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Understanding factors that regulate the patterns of diversity, richness, and density of organisms is of enormous importance to manage biodiversity in a global change context.We investigate the importance of environmental factors in regulating the patterns of diversity, richness, and density of diurnal butterflies in the Sierra Nevada mountain range (SE Spain).Diversity, richness, and density seem to be strongly correlated, being mainly defined by land‐use and topographic‐related variables. The sites with the highest values correspond to areas of dense scrubland, near patches of forest, oriented to the west and with a high rate of solar radiation but not excessively exposed from the topographical point of view. Topographic wetness index seems to be also important but with a positive relation in the case of density and negative in the case of diversity and richness.Our results show a pattern of mid‐elevation maxima, with highest values between 1600 and 2000 masl and lower in the summits and the piedmont (<1400 masl). This brings us the possibility to identify a series of areas of high value for the conservation of butterflies in this protected area, with important applications towards the conservation and management of this group of insects.Finally, a series of management recommendations to improve the conservation status of the butterfly communities in the Sierra Nevada protected area are inferred. One of the main recommendations is based on the maintenance of spatial heterogeneity, taking into account traditional land uses that enhance biodiversity. [ABSTRACT FROM AUTHOR]

We estimated the potential impact of Global Warming on the species richness of Iberian butterflies. First, we determined the grid size that maximized the balance between geographic resolution, area coverage and environmental representativeness. Contemporary richness was modelled in several alternative ways that differed in how sampling effort was controlled for, and in whether the non-climatic variables (physiography, lithology, position) were incorporated. The results were extrapolated to four WorldClim scenarios. Richness loss is to be expected for at least 70% of the area, with forecasts from the combined models being only slightly more optimistic than those from the purely climatic ones. Overall, the most intense losses are predicted for areas of highest contemporary species richness, while the potential slightly positive or nearly neutral changes would most often concentrate in cells of low to moderate present richness. The environmental determinants of richness might not be uniform across the geographical range of sampling effort, suggesting the need of additional data from the least intensively surveyed areas. Implications for insect conservation: Re-assessing richness and its environmental determinants in the area proves necessary for more detailed forecasts of the climate-driven changes in butterfly species richness. The expected future conditions imply widespread losses of regional richness, even under the less severe scenarios. Since the negative impact of warming is expected to be extensive, long term conservation plans should concentrate in the present protected areas of highest richness as these are most likely to represent the last refuges for mountain species. [ABSTRACT FROM AUTHOR]

Economic recession has dire consequences on overall health. None have explored the impact of economic crisis (EC) on infective endocarditis (IE) mortality. We conducted a retrospective, nationwide, temporal trend study analyzing mortality trends by age, sex, and adverse outcomes in patients diagnosed with IE in Spain from 1997 to 2014. Data were divided into two subperiods: pre-EC (January 1997-August 2008) and post-EC (September 2008-December 2014). A total of 25 952 patients presented with IE. The incidence increased from 301.4 to 365.1 per 10 000 000 habitants, and the mortality rate rose from 24.3% to 28.4%. Those aged >75 years experienced more adverse outcomes. Complications due to sepsis, shock, acute kidney injury requiring dialysis, and heart failure increased after the EC onset, and expenditures soared to €16 216. Expenditure per community was related to mortality (P <.001). The EC resulted as an independent predictor for mortality (hazard ratio 1.06; 95% confidence interval 1.01-1.11). Incidence and mortality rate in patients with IE after the onset of the EC have increased as a result of rising adverse outcomes despite an overall increased investment. [ABSTRACT FROM AUTHOR]

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Objective: To develop and validate a calculator to predict the risk of in-hospital mortality in patients with active infective endocarditis (IE) undergoing cardiac surgery.Methods: Thousand two hundred and ninety-nine consecutive patients with IE were prospectively recruited (1996-2014) and retrospectively analysed. Left-sided patients who underwent cardiac surgery (n=671) form our study population and were randomised into development (n=424) and validation (n=247) samples. Variables statistically significant to predict in-mortality were integrated in a multivariable prediction model, the Risk-Endocarditis Score (RISK-E). The predictive performance of the score and four existing surgical scores (European System for Cardiac Operative Risk Evaluation (EuroSCORE) I and II), Prosthesis, Age ≥70, Large Intracardiac Destruction, Staphylococcus, Urgent Surgery, Sex (Female) (PALSUSE), EuroSCORE ≥10) and Society of Thoracic Surgeons's Infective endocarditis score (STS-IE)) were assessed and compared in our cohort. Finally, an external validation of the RISK-E in a separate population was done.Results: Variables included in the final model were age, prosthetic infection, periannular complications, Staphylococcus aureus or fungi infection, acute renal failure, septic shock, cardiogenic shock and thrombocytopaenia. Area under the receiver operating characteristic curve in the validation sample was 0.82 (95% CI 0.75 to 0.88). The accuracy of the other surgical scores when compared with the RISK-E was inferior (p=0.010). Our score also obtained a good predictive performance, area under the curve 0.76 (95% CI 0.64 to 0.88), in the external validation.Conclusions: IE-specific factors (microorganisms, periannular complications and sepsis) beside classical variables in heart surgery (age, haemodynamic condition and renal failure) independently predicted perioperative mortality in IE. The RISK-E had better ability to predict surgical mortality in patients with IE when compared with other surgical scores. [ABSTRACT FROM AUTHOR]

Major changes have occurred in the epidemiology and etiology of infective endocarditis (IE). Nevertheless, the differences between nosocomial infective endocarditis (NIE) and community-acquired infective endocarditis (CIE) have not been addressed in a population-based study. We conducted a retrospective, nationwide, temporal trend study from 1997 to 2014 analyzing the epidemiology, clinical, geographical, meteorological characteristics of patients diagnosed with IE in Spain, to distinguish NIE from CIE. Among 25,952 patients with IE (62.2 ± 18·6 years; 65.9% men), 45.9% had NIE. The incidence of IE increased from 2.83 to 3.73 due to the NIE incidence increment with a decline in CIE. Patients with NIE were older (63.8 years vs. 60.8 years, p < 0·001), presented a higher Charlson index (1.22 vs. 1.03, p < 0.001), a greater history of implanted cardiac devices (8.7% vs. 4.6%, p < 0.001), and higher mortality (31.5% vs. 21.7%, p < 0.001). The most frequent microorganism for both NIE and CIE was Staphylococcus (p < 0.001), and the North reported a higher incidence (p < 0.001). Risk factors of mortality for NIE were age, Charlson index, hemodialysis, shock, heart failure, and stroke. Risk factors for CIE included female sex, renal disease, and cardiac-device carriers. The etiology of IE shifted from community origins to mostly nosocomial-associated infections. Higher morbidity, mortality, and poorer outcomes are associated with NIE. [ABSTRACT FROM AUTHOR]