Objective:The objectives of this study were to measure the global impact of the pandemic on the volumes for intravenous thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with two control 4-month periods.Methods:We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes and/or classifications in stroke databases.Results:There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95%CI, -11.7 to - 11.3, p<0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95%CI, -13.8 to -12.7, p<0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95%CI, -13.7 to -10.3, p=0.001). Recovery of stroke hospitalization volume (9.5%, 95%CI 9.2-9.8, p<0.0001) was noted over the two later (May, June) versus the two earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.3% (1,722/52,026) of all stroke admissions.Conclusions:The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months.

Forest cover in the eastern United States has increased over the past century and while some late-successional species have benefited from this process as expected, others have experienced population declines. These declines may be in part related to contemporary reductions in small-scale forest interior disturbances such as fire, windthrow, and treefalls. To mitigate the negative impacts of disturbance alteration and suppression on some late-successional species, strategies that emulate natural disturbance regimes are often advocated, but large-scale evaluations of these practices are rare. Here, we assessed the consequences of experimental disturbance (using partial timber harvest) on a severely declining late-successional species, the cerulean warbler (Setophaga cerulea), across the core of its breeding range in the Appalachian Mountains. We measured numerical (density), physiological (body condition), and demographic (age structure and reproduction) responses to three levels of disturbance and explored the potential impacts of disturbance on source-sink dynamics. Breeding densities of warblers increased one to four years after all canopy disturbances (vs. controls) and males occupying territories on treatment plots were in better condition than those on control plots. However, these beneficial effects of disturbance did not correspond to improvements in reproduction; nest success was lower on all treatment plots than on control plots in the southern region and marginally lower on light disturbance plots in the northern region. Our data suggest that only habitats in the southern region acted as sources, and interior disturbances in this region have the potential to create ecological traps at a local scale, but sources when viewed at broader scales. Thus, cerulean warblers would likely benefit from management that strikes a landscape-level balance between emulating natural disturbances in order to attract individuals into areas where current structure is inappropriate, and limiting anthropogenic disturbance in forests that already possess appropriate structural attributes in order to maintain maximum productivity.

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b s t r a c tTimber harvesting has been proposed as a management tool to enhance breeding habitat for the Cerulean Warbler (Setophaga cerulea), a declining Neotropical-Nearctic migratory songbird that nests in the canopy of mature eastern deciduous forests. To evaluate how this single-species management focus might fit within an ecologically based management approach for multiple forest birds, we performed a manipulative experiment using four treatments (three intensities of timber harvests and an unharvested control) at each of seven study areas within the core Cerulean Warbler breeding range. We collected preharvest (one year) and post-harvest (four years) data on the territory density of Cerulean Warblers and six additional focal species, avian community relative abundance, and several key habitat variables. We evaluated the avian and habitat responses across the 3-32 m 2 ha À1 residual basal area (RBA) range of the treatments. Cerulean Warbler territory density peaked with medium RBA ($16 m 2 ha À1 ). In contrast, territory densities of the other focal species were negatively related to RBA (e.g., Hooded Warbler [Setophaga citrina]), were positively related to RBA (e.g., Ovenbird [Seiurus aurocapilla]), or were not sensitive to this measure (Scarlet Tanager [Piranga olivacea]). Some species (e.g., Hooded Warbler) increased with time post-treatment and were likely tied to a developing understory, whereas declines (e.g., Ovenbird) were immediate. Relative abundance responses of additional species were consistent with the territory density responses of the focal species. Across the RBA gradient, greatest separation in the avian community was between early successional forest species (e.g., Yellow-breasted Chat [Icteria virens]) and closed-canopy mature forest species (e.g., Ovenbird), with the Cerulean Warbler and other species located intermediate to these two extremes. Overall, our results suggest that harvests within 10-20 m 2 ha À1 RBA yield the largest increases in Cerulean Warblers, benefit additional disturbance-dependent species, and may retain closed-canopy species but at reduced levels. Harvests outside the optimum RBA range for Cerulean Warblers can support bird assemblages specifically associated with early or late (closed-canopy) successional stages.

Climate change is influencing bird phenology worldwide, but we still lack information on how many species are responding over long temporal periods. We assessed how climate affected passerine reproductive timing and productivity at a constant effort mist-netting station in western Pennsylvania using a model comparison approach. Several lines of evidence point to the sensitivity of 21 breeding passerines to climate change over five decades. The trends for temperature and precipitation over 53 years were slightly positive due to intraseasonal variation, with the greatest temperature increases and precipitation declines in early spring. Regardless of broodedness, migration distance, or breeding season, 13 species hatched young earlier over time with most advancing >3 days per decade. Warm springs were associated with earlier captures of juveniles for 14 species, ranging from 1- to 3-day advancement for every 1 °C increase. This timing was less likely to be influenced by spring precipitation; nevertheless, higher rainfall was usually associated with later appearance of juveniles and breeding condition in females. Temperature and precipitation were positively related to productivity for seven and eleven species, respectively, with negative relations evident for six and eight species. We found that birds fledged young earlier with increasing spring temperatures, potentially benefiting some multibrooded species. Indeed, some extended the duration of breeding in these warm years. Yet, a few species fledged fewer juveniles in warmer and wetter seasons, indicating that expected future increases could be detrimental to locally breeding populations. Although there were no clear relationships between life history traits and breeding phenology, species-specific responses to climate found in our study provide novel insights into phenological flexibility in songbirds. Our research underscores the value of long-term monitoring studies and the importance of continuing constant effort sampling in the face of climate change.