13 research outputs found

    Breaking Down Barriers: Successful Transition Planning for Culturally and Linguistically Diverse Exceptional Students

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    While transition services provided to the majority of students with disabilities may be seen as beneficial and as having the potential to lead to positive post-school outcomes, involvement and expectations of several students’ families are taking a backseat to the involvement and expectations of professionals in this process. Discrepancies between family and school expectations and desires can only lead to the failure of students’ transition plans. It is increasingly more likely that service providers who develop individual education plans and collaborate on transition planning teams will work with culturally and linguistically diverse students and families. Despite growing diversity in our school systems, many legal mandates and transition components are based on European-American cultural beliefs regarding disability, optimal post-school outcomes, and how best to achieve these outcomes. These beliefs about disability and post-school outcomes are not necessarily shared by all cultures, and thus, cultural conflicts are quite probable when service providers simply comply with transition mandates. This article addresses the challenges that culturally diverse families face as they go through the transition process of their children with disabilities as well as discusses practices that will lead to more successful transition planning for these students and their families

    Taking the pulse of Earth's tropical forests using networks of highly distributed plots

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    Tropical forests are the most diverse and productive ecosystems on Earth. While better understanding of these forests is critical for our collective future, until quite recently efforts to measure and monitor them have been largely disconnected. Networking is essential to discover the answers to questions that transcend borders and the horizons of funding agencies. Here we show how a global community is responding to the challenges of tropical ecosystem research with diverse teams measuring forests tree-by-tree in thousands of long-term plots. We review the major scientific discoveries of this work and show how this process is changing tropical forest science. Our core approach involves linking long-term grassroots initiatives with standardized protocols and data management to generate robust scaled-up results. By connecting tropical researchers and elevating their status, our Social Research Network model recognises the key role of the data originator in scientific discovery. Conceived in 1999 with RAINFOR (South America), our permanent plot networks have been adapted to Africa (AfriTRON) and Southeast Asia (T-FORCES) and widely emulated worldwide. Now these multiple initiatives are integrated via ForestPlots.net cyber-infrastructure, linking colleagues from 54 countries across 24 plot networks. Collectively these are transforming understanding of tropical forests and their biospheric role. Together we have discovered how, where and why forest carbon and biodiversity are responding to climate change, and how they feedback on it. This long-term pan-tropical collaboration has revealed a large long-term carbon sink and its trends, as well as making clear which drivers are most important, which forest processes are affected, where they are changing, what the lags are, and the likely future responses of tropical forests as the climate continues to change. By leveraging a remarkably old technology, plot networks are sparking a very modern revolution in tropical forest science. In the future, humanity can benefit greatly by nurturing the grassroots communities now collectively capable of generating unique, long-term understanding of Earth's most precious forests.Additional co-authors: Susan Laurance, William Laurance, Francoise Yoko Ishida, Andrew Marshall, Catherine Waite, Hannsjoerg Woell, Jean-Francois Bastin, Marijn Bauters, Hans Beeckman, Pfascal Boeckx, Jan Bogaert, Charles De Canniere, Thales de Haulleville, Jean-Louis Doucet, Olivier Hardy, Wannes Hubau, Elizabeth Kearsley, Hans Verbeeck, Jason Vleminckx, Steven W. Brewer, Alfredo AlarcĂłn, Alejandro Araujo-Murakami, Eric Arets, Luzmila Arroyo, Ezequiel Chavez, Todd Fredericksen, RenĂ© GuillĂ©n Villaroel, Gloria Gutierrez Sibauty, Timothy Killeen, Juan Carlos Licona, John Lleigue, Casimiro Mendoza, Samaria Murakami, Alexander Parada Gutierrez, Guido Pardo, Marielos Peña-Claros, Lourens Poorter, Marisol Toledo, Jeanneth Villalobos Cayo, Laura Jessica Viscarra, Vincent Vos, Jorge Ahumada, Everton Almeida, Jarcilene Almeida, Edmar Almeida de Oliveira, Wesley Alves da Cruz, Atila Alves de Oliveira, FabrĂ­cio Alvim Carvalho, FlĂĄvio Amorim Obermuller, Ana Andrade, Fernanda Antunes Carvalho, Simone Aparecida Vieira, Ana Carla Aquino, Luiz AragĂŁo, Ana Claudia AraĂșjo, Marco Antonio Assis, Jose Ataliba Mantelli Aboin Gomes, FabrĂ­cio Baccaro, PlĂ­nio Barbosa de Camargo, Paulo Barni, Jorcely Barroso, Luis Carlos Bernacci, Kauane Bordin, Marcelo Brilhante de Medeiros, Igor Broggio, JosĂ© LuĂ­s Camargo, Domingos Cardoso, Maria Antonia Carniello, Andre Luis Casarin Rochelle, Carolina Castilho, Antonio Alberto Jorge Farias Castro, Wendeson Castro, Sabina Cerruto Ribeiro, FlĂĄvia Costa, Rodrigo Costa de Oliveira, Italo Coutinho, John Cunha, Lola da Costa, Lucia da Costa Ferreira, Richarlly da Costa Silva, Marta da Graça Zacarias Simbine, Vitor de Andrade Kamimura, Haroldo Cavalcante de Lima, Lia de Oliveira Melo, Luciano de Queiroz, JosĂ© Romualdo de Sousa Lima, MĂĄrio do EspĂ­rito Santo, Tomas Domingues, Nayane Cristina dos Santos Prestes, Steffan Eduardo Silva Carneiro, Fernando Elias, Gabriel Eliseu, Thaise Emilio, Camila LaĂ­s Farrapo, LetĂ­cia Fernandes, Gustavo Ferreira, Joice Ferreira, Leandro Ferreira, Socorro Ferreira, Marcelo Fragomeni Simon, Maria Aparecida Freitas, Queila S. GarcĂ­a, Angelo Gilberto Manzatto, Paulo Graça, Frederico Guilherme, Eduardo Hase, Niro Higuchi, Mariana Iguatemy, Reinaldo Imbrozio Barbosa, Margarita Jaramillo, Carlos Joly, Joice Klipel, IĂȘda LeĂŁo do Amaral, Carolina Levis, Antonio S. Lima, MaurĂ­cio Lima Dan, Aline Lopes, Herison Madeiros, William E. Magnusson, Rubens Manoel dos Santos, Beatriz Marimon, Ben Hur Marimon Junior, Roberta Marotti Martelletti Grillo, Luiz Martinelli, Simone Matias Reis, SalomĂŁo Medeiros, Milton Meira-Junior, Thiago Metzker, Paulo Morandi, Natanael Moreira do Nascimento, Magna Moura, Sandra Cristina MĂŒller, Laszlo Nagy, Henrique Nascimento, Marcelo Nascimento, Adriano Nogueira Lima, Raimunda Oliveira de AraĂșjo, Jhonathan Oliveira Silva, Marcelo Pansonato, Gabriel Pavan Sabino, Karla Maria Pedra de Abreu, Pablo JosĂ© Francisco Pena Rodrigues, Maria Piedade, Domingos Rodrigues, JosĂ© Roberto Rodrigues Pinto, Carlos Quesada, Eliana Ramos, Rafael Ramos, Priscyla Rodrigues, Thaiane Rodrigues de Sousa, Rafael SalomĂŁo, FlĂĄvia Santana, Marcos Scaranello, Rodrigo Scarton Bergamin, Juliana Schietti, Jochen Schöngart, Gustavo Schwartz, Natalino Silva, Marcos Silveira, Cristiana SimĂŁo Seixas, Marta Simbine, Ana Claudia Souza, Priscila Souza, Rodolfo Souza, Tereza Sposito, Edson Stefani Junior, Julio Daniel do Vale, Ima CĂ©lia GuimarĂŁes Vieira, Dora Villela, Marcos Vital, Haron Xaud, Katia Zanini, Charles Eugene Zartman, Nur Khalish Hafizhah Ideris, Faizah binti Hj Metali, Kamariah Abu Salim, Muhd Shahruney Saparudin, Rafizah Mat Serudin, Rahayu Sukmaria Sukri, Serge Begne, George Chuyong, Marie Noel Djuikouo, Christelle Gonmadje, Murielle Simo-Droissart, Bonaventure SonkĂ©, Hermann Taedoumg, Lise Zemagho, Sean Thomas, FidĂšle Baya, Gustavo Saiz, Javier Silva Espejo, Dexiang Chen, Alan Hamilton, Yide Li, Tushou Luo, Shukui Niu, Han Xu, Zhang Zhou, Esteban Álvarez-DĂĄvila, Juan Carlos AndrĂ©s Escobar, Henry Arellano-Peña, Jaime Cabezas Duarte, Jhon CalderĂłn, Lina Maria Corrales Bravo, Borish Cuadrado, Hermes Cuadros, Alvaro Duque, Luisa Fernanda Duque, Sandra Milena Espinosa, Rebeca Franke-Ante, Hernando GarcĂ­a, Alejandro GĂłmez, Roy GonzĂĄlez-M., Álvaro IdĂĄrraga-PiedrahĂ­ta, Eliana Jimenez, RubĂ©n Jurado, Wilmar LĂłpez Oviedo, RenĂ© LĂłpez-Camacho, Omar Aurelio Melo Cruz, Irina Mendoza Polo, Edwin Paky, Karen PĂ©rez, Angel Pijachi, Camila Pizano, Adriana Prieto, Laura Ramos, Zorayda Restrepo Correa, James Richardson, Elkin RodrĂ­guez, Gina M. Rodriguez M., AgustĂ­n Rudas, Pablo Stevenson, MarkĂ©ta ChudomelovĂĄ, Martin Dancak, Radim HĂ©dl, Stanislav Lhota, Martin Svatek, Jacques Mukinzi, Corneille Ewango, Terese Hart, Emmanuel Kasongo Yakusu, Janvier Lisingo, Jean-Remy Makana, Faustin Mbayu, Benjamin Toirambe, John Tshibamba Mukendi, Lars Kvist, Gustav Nebel, Selene BĂĄez, Carlos CĂ©ron, Daniel M. Griffith, Juan Ernesto Guevara Andino, David Neill, Walter Palacios, Maria Cristina Peñuela-Mora, Gonzalo Rivas-Torres, Gorky Villa, Sheleme Demissie, Tadesse Gole, Techane Gonfa, Kalle Ruokolainen, Michel Baisie, Fabrice BĂ©nĂ©det, Wemo Betian, Vincent Bezard, Damien Bonal, JerĂŽme Chave, Vincent Droissart, Sylvie Gourlet-Fleury, Annette Hladik, Nicolas LabriĂšre, PĂ©trus Naisso, Maxime RĂ©jou-MĂ©chain, Plinio Sist, Lilian Blanc, Benoit Burban, GĂ©raldine Derroire, AurĂ©lie Dourdain, Clement Stahl, Natacha Nssi Bengone, Eric Chezeaux, FidĂšle Evouna Ondo, Vincent Medjibe, Vianet Mihindou, Lee White, Heike Culmsee, Cristabel DurĂĄn Rangel, Viviana Horna, Florian Wittmann, Stephen Adu-Bredu, Kofi Affum-Baffoe, Ernest Foli, Michael Balinga, Anand Roopsind, James Singh, Raquel Thomas, Roderick Zagt, Indu K. Murthy, Kuswata Kartawinata, Edi Mirmanto, Hari Priyadi, Ismayadi Samsoedin, Terry Sunderland, Ishak Yassir, Francesco Rovero, Barbara Vinceti, Bruno HĂ©rault, Shin-Ichiro Aiba, Kanehiro Kitayama, Armandu Daniels, Darlington Tuagben, John T. Woods, Muhammad Fitriadi, Alexander Karolus, Kho Lip Khoon, Noreen Majalap, Colin Maycock, Reuben Nilus, Sylvester Tan, Almeida Sitoe, Indiana Coronado G., Lucas Ojo, Rafael de Assis, Axel Dalberg Poulsen, Douglas Sheil, Karen ArĂ©valo Pezo, Hans Buttgenbach Verde, Victor Chama Moscoso, Jimmy Cesar Cordova Oroche, Fernando Cornejo Valverde, Massiel Corrales Medina, Nallaret Davila Cardozo, Jano de Rutte Corzo, Jhon del Aguila Pasquel, Gerardo Flores Llampazo, Luis Freitas, Darcy Galiano Cabrera, Roosevelt GarcĂ­a Villacorta, Karina Garcia Cabrera, Diego GarcĂ­a Soria, Leticia Gatica Saboya, Julio Miguel Grandez Rios, Gabriel Hidalgo Pizango, EurĂ­dice Honorio Coronado, Isau Huamantupa-Chuquimaco, Walter Huaraca Huasco, Yuri Tomas Huillca Aedo, Jose Luis Marcelo Peña, Abel Monteagudo Mendoza, Vanesa Moreano Rodriguez, Percy NĂșñez Vargas, Sonia Cesarina Palacios Ramos, Nadir Pallqui Camacho, Antonio Peña Cruz, Freddy Ramirez Arevalo, JosĂ© Reyna Huaymacari, Carlos Reynel Rodriguez, Marcos Antonio RĂ­os Paredes, Lily Rodriguez Bayona, Rocio del Pilar Rojas Gonzales, Maria Elena Rojas Peña, Norma Salinas Revilla, Yahn Carlos Soto Shareva, Raul Tupayachi Trujillo, Luis Valenzuela Gamarra, Rodolfo Vasquez Martinez, Jim Vega Arenas, Christian Amani, Suspense Averti Ifo, Yannick Bocko, Patrick Boundja, Romeo Ekoungoulou, Mireille Hockemba, Donatien Nzala, Alusine Fofanah, David Taylor, Guillermo Bañares-de Dios, Luis Cayuela, ĂĂ±igo Granzow-de la Cerda, Manuel MacĂ­a, Juliana Stropp, Maureen Playfair, Verginia Wortel, Toby Gardner, Robert Muscarella, Hari Priyadi, Ervan Rutishauser, Kuo-Jung Chao, Pantaleo Munishi, Olaf BĂĄnki, Frans Bongers, Rene Boot, Gabriella Fredriksson, Jan Reitsma, Hans ter Steege, Tinde van Andel, Peter van de Meer, Peter van der Hout, Mark van Nieuwstadt, Bert van Ulft, Elmar Veenendaal, Ronald Vernimmen, Pieter Zuidema, Joeri Zwerts, Perpetra Akite, Robert Bitariho, Colin Chapman, Eilu Gerald, Miguel Leal, Patrick Mucunguzi, Miguel Alexiades, Timothy R. Baker, Karina Banda, Lindsay Banin, Jos Barlow, Amy Bennett, Erika Berenguer, Nicholas Berry, Neil M. Bird, George A. Blackburn, Francis Brearley, Roel Brienen, David Burslem, Lidiany Carvalho, Percival Cho, Fernanda Coelho, Murray Collins, David Coomes, Aida Cuni-Sanchez, Greta Dargie, Kyle Dexter, Mat Disney, Freddie Draper, Muying Duan, Adriane Esquivel-Muelbert, Robert Ewers, Belen Fadrique, Sophie Fauset, Ted R. Feldpausch, Filipe França, David Galbraith, Martin Gilpin, Emanuel Gloor, John Grace, Keith Hamer, David Harris, Tommaso Jucker, Michelle Kalamandeen, Bente Klitgaard, Aurora Levesley, Simon L. Lewis, Jeremy Lindsell, Gabriela Lopez-Gonzalez, Jon Lovett, Yadvinder Malhi, Toby Marthews, Emma McIntosh, Karina Melgaço, William Milliken, Edward Mitchard, Peter Moonlight, Sam Moore, Alexandra Morel, Julie Peacock, Kelvin Peh, Colin Pendry, R. Toby Pennington, Luciana de Oliveira Pereira, Carlos Peres, Oliver L. Phillips, Georgia Pickavance, Thomas Pugh, Lan Qie, Terhi Riutta, Katherine Roucoux, Casey Ryan, Tiina Sarkinen, Camila Silva Valeria, Dominick Spracklen, Suzanne Stas, Martin Sullivan, Michael Swaine, Joey Talbot, James Taplin, Geertje van der Heijden, Laura Vedovato, Simon Willcock, Mathew Williams, Luciana Alves, Patricia Alvarez Loayza, Gabriel Arellano, Cheryl Asa, Peter Ashton, Gregory Asner, Terry Brncic, Foster Brown, Robyn Burnham, Connie Clark, James Comiskey, Gabriel Damasco, Stuart Davies, Tony Di Fiore, Terry Erwin, William Farfan-Rios, Jefferson Hall, David Kenfack, Thomas Lovejoy, Roberta Martin, Olga Martha Montiel, John Pipoly, Nigel Pitman, John Poulsen, Richard Primack, Miles Silman, Marc Steininger, Varun Swamy, John Terborgh, Duncan Thomas, Peter Umunay, Maria Uriarte, Emilio Vilanova Torre, Ophelia Wang, Kenneth Young, Gerardo A. Aymard C., Lionel HernĂĄndez, Rafael Herrera FernĂĄndez, Hirma RamĂ­rez-Angulo, Pedro Salcedo, Elio Sanoja, Julio Serrano, Armando Torres-Lezama, Tinh Cong Le, Trai Trong Le, Hieu Dang Tra

    COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

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    Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≀ 18 years: 69, 48, 23; 85%), older adults (≄ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

    Taking the pulse of Earth's tropical forests using networks of highly distributed plots

    No full text
    Tropical forests are the most diverse and productive ecosystems on Earth. While better understanding of these forests is critical for our collective future, until quite recently efforts to measure and monitor them have been largely disconnected. Networking is essential to discover the answers to questions that transcend borders and the horizons of funding agencies. Here we show how a global community is responding to the challenges of tropical ecosystem research with diverse teams measuring forests tree-by-tree in thousands of long-term plots. We review the major scientific discoveries of this work and show how this process is changing tropical forest science. Our core approach involves linking long-term grassroots initiatives with standardized protocols and data management to generate robust scaled-up results. By connecting tropical researchers and elevating their status, our Social Research Network model recognises the key role of the data originator in scientific discovery. Conceived in 1999 with RAINFOR (South America), our permanent plot networks have been adapted to Africa (AfriTRON) and Southeast Asia (T-FORCES) and widely emulated worldwide. Now these multiple initiatives are integrated via ForestPlots.net cyber-infrastructure, linking colleagues from 54 countries across 24 plot networks. Collectively these are transforming understanding of tropical forests and their biospheric role. Together we have discovered how, where and why forest carbon and biodiversity are responding to climate change, and how they feedback on it. This long-term pan-tropical collaboration has revealed a large long-term carbon sink and its trends, as well as making clear which drivers are most important, which forest processes are affected, where they are changing, what the lags are, and the likely future responses of tropical forests as the climate continues to change. By leveraging a remarkably old technology, plot networks are sparking a very modern revolution in tropical forest science. In the future, humanity can benefit greatly by nurturing the grassroots communities now collectively capable of generating unique, long-term understanding of Earth's most precious forests

    Taking the pulse of Earth's tropical forests using networks of highly distributed plots

    No full text
    Tropical forests are the most diverse and productive ecosystems on Earth. While better understanding of these forests is critical for our collective future, until quite recently efforts to measure and monitor them have been largely disconnected. Networking is essential to discover the answers to questions that transcend borders and the horizons of funding agencies. Here we show how a global community is responding to the challenges of tropical ecosystem research with diverse teams measuring forests tree-by-tree in thousands of long-term plots. We review the major scientific discoveries of this work and show how this process is changing tropical forest science. Our core approach involves linking long-term grassroots initiatives with standardized protocols and data management to generate robust scaled-up results. By connecting tropical researchers and elevating their status, our Social Research Network model recognises the key role of the data originator in scientific discovery. Conceived in 1999 with RAINFOR (South America), our permanent plot networks have been adapted to Africa (AfriTRON) and Southeast Asia (T-FORCES) and widely emulated worldwide. Now these multiple initiatives are integrated via ForestPlots.net cyber-infrastructure, linking colleagues from 54 countries across 24 plot networks. Collectively these are transforming understanding of tropical forests and their biospheric role. Together we have discovered how, where and why forest carbon and biodiversity are responding to climate change, and how they feedback on it. This long-term pan-tropical collaboration has revealed a large long-term carbon sink and its trends, as well as making clear which drivers are most important, which forest processes are affected, where they are changing, what the lags are, and the likely future responses of tropical forests as the climate continues to change. By leveraging a remarkably old technology, plot networks are sparking a very modern revolution in tropical forest science. In the future, humanity can benefit greatly by nurturing the grassroots communities now collectively capable of generating unique, long-term understanding of Earth's most precious forests. Resumen: Los bosques tropicales son los ecosistemas mĂĄs diversos y productivos del mundo y entender su funcionamiento es crĂ­tico para nuestro futuro colectivo. Sin embargo, hasta hace muy poco, los esfuerzos para medirlos y monitorearlos han estado muy desconectados. El trabajo en redes es esencial para descubrir las respuestas a preguntas que trascienden las fronteras y los plazos de las agencias de financiamiento. AquĂ­ mostramos cĂłmo una comunidad global estĂĄ respondiendo a los desafĂ­os de la investigaciĂłn en ecosistemas tropicales a travĂ©s de diversos equipos realizando mediciones ĂĄrbol por ĂĄrbol en miles de parcelas permanentes de largo plazo. Revisamos los descubrimientos mĂĄs importantes de este trabajo y discutimos cĂłmo este proceso estĂĄ cambiando la ciencia relacionada a los bosques tropicales. El enfoque central de nuestro esfuerzo implica la conexiĂłn de iniciativas locales de largo plazo con protocolos estandarizados y manejo de datos para producir resultados que se puedan trasladar a mĂșltiples escalas. Conectando investigadores tropicales, elevando su posiciĂłn y estatus, nuestro modelo de Red Social de InvestigaciĂłn reconoce el rol fundamental que tienen, para el descubrimiento cientĂ­fico, quienes generan o producen los datos. Concebida en 1999 con RAINFOR (SuramĂ©rica), nuestras redes de parcelas permanentes han sido adaptadas en África (AfriTRON) y el sureste asiĂĄtico (T-FORCES) y ampliamente replicadas en el mundo. Actualmente todas estas iniciativas estĂĄn integradas a travĂ©s de la ciber-infraestructura de ForestPlots.net, conectando colegas de 54 paĂ­ses en 24 redes diferentes de parcelas. Colectivamente, estas redes estĂĄn transformando nuestro conocimiento sobre los bosques tropicales y el rol de Ă©stos en la biĂłsfera. Juntos hemos descubierto cĂłmo, dĂłnde y porquĂ© el carbono y la biodiversidad de los bosques tropicales estĂĄ respondiendo al cambio climĂĄtico y cĂłmo se retroalimentan. Esta colaboraciĂłn pan-tropical de largo plazo ha expuesto un gran sumidero de carbono y sus tendencias, mostrando claramente cuĂĄles son los factores mĂĄs importantes, quĂ© procesos se ven afectados, dĂłnde ocurren los cambios, los tiempos de reacciĂłn y las probables respuestas futuras mientras el clima continĂșa cambiando. Apalancando lo que realmente es una tecnologĂ­a antigua, las redes de parcelas estĂĄn generando una verdadera y moderna revoluciĂłn en la ciencia tropical. En el futuro, la humanidad puede beneficiarse enormemente si se nutren y cultivan comunidades de investigadores de base, actualmente con la capacidad de generar informaciĂłn Ășnica y de largo plazo para entender los que probablemente son los bosques mĂĄs preciados de la tierra. Resumo: Florestas tropicais sĂŁo os ecossistemas mais diversos e produtivos da Terra. Embora uma boa compreensĂŁo destas florestas seja crucial para o nosso futuro coletivo, atĂ© muito recentemente os esforços de mediçÔes e monitoramento tem sido amplamente desconexos. É essencial formarmos redes para obtermos respostas que transcendam as fronteiras e horizontes das agĂȘncias financiadoras. Neste estudo nĂłs mostramos como uma comunidade global estĂĄ respondendo aos desafios da pesquisa de ecossistemas tropicais, com equipes diversas medindo florestas, ĂĄrvore por ĂĄrvore, em milhares de parcelas monitoradas a longo prazo. NĂłs revisamos as maiores descobertas cientĂ­ficas deste esforço global, e mostramos tambĂ©m como este processo vem mudando a ciĂȘncia de florestas tropicais. Nossa abordagem principal envolve unir iniciativas de base a protocolos padronizados e gerenciamento de dados a fim de gerar resultados robustos em grandes escalas. Ao conectar pesquisadores tropicais e elevar seus status, nosso modelo de Rede de Pesquisa Social reconhece o papel chave do produtor dos dados na descoberta cientĂ­fica. Concebida em 1999 com o RAINFOR (AmĂ©rica do Sul), nossa rede de parcelas permanentes foi adaptada para África (AfriTRON) e Sudeste AsiĂĄtico (T-FORCES), e tem sido extensamente reproduzida em todo o mundo. Agora estas mĂșltiplas iniciativas estĂŁo integradas atravĂ©s da infraestrutura cibernĂ©tica do ForestPlots.net, conectando colegas de 54 paĂ­ses e 24 redes de parcelas. Estas iniciativas estĂŁo transformando coletivamente o entendimento das florestas tropicais e seus papĂ©is na biosfera. Juntos nĂłs descobrimos como, onde e por que o carbono e a biodiversidade da floresta estĂŁo respondendo Ă s mudanças climĂĄticas, e seus efeitos de retroalimentação. Esta duradoura colaboração pantropical revelou um grande sumidouro de carbono persistente e suas tendĂȘncias, assim como tem evidenciado quais os fatores que influenciam essas tendĂȘncias, quais processos florestais sĂŁo mais afetados, onde eles estĂŁo mudando, seus atrasos no tempo de resposta, e as provĂĄveis respostas das florestas tropicais conforme o clima continua a mudar. Dessa forma, aproveitando uma notĂĄvel tecnologia antiga, redes de parcelas acendem as faĂ­scas de uma moderna revolução na ciĂȘncia das florestas tropicais. No futuro a humanidade pode se beneficiar incentivando estas comunidades locais que agora sĂŁo coletivamente capazes de gerar conhecimentos Ășnicos e duradouros sobre as florestas mais preciosas da Terra. RĂ©sume: Les forĂȘts tropicales sont les Ă©cosystĂšmes les plus diversifiĂ©s et les plus productifs de la planĂšte. Si une meilleure comprĂ©hension de ces forĂȘts est essentielle pour notre avenir collectif, jusqu'Ă  tout rĂ©cemment, les efforts dĂ©ployĂ©s pour les mesurer et les surveiller ont Ă©tĂ© largement dĂ©connectĂ©s. La mise en rĂ©seau est essentielle pour dĂ©couvrir les rĂ©ponses Ă  des questions qui dĂ©passent les frontiĂšres et les horizons des organismes de financement. Nous montrons ici comment une communautĂ© mondiale relĂšve les dĂ©fis de la recherche sur les Ă©cosystĂšmes tropicaux avec diverses Ă©quipes qui mesurent les forĂȘts arbre aprĂšs arbre dans de milliers de parcelles permanentes. Nous passons en revue les principales dĂ©couvertes scientifiques de ces travaux et montrons comment ce processus modifie la science des forĂȘts tropicales. Notre approche principale consiste Ă  relier les initiatives de base Ă  long terme Ă  des protocoles standardisĂ©s et une gestion de donnĂ©es afin de gĂ©nĂ©rer des rĂ©sultats solides Ă  grande Ă©chelle. En reliant les chercheurs tropicaux et en Ă©levant leur statut, notre modĂšle de rĂ©seau de recherche sociale reconnaĂźt le rĂŽle clĂ© de l'auteur des donnĂ©es dans la dĂ©couverte scientifique. Conçus en 1999 avec RAINFOR (AmĂ©rique du Sud), nos rĂ©seaux de parcelles permanentes ont Ă©tĂ© adaptĂ©s Ă  l'Afrique (AfriTRON) et Ă  l'Asie du Sud-Est (T-FORCES) et largement imitĂ©s dans le monde entier. Ces multiples initiatives sont dĂ©sormais intĂ©grĂ©es via l'infrastructure ForestPlots.net, qui relie des collĂšgues de 54 pays Ă  travers 24 rĂ©seaux de parcelles. Ensemble, elles transforment la comprĂ©hension des forĂȘts tropicales et de leur rĂŽle biosphĂ©rique. Ensemble, nous avons dĂ©couvert comment, oĂč et pourquoi le carbone forestier et la biodiversitĂ© rĂ©agissent au changement climatique, et comment ils y rĂ©agissent. Cette collaboration pan-tropicale Ă  long terme a rĂ©vĂ©lĂ© un important puits de carbone Ă  long terme et ses tendances, tout en mettant en Ă©vidence les facteurs les plus importants, les processus forestiers qui sont affectĂ©s, les endroits oĂč ils changent, les dĂ©calages et les rĂ©actions futures probables des forĂȘts tropicales Ă  mesure que le climat continue de changer. En tirant parti d'une technologie remarquablement ancienne, les rĂ©seaux de parcelles dĂ©clenchent une rĂ©volution trĂšs moderne dans la science des forĂȘts tropicales. À l'avenir, l'humanitĂ© pourra grandement bĂ©nĂ©ficier du soutien des communautĂ©s de base qui sont maintenant collectivement capables de gĂ©nĂ©rer une comprĂ©hension unique et Ă  long terme des forĂȘts les plus prĂ©cieuses de la Terre. Abstrak: Hutan tropika adalah di antara ekosistem yang paling produktif dan mempunyai kepelbagaian biodiversiti yang tinggi di seluruh dunia. Walaupun pemahaman mengenai hutan tropika amat penting untuk masa depan kita, usaha-usaha untuk mengkaji dan mengawas hutah-hutan tersebut baru sekarang menjadi lebih diperhubungkan. Perangkaian adalah sangat penting untuk mencari jawapan kepada soalan-soalan yang menjangkaui sempadan dan batasan agensi pendanaan. Di sini kami menunjukkan bagaimana sebuah komuniti global bertindak balas terhadap cabaran penyelidikan ekosistem tropika melalui penglibatan pelbagai kumpulan yang mengukur hutan secara pokok demi pokok dalam beribu-ribu plot jangka panjang. Kami meninjau semula penemuan saintifik utama daripada kerja ini dan menunjukkan bagaimana proses ini sedang mengubah bidang sains hutan tropika. Teras pendekatan kami memberi tumpuan terhadap penghubungan inisiatif akar umbi jangka panjang dengan protokol standar serta pengurusan data untuk mendapatkan hasil skala besar yang kukuh. Dengan menghubungkan penyelidik-penyelidik tropika dan meningkatkan status mereka, model Rangkaian Penyelidikan Sosial kami mengiktiraf kepentingan peranan pengasas data dalam penemuan saintifik. Bermula dengan pengasasan RAINFOR (Amerika Selatan) pada tahun 1999, rangkaian-rangkaian plot kekal kami kemudian disesuaikan untuk Afrika (AfriTRON) dan Asia Tenggara (T-FORCES) dan selanjutnya telah banyak dicontohi di seluruh dunia. Kini, inisiatif-inisiatif tersebut disepadukan melalui infrastruktur siber ForestPlots.net yang menghubungkan rakan sekerja dari 54 negara di 24 buah rangkaian plot. Secara kolektif, rangkaian ini sedang mengubah pemahaman tentang hutan tropika dan peranannya dalam biosfera. Kami telah bekerjasama untuk menemukan bagaimana, di mana dan mengapa karbon serta biodiversiti hutan bertindak balas terhadap perubahan iklim dan juga bagaimana mereka saling bermaklum balas. Kolaborasi pan-tropika jangka panjang ini telah mendedahkan sebuah sinki karbon jangka panjang serta arah alirannya dan juga menjelaskan pemandu-pemandu perubahan yang terpenting, di mana dan bagaimana proses hutan terjejas, masa susul yang ada dan kemungkinan tindakbalas hutan tropika pada perubahan iklim secara berterusan di masa depan. Dengan memanfaatkan pendekatan lama, rangkaian plot sedang menyalakan revolusi yang amat moden dalam sains hutan tropika. Pada masa akan datang, manusia sejagat akan banyak mendapat manfaat jika memupuk komuniti-komuniti akar umbi yang kini berkemampuan secara kolektif menghasilkan pemahaman unik dan jangka panjang mengenai hutan-hutan yang paling berharga di dunia

    Taking the pulse of Earth's tropical forests using networks of highly distributed plots

    No full text
    Tropical forests are the most diverse and productive ecosystems on Earth. While better understanding of these forests is critical for our collective future, until quite recently efforts to measure and monitor them have been largely disconnected. Networking is essential to discover the answers to questions that transcend borders and the horizons of funding agencies. Here we show how a global community is responding to the challenges of tropical ecosystem research with diverse teams measuring forests tree-by-tree in thousands of long-term plots. We review the major scientific discoveries of this work and show how this process is changing tropical forest science. Our core approach involves linking long-term grassroots initiatives with standardized protocols and data management to generate robust scaled-up results. By connecting tropical researchers and elevating their status, our Social Research Network model recognises the key role of the data originator in scientific discovery. Conceived in 1999 with RAINFOR (South America), our permanent plot networks have been adapted to Africa (AfriTRON) and Southeast Asia (T-FORCES) and widely emulated worldwide. Now these multiple initiatives are integrated via ForestPlots.net cyber-infrastructure, linking colleagues from 54 countries across 24 plot networks. Collectively these are transforming understanding of tropical forests and their biospheric role. Together we have discovered how, where and why forest carbon and biodiversity are responding to climate change, and how they feedback on it. This long-term pan-tropical collaboration has revealed a large long-term carbon sink and its trends, as well as making clear which drivers are most important, which forest processes are affected, where they are changing, what the lags are, and the likely future responses of tropical forests as the climate continues to change. By leveraging a remarkably old technology, plot networks are sparking a very modern revolution in tropical forest science. In the future, humanity can benefit greatly by nurturing the grassroots communities now collectively capable of generating unique, long-term understanding of Earth's most precious forests. Resumen: Los bosques tropicales son los ecosistemas mĂĄs diversos y productivos del mundo y entender su funcionamiento es crĂ­tico para nuestro futuro colectivo. Sin embargo, hasta hace muy poco, los esfuerzos para medirlos y monitorearlos han estado muy desconectados. El trabajo en redes es esencial para descubrir las respuestas a preguntas que trascienden las fronteras y los plazos de las agencias de financiamiento. AquĂ­ mostramos cĂłmo una comunidad global estĂĄ respondiendo a los desafĂ­os de la investigaciĂłn en ecosistemas tropicales a travĂ©s de diversos equipos realizando mediciones ĂĄrbol por ĂĄrbol en miles de parcelas permanentes de largo plazo. Revisamos los descubrimientos mĂĄs importantes de este trabajo y discutimos cĂłmo este proceso estĂĄ cambiando la ciencia relacionada a los bosques tropicales. El enfoque central de nuestro esfuerzo implica la conexiĂłn de iniciativas locales de largo plazo con protocolos estandarizados y manejo de datos para producir resultados que se puedan trasladar a mĂșltiples escalas. Conectando investigadores tropicales, elevando su posiciĂłn y estatus, nuestro modelo de Red Social de InvestigaciĂłn reconoce el rol fundamental que tienen, para el descubrimiento cientĂ­fico, quienes generan o producen los datos. Concebida en 1999 con RAINFOR (SuramĂ©rica), nuestras redes de parcelas permanentes han sido adaptadas en África (AfriTRON) y el sureste asiĂĄtico (T-FORCES) y ampliamente replicadas en el mundo. Actualmente todas estas iniciativas estĂĄn integradas a travĂ©s de la ciber-infraestructura de ForestPlots.net, conectando colegas de 54 paĂ­ses en 24 redes diferentes de parcelas. Colectivamente, estas redes estĂĄn transformando nuestro conocimiento sobre los bosques tropicales y el rol de Ă©stos en la biĂłsfera. Juntos hemos descubierto cĂłmo, dĂłnde y porquĂ© el carbono y la biodiversidad de los bosques tropicales estĂĄ respondiendo al cambio climĂĄtico y cĂłmo se retroalimentan. Esta colaboraciĂłn pan-tropical de largo plazo ha expuesto un gran sumidero de carbono y sus tendencias, mostrando claramente cuĂĄles son los factores mĂĄs importantes, quĂ© procesos se ven afectados, dĂłnde ocurren los cambios, los tiempos de reacciĂłn y las probables respuestas futuras mientras el clima continĂșa cambiando. Apalancando lo que realmente es una tecnologĂ­a antigua, las redes de parcelas estĂĄn generando una verdadera y moderna revoluciĂłn en la ciencia tropical. En el futuro, la humanidad puede beneficiarse enormemente si se nutren y cultivan comunidades de investigadores de base, actualmente con la capacidad de generar informaciĂłn Ășnica y de largo plazo para entender los que probablemente son los bosques mĂĄs preciados de la tierra. Resumo: Florestas tropicais sĂŁo os ecossistemas mais diversos e produtivos da Terra. Embora uma boa compreensĂŁo destas florestas seja crucial para o nosso futuro coletivo, atĂ© muito recentemente os esforços de mediçÔes e monitoramento tem sido amplamente desconexos. É essencial formarmos redes para obtermos respostas que transcendam as fronteiras e horizontes das agĂȘncias financiadoras. Neste estudo nĂłs mostramos como uma comunidade global estĂĄ respondendo aos desafios da pesquisa de ecossistemas tropicais, com equipes diversas medindo florestas, ĂĄrvore por ĂĄrvore, em milhares de parcelas monitoradas a longo prazo. NĂłs revisamos as maiores descobertas cientĂ­ficas deste esforço global, e mostramos tambĂ©m como este processo vem mudando a ciĂȘncia de florestas tropicais. Nossa abordagem principal envolve unir iniciativas de base a protocolos padronizados e gerenciamento de dados a fim de gerar resultados robustos em grandes escalas. Ao conectar pesquisadores tropicais e elevar seus status, nosso modelo de Rede de Pesquisa Social reconhece o papel chave do produtor dos dados na descoberta cientĂ­fica. Concebida em 1999 com o RAINFOR (AmĂ©rica do Sul), nossa rede de parcelas permanentes foi adaptada para África (AfriTRON) e Sudeste AsiĂĄtico (T-FORCES), e tem sido extensamente reproduzida em todo o mundo. Agora estas mĂșltiplas iniciativas estĂŁo integradas atravĂ©s da infraestrutura cibernĂ©tica do ForestPlots.net, conectando colegas de 54 paĂ­ses e 24 redes de parcelas. Estas iniciativas estĂŁo transformando coletivamente o entendimento das florestas tropicais e seus papĂ©is na biosfera. Juntos nĂłs descobrimos como, onde e por que o carbono e a biodiversidade da floresta estĂŁo respondendo Ă s mudanças climĂĄticas, e seus efeitos de retroalimentação. Esta duradoura colaboração pantropical revelou um grande sumidouro de carbono persistente e suas tendĂȘncias, assim como tem evidenciado quais os fatores que influenciam essas tendĂȘncias, quais processos florestais sĂŁo mais afetados, onde eles estĂŁo mudando, seus atrasos no tempo de resposta, e as provĂĄveis respostas das florestas tropicais conforme o clima continua a mudar. Dessa forma, aproveitando uma notĂĄvel tecnologia antiga, redes de parcelas acendem as faĂ­scas de uma moderna revolução na ciĂȘncia das florestas tropicais. No futuro a humanidade pode se beneficiar incentivando estas comunidades locais que agora sĂŁo coletivamente capazes de gerar conhecimentos Ășnicos e duradouros sobre as florestas mais preciosas da Terra. RĂ©sume: Les forĂȘts tropicales sont les Ă©cosystĂšmes les plus diversifiĂ©s et les plus productifs de la planĂšte. Si une meilleure comprĂ©hension de ces forĂȘts est essentielle pour notre avenir collectif, jusqu'Ă  tout rĂ©cemment, les efforts dĂ©ployĂ©s pour les mesurer et les surveiller ont Ă©tĂ© largement dĂ©connectĂ©s. La mise en rĂ©seau est essentielle pour dĂ©couvrir les rĂ©ponses Ă  des questions qui dĂ©passent les frontiĂšres et les horizons des organismes de financement. Nous montrons ici comment une communautĂ© mondiale relĂšve les dĂ©fis de la recherche sur les Ă©cosystĂšmes tropicaux avec diverses Ă©quipes qui mesurent les forĂȘts arbre aprĂšs arbre dans de milliers de parcelles permanentes. Nous passons en revue les principales dĂ©couvertes scientifiques de ces travaux et montrons comment ce processus modifie la science des forĂȘts tropicales. Notre approche principale consiste Ă  relier les initiatives de base Ă  long terme Ă  des protocoles standardisĂ©s et une gestion de donnĂ©es afin de gĂ©nĂ©rer des rĂ©sultats solides Ă  grande Ă©chelle. En reliant les chercheurs tropicaux et en Ă©levant leur statut, notre modĂšle de rĂ©seau de recherche sociale reconnaĂźt le rĂŽle clĂ© de l'auteur des donnĂ©es dans la dĂ©couverte scientifique. Conçus en 1999 avec RAINFOR (AmĂ©rique du Sud), nos rĂ©seaux de parcelles permanentes ont Ă©tĂ© adaptĂ©s Ă  l'Afrique (AfriTRON) et Ă  l'Asie du Sud-Est (T-FORCES) et largement imitĂ©s dans le monde entier. Ces multiples initiatives sont dĂ©sormais intĂ©grĂ©es via l'infrastructure ForestPlots.net, qui relie des collĂšgues de 54 pays Ă  travers 24 rĂ©seaux de parcelles. Ensemble, elles transforment la comprĂ©hension des forĂȘts tropicales et de leur rĂŽle biosphĂ©rique. Ensemble, nous avons dĂ©couvert comment, oĂč et pourquoi le carbone forestier et la biodiversitĂ© rĂ©agissent au changement climatique, et comment ils y rĂ©agissent. Cette collaboration pan-tropicale Ă  long terme a rĂ©vĂ©lĂ© un important puits de carbone Ă  long terme et ses tendances, tout en mettant en Ă©vidence les facteurs les plus importants, les processus forestiers qui sont affectĂ©s, les endroits oĂč ils changent, les dĂ©calages et les rĂ©actions futures probables des forĂȘts tropicales Ă  mesure que le climat continue de changer. En tirant parti d'une technologie remarquablement ancienne, les rĂ©seaux de parcelles dĂ©clenchent une rĂ©volution trĂšs moderne dans la science des forĂȘts tropicales. À l'avenir, l'humanitĂ© pourra grandement bĂ©nĂ©ficier du soutien des communautĂ©s de base qui sont maintenant collectivement capables de gĂ©nĂ©rer une comprĂ©hension unique et Ă  long terme des forĂȘts les plus prĂ©cieuses de la Terre. Abstrak: Hutan tropika adalah di antara ekosistem yang paling produktif dan mempunyai kepelbagaian biodiversiti yang tinggi di seluruh dunia. Walaupun pemahaman mengenai hutan tropika amat penting untuk masa depan kita, usaha-usaha untuk mengkaji dan mengawas hutah-hutan tersebut baru sekarang menjadi lebih diperhubungkan. Perangkaian adalah sangat penting untuk mencari jawapan kepada soalan-soalan yang menjangkaui sempadan dan batasan agensi pendanaan. Di sini kami menunjukkan bagaimana sebuah komuniti global bertindak balas terhadap cabaran penyelidikan ekosistem tropika melalui penglibatan pelbagai kumpulan yang mengukur hutan secara pokok demi pokok dalam beribu-ribu plot jangka panjang. Kami meninjau semula penemuan saintifik utama daripada kerja ini dan menunjukkan bagaimana proses ini sedang mengubah bidang sains hutan tropika. Teras pendekatan kami memberi tumpuan terhadap penghubungan inisiatif akar umbi jangka panjang dengan protokol standar serta pengurusan data untuk mendapatkan hasil skala besar yang kukuh. Dengan menghubungkan penyelidik-penyelidik tropika dan meningkatkan status mereka, model Rangkaian Penyelidikan Sosial kami mengiktiraf kepentingan peranan pengasas data dalam penemuan saintifik. Bermula dengan pengasasan RAINFOR (Amerika Selatan) pada tahun 1999, rangkaian-rangkaian plot kekal kami kemudian disesuaikan untuk Afrika (AfriTRON) dan Asia Tenggara (T-FORCES) dan selanjutnya telah banyak dicontohi di seluruh dunia. Kini, inisiatif-inisiatif tersebut disepadukan melalui infrastruktur siber ForestPlots.net yang menghubungkan rakan sekerja dari 54 negara di 24 buah rangkaian plot. Secara kolektif, rangkaian ini sedang mengubah pemahaman tentang hutan tropika dan peranannya dalam biosfera. Kami telah bekerjasama untuk menemukan bagaimana, di mana dan mengapa karbon serta biodiversiti hutan bertindak balas terhadap perubahan iklim dan juga bagaimana mereka saling bermaklum balas. Kolaborasi pan-tropika jangka panjang ini telah mendedahkan sebuah sinki karbon jangka panjang serta arah alirannya dan juga menjelaskan pemandu-pemandu perubahan yang terpenting, di mana dan bagaimana proses hutan terjejas, masa susul yang ada dan kemungkinan tindakbalas hutan tropika pada perubahan iklim secara berterusan di masa depan. Dengan memanfaatkan pendekatan lama, rangkaian plot sedang menyalakan revolusi yang amat moden dalam sains hutan tropika. Pada masa akan datang, manusia sejagat akan banyak mendapat manfaat jika memupuk komuniti-komuniti akar umbi yang kini berkemampuan secara kolektif menghasilkan pemahaman unik dan jangka panjang mengenai hutan-hutan yang paling berharga di dunia

    Taking the pulse of Earth\u27s tropical forests using networks of highly distributed plots

    No full text
    Tropical forests are the most diverse and productive ecosystems on Earth. While better understanding of these forests is critical for our collective future, until quite recently efforts to measure and monitor them have been largely disconnected. Networking is essential to discover the answers to questions that transcend borders and the horizons of funding agencies. Here we show how a global community is responding to the challenges of tropical ecosystem research with diverse teams measuring forests tree-by-tree in thousands of long-term plots. We review the major scientific discoveries of this work and show how this process is changing tropical forest science. Our core approach involves linking long-term grassroots initiatives with standardized protocols and data management to generate robust scaled-up results. By connecting tropical researchers and elevating their status, our Social Research Network model recognises the key role of the data originator in scientific discovery. Conceived in 1999 with RAINFOR (South America), our permanent plot networks have been adapted to Africa (AfriTRON) and Southeast Asia (T-FORCES) and widely emulated worldwide. Now these multiple initiatives are integrated via ForestPlots.net cyber-infrastructure, linking colleagues from 54 countries across 24 plot networks. Collectively these are transforming understanding of tropical forests and their biospheric role. Together we have discovered how, where and why forest carbon and biodiversity are responding to climate change, and how they feedback on it. This long-term pan-tropical collaboration has revealed a large long-term carbon sink and its trends, as well as making clear which drivers are most important, which forest processes are affected, where they are changing, what the lags are, and the likely future responses of tropical forests as the climate continues to change. By leveraging a remarkably old technology, plot networks are sparking a very modern revolution in tropical forest science. In the future, humanity can benefit greatly by nurturing the grassroots communities now collectively capable of generating unique, long-term understanding of Earth\u27s most precious forests

    Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19

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    Background: We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world's largest international, standardized data sets concerning hospitalized patients. Methods: The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV). Results: Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60 years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%. Conclusions: Age was the strongest determinant of risk of death, with a ∌30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death. The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death

    Thrombotic and hemorrhagic complications of COVID-19 in adults hospitalized in high-income countries compared with those in adults hospitalized in low- and middle-income countries in an international registry

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    Background: COVID-19 has been associated with a broad range of thromboembolic, ischemic, and hemorrhagic complications (coagulopathy complications). Most studies have focused on patients with severe disease from high-income countries (HICs). Objectives: The main aims were to compare the frequency of coagulopathy complications in developing countries (low- and middle-income countries [LMICs]) with those in HICs, delineate the frequency across a range of treatment levels, and determine associations with in-hospital mortality. Methods: Adult patients enrolled in an observational, multinational registry, the International Severe Acute Respiratory and Emerging Infections COVID-19 study, between January 1, 2020, and September 15, 2021, met inclusion criteria, including admission to a hospital for laboratory-confirmed, acute COVID-19 and data on complications and survival. The advanced-treatment cohort received care, such as admission to the intensive care unit, mechanical ventilation, or inotropes or vasopressors; the basic-treatment cohort did not receive any of these interventions. Results: The study population included 495,682 patients from 52 countries, with 63% from LMICs and 85% in the basic treatment cohort. The frequency of coagulopathy complications was higher in HICs (0.76%-3.4%) than in LMICs (0.09%-1.22%). Complications were more frequent in the advanced-treatment cohort than in the basic-treatment cohort. Coagulopathy complications were associated with increased in-hospital mortality (odds ratio, 1.58; 95% CI, 1.52-1.64). The increased mortality associated with these complications was higher in LMICs (58.5%) than in HICs (35.4%). After controlling for coagulopathy complications, treatment intensity, and multiple other factors, the mortality was higher among patients in LMICs than among patients in HICs (odds ratio, 1.45; 95% CI, 1.39-1.51). Conclusion: In a large, international registry of patients hospitalized for COVID-19, coagulopathy complications were more frequent in HICs than in LMICs (developing countries). Increased mortality associated with coagulopathy complications was of a greater magnitude among patients in LMICs. Additional research is needed regarding timely diagnosis of and intervention for coagulation derangements associated with COVID-19, particularly for limited-resource settings
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