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1.
Conserv Biol ; 38(2): e14190, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37768181

RESUMO

The fundamental goal of a rare plant translocation is to create self-sustaining populations with the evolutionary resilience to persist in the long term. Yet, most plant translocation syntheses focus on a few factors influencing short-term benchmarks of success (e.g., survival and reproduction). Short-term benchmarks can be misleading when trying to infer future growth and viability because the factors that promote establishment may differ from those required for long-term persistence. We assembled a large (n = 275) and broadly representative data set of well-documented and monitored (7.9 years on average) at-risk plant translocations to identify the most important site attributes, management techniques, and species' traits for six life-cycle benchmarks and population metrics of translocation success. We used the random forest algorithm to quantify the relative importance of 29 predictor variables for each metric of success. Drivers of translocation outcomes varied across time frames and success metrics. Management techniques had the greatest relative influence on the attainment of life-cycle benchmarks and short-term population trends, whereas site attributes and species' traits were more important for population persistence and long-term trends. Specifically, large founder sizes increased the potential for reproduction and recruitment into the next generation, whereas declining habitat quality and the outplanting of species with low seed production led to increased extinction risks and a reduction in potential reproductive output in the long-term, respectively. We also detected novel interactions between some of the most important drivers, such as an increased probability of next-generation recruitment in species with greater seed production rates, but only when coupled with large founder sizes. Because most significant barriers to plant translocation success can be overcome by improving techniques or resolving site-level issues through early intervention and management, we suggest that by combining long-term monitoring with adaptive management, translocation programs can enhance the prospects of achieving long-term success.


Identificación de pronosticadores del éxito de reubicación en especies raras de plantas Resumen El objetivo fundamental de la reubicación de plantas raras es la creación de poblaciones autosuficientes con resiliencia evolutiva que persistan a la larga. De todas maneras, la mayoría de las síntesis de estas reubicaciones se enfocan en unos cuantos factores que influyen sobre los parámetros a corto plazo del éxito (supervivencia y reproducción). Los parámetros a corto plazo pueden ser engañosos si se intenta inferir el crecimiento y la viabilidad en el futuro ya que los factores que promueven el establecimiento pueden diferir de aquellos requeridos para la persistencia a largo plazo. Ensamblamos un conjunto grande de datos representativos en general (n = 275) de las reubicaciones de plantas en riesgo bien documentadas y monitoreadas (7.9 años en promedio) para identificar los atributos de sitio más importantes, las técnicas de manejo y los rasgos de las especies para seis parámetros de ciclos de vida y medidas poblacionales del éxito de reubicación. Usamos el algoritmo de bosque aleatorio para cuantificar la importancia relativa de las 29 variables de pronosticadores para cada medida del éxito. Los factores en los resultados de las reubicaciones variaron con los marcos temporales y las medidas de éxito. Las técnicas de manejo tuvieron la mayor influencia relativa sobre la obtención de parámetros de ciclos de vida y tendencias poblacionales a corto plazo, mientras que los atributos de sitio y los rasgos de la especie fueron más importantes para la persistencia poblacional y las tendencias a largo plazo. En específico, las grandes cantidades de fundadores incrementaron el potencial de reproducción y reclutamiento de la siguiente generación, mientras que la declinación de la calidad del hábitat incrementó el riesgo de extinción y el trasplante de especies con baja producción de semillas redujo el rendimiento del potencial reproductivo a la larga. También detectamos interacciones novedosas entre algunos de los factores más importantes, como el aumento en la probabilidad del reclutamiento en la siguiente generación en especies con tasas mayores de producción de semillas, pero sólo cuando se emparejó con grandes cantidades de fundadores. Ya que las barreras más significativas para el éxito de la reubicación de plantas pueden superarse al mejorar las técnicas o resolver los temas a nivel de sitio por medio de un manejo y una intervención temprana, sugerimos que con la combinación del monitoreo a largo plazo con el manejo adaptativo los programas de reubicación pueden aumentar el prospecto de lograr el éxito a largo plazo.


Assuntos
Conservação dos Recursos Naturais , Plantas , Conservação dos Recursos Naturais/métodos , Reprodução , Sementes , Ecossistema
2.
Lab Anim (NY) ; 52(12): 282-283, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38017177
3.
Anthropol Med ; 30(4): 362-379, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37781888

RESUMO

Previous research on the stigma associated with cutaneous leishmaniasis, a vector-transmitted parasitic disease, focuses on aesthetic appearance affectation as the leading cause of stigmatisation. However, Indigenous populations in the hinterland of Amazonian Ecuador trigger stigma expressions by recognising (muco)cutaneous leishmaniasis, primarily through atypical smell, followed by the odd voice sound, appearance and taste. This empirical way of recognising symptoms relies on embodied forms of identifying a disease, contrasting the Western supremacy of visuality and demanding to be understood via multi-sensorial anthropology. Through ethnographic research and data retrieved from eighty-three semistructured interviews and fifteen focus groups in seven Ecuadorian ethnic groups - including six Indigenous groups in the Amazon region - this paper analyses how the sensorium is a health thermometer. Findings reveal that differentiated cultural responses to a sense of peril, contagion and social (self)rejection, understood as stigma expressions, are linked to the holistic approach to health (or well-being) shared by Indigenous populations. In forest societies, well-being is explained through successful (non-)human relationships, and disease permeates through bodies that lack balanced relations.


Assuntos
Leishmaniose Cutânea , Humanos , Equador , Antropologia Médica , Estigma Social , Antropologia Cultural
4.
Arthroscopy ; 39(3): 682-688, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36740291

RESUMO

PURPOSE: The purpose of this study was to compare rates of recurrent dislocation and postsurgical outcomes in patients undergoing arthroscopic Bankart repair for anterior shoulder instability immediately after a first-time traumatic anterior dislocation versus patients who sustained a second dislocation event after initial nonoperative management. METHODS: A retrospective chart review was performed of patients undergoing primary arthroscopic stabilization for anterior shoulder instability without concomitant procedures and minimum 2-year clinical follow-up. Primary outcome was documentation of a recurrent shoulder dislocation. Secondary clinical outcomes included range of motion, Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons Shoulder Score (ASES), and Shoulder Activity Scale (SAS). RESULTS: Seventy-seven patients (mean age 21.3 years ± 7.3 years) met inclusion criteria. Sixty-three shoulders underwent surgical stabilization after a single shoulder dislocation, and 14 underwent surgery after 2 dislocations. Average follow-up was 35.9 months. The rate of recurrent dislocation was significantly higher in the 2-dislocation group compared to single dislocations (42.8% vs 14.2%, P = .03). No significant difference was present in range of motion, VAS, ASES, and SAS scores. The minimal clinically important difference (MCID) was 1.4 for VAS and 1.8 for SAS scores. The MCID was met or exceeded in the primary dislocation group in 31/38 (81.6%) patients for VAS, 23/31 (74.1%) for ASES, and 24/31 for SES (77.4%) scores. For the second dislocation cohort, MCID was met or exceeded in 7/9 (77.8%) for VAS, 4/7 (57.1%) for ASES, and 5/7 for SES (71.4%) scores. CONCLUSION: Immediate arthroscopic surgical stabilization after a first-time anterior shoulder dislocation significantly decreases the risk of recurrent dislocation in comparison to those who undergo surgery after 2 dislocation events, with comparable clinical outcome scores. These findings suggest that patients who return to activities after a primary anterior shoulder dislocation and sustain just 1 additional dislocation event are at increased risk of a failing arthroscopic repair. STUDY DESIGN: Retrospective comparative study; Level of evidence, 3.


Assuntos
Luxações Articulares , Instabilidade Articular , Luxação do Ombro , Articulação do Ombro , Humanos , Adulto Jovem , Adulto , Luxação do Ombro/cirurgia , Luxação do Ombro/complicações , Instabilidade Articular/cirurgia , Articulação do Ombro/cirurgia , Estudos Retrospectivos , Recidiva , Luxações Articulares/cirurgia , Artroscopia/métodos
6.
Environ Monit Assess ; 193(9): 580, 2021 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-34398272

RESUMO

Pyrodinium bahamense, a harmful alga which causes paralytic shellfish poisoning (PSP), has been found in seawater samples collected along bays in Eastern Visayas in the Philippines. Due to its negative impacts and uncertainty in its occurrence, there is a need to develop a real-time monitoring device of the harmful algal bloom (HAB) occurrence. This study aims to determine whether there is significant relationship between the dependent variable, the P. bahamense cell density, and the independent variables, namely, temperature, rainfall and humidity, bays in Eastern Visayas, and sampling month. This was done through data mining technique of P. bahamense cell density and weather patterns and statistically analyzing the datasets, with P. bahamense cell density as the dependent variable and weather patterns, bays and sampling month as independent variables using M5P regression analysis. Through the regression analysis, the usefulness of the predictive model as an initial development can be assessed. Results of the study showed that the correlation coefficient of P. bahamense with the five independent variables is 0.725 which signified a moderate correlation between P. bahamense cell density and bay, sampling month, temperature, rainfall and humidity. Maximum cell density, which was 20 cells/L occurred during months of wet season in the bays in Eastern Visayas, except in Cancabato bay while the minimum cell density, which was 0 cell/L occurred during months of dry season. It can be concluded from the results that there is enough data to say that there is a significant relationship between P. bahamense occurrence and temperature, rainfall and humidity, so the model is meaningful and useful at alpha = 0.05 or 95% and 0.01 or 99% confidence interval. The data can be used to generate a predictive model for P. bahamense occurrence relative to its cell density.


Assuntos
Dinoflagellida , Monitoramento Ambiental , Proliferação Nociva de Algas , Filipinas , Temperatura , Tempo (Meteorologia)
8.
Ann Plast Surg ; 87(1s Suppl 1): S17-S20, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33833166

RESUMO

PURPOSE: Interest in labiaplasty as a way to alter and improve genital appearance has been on the rise. Labiaplasty procedures can be performed in the office setting under local anesthesia. However, these procedures are often performed under general anesthesia for patient comfort and to facilitate the operative technique and to potentially improve outcomes. Outcomes after labiaplasty performed under general anesthesia as compared with that performed under local anesthesia in the office setting have not been well-defined. This article aimed to compare outcomes after central wedge labiaplasty performed under general anesthesia versus that performed under local anesthesia. METHODS: A retrospective chart review identified patients who underwent central wedge labiaplasty performed by a single surgeon from 2011 to 2019. Demographic, clinical, and operative information were reviewed and recorded. Outcomes were assessed by evaluating postoperative complications and the need for revision surgery. RESULTS: Thirty-two women with a mean age of 32.8 ± 11.2 years and a mean body mass index of 22.0 ± 3.5 kg/m2 underwent central wedge or extended central wedge labiaplasty during the study period. Ten (31.2%) labiaplasties were performed under local anesthesia in an office setting, and 22 (68.8%) were performed under general anesthesia. Demographic, clinical, and operative characteristics were comparable between labiaplasties performed under local anesthesia and those performed under general anesthesia. Postoperative asymmetry and wound dehiscence were the most common complications. Outcomes after labiaplasty performed under general anesthesia were comparable to those performed under local anesthesia, with regard to asymmetry (27.3% vs 10.0%; P = 0.387), dehiscence (27.3% vs 40.0%; P = 0.683), scarring (4.5% vs 0.0%; P = 1.000), and the need for revision surgery (31.8% vs 40.0%; P = 0.703), respectively. There were no cases of infection, hematoma, decreased sensation, or dyspareunia. CONCLUSIONS: Postoperative asymmetry and dehiscence were the most common complications after labiaplasty performed under general or local anesthesia. Outcomes after labiaplasty performed under general anesthesia were comparable to those performed under local anesthesia. Further studies are needed to assess outcomes after labiaplasty performed under general anesthesia versus that performed under local anesthesia.


Assuntos
Anestesia Local , Procedimentos de Cirurgia Plástica , Adulto , Anestesia Geral , Feminino , Humanos , Reoperação , Estudos Retrospectivos , Vulva/cirurgia , Adulto Jovem
9.
PLoS One ; 16(3): e0248635, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33755682

RESUMO

Invasive plants have the potential to interfere with native species' reproductive success through a number of mechanisms, including heterospecific pollination and hybridization. This study investigated reproductive interactions between a native North American woody vine (American bittersweet, Celastrus scandens) and an introduced congener (oriental bittersweet, C. orbiculatus). The decline of C. scandens in the eastern portion of its range is coincident with the introduction and spread of C. orbiculatus, and the two species are known to hybridize. The relationship between proximity and floral production of conspecific and heterospecific males on fertilization and hybridization rates was measured at a field site in northwestern Indiana, USA where both species occur and reproduce. We found that the invasive vine had an extreme advantage in both male and female floral production, producing nearly 200 times more flowers per staminate plant and 65 times more flowers per pistillate plant than the native. Using nuclear microsatellite DNA markers we found that hybridization rates were asymmetric; 39% of the C. scandens seeds tested were hybrids, compared to only 1.6% of C. orbiculatus seeds. The asymmetric hybridization rates were likely not solely due to greater abundance of C. orbiculatus pollen because experimental hand crosses revealed that C. scandens had a higher rate (41%) of heterospecific fertilization than C. orbiculatus (2.4%). We previously reported that few hybrids were observed in the wild, and hybrids had greatly reduced fecundity. Thus, in our system, the threat posed by heterospecific pollen is not replacement by hybrids or introgression, but rather asymmetric reproductive interference. Reproductive interference extended to distances as great as 100 meters, thus, efforts to conserve the native species must reduce its exposure to C. orbiculatus over a relatively large spatial scale.


Assuntos
Celastrus/genética , Hibridização Genética , Espécies Introduzidas , Polinização , Indiana
12.
Cureus ; 12(8): e9544, 2020 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-32905507

RESUMO

Miscommunication during patient handover can be a major cause of preventable medical errors. Emergency traumas are situations where high stress and cognitive load make communication more difficult. Simulation allows for junior learners to practice emergency scenarios in a low-risk setting. This technical report outlines a simulation involving patient handover in emergency trauma scenarios. The intended group of learners are first-year surgery and emergency medicine residents. The scenarios were developed based on the learning objectives of communication, collaboration, and information transfer. Using a high-fidelity simulation mimicking a tertiary care facility, the skills performed in these scenarios can be applied to everyday practice.

13.
Cureus ; 12(7): e9020, 2020 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-32775100

RESUMO

The current generation of graduating medical students is entering into practice with minimal exposure to the digital rectal examination (DRE), a necessary component of a complete physical examination. Simulation-based medical education (SBME) using anatomical silicone models and task trainers can provide hands-on training opportunities for medical students to rehearse DREs. However, there is a scarcity of affordable, validated, and anatomically correct silicone prostate models and task trainers for rehearsing DREs. This technical report describes and validates evidence for silicone prostate models and a DRE task trainer created from three-dimensional (3D)-printed molds for medical student- and resident-training and clinical skills maintenance. A pre-existing 3D human model and five different prostate models from open-source, royalty-free websites were converted using Fusion360™ (Autodesk Inc., San Rafael, CA) into stereolithography files and altered to produce negative molds. The prostate molds were filled with silicone and polylactic acid filament "nodules". The buttocks were isolated from the human model and an anal canal was designed with a larger cavity on the interior to hold the silicone prostate models to simulate a real DRE. Five practicing urologists were recruited to evaluate the 3D-printed silicone prostate models and the DRE task trainer. The participants were provided with a qualitative survey and asked to rate the perceived realism and educational effectiveness of the prostate models and task trainer. The silicone models and task trainer were found to be useful for simulation training when attempting DRE techniques. The feedback from the participants was positive overall and provided recommendations for improvement including stabilizing the prostate models in the task trainer, smoothening the transition between the rectum and the prostate, and adding an additional "normal" prostate model. Silicone prostate models and DRE task trainers created from 3D molds are economical and anatomically and tactically accurate training tools to teach and maintain DRE skills as compared to commercially available, cost-prohibitive models. After making the suggested and appropriate modifications, the prostate models and DRE task trainer could potentially be used as tools for clinical skills training and maintenance and for patient education in the future.

14.
PLoS One ; 15(6): e0234139, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32559760

RESUMO

Temperate savannas and grasslands are globally threatened. In the Midwest United States of America (USA), for example, oak savannas persist today at a small percentage of recent historic coverage. Therefore, restoration of habitats of low and intermediate canopy cover is a landscape conservation priority that often emphasizes returning tree density to a savanna-like target value. Understanding how animal species react to such changes in vegetation structure is important for assessing the value of these restoration plans. We examined how butterfly community attributes in northwest Indiana USA, including community composition, richness, and abundance responded to a grassland-to-forest gradient of canopy cover. Butterfly community composition under intermediate canopy cover differed significantly from community composition in the most open or closed-canopy habitats. Composition of the plant community in flower was a significant predictor of three assessed attributes of the butterfly community-composition, richness, and abundance. Phenology, expressed as day-of-the-year, was also a strong predictor of these butterfly community attributes. Few butterfly species were habitat specialists as adults although canopy cover was a more important predictor of adult community composition than of richness or abundance of butterflies. Therefore, adult butterfly community differences along the canopy cover gradient were less about butterfly communities filled with habitat specialists for different canopy-defined habitats and more about gradual changes in community composition along this gradient. Overall, butterfly community richness was predicted to peak at about 34% canopy cover, butterfly abundance at about 53% canopy cover, community conservation value at about 59% canopy cover, and a combination of desirable conservation attributes-high diversity, high abundance, and high conservation value-was predicted to reach a peak of co-occurrence at about 67% canopy cover suggesting that habitats of intermediate canopy cover might be particularly effective for butterfly conservation in this region.


Assuntos
Borboletas/fisiologia , Florestas , Pradaria , Animais , Conservação dos Recursos Naturais
15.
Ann Plast Surg ; 85(S1 Suppl 1): S17-S22, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32530846

RESUMO

PURPOSE: Patient-reported outcomes after female cosmetic genital surgery (FCGS) have been well documented; however, methods vary widely between studies and are often very detailed, time-consuming, and difficult to reproduce. The purpose of this study was to assess patient-reported outcomes after FCGS using a novel method and survey as well as to present the results of a pilot study aimed at validating this survey. METHODS: A retrospective chart review identified patients who underwent FCGS. Demographic, clinical, operative, and outcome characteristics were recorded. A novel survey, including 14 items administered by telephone interview, was developed and extrapolated from the BREAST-Q for augmentation mammaplasty, to assess patient-reported outcomes after FCGS with regard to satisfaction with outcome and physical, psychosocial, and sexual well-being. RESULTS: The survey response rate was 50.6% (39 patients). Over a mean time after surgery of 56 months, 14 complications occurred in 11 patients (28.2%), and 10 complications required revision surgery. Postoperative asymmetry and dehiscence were the most common complications. Despite the higher complication and revision surgery rates, 97.4% agreed that the surgery was a good experience and were satisfied with the results after surgery. In addition, patient-reported outcomes after FCGS showed significant improvement in physical well-being, psychosocial well-being, and sexual well-being (P < 0.001). CONCLUSIONS: This novel survey can be used to assess patient-reported outcomes after FCGS in an efficient approach. Despite the potential complications and need for revision surgery, the vast majority of patients who undergo FCGS feel that it is a good experience, are satisfied with the results after surgery, and show significant improvement in physical, psychosocial, and sexual well-being after surgery.


Assuntos
Mamoplastia , Satisfação do Paciente , Feminino , Genitália , Humanos , Medidas de Resultados Relatados pelo Paciente , Projetos Piloto , Qualidade de Vida , Estudos Retrospectivos , Resultado do Tratamento
16.
Ann Plast Surg ; 85(S1 Suppl 1): S68-S75, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32530849

RESUMO

PURPOSE: Outcomes after female cosmetic genital surgery (FCGS) performed by plastic surgeons working in a group practice setting have not been well documented. This article aimed to assess outcomes and to describe FCGS techniques used in a large group private plastic surgery practice. METHODS: A retrospective chart review identified patients who underwent FCGS from 2009 to 2018. Demographic, clinical, and operative information was reviewed and recorded. Outcomes were assessed by evaluating postoperative complications and the need for revision surgery. RESULTS: Seventy-seven women between the ages of 14 and 53 years underwent FCGS performed by 1 of 6 surgeons. Forty-five patients underwent central wedge excision for labia minora hypertrophy, whereas 32 patients underwent extended central wedge excision for labia minora and clitoral hood hypertrophy. Four patients underwent liposuction of the mons pubis as an additional procedure. Over a mean follow-up of 37.4 months, postoperative asymmetry/redundancy occurred in 12 patients, requiring revision in 10. Wound dehiscence occurred in 12 patients, requiring revision in 9. There was one hematoma postoperatively requiring evacuation, one case of dyspareunia, and one case of decreased sensation. A single-layer wound closure (P = 0.050) and mons liposuction (P = 0.011) were risk factors for wound dehiscence. CONCLUSIONS: Central wedge excision and extended central wedge excision labiaplasty were the techniques used in a large group plastic surgery practice. Postoperative asymmetry and dehiscence were the most common complications, and the revision surgery rate was high. A single-layer wound closure and additional mons liposuction were risk factors for dehiscence after central wedge labiaplasty.


Assuntos
Procedimentos de Cirurgia Plástica , Cirurgia Plástica , Adolescente , Adulto , Clitóris/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Vulva/cirurgia , Adulto Jovem
17.
Cureus ; 12(4): e7510, 2020 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-32382452

RESUMO

Post-operative myocardial infarctions (MI) are a challenging diagnosis due to the alterations in the presenting complaint compared to an acute MI. Patients may be asymptomatic due to their anesthetics and sedatives from their operation which may create clinical confusion. As such, there is an increased risk for delayed administration of reperfusion therapies in this patient population which has shown to increase morbidity and mortality. It is anticipated that the difficulty of recognizing a post-operative MI would be exacerbated for clinical clerks due to their lack of clinical experience and overstimulation. Fortunately, the use of simulation-based learning has been proven to be a useful teaching tool to help clinical clerks manage medical problems in a controlled environment. This technical report describes a simulation case designed to enhance the recognition and response to a post-operative MI by a third-year clinical clerk. In this scenario, a 56-year-old male accountant presents with shortness of breath while recovering in the orthopaedic ward 12 hours following a total knee replacement (TKR). The clinical clerks are expected to conduct an independent follow-up prior to finishing their shift during which the patient begins complaining of shortness of breath. The clerk is required to order an electrocardiogram (ECG) for further analysis which reveals an anterior ST-segment elevation. Once recognized, a request for the crash cart and patient handover to the senior physician are expected.

18.
Eur Heart J Acute Cardiovasc Care ; 9(8): 966-974, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31452378

RESUMO

BACKGROUND: Limited data exists regarding sex differences in outcome and predictive accuracy of intensive care unit-based scoring systems when applied to cardiac intensive care unit patients. METHODS: We reviewed medical records of patients admitted to cardiac intensive care unit from 1 January 2011-31 December 2016. Sex differences in mortality rates and the performance of intensive care unit-based scoring systems in predicting in-hospital mortality were analyzed. Calibration was assessed by the Hosmer-Lemeshow test and locally weighted scatterplot smoothing curves. Discrimination was assessed using the c statistic and receiver-operating characteristic curve. RESULTS: Among 6963 patients, 2713 (39%) were women. Overall in-hospital and cardiac intensive care unit mortality rates were similar in women and men (9.1% vs 9.4%, p=0.67 and 5.9% vs 6%, p=0.88, respectively) and in age and major diagnosis subgroups. Of the scoring systems, Acute Physiology and Chronic Health Evaluation III and Sequential Organ Failure Assessment had poor calibration (Hosmer-Lemeshow p value <0.001), while Simplified Acute Physiology Score II performed better (Hosmer-Lemeshow p value 0.09), in both women and men. All scores had good discrimination (C statistics >0.8). In the subgroups of acute myocardial infarction and heart failure patients, all scores had good calibration (Hosmer-Lemeshow p>0.001) and discrimination (C statistic >0.8) while in diagnosis subgroups with highest mortality, the calibration varied among scores and by sex, and discrimination was poor. CONCLUSIONS: No sex differences in mortality were seen in cardiac intensive care unit patients. The mortality predictive value of intensive care unit-based scores is limited in both sexes and variable among different subgroups of diagnoses.


Assuntos
Cardiopatias/mortalidade , Unidades de Terapia Intensiva/estatística & dados numéricos , Medição de Risco/métodos , Idoso , Feminino , Seguimentos , Cardiopatias/terapia , Mortalidade Hospitalar/tendências , Humanos , Masculino , Prognóstico , Estudos Retrospectivos , Distribuição por Sexo , Fatores Sexuais , Taxa de Sobrevida/tendências
19.
Conserv Biol ; 33(3): 601-611, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30461065

RESUMO

Reintroductions are important components of conservation and recovery programs for rare plant species, but their long-term success rates are poorly understood. Previous reviews of plant reintroductions focused on short-term (e.g., ≤3 years) survival and flowering of founder individuals rather than on benchmarks of intergenerational persistence, such as seedling recruitment. However, short-term metrics may obscure outcomes because the unique demographic properties of reintroductions, including small size and unstable stage structure, could create lags in population growth. We used time-to-event analysis on a database of unusually well-monitored and long-term (4-28 years) reintroductions of 27 rare plant species to test whether life-history traits and population characteristics of reintroductions create time-lagged responses in seedling recruitment (i.e., recruitment time lags [RTLs]), an important benchmark of success and indicator of persistence in reintroduced populations. Recruitment time lags were highly variable among reintroductions, ranging from <1 to 17 years after installation. Recruitment patterns matched predictions from life-history theory with short-lived species (fast species) exhibiting consistently shorter and less variable RTLs than long-lived species (slow species). Long RTLs occurred in long-lived herbs, especially in grasslands, whereas short RTLs occurred in short-lived subtropical woody plants and annual herbs. Across plant life histories, as reproductive adult abundance increased, RTLs decreased. Highly variable RTLs were observed in species with multiple reintroduction events, suggesting local processes are just as important as life-history strategy in determining reintroduction outcomes. Time lags in restoration outcomes highlight the need to scale success benchmarks in reintroduction monitoring programs with plant life-history strategies and the unique demographic properties of restored populations. Drawing conclusions on the long-term success of plant reintroduction programs is premature given that demographic processes in species with slow life-histories take decades to unfold.


Efectos de la Historia de Vida y la Reproducción sobre las Demoras en el Tiempo de Reclutamiento en la Reintroducción de Plantas Raras Resumen Las reintroducciones son componentes importantes de los programas de conservación y recuperación de especies raras de plantas, pero las tasas de éxito a largo plazo cuentan con muy poco entendimiento. Las revisiones previas de las reintroducciones de plantas se han enfocado en la supervivencia a corto plazo (p. ej.: ≤ 3 años) y en el florecimiento de individuos fundadores en lugar de enfocarse en puntos de referencia para la persistencia inter-generacional, como el reclutamiento de plántulas. Sin embargo, las medidas a corto plazo pueden ocultar los resultados ya que las propiedades demográficas únicas de las reintroducciones, incluyendo el menor tamaño y la estructura inestable de estadio, podrían crear demoras en el crecimiento poblacional. Usamos un análisis de tiempo-para-evento en una base de datos de reintroducciones inusualmente bien monitoreadas y de largo plazo (4-28 años) de 27 especies raras de plantas para probar si los atributos de la historia de vida y las características poblacionales de la reintroducción crean respuestas con demoras temporales en el reclutamiento de plántulas (es decir, demoras temporales en el reclutamiento), un punto de referencia importante para el éxito y un indicador de la persistencia en poblaciones reintroducidas. Las demoras temporales de reclutamiento (RTLs, en inglés) fueron muy variables entre las reintroducciones, abarcando desde <1 hasta 17 años después de la instalación. Los patrones de reclutamiento se acoplaron a las predicciones de la teoría de historias de vida, donde las especies de vida corta (especies rápidas) exhibieron RTLs consistentemente más cortas y menos variables que las especies de vida larga (especies lentas). Las RTLs largas ocurrieron en hierbas de vida larga, especialmente en los pastizales, mientras que las RTLs cortas ocurrieron en plantas leñosas subtropicales de vida corta y en hierbas anuales. En todas las historias de vida de las plantas, conforme incrementó la abundancia de adultos reproductivos, las RTLs disminuyeron. Se observaron RTLs altamente variables en las especies con eventos de reintroducción múltiples, lo que sugiere que los procesos locales son igual de importantes que la estrategia de historia de vida para determinar los resultados de las reintroducciones. Las demoras temporales en los resultados de restauración resaltan la necesidad de poner a escala los puntos de referencia de éxito en los programas de monitoreo de reintroducciones que tengan estrategias de historia de vida de las plantas y las propiedades demográficas únicas de las poblaciones restauradas. La obtención de conclusiones sobre el éxito a largo plazo de los programas de reintroducción de plantas es algo prematuro ya que los procesos demográficos de especies con historias de vida lentas tardan décadas en desarrollarse.


Assuntos
Conservação dos Recursos Naturais , Reprodução , Demografia , Plantas , Crescimento Demográfico
20.
J Geophys Res Oceans ; 123(3): 1827-1837, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29938150

RESUMO

The freshwater budget of the Arctic and sub-polar North Atlantic Oceans has been changing due, primarily, to increased river runoff, declining sea ice and enhanced melting of Arctic land ice. Since the mid-1990s this latter component has experienced a pronounced increase. We use a combination of satellite observations of glacier flow speed and regional climate modeling to reconstruct the land ice freshwater flux from the Greenland ice sheet and Arctic glaciers and ice caps for the period 1958-2016. The cumulative freshwater flux anomaly exceeded 6,300 ± 316 km3 by 2016. This is roughly twice the estimate of a previous analysis that did not include glaciers and ice caps outside of Greenland and which extended only to 2010. From 2010 onward, the total freshwater flux is about 1,300 km3/yr, equivalent to 0.04 Sv, which is roughly 40% of the estimated total runoff to the Arctic for the same time period. Not all of this flux will reach areas of deep convection or Arctic and Sub-Arctic seas. We note, however, that the largest freshwater flux anomalies, grouped by ocean basin, are located in Baffin Bay and Davis Strait. The land ice freshwater flux displays a strong seasonal cycle with summer time values typically around five times larger than the annual mean. This will be important for understanding the impact of these fluxes on fjord circulation, stratification, and the biogeochemistry of, and nutrient delivery to, coastal waters.

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