Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

A Influência do habitat em comunidades de anuros em uma área no limite sul de distribuição da mata atlântica : implicações no manejo e conservação

Em nosso estudo analisamos vocalizações de anuros em quatro banhados diferentes no Parque Estadual de Itapeva no limite sul de distribuição da Mata Atlântica (29º S, 49º 5 W). Dados de campo foram coletados entre Novembro de 2005 e Fevereiro de 2006. Treze espécies de cinco famílias foram registradas: Hylidae (7), Leiuperidae (2), Leptodactylidae (2), Microhylidae (1) e Ranidae (1). Nossos dados indicam que as várias espécies de anuros exibem modelos diferentes de presença e ausência e abundância nos banhados, que são explicados pelas variáveis de habitat. As assembléias de anuros do estudo formaram duas categorias, as espécies que necessitam de habitats mais específicos e áreas com menos distúrbio e as espécies que ocorrem em áreas com distúrbio e sem distúrbio de habitat por ação antrópica. Atividades humanas e a subseqüente fragmentação do habitat são claramente relacionadas com a distribuição de todas as espécies de anuros, sendo que as espécies sensíveis são cada vez mais confinadas a manchas menores de habitat e as espécies generalistas são beneficiadas com mais áreas antropizadas

A Influência do habitat em comunidades de anuros em uma área no limite sul de distribuição da mata atlântica : implicações no manejo e conservação

Em nosso estudo analisamos vocalizações de anuros em quatro banhados diferentes no Parque Estadual de Itapeva no limite sul de distribuição da Mata Atlântica (29º S, 49º 5 W). Dados de campo foram coletados entre Novembro de 2005 e Fevereiro de 2006. Treze espécies de cinco famílias foram registradas: Hylidae (7), Leiuperidae (2), Leptodactylidae (2), Microhylidae (1) e Ranidae (1). Nossos dados indicam que as várias espécies de anuros exibem modelos diferentes de presença e ausência e abundância nos banhados, que são explicados pelas variáveis de habitat. As assembléias de anuros do estudo formaram duas categorias, as espécies que necessitam de habitats mais específicos e áreas com menos distúrbio e as espécies que ocorrem em áreas com distúrbio e sem distúrbio de habitat por ação antrópica. Atividades humanas e a subseqüente fragmentação do habitat são claramente relacionadas com a distribuição de todas as espécies de anuros, sendo que as espécies sensíveis são cada vez mais confinadas a manchas menores de habitat e as espécies generalistas são beneficiadas com mais áreas antropizadas

Land use explains the distribution of threatened new world amphibians better than climate

Background: We evaluated the direct and indirect influence of climate, land use, phylogenetic structure, species richness and endemism on the distribution of New World threatened amphibians. Methodology/Principal Findings: We used the WWF’s New World ecoregions, the WWFs amphibian distributional data and the IUCN Red List Categories to obtain the number of threatened species per ecoregion. We analyzed three different scenarios urgent, moderate, and the most inclusive scenario. Using path analysis we evaluated the direct and indirect effects of climate, type of land use, phylogenetic structure, richness and endemism on the number of threatened amphibians in New World ecoregions. In all scenarios we found strong support for direct influences of endemism, the cover of villages and species richness on the number of threatened species in each ecoregion. The proportion of wild area had indirect effects in the moderate and the most inclusive scenario. Phylogenetic composition was important in determining the species richness and endemism in each ecoregion. Climate variables had complex and indirect effects on the number of threatened species. Conclusion/Significance: Land use has a more direct influence than climate in determining the distribution of New World threatened amphibians. Independently of the scenario analyzed, the main variables influencing the distribution of threatened amphibians were consistent, with endemism having the largest magnitude path coefficient. The importance of phylogenetic composition could indicate that some clades may be more threatened than others, and their presence increases the number of threatened species. Our results highlight the importance of man-made land transformation, which is a local variable, as a critical factor underlying the distribution of threatened amphibians at a biogeographic scale

Land Use Explains the Distribution of Threatened New World Amphibians Better than Climate

<div><p>Background</p><p>We evaluated the direct and indirect influence of climate, land use, phylogenetic structure, species richness and endemism on the distribution of New World threatened amphibians.</p><p>Methodology/Principal Findings</p><p>We used the WWF’s New World ecoregions, the WWFs amphibian distributional data and the IUCN Red List Categories to obtain the number of threatened species per ecoregion. We analyzed three different scenarios urgent, moderate, and the most inclusive scenario. Using path analysis we evaluated the direct and indirect effects of climate, type of land use, phylogenetic structure, richness and endemism on the number of threatened amphibians in New World ecoregions. In all scenarios we found strong support for direct influences of endemism, the cover of villages and species richness on the number of threatened species in each ecoregion. The proportion of wild area had indirect effects in the moderate and the most inclusive scenario. Phylogenetic composition was important in determining the species richness and endemism in each ecoregion. Climate variables had complex and indirect effects on the number of threatened species.</p><p>Conclusion/Significance</p><p>Land use has a more direct influence than climate in determining the distribution of New World threatened amphibians. Independently of the scenario analyzed, the main variables influencing the distribution of threatened amphibians were consistent, with endemism having the largest magnitude path coefficient. The importance of phylogenetic composition could indicate that some clades may be more threatened than others, and their presence increases the number of threatened species. Our results highlight the importance of man-made land transformation, which is a local variable, as a critical factor underlying the distribution of threatened amphibians at a biogeographic scale.</p></div

Maps showing the spatial pattern of richness of amphibian species, endemism and the number of threatened amphibian species according to the three different scenarios per ecoregion: the urgent scenario, containing only CR species and those EW and EX, the moderate scenario containing all EN species and those at threat categories higher than EN (i.e. CR, EW, and EX), and the most inclusive scenario, which included all VU species and those at higher threat categories.

<p>Maps showing the spatial pattern of richness of amphibian species, endemism and the number of threatened amphibian species according to the three different scenarios per ecoregion: the urgent scenario, containing only CR species and those EW and EX, the moderate scenario containing all EN species and those at threat categories higher than EN (i.e. CR, EW, and EX), and the most inclusive scenario, which included all VU species and those at higher threat categories.</p

Hypothetical causal model establishing all possible and plausible causal connections between variables.

<p>Hypothetical causal model establishing all possible and plausible causal connections between variables.</p

Correlation scatter plot for amphibian phylogenetic clades showing correlation values with three Principal Coordinates of Phylogenetic Structure (PCPS 1, PCPS2 and PCPS3) axes.

<p>Each point represents an amphibian genus. Genera are grouped within higher clades represented by different symbols.</p

Correlation values of each climatic variable with the two first axes of the principal components analysis. M indicates mean values and R indicates range values.

<p>Correlation values of each climatic variable with the two first axes of the principal components analysis. M indicates mean values and R indicates range values.</p

Maps depicting the spatial pattern of the proportion of land use cover in the New World ecoregions.

<p>Maps depicting the spatial pattern of the proportion of land use cover in the New World ecoregions.</p