Soundscapes predict species occurrence in tropical forests

Accurate occurrence data is necessary for the conservation of keystone or endangered species, but acquiring it is usually slow, laborious and costly. Automated acoustic monitoring offers a scalable alternative to manual surveys but identifying species vocalisations requires large manually annotated training datasets, and is not always possible (e.g. for lesser studied or silent species). A new approach is needed that rapidly predicts species occurrence using smaller and more coarsely labelled audio datasets. We investigated whether local soundscapes could be used to infer the presence of 32 avifaunal and seven herpetofaunal species in 20 min recordings across a tropical forest degradation gradient in Sabah, Malaysia. Using acoustic features derived from a convolutional neural network (CNN), we characterised species indicative soundscapes by training our models on a temporally coarse labelled point-count dataset. Soundscapes successfully predicted the occurrence of 34 out of the 39 species across the two taxonomic groups, with area under the curve (AUC) metrics from 0.53 up to 0.87. The highest accuracies were achieved for species with strong temporal occurrence patterns. Soundscapes were a better predictor of species occurrence than above-ground carbon density – a metric often used to quantify habitat quality across forest degradation gradients. Our results demonstrate that soundscapes can be used to efficiently predict the occurrence of a wide variety of species and provide a new direction for data driven large-scale assessments of habitat suitability

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Soundscapes predict species occurrence in tropical forests

Accurate occurrence data is necessary for the conservation of keystone or endangered species, but acquiring it is usually slow, laborious, and costly. Automated acoustic monitoring offers a scalable alternative to manual surveys, but identifying species vocalisations requires large manually annotated training datasets, and is not always possible (e.g., for silent species). A new, intermediate approach is needed that rapidly predicts species occurrence without requiring extensive labelled data. We investigated whether local soundscapes could be used to infer the presence of 32 avifaunal and seven herpetofaunal species across a tropical forest degradation gradient in Sabah, Malaysia. We developed a machine-learning based approach to characterise species indicative soundscapes, training our models on a coarsely labelled manual point-count dataset. Soundscapes successfully predicted the occurrence of 34 out of the 39 species across the two taxonomic groups, with area under the curve (AUC) metrics of up to 0.87 (Bold-striped Tit-babbler Macronus bornensis). The highest accuracies were achieved for common species with strong temporal occurrence patterns. Soundscapes were a better predictor of species occurrence than above-ground biomass – a metric often used to quantify habitat quality across forest degradation gradients. Synthesis and applications: Our results demonstrate that soundscapes can be used to efficiently predict the occurrence of a wide variety of species. This provides a new direction for audio data to deliver large-scale, accurate assessments of habitat suitability using cheap and easily obtained field datasets