Low Annual Mortality Research Articles

Carcinogenic risk to the health of the population of a large industrial city as a result of multi-environmental and multi-route exposure to chemicals

Introduction. Despite the relatively low average annual mortality rate, the increased incidence of cancer in the population of the Omsk region, together with indicators of the quality of oncological care, indicate a tense epidemiological situation. The purpose of the study is to determine priority environments and routes of exposure to chemicals in the formation of long-term carcinogenic risks in the city of Omsk. Materials and methods. There were used results of environmental and social-hygienic monitoring of habitat objects for the period 2017–2022. To assess the cumulative carcinogenic risk, atmospheric air, drinking tap water, open water, soil, food products, and 3 routes of exposure were taken into account: inhalation, oral and cutaneous. The assessment of carcinogenic risks was carried out in accordance with Guideline R 2.1.10.3968–23, taking into account the severity coefficient of malignant neoplasms. Results. The carcinogenic risk to the health of the population of the city of Omsk as a result of multi–environmenal and multi-route exposure to chemicals was assessed as alarming (high in an the engraved script). The structure of contributions to the cumulative carcinogenic risk: drinking water – 63.3%, atmospheric air – 33.1%, food products – 3.3 %, other environments less than 0.5%. The main route of entry of chemical carcinogens is inhalation (77.4%). Alarming carcinogenic risks were formed through the inhalation route of chloroform from drinking water; chromium VI, formaldehyde, benzene, and soot from atmospheric air. Among the target organs of malignant neoplasms, the greatest risk was in the gastrointestinal tract, which was assessed as alarming. Limitations. Not all habitat objects were analyzed, which may reduce the objectivity of the conclusions. Conclusion. An assessment of the long-term cumulative carcinogenic risk made it possible to prioritize the list of chemical pollutants, environmental objects, and routes of exposure to carcinogens. For more accurate planning of sanitary and hygienic measures to reduce public health risks, improve comprehensive monitoring of pollutants in all environments, taking into account all routes of entry into the human body, it is advisable to analyze the total risks for multi-environmental and multi-route exposure with an analysis of the contribution of chemicals, media, routes to their formation.

Evaluating urban park ecosystem services and modeling improvement scenarios

Three ecosystem services of the 25 public parks in Bangkok, including carbon sequestration, avoided runoff, four air pollutant removals (CO, NO2, PM10, and PM2.5), and the relevant monetary values, were determined using i-Tree Eco software. Two modeling scenarios (MS) including MS1 (no greening improvement) and MS2 (improvement by increasing either green area or tree planting, or both in the parks) with tree annual mortality rates (AMR) of 1 and 3% were developed to forecast the parks' ecosystem services for 50 years after 2020 (2021–2071). The results revealed the synergistic interactions of the different tree planting specifications (MS1 and MS2) and tree mortality rates on the parks' ecosystem services. For MC2 with the assigned 1% AMR, the parks’ optimal ecosystem services were obtained and the average annual monetary value (0.55 million USD) of the total ecosystem services of the 25 parks over the 50-year forecast was 150% higher than that (0.22 million USD) in 2020. Based on MS1 and MS2, tree rotations should be conducted in the parks after 2057 and 2065, respectively, for the low tree AMR (≤1%) but not later than 2041 and 2043, respectively, for the higher tree AMR.

STEMI Pakistan; A National Heart Attack Management Program.

Coronary artery disease (CAD) accounts for more than two-thirds of these deaths. It is indicated per the latest information that one in four Pakistani adults over 40 has CAD.
 The stable coronary disease has a relatively low annual mortality, while acute myocardial infarction (MI) carries a high mortality and morbidity. Though recent advancements in coronary interventions have however revolutionized the management of acute myocardial infarction, resulting in a significant reduction of cardiovascular morbidity and mortality in the developed world but in Pakistan, the majority of ST-elevation myocardial infarction (STEMI) patients still remain sub-optimally managed. Urban areas are relatively better equipped, but this does not necessarily translate into universal access to quality and timely cardiac care. There is not only substantial variation in accessibility and practices amongst cardiac healthcare facilities between rural and urban areas but also amongst major city hospitals. Such variations clearly indicate an urgent need for a nationwide standardized STEMI management program to ensure that everyone with an acute STEMI will have speedy access to quality and standard acute care without being economically burdened.

Effects of Peripheral Arterial Disease Interventions on Survival: A Propensity-Score Matched Analysis Using VQI Data

Atherectomy is currently being used extensively for occlusive peripheral artery disease (PAD) interventions without proven benefits. This analysis examines the effects of atherectomy and other endovascular interventions on patient survival. The aim of this study is to compare overall survival for patients undergoing PAD endovascular interventions, such as plain old balloon angioplasty (POBA), stent deployment and atherectomy. Propensity score matched cohorts were constructed to conduct pairwise comparisons of overall survival in patients who underwent stenosis and occlusive PAD interventions between May 2011 and February 2020 using Vascular Quality Initiative (VQI) regional registry data. Inverse probability treatment weighting method was used to compare secondary outcomes of in-hospital mortality, length of stay, complications and major amputations. Comparative analysis was performed for POBA vs stenting, POBA vs atherectomy, and stenting vs atherectomy. A total number of 15281 eligible cases were identified. After propensity score matching, 6094, 4032, and 3312 cases were used to compare POBA versus stent deployment, POBA versus atherectomy and stent versus atherectomy, respectively. Stent deployment had significantly better overall survival compared with POBA and atherectomy (P < 0.001). Multivariable Cox proportional hazard models suggested stenting was associated with a reduction in mortality hazard by 30% compared with POBA (HR: 0.7; 95% CI: 0.6-0.82; P < 0.001) and a 40% mortality reduction compared with atherectomy (HR: 0.6; 95% CI: 0.48-0.75; P < 0.001). No significant difference was found between POBA and atherectomy. There was no statistical difference in other secondary outcomes which were comparable among all cohorts. Stent deployment was significantly superior to POBA and atherectomy in terms of overall survival with comparable complication and amputation rates. The natural history of PAD patients presenting with claudication is associated with an extremely low annual mortality risk. Therefore, further examinations of outcomes, especially in regards to mortality rates, both POBA and atherectomy on the management of PAD patients especially those presenting with claudication is warranted.

Spatiotemporal dynamics and risk factors of oak decline and Mortality in the Missouri Ozarks of the United States based on repeatedly measured FIA data

During recent decades there has been widespread oak decline and mortality in the Missouri Ozarks, USA. We extracted data of 18,403 oak trees measured during 1999–2019 from the US Forest Service’s Forest Inventory and Analysis (FIA) database to examine the spatiotemporal patterns of oak decline and mortality and associated risk factors. The Missouri Ozarks were classified into three spatial clusters with low (<1.0%), moderate (1.0–1.5%) and high (>1.5%) annual oak mortality rates using kernel smoothing and the Jenks natural breaks method. Oaks within each spatial cluster were further divided into four, five and three risk groups respectively with differentiated annual mortalities (0.35%–3.05%) using a classification and regression tree model. The Kaplan-Meier survival analyses showed that oak trees from individual spatial clusters and risk groups responded differently to droughts, a major regional or sub-regional inciting factor of oak decline. Droughts could have a three to nine year lagged impact on tree mortality in the high risk groups, whereas had little effect on oak mortality in the low risk groups. Tree species, crown class, and stand age were the regionwide predisposing factors of oak decline. However, localized disturbances and geographic/vegetation conditions (e.g., drought, fire, insects, aspect, elevation, ecoregions, historical forest types) could either incite or alleviate the decline process and the fate of declining trees depending on the differentiated spatial clusters or risk groups. Resource managers can base associated risk factors and spatial clusters to rank risk levels to prioritize and plan management activities to mitigate oak decline and mortality.

Seasonal variation of health in Asian elephants

Long-lived species are often predicted to be buffered against seasonal variation: longevity means low annual mortality and reproductive rates and annual variability in climate may therefore have a smaller impact on population growth rates of long-lived species in comparison to short-lived ones. However, little is known of the physiological mechanisms underlying such patterns in long-lived species. In this study, we investigated seasonal variation in the health of Asian elephants living in a seasonal monsoon climate. We used two complementary methods: (i) global and (ii) trait-by-trait analyses of seasonal effects on 23 health parameters of 225 individually marked elephants with known age and reproductive and health history, with repeated measures per individual over a 26-month period. The global analysis highlighted the biggest differences in health between the hot and monsoon seasons. Our trait-specific analyses identified the physiological functions underlying such health variation in different ecological settings, including haematological, immunological, muscular, kidney and liver functions, as well as protein balance and electrolytes. Overall, the results suggest that even long-lived, large mammals may experience physiological changes in response to seasonal variation that in extreme circumstances can pose a significant health risk.

Lifetime Sex‐Specific Moose Mortality During an Intentional Population Reduction

ABSTRACTWhere elevated harvest of ungulates is a priority, managers benefit by understanding how various sources of mortality affect the age and sex structure and trend of ungulate populations. Prior studies reported a long period (1997–2014) of moose (Alces alces gigas) nutritional stress from overabundance in our study area, an intentional 31% reduction in moose numbers using liberal harvests of females (2004–2012), and low bear (Ursus spp.) predation and high moose harvest densities relative to other largely roadless systems with moose, bears, and wolves (Canis lupus). In this paper, we detailed management findings after describing causes and rates of mortality from 226 female and 164 male moose radio‐collared at 9 months of age (1997–2008) and followed through life (1997–2019) and throughout the population reduction. We listened for mortality signals on radio‐collars 1–2 times/month when snow cover was complete and 2–4 times/month when snow cover was incomplete. Upon hearing a mortality signal, we investigated mortality sites usually within 24 hours via helicopter. Excluding hunter‐caused mortality, we estimated 28% annual mortality for male yearlings versus 17% for female yearlings, then low annual mortality rates (0–4%) to 84 months of age for males and 96 months of age for females, and gradually increasing annual mortality rates thereafter. Most (83%) male moose ≥24 months of age died from hunters; minor causes included wolves (8%), malnutrition or disease (5%), grizzly bears (U. arctos; 2%), and accidents (2%). Most female moose ≥24 months of age died from wolves (37%) or hunters (33%); minor causes included malnutrition or disease (15%), grizzly bears (10%), and accidents (5%). The proportion of radio‐collared females killed by hunters varied depending on numbers of permits issued to hunters; the kill rate of females ≥24 months of age was 58% during the initial 4 years of the 9‐year reduction, moderated at 29% during the final 5 years of the reduction, and was only 7% for all other study years. We attributed 32% of hunter kills to illegal harvest and unrecovered hunter kills. Hunters played a key role in the intentional population reduction by harvesting prime‐age and near prime‐age male and female moose that rarely died from other sources of mortality compared with calf, yearling, and older moose. Restricting general season hunters to primarily harvesting prime‐age and older male moose with antler spreads ≥127 cm did not appreciably reduce harvest of adult males. Male moose 2.0–5.3 years of age rarely died from non‐hunter causes and were largely harvested at older, prime ages (5.3–8.3 yr of age). Yearling moose of both sexes died primarily from wolves, with wolves selecting more for males. By using liberal harvests of female moose to reduce the population, managers improved moose nutrition and reproduction, met mandates for elevated harvests, and may have avoided a reoccurrence of a previous precipitous decline in moose numbers that was initiated by overabundance and extreme snow depths. © 2019 The Wildlife Society.

Population Characteristics and the Potential Suppression of Common Carp in Lake Spokane, Washington

Abstract Common Carp Cyprinus carpio is a nonnative species that often has deleterious effects on aquatic systems. As such, there is interest in suppressing nonnative Common Carp populations in areas where humans have introduced them. The objectives of this study were to 1) provide insight on efficient techniques for capturing Common Carp, 2) describe their population demographics and dynamics, 3) evaluate whether temperature and water elevation were related to growth and recruitment, and 4) develop an age-structured population model for evaluating different management scenarios of Common Carp removal in Lake Spokane, Washington. Catch rates of Common Carp varied among sampling gears with slightly higher catch rates in monofilament (mean ± SD; 15.5 ± 9.8 fish/net night) vs. multifilament (12.7 ± 7.3 fish/net night) gill nets. Catch rates of Common Carp with nighttime electrofishing (0.3 ± 0.4 fish/min) were higher than daytime electrofishing (0.1 ± 0.2 fish/min). Common Carp in Lake Spokane exhibited variable recruitment, rapid growth, large-length structure, high longevity (i.e., age 18 y), and low total annual mortality (17.0%). Air temperature was positively associated with annual growth increments (R2 ≤ 0.25). Neither air temperature nor water elevation was highly correlated (R2 ≤ 0.20) to recruitment of Common Carp. A Beverton–Holt yield-per-recruit model suggested that yield declined with increasing exploitation. Recruitment overfishing would occur at exploitation rates of 20–40% for all targeted minimum length categories (i.e., 150, 300, 450 mm) except 600 mm. Results from this study provide important information on the ecology of Common Carp that can be used to guide management efforts (e.g., suppression) in western systems.

Revascularization in “no option” patients with refractory angina: Frequency, etiology and outcomes

A significant proportion of patients with complex, advanced coronary artery disease have refractory angina (RA) despite maximal pharmacological therapy and are deemed suboptimal candidates for revascularization. These patients are frequently termed "no-option" patients. However, despite this designation, many subsequently undergo coronary revascularization. We sought to determine the incidence, etiology and outcome of revascularization in "no-option" patients. We examined a comprehensive, prospective RA database to identify 342 of 1363 (25.1%) patients who subsequently underwent revascularization after a median interval of 2.2 years from the "no-option" diagnosis. Coronary revascularization was achieved by percutaneous coronary intervention (PCI) (n = 274, 20.1%), coronary bypass graft surgery (n = 44, 3.2%) or both (n = 24, 1.8%). During a median follow-up of 5.1 years, patients who underwent revascularization had lower annual mortality (2% vs. 4.4%, P < .001). Detailed paired angiographic records were available for 181 PCI patients with a combined 302 lesions. Of these interventions, 48% were for a new lesion, 31% for an existing lesion and 21% for restenosis. The location was a native vessel in 77% and a bypass graft in 23%. The "no-option" or non-revascularizable designation is frequently based on angiography at a single time-point. However, coronary artery disease is a progressive and dynamic process and new lesions often develop in such patients. Given the association between revascularization and better survival, careful consideration should be given to repeat revascularization in patients with refractory angina previously classified as "no-option".

Estimation of annual, time-varying natural mortality and survival for Eastern Bering Sea snow crab (Chionoecetes opilio) with state-space population models

Sex-specific, state-space population models with size and stage structure and fit to survey and fishery data were developed for the eastern Bering Sea (EBS) snow crab for the years 1982–2017. Motivation for model development was to estimate population dynamics by shell condition for female crabs; estimate sex-specific annual, time-varying natural morality rates; and explore in general the feasibility of state space modeling for EBS snow crab. Model fits were very good and mean natural mortality estimates agreed with previous studies but several quite high and/or quite low annual natural mortality values were estimated for both sexes. Estimated mean female natural mortality was 0.49 yr−1 (s.d. = 0.01) with annual values from 0.04 yr−1 to 3.34 yr−1. Estimated mean male natural mortality was 0.36 yr−1 (s.d. = 0.07) with annual values from 0.03 yr−1 to 0.91 yr−1. Episodic high and low annual natural mortality estimates indicate potential model overfitting which an autoregressive or random walk estimation framework for natural mortality may address. We consider the models as proof-of-concept estimation frameworks and their results preliminary. After further refinement and testing, they could be a complementary approach to ongoing stock assessment modeling or prototypes for state-space assessment models. Additional process variability, such as for growth and maturation, can be incorporated in future work. Abundance estimates by mature female shell condition makes feasible estimation of annual and biennial spawner abundances, necessary for accurate egg production estimation. State-space population dynamics models of other Chionoecetes populations with both size and stage-based data (e.g., maturity status or shell condition) can be developed utilizing this study’s modeling framework.

First assessment of the population structure of the Asiatic wild ass in Mongolia

The Mongolian Gobi is the most important stronghold of the Asiatic wild ass (Equus hemionus), housing > 75% of the remaining global population. However, even in this remote refuge, poaching and changes in land use are challenging the species’ conservation. Whereas progress has been made in monitoring population size, little data are available on population structure and dynamics. To fill this gap, we determined the age and sex of 440 skulls collected in two regions of the Mongolian Gobi. Foals and yearlings were underrepresented in our skull sample with 3 and 7.3% only, but the rest of the age pyramid was well balanced. The mean age was 7.7 years, the maximum age 29 years, and the sex ratio was not different from even. Mortality risk analysis revealed low annual mortality rates of about 15% in the most productive age classes of 5–10 years, followed by a slow increase with age until about 17 years and a likely faster increase thereafter. As the large majority of carcasses suggested a poaching-related mortality which appears random, our dataset provides the first insight into the structure of the largest remaining Asiatic wild ass population and can be used as a benchmark for future monitoring and population viability modeling.

Coral reef fish populations can persist without immigration.

Determining the conditions under which populations may persist requires accurate estimates of demographic parameters, including immigration, local reproductive success, and mortality rates. In marine populations, empirical estimates of these parameters are rare, due at least in part to the pelagic dispersal stage common to most marine organisms. Here, we evaluate population persistence and turnover for a population of orange clownfish, Amphiprion percula, at Kimbe Island in Papua New Guinea. All fish in the population were sampled and genotyped on five occasions at 2-year intervals spanning eight years. The genetic data enabled estimates of reproductive success retained in the same population (reproductive success to self-recruitment), reproductive success exported to other subpopulations (reproductive success to local connectivity), and immigration and mortality rates of sub-adults and adults. Approximately 50% of the recruits were assigned to parents from the Kimbe Island population and this was stable through the sampling period. Stability in the proportion of local and immigrant settlers is likely due to: low annual mortality rates and stable egg production rates, and the short larval stages and sensory capacities of reef fish larvae. Biannual mortality rates ranged from 0.09 to 0.55 and varied significantly spatially. We used these data to parametrize a model that estimated the probability of the Kimbe Island population persisting in the absence of immigration. The Kimbe Island population was found to persist without significant immigration. Model results suggest the island population persists because the largest of the subpopulations are maintained due to having low mortality and high self-recruitment rates. Our results enable managers to appropriately target and scale actions to maximize persistence likelihood as disturbance frequencies increase.

Heart failure with Preserved EF: A Bird Eye View

The concept of ''diastolic'' heart failure grew out of the observation that many patients who have the symptoms and signs of heart failure had an apparently normal left ventricular (LV) ejection fraction. Thus it was assumed that since systolic function was ''pre- served'' the problem must lie in diastole, although it is not clear by whom or when this assumption was made. Nevertheless, many guidelines followed on how to diagnose ''diastolic'' heart failure backed up by indicators of diastolic dysfunction derived from Doppler echoardiography. Diastolic heart failure is associated with a lower annual mortality rate of approximately 8% as compared to annual mortality of 19% in heart failure with systolic dysfunction, however, morbidity rate can be substantial. Thus, diastolic heart failure is an important clinical disorder mainly seen in the elderly patients with hypertensive heart disease. Early recognition and appropriate therapy of diastolic dysfunction is advisable to prevent further progression to diastolic heart failure and death. There is no specific therapy to improve LV diastolic function directly. Medical therapy of diastolic dysfunction is often empirical and lacks clear-cut pathophysiologic concepts. Nevertheless, there is growing evidence that calcium channel blockers, beta-blockers, ACE-inhibitors and ARB as well as nitric oxide donors can be beneficial. Treatment of the underlying disease is currently the most important therapeutic approach.

Some Question Use of Statins to Reduce Cardiovascular Risks in Healthy Women

CLINICIANS FREQUENTLY PREscribe statin therapy for women to decrease low-density lipoprotein cholesterol (LDL-C) levels for primary prevention of cardiovascular disease. Statin therapy for secondary prevention for both sexes is widely accepted to reduce the likelihood of another cardiovascular event. But should women without established coronary disease be taking statins? Current analyses suggest that the answer is yes. The authors of a recently published meta-analysis of 18 trials with 141 235 participants concluded that statin therapy was beneficial in both the primary and secondary prevention settings for both men and women. When the authors assessed primary prevention trials separately, they found that statins reduced all-cause mortality for women (Kostis WJ et al. J Am Coll Cardiol. 2012;59[6]:572-582). But the optimistic findings do not convince some researchers, who worry about the rigor of statin studies and the emergence of other research that points to increased risk of harms associated with statin use in the primary prevention setting. Such harms could disproportionately affect women without cardiovascular disease, who have a lower annual mortality risk to begin with when compared with their male counterparts. For example, an observational study published in January, involving 153 840 postmenopausal women enrolled in the Women’s Health Initiative, assessed participants for statin use at baseline and then for 3 years. At baseline, 7% of this cohort reported taking statin medication. After adjusting for potential confounders, the authors found that use of any statins at baseline was associated with a 48% greater risk of developing diabetes mellitus when compared with women not receiving the medications at baseline (Culver AL et al. Arch Intern Med. 2012;172[2]:144-152).

Are symptomatic guidelines for chemotherapy appropriate to ER-positive screen-detected breast cancer (SDBC)?

Oncologists recommend chemotherapy to postmenopausal women with adverse prognostic factors, but predictors of the benefit of chemotherapy are mainly based on mortality from symptomatic cancer trials. From 1990 to 1998, 1475 breast cancers (875 screen detected cancers [SDBCs]: 600 symptomatic) were treated in women aged 50-65years and prognostic factors compared with cancer mortality. Median follow-up was 110months. The Nottingham Prognostic Index (NPI) was calculated for 6737 breast cancers which were part of the Association of Breast Surgery (ABS) 2001/2002 Audit of SDBCs to validate survival figures. Ten year survival was 92.1% for SDBC and 77.6% for symptomatic cancers. Adjusting for baseline factors, SDBCs had a reduced mortality (RR=0.42 (0.31-0.57), independent of grade, node status and tumour size. Oestrogen receptor (ER) positive SDBC had a lower annual mortality rate (0.6%) compared with symptomatic (4.3%: P<0.001) or ER negative SDBC (1.8%). Epithelial proliferation was lower in SDBC in all NPI groups compared with symptomatic cancers (P≤0.001). Grade, node status, ER status, size and mode of detection predicted survival. Survival for each NPI group was better for SDBC. For ER positive SDBC in the Moderate Prognostic Group 1 (MPG1), 10year mortality was 6.4% compared with 17.6% in symptomatic (P=0.001). NPI on 6,737 operable SDBC confirmed similar mortality in all groups (4% mortality in MPG1 group). SDBC have lower mortality than symptomatic due to a lower proliferative index. The use of adjuvant chemotherapy is over-treatment for ER positive SDBCs with Good Prognostic Group (GPG) and MPG1 NPI scores.

Lp-PLA2 (PLAC): Relationship to Conventional Risk Factors and Cardioprotective Drug Therapies in Coronary Patients

PLAC is a blood test measuring lipoprotein-associated phospholipase A2 (Lp-PLA2), a marker of arterial inflammation. Elevated levels of PLAC (> 235 ng/mL) suggest an increased risk of cardiovascular events, whereas reduced values (especially < 160 ng/mL) are associated with a low annual mortality. PURPOSE: To determine the associations among PLAC values and other indices of health among cardiac patients participating in a formalized risk reduction program. METHODS: Patients enrolled in Phase III cardiac rehabilitation (n = 86; 69 men, 17 women) received 6 months of education and counseling focused on exercise progression, nutrition, stress management, and risk factor awareness. Patients also updated blood chemistry studies, including a lipid/lipoprotein profile, fasting blood glucose (FBG), glycosylated hemoglobin (HgA1C), and PLAC. RESULTS: Patients taking a statin had significantly lower mean PLAC values than those not on statins (p = 0.038), 163 ± 47 vs 194 ± 56 ng/mL, respectively. Positive correlations were observed for LDL and PLAC (r = 0.28, p = 0.011) and total cholesterol (TC) and PLAC (r = 0.26, p = 0.018). PLAC values were unrelated to gender, diabetic status, or aspirin therapy; however, PLAC and BMI were inversely related (r = -0.22, p = 0.047). When patients with and without ideal PLAC levels were compared, the former had significantly lower LDL values and a higher frequency of statin usage. Mean ± SD for selected variables are shown:TABLECONCLUSION: In this group of cardiac patients, statin usage was associated with lower LDL and TC values, as well as decreased arterial inflammation measured by PLAC testing. These data suggest that the cardioprotective effect

Mortality of silver fir and Norway Spruce in the Western Alps — a semi-parametric approach combining size-dependent and growth-dependent mortality

• Question: Tree mortality can be modeled using two complementary covariates, tree size and tree growth. Tree growth is an integrative measure of tree vitality while tree diameter is a good index of sensitivity to disturbances and can be considered as a proxy for tree age which may indicate senescence. Few mortality models integrate both covariates because classical model calibration requires large permanent plot data-sets which are rare. How then can we calibrate a multivariate mortality model including size and growth when permanent plots data are not available?• Location: To answer this question, we studied Abies alba and Picea abies mortality in the French Swiss and Italian Alps.• Method: Our study proposes an alternative semi-parametric method which includes a random sample of living and dead trees with diameter and growth measurements.• Results: We were able to calibrate a mortality model combining both size-dependent and growth-dependent mortality. We demonstrated that A. alba had a lower annual mortality rate (10%) than P. abies (18%) for low growth ( −1 ). We also demonstrated that for higher diameters (DBH ≥ 70 cm), P. abies had a higher mortality rate (0.45%) than A. alba (0.32%).• Conclusion: Our results are consistent with the mechanisms of colonization-competition trade-off and of successional niche theory which may explain the coexistence of these two species in the Alps. The method we developed should be useful for forecasting tree mortality and can improve the efficiency of forest dynamics models.

Biases in the estimation of size-dependent mortality models: advantages of a semiparametric approach

Mortality rate is thought to show a U-shape relationship to tree size. This shape could result from a decrease of competition-related mortality as diameter increases, followed by an increase of senescence and disturbance-related mortality for large trees. Modeling mortality rate as a function of diameter is nevertheless difficult, first because this relationship is strongly nonlinear, and second because data can be unbalanced, with few observations for large trees. Parametric functions, which are inflexible and sensitive to the distribution of observations, tend to introduce biases in mortality rate estimates. In this study we use mortality data for Abies alba Mill. and Picea abies (L.) Karst. to demonstrate that mortality rate estimates for extreme diameters were biased when using classical parametric functions. We then propose a semiparametric approach allowing a more flexible relationship between mortality and diameter. We show that the relatively shade-tolerant A. alba has a lower annual mortality rate (2.75%) than P. abies (3.78%) for small trees (DBH &lt;15 cm). Picea abies, supposedly more sensitive to bark beetle attacks and windthrows, had a higher mortality rate (up to 0.46%) than A. alba (up to 0.30%) for large trees (DBH ≥50 cm).

Recommendations for advancing the care of Canadians living with refractory angina pectoris: A Canadian Cardiovascular Society position statement

Refractory angina (RFA) is a debilitating disease characterized by severe, unremitting cardiac pain (1,2). This pain or discomfort, by definition, is resistant to all conventional treatments for coronary artery disease (CAD) including nitrates, calcium channel and beta-adrenoceptor blockade, vasculoprotective agents, percutaneous coronary interventions and coronary artery bypass grafting (1,2). Patients living with RFA have a low annual mortality rate of 3% but suffer from a severely impaired health-related quality of life (3). They typically experience recurrent and sustained pain, poor general health status, psychological distress, impaired role functioning, activity restriction and inability to self-manage (4–7). As more patients survive primary and subsequent cardiac events, the global prevalence of RFA is ever increasing (1,2,8,9).

Genetic monogamy in two long‐lived New Zealand passerines

High rates of extra‐pair paternity (EPP) can be relatively common in passerines whereas low rates or absence of EPP are often associated with taxa that are long‐lived and exhibit obligatory paternal care. We examined EPP in an under‐represented category: passerine species with relatively long life spans (or low annual mortality rates). Specifically, we studied EPP in New Zealand saddlebacks Philesturnus carunculatus and robins Petroica australis, two species with unusually low annual mortality rates (6.5–11% and 10–20% respectively). No EPP (0%) was detected in saddlebacks (39 pairs, 202 offspring) and only one case of EPP (1.9%) was detected in robins (54 pairs, 198 offspring). Genetic monogamy in these passerine species supports the hypothesis that low annual mortality rates play an important role in explaining variation in rates of EPP across species.