Objective: To evaluate the reliability of sagittal abdominal diameter (SAD)—a surrogate of visceral obesity—in MRI, and its accuracy to predict the surgical morbidity of aortic lymphadenectomy. Design: A multicentre reliability (phase 1) and accuracy (phase 2) cohort study. Setting: Three Spanish referral hospitals. Population: High-risk endometrial cancer patients undergoing minimally invasive surgical staging. Patients were classified into subgroups: conventional vs. robotic-assisted laparoscopy, and transperitoneal vs. extraperitoneal technique. Methods: Retrospective analysis of data from the STELLA-2 randomized controlled trial. In the first phase, we measured the agreement of three SAD measurements (at the umbilicus, the renal vein, and the inferior mesenteric artery) and selected the most reliable one. In phase two, we evaluated the diagnostic accuracy of SAD to predict surgical morbidity. Main Outcome Measures: surgical morbidity was defined by a core outcome set including variables related to blood loss, operative time, surgical complications, and para-aortic lymphadenectomy difficulty. Results: In phase one, all measurements showed good inter-rater and intra-rater agreement. Umbilical SAD was the most reliable one. In phase two, we included 136 patients. Umbilical SAD had a good diagnostic accuracy to predict surgical morbidity in patients undergoing transperitoneal laparoscopic lymphadenectomy (0.73 in ROC curve). It performed better than BMI and other anthropometric measurements. We calculated a cut-off point of 246 mm (sensitivity: 0.56 and specificity: 0.80). Conclusions: Umbilical SAD is a simple, reliable, and potentially useful measurement to predict surgical morbidity in endometrial cancer patients undergoing minimally invasive surgical staging, especially when facing transperitoneal aortic lymphadenectomy.

Algae are an attractive option for CO2 sequestration due to their natural ability to simultaneously fix CO2 and accumulate algal biomass for value-added products. However, the commercial implementation of such technology for efficient capture of CO2 from fossil-derived flue gases is not a reality yet due to several major challenges, such as low gas-liquid mass transport efficiency and relatively high light irradiance demand of algal growth. This study explored an algal-bacterial symbiotic system to utilize formate, a potential intermediate liquid compound of CO2, as carbon source to support microbial growth. The algal-bacterial assemblage, after an adaptive evolution using the formate medium, demonstrated a new route to assimilate CO2 without using high pH cultivations and promote biomass production under low light irradiance condition. The formate based culture system not only resolves CO2 mass transfer limitation, but also expels algae grazers in non-sterilized cultivation conditions. Continuous cultivation of the assemblage on formate led to a carbon capture efficiency of 90% with biomass concentration of 0.92 g/L and biomass productivity of 0.31 g/L/day, which is significantly better than the control cultivation on saturated CO2. In addition, isotope tracing and microbial community analysis offer new insights into formate metabolism and algal-bacterial symbiosis under light and carbon conditions. This study demonstrates a promising route of using electrochemical-derived formate to support algal biorefining.

Viral surrogates to screen for virus inactivation (VI) can be a faster, cheaper and safer alternative to third-party testing of pathogenic BSL2 (Biosafety Level 2) model viruses. Although the bacteriophage surrogate, Ø6, has been used to assess low pH BSL2 VI, it has not been used for evaluation of detergent-mediated VI. Furthermore, Ø6 is typically assayed through host cell infectivity which introduces the risk of cross-contaminating other cell lines in the facility. To circumvent contamination, we developed an in-house RT-qPCR (reverse transcriptase quantitative polymerase chain reaction) assay for selective detection of active Ø6 from a population of live and dead phage. The RT-qPCR assay was used to evaluate Ø6 inactivation in cell culture fluid of monoclonal antibody and fusion protein. Complementary Ø6 infectivity was also conducted at a third-party testing facility. The Ø6 RT-qPCR and infectivity data was modeled against VI of three BSL2 viruses, X- MuLV, A- MuLV and HSV-1 in corresponding therapeutics. Both Ø6 methods demonstrate that any VI agent showing Ø6 clearance of ≥ 2.5 logs would demonstrate complete BSL2 VI of ≥ 4.0 logs. Compared to BSL2 virus testing, this in-house Ø6 RT-qPCR tool can screen VI agents at 5% the cost and a turnaround time of 2-3 days versus 4-7 months.

Authors: Michael S. Crawford1,2,3,§,*, Kathryn E. Barry1,4,5§, Adam T. Clark1,6,7, Caroline E. Farrior8, Jes Hines1,9, Emma Ladouceur1,6,10, Jeremy W. Lichstein11, Isabelle Maréchaux12,13, Felix May14, Akira S. Mori15, Björn Reineking16, Lindsay A. Turnbull17, Christian Wirth1,4,16 & Nadja Rüger1,2,19 Affiliations:1 German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Puschstr. 4, 04103 Leipzig, Germany2 Institute of Empirical Economic Research, Department of Economics, University of Leipzig, Grimmaische Straße 12, 04109 Leipzig, Germany3 Department of Land-Use Management, Potsdam Institute for Climate Impact Research (PIK), Telegrafenberg, 14473 Potsdam, Germany4 Institute of Biology, University of Leipzig, Johannisallee 21-23, 04103 Leipzig, Germany 5 Ecology and Biodiversity Group, Department of Biology, Utrecht University, Utrecht,  Netherlands6 Department of Physiological Diversity, Helmholtz Centre for Environmental Research (UFZ), Permoserstraße 15, 04318 Leipzig, Germany7 Institute of Biology, University of Graz, Holteigasse 6, 8010 Graz, Austria8 Department of Integrative Biology, University of Texas at Austin, 2415 Speedway Austin, TX 78705, USA9 University of Leipzig, Puschstr. 4, 04107 Leipzig, Germany10 Biodiversity Synthesis, Institute of Computer Science, Martin Luther University Halle-Wittenberg, 06120 Halle (Saale), Germany11 Department of Biology, University of Florida, P.O. Box 118525, Gainesville, FL 32611, USA12 AMAP, Univ Montpellier, CIRAD, CNRS, INRAE, IRD, 34000 Montpellier, France13 Laboratoire Évolution et Diversité Biologique, UMR 5174 (CNRS/IRD/UPS), 118 Route de Narbonne, Toulouse Cedex 9 31062, France14 Freie Universität Berlin, Institute of Biology, Königin-Luise-Straße 2/4, Gartenhaus, 14195 Berlin, Germany15 Graduate School of Environment and Information Sciences, Yokohama National University, Yokohama, 240-8501, Japan16 Univ. Grenoble Alpes, INRAE, LESSEM, 38000 Grenoble, France17 Department of Plant Sciences, University of Oxford, South Parks Road, Oxford, England OX1 3RB18 Max-Planck-Institute for Biogeochemistry, Hans-Knöll-Str. 20, 07745 Jena, Germany19 Smithsonian Tropical Research Institute, Apartado 0843-03092, Balboa, Ancón, Panama § Joint first authors* Corresponding author: mscrawfor@gmail.com

A fundamental aspect of evolutionary biology is natural selection on trait variation. Classically, selection has been estimated primarily on external morphological traits such as beak size and coloration, or on easily-assayable physiological traits such as heat-tolerance. As technologies and methods improved, evolutionary biologists began examining selection on molecular traits such as protein sequences and cellular processes. In a From the Cover manuscript in this issue of Molecular Ecology, Ahmad et al. (2021) continue this trend by estimating parasite driven selection on the molecular trait of transcript abundance in a wild population of brown trout (Salmo trutta) by uniquely combining a mark-recapture experimental design with non-invasive RNA sampling. Using transcript abundance to estimate selection allows for many different traits (each unique gene’s transcript counts) to be tested in a single experiment, providing the opportunity to examine trends in selection. Ahmad et al.(2021) find directional selection strength on transcript counts is generally low and normally distributed. Surprisingly, transcripts under non-linear selection showed a disruptive selection bias contradicting previous comparative studies and theoretical work. This highlights the importance of within-generation selection studies, where mechanisms may differ from longer time frames. Their manuscript also highlights the benefits of an improved 3’ RNA sequencing technique to measure gene expression.

Predicting the fate of a microbial population (i.e., growth, gene expression…) remains a challenge, especially when this population is exposed to very dynamic environmental conditions, such as those encountered during continuous cultivation. Indeed, the dynamic nature of continuous cultivation process implies the potential deviation of the microbial population involving genotypic and phenotypic diversification. This work has been focused on the induction of the arabinose operon in Escherichia coli as a model system. As a preliminary step, the GFP level triggered by an arabinose-inducible ParaBAD promoter has been tracked by flow cytometry in chemostat with glucose-arabinose co-feeding. For a large range of glucose-arabinose co-feeding, the simultaneous occurrence of GFP positive and negative subpopulation was observed. In a second set of experiments, continuous cultivation was performed by adding either glucose or arabinose, based on the ability of individual cells for switching from low GFP to high GFP states, according to a technology called segregostat. In segregostat mode of cultivation, on-line flow cytometry analysis was used for adjusting the arabinose/glucose transitions based on the phenotypic switching capabilities of the microbial population. This strategy allowed finding an appropriate arabinose pulsing frequency, leading to a prolonged maintenance of the induction level with limited impact on phenotypic diversity for more than 60 generations. This result suggests that constraining individual cells into a given phenotypic trajectory is maybe not the best strategy for directing cell population. Instead, allowing individual cells switching around a predefined threshold seems to be a robust strategy leading to oscillating, but predictable, cell population behavior.

This paper is concerned with the inverse scattering of acoustic waves by an unbounded periodic elastic medium in the three-dimensional case. A novel uniqueness theorem is proved for the inverse problem of recovering a bi-periodic interface between acoustic and elastic waves using the near-field data measured only from the acoustic side of the interface, corresponding to a countably infinite number of quasi-periodic incident acoustic waves. The proposed method depends only on a fundamental a priori estimate established for the acoustic and elastic wave fields and a new mixed-reciprocity relation established in this paper for the solutions of the fluid-solid interaction scattering problem.

Objectives: Pneumothorax (PTX) in newborns is a life-threatening condition associated with high morbidity and mortality especially in premature infants. The frequency of PTX in neonates at different gestational ages (GA) and its impact on neonatal mortality have not been quantified. We aimed to determine: 1) the prevalence of PTX in neonates at different GA from ≤24 weeks to ≥37 weeks, 2) the impact of PTX on mortality per GA, and 3) the impact of PTX on the length of stay (LOS) per GA. Methods: The national Kids’ Inpatient Database (KID) for the years of 2006 to 2012 were used. We included all infants admitted to the hospital with a documented GA and ICD9 code of pneumothorax. Bivariate and multivariate analyses were conducted and odds ratios (OR) were calculated. Results: A total of 10 625 036 infants were included; of them 3665 infants (0.034 %) had a diagnosis of PTX, with highest prevalence at ≤24 weeks GA (0.67%), and lowest at term (0.02%). The overall mortality rate of patients with PTX was 8.8%, and greater in preterm (16.3%) vs. term infants (2.7%). The association of mortality with PTX was greatest at GA of 29−32 weeks (OR = 8.55 (95% CI: 6.56−11.13). Infants who survived until discharge had a median of 2–12 days longer length of stay depending on GA category. Conclusions: The prevalence of PTX peaks in infants <24 weeks, however its impact on mortality is greatest at 29-32 weeks. PTX is associated with longer length of stay in survivors.

Guillain-Barré syndrome (GBS) after surgery may be more common than previously recognized; however, GBS after open heart surgery is exceedingly rare. We describe a rare case of GBS occurring after aortic, tricuspid and mitral valve surgery and review the world’s literature. Vigilance for GBS among post-surgical patients is needed.

The case of a 45 year old female with chronic migraine undergoing treatment with erenumab 70 mg subcutaneous injection who developed Raynaud’s phenomenon (RP) as a side effect with relevant clinical implications two weeks after the second dose of erenumab injection.

Light pollution modelling and monitoring has traditionally used zenith sky brightness as its main indicator. Several other indicators (e.g. average sky radiance, horizontal irradiance, average sky radiance at given interval of zenith distances) may be more useful, both for general and for specific purposes of ecology studies, night sky and environmental monitoring. These indicators can be calculated after the whole sky radiance is known with sufficient angular detail. This means, for each site, to integrate the contribution in each direction of the sky of each light source in the radius of hundreds of km. This approach is extremely high time consuming if the mapping is desired for a large territory. Here we present a way to obtain maps of large territories for a large subset of useful indicators, bypassing the need to calculate first the radiance map of the whole sky in each site to obtain from it the desired indicator in that site. For each indicator, a point spread function (PSF) is calculated from the whole sky radiance maps generated by a single source at sufficiently dense number of distances from the observing site. If the PSF is transversally shift-invariant, i.e. if it depends only on the relative position of source and observer, then we can further speed up the map calculation via the use of fast Fourier-transform (FFT). We present here examples of maps for different indicators. Precise results can be calculated for any single site, taking into account the site and light sources altitudes, by means of specific inhomogeneous (spatially-variant) and anisotropic (non rotationally symmetric) PSFs.

The aim of this paper is to give a precise proof of the completeness of Lamb modes and associated modes. This proof is relatively simple and short but relies on two powerful mathematical theorems. The first one is a theorem on elliptic systems with a parameter due to Agranovich and Vishik. The second one is a theorem due to Locker which gives a criterion to show the completeness of the set of generalized eigenvectors of a Hilbert-Schmidt discrete operator.

Ethiopia has undergone significant land use change during the past centuries, particularly deforestation. These changes have resulted in the loss of topsoil as well as the associated soil ecosystem functions. Grazing exclusion and planting of eucalyptus are measures used to recover degraded lands and reduce deforestation, respectively. Using a gradient of the intensity of land use from natural forest to croplands, we investigated whether these measures also result in restoration of the soil microbial community. We identified the soil bacterial and fungal communities using paired-end amplicon sequencing. A total of 12,765 fungal and 12,325 bacterial OTUs were detected in the five land use types, and only ca. 2% and 17% were shared among the land uses, respectively. Total fungal and bacterial OTU richness was not significantly affected by land use change, but the conversion of forest to cropland resulted in the loss of approximately 40% and 11% of the total native fungal and bacterial OTUs, respectively. Soil pH, C, N, and aggregate stability were key factors corresponding to the overall bacterial and fungal community compositions. We also showed relationships between the microbial functional group and enzyme activities. The exclusion of grazing led to an enrichment of soil microbial communities that overlapped with the communities of the natural forest. Our results suggest that remnant native forests act as refugia for microbial communities and that restoration of microbial communities and concomitant recovery of ecosystem function via deintensification of land use is possible. Keywords: ectomycorrhiza, ericoid mycorrhiza, exclosure, microbial diversity, soil enzymes

Background and aim The aim of the study is to determine the LUTS and the factors affecting it among young women living in the dormitory. Methods The study is descriptive and cross-sectional. In the study, a total of 355 women attending education in a public university with a 95% confidence interval were interviewed. Data were collected using the descriptive form and the Bristol Female Lower Urinary Tract Symptoms Scale. Necessary permissions were obtained and appropriate analyzes were made with the SPSS-22 program. Results The average age of women is 20.21±1.62 (min=18, max=27). 40.8% of the participants have frequent urinary tract infections, about half (50.7%) of them have no knowledge about urinary tract infections. 71.6% of women have storage, 29.7% have urinating, 18.4% have incontinence, 8.8% have sexual life, and 37.2% have symptoms related to quality of life. Factors affecting the symptoms; history of chronic disease (such as neurological diseases, depression), smoking, low income, history of urinary incontinence in childhood, presence of symptoms in the mother or family history, the presence and number of urinary tract infections, chronic constipation, and not paying attention to toilet cleaning. Conclusion It is recommended to carry out community-based studies, to raise awareness of women, to support priority risk groups by screening, and to increase the number of specialist healthcare personnel for care and treatment.

Aim: Percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) are common surgical methods in the treatment of kidney stones. Possible effects on kidneys are an important factor in determining the surgical procedure and the surgical method. In our study, kidney injury molecule-1 (KIM-1) and myo-inositol oxygenase (MIOX) were used to compare acute kidney injury in patients that underwent PNL and RIRS. Material and Method:Eighty patients aged 20 to 75, who underwent PNL or RIRS in our urology clinic between November 2018 and February 2020 were included in the study. In this prospective study, the demographic characteristics, stone size, operation time, preoperative and postoperative hemoglobin and biochemistry values of the patients were recorded. 5 cc blood samples taken from the patients before the operation and at the fourth hour after the operation were centrifuged and kept at -80 °C, and the KIM-1 and MIOX levels were measured in the biochemistry department. Results: There was no difference between the groups in terms of demographic data; however,the operation time and length of hospital stay were significantly longer in the PNL group. The mean increase in MIOX was 10.583±9.73 ng/ml and 7.501±16.46 ng/ml in the PNL and RIRS groups, respectively. Although there was a statistically significant increase in both groups, this increase was greater in the PNL group. A significant increase was observed only in the PNL group in the postoperative period (p=0.003). Discussion and Conclusion:The findings of the study suggest that the PNL procedure causes more damage to the kidneys than RIRS.

Aims: Today, we have technology to break up a ureter stone in ureter as well as in renal pelvis during ureterorenoscopic procedures. In the past, when this option was not available, the surgeons improved several techniques and antiretropulsion devices in order not to let the stone migrate through renal pelvis. However, we still do not know whether it is advantageous to dust a stone in ureter where it is impacted or in a wider area such as renal pelvis. This study was carried out to clarify whether it is advantageous to breaking an upper ureter stone up where it is enclaved or in a wider area such as renal pelvis. Study Design: The data of 134 patients who underwent semirigid ureterorenoscopy (srURS) due to single and primary upper ureteral stones were included in our study and analyzed retrospectively. The patients were divided into two groups according to the development of spontaneous push-up during surgery (Group 1: non-push-up group, Group 2: push-up group). Results: Laboratory findings were changed significantly in both groups before and after surgery. However, this change was not significant between the groups. Operation times were statistically similar in both groups in contrast with the literature. Stone-free rates were significantly higher in srURS than in flexible ureterorenoscopy (fURS) (p<0,05). Complication rates were also found similar in this study. Conclusion: The application of srURS after fixing an upper ureter stone at its location using a Stone Cone® results in higher stone-free rates than pushing it back in order to dust it in renal pelvis. We recommend srURS supported by an antiretropulsion method as a treatment for upper ureteral stones.

Rampant structural inequality exists across human societies, exerting a powerful influence on the health of individuals around the globe. Differential access to -- and variation in -- material wealth contributes greatly to this imbalance. Intergenerational transfer of material wealth can advantage some individuals over less fortunate individuals, shaping divergent destinies and creating a hierarchy of privilege. This concept is familiar within the context of human economic and social systems, but we argue that privilege is not a uniquely human phenomenon. Rather, privilege has evolved multiple times and its phylogenetic reach may be startlingly widespread across the Tree of Life, raising the provocative possibility that comparative study of privilege may offer insights leading to effective strategies countering inequality in human societies.

1. Restoration ecology has historically focused on reconstructing communities of highly visible taxa whilst less visible taxa, such as invertebrates and microbes, are ignored. This is problematic as invertebrates and microbes make up the vast bulk of biodiversity and drive many key ecosystem processes, yet they are rarely actively reintroduced following restoration, potentially limiting ecosystem function and biodiversity in these areas. 2. In this review, we discuss the current (limited) incorporation of invertebrates and microbes in restoration and rewilding projects. We argue that these groups should be actively rewilded during restoration to improve biodiversity and ecosystem function outcomes and highlight how they can be used to greater effect in the future. For example, invertebrates and microbes are easily manipulated, meaning whole communities can potentially be rewilded through habitat transplants in a practice that we refer to as “whole-of-community” rewilding. 3. We provide a framework for whole-of-community rewilding and describe empirical case studies as practical applications of this under-researched restoration tool that land managers can use to improve restoration outcomes. 4. We hope this new perspective on whole-of-community restoration will promote applied research into restoration that incorporates all biota, irrespective of size, whilst also enabling a better understanding of fundamental ecological theory, such as colonisation- competition trade-offs. This may be a necessary consideration as invertebrates that are important in providing ecosystem services are declining globally; targeting invertebrate communities during restoration may be crucial in stemming this decline.

Marine Lenhart Syndrome (MLS) is caused by a coexistence of active thyroid nodules and Graves’ disease1. Here, we present a case of hyperthyroidism characterized by the presence of stimulating TSH receptor antibodies, unsuccessful radioactive iodine ablation, ultimately requiring Methimazole followed by thyroidectomy. We review the current literature.

Acute esophageal necrosis (AEN), commonly referred to as “black esophagus”, is a rare clinical disease. Though AEN remains a rare cause of upper gastrointestinal bleeding, it is a potentially life-threatening condition. We present a case of AEN associated with diabetic ketoacidosis.

Species delimitation among closely related species is challenging because traditional phenotype-based approaches, e.g., morphology, ecological, or chemical characteristics, often produce conflicting results. With the advent of high-throughput sequencing, it has become increasingly cost-effective to acquire genome-scale data which can resolve previously ambiguous species boundaries. As the availability of genome-scale data has increased, numerous species delimitation analyses, such as BPP and SNAPP+Bayes factor delimitation (BFD*), have been developed to delimit species boundaries. However, even empirical molecular species delimitation approaches can be biased by confounding evolutionary factors, e.g., hybridization/introgression and incomplete lineage sorting, and computational limitations. Here we investigate species boundaries and the potential for micro-endemism in a lineage of lichen-forming fungi, Niebla Rundel & Bowler in the family Ramalinaceae. The species delimitation models tend to support more specious groupings, but were unable to infer robust, consistent species delimitations. The results of our study highlight the problem of delimiting species, particularly in groups such as Niebla, with complex, recent phylogeographic histories.

Appendiceal diseases are relatively rare reported complications during hematopoietic stem cell transplantation with no guidance on management. Pre- and post-transplant patients should receive a trial of medical therapy with appendectomy after recovery but prior to transplant in the former and plan for appendectomy after completion of immunosuppression in the latter.

Background Open aortic arch surgery is a complex cardiac surgical procedure. Aims We have reviewed the 10-year outcomes of elective surgery for aortic arch aneurysm in the Cardiac Surgery Department, Upper-Silesian Medical Center of the Medical University of Silesia. Methods The analysis includes all patients who underwent elective aortic arch surgery at our institution from January 2010 to December 2020. To assess the impact of the surgical learning curve the study population was divided into group A consisting of patients operated during the first 5 years, and group B, including patients operated during the subsequent 5 years. Both groups were compared with regard to baseline characteristics, scope of the surgery, operative and postoperative data as well as morbidity and mortality. Results Eighty-six elective aortic arch surgeries were performed during the analyzed period, including 25 patients (29%) in group A and 61 patients in group B (71%). The hemiarch procedure was more frequently performed in group A (17 patients, 68%) in comparison to group B (21 patients, 34%) (P=0.008). More procedures on the descending aorta were performed in group B (27 patients, 44%) than in group A (6 patients, 24%) (P=0.09). Stroke was recorded in 6 patients (20%) from group A and 5 patients (8.2%) from group B (P=0.002). Five-year survival was 60±9.8% for group A, and 81±6.2% for group B (log-rank test, P=0.003). Conclusions After completion of the learning curve, open aortic arch surgery is associated with acceptable early mortality, low incidence of stroke, and high 5-year survival rate.

Kidney microphysiological systems (MPS) serve as valuable preclinical instruments in recapitulating physiological conditions and determining underlying interactions involved in renal clearance and osmoregulation. Current kidney MPS models target individual regions of the nephron, such as the glomerulus and proximal tubule, but fail to incorporate multiple filtration and absorption interfaces. In the current study, an in vitro MPS features key filtration and reabsorption properties of the human glomerulus and proximal tubule for seven days of operation. Three human-derived cell types, including the conditionally immortalized human podocytes (CIHP-1), human umbilical vein endothelial cells (HUVECs), and human proximal tubule cells (HK-2), were adapted to serum-free medium prior to being seeded into the three-component MPS (T-Junction splitter, glomerular housing unit, and parallel proximal tubule barrier model), which was optimized using in silico computational modeling. The tri-culture MPS successfully filtered blood serum protein, resorbed glucose, and generated filtrate. This glomerulus and proximal convoluted tubule MPS is a novel system for both human-relevant testing and examining pharmacokinetic interactions.