Tree mortality and recruitment in secondary Andean tropical mountain forests along a 3000 m elevation gradient.

This study addresses the understudied dynamics of mortality and recruitment in Tropical Mountain forests, critical determinants of forest structural processes and biomass turnover. We examine how these demographic processes change with elevation and varying degrees of forest recovery by utilizing two forest censuses (2015 and 2019) from 16 plots (0.36 ha) across a 600-3500 m asl elevation gradient in the Ecuadorian Andes. Employing multivariate PCA analyses, we characterize successional forest dynamics and explore relationships between demographic rates, elevation, and indicators of forest recovery using standard linear regression and generalized additive models (GAMs). Contrary to our hypothesis, mortality exhibits a unimodal response, peaking at mid-elevations, with no significant relationship to above-ground biomass productivity (AGBp). In our successional forests, dominance by fast-growing species alters expected patterns, leading to increased mortality rates and AGBp, particularly at low-mid elevations. Forest recovery emerges as a significant driver of mortality and the sole predictor of recruitment, especially across different recovery statuses. Although forest recovery doesn't impact mortality rates, it elucidates the identity of declining species in forests with varying recovery degrees. Our findings underscore that while forest recovery does not alter mortality rates, it provides critical insights into understanding which species are affected under varying recovery conditions. Recruitment, primarily driven by successional dynamics, exhibits higher rates in sites with less recovery. Furthermore, we demonstrate the utility of forest structure indicators, such as above-ground biomass, in inferring successional dynamics when the time since the last disturbance is unknown. The study emphasizes the importance of considering disturbances in comprehending the intricate interplay between the environment and forest dynamics in secondary forests.

Population pharmacokinetics of fluconazole in critically ill patients receiving extracorporeal membrane oxygenation and continuous renal replacement therapy: an ASAP ECMO study.

This multicenter study describes the population pharmacokinetics (PK) of fluconazole in critically ill patients receiving concomitant extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) and includes an evaluation of different fluconazole dosing regimens for achievement of target exposure associated with maximal efficacy. Serial blood samples were obtained from critically ill patients on ECMO and CRRT receiving fluconazole. Total fluconazole concentrations were measured in plasma using a validated chromatographic assay. A population PK model was developed and Monte Carlo dosing simulations were performed using Pmetrics in R. The probability of target attainment (PTA) of various dosing regimens to achieve fluconazole area under the curve to minimal inhibitory concentration ratio (AUC0-24/MIC) >100 was estimated. Eight critically ill patients receiving concomitant ECMO and CRRT were included. A two-compartment model including total body weight as a covariate on clearance adequately described the data. The mean (±standard deviation, SD) clearance and volume of distribution were 2.87 ± 0.63 L/h and 15.90 ± 13.29 L, respectively. Dosing simulations showed that current guidelines (initial loading dose of 12 mg/kg then 6 mg/kg q24h) achieved >90% of PTA for a MIC up to 1 mg/L. None of the tested dosing regimens achieved 90% of PTA for MIC above 2 mg/L. Current fluconazole dosing regimen guidelines achieved >90% PTA only for Candida species with MIC <1 mg/L and thus should be only used for Candida-documented infections in critically ill patients receiving concomitant ECMO and CRRT. Total body weight should be considered for fluconazole dose.

Patterns of shade plant diversity in four agroforestry systems across Central America: a meta-analysis.

Agroforestry systems can potentially increase tree diversity within agricultural landscapes, but to date, there is little understanding of the patterns of shade plant diversity within different agroforestry systems (AFS) at large spatial scales. Using compiled plant inventory data (from 23 sources, 2517 plots, and 148,255 individuals) encompassing four AFS (shaded coffee; shaded cocoa; dispersed trees on pastures; and live fences) across six countries in Central America we estimated different metrics of diversity to assess the conservation value of different AFS for shade plants. 458 shade plant species were recorded across the four agroforestry systems. Primary forest species accounted for 28% of the shade species recorded, but only 6% of the recorded individuals. No single AFS was consistently the most diverse across countries when considering rarefied species richness. Trees on pastures can potentially reach a similar species richness as cocoa and coffee systems but require sampled areas 7-30 times larger. In terms of composition, 29 species were shared across the agroforestry systems in different countries, illustrating the strong selection pressure of farmers for species that provide timber, firewood, and fruit. Our study highlights the potential contribution and limitations of different AFS for tree diversity conservation within agricultural landscapes.

Population pharmacokinetics of ticarcillin in critically ill patients receiving extended daily diafiltration.

The aim of this study was to describe the population pharmacokinetics of ticarcillin during extended daily diafiltration (EDDf) in critically ill patients with acute kidney injury. Blood samples were collected from critically ill patients prescribed ticarcillin during one to two dosing intervals during which EDDf was performed. Plasma samples were measured using a validated ultra high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method. Concentration-time data were analysed using a population pharmacokinetics approach with Pmetrics®. A total of 53 blood samples were collected from six critically ill patients (three male). The mean ± standard deviation patient age, weight and body mass index (BMI) was 43 ± 22 years, 88 ± 14 kg and 31 ± 5 kg/m2, respectively. A two-compartment linear model adequately described the data. Median population pharmacokinetic parameter estimates were as follows: clearance in the presence of EDDf (CLEDDf), 6.41 L/h; clearance of EDDf (CLnon-EDDf), 4.97 L/h; volume of distribution of the central compartment (Vc), 56.46 L; intercompartmental clearance from the central to peripheral compartment (kCP), 13.54 L/h; and intercompartmental clearance from the peripheral to central compartment (kPC), 21.93 L/h. This is the first population pharmacokinetic model of ticarcillin in patients receiving EDDf. Large pharmacokinetic variability was found, supporting further investigation of the pharmacokinetics of less-studied ß-lactam antibiotics in prolonged intermittent renal replacement therapy.

The future of coffee and cocoa agroforestry in a warmer Mesoamerica.

Climate change threatens coffee production and the livelihoods of thousands of families in Mesoamerica that depend on it. Replacing coffee with cocoa and integrating trees in combined agroforestry systems to ameliorate abiotic stress are among the proposed alternatives to overcome this challenge. These two alternatives do not consider the vulnerability of cocoa and tree species commonly used in agroforestry plantations to future climate conditions. We assessed the suitability of these alternatives by identifying the potential changes in the distribution of coffee, cocoa and the 100 most common agroforestry trees found in Mesoamerica. Here we show that cocoa could potentially become an alternative in most of coffee vulnerable areas. Agroforestry with currently preferred tree species is highly vulnerable to future climate change. Transforming agroforestry systems by changing tree species composition may be the best approach to adapt most of the coffee and cocoa production areas. Our results stress the urgency for land use planning considering climate change effects and to assess new combinations of agroforestry species in coffee and cocoa plantations in Mesoamerica.

Actitudes frente a la prevención del cáncer de cuello uterino en mujeres de un centro de educación técnica / Attitudes towards the prevention of cervical cancer in women in a technical education center

Objetivo: el objetivo de la presente investigación, es describir las actitudes frente a la prevención del cáncer de cuello uterino en mujeres del instituto Formarte, de la ciudad de Cali- Colombia. Materiales y métodos: se realizó un estudio de corte transversal. Se incluyeron 138 mujeres matriculadas en cualquiera de los programas académicos, a quienes se les realizó una encuesta con el fin de medir las variables propósito de la investigación. Resultados: se encontró una media de edad de 33,7 años (DE 13,2). De estas, 22,5% iniciaron relaciones por debajo de los 14 años, 42,8% informó haber tenido al menos 3 compañeros sexuales, 48% rara vez recurre al uso del condón, 28,3% refirió el consumo de cigarrillo. El 23,2% ha recibido algún tipo de educación respecto a la prevención del cáncer de cérvix, aunque el 82,6% reconoce la importancia de la citología y en su mayoría, 42% se realiza el examen anualmente. Conclusiones: se encontraron deficiencias respecto a actitudes en la prevención del cáncer de cuello uterino, las cuales parecen estar relacionadas con el contexto cultural particular de la población estudiada y que guardan disimilitud con las observadas en otras localizaciones geográficas..(AU)

Objective: the objective of the present investigation is to describe the attitudes towards the prevention of cervical cancer in women from Formarte Institute in the city of Cali- Colombia. Materials and methods: a cross-sectional study was carried out. We included 138 women enrolled in any of the academic programs, who were surveyed in order to measure the variables of the research. Results: an average age of 33,7 years was found (SD 13,2). Of these, 22,5% began relationships below 14 years of age, 42,8% reported having had at least 3 sexual partners, 48% rarely resorted to condom use,28,3% reported smoking. 23,2% have received some type of education regarding the prevention of cervical cancer, although 82,6% recognize the importance of cytology and in the majority, 42% perform the exam annually. Conclusions: We found deficiencies regarding attitudes in the prevention of cervical cancer, which seem to be related to the particular cultural context of the population studied and that are dissimilar to those observed in other geographical locations..(AU)

Scaling up functional traits for ecosystem services with remote sensing: concepts and methods.

Ecosystem service-based management requires an accurate understanding of how human modification influences ecosystem processes and these relationships are most accurate when based on functional traits. Although trait variation is typically sampled at local scales, remote sensing methods can facilitate scaling up trait variation to regional scales needed for ecosystem service management. We review concepts and methods for scaling up plant and animal functional traits from local to regional spatial scales with the goal of assessing impacts of human modification on ecosystem processes and services. We focus our objectives on considerations and approaches for (1) conducting local plot-level sampling of trait variation and (2) scaling up trait variation to regional spatial scales using remotely sensed data. We show that sampling methods for scaling up traits need to account for the modification of trait variation due to land cover change and species introductions. Sampling intraspecific variation, stratification by land cover type or landscape context, or inference of traits from published sources may be necessary depending on the traits of interest. Passive and active remote sensing are useful for mapping plant phenological, chemical, and structural traits. Combining these methods can significantly improve their capacity for mapping plant trait variation. These methods can also be used to map landscape and vegetation structure in order to infer animal trait variation. Due to high context dependency, relationships between trait variation and remotely sensed data are not directly transferable across regions. We end our review with a brief synthesis of issues to consider and outlook for the development of these approaches. Research that relates typical functional trait metrics, such as the community-weighted mean, with remote sensing data and that relates variation in traits that cannot be remotely sensed to other proxies is needed. Our review narrows the gap between functional trait and remote sensing methods for ecosystem service management.

Random measurements of adiponectin and IL-6 may not be indicative of the 24-h profile in critically ill patients.

CONTEXT: The anti-inflammatory role of adiponectin has prompted interest in a potential role in acute inflammatory conditions associated with critical illness. It is unclear whether a random adiponectin measurement adequately reflects the 24-h profile in critically ill patients. OBJECTIVE: To assess the temporal profile of total and high molecular weight (HMW) adiponectin and interleukin-6 (IL-6) in 15 critically ill patients. DESIGN: A prospective, observational study. SETTING: Level II intensive care unit in a metropolitan hospital. PATIENTS OR OTHER PARTICIPANTS: Fifteen critically ill patients expected to stay in the ICU for longer than 48 h were eligible for enrolment. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Serial, hourly measurements of total and HMW adiponectin and IL-6. RESULTS: Over a 24-h period, total and HMW adiponectin display considerable within-patient variability (coefficient of variation 34% and 87% respectively) and show no trend over time. Averaging 2 or 3 continuous measures reduced within-patient variability of both total and HMW adiponectin by up to 50% compared to one measure. There was a negative correlation between serum glucose and adiponectin (total P = 0·016, HMW P = 0·039). No relationship existed between adiponectin and IL-6 (total P = 0·62, HMW P = 0·35). CONCLUSIONS: Marked within-patient, hourly variability in total and HMW adiponectin is evident in critically ill patients. A random measurement may not be reflective of the 24-h profile in these patients. A negative correlation exists between adiponectin and blood glucose levels and a positive correlation between adiponectin and oxygen saturation. No clear relationship exists between adiponectin and IL-6.

Effect of a hypertonic balanced ketone solution on plasma, CSF and brain beta-hydroxybutyrate levels and acid-base status.

PURPOSE: Although glucose is the main source of energy for the human brain, ketones play an important role during starvation or injury. The purpose of our study was to investigate the metabolic effects of a novel hypertonic sodium ketone solution in normal animals. METHODS: Adult Sprague-Dawley rats (420-570 g) were divided into three groups of five, one control and two study arms. The control group received an intravenous infusion of 3 % NaCl at 5 ml/kg/h. The animals in the two study arms were assigned to receive one of the two formulations of ketone solutions, containing hypertonic saline with 40 and 120 mmol/l beta-hydroxybutyrate, respectively. This was infused for 6 h and then the animal was euthanized and brains removed and frozen. RESULTS: Both blood and cerebrospinal fluid (CSF) levels of beta-hydroxybutyrate (BHB) demonstrated strong evidence of a change over time (p < 0.0001). There was also strong evidence of a difference between groups (p < 0.0001). Multiple comparisons showed all these means were statistically different (p < 0.05). Measurement of BHB levels in brain tissue found strong evidence of a difference between groups (p < 0.0001) with control: 0.15 mmol/l (0.01), BHB 40: 0.19 mmol/l (0.01), and BHB 120: 0.28 mmol/l (0.01). Multiple comparisons showed all these means were statistically different (p < 0.05). There were no differences over time (p = 0.31) or between groups (p = 0.33) or an interaction between groups and time (p = 0.47) for base excess. CONCLUSION: The IV infusions of hypertonic saline/BHB are feasible and lead to increased plasma, CSF and brain levels of BHB without significant acid/base effects.

Leaf habit and woodiness regulate different leaf economy traits at a given nutrient supply.

The large variation in the relationships between environmental factors and plant traits observed in natural communities exemplifies the alternative solutions that plants have developed in response to the same environmental limitations. Qualitative attributes, such as growth form, woodiness, and leaf habit can be used to approximate these alternative solutions. Here, we quantified the extent to which these attributes affect leaf trait values at a given resource supply level, using measured plant traits from 105 different species (254 observations) distributed across 50 sites in mesic to wet plant communities in The Netherlands. For each site, soil total N, soil total P, and water supply estimates were obtained by field measurements and modeling. Effects of growth forms, woodiness, and leaf habit on relations between leaf traits (SLA, specific leaf area; LNC, leaf nitrogen concentration; and LPC, leaf phosphorus concentration) vs. nutrient and water supply were quantified using maximum-likelihood methods and Bonferroni post hoc tests. The qualitative attributes explained 8-23% of the variance within sites in leaf traits vs. soil fertility relationships, and therefore they can potentially be used to make better predictions of global patterns of leaf traits in relation to nutrient supply. However, at a given soil fertility, the strength of the effect of each qualitative attribute was not the same for all leaf traits. These differences may imply a differential regulation of the leaf economy traits at a given nutrient supply, in which SLA and LPC seem to be regulated in accordance to changes in plant size and architecture while LNC seems to be primarily regulated at the leaf level by factors related to leaf longevity.

Plant strategies in relation to resource supply in mesic to wet environments: does theory mirror nature?

In ecology, strategy schemes based on propositions about the selection of plant attributes are common, but quantification of such schemes in relation to nutrient and water supply is lacking. Through structural equation modeling, we tested whether plant strategies related to nutrient and water/oxygen supply are reflected in a coordination of traits in natural communities. Structural equation models, based on accepted ecological concepts, were tested with measured plant traits of 105 different species across 50 sites in mesic to wet plant communities in the Netherlands. For each site, nutrient and water supply were measured and modeled. Hypothesized multivariate strategy models only partly reflected current theoretical schemes. Alternative models were consistent, showing that lack of consistency of the original models was because of (i) strong correlations among traits that supposedly belong to different strategy components; (ii) poor understanding of mechanisms determining the covariation of plant maximum height, leaf size, and stem density; and (iii) lack of integrative and long-term measures of nutrient supply needed to predict coordinated plant trait responses. Our main conclusion is that a combination of trade-offs (partly) across different plant organs and diverging effects of resource supply ultimately determines the coordination of plant traits needed to "make a living."