Using Wildlife as Receptor Species: A Landscape

To assist risk assessors at the Department of Energy’s Savannah River Site (SRS), a Geographic Information System (GIS) application was developed to provide relevant information about specific receptor species of resident wildlife that can be used for ecological risk assessment. Information was obtained from an extensive literature review of publications and reports on vertebrate- and contaminant- related research since 1954 and linked to a GIS. Although this GIS is a useful tool for risk assessors because the data quality is high, it does not describe the species’ site-wide spatial distribution or life history, which may be crucial when developing a risk assessment. Specific receptor species on the SRS were modeled to provide an estimate of an overall distribution (probability of being in an area). Each model is a stand-alone tool consisting of algorithms independent of the GIS data layers to which it is applied and therefore is dynamic and will respond to changes such as habitat disturbances and natural succession. This paper describes this modeling process and demonstrates how these resource selection models can then be used to produce spatially explicit exposure estimates. This approach is a template for other large federal facilities to establish a framework for site-specific risk assessments that use wildlife species as endpoints

Using Wildlife as Receptor Species: A Landscape

To assist risk assessors at the Department of Energy’s Savannah River Site (SRS), a Geographic Information System (GIS) application was developed to provide relevant information about specific receptor species of resident wildlife that can be used for ecological risk assessment. Information was obtained from an extensive literature review of publications and reports on vertebrate- and contaminant- related research since 1954 and linked to a GIS. Although this GIS is a useful tool for risk assessors because the data quality is high, it does not describe the species’ site-wide spatial distribution or life history, which may be crucial when developing a risk assessment. Specific receptor species on the SRS were modeled to provide an estimate of an overall distribution (probability of being in an area). Each model is a stand-alone tool consisting of algorithms independent of the GIS data layers to which it is applied and therefore is dynamic and will respond to changes such as habitat disturbances and natural succession. This paper describes this modeling process and demonstrates how these resource selection models can then be used to produce spatially explicit exposure estimates. This approach is a template for other large federal facilities to establish a framework for site-specific risk assessments that use wildlife species as endpoints

Using Wildlife as Receptor Species: A Landscape

To assist risk assessors at the Department of Energy’s Savannah River Site (SRS), a Geographic Information System (GIS) application was developed to provide relevant information about specific receptor species of resident wildlife that can be used for ecological risk assessment. Information was obtained from an extensive literature review of publications and reports on vertebrate- and contaminant- related research since 1954 and linked to a GIS. Although this GIS is a useful tool for risk assessors because the data quality is high, it does not describe the species’ site-wide spatial distribution or life history, which may be crucial when developing a risk assessment. Specific receptor species on the SRS were modeled to provide an estimate of an overall distribution (probability of being in an area). Each model is a stand-alone tool consisting of algorithms independent of the GIS data layers to which it is applied and therefore is dynamic and will respond to changes such as habitat disturbances and natural succession. This paper describes this modeling process and demonstrates how these resource selection models can then be used to produce spatially explicit exposure estimates. This approach is a template for other large federal facilities to establish a framework for site-specific risk assessments that use wildlife species as endpoints

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status