The National Early Warning Score and its subcomponents recorded within ±24 hours of emergency medical admission are poor predictors of hospital-acquired acute kidney injury

YesBackground: Hospital-acquired Acute Kidney Injury (H-AKI) is a common cause of avoidable morbidity and mortality. Aim: To determine if the patients’ vital signs data as defined by a National Early Warning Score (NEWS), can predict H-AKI following emergency admission to hospital. Methods: Analyses of emergency admissions to York hospital over 24-months with NEWS data. We report the area under the curve (AUC) for logistic regression models that used the index NEWS (model A0), plus age and sex (A1), plus subcomponents of NEWS (A2) and two-way interactions (A3). Likewise for maximum NEWS (models B0,B1,B2,B3). Results: 4.05% (1361/33608) of emergency admissions had H-AKI. Models using the index NEWS had the lower AUCs (0.59 to 0.68) than models using the maximum NEWS AUCs (0.75 to 0.77). The maximum NEWS model (B3) was more sensitivity than the index NEWS model (A0) (67.60% vs 19.84%) but identified twice as many cases as being at risk of H-AKI (9581 vs 4099) at a NEWS of 5. Conclusions: The index NEWS is a poor predictor of H-AKI. The maximum NEWS is a better predictor but seems unfeasible because it is only knowable in retrospect and is associated with a substantial increase in workload albeit with improved sensitivity.The Health Foundatio

California Vegetation by V. L. Holland, D. J. Keil

Volume: 43Start Page: 99End Page: 10

VEGETATION OF THE UPPER RAIDER AND HORNBACK CREEK BASINS, SOUTH WARNER MOUNTAINS: NORTHWESTERN LIMIT OF ABIES CONCOLOR VAR. LOWIANA

Volume: 41Start Page: 53End Page: 6

NOTEWORTHY COLLECTIONS

Volume: 36Start Page: 207End Page: 20

Causes and consequences of invasive plants in wetlands: Opportunities, opportunists, and outcomes. Critical Rev.

Wetlands seem to be especially vulnerable to invasions. Even though ≤6% of the earth's land mass is wetland, 24% (8 of 33) of the world's most invasive plants are wetland species. Furthermore, many wetland invaders form monotypes, which alter habitat structure, lower biodiversity (both number and "quality" of species), change nutrient cycling and productivity (often increasing it), and modify food webs. Wetlands are landscape sinks, which accumulate debris, sediments, water, and nutrients, all of which facilitate invasions by creating canopy gaps or accelerating the growth of opportunistic plant species. These and other disturbances to wetlands, such as propagule influx, salt influx, and hydroperiod alteration, create opportunities that are well matched by wetland opportunists. No single hypothesis or plant attribute explains all wetland invasions, but the propensity for wetlands to become dominated by invasive monotypes is arguably an effect of the cumulative impacts associated with landscape sinks, including import of hydrophytes that exhibit efficient growth (high plant volume per unit biomass)

A GENETIC AND MORPHOLOGICAL STUDY OF CLARKIA STELLATA (ONAGRACEAE) AND RELATED SPECIES IN NORTHEASTERN CALIFORNIA

Volume: 52Start Page: 148End Page: 15

Indirect effects of parasites in invasions

1. Introduced species disrupt native communities and biodiversity worldwide. Parasitic infections (and at times, their absence) are thought to be a key component in the success and impact of biological invasions by plants and animals. They can facilitate or limit invasions, and positively or negatively impact native species. 2. Parasites have not only direct effects on their hosts, but also indirect effects on the species with which their hosts interact. Indirect effects include density-mediated effects (resulting from parasite-induced reduction in host reproduction and survival) as well as trait-mediated indirect effects (resulting from parasite-induced changes in host phenotype, behavior or life history). These effects are not mutually exclusive but often interact. 3. The importance of these indirect interactions for invasion success, and the extent to which these effects ramify throughout communities and influence ecosystems undergoing biological invasion provide the focus of our review. Examples from the animal and plant literature illustrate the importance of parasites in mediating both competitive and consumer–resource interactions between native and invasive species. 4. Parasites are involved in indirect interactions at all trophic levels. Furthermore, the indirect effects of parasitic infection are important at a range of biological scales from within a host to the whole ecosystem in determining invasion success and impact. 5. To understand the importance of parasitic infection in invasion success and in the outcomes for invaded communities requires an interdisciplinary approach by ecologists and parasitologists, across animal and plant systems. Future research should develop a framework integrating community ecology, evolution and immunology to better understand and manage the spread of invasive species and their diseases