Patches of riparian woody vegetation potentially help mitigate environmental impacts of agriculture and safeguard biodiversity. We investigated the effects of riparian forest on invertebrate ...diversity in coupled stream-riparian networks using a case study in the Zwalm river basin (Flanders, Belgium). Agriculture is one of the main pressures in the basin and riparian forest is limited to a number of isolated patches. Our 32 study sites comprised nine unshaded “unbuffered” sites which were paired with nine shaded “buffered” sites on the same stream reach, along with five ‘least-disturbed’ sites and nine downstream sites. We sampled water chemistry, habitat characteristics and stream and riparian invertebrates (carabid beetles and spiders) at each site. Three methods were used to quantify riparian attributes at different spatial scales: a visually-assessed qualitative index, quantitative estimates of habitat categories in six rectangular plots (10 × 5 m) and geographic information system (GIS)-derived land cover data. We investigated relationships between invertebrates and riparian attributes at different scales with linear regression and redundancy analyses. Spiders and carabids were most associated with local riparian attributes. In contrast, aquatic macroinvertebrates were strongly influenced by the extent of riparian vegetation in a riparian band upstream (100–300 m). These findings demonstrate the value of quantifying GIS-based metrics of riparian cover over larger spatial scales into assessments of the efficacy of riparian management as a complement to more detailed local scale riparian assessments in situ. Our findings highlight the value of even small patches of riparian vegetation in an otherwise extensively disturbed landscape in supporting biodiversity of both terrestrial and freshwater invertebrates and emphasize the need to consider multiple spatial scales in riparian management strategies which aim to mitigate human impacts on biodiversity in stream-riparian networks.
Riparian forest buffers have multiple benefits for biodiversity and ecosystem services in both freshwater and terrestrial habitats but are rarely implemented in water ecosystem management, partly ...reflecting the lack of information on the effectiveness of this measure. In this context, social learning is valuable to inform stakeholders of the efficacy of riparian vegetation in mitigating stream degradation. We aim to develop a Bayesian belief network (BBN) model for application as a learning tool to simulate and assess the reach- and segment-scale effects of riparian vegetation properties and land use on instream invertebrates. We surveyed reach-scale riparian conditions, extracted segment-scale riparian and subcatchment land use information from geographic information system data, and collected macroinvertebrate samples from four catchments in Europe (Belgium, Norway, Romania, and Sweden). We modelled the ecological condition based on the Average Score Per Taxon (ASPT) index, a macroinvertebrate-based index widely used in European bioassessment, as a function of different riparian variables using the BBN modelling approach. The results of the model simulations provided insights into the usefulness of riparian vegetation attributes in enhancing the ecological condition, with reach-scale riparian vegetation quality associated with the strongest improvements in ecological status. Specifically, reach-scale buffer vegetation of score 3 (i.e. moderate quality) generally results in the highest probability of a good ASPT score (99–100%). In contrast, a site with a narrow width of riparian trees and a small area of trees with reach-scale buffer vegetation of score 1 (i.e. low quality) predicts a high probability of a bad ASPT score (74%). The strengths of the BBN model are the ease of interpretation, fast simulation, ability to explicitly indicate uncertainty in model outcomes, and interactivity. These merits point to the potential use of the BBN model in workshop activities to stimulate key learning processes that help inform the management of riparian zones.
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•Reach-scale riparian vegetation condition had the strongest improvements in ecological status.•Bayesian belief network models were developed as a potential learning tool.•Data collected from four European catchments were used to train the model.•Model's strengths are fast simulation time and clarity, stimulating users' learning.
Abstract Pediatric central nervous system tumors remain challenging to diagnose. Imaging approaches do not provide sufficient detail to discriminate between different tumor types, while the ...histopathological examination of tumor tissue shows high inter-observer variability. Recent studies have demonstrated the accurate classification of central nervous system tumors based on the DNA methylation profile of a tumor biopsy. However, a brain biopsy holds significant risk of bleeding and damaging the surrounding tissues. Liquid biopsy approaches analyzing circulating tumor DNA show high potential as an alternative and less invasive tool to study the DNA methylation pattern of tumors. Here, we explore the potential of classifying pediatric brain tumors based on methylation profiling of the circulating cell-free DNA (cfDNA) in cerebrospinal fluid (CSF). For this proof-of-concept study, we collected cerebrospinal fluid samples from 19 pediatric brain cancer patients via a ventricular drain placed for reasons of increased intracranial pressure. Analyses on the cfDNA showed high variability of cfDNA quantities across patients ranging from levels below the limit of quantification to 40 ng cfDNA per milliliter of CSF. Classification based on methylation profiling of cfDNA from CSF was correct for 7 out of 20 samples in our cohort. Accurate results were mostly observed in samples of high quality, more specifically those with limited high molecular weight DNA contamination. Interestingly, we show that centrifugation of the CSF prior to processing increases the fraction of fragmented cfDNA to high molecular weight DNA. In addition, classification was mostly correct for samples with high tumoral cfDNA fraction as estimated by computational deconvolution (> 40%). In summary, analysis of cfDNA in the CSF shows potential as a tool for diagnosing pediatric nervous system tumors especially in patients with high levels of tumoral cfDNA in the CSF. Further optimization of the collection procedure, experimental workflow and bioinformatic approach is required to also allow classification for patients with low tumoral fractions in the CSF.
Surgery is often advised when conservative treatment fails in musculoskeletal pain conditions, but a substantial proportion still suffers chronic pain after surgery. Somatosensory processing system ...(SPS) signs were previously studied as potential predictors for chronic postsurgical pain, but results are inconsistent. Therefore, studying the evolution of SPS signs could be of added value. The aim was to summarize all studies that measured how SPS signs evolved after nociceptive targeted surgery in musculoskeletal disorders and to find preoperative, perioperative, and postoperative predictors for the evolution of these SPS signs. Data were summarized, and risk of bias and level of evidence and recommendation were determined. Twenty-one studies were included. Five scored a low, 3 a moderate, and 13 a high risk of bias. In general, no consistent evolution of SPS signs comparing preoperative and postoperative values and predictors for this evolution in musculoskeletal disorders could be found. In most cases, static quantitative sensory testing (QST) did not change or conflicting results were found. On the other hand, dynamic QST mostly improved after surgery. Worthfully mentioning is that worsening of SPS signs was only seen at a follow-up of <3 months after surgery, that conclusions are stronger when evaluating dynamic QST with a follow-up of ≥3 months after surgery, and that pain improvement postsurgery was an important predictor. Future high-quality research should focus on the evolution of SPS signs after nociceptive targeted surgery, accounting for pain improvement groups and focusing on preoperative, perioperative, and postoperative predictors of this evolution.
All studies that investigated personal factors influencing pressure pain threshold (PPT) in healthy people were synthesized. Data was summarized, and risk of bias (RoB) and level of evidence were ...determined. Results were pooled per influencing factor, grouped by body region and included in meta-analyses. Fifty-four studies were eligible. Five had low, nine moderate, and 40 high RoB. Following meta-analyses, a strong conclusion was found for the influence of scapular position, a moderate for the influence of gender, and a weak for the influence of age (shoulder/arm region) and blood pressure on PPT. In addition, body mass index, gender (leg region), alcohol consumption and pain vigilance may not influence PPT. Based on qualitative summary, depression and menopause may not influence PPT. For other variables there was only preliminary or conflicting evidence. However, caution is advised, since the majority of included studies showed a high RoB and several were not eligible to include in meta-analyses. Heterogeneity was high in the performed meta-analyses, and most conclusions were weak. More standardized research is necessary.
•Scapular position influenced pressure pain threshold (strong conclusion).•Gender influenced pressure pain threshold (moderate conclusion).•Age and blood pressure influenced pressure pain threshold (weak conclusion).•Other personal factors had no influence, were preliminary or contradictory.
Preoperative rehabilitation (hereafter called “prehabilitation”) has been proposed as a potentially effective treatment to target preoperative risk factors to prevent insufficient outcome after total ...knee arthroplasty (TKA).
We aimed to assess whether previous clinical trials of non-surgical, non-pharmacological prehabilitation in individuals with knee osteoarthritis (KOA) awaiting TKA focused on specific clinical phenotypes or specific individual characteristics and whether the content of the prehabilitation was stratified accordingly. Second, we aimed to summarize and compare the long-term effects of stratified and non-stratified care on pain, satisfaction, function and quality of life.
A systematic literature search of PubMed, Web of Science, Scopus and Embase was performed. All relevant articles published up to April 19, 2021 reporting “(randomized controlled) clinical trials or prospective cohort studies” (S) related to the key words “total knee arthroplasty” (P), “preoperative conservative interventions” (I), “pain, function, quality of life and/or satisfaction” (O) were included.
After screening 3498 potentially eligible records, 18 studies were assessed for risk of bias. Twelve studies had low, 2 moderate, 3 serious, and one high risk of bias. The latter study was excluded, resulting in 17 included studies. Five studies investigated a“stratified prehabilitation care” and 12 “non-stratified prehabilitation care”. Stratified prehabilitation in 4 studies meant that the study sample was chosen considering a predefined intervention, and in the fifth study, the prehabilitation was stratified to individuals’ needs. No direct comparison between the 2 approaches was possible. We found weak evidence for a positive effect of biopsychosocial prehabilitation compared to no prehabilitation on function (stratified studies) and pain neuroscience education prehabilitation compared to biomedical education on satisfaction (non-stratified studies) at 6 months post-TKA. We found strong evidence for positive effects of exercise prehabilitation compared to no prehabilitation on pain at 6 months and on function at 12 months post-TKA (non-stratified studies).
More research is needed of stratified prehabilitation care focusing on individual characteristics in people with KOA awaiting TKA.
This systematic review was prospectively registered at PROSPERO on March 22, 2021 (no. CRD42021221098).
The aim of this study was to identify preoperative predictors for 1-year posttotal knee arthroplasty (TKA) pain and pre- to post-TKA pain difference in knee osteoarthritis (KOA) patients.
From March ...2018 to July 2023, this prospective longitudinal cohort study enrolled KOA patients awaiting TKA from four hospitals in Belgium and the Netherlands. Different biopsychosocial predictors were assessed preoperatively by questionnaires and physical examinations (input variables). The Knee injury and Osteoarthritis Outcome Score (KOOS) subscale pain was used to measure pain intensity. The absolute KOOS subscale pain score 1-year post-TKA and the difference score (ΔKOOS = 1-year postoperative - preoperative) were used as primary outcome measures (output variables). Two multivariable linear regression analyses were performed.
Two hundred and twenty-three participants were included after multiple imputation. Worse absolute KOOS subscale pain scores 1-year post-TKA and negative or closer to zero ΔKOOS subscale pain scores were predicted by self-reported central sensitisation, lower KOA grade and preoperative satisfaction, and higher glycated haemoglobin, number of pain locations and personal control (adjusted R
= 0.25). Additional predictors of negative or closer to zero ΔKOOS subscale pain scores were being self-employed, higher preoperative pain and function (adjusted R
= 0.37).
This study reports different biopsychosocial predictors for both outcomes that have filtered out other potential predictors and provide value for future studies on developing risk assessment tools for the prediction of chronic TKA pain.
The protocol is registered at clinicaltrials.gov (NCT05380648) on 13 May 2022.
Level II.
To identify metabolic factors and inflammatory markers that are predictive of postoperative total knee arthroplasty (TKA) outcome.
A systematic search of the existing literature was performed using ...the electronic databases PubMed, Web of Science and Embase until the 1
of August 2022. Studies that evaluated the influence of metabolic or inflammatory markers (I) on postsurgical outcome (O) in end-stage knee osteoarthritis patients awaiting primary TKA (P) were included in this review.
In total, 49 studies were included. Risk of bias of the included studies was low for one study, moderate for 10 studies and high for the remaining 38 studies. Conflicting evidence was found for the influence of body mass index, diabetes, cytokine levels and dyslipidaemia on pain, function, satisfaction and quality of life at more than six months after TKA.
Several limitations such as not taking into account known confounding factors, the use of many different outcome measures and a widely varying follow-up period made it challenging to draw firm conclusions and clinical implications. Therefore large-scaled longitudinal studies assessing the predictive value of metabolic and inflammatory factors pre-surgery in addition to the already evidenced risk factors with follow-up of one year after TKA are warranted.
To assess the immediate and three days postintervention effect of one dry needling session compared to one sham needling session on pain, central pain processing, muscle co-contraction and ...spatiotemporal parameters during gait in knee osteoarthritis patients.
A double-blind randomized controlled trial was conducted. Sixty-one knee osteoarthritis patients were randomly assigned to the dry needling or sham needling group. Primary outcomes were pain and central pain processing. Secondary outcomes included muscle co-contraction and spatiotemporal parameters during gait. Patients were assessed at baseline and 15 min after the intervention, and pain also three days after the intervention. Linear mixed models were used to examine between- and within-group differences.
No significant between-group differences for pain were found, but within-group scores showed a significant decrease 15 min after sham needling and three days after dry needling. The mean conditioned pain modulation effect measured at the m. Trapezius worsened significantly 15 min after sham needling compared to after dry needling (between-group difference). However, individual conditioned pain modulation percentage scores remained stable over time. Various significant within-group differences were found 15 min after sham needling: a decrease of conditioned pain modulation measured at m. Quadriceps and m. Trapezius and stride- and step-time scores, and an increase in step length and widespread pain pressure threshold. A significant decrease in muscle co-contraction index of the m. Vastus Medialis and Semitendinosus was found as within-group difference 15 min after dry needling.
Dry needling has no larger effect on pain, central pain processing, muscle co-contraction and gait pattern 15 min and three days postintervention compared to sham needling. Mean conditioned pain modulation scores worsened after sham needling compared to after dry needling. Further research remains necessary.
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