Understanding and Finding Solutions to the Problem of Sedimentation in the National Wildlife Refuge System

The National Wildlife Refuge System (Refuge System) is a collection of public lands maintained by the U.S. Fish and Wildlife Service for migratory birds and other wildlife. Wetlands on individual National Wildlife Refuges (Refuges) may be at risk of increased sedimentation because of land use and water management practices. Increased sedimentation can reduce wetland habitat quality by altering hydrologic function, degrading water quality, and inhibiting growth of vegetation and invertebrates. On Refuges negatively affected by increased sedimentation, managers have to address complex questions about how to best remediate and mitigate the negative effects. The best way to account for these complexities is often not clear. On other Refuges, managers may not know whether sedimentation is a problem. Decision makers in the Refuge System may need to allocate resources to studying which Refuges could be at risk. Such analyses would help them understand where to direct support for managing increased sedimentation. In this paper, we summarize a case study demonstrating the use of decision-analytic tools in the development of a sedimentation management plan for Agassiz National Wildlife Refuge, Minnesota. Using what we learned from that process, we surveyed other Refuges in U.S. Fish and Wildlife Service Region 3 (an area encompassing the states of Illinois, Indiana, Iowa, Ohio, Michigan, Minnesota, Missouri, and Wisconsin) and Region 6 (an area encompassing the states of Colorado, Kansas, Montana, Nebraska, North Dakota, South Dakota, Utah, and Wyoming) about whether they experience sediment-related impacts to management. Our results show that cases of management being negatively affected by increased sedimentation are not isolated. We suggest that the Refuge System conduct a comprehensive and systematic assessment of increased sedimentation among Refuges to understand the importance of sedimentation in context with other management problems that Refuges face. The results of such an assessment could guide how the Refuge System allocates resources to studying and managing widespread stressors

Combined In Silico, In Vivo, and In Vitro Studies Shed Insights into the Acute Inflammatory Response in Middle-Aged Mice

We combined in silico, in vivo, and in vitro studies to gain insights into age-dependent changes in acute inflammation in response to bacterial endotoxin (LPS). Time-course cytokine, chemokine, and NO2-/NO3- data from "middle-aged" (6-8 months old) C57BL/6 mice were used to re-parameterize a mechanistic mathematical model of acute inflammation originally calibrated for "young" (2-3 months old) mice. These studies suggested that macrophages from middle-aged mice are more susceptible to cell death, as well as producing higher levels of pro-inflammatory cytokines, vs. macrophages from young mice. In support of the in silico-derived hypotheses, resident peritoneal cells from endotoxemic middle-aged mice exhibited reduced viability and produced elevated levels of TNF-α, IL-6, IL-10, and KC/CXCL1 as compared to cells from young mice. Our studies demonstrate the utility of a combined in silico, in vivo, and in vitro approach to the study of acute inflammation in shock states, and suggest hypotheses with regard to the changes in the cytokine milieu that accompany aging. © 2013 Namas et al

Understanding and Finding Solutions to the Problem of Sedimentation in the National Wildlife Refuge System

The National Wildlife Refuge System (Refuge System) is a collection of public lands maintained by the U.S. Fish and Wildlife Service for migratory birds and other wildlife. Wetlands on individual National Wildlife Refuges (Refuges) may be at risk of increased sedimentation because of land use and water management practices. Increased sedimentation can reduce wetland habitat quality by altering hydrologic function, degrading water quality, and inhibiting growth of vegetation and invertebrates. On Refuges negatively affected by increased sedimentation, managers have to address complex questions about how to best remediate and mitigate the negative effects. The best way to account for these complexities is often not clear. On other Refuges, managers may not know whether sedimentation is a problem. Decision makers in the Refuge System may need to allocate resources to studying which Refuges could be at risk. Such analyses would help them understand where to direct support for managing increased sedimentation. In this paper, we summarize a case study demonstrating the use of decision-analytic tools in the development of a sedimentation management plan for Agassiz National Wildlife Refuge, Minnesota. Using what we learned from that process, we surveyed other Refuges in U.S. Fish and Wildlife Service Region 3 (an area encompassing the states of Illinois, Indiana, Iowa, Ohio, Michigan, Minnesota, Missouri, and Wisconsin) and Region 6 (an area encompassing the states of Colorado, Kansas, Montana, Nebraska, North Dakota, South Dakota, Utah, and Wyoming) about whether they experience sediment-related impacts to management. Our results show that cases of management being negatively affected by increased sedimentation are not isolated. We suggest that the Refuge System conduct a comprehensive and systematic assessment of increased sedimentation among Refuges to understand the importance of sedimentation in context with other management problems that Refuges face. The results of such an assessment could guide how the Refuge System allocates resources to studying and managing widespread stressors

Determinants of Rejection Rate for Coronary CT Angiography Fractional Flow Reserve Analysis.

Background Coronary artery fractional flow reserve (FFR) derived from CT angiography (FFTCT) enables functional assessment of coronary stenosis. Prior clinical trials showed 13%-33% of coronary CT angiography studies had insufficient quality for quantitative analysis with FFRCT. Purpose To determine the rejection rate of FFRCT analysis and to determine factors associated with technically unsuccessful calculation of FFRCT. Materials and Methods Prospectively acquired coronary CT angiography scans submitted as part of the Assessing Diagnostic Value of Noninvasive FFRCT in Coronary Care (ADVANCE) registry (https://ClinicalTrials.gov: NCT02499679) and coronary CT angiography series submitted for clinical analysis were included. The primary outcome was the FFRCT rejection rate (defined as an inability to perform quantitative analysis with FFRCT). Factors that were associated with FFRCT rejection rate were assessed with multiple linear regression. Results In the ADVANCE registry, FFRCT rejection rate due to inadequate image quality was 2.9% (80 of 2778 patients; 95% confidence interval [CI]: 2.1%, 3.2%). In the 10 621 consecutive patients who underwent clinical analysis, the FFRCT rejection rate was 8.4% (n = 892; 95% CI: 6.2%, 7.2%; P < .001 vs the ADVANCE cohort). The main reason for the inability to perform FFRCT analysis was the presence of motion artifacts (63 of 80 [78%] and 729 of 892 [64%] in the ADVANCE and clinical cohorts, respectively). At multivariable analysis, section thickness in the ADVANCE (odds ratio [OR], 1.04; 95% CI: 1.001, 1.09; P = .045) and clinical (OR, 1.03; 95% CI: 1.02, 1.04; P < .001) cohorts and heart rate in the ADVANCE (OR, 1.05; 95% CI: 1.02, 1.08; P < .001) and clinical (OR, 1.06; 95% CI: 1.05, 1.07; P < .001) cohorts were independent predictors of rejection. Conclusion The rates for technically unsuccessful CT-derived fractional flow reserve in the ADVANCE registry and in a large clinical cohort were 2.9% and 8.4%, respectively. Thinner CT section thickness and lower patient heart rate may increase rates of completion of CT fractional flow reserve analysis. Published under a CC BY 4.0 license. Online supplemental material is available for this article. See also the editorial by Sakuma in this issue

Prognostic value of coronary computed tomography angiographic derived fractional flow reserve: a systematic review and meta-analysis.

OBJECTIVES: To obtain more powerful assessment of the prognostic value of fractional flow reserveCT testing we performed a systematic literature review and collaborative meta-analysis of studies that assessed clinical outcomes of CT-derived calculation of FFR (FFRCT) (HeartFlow) analysis in patients with stable coronary artery disease (CAD). METHODS: We searched PubMed and Web of Science electronic databases for published studies that evaluated clinical outcomes following fractional flow reserveCT testing between 1 January 2010 and 31 December 2020. The primary endpoint was defined as 'all-cause mortality (ACM) or myocardial infarction (MI)' at 12-month follow-up. Exploratory analyses were performed using major adverse cardiovascular events (MACEs, ACM+MI+unplanned revascularisation), ACM, MI, spontaneous MI or unplanned (>3 months) revascularisation as the endpoint. RESULTS: Five studies were identified including a total of 5460 patients eligible for meta-analyses. The primary endpoint occurred in 60 (1.1%) patients, 0.6% (13/2126) with FFRCT>0.80% and 1.4% (47/3334) with FFRCT ≤0.80 (relative risk (RR) 2.31 (95% CI 1.29 to 4.13), p=0.005). Likewise, MACE, MI, spontaneous MI or unplanned revascularisation occurred more frequently in patients with FFRCT ≤0.80 versus patients with FFRCT >0.80. Each 0.10-unit FFRCT reduction was associated with a greater risk of the primary endpoint (RR 1.67 (95% CI 1.47 to 1.87), p<0.001). CONCLUSIONS: The 12-month outcomes in patients with stable CAD show low rates of events in those with a negative FFRCT result, and lower risk of an unfavourable outcome in patients with a negative test result compared with patients with a positive test result. Moreover, the FFRCT numerical value was inversely associated with outcomes

Impact of Smoking on Coronary Volume–to–Myocardial Mass Ratio:An ADVANCE Registry Substudy

Purpose: To examine the relationship between smoking status and coronary volume–to–myocardial mass ratio (V/M) among individuals with coronary artery disease (CAD) undergoing CT fractional flow reserve (CT-FFR) analysis. Materials and Methods: In this secondary analysis, participants from the ADVANCE registry evaluated for suspected CAD from July 15, 2015, to October 20, 2017, who were found to have coronary stenosis of 30% or greater at coronary CT angiography (CCTA) were included if they had known smoking status and underwent CT-FFR and V/M analysis. CCTA images were segmented to calculate coronary volume and myocardial mass. V/M was compared between smoking groups, and predictors of low V/M were determined. Results: The sample for analysis included 503 current smokers, 1060 former smokers, and 1311 never-smokers (2874 participants; 1906 male participants). After adjustment for demographic and clinical factors, former smokers had greater coronary volume than never-smokers (former smokers, 3021.7 mm3 ± 934.0 [SD]; never-smokers, 2967.6 mm3 ± 978.0; P =.002), while current smokers had increased myocardial mass compared with never-smokers (current smokers, 127.8 g ± 32.9; never-smokers, 118.0 g ± 32.5; P =.02). However, both current and former smokers had lower V/M than never-smokers (current smokers, 24.1 mm3/g ± 7.9; former smokers, 24.9 mm3/g ± 7.1; never-smokers, 25.8 mm3/g ± 7.4; P &lt;.001 [unadjusted] and P =.002 [unadjusted], respectively). Current smoking status (odds ratio [OR], 0.74 [95% CI: 0.59, 0.93]; P =.009), former smoking status (OR, 0.81 [95% CI: 0.68, 0.97]; P =.02), stenosis of 50% or greater (OR, 0.62 [95% CI: 0.52, 0.74]; P &lt;.001), and diabetes (OR, 0.67 [95% CI: 0.56, 0.82]; P &lt;.001) were independent predictors of low V/M. Conclusion: Both current and former smoking status were independently associated with low V/M.</p