14 research outputs found

    Data from: Regional variation in Caribbean dry forest tree species composition

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    How does tree species composition vary in relation to geographical and environmental gradients in a globally rare tropical/subtropical broadleaf dry forest community in the Caribbean? We analyzed data from 153 Forest Inventory and Analysis (FIA) plots from Puerto Rico and the U.S. Virgin Islands (USVI), along with 42 plots that we sampled in the Bahamian Archipelago (on Abaco and Eleuthera Islands). FIA data were collected using published protocols. In the Bahamian Archipelago, we recorded terrain and landscape variables, and identified to species and measured the diameter of all stems ≥5 cm at 1.3 m height in 10 m radius plots. All data were analyzed using clustering, ordination, and indicator species analysis at regional and local scales. Regionally, the largest cluster group included over half of all plots and comprised plots from all three island groups. Indicator species were native Bursera simaruba (Burseraceae) and Metopium toxiferum (Anacardiaceae). Species composition was similar to dry forests throughout the region based on published studies. Other groups we identified at the regional scale consisted of many Puerto Rico and USVI plots that were dominated by non-native species, documenting the widespread nature of novel ecosystems. At the local scale the Bahamian data clustered into two main groups corresponding largely to the two islands sampled, a pattern consistent with the latitudinal aridity gradient. Bahamian dry forests share previously undocumented compositional similarity with native-dominated dry forests found throughout the Caribbean, but they lack extensive post-disturbance novel dry forests dominated by non-native trees found in the Greater Antilles

    Ageing and the epidemiology of multimorbidity

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    The consequences of fear

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    Our modern world is a risky place and evokes many well-founded fears. But these fears themselves create a new risk for our health and well-being that needs to be addresse

    Laparoscopic radical prostatectomy: omitting a pelvic drain

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    PURPOSE: Our goal was to assess outcomes of a selective drain placement strategy during laparoscopic radical prostatectomy (LRP) with a running urethrovesical anastomosis (RUVA) using cystographic imaging in all patients. Materials and Methods: A retrospective chart review was performed for all patients undergoing LRP between January 2003 and December 2004. The anastomosis was performed using a modified van Velthoven technique. A drain was placed at the discretion of the senior surgeon when a urinary leak was demonstrated with bladder irrigation, clinical suspicion for a urinary leak was high, or a complex bladder neck reconstruction was performed. Routine postoperative cystograms were obtained. RESULTS: 208 patients underwent LRP with a RUVA. Data including cystogram was available for 206 patients. The overall rate of cystographic urine leak was 5.8%. A drain was placed in 51 patients. Of these, 8 (15.6%) had a postoperative leak on cystogram. Of the 157 undrained patients, urine leak was radiographically visible in 4 (2.5%). The higher leak rate in the drained vs. undrained cohort was statistically significant (p = 0.002). Twenty-four patients underwent pelvic lymph node dissection (8 drained, 16 undrained). Three undrained patients developed lymphoceles, which presented clinically on average 3 weeks postoperatively. There were no urinomas or hematomas in either group. CONCLUSIONS: Routine placement of a pelvic drain after LRP with a RUVA is not necessary, unless the anastomotic integrity is suboptimal intraoperatively. Experienced clinical judgment is essential and accurate in identifying patients at risk for postoperative leakage. When suspicion is low, omitting a drain does not increase morbidity
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