The awareness of the need for robust impact evaluations in conservation is growing and statistical matching techniques are increasingly being used to assess the impacts of conservation interventions. ...Used appropriately matching approaches are powerful tools, but they also pose potential pitfalls. We outlined important considerations and best practice when using matching in conservation science. We identified 3 steps in a matching analysis. First, develop a clear theory of change to inform selection of treatment and controls and that accounts for real‐world complexities and potential spillover effects. Second, select the appropriate covariates and matching approach. Third, assess the quality of the matching by carrying out a series of checks. The second and third steps can be repeated and should be finalized before outcomes are explored. Future conservation impact evaluations could be improved by increased planning of evaluations alongside the intervention, better integration of qualitative methods, considering spillover effects at larger spatial scales, and more publication of preanalysis plans. Implementing these improvements will require more serious engagement of conservation scientists, practitioners, and funders to mainstream robust impact evaluations into conservation. We hope this article will improve the quality of evaluations and help direct future research to continue to improve the approaches on offer.
Emparejamiento Estadístico para la Ciencia de la Conservación
Resumen
Hay más conciencia sobre la necesidad de evaluaciones de impacto más rigurosas y las técnicas de emparejamiento estadístico se están usan con más frecuencia para evaluar los impactos de intervenciones de conservación. Las técnicas de emparejamiento pueden ser herramientas poderosas si son utilizadas correctamente, pero también pueden llevar a conclusiones erróneas. En este artículo describimos consideraciones importantes para realizar estudios de conservación que utilizan técnicas de emparejamiento estadístico. Identificamos tres pasos dentro de un análisis de emparejamiento. Primero, es importante desarrollar una teoría del cambio que considere las complejidades del mundo real y las posibles consecuencias indirectas para poder seleccionar unidades de tratamiento y controles. Segundo, es clave seleccionar las covarianzas y la estrategia de emparejamiento apropiadas. Tercero, evaluar la calidad del emparejamiento a través de una serie de revisiones. El segundo y el tercer paso pueden ser repetidos y deben concluirse antes de que se exploren los resultados. Evaluaciones de impacto de intervenciones de conservación podrían mejorarse con una mejor planeación de las evaluaciones junto con la intervención, una mejor integración de los métodos cualitativos, mejor consideración de consecuencias indirectas a grandes escalas espaciales y un incremento en la publicación de planes pre‐analíticos. La implementación de estas mejoras requerirá de un compromiso más serio por parte de científicos de la conservación, y de practicantes y financiadores. Esperamos que este artículo mejore la calidad de evaluaciones y ayude a guiar futuras investigaciones e intervenciones de conservación.
摘要
目前, 已经有越来越多的人认识到需要对保护的效果进行稳健的评估, 在评估保护措施的影响时也越来越多地应用了统计匹配方法。匹配方法若使用得当可成为有力工具, 但也可能带来潜在陷阱。本研究概述了在保护科学中使用匹配方法时的重要注意事项和最佳实践。我们确定了匹配分析的三个步骤。首先是提出清晰的变化理论来指导实验组和控制组的选择, 其中要考虑到现实世界的复杂性和潜在的溢出效应。接下来, 应选择合适的协变量和匹配方法。最后, 需通过一系列的检查来评估匹配的质量。第二步和第三步可以重复进行, 但要在输出匹配结果前完全确定。在实施保护措施的同时加强评估规划、更好地整合总结定性方法、考虑更大空间尺度的溢出效应, 以及更多地公开发表预分析计划, 将有助于改善未来的保护效果评估体系。实施以上改进措施还需要保护科学家、实践者和资助者的认真参与, 推动保护效果的稳健评估纳入保护工作的主流。我们希望本文有助于提升保护效果评估的质量, 并帮助指导今后的研究以进一步改进现有的方法。【翻译: 胡怡思; 审校: 聂永刚】
Article Impact statement: The article identifies 3 steps in using matching in conservation impact evaluation, highlighting best practice and areas for improvement.
National Trends in Ambulatory Oral Anticoagulant Use Barnes, Geoffrey D., MD, MSc; Lucas, Eleanor, BA; Alexander, G. Caleb, MD, MS ...
The American journal of medicine,
12/2015, Letnik:
128, Številka:
12
Journal Article
Recenzirano
Odprti dostop
Abstract Background Four direct oral anticoagulants (DOACs) have been brought to market for the treatment of nonvalvular atrial fibrillation and venous thromboembolism. Many forces, including ...numerous positive trial results, emerging safety concerns, marketing, and promotion, may shape DOAC adoption by providers. However, relatively little is known regarding their ambulatory utilization compared with warfarin, as well as the degree to which they have decreased under-treatment of atrial fibrillation. Methods We used the IMS Health National Disease and Therapeutic Index, a nationally representative audit of outpatient office visits, to estimate the use of warfarin and DOACs between 2009 and 2014. Results Overall, visits with anticoagulation use increased from 2.05 (95% confidence interval CI, 1.82-2.27) to 2.83 (95% CI, 2.49-3.17) million (M) quarterly visits ( P < .001). Of these, DOAC use has grown to 4.21M (95% CI, 3.63M-4.79M; 38.2% of total) treatment visits in 2014 since their introduction in 2010. Use of all oral anticoagulants in treatment visits for atrial fibrillation has increased from 0.88M (95% CI, 0.74M-1.02M) to 1.72M (95% CI, 1.47M-1.97M; P < .001), with similar DOAC and warfarin use in 2014. Atrial fibrillation visits with anticoagulant use increased from 51.9% (95% CI, 50.4%-53.8%) to 66.9% (95% CI, 65.0%-69.3%) between 2009 and 2014 ( P < .001). In 2014, rivaroxaban was the most commonly prescribed DOAC for atrial fibrillation (47.9% of office visits), followed by apixaban (26.5%) and dabigatran (25.5%). Conclusions Direct oral anticoagulants have been adopted rapidly, matching the use of warfarin, and are associated with increased use of oral anticoagulation for patients with atrial fibrillation.
Though the defense ministry has been a bastion of male power, a growing number of states have appointed women to this portfolio. What explains men's dominance over these positions? Which factors ...predict women's appointments? With comprehensive cross-national data from the post–Cold War era, we develop and test three sets of hypotheses concerning women's access to the defense ministry. We show that women remain excluded when the portfolio's remit reinforces traditional beliefs about the masculinity of the position, particularly in states that are engaged in fatal disputes, governed by military dictators, and large military spenders. By contrast, female defense ministers emerge when expectations about women's role in politics have changed—that is, in states with female chief executives and parliamentarians. Women are also first appointed to the post when its meaning diverges from traditional conceptions of the portfolio, particularly in countries concerned with peacekeeping and in former military states with left-wing governments.
This paper discusses a novel fully implicit formulation for a one-dimensional electrostatic particle-in-cell (PIC) plasma simulation approach. Unlike earlier implicit electrostatic PIC approaches ...(which are based on a linearized Vlasov–Poisson formulation), ours is based on a nonlinearly converged Vlasov–Ampére (VA) model. By iterating particles and fields to a tight nonlinear convergence tolerance, the approach features superior stability and accuracy properties, avoiding most of the accuracy pitfalls in earlier implicit PIC implementations. In particular, the formulation is stable against temporal (Courant–Friedrichs–Lewy) and spatial (aliasing) instabilities. It is charge- and energy-conserving to numerical round-off for arbitrary implicit time steps (unlike the earlier “energy-conserving” explicit PIC formulation, which only conserves energy in the limit of arbitrarily small time steps). While momentum is not exactly conserved, errors are kept small by an adaptive particle sub-stepping orbit integrator, which is instrumental to prevent particle tunneling (a deleterious effect for long-term accuracy). The VA model is orbit-averaged along particle orbits to enforce an energy conservation theorem with particle sub-stepping. As a result, very large time steps, constrained only by the dynamical time scale of interest, are possible without accuracy loss. Algorithmically, the approach features a Jacobian-free Newton–Krylov solver. A main development in this study is the nonlinear elimination of the new-time particle variables (positions and velocities). Such nonlinear elimination, which we term particle enslavement, results in a nonlinear formulation with memory requirements comparable to those of a fluid computation, and affords us substantial freedom in regards to the particle orbit integrator. Numerical examples are presented that demonstrate the advertised properties of the scheme. In particular, long-time ion acoustic wave simulations show that numerical accuracy does not degrade even with very large implicit time steps, and that significant CPU gains are possible.
Climate forcing of sea-ice losses from the Arctic and West Antarctic are blueing the poles. These losses are accelerating, reducing Earth’s albedo and increasing heat absorption 1. Subarctic forest ...(area expansion and increased growth) and ice-shelf losses (resulting in new phytoplankton blooms which are eaten by benthos) are the only significant described negative feedbacks acting to counteract the effects of increasing CO2 on a warming planet, together accounting for uptake of ∼107 tonnes of carbon per year 2. Most sea-ice loss to date has occurred over polar continental shelves, which are richly, but patchily, colonised by benthic animals. Most polar benthos feeds on microscopic algae (phytoplankton), which has shown increased blooms coincident with sea-ice losses 3. Here, growth responses of Antarctic shelf benthos to sea-ice losses and phytoplankton increases were investigated. Analysis of two decades of benthic collections showed strong increases in annual production of shelf seabed carbon in West Antarctic bryozoans. These were calculated to have nearly doubled to >2x105 tonnes of carbon per year since the 1980s. Annual production of bryozoans is median within wider Antarctic benthos 4, so upscaling to include other benthos (combined study species typically constitute ∼3% benthic biomass) suggests an increased drawdown of ∼2.9x106 tonnes of carbon per year. This drawdown could become sequestration because polar continental shelves are typically deeper than most modern iceberg scouring, bacterial breakdown rates are slow, and benthos is easily buried. To date, most sea-ice losses have been Arctic, so, if hyperboreal benthos shows a similar increase in drawdown, polar continental shelves would represent Earth’s largest negative feedback to climate change.
Barnes shows that loss of sea ice in the Antarctic leads to strong increases in benthic bryozoan biomass, possibly providing a negative feedback to CO2-driven climate change.
Earth's biodiversity and human societies face pollution, overconsumption of natural resources, urbanization, demographic shifts, social and economic inequalities, and habitat loss, many of which are ...exacerbated by climate change. Here, we review links among climate, biodiversity, and society and develop a roadmap toward sustainability. These include limiting warming to 1.5°C and effectively conserving and restoring functional ecosystems on 30 to 50% of land, freshwater, and ocean "scapes." We envision a mosaic of interconnected protected and shared spaces, including intensively used spaces, to strengthen self-sustaining biodiversity, the capacity of people and nature to adapt to and mitigate climate change, and nature's contributions to people. Fostering interlinked human, ecosystem, and planetary health for a livable future urgently requires bold implementation of transformative policy interventions through interconnected institutions, governance, and social systems from local to global levels.
Motivational interviewing (MI) is a client‐centred method of intervention focused on enhancing intrinsic motivation and behaviour change. A previous review of the literature and meta‐analyses support ...the effectiveness of MI for weight loss. None of these studies, however, focused on the bourgeoning literature examining MI for weight loss among adults within primary care settings, which confers unique barriers to providing weight loss treatment. Further, the current review includes 19 studies not included in previous reviews or meta‐analyses. We conducted a comprehensive review of PubMed, MI review papers, and citations from relevant papers. A total of 24 adult randomized controlled trials were identified. MI interventions typically were provided individually by a range of clinicians and compared with usual care. Few studies provided adequate information regarding MI treatment fidelity. Nine studies (37.5%) reported significant weight loss at post‐treatment assessment for the MI condition compared with control groups. Thirteen studies (54.2%) reported MI patients achieving at least 5% loss of initial body weight. There is potential for MI to help primary care patients lose weight. Conclusions, however, must be drawn cautiously as more than half of the reviewed studies showed no significant weight loss compared with usual care and few reported MI treatment fidelity.
To develop a late-life dementia risk index that can accurately stratify older adults into those with a low, moderate, or high risk of developing dementia within 6 years.
Subjects were 3,375 ...participants in the Cardiovascular Health Cognition Study without evidence of dementia at baseline. We used logistic regression to identify those factors most predictive of developing incident dementia within 6 years and developed a point system based on the logistic regression coefficients.
Subjects had a mean age of 76 years at baseline; 59% were women and 15% were African American. Fourteen percent (n = 480) developed dementia within 6 years. The final late-life dementia risk index included older age (1-2 points), poor cognitive test performance (2-4 points), body mass index <18.5 (2 points), > or =1 apolipoprotein E epsilon4 alleles (1 point), cerebral MRI findings of white matter disease (1 point) or ventricular enlargement (1 point), internal carotid artery thickening on ultrasound (1 point), history of bypass surgery (1 point), slow physical performance (1 point), and lack of alcohol consumption (1 point) (c statistic, 0.81; 95% confidence interval, 0.79-0.83). Four percent of subjects with low scores developed dementia over 6 years compared with 23% of subjects with moderate scores and 56% of subjects with high scores.
The late-life dementia risk index accurately stratified older adults into those with low, moderate, and high risk of developing dementia. This tool could be used in clinical or research settings to target prevention and intervention strategies toward high-risk individuals.
Coronavirus disease 2019 (COVID-19) is a viral infection that can, in severe cases, result in cytokine storm, systemic inflammatory response and coagulopathy that is prognostic of poor outcomes. ...While some, but not all, laboratory findings appear similar to sepsis-associated disseminated intravascular coagulopathy (DIC), COVID-19- induced coagulopathy (CIC) appears to be more prothrombotic than hemorrhagic. It has been postulated that CIC may be an uncontrolled immunothrombotic response to COVID-19, and there is growing evidence of venous and arterial thromboembolic events in these critically ill patients. Clinicians around the globe are challenged with rapidly identifying reasonable diagnostic, monitoring and anticoagulant strategies to safely and effectively manage these patients. Thoughtful use of proven, evidence-based approaches must be carefully balanced with integration of rapidly emerging evidence and growing experience. The goal of this document is to provide guidance from the Anticoagulation Forum, a North American organization of anticoagulation providers, regarding use of anticoagulant therapies in patients with COVID-19. We discuss in-hospital and post-discharge venous thromboembolism (VTE) prevention, treatment of suspected but unconfirmed VTE, laboratory monitoring of COVID-19, associated anticoagulant therapies, and essential elements for optimized transitions of care specific to patients with COVID-19.
Abstract
Climate-related disturbance regimes are changing rapidly with profound consequences for ecosystems. Disturbance is often perceived as detrimental to biodiversity; however, the literature is ...divided on how they influence each other. Disturbance events in nature are diverse, occurring across numerous interacting trophic levels and multiple spatial and temporal scales, leading to divergence between empirical and theoretical studies. The shallow Antarctic seafloor has one of the largest disturbance gradients on earth, due to iceberg scouring. Scour rates are changing rapidly along the Western Antarctic Peninsula because of climate change and with further changes predicted, the Antarctic benthos will likely undergo dramatic shifts in diversity. We investigated benthic macro and megafaunal richness across 10–100 m depth range, much of which, 40–100 m, has rarely been sampled. Macro and megafauna species richness peaked at 50–60 m depth, a depth dominated by a diverse range of sessile suspension feeders, with an intermediate level of iceberg disturbance. Our results show that a broad range of disturbance values are required to detect the predicted peak in biodiversity that is consistent with the Intermediate Disturbance Hypothesis, suggesting ice scour is key to maintaining high biodiversity in Antarctica’s shallows.
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