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1.
Chromosome Res ; 31(2): 13, 2023 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-37043058

RESUMO

We report the first chromosome-length genome assemblies for three species in the mammalian order Pholidota: the white-bellied, Chinese, and Sunda pangolins. Surprisingly, we observe extraordinary karyotypic plasticity within this order and, in female white-bellied pangolins, the largest number of chromosomes reported in a Laurasiatherian mammal: 2n = 114. We perform the first karyotype analysis of an African pangolin and report a Y-autosome fusion in white-bellied pangolins, resulting in 2n = 113 for males. We employ a novel strategy to confirm the fusion and identify the autosome involved by finding the pseudoautosomal region (PAR) in the female genome assembly and analyzing the 3D contact frequency between PAR sequences and the rest of the genome in male and female white-bellied pangolins. Analyses of genetic variability show that white-bellied pangolins have intermediate levels of genome-wide heterozygosity relative to Chinese and Sunda pangolins, consistent with two moderate declines of historical effective population size. Our results reveal a remarkable feature of pangolin genome biology and highlight the need for further studies of these unique and endangered mammals.


Assuntos
Mamíferos , Pangolins , Animais , Masculino , Feminino , Pangolins/genética , Mamíferos/genética , Genoma , Cromossomos/genética
2.
J Hered ; 115(3): 317-325, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38401156

RESUMO

The Yellow Warbler (Setophaga petechia) is a small songbird in the wood-warbler family (Parulidae) that exhibits phenotypic and ecological differences across a widespread distribution and is important to California's riparian habitat conservation. Here, we present a high-quality de novo genome assembly of a vouchered female Yellow Warbler from southern California. Using HiFi long-read and Omni-C proximity sequencing technologies, we generated a 1.22 Gb assembly including 687 scaffolds with a contig N50 of 6.80 Mb, scaffold N50 of 21.18 Mb, and a BUSCO completeness score of 96.0%. This highly contiguous genome assembly provides an essential resource for understanding the history of gene flow, divergence, and local adaptation in Yellow Warblers and can inform conservation management of this charismatic bird species.


Assuntos
Genoma , Aves Canoras , Animais , Aves Canoras/genética , Feminino , California , Fluxo Gênico
3.
Ecol Lett ; 26(9): 1597-1613, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37419868

RESUMO

Ecosystems function in a series of feedback loops that can change or maintain vegetation structure. Vegetation structure influences the ecological niche space available to animals, shaping many aspects of behaviour and reproduction. In turn, animals perform ecological functions that shape vegetation structure. However, most studies concerning three-dimensional vegetation structure and animal ecology consider only a single direction of this relationship. Here, we review these separate lines of research and integrate them into a unified concept that describes a feedback mechanism. We also show how remote sensing and animal tracking technologies are now available at the global scale to describe feedback loops and their consequences for ecosystem functioning. An improved understanding of how animals interact with vegetation structure in feedback loops is needed to conserve ecosystems that face major disruptions in response to climate and land-use change.


Assuntos
Ecossistema , Tecnologia de Sensoriamento Remoto , Animais , Retroalimentação , Ecologia , Clima , Mudança Climática
4.
Mol Ecol ; 32(9): 2287-2300, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36718952

RESUMO

Accelerating climate change and habitat loss make it imperative that plans to conserve biodiversity consider species' ability to adapt to changing environments. However, in biomes where biodiversity is highest, the evolutionary mechanisms responsible for generating adaptative variation and, ultimately, new species are frequently poorly understood. African rainforests represent one such biome, as decadal debates continue concerning the mechanisms generating African rainforest biodiversity. These debates hinge on the relative importance of geographic isolation versus divergent natural selection across environmental gradients. Hindering progress is a lack of robust tests of these competing hypotheses. Because African rainforests are severely at-risk due to climate change and other anthropogenic activities, addressing this long-standing debate is critical for making informed conservation decisions. We use demographic inference and allele frequency-environment relationships to investigate mechanisms of diversification in an African rainforest skink, Trachylepis affinis, a species inhabiting the gradient between rainforest and rainforest-savanna mosaic (ecotone). We provide compelling evidence of ecotone speciation, in which gene flow has all but ceased between rainforest and ecotone populations, at a level consistent with infrequent hybridization between sister species. Parallel patterns of genomic, morphological, and physiological divergence across this environmental gradient and pronounced allele frequency-environment correlation indicate speciation is mostly probably driven by ecological divergence, supporting a central role for divergent natural selection. Our results provide strong evidence for the importance of ecological gradients in African rainforest speciation and inform conservation strategies that preserve the processes that produce and maintain biodiversity.


Assuntos
Lagartos , Floresta Úmida , Animais , Pradaria , Ecossistema , Frequência do Gene , Biodiversidade , Lagartos/genética , Especiação Genética
5.
Mol Ecol ; 32(20): 5528-5540, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37706673

RESUMO

Understanding the geographic linkages among populations across the annual cycle is an essential component for understanding the ecology and evolution of migratory species and for facilitating their effective conservation. While genetic markers have been widely applied to describe migratory connections, the rapid development of new sequencing methods, such as low-coverage whole genome sequencing (lcWGS), provides new opportunities for improved estimates of migratory connectivity. Here, we use lcWGS to identify fine-scale population structure in a widespread songbird, the American Redstart (Setophaga ruticilla), and accurately assign individuals to genetically distinct breeding populations. Assignment of individuals from the nonbreeding range reveals population-specific patterns of varying migratory connectivity. By combining migratory connectivity results with demographic analysis of population abundance and trends, we consider full annual cycle conservation strategies for preserving numbers of individuals and genetic diversity. Notably, we highlight the importance of the Northern Temperate-Greater Antilles migratory population as containing the largest proportion of individuals in the species. Finally, we highlight valuable considerations for other population assignment studies aimed at using lcWGS. Our results have broad implications for improving our understanding of the ecology and evolution of migratory species through conservation genomics approaches.


Assuntos
Passeriformes , Aves Canoras , Humanos , Animais , Estados Unidos , Migração Animal , Passeriformes/genética , Aves Canoras/genética , Sequenciamento Completo do Genoma , Região do Caribe
6.
J Hered ; 114(1): 44-51, 2023 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-36099176

RESUMO

The tricolored blackbird, Agelaius tricolor, is a gregarious species that forms enormous breeding and foraging colonies in wetland and agricultural habitats, primarily in California, USA. Once extremely abundant, species numbers have declined dramatically in the past century, largely due to losses of breeding and foraging habitats. Tricolored blackbirds are currently listed as Endangered by the IUCN, and Threatened under the California Endangered Species Act. Increased genetic information is needed to detail the evolutionary consequences of a species-wide bottleneck and inform conservation management. Here, we present a contiguous tricolored blackbird reference genome, assembled with PacBio HiFi long reads and Dovetail Omni-C data to generate a scaffold-level assembly containing multiple chromosome-length scaffolds. This genome adds a valuable resource for important evolutionary and conservation research on tricolored blackbirds and related species.


Assuntos
Genoma , Aves Canoras , Aves Canoras/genética , Animais , Conservação dos Recursos Naturais
7.
Ecol Lett ; 24(9): 1848-1858, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34173311

RESUMO

Birds exhibit a remarkable array of seasonal migrations. Despite much research describing migratory behaviour, the underlying forces driving how a species' breeding and wintering populations redistribute each year, that is, migratory connectivity, remain largely unknown. Here, we test the hypothesis that birds migrate in a way that minimises energy expenditure while considering intraspecific competition for energy acquisition, by developing a modelling framework that simulates an optimal redistribution of individuals between breeding and wintering areas. Using 25 species across the Americas, we find that the model accurately predicts empirical migration patterns, and thus offers a general explanation for migratory connectivity based on first ecological and energetic principles. Our model provides a strong basis for exploring additional processes underlying the ecology and evolution of migration, but also a framework for predicting how migration impacts local adaptation across seasons and how environmental change may affect population dynamics in migratory species.


Assuntos
Migração Animal , Aves , Adaptação Fisiológica , Animais , Humanos , Dinâmica Populacional , Estações do Ano
8.
Ecol Lett ; 24(4): 819-828, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33594778

RESUMO

For migratory species, seasonal movements complicate local climate adaptation, as it is unclear whether individuals track climate niches across the annual cycle. In the migratory songbird yellow warbler (Setophaga petechia), we find a correlation between individual-level wintering and breeding precipitation, but not temperature. Birds wintering in the driest regions of the Neotropics breed in the driest regions of North America. Individuals from drier regions also possess distinct morphologies and population responses to varying rainfall. We find a positive association between bill size and breeding season precipitation which, given documented climate-associated genomic variation, might reflect adaptation to local precipitation regimes. Relative abundance in the breeding range is linked to interannual fluctuations in precipitation, but the directionality of this response varies across geography. Together, our results suggest that variation in climate optima may exist across the breeding range of yellow warblers and provide a mechanism for selection across the annual cycle.


Assuntos
Migração Animal , Mudança Climática , Animais , Clima , Variação Genética , Humanos , América do Norte , Estações do Ano
9.
Mol Ecol ; 30(2): 379-390, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33174253

RESUMO

One of the most iconic wild equids, the plains zebra occupies a broad region of sub-Saharan Africa and exhibits a wide range of phenotypic diversity in stripe patterns that have been used to classify multiple subspecies. After decades of relative stability, albeit with a loss of at least one recognized subspecies, the total population of plains zebras has undergone an approximate 25% decline since 2002. Individuals with abnormal stripe patterns have been recognized in recent years but the extent to which their appearance is related to demography and/or genetics is unclear. Investigating population genetic health and genetic structure are essential for developing effective strategies for plains zebra conservation. We collected DNA from 140 plains zebra, including seven with abnormal stripe patterns, from nine locations across the range of plains zebra, and analyzed data from restriction site-associated and whole genome sequencing (RAD-seq, WGS) libraries to better understand the relationships between population structure, genetic diversity, inbreeding, and abnormal phenotypes. We found that genetic structure did not coincide with described subspecific variation, but did distinguish geographic regions in which anthropogenic habitat fragmentation is associated with reduced gene flow and increased evidence of inbreeding, especially in certain parts of East Africa. Further, zebras with abnormal striping exhibited increased levels of inbreeding relative to normally striped individuals from the same populations. Our results point to a genetic cause of stripe pattern abnormalities, and dramatic evidence of the consequences of habitat fragmentation.


Assuntos
Equidae , Endogamia , África Oriental , Animais , Sequência de Bases , Equidae/genética , Variação Genética
10.
Glob Chang Biol ; 27(15): 3519-3531, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33844878

RESUMO

Global loss of biodiversity has placed new urgency on the need to understand factors regulating species response to rapid environmental change. While specialists are often less resilient to rapid environmental change than generalists, species-level analyses may obscure the extent of specialization when locally adapted populations vary in climate tolerances. Until recently, quantification of the degree of climate specialization in migratory birds below the species level was hindered by a lack of genomic and tracking information, but recent technological advances have helped to overcome these barriers. Here we take a genome-wide genetic approach to mapping population-specific migratory routes and quantifying niche breadth within genetically distinct populations of a migratory bird, the willow flycatcher (Empidonax traillii), which exhibits variation in the severity of population declines across its breeding range. While our sample size is restricted to the number of genetically distinct populations within the species, our results support the idea that locally adapted populations of the willow flycatcher with narrow climatic niches across seasons are already federally listed as endangered or in steep decline, while populations with broader climatic niches have remained stable in recent decades. Overall, this work highlights the value of quantifying niche breadth within genetically distinct groups across time and space when attempting to understand the factors that facilitate or constrain the response of locally adapted populations to rapid environmental change.


Assuntos
Migração Animal , Passeriformes , Animais , Biodiversidade , Mudança Climática , Ecossistema , Dinâmica Populacional , Estações do Ano
11.
Proc Biol Sci ; 287(1930): 20200449, 2020 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-32635865

RESUMO

Predicting species' capacity to respond to climate change is an essential first step in developing effective conservation strategies. However, conservation prioritization schemes rarely take evolutionary potential into account. Ecotones provide important opportunities for diversifying selection and may thus constitute reservoirs of standing variation, increasing the capacity for future adaptation. Here, we map patterns of environmentally associated genomic and craniometric variation in the central African rodent Praomys misonnei to identify areas with the greatest turnover in genomic composition. We also project patterns of environmentally associated genomic variation under future climate change scenarios to determine where populations may be under the greatest pressure to adapt. While precipitation gradients influence both genomic and craniometric variation, vegetation structure is also an important determinant of craniometric variation. Areas of elevated environmentally associated genomic and craniometric variation overlap with zones of rapid ecological transition underlining their importance as reservoirs of evolutionary potential. We also find that populations in the Sanaga river basin, central Cameroon and coastal Gabon are likely to be under the greatest pressure from climate change. Lastly, we make specific conservation recommendations on how to protect zones of high evolutionary potential and identify areas where populations may be the most susceptible to climate change.


Assuntos
Mudança Climática , Murinae , Adaptação Fisiológica , Animais , Evolução Biológica , Ecossistema
12.
Conserv Biol ; 34(6): 1482-1491, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32391608

RESUMO

Migratory animals are declining worldwide and coordinated conservation efforts are needed to reverse current trends. We devised a novel genoscape-network model that combines genetic analyses with species distribution modeling and demographic data to overcome challenges with conceptualizing alternative risk factors in migratory species across their full annual cycle. We applied our method to the long distance, Neotropical migratory bird, Wilson's Warbler (Cardellina pusilla). Despite a lack of data from some wintering locations, we demonstrated how the results can be used to help prioritize conservation of breeding and wintering areas. For example, we showed that when genetic, demographic, and network modeling results were considered together it became clear that conservation recommendations will differ depending on whether the goal is to preserve unique genetic lineages or the largest number of birds per unit area. More specifically, if preservation of genetic lineages is the goal, then limited resources should be focused on preserving habitat in the California Sierra, Basin Rockies, or Coastal California, where the 3 most vulnerable genetic lineages breed, or in western Mexico, where 2 of the 3 most vulnerable lineages overwinter. Alternatively, if preservation of the largest number of individuals per unit area is the goal, then limited conservation dollars should be placed in the Pacific Northwest or Central America, where densities are estimated to be the highest. Overall, our results demonstrated the utility of adopting a genetically based network model for integrating multiple types of data across vast geographic scales and better inform conservation decision-making for migratory animals.


Un Modelo de Redes de Panorama Poblacional para la Priorización de la Conservación de un Ave Migratoria Resumen Los animales migratorios están pasando por una declinación mundial y se requieren esfuerzos coordinados de conservación para revertir las tendencias actuales. Diseñamos un modelo novedoso de redes de panorama poblacional que combina el análisis genético con el modelado de la distribución de especies y los datos demográficos para sobreponerse a los obstáculos con la conceptualización de los factores alternativos de riesgo en las especies migratorias durante su ciclo anual completo. Aplicamos nuestro método al chipe de corona negra (Cardellina pusilla), un ave migratoria neotropical que recorre largas distancias. A pesar de la falta de datos de algunas localidades de invernación, mostramos cómo pueden usarse los resultados para ayudar a priorizar la conservación de las áreas de reproducción y de invernación. Por ejemplo, mostramos que cuando se consideraron en conjunto los resultados del modelado genético, demográfico y de redes queda claro que las recomendaciones de conservación diferirán dependiendo de si el objetivo es preservar linajes genéticos únicos o el mayor número de aves por unidad de área. Más específicamente, si el objetivo es la conservación de los linajes genéticos, entonces los recursos limitados deberían enfocarse en preservar el hábitat en la Sierra de California, la Cuenca de las Rocallosas, la costa de California (lugares en donde se reproducen los tres linajes genéticos más vulnerables) o en el oeste de México (en donde dos de los tres linajes más vulnerables pasan el invierno). Alternativamente, si el objetivo es la conservación del mayor número de individuos por unidad de área, entonces el financiamiento limitado debería aplicarse en el noroeste del Pacífico o en América Central, en donde se estima que las densidades poblacionales son las más altas. En general, nuestros resultados demostraron la utilidad de adoptar un modelo de redes basadas en la genética para la integración de datos a lo largo de escalas geográficas amplias y para informar de mejor manera la toma de decisiones de conservación para los animales migratorios.


Assuntos
Migração Animal , Conservação dos Recursos Naturais , Animais , Aves/genética , América Central , México , Noroeste dos Estados Unidos , Estações do Ano
13.
Phys Rev Lett ; 122(16): 166802, 2019 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-31075009

RESUMO

The thermoelectric (TE) properties of a material are dramatically altered when electron-electron interactions become the dominant scattering mechanism. In the degenerate hydrodynamic regime, the thermal conductivity is reduced and becomes a decreasing function of the electronic temperature, due to a violation of the Wiedemann-Franz law. We here show how this peculiar temperature dependence gives rise to new striking TE phenomena. These include an 80-fold increase in TE efficiency compared to the Wiedemann-Franz regime, dramatic qualitative changes in the steady state temperature profile, and an anomalously large Thomson effect. In graphene, which we pay special attention to here, these effects are further amplified due to a doubling of the thermopower.

14.
Ecol Lett ; 21(7): 1085-1096, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29745027

RESUMO

Few regions have been more severely impacted by climate change in the USA than the Desert Southwest. Here, we use ecological genomics to assess the potential for adaptation to rising global temperatures in a widespread songbird, the willow flycatcher (Empidonax traillii), and find the endangered desert southwestern subspecies (E. t. extimus) most vulnerable to future climate change. Highly significant correlations between present abundance and estimates of genomic vulnerability - the mismatch between current and predicted future genotype-environment relationships - indicate small, fragmented populations of the southwestern willow flycatcher will have to adapt most to keep pace with climate change. Links between climate-associated genotypes and genes important to thermal tolerance in birds provide a potential mechanism for adaptation to temperature extremes. Our results demonstrate that the incorporation of genotype-environment relationships into landscape-scale models of climate vulnerability can facilitate more precise predictions of climate impacts and help guide conservation in threatened and endangered groups.


Assuntos
Mudança Climática , Genômica , Aves Canoras , Adaptação Fisiológica , Animais , Ecologia , Espécies em Perigo de Extinção , Aves Canoras/genética
16.
Conserv Biol ; 32(1): 148-158, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28631859

RESUMO

Understanding the environmental contributors to population structure is of paramount importance for conservation in urbanized environments. We used spatially explicit models to determine genetic population structure under current and future environmental conditions across a highly fragmented, human-dominated environment in Southern California to assess the effects of natural ecological variation and urbanization. We focused on 7 common species with diverse habitat requirements, home-range sizes, and dispersal abilities. We quantified the relative roles of potential barriers, including natural environmental characteristics and an anthropogenic barrier created by a major highway, in shaping genetic variation. The ability to predict genetic variation in our models differed among species: 11-81% of intraspecific genetic variation was explained by environmental variables. Although an anthropogenically induced barrier (a major highway) severely restricted gene flow and movement at broad scales for some species, genetic variation seemed to be primarily driven by natural environmental heterogeneity at a local level. Our results show how assessing environmentally associated variation for multiple species under current and future climate conditions can help identify priority regions for maximizing population persistence under environmental change in urbanized regions.


Assuntos
Conservação dos Recursos Naturais , Genética Populacional , California , Ecossistema , Fluxo Gênico , Variação Genética , Humanos
17.
Proc Natl Acad Sci U S A ; 112(46): 14290-4, 2015 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-26578774

RESUMO

Since its introduction to North America in 1999, West Nile virus (WNV) has had devastating impacts on native host populations, but to date these impacts have been difficult to measure. Using a continental-scale dataset comprised of a quarter-million birds captured over nearly two decades and a recently developed model of WNV risk, we estimated the impact of this emergent disease on the survival of avian populations. We find that populations were negatively affected by WNV in 23 of the 49 species studied (47%). We distinguished two groups of species: those for which WNV negatively impacted survival only during initial spread of the disease (n = 11), and those that show no signs of recovery since disease introduction (n = 12). Results provide a novel example of the taxonomic breadth and persistent impacts of this wildlife disease on a continental scale. Phylogenetic analyses further identify groups (New World sparrows, finches, and vireos) disproportionally affected by temporary or persistent WNV effects, suggesting an evolutionary dimension of disease risk. Identifying the factors affecting the persistence of a disease across host species is critical to mitigating its effects, particularly in a world marked by rapid anthropogenic change.


Assuntos
Doenças das Aves , Evolução Molecular , Filogenia , Febre do Nilo Ocidental , Vírus do Nilo Ocidental/genética , Animais , Doenças das Aves/epidemiologia , Doenças das Aves/genética , Doenças das Aves/virologia , Aves , Humanos , América do Norte/epidemiologia , Febre do Nilo Ocidental/epidemiologia , Febre do Nilo Ocidental/genética , Febre do Nilo Ocidental/veterinária
18.
Mol Ecol ; 26(19): 4966-4977, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28752944

RESUMO

The little greenbul, a common rainforest passerine from sub-Saharan Africa, has been the subject of long-term evolutionary studies to understand the mechanisms leading to rainforest speciation. Previous research found morphological and behavioural divergence across rainforest-savannah transition zones (ecotones), and a pattern of divergence with gene flow suggesting divergent natural selection has contributed to adaptive divergence and ecotones could be important areas for rainforests speciation. Recent advances in genomics and environmental modelling make it possible to examine patterns of genetic divergence in a more comprehensive fashion. To assess the extent to which natural selection may drive patterns of differentiation, here we investigate patterns of genomic differentiation among populations across environmental gradients and regions. We find compelling evidence that individuals form discrete genetic clusters corresponding to distinctive environmental characteristics and habitat types. Pairwise FST between populations in different habitats is significantly higher than within habitats, and this differentiation is greater than what is expected from geographic distance alone. Moreover, we identified 140 SNPs that showed extreme differentiation among populations through a genomewide selection scan. These outliers were significantly enriched in exonic and coding regions, suggesting their functional importance. Environmental association analysis of SNP variation indicates that several environmental variables, including temperature and elevation, play important roles in driving the pattern of genomic diversification. Results lend important new genomic evidence for environmental gradients being important in population differentiation.


Assuntos
Ecossistema , Genética Populacional , Aves Canoras/genética , África Central , Animais , Fluxo Gênico , Polimorfismo de Nucleotídeo Único , Seleção Genética , Transcriptoma
19.
Ann Emerg Med ; 69(1): 12-17, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27238825

RESUMO

STUDY OBJECTIVE: We compare received minute volume with an intraoral mask versus conventional cuffed face mask among medics obtaining a 1-handed mask seal on a cadaver model. METHODS: This study comprised a randomized crossover trial of adult US Army combat medic volunteers participating in a cadaver laboratory as part of their training. We randomized participants to obtain a 1-handed mask seal during ventilation of a fresh unembalmed cadaver, first using either an intraoral airway device or conventional cuffed face mask. Participants obtained a 1-handed mask seal while a ventilator delivered 10 standardized 750-mL breaths during 1 minute. After a 5-minute rest period, they repeated the study with the alternative mask. The primary outcome measure was received minute volume as measured by a respirometer. RESULTS: Of 27 recruited participants, all completed the study. Median received minute volume was higher with the intraoral mask compared with conventional cuffed mask by 1.7 L (95% confidence interval 1.0 to 1.9 L; P<.001). CONCLUSION: The intraoral mask resulted in greater received minute volume received compared with conventional cuffed face mask during ventilation with a 1-handed mask seal in a cadaver model. The intraoral mask may prove a useful airway adjunct for ventilation.


Assuntos
Máscaras Laríngeas , Respiração Artificial/métodos , Cadáver , Estudos Cross-Over , Humanos , Masculino , Respiração Artificial/instrumentação
20.
Am J Emerg Med ; 35(8): 1111-1117, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28343815

RESUMO

OBJECTIVE: We evaluated a soft tissue oxygen saturation (Sto2) measurement at triage for predicting admission to the hospital in adults presenting to the emergency department (ED) in addition to data routinely gathered at triage. METHODS: This was a prospective, observational, single center study of adults presenting to the ED for evaluation. Research assistants obtained thenar eminence Sto2 measurements on subjects in ED triage. ED providers not involved in the study then made all management and disposition decisions. We prospectively collected data on each subject's final ED disposition (admission versus discharge). We identified the optimal Sto2 cutoff value for predicting admission. We then used logistic regression modeling to describe the added predictive value of Sto2 beyond routinely collected triage data including Emergency Severity Index level, age, and vital signs. RESULTS: We analyzed 2588 adult (>17years) subjects with 743 subjects (28.7%) admitted to the hospital. Sto2<76% was the optimal diagnostic cutoff for predicting admission. Of subjects with Sto2<76%, 158 of 384 (41.1%) underwent admission versus 585 of 2204 (26.5%) subjects with Sto2≥76. After controlling for age, vital signs, and ESI level in the logistic regression analysis, Sto2<76% had an odds ratio of 1.54 (95% confidence interval (CI), 1.19 to 1.98) for predicting admission. CONCLUSIONS: Sto2 may provide additional prognostic data to routine triage assessment regarding the disposition for undifferentiated adult patients presenting to the ED.


Assuntos
Estado Terminal/terapia , Serviço Hospitalar de Emergência , Hospitalização/estatística & dados numéricos , Oximetria , Triagem/métodos , Adulto , Idoso , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Oximetria/métodos , Consumo de Oxigênio , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Curva ROC , Índice de Gravidade de Doença , Espectroscopia de Luz Próxima ao Infravermelho , Estados Unidos
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