Aim of study: To survey a yew tree grove and to evaluate its conservation status to ascertain whether its proposal to class it as Habitat 9580* is appropriate.
Area of study: Eastern end of Central ...Mountain Range, Spain.
Material and methods: We conducted a field survey collecting data of UTM coordinates, altitude, orientation, companion woody species, height, stem perimeter, sex and browsing evidence. Individuals were classified in four age groups, considering height and stem perimeter: 1) seedling, 2) juvenile, 3), adult and 4) old. Companion species were analysed to assess the presence of habitat 9580* according to the Habitats Directive. Population structural complexity, stability and compactness were analysed to assess the conservation status.
Main results: We registered 8,304 yews along with seventeen distinctive accompanying species, thus confirming the presence of priority habitat of community interest 9580* "Mediterranean Taxus baccata woods”. Population analysis leads us to appreciate a favourable conservation status for the whole habitat in the study area.
Research highlights: We have described the largest T. baccata grove registered to date in the Central Mountain Range of the Iberian Peninsula. We confirm the presence of priority habitat of community interest 9580* "Mediterranean Taxus baccata woods", being the first description of this habitat in the Community of Madrid. As the study area is located within a Special Area of Conservation (SAC), we propose its inclusion on the SAC habitats list.
Aim of study: Our study design presents two main objectives: 1) to create a census that details the number of yew individuals and their geographic distribution, and 2) to attempt to unravel possible ...reproductive relationships and their connection between true population nuclei and meta-population models.Area of study: Recently identified yew populations (Taxus baccata L.) were studied in the western sector of the Sistema Central mountain range of theIberian Peninsula, known as the Sierra de Francia. The study was carried out in five watersheds within Las Batuecas-Sierra de Francia Natural Park.Material and Methods: All yew specimens were counted and assigned to age groups. The notable differences observed in regeneration aof these communities propitiates population analysis aimed at explaining the landscape connectivity relationships between the different population nuclei and the possibility of defining the meta-population set. Ecological niche models were also created to define the main ecological characteristics of the different subpopulations studied, and to compare them.Main results: Yew in the Sierra de Francia live in an array of different Mediterranean forests, indicative of species dynamics in theIberian Peninsula. 2,450 specimens were recorded and classified into the three types of yew forest population dynamics: regressional-, naturally regenerating-, and incipient- (i.e. colonizing new territories).Research highlights: The essential role of connectivity between populations was recognized and confirmed in this study, specifically among the large female trees located at the headwaters. Based on the role of these female trees, we have created a model called “yew matriarchies”, which serves to express the relevance of large female yew trees in population dynamics.Keywords: Taxus baccata; census; connectivity; seed dispersal.
Resumen. El cáncer de pulmón es una de las principales causas de mortalidad alrededor del mundo. Su historia natural, con la manifestación de síntomas en etapas avanzadas y el retraso en su ...diagnóstico hacen que una gran proporción de pacientes se diagnostiquen en estadios tardíos de la enfermedad, lo que hace muy complicado el tratamiento exitoso de la misma. De esto deriva la importancia de dar origen a recomendaciones basadas en evidencia para soportar la toma de decisiones clínicas por parte de los grupos interdisicplinarios que se encargan del manejo de este padecimiento. Objetivos. Esta Guía de Práctica Clínica (GPC) contiene recomendaciones clínicas desarrolladas de forma sistematizada para asistir la toma de decisiones de médicos especialistas, pacientes, cuidadores de pacientes y elaboradores de políticas públicas involucrados en el manejo de pacientes con cáncer de pulmón en estadios tempranos, localmente avanzados y metastásicos. Material y métodos. Este documento se desarrolló por parte de la Sociedad Mexicana de Oncología en colaboración con el Centro Nacional de Excelencia Tecnológica de México (Cenetec) a través de la dirección de integración de Guías de Práctica Clínica en cumplimiento a estándares internacionales como los descritos por el Instituto de Medicina de EUA (IOM, por sus siglas en inglés), el Instituto de Excelencia Clínica de Gran Bretaña (NICE, por sus siglas en inglés), la Red Colegiada para el Desarrollo de Guías de Escocia (SIGN, por sus siglas en inglés), la Red Internacional de Guías (G-I-N, por sus siglas en inglés); entre otros. Se integró en representación de la Sociedad Mexicana de Oncología un Grupo de Desarrollo de la Guía (GDG) de manera interdisciplinaria, considerando oncólogos médicos, cirujanos oncólogos, cirujanos de tórax, radio-oncólogos, y metodólogos con experiencia en revisiones sistemáticas de la literatura y guías de práctica clínica. Resultados. Se consensuaron 62 preguntas cllínicas que abarcaron lo establecido previamente por el GDG en el documento de alcances de la Guía. Se identificó la evidencia científica que responde a cada una de estas preguntas clínicas y se evaluó críticamente la misma, antes de ser incorporada en el cuerpo de evidencia de la Guía. El GDG acordó mediante la técnica de consenso formal de expertos Panel Delphi la redacción final de las recomendaciones clínicas. Conclusión. Esta Guía de Práctica Clínica pretende proveer recomendaciones clínicas para el manejo de los distintos estadios de la enfermedad y que asistan en el proceso de toma de decisiones compartida. El GDG espera que esta guía contribuya a mejorar la calidad de la atención clínica en las pacientes con cáncer de pulmón de células no pequeñas.
In-stent reocclusion after endovascular therapy has a negative impact on outcomes in acute ischemic stroke (AIS) due to tandem lesions (TL). Optimal antiplatelet therapy approach in these patients to ...avoid in-stent reocclusion is yet to be elucidated.
To assess efficacy and safety of intravenous tirofiban versus intravenous aspirin in patients undergoing MT plus carotid stenting in the setting of AIS due to TL.
Two hundred forty patients will be enrolled, 120 in every treatment arm.
A multicenter, prospective, randomized, controlled (aspirin group), assessor-blinded clinical trial will be conducted. Patients fulfilling the inclusion criteria will be randomized at MT onset to the experimental or control group (1:1). Intravenous aspirin will be administered at a 500-mg single dose and tirofiban at a 500-mcg bolus followed by a 200-mcg/h infusion during the first 24 h. All patients will be followed for up to 3 months.
Primary efficacy outcome will be the proportion of patients with carotid in-stent thrombosis within the first 24 h after MT. Primary safety outcome will be the rate of symptomatic intracranial hemorrhage.
This will be the first clinical trial to assess the best antiplatelet therapy to avoid in-stent thrombosis after MT in patients with TL.
The trial is registered as NCT05225961. February, 7th, 2022.
The polar regions provide valuable insights into the functioning of the Earth’s regulating systems. Conducting field research in such harsh and remote environments requires strong international ...cooperation, extended planning horizons, sizable budgets and long-term investment. Consequently, polar research is particularly vulnerable to societal and economic pressures during periods of austerity. The global financial crisis of 2008, and the ensuing decade of economic slowdown, have already adversely affected polar research, and the current COVID-19 pandemic has added further pressure. In this article we present the outcomes of a community survey that aimed to assess the main barriers and success factors identified by academic researchers at all career stages in response to these global crises. The survey results indicate that the primary barriers faced by polar early and mid-career researchers (EMCRs) act at institutional level, while mitigating factors are developed at individual and group levels. Later career scientists report pressure toward taking early retirement as a means of institutions saving money, reducing both academic leadership and the often unrecognized but vital mentor roles that many play. Gender and social inequalities are also perceived as important barriers. Reorganization of institutional operations and more effective strategies for long-term capacity building and retaining of talent, along with reduction in non-research duties shouldered by EMCRs, would make important contributions toward ensuring continued vitality and innovation in the polar research community.
Background:
In-stent thrombosis after mechanical thrombectomy (MT) worsen outcomes in acute ischemic stroke (AIS) due to tandem lesions (TL). Although an optimal antiplatelet therapy is needed, the ...best approach to avoid in-stent thrombosis is yet to be elucidated.
Hypothesis:
Low-dose intravenous tirofiban is superior to intravenous aspirin in avoiding in-stent thrombosis in patients undergoing MT plus carotid stenting in the setting of AIS due to TL.
Methods:
The ATILA-trial is a multicenter, prospective, phase IV, randomized, controlled (aspirin group as control), assessor-blinded clinical trial. Patients fulfilling inclusion criteria (AIS due to TL, ASPECTS ⩾ 6, pre-stroke modified Rankin Scale ⩽2 and onset <24 h) will be randomized (1:1) at MT onset to experimental (intravenous tirofiban) or control group (intravenous aspirin). Intravenous aspirin will be administered at a 500 mg single dose and tirofiban at a 500 µg bolus followed by a 200 µg/h infusion during first 22 h. All patients will be followed up to 3 months. Sample size estimated is 240 patients.
Outcomes:
The primary efficacy outcome is the proportion of patients with carotid in-stent thrombosis within the first 24 h after MT. The primary safety outcome is the rate of symptomatic intracranial hemorrhage. Secondary outcomes include functional independence defined as modified Rankin Scale 0–2, proportion of patients undergoing rescue therapy due to in-stent aggregation during MT and carotid reocclusion at 30 days.
Discussion:
ATILA-trial will be the first clinical trial regarding the best antiplatelet therapy to avoid in-stent thrombosis after MT in patients with TL.
Trial registration:
NCT0522596.
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