Attempt at deriving a formula for setting general practitioner fundholding budgets.

OBJECTIVE--To explore the possibility of using routine Hospital Episode Statistics, census data, and vital statistics to derive weights for an equitable capitation formula for setting general practitioner fundholding budgets for buying acute hospital services. DESIGN--Analysis of a routine dataset of 9 million hospital episodes in 1991-2, extracting elective general practitioner fundholding procedures, combined with 1991 census variables, vital statistics, and data on supply of health care at ward level. Costs were attached to each procedure according to the average cost of the relevant "Mersey" band category. MAIN OUTCOME MEASURES--Variation in age and sex adjusted expenditure per head on fundholding procedures across wards modelled for the impact of health and social needs variables after adjusting for variations in supply. RESULTS--No sensible simple model including determinants of use other than age and sex could be derived. The most parsimonious but statistically acceptable model showed that though standardised mortality ratio and self reported illness and several social class variables were associated with utilisation, the signs and the size of the coefficients were contradictory. The most important explanation of variation was provided by age and sex differences between wards. CONCLUSIONS--An equitable system of setting general practitioner fundholders'' budgets is needed. In the short term age and sex weighted capitation should form the principal basis of fundholder budgets. Utilisation data at ward level are inadequate for developing a formula which adequately adjusts for the differences in the health care needs of populations. A capitation formula based on information derived from individual cohort data may be the only means of promoting equity and efficiency and of avoiding discriminating against patients with known high cost health problems.     

Biosocial covariates of adult male body mass index in Central India

Body mass index (BMI) is the 'measuring rod' of nutritional status. This study investigates the type and extent of correlation between adult male BMI and socioeconomic, cultural and bio-demographical variables using data from 11,496 individuals from 38 districts of Central India. For each individual, stature, body weight and sitting height data were collected, their Cormic index and BMI computed, and averages for each district calculated. Mean BMI was found to be lowest for the population of Tikamgarh (17.90+/-1.91 kg m(-2)) and highest for that of Durg district (19.33+/-2.16 kg m(-2)), whereas the mean BMI for the total population of Central India was 18.67+/-2.18 kg m(-2), which is lower than that of well-to-do individuals in India as a whole. The F ratio indicates that there is inter-district variation in anthropometric characteristics of populations. District-wise biosocial indicators were obtained, namely population density per square kilometre, percentage urban population, percentage of population that is of scheduled caste/tribe, sex ratio, average rural population per PHC/CHC (primary or community health centre), literacy rate, life expectancy, total fertility rate, infant mortality rate, gender development index and human development index. Most of these variables were found to be significantly correlated with each other, but BMI was only significantly correlated with three of them, viz. gender development index (R2=0.211), life expectancy (R2=0.130) and infant mortality rate (R2=0.128). Gender development index and life expectancy were positively correlated with BMI, whereas infant mortality rate was negatively correlated. It is concluded that if BMI increases then life expectancy will also increase. Thus better nutritional status may be a helpful tool for reducing infant mortality rate, which is an indicator of socioeconomic status, health condition, health care and ultimately overall development of a region or population.     

Comparative Population Dynamics of an Invading Species in its Native and Novel Ranges

Although the ecology of many exotic invaders has been intensively examined in the novel range, few studies have comparatively explored how population dynamics differ in native and novel parts of an invading plants’ range. The population dynamics of mile-a-minute weed, Polygonum perfoliatum L., was explored in both the native (Japan) and novel (northeastern USA) portions of its range and evaluated using periodic matrix models. Projected per capita population growth rate (λ) varied within and between native and novel range populations. Surprisingly, five of the six populations in the novel range were projected to fail to replace themselves (λ<1) while only two of the four native range populations were projected to decline, although these projections had wider confidence intervals than in the novel habitat. While changes in germination, survivorship, fecundity and seed banking would have equivalent effects on population growth in the invasive habitat, small increases in plant survivorship would greatly increase λ in native populations. The differences between native and novel population growth rates were driven by lower adult survival in the native range caused by annual flooding and higher fecundity. Simulation analyses indicated that a 50% reduction in plant survival would be required to control growing populations in the novel range. Further comparative studies of other invading species in both their native and novel ranges are needed to examine whether the high per capita population growth and strong regulatory effects of adult survival in the native habitat are generally predictive of invasive behavior in novel habitats. Sachiko Araki: (Deceased)     

Years of potential life lost caused by prostate cancer deaths in the United States—Projection from 2004 through 2050

BackgroundThe purpose of this study is to estimate and project the number of years of potential life lost (YPLL) among males who die of prostate cancer in the United States from 2004 through 2050 and compare the projections by race/ethnicity and age, accounting for demographic changes and population growth.MethodsWe applied the life expectancy method to estimate YPLL caused by deaths of prostate cancer and all cancers in men by using 1999–2004 national mortality data, 2008 census population demographic projections, and 2004 U.S. life tables. We performed sensitivity analyses by varying death rate and population projections, and examined increase in YPLL from population growth, changes in demographics, and death rates.ResultsThe number of YPLL caused by prostate cancer deaths was projected to increase by 226.1%, from 291,853 in 2004 to 951,753 in 2050. Hispanics were projected to have the fastest growth in YPLL (977.1% from 2004 to 2050) caused by prostate cancer, followed by non-Hispanic blacks (543.1%), and non-Hispanic others (269.7%). People aged 75 or older was projected to account for 62.0% of YPLL from prostate cancer in 2050 compared with 50.8% in 2004. Of the projected increase in YPLL caused by prostate cancer deaths by 2050, 9.8% were due to changes in demographic composition, 26.8% because of mortality change, and 63.4% because of population growth.ConclusionsYPLL due to prostate cancer deaths are projected to increase dramatically, and become a greater burden in the future. The projections highlight the importance of comprehensive cancer control and research on cancers including prostate cancer and racial/ethnic-specific estimates.     

COVID-19 vaccination in Sindh Province,Pakistan: A modelling study of health impact and cost-effectiveness

BackgroundMultiple Coronavirus Disease 2019 (COVID-19) vaccines appear to be safe and efficacious, but only high-income countries have the resources to procure sufficient vaccine doses for most of their eligible populations. The World Health Organization has published guidelines for vaccine prioritisation, but most vaccine impact projections have focused on high-income countries, and few incorporate economic considerations. To address this evidence gap, we projected the health and economic impact of different vaccination scenarios in Sindh Province, Pakistan (population: 48 million).Methods and findingsWe fitted a compartmental transmission model to COVID-19 cases and deaths in Sindh from 30 April to 15 September 2020. We then projected cases, deaths, and hospitalisation outcomes over 10 years under different vaccine scenarios. Finally, we combined these projections with a detailed economic model to estimate incremental costs (from healthcare and partial societal perspectives), disability-adjusted life years (DALYs), and incremental cost-effectiveness ratio (ICER) for each scenario.We project that 1 year of vaccine distribution, at delivery rates consistent with COVAX projections, using an infection-blocking vaccine at $3/dose with 70% efficacy and 2.5-year duration of protection is likely to avert around 0.9 (95% credible interval (CrI): 0.9, 1.0) million cases, 10.1 (95% CrI: 10.1, 10.3) thousand deaths, and 70.1 (95% CrI: 69.9, 70.6) thousand DALYs, with an ICER of $27.9 per DALY averted from the health system perspective. Under a broad range of alternative scenarios, we find that initially prioritising the older (65+) population generally prevents more deaths. However, unprioritised distribution has almost the same cost-effectiveness when considering all outcomes, and both prioritised and unprioritised programmes can be cost-effective for low per-dose costs. High vaccine prices ($10/dose), however, may not be cost-effective, depending on the specifics of vaccine performance, distribution programme, and future pandemic trends.The principal drivers of the health outcomes are the fitted values for the overall transmission scaling parameter and disease natural history parameters from other studies, particularly age-specific probabilities of infection and symptomatic disease, as well as social contact rates. Other parameters are investigated in sensitivity analyses.This study is limited by model approximations, available data, and future uncertainty. Because the model is a single-population compartmental model, detailed impacts of nonpharmaceutical interventions (NPIs) such as household isolation cannot be practically represented or evaluated in combination with vaccine programmes. Similarly, the model cannot consider prioritising groups like healthcare or other essential workers. The model is only fitted to the reported case and death data, which are incomplete and not disaggregated by, e.g., age. Finally, because the future impact and implementation cost of NPIs are uncertain, how these would interact with vaccination remains an open question.ConclusionsCOVID-19 vaccination can have a considerable health impact and is likely to be cost-effective if more optimistic vaccine scenarios apply. Preventing severe disease is an important contributor to this impact. However, the advantage of prioritising older, high-risk populations is smaller in generally younger populations. This reduction is especially true in populations with more past transmission, and if the vaccine is likely to further impede transmission rather than just disease. Those conditions are typical of many low- and middle-income countries.

In a modelling study, Carl A B Pearson and coauthors investigate the health impact and cost-effectiveness of various COVID-19 vaccination scenarios in Sindh Province, Pakistan     

Population and individual elephant response to a catastrophic fire in Pilanesberg National Park

In predator-free large herbivore populations, where density-dependent feedbacks occur at the limit where forage resources can no longer support the population, environmental catastrophes may play a significant role in population regulation. The potential role of fire as a stochastic mass-mortality event limiting these populations is poorly understood, so too the behavioural and physiological responses of the affected animals to this type of large disturbance event. During September 2005, a wildfire resulted in mortality of 29 (18% population mortality) and injury to 18, African elephants in Pilanesberg National Park, South Africa. We examined movement and herd association patterns of six GPS-collared breeding herds, and evaluated population physiological response through faecal glucocorticoid metabolite (stress) levels. We investigated population size, structure and projected growth rates using a simulation model. After an initial flight response post-fire, severely injured breeding herds reduced daily displacement with increased daily variability, reduced home range size, spent more time in non-tourist areas and associated less with other herds. Uninjured, or less severely injured, breeding herds also shifted into non-tourist areas post-fire, but in contrast, increased displacement rate (both mean and variability), did not adjust home range size and formed larger herds post-fire. Adult cow stress hormone levels increased significantly post-fire, whereas juvenile and adult bull stress levels did not change significantly. Most mortality occurred to the juvenile age class causing a change in post-fire population age structure. Projected population growth rate remained unchanged at 6.5% p.a., and at current fecundity levels, the population would reach its previous level three to four years post-fire. The natural mortality patterns seen in elephant populations during stochastic events, such as droughts, follows that of the classic mortality pattern seen in predator-free large ungulate populations, i.e. mainly involving juveniles. Fire therefore functions in a similar manner to other environmental catastrophes and may be a natural mechanism contributing to population limitation. Welfare concerns of arson fires, burning during "hot-fire" conditions and the conservation implications of fire suppression (i.e. removal of a potential contributing factor to natural population regulation) should be integrated into fire management strategies for conservation areas.     

Predicting fluctuations of reintroduced ibex populations: the importance of density dependence, environmental stochasticity and uncertain population estimates

1. Development of population projections requires estimates of observation error, parameters characterizing expected dynamics such as the specific population growth rate and the form of density regulation, the influence of stochastic factors on population dynamics, and quantification of the uncertainty in the parameter estimates. 2. Here we construct a Population Prediction Interval (PPI) based on Bayesian state space modelling of future population growth of 28 reintroduced ibex populations in Switzerland that have been censused for up to 68 years. Our aim is to examine whether the interpopulation variation in the precision of the population projections is related to differences in the parameters characterizing the expected dynamics, in the effects of environmental stochasticity, in the magnitude of uncertainty in the population parameters, or in the observation error. 3. The error in the population censuses was small. The median coefficient of variation in the estimates across populations was 5.1%. 4. Significant density regulation was present in 53.6% of the populations, but was in general weak. 5. The width of the PPI calculated for a period of 5 years showed large variation among populations, and was explained by differences in the impact of environmental stochasticity on population dynamics. 6. In spite of the high accuracy in population estimates, the uncertainty in the parameter estimates was still large. This uncertainty affected the precision in the population predictions, but it decreased with increasing length of study period, mainly due to higher precision in the estimates of the environmental variance in the longer time-series. 7. These analyses reveal that predictions of future population fluctuations of weakly density-regulated populations such as the ibex often become uncertain. Credible population predictions require that this uncertainty is properly quantified.     

Distribution, endogamy, and isolation of Malas of Chittoor district, Andhra Pradesh, India

This study investigates the distribution of Malas, a scheduled caste population of Andhra Pradesh, their isolates in different eco-cultural zones, and their endogamy and isolation by marriage district. The Malas, formerly "untouchables," occupy the lowest status in the Hindu hierarchy. The sample consists of 10% of Malas from 10% of the villages in 2 taluks of Chitoor district of Andhra Pradesh. 6 Mala populations--Tangala, Maladasari, Pakanati, Rampala, Murikinati, and Bommanati--live in the area. These populations show a regionality in their distribution, with very little overlapping even when 2 populations inhabit the same village. Of 885 marriages in the 6 endogamous populations, all but 3 have been contracted between individuals belonging to the same Mala group. The 3 exogamous marriages took place between Mala men and women from another caste. Such small exceptions to the general rule do not mean that the Mala populations are not breeding isolates; these 6 populations satisfy Wright's island model. The high incidence of matings between closely related populations also contributes to their genetic and breeding isolation. Consanguineous marriages range from 26.76 to 38.75%. The distance between the birth place of spouses in miles, called marriage distance, shows a range from 7.72 to 15.71 miles. Lower values mean higher population densities. Groups within each population are isolated by distance and form small overlapping Mendelian populations, approaching a stepping stone model with continuous variation of genetic traits between adjacent groups of people.     

Relative Contributions of Geographic,Socioeconomic, and Lifestyle Factors to Quality of Life,Frailty, and Mortality in Elderly

Background

To date, few studies address disparities in older populations specifically using frailty as one of the health outcomes and examining the relative contributions of individual and environmental factors to health outcomes.

Methodology/Principal Findings

Using a data set from a health survey of 4,000 people aged 65 years and over living in all regions of Hong Kong, we examined regional variations in self-rated health, frailty, and four-year mortality, and analyzed the relative contributions of lifestyle, socioeconomic status, and geographical location of residence to these outcomes using path analysis. We hypothesize that lifestyle, socioeconomic status, and regional characteristics directly and indirectly through interactions contribute to self-rated physical and psychological health, frailty, and four-year mortality.District variations directly affect self-rated physical health, and also exert an effect through socioeconomic position as well as lifestyle factors. Socioeconomic position in turn directly affects self-rated physical health, as well as indirectly through lifestyle factors. A similar pattern of interaction is observed for self-rated mental health, frailty, and mortality, although there are differences in different lifestyle factors and district associations. Lifestyle factors also directly affect physical and mental components of health, frailty, and mortality. The magnitude of direct district effect is comparable to those of lifestyle and socioeconomic position.

Conclusions/Significance

We conclude that district variations in health outcomes exist in the Hong Kong elderly population, and these variations result directly from district factors, and are also indirectly mediated through socioeconomic position as well as lifestyle. Provision and accessibility to health services are unlikely to play a significant role. Future studies on these district factors would be important in reducing health disparities in the older population.     

Minimum Incidence of Adult Invasive Pneumococcal Disease in Blantyre,Malawi an Urban African Setting: A Hospital Based Prospective Cohort Study

Invasive pneumococcal disease causes substantial morbidity and mortality in Africa. Evaluating population level indirect impact on adult disease of pneumococcal conjugate vaccine (PCV) programmes in infants requires baseline population incidence rates but these are often lacking in areas with limited disease surveillance. We used hospital based blood culture and cerebrospinal fluid surveillance to calculate minimal incidence of invasive pneumococcal disease in the adult (≥15 years old) population of Blantyre, a rapidly growing urban centre in southern Malawi, in the period preceding vaccine introduction. Invasive pneumococcal disease incidence in Blantyre district was high, mean 58.1 (95% confidence interval (CI): 53.7, 62.7) per 100,000 person years and peaking among 35 to 40 year olds at 108.8 (95%CI: 89.0, 131.7) mirroring the population age prevalence of HIV infection. For pneumococcal bacteraemia in urban Blantyre, mean incidence was 60.6 (95% CI: 55.2, 66.5) per 100,000 person years, peaking among 35 to 40 year olds at 114.8 (95%CI: 90.3, 143.9). We suspected that our surveillance may under-ascertain the true burden of disease, so we used location data from bacteraemic subjects and projected population estimates to calculate local sub-district incidence, then examined the impact of community level socio-demographic covariates as possible predictors of local sub-district incidence of pneumococcal and non-pneumococcal pathogenic bacteraemia. Geographic heterogeneity in incidence was marked with localised hotspots but ward level covariates apart from prison were not associated with pneumococcal bacteraemia incidence. Modelling suggests that the current sentinel surveillance system under-ascertains the true burden of disease. We outline a number of challenges to surveillance for pneumococcal disease in our low-resource setting. Subsequent surveillance in the vaccine era will have to account for geographic heterogeneity when evaluating population level indirect impact of PCV13 introduction to the childhood immunisation program.     

AGE- AND SEX-SPECIFIC MORTALITY AND POPULATION STRUCTURE IN SEA OTTERS

We used 742 beach-cast carcasses to characterize age- and sex-specific sea otter mortality during the winter of 1990-1991 at Bering Island, Russia. We also examined 363 carcasses recovered after the 1989 grounding of the T/V Exxon Valdez , to characterize age and sex composition in the living western Prince William Sound (WPWS) sea otter population. At Bering Island, mortality was male-biased (81%), and 75% were adults. The WPWS population was female-biased (59%) and most animals were subadult (79% of the males and 45% of the females). In the decade prior to 1990-1991 we found increasing sea otter densities (particularly among males), declining prey resources, and declining weights in adult male sea otters at Bering Island. Our findings suggest the increased mortality at Bering Island in 1990-1991 was a density-dependent population response. We propose male-maintained breeding territories and exclusion of juvenile females by adult females, providing a mechanism for maintaining densities in female areas below densities in male areas and for potentially moderating the effects of prey reductions on the female population. Increased adult male mortality at Bering Island in 1990-1991 likely modified the sex and age class structure there toward that observed in Prince William Sound.     

Fruit set,fruit reduction,and fruiting strategy in Cornus sanguinea (Cornaceae)

We studied various aspects of the fruiting biology of Cornus sanguinea (Cornaceae), a fleshy-fruit-producing deciduous shrub, in four populations in northwest Spain. One population was studied over a 5-yr period (1989-1994), and the remaining populations in 1994 only. Fruit-set level varied among years (range 11-18%) and among populations (range 8-22%), but was in all cases low. Within plants, fruit-set level did not vary significantly among inflorescences, indicating that inflorescence fruit set is independent of inflorescence position and inflorescence, phenology. To investigate the function of surplus flowers, we carried out flower removal experiments. Inflorescence fruit-set level was unaffected by removal of up to =75% of flowers. These results suggest that Cornus sanguinea regulates its fruit-set level via plasticity in the number of fruits aborted: if flower mortality has been high, fewer fruits will be aborted. Within the inflorescence, surplus flowers thus act as insurance against flower loss.     

Effects of forage availability on growth and maturation rates in water voles

1. In populations of small mammals, food supplementation typically results in higher population densities, body weights, growth rates and reproductive rates. However, few studies have demonstrated a relationship between forage levels and demographic rates in wild populations in the absence of supplementation. 2. We examined the association of levels of available forage with individual growth rates and time to sexual maturity in eight re-introduced and three naturally occurring populations of water voles (Arvicola terrestris). 3. Range sizes were smaller at sites with higher population densities. Mean forage availability and individual growth rates covaried with range size at each site. 4. The weight at which water voles became sexually mature was 112 g for females and 115 g for males and did not vary between study sites. Differences in growth rates therefore translated into differences in the time taken to reach maturity between sites. 5. In the re-introduced populations, mean days to maturity varied inversely with mean range length. Females took 7 days (18%, range 40-47 days) longer and males 5 days (13%, range 40-45 days) longer to reach breeding condition at the sites with the shortest mean range lengths. 6. Evidence from this study suggests a possible mechanism by which increased population densities may reduce maturation rates in water voles through a reduction in mean range size, thereby limiting the availability of forage to each individual.     

Can road mortality limit populations of pool-breeding amphibians?

We integrated road maps, traffic volume data, and pool locations in a modeling study to estimate the potential effects of road mortality on populations of pool-breeding spotted salamanders (Ambystoma maculatum Shaw). Population projections based on spotted salamander life tables imply that an annual risk of road mortality for adults of >10% can lead to local population extirpation; mitigation efforts (tunnels, road closures, and other measures) should seek to reduce road mortality rates to below this threshold. For central and western Massachusetts, we estimated that salamanders would be exposed to at least this threshold level of risk at 22–73% of populations (assuming a 100 vs. 500 m migration distance, respectively). We conclude that road mortality can be a significant source of additive mortality for individual spotted salamanders in many parts of the species’ range. Efforts to prevent such mortality by transportation planners are likely warranted strictly on a biological basis in areas with road densities >2.5 km per km² of landscape and traffic volumes >250 vehicles/lane/day within the migration range of a breeding population of spotted salamanders.     

Population Assessment of Future Trajectories in Coronary Heart Disease Mortality

Background

Coronary heart disease (CHD) mortality rates have been decreasing in Iceland since the 1980s, largely reflecting improvements in cardiovascular risk factors. The purpose of this study was to predict future CHD mortality in Iceland based on potential risk factor trends.

Methods and findings

The previously validated IMPACT model was used to predict changes in CHD mortality between 2010 and 2040 among the projected population of Iceland aged 25–74. Calculations were based on combining: i) data on population numbers and projections (Statistics Iceland), ii) population risk factor levels and projections (Refine Reykjavik study), and iii) effectiveness of specific risk factor reductions (published meta-analyses). Projections for three contrasting scenarios were compared: 1) If the historical risk factor trends of past 30 years were to continue, the declining death rates of past decades would level off, reflecting population ageing. 2) If recent trends in risk factors (past 5 years) continue, this would result in a death rate increasing from 49 to 70 per 100,000. This would reflect a recent plateau in previously falling cholesterol levels and recent rapid increases in obesity and diabetes prevalence. 3) Assuming that in 2040 the entire population enjoys optimal risk factor levels observed in low risk cohorts, this would prevent almost all premature CHD deaths before 2040.

Conclusions

The potential increase in CHD deaths with recent trends in risk factor levels is alarming both for Iceland and probably for comparable Western populations. However, our results show considerable room for reducing CHD mortality. Achieving the best case scenario could eradicate premature CHD deaths by 2040. Public health policy interventions based on these predictions may provide a cost effective means of reducing CHD mortality in the future.     

A Preliminary Continental Risk Map for Malaria Mortality among African Children

Approaches to global public health are increasingly driven by an understanding of regional patterns of disease-specific mortality and disability. Current estimates of disease risks associated with Plasmodium falciparum in sub-Saharan Africa remain poorly defined. Through the integration of high-resolution population and climate probability models of P. falciparum transmission, geographical information systems have been used to define the spatial limits of populations exposed to the risk of infection in Africa. These estimates were combined with a range of annual malaria-specific mortality rates, derived from a variety of epidemiological approaches, among children aged 0–4 years. The best estimates of malaria-attributable mortality using this approach ranged between 0.43 million and 0.68 million deaths per annum among an exposed population of ∼66 million children in 1990. Despite the limitations of modelled transmission and population distributions, these empirical approaches to probabilities of infection risk and epidemiological data on mortality provide a novel approach to present and projected burdens of malaria mortality, as discussed here by Bob Snow, Marlies Craig, Uwe Deichmann and Dave le Sueur.     

Incorporating population-level variation in thermal performance into predictions of geographic range shifts

Determining how species' geographic ranges are governed by current climates and how they will respond to rapid climatic change poses a major biological challenge. Geographic ranges are often spatially fragmented and composed of genetically differentiated populations that are locally adapted to different thermal regimes. Tradeoffs between different aspects of thermal performance, such as between tolerance to high temperature and tolerance to low temperature or between maximal performance and breadth of performance, suggest that the performance of a given population will be a subset of that of the species. Therefore, species-level projections of distribution might overestimate the species' ability to persist at any given location. However, current approaches to modeling distributions often do not consider variation among populations. Here, we estimated genetically-based differences in thermal performance curves for growth among 12 populations of the scarlet monkeyflower, Mimulus cardinalis, a perennial herb of western North America. We inferred the maximum relative growth rate (RGR(max)), temperature optimum (T(opt)), and temperature breadth (T(breadth)) for each population. We used these data to test for tradeoffs in thermal performance, generate mechanistic population-level projections of distribution under current and future climates, and examine how variation in aspects of thermal performance influences forecasts of range shifts. Populations differed significantly in RGR(max) and had variable, but overlapping, estimates of T(opt) and T(breadth). T(opt) declined with latitude and increased with temperature of origin, consistent with tradeoffs between performances at low temperatures versus those at high temperatures. Further, T(breadth) was negatively related to RGR(max), as expected for a specialist-generalist tradeoff. Parameters of the thermal performance curve influenced properties of projected distributions. For both current and future climates, T(opt) was negatively related to latitudinal position, while T(breadth) was positively related to projected range size. The magnitude and direction of range shifts also varied with T(opt) and T(breadth), but sometimes in unexpected ways. For example, the fraction of habitat remaining suitable increased with T(opt) but decreased with T(breadth). Northern limits of all populations were projected to shift north, but the magnitude of shift decreased with T(opt) and increased with T(breadth). Median latitude was projected to shift north for populations with high T(breadth) and low T(opt), but south for populations with low T(breadth) and high T(opt). Distributions inferred by integrating population-level projections did not differ from a species-level projection that ignored variation among populations. However, the species-level approach masked the potential array of divergent responses by populations that might lead to genotypic sorting within the species' range. Thermal performance tradeoffs among populations within the species' range had important, but sometimes counterintuitive, effects on projected responses to climatic change.     

Widespread drought‐induced tree mortality at dry range edges indicates that climate stress exceeds species' compensating mechanisms

Drought‐induced tree mortality is projected to increase due to climate change, which will have manifold ecological and societal impacts including the potential to weaken or reverse the terrestrial carbon sink. Predictions of tree mortality remain limited, in large part because within‐species variations in ecophysiology due to plasticity or adaptation and ecosystem adjustments could buffer mortality in dry locations. Here, we conduct a meta‐analysis of 50 studies spanning >100 woody plant species globally to quantify how populations within species vary in vulnerability to drought mortality and whether functional traits or climate mediate mortality patterns. We find that mortality predominantly occurs in drier populations and this pattern is more pronounced in species with xylem that can tolerate highly negative water potentials, typically considered to be an adaptive trait for dry regions, and species that experience higher variability in water stress. Our results indicate that climate stress has exceeded physiological and ecosystem‐level tolerance or compensating mechanisms by triggering extensive mortality at dry range edges and provides a foundation for future mortality projections in empirical distribution and mechanistic vegetation models.     

Aging, cancer, and cancer vaccines

ABSTRACT: World population has experienced continuous growth since 1400 A.D. Current projections show a continued increase - but a steady decline in the population growth rate - with the number expected to reach between 8 and 10.5 billion people within 40 years. The elderly population is rapidly rising: in 1950 there were 205 million people aged 60 or older, while in 2000 there were 606 million. By 2050, the global population aged 60 or over is projected to expand by more than three times, reaching nearly 2 billion people 1. Most cancers are age-related diseases: in the US, 50% of all malignancies occur in people aged 65-95. 60% of all cancers are expected to be diagnosed in elderly patients by 2020 2. Further, cancer-related mortality increases with age: 70% of all malignancy-related deaths are registered in people aged 65 years or older 3. Here we introduce the microscopic aspects of aging, the pro-inflammatory phenotype of the elderly, and the changes related to immunosenescence. Then we deal with cancer disease and its development, the difficulty of treatment administration in the geriatric population, and the importance of a comprehensive geriatric assessment. Finally, we aim to analyze the complex interactions of aging with cancer and cancer vaccinology, and the importance of this last approach as a complementary therapy to different levels of prevention and treatment. Cancer vaccines, in fact, should at present be recommended in association to a stronger cancer prevention and conventional therapies (surgery, chemotherapy, radiation therapy), both for curative and palliative intent, in order to reduce morbidity and mortality associated to cancer progression.     

Mortality,fertility, and the OY ratio in a model hunter–gatherer system

An agent‐based model (ABM) is used to explore how the ratio of old to young adults (the OY ratio) in a sample of dead individuals is related to aspects of mortality, fertility, and longevity experienced by the living population from which the sample was drawn. The ABM features representations of rules, behaviors, and constraints that affect person‐ and household‐level decisions about marriage, reproduction, and infant mortality in hunter–gatherer systems. The demographic characteristics of the larger model system emerge through human‐level interactions playing out in the context of “global” parameters that can be adjusted to produce a range of mortality and fertility conditions. Model data show a relationship between the OY ratios of living populations (the living OY ratio) and assemblages of dead individuals drawn from those populations (the dead OY ratio) that is consistent with that from empirically known ethnographic hunter–gatherer cases. The dead OY ratio is clearly related to the mean ages, mean adult mortality rates, and mean total fertility rates experienced by living populations in the model. Sample size exerts a strong effect on the accuracy with which the calculated dead OY ratio reflects the actual dead OY ratio of the complete assemblage. These results demonstrate that the dead OY ratio is a potentially useful metric for paleodemographic analysis of changes in mortality and mean age, and suggest that, in general, hunter–gatherer populations with higher mortality, higher fertility, and lower mean ages are characterized by lower dead OY ratios. Am J Phys Anthropol 154:222–231, 2014. © 2014 Wiley Periodicals, Inc.