Preventing extinction in an age of species migration and planetary change.

International and national conservation policies almost exclusively focus on conserving species in their historic native ranges, thus excluding species that have been introduced by people and some of those that have extended their ranges on their own accord. Given that many of such migrants are threatened in their native ranges, conservation goals that explicitly exclude these populations may overlook opportunities to prevent extinctions and respond dynamically to rapidly changing environmental and climatic conditions. Focusing on terrestrial mammals, we quantified the number of threatened mammals that have established new populations through assisted migration (i.e., introduction). We devised 4 alternative scenarios for the inclusion of assisted-migrant populations in mainstream conservation policy with the aim of preventing global species extinctions. We then used spatial prioritization algorithms to simulate how these scenarios could change global spatial conservation priorities. We found that 22% (70 species out of 265) of all identified assisted-migrant mammals were threatened in their native ranges, mirroring the 25% of all mammals that are threatened. Reassessing global threat statuses by combining native and migrant ranges reduced the threat status of 23 species (∼33% of threatened assisted migrants). Thus, including migrant populations in threat assessments provides a more accurate assessment of actual global extinction risk among species. Spatial prioritization simulations showed that reimagining the role of assisted-migrant populations in preventing species extinction could increase the importance of overlooked landscapes, particularly in central Australia, Europe, and the southwestern United States. Our results indicated that these various and nonexhaustive ways to consider assisted-migrant populations, with due consideration of potential conservation conflicts with resident taxa, may provide unprecedented opportunities to prevent species extinctions.

Prevención de la extinción en una época de migración de especies y cambios planetarios Resumen Las políticas de conservación nacionales e internacionales casi siempre se enfocan en la conservación de las especies dentro de su distribución histórica y nativa, por lo que se excluyen especies que han sido introducidas por el humano y algunas que se han extendido por cuenta propia más allá de su distribución. Ya que muchas de estas especies migrantes están amenazadas dentro de su distribución nativa, los objetivos de conservación que excluyen explícitamente a estas poblaciones pueden ignorar las oportunidades para prevenir extinciones y responder de forma dinámica a las condiciones ambientales y climáticas que cambian con rapidez. Nos enfocamos en los mamíferos terrestres para cuantificar el número de especies amenazadas que han establecido poblaciones nuevas mediante la migración asistida (introducción). Diseñamos cuatro escenarios alternativos para la inclusión de las poblaciones con migración asistida dentro de las políticas de conservación generales con el objetivo de prevenir extinciones globales de especies. Después usamos algoritmos de priorización espacial para simular cómo estos escenarios podrían cambiar las prioridades de conservación espacial en todo el mundo. Descubrimos que el 22% (70 de 765 especies) de todos los mamíferos con migración asistida están amenazados dentro de su distribución nativa, lo que es similar al 25% de especies amenazadas de todas las especies de mamíferos. La reevaluación de los estados mundiales de amenaza mediante la combinación de la distribución nativa y migrante redujo el estado de amenaza de 23 especies (∼33% de los migrantes asistidos amenazados). Por esto, incluir a las poblaciones migrantes en la evaluación de amenazas proporciona una evaluación más certera del riesgo de extinción que existe entre las especies a nivel mundial. Las simulaciones de priorización espacial mostraron que reinventar el papel que tienen las poblaciones con migración asistida en la prevención de la extinción de especies podría incrementar la importancia de los paisajes ignorados, particularmente en Australia central, Europa y el suroeste de los Estados Unidos. Nuestros resultados indican que estas maneras diversas y no exhaustivas de considerar a las poblaciones con migración asistida, con la debida consideración de los potenciales conflictos de conservación con los taxones residentes, puede proporcionar oportunidades sin precedentes para prevenir la extinción de las especies.

Valuing the contributions of non-native species to people and nature.

While decision-making can benefit from considering positive and negative outcomes of change, over the past half-century, research on non-native species has focused predominately on their negative impacts. Here we provide a framework for considering the positive consequences of non-native species relative to relational, instrumental, and intrinsic values. We demonstrate that their beneficial outcomes are common and profoundly important for human well-being. Identified benefits include social cohesion, cultural identity, mental health, food and fuel production, regulation of clean waters, and attenuation of climate change. We argue that long-standing biases against non-native species within the literature have clouded the scientific process and hampered policy advances and sound public understanding. Future research should consider both costs and benefits of non-native species.

Misleading estimates of economic impacts of biological invasions: Including the costs but not the benefits.

The economic costs of non-indigenous species (NIS) are a key factor for the allocation of efforts and resources to eradicate or control baneful invasions. Their assessments are challenging, but most suffer from major flaws. Among the most important are the following: (1) the inclusion of actual damage costs together with various ancillary expenditures which may or may not be indicative of the real economic damage due to NIS; (2) the inclusion of the costs of unnecessary or counterproductive control initiatives; (3) the inclusion of controversial NIS-related costs whose economic impacts are questionable; (4) the assessment of the negative impacts only, ignoring the positive ones that most NIS have on the economy, either directly or through their ecosystem services. Such estimates necessarily arrive at negative and often highly inflated values, do not reflect the net damage and economic losses due to NIS, and can significantly misguide management and resource allocation decisions. We recommend an approach based on holistic costs and benefits that are assessed using likely scenarios and their counter-factual.

Predictors of blood loss in lung transplant surgery-a single center retrospective cohort analysis.

BACKGROUND: This retrospective study aims to identify clinical predictors of intraoperative blood loss during lung transplantation. While for other surgical specialties predictors of blood loss have been identified such as previous likewise located surgery, poor preoperative health status of patients, blood coagulation status, and use of extra corporeal circulation, predictors of blood loss during lung transplantation are not yet established. METHODS: A total of 326 lung transplants were performed between January 2000 and February 2014 at a tertiary hospital. The primary aim was to associate blood loss with the following potential predictors: pulmonary arterial hypertension, pre- or intraoperative extracorporeal life support (ECLS), previous thoracic surgery, previous lung transplant, and Charlson Comorbidity Index (CCI). Postoperative complications and 30-day mortality were secondary endpoints of the study. RESULTS: Median estimated blood loss during lung transplant was 1,500 mL (IQR, 1,000-2,875 mL). Pre- and intraoperative ECLS (P=0.02, P<0.001) independently increased blood loss by 59% and 107%, respectively. The higher blood loss during re-transplant marginally missed the significance level (P=0.05). Pulmonary arterial hypertension, previous thoracic surgery and high CCI were not associated with increased blood loss. As secondary outcomes, postoperative complications were more common in patients with a higher blood loss (P=0.04) but was not associated with higher 30-day mortality (P=0.18). CONCLUSIONS: Pre- and intraoperative ECLS were significant risk factors for higher blood loss during lung transplantation. Higher blood loss was associated with higher incidence of postoperative complications but not with a higher 30-day mortality.

Tracheal intubation with channeled vs. non-channeled videolaryngoscope blades.

STUDY OBJECTIVE: Videolaryngoscopes can be fitted either with channeled or non-channeled blades, which may result in a different performance and success of tracheal intubation. We investigated the characteristics of the two different blade types of the commercially available KingVision™ videolaryngoscope. DESIGN: A prospective, randomized, single center investigation study in a urological operation unit of a tertiary hospital. SUBJECTS AND METHODS: Forty adult patients undergoing elective urological surgery in general anaesthesia with tracheal intubation were randomly allocated into group 1 (channeled videolaryngoscopy, n = 20) and group 2 (non-channeled videolaryngoscopy, n = 20). We measured the times from laryngoscope insertion to recognize the glottis and to conclude tracheal intubation. The number of laryngoscopy/intubation attempts and the degree of visual glottis exposure on a visual analog scale from 0 (glottis not visible) to 10 (glottis fully visible) was assessed. The lowest SpO2 value during airway management was recorded. RESULTS: There was no statistically significant difference in biometric data between the 2 groups. The time from the laryngoscope insertion to glottis recognition with the non-channeled blades was 5 (4-8) s as compared to the channeled ones with 11 (7-14) s (median and range; p = 0.01). Intubation duration was shorter with the channeled blades 17 (12-27) s vs. 29 (25-51) s (median and range; p < 0.001). Number of laryngoscopy/intubation attempts, grades for glottis visibility, intubation difficulty were not different. The lowest SpO2 was 98% in both groups. CONCLUSIONS: Videolaryngoscopic glottis recognition time was longer and the total time to secure the airway was shorter with the channeled blades.

On the importance of monitoring and valuing all forms of biodiversity.

Pauchard et al claim that non-native species should not be granted conservation value, as this could hinder effort to curtail novel introductions. In this response, Schlaepfer counters that the positive contributions of non-native species to biodiversity and conservation must be included to provide a complete and objective snapshot to policy makers.

Established and potential predictors of blood loss during lung transplant surgery.

Lung transplantation is an established therapeutic procedure for end stage lung diseases. Its success may be impaired by perioperative complications. Intraoperative blood loss and the resulting blood transfusion are among the most common complications. The various factors contributing to increased blood loss during lung transplantation are only scarcely investigated and not yet completely understood. This is in sharp contrast to other surgical fields, as in orthopedic surgery, liver transplantation and cardiac surgery the contributors to blood loss are well identified. This narrative review article aims to highlight the acknowledged factors influencing blood loss in lung transplantation (such as double vs. single lung transplant) and to discuss potential factors that may be of interest for further research or helpful to develop strategies targeting risk factors in order to minimize blood loss during lung transplantation and finally improve patient outcome.

Do non-native species contribute to biodiversity?

The Convention on Biological Diversity (CBD) emphasises the role of biodiversity in delivering benefits essential for all people and, as a result, seeks to safeguard all life-forms. The indices that are used to measure progress towards international conservation and sustainability goals, however, focus solely on the 'native' component of biodiversity. A subset of non-native species can cause undesirable economic, social, or biological effects. But non-native species also contribute to regional biodiversity (species richness and biotic interactions) and ecosystem services. In some regions and cities, non-native species make up more than half of all species. Currently, the contributions of these species to biodiversity and ecosystem services are overlooked. Here, I argue that biodiversity and sustainability indices should include all species. This is not only consistent with definitions of biodiversity but also will promote the idea that long-term, sustainable, human well-being is intricately tied to benefits derived from nature.

C-MAC videolaryngoscope compared with direct laryngoscopy for rapid sequence intubation in an emergency department: A randomised clinical trial.

BACKGROUND: Airway management in the emergency room can be challenging when patients suffer from life-threatening conditions. Mental stress, ignorance of the patient's medical history, potential cervical injury or immobilisation and the presence of vomit and/or blood may also contribute to a difficult airway. Videolaryngoscopes have been introduced into clinical practice to visualise the airway and ultimately increase the success rate of airway management. OBJECTIVE: The aim of this study was to test the hypothesis that the C-MAC videolaryngoscope improves first-attempt intubation success rate compared with direct laryngoscopy in patients undergoing emergency rapid sequence intubation in the emergency room setting. DESIGN: A randomised clinical trial. SETTING: Emergency Department of the University Hospital, Zurich, Switzerland. PATIENTS: With approval of the local ethics committee, we prospectively enrolled 150 patients between 18 and 99 years of age requiring emergency rapid sequence intubation in the emergency room of the University Hospital Zurich. Patients were randomised (1 : 1) to undergo tracheal intubation using the C-MAC videolaryngoscope or by direct laryngoscopy. INTERVENTIONS: Owing to ethical considerations, patients who had sustained maxillo-facial trauma, immobilised cervical spine, known difficult airway or ongoing cardiopulmonary resuscitation were excluded from our study. All intubations were performed by one of three very experienced anaesthesia consultants. MAIN OUTCOME MEASURES: First-attempt success rate served as our primary outcome parameter. Secondary outcome parameters were time to intubation; total number of intubation attempts; Cormack and Lehane score; inadvertent oesophageal intubation; ease of intubation; complications including violations of the teeth, injury/bleeding of the larynx/pharynx and aspiration/regurgitation of gastric contents; necessity of using further alternative airway devices for successful intubation; maximum decrease of oxygen saturation and technical problems with the device. RESULTS: A total of 150 patients were enrolled, but three patients had to be excluded from the analysis, resulting in 74 patients in the C-MAC videolaryngoscopy group and 73 patients in the direct laryngoscopy group. Tracheal intubation was achieved successfully at the first attempt in 73 of 74 patients in the C-MAC group and all patients in the direct laryngoscopy group (P = 1.0). Time to intubation was similar (32 ±â€Š11 vs. 31 ±â€Š9 s, P = 0.51) in both groups. Visualisation of the vocal cords, represented as the Cormack and Lehane score, was significantly better using the C-MAC videolaryngoscope (P < 0.001). CONCLUSION: Our study demonstrates that visualisation of the vocal cords was improved by using the C-MAC videolaryngoscope compared with direct laryngoscopy. Better visualisation did not improve first-attempt success rate, which in turn was probably based on the high level of experience of the participating anaesthesia consultants. TRIAL REGISTRATION: Clinicaltrials.gov identifier NCT02297113.

Advanced airway management in an anaesthesiologist-staffed Helicopter Emergency Medical Service (HEMS): A retrospective analysis of 1047 out-of-hospital intubations.

INTRODUCTION: Airway management in the out-of-hospital emergency setting is challenging. Failed and even prolonged airway management is associated with serious clinical consequences, such as desaturation, bradycardia, airway injuries, or aspiration. The overall success rate of tracheal intubation ranges between 77% and 99%, depending on the level of experience of the provider. Therefore, advanced airway management should only be performed by highly-skilled and experienced providers. METHODS: 9765 patients were treated in the out-of-hospital emergency setting by the anaesthesiologist-staffed Helicopter Emergency Medical Services (HEMS) between 2002 and 2014. Patients successfully intubated upon the first attempt were compared to patients who required more than one intubation attempts regarding several potential confounding factors such as age, gender, on-going CPR, NACA Score, initial GCS, prior administration of anaesthetic drugs, neuromuscular blocking agents, and vasopressors. RESULTS: 1573 out of 9765 patients (16.1%) required advanced airway management. 459 patients had already been intubated upon arrival of the HEMS, whereas 1114 patients (11.4%) underwent advanced airway management by the HEMS physician. 67 patients had to be excluded. Data for the remaining 1047 patients (790 males and 257 females) were analyzed further. Primary use of an alternative airway device was reported in 59 patients (5.6%), whereas 988 patients (94.4%) underwent laryngoscopy-guided tracheal intubation. 952 patients (96.4%) could be intubated upon the first attempt and overall intubation success was 99.5% (983 out of 988). CONCLUSION: Our study demonstrates that HEMS physicians performed airway management frequently and that both the first attempt as well as the overall success rate of tracheal intubation was high. Together with the fact that all failed and difficult intubations were successfully recognized and handled and that no surgical airway had to be established, the current study once more underlines the importance of proper training of HEMS care providers regarding airway management.

Hands-Off Time for Endotracheal Intubation during CPR Is Not Altered by the Use of the C-MAC Video-Laryngoscope Compared to Conventional Direct Laryngoscopy. A Randomized Crossover Manikin Study.

INTRODUCTION: Sufficient ventilation and oxygenation through proper airway management is essential in patients undergoing cardio-pulmonary resuscitation (CPR). Although widely discussed, securing the airway using an endotracheal tube is considered the standard of care. Endotracheal intubation may be challenging and causes prolonged interruption of chest compressions. Videolaryngoscopes have been introduced to better visualize the vocal cords and accelerate intubation, which makes endotracheal intubation much safer and may contribute to intubation success. Therefore, we aimed to compare hands-off time and intubation success of direct laryngoscopy with videolaryngoscopy (C-MAC, Karl Storz, Tuttlingen, Germany) in a randomized, cross-over manikin study. METHODS: Twenty-six anesthesia residents and twelve anesthesia consultants of the University Hospital Zurich were recruited through a voluntary enrolment. All participants performed endotracheal intubation using direct laryngoscopy and C-MAC in a random order during ongoing chest compressions. Participants were strictly advised to stop chest compression only if necessary. RESULTS: The median hands-off time was 1.9 seconds in direct laryngoscopy, compared to 3 seconds in the C-MAC group. In direct laryngoscopy 39 intubation attempts were recorded, resulting in an overall first intubation attempt success rate of 97%, compared to 38 intubation attempts and 100% overall first intubation attempt success rate in the C-MAC group. CONCLUSION: As a conclusion, the results of our manikin-study demonstrate that video laryngoscopes might not be beneficial compared to conventional, direct laryngoscopy in easily accessible airways under CPR conditions and in experienced hands. The benefits of video laryngoscopes are of course more distinct in overcoming difficult airways, as it converts a potential "blind intubation" into an intubation under visual control.

Evaluation of six different airway devices regarding regurgitation and pulmonary aspiration during cardio-pulmonary resuscitation (CPR) - A human cadaver pilot study.

BACKGROUND: Chest compressions and ventilation are lifesaving tasks during cardio-pulmonary resuscitation (CPR). Besides oxygenation, endotracheal intubation (ETI) during CPR is performed to avoid aspiration of gastric contents. If intubation is difficult or impossible, supraglottic airway devices are utilized. We tested six different airway devices regarding their potential to protect against regurgitation and aspiration during CPR in a randomized experimental human cadaver study. METHODS: Five-hundred ml of 0.01% methylene-blue-solution were instilled into the stomach of 30 adult human cadavers via an oro-gastric tube. The cadavers were then randomly assigned to one of six groups, resulting in 5 cadavers in each group. Airway management was performed with either bag-valve ventilation, Laryngeal Tube, EasyTube, Laryngeal Mask (Classic), I-Gel, or ETI. Thereafter 5min of CPR were performed according to the 2010 Guidelines of the European Resuscitation Council. Pulmonary aspiration was defined as the presence of methylene-blue-solution below the vocal cords or the ETI cuff as assessed by fiber-optic bronchoscopy. RESULTS: Thirty cadavers were included (14 females, 16 males). Aspiration was detected in three out of five cadavers receiving bag-valve ventilation and in two out of five intubated with LMA or I-Gel. In cadavers intubated with the LT, aspiration occurred in one out of five cases. No aspiration could be detected in cadavers intubated with ETI and EasyTube. CONCLUSION: This study provides experimental evidence that, during CPR, ETI offers superior protection against regurgitation and pulmonary aspiration of gastric contents than supraglottic airway devices or bag-valve ventilation.

Nothing a hot bath won't cure: infection rates of amphibian chytrid fungus correlate negatively with water temperature under natural field settings.

Dramatic declines and extinctions of amphibian populations throughout the world have been associated with chytridiomycosis, an infectious disease caused by the pathogenic chytrid fungus Batrachochytrium dendrobatidis (Bd). Previous studies indicated that Bd prevalence correlates with cooler temperatures in the field, and laboratory experiments have demonstrated that Bd ceases growth at temperatures above 28°C. Here we investigate how small-scale variations in water temperature correlate with Bd prevalence in the wild. We sampled 221 amphibians, including 201 lowland leopard frogs (Rana [Lithobates] yavapaiensis), from 12 sites in Arizona, USA, and tested them for Bd. Amphibians were encountered in microhabitats that exhibited a wide range of water temperatures (10-50°C), including several geothermal water sources. There was a strong inverse correlation between the water temperature in which lowland leopard frogs were captured and Bd prevalence, even after taking into account the influence of year, season, and host size. In locations where Bd was known to be present, the prevalence of Bd infections dropped from 75-100% in water <15°C, to less than 10% in water >30°C. A strong inverse correlation between Bd infection status and water temperature was also observed within sites. Our findings suggest that microhabitats where water temperatures exceed 30°C provide lowland leopard frogs with significant protection from Bd, which could have important implications for disease dynamics, as well as management applications.There must be quite a few things a hot bath won't cure, but I don't know many of them--Sylvia Plath, "The Bell Jar" (1963).

Mercury concentrations in snapping turtles (Chelydra serpentina) correlate with environmental and landscape characteristics.

Mercury (Hg) deposited onto the landscape can be transformed into methylmercury (MeHg), a neurotoxin that bioaccumulates up the aquatic food chain. Here, we report on Hg concentrations in snapping turtles (Chelydra serpentina) across New York State, USA. The objectives of this study were to: (1) test which landscape, water, and biometric characteristics correlate with total Hg (THg) concentrations in snapping turtles; and (2) determine whether soft tissue THg concentrations correlate with scute (shell) concentrations. Forty-eight turtles were sampled non-lethally from ten lakes and wetlands across New York to observe patterns under a range of ecosystem variables and water chemistry conditions. THg concentrations ranged from 0.041 to 1.50 µg/g and 0.47 to 7.43 µg/g wet weight of muscle tissue and shell, respectively. The vast majority of mercury (~94%) was in the MeHg form. Sixty-one percent of turtle muscle samples exceeded U.S. Environmental Protection Agency (U.S. EPA) consumption advisory limit of 0.3 µg Hg/g for fish. Muscle THg concentrations were significantly correlated with sulfate in water and the maximum elevation of the watershed. Shell THg concentrations were significantly correlated with the acid neutralizing capacity (ANC) of water, the maximum elevation of the watershed, the percent open water in the watershed, the lake to watershed size, and various forms of atmospheric Hg deposition. Thus, our results demonstrate that THg concentrations in snapping turtles are spatially variable, frequently exceed advisory limits, and are significantly correlated with several landscape and water characteristics.

The potential conservation value of non-native species.

Non-native species can cause the loss of biological diversity (i.e., genetic, species, and ecosystem diversity) and threaten the well-being of humans when they become invasive. In some cases, however, they can also provide conservation benefits. We examined the ways in which non-native species currently contribute to conservation objectives. These include, for example, providing habitat or food resources to rare species, serving as functional substitutes for extinct taxa, and providing desirable ecosystem functions. We speculate that non-native species might contribute to achieving conservation goals in the future because they may be more likely than native species to persist and provide ecosystem services in areas where climate and land use are changing rapidly and because they may evolve into new and endemic taxa. The management of non-native species and their potential integration into conservation plans depends on how conservation goals are set in the future. A fraction of non-native species will continue to cause biological and economic damage, and substantial uncertainty surrounds the potential future effects of all non-native species. Nevertheless, we predict the proportion of non-native species that are viewed as benign or even desirable will slowly increase over time as their potential contributions to society and to achieving conservation objectives become well recognized and realized.

Gaps and mismatches between global conservation priorities and spending.

Several international conservation organizations have recently produced global priority maps to guide conservation activities and spending in their own and other conservation organizations. Surprisingly, it is not possible to directly evaluate the relationship between priorities and spending within a given organization because none of the organizations with global priority models tracks how they spend their money relative to their priorities. We were able, however to evaluate the spending patterns of five other large biodiversity conservation organizations without their own published global priority models and investigate the potential influence of priority models on this spending. On average, countries with priority areas received greater conservation investment; global prioritization systems, however explained between only 2 and 32% of the U.S. dollars 1.5 billion spent in 2002, depending on whether the United States was removed from analyses and whether conservation spending was adjusted by the per capita gross domestic product within each country. We also found little overlap in the spending patterns of the five conservation organizations evaluated, suggesting that informal coordination or segregation of effort may be occurring. Our results also highlight a number of potential gaps and mismatches in how limited conservation funds are spent and provide the first audit of global conservation spending patterns. More explicit presentation of conservation priorities by organizations currently withoutpriority models and better tracking of spending by those with published priorities are clearly needed to help make future conservation activities as efficient as possible.