A Retrospective Analysis and Comparative Study of Stony Coral Assemblages in Biscayne National Park, FL (1977-2000)

The hardbottom, patch, and bank reefs of Biscayne National Park (BNP) are among the most northern reef communities in the Florida Keys reef tract. The close proximity of BNP reefs to highly developed areas (i.e., the greater Miami metropolitan area) make them both heavily used and susceptible to a multitude of anthropogenic stresses. This study analyzes a unique 1977-1981 data set on stony-coral abundances and percent cover, collected from eight reefs in BNP, and compares this more than 25-year old data set with published data from surveys conducted from 1994-1996 and 1998-2000. In 1977-81, stony-coral cover on the eight reefs ranged between 8% and 28%, whereas coral cover reported from surveys in 1998-2000 ranged between 0.4% and 10%. Significant declines in cover of all coral species were seen at BNP reefs in the -20 years between data sets, although few changes were observed in species richness and taxonomic distinctness values. Spatial differences were observed between lagoonal patch reefs and outer bank reefs, consistent with previous reports of greater loss of coral cover on offshore reefs. Previous reports have suggested that high juvenile coral mortality due to fish predation, physical stresses, and thermal stresses have contributed to reduced cover at offshore BNP reefs

Predictors of outcome in patients with acute coronary syndromes without persistent ST-segment elevation. Results from an international trial of 9461 patients. The PURSUIT Investigators

BACKGROUND: Appropriate treatment policies should include an accurate estimate of a patient's baseline risk. Risk modeling to date has been underutilized in patients with acute coronary syndromes without persistent ST-segment elevation. METHODS AND RESULTS: We analyzed the relation between baseline characteristics and the 30-day incidence of death and the composite of death or myocardial (re)infarction in 9461 patients with acute coronary syndromes without persistent ST-segment elevation enrolled in the PURSUIT trial [Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin (eptifibatide) Therapy]. Variables examined included demographics, history, hemodynamic condition, and symptom duration. Risk models were created with multivariable logistic regression and validated by bootstrapping techniques. There was a 3.6% mortality rate and 11.4% infarction rate by 30 days. More than 20 significant predictors for mortality and for the composite end point were identified. The most important baseline determinants of death were age (adjusted chi(2)=95), heart rate (chi(2)=32), systolic blood pressure (chi(2)=20), ST-segment depression (chi(2)=20), signs of heart failure (chi(2)=18), and cardiac enzymes (chi(2)=15). Determinants of mortality were generally also predictive of death or myocardial (re)infarction. Differences were observed, however, in the relative prognostic importance of predictive variables for mortality alone or the composite end point; for example, sex was a more important determinant of the composite end point (chi(2)=21) than of death alone (chi(2)=10). The accuracy of the prediction of the composite end point was less than that of mortality (C-index 0.67 versus 0.81). CONCLUSIONS: The occurrence of adverse events after presentation with acute coronary syndromes is affected by multiple factors. These factors should be considered in the clinical decision-making process