Local and regional factors influence the structure of treehole metacommunities

Abstract Background Abiotic and biotic factors in a local habitat may strongly impact the community residing within, but spatially structured metacommunities are also influenced by regional factors such as immigration and colonization. We used three years of monthly treehole census data to evaluate the relative influence of local and regional factors on our study system. Results Every species responded to at least one of three local environmental factors measured: water volume, leaf litter mass, and presence of a top predator. Several species were affected by water volume, and a non-exclusive group of species were influenced by leaf litter mass. Relative abundance of Aedes triseriatus was higher in treeholes with higher volumes of water, and relative abundances of three out of six other species were lower in treeholes with higher volumes of water. Leaf litter mass positively affected densities of Aedes triseriatus and relative abundance of several dipteran species. The density of the top predator, Toxorhynchites rutilus, affected the relative abundance of the two most common species, A. triseriatus and Culicoides guttipennis. Treeholes with T. rutilus had an average of two more species than treeholes without T. rutilus. We found little evidence of synchrony between pairs of treeholes, either spatially or temporally. There were high levels of spatial and temporal turnover, and spatial turnover increased with distance between patches. Conclusion The strong effects of water volume, leaf litter mass, and presence of a top predator, along with the high temporal turnover strongly suggest that species presence and density are determined by local factors and changes in those factors over time. Both low water volume and high predator densities can eliminate populations in local patches, and those populations can recolonize patches when rain refills or predators exit treeholes. Population densities of the same species were not matched between pairs of treeholes, suggesting variation in local factors and limited dispersal. Distance effects on spatial turnover also support limitations to dispersal in the metacommunity, and we conclude that the weight of evidence favors a strong influence of local factors relative to regional factors.</p

Value of Neutrophil to Lymphocyte Ratio and Its Trajectory in Patients Hospitalized With Acute Heart Failure and Preserved Ejection Fraction

The neutrophil to lymphocyte ratio (NLR) has been proposed as a simple and routinely obtained marker of inflammation. This study sought to determine whether the NLR on admission as well as NLR trajectory would be complementary to the Get with the Guidelines Heart Failure (GWTG-HF) risk score in patients hospitalized with acute heart failure with preserved ejection fraction (HFpEF).Using the Stanford Translational Research Database, we identified 443 patients between January 2002 and December 2013 hospitalized with acute HFpEF and with complete data of NLR both on admission and at discharge. The primary endpoint was all-cause mortality. Mean age was 77 ± 16 years, 58% were female, with a high prevalence of diabetes mellitus (35.4%), coronary artery disease (58.2%), systemic hypertension (96.6%) and history of atrial fibrillation (57.5%). Over a median follow-up of 2.2 years, 121 (27.3%) patients died. The median NLR on admission was 6.5 (IQR 3.6 - 11.1); a majority of patients decreased their NLR during the course of hospitalization. On multivariable Cox modeling, both NLR on admission (HR 1.18 95% CI (1.00 - .38), p = 0.04) and absolute NLR trajectory (HR 1.26 95% CI (1.10 - 1.45), p = 0.001) were shown to be incremental to GWTG-HF risk score (p < 0.05) for outcome prediction. Adding the NLR or absolute NLR trajectory to the GWTG-HF risk score significantly improved the area under the operator-receiver curve and the reclassification up to 3 years after admission.This simple, readily available marker of inflammation may be useful when stratifying the risk of patients hospitalized with HFpEF.status: publishe

Improving risk stratification in heart failure with preserved ejection fraction by combining two validated risk scores

Introduction: The Intermountain Risk Score (IMRS) was developed and validated to predict short-term and long-term mortality in hospitalised patients using demographics and commonly available laboratory data. In this study, we sought to determine whether the IMRS also predicts all-cause mortality in patients hospitalised with heart failure with preserved ejection fraction (HFpEF) and whether it is complementary to the Get with the Guidelines Heart Failure (GWTG-HF) risk score or N-terminal pro-B-type natriuretic peptide (NT-proBNP). Methods and results: We used the Stanford Translational Research Integrated Database Environment to identify 3847 adult patients with a diagnosis of HFpEF between January 1998 and December 2016. Of these, 580 were hospitalised with a primary diagnosis of acute HFpEF. Mean age was 76±16 years, the majority being female (58%), with a high prevalence of diabetes mellitus (36%) and a history of coronary artery disease (60%). Over a median follow-up of 2.0 years, 140 (24%) patients died. On multivariable analysis, the IMRS and GWTG-HF risk score were independently associated with all-cause mortality (standardised HRs IMRS (1.55 (95% CI 1.27 to 1.93)); GWTG-HF (1.60 (95% CI 1.27 to 2.01))). Combining the two scores, improved the net reclassification over GWTG-HF alone by 36.2%. In patients with available NT-proBNP (n=341), NT-proBNP improved the net reclassification of each score by 46.2% (IMRS) and 36.3% (GWTG-HF). Conclusion: IMRS and GWTG-HF risk scores, along with NT-proBNP, play a complementary role in predicting outcome in patients hospitalised with HFpEF.status: publishe

‹Loving the Distance Between Them:’ Thinking Beyond Howard Gardner’s “Five Minds for the Future”

teaching business ethics, Howard Gardner, spirituality,