RESUMO
Understanding the socioeconomic drivers of biological invasion informs policy development for curtailing future invasions. While early 20th-century plant trade expansions preceded increased establishments of plant pests in Northern America, increased establishments did not follow accelerating imports later that century. To explore this puzzle, we estimate the historical establishment of plant-feeding Hemiptera in Northern America as a function of historical U.S. imports of live plants from seven world regions. Delays between establishment and discovery are modeled using a previously unused proxy for dynamic discovery effort. By recovering the timing of pest arrivals from their historical discoveries, we disentangle the joint establishment-discovery process. We estimate long delays to discovery, which are partially attributable to the low detectability of less economically important insect species. We estimate that many introduced species remain undiscovered, ranging from around one-fifth for Eurasian regions to two-fifths for Central and South America.
RESUMO
PURPOSE: To describe the characteristics and outcomes of endogenous endophthalmitis. DESIGN: Retrospective case series. PARTICIPANTS: Patients with endogenous endophthalmitis. METHODS: A retrospective chart review of patients diagnosed with endogenous endophthalmitis between September 1, 2006, and November 1, 2014. MAIN OUTCOME MEASURES: Clinical findings, treatments, microbial results, visual outcomes, and secondary ocular sequelae. RESULTS: Sixty-three patients (68 eyes) were diagnosed with endogenous endophthalmitis. Ocular symptoms were the first manifestation of disease in 76% of patients. Fungal and bacterial endophthalmitis were seen in 37% (n = 25) and 43% (n = 29) of eyes, respectively. In 47% of eyes (n = 32), the disease was associated with intravenous drug use. Eighteen percent of eyes (n = 12) underwent an initial pars plana vitrectomy (PPV) with intravitreal antibiotics, none of which required a secondary intervention for acute infection. Four percent of eyes (n = 3) received only systemic treatment. Seventy-eight percent of eyes (n = 53) underwent initial bedside aspirate with intravitreal injection of antibiotics (tap-and-injection), of which 55% (n = 29) required a secondary PPV. Of eyes that underwent secondary PPV after initially negative culture results from the tap-and-injection, 52% demonstrated positive culture results at the time of secondary PPV (n = 11/21) despite all but 1 having received appropriate antimicrobial coverage initially. Fifty-four percent of eyes (n = 37) experienced secondary ocular sequelae. Eyes that received initial tap-and-injection had statistically nonsignificant better average initial vision, but worse average vision at each follow-up interval, compared to PPV while being less likely to gain 2 lines or more of vision at every follow-up interval except 6 months, with the difference reaching statistical significance at 1 week (odds ratio = 0.014; P = 0.037). Eyes that underwent initial tap-and-injection were statistically significantly more likely to require a secondary PPV (55% vs. 0%; P = 0.0006) and had fewer positive microbial results (19% vs. 67%) than those that underwent initial PPV (P = 0.002). CONCLUSIONS: Most eyes that received initial tap-and-injection eventually underwent a secondary PPV. Initial PPV may have an important role in management because it was associated with better diagnostic yield and a trend toward better visual outcomes.