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1.
Proc Natl Acad Sci U S A ; 121(12): e2312252121, 2024 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-38466845

RESUMO

The social system of animals involves a complex interplay between physiology, natural history, and the environment. Long relied upon discrete categorizations of "social" and "solitary" inhibit our capacity to understand species and their interactions with the world around them. Here, we use a globally distributed camera trapping dataset to test the drivers of aggregating into groups in a species complex (martens and relatives, family Mustelidae, Order Carnivora) assumed to be obligately solitary. We use a simple quantification, the probability of being detected in a group, that was applied across our globally derived camera trap dataset. Using a series of binomial generalized mixed-effects models applied to a dataset of 16,483 independent detections across 17 countries on four continents we test explicit hypotheses about potential drivers of group formation. We observe a wide range of probabilities of being detected in groups within the solitary model system, with the probability of aggregating in groups varying by more than an order of magnitude. We demonstrate that a species' context-dependent proclivity toward aggregating in groups is underpinned by a range of resource-related factors, primarily the distribution of resources, with increasing patchiness of resources facilitating group formation, as well as interactions between environmental conditions (resource constancy/winter severity) and physiology (energy storage capabilities). The wide variation in propensities to aggregate with conspecifics observed here highlights how continued failure to recognize complexities in the social behaviors of apparently solitary species limits our understanding not only of the individual species but also the causes and consequences of group formation.


Assuntos
Carnívoros , Comportamento Social , Animais , Carnívoros/fisiologia
2.
Ecol Appl ; 34(6): e3004, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38925578

RESUMO

Compound effects of anthropogenic disturbances on wildlife emerge through a complex network of direct responses and species interactions. Land-use changes driven by energy and forestry industries are known to disrupt predator-prey dynamics in boreal ecosystems, yet how these disturbance effects propagate across mammal communities remains uncertain. Using structural equation modeling, we tested disturbance-mediated pathways governing the spatial structure of multipredator multiprey boreal mammal networks across a landscape-scale disturbance gradient within Canada's Athabasca oil sands region. Linear disturbances had pervasive direct effects, increasing site use for all focal species, except black bears and threatened caribou, in at least one landscape. Conversely, block (polygonal) disturbance effects were negative but less common. Indirect disturbance effects were widespread and mediated by caribou avoidance of wolves, tracking of primary prey by subordinate predators, and intraguild dependencies among predators and large prey. Context-dependent responses to linear disturbances were most common among prey and within the landscape with intermediate disturbance. Our research suggests that industrial disturbances directly affect a suite of boreal mammals by altering forage availability and movement, leading to indirect effects across a range of interacting predators and prey, including the keystone snowshoe hare. The complexity of network-level direct and indirect disturbance effects reinforces calls for increased investment in addressing habitat degradation as the root cause of threatened species declines and broader ecosystem change.


Assuntos
Mamíferos , Animais , Mamíferos/fisiologia , Modelos Biológicos , Ecossistema
3.
J Therm Biol ; 123: 103937, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39111062

RESUMO

Under simultaneous ambient temperature and postural stressors, integrated regional blood flow responses are required to maintain blood pressure and thermoregulatory homeostasis. The aim of the present study was to assess the effect of ambient temperature and body posture on regional regulation of microvascular blood flow, specifically in the arms and legs. Participants (N = 11) attended two sessions in which they experienced transient ambient conditions, in a climatic chamber. During each 60-min trial, ambient temperature increased from 15.7 (0.6) °C to 38.9 (0.6) °C followed by a linear decrease, and the participants were either standing or in a supine position throughout the trial; relative humidity in the chamber was maintained at 25.9 (6.6) %. Laser doppler flowmetry of the forearm (SkBFarm) and calf (SkBFcalf), and haemodynamic responses (heart rate, HR; stroke volume, SV; cardiac output, CO; blood pressure, BP), were measured continuously. Analyses of heart rate variability and wavelet transform were also conducted. SkBFarm increased significantly at higher ambient temperatures (p = 0.003), but not SkBFcalf. The standing posture caused lower overall SkBF in both regions throughout the protocol, regardless of temperature (p < 0.001). HR and BP were significantly elevated, and SV significantly lowered, in response to separate and combined effects of higher ambient temperatures and a standing position (all p < 0.05); CO remained unchanged. Mechanistic analyses identified greater sympathetic nerve activation, and higher calf myogenic activation at peak temperatures, in the standing condition. Mechanistically and functionally, arm vasculature responds to modulation from both thermoregulation and baroreceptor activity. The legs, meanwhile, are more sensitive to baroreflex regulatory mechanisms.


Assuntos
Frequência Cardíaca , Hemodinâmica , Postura , Fluxo Sanguíneo Regional , Humanos , Masculino , Adulto , Pressão Sanguínea , Adulto Jovem , Feminino , Temperatura , Regulação da Temperatura Corporal , Perna (Membro)/irrigação sanguínea , Perna (Membro)/fisiologia
4.
Ecol Appl ; 33(1): e2722, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36053995

RESUMO

Landscape change is a driver of global biodiversity loss. In the western Nearctic, petroleum exploration and extraction is a major contributor to landscape change, with concomitant effects on large mammal populations. One of those effects is the continued expansion of invasive white-tailed deer populations into the boreal forest, with ramifications for the whole ecosystem. We explored deer resource selection within the oil sands region of the boreal forest using a novel application of aerial ungulate survey (AUS) data. Deer locations from AUS were "used" points and together with randomly allocated "available" points informed deer resource selection in relation to landscape variables in the boreal forest. We created a candidate set of generalized linear models representing competing hypotheses about the role of natural landscape features, forest harvesting, cultivation, roads, and petroleum features. We ranked these in an information-theoretic framework. A combination of natural and anthropogenic landscape features best explained deer resource selection. Deer strongly selected seismic lines and other linear features associated with petroleum exploration and extraction, likely as movement corridors and resource subsidies. Forest harvesting and cultivation, important contributors to expansion in other parts of the white-tailed deer range, were not as important here. Stemming deer expansion to conserve native ungulates and maintain key predator-prey processes will likely require landscape management to restore the widespread linear features crossing the vast oil sands region.


Assuntos
Cervos , Petróleo , Humanos , Animais , Ecossistema , Campos de Petróleo e Gás
5.
Conserv Biol ; : e14221, 2023 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-37937455

RESUMO

Reliable maps of species distributions are fundamental for biodiversity research and conservation. The International Union for Conservation of Nature (IUCN) range maps are widely recognized as authoritative representations of species' geographic limits, yet they might not always align with actual occurrence data. In recent area of habitat (AOH) maps, areas that are not habitat have been removed from IUCN ranges to reduce commission errors, but their concordance with actual species occurrence also remains untested. We tested concordance between occurrences recorded in camera trap surveys and predicted occurrences from the IUCN and AOH maps for 510 medium- to large-bodied mammalian species in 80 camera trap sampling areas. Across all areas, cameras detected only 39% of species expected to occur based on IUCN ranges and AOH maps; 85% of the IUCN only mismatches occurred within 200 km of range edges. Only 4% of species occurrences were detected by cameras outside IUCN ranges. The probability of mismatches between cameras and the IUCN range was significantly higher for smaller-bodied mammals and habitat specialists in the Neotropics and Indomalaya and in areas with shorter canopy forests. Our findings suggest that range and AOH maps rarely underrepresent areas where species occur, but they may more often overrepresent ranges by including areas where a species may be absent, particularly at range edges. We suggest that combining range maps with data from ground-based biodiversity sensors, such as camera traps, provides a richer knowledge base for conservation mapping and planning.


Combinación de censos con fototrampas y mapas de extensión de la UICN para incrementar el conocimiento sobre la distribución de las especies Resumen Los mapas confiables de la distribución de las especies son fundamentales para la investigación y conservación de la biodiversidad. Los mapas de distribución de la Unión Internacional para la Conservación de la Naturaleza (UICN) están reconocidos como representaciones de autoridad de los límites geográficos de las especies, aunque no siempre se alinean con los datos actuales de su presencia. En los mapas recientes de área de hábitat (ADH), las áreas que no son hábitat han sido eliminadas de la distribución de la UICN para reducir los errores de comisión, pero su concordancia con la presencia actual de las especies tampoco ha sido analizada. Analizamos la concordancia entre la presencia registrada por los censos de fototrampas y pronosticamos la presencia a partir de los mapas de la UICN y de ADH de 510 especies de mamíferos de talla mediana a grande en 80 áreas de muestreo de fototrampas. Las cámaras detectaron sólo el 39% de las especies esperadas con base en la distribución de la UICN y los mapas de ADH en todas las áreas; el 85% de las disparidades con la UICN ocurrieron dentro de los 200 km a partir del borde de la distribución. Sólo el 4% de la presencia de las especies fue detectada por las cámaras ubicadas fuera de la distribución de la UICN. La probabilidad de disparidad entre las cámaras y la UICN fue significativamente mayor para los mamíferos de talla pequeña y para los especialistas de hábitat en las regiones Neotropical e Indomalaya y en áreas con doseles forestales más bajos. Nuestros hallazgos sugieren que los mapas de distribución y ADH pocas veces subrepresentan las áreas con presencia de las especies, pero con frecuencia pueden sobrerrepresentar la distribución al incluir áreas en donde las especies pueden estar ausentes, en particular los bordes de la distribución. Sugerimos que la combinación de los mapas de distribución con los sensores de biodiversidad en tierra, como las fototrampas, proporciona una base más rica de conocimiento para el mapeo y la planeación de la conservación.

6.
Endocr Pract ; 29(11): 890-896, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37678470

RESUMO

OBJECTIVE: Hungry bone syndrome (HBS) is a known complication of parathyroidectomy. Patients with renal hyperparathyroidism are particularly vulnerable to HBS because of their prolonged exposure to electrolyte abnormalities and elevated parathyroid hormone (PTH). However, in-depth characterization of predictive factors for HBS in these patients is lacking. METHODS: A retrospective analysis was performed of patients with renal hyperparathyroidism who underwent parathyroidectomy at a single institution from 2011-2021. Patient demographics, clinical characteristics, and biochemical data were collected and analyzed. Boruta and binary logistic regression analyses were used to develop a scoring system. RESULTS: Thirty-three patients were identified; 16 (48%) developed HBS. Patients with HBS had significantly higher preoperative levels of serum PTH (mean difference [MS] = 2167.2 pg/mL, P <.001), phosphorus (MD = 3.5 mg/dl, P <.001), and alkaline phosphatase (ALP) (MD = 344.2 U/L, P =.002) and significantly lower levels of preoperative serum calcium (MD = -0.96 mg/dL, P =.004). Stepwise regression analysis identified elevated ALP (>150 U/L) and markedly elevated PTH (>1000 pg/mL) as positive predictors of HBS. A two-point scoring system with these 2 variables had overall diagnostic accuracy of 96.8% (sensitivity 100% and specificity 94.1%) with 1 point conferring 93.8% positive predictive value and 2 points conferring 100% positive predictive value. CONCLUSION: Preoperative serum PTH and ALP are significantly associated with HBS in patients with renal hyperparathyroidism undergoing parathyroidectomy for renal hyperparathyroidism. A scoring system with these 2 variables may be of clinical utility in predicting patients at high risk of HBS.


Assuntos
Doenças Ósseas Metabólicas , Hiperparatireoidismo Secundário , Hipocalcemia , Humanos , Paratireoidectomia/efeitos adversos , Estudos Retrospectivos , Hiperparatireoidismo Secundário/cirurgia , Hipocalcemia/etiologia , Hipocalcemia/cirurgia , Doenças Ósseas Metabólicas/diagnóstico , Fatores de Risco , Hormônio Paratireóideo , Cálcio
7.
J Perinat Med ; 51(5): 697-703, 2023 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-36508606

RESUMO

OBJECTIVES: We aimed to critically evaluate the effectiveness of a designated ECMO team in our ECMO selection process and patient outcomes in the first 3 years of our low-volume pediatric ECMO program. METHODS: We conducted a retrospective chart review of patients who received an ECMO consultation between the start of our program in March 2015 and May 2018. We gathered clinical and demographic information on patients who did and did not receive ECMO, and described our selection process. We reflected on the processes used to initiate our program and our outcomes in the first 3 years. RESULTS: Sixty-nine patients received consultations, and of those, 50 patients were potential candidates. 19 (38%) of the candidates were ultimately placed on ECMO. There were statistically significant differences in oxygen saturation, paO2, oxygenation index, A-aDO2, lactate, and pH between the patients who went on ECMO and who did not. We improved our outcomes from 0% survival to discharge in 2015, to 60% in 2018, with an average of 63% survival to discharge over the first 3 years of our program. CONCLUSIONS: In a low-volume pediatric ECMO center, having a designated team to assist in the patient selection process and management can help provide safe and efficient care to these patients, and improve patient outcomes. Having a strict management protocol and simulation sessions involving all members of the medical team yields comfort for the providers and optimal care for patients. This study describes our novel structure, processes, and outcomes, which we hope will be helpful to others seeking to develop a new pediatric ECMO program.


Assuntos
Oxigenação por Membrana Extracorpórea , Humanos , Criança , Oxigenação por Membrana Extracorpórea/métodos , Estudos Retrospectivos , Alta do Paciente , Resultado do Tratamento
8.
Glob Ecol Biogeogr ; 31(8): 1526-1541, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36247232

RESUMO

Aim: Macroecological studies that require habitat suitability data for many species often derive this information from expert opinion. However, expert-based information is inherently subjective and thus prone to errors. The increasing availability of GPS tracking data offers opportunities to evaluate and supplement expert-based information with detailed empirical evidence. Here, we compared expert-based habitat suitability information from the International Union for Conservation of Nature (IUCN) with habitat suitability information derived from GPS-tracking data of 1,498 individuals from 49 mammal species. Location: Worldwide. Time period: 1998-2021. Major taxa studied: Forty-nine terrestrial mammal species. Methods: Using GPS data, we estimated two measures of habitat suitability for each individual animal: proportional habitat use (proportion of GPS locations within a habitat type), and selection ratio (habitat use relative to its availability). For each individual we then evaluated whether the GPS-based habitat suitability measures were in agreement with the IUCN data. To that end, we calculated the probability that the ranking of empirical habitat suitability measures was in agreement with IUCN's classification into suitable, marginal and unsuitable habitat types. Results: IUCN habitat suitability data were in accordance with the GPS data (> 95% probability of agreement) for 33 out of 49 species based on proportional habitat use estimates and for 25 out of 49 species based on selection ratios. In addition, 37 and 34 species had a > 50% probability of agreement based on proportional habitat use and selection ratios, respectively. Main conclusions: We show how GPS-tracking data can be used to evaluate IUCN habitat suitability data. Our findings indicate that for the majority of species included in this study, it is appropriate to use IUCN habitat suitability data in macroecological studies. Furthermore, we show that GPS-tracking data can be used to identify and prioritize species and habitat types for re-evaluation of IUCN habitat suitability data.

9.
Proc Natl Acad Sci U S A ; 116(5): 1745-1754, 2019 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-30635416

RESUMO

The past two decades have witnessed an alarming expansion of staphylococcal disease caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). The factors underlying the epidemic expansion of CA-MRSA lineages such as USA300, the predominant CA-MRSA clone in the United States, are largely unknown. Previously described virulence and antimicrobial resistance genes that promote the dissemination of CA-MRSA are carried by mobile genetic elements, including phages and plasmids. Here, we used high-resolution genomics and experimental infections to characterize the evolution of a USA300 variant plaguing a patient population at increased risk of infection to understand the mechanisms underlying the emergence of genetic elements that facilitate clonal spread of the pathogen. Genetic analyses provided conclusive evidence that fitness (manifest as emergence of a dominant clone) changed coincidently with the stepwise emergence of (i) a unique prophage and mutation of the regulator of the pyrimidine nucleotide biosynthetic operon that promoted abscess formation and colonization, respectively, thereby priming the clone for success; and (ii) a unique plasmid that conferred resistance to two topical microbiocides, mupirocin and chlorhexidine, frequently used for decolonization and infection prevention. The resistance plasmid evolved through successive incorporation of DNA elements from non-S. aureus spp. into an indigenous cryptic plasmid, suggesting a mechanism for interspecies genetic exchange that promotes antimicrobial resistance. Collectively, the data suggest that clonal spread in a vulnerable population resulted from extensive clinical intervention and intense selection pressure toward a pathogen lifestyle that involved the evolution of consequential mutations and mobile genetic elements.


Assuntos
Infecções Comunitárias Adquiridas/microbiologia , Staphylococcus aureus Resistente à Meticilina/genética , Virulência/genética , Animais , Antibacterianos/farmacologia , Criança , Clorexidina/farmacologia , Infecções Comunitárias Adquiridas/tratamento farmacológico , Genoma Bacteriano/genética , Humanos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Camundongos , Testes de Sensibilidade Microbiana/métodos , Mupirocina/farmacologia , Filogenia , Plasmídeos/genética , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia
10.
Sensors (Basel) ; 22(3)2022 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-35161573

RESUMO

There is a need to rapidly screen individuals for heat strain and fever using skin temperature (Tsk) as an index of deep body temperature (Tb). This study's aim was to assess whether Tsk could serve as an accurate and valid index of Tb during a simulated heatwave. Seven participants maintained a continuous schedule over 9-days, in 3-day parts; pre-/post-HW (25.4 °C), simulated-HW (35.4 °C). Contact thermistors measured Tsk (Tforehead, Tfinger); radio pills measured gastrointestinal temperature (Tgi). Proximal-distal temperature gradients (ΔTforehead-finger) were also measured. Measurements were grouped into ambient conditions: 22, 25, and 35 °C. Tgi and Tforehead only displayed a significant relationship in 22 °C (r: 0.591; p < 0.001) and 25 °C (r: 0.408; p < 0.001) conditions. A linear regression of all conditions identified Tforehead and ΔTforehead-finger as significant predictors of Tgi (r2: 0.588; F: 125.771; p < 0.001), producing a root mean square error of 0.26 °C. Additional residual analysis identified Tforehead to be responsible for a plateau in Tgi prediction above 37 °C. Contact Tforehead was shown to be a statistically suitable indicator of Tgi in non-HW conditions; however, an error of ~1 °C makes this physiologically redundant. The measurement of multiple sites may improve Tb prediction, though it is still physiologically unsuitable, especially at higher ambient temperatures.


Assuntos
Temperatura Corporal , Temperatura Cutânea , Febre , Testa , Temperatura Alta , Humanos , Temperatura
11.
Mil Psychol ; 34(3): 315-325, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-38536269

RESUMO

Rates of Veteran suicide continue to be unacceptably high. Suicidal ideation and behavior are contextually and situationally based, limiting the ability of traditional prevention and assessment strategies to prevent acute crises. The Mobile Application for the Prevention of Suicide (MAPS) is a novel, smartphone-based intervention strategy that utilizes ecological momentary assessment to identify suicide risk in the moment and delivers treatment strategies in real-time. The app is personalized to each patient, utilizes empirically intervention strategies, and is delivered adjunctively to Veterans Affairs (VA) treatment as usual. This article outlines the MAPS intervention and presents results of an open trial to assess its feasibility and acceptability. Eight Veterans were recruited from aVeterans Affairs Medical Center (VAMC) psychiatric inpatient unit following hospitalization for either a suicide ideation or attempt. Veterans received MAPS for 2 weeks post-hospitalization. Veterans reported high levels of satisfaction with MAPS and all opted to extend their use of MAPS beyond the 2-week trial period. MAPS may be a useful adjunctive to treatment as usual for high-risk Veterans by allowing patients and their providers to better track suicide risk and deploy intervention strategies when risk is detected.

12.
Ann Surg ; 273(3): 410-415, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32976285

RESUMO

OBJECTIVE: The aim of the study was to determine whether perforated appendicitis rates in children were influenced by the Coronavirus disease 2019 (COVID-19) surge. BACKGROUND: Disruption of care pathways during a public health crisis may prevent children from obtaining prompt assessment for surgical conditions. Progression of appendicitis to perforation is influenced by timeliness of presentation. In the context of state-mandated controls and public wariness of hospitals, we investigated the impact of the COVID-19 outbreak on perforated appendicitis in children. STUDY DESIGN: We conducted an analysis of all children presenting to 3 hospital sites with acute appendicitis between March 1 and May 7, 2020, corresponding with the peak COVID-19 outbreak in the New York City region. Control variables were collected from the same institutions for the preceding 5 years. The primary outcome measure was appendiceal perforation. RESULTS: Fifty-five children presented with acute appendicitis over 10 weeks. Compared to a 5-year control cohort of 1291 patients, we observed a higher perforation rate (45% vs 27%, odds ratio 2.23, 95% confidence interval 1.29-3.85, P = 0.005) and longer mean duration of symptoms in children with perforations (71 ±â€Š39 vs 47 ±â€Š27 h, P = 0.001) during the COVID-19 period. There were no differences in perforation rates (55% vs 59%, P = 0.99) or median length of stay (1.0 vs 3.0 days, P = 0.58) among children screening positive or negative for SARS-CoV-2. CONCLUSIONS: Children in the epicenter of the COVID-19 outbreak demonstrated higher rates of perforated appendicitis compared to historical controls. Preoperative detection of SARS-CoV-2 was not associated with inferior outcomes. Although children likely avoid much of the morbidity directly linked to COVID-19, disruption to local healthcare delivery systems may negatively impact other aspects of pediatric surgical disease.


Assuntos
Apendicite/epidemiologia , COVID-19/epidemiologia , Adolescente , Apendicectomia , Apendicite/diagnóstico , Apendicite/cirurgia , COVID-19/diagnóstico , Criança , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Cidade de Nova Iorque , Estudos Retrospectivos
13.
Pancreatology ; 21(4): 698-703, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33741267

RESUMO

BACKGROUND: Coronavirus SARS-CoV-2 affects multiple organs. Studies have reported mild elevations of lipase levels of unclear significance. Our study aims to determine the outcomes in patients with COVID-19 and hyperlipasemia, and whether correlation with D-dimer levels explains the effect on outcomes. METHODS: Case-control study from two large tertiary care health systems, of patients with COVID-19 disease admitted between March 1 and May 1, 2020 who had lipase levels recorded. Data analyzed to study primary outcomes of mortality, length of stay (LOS) and intensive care utilization in hyperlipasemia patients, and correlation with D-dimer and outcomes. RESULTS: 992 out of 5597 COVID-19 patients had lipase levels, of which 429 (43%) had hyperlipasemia. 152 (15%) patients had a lipase > 3x ULN, with clinical pancreatitis in 2 patients. Hyperlipasemia had a higher mortality than normal lipase patients (32% vs. 23%, OR = 1.6,95%CI = 1.2-2.1, P = 0.002). In subgroup analysis, hyperlipasemia patients had significantly worse LOS (11vs.15 days, P = 0.01), ICU admission rates (44% vs. 66%,OR = 2.5,95%CI = 1.3-5.0,P = 0.008), ICU LOS (12vs.19 days,P = 0.01), mechanical ventilation rates (34% vs. 55%,OR = 2.4,95%CI = 1.3-4.8,P = 0.01), and durations of mechanical ventilation (14 vs. 21 days, P = 0.008). Hyperlipasemia patients were more likely to have a D-dimer value in the highest two quartiles, and had increased mortality (59% vs. 15%,OR = 7.2,95%CI = 4.5-11,P < 0.001) and LOS (10vs.7 days,P < 0.001) compared to those with normal lipase and lower D-dimer levels. CONCLUSION: There is high prevalence of hyperlipasemia without clinical pancreatitis in COVID-19 disease. Hyperlipasemia was associated with higher mortality and ICU utilization, possibly explained by elevated D-dimer.


Assuntos
COVID-19/complicações , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Lipase/sangue , Pancreatite/complicações , SARS-CoV-2 , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Lipase/metabolismo , Masculino , Pessoa de Meia-Idade , Pancreatite/sangue , Pancreatite/enzimologia , Centros de Atenção Terciária
14.
J Surg Res ; 256: 56-60, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32683057

RESUMO

BACKGROUND: There is little consensus regarding the use of postoperative antibiotics in the management of perforated appendicitis in children. Patients are commonly discharged with oral antibiotics after a course of intravenous antibiotics; however, recent literature suggests that patients can be safely discharged without any oral antibiotics. To further evaluate this protocol, we conducted a multicenter retrospective preimplementation/postimplementation study comparing rates of abscess formation and rehospitalization between patients discharged with and without oral antibiotics. MATERIALS AND METHODS: We reviewed the records of all pediatric patients who underwent appendectomies for perforated appendicitis at NYU Tisch Hospital, Bellevue Hospital, and Hackensack University Medical Center from January 2014 to June 2019. Data pertaining to patient demographics, hospital course, intraoperative appearance of the appendix, antibiotic treatment, abscess formation, and rehospitalization were collected. RESULTS: A total of 253 patients were included: 162 received oral antibiotics and 91 did not. The median length of antibiotic treatment (oral and intravenous) was 11 (10-14) d for patients on oral antibiotics and 5 (3-6) d for patients without oral antibiotics (P < 0.01). The median leukocyte count at discharge was 9.5 (7.4-10.9) and 8.1 (6.8-10.4) for these groups, respectively (P = 0.02). Postoperative abscesses occurred in 22% of patients receiving oral antibiotics and 15% of patients on no antibiotics (P = 0.25). Rates of rehospitalization for these groups were 10% and 11%, respectively (P = 0.99). CONCLUSIONS: Children who have undergone appendectomy for perforated appendicitis can be safely discharged without oral antibiotics on meeting clinical discharge criteria and white blood cell count normalization.


Assuntos
Abscesso Abdominal/epidemiologia , Antibacterianos/administração & dosagem , Apendicectomia/efeitos adversos , Apendicite/cirurgia , Cuidados Pós-Operatórios/normas , Complicações Pós-Operatórias/epidemiologia , Abscesso Abdominal/sangue , Abscesso Abdominal/etiologia , Abscesso Abdominal/prevenção & controle , Administração Intravenosa , Administração Oral , Adolescente , Apendicite/sangue , Apendicite/complicações , Criança , Pré-Escolar , Esquema de Medicação , Feminino , Humanos , Contagem de Leucócitos , Masculino , Alta do Paciente/normas , Alta do Paciente/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Cuidados Pós-Operatórios/estatística & dados numéricos , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Estudos Retrospectivos , Resultado do Tratamento
15.
Conserv Biol ; 33(3): 709-715, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30306635

RESUMO

Conservation of species at risk of extinction is complex and multifaceted. However, mitigation strategies are typically narrow in scope, an artifact of conservation research that is often limited to a single species or stressor. Knowledge of an entire community of strongly interacting species would greatly enhance the comprehensiveness and effectiveness of conservation decisions. We investigated how camera trapping and spatial count models, an extension of spatial-recapture models for unmarked populations, can accomplish this through a case study of threatened boreal woodland caribou (Rangifer tarandus caribou). Population declines in caribou are precipitous and well documented, but recovery strategies focus heavily on control of wolves (Canis lupus) and pay less attention to other known predators and apparent competitors. Obtaining necessary data on multispecies densities has been difficult. We used spatial count models to concurrently estimate densities of caribou, their predators (wolf, black bear [Ursus americanus], and coyote [Canis latrans]), and alternative prey (moose [Alces alces] and white-tailed deer [Odocoileus virginianus]) from a camera-trap array in a highly disturbed landscape within northern Alberta's Oil Sands Region. Median densities were 0.22 caribous (95% Bayesian credible interval [BCI] = 0.08-0.65), 0.77 wolves (95% BCI = 0.26-2.67), 2.39 moose (95% BCI = 0.56-7.00), 2.64 coyotes (95% BCI = 0.45-6.68), and 3.63 black bears (95% BCI = 1.25-8.52) per 100 km2 . (The white-tailed deer model did not converge.) Although wolf densities were higher than densities recommended for caribou conservation, we suggest the markedly higher black bear and coyote densities may be of greater concern, especially if government wolf control further releases these species. Caribou conservation with a singular focus on wolf control may leave caribou vulnerable to other predators. We recommend a broader focus on the interacting species within a community when conserving species.


Importancia de Considerar Múltiples Especies que Interactúan para la Conservación de Especies en Riesgo Resumen La conservación de las especies en riesgo de extinción es compleja y multifacética. Sin embargo, las estrategias de mitigación con frecuencia son estrechas en cuanto a su enfoque, un artefacto de la investigación para la conservación que comúnmente se limita a una sola especie o un solo estresante. El conocimiento sobre toda una comunidad de especies con fuertes interacciones mejoraría enormemente la efectividad y la amplitud de las decisiones de conservación. Investigamos cómo las cámaras trampa y los modelos de conteo espacial, una extensión de los modelos de recaptura espacial para poblaciones sin marcaje, pueden lograr esto por medio de un estudio de caso del caribú de bosques boreales (Rangifer tarandus caribou), una especie en peligro de extinción. Las declinaciones poblacionales del caribú son abruptas y están bien documentadas, aunque las estrategias de recuperación se enfocan en el control de la población de lobos (Canis lupus) y le prestan menos atención a otros depredadores conocidos y a posibles competidores. Obtener los datos necesarios sobre la densidad poblaciones de múltiples especies ha sido complicado. Usamos modelos de conteo espacial para estimar simultáneamente la densidad de los caribúes, sus depredadores (lobos, osos negros [Ursus americanus] y coyotes [Canis latrans]), y presas alternativas (alces [Alces alces] y venados cola blanca [Odocoileus virginianus]) a partir de un despliegue de cámaras trampa en un paisaje altamente perturbado dentro de la región de Oil Sands en el norte de Alberta, Canadá. La densidad media fue de 0.22 caribúes (95% bayesiano CI [BCI] = 0.08-0.65), 0.77 lobos (95% BCI = 0.26-2.67), 2.39 alces (95% BCI = 0.56-7.00), 2.64 coyotes (95% BCI = 0.45-6.68), y 3.63 osos negros (95% BCI = 1.25-8.52) por 100 km2 (el modelo para el venado cola blanca no convergió). Aunque la densidad de lobos fue mayor que la densidad recomendada para la conservación de los caribúes, creemos que la densidad poblaciones de los osos negros y los coyotes es marcadamente más alta, por lo que deberían ser de mayor preocupación, especialmente si los controles gubernamentales de lobos continúan liberándolos. La conservación de caribúes con un enfoque único en el control de lobos puede dejar vulnerables a los caribúes antes otros depredadores. Recomendamos un enfoque más amplio en las especies que interactúan dentro de una comunidad cuando se busca conservar a una especie.


Assuntos
Cervos , Rena , Lobos , Alberta , Animais , Teorema de Bayes , Conservação dos Recursos Naturais , Campos de Petróleo e Gás , Comportamento Predatório
17.
Conserv Biol ; 28(5): 1249-59, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24762089

RESUMO

Conservation programs often manage populations indirectly through the landscapes in which they live. Empirically, linking reproductive success with landscape structure and anthropogenic change is a first step in understanding and managing the spatial mechanisms that affect reproduction, but this link is not sufficiently informed by data. Hierarchical multistate occupancy models can forge these links by estimating spatial patterns of reproductive success across landscapes. To illustrate, we surveyed the occurrence of grizzly bears (Ursus arctos) in the Canadian Rocky Mountains Alberta, Canada. We deployed camera traps for 6 weeks at 54 surveys sites in different types of land cover. We used hierarchical multistate occupancy models to estimate probability of detection, grizzly bear occupancy, and probability of reproductive success at each site. Grizzly bear occupancy varied among cover types and was greater in herbaceous alpine ecotones than in low-elevation wetlands or mid-elevation conifer forests. The conditional probability of reproductive success given grizzly bear occupancy was 30% (SE = 0.14). Grizzly bears with cubs had a higher probability of detection than grizzly bears without cubs, but sites were correctly classified as being occupied by breeding females 49% of the time based on raw data and thus would have been underestimated by half. Repeated surveys and multistate modeling reduced the probability of misclassifying sites occupied by breeders as unoccupied to <2%. The probability of breeding grizzly bear occupancy varied across the landscape. Those patches with highest probabilities of breeding occupancy-herbaceous alpine ecotones-were small and highly dispersed and are projected to shrink as treelines advance due to climate warming. Understanding spatial correlates in breeding distribution is a key requirement for species conservation in the face of climate change and can help identify priorities for landscape management and protection.


Assuntos
Distribuição Animal , Conservação dos Recursos Naturais , Reprodução , Ursidae/fisiologia , Alberta , Animais , Ecossistema , Feminino , Masculino , Modelos Biológicos , Probabilidade
18.
J Dev Behav Pediatr ; 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38990148

RESUMO

PURPOSE: The premature infant brain may be particularly vulnerable to anesthesia effects, but there is conflicting evidence on the association between anesthesia exposure and developmental outcomes. Twin studies can control for confounding factors. A twin cohort of premature twins provides internal control of difficulty to measure confounders and delivers added power to a study examining the effects of anesthesia on neurodevelopmental outcomes. METHODS: We conducted a retrospective cohort study of sets of premature twins and multiples born at an academic medical center, in which 1 member of the set was exposed to general anesthesia. The primary outcome was the composite scores using Bayley Scale of Infant and Toddler Development III performed at age 6 months to 18 months. Unpaired and paired analyses were performed with linear regression models, Wilcoxon signed rank test, and Mann-Whitney U test. RESULTS: We identified 81 children born at less than 32 weeks gestation within 39 sets of twins and 1 set of triplets for a total of 18 paired observations. All of the exposed infants had a single exposure to general anesthesia. There was no significant association between anesthesia exposure and a diagnosis of developmental delay (OR = 0.8; 95% confidence interval, 0.2-3.2; p = 0.99). Regression models demonstrated no association between anesthesia exposure and cognitive (96.67 vs 97.50; p = 0.74), language (98.33 vs 98.61; p = 0.94), or motor (96.25 vs. 96.44; p = 0.91) composite Bayley scores. There was no association between duration of anesthesia and the 3 composite Bayley scores (p = 0.33; p = 0.40; p = 0.74). CONCLUSION: Using a premature twin cohort with discordant exposure to anesthesia, our data did not demonstrate any association between anesthesia exposure and developmental delay in this vulnerable population of premature infants.

19.
Ecol Evol ; 14(4): e11146, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38571804

RESUMO

Many large carnivores, despite widespread habitat alteration, are rebounding in parts of their former ranges after decades of persecution and exploitation. Cougars (Puma concolor) are apex predator with their remaining northern core range constricted to mountain landscapes and areas of western North America; however, cougar populations have recently started rebounding in several locations across North America, including northward in boreal forest landscapes. A camera-trap survey of multiple landscapes across Alberta, Canada, delineated a range edge; within this region, we deployed an array of 47 camera traps in a random stratified design across a landscape spanning a gradient of anthropogenic development relative to the predicted expansion front. We completed multiple hypotheses in an information-theoretic framework to determine if cougar occurrence is best explained by natural land cover features, anthropogenic development features, or competitor and prey activity. We predicted that anthropogenic development features from resource extraction and invading white-tailed deer (Odocoileus virgianius) explain cougar distribution at this boreal range edge. Counter to our predictions, the relative activity of native prey, predominantly snowshoe hare (Lepus americanus), was the best predictor of cougar occurrence at this range edge. Small-bodied prey items are particularly important for female and sub-adult cougars and may support breeding individuals in the northeast boreal forest. Also, counter to our predictions, there was not a strong relationship detected between cougar occurrence and gray wolf (Canis lupus) activity at this range edge. However, further investigation is recommended as the possibility of cougar expansion into areas of the multi-prey boreal system, where wolves have recently been controlled, could have negative consequences for conservation goals in this region (e.g. the recovery of woodland caribou [Rangifer tarandus caribou]). Our study highlights the need to monitor contemporary distributions to inform conservation management objectives as large carnivores recover across North America.

20.
Front Physiol ; 15: 1398816, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39050481

RESUMO

Introduction: During heatwaves, it is important to monitor workers' cardiovascular health since 35% of those working in hot environments experience symptoms of heat strain. Wearable technology has been popularized for monitoring heart rate (HR) during recreational activities, but it can also be used to monitor occupational heat strain based on core and skin temperatures and HR. To our knowledge, no devices estimate the cardiovascular strain directly based on stroke volume (SV) or cardiac output (CO). In addition to the hardware, there are limitations regarding the lack of suitable algorithms that would provide such an index based on relevant physiological responses. The validation of the formulae already existing in literature was the principle aim of the present study. Methods: We monitored the cardiovascular responses of our participants to a supine and 60° head-up tilt at the same time each day. During the test, we measured blood pressure derived by finger photoplethysmography, which also provided beat-by-beat measures of SV and CO. Afterwards, we compared the SV derived from the photoplethysmography with the one calculated with the different equations that already exist in literature. Results: The evaluation of the formulae was based on comparing the error of prediction. This residual analysis compared the sum of the squared residuals generated by each formula using the same data set. Conclusion: Our findings suggest that estimating SV with existing formulae is feasible, showing a good correlation and a relatively small bias. Thus, simply measuring workers' blood pressure during breaks could estimate their cardiac strain.

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