We devised a participatory modeling approach for setting management thresholds that show when management intervention is required to address undesirable ecosystem changes. This approach was designed to be used when management thresholds: must be set for environmental indicators in the face of multiple competing objectives; need to incorporate scientific understanding and value judgments; and will be set by participants with limited modeling experience. We applied our approach to a case study where management thresholds were set for a mat-forming brown alga, Hormosira banksii, in a protected area management context. Participants, including management staff and scientists, were involved in a workshop to test the approach, and set management thresholds to address the threat of trampling by visitors to an intertidal rocky reef. The approach involved trading off the environmental objective, to maintain the condition of intertidal reef communities, with social and economic objectives to ensure management intervention was cost-effective. Ecological scenarios, developed using scenario planning, were a key feature that provided the foundation for where to set management thresholds. The scenarios developed represented declines in percent cover of H. banksii that may occur under increased threatening processes. Participants defined 4 discrete management alternatives to address the threat of trampling and estimated the effect of these alternatives on the objectives under each ecological scenario. A weighted additive model was used to aggregate participants' consequence estimates. Model outputs (decision scores) clearly expressed uncertainty, which can be considered by decision makers and used to inform where to set management thresholds. This approach encourages a proactive form of conservation, where management thresholds and associated actions are defined a priori for ecological indicators, rather than reacting to unexpected ecosystem changes in the future.
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http://dx.doi.org/10.1111/cobi.12544 | DOI Listing |
Alzheimers Dement
December 2024
Massachusetts General Hospital, Boston, MA, USA.
Background: Underdiagnosis of Alzheimer's disease and related dementias (ADRD) leads to lost opportunities for timely intervention, increased healthcare costs, and underestimation of the true burden of disease. To address this problem, we developed an AI algorithm, Decipher-AI (DEtection of Cognitive Impairment PHenotypes in EHR), to screen primary care patients for undiagnosed cognitive impairment (CI). We evaluated performance across sociodemographic groups using 3 years of EHR data before the first diagnosis or most recent visit.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Massachusetts General Hospital, Boston, MA, USA.
Background: Underdiagnosis of Alzheimer's disease and related dementias (ADRD) leads to lost opportunities for timely intervention, increased healthcare costs, and underestimation of the true burden of disease. To address this problem, we developed an AI algorithm, Decipher-AI (DEtection of Cognitive Impairment PHenotypes in EHR), to screen primary care patients for undiagnosed cognitive impairment (CI). We evaluated performance across sociodemographic groups using 3 years of EHR data before the first diagnosis or most recent visit.
View Article and Find Full Text PDFCancer Med
January 2025
Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Objective: Cancer-related fatigue is one of the most common burdens of cancer patients. To date, most studies focused on fatigue during or after treatment. However, investigation of pretreatment fatigue is crucial to identify causal or risk factors other than cancer therapy and to enable timely fatigue management.
View Article and Find Full Text PDFClin Kidney J
January 2025
Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Bone and Mineral Research Unit, REDinREN (RD06/0016/1013, RD12/0021/0023 and RD16/0009/0017) and RICORS2040 (RD21/0005/0019) del ISCIII, Oviedo, Spain.
Background: Ageing often affects biomarker production. Yet, clinical/optimal thresholds to guide clinical decisions do not consider this. Serum albumin decreases with age, but hypoalbuminaemia is defined as serum albumin <4.
View Article and Find Full Text PDFKardiochir Torakochirurgia Pol
December 2024
Department of Cardiovascular Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Introduction: Patients who need tricuspid valve replacement (TVR) surgery often have permanent transvalvular pacemaker (PM) leads, which pose an important challenge in lead management.
Aim: The objective of this study was to evaluate the results of paravalvular positioning of a permanent pacemaker lead during TVR surgery.
Material And Methods: Between 2014 and 2024, a total of 15 patients who had previously had a transvenous pacemaker system underwent TVR.
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