A New High-Resolution Map of World Mountains and an Online Tool for Visualizing and Comparing

Answers to the seemingly straightforward questions “what is a mountain?” and “where are the mountains of the world?” are in fact quite complex, and there have been few attempts to map the mountains of the earth in a consistent and rigorous fashion. However, knowing exactly where mountain ecosystems are distributed on the planet is a precursor to conserving them, as called for in Sustainable Development Goals 6 and 15 of the United Nations 2030 Agenda for Sustainable Development. In this article we first compare 3 characterizations of global mountain distributions, including a new, high-resolution (250 m) map of global mountains derived from terrain characteristics. We show how differences in conceptual definition, methodology, and spatial resolution of source data can result in differences in the extent and location of lands classed as mountains. For example, the new 250-m resource documents a larger global mountain extent than previous characterizations, although it excludes plateaus, hilly forelands, and other landforms that are often considered part of mountain areas. We then introduce the Global Mountain Explorer, a new web-based application specifically developed for exploration, visualization, and comparison of these maps. This new open-access tool is an intuitive and versatile resource suitable for a broad range of users and applications

An Assessment of the Representation of Ecosystems in Global Protected Areas Using New Maps of World Climate Regions and World Ecosystems

Representation of ecosystems in protected area networks and conservation strategies is a core principle of global conservation priority setting approaches and a commitment in Aichi Target 11 of the Convention on Biological Diversity. The 2030 Sustainable Development Goals (SDGs) explicitly call for the conservation of terrestrial, freshwater, and marine ecosystems. Accurate ecosystem distribution maps are required to assess representation of ecosystems in protected areas, but standardized, high spatial resolution, and globally comprehensive ecosystem maps have heretofore been lacking. While macroscale global ecoregions maps have been used in global conservation priority setting exercises, they do not identify distinct localized ecosystems at the occurrence (patch) level, and instead describe large ecologically meaningful areas within which additional conservation planning and management are necessary. We describe a new set of maps of globally consistent climate regions and ecosystems at a much finer spatial resolution (250 m) than existing ecological regionalizations. We then describe a global gap analysis of the representation of these ecosystems in protected areas. The new map of terrestrial World Ecosystems was derived from the objective development and integration of 1) global temperature domains, 2) global moisture domains, 3) global landforms, and 4) 2015 global vegetation and land use. These new terrestrial World Ecosystems do not include either freshwater or marine ecosystems, but analog products for the freshwater and marine domains are in development. A total of 431 World Ecosystems were identified, and of these a total of 278 units were natural or semi-natural vegetation/environment combinations, including different kinds of forestlands, shrublands, grasslands, bare areas, and ice/snow regions. The remaining classes were different kinds of croplands and settlements. Of the 278 natural and semi-natural classes, 9 were not represented in global protected areas with a strict biodiversity conservation management objective (IUCN management categories I-IV), and an additional 206 were less than 8.5% protected (half way to the 17% Aichi Target 11 goal). Forty four classes were between 8.5% and 17% protected (more than half way towards the Aichi 17% target), and only 19 classes exceeded the 17% Aichi target. However, when all protected areas (IUCN management categories I-VI plus protected areas with no IUCN designation) were included in a separate global gap analysis, representation of ecosystems increases substantially, with a third of the ecosystems exceeding the 17% Aichi target, and another third between 8.5% and 17%. The overall protection (representation) of global ecosystems in protected areas is considerably less when assessed using only strictly conserved protected areas, and more if all protected areas are included in the analysis. Protected area effectiveness should be included in further evaluations of global ecosystem protection. The ecosystems with the highest representation in protected areas were often bare or sparsely vegetated and found in inhospitable environments (e.g. cold mountains, deserts), and the eight most protected ecosystems were all snow and ice ecosystems. In addition to the global gap analysis of World Ecosystems in protected areas, we report on the representation results for the ecosystems in each biogeographic realm (Neotropical, Nearctic, Afrotropical, Palearctic, Indomalayan, Australasian, and Oceania)

A Global Ecological Classification of Coastal Segment Units to Complement Marine Biodiversity Observation Network Assessments

A new data layer provides Coastal and Marine Ecological Classification Standard (CMECS) labels for global coastal segments at 1 km or shorter resolution. These characteristics are summarized for six US Marine Biodiversity Observation Network (MBON) sites and one MBON Pole to Pole of the Americas site in Argentina. The global coastlines CMECS classifications were produced from a partitioning of a 30 m Landsat-derived shoreline vector that was segmented into 4 million 1 km or shorter segments. Each segment was attributed with values from 10 variables that represent the ecological settings in which the coastline occurs, including properties of the adjacent water, adjacent land, and coastline itself. The 4 million segments were classified into 81,000 coastal segment units (CSUs) as unique combinations of variable classes. We summarize the process to develop the CSUs and derive summary descriptions for the seven MBON case study sites. We discuss the intended application of the new CSU data for research and management in coastal areas

The American Association for the Surgery of Trauma renal injury grading scale: Implications of the 2018 revisions for injury reclassification and predicting bleeding interventions.

BackgroundIn 2018, the American Association for the Surgery of Trauma (AAST) published revisions to the renal injury grading system to reflect the increased reliance on computed tomography scans and non-operative management of high-grade renal trauma (HGRT). We aimed to evaluate how these revisions will change the grading of HGRT and if it outperforms the original 1989 grading in predicting bleeding control interventions.MethodsData on HGRT were collected from 14 Level-1 trauma centers from 2014 to 2017. Patients with initial computed tomography scans were included. Two radiologists reviewed the scans to regrade the injuries according to the 1989 and 2018 AAST grading systems. Descriptive statistics were used to assess grade reclassifications. Mixed-effect multivariable logistic regression was used to measure the predictive ability of each grading system. The areas under the curves were compared.ResultsOf the 322 injuries included, 27.0% were upgraded, 3.4% were downgraded, and 69.5% remained unchanged. Of the injuries graded as III or lower using the 1989 AAST, 33.5% were upgraded to grade IV using the 2018 AAST. Of the grade V injuries, 58.8% were downgraded using the 2018 AAST. There was no statistically significant difference in the overall areas under the curves between the 2018 and 1989 AAST grading system for predicting bleeding interventions (0.72 vs. 0.68, p = 0.34).ConclusionAbout one third of the injuries previously classified as grade III will be upgraded to grade IV using the 2018 AAST, which adds to the heterogeneity of grade IV injuries. Although the 2018 AAST grading provides more anatomic details on injury patterns and includes important radiologic findings, it did not outperform the 1989 AAST grading in predicting bleeding interventions.Level of evidencePrognostic and Epidemiological Study, level III

The Impact of Social Deprivation on Anterior Urethral Stricture Recurrence After Urethroplasty - A Trauma and Urologic Reconstructive Network of Surgeons (TURNS) Analysis.

Introduction and objectivesSeveral factors influence recurrence after urethral stricture repair. The impact of socioeconomic factors on stricture recurrence after urethroplasty is poorly understood. This study aims to assess the impact that social deprivation, an area-level measure of disadvantage, has on urethral stricture recurrence after urethroplasty.MethodsWe performed a retrospective review of patients undergoing urethral reconstruction by surgeons participating in a collaborative research group. Home zip code was used to calculate Social Deprivation Indices (SDI; 0-100), which quantifies the level of disadvantage across several sociodemographic domains collected in the American Community Survey. Patients without zip code data were excluded from the analysis. The Cox Proportional Hazards model was used to study the association between SDI and the hazard of functional recurrence, adjusting for stricture characteristics as well as age and body mass index.ResultsMedian age was 46.0 years with a median follow up of 367 days for the 1452 men included in the study. Patients in the fourth SDI quartile (worst social deprivation) were more likely to be active smokers with traumatic and infectious strictures compared to the first SDI quartile. Patients in the fourth SDI quartile had 1.64 times the unadjusted hazard of functional stricture recurrence vs patients in the first SDI quartile (95% CI 1.04-2.59). Compared to anastomotic ± excision, substitution only repair had 1.90 times the unadjusted hazard of recurrence. The adjusted hazard of recurrence was 1.08 per 10-point increase in SDI (95% CI 1.01-1.15, P = .027).ConclusionsPatient social deprivation identifies those at higher risk for functional recurrence after anterior urethral stricture repair, offering an opportunity for preoperative counseling and postoperative surveillance. Addressing these social determinants of health can potentially improve outcomes in reconstructive surgery

Earth Virtualization Engines (EVE)

To manage Earth in the Anthropocene, new tools, new institutions, and new forms of international cooperation will be required. Earth Virtualization Engines is proposed as an international federation of centers of excellence to empower all people to respond to the immense and urgent challenges posed by climate change

Urinary Diversion for Severe Urinary Adverse Events of Prostate Radiation: Results from a Multi-Institutional Study

PurposeWe evaluated the short and long-term surgical outcomes of urinary diversion done for urinary adverse events arising from prostate radiation therapy. We hypothesized that patient characteristics are associated with complications after urinary diversion.Materials and methodsWe performed a retrospective cohort study of 100 men who underwent urinary diversion (urinary conduit or continent catheterizable pouch) due to urinary adverse events after prostate radiotherapy from 2007 to 2016 from 9 academic centers in the United States. Outcome measurements included predictors of short and long-term complications, and readmission after urinary diversion of patients who had prostate cancer treated with radiotherapy. The data were summarized using descriptive statistics and univariate associations with complications were identified with logistic regression controlling for center.ResultsMean patient age was 71 years and median time from radiotherapy to urinary diversion was 8 years. Overall 81 (81%) patients had combined modality therapy (radical prostatectomy plus radiotherapy or various combinations of radiotherapy). Grade 3a or greater Clavien-Dindo complications occurred in 31 (35%) men, including 4 deaths (4.5%). Normal weight men had more short-term complications compared to overweight (OR 4.9, 95% CI 1.3-23.1, p=0.02) and obese men (OR 6.3, 95% CI 1.6-31.1, p=0.009). Hospital readmission within 6 weeks of surgery occurred for 35 (38%) men. Surgery was needed to treat long-term complications after urinary diversion in 19 (22%) patients with a median followup of 16.3 months.ConclusionsUrinary diversion after prostate radiotherapy has a considerable short and long-term surgical complication rate. Urinary diversion most often cannot be avoided in these patients but appreciation of the risks allows for informed shared decision making between surgeons and patients