| 1. |
- Boeddinghaus, Jasper, et al.
(författare)
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Impact of age on the performance of the ESC 0/1h-algorithms for early diagnosis of myocardial infarction
- 2018
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Ingår i: European Heart Journal. - : OXFORD UNIV PRESS. - 0195-668X .- 1522-9645. ; 39:42, s. 3780-3794
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Tidskriftsartikel (refereegranskat)abstract
- Aims We aimed to evaluate the impact of age on the performance of the European Society of Cardiology (ESC) 0/1h-algorithms and to derive and externally validate alternative cut-offs specific to older patients. Methods and results We prospectively enrolled patients presenting to the emergency department (ED) with symptoms suggestive of and results acute myocardial infarction in three large diagnostic studies. Final diagnoses were adjudicated by two independent cardiologists. High-sensitivity cardiac troponin (hs-cTn) T and I concentrations were measured at presentation and after 1 h. Patients were stratified according to age [<55 years (young), >= 55 to <70 years (middle-age), >= 70 years (old)]. Rule-out safety of the ESC hs-cTnT 0/1h-algorithm was very high in all age-strata: sensitivity 100% [95% confidence interval (95% CI) 94.9-100] in young, 99.3% (95% CI 96.0-99.9) in middle-age, and 99.3% (95% CI 97.599.8) in old patients. Accuracy of rule-in decreased with age: specificity 97.0% (95% CI 95.8-97.9) in young, 96.1% (95% CI 94.5-97.2) in middle-age, and 92.7% (95% CI 90.7-94.3) in older patients. Triage efficacy decreased with increasing age (young 93%, middle-age 80%, old 55%, P <0.001). Similar results were found for the ESC hs-cTnT 0/1h-algorithm. Alternative, slightly higher cut-off concentrations optimized for older patients maintained very high safety of rule-out, increased specificity of rule-in (P< 0.01), reduced overall efficacy for hs-cTnT (P <0.01), while maintaining efficacy for hs-cTnl. Findings were confirmed in two validation cohorts (n = 2767). Conclusion While safety of the ESC 0/1h-algorithms remained very high, increasing age significantly reduced overall efficacy and the accuracy of rule-in. Alternative slightly higher cut-off concentrations may be considered for older patients, particularly if using hs-cTnl.
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| 2. |
- Gaget, Elie, et al.
(författare)
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Benefits of protected areas for nonbreeding waterbirds adjusting their distributions under climate warming
- 2021
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Ingår i: Conservation Biology. - : Wiley. - 0888-8892 .- 1523-1739. ; 35:3, s. 834-845
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Tidskriftsartikel (refereegranskat)abstract
- Climate warming is driving changes in species distributions and community composition. Many species have a so-called climatic debt, that is, shifts in range lag behind shifts in temperature isoclines. Inside protected areas (PAs), community changes in response to climate warming can be facilitated by greater colonization rates by warm-dwelling species, but also mitigated by lowering extirpation rates of cold-dwelling species. An evaluation of the relative importance of colonization-extirpation processes is important to inform conservation strategies that aim for both climate debt reduction and species conservation. We assessed the colonization-extirpation dynamics involved in community changes in response to climate inside and outside PAs. To do so, we used 25 years of occurrence data of nonbreeding waterbirds in the western Palearctic (97 species, 7071 sites, 39 countries, 1993–2017). We used a community temperature index (CTI) framework based on species thermal affinities to investigate species turnover induced by temperature increase. We determined whether thermal community adjustment was associated with colonization by warm-dwelling species or extirpation of cold-dwelling species by modeling change in standard deviation of the CTI (CTISD). Using linear mixed-effects models, we investigated whether communities in PAs had lower climatic debt and different patterns of community change than communities outside PAs. For CTI and CTISD combined, communities inside PAs had more species, higher colonization, lower extirpation, and lower climatic debt (16%) than communities outside PAs. Thus, our results suggest that PAs facilitate 2 independent processes that shape community dynamics and maintain biodiversity. The community adjustment was, however, not sufficiently fast to keep pace with the large temperature increases in the central and northeastern western Palearctic. Our results underline the potential of combining CTI and CTISD metrics to improve understanding of the colonization-extirpation patterns driven by climate warming.
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| 3. |
- Grünwald, Jan, et al.
(författare)
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Ecological traits predict population trends of urban birds in Europe
- 2024
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Ingår i: Ecological Indicators. - 1470-160X. ; 160
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Tidskriftsartikel (refereegranskat)abstract
- The population dynamics of urban animals has been so far remarkably understudied. At the same time, urban species’ population trends can provide important information on the consequences of environmental changes in cities. We modelled long-term population trends of 93 bird species breeding in urban areas in 16 European countries as a function of species’ traits, characterising variability in their urbanization and ecology. We found that: (i) earlier colonisers have more negative population trends than recent colonisers; (ii) more urbanized open habitat species had more positive population trends than less urbanized open habitat species; (iii) highly urbanized birds breeding above the ground had more negative trends than highly urbanized ground breeders. These patterns can be explained by several processes occurring in cities as well as outside city borders. Namely, (i) pre-industrial colonisers might struggle to persist in rapidly changing urban areas, limiting their foraging and breeding opportunities of the birds. (ii) Open habitats are under pressure of intensive agricultural exploitation in rural areas, which may negatively affect populations of less urbanized birds. In contrast, urban areas do not experience such pressure keeping the trends of urbanized open habitat species more positive. (iii) Differences in population trends between highly urbanized ground and above-ground breeders suggest that the latter may lose their breeding opportunities in modern buildings that do not provide suitable breeding sites. Our results indicate that even once successful, city dwellers may not keep pace with changes in urban areas, but these areas may also provide suitable habitats for biodiversity.
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