Drowning in data, thirsty for information and starved for understanding: A biodiversity information hub for cooperative environmental monitoring in South Africa

The world is firmly cemented in a notitian age (Latin: notitia, meaning data) – drowning in data, yet thirsty for information and the synthesis of knowledge into understanding. As concerns over biodiversity declines escalate, the volume, diversity and speed at which new environmental and ecological data are generated has increased exponentially. Data availability primes the research and discovery engine driving biodiversity conservation. South Africa (SA) is poised to become a world leader in biodiversity conservation. However, continent-wide resource limitations hamper the establishment of inclusive technologies and robust platforms and tools for biodiversity informatics. In this perspectives piece, we bring together the opinions of 37 co-authors from 20 different departments, across 10 SA universities, 7 national and provincial conservation research agencies, and various institutes and private conservation, research and management bodies, to develop a way forward for biodiversity informatics in SA. We propose the development of a SA Biodiversity Informatics Hub and describe the essential components necessary for its design, implementation and sustainability. We emphasise the importance of developing a culture of cooperation, collaboration and interoperability among custodians of biodiversity data to establish operational workflows for data synthesis. However, our biggest challenges are misgivings around data sharing and multidisciplinary collaboration

Drowning in data, thirsty for information and starved for understanding: A biodiversity information hub for cooperative environmental monitoring in South Africa

The world is firmly cemented in a notitian age (Latin: notitia, meaning data) – drowning in data, yet thirsty for information and the synthesis of knowledge into understanding. As concerns over biodiversity declines escalate, the volume, diversity and speed at which new environmental and ecological data are generated has increased exponentially. Data availability primes the research and discovery engine driving biodiversity conservation. South Africa (SA) is poised to become a world leader in biodiversity conservation. However, continent-wide resource limitations hamper the establishment of inclusive technologies and robust platforms and tools for biodiversity informatics. In this perspectives piece, we bring together the opinions of 37 co-authors from 20 different departments, across 10 SA universities, 7 national and provincial conservation research agencies, and various institutes and private conservation, research and management bodies, to develop a way forward for biodiversity informatics in SA. We propose the development of a SA Biodiversity Informatics Hub and describe the essential components necessary for its design, implementation and sustainability. We emphasise the importance of developing a culture of cooperation, collaboration and interoperability among custodians of biodiversity data to establish operational workflows for data synthesis. However, our biggest challenges are misgivings around data sharing and multidisciplinary collaboration

Kidney Function Following Left Ventricular Assist Device Implantation: An Observational Cohort Study

Rationale & objectiveNearly half the patients with heart failure have chronic kidney disease. Implantation of a left ventricular assist device (LVAD) improves kidney function in some but not all patients, and lack of improvement is associated with worse outcomes. Preimplantation factors that predict change in kidney function after LVAD placement are not well described.Study designSingle-center observational study.Setting & participantsConsecutive patients undergoing LVAD implantation.Predictors48 diverse preimplantation variables including demographic, clinical, laboratory, hemodynamic, and echocardiographic variables.OutcomesThe primary outcome was change in estimated glomerular filtration rate (eGFR) at 1 month after implantation. Secondary outcomes included eGFR changes at 3, 6, and 12 months.Analytic approachUnivariable and multivariable linear regression.ResultsAmong 131 patients, average age was 60 ± 13 years, 83% were men, 47% had pre-existing chronic kidney disease, and mean preimplantation eGFR was 57 ± 23 mL/min/1.73 m2. At 1-month following LVAD implantation, eGFR improved in 98 (75%) patients. Variables associated with 1-month increases in eGFR were younger age, absence of diabetes mellitus (DM), use of inotropes, lower implantation eGFR, and higher implantation serum urea nitrogen, alanine aminotransferase, bilirubin, and creatinine levels. In multivariable models, younger age (β = 7.14 mL/min/1.73 m2 per SD; 95% CI, 3.17-11.10), lower eGFR (β = 7.72 mL/min/1.73 m2 per SD; 95% CI, 3.10-12.34), and absence of DM (β = 10.36 mL/min/1.73 m2; 95% CI, 2.99-17.74) were each independently associated with 1-month improvement in eGFR. Only younger age and lower eGFR were associated with improvements in eGFR at later months.LimitationsSingle-center study. Loss to follow-up from heart transplantation and death over duration of study.ConclusionsOnly younger age, lower eGFR, and absence of DM were associated with improvement in eGFR at 1 month. Thus, prediction of eGFR change at 1 month and beyond is limited by using preimplantation variables

Drowning in data, thirsty for information and starved for understanding : a biodiversity information hub for cooperative environmental monitoring in South Africa

SUPPLEMENTARY MATERIAL : TABLE S1: List of all biodiversity data stakeholders in SA, collated to encourage collaborative partnerships that can leverage combined expertise and datasets. TABLE S2: List of online biodiversity databases highlighting the magnitude of the challenge behind heterogeneous data integration. TABLE S3: Challenges (red) and opportunities (green) for biodiversity informatics in South Africa illustrated in Figure 1.DATA AVAILABILITY : No data was used for the research described in the article.The world is firmly cemented in a notitian age (Latin: notitia, meaning data) – drowning in data, yet thirsty for information and the synthesis of knowledge into understanding. As concerns over biodiversity declines escalate, the volume, diversity and speed at which new environmental and ecological data are generated has increased exponentially. Data availability primes the research and discovery engine driving biodiversity conservation. South Africa (SA) is poised to become a world leader in biodiversity conservation. However, continent-wide resource limitations hamper the establishment of inclusive technologies and robust platforms and tools for biodiversity informatics. In this perspectives piece, we bring together the opinions of 37 co-authors from 20 different departments, across 10 SA universities, 7 national and provincial conservation research agencies, and various institutes and private conservation, research and management bodies, to develop a way forward for biodiversity informatics in SA. We propose the development of a SA Biodiversity Informatics Hub and describe the essential components necessary for its design, implementation and sustainability. We emphasise the importance of developing a culture of cooperation, collaboration and interoperability among custodians of biodiversity data to establish operational workflows for data synthesis. However, our biggest challenges are misgivings around data sharing and multidisciplinary collaboration. We recommend a system that is free, user friendly, functional, stable, integrative and designed to cater for different data access agreement levels. Sharing data through this pipeline will directly advance the science and practice of conservation, giving multiple stakeholders and decision-makers access to valuable biodiversity data to support research and biodiversity conservation.The National Research Foundation of South Africa (NRF) and the National Institute for Theoretical and Computational Sciences (NITheCS) research programme: Advancing Biodiversity Informatics and Ecological Modelling.https://www.elsevier.com/locate/biocon2023-09-28hj2023Zoology and Entomolog

Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Background: Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial. Methods: NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS. For this prespecified subgroup analysis, cohorts with and without PFO were defined on the basis of transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE). The primary efficacy outcome was time to recurrent ischaemic stroke between treatment groups. The primary safety outcome was major bleeding, according to the criteria of the International Society of Thrombosis and Haemostasis. The primary analyses were based on the intention-to-treat population. Additionally, we did a systematic review and random-effects meta-analysis of studies in which patients with cryptogenic stroke and PFO were randomly assigned to receive anticoagulant or antiplatelet therapy. Findings: Between Dec 23, 2014, and Sept 20, 2017, 7213 participants were enrolled and assigned to receive rivaroxaban (n=3609) or aspirin (n=3604). Patients were followed up for a mean of 11 months because of early trial termination. PFO was reported as present in 534 (7·4%) patients on the basis of either TTE or TOE. Patients with PFO assigned to receive aspirin had a recurrent ischaemic stroke rate of 4·8 events per 100 person-years compared with 2·6 events per 100 person-years in those treated with rivaroxaban. Among patients with known PFO, there was insufficient evidence to support a difference in risk of recurrent ischaemic stroke between rivaroxaban and aspirin (hazard ratio [HR] 0·54; 95% CI 0·22–1·36), and the risk was similar for those without known PFO (1·06; 0·84–1·33; pinteraction=0·18). The risks of major bleeding with rivaroxaban versus aspirin were similar in patients with PFO detected (HR 2·05; 95% CI 0·51–8·18) and in those without PFO detected (HR 2·82; 95% CI 1·69–4·70; pinteraction=0·68). The random-effects meta-analysis combined data from NAVIGATE ESUS with data from two previous trials (PICSS and CLOSE) and yielded a summary odds ratio of 0·48 (95% CI 0·24–0·96; p=0·04) for ischaemic stroke in favour of anticoagulation, without evidence of heterogeneity. Interpretation: Among patients with ESUS who have PFO, anticoagulation might reduce the risk of recurrent stroke by about half, although substantial imprecision remains. Dedicated trials of anticoagulation versus antiplatelet therapy or PFO closure, or both, are warranted. Funding: Bayer and Janssen

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes