第790回千葉医学会例会・第一外科教室談話会 5.

Parental ovipositio

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

An ecological explanation for hyperallometric scaling of reproduction

1. In wild populations, large individuals have disproportionately higher repro-ductive output than smaller individuals. Some theoretical models explain this pattern—termed reproductive hyperallometry—by individuals allocating a greater fraction of available energy towards reproductive effort as they grow.2. Here, we propose a simple ecological explanation for this observation: dif-ferences between individuals in rates of resource assimilation, where greater assimilation causes both increased reproduction and body size, resulting in re-productive hyperallometry at the level of the population.3. We illustrate this effect by determining the relationship between size and re-production in wild and laboratory- reared Trinidadian guppies. We show that (a) reproduction increased disproportionately with body size in the wild but not in the laboratory, where resource competition was eliminated; (b) in the wild, hyperallometry was greatest during the wet season, when resource competi-tion is strongest; and (c) detection of hyperallometric scaling of reproduction at the population level was inevitable if individual differences in assimilation were ignored.4. We propose that ecologically driven variation in assimilation—caused by size- dependent resource competition, niche expansion and chance—contributes sub-stantially to observations of hyperallometric scaling of reproduction in natural populations. We recommend that models incorporate such ecologically caused variation when seeking to explain reproductive hyperallome

Data from: Competitive asymmetry and local adaptation in Trinidadian guppies

1. The outcome of competition between individuals often depends on body-size. These competitive asymmetries can drive variation in demographic rates, influencing the ecology and evolution of life-histories. The magnitude and direction of such asymmetries differ among taxa, yet little is known empirically about how adaptation to resource limitation alters competitive asymmetries. 2. Here, we investigate the relationship between size-dependent competitive ability and adaptation to resource limitation. 3. We examined size-dependent competition in two ecotypes of Trinidadian guppy, adapted to high or low levels of resource competition. Using aquaria-based competition experiments, we describe how the size and ecotype of competitors influence somatic growth rate, whilst controlling for the confounding effect of niche differentiation. We replicated our study across two independent evolutionary origins of the 'competitive' ecotype. 4. The two 'competitive' ecotypes differed markedly in size-dependent asymmetry, indicating that adaptation to resource limitation alone is insufficient to explain changes in size-dependent competitive asymmetry. For one origin, the ecotype adapted to resource limitation was a superior competitor over a wide range of size pairings. 5. The equivalence of competitors varied over five-fold, dependent on size and ecotype; in three of four populations, larger individuals had a competitive advantage. 6. Our results demonstrate that competitive asymmetry has strong effects on somatic growth. Because somatic growth contributes to demographic parameters, intraspecific trait variation is likely to play a key role in regulating demographic rates. Our findings imply that the evolution of size-dependent asymmetries under conditions of intense competition is likely to be constrained by niche availability, although further research is needed to verify this

Life histories as mosaics: plastic and genetic components differ among traits that underpin life-history strategies

Life-history phenotypes emerge from clusters of traits that are the product of genes and phenotypic plasticity. If the impact of the environment differs substantially between traits, then life histories might not evolve as a cohesive whole. We quantified the sensitivity of components of the life history to food availability, a key environmental difference in the habitat occupied by contrasting ecotypes, for 36 traits in fast- and slow-reproducing Trinidadian guppies. Our dataset included six putatively independent origins of the slow-reproducing, derived ecotype. Traits varied substantially in plastic and genetic control. Twelve traits were influenced only by food availability (body lengths, body weights), five only by genetic differentiation (interbirth intervals, offspring sizes), 10 by both (litter sizes, reproductive timing), and nine by neither (fat contents, reproductive allotment). Ecotype-by-food interactions were negligible. The response to low food was aligned with the genetic difference between high- and low-food environments, suggesting that plasticity was adaptive. The heterogeneity among traits in environmental sensitivity and genetic differentiation reveals that the components of the life history may not evolve in concert. Ecotypes may instead represent mosaics of trait groups that differ in their rate of evolution

Life histories as mosaics: Plastic and genetic components differ among traits that underpin life‐history strategies

Life‐history phenotypes emerge from clusters of traits that are the product of genes and phenotypic plasticity. If the impact of the environment differs substantially between traits, then life histories might not evolve as a cohesive whole. We quantified the sensitivity of components of the life history to food availability, a key environmental difference in the habitat occupied by contrasting ecotypes, for 36 traits in fast‐ and slow‐reproducing Trinidadian guppies. Our dataset included six putatively independent origins of the slow‐reproducing, derived ecotype. Traits varied substantially in plastic and genetic control. Twelve traits were influenced only by food availability (body lengths, body weights), five only by genetic differentiation (interbirth intervals, offspring sizes), 10 by both (litter sizes, reproductive timing), and nine by neither (fat contents, reproductive allotment). Ecotype‐by‐food interactions were negligible. The response to low food was aligned with the genetic difference between high‐ and low‐food environments, suggesting that plasticity was adaptive. The heterogeneity among traits in environmental sensitivity and genetic differentiation reveals that the components of the life history may not evolve in concert. Ecotypes may instead represent mosaics of trait groups that differ in their rate of evolution

Allele frequencies - CMH

Dataset used for comparison of allele frequencies between hybrid groups: Cochran-Mantel-Haenszel tests. See R script for details

Allele frequencies - Fisher

Dataset used for comparison of allele frequencies between hybrid groups: Fisher exact tests of independence. See R script for details

F1 sex ratio

F1 sex rati