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1.
Kidney Int Rep ; 6(11): 2775-2781, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34805629

RESUMO

Introduction: Knowledge of effects of catheter port reversal (CathPR), when blood is withdrawn from the venous port and returned via the arterial port, often used in dysfunctional catheters in renal replacement therapy, is limited in the setting of citrate continuous veno-venous hemofiltration (CVVH). Methods: In this open trial, post-filter ionized calcium (PfiCa), post-filter citrate concentration (PfCC), catheter recirculation, and solute clearance were measured before, during, and after 6 hours of CathPR, in well-functioning catheters. All other settings, including citrate settings, were left constant during the study. Results: Twenty-three patients were included. Mean PfiCa before CathPR of 0.36 mmol/L (SD 0.06) decreased to 0.31 (0.04) after 2 hours (P = 0.002), 0.31 (0.04) (P = 0.002) at 4 hours, and 0.31 (0.04) at 6 hours (P = 0.001). Return to normal increased mean PfiCa to 0.34 (0.06) (P = 0.006). Mean PfCC rose from 592 mg/L (SD 164) before CathPR to 649 mg/L (190) after 2 hours (P = 0.045), to 696 mg/L (192) after 4 hours (P < 0.001), and to 657 mg/L (214) after 6 hours (P = 0.018). Return to normal decreased mean PfCC to 598 mg/L (184) (P = 0.024). Mean recirculation increased during CathPR (from 4.3% [0-8.7] before to 13.8% [9.7-22.2], P < 0.001). Urea, potassium, and creatinine clearances dropped significantly, but calcium clearance was unaffected. Conclusion: CathPR caused a significant decrease in PfiCA and increase in PfCC. Calcium handling differs from other solutes because of increases caused in citrate concentration and subsequent effects on calcium chelation. In citrate CVVH, CathPR in dysfunctional catheters should be limited in time, with intensive follow-up. Trial registration: ClinicalTrials.gov: NCT024600416. Registered 9 November 2015.

3.
Prev Med ; 153: 106823, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34624391

RESUMO

Covid-19 and measures to contain spreading the disease have led to changed physical activity behavior. This study aims to investigate the relationship between socioeconomic status (SES) and changes in the amount of moderate to vigorous physical activity (MVPA) during the Covid-19 crisis. Using the Dutch Lifelines Covid-19 cohort study (n = 17,749), the amount of MVPA was measured at 15 time-points between March and December 2020, and compared with the amount before the Covid19 pandemic. For SES, the population was stratified in three education and income levels. Logistic regression models were used to estimate the odds ratio (OR) and confidence interval (CI) of altered MVPA for low and high SES groups, with the middle SES category as the reference group. A clear socioeconomic gradient in changes in MVPA behavior was observed. Low educated individuals had significantly higher odds (OR = 1.14; CI: 1.03-1.27) of decreasing MVPA, while the high educated had significantly lower odds of decreased MVPA (OR = 0.84, CI: 0.79-0.90). Both low education (OR = 0.87; CI: 0.77-0.98) and low income (OR = 0.85; CI 0.78-0.92) had significantly lower odds to increase MVPA, while high education (OR = 1.21, CI: 1.12-1.30) and high income (OR = 1.17; CI: 1.07-1.28) had significantly higher odds to increase MVPA. Most findings were consistent over the full research period. Socioeconomic inequalities in MVPA have increased during the Covid-19 pandemic, even when Covid-19 containment measures were relaxed. Our findings suggest that future public health policies need to increase efforts to improve physical activity behavior with an even larger focus on low SES groups.


Assuntos
COVID-19 , Estudos de Coortes , Exercício Físico , Humanos , Pandemias , SARS-CoV-2 , Classe Social , Fatores Socioeconômicos
6.
Glob Chang Biol ; 27(20): 4995-5007, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34214237

RESUMO

As a source of emerging infectious diseases, wildlife assemblages (and related spatial patterns) must be quantitatively assessed to help identify high-risk locations. Previous assessments have largely focussed on the distributions of individual species; however, transmission dynamics are expected to depend on assemblage composition. Moreover, disease-diversity relationships have mainly been studied in the context of species loss, but assemblage composition and disease risk (e.g. infection prevalence in wildlife assemblages) can change without extinction. Based on the predicted distributions and abundances of 4466 mammal species, we estimated global patterns of disease risk through the calculation of the community-level basic reproductive ratio R0, an index of invasion potential, persistence, and maximum prevalence of a pathogen in a wildlife assemblage. For density-dependent diseases, we found that, in addition to tropical areas which are commonly viewed as infectious disease hotspots, northern temperate latitudes included high-risk areas. We also forecasted the effects of climate change and habitat loss from 2015 to 2035. Over this period, many local assemblages showed no net loss of species richness, but the assemblage composition (i.e. the mix of species and their abundances) changed considerably. Simultaneously, most areas experienced a decreased risk of density-dependent diseases but an increased risk of frequency-dependent diseases. We further explored the factors driving these changes in disease risk. Our results suggest that biodiversity and changes therein jointly influence disease risk. Understanding these changes and their drivers and ultimately identifying emerging infectious disease hotspots can help health officials prioritize resource distribution.


Assuntos
Doenças Transmissíveis Emergentes , Animais , Biodiversidade , Mudança Climática , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/veterinária , Ecossistema , Mamíferos
7.
Geospat Health ; 16(1)2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-34000793

RESUMO

Long-distance migrations influence the dynamics of hostpathogen interactions and understanding the role of migratory waterfowl in the spread of the highly pathogenic avian influenza viruses (HPAIV) is important. While wild geese have been associated with outbreak events, disease ecology of closely related species has not been studied to the same extent. The swan goose (Anser cygnoides) and the bar-headed goose (Anser indicus) are congeneric species with distinctly different HPAIV infection records; the former with few and the latter with numerous records. We compared movements of these species, as well as the more distantly related whooper swan (Cygnus cygnus) through their annual migratory cycle to better understand exposure to HPAIV events and how this compares within and between congeneric and noncongeneric species. In spite of their record of fewer infections, swan geese were more likely to come in contact with disease outbreaks than bar-headed geese. We propose two possible explanations: i) frequent prolonged contact with domestic ducks increases innate immunity in swan geese, and/or ii) the stress of high-elevation migration reduces immunity of bar-headed geese. Continued efforts to improve our understanding of species-level pathogen response is critical to assessing disease transmission risk.


Assuntos
Virus da Influenza A Subtipo H5N1 , Influenza Aviária , Animais , Surtos de Doenças , Gansos , Influenza Aviária/epidemiologia
8.
Scand J Med Sci Sports ; 31(6): 1342-1351, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33609297

RESUMO

This study examined the association of sport participation with health outcomes and whether this relation differs between body mass index (BMI)-level subpopulations. Research outcomes for sport participation were compared with other types of leisure-time physical activity (PA). We used the Cox proportional hazards regression models to assess the associations of sport participation, and four other PA types (cycling, gardening, doing odd jobs, and walking), with the risk of prediabetes, type 2 diabetes mellitus (T2DM), and all-cause mortality in 97,212 individuals (58.4% women; mean age: 46.5 years) in the Dutch LifeLines cohort. Outcomes were stratified by three BMI levels: healthy weight (BMI: 18.5-24.9 kg/m2 ), overweight (BMI: 25.0-29.9 kg/m2 ), and obesity (BMI: 30.0 kg/m2 or above). Sport participation was associated with lower health risks, but only significantly so for prediabetes (HR = 0.86, 95% CI: 0.81-0.92). For healthy weight persons, sport participation was associated with the largest risk reductions, with significantly lower risks of prediabetes (HR = 0.78, 95% CI: 0.68-0.90) and all-cause mortality (HR = 0.79, 95% CI 0.65-0.96). Other PA types were not associated with significantly lower health risks, with the exception of cycling, for which significantly lower health risks for persons with overweight were found. Our findings show that sport participation is associated with lower health risks, especially prediabetes, but the effect varies between BMI levels, with the strongest link for persons with a healthy weight. Sport participation, together with cycling, is likely to be more effective in reducing health risks than other types of PA.


Assuntos
Índice de Massa Corporal , Causas de Morte , Diabetes Mellitus Tipo 2/epidemiologia , Exercício Físico , Estado Pré-Diabético/epidemiologia , Esportes , Ciclismo , Peso Corporal , Estudos de Coortes , Feminino , Jardinagem , Humanos , Atividades de Lazer , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Modelos de Riscos Proporcionais , Comportamento de Redução do Risco , Caminhada , Trabalho
9.
Sci Total Environ ; 771: 144816, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33545476

RESUMO

Environmental pollution, especially because of trace metals, seriously affects ecological safety, and bird feathers are often used as bioindicators to monitor this risk in various environments. However, the feasibility of feathers as bioindicators for trace metals in polymetallic contaminated areas has not been extensively studied. In this study, we used inductively coupled plasma mass spectrometry (ICP-MS) to quantify and compare the contents of nine trace metal(loid)s (V, Cr, Mn, Co, Cu, Zn, As, Cd and Pb) among soil, plants, insects and birds (feathers and internal tissues) sampled in the mining area of Tongling, a polymetallic contaminated area in Anhui Province, eastern China. We detected significant trace metal pollution in the abiotic and biotic materials. The contents of Cr, Cu, Zn, As and Pb in feathers differed among bird species and among sampling sites, with higher contents often recorded in tree sparrows (Passer montanus). The metal(loid)s V, Mn, Co, Zn, and As had higher contents in feathers than in internal tissues including heart, liver, kidneys, muscles and bones. The contents of some elements in feathers were positively correlated with those in internal tissues, for example, Co, As, and Cd in the heart, V and Co in the kidneys, Cd in the liver, Pb in bones, and As in muscles. Furthermore, the contents of V, Cr, As and Pb in feathers were higher than those in other biomaterials, implying an increasing trend from plants, insects, and feathers. Our study indicates that bird feathers can be used as effective, non-destructive bioindicators to monitor trace metal(loid) pollution, especially for V, Co, As, Cd and Pb, in polymetallic contaminated areas, providing reliable information for ecological assessment.


Assuntos
Metais Pesados , Oligoelementos , Animais , Aves , China , Biomarcadores Ambientais , Monitoramento Ambiental , Plumas/química , Metais Pesados/análise , Oligoelementos/análise
10.
J Clin Monit Comput ; 35(1): 165-173, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31916223

RESUMO

We aimed to confirm the positive association between a successful electrical cardioversion (ECV) and increase in SctO2 and investigated whether this increase is persisting or not. Secondary, the influence of a successful ECV on the neuropsychological function and the association with SctO2 was assessed as well. SctO2 was measured continuously during elective ECV using near-infrared spectroscopy. Measurements started before induction of sedation and ended 15 min after awakening. A second measurement took place 4 to 6 weeks after ECV. To assess neuropsychological functioning, patients performed standardized neuropsychological tests before ECV and at follow-up and were compared to healthy volunteers as control group. SctO2 was measured in 60 patients during elective ECV. ECV was successful in 50 AF patients, while in ten patients sinus rhythm was not obtained. SctO2 increased immediately after successful ECV in 50 patients (1% (- 5 to 4); p = 0.031), but not after unsuccessful ECV in 10 patients (- 1% (- 5;3); p = 0.481). This SctO2 change was positively correlated with the instant change in blood pressure (R2 = 0.391; p = 0.004). At follow-up, SctO2 values were no longer increased. Nevertheless, successful ECV improved the patient's quality of life but did not influence neuropsychological functioning at follow-up. A transient, instant SctO2 increase was observed after successful ECV. This temporary increase in SctO2 did not influence the neuropsychological functioning of the patients. Though, the quality of life of patients with a successful ECV improved.

11.
Infect Ecol Epidemiol ; 10(1): 1782042, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32939230

RESUMO

The number of dengue fever incidence and its distribution has increased considerably in recent years in Africa. However, due to inadequate research at the continental level, there is a limited understanding regarding the current and future spatial distribution of the main vector, the mosquitoAedes aegypti, and the associated dengue risk due to climate change. To fill this gap we used reported dengue fever incidences, the presence of Ae. aegypti, and bioclimatic variables in a species distribution model to assess the current and future (2050 and 2070) climatically suitable areas. High temperatures and with high moisture levels are climatically suitable for the distribution of Ae. aegypti related to dengue fever. Under the current climate scenario indicated that 15.2% of the continent is highly suitable for dengue fever outbreaks. We predict that climatically suitable areas for Ae. aegypti related to dengue fever incidences in eastern, central and western part of Africa will increase in the future and will expand further towards higher elevations. Our projections provide evidence for the changing continental threat of vector-borne diseases and can guide public health policy decisions in Africa to better prepare for and respond to future changes in dengue fever risk.

12.
Parasit Vectors ; 13(1): 464, 2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32912330

RESUMO

BACKGROUND: Arboviruses are a growing public health concern in Europe, with both endemic and exotic arboviruses expected to spread further into novel areas in the next decades. Predicting where future outbreaks will occur is a major challenge, particularly for regions where these arboviruses are not endemic. Spatial modelling of ecological risk factors for arbovirus circulation can help identify areas of potential emergence. Moreover, combining hazard maps of different arboviruses may facilitate a cost-efficient, targeted multiplex-surveillance strategy in areas where virus transmission is most likely. Here, we developed predictive hazard maps for the introduction and/or establishment of six arboviruses that were previously prioritized for the Netherlands: West Nile virus, Japanese encephalitis virus, Rift Valley fever virus, tick-borne encephalitis virus, louping-ill virus and Crimean-Congo haemorrhagic fever virus. METHODS: Our spatial model included ecological risk factors that were identified as relevant for these arboviruses by an earlier systematic review, including abiotic conditions, vector abundance, and host availability. We used geographic information system (GIS)-based tools and geostatistical analyses to model spatially continuous datasets on these risk factors to identify regions in the Netherlands with suitable ecological conditions for arbovirus introduction and establishment. RESULTS: The resulting hazard maps show that there is spatial clustering of areas with either a relatively low or relatively high environmental suitability for arbovirus circulation. Moreover, there was some overlap in high-hazard areas for virus introduction and/or establishment, particularly in the southern part of the country. CONCLUSIONS: The similarities in environmental suitability for some of the arboviruses provide opportunities for targeted sampling of vectors and/or sentinel hosts in these potential hotspots of emergence, thereby increasing the efficient use of limited resources for surveillance.


Assuntos
Infecções por Arbovirus/virologia , Arbovírus/isolamento & purificação , Espécies Introduzidas/estatística & dados numéricos , Infecções por Arbovirus/epidemiologia , Arbovírus/classificação , Arbovírus/genética , Arbovírus/fisiologia , Humanos , Países Baixos/epidemiologia , Análise Espaço-Temporal
14.
J Crit Care ; 59: 16-22, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32485438

RESUMO

PURPOSE: To identify potential determinants of the Total/ionized Ca ratio (T/iCa), a marker of citrate accumulation. MATERIALS AND METHODS: Single-center retrospective observational study evaluating citrate dose, citrate target, albumin, phosphate, pH, lactate, and APACHE II score as potential determinants. Linear mixed models (LMM) using citrate dose and citrate target were developed describing associations with T/iCa. RESULTS: From a dataset of 471 samples in 103 patients, an LMM in 379 complete samples (95 patients) sets revealed that citrate dose, pH, phosphate, albumin and APACHE were interactively related to T/iCa. A rising citrate dose was associated with a higher increase in T/iCa when phosphate was high, and less when phosphate was low. A rising albumin was associated with a higher increase in T/iCa when APACHE was high and phosphate was low and less when APACHE was low and phosphate high. In case of acidosis, a rising lactate was associated with a higher increase in T/iCa. In the LMM using citrate target, citrate target and pH were the main independent predictors of T/iCa with albumin, phosphate and APACHE score as modifiers. CONCLUSIONS: Besides citrate dose, a high pH and high phosphate, albumin and APACHE are also associated with a rising T/iCa.


Assuntos
Anticoagulantes/efeitos adversos , Anticoagulantes/sangue , Cálcio/sangue , Ácido Cítrico/efeitos adversos , Ácido Cítrico/sangue , Terapia de Substituição Renal Contínua/métodos , APACHE , Idoso , Feminino , Humanos , Concentração de Íons de Hidrogênio , Masculino , Pessoa de Meia-Idade , Fosfatos/sangue , Estudos Prospectivos , Estudos Retrospectivos , Albumina Sérica Humana/análise , Resultado do Tratamento
15.
J Theor Biol ; 502: 110315, 2020 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-32387368

RESUMO

Migration can influence dynamics of pathogen-host interactions. However, it is not clearly known how migration pattern, in terms of the configuration of the migration network and the synchrony of migration, affects infection prevalence. We therefore applied a discrete-time SIR model, integrating environmental transmission and migration, to various migration networks, including networks with serial, parallel, or both serial and parallel stopover sites, and with various levels of migration synchrony. We applied the model to the infection of avian influenza virus in a migratory geese population. In a network with only serial stopover sites, increasing the number of stopover sites reduced infection prevalence, because with every new stopover site, the amount of virus in the environment was lower than that in the previous stopover site, thereby reducing the exposure of the migratory population. In a network with parallel stopover sites, both increasing the number and earlier appearance of the stopover sites led to an earlier peak of infection prevalence in the migratory population, because the migratory population is exposed to larger total amount of virus in the environment, speeding-up the infection accumulation. Furthermore, higher migration synchrony reduced the average number of cumulative infection, because the majority of the population can fly to a new stopover site where the amount of virus is still relatively low and has not been increased due to virus shedding of infected birds. Our simulations indicate that a migration pattern with multiple serial stopover sites and with highly synchronized migration reduces the infection prevalence.


Assuntos
Gansos , Vírus da Influenza A , Migração Animal , Animais , Prevalência , Estações do Ano
16.
Sci Total Environ ; 729: 139066, 2020 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-32388134

RESUMO

The unique geochemistry surrounding the Palabora Mining Company (PMC) land may act as a micronutrient hotspot, attracting elephants to the area. The PMC produces refined copper and extracts phosphates and other minerals. Understanding the spatial influence of geochemistry on the home range size of African elephants is important for elephant population management and conservation. The home ranges of collared elephants surrounding the PMC were significantly smaller (P = 0.001) than conspecifics in surrounding reserves, suggesting that their resource needs were met within these smaller areas. Environmental samples (soil, water and plants) were analysed from the mine area and along six transects radiating from the mine centre. Tail hair and faecal samples from elephants at the PMC, and conspecifics within the surrounding area were analysed. All samples were analysed for minerals essential to health and potentially toxic elements (PTEs; As, Ca, Cd, Cu, Fe, K, Mg, Mn, Na, P, Pb, Se, U, V and Zn). Results show that the geochemistry at the PMC is different compared to surrounding areas, with significant elevations seen in all analysed minerals and PTEs in soil closer to the mine, thereby drawing the elephants to the area. Additionally significant elevations were seen in elements analysed in water and vegetation samples. Elephant tail hair from elephants at the mine was significantly greater in Cd, whilst Mg, P, Cu, As, Cd, Pb and U concentrations were significantly greater in elephant faecal samples at the mine compared to the non-mine samples. When micronutrient hotspots overlap with human activity (such as mining), this can lead to poor human-elephant coexistence and thus conflict. When managing elephant populations, the influence of mineral provision on elephant movement must be considered. Such detailed resource information can inform conservation efforts for coordinated programmes (UN SDGs 15 and 17) and underpin sustainable economic activity (UN SDG 8, 11 and 12).


Assuntos
Elefantes , Animais , Comportamento de Retorno ao Território Vital , Atividades Humanas , Humanos , Mineração , Solo
17.
Ann Intensive Care ; 10(1): 23, 2020 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-32052229

RESUMO

RATIONALE/METHODS: The primary aim of the present contribution is to find a literature-based agreement on dose adjustments of vitamin C in critically ill patients undergoing renal replacement therapy (RRT). AVAILABLE DATA/STUDY RESULTS: Critical illness is frequently accompanied by severe vitamin C deficiency. High-dose supplementation beneficially affects clinical outcome in small cohorts of patients with sepsis, burn injury, and trauma. There are no specific data on clinical outcomes in patients receiving renal replacement therapy (RRT). Vitamin C plasma concentrations in patients on RRT are comparable to critically ill patients not receiving RRT. Vitamin C is cleared from the circulation during RRT at a rate dependent on the plasma concentration, dose and duration of RRT. Sieving coefficient is about 1. While the dose of RRT is lower than normal renal function, tubular reabsorption is absent. Sparse evidence suggests that vitamin C dosing during continuous RRT should not exceed the dose administered to critically ill patients not receiving continuous RRT. Low plasma concentrations are expected during prolonged RRT because of persistent extracorporeal removal, absent renal reabsorption and enhanced metabolic loss due to circuit-induced oxidative stress. A dosage of twice 1 g vitamin C daily may be necessary to achieve normal plasma concentrations during RRT, but more studies are needed. There is no available evidence that high doses of vitamin C administered over a short period can induce oxalate stones or has pro-oxidant effects. CONCLUSIONS: Supplementing vitamin C 1 g twice daily to critically ill patients has a solid pathophysiological rationale and a good safety profile. Patients on RRT probably need similar doses as critically ill patients not receiving RRT. Intravenous vitamin C in a dose of 2 g/day may be necessary to achieve normal plasma concentrations during RRT. However, data on dose adjustment of vitamin C during intermittent or chronic RRT are sparse and require more thorough pharmacokinetic and dose-response studies.

18.
Prev Med ; 130: 105929, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31778685

RESUMO

INTRODUCTION: There is a strong socioeconomic gradient in health care costs. However, little is known about the role of lifestyle factors in the association between health care costs and socioeconomic status (SES). This study investigates variation in the association between lifestyle indicators and health care costs between and within neighborhoods with similar SES. METHOD: Using 2016 whole-population data for all 790 neighborhoods of the Netherlands, we estimated the association between neighborhood average health care cost performance (i.e., health care costs adjusted for population age and gender) and neighborhood socioeconomic status (NSES) and four lifestyle indicators - smoking, alcohol consumption, exercise and sport club membership. Additionally, using regression analysis, we explored the multivariate relationship between average health care cost performance, NSES and lifestyle indicators. RESULTS: Neighborhoods with proportionally fewer smokers and more sport club members had significantly lower average health care costs. Remarkably, neighborhoods with more people who complied with the recommended maximum alcohol consumption had significantly higher health care costs. These findings were consistent within and between neighborhoods with different SES levels. Neighborhoods with more compliance with exercise guidelines had lower health care costs. However, this relationship was inconsistent across different NSES levels, with the largest cost reductions found in the most deprived neighborhoods. CONCLUSION: Our findings suggest that prevention policies aimed at reducing the number of smokers and increasing sport club membership may reduce health care costs across all NSES groups, while increasing compliance with physical exercise norms may be effective mainly in low SES neighborhoods.


Assuntos
Custos de Cuidados de Saúde/estatística & dados numéricos , Estilo de Vida , Características de Residência/estatística & dados numéricos , Fatores Socioeconômicos , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Exercício Físico/fisiologia , Feminino , Humanos , Masculino , Países Baixos , Fumar/efeitos adversos
19.
Conserv Biol ; 34(2): 416-426, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31268188

RESUMO

Habitat loss can trigger migration network collapse by isolating migratory bird breeding grounds from nonbreeding grounds. Theoretically, habitat loss can have vastly different impacts depending on the site's importance within the migratory corridor. However, migration-network connectivity and the impacts of site loss are not completely understood. We used GPS tracking data on 4 bird species in the Asian flyways to construct migration networks and proposed a framework for assessing network connectivity for migratory species. We used a node-removal process to identify stopover sites with the highest impact on connectivity. In general, migration networks with fewer stopover sites were more vulnerable to habitat loss. Node removal in order from the highest to lowest degree of habitat loss yielded an increase of network resistance similar to random removal. In contrast, resistance increased more rapidly when removing nodes in order from the highest to lowest betweenness value (quantified by the number of shortest paths passing through the specific node). We quantified the risk of migration network collapse and identified crucial sites by first selecting sites with large contributions to network connectivity and then identifying which of those sites were likely to be removed from the network (i.e., sites with habitat loss). Among these crucial sites, 42% were not designated as protected areas. Setting priorities for site protection should account for a site's position in the migration network, rather than only site-specific characteristics. Our framework for assessing migration-network connectivity enables site prioritization for conservation of migratory species.


Assuntos
Migração Animal , Conservação dos Recursos Naturais , Animais , Aves , Cruzamento , Ecossistema
20.
Br J Anaesth ; 124(2): 146-153, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31862160

RESUMO

BACKGROUND: Near-infrared spectroscopy non-invasively measures regional cerebral oxygen saturation. Intraoperative cerebral desaturations have been associated with worse neurological outcomes. We investigated whether perioperative cerebral desaturations are associated with postoperative delirium in older patients after cardiac surgery. METHODS: Patients aged 70 yr and older scheduled for on-pump cardiac surgery were included between 2015 and 2017 in a single-centre, prospective, observational study. Baseline cerebral oxygen saturation was measured 1 day before surgery. Throughout surgery and after ICU admission, cerebral oxygen saturation was monitored continuously up to 72 h after operation. The presence of delirium was assessed using the confusion assessment method for the ICU. Association with delirium was evaluated with unadjusted analyses and multivariable logistic regression. RESULTS: Ninety-six of 103 patients were included, and 29 (30%) became delirious. Intraoperative cerebral oxygen saturation was not significantly associated with postoperative delirium. The lowest postoperative cerebral oxygen saturation was lower in patients who became delirious (P=0.001). The absolute and relative postoperative cerebral oxygen saturation decreases were more marked in patients with delirium (13 [6]% and 19 [9]%, respectively) compared with patients without delirium (9 [4]% and 14 [5]%; P=0.002 and P=0.001, respectively). These differences in cerebral oxygen saturation were no longer present after excluding cerebral oxygen saturation values after patients became delirious. Older age, previous stroke, higher EuroSCORE II, lower preoperative Mini-Mental Status Examination, and more substantial absolute postoperative cerebral oxygen saturation decreases were independently associated with postoperative delirium incidence. CONCLUSIONS: Postoperative delirium in older patients undergoing cardiac surgery is associated with absolute decreases in postoperative cerebral oxygen saturation. These differences appear most detectable after the onset of delirium. CLINICAL TRIAL REGISTRATION: NCT02532530.


Assuntos
Encéfalo/metabolismo , Procedimentos Cirúrgicos Cardíacos , Delírio/etiologia , Avaliação Geriátrica/métodos , Oxigênio/metabolismo , Complicações Pós-Operatórias/etiologia , Idoso , Idoso de 80 Anos ou mais , Bélgica , Delírio/metabolismo , Feminino , Humanos , Masculino , Complicações Pós-Operatórias/metabolismo , Estudos Prospectivos , Espectroscopia de Luz Próxima ao Infravermelho
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