Nocturnal Movements Research Articles

265 Connecting Electronic Medical Record Sub-phenotypes of Obstructive Sleep Apnea to Adverse Outcome Risks

OBJECTIVES/GOALS: Prior work has established subtypes of OSA and linked them to risks of future adverse events but rarely with the longitudinality and richness of data available in the EMR. Our goal is to leverage EMR data identify clinically meaningful sub-phenotypes of OSA and better study how they affect risks of adverse outcomes. METHODS/STUDY POPULATION: Vanderbilt’s EMR database has over 61,000 adult patients with a literature-validated EMR definition of OSA with a median EMR follow-up period of 4 years after OSA diagnosis. Of these patients, 12,516 have fully recorded sleep study data in addition to EMR variables such as age at study and most recent BMI. We applied several clustering methods including to identify natural sub-phenotypes of OSA and assessed cluster quality. We also applied techniques which allow a single patient to belong to multiple clusters in various degrees. After selecting final clusters, we plan to analyze the associations between OSA sub-phenotypes and risks using statistical tools like logistic regression and Cox proportional hazards regression, with and without adjusting for factors such as age, gender, and certain medications. RESULTS/ANTICIPATED RESULTS: Preliminary clustering with primarily sleep study data has shown overlap with literature-described patient clusters, including a severe, high non-REM stage 1 sleep, high BMI cluster and a high nocturnal limb movement cluster. As we incorporate more EMR variables, we will select a final set of OSA sub-types. We anticipate patients in different clusters to have different risks of various adverse OSA-associated outcomes that are tracked in our EMR data. Notable outcomes with sufficient incidence rates (>3%) after OSA diagnosis include essential hypertension (43.4%), hyperlipidemia (28.8%), type 2 diabetes (21.9%), anxiety disorder (19.2%), coronary atherosclerosis (14.9%), cerebrovascular disease (7.7%), and pulmonary heart disease (5.9%). DISCUSSION/SIGNIFICANCE: If our results match anticipations, we will show how EMR data can be used to define OSA sub-phenotypes and predict patient risks of various OSA-associated outcomes. This analysis enables work in personalized risk and treatment predictions for OSA patients. By better understanding these risks, providers can better tailor treatments to patients.

Partial Migration by Great Egrets Ardea alba in Coastal California

Migratory behavior of California Great Egrets (Ardea alba) is poorly understood. GPS tags were deployed on eleven Great Egrets on Tomales Bay, Marin County, California, USA. Six individuals displayed migratory behavior, four remained resident, and one individual employed both strategies across three winters. Both diurnal and nocturnal migratory movements were observed. Five of the Great Egrets flew through or wintered in the Sacramento-San Joaquin Delta and California's Central Valley, and one Great Egret moved through Nevada, Arizona, and Mexico, indicating use of wintering grounds outside of California. This study provides the first documentation of partial migration by Great Egrets, and the first information on round trip migration of this species on the U.S. west coast. Our results further illustrate the importance of connectivity between coastal and inland habitats for migratory birds.

Coursing hyenas and stalking lions: The potential for inter- and intraspecific interactions.

Resource partitioning promotes coexistence among guild members, and carnivores reduce interference competition through behavioral mechanisms that promote spatio-temporal separation. We analyzed sympatric lion and spotted hyena movements and activity patterns to ascertain the mechanisms facilitating their coexistence within semi-arid and wetland ecosystems. We identified recurrent high-use (revisitation) and extended stay (duration) areas within home ranges, as well as correlated movement-derived measures of inter- and intraspecific interactions with environmental variables. Spatial overlaps among lions and hyenas expanded during the wet season, and occurred at edges of home ranges, around water-points, along pathways between patches of high-use areas. Lions shared more of their home ranges with spotted hyenas in arid ecosystems, but shared more of their ranges with conspecifics in mesic environments. Despite shared space use, we found evidence for subtle temporal differences in the nocturnal movement and activity patterns between the two predators, suggesting a fine localized-scale avoidance strategy. Revisitation frequency and duration within home ranges were influenced by interspecific interactions, after land cover categories and diel cycles. Intraspecific interactions were also important for lions and, important for hyenas were moon illumination and ungulates attracted to former anthrax carcass sites in Etosha, with distance to water in Chobe/Linyanti. Recursion and duration according to locales of competitor probabilities were similar among female lions and both sexes of hyenas, but different for male lions. Our results suggest that lions and spotted hyenas mediate the potential for interference competition through subtle differences in temporal activity, fine-scale habitat use differentiation, and localized reactive-avoidance behaviors. These findings enhance our understanding of the potential effects of interspecific interactions among large carnivore space-use patterns within an apex predator system and show adaptability across heterogeneous and homogeneous environments. Future conservation plans should emphasize the importance of inter- and intraspecific competition within large carnivore communities, particularly moderating such effects within increasingly fragmented landscapes.

Factors associated with reacquisition of nocturnal voiding-related movements in postoperative hip fracture patients

Factors associated with reacquisition of nocturnal voiding-related movements in postoperative hip fracture patients

Automated acoustic monitoring captures timing and intensity of bird migration

AbstractMonitoring small, mobile organisms is crucial for science and conservation, but is technically challenging. Migratory birds are prime examples, often undertaking nocturnal movements of thousands of kilometres over inaccessible and inhospitable geography. Acoustic technology could facilitate widespread monitoring of nocturnal bird migration with minimal human effort. Acoustics complements existing monitoring methods by providing information about individual behaviour and species identities, something generally not possible with tools such as radar. However, the need for expert humans to review audio and identify vocalizations is a challenge to application and development of acoustic technologies.Here, we describe an automated acoustic monitoring pipeline that combines acoustic sensors with machine listening software (BirdVoxDetect). We monitor 4 months of autumn migration in the northeastern United States with five acoustic sensors, extracting nightly estimates of nocturnal calling activity of 14 migratory species with distinctive flight calls. We examine the ability of acoustics to inform two important facets of bird migration: (1) the quantity of migrating birds aloft and (2) the migration timing of individual species. We validate these data with contemporaneous observations from Doppler radars and a large community of citizen scientists, from which we derive independent measures of migration passage and timing.Together, acoustic and weather data produced accurate estimates of the number of actively migrating birds detected with radar. A model combining acoustic data, weather and seasonal timing explained 75% of variation in radar‐derived migration intensity. This model outperformed models that lacked acoustic data. Including acoustics in the model decreased prediction error by 33%. A model with only acoustic information outperformed a model comprising weather and date (57% vs. 48% variation explained, respectively).Acoustics also successfully measured migration phenology: species‐specific timing estimated by acoustic sensors explained 71% of variation in timing derived from citizen science observations.Synthesis and applications. Our results demonstrate that cost‐effective acoustic sensors can monitor bird migration at species resolution at the landscape scale and should be an integral part of management toolkits. Acoustic monitoring presents distinct advantages over radar and human observation, especially in inaccessible and inhospitable locations, and requires significantly less expense. Managers should consider using acoustic tools for monitoring avian movements and identifying and understanding dangerous situations for birds. These recommendations apply to a variety of conservation and policy applications, including mitigating the impacts of light pollution, siting energy infrastructure (e.g. wind turbines) and reducing collisions with structures and aircraft.

Effects of a modern exhibit design on captive tiger welfare.

Offering captive animals larger, more complex spaces are thought to benefit their welfare. To this end, some zoos use trail systems linked to several enclosures. Since little is known about the effects of such designs on the welfare of captive carnivores specifically, we timed the behaviors exhibited by four tigers (Panthera tigris [Linnaeus]) given access to three exhibit configurations: one exhibit only (E, baseline); one exhibit and approximately 19 m2 of trail (ET); and two exhibits connected by approximately 46 m2 of trail (E2T). Behaviors were recorded during 1-h AM, Noon, and PM periods in Phase I (2017), and 2-h AM and PM periods in Phase II (2018). Percentages of behavior occurrence were analyzed using generalized linear mixed models (GLMM), with treatment and time of day as fixed effects. Tigers were least active at noon (Phase I), while active behaviors were prevalent during mornings and afternoons in both Phases. In Phase II (E2T vs. E), active and exploratory behaviors such as sniffing increased, while pacing and inactivity decreased (all p ≤ .001). We also examined nocturnal tiger movement using infrared motion-activated cameras. In parallel with diurnal observations, tiger activity in E2T greatly exceeded that in E. Nocturnal movement was most pronounced from 1800 to 2200 and least frequent from 0100 to 0400, closely matching patterns observed in the wild. Results indicate that offering tigers voluntary access to larger and more complex spaces stimulates natural behaviors and decreases stereotypical behaviors.

Timing of scratch and limb movements during sleep in children with atopic dermatitis.

In this retrospective analysis of children with atopic dermatitis (n=6) who coincidentally had a video polysomnography, we found that most nocturnal limb movements in children with atopic dermatitis are non-scratch versus scratch, 109.0 ± 67.9 vs. 15.3 ± 5.4 (p=0.01). Average scratch duration was 8.4 ± 2.7 s, which was not different by sleep stage. Scratch movements are distinct in timing, occurring most often during N2 sleep, in the first third of sleep, and peaking at 90 minutes after sleep onset, corresponding with completion of the first sleep cycle.

Spatio-temporal patterns of the European wildcat in a Mediterranean coastal area

Like most small felids, the European wildcat Felis silvestris is a rather elusive species, poorly detectable in the wild, due to several aspects of its biology. Camera trapping can represent a suitable tool to understand temporal activity patterns and habitat preferences of such elusive species. We used intensive camera trapping over two full years to investigate spatio-temporal patterns of the wildcat in a Mediterranean coastal protected area (Maremma Regional Park, central Italy). At the seasonal scale, the wildcat showed a marked twilight activity in summer and winter (mating period), and nocturnal activity in autumn. Conversely, a peak of activity during the day, i.e., in broad daylight, was reported in spring. Reproductive females may limit their nocturnal movements in spring to increase protection from predators to their kittens at the den, although further data are required to support this conclusion. At seasonal, semestral, and yearly temporal scales, the frequency of wildcat detections increased along with availability of shrubwood. These results emphasise the importance for this small felid of areas with dense vegetation cover (Mediterranean maquis and shrubwood, in our study area). Areas densely covered with shrubby vegetation are expected to provide benefits to this elusive small cat in terms of reduced human disturbance (included tourists), availability of prey (e.g., small mammals), as well as shelter, essential to ensure protection towards potential larger predators.

S2778 Ulcerative Colitis and Concomitant Pulmonary Sarcoidosis Leading to Colectomy: A Case Series

Introduction: A recent analysis of 24 cases of ulcerative colitis (UC) with concomitant sarcoidosis found a common HLA serotype (Toshiyuki 2021), however its role in disease severity is unknown. We describe 2 pulmonary sarcoidosis patients with rapidly progressing refractory UC needing colectomy. Case Description/Methods: A 45-year-old male presented with 15-20 episodes of hematochezia a day with nocturnal bowel movements. He was diagnosed with UC and started on mesalamine and vedolizumab. He did not respond and was switched to multiple biologics including ustekinumab, adalimumab and infliximab. He ultimately underwent total colectomy within 1 year of diagnosis. He was diagnosed with pulmonary sarcoidosis 10 years prior, presenting with weight loss and chest pain. Prior to his UC diagnosis, he was not taking steroids for his pulmonary disease. His annual pulmonary function tests had been normal. A 52-year-old female presented with 3 months of hematochezia and anemia. She was treated for gastroenteritis but was hospitalized due to minimal improvement. Imaging, endoscopy, and histology confirmed colitis, thought to be Crohn’s disease (CD) but later reclassified as UC. She was started on infliximab but was a primary non-responder. After 1 year of therapy she was switched to vedolizumab but received 3 doses before switching to ustekinumab. Soon after induction, her symptoms warranted hospitalization, and colectomy was performed 3 years after diagnosis. She was diagnosed with pulmonary sarcoidosis 3 years prior to her UC diagnosis and had been on daily low-dose prednisone since then. (Figure) Discussion: Our patients were diagnosed with sarcoidosis well before their UC and had rapidly progressing disease despite biologic therapy requiring colectomy. Most studies address the link between CD and sarcoidosis. Increased CD4/CD8 ratios are specific for sarcoidosis with similar expansion of T cell subsets in patients with CD. Both have been observed more often among siblings and monozygotic twins suggesting a genetic component. A similar analysis has not been performed in UC patients. To date, there is only one case that found specific HLA serotypes associated with both UC and sarcoidosis. In addition, sarcoidosis was thought to lead to less penetrative disease and fewer colectomies. This contrasts with the cases presented here, which both progressed to colectomy within 3 years of diagnosis. Thus, more studies need to be conducted in patients with UC and sarcoidosis to further elucidate the prognosis and potential complications.Figure 1.: Diffuse severe inflammation characterized by erythema, friability and deep ulcerations of the rectum (Fig 1a. and 1b.). Less severe inflammation characterized by erythema of the sigmoid colon (Fig 2a. and 2b.).

Assessment of Executive and Cognitive Functions in Children with Restless Sleep Disorder: A Pilot Study.

Restless sleep disorder affects children and is characterized by frequent nocturnal movements, iron deficiency, and daytime symptoms such as poor school performance or behavioral problems. Although sleep parameters have been thoroughly studied and daytime sleepiness has been previously assessed, neurocognitive and executive functions have not. In this study, we evaluated neurocognitive functions in a group of 13 children diagnosed with restless sleep disorder using the National Institute of Health Toolbox (NIH toolbox). The mean age was 10.62 (S.D. 2.785). Among them, seven were male and six were female. The fully corrected T-scores (adjusted for demographic variables: age, ethnicity, and education level) showed the lowest values for the Flanker test (selective attention) and dimensional change card sorting test (cognitive flexibility and inhibitory control), with a very large effect size vs. the corresponding expected frequencies. For all the other tests, the average scores were 50; however, individual children scored low on pattern recognition and two composite scores (fluid and total). In conclusion, these data support the fact that cognitive functions are affected in children with restless sleep disorder, especially selective attention. Clinicians must recognize sleep disorders and daytime impairment in order to promptly intervene and prevent cognitive impairments.

Impact of a person-centered bowel program on the frequency of nights with bowel movement in dependent elderly people in nursing home: A single-centre randomized controlled trial

IntroductionBowel movements and sleep disturbances in the elderly impact their quality of life and dignity. The management of bowel movements is one of carers' main activities in nursing homes. This activity is under-recognized. It is routinely managed with laxatives or anti-diarrhea treatments, rather than being targeted at each resident's habits. We hypothesized that the implementation of a daytime person-centered bowel program in dependent elderly nursing-home residents could reduce nocturnal bowel movements and sleep disturbance due to night-time care activities. Our study evaluated the impact of a bowel program on the frequency of nights with bowel movement. MethodWe conducted a single-center randomized controlled trial in two parallel groups: a control group with usual management versus an experimental group with the implementation of the person-centered bowel program. ResultsFifty dependent elderly residents of nursing homes for over one month were included. The implementation of the person-centered bowel program significantly impacted the frequency of nights with bowel movement: 12.0 (7.0; 15.5) in the control group versus 3.7 (2.0; 6.0) in the experimental group (p < 0.000). The strategy had no significant impact on laxative intake (p = 0.470). ConclusionsThe introduction of a daytime person-centered bowel program significantly reduces the frequency of nights with bowel movements for dependent nursing-home residents. This person-centered strategy restores a key role to this basic need care. Further studies could explore the impact of this program on respect, dignity, comfort and night-time rest. It also offers carers new perspectives on care, with respect to the human being. Study registrationThe study was registered in ClinicalTrials N°NCT03118401. Tweetable abstractA daytime bowel program significantly reduces the number of nights with bowel movements for dependent nursing-home residents.

Understanding how diel and seasonal rhythms affect the movements of a small non‐migratory bird

AbstractDiel and seasonal rhythms affect an animal's environment and life history. Understanding how these rhythms influence movement increases our knowledge on how animals adjust to changing resources, environmental conditions, and risk to their survival. To better understand how diel and seasonal rhythms affect animals, we evaluated movements of Northern Bobwhite (Colinus virginianus, hereafter bobwhite). Because bobwhite are a small non‐migratory species that must cope with daily and seasonal changes in their environment year‐around, they are a model species to study how diel and seasonal rhythms influence animal movement of a non‐migratory species. GPS data from transmitters attached to bobwhite at four wildlife management sites across Oklahoma were collected during 2019–2021. We parsed the diel data as daytime (7:00 AM–7:00 PM Central Daylight Savings Time [CDT]) and nighttime (7:00 PM–7:00 AM CDT), and diurnal (sunrise–sunset) and nocturnal (sunset–sunrise), as well as by astronomical season. We calculated three movement metrics: net displacement (Euclidean distance from the starting fix to the ending fix of a path, which encompasses consecutive relocations in a time series of geographic fixes); cumulative distance (sum of all Euclidean distances between each consecutive fix along the path); and hourly movement. We modeled the data using a generalized linear mixed modeling approach. Across season, model predictions showed that net displacement was highest during spring, and daytime cumulative distance slowly increased as the year progressed. Bobwhite had two movement peaks during the diurnal period, one during 9:00 AM–10:00 AM and the other during 5:00 PM–8:00 PM depending on the season. Despite being diurnal, bobwhite occasionally made nocturnal movements, likely in response to a disturbance by a predator, inclement weather, or energetic demands. Movement peaks during the diurnal period may reflect changes in behavior in response to energy requirements, predator risk, and changes in air temperature. Life history events likely cause seasonal differences in movement. This study furthers our understanding of how animals move daily and seasonally, suggesting the importance of analyzing movement across the entire year because animals move differently across the day and year.

0818 Psychosis associated with sodium oxybate

Abstract Introduction Sodium oxybate is commonly used to treat narcolepsy with cataplexy. At the approved doses, the most common side effects are typically described as nausea, vomiting, dizziness, hypersomnia, urinary disturbances, and weight loss. Cases of medication-induced psychosis have been reported in the literature but remain exceedingly rare. We present a case of rapid-onset psychosis in a patient with systemic lupus erythematosus, which added complexity to the evaluation, treatment and clinical course. Report of Cases: The patient is a 42 year old woman with a past history of fibromyalgia, lupus and a prior diagnosis of narcolepsy evaluated for daytime hypersomnia and poor night time sleep. Prior medications included sodium oxybate which was effective; and modafinil and amphetamines which created intolerable side effects. Prior sleep studies were not available and a repeat PSG/MSLT were performed. PSG did not show sleep disordered breathing or nocturnal movements and MSLT showed an average sleep latency of 5.4 minutes and 4 SOREMs. HLA DQB10602 was positive. The patient was reinitiated on sodium oxybate and titrated to 4.5g twice nightly. A few weeks later the patient developed visual hallucinations, persecutory delusions, and insomnia for 3 days. She was admitted for an evaluation to rule out lupus cerebritis, and auto-immune vs. infectious encephalitis. MRI/MRA, lumbar puncture, as well as inflammatory markers and rheumatologic and infectious work up were unrevealing. Sodium oxybate was discontinued on the day of admission and the patient’s mentation returned to baseline over the next few days. Discharge diagnosis was psychosis secondary to sodium oxybate. Conclusion Psychosis is an extremely rare side effect of sodium oxybate therapy among patients treated for cataplectic narcolepsy. It remains a diagnosis of exclusion, and any alternative diagnoses must be explored prior to making the diagnosis of psychosis secondary to sodium oxybate, particularly in the medically complex patient. Support (If Any) None

0817 Conquering Two Sleep Birds with One Iron stone: The Case of Resolved Restless Sleep Disorder and Parasomnia with Iron Therapy

Abstract Introduction Restless Sleep Disorder (RSD) is characterized by frequent nocturnal movements of large muscle groups or a complaint of restless sleep by observers with associated daytime dysfunction.1 RSD, like other movement disorders of sleep, is associated with low iron stores.2 Children with RSD have increased NREM sleep instability and a propensity for parasomnia.2 No reports to date have demonstrated the use of iron therapy for parasomnia in patients with RSD. Furthermore, studies are limited in very young children with this disorder as they currently fall outside proposed diagnostic criteria.1 Report of Cases: A 2 year-old male presented to the sleep clinic with parental complaints of nightly sleep initiation and maintenance difficulty, mild snoring, restless sleep, episodes of sleepwalking and night terrors multiple times per week. Symptoms worsened over 6 months and were associated with daytime irritability and behavioral problems. Sleep quality measures assessed progress between visits: the PROMIS Sleep Disturbance (PROMIS SD) and Sleep Related Impairment (PROMIS SRI). Serum ferritin was initially 20ug/L. Polysmnogram demonstrated no significant sleep related breathing disorder, a large muscle group movement index of 14, periodic limb movement index of 3. Initial treatment included oral iron therapy, scheduled awakenings, and hypnotic dose melatonin. The sleep psychologist addressed limit setting and negative sleep associations with improved insomnia symptoms but parasomnia and restless sleep continued. The parent noted reduction in both movements and parasomnia frequency after one month of iron therapy. After a 3 month period on treatment, the parent reported complete cessation of the parasomnia, drastic reduction in restlessness, and near resolution of insomnia. Sleep quality measure PROMIS SD improved by 11, demonstrating reduced sleep disturbance. PROMIS SRI did not change. Ferritin level increased to 47ug/L. Conclusion RSD in a very young child with NREM parasomnia responded to oral iron therapy improving overall sleep quality. This case demonstrates the relationship between relative iron deficiency, RSD and associated parasomnia. Support (If Any) 1. DelRosso LM, Ferri R, Allen RP, et al. Consensus diagnostic criteria for a newly defined pediatric sleep disorder: restless sleep disorder(RSD).SleepMed.2020;75:335-340. 2. Leung W, Singh I, McWilliams S, Stockler S, Ipsiroglu OS. Iron deficiency and sleep - A scoping review. SleepMedRev.2020;51:101274

Effects of mattress support on sleeping position and low-back pain

PurposeTo determine the efficacy of decreasing spinal curvature – when sleeping laterally – in reducing low-back pain (LBP) and improving sleep quality in people with chronic LBP. Secondly, to investigate whether sleeping positions, nocturnal movements, and skin temperature are related to pain in people with chronic LBP.MethodsSixteen subjects with chronic LBP (50% female, mean age 45.6 ± 13.1 years) slept for one night on their own mattress, followed by three nights on an experimental mattress – designed to reduce spinal curvature in lateral sleeping positions – and then a final night again on their own mattress. Sleep positions, nocturnal movements, skin temperature, and room temperature were measured throughout the five nights. Numerical pain ratings for pain while lying, pain on rising, stiffness on rising, sleep quality, and mattress comfort were recorded for both mattresses.ResultsThe experimental mattress was associated with 18% (p<.05) lower pain scores while lying and a 25% (p<.01) higher comfort rating. Pain on rising, stiffness on rising, and sleep quality were not different between own and experimental mattress. The relationship between sleep positions and pain scores was non-significant, but pain when rising was positively correlated with nocturnal movement (p<.05) and skin temperature was negatively correlated with pain while lying (p<0.05).ConclusionPain while lying in bed decreased and comfort was higher for the experimental mattress compared to the participants’ own mattresses.

Nocturnal Seizure Detection Using Off-the-Shelf WiFi

The detection of nocturnal seizures in epilepsy patients is essential, both for the quick management of the seizure complications, and for the assessment of the ongoing seizure treatment. Traditional seizure detection products (e.g., wearables), however, are either very costly, uncomfortable, or unreliable. In this article, we then propose to utilize everyday WiFi signals for robust, fast, and noninvasive detection of nocturnal seizures. We first present a new and rigorous mathematical characterization for the spectral content/bandwidth of the WiFi signal, measured on a WiFi device placed near a sleeping patient, during different kinds of sleep motions: seizures, normal movements (e.g., posture adjustments), and breathing. Based on this mathematical modeling, we propose a novel pipeline for processing the received WiFi signals to robustly detect all nocturnal nonbreathing movements, and then classify them into normal body movements or seizures. In order to validate this, we carry out extensive experiments in seven different typical bedroom locations, where a set of 20 actors simulate the state of having seizures (a total of 260 instances), as well as normal sleep movements (a total of 410 instances). Our proposed system detects 93.85&#x0025; of the seizures with a mean response time (MRT) of only 5.69 s since the onset of the seizure. Moreover, our proposed system achieves a probability of false alarm of only 0.0097, when classifying normal sleep movements. Overall, our new mathematical modeling and experimental results show the great potential the ubiquitous WiFi signals have for detecting nocturnal seizures, which can provide better support for epilepsy patients and their caregivers.

Impaired bed mobility in prediagnostic and de novo Parkinson's disease

BackgroundWearable technology research suggests that nocturnal movements are disturbed in early Parkinson's disease (PD). In this study, we investigate if patients also already experience impaired bed mobility before PD diagnosis. Furthermore, we explore its association with motor and nonmotor features and its value for phenoconversion and disease progression prediction. MethodsPPMI data were downloaded for de novo PD subjects, subjects at-risk for developing a synucleinopathy (with isolated REM sleep behavior disorder, hyposmia or a pathogenic genetic variant) and controls. Impaired bed mobility was assessed with the MDS-UPDRS part 2 item 9. A frequency analysis was performed. Multivariable logistic regression analyses were used to investigate the association with other PD variables. Cox proportional-hazards models were used to test if difficulties with turning in bed could predict phenoconversion. Linear mixed models were used to evaluate if difficulties with turning in bed could predict disease progression. ResultsOf the at-risk subjects, 9.2–12.5% experienced difficulties with turning in bed vs. 25.0% of de novo PD subjects and 2.5% of controls. Impaired turning ability was associated with MDS-UPDRS motorscore (axial signs in the at-risk group, bradykinesia in the de novo PD group) and SCOPA-AUT score (gastrointestinal symptoms). In addition, difficulties with turning in bed were a significant predictor for phenoconversion in the at-risk group and for development of motor complications in the de novo PD group. ConclusionOur findings suggest that difficulties with turning in bed can be helpful as clinical symptom for a prodromal PD screening and for motor complication prediction in early PD.

Modelling physiological costs to assess impacts of climate change on amphibians in Yellowstone National Park, U.S.A

Amphibians are vital elements of ecosystems, serving as predator and prey. Their biphasic nature makes them dependent on aquatic and terrestrial habitats; as wet-skinned ectotherms, they are vulnerable to a range of environmental threats, including climate change. Yellowstone National Park (YNP) is becoming warmer and drier, and some wetlands important to amphibians have diminished. Continued climate change is predicted to reduce snowpack, soil moisture, and forest cover. We used data from models of future climate and vegetation cover to mechanistically model how climate change might affect the movements of Western Toads (Anaxyrus boreas) across the landscape of three test areas in YNP for the years 2050 and 2090, compared to 2000 as a baseline. Least-cost path analysis produced mixed results: for 2050 and 2090, physiological costs of movement increased in one test area and decreased in another; they were mixed in the third. These changes generally reflect the preference by toads for more open forests. Estimating costs for other species of YNP amphibians produced more negative results. For Columbia Spotted Frogs (Rana luteiventris) and Boreal Chorus Frogs (Pseudacris maculata) (both more aquatic and less adapted to terrestrial habitats), movement costs increased by about 2–15X. Reduced frequency or duration of rain events might limit the nocturnal movements of Western Tiger Salamanders (Ambystoma mavortium). Climate change may not have negative impacts on all amphibians throughout YNP, but increased movement costs for terrestrial habitats will accentuate effects of drying wetlands in at least parts of YNP. Land management actions that preserve habitat structure of both forest and low shrub cover may help mitigate continued drying conditions of climate change.

Migrants employ mixed strategies to route across the Great Lakes basin

Millions of migrants encounter the Great Lakes during spring and autumn migratory movements. How migrants behave when encountering these lakes is relatively unknown at the local and basin scales. Using seven years of radar data from 33 sites along the Great Lakes coastline, we investigated three hypotheses on migrant behavior during crepuscular and nocturnal movements. First, we hypothesized migrants’ direction is driven by local geography and its relation to the destination of migration. Second, we hypothesized migrants would move toward shore at dawn. Finally, we hypothesized that the Great Lakes would have different directional movements at lakes on the outside of the basin versus the interior. We found partial support for our first hypothesis, as well as evidence of decision making when migrants first encounter the Great Lakes. We found partial support for our second hypothesis. We found that migrants moved toward land at elevated levels at dawn compared to night during fall migration, but no effect was found during spring. We found support for our final hypothesis during spring migration, but not during fall. This pattern may be because of a combination of geographical, biological, and data bias, and will require additional work to disentangle. Taken together, we found that migrants perceive and react to the Great Lakes, and attempt to decrease risk, perceived or real, as they make their way to their migratory destination. Better understanding of directional movement has conservation implications, including mitigating anthropogenic obstacle collision risk and prioritizing stopover habitat restoration.

Diurnal and nocturnal movements of Kori Bustards in the Serengeti ecosystem

Although Kori Bustards (<em>Ardeotis kori</em>) are reported as diurnal, the species’ activity patterns have not been assessed to date. We report on the movement during different parts of the day of eight GPS-tagged individuals in the Serengeti ecosystem, Tanzania. Overall, mean distance moved was 206.2 m per hour. The shortest movements were recorded during the night (18.7 m per hour). Our results show strong support for Kori Bustards remaining mostly stationary during the nighttime compared with higher levels of movement during the day.