Agate Fossil Beds National Monument, Paleontological Resources Management Plan (Public Version)

Executive Summary Since Agate Springs Ranch was founded by James H. Cook in 1887, exquisite examples of transitional Miocene mammalian fauna have been found along this stretch of the Niobrara River valley. Collectively these paleontological discoveries, along with the existing archeological and historical Native American collection, were the basis for establishing Agate Fossil Beds National Monument (AGFO) as a unit of the National Park System (NPS). The fossil remains from the Harrison and Anderson Ranch formations span a short, but important, time period within the Miocene Epoch. AGFO has provided science with an intimate look into North American mammalian evolution of the time that is matched nowhere else, with body fossils and trace fossils (burrows) of many mammals in excellent condition. Investigation of the paleontological resources at AGFO has been very limited since its establishment, but the opportunities for research and discovery are still substantial. Public and academic interest in the Monument’s paleontological resources are considerable. Although there are existing legal authorities, policies and guidelines regarding the management of paleontological resources, at both the departmental and agency levels, more specific guidance would be helpful for the management of AGFO’s non-renewable fossils. This document has been prepared to provide more specific guidance and recommendations for paleontological resources management at AGFO. The Introduction outlines the significance of AGFO’s paleontological resources and defines the purpose, need, and objectives for the Agate Fossil Beds National Monument Paleontological Resources Management Plan (PRMP). This plan also identifies the legal authorities, requirements, and mandates underpinning AGFO’s mission as a unit of the NPS, with special attention to authorities that address managing and preserving paleontological resources. Background Geology and Paleontology provides a basic park geologic description, discusses the scope of AGFO’s paleontological resources, and summarizes past paleontological work performed at the Monument. This information includes historical information from periods both before and after authorization of the Monument as a unit of the NPS. This section also presents the paleontological significance of AGFO and its specimens, such as how AGFO’s taxa are cornerstones of North American geochronology and biostratigraphy. Paleontological Resources Management begins by listing in greater detail the strategic objectives related to paleontological resources within the NPS and at AGFO. This section then proceeds to discuss the specific considerations related to paleontological resource inventories and monitoring along with management requirements (from policy and guidelines) specific to AGFO. This section discusses what a paleontology inventory is and why, when and how to conduct one; fundamentals of paleontological resource monitoring; the various types of threats to paleontological resources and how to mitigate them; and resource condition assessment and site monitoring protocols. It also addresses how to handle paleontological resources discovered or recovered during other park activities. Paleontological Research Management presents NPS and AGFO research goals, how to evaluate the scientific significance of research, and how to weigh the significance of research against other park mandates, operations, and goals. The section also includes a description of the permitting process, recommended park-specific permit conditions, and rules for overseeing collection and excavation. Museum Collections and Curation documents AGFO’s current paleontological collections, collections management and curation policies, AGFO’s photographic archives, collections from AGFO in external repositories, type specimens from AGFO, and Monument compliance with museum security policies. Interpretation discusses goals and current implementation for how AGFO interprets its paleontological resources for the public. This includes: the primary themes for interpretation; the exhibits, tools and programs used by AGFO to interpret fossil resources; the target audiences for the interpretive programs; teaching good stewardship of paleontological resources; and a discussion of public accessibility to AGFO, its interpretive materials, and the paleontological resources. Relation of Paleontological Resources to Other Park Programs provides an overview of how each park division may interact with paleontological resources and have their duties cross over with paleontological resource management related actions. It also discusses the potential impacts of paleontological resource management on other types of AGFO resources (archeological, biological, historical, and physical). Paleontological Resource Data Management discusses various paleontological resource records, datasets, and other archives. AGFO’s paleontological archives and library, as well as their current status, are discussed along with an overview of the type of contents stored within them. The NPS Paleontology Program Archives and Library, and how to exchange data and records between them and the AGFO archives, are also described. This section also reviews geospatial data available to AGFO and issues of sensitivity and confidentially related to paleontological resource data and information. Finally, the Summary, Conclusions, and Recommendations summarizes the work done on the AGFO PRMP, discusses ongoing and planned projects which assist in implementing the instructions and goals set out in this PRMP, and makes a variety of recommendations for future paleontological resource management at AGFO

Concomitant ablation of atrial fibrillation in octogenarians: an observational study

<p>Abstract</p> <p>Background</p> <p>Cardiac surgery is increasingly required in octogenarians. These patients frequently present atrial fibrillation (AF), a significant factor for stroke and premature death. During the last decade, AF ablation has become an effective procedure in cardiac surgery. Because the results of concomitant AF ablation in octogenarians undergoing cardiac surgery are still not clear, we evaluated the outcome in these patients.</p> <p>Methods</p> <p>Among 200 patients undergoing concomitant AF ablation (87% persistent AF), 28 patients were ≥ 80 years (82 ± 2.4 years). The outcome was analysed by prospective follow up after 3, 6, 12 months and annually thereafter. Freedom from AF was calculated according to the Kaplan-Meier method.</p> <p>Results</p> <p>Octogenarians were similar to controls regarding AF duration (48 ± 63.2 versus 63 ± 86.3 months, n.s.) and left atrial diameter (49 ± 6.1 versus 49 ± 8.8 mm, n.s.), but differed in EuroSCORE (17.3 ± 10.93 versus 7.4 ± 7.31%, p < 0.001), prevalence of paroxysmal AF (25.0 versus 11.0%, p = 0.042) and aortic valve disease (67.8 versus 28.5%, p < 0.001). ICU stay (8 ± 16.9 versus 4 ± 7.2 days, p = 0.027), hospital stay (20 ± 23.9 versus 14 ± 30.8 days, p < 0.05), and 30-d-mortality (14.3 versus 4.6%, p = 0.046) were increased. After 12 ± 6.1 months of follow-up (95% complete), 14 octogenarians (82%) and 101 controls (68%, n.s.) were in sinus rhythm; 59% without antiarrhythmic drugs in either group (n.s.). Sinus rhythm restoration was associated with improved NYHA functional class and renormalization of left atrial size. Cumulative freedom from AF demonstrated no difference between groups. Late mortality was higher in octogenarians (16.7 versus 6.1%, p = 0.065).</p> <p>Conclusion</p> <p>Sinus rhythm restoration rate and functional improvement are satisfactory in octogenarians undergoing concomitant AF ablation. Hence, despite an increased perioperative risk, this procedure should be considered even in advanced age.</p

withdrawn 2017 hrs ehra ecas aphrs solaece expert consensus statement on catheter and surgical ablation of atrial fibrillation

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Risk of COVID-19 after natural infection or vaccinationResearch in context

Summary: Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health

Risk of COVID-19 after natural infection or vaccinationResearch in context

Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health