Development of a novel environmental DNA (eDNA) tool for monitoring Vulnerable Freckled Guitarfish, Pseudobatos lentiginosus, in the Western Central Atlantic

Rhino-rays are the most threatened group of elasmobranchs, having experienced widespread declines due to mortalities in fisheries and habitat degradation. Within the Western Central Atlantic, there are two extant species of Rhino-rays, the Critically Endangered Smalltooth Sawfish, Pristis pectinata, and the Vulnerable Freckled Guitarfish, Pseudobatos lentiginosus. Although there is research committed to P. pectinata in this region, less is known about the distribution status of P. lentiginosus. Over the past 50 years, P. lentiginosus have undergone a presumed range contraction in U.S. waters; once found from North Carolina to Texas, and historically common in the north central Gulf of Mexico, they are now only abundant in Florida. Their occurrence in the north-central Gulf of Mexico remains uncertain, and they have not been sighted in the Mississippi Sound in 15 years. Therefore, a highly sensitive, species-specific Droplet Digital™ PCR environmental DNA (eDNA) assay was designed to detect the presence of this species, targeting a 174 base pair portion of the mitochondrial 16S rRNA gene. The assay detects DNA from only P. lentiginosus, and not from other co-occurring closely related species. This tool can be used in future eDNA surveys across the northern Gulf of Mexico and Western Central Atlantic to inform the current distribution of this threatened species and implement conservation action

Potentially inappropriate medication in older people: prevalence, patient characteristics & association with functional capacity - analysis of follow-up data from the Berlin Aging Study II

Einleitung: Zunehmende Morbidität und altersabhängige Veränderungen stellen die Pharmakotherapie geriatrischer Patienten vor besondere Herausforderungen. Das Vermeiden potenziell inadäquater Medikation (PIM), unnötiger Polypharmazie und Verschreibungsauslassungen indizierter Medikamente sind Ansatzpunkte die Arzneimitteltherapiesicherheit älterer Erwachsener zu erhöhen und unerwünschte Arzneimittelereignisse (UAEs) zu minimieren. Ziele dieser Studie waren es, PIM-Nutzer in einer Kohorte älterer, überwiegend gesunder Erwachsener zu identifizieren, sowie Verlaufstendenzen der PIM-Nutzung, Geschlechterunterschiede und Assoziationen mit Polypharmazie zu beschreiben. In Querschnittsanalyse sollte geprüft werden, ob Probandenmerkmale und funktionelle Kapazitäten mit PIM-Nutzung zusammenhängen. Methoden: Ersterhebungsdaten von 1.382 Teilnehmenden (Medianalter 69 Jahre, Interquartilsabstand (IQR) 67–71, 51,3% weiblich) der Berliner Altersstudie II (BASE-II) wurden ausgewertet. Zusätzlich wurden Daten der Folgeuntersuchung, die durchschnittlich 7,4 Jahre später stattfand, von 1.100 Teilnehmenden berücksichtigt (Medianalter 76 Jahre, IQR 73-78, 52,1% weiblich). PIM wurde gemäß PRISCUS- und EU(7)-PIM-Liste klassifiziert und Polypharmazie als gleichzeitige Anwendung von fünf oder mehr Arzneimitteln definiert. Ergebnisse: Der Anteil der Teilnehmenden, die fünf oder mehr Medikamente nutzten, stieg von 24,1% auf 30,4% an (p<0,001). Laut PRISCUS- und EU(7)-PIM-Liste nahmen 5,9% bzw. 22,6% der Teilnehmenden bei der Ersterhebung mindestens ein PIM ein, während der Anteil der Frauen signifikant höher war als der Anteil der Männer (25,5% gegenüber 19,6%, p=0,01, EU(7)-PIM-Liste). Bei der Zweiterhebung erhielten 5,6% bzw. 21,8% der Teilnehmenden mindestens ein PIM laut PRISCUS- und EU(7)-PIMListe, wobei kein Geschlechterunterschied bestand. Zu beiden Erhebungszeitpunkten war die Anzahl regelmäßig verwendeter Medikamente in Teilnehmenden, die PIM nutzten, höher als in Teilnehmenden, die keine PIM nutzten. Durch Querschnittsanalyse der Ersterhebungsdaten konnten auf Basis der EU(7)-PIM-Liste folgende Assoziationen identifiziert werden: PIM-Gebrauch war bei Männern mit höherer Morbidität, Gebrechlichkeit, geringerer Bildung und einem schlechteren Ernährungszustand verbunden. Bei Frauen waren Stürze mit PIM-Anwendung assoziiert. Depressive Symptomatik war in beiden Geschlechtern mit PIM-Anwendung verbunden. Anticholinerge Wirkstoffe wurden in beiden Geschlechtern ähnlich häufig genutzt. Die Anwendung direkter oraler Antikoagulanzien (DOAKs) als PIMs laut EU(7)-PIM Liste hat zur Folgeuntersuchung stark zugenommen, wobei die Einstufung als PIMs vor dem Hintergrund aktueller Studien kritisch zu sehen ist. Änderungen der Nutzen-Risiko-Bewertung können Ursache für veränderte Einnahmehäufigkeiten einzelner Arzneistoffe in der untersuchten Kohorte sein und unterstreichen die Notwendigkeit regelmäßiger Aktualisierungen von Instrumenten zur Optimierung der Pharmakotherapie.Introduction: Increasing morbidity and age-related changes makes pharmacotherapy in geriatric patients challenging. To avoid PIM, unnecessary polypharmacy, and prescribing omissions of indicated drugs are approaches to increase safety in drug therapy of older adults and to minimize adverse drug events. Objectives of this study were to identify PIM users in a cohort of older adults and to describe trends in PIM use as well as sex differences and associations of PIM use with polypharmacy. Crosssectional analysis should identify subjects’ characteristics and capacities associated with PIM use. Methods: Data from 1,382 participants (median age 69 years, IQR 67-71, 51.3% female) of the Berlin Aging Study II were used at baseline. For follow-up assessments, data from 1,100 participants (median age 76 years, IQR 73-78, 52.1% female) were analysed. On average, follow-up assessments were 7.4 years after baseline assessments. PIM was classified by the PRISCUS list and the EU(7)-PIM list. The regular use of five or more medications was defined as polypharmacy. Results: The proportion of subjects with polypharmacy increased significantly from 24.1% to 30.4% (p<0.001). Based on the PRISCUS list and the EU(7)-PIM lists, 5.9% and 22.6% of the participants used at least one PIM at baseline, while the proportion of women using PIM was higher compared to the proportion of men using PIM (25.5% vs. 19.6%, p=0.01, EU(7)-PIM list). In the follow-up examination 5.6% and 21.8% of the participants received at least one PIM according to the PRISCUS and the EU(7)-PIM list, while no sex differences were identified. Both at baseline and at follow-up examinations PIM users generally used more drugs compared to non-PIM users. The following associations were identified by cross-sectional analysis of the baseline data according to the EU(7)-PIM list: PIM use was related to higher morbidity, frailty, lower education, and poorer nutritional status in men. In women, falls were associated with PIM use. Depressive symptoms were associated with PIM use in both men and women. Anticholinergic drugs were used with similar frequency in both sexes. The use of direct oral anticoagulants as PIMs by EU(7)-PIM has increased from baseline assessments to follow-up assessments, but rating them as inappropriate can be seen critically now. Studies constantly change the evaluation of risks and benefits of drugs, which is shown in changing frequencies of individual drugs used in this cohort. Our findings confirm the need for regular updates of tools that should help to optimize pharmacotherapy

Potentially inappropriate medication in older participants of the Berlin Aging Study II (BASE-II) - Sex differences and associations with morbidity and medication use

INTRODUCTION: Multimorbidity in advanced age and the need for drug treatment may lead to polypharmacy, while pharmacokinetic and pharmacodynamic changes may increase the risk of adverse drug events (ADEs). OBJECTIVE: The aim of this study was to determine the proportion of subjects using potentially inappropriate medication (PIM) in a cohort of older and predominantly healthy adults in relation to polypharmacy and morbidity. METHODS: Cross-sectional data were available from 1,382 study participants (median age 69 years, IQR 67-71, 51.3% females) of the Berlin Aging Study II (BASE-II). PIM was classified according to the EU(7)-PIM and German PRISCUS (representing a subset of the former) list. Polypharmacy was defined as the concomitant use of at least five drugs. A morbidity index (MI) largely based on the Charlson Index was applied to evaluate the morbidity burden. RESULTS: Overall, 24.1% of the participants were affected by polypharmacy. On average, men used 2 (IQR 1-4) and women 3 drugs (IQR 1-5). According to PRISCUS and EU(7)-PIM, 5.9% and 22.6% of participants received at least one PIM, while use was significantly more prevalent in females (25.5%) compared to males (19.6%) considering EU(7)-PIM (p = 0.01). In addition, morbidity in males receiving PIM according to EU(7)-PIM was higher (median MI 1, IQR 1-3) compared to males without PIM use (median MI 1, IQR 0-2, p<0.001). CONCLUSION: PIM use occurred more frequently in women than in men, while it was associated with higher morbidity in males. As expected, EU(7)-PIM identifies more subjects as PIM users than the PRISCUS list but further studies are needed to investigate the differential impact of both lists on ADEs and outcome. KEY POINTS: We found PIM use to be associated with a higher number of regular medications and with increased morbidity. Additionally, we detected a higher prevalence of PIM use in females compared to males, suggesting that women and people needing intensive drug treatment are patient groups, who are particularly affected by PIM use

Effect of a common UMOD variant on kidney function, blood pressure, cognitive and physical function in a community-based cohort of older adults

In genome-wide association studies, genetic variants in the UMOD gene associate with kidney function, blood pressure (BP), and hypertension. Elevated BP is linked to kidney function and impaired cognitive as well as physical performance in later life. We investigated the association between UMOD rs4293393-A > G and kidney function, BP, cognitive and physical function in the Berlin Aging Study II (BASE-II). Data of 1556 older BASE-II participants (mean age 68.2 +/- 3.7 years) were analyzed. BP was determined by standardized automated measurements, estimated glomerular filtration rate (eGFR) by CKD Epidemiology Collaboration creatinine equation. Cognitive function was assessed by Mini-Mental State Examination and Digit Symbol Substitution Test, while physical function by Handgrip Strength and Timed Up and Go-Test. Association analyses were performed by covariance and logistic regression models adjusting for sex. G-allele carriers at UMOD rs4293393 exhibited significantly higher eGFR values compared to non-carriers (AA, 76.4 ml/min/1.73 m(2), CI: 75.7-77.2 vs. AG, 78.4 ml/min/1.73 m(2), CI: 77.3-79.5 vs. GG, 78.5 ml/min/1.73 m(2), CI: 75.4-81.7; P = 0.010), and a lower risk of eGFR < 60 mL/min/1.73 m(2) (AG, OR: 0.63, CI: 0.41-0.97, P = 0.033). However, UMOD rs4293393 genotypes were not associated with BP, diagnosis of hypertension or cognitive and physical function parameters. Our data corroborate previous findings on the association of UMOD rs4293393-G with better kidney function in older adults. However, no association between UMOD and BP or physical and cognitive parameters in these community-dwelling older adults was detected

Relationship between Lipoprotein (a) and cognitive function – Results from the Berlin Aging Study II

It has been suggested that an age-related loss of cognitive function might be driven by atherosclerotic effects associated with altered lipid patterns. However, the relationship between Lipoprotein (a) [Lp(a)] and healthy cognitive aging has not yet been sufficiently investigated. For the current analysis we used the cross-sectional data of 1,380 Berlin Aging Study II (BASE-II) participants aged 60 years and older (52.2% women, mean age 68 ± 4 years). We employed the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD)-Plus test battery to establish latent factors representing continuous measures of domain specific cognitive functions. Regression models adjusted for APOE genotypes, lipid parameters and other risk factors for cognitive impairment were applied to assess the association between Lp(a) and performance in specific cognitive domains. Men within the lowest Lp(a)-quintile showed better cognitive performance in the cognitive domain executive functions and processing speed (p = 0.027). No significant results were observed in women. The results of the current analysis of predominantly healthy BASE-II participants point towards an association between low Lp(a) concentrations and better cognitive performance. However, evidence for this relationship resulting from the current analysis and the employment of a differentiated cognitive assessment is rather weak

Effects of the Training Dataset Characteristics on the Performance of Nine Species Distribution Models: Application to Diabrotica virgifera virgifera

Many distribution models developed to predict the presence/absence of invasive alien species need to be fitted to a training dataset before practical use. The training dataset is characterized by the number of recorded presences/absences and by their geographical locations. The aim of this paper is to study the effect of the training dataset characteristics on model performance and to compare the relative importance of three factors influencing model predictive capability; size of training dataset, stage of the biological invasion, and choice of input variables. Nine models were assessed for their ability to predict the distribution of the western corn rootworm, Diabrotica virgifera virgifera, a major pest of corn in North America that has recently invaded Europe. Twenty-six training datasets of various sizes (from 10 to 428 presence records) corresponding to two different stages of invasion (1955 and 1980) and three sets of input bioclimatic variables (19 variables, six variables selected using information on insect biology, and three linear combinations of 19 variables derived from Principal Component Analysis) were considered. The models were fitted to each training dataset in turn and their performance was assessed using independent data from North America and Europe. The models were ranked according to the area under the Receiver Operating Characteristic curve and the likelihood ratio. Model performance was highly sensitive to the geographical area used for calibration; most of the models performed poorly when fitted to a restricted area corresponding to an early stage of the invasion. Our results also showed that Principal Component Analysis was useful in reducing the number of model input variables for the models that performed poorly with 19 input variables. DOMAIN, Environmental Distance, MAXENT, and Envelope Score were the most accurate models but all the models tested in this study led to a substantial rate of mis-classification

UN Environmental Programme Policy Series

This publication focuses on the gender-related aspects of land, water, and biodiversity conservation and management

Sex Differences in Characteristics Associated with Potentially Inappropriate Medication Use and Associations with Functional Capacity in Older Participants of the Berlin Aging Study II

&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; Medication safety is a vital aim in older adults’ pharmacotherapy. Increased morbidity and vulnerability require particularly careful prescribing. Beneath avoiding unnecessary polypharmacy and prescribing omissions, physicians have to be aware of potentially inappropriate medications (PIMs) and related outcomes to optimize older adults’ drug therapy, and to reduce adverse drug events. &lt;b&gt;&lt;i&gt;Objective:&lt;/i&gt;&lt;/b&gt; The aim of this study was to identify participants characteristics associated with PIM use and associations of PIM use with functional capacity with a focus on sex differences. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Multivariable logistic regression analyses of cross-sectional Berlin Aging Study II (BASE-II) data (&lt;i&gt;N&lt;/i&gt; = 1,382, median age 69 years, interquartile range 67–71, 51.3% women) were performed with PIM classification according to the EU(7)-PIM list. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; In the overall study population, higher education was associated with lower odds of PIM use (odds ratio [OR] 0.93, confidence interval [CI] 95% 0.87–0.99, &lt;i&gt;p&lt;/i&gt; = 0.017). Falls (OR 1.53, CI 95% 1.08–2.17, &lt;i&gt;p&lt;/i&gt; = 0.016), frailty/prefrailty (OR 1.68, 1.17–2.41, &lt;i&gt;p&lt;/i&gt; = 0.005), and depression (OR 2.12, CI 95% 1.32–3.41, &lt;i&gt;p&lt;/i&gt; = 0.002) were associated with increased odds of PIM use. A better nutritional status was associated with lower odds of PIM use (OR 0.88, CI 95% 0.81–0.97, &lt;i&gt;p&lt;/i&gt; = 0.008). In the sex-stratified analysis, higher education was associated with lower odds of PIM use in men (OR 0.90, CI 95% 0.82–0.99, &lt;i&gt;p&lt;/i&gt; = 0.032). Frailty/prefrailty was associated with increased odds of PIM use in men (OR 2.04, CI 95% 1.18–3.54, &lt;i&gt;p&lt;/i&gt; = 0.011) and a better nutritional status was associated with lower odds of PIM use in men (OR 0.83, CI 95% 0.72–0.96, &lt;i&gt;p&lt;/i&gt; = 0.011). Falls in the past 12 months were related to an increased prevalence of PIM use in women (OR 1.74, CI 95% 1.10–2.75, &lt;i&gt;p&lt;/i&gt; = 0.019). Depression was associated with a higher prevalence of PIM use in both men (OR 2.74, CI 95% 1.20–6.24, &lt;i&gt;p&lt;/i&gt; = 0.016) and women (OR 2.06, CI 95% 1.14–3.71, &lt;i&gt;p&lt;/i&gt; = 0.017). We did not detect sex differences regarding the overall use of drugs with anticholinergic effects, but more men than women used PIMs referring to the cardiovascular system (&lt;i&gt;p&lt;/i&gt; = 0.036), while more women than men used PIMs referring to the genitourinary system and sex hormones (&lt;i&gt;p&lt;/i&gt; &amp;#x3c; 0.001). &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; We found similarities, but also differences between men and women as to the associations between PIM use and participants’ characteristics and functional capacity assessments. The association of lower education with PIM use may suggest that physicians’ prescribing behavior is modified by patient education, a relationship that could evolve from more critical attitudes of educated patients towards medication use. We conclude that sex differences in associations of PIM use with functional capacities might be partly attributable to sex differences in drug classes used, but not with regard to anticholinergics, as these are used to a similar extent in men and women in the cohort studied here. </jats:p

Potentially inappropriate medication in older participants of the Berlin Aging Study II (BASE-II) – Sex differences and associations with morbidity and medication use - Fig 1

Number of regular medications and PIM use: A) PRISCUS list, B) EU(7)-PIM list. The median number of regular medications is higher in participants using at least one PIM compared to participants without PIM use according to both the PRISCUS criteria and the EU(7)-PIM criteria (Mann-Whitney U test, p<0.001).</p