Unclear relationships between mean survival rate and its environmental variance in vertebrates.

Current environmental changes may increase temporal variability of life history traits of species thus affecting their long-term population growth rate and extinction risk. If there is a general relationship between environmental variances (EVs) and mean annual survival rates of species, that relationship could be used as a guideline for analyses of population growth and extinction risk for populations, where data on EVs are missing. For this purpose, we present a comprehensive compilation of 252 EV estimates from 89 species belonging to five vertebrate taxa (birds, mammals, reptiles, amphibians and fish) covering mean annual survival rates from 0.01 to 0.98. Since variances of survival rates are constrained by their means, particularly for low and high mean survival rates, we assessed whether any observed relationship persisted after applying two types of commonly used variance stabilizing transformations: relativized EVs (observed/mathematical maximum) and logit-scaled EVs. With raw EVs at the arithmetic scale, mean-variance relationships of annual survival rates were hump-shaped with small EVs at low and high mean survival rates and higher (and widely variable) EVs at intermediate mean survival rates. When mean annual survival rates were related to relativized EVs the hump-shaped pattern was less distinct than for raw EVs. When transforming EVs to logit scale the relationship between mean annual survival rates and EVs largely disappeared. The within-species juvenile-adult slopes were mainly positive at low (<0.5) and negative at high (>0.5) mean survival rates for raw and relativized variances while these patterns disappeared when EVs were logit transformed. Uncertainties in how to interpret the results of relativized and logit-scaled EVs, and the observed high variation in EV's for similar mean annual survival rates illustrates that extrapolations of observed EVs and tests of life history drivers of survival-EV relationships need to also acknowledge the large variation in these parameters.

Refining Vascular Care Through Science Without Losing the Art.

The science of medicine involves the incorporation of data from evidence-based medicine (collecting, analyzing, conducting clinical trials), medical knowledge (learned patterns of health and disease), diagnostic testing (objective evidence), treatment protocols (guidelines based on scientific evidence and/or expert consensus), and pharmacology (prescribing safely and effectively). The art of medicine involves clinical judgment (learn to interpret clinical signs, symptoms, and histories often relying on intuition and gut feelings), bedside manner (understanding patient needs), customization of care (artistic touch to meet each person's unique circumstances including values, preferences, and social determinants of health), complex decision-making (decision-making based on experience or expertise when confronted with limited or conflicting data), and managing uncertainty (making decisions keeping "doors open" when faced with limited objective confirmation). The delivery of healthcare is not "either science or art" but rather "both science and art" proposition. So, how do we wrestle with this potential paradox?

Affordance-based practice: An ecological-enactive approach to chronic musculoskeletal pain management.

BACKGROUND: The biomedical understanding of chronic musculoskeletal pain endorses a linear relationship between noxious stimuli and pain, and is often dualist or reductionist. Although the biopsychosocial approach is an important advancement, it has a limited theoretical foundation. As such, it tends to be misinterpreted in manners that lead to artificial boundaries between the biological, psychological, and social, with fragmented and polarized clinical applications. OBJECTIVE: We present an ecological-enactive approach to complement the biopsychosocial model. In this approach, the disabling aspect of chronic pain is characterized as an embodied, embedded, and enactive process of experiencing a closed-off field of affordances (i.e., shutting down of action possibilities). Pain is considered as a multi-dimensional, multicausal, and dynamic process, not locatable in any of the biopsychosocial component domains. Based on a person-centered reasoning approach and a dispositional view of causation, we present tools to reason about complex clinical problems in face of uncertainty and the absence of 'root causes' for pain. Interventions to open up the field of affordances include building ability and confidence, encouraging movement variability, carefully controlling contextual factors, and changing perceptions through action according to each patient's self-identified goals. A clinical case illustrates how reasoning based on an ecological-enactive approach leads to an expanded, multi-pronged, affordance-based intervention. CONCLUSIONS: The ecological-enactive perspective can provide an overarching conceptual and practical framework for clinical practice, guiding and constraining clinicians to choose, combine, and integrate tools that are consistent with each other and with a true biopsychosocial approach.

The prevalence of rodent-borne zoonotic pathogens in the South Gobi desert region of Mongolia.

The alpine ecosystems and communities of central Asia are currently undergoing large-scale ecological and socio-ecological changes likely to affect wildlife-livestock-human disease interactions and zoonosis transmission risk. However, relatively little is known about the prevalence of pathogens in this region. Between 2012 and 2015 we screened 142 rodents in Mongolia's Gobi desert for exposure to important zoonotic and livestock pathogens. Rodent seroprevalence to Leptospira spp. was >1/3 of tested animals, Toxoplasma gondii and Coxiella burnetii approximately 1/8 animals, and the hantaviruses being between 1/20 (Puumala-like hantavirus) and <1/100 (Seoul-like hantavirus). Gerbils trapped inside local dwellings were one of the species seropositive to Puumala-like hantavirus, suggesting a potential zoonotic transmission pathway. Seventeen genera of zoonotic bacteria were also detected in the faeces and ticks collected from these rodents, with one tick testing positive to Yersinia. Our study helps provide baseline patterns of disease prevalence needed to infer potential transmission between source and target populations in this region, and to help shift the focus of epidemiological research towards understanding disease transmission among species and proactive disease mitigation strategies within a broader One Health framework.

Pounce Thrombectomy System to Treat Acute and Chronic Peripheral Arterial Occlusions.

Peripheral arterial occlusions are composed of variable amounts of thrombus. Endovascular techniques should initially address the variably aged thrombus prior to treating plaque (percutaneous transluminal angioplasty (PTA) ± stenting). This should ideally be accomplished in a single procedural session. Forty-four consecutive patients treated with the Pounce thrombectomy system (PTS) as captured in a retrospective database, who presented with acute (n = 18), subacute (n = 7), or chronic (n = 19) lower extremity ischemia, were treated and followed for a mean of 7 months. The peripheral occlusions were considered thrombus-dominant by the feel and ease of wire traversal. They were treated with PTS along with complimentary PTA/stenting when appropriate. The mean number of passes with PTS was 4.0 ± 2.7. Sixty-five percent (29/44) were successfully revascularized in a single setting with only 2 requiring concomitant thrombolysis for incomplete thrombus removal from the PTS target artery. An additional 15 patients (34%) had thrombolysis for tibial thrombus that was not attempted with PTS. PTA ± stenting after PTS occurred in 57% of limbs. Technical success was 83% and procedural success was 95%. Reintervention rate throughout follow-up was 22.7%. Major amputation occurred in 4.5%. Complications were limited to minor groin hematomas (n = 3). Outcomes were equally effective in patients with pre-existing stents or denovo arterial occlusions as evidenced with ankle brachial index improvement from 0.48 pre-to 0.93 postintervention and 0.95 at latest follow-up (P < 0.001). PTS coupled with PTA/stenting is expeditiously safe and effective in patients with thrombus-associated lower limb occlusion.

CycLing and EducATion (CLEAT): protocol for a single centre randomised controlled trial of a cycling and education intervention versus standard physiotherapy care for the treatment of hip osteoarthritis.

BACKGROUND: Osteoarthritis (OA) is a chronic degenerative joint disorder for which there is no known cure. Non-surgical management for people with mild-to-moderate hip OA focuses mainly on alleviating pain and maximising function via the National Institute for Health and Care Excellence (NICE) recommended combination of education and advice, exercise, and, where appropriate, weight loss. The CHAIN (Cycling against Hip pAIN) intervention is a group cycling and education intervention conceived as a way of implementing the NICE guidance. METHODS: CycLing and EducATion (CLEAT) is a pragmatic, two parallel arm, randomised controlled trial comparing CHAIN with standard physiotherapy care for the treatment of mild-to-moderate hip OA. We will recruit 256 participants referred to the local NHS physiotherapy department over a 24-month recruitment period. Participants diagnosed with hip OA according to NICE guidance and meeting the criteria for GP exercise referral will be eligible to participate. Primary outcome is the difference in Hip Disability and Osteoarthritis Outcome Score (HOOS) function, daily living subscale between those receiving CHAIN and standard physiotherapy care. Secondary outcomes include performance-based functional measures (40 m walking, 30s chair stand and stair climb tests), ability for patient to self-care (patient activation measure) and self-reported health-related resource use including primary and secondary care contacts. The primary economic endpoint is the number of quality adjusted life years (QALYs) at 24 weeks follow-up. The study is funded by the National Institute for Health Research, Research for Patient Benefit PB-PG-0816-20033. DISCUSSION: The literature identifies a lack of high-quality trials which inform on the content and design of education and exercise in the treatment of patients with hip OA and explore cost-effectiveness. CLEAT is a pragmatic trial which seeks to build further evidence of the clinical benefits of the CHAIN intervention compared to standard physiotherapy care within a randomised, controlled trial setting, and examine its cost-effectiveness. TRIAL REGISTRATION NUMBER: ISRCTN19778222. Protocol v4.1, 24th October 2022.

Birds differentially prioritize visual and olfactory foraging cues depending on habitat of origin and sex.

Animals interpret their environment by combining information from multiple senses. The relative usefulness of different senses may vary between species, habitats and sexes; yet, how multimodal stimuli are integrated and prioritized is unknown for most taxa. We experimentally assessed foraging preferences of great tits (Parus major) to test whether urban and forest individuals prioritize visual and olfactory cues differently during foraging. We trained 13 wild-caught birds to associate multimodal (colour + odour) cues with a food reward and assessed their foraging preferences in a cue-separation test. In this, the birds could choose between the multimodal training cue and its olfactory or visual components. Our results suggest that the birds did not perceive multimodal cues in an integrated way, as their response was not stronger than for unimodal cue components. Urban birds preferred olfactory cues, while forest birds preferred visual cues. Nevertheless, female birds preferred the multimodal cue, while males foraged more randomly with respect to which cue was present. These findings contribute to our understanding of the relative roles of vision and olfaction in bird foraging behaviour. Future work should focus on how habitat- and sex-specific sensory prioritization modifies bird foraging behaviour and foraging success in the context of urban adaptations across populations.

Seasonal variation in daily activity patterns of snow leopards and their prey.

The daily and seasonal activity patterns of snow leopards (Panthera uncia) are poorly understood, limiting our ecological understanding and hampering our ability to mitigate threats such as climate change and retaliatory killing in response to livestock predation. We fitted GPS-collars with activity loggers to snow leopards, Siberian ibex (Capra sibirica: their main prey), and domestic goats (Capra hircus: common livestock prey) in Mongolia between 2009 and 2020. Snow leopards were facultatively nocturnal with season-specific crepuscular activity peaks: seasonal activity shifted towards night-sunrise during summer, and day-sunset in winter. Snow leopard activity was in contrast to their prey, which were consistently diurnal. We interpret these results in relation to: (1) darkness as concealment for snow leopards when stalking in an open landscape (nocturnal activity), (2) low-intermediate light preferred for predatory ambush in steep rocky terrain (dawn and dusk activity), and (3) seasonal activity adjustments to facilitate thermoregulation in an extreme environment. These patterns suggest that to minimise human-wildlife conflict, livestock should be corralled at night and dawn in summer, and dusk in winter. It is likely that climate change will intensify seasonal effects on the snow leopard's daily temporal niche for thermoregulation in the future.

Repeatability of radiographic assessments for feline hip dysplasia suggest consensus scores in radiology are more uncertain than commonly assumed.

Variation in the diagnostic interpretation of radiographs is a well-recognised problem in human and veterinary medicine. One common solution is to create a 'consensus' score based on a majority or unanimous decision from multiple observers. While consensus approaches are generally assumed to improve diagnostic repeatability, the extent to which consensus scores are themselves repeatable has rarely been examined. Here we use repeated assessments by three radiologists of 196 hip radiographs from 98 cats within a health-screening programme to examine intra-observer, inter-observer, majority-consensus and unanimous-consensus repeatability scores for feline hip dysplasia. In line with other studies, intra-observer and inter-observer repeatability was moderate (63-71%), and related to the reference assessment and time taken to reach a decision. Consensus scores did show reduced variation between assessments compared to individuals, but consensus repeatability was far from perfect. Only 75% of majority consensus scores were in agreement between assessments, and based on Bayesian multinomial modelling we estimate that unanimous consensus scores can have repeatabilities as low as 83%. These results clearly show that consensus scores in radiology can have large uncertainties, and that future studies in both human and veterinary medicine need to include consensus-uncertainty estimates if we are to properly interpret radiological diagnoses and the extent to which consensus scores improve diagnostic accuracy.

Viral infection changes the expression of personality traits in an insect species reared for consumption.

Disease-induced personality change results from endogenous and adaptive host responses or parasitic manipulation. Within animal husbandry systems understanding the connection between behaviour and disease is important for health monitoring and for designing systems considerate to animal welfare. However, understanding these relationships within insect mass-rearing systems is still in its infancy. We used a simple repeated behavioural-emergence test to examine parasite-induced differences in group personality traits in the house cricket Acheta domesticus, by comparing the behaviours of 37 individuals infected with the Acheta domesticus densovirus (AdDV) and 50 virus-free individuals. AdDV-infected animals had a much lower emergence probability, longer times until emergence, and did not change their behaviour with experience compared to the virus-free animals. AdDV-infected animals also had lower variation in their probability of emergence within the population, most likely related to animals displaying a relatively uniform sickness response. These infected animals also had higher variation in their response to experimental trial experience; this greater variation resulted from a difference between males and females. Infected females responded to experience in a similar way as virus-free animals, while AdDV-infected males showed a response to experience in the opposite direction: i.e., while all other groups reduced emergence time with experience, infected males always increased their mean emergence time as trials progressed. Our results are important not only in the context of animal personality research, but also with regards to creating husbandry systems and disease monitoring within the insects-as-food industry that are considerate to both production traits and animal welfare.

Pre- and apnoeic high-flow oxygenation for rapid sequence intubation in the emergency department (the Pre-AeRATE trial): A multicentre randomised controlled trial.

INTRODUCTION: Evidence regarding the efficacy of high-flow nasal cannula (HFNC) oxygenation for preoxygenation and apnoeic oxygenation is conflicting. Our objective is to evaluate whether HFNC oxygenation for preoxygenation and apnoeic oxygenation maintains higher oxygen saturation (SpO2) during rapid sequence intubation (RSI) in ED patients compared to usual care. METHODS: This was a multicentre, open-label, randomised controlled trial in adult ED patients requiring RSI. Patients were randomly assigned 1:1 to either intervention (HFNC oxygenation at 60L/min) group or control (non-rebreather mask for preoxygenation and nasal prongs of at least 15L/min oxygen flow for apnoeic oxygenation) group. Primary outcome was lowest SpO2 during the first intubation attempt. Secondary outcomes included incidence of SpO2 falling below 90% and safe apnoea time. RESULTS: One hundred and ninety patients were included, with 97 in the intervention and 93 in the control group. Median lowest SpO2 during the first intubation attempt was 100% in both groups. Incidence of SpO2 falling below 90% was lower in the intervention group (15.5%) compared to the control group (22.6%) (adjusted relative risk=0.68, 95% confidence interval [CI] 0.37-1.25). Post hoc quantile regression analysis showed that the first quartile of lowest SpO2 during the first intubation attempt was greater by 5.46% (95% CI 1.48-9.45%, P=0.007) in the intervention group. CONCLUSION: Use of HFNC for preoxygenation and apnoeic oxygenation, when compared to usual care, did not improve lowest SpO2 during the first intubation attempt but may prolong safe apnoea time.

Increasing risks for emerging infectious diseases within a rapidly changing High Asia.

The cold and arid mountains and plateaus of High Asia, inhabited by a relatively sparse human population, a high density of livestock, and wildlife such as the iconic snow leopard Panthera uncia, are usually considered low risk for disease outbreaks. However, based on current knowledge about drivers of disease emergence, we show that High Asia is rapidly developing conditions that favor increased emergence of infectious diseases and zoonoses. This is because of the existing prevalence of potentially serious pathogens in the system; intensifying environmental degradation; rapid changes in local ecological, socio-ecological, and socio-economic factors; and global risk intensifiers such as climate change and globalization. To better understand and manage the risks posed by diseases to humans, livestock, and wildlife, there is an urgent need for establishing a disease surveillance system and improving human and animal health care. Public health must be integrated with conservation programs, more ecologically sustainable development efforts and long-term disease surveillance.

Factors influencing the global distribution of the endangered Egyptian vulture.

Vultures are ecologically important primarily because of their scavenging role in cleaning carcasses of the environment. Because of anthropogenic impacts, the Egyptian vulture (Neophron percnopterus) has suffered catastrophic declines in parts of its range and, thus, information about its global distribution and factors influencing its occurrence within this range are essential for its conservation. To this end, we estimated the global distribution of Egyptian vulture and variables related to this distribution. We used occurrence points (n = 4740) from online data sources and literature, environmental variables related to these sites and Maximum Entropy software to model the distribution of this species and its relationship to environmental variables during the entire year, breeding and overwintering. Out of ~ 49 million km2 study area, the Egyptian vulture had a predicted range of 6,599,508 km2 distributed across three continents: Africa, Asia and Europe. The densest distribution was in Southern Europe, India and Northern Africa and a sparser distribution was around Mid and Western Africa, the Middle East and Afghanistan. Climate was related to the vulture's most probable range: in particular medium temperature seasonality and low precipitation during the coldest yearly quarter were important variables regardless of the season of observations examined. Conservation of identified habitats and mitigation of anthropogenic impacts to conserve these vultures are recommended for immediate and long-term conservation of the Egyptian vulture globally.

Tree species identity and composition shape the epiphytic lichen community of structurally simple boreal forests over vast areas.

Greatly simplified ecosystems are often neglected for biodiversity studies. However, these simplified systems dominate in many regions of the world, and a lack of understanding of what shapes species occurrence in these systems can have consequences for biodiversity and ecosystem services at a massive scale. In Fennoscandia, ~90% of the boreal forest (~21Mha) is structurally simplified with little knowledge of how forest structural elements shape the occurrence and diversity of for example epiphytic lichens in these managed forests. One form of structural simplification is the reduction of the number and frequency of different tree species. As many lichen species have host tree preferences, it is particularly likely that this simplification has a huge effect on the lichen community in managed forests. In a 40-70 years old boreal forest in Sweden, we therefore related the occurrence and richness of all observed epiphytic lichens to the host tree species and beta and gamma lichen diversity at the forest stand level to the stand's tree species composition and stem diameter. Picea abies hosted the highest lichen richness followed by Pinus sylvestris, Quercus robur, Alnus glutinosa, Betula spp., and Populus tremula. However, P. tremula hosted twice as many uncommon species as any of the other tree species. Stand level beta and gamma diversity was twice as high on stands with four compared to one tree species, and was highest when either coniferous or deciduous trees made up 40-50% of the trees. The stem diameter was positively related to lichen richness at the tree and stand level, but negatively to beta diversity. For biodiversity, these findings imply that leaving a few trees of a different species during forest thinning is unlikely as effective as combining life-boat trees for endangered species with an even tree species mixture.

Virus Diversity and Loads in Crickets Reared for Feed: Implications for Husbandry.

Insects generally have high reproductive rates leading to rapid population growth and high local densities; ideal conditions for disease epidemics. The parasites and diseases that naturally regulate wild insect populations can also impact when these insects are produced commercially, on farms. While insects produced for human or animal consumption are often reared under high density conditions, very little is known about the microbes associated with these insects, particularly those with pathogenic potential. In this study we used both target-free and targeted screening approaches to explore the virome of two cricket species commonly reared for feed and food, Acheta domesticus and Gryllus bimaculatus. The target-free screening of DNA and RNA from a single A. domesticus frass sample revealed that only 1% of the nucleic acid reads belonged to viruses, including known cricket, insect, bacterial and plant pathogens, as well as a diverse selection of novel viruses. The targeted screening revealed relatively high levels of Acheta domesticus densovirus, invertebrate iridovirus 6 and a novel iflavirus, as well as low levels of Acheta domesticus volvovirus, in insect and frass samples from several retailers. Our findings highlight the value of multiple screening approaches for a comprehensive and robust cricket disease monitoring and management strategy. This will become particularly relevant as-and-when cricket rearing facilities scale up and transform from producing insects for animal feed to producing insects for human consumption.

Adapted tolerance to virus infections in four geographically distinct Varroa destructor-resistant honeybee populations.

The ectoparasitic mite, Varroa destructor, is unarguably the leading cause of honeybee (Apis mellifera) mortality worldwide through its role as a vector for lethal viruses, in particular, strains of the Deformed wing virus (DWV) and Acute bee paralysis virus (ABPV) complexes. Several honeybee populations across Europe have well-documented adaptations of mite-resistant traits but little is known about host adaptations towards the virus infections vectored by the mite. The aim of this study was to assess and compare the possible contribution of adapted virus tolerance and/or resistance to the enhanced survival of four well-documented mite-resistant honeybee populations from Norway, Sweden, The Netherlands and France, in relation to unselected mite-susceptible honeybees. Caged adult bees and laboratory reared larvae, from colonies of these four populations, were inoculated with DWV and ABPV in a series of feeding infection experiments, while control groups received virus-free food. Virus infections were monitored using RT-qPCR assays in individuals sampled over a time course. In both adults and larvae the DWV and ABPV infection dynamics were nearly identical in all groups, but all mite-resistant honeybee populations had significantly higher survival rates compared to the mite-susceptible honeybees. These results suggest that adapted virus tolerance is an important component of survival mechanisms.

Navigating between the science and art of acute limb ischemia treatment.

The diagnosis and treatment of acute limb ischemia (ALI) has long been a fierce adversary that has evolved over the last several decades with scientific advancements in endovascular therapy. History and physical examination remain the mainstay of diagnosis enhanced by detailed imaging to guide therapy. Many endovascular tools are available for prompt restoration of flow that compliment traditional surgical options. These devices incorporate the mechanical removal of thrombus and the chemical dissolution of thrombus . Medical decision-making for ALI patients must take into account the patient characteristics, anatomic variables, mechanism of ischemia, degree of ischemia, and operator skill to employ the right strategy for the right patient. This moving target challenges scientific study, making the therapeutic bedside decision making an artform. We present an overview of the field, supportive data, and a treatment algorithm that hopefully captures this delicate balance.

Trends in seabird breeding populations across the Great Barrier Reef.

The Great Barrier Reef is an iconic ecosystem, known globally for its rich marine biodiversity that includes many thousands of tropical breeding seabirds. Despite indications of localized declines in some seabird species from as early as the mid-1990s, trends in seabird populations across the reef have never been quantified. With a long history of human impact and ongoing environmental change, seabirds are likely sentinels in this important ecosystem. Using 4 decades of monitoring data, we estimated site-specific trends for 9 seabird species from 32 islands and cays across the reef. Trends varied markedly among species and sites, but probable declines occurred at 45% of the 86 species-by-site combinations analyzed compared with increases at 14%. For 5 species, we combined site-specific trends into a multisite trend in scaled abundance, which revealed probable declines of Common Noddy (Anous stolidus), Sooty Tern (Onychoprion fuscatus), and Masked Booby (Sula dactylatra), but no long-term changes in the 2 most widely distributed species, Greater Crested Tern (Thalasseus bergii) and Brown Booby (Sula leucogaster). For Brown Booby, long-term stability largely resulted from increases at a single large colony on East Fairfax Island that offset declines at most other sites. Although growth of the Brown Booby population on East Fairfax points to the likely success of habitat restoration on the island, it also highlights a general vulnerability wherein large numbers of some species are concentrated at a small number of key sites. Identifying drivers of variation in population change across species and sites while ensuring long-term protection of key sites will be essential to securing the future of seabirds on the reef.

Tendencias en las Poblaciones de Aves Marinas Reproductoras a lo largo de la Gran Barrera de Arrecifes Resumen La Gran Barrera de Arrecife es un ecosistema icónico, conocido mundialmente por la riqueza de biodiversidad marina que incluye a miles de aves marinas tropicales en reproducción. A pesar de las indicaciones de la declinación localizada de algunas especies de aves marinas que datan desde tan temprano como mediados de la década de 1990, nunca se han cuantificado las tendencias de las poblaciones de aves marinas a lo largo del arrecife. Con una larga historia de impacto antropogénico y el cambio climático en curso, las aves marinas son los probables centinelas de este importante ecosistema. Usamos cuatro décadas de datos de monitoreo para estimar las tendencias específicas de sitio para nueve especies de aves marinas en 32 islas y cayos en todo el arrecife. Las tendencias variaron notablemente entre especies y sitios, aunque las declinaciones probables ocurrieron en 45% de las 86 combinaciones de especie por sitio analizadas en comparación con los incrementos al 14%. Combinamos las tendencias específicas de sitio para cinco especies con una tendencia multisitio con abundancia escalada. Lo anterior reveló declinaciones probables para las siguientes especies: Anous stolidus, Onychoprion fuscatus y Sula dactylatra, pero ningún cambio a largo plazo para las dos especies con mayor distribución: Thalasseus bergii y Sula leucogaster. Para Sula leucogaster, la estabilidad a largo plazo resultó principalmente de los incrementos en una gran colonia única en la isla Fairfax del Este, la cual compensó las declinaciones en casi todos los demás sitios. Aunque el crecimiento de la población de Sula leucogaster en la isla Fairfax del Este apunta hacia el éxito probable de la restauración del hábitat en la isla, también resalta una vulnerabilidad general en la que los grandes números de algunas especies están concentrados en un número reducido de sitios importantes. La identificación de los causantes de la variación en los cambios poblacionales en las especies y en los sitios mientras se asegura la protección a largo plazo de los sitios importantes será esencial para asegurar el futuro de las aves marinas del arrecife.