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- Shackelford, Nancy, et al.
(författare)
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Isolation predicts compositional change after discrete disturbances in a global meta-study
- 2017
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Ingår i: Ecography. - : John Wiley & Sons. - 0906-7590 .- 1600-0587. ; 40:11, s. 1256-1266
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Tidskriftsartikel (refereegranskat)abstract
- Globally, anthropogenic disturbances are occurring at unprecedented rates and over extensive spatial and temporal scales. Human activities also affect natural disturbances, prompting shifts in their timing and intensities. Thus, there is an urgent need to understand and predict the response of ecosystems to disturbance. In this study, we investigated whether there are general determinants of community response to disturbance across different community types, locations, and disturbance events. We compiled 14 case studies of community response to disturbance from four continents, twelve aquatic and terrestrial ecosystem types, and eight different types of disturbance. We used community compositional differences and species richness to indicate community response. We used mixed-effects modeling to test the relationship between each of these response metrics and four potential explanatory factors: regional species pool size, isolation, number of generations passed, and relative disturbance intensity. We found that compositional similarity was higher between pre- and post-disturbance communities when the disturbed community was connected to adjacent undisturbed habitat. The number of generations that had passed since the disturbance event was a significant, but weak, predictor of community compositional change; two communities were responsible for the observed relationship. We found no significant relationships between the factors we tested and changes in species richness. To our knowledge, this is the first attempt to search for general drivers of community resilience from a diverse set of case studies. The strength of the relationship between compositional change and isolation suggests that it may be informative in resilience research and biodiversity management.
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- Iqbal, Javaid, et al.
(författare)
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Optimal Medical Therapy Improves Clinical Outcomes in Patients Undergoing Revascularization With Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting Insights From the Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) Trial at the 5-Year Follow-Up
- 2015
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Ingår i: Circulation. - 0009-7322 .- 1524-4539. ; 131:14, s. 1269-1277
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Tidskriftsartikel (refereegranskat)abstract
- Background-There is a paucity of data on the use of optimal medical therapy (OMT) in patients with complex coronary artery disease undergoing revascularization with percutaneous coronary intervention or coronary artery bypass grafting (CABG) and its long-term prognostic significance. Methods and Results-The Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) trial is a multicenter, randomized, clinical trial of patients (n=1800) with complex coronary disease randomized to revascularization with percutaneous coronary intervention or CABG. Detailed drug history was collected for all patients at discharge and at the 1-month, 6-month, 1-year, 3-year, and 5-year follow-ups. OMT was defined as the combination of at least 1 antiplatelet drug, statin, beta-blocker, and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker. Five-year clinical outcomes were stratified by OMT and non-OMT. OMT was underused in patients treated with coronary revascularization, especially CABG. OMT was an independent predictor of survival. OMT was associated with a significant reduction in mortality (hazard ratio, 0.64; 95% confidence interval, 0.48-0.85; P=0.002) and composite end point of death/myocardial infarction/stroke (hazard ratio, 0.73; 95% confidence interval, 0.58-0.92; P=0.007) at the 5-year follow-up. The treatment effect with OMT (36% relative reduction in mortality over 5 years) was greater than the treatment effect of revascularization strategy (26% relative reduction in mortality with CABG versus percutaneous coronary intervention over 5 years). On stratified analysis, all the components of OMT were important for reducing adverse outcomes regardless of revascularization strategy. Conclusions-The use of OMT remains low in patients with complex coronary disease requiring coronary intervention with percutaneous coronary intervention and even lower in patients treated with CABG. Lack of OMT is associated with adverse clinical outcomes. Targeted strategies to improve OMT use in postrevascularization patients are warranted.
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