Forest Biomass Density across Large Climate Gradients in Northern South America is related to Water Availability but not with Temperature

Understanding and predicting the likely response of ecosystems to climate change are crucial challenges for ecology and for conservation biology. Nowhere is this challenge greater than in the tropics as these forests store more than half the total atmospheric carbon stock in their biomass. Biomass is determined by the balance between biomass inputs (i.e., growth) and outputs (mortality). We can expect therefore that conditions that favor high growth rates, such as abundant water supply, warmth, and nutrient-rich soils will tend to correlate with high biomass stocks. Our main objective is to describe the patterns of above ground biomass (AGB) stocks across major tropical forests across climatic gradients in Northwestern South America. We gathered data from 200 plots across the region, at elevations ranging between 0 to 3400 m. We estimated AGB based on allometric equations and values for stem density, basal area, and wood density weighted by basal area at the plot-level. We used two groups of climatic variables, namely mean annual temperature and actual evapotranspiration as surrogates of environmental energy, and annual precipitation, precipitation seasonality, and water availability as surrogates of water availability. We found that AGB is more closely related to water availability variables than to energy variables. In northwest South America, water availability influences carbon stocks principally by determining stand structure, i.e. basal area. When water deficits increase in tropical forests we can expect negative impact on biomass and hence carbon storage

Renal Cell Carcinoma Associated With Xp11.2 Translocation/TFE3 Gene-fusion: A Long Response to mammalian target of rapamycin (mTOR) Inhibitors

[Objective]: To demonstrate that patients with Xp11.2/TFE3 gene-fusion translocation renal cell carcinoma (RCC), despite having an aggressive course in young adults, could have valid treatment options such as mammalian target of rapamycin (mTOR) inhibitors with good outcomes. Furthermore, to explain possible mechanisms of action of mTOR inhibitors in this type of RCC.[Materials and Methods]: We report a case of a 44-year-old man who has been treated with everolimus for a Xp11.2 translocation/TFE3 gene-fusion RCC after 2 previous failed treatments with tyrosine kinase inhibitor. During the follow-up, we evaluated type and duration of response with everolimus.[Results]: The patient obtained a long-lasting response of disease of 25 months with everolimus without any symptom.[Conclusion]: We believe that mTOR inhibitors could be a good line option treatment to consider for this type of patients

Distribution of plots used to estimate aboveground biomass in the studied Northwest South American region (Colombia, Brazil, Peru and Ecuador).

<p>Color of the symbols represent the forest types in the region: Blue for forest plots in Amazonia; yellow for forest plots in the Andean uplands; red for plots in the inter-andean valleys; Orange for the Caribbean plots; Green for the Orinoco region and the green triangles for the forest plot in the Choco region. The grey scale is displayed to denote altitude (m. a.s.l).</p

Relationship between Aboveground Biomass (AGB) and (a) Water Availability (WA), (b) Precipitation Variability (PV), Actual Evapotranspiration (AET) and (d) Annual Mean Temperature (AMT).

<p>Bioregions are shown with different colors. Solid lines represent the trend of relationships, based on the original data (without transformation), according to the best models (highest AIC scores) presented in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0171072#pone.0171072.t002" target="_blank">Table 2</a>; pR² is a partial regression coefficient for each of the relationships.</p

Explanatory models of aboveground biomass.

<p>Explanatory models of aboveground biomass.</p

Plots of forest structure parameters and aboveground biomass.

<p>The Coefficient of determination is showed in each plot. *P<0.01; **P<0.001; ***P<0.000; ns: non-significant.</p

Mean and standard deviation of aboveground biomass (AGB) across geographic regions of Northwest South America.

<p>Mean and standard deviation of aboveground biomass (AGB) across geographic regions of Northwest South America.</p

Climatic space represented for each vegetation plot used in this analysis.

<p>The climatic space is shown as principal components analysis to reduce climatic variables used. The first axis represents temperature variability and second axis represents precipitation variability. Gray points represent the climatic space availability across Northwest South America. Blue points represent actual climatic conditions of each of the vegetation plots sampled.</p

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine