More losers than winners: investigating Anthropocene defaunation through the diversity of population trends.

The global-scale decline of animal biodiversity ('defaunation') represents one of the most alarming consequences of human impacts on the planet. The quantification of this extinction crisis has traditionally relied on the use of IUCN Red List conservation categories assigned to each assessed species. This approach reveals that a quarter of the world's animal species are currently threatened with extinction, and ~1% have been declared extinct. However, extinctions are preceded by progressive population declines through time that leave demographic 'footprints' that can alert us about the trajectories of species towards extinction. Therefore, an exclusive focus on IUCN conservation categories, without consideration of dynamic population trends, may underestimate the true extent of the processes of ongoing extinctions across nature. In fact, emerging evidence (e.g. the Living Planet Report), reveals a widespread tendency for sustained demographic declines (an average 69% decline in population abundances) of species globally. Yet, animal species are not only declining. Many species worldwide exhibit stable populations, while others are even thriving. Here, using population trend data for >71,000 animal species spanning all five groups of vertebrates (mammals, birds, reptiles, amphibians and fishes) and insects, we provide a comprehensive global-scale assessment of the diversity of population trends across species undergoing not only declines, but also population stability and increases. We show a widespread global erosion of species, with 48% undergoing declines, while 49% and 3% of species currently remain stable or are increasing, respectively. Geographically, we reveal an intriguing pattern similar to that of threatened species, whereby declines tend to concentrate around tropical regions, whereas stability and increases show a tendency to expand towards temperate climates. Importantly, we find that for species currently classed by the IUCN Red List as 'non-threatened', 33% are declining. Critically, in contrast with previous mass extinction events, our assessment shows that the Anthropocene extinction crisis is undergoing a rapid biodiversity imbalance, with levels of declines (a symptom of extinction) greatly exceeding levels of increases (a symptom of ecological expansion and potentially of evolution) for all groups. Our study contributes a further signal indicating that global biodiversity is entering a mass extinction, with ecosystem heterogeneity and functioning, biodiversity persistence, and human well-being under increasing threat.

Current views and practices in the management of low-grade cervical abnormalities-results of a British Society for Colposcopy and Cervical Pathology Study.

OBJECTIVE: To determine current views and practice of the management of low-grade cervical abnormalities. MATERIALS AND METHODS: A questionnaire survey was distributed to all accredited colposcopists whose details were available on the British Society for Colposcopy and Cervical Pathology database. RESULTS: Of the 1292 colposcopists contacted, 470 responded to the questionnaire. Of these respondents, 57% were obstetricians/gynecologists, 16% were nurse colposcopists, and 12% were gynecological oncologists. Most colposcopists would only advise a woman to undergo treatment of low-grade cytology (atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion) with low-grade colposcopic findings if the disease was persistent for 24 months or more. There was significant diversity in the management between colposcopists working in different medical specialties. Gynecological oncologists and nurse colposcopists were less likely to be influenced by poor compliance (p <.01) or immunosuppression (p <.01) into offering treatment earlier for low-grade disease. Also, community gynecologists were more likely to routinely offer ablative treatment of low-grade disease compared with colposcopists based on secondary care, p <.01. CONCLUSIONS: The need for conservative management with low-grade cervical abnormalities and the accurate diagnosis of disease progression seem to be well understood. The reported management of low-grade cervical abnormalities seem to follow the National Health Service Cervical Screening Programme guidelines; however, there is diversity in practice between colposcopists working in different medical specialties.

Transitional cell carcinoma of the endometrium: a case report and review of the literature.

We report a case of primary transitional cell carcinoma of the endometrium and review the literature which reveals only 12 cases described to date. The patient presented with postmenopausal bleeding, and there were no distinctive clinical features. An endometrial sample taken at hysteroscopy was reported as a poorly differentiated, papillary, nonserous carcinoma with probable squamous metaplasia. The tumor removed at hysterectomy and bilateral salpingo-oophorectomy was almost all transitional cell with small areas of endometrioid, glandular differentiation. Immunohistochemistry demonstrated a similar immunoprofile to endometrioid carcinoma of the endometrium and different from reported cases of transitional cell carcinoma of the ovary and of the urinary tract.