Electronic tracking technologies revolutionized wildlife ecology, notably for studying the movements of elusive species such as seabirds. Those advances are key to seabird conservation, for example ...in guiding the design of marine protected areas for this highly threatened group. Tracking data are also boosting scientific understanding of marine ecosystem dynamics in the context of global change. To optimize future tracking efforts, we performed a global assessment of seabird tracking data. We identified and mined 689 seabird tracking studies, reporting on > 28,000 individuals of 216 species from 17 families over the last four decades. We found substantial knowledge gaps, reflecting a historical neglect of tropical seabird ecology, with biases toward species that are heavier, oceanic, and from high‐latitude regions. Conservation status had little influence on seabird tracking propensity. We identified 54 threatened species for which we did not find published tracking records, and 19 with very little data. Additionally, much of the existing tracking data are not yet available to other researchers and decision‐makers in online databases. We highlight priority species and regions for future tracking efforts. More broadly, we provide guidance toward an ethical, rational, and efficient global tracking program for seabirds, as a contribution to their conservation.
Chemotherapy (three cycles of bleomycin + etoposide + cisplatin or four of etoposide + cisplatin) cures the vast majority of stage II seminomas. Retroperitoneal lymph node dissection (RPLND) is safe ...in early-stage seminoma, but the risk of relapse is not negligible. Long-term chemotherapy side effects are a reality but may be reduced using de-escalation strategies such as in the SEMITEP trial design, motivated by growing interest in survivorship. RPLND may be an option for well-informed select patients who understand that it may be associated with a higher rate of relapse than with cisplatin-based chemotherapy. In any case, local and systemic treatment should not be performed outside high-volume centers.
Introduction
Epstein‐Barr virus (EBV) is a herpesvirus linked to pre‐malignant lymphoproliferative diseases and up to nine distinct human tumors. The most frequent EBV‐associated malignancies are ...lymphomas and nasopharyngeal carcinoma. By promoting smooth muscle proliferation, EBV can induce EBV‐associated smooth muscle tumors (SMT) which remain a very rare oncological entity. This study reports one case report of SMT and aims to offer the largest review of literature on post‐transplantation‐SMT (PT‐SMT) in kidney transplant recipients, with a focus on therapeutic management and evolution of graft function.
Methods
Case reports and case series of PT‐SMT in kidney transplant recipients were collected from 1996 to 2019.
Results
A total of 59 PT‐SMT were evaluated. The median time at diagnosis was 74.6 months after kidney transplantation. The most frequent localizations were liver and lung. EBV seroconversion was notified in all six patients with previously negative status. Preferred therapeutic option was surgery (65.9%), associated with a reduction in immunosuppression (77.2%), which includes switch to mTOR inhibitors (29.5%), and discontinuation of MMF (32%). In our review, 13% of patients experienced rejection, 8.7% lost their graft and went back on hemodialysis; 8.8% of patients died of PT‐SMT.
Conclusion
PT‐SMT is a rare but serious condition in kidney transplant recipients. EBV seroconversion following transplantation appears as a risk factor in developing PT‐SMT in solid‐organ recipients. In the absence of guidelines, therapeutic management for PT‐SMT is challenging and exposes the patient to high risk of graft loss.
After failure of first line FOLFOX‐bevacizumab for metastatic colorectal cancer (mCRC), adding either bevacizumab or aflibercept to second‐line FOLFIRI increases survival compared to FOLFIRI alone. ...In this French retrospective multicentre cohort, we included patients with a mCRC treated with either FOLFIRI‐aflibercept or FOLFIRI‐bevacizumab. The primary endpoint was overall survival (OS), and secondary endpoints were progression‐free survival (PFS), disease control rate (DCR: CR + PR + SD) and safety. We included 681 patients from 36 centers, 326 and 355 in the aflibercept and bevacizumab groups, respectively. Median age was 64.2 years and 45.2% of patients were men. Most patients had RAS‐mutated tumors (80.8%) and synchronous metastases (85.7%). After a median follow up of 31.2 months, median OS was 13.0 months (95% CI: 11.3‐14.7) and 10.4 months (95% CI: 8.8‐11.4) in the bevacizumab and aflibercept groups, respectively (P < .0001). Median PFS was 6.0 months (95% CI: 5.4‐6.5) and 5.1 months (95% CI: 4.3‐5.6) (P < .0001). After adjustment on age, PS, PFS of first line, primary tumor resection, metastasis location and RAS/BRAF status, bevacizumab was still associated with better OS (HR: 0.71, 95% CI: 0.59‐0.86, P = .0003). FOLFIRI‐bevacizumab combination was associated with longer OS and PFS, and a better tolerability, as compared to FOLFIRI‐aflibercept after progression on FOLFOX‐bevacizumab.
What's new?
Second‐line treatment with chemotherapy plus an antiangiogenic agent such as bevacizumab or aflibercept is associated with improved survival among patients with metastatic colorectal cancer (mCRC) who failed first‐line therapy. Here, the efficacy of FOLFIRI plus bevacizumab or aflibercept was investigated in a retrospective, real‐world study in French mCRC patients. Compared to patients who received FOLFIRI plus aflibercept, those who received FOLFIRI plus bevacizumab had significantly improved overall and progression‐free survivals. FOLFIRI plus bevacizumab was also associated with superior tolerability. The findings warrant further investigation to determine whether FOLFIRI plus bevacizumab should be the second‐line therapy of choice for mCRC.
Health-related quality of life after surviving acute respiratory distress syndrome has come into focus in recent years, especially during the coronavirus disease 2019 pandemic.
A total of 144 ...patients with acute respiratory distress syndrome caused by COVID-19 or of other origin were recruited in a randomized multicenter trial.
Clinical data during intensive care treatment and data up to 180 days after study inclusion were collected. Changes in the Sequential Organ Failure Assessment score were used to quantify disease severity. Disability was assessed using the Barthel index on days 1, 28, 90, and 180.
Mortality rate and morbidity after 180 days were compared between patients with and without COVID-19. Independent risk factors associated with high disability were identified using a binary logistic regression.
The SOFA score at day 5 was an independent risk factor for high disability in both groups, and score dynamic within the first 5 days significantly impacted disability in the non-COVID group. Mortality after 180 days and impairment measured by the Barthel index did not differ between patients with and without COVID-19.
Resolution of organ dysfunction within the first 5 days significantly impacts long-term morbidity. Acute respiratory distress syndrome caused by COVID-19 was not associated with increased mortality or morbidity.
Abstract
Background
Venovenous extracorporeal membrane oxygenation (vvECMO) is used to treat hypoxia in patients with severe acute respiratory distress syndrome (ARDS). Nevertheless, uncertainty ...exists regarding the optimal timing of initiation of vvECMO therapy. We aimed to investigate the association between number of days of invasive mechanical ventilation (IMV) prior to vvECMO implantation and mortality.
Methods
In this retrospective observational study, we included patients treated at an academic intensive care unit with vvECMO for severe ARDS. The primary outcome was all-cause 28-day mortality. We conducted a multivariate logistic regression analysis to estimate the association between number of days of IMV prior to vvECMO implantation and mortality after adjustment for confounders.
Results
Out of 274 patients who underwent ECMO for severe ARDS, 158 patients (median age: 58 years) with relevant data were included in the analysis. The mean duration of IMV prior to vvECMO was significantly shorter in survivors than in nonsurvivors survivors median: 1; interquartile range: 1–3; non-survivors median 4; interquartile range: 1–5.75; p = 0.0001). Logistic regression showed an association between the duration of ventilation prior to vvECMO and patient mortality. The odds ratio for the all-cause 28-day mortality and in-hospital mortality was significantly reduced in patients who received vvECMO within the first 5 days of IMV.
Conclusions
Early vvECMO implantation may be associated with lower mortality in ARDS.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Lymphangiogenesis, the formation of lymphatic vessels, is tightly linked to the development of the venous vasculature, both at the cellular and molecular levels. Here, we identify a novel role for ...Sorbs1, the founding member of the SoHo family of cytoskeleton adaptor proteins, in vascular and lymphatic development in the zebrafish.
We show that Sorbs1 is required for secondary sprouting and emergence of several vascular structures specifically derived from the axial vein. Most notably, formation of the precursor parachordal lymphatic structures is affected in sorbs1 mutant embryos, severely impacting the establishment of the trunk lymphatic vessel network. Interestingly, we show that Sorbs1 interacts with the BMP pathway and could function outside of Vegfc signaling. Mechanistically, Sorbs1 controls FAK/Src signaling and subsequently impacts on the cytoskeleton processes regulated by Rac1 and RhoA GTPases. Inactivation of Sorbs1 altered cell-extracellular matrix (ECM) contacts rearrangement and cytoskeleton dynamics, leading to specific defects in endothelial cell migratory and adhesive properties.
Overall, using in vitro and in vivo assays, we identify Sorbs1 as an important regulator of venous and lymphatic angiogenesis independently of the Vegfc signaling axis. These results provide a better understanding of the complexity found within context-specific vascular and lymphatic development.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Accurate information on wildlife occurrence in anthropogenic landscapes is essential to develop effective conservation measures. Monitoring multiple mammal species in heterogeneous landscapes can be ...challenging because of the diversity of land‐uses and species behaviors. Therefore, different monitoring methods are better adapted to different contexts. We compared data obtained from camera traps with data gathered through an online survey to document the presence of mammal species in mosaic landscapes of the Garden Route Biosphere Reserve in South Africa. The survey detected the same 15 species as the camera traps as well as the additional common duiker. Both methods effectively detected most large mammal species, whereas results were less consistent for smaller species and carnivores. Combining the two methods enabled us to produce more robust estimates of species absence and confirm species presence reported by survey respondents. In less disturbed areas, respondents with good ecological knowledge were effective at monitoring mammal species, while extending the spatial coverage of the study. Bearing in mind the limitations of each method, camera traps and an online survey could complement each other if combined. Together, they can provide a more comprehensive understanding of mammal communities in anthropogenic landscapes, increasing both spatial coverage and the number of species sightings.
Data obtained from camera traps with data gathered through an online survey to document the presence of mammal species in anthropogenic landscapes proved consistent for detecting most large mammal species, whereas results were less consistent for smaller species and carnivores. Combining the two methods enabled researchers to produce more robust estimates of species absence and confirm species presence reported by survey respondents. Weaving both methods can provide a more comprehensive understanding of mammal communities in anthropogenic landscapes, increasing both spatial coverage and the number of species sightings.
Acute respiratory distress syndrome (ARDS) results in significant hypoxia, and ARDS is the central pathology of COVID-19. Inhaled prostacyclin has been proposed as a therapy for ARDS, but data ...regarding its role in this syndrome are unavailable. Therefore, we investigated whether inhaled prostacyclin would affect the oxygenation and survival of patients suffering from ARDS.
We performed a prospective randomized controlled single-blind multicenter trial across Germany. The trial was conducted from March 2019 with final follow-up on 12th of August 2021. Patients with moderate to severe ARDS were included and randomized to receive either inhaled prostacyclin (3 times/day for 5 days) or sodium chloride (Placebo). The primary outcome was the oxygenation index in the intervention and control groups on Day 5 of therapy. Secondary outcomes were mortality, secondary organ failure, disease severity and adverse events.
Of 707 patients approached 150 patients were randomized to receive inhaled prostacyclin (n = 73) or sodium chloride (n = 77). Data from 144 patients were analyzed. The baseline PaO
/FiO
ratio did not differ between groups. The primary analysis of the study was negative, and prostacyclin improved oxygenation by 20 mmHg more than Placebo (p = 0.17). Secondary analysis showed that the oxygenation was significantly improved in patients with ARDS who were COVID-19-positive (34 mmHg, p = 0.04). Mortality did not differ between groups. Secondary organ failure and adverse events were similar in the intervention and control groups.
The primary result of our study was negative. Our data suggest that inhaled prostacyclin might be beneficial treatment in patients with COVID-19 induced ARDS.
The study was approved by the Institutional Review Board of the Research Ethics Committee of the University of Tübingen (899/2018AMG1) and the corresponding ethical review boards of all participating centers. The trial was also approved by the Federal Institute for Drugs and Medical Devices (BfArM, EudraCT No. 2016003168-37) and registered at clinicaltrials.gov (NCT03111212) on April 6th 2017.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Based on animal and ex-vivo experiments, Growth/Differentiation Factor-15 (GDF15, also called Macrophage Inhibitory Cytokine-1, MIC1), a member of the transforming growth factor-beta family, and ...Matrix Metalloproteinase-9 (MMP9), a member of the matrix metalloprotease family may be potential markers for Lewy body disorders, i.e. Parkinson's disease with (PDD) and without dementia (PDND) and Lewy body dementia (DLB). GDF15 has a prominent role in development, cell proliferation, differentiation, and repair, whereas MMP9 degrades, as a proteolytic enzyme, components of the extracellular matrix. In this study, cerebrospinal fluid GDF15 and MMP9 levels of 59 PDND, 17 PDD and 23 DLB patients, as well as of 95 controls were determined, and associated with demographic, clinical and biochemical parameters. Our analysis confirmed the already described association of GDF15 levels with age and gender. Corrected GDF15 levels were significantly higher in PDD than in PDND patients, and intermediate in DLB patients. Within Lewy body disorders, GDF15 levels correlated positively with age at onset of Parkinsonism and dementia, Hoehn & Yahr stage and cerebrospinal fluid t-Tau and p-Tau levels, and negatively with the Mini Mental State Examination. Remarkably, it does not relevantly correlate with disease duration. MMP9 was not relevantly associated with any of these parameters. Cerebrospinal GDF15, but not MMP9, may be a potential marker of and in Lewy body disorders.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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