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1.
Proc Biol Sci ; 291(2017): 20232016, 2024 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-38378152

RESUMO

Migratory species trade-off long-distance movement with survival and reproduction, but the spatio-temporal scales at which these decisions occur are relatively unknown. Technological and statistical advances allow fine-scale study of animal decision-making, improving our understanding of possible causes and therefore conservation management. We quantified effects of reproductive preparation during spring migration on subsequent breeding outcomes, breeding outcomes on autumn migration characteristics and autumn migration characteristics on subsequent parental survival in Greenland white-fronted geese (Anser albifrons flavirostris). These are long-distance migratory birds with an approximately 50% population decline from 1999 to 2022. We deployed GPS-acceleration devices on adult females to quantify up to 5 years of individual decision-making throughout the annual cycle. Weather and habitat-use affected time spent feeding and overall dynamic body acceleration (i.e. energy expenditure) during spring and autumn. Geese that expended less energy and fed longer during spring were more likely to successfully reproduce. Geese with offspring expended more energy and fed for less time during autumn, potentially representing adverse fitness consequences of breeding. These behavioural comparisons among Greenland white-fronted geese improve our understanding of fitness trade-offs underlying abundance. We provide a reproducible framework for full annual cycle modelling using location and behaviour data, applicable to similarly studied migratory animals.


Assuntos
Migração Animal , Gansos , Feminino , Animais , Estações do Ano , Tempo (Meteorologia) , Reprodução
2.
Oecologia ; 201(2): 369-383, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36576527

RESUMO

Arctic-nesting geese face energetic challenges during spring migration, including ecological barriers and weather conditions (e.g., precipitation and temperature), which in long-lived species can lead to a trade-off to defer reproduction in favor of greater survival. We used GPS location and acceleration data collected from 35 greater white-fronted geese of the North American midcontinent and Greenland populations at spring migration stopovers, and novel applications of Bayesian dynamic linear models to test daily effects of minimum temperature and precipitation on energy expenditure (i.e., overall dynamic body acceleration, ODBA) and proportion of time spent feeding (PTF), then examined the daily and additive importance of ODBA and PTF on probability of breeding deferral using stochastic antecedent models. We expected distinct responses in behavior and probability of breeding deferral between and within populations due to differences in stopover area availability. Time-varying coefficients of weather conditions were variable between ODBA and PTF, and often did not show consistent patterns among birds, indicating plasticity in how individuals respond to conditions. An increase in antecedent ODBA was associated with a slightly increased probability of deferral in midcontinent geese but not Greenland geese. Probability of deferral decreased with increased PTF in both populations. We did not detect any differentially important time periods. These results suggest either that movements and behavior throughout spring migration do not explain breeding deferral or that ecological linkages between bird decisions during spring and subsequent breeding deferral were different between populations and across migration but occurred at different time scales than those we examined.


Assuntos
Migração Animal , Gansos , Humanos , Animais , Gansos/fisiologia , Teorema de Bayes , Migração Animal/fisiologia , Estações do Ano , Temperatura , Cruzamento , Probabilidade
3.
Int J Biometeorol ; 66(5): 1005-1012, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35194684

RESUMO

To test for the degree of species-specific variation in clutch initiation date in relation to spring thaw, we recorded first egg dates in 1433 nests of seven large bodied long-distance migratory waterbird species breeding on Ayopechan Island in the Chaun Delta, Chukotka, in the Russian Arctic during 2002-2020. Pacific Loon Gavia pacifica, Sandhill Crane Grus canadensis and Glaucous Gull Larus hyperboreus all adjusted timing of clutch initiation completely to annual variation in first frost-free dates. First egg dates of Spectacled Eider Somateria fischeri also significantly advanced in warmer springs, but the rate of change was significantly less than unity, implying a reduced capacity to accommodate change in vernal thaw that may not be able to keep up with greater change in the future. Long-tailed Duck Clangula hyemalis and Vega Gull Larus vegae showed a tendency for earlier first egg dates in years with earlier first frost-free date, but for both species, the relationship failed to reach statistical significance. Bewick's Swan Cygnus columbianus showed almost no change in mean first egg date across the observed variation in first frost-free dates. Based on these data, we suggest that while all seven species showed signs of plasticity in their timing of onset of breeding, Pacific Loon, Sandhill Crane and Glaucous Gull showed greater adaptability to adjust the timing of their breeding season to recent variation in spring thaw than the other four species studied here over this period.


Assuntos
Aves , Reprodução , Animais , Regiões Árticas , Estações do Ano , Especificidade da Espécie
4.
J Community Health ; 46(5): 861-868, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33507489

RESUMO

In Washington, DC, 2% of residents are living with HIV, with 15.3% of them experiencing homelessness. Additionally, over half of DC-area renters are paying over 30% of their income for housing. The primary objective of this study was to describe HIV outcomes at initial intake at Housing Counseling Services (HCS). This retrospective study included adults with HIV completing HCS intake between 2015 and 2018 and linked HCS data with DC Department of Health (DOH) HIV/AIDS, Hepatitis, STD, and TB Administration (HAHSTA) surveillance data. Proportions of individuals with retention in care (RIC) and viral suppression (VS) were compared across client subgroups using chi-square or rank sum tests. The sample of 734 participants was mostly male (67%), Non-Hispanic Black (89%), had MSM as the HIV transmission risk factor (44%) and had rental housing (60%). Most participants (634/734, 86%) were RIC at HCS intake. A majority of participants (477/621 or 77%) had VS at intake. Older age was associated with VS (p = 0.0007). Homeless individuals (with intake from the street) were less likely to be VS (4.8% vs. 11.1%, p < 0.0045). Our results suggest that PWH who have unstable housing or who are homeless may need additional support services for maintaining RIC and VS, as the proportion meeting those benchmarks was not at goal when they sought services at HCS.


Assuntos
Infecções por HIV , Pessoas Mal Alojadas , Minorias Sexuais e de Gênero , Adulto , Idoso , Serviços de Saúde Comunitária , District of Columbia/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Habitação , Humanos , Masculino , Estudos Retrospectivos
5.
J Environ Manage ; 290: 112647, 2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-33901827

RESUMO

The proliferation of ever-larger wind turbines poses risks to wildlife, especially from avian collision, yet avoidance behaviour of large-bodied, long-lived bird species in relation to wind turbines remains little studied away from collision "black spots" and offshore marine environments. Here, three-dimensional flight trajectory data are reported from a laser range-finder study of local movements of large-bodied birds (e.g. swans, geese, gulls, cormorants, raptors and cranes, whose populations are relatively more demographically sensitive to collision mortality) in relation to seven terrestrial 150-222 m high (mean 182 m) wind turbines constructed in Denmark in a N-S line. Comparisons of two-dimensional flight passages between turbines pre- (n = 287) and post-construction (n = 1210) showed significant (P < 0.0001) reductions from 48% to 35% within 150 m of each turbine, with corresponding increase 200-300 m from turbines. Results also showed a significant (P < 0.001) 50% reduction in the percentage of avian passages (from 21% to 10%) through the maximum turbine sweep area after construction and that the proportion of birds that passed between turbines at heights below (0-45 m) and above the turbine sweep area (> 182 m) were significantly greater (P < 0.0001) post-construction than prior to construction. These are the first results from tracking large-bodied bird flight trajectories to show the magnitude of their vertical and horizontal adjustments to the presence of turbines, which have implications for assumptions of even flight densities made by collision risk models currently used to predict avian turbine collision rates.


Assuntos
Aves , Charadriiformes , Animais
6.
Conserv Biol ; 33(5): 1120-1130, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30912605

RESUMO

Evidence of declines in insect populations has recently received considerable scientific and societal attention. However, the lack of long-term insect monitoring makes it difficult to assess whether declines are geographically widespread. By contrast, bird populations are well monitored and often used as indicators of environmental change. We compared the population trends of European insectivorous birds with those of other birds to assess whether patterns in bird population trends were consistent with declines of insects. We further examined whether declines were evident for insectivores with different habitats, foraging strata, and other ecological preferences. Bird population trends were estimated for Europe (1990-2015) and Denmark (1990-2016). On average, insectivores declined over the study period (13% across Europe and 28% in Denmark), whereas omnivores had stable populations. Seedeaters also declined (28% across Europe; 34% in Denmark), but this assessment was based on fewer species than for other groups. The effects of insectivory were stronger for farmland species (especially grassland species), for ground feeders, and for cold-adapted species. Insectivory was associated with long-distance migration, which was also linked to population declines. However, many insectivores had stable populations, especially habitat generalists. Our findings suggest that the decline of insectivores is primarily associated with agricultural intensification and loss of grassland habitat. The loss of both seed and insect specialists indicates an overall trend toward bird communities dominated by diet generalists.


Declinaciones a Largo Plazo de Poblaciones de Aves Insectívoras en Europa y las Causas Probables Resumen La evidencia de las declinaciones poblacionales de insectos ha recibido recientemente una atención considerable por parte de la comunidad científica y la sociedad. Sin embargo, la falta de un monitoreo prolongado de los insectos complica valorar si estas declinaciones tienen una distribución extensa geográficamente. Como contraste, las poblaciones de aves tienen un monitoreo constante y con frecuencia se usan como indicadores del cambio climático. Comparamos las tendencias poblacionales de las aves insectívoras de Europa con las de otras aves para valorar si los patrones en las tendencias poblacionales de aves son consistentes con las declinaciones de insectos. Además examinamos si las declinaciones eran evidentes para aves insectívoras con diferentes hábitats, estratos de alimentación, y otras preferencias ecológicas. Las tendencias poblacionales de las aves se estimaron para Europa (1990 - 2015) y para Dinamarca (1990 - 2016). En promedio, las aves insectívoras declinaron a lo largo del periodo de estudio (13% en Europa y 28% en Dinamarca) mientras que las aves omnívoras tuvieron poblaciones estables. Las poblaciones de aves que se alimentan de semillas también declinaron (28% en Europa; 34% en Dinamarca), pero esta valoración se basó en menos especies que para los otros grupos. Los efectos de la insectivoría fueron más evidentes para las especies de tierras agrícolas (especialmente las especies de pastizales), para las especies que se alimentan sobre el suelo y para las especies adaptadas al frío. La insectivoría estuvo asociada con la migración de larga distancia, la cual también estuvo ligada a las declinaciones poblacionales. Sin embargo, muchas aves insectívoras tuvieron poblaciones estables, especialmente aquellas generalistas de hábitat. Nuestros hallazgos sugieren que la declinación de las aves insectívoras está asociada principalmente con la intensificación agrícola y la pérdida de pastizales. La pérdida de aves cuya alimentación es especialista en insectos o en semillas indica una tendencia general hacia comunidades de aves dominadas por aquellas con dietas generalistas.


Assuntos
Aves , Conservação dos Recursos Naturais , Agricultura , Animais , Ecossistema , Europa (Continente) , Dinâmica Populacional
7.
Ecol Appl ; 28(2): 427-441, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29205644

RESUMO

The demography of many European waterbirds is not well understood because most countries have conducted little monitoring and assessment, and coordination among countries on waterbird management has little precedent. Yet intergovernmental treaties now mandate the use of sustainable, adaptive harvest strategies, whose development is challenged by a paucity of demographic information. In this study, we explore how a combination of allometric relationships, fragmentary monitoring and research information, and expert judgment can be used to estimate the parameters of a theta-logistic population model, which in turn can be used in a Markov decision process to derive optimal harvesting strategies. We show how to account for considerable parametric uncertainty, as well as for different management objectives. We illustrate our methodology with a poorly understood population of Taiga Bean Geese (Anser fabalis fabalis), which is a popular game bird in Fennoscandia. Our results for Taiga Bean Geese suggest that they may have demographic rates similar to other, well-studied species of geese, and our model-based predictions of population size are consistent with the limited monitoring information available. Importantly, we found that by using a Markov decision process, a simple scalar population model may be sufficient to guide harvest management of this species, even if its demography is age structured. Finally, we demonstrated how two different management objectives can lead to very different optimal harvesting strategies, and how conflicting objectives may be traded off with each other. This approach will have broad application for European waterbirds by providing preliminary estimates of key demographic parameters, by providing insights into the monitoring and research activities needed to corroborate those estimates, and by producing harvest management strategies that are optimal with respect to the managers' objectives, options, and available demographic information.


Assuntos
Gansos , Modelos Biológicos , Animais , Europa (Continente) , Cadeias de Markov , Dinâmica Populacional
8.
J Anim Ecol ; 87(4): 1034-1045, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29577274

RESUMO

The effects of different environmental drivers on the changes in species' population abundances can be difficult to disentangle as they often act simultaneously. Researchers have built statistical models that include environmental variables (such as annual temperature) or species attributes (such as a species' temperature preference), which are assumed to detect the impacts of specific drivers (such as climate change). However, these approaches are often applied separately or, if combined, not explicitly compared. We show the complementary insights gained by applying both these approaches to a community dataset on Danish terrestrial birds. We use our analysis to compare the relative importance of climate change and agricultural land-use change for the abundance changes within the community between 1983 and 2013. Population models were fitted to the community data of species' annual abundances with predictors comprising: species attributes (species' temperature and habitat preferences), environmental variables (climatic and agricultural land-use change variables) or both. Relationships between species' abundances and environmental variables were used to identify the drivers associated with average abundance changes of species in the community. Relationships between species' abundances and their attributes were used to understand the drivers causing interspecific variation in abundance changes. Warmer winters were positively associated with community-level abundances, and warm-adapted species had more positive abundance changes than cold-adapted ones. Agricultural land-use area was negatively associated with community-level abundances, and birds using a high proportion of meadow and habitat specialists had more negative abundance changes than birds using other habitats and habitat generalists. Effect sizes of environmental variables were larger for agricultural land-use change while those of species attributes were larger for climate change. The environmental data approach suggested that agricultural land-use change has decreased the average abundances of species in the community, affecting total community size while the species attribute-based approach suggested that climate change has caused variation in abundance among species, affecting community composition. Environmental variables and species attributes that are hypothesized to link to specific drivers can be used together to provide complementary information on the impacts of different drivers on communities.


Assuntos
Agricultura/métodos , Aves/fisiologia , Mudança Climática , Características de História de Vida , Animais , Dinamarca , Modelos Estatísticos , Densidade Demográfica
9.
Bioscience ; 67(2): 118-133, 2017 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-28596614

RESUMO

The Kangerlussuaq area of southwest Greenland encompasses diverse ecological, geomorphic, and climate gradients that function over a range of spatial and temporal scales. Ecosystems range from the microbial communities on the ice sheet and moisture-stressed terrestrial vegetation (and their associated herbivores) to freshwater and oligosaline lakes. These ecosystems are linked by a dynamic glacio-fluvial-aeolian geomorphic system that transports water, geological material, organic carbon and nutrients from the glacier surface to adjacent terrestrial and aquatic systems. This paraglacial system is now subject to substantial change because of rapid regional warming since 2000. Here, we describe changes in the eco- and geomorphic systems at a range of timescales and explore rapid future change in the links that integrate these systems. We highlight the importance of cross-system subsidies at the landscape scale and, importantly, how these might change in the near future as the Arctic is expected to continue to warm.

10.
J Anim Ecol ; 85(2): 467-75, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26717445

RESUMO

Demographic links among fragmented populations are commonly studied as source-sink dynamics, whereby source populations exhibit net recruitment and net emigration, while sinks suffer net mortality but enjoy net immigration. It is commonly assumed that large, persistent aggregations of individuals must be sources, but this ignores the possibility that they are sinks instead, buoyed demographically by immigration. We tested this assumption using Bayesian integrated population modelling of Greenland white-fronted geese (Anser albifrons flavirostris) at their largest wintering site (Wexford, Ireland), combining capture-mark-recapture, census and recruitment data collected from 1982 to 2010. Management for this subspecies occurs largely on wintering areas; thus, study of source-sink dynamics of discrete regular wintering units provides unprecedented insights into population regulation and enables identification of likely processes influencing population dynamics at Wexford and among 70 other Greenland white-fronted goose wintering subpopulations. Using results from integrated population modelling, we parameterized an age-structured population projection matrix to determine the contribution of movement rates (emigration and immigration), recruitment and mortality to the dynamics of the Wexford subpopulation. Survival estimates for juvenile and adult birds at Wexford and adult birds elsewhere fluctuated over the 29-year study period, but were not identifiably different. However, per capita recruitment rates at Wexford in later years (post-1995) were identifiably lower than in earlier years (pre-1995). The observed persistence of the Wexford subpopulation was only possible with high rates of immigration, which exceeded emigration in each year. Thus, despite its apparent stability, Wexford has functioned as a sink over the entire study period. These results demonstrate that even large subpopulations can potentially be sinks, and that movement dynamics (e.g. immigration) among winters can dramatically obscure key processes driving subpopulation size. Further, novel population models which integrate capture-mark-recapture, census and recruitment data are essential to correctly ascribing source-sink status and accurately informing development of site-safeguard networks.


Assuntos
Migração Animal , Gansos/fisiologia , Animais , Teorema de Bayes , Irlanda , Modelos Biológicos , Dinâmica Populacional , Estações do Ano
11.
Oecologia ; 181(3): 809-17, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-26995680

RESUMO

Theory predicts persistence of long-term family relationships in vertebrates will occur until perceived fitness costs exceed benefits to either parents or offspring. We examined whether increased breeding probability and survival were associated with prolonged parent-offspring and sibling-sibling relationships in a long-lived Arctic migrant herbivore, the Greenland white-fronted goose (Anser albifrons flavirostris). Although offspring associated with parents for 1-13 years, 79 % of these associations lasted two or less years. Only 65 (9.9 %) of the 656 marked offspring bred once in their lifetime, and just 16 (2.4 %) bred twice or more. The probability of birds with siblings breeding successfully in a subsequent year was credibly greater than that of independent birds at ages 5, 6, and 7. Survival of offspring with parents was credibly greater than that of independent/nonbreeder birds at all possible ages (i.e., ages 2-7+). A cost-benefit matrix model utilizing breeding and survival probabilities showed that staying with family groups was favored over leaving until age 3, after which there were no credible differences between staying and leaving strategies until the oldest ages, when leaving family groups was favored. Thus, most birds in this study either departed family groups early (e.g., at age 2, when the "stay" strategy was favored) or as predicted by our cost-benefit model (i.e., at age 3). Although extended family associations are a feature of this population, we contend that the survival benefits are not sufficient enough to yield clear fitness benefits, and associations only persist because parents and offspring mutually benefit from their persistence.


Assuntos
Gansos , Irmãos , Animais , Cruzamento , Análise Custo-Benefício , Pais
12.
Korean J Parasitol ; 54(5): 685-691, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27853128

RESUMO

Chewing lice (Phthiraptera) that parasitize the globally threatened swan goose Anser cygnoides have been long recognized since the early 19th century, but those records were probably biased towards sampling of captive or domestic geese due to the small population size and limited distribution of its wild hosts. To better understand the lice species parasitizing swan geese that are endemic to East Asia, we collected chewing lice from 14 wild geese caught at 3 lakes in northeastern Mongolia. The lice were morphologically identified as 16 Trinoton anserinum (Fabricius, 1805), 11 Ornithobius domesticus Arnold, 2005, and 1 Anaticola anseris (Linnaeus, 1758). These species are known from other geese and swans, but all of them were new to the swan goose. This result also indicates no overlap in lice species between older records and our findings from wild birds. Thus, ectoparasites collected from domestic or captive animals may provide biased information on the occurrence, prevalence, host selection, and host-ectoparasite interactions from those on wild hosts.


Assuntos
Doenças das Aves/parasitologia , Gansos , Infestações por Piolhos/veterinária , Ftirápteros/anatomia & histologia , Ftirápteros/classificação , Animais , Infestações por Piolhos/parasitologia , Microscopia , Mongólia
13.
Aging Male ; 18(4): 205-6, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26586191

RESUMO

An international expert consensus conference regarding testosterone deficiency (TD) (also known as hypogonadism) and its treatment was held on 1 October 2015, in Prague, Czech Republic. The impetus for this meeting was to address several key scientific issues that have been misunderstood or distorted during the recent intense media attention to this topic. Eighteen experts from 11 countries participated, from the disciplines of urology, endocrinology, andrology, diabetology, and basic science research. The goal was to identify scientific concepts for which there was broad agreement. It was noted that recent public controversies regarding testosterone therapy have been anchored by two retrospective studies reporting increased cardiovascular (CV) risks. Both these studies contained major flaws, and are contradicted by a large body of evidence suggesting CV benefits with testosterone therapy. Other topics discussed included the negative impact of TD on male health; the questionable validity of restrictions on treatment based on age-specific cut-offs, presence of identified underlying conditions, or application of rigid biochemical thresholds; and the lack of evidence regarding prostate cancer risks. Final consensus statements (resolutions) are under development. It is hoped these will serve as a scientific foundation for further discussion, and will thereby reduce misinformation regarding TD and its treatment.


Assuntos
Terapia de Reposição Hormonal , Testosterona/deficiência , Envelhecimento/fisiologia , Doenças Cardiovasculares , República Tcheca , Humanos , Masculino , Neoplasias da Próstata , Estudos Retrospectivos , Medição de Risco
14.
Handb Exp Pharmacol ; 229: 65-80, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26091636

RESUMO

Safety pharmacology is essential throughout the spectrum of drug discovery and development. Prior to first-in-human studies, safety pharmacology assays, tests, and models predict the clinical risk profile of a potential new drug. During clinical development, safety pharmacology can be used to explore--and potentially explain--both predicted and unpredicted side effects (e.g., adverse events, changes in vital signs, abnormal laboratory values) in order to refine the original clinical risk profile. This chapter will introduce the reader to safety pharmacology's role in translational medicine: the science of translating potential drugs' on- and off-target nonclinical properties to clinical consequences in order to select the best drug candidates to move into early clinical testing. Case studies will be used to illustrate the importance of safety pharmacology testing throughout all phases of drug development.


Assuntos
Descoberta de Drogas , Avaliação Pré-Clínica de Medicamentos , Humanos , Segurança , Pesquisa Translacional Biomédica
15.
Vascular ; 23(5): 494-7, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25331071

RESUMO

True infrainguinal vein graft aneurysms are reported infrequently in the literature. We sought to identify the true incidence of these graft aneurysms after popliteal aneurysm repair and identify factors which may increase the risk of such aneurysms developing. Using a prospectively compiled database, we identified patients who underwent a popliteal aneurysm repair between January 1996 and January 2011 at a single district general hospital. Patients were routinely followed up in a graft surveillance programme. Out of 45 patients requiring repair of a popliteal aneurysm over a 15-year period, four (8.8%) patients developed aneurysmal graft disease. Of the patients who developed graft aneurysms, all had aneurysmal disease at other sites compared with 18 (45.0%) patients who did not develop graft aneurysms. Patients with graft aneurysms had a mean of 1.60 aneurysms elsewhere compared to 0.58 in patients with non-aneurysmal grafts (P = 0.005). True vein graft aneurysms occur in a significant number of patients following popliteal aneurysm repair. Our data would suggest this to be more likely in patients who have aneurysms elsewhere and therefore a predisposition to aneurysmal disease. It may be appropriate for patients with aneurysms at other sites to undergo more prolonged post-operative graft surveillance.


Assuntos
Aneurisma/cirurgia , Veia Safena/transplante , Enxerto Vascular/efeitos adversos , Idoso , Aneurisma/diagnóstico , Aneurisma/etiologia , Bases de Dados Factuais , Inglaterra , Feminino , Hospitais de Distrito , Hospitais Gerais , Humanos , Masculino , Reoperação , Estudos Retrospectivos , Fatores de Risco , Veia Safena/diagnóstico por imagem , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia Doppler Dupla
16.
Ann Vasc Surg ; 28(7): 1697-702, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24704851

RESUMO

BACKGROUND: Traditionally, multilevel arterial disease has been treated with an inflow procedure only but simultaneous multilevel bypass graft procedures have been attempted. However, these procedures are potentially high risk. We report our single-center experience of performing multilevel bypass grafts over the last 15 years. METHODS: We retrospectively identified patients undergoing simultaneous aortoiliac and infrainguinal bypasses between January 1996 and January 2011 at a single district general hospital. RESULTS: There were 32 multilevel procedures performed. Indication for surgery was acute ischemia in 10 (31.3%), critical ischemia without tissue loss in 10 (31.3%), with tissue loss in 10 (31.3%), and claudication in 2 (6.3%). In 23 (71.9%) cases inflow was restored using a direct iliofemoral or aortofemoral reconstruction. In the remaining 9 (28.1%), an extra-anatomic bypass was constructed. Two (6.3%) patients died within 30 days of surgery. Twenty-nine (90.6%) patients survived to discharge. Twenty-eight patients (87.5%) were alive 1 year after surgery. Limb salvage was 96.9%, 85.7%, and 75.9% at 30 days, 1 year, and 5 years, respectively. Twelve (37.5%) patients required a total of 19 further ipsilateral vascular procedures. CONCLUSIONS: Our results demonstrate that multilevel bypass procedures can be performed with good long-term outcomes and acceptable mortality, in what is typically a high-risk group with extensive comorbidities. In patients with severe critical limb ischaemia and tissue loss, who have a combination of aortoiliac and infrainguinal disease, there are significant benefits to a primary multilevel grafting procedure.


Assuntos
Arteriopatias Oclusivas/cirurgia , Claudicação Intermitente/cirurgia , Isquemia/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos , Idoso , Aorta Abdominal/cirurgia , Arteriopatias Oclusivas/mortalidade , Feminino , Rejeição de Enxerto , Sobrevivência de Enxerto , Humanos , Artéria Ilíaca/cirurgia , Canal Inguinal/irrigação sanguínea , Claudicação Intermitente/mortalidade , Isquemia/mortalidade , Salvamento de Membro , Extremidade Inferior/irrigação sanguínea , Masculino , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida , Resultado do Tratamento , Grau de Desobstrução Vascular , Procedimentos Cirúrgicos Vasculares/mortalidade
17.
J Nerv Ment Dis ; 202(3): 193-9, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24566504

RESUMO

Depression has been shown to moderate the effects of physical illness self-management (ISM) programs. We attempted to replicate these findings for a mental ISM intervention. Outpatients with serious mental illness (N = 428) from eight Tennessee communities were randomly assigned to receive a peer-led self-management intervention called Building Recovery of Individual Dreams and Goals Through Education and Support or services as usual. Psychiatric symptoms were assessed with the Brief Symptom Inventory; the outcome of personal empowerment was measured by the Empowerment Scale. Intent-to-treat analysis using mixed-effects random regression found significant interaction effects between study condition and three moderating symptom profiles. Empowerment was greater for the intervention participants with high levels of depressive symptoms, anxiety symptoms, and general symptom distress than for the experimental participants with low symptom levels and the control subjects with high or low levels of symptoms. These results shed light on how mental ISM programs operate and ways these can be improved.


Assuntos
Sintomas Comportamentais/terapia , Transtornos Mentais/terapia , Educação de Pacientes como Assunto/métodos , Poder Psicológico , Psicoterapia/métodos , Autocuidado/métodos , Adulto , Ansiedade/terapia , Depressão/terapia , Gerenciamento Clínico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Autocuidado/tendências , Tennessee , Resultado do Tratamento
18.
Biol Rev Camb Philos Soc ; 99(2): 390-408, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37866401

RESUMO

Stoneworts (Charales) are green algae that represent an important food resource for many waterbird species in Europe and elsewhere. Browsing avian herbivores (e.g. swan, goose, duck and coot species) consume Charales plant vegetative parts, by head-dipping, up-ending or diving. A lower fibre content and longer growing season may make Charales as attractive to such herbivores as sympatric submerged higher plant species in some circumstances. Charales respond to environmental stress (e.g. drought) by producing abundant diaspores, in the form of oospores (sexual) and bulbils (asexual), both rich in starch, generating abundant food for waterbirds at critical stages in their annual migratory cycles. Waterbirds feed on these by diving (e.g. common pochard Aythya ferina and red-crested pochard Netta rufina) or by filtering from the water column (e.g. dabbling duck species), ensuring dispersal of sexually produced and vegetative diaspores locally (because of predator swamping) and remotely (through endo- and ectozoochorous dispersal by long-distance migratory waterbirds). Greater invertebrate density and diversity associated with Charales canopies enhances their attractiveness over other submerged macrophyte beds to diving predators [e.g. tufted duck Aythya fuligula, common pochard and Eurasian coot Fulica atra (hereafter coot)]. Fish fry preying on these invertebrates use such vegetation as predator cover, in turn providing prey for avian piscivores such as grebes and cormorants. Abundant Charales contribute to maintaining a transparent water column due to canopy density, nutrient effects, dampening of sedimentation/remobilisation of suspended matter and nutrients and allelopathic effects on other plants (especially phytoplankton). Shallow, relatively eutrophic waters can flip between clear-water high-biodiversity (where Charales thrive) and turbid species-poor depauperate stable states (lacking Charales). Shifts between turbid conditions and rich submerged Charales beds have profound elevating effects on aquatic diversity, to which waterbirds show rapid aggregative responses, making them ideal indicator species of ecological change; in the case of Charales specialists (such as red-crested and common pochard), indicators of the presence and abundance of these plants. Large-bodied colonial nesting birds (e.g. cormorants, gulls, heron and egrets) aggregating along lake shores contribute high N and P loadings to water bodies sensitive to such external and internal inputs and can cause local eutrophication and potential loss of Charales. Despite variation from complete seasonal removal of Charales biomass to undetectable grazing effects by herbivorous birds, evidence suggests little effect of avian grazing on biomass accumulation or the stability of community composition (under otherwise stable conditions), but we urge more research on this under-researched topic. We also lack investigations of the relative foraging profitability of different Charales organs to waterbirds and the degree of viability of gyrogonites (fertilised and calcified oospores), vegetative bulbils and plant fragments after passage through the guts of waterbirds. We especially need to understand better how much the carbonate armour of these organs affects their viability/dispersal via waterbirds and urge more research on these neglected plants and their relationships and interactions with other organisms in the aquatic biota.


Assuntos
Carofíceas , Ecossistema , Animais , Biomassa , Áreas Alagadas , Aves , Água
19.
Pharmaceut Med ; 37(5): 343-347, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37353716

RESUMO

The centralised clinical trial authorisation process, introduced by European Regulation 536/2014, came into force on 31 January 2022. The Regulation is inflexible, both legally and in the technical detail of the authorisation process itself. The principal justification for moving away from the older European Directive 2001/20 seems to be limited to multinational trials: multiple applications to national competent authorities (NCAs), would theoretically be replaced by a single, internationally harmonised authorisation. In fact, the Regulation itself reserves many powers to the NCAs, and the latter, in any case, can lawfully impose further requirements even after that harmonised approval; the year's experience reflects these disadvantages. It would have been better if Regulation 536/2014 had been written to allow the European Medicines Agency greater flexibility, and offered an alternative, optional approach to clinical trial authorisation in the European Union.


Assuntos
Aprovação de Drogas , União Europeia
20.
Sci Total Environ ; 898: 165447, 2023 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-37442460

RESUMO

Spring staging Greater White-fronted Geese Anser albifrons have increasingly shifted from traditional diverse grassland fields to monocultures of winter cereals, causing conflict with farmers. To account for this transition, we tested two key predictions, controlling for goose age effects and sward height. Firstly, that cereal is better quality than grass (based on crude protein content). Secondly, that geese show higher peck rate and step rate on grassland than cereal, enabling them to compensate for lower, less selective intake rates there compared to the uniform, dense, high quality arable sward where all blades are equally of high profitability. Laboratory analyses showed that winter cereal had 27 % higher crude protein content than grass. Based on data extracted from video sequences of spring foraging geese in NE Poland, first-year birds ("immatures") showed significantly higher peck rates and step rates than adults in all situations, likely reflecting their less efficient foraging abilities. Both age classes showed significantly higher peck rates on grass than winter cereal as predicted. Combining differential protein content and lamina length/dry weight relationships of grass versus cereal showed that geese obtained 17-33 % more protein from cereal lamina of the same length. At observed peck rates, this equated to a 6 % greater hourly crude protein intake rate on cereals compared to grass at lamina length 2.5 cm, increasing to 29 % difference at 12.5 cm. Hence, at longer swards, cereals become increasingly profitable for foraging geese over grass swards, despite the higher peck rates observed on grass which failed to compensate for lower lamina quality. We contend that these interactions explain the simultaneous attraction of cereal over grass swards in this study area and likely elsewhere and we discuss the management implications of these findings.

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