. Based on 204 rotavirus case patients and 601 test-negative controls aged 5–23 months, the VE of 2 RV1 doses against hospitalization for rotavirus diarrhea was 57% (95% confidence interval, 14%–78%). VE tended to increase against hospitalizations with higher severity, reaching 69% (95% confidence interval, 15%–88%) against the severity score for the top quarter of case patients. Compared with the prevaccine period, there were estimated reductions of 40%, 46%, and 69% in the number of rotavirus hospitalizations among infants in 2013, 2014, and 2015, respectively, and reductions of 36%, 26%, and 64%, respectively, among children aged <5 years. Conclusions. With data encompassing 3 years before and 3 years after vaccine introduction, our results indicate that successful delivery of RV1 on the current World Health Organization schedule can provide substantial health benefits in a resource-limited setting.