Conserving the evolutionary history of birds.

In the midst of the sixth mass extinction, limited resources are forcing conservationists to prioritize which species and places will receive conservation action. Evolutionary distinctiveness measures the isolation of a species on its phylogenetic tree. Combining a species' evolutionary distinctiveness with its globally endangered status creates an EDGE score. We use EDGE scores to prioritize the places and species that should be managed to conserve bird evolutionary history. We analyzed all birds in all countries and important bird areas. We examined parrots, raptors, and seabirds in depth because these groups are especially threatened and relatively speciose. The three focal groups had greater median threatened evolutionary history than other taxa, making them important for conserving bird evolutionary history. Australia, Brazil, Indonesia, Madagascar, New Zealand, and the Philippines were especially critical countries for bird conservation because they had the most threatened evolutionary history for endemic birds and are important for parrots, raptors, and seabirds. Increased enforcement of international agreements for the conservation of parrots, raptors, and seabirds is needed because these agreements protect hundreds of millions of years of threatened bird evolutionary history. Decisive action is required to conserve the evolutionary history of birds into the Anthropocene.

En medio de la sexta extinción masiva, los recursos limitados están obligando a los conservacionistas a priorizar cuáles especies y lugares recibirán acciones de conservación. La peculiaridad evolutiva mide el aislamiento de una especie con respecto a su árbol filogenético. La combinación entre la peculiaridad evolutiva de una especie y su estado de conservación mundial genera un puntaje EDGE. Usamos estos puntajes para priorizar los lugares y especies que se deben gestionar para conservar la historia evolutiva ornitológica. Analizamos todas las especies de aves en todos los países y áreas de importancia ornitológica. Estudiamos a profundidad a los psitácidos, rapaces, y aves marinas por el nivel de amenaza que enfrentan estos grupos y porque cuentan con muchas especies. Estos tres grupos tuvieron una mayor mediana de historia evolutiva amenazada que los demás taxones, por lo que son de suma importancia para la conservación de la historia evolutiva ornitológica. Australia, Brasil, Indonesia, Madagascar, Nueva Zelanda y las Filipinas fueron países particularmente críticos para la conservación de las aves pues cuentan con la mayor historia evolutiva amenazada de aves endémicas y son localidades importantes para nuestros tres grupos focales. Se requiere de un incremento en la aplicación de los acuerdos internaciones para la conservación de los psitácidos, rapaces y aves marinas ya que estos acuerdos protegen cientos de millones de años de historia evolutiva ornitológica. Se necesitan acciones decisivas para conservar la historia evolutiva de las aves en el Antropoceno.

Towards reconciliation of the four world bird lists: hotspots of disagreement in taxonomy of raptors.

There are currently four world bird lists referenced by different stakeholders including governments, academic journals, museums and citizen scientists. Consolidation of these lists is a conservation and research priority. In reconciling lists, care must be taken to ensure agreement in taxonomic concepts-the actual groups of individual organisms circumscribed by a given scientific epithet. Here, we compare species-level taxonomic concepts for raptors across the four lists, highlighting areas of disagreement. Of the 665 species-level raptor taxa observed at least once among the four lists, only 453 (68%) were consistent across all four lists. The Howard and Moore Checklist of the Birds of the World contains the fewest raptor species (528), whereas the International Ornithological Community World Bird List contains the most (580) and these two lists are in the most disagreement. Of the disagreements, 67% involved owls, and Indonesia was the country containing the most disagreed upon species (169). Finally, we calculated the amount of species-level agreement across lists for each avian order and found raptor orders spread throughout the rankings of agreement. Our results emphasize the need to reconcile the four world bird lists for all avian orders, highlight broad disagreements across lists and identify hotspots of disagreement for raptors, in particular.

Reducing Length of Stay Does Not Increase Emergency Room Visits or Readmissions in Patients Undergoing Primary Hip and Knee Arthroplasties.

BACKGROUND: Total hip and total knee arthroplasty (total joint arthroplasty [TJA]) are 2 of the most common elective surgeries. Identifying which patients are at highest risk for emergency room (ER) visits or readmissions within 90 days of surgery and the reasons for return are crucial to formulate ways to decrease these visits and improve patient outcomes. METHODS: This is a retrospective review of a consecutive series of 7466 unilateral primary TJA performed from July 2013 to June 2017; any patients who had an ER visit or readmission in the first 90 days after surgery were identified, and a detailed chart review was performed. Patients discharged home or to rehab were analyzed separately. RESULTS: Three hundred thirty-six (4.5%) patients had 380 ER visits and 250 (3.3%) patients had 291 readmissions in the first 90 days after TJA. Patients returning to the ER were equivalent to those who did not. Patients who went to a rehab facility on discharge were significantly more likely to be readmitted (P = .000). Patients who were readmitted had a higher American Society of Anesthesiologists score (P = .000). Length of stay decreased over the study period from 2.66 days to 1.63 days, while the number of unplanned interventions remained steady. Pain and swelling was the most common reason for return for ER visits (33.2%) and readmissions (14.1%). CONCLUSION: The overall number of unplanned interventions after TJA in this population was low and remained consistent over time despite decreasing length of stay. Patients who went to rehab were more likely to experience readmission. The majority of unplanned interventions occurred in the first 4 weeks after surgery.

Robotic-Assisted Cholecystoduodenal Fistula and Bile Leak Repair.

Cholelithiasis and its complications are among the most prevalent and costly medical conditions in the United States. Chronic gallbladder disease can progress into more complicated conditions, such as a cholecystoenteric fistula and, more specifically, a cholecystoduodenal fistula (CDF). Repair of these fistulas is complex and usually performed with an open approach. However, if discovered pre-operatively, they can be referred to a hepatobiliary surgery center, where surgeons have specialized training to do such procedures laparoscopically. Here, we present a case of a 57-year-old female with a past medical history of migraines, arthritis, chronic back pain, and fibromyalgia, with no prior surgical history. She presented with an approximately six-month history of colicky right upper quadrant pain and symptomatology consistent with symptomatic cholelithiasis. She elected to have a robotic-assisted laparoscopic cholecystectomy performed. Intraoperatively, she was found to have a CDF and subsequent bile duct leak that were successfully repaired. While more research is required to further characterize and more quickly identify this complication of gallbladder disease, this case highlights the value of robotic-assisted surgery in technically challenging cases. We aim to describe and advocate for the adoption of a robotic approach in patients with comparable presentations, allowing for excellent visualization and control in the removal of inflamed gallbladders, repair of fistulized tissues, and stabilization of bile leaks.

African savanna raptors show evidence of widespread population collapse and a growing dependence on protected areas.

The conversion of natural habitats to farmland is a major cause of biodiversity loss and poses the greatest extinction risk to birds worldwide. Tropical raptors are of particular concern, being relatively slow-breeding apex predators and scavengers, whose disappearance can trigger extensive cascading effects. Many of Africa's raptors are at considerable risk from habitat conversion, prey-base depletion and persecution, driven principally by human population expansion. Here we describe multiregional trends among 42 African raptor species, 88% of which have declined over a ca. 20-40-yr period, with 69% exceeding the International Union for Conservation of Nature criteria classifying species at risk of extinction. Large raptors had experienced significantly steeper declines than smaller species, and this disparity was more pronounced on unprotected land. Declines were greater in West Africa than elsewhere, and more than twice as severe outside of protected areas (PAs) than within. Worryingly, species suffering the steepest declines had become significantly more dependent on PAs, demonstrating the importance of expanding conservation areas to cover 30% of land by 2030-a key target agreed at the UN Convention on Biological Diversity COP15. Our findings also highlight the significance of a recent African-led proposal to strengthen PA management-initiatives considered fundamental to safeguarding global biodiversity, ecosystem functioning and climate resilience.

A pilot study of rhythm and timing training as a supplement to occupational therapy in stroke rehabilitation.

INTRODUCTION: Stroke is the leading cause of disability. A need exists for an effective intervention to enhance upper extremity (UE) motor abilities and activities of daily living (ADL) performance. OBJECTIVE: The objectives of this pilot study were to (1) determine the feasibility of adding Interactive Metronome (IM) to an occupational therapy (OT) program; and (2) determine changes in UE impairments, function, quality of life, and perceived physical performance ability and satisfaction using a combined IM + OT regimen compared with OT alone for adults with chronic stroke. METHODS: This pilot study (n=10) used a 2-group (OT or IM+OT) pretest-posttest design. The intervention involved 60 minutes of IM + OT or OT alone, 3 days a week for 10 weeks. Outcome measures included the UE Fugl-Meyer (impairment), the Arm Motor Ability Test (function), the Box and Block Test (function), Stroke Impact Scale (quality of life), and the Canadian Occupational Performance Measure (perceived performance ability and satisfaction). RESULTS: It was feasible to add IM to OT. The IM+OT group demonstrated decreased impairment and increased quality of life. However, the OT-alone group demonstrated greater gains in function, perceived physical performance ability, and satisfaction. CONCLUSION: These findings suggest that rhythm and timing training using the IM is a feasible intervention to consider as part of therapy treatment. However, IM may fit best for prefunctional treatment, as it seemed to primarily decrease impairment. It may also serve as a supplement before or after treatment in order to maximize rehabilitation potential. Clinical implications and suggestions for future studies are provided.

Eagles enter rotor-swept zones of wind turbines at rates that vary per turbine.

There is increasing pressure on wind energy facilities to manage or mitigate for wildlife collisions. However, little information exists regarding spatial and temporal variation in collision rates, meaning that mitigation is most often a blanket prescription. To address this knowledge gap, we evaluated variation among turbines and months in an aspect of collision risk-probability of entry by an eagle into a rotor-swept zone (hereafter, "probability of entry"). We examined 10,222 eagle flight paths identified and recorded by an automated bird monitoring system at a wind energy facility in Wyoming, USA. Probabilities of entry per turbine-month combination were 4.03 times greater in some months than others, ranging 0.15 to 0.62. The overall probability of entry for the riskiest turbine (i.e., the one with the greatest probability of entry) was 2.39 times greater than the least-risky turbine. Our methodology describes large variation across turbines and months in the probability of entry. If subsequently combined with information on other sources of variation (i.e., weather, topography), this approach can identify risky versus safe situations for eagles under which cost of management, curtailment prescriptions, and collision risk can be simultaneously minimized.