Late Holocene vegetation, fire, climate and upper forest line dynamics in the Podocarpus National Park, southeastern Ecuador

Late Holocene vegetation, fire, climate and upper forest line dynamics were studied based on detailed pollen and charcoal analyses. Two sediment cores, from the Rabadilla de Vaca mire (RVM) and the Valle Pequeo bog (VP), with an age of about 2100 and 1630 cal yrs b.p., respectively, were taken at the modern upper forest line in the Parque Nacional Podocarpus (Podocarpus National Park) in southeastern Ecuador. The two pollen records reflect relatively stable vegetation with slight changes in floral composition during the recorded period. Changes of the proportion between subparamo and paramo vegetation are related to lower and higher frequency of fires. The RVM records show that the upper forest line moved to a higher elevation between 1630 and 880 cal yrs b.p., stabilising after 310 cal yrs b.p. Human impact is suggested by a high fire frequency, mainly between 1800-1600 and 880-310 cal yrs b.p. The VP records indicate no marked changes in the upper forest line. The charcoal records suggest an increased human impact from 230 cal yrs b.p. to the present. The results indicate that high fire frequency is an important factor in reducing the expansion of subparamo vegetation and upper montane rainforest and in favouring the distribution of grass paramo. Since there is a clear correlation between fire and vegetation dynamics, it is difficult to detect how far climate change also played a significant role in upper forest line changes during the late Holocene

APACHE III outcome prediction in patients admitted to the intensive care unit after liver transplantation: a retrospective cohort study

<p>Abstract</p> <p>Background</p> <p>The Acute Physiology and Chronic Health Evaluation (APACHE) III prognostic system has not been previously validated in patients admitted to the intensive care unit (ICU) after orthotopic liver transplantation (OLT). We hypothesized that APACHE III would perform satisfactorily in patients after OLT</p> <p>Methods</p> <p>A retrospective cohort study was performed. Patients admitted to the ICU after OLT between July 1996 and May 2008 were identified. Data were abstracted from the institutional APACHE III and liver transplantation databases and individual patient medical records. Standardized mortality ratios (with 95% confidence intervals) were calculated by dividing the observed mortality rates by the rates predicted by APACHE III. The area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow C statistic were used to assess, respectively, discrimination and calibration of APACHE III.</p> <p>Results</p> <p>APACHE III data were available for 918 admissions after OLT. Mean (standard deviation [SD]) APACHE III (APIII) and Acute Physiology (APS) scores on the day of transplant were 60.5 (25.8) and 50.8 (23.6), respectively. Mean (SD) predicted ICU and hospital mortality rates were 7.3% (15.4) and 10.6% (18.9), respectively. The observed ICU and hospital mortality rates were 1.1% and 3.4%, respectively. The standardized ICU and hospital mortality ratios with their 95% C.I. were 0.15 (0.07 to 0.27) and 0.32 (0.22 to 0.45), respectively.</p> <p>There were statistically significant differences in APS, APIII, predicted ICU and predicted hospital mortality between survivors and non-survivors. In predicting mortality, the AUC of APACHE III prediction of hospital death was 0.65 (95% CI, 0.62 to 0.68). The Hosmer-Lemeshow C statistic was 5.288 with a p value of 0.871 (10 degrees of freedom).</p> <p>Conclusion</p> <p>APACHE III discriminates poorly between survivors and non-survivors of patients admitted to the ICU after OLT. Though APACHE III has been shown to be valid in heterogenous populations and in certain groups of patients with specific diagnoses, it should be used with caution – if used at all – in recipients of liver transplantation.</p