59 research outputs found

    A Landscape and Climate Data Logistic Model of Tsetse Distribution in Kenya

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    , biologically transmitted by the tsetse fly in Africa, are a major cause of illness resulting in both high morbidity and mortality among humans, cattle, wild ungulates, and other species. However, tsetse fly distributions change rapidly due to environmental changes, and fine-scale distribution maps are few. Due to data scarcity, most presence/absence estimates in Kenya prior to 2000 are a combination of local reports, entomological knowledge, and topographic information. The availability of tsetse fly abundance data are limited, or at least have not been collected into aggregate, publicly available national datasets. Despite this limitation, other avenues exist for estimating tsetse distributions including remotely sensed data, climate information, and statistical tools.Here we present a logistic regression model of tsetse abundance. The goal of this model is to estimate the distribution of tsetse fly in Kenya in the year 2000, and to provide a method by which to anticipate their future distribution. Multiple predictor variables were tested for significance and for predictive power; ultimately, a parsimonious subset of variables was identified and used to construct the regression model with the 1973 tsetse map. These data were validated against year 2000 Food and Agriculture Organization (FAO) estimates. Mapcurves Goodness-Of-Fit scores were used to evaluate the modeled fly distribution against FAO estimates and against 1973 presence/absence data, each driven by appropriate climate data.Logistic regression can be effectively used to produce a model that projects fly abundance under elevated greenhouse gas scenarios. This model identifies potential areas for tsetse abandonment and expansion

    Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes.

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    Abstract BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy. RESULTS: In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups. CONCLUSIONS: Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo. (Funded by Amylin Pharmaceuticals; EXSCEL ClinicalTrials.gov number, NCT01144338 .)

    Are hedgerows effective corridors between fragments of woodland habitat? An evidence-based approach

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    Anthropogenic modification of the countryside has resulted in much of the landscape consisting of fragments of once continuous habitat. Increasing habitat connectivity at the landscape-scale has a vital role to play in the conservation of species restricted to such remnant patches, especially as species may attempt to track zones of habitat that satisfy their niche requirements as the climate changes. Conservation policies and management strategies frequently advocate corridor creation as one approach to restore connectivity and to facilitate species movements through the landscape. Here we examine the utility of hedgerows as corridors between woodland habitat patches using rigorous systematic review methodology. Systematic searching yielded 26 studies which satisfied the review inclusion criteria. The empirical evidence currently available is insufficient to evaluate the effectiveness of hedgerow corridors as a conservation tool to promote the population viability of woodland fauna. However, the studies did provide anecdotal evidence of positive local population effects and indicated that some species use hedgerows as movement conduits. More replicated and controlled field investigations or long term monitoring are required in order to allow practitioners and policy makers to make better informed decisions about hedgerow corridor creation and preservation. The benefits of such corridors in regard to increasing habitat connectivity remain equivocal, and the role of corridors in mitigating the effects of climate change at the landscape-scale is even less well understood
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