Absence of Medical Record Documentation of Advance Care Planning Status in At-Risk Emergency Department Patients.

Background The majority of those aged 65 and older will visit the emergency department (ED) in the last six months of life. Knowing a patient's goals of care is important, and existing medical records do not always represent them well. We set out to determine the baseline availability of advance directives and goals of treatment in those ED patients at increased risk for mortality.

Biological invasions: a global assessment of geographic distributions, long-term trends, and data gaps.

Biological invasions are one of the major drivers of biodiversity decline and have been shown to have far-reaching consequences for society and the economy. Preventing the introduction and spread of alien species represents the most effective solution to reducing their impacts on nature and human well-being. However, implementing effective solutions requires a good understanding of where the species are established and how biological invasions develop over time.

Global proliferation of nonnative plants is a major driver of insect invasions.

Invasions by nonnative insect species can massively disrupt ecological processes, often leading to serious economic impacts. Previous work has identified propagule pressure as important driver of the trend of increasing numbers of insect invasions worldwide. In the present article, we propose an alternative hypothesis-that insect invasions are being driven by the proliferation of nonnative plants, which create niches for insect specialists and facilitate their establishment outside their native ranges where their hosts are planted or are invasive.

Monitoring urban biological invasions using citizen science: the polyphagous shot hole borer ().

Unlabelled: Benefits provided by urban trees are increasingly threatened by non-native pests and pathogens. Monitoring of these invasions is critical for the effective management and conservation of urban tree populations. However, a shortage of professionally collected species occurrence data is a major impediment to assessments of biological invasions in urban areas.

Current and future scenarios of suitability and expansion of cassava brown streak disease, species complex, and cassava planting in Africa.

Cassava () is among the most important staple crops globally, with an imperative role in supporting the Sustainable Development Goal of 'Zero hunger'. In sub-Saharan Africa, it is cultivated mainly by millions of subsistence farmers who depend directly on it for their socio-economic welfare. However, its yield in some regions has been threatened by several diseases, especially the cassava brown streak disease (CBSD).

Potential sources of time lags in calibrating species distribution models.

The Anthropocene is characterized by a rapid pace of environmental change and is causing a multitude of biotic responses, including those that affect the spatial distribution of species. Lagged responses are frequent and species distributions and assemblages are consequently pushed into a disequilibrium state. How the characteristics of environmental change-for example, gradual 'press' disturbances such as rising temperatures due to climate change versus infrequent 'pulse' disturbances such as extreme events-affect the magnitude of responses and the relaxation times of biota has been insufficiently explored.

Dynamic Species Distribution Modeling Reveals the Pivotal Role of Human-Mediated Long-Distance Dispersal in Plant Invasion.

Plant invasions generate massive ecological and economic costs worldwide. Predicting their spatial dynamics is crucial to the design of effective management strategies and the prevention of invasions. Earlier studies highlighted the crucial role of long-distance dispersal in explaining the speed of many invasions.

Guiding restoration of riparian ecosystems degraded by plant invasions: Insights from a complex social-ecological system in the Global South.

Restoring riparian ecosystems in human-dominated landscapes requires attention to complexity, and consideration of diverse drivers, social actors, and contexts. Addressing a Global North bias, this case study uses a mixed-method approach, integrating historical data, remote sensing techniques and stakeholder perceptions to guide restoration of a river in the Western Cape, South Africa. An analysis of aerial photographs of the riparian zone from 1953 to 2016 revealed that although anthropogenic land conversion happened primarily before the 1950s, several land use and land cover classes showed marked increases in area, including: waterbodies (+ 1074%), urban areas (+ 316%), alien weeds (+ 311%) and terrestrial alien trees (+ 79%).

Mechanistic reconciliation of community and invasion ecology.

Community and invasion ecology have mostly grown independently. There is substantial overlap in the processes captured by different models in the two fields, and various frameworks have been developed to reduce this redundancy and synthesize information content. Despite broad recognition that community and invasion ecology are interconnected, a process-based framework synthesizing models across these two fields is lacking.

Holistic understanding of contemporary ecosystems requires integration of data on domesticated, captive and cultivated organisms.

Domestic and captive animals and cultivated plants should be recognised as integral components in contemporary ecosystems. They interact with wild organisms through such mechanisms as hybridization, predation, herbivory, competition and disease transmission and, in many cases, define ecosystem properties. Nevertheless, it is widespread practice for data on domestic, captive and cultivated organisms to be excluded from biodiversity repositories, such as natural history collections.

Highly diverse and highly successful: invasive Australian acacias have not experienced genetic bottlenecks globally.

Background And Aims: Invasive species may undergo rapid evolution despite very limited standing genetic diversity. This so-called genetic paradox of biological invasions assumes that an invasive species has experienced (and survived) a genetic bottleneck and then underwent local adaptation in the new range. In this study, we test how often Australian acacias (genus Acacia), one of the world's most problematic invasive tree groups, have experienced genetic bottlenecks and inbreeding.

A Case Report of Widely Disseminated Tuberculosis in Immunocompetent Adult Male.

Introduction: Disseminated tuberculosis (TB) is rare, affects any organ system, and presents mainly in immunocompromised populations. Typical presentation is non-specific, posing a challenge for diagnosis.

Case Report: This case presents an immunocompetent male presenting with severe headaches with meningeal signs.

Sex-specific Outcomes in a Substance Use Intervention Program.

Purpose: We performed an emergency department (ED)-based substance use screening, motivational interview-based intervention, and treatment referral program with the goal of determining sex-specific outcomes. Specifically, in this quality improvement project, we aimed to determine whether there was a difference among sexes in the type of substances used; the frequency of positive screening results for substance use disorder; agreeing to an intervention; the type of follow-up evaluation, participation, and referral; and attempts to change substance use after intervention.

Methods: We prospectively studied a convenience sample of patients at 3 hospitals in Northeastern Pennsylvania from May 2017 through February 2018.