Updating the distribution of Dicrodon guttulatum Duméril & Bibron, 1839 (Reptilia, Teiidae) with a disjunct population in the eastern slope of the Peruvian Andes

We report a disjunct population of Dicrodon guttulatum Duméril & Bibron, 1839 on the eastern slope of the Cordillera Occidental in the inter-Andean Seasonally Dry Forests of the Marañón River, in the Departments of Cajamarca and Piura in northwestern Peru. We include an updated range distribution map using records from museum specimens, the Global Biodiversity Information Facility, and available photographic records on iNaturalist. In addition, we identify widespread cultivation of rice crops as the main threat to D. guttulatum in the inter-Andean Seasonally Dry Forests of the Marañón

Predicting potential distribution and identifying priority areas for conservation of the Yellow-tailed Woolly Monkey (Lagothrix flavicauda) in Peru

Species distribution models (SDMs) provide conservationist with spatial distributions estimations of priority species. Lagothrix flavicauda (Humboldt, 1812), commonly known as the Yellow-tailed Woolly Monkey, is one of the largest primates in the New World. This species is endemic to the montane forests of northern Peru, in the departments of Amazonas, San Martín, Huánuco, Junín, La Libertad, and Loreto at elevation from1,000 to 2,800 m. It is classified as “Critically Endangered” (CR) by the International Union for Conservation of Nature (IUCN) as well as by Peruvian legislation. Furthermore, it is listed in Appendix I of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). Research on precise estimates of its potential distribution are scare. Therefore, in this study we modeled the potential distribution area of this species in Peru, the model was generated using the MaxEnt algorithm, along with 80 georeferenced occurrence records and 28 environmental variables. The total distribution (high, moderate, and low) for L. flavicauda is 29,383.3 km2, having 3,480.7 km2 as high potential distribution. In effect, 22.64 % (6,648.49 km2) of the total distribution area of L. flavicauda is found within Natural Protected Areas (NPAs), with the following categories representing the largest areas of distribution: Protected Forests (1,620.41 km2), Regional Conservation Areas (1,976.79 km2), and Private Conservation Areas (1,166.55 km2). After comparing the predicted distribution with the current NPAs system, we identified new priority areas for the conservation of the species. We, therefore, believe that this study will contribute significantly to the conservation of L. flavicauda in Peru

A geostatistical approach for quantification of contaminant mass discharge uncertainty using multilevel sampler measurements

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/95058/1/wrcr11058.pd

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Therapeutic impact of cytoreductive surgery and irradiation of posterior fossa ependymoma in the molecular era: a retrospective multicohort analysis

PURPOSE: Posterior fossa ependymoma comprises two distinct molecular variants termed EPN_PFA and EPN_PFB that have a distinct biology and natural history. The therapeutic value of cytoreductive surgery and radiation therapy for posterior fossa ependymoma after accounting for molecular subgroup is not known. METHODS: Four independent nonoverlapping retrospective cohorts of posterior fossa ependymomas (n = 820) were profiled using genome-wide methylation arrays. Risk stratification models were designed based on known clinical and newly described molecular biomarkers identified by multivariable Cox proportional hazards analyses. RESULTS: Molecular subgroup is a powerful independent predictor of outcome even when accounting for age or treatment regimen. Incompletely resected EPN_PFA ependymomas have a dismal prognosis, with a 5-year progression-free survival ranging from 26.1% to 56.8% across all four cohorts. Although first-line (adjuvant) radiation is clearly beneficial for completely resected EPN_PFA, a substantial proportion of patients with EPN_PFB can be cured with surgery alone, and patients with relapsed EPN_PFB can often be treated successfully with delayed external-beam irradiation. CONCLUSION: The most impactful biomarker for posterior fossa ependymoma is molecular subgroup affiliation, independent of other demographic or treatment variables. However, both EPN_PFA and EPN_PFB still benefit from increased extent of resection, with the survival rates being particularly poor for subtotally resected EPN_PFA, even with adjuvant radiation therapy. Patients with EPN_PFB who undergo gross total resection are at lower risk for relapse and should be considered for inclusion in a randomized clinical trial of observation alone with radiation reserved for those who experience recurrence

Therapeutic Impact of Cytoreductive Surgery and Irradiation of Posterior Fossa Ependymoma in the Molecular Era: A Retrospective Multicohort Analysis

Posterior fossa ependymoma comprises two distinct molecular variants termed EPN_PFA and EPN_PFB that have a distinct biology and natural history. The therapeutic value of cytoreductive surgery and radiation therapy for posterior fossa ependymoma after accounting for molecular subgroup is not known

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Impact of Optimized Breastfeeding on the Costs of Necrotizing Enterocolitis in Extremely Low Birthweight Infants

To estimate risk of NEC for ELBW infants as a function of preterm formula and maternal milk (MM) intake and calculate the impact of suboptimal feeding on NEC incidence and costs

Biogeographic Distribution of Cedrela spp. Genus in Peru Using MaxEnt Modeling: A Conservation and Restoration Approach

The increasing demand for tropical timber from natural forests has reduced the population sizes of native species such as Cedrela spp. because of their high economic value. To prevent the decline of population sizes of the species, all Cedrela species have been incorporated into Appendix II of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). The study presents information about the modeled distribution of the genus Cedrela in Peru that aims to identify potential habitat distribution of the genus, its availability in areas protected by national service of protected areas, and highlighted some areas because of their conservation relevance and the potential need for restoration. We modeled the distribution of the genus Cedrela in Peru using 947 occurrence records that included 10 species (C. odorata, C. montana, C. fissilis, C. longipetiolulata, C. angustifolia, C. nebulosa, C. kuelapensis, C. saltensis, C. weberbaueri, and C. molinensis). We aim to identify areas environmentally suitable for the occurrence of Cedrela that are legally protected by the National Service of Protected Areas (PAs) and those that are ideal for research and restoration projects. We used various environmental variables (19 bioclimatic variables, 3 topographic factors, 9 edaphic factors, solar radiation, and relative humidity) and the maximum entropy model (MaxEnt) to predict the probability of occurrence. We observed that 6.7% (86,916.2 km2) of Peru presents a high distribution probability of occurrence of Cedrela, distributed in 17 departments, with 4.4% (10,171.03 km2) of the area protected by PAs mainly under the category of protection forests. Another 11.65% (21,345.16 km2) of distribution covers areas highly prone to degradation, distributed mainly in the departments Ucayali, Loreto, and Madre de Dios, and needs immediate attention for its protection and restoration. We believe that the study will contribute significantly to conserve Cedrela and other endangered species, as well as to promote the sustainable use and management of timber species as a whole

Updating the distribution of Dicrodon guttulatum Duméril & Bibron, 1839 (Reptilia, Teiidae) with a disjunct population in the eastern slope of the Peruvian Andes

We report a disjunct population of Dicrodon guttulatum Duméril & Bibron, 1839 on the eastern slope of the Cordillera Occidental in the inter-Andean Seasonally Dry Forests of the Marañón River, in the Departments of Cajamarca and Piura in northwestern Peru. We include an updated range distribution map using records from museum specimens, the Global Biodiversity Information Facility, and available photographic records on iNaturalist. In addition, we identify widespread cultivation of rice crops as the main threat to D. guttulatum in the inter-Andean Seasonally Dry Forests of the Marañón