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The distribution of canopy heights in tropical rain forests directly affects carbon storage and the maintenance of biodiversity. We report results from a unique 20‐yr record of annual monitoring of canopy‐height distributions across an old‐growth tropical rain forest landscape at the La Selva Biological Station in Costa Rica. Canopy heights to 15 m were measured annually in 18 0.50‐ha plots at 231 points on a 5 × 5 m grid from 1999–2018 (nine plots in 1999), and heights >15 m were classified as "high canopy." During the study two major disturbance events (one immediately prior to the study) dominated the landscape‐scale distribution of canopy heights. Height recovery from the 1997–1998 strong El Niño disturbance took approximately 15 yr. Frequency of canopy gaps varied an order of magnitude among years and 96% disappeared in ≤2 yr. High‐canopy coverage and gap frequency varied substantially across the local gradients of soil nutrients and topography, and plot‐level conditions and trends frequently differed from the landscape‐level patterns. In contrast to the two major landscape‐level disturbances, significant plot‐level disturbances were common throughout two decades. Including a similar data set taken in 1992, canopy‐height distributions for the last three decades over this old‐growth tropical rain forest landscape are most parsimoniously interpreted as showing local disturbance and recovery and no unidirectional trends over time. Together these results suggest that understanding the landscape‐ and plot‐level dynamics of tropical rain forest canopy‐height distributions will require repeat sampling for multiple decades, while accurately measuring gap frequency and recovery will require sample intervals of ≤2 yr. [ABSTRACT FROM AUTHOR]

Abstract Background Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory, non-infectious osteopathy that affects predominantly patients ≤ 18 years of age. There is no uniformly effective treatment. Our objective is to describe clinical, magnetic resonance imaging (MRI), and bone resorption response to intravenous pamidronate in pediatric CRMO. Methods We report our prospectively documented experience with all CRMO patients treated with pamidronate between 2003 and 2008 at a tertiary pediatric centre. Pamidronate was administered as intravenous cycles. The dose of pamidronate varied among subjects but was given as monthly to every 3 monthly cycles depending on the distance the patient lived from the infusion center. Maximum cumulative dose was ≤ 11.5 mg/kg/year. Pamidronate treatment was continued until resolution of MRI documented bone inflammation. Visual analog scale for pain (VAS) and bone resorption marker urine N-telopeptide/urine creatinine (uNTX/uCr) were measured at baseline, preceding each subsequent pamidronate treatment, at final follow-up, and/or at time of MRI confirmed CRMO flare. MRI of the affected site(s) was obtained at baseline, preceding every 2nd treatment, and with suspected CRMO recurrence. Results Nine patients (5 F: 4 M) were treated, with a median (range) age at treatment of 12.9 (4.5–16.3) years, and median (range) duration of symptoms of 18 (6–36) months. VAS decreased from 10/10 to 0–3/10 by the end of first 3–day treatment for all patients. The mean (range) time to complete MRI resolution of bone inflammation was 6.0 (2–12) months. The mean (confidence interval (CI)) baseline uNTX/uCr was 738.83 (CI 464.25, 1013.42)nmol/mmol/creatinine and the mean (CI) decrease from baseline to pamidronate discontinuation was 522.17 (CI 299.77, 744.56)nmol/mmol/creatinine. Median (range) of follow-up was 31.4 (24–54) months. Four patients had MRI confirmed CRMO recurrence, which responded to one pamidronate re-treatment. The mean (range) uNTX/uCr change as a monthly rate from the time of pamidronate discontinuation to flare was 9.41 (1.38–19.85)nmol/mmol/creatinine compared to -29.88 (-96.83–2.01)nmol/mmol/creatinine for patients who did not flare by the time of final follow-up. Conclusion Pamidronate resulted in resolution of pain and MRI documented inflammation in all patients. No patient flared while his/her uNTX/uCr remained suppressed. We propose that pamidronate is an effective second-line therapy in persistent CRMO.

Background: There is ongoing debate regarding potential associations between restrictions of antimicrobial use and prevalence of antimicrobial resistance (AMR) in bacteria.Objectives: To summarize the effects of interventions reducing antimicrobial use in food-producing animals on the prevalence of AMR genes (ARGs) in bacteria from animals and humans.Methods: We published a full systematic review of restrictions of antimicrobials in food-producing animals and their associations with AMR in bacteria. Herein, we focus on studies reporting on the association between restricted antimicrobial use and prevalence of ARGs. We used multilevel mixed-effects models and a semi-quantitative approach based on forest plots to summarize findings from studies.Results: A positive effect of intervention [reduction in prevalence or number of ARGs in group(s) with restricted antimicrobial use] was reported from 29 studies for at least one ARG. We detected significant associations between a ban on avoparcin and diminished presence of the vanA gene in samples from animals and humans, whereas for the mecA gene, studies agreed on a positive effect of intervention in samples only from animals. Comparisons involving mcr-1, blaCTX-M, aadA2, vat(E), sul2, dfrA5, dfrA13, tet(E) and tet(P) indicated a reduced prevalence of genes in intervention groups. Conversely, no effects were detected for β-lactamases other than blaCTX-M and the remaining tet genes.Conclusions: The available body of scientific evidence supported that restricted use of antimicrobials in food animals was associated with an either lower or equal presence of ARGs in bacteria, with effects dependent on ARG, host species and restricted drug. [ABSTRACT FROM AUTHOR]

Abstract Background Although the incidence of serious morbidity with childhood pneumonia has decreased over time, empyema as a complication of community-acquired pneumonia continues to be an important clinical problem. We reviewed the epidemiology and clinical management of empyema at 8 pediatric hospitals in a period before the widespread implementation of universal infant heptavalent pneumococcal vaccine programs in Canada. Methods Health records for children < 18 years admitted from 1/1/00–31/12/03 were searched for ICD-9 code 510 or ICD-10 code J869 (Empyema). Empyema was defined as at least one of: thoracentesis with microbial growth from pleural fluid, or no pleural fluid growth but compatible chemistry or cell count, or radiologist diagnosis, or diagnosis at surgery. Patients with empyemas secondary to chest trauma, thoracic surgery or esophageal rupture were excluded. Data was retrieved using a standard form with a data dictionary. Results 251 children met inclusion criteria; 51.4% were male. Most children were previously healthy and those ≤ 5 years of age comprised 57% of the cases. The median length of hospitalization was 9 days. Admissions occurred in all months but peaked in winter. Oxygen supplementation was required in 77% of children, 75% had chest tube placement and 33% were admitted to an intensive care unit. While similarity in use of pain medication, antipyretics and antimicrobial use was observed, a wide variation in number of chest radiographs and invasive procedures (thoracentesis, placement of chest tubes) was observed between centers. The most common organism found in normally sterile samples (blood, pleural fluid, lung biopsy) was Streptococcus pneumoniae. Conclusion Empyema occurs most commonly in children under five years and is associated with considerable morbidity. Variation in management by center was observed. Enhanced surveillance using molecular methods could improve diagnosis and public health planning, particularly with regard to the relationship between immunization programs and the epidemiology of empyema associated with community-acquired pneumonia in children.

Current and planned space missions will produce aboveground biomass density data products at varying spatial resolution. Calibration and validation of these data products is critically dependent on the existence of field estimates of aboveground biomass and coincident remote sensing data from airborne or terrestrial lidar. There are few places that meet these requirements, and they are mostly in the northern hemisphere and temperate zone. Here we summarize the potential for low-altitude drones to produce new observations in support of mission science. We describe technical requirements for producing high-quality measurements from autonomous platforms and highlight differences among commercially available laser scanners and drone aircraft. We then describe a case study using a heavy-lift autonomous helicopter in a temperate mountain forest in the southern Czech Republic in support of calibration and validation activities for the NASA Global Ecosystem Dynamics Investigation. Low-altitude flight using drones enables the collection of ultra-high-density point clouds using wider laser scan angles than have been possible from traditional airborne platforms. These measurements can be precise and accurate and can achieve measurement densities of thousands of points · m−2. Analysis of surface elevation measurements on a heterogeneous target observed 51 days apart indicates that the realized range accuracy is 2.4 cm. The single-date precision is 2.1–4.5 cm. These estimates are net of all processing artifacts and geolocation errors under fully autonomous flight. The 3D model produced by these data can clearly resolve branch and stem structure that is comparable to terrestrial laser scans and can be acquired rapidly over large landscapes at a fraction of the cost of traditional airborne laser scanning. [ABSTRACT FROM AUTHOR]

Proven or presumptive multidrug-resistant Streptococcus pneumoniae pneumonia was diagnosed simultaneously in three married couples in Alberta, Canada. The pair of isolates from each couple had identical antibiotic resistance profiles, serotypes, [...]

Aim: Large tropical trees form the interface between ground and airborne observations, offering a unique opportunity to capture forest properties remotely and to investigate their variations on broad scales. However, despite rapid development of metrics to characterize the forest canopy from remotely sensed data, a gap remains between aerial and field inventories. To close this gap, we propose a new pan‐tropical model to predict plot‐level forest structure properties and biomass from only the largest trees. Location: Pan‐tropical. Time period: Early 21st century. Major taxa studied: Woody plants. Methods: Using a dataset of 867 plots distributed among 118 sites across the tropics, we tested the prediction of the quadratic mean diameter, basal area, Lorey's height, community wood density and aboveground biomass (AGB) from the ith largest trees. Results: Measuring the largest trees in tropical forests enables unbiased predictions of plot‐ and site‐level forest structure. The 20 largest trees per hectare predicted quadratic mean diameter, basal area, Lorey's height, community wood density and AGB with 12, 16, 4, 4 and 17.7% of relative error, respectively. Most of the remaining error in biomass prediction is driven by differences in the proportion of total biomass held in medium‐sized trees (50–70 cm diameter at breast height), which shows some continental dependency, with American tropical forests presenting the highest proportion of total biomass in these intermediate‐diameter classes relative to other continents. Main conclusions: Our approach provides new information on tropical forest structure and can be used to generate accurate field estimates of tropical forest carbon stocks to support the calibration and validation of current and forthcoming space missions. It will reduce the cost of field inventories and contribute to scientific understanding of tropical forest ecosystems and response to climate change. [ABSTRACT FROM AUTHOR]

The Janzen-Connell hypothesis is a well-known explanation for why tropical forests have large numbers of tree species. A fundamental prediction of the hypothesis is that the probability of adult recruitment is less in regions of high conspecific adult density, a pattern mediated by density-dependent mortality in juvenile life stages. Although there is strong evidence in many tree species that seeds, seedlings, and saplings suffer conspecific densitydependent mortality, no study has shown that adult tree recruitment is negatively density dependent. Density-dependent adult recruitment is necessary for the Janzen-Connell mechanism to regulate tree populations. Here, we report density-dependent adult recruitment in the population of Handroanthus guayacan, a winddispersed Neotropical canopy tree species. We use data from highresolution remote sensing to track individual trees with proven capacity to flower in a lowland moist forest landscape in Panama and analyze these data in a Bayesian framework similar to capture-recapture analysis. We independently quantify probabilities of adult tree recruitment and detection and show that adult recruitment is negatively density dependent. The annualized probability of adult recruitment was 3.03% · year-1. Despite the detection of negative density dependence in adult recruitment, it was insufficient to stabilize the adult population of H. guayacan, which increased significantly in size over the decade of observation. [ABSTRACT FROM AUTHOR]