The presence of clonal circulating plasma cells (cPCs) is a marker of high-risk disease in all stages of monoclonal gammopathies. However, the prognostic utility of quantitating cPCs using ...multiparametric flow cytometry in multiple myeloma (MM) patients with current treatments is unknown. There were 157 consecutive patients with newly diagnosed MM seen at the Mayo Clinic, Rochester from 2009 to 2011 that had their peripheral blood evaluated for cPCs by multiparameter flow cytometry. Survival analysis was performed by the Kaplan-Meier method and differences assessed using the log-rank test. Using a receiver operating characteristics (ROC) analysis, ⩾400 cPCs were considered as the optimal cutoff for defining high-risk disease. The presence of ⩾400 cPCs was associated with higher plasma cell (PC) proliferation and adverse cytogenetics. The median time-to-next-treatment and overall survival (OS) in patients with ⩾400 cPCs (N=37, 24%) was 14 months and 32 months compared with 26 months and not reached for the rest (P<0.001). In a multivariable model, the presence of ⩾400 cPCs and older age adversely affected OS. Flow cytometry to quantify cPCs is a valuable test for risk stratifying newly diagnosed MM patients in the era of novel agents. Future studies are needed to determine its role in developing a risk-adapted treatment approach.
The structure and function of microbial communities is deeply influenced by the physical and chemical architecture of the local microenvironment and the abundance of its community members. The ...complexity of this natural parameter space has made characterization of the key drivers of community development difficult. In order to facilitate these characterizations, we have developed a microwell platform designed to screen microbial growth and interactions across a wide variety of physical and initial conditions. Assembly of microbial communities into microwells was achieved using a novel biofabrication method that exploits well feature sizes for control of innoculum levels. Wells with incrementally smaller size features created populations with increasingly larger variations in inoculum levels. This allowed for reproducible growth measurement in large (20 μm diameter) wells, and screening for favorable growth conditions in small (5, 10 μm diameter) wells. We demonstrate the utility of this approach for screening and discovery using 5 μm wells to assemble P. aeruginosa colonies across a broad distribution of innoculum levels, and identify those conditions that promote the highest probability of survivial and growth under spatial confinement. Multi-member community assembly was also characterized to demonstrate the broad potential of this platform for studying the role of member abundance on microbial competition, mutualism and community succession.
Woody plant increase in grassy biomes has been widely reported over the last century. Increases have been attributed to local drivers associated with land use change, such as heavy grazing or fire ...suppression, or, controversially, to global drivers such as increased atmospheric carbon dioxide (CO₂). Here, we report a comparison of woody increase since the 1930s in three neighbouring areas with highly contrasting land use systems to help distinguish between local and global causes of woody increase. Aerial photography was used to measure changes in tree cover for three time intervals (1937, 1960, 2004) for three adjacent 25 km² sites which remained under radically different tenure (conservation, commercial farms, and communal rangeland) over the study period. From previous studies on drivers affecting savanna dynamics, we predicted a decrease in tree cover for the conservation and communal sites and an increase in tree cover at the commercial site. The analyses showed highly significant increases in tree cover at all sites. Total tree cover increased from 14% in 1937 to 58% in 2004 at the conservation site, 3-50% in the commercial ranching area and 6-25% in the communal farming area. Reconstruction of past land use practices showed large differences in stocking rates, herbivore species, burning practices, human population densities and natural resource harvesting between the three sites. These land use differences are reflected in differences in woody cover among the three sites in 2004. However, despite major differences in land use, tree cover also increased significantly in all three areas. This suggests global drivers favouring woody plant increase in grassy vegetation regardless of land use practises. In our study area the most likely candidates are increased CO₂ and/or atmospheric nitrogen deposition.
Abstract Background In patients referred for radiofrequency catheter ablation (RFCA) of ventricular tachycardia (VT) in the setting of structural heart disease, early post-procedural mortality (EM) ...has not been previously investigated. Objectives The purpose of this study was to evaluate EM after catheter ablation of scar-related VT. Methods Associations between clinical and procedural variables and EM (within 31 days of the procedure) were tested in patients with structural heart disease undergoing RFCA of VT at 12 international centers. Results Of 2,061 patients (mean age 62 ± 13 years; left ventricular ejection fraction LVEF 34 ± 13%; 53% ischemic etiology), EM occurred in 100 (5%; 95% confidence interval CI: 4% to 6%). A total of 54 (3%) patients died before hospital discharge (median 9 days after the procedure; 25% for refractory VT), including 12 (0.6%) after a major procedure-related complication. In multivariable analysis, the following factors were found to be significantly associated with EM: LVEF (odds ratio OR per percent decrease: 1.12; 95% CI: 1.05 to 1.20; p < 0.001), chronic kidney disease (OR: 2.73; 95% CI: 1.10 to 6.80; p = 0.030), presentation with VT storm (OR: 3.61; 95% CI: 1.37 to 9.48; p = 0.009), and presence of unmappable VTs (OR: 5.69; 95% CI: 1.37 to 23.69; p = 0.017). Recurrent VT was also associated with an increased risk of subsequent death (hazard ratio: 7.19; 95% CI: 5.57 to 9.28; p < 0.001) and EM (hazard ratio: 11.45; 95% CI: 7.47 to 17.59; p < 0.001). Conclusions In a contemporary cohort of patients with scar-related VT undergoing RFCA, EM occurred in 5% of cases. Clinical and procedural variables indicating poorer clinical status (low LVEF, chronic kidney disease, VT storm, and unmappable VTs) and post-procedural VT recurrence may predict EM. Identification of such features may prompt early consideration for hemodynamic support or other care to help mitigate later potential complications.
Most protected area impact research that uses counterfactuals draws heavily on quantitative methods, data, and knowledge types, making it valuable in producing generalizations but limited in temporal ...scope, historical detail, and habitat diversity and coverage of ecosystem services. We devised a methodological pluralistic approach, which supports social science qualitative methods, narratives, mixed methods, and interdisciplinarity, to fully unlock the potential of counterfactuals in ensuring a place‐based and detailed understanding of the socioecological context and impacts of protected areas. We applied this approach to derive possible counterfactual conditions for the impact of a montane protected area on 40 years of vegetation change in the Cape Floristic Region—a global biodiversity hotspot and UNESCO World Heritage Site in South Africa. We incorporated diverse methods, knowledge, and information sources, drawing on before–after protected area comparisons for inside and outside the protected area. A significant increase in shrubland vegetation (17–30%) was observed and attributed primarily to a decline in frequent burning for grazing. This also occurred outside the protected area and was driven by socioeconomic drivers and not by concerns over biodiversity conservation or land degradation. Had the protected area not been established the area would have seen intensification of cultivation and increased road networks, buildings, and water storage in dams. Our approach increased historical temporal coverage of socioecological change and contextualized assumptions around causality. Protected area impact evaluation should reengage in place‐based research that fully incorporates pluralism in methodologies for constructing counterfactuals in a way that builds regional and global understanding from the local level upward. We devised 10 key principles for deriving counterfactuals grounded in methodological pluralism, covering aspects of collaboration, cocreation, inter‐ and transdisciplinarity, diverse values and lived experiences, multiple knowledge types, multiple possible causal mechanisms, social science qualitative methods, perceptions, perspectives, and narratives.
Importancia del pluralismo metodológico en la derivación de situaciones contrafactuales para la conservación basada en evidencias
Resumen
La mayoría de las investigaciones sobre el impacto de las áreas protegidas que usan situaciones contrafactuales se basan en gran medida en métodos cuantitativos, datos y tipos de conocimiento, por lo que son muy valiosas para producir generalizaciones, pero limitadas en el enfoque temporal, el detalle histórico y la diversidad de hábitats y cobertura de los servicios ambientales. Diseñamos una estrategia metodológica pluralista, la cual apoya los métodos cualitativos de las ciencias sociales, narrativas, métodos mixtos e interdisciplinarios para utilizar por completo el potencial de las situaciones contrafactuales para asegurar un conocimiento detallado y basado en el lugar del contexto socio ecológico y el impacto de las áreas protegidas. Aplicamos esta estrategia para derivar las posibles condiciones contrafactuales del impacto de un área protegida montañosa sobre 40 años de cambio de vegetación en el reino florístico del Cabo – un punto caliente de biodiversidad y Sitio de Patrimonio Mundial de la UNESCO en Sudáfrica. Incorporamos varios métodos, conocimientos y fuentes de información a partir de las comparaciones antes‐después dentro y fuera del área protegida. Observamos un incremento significativo en la vegetación del matorral (17‐30%), el cual atribuimos principalmente en la disminución de la quema frecuente para el pastoreo. Esto también ocurrió fuera del área protegida y fue causado por factores socioeconómicos y no por preocupación por la conservación de la biodiversidad o por la degradación del suelo. De no haberse establecido el área protegida, la zona habría sufrido una intensificación de cultivos y un incremento de carreteras, edificios y almacenamiento de agua en presas. Nuestra estrategia incrementó la cobertura histórica temporal del cambio socio‐ecológico y contextualizó las suposiciones sobre la causalidad. La evaluación del impacto del área protegida debe volver a la investigación basada en el lugar que incorpora de lleno el pluralismo en la metodología para construir situaciones contrafactuales de una forma que genere conocimiento regional y global a partir del nivel local y hacia arriba. Diseñamos diez principios clave para derivar las situaciones contrafactuales basados en el pluralismo metodológico, la cobertura de los aspectos de colaboración, creación conjunta, inter‐ y transdisciplinariedad, valores diversos y experiencias vividas, varios tipos de conocimiento, diferentes mecanismos causales posibles, métodos cualitativos de las ciencias sociales, percepciones, perspectivas, historias y narrativas.
Rangeland Ecology in a Changing World Gillson, Lindsey; Hoffman, M. Timm
Science (American Association for the Advancement of Science),
01/2007, Letnik:
315, Številka:
5808
Journal Article
Recenzirano
A synthesis of different models for assessing the balance between vegetation and livestock numbers in grazing lands may help policy-makers integrate human and ecosystem needs.
Fynbos and afrotemperate forest exist as alternate stable states in the Cape Floristic Region of South Africa. In parts of Table Mountain National Park, afrotemperate forest has expanded in recent ...decades. The aim of this project was to explore the drivers of this change and distinguish whether this expansion represents a recovery of forest after previous clearance during the 18th century or is a novel expansion of forest range that resulted from policies of fire suppression in the 20th century. To determine the relationships between forest and fynbos and its key drivers, pollen, non-pollen palynomorphs, charcoal, stable isotope ratios (δ13C) and major and trace elements were analysed from late-Holocene sediments extracted from Orange Kloof. Pollen data show that forest cover has fluctuated over the past 3690 years. At the start of the record, under drier conditions from 1670 BCE to ~170 CE, forests contracted, and dry, asteraceous fynbos dominated the landscape. Around ~170 CE there was a shift to ericaceous fynbos as water availability increased. Weak signals of Khoekhoen pastoralists may be visible in the record around 50 CE, indicated by increased spores and charcoal. A regime shift towards increased dominance of the forest occurred ~250 CE, associated with wetter climate. Clear anthropogenic signals are associated with European settlement from 1650 CE. Reinforced by human clearance of forest, fynbos expanded during the cool conditions of the late phase of Little Ice Age (~1750–1850 CE). Forest expansion in the 20th century likely reflects fire suppression and recovery from past forest clearance. Fire needs to be managed accordingly if further expansion of forest into fynbos is to be curbed.
The transition to parenthood, or the addition of another child to the family system is a life altering event for both mothers and fathers that can affect both parents individually and their ...relationship. For some parents, this includes perinatal suicidal ideation. Despite the prevalence of perinatal mood disorders, there are no systemic models designed specifically for couples who are at risk for suicide. This paper reviews the literature on the prevalence of perinatal suicidal ideation and proposes an integrative treatment model using aspects of Collaborative Assessment of Suicidality (CAMS), Attachment based family therapy (ABFT), and Emotionally Focused Therapy (EFT).
Bush encroachment has been recognised in southern Africa since the late nineteenth century. Our review of 23 studies showed that the rate of woody cover change has ranged from −0.131 to 1.275% y ⁻¹. ...Encroachment was most rapid on small protected areas, intermediate under commercial tenure, and slowest under communal tenure and large, natural environments with mega-herbivores present. Several drivers of bush encroachment, which interact and change over time, have been proposed. Fires, for example, were actively suppressed during the early twentieth century. However, rainfall interacts with fire and the rate of woody increase under fire exclusion is linearly related to mean annual rainfall. A reduction in browsing herbivores from the nineteenth century would have had a positive cumulative effect on woody cover whilst an increase in grazing herbivores would have reduced the competitive effect of grasses. Encroachment was most rapid during the high rainfall, mid-1970s, which followed the 1960s drought when cattle numbers were at their peak, and the grass layer was degraded. Increasing atmospheric CO ₂ and climate change have emerged as important drivers in the recent literature. Bush encroachment depends on the interplay of history, environment, management and vegetation, recognition of which is essential for containing encroachment.
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