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1.
JAMA Netw Open ; 7(3): e240073, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38436959

RESUMO

Importance: American Indian or Alaska Native and Black adults experience elevated rates of firearm injury and death, but both groups are severely underrepresented in research on firearm exposure and behaviors. Objective: To explore geodemographic differences in firearm behaviors and violence exposure among American Indian or Alaska Native and Black adults in the US. Design, Setting, and Participants: In this survey study, nationally representative samples of American Indian or Alaska Native and/or Black adults recruited from KnowledgePanel were surveyed cross-sectionally. Surveys were administered online between April 12 and May 4, 2023. Main Outcomes and Measures: Firearm access, storage, and carrying behaviors and lifetime firearm violence exposure were the primary outcomes. Demographic factors such as age, geographic location, and political affiliation were considered. Data were weighted to geodemographic distributions from the US Census Bureau's 2022 Current Population Survey. Results: Of 3542 participants, 527 (14.9%) were American Indian or Alaska Native (280 [53.1%] female) and 3015 (85.1%) were Black (1646 [54.6%] female). Both groups exhibited high firearm access rates (American Indian or Alaska Native adults: 238 [45.4%; 95% CI, 39.4%-51.7%]; Black adults: 909 [30.4%; 95% CI, 28.0%-32.9%]), predominantly owning handguns for home protection. The groups demonstrated similar firearm storage patterns, and a substantial proportion endorsed always or almost always carrying firearms outside the home (American Indian or Alaska Native adults: 18.9%; Black adults: 15.2%). Self-protection was a common reason for carrying a firearm (American Indian or Alaska Native adults: 104 [84.9%; 95% CI, 74.1%-91.7%]; Black adults: 350 [88.3%; 95% CI, 82.3%-92.4%]), and a minority of participants cited lack of faith in the police (American Indian or Alaska Native adults: 19 [15.2%; 95% CI, 8.2%-26.7%]; Black adults: 61 [15.4%; 95% CI, 10.3%-21.2%]), indicating potential shifts in public safety dynamics. Conclusions and Relevance: In this survey study of American Indian or Alaska Native and Black US adults, a substantial percentage of both groups reported living in homes with firearms, storing firearms loaded and unlocked, frequently carrying firearms outside the home, and having been exposed directly and indirectly to gun violence. These findings underscore the need for nuanced public health campaigns and policies and highlight challenges for law enforcement in contexts of racial disparities and changing legal frameworks.


Assuntos
Exposição à Violência , Armas de Fogo , Violência com Arma de Fogo , Ferimentos por Arma de Fogo , Adulto , Feminino , Humanos , Masculino , Indígena Americano ou Nativo do Alasca , Negro ou Afro-Americano
2.
Mar Environ Res ; 196: 106385, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38309245

RESUMO

Previous studies of dispersion of intertidal seagrass-associated macrobenthos in subtropical Moreton Bay, Queensland, showed that patchiness characterised its assemblage abundance with scale-invariant magnitude across areas ranging from >8000 to 0.1 m2. Those studies were here continued across the smaller scales (down to 0.014 m2) arguably more relevant to the dominant 2-10 mm long animals, using 16 replicate blocks of 5x5 contiguous 0.0024 m2 cores nested within the previously studied site. At microscales ≥0.09 m2, the earlier congruence of conclusions derived from patchiness indices and spatial autocorrelation broke down. At >0.014 m2, adjacent points (cores) no longer together formed larger spatial units of related abundance (i.e. showed no autocorrelation), but point abundances were still highly disparate (as reflected in patchiness indices). Congruent indications of patchiness only manifested at 0.014 m2 spatial scales. Assemblage dispersion pattern was partly consequent on one microgastropod (Pseudoliotia) occurring superabundantly in scattered 0.0024 m2 hotspots.


Assuntos
Biodiversidade , Ecossistema , Animais , Queensland
3.
Artigo em Inglês | MEDLINE | ID: mdl-37638142

RESUMO

Background: Bronchiectasis is a chronic lung disorder that affects the lives of many South Africans. Post-tuberculosis (TB) bronchiectasis is an important complication of previous pulmonary TB and a common cause of bronchiectasis in South Africa (SA). No previous statements on the management of bronchiectasis in SA have been published. Objectives: To provide a position statement that will act as a template for the management of adult patients with bronchiectasis in SA. Methods: The South African Thoracic Society appointed an editorial committee to compile a position statement on the management of adult non-cystic fibrosis (CF) bronchiectasis in SA. Results: A position statement addressing the management of non-CF bronchiectasis in adults in SA was compiled. This position statement covers the epidemiology, aetiology, diagnosis, investigations and various aspects of management of adult patients with non-CF bronchiectasis in SA. Conclusion: Bronchiectasis has largely been a neglected lung condition, but new research has improved the outlook for patients. Collaboration between interprofessional team members in patient management is important. In SA, more research into the epidemiology of bronchiectasis, especially post-TB bronchiectasis and HIV-associated bronchiectasis, is required. Abstract: The South African Thoracic Society mandated a multidisciplinary team of healthcare providers to compile a position statement on the management of non-cystic fibrosis bronchiectasis in South Africa (SA). International guidelines on the management of bronchiectasis were reviewed and used as a basis from which the current position statement was compiled. This is the first position statement on the management of adult non-cystic fibrosis bronchiectasis in SA. A description of the epidemiology and aetiology of bronchiectasis is provided, as well as guidance on its diagnosis and management. The position statement provides guidance on the management of bronchiectasis to healthcare providers, policymakers and regulatory authorities.

4.
Artigo em Inglês | MEDLINE | ID: mdl-37406796

RESUMO

OBJECTIVES: Repetitive transcranial magnetic stimulation (rTMS) is a level 1a evidence-based treatment for major depression, but high cost of care and limited effectiveness in naturalistic cohorts have been lingering criticisms. This naturalistic, retrospective cohort analysis compares the effect of once and twice daily treatment protocols of rTMS using quality assurance data collected at an Australian private psychiatric hospital. METHODS: A total of 210 inpatients self-selected into two groups receiving up to 30 sessions of either daily (n = 101) or twice daily (n = 109) 10 Hz rTMS to the left dorsolateral prefrontal cortex (DLPFC). The a priori primary outcome measure was remission rate as measured by pre and post treatment HAMD-17 scores. Length of hospital stay was a secondary post hoc outcome adopted due to the importance to cost of acute psychiatric care. RESULTS: Remission rates were similar across groups, with 44.9% and 45.4% for twice daily and daily rTMS groups respectively, although these may be confounded by patient expectations, other treatments and medication changes given the naturalistic setting. The length of hospital stay was 10.11 days and 18.44 days for twice daily and daily rTMS respectively - the twice daily rTMS length of hospital stay was 45.1% shorter 95% CI [38.7% - 51.56%]. Dropout rates were high; Twenty-seven (24.77%) twice daily participants dropped out before 20 sessions were completed, and 35 (34.65%) of daily participants. CONCLUSIONS: Twice daily 10 Hz left sided rTMS remission outcomes were similar to traditional once daily rTMS but required a shorter length of hospital stay. This finding has substantial cost of care implications. If these findings are independently replicated, twice daily rTMS may become the standard of care for inpatient rTMS.


Assuntos
Transtorno Depressivo Maior , Humanos , Transtorno Depressivo Maior/psicologia , Depressão/terapia , Tempo de Internação , Estimulação Magnética Transcraniana/métodos , Estudos Retrospectivos , Resultado do Tratamento , Austrália , Córtex Pré-Frontal/fisiologia
5.
Behav Anal Pract ; 16(1): 40-50, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37006420

RESUMO

Recommendations for intervention for young children with autism spectrum disorders (ASD) focus on early, intensive, and often individual intervention based on methods of applied behavior analysis. In much of the world, there are few options for early intervention. This article examines this question: in a context where intensive and high staff-to-student ratio intervention is not possible, how can provision of high-quality evidence-based intervention be ensured? We consider the case of China, where intervention for young children with autism is provided at diverse educational organizations, and funding limitations impact teacher-to-student ratio. Due to challenges, rigorous use of evidence-based methods often lags behind best practices. This article presents an ethical analysis of the choices educators face and research-based recommendations consistent with the ethical analysis. Given the current context, we recommend a socially valid approach of systematically using group instruction based on ABA principles to increase the effectiveness and intensity of each aspect of intervention programs. While focused on the case of China, recommendations and analysis have implications for other settings with limited resources.

6.
Mar Environ Res ; 185: 105897, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36738698

RESUMO

Coastal lagoon ecology often changes on progression from the open, well-flushed mouth region to the depositional zone furthest from the open sea. This is generally considered consequent on increasing 'confinement' and associated features, rather than on the often co-occurringly decreasing salinity. The 12 km Rainbow Channel connecting part of Moreton Bay, a microtidal leaky lagoon, to the adjacent Pacific provides a gradient of increasing confinement without any significant salinity change, i.e. a tenfold increase in water residence time for a salinity decrease of <1. Macrobenthic faunal assemblages characterising intertidal Zostera seagrass at strategic points along its length were compared to test whether their nature changed in conformity with confinement models. Results suggest that it does not; faunal abundance, species richness, evenness and composition remaining effectively unchanged along the gradient. Seagrass systems may constitute a special case because they decouple renewal times of the overlying water and local organic enrichment/decomposition; as may leaky lagoons because of their high tidal velocities.


Assuntos
Biodiversidade , Invertebrados , Animais , Ecologia , Oceanos e Mares , Água , Ecossistema
7.
Soc Sci Med ; 314: 115463, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36332533

RESUMO

Very brief opportunistic interventions for smoking cessation are effective, cost-saving for health systems, and universally recommended in guidelines. However, evidence suggests that clinicians are reluctant to intervene, citing interactional difficulties. Only one UK study has specifically examined smoking discussions, within naturally occurring primary care consultations. However smoking cessation treatment was not available at the time. We examined existing datasets amounting to 519 video-recordings of GP consultations in England for instances of talk about smoking. We used conversation analytic methods to assess patients' responses to doctors asking about smoking, giving advice on smoking, and offering cessation treatment. In 31 recordings it was apparent that the patient smoked, and, in 25/31 consultations, doctors initiated the topic of smoking. They did so by asking about smoking status, commonly during the history-taking phase of the consultation. In many instances, these questions led to active resistance from patients against being placed in a discreditable category, for example by minimising their smoking. This was more pronounced when GPs pursued efforts to quantify the amount smoked. Thereafter, where doctors returned to the topic of smoking, they did so typically by linking smoking to the patient's medical condition, which likewise led to resistance. Guidance recommends that GPs advise on how best to quit smoking where patients are interested in doing so, but this was only evident in a minority of consultations. Where GPs offered support for cessation, they did so using interactional practices that minimised the need for the patient to respond and thereby accept. Interactional difficulties were found to be common in consultations between GPs and people who smoke when GPs actions aligned with some VBA guidelines. Future research should examine when and how advice on how best to quit, and offers of support, should be delivered within primary care consultations.


Assuntos
Clínicos Gerais , Abandono do Hábito de Fumar , Humanos , Comunicação , Encaminhamento e Consulta , Assistência Médica
8.
Mar Environ Res ; 181: 105755, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36162219

RESUMO

Do interspecific abundance-occupancy (A-O) relationships vary systematically along environmental gradients? A-O relationships of macrobenthic assemblages of seagrass and adjacent bare-sediment were compared at series of sites along two types of estuarine gradient; the longitudinal one of the main axial channel, and a transverse one from that channel into progressively smaller channels and creeks enclosed within fringing saltmarsh. Three general features emerged: A-O regression slopes were remarkably uniform across all the disparate assemblages and sites (1.04 ± 0.08); values of R2 were very high (≈0.96); and where small but significant differences between sites occurred, they were associated with the stronger gradients (i.e. those with the larger differentials in abundance and smaller compositional similarities). In two such cases, slope values were correlated with position along the gradient (although only at the margin of statistical significance). Variation in A-O relationships along estuarine gradients does clearly occur, but their constancy leaves the stronger impression.


Assuntos
Ecossistema , Estuários
9.
Zootaxa ; 5026(4): 480-506, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34810920

RESUMO

Ten species of fiddler crab are reported inhabiting the intertidal zone of a shore on Kaledupa Island, Indonesia. This is one of the highest recorded numbers of fiddler crab species living in sympatry, equating to over two-thirds of those known from the Wallacea biogeographic region and more than half of all those recorded from Indonesia. The descriptions to identify and distinguish these ten species are provided using a suite of characters e.g., carapace, major cheliped, male gonopods, gastric mills, life colouration in males and females, and notes on their ecology and distribution. Specimens were observed and collected in the Wakatobi National Park, near the village of Ambeua on Kaledupa island, Sulawesi Tenggara, Indonesia. Gastric mills are described for the first time for Gelasimus jocelynae, Paraleptuca crassipes, Tubuca coarctata, T. demani and T. dussumieri. A tabulation of anatomical features and colouration for all species in this study is provided as a support for field studies. It identifies features that support the recently proposed taxonomic revision of fiddler crabs by Shih et al. (2016).


Assuntos
Braquiúros , Decápodes , Animais , Ecossistema , Feminino , Masculino , Simpatria
10.
Mar Environ Res ; 172: 105500, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34653926

RESUMO

Relationships between species diversity and other species-density and species-richness metrics were investigated in the seagrass macrobenthos of Knysna estuarine bay, South Africa. Although a wide range of species density occurred across sites, neither Hill-Shannon nor Hill-Simpson diversity showed any significant relationship with it, although they did with species richness. Instead species diversity was very closely related to relative evenness, and (negatively) to overall assemblage abundance. No significant relationship was found between species density and evenness. Whilst there was a clear and marked decrease in species density upstream along the main estuarine channel, only one of the species-diversity indices (the Hill-Shannon) showed a significant equivalent decrease. Relationships depended on how 'species richness' was assessed, and were very strongly influenced by the superabundant local occurrence of a few individual faunal components (three gastropod and one tanaid species). Species-diversity analysis contributes nothing new in such estuarine seagrass meadows and seems best avoided.


Assuntos
Biodiversidade , Ecossistema , África do Sul
11.
Oecologia ; 196(4): 1107-1117, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34241686

RESUMO

For the first time, intraspecific relationships between the macroecological metrics patchiness (P) and both abundance (A) and occupancy (O) were investigated in a faunal assemblage. As a companion study to recent work on interspecific P, A and O patterns at the same localities, intraspecific patterns were documented within each of the more dominant invertebrates forming the seagrass macrobenthos of warm-temperate Knysna estuarine bay (South Africa) and of sub-tropical Moreton Bay (Australia). As displayed interspecifically, individual species showed strong A-O patterns (mean scaling coefficient - 0.76 and mean R2 > 0.8). All P-O relations were negative and most (67%) were statistically significant, although weaker (mean R2 0.5) than A-O ones; most P-A ones were also negative but fewer (43%) achieved significance, and were even weaker (mean R2 0.4); 33% of species showed no significant interrelations of either O or A with P. No species showed only a significant P-A relationship. Compared with interspecific P-A-O data from the same assemblages, power-law scaling exponents were equivalent, but R2 values were larger. Larviparous species comprised 70% of the total studied, but 94% of those displaying significant patchiness interrelationships; 5 of the 9 showing no P-A or P-O relationships, however, were also larviparous. At Knysna, though not in Moreton Bay, larviparous species also showed higher levels of occupancy than non-larviparous ones, whilst non-larviparous species showed higher levels of patchiness. Dominant Moreton Bay species, but not those at Knysna, exhibited homogeneously sloped P-O relationships.


Assuntos
Biodiversidade , Invertebrados , Animais , Austrália , Ecossistema , África do Sul
12.
J Antimicrob Chemother ; 76(3): 635-638, 2021 02 11.
Artigo em Inglês | MEDLINE | ID: mdl-33374010

RESUMO

BACKGROUND: The performance of the galactomannan enzyme immunoassay (GM-EIA) is impaired in patients receiving mould-active antifungal therapy. The impact of mould-active antifungal therapy on Aspergillus PCR testing needs to be determined. OBJECTIVES: To determine the influence of anti-mould prophylaxis (AMP) on the performance of PCR blood testing to aid the diagnosis of proven/probable invasive aspergillosis (IA). METHODS: As part of the systematic review and meta-analysis of 22 cohort studies investigating Aspergillus PCR blood testing in 2912 patients at risk of IA, subgroup analysis was performed to determine the impact of AMP on the accuracy of Aspergillus PCR. The incidence of IA was calculated in patients receiving and not receiving AMP. The impact of two different positivity thresholds (requiring either a single PCR positive test result or ≥2 consecutive PCR positive test results) on accuracy was evaluated. Meta-analytical pooling of sensitivity and specificity was performed by logistic mixed-model regression. RESULTS: In total, 1661 (57%) patients received prophylaxis. The incidence of IA was 14.2%, significantly lower in the prophylaxis group (11%-12%) compared with the non-prophylaxis group (18%-19%) (P < 0.001). The use of AMP did not affect sensitivity, but significantly decreased specificity [single PCR positive result threshold: 26% reduction (P = 0.005); ≥2 consecutive PCR positive results threshold: 12% reduction (P = 0.019)]. CONCLUSIONS: Contrary to its influence on GM-EIA, AMP significantly decreases Aspergillus PCR specificity, without affecting sensitivity, possibly as a consequence of AMP limiting the clinical progression of IA and/or leading to false-negative GM-EIA results, preventing the classification of probable IA using the EORTC/MSGERC definitions.


Assuntos
Aspergilose , Infecções Fúngicas Invasivas , Aspergilose/diagnóstico , Aspergilose/prevenção & controle , Aspergillus/genética , Humanos , Mananas , Metanálise como Assunto , Reação em Cadeia da Polimerase , Sensibilidade e Especificidade
13.
Med Mycol ; 59(2): 126-138, 2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32534456

RESUMO

Interlaboratory evaluations of Mucorales qPCR assays were developed to assess the reproducibility and performance of methods currently used. The participants comprised 12 laboratories from French university hospitals (nine of them participating in the Modimucor study) and 11 laboratories participating in the Fungal PCR Initiative. For panel 1, three sera were each spiked with DNA from three different species (Rhizomucor pusillus, Lichtheimia corymbifera, Rhizopus oryzae). For panel 2, six sera with three concentrations of R. pusillus and L. corymbifera (1, 10, and 100 genomes/ml) were prepared. Each panel included a blind negative-control serum. A form was distributed with each panel to collect results and required technical information, including DNA extraction method, sample volume used, DNA elution volume, qPCR method, qPCR template input volume, qPCR total reaction volume, qPCR platform, and qPCR reagents used. For panel 1, assessing 18 different protocols, qualitative results (positive or negative) were correct in 97% of cases (70/72). A very low interlaboratory variability in Cq values (SD = 1.89 cycles) were observed. For panel 2 assessing 26 different protocols, the detection rates were high (77-100%) for 5/6 of spiked serum. There was a significant association between the qPCR platform and performance. However, certain technical steps and optimal combinations of factors may also impact performance. The good reproducibility and performance demonstrated in this study support the use of Mucorales qPCR as part of the diagnostic strategy for mucormycosis.


Assuntos
Técnicas de Laboratório Clínico/normas , DNA Fúngico/genética , Técnicas de Diagnóstico Molecular/normas , Mucorales/genética , Mucormicose/sangue , Mucormicose/diagnóstico , Reação em Cadeia da Polimerase em Tempo Real/normas , Técnicas de Laboratório Clínico/instrumentação , Técnicas de Laboratório Clínico/métodos , França , Hospitais Universitários/estatística & dados numéricos , Humanos , Variações Dependentes do Observador , Reprodutibilidade dos Testes
14.
Mar Environ Res ; 160: 104983, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32907721

RESUMO

Intertidal macrobenthic assemblages associated with monospecific areas of different sympatric though not syntopic seagrasses [Cymodocea, Halodule, Zostera and Halophila] were investigated in Moreton Bay across a continuous <0.12 ha seagrass area with minimal potentially-confounding environmental variables. Results indicated patterns of unchanging faunal metrics across seagrass types (abundance, richness, diversity, evenness, taxonomic distinctness, and patchiness) but variation in relative proportions of dominant taxa, particularly microgastropods (abundant in Zostera, insignificant in Cymodocea and Halodule). Although assemblage composition varied, faunal dissimilarities (except with Zostera) were very low and of similar magnitudes within and between different 'host' seagrasses. This suggests that such macroecological faunal characteristics are not consequent on the precise local ecosystem engineer but largely reflect those of a common pool of locally available species, so that the differences in animal abundance and biodiversity described in some studies relate not directly to features inherent in the different seagrasses, but to associated habitat variables.


Assuntos
Alismatales , Biodiversidade , Zosteraceae , Animais , Ecossistema , Simpatria
15.
J Intellect Disabil Res ; 64(7): 489-496, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32490559

RESUMO

BACKGROUND: It is unknown how the novel Coronavirus SARS-CoV-2, the cause of the current acute respiratory illness COVID-19 pandemic that has infected millions of people, affects people with intellectual and developmental disability (IDD). The aim of this study is to describe how individuals with IDD have been affected in the first 100 days of the COVID-19 pandemic. METHODS: Shortly after the first COVID-19 case was reported in the USA, our organisation, which provides continuous support for over 11 000 individuals with IDD, assembled an outbreak committee composed of senior leaders from across the health care organisation. The committee led the development and deployment of a comprehensive COVID-19 prevention and suppression strategy, utilising current evidence-based practice, while surveilling the global and local situation daily. We implemented enhanced infection control procedures across 2400 homes, which were communicated to our employees using multi-faceted channels including an electronic resource library, mobile and web applications, paper postings in locations, live webinars and direct mail. Using custom-built software applications enabling us to track patient, client and employee cases and exposures, we leveraged current public health recommendations to identify cases and to suppress transmission, which included the use of personal protective equipment. A COVID-19 case was defined as a positive nucleic acid test for SARS-CoV-2 RNA. RESULTS: In the 100-day period between 20 January 2020 and 30 April 2020, we provided continuous support for 11 540 individuals with IDD. Sixty-four per cent of the individuals were in residential, community settings, and 36% were in intermediate care facilities. The average age of the cohort was 46 ± 12 years, and 60% were male. One hundred twenty-two individuals with IDD were placed in quarantine for exhibiting symptoms and signs of acute infection such as fever or cough. Sixty-six individuals tested positive for SARS-CoV-2, and their average age was 50. The positive individuals were located in 30 different homes (1.3% of total) across 14 states. Fifteen homes have had single cases, and 15 have had more than one case. Fifteen COVID-19-positive individuals were hospitalised. As of 30 April, seven of the individuals hospitalised have been discharged back to home and are recovering. Five remain hospitalised, with three improving and two remaining in intensive care and on mechanical ventilation. There have been three deaths. We found that among COVID-19-positive individuals with IDD, a higher number of chronic medical conditions and male sex were characteristics associated with a greater likelihood of hospitalisation. CONCLUSIONS: In the first 100 days of the COVID-19 outbreak in the USA, we observed that people with IDD living in congregate care settings can benefit from a coordinated approach to infection control, case identification and cohorting, as evidenced by the low relative case rate reported. Male individuals with higher numbers of chronic medical conditions were more likely to be hospitalised, while most younger, less chronically ill individuals recovered spontaneously at home.


Assuntos
Betacoronavirus , Doença Crônica/epidemiologia , Infecções por Coronavirus/epidemiologia , Cuidados Críticos/estatística & dados numéricos , Deficiências do Desenvolvimento/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Controle de Infecções/estatística & dados numéricos , Deficiência Intelectual/epidemiologia , Pneumonia Viral/epidemiologia , Adulto , COVID-19 , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Instituições Residenciais/estatística & dados numéricos , SARS-CoV-2 , Fatores Sexuais , Estados Unidos/epidemiologia
16.
Anaesthesia ; 75(8): 1070-1075, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-31872422

RESUMO

Laryngeal surgery requires a shared airway and close collaboration between surgeon and anaesthetist in order to optimise operating conditions. Apnoeic oxygenation uses the principle of aventilatory mass flow to maintain oxygenation of pulmonary capillary blood under apnoeic conditions while minimising laryngeal movement. Concerns regarding accumulation of carbon dioxide and resultant acidaemia have limited the use of the technique. We performed a prospective study of low-flow apnoeic oxygenation for patients undergoing microlaryngoscopy under general anaesthesia in order to evaluate the ability of the technique to maintain oxygenation and determine the resultant rate of carbon dioxide accumulation. Sixty-four patients undergoing microlaryngoscopy under general anaesthesia were studied between November 2016 and December 2018. Intra-operative oxygenation was provided via a 10-French oxygen catheter placed into the trachea delivering oxygen at 0.5-1.0 l.min-1 . Data regarding apnoea time, peripheral oxygen saturation and venous blood gas concentrations were recorded. The mean (SD) duration of apnoea was 18.7 (7.2) min. Apnoeic oxygenation allowed successful completion of the surgical procedure in 62/64 patients. Mean (SD) rate of rise of the venous partial pressure of carbon dioxide was 0.15 (0.10) kPa.min-1 . Operating conditions were recorded qualitatively as being adequate in all cases. No adverse effects were reported. Low-flow intra-tracheal apnoeic oxygenation is a simple, effective and inexpensive technique to maintain oxygenation for laryngeal surgery.


Assuntos
Manuseio das Vias Aéreas/métodos , Apneia , Laringe/cirurgia , Oxigenoterapia/métodos , Adulto , Idoso , Anestesia Geral , Gasometria , Dióxido de Carbono/sangue , Feminino , Humanos , Cuidados Intraoperatórios , Laringoscopia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Troca Gasosa Pulmonar
17.
Mar Environ Res ; 148: 99-107, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31170657

RESUMO

Spatial variation in the degree of local patchiness of macrobenthic assemblage abundance was assessed across the 16 km2 warm-temperate Knysna estuarine bay (South Africa) where the seagrass Zostera (Zosterella) capensis grows under a broad spectrum of environmental conditions and supports invertebrate assemblages at a wide range of local density (<2000->320000 ind. m-2). Macrobenthic assemblage abundance at all 27 representative sites examined displayed low-level but highly-significant spatial patchiness (mean Lloyd's index, IP = 1.148). Except at high tidal levels, however, the magnitude of this local patchiness did not vary statistically across the system (CV 4.3%) regardless of assemblage abundance, location or species composition. Patchinesses well within ±1 standard deviation of Knysna's value also characterise an equivalent Z. (Zosterella) capricorni assemblage in subtropical Queensland (IP 1.169) and another, Z. (Zosterella) noltei, assemblage in cool-temperate England (IP 1.135), suggesting that at local scales intertidal dwarf-eelgrass macrobenthic abundance displays a characteristic level of patchiness.


Assuntos
Monitoramento Ambiental , Estuários , Zosteraceae , Animais , Biodiversidade , Invertebrados , Biologia Marinha , África do Sul , Zosteraceae/crescimento & desenvolvimento
18.
Mar Environ Res ; 146: 89-100, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30928018

RESUMO

Following earlier studies across 2115 → 33 m2 scales (Barnes and Laurie, 2018), patchiness of macrobenthic abundance in intertidal Queensland seagrass was assessed by dispersion indices, spatial autocorrelation and hotspot analysis across a hierarchically-nested series of smaller scales (5.75 → 0.09 m2). Overall patterns of distribution and abundance over larger extents and with greater lag were mirrored across these smaller ones. Assemblage abundance per station varied by a factor of >10, but all three approaches showed effective constancy of total assemblage patchiness across all sub-2115 m2 scales (across-scales-mean Lloyd's IP of 1.06 and global Moran's I of 0.13). Equivalent constancy was also shown by most numerically-dominant species (scaling exponent ß = 0.93-1.15). Decreasing patchiness of some species with decreasing scale, however, resulted in two no longer being patchily dispersed across small scales. Significant hotspots of abundance occurred at a constant proportion of stations across scales, against a background of randomly scattered peak-abundance points.


Assuntos
Monitoramento Ambiental/métodos , Animais , Baías , Biodiversidade , Invertebrados/classificação , Queensland , Zosteraceae
19.
Zootaxa ; 4514(2): 256-262, 2018 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-30486218

RESUMO

The genus Eriopisella is recorded for the first time from Australia. Material from Moreton Bay, Queensland, proved to be an undescribed species and is here fully described and figured under the name E. moretoni sp. nov. An identification key to the nine known world species of Eriopisella is provided.


Assuntos
Anfípodes , Animais , Austrália , Queensland
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