Assembly of functional diversity in an oceanic island flora

Oceanic island floras are well known for their morphological peculiarities and exhibit striking examples of trait evolution1-3. These morphological shifts are commonly attributed to insularity and are thought to be shaped by the biogeographical processes and evolutionary histories of oceanic islands2,4. However, the mechanisms through which biogeography and evolution have shaped the distribution and diversity of plant functional traits remain unclear5. Here we describe the functional trait space of the native flora of an oceanic island (Tenerife, Canary Islands, Spain) using extensive field and laboratory measurements, and relate it to global trade-offs in ecological strategies. We find that the island trait space exhibits a remarkable functional richness but that most plants are concentrated around a functional hotspot dominated by shrubs with a conservative life-history strategy. By dividing the island flora into species groups associated with distinct biogeographical distributions and diversification histories, our results also suggest that colonization via long-distance dispersal and the interplay between inter-island dispersal and archipelago-level speciation processes drive functional divergence and trait space expansion. Contrary to our expectations, speciation via cladogenesis has led to functional convergence, and therefore only contributes marginally to functional diversity by densely packing trait space around shrubs. By combining biogeography, ecology and evolution, our approach opens new avenues for trait-based insights into how dispersal, speciation and persistence shape the assembly of entire native island floras.

Think globally, measure locally: The MIREN standardized protocol for monitoring plant species distributions along elevation gradients

Climate change and other global change drivers threaten plant diversity in mountains worldwide. A widely documented response to such environmental modifications is for plant species to change their elevational ranges. Range shifts are often idiosyncratic and difficult to generalize, partly due to variation in sampling methods. There is thus a need for a standardized monitoring strategy that can be applied across mountain regions to assess distribution changes and community turnover of native and non‐native plant species over space and time. Here, we present a conceptually intuitive and standardized protocol developed by the Mountain Invasion Research Network (MIREN) to systematically quantify global patterns of native and non‐native species distributions along elevation gradients and shifts arising from interactive effects of climate change and human disturbance. Usually repeated every five years, surveys consist of 20 sample sites located at equal elevation increments along three replicate roads per sampling region. At each site, three plots extend from the side of a mountain road into surrounding natural vegetation. The protocol has been successfully used in 18 regions worldwide from 2007 to present. Analyses of one point in time already generated some salient results, and revealed region‐specific elevational patterns of native plant species richness, but a globally consistent elevational decline in non‐native species richness. Non‐native plants were also more abundant directly adjacent to road edges, suggesting that disturbed roadsides serve as a vector for invasions into mountains. From the upcoming analyses of time series, even more exciting results can be expected, especially about range shifts. Implementing the protocol in more mountain regions globally would help to generate a more complete picture of how global change alters species distributions. This would inform conservation policy in mountain ecosystems, where some conservation policies remain poorly implemented.

[AKTIN - The German Emergency Department Data Registry - real-time data from emergency medicine : Implementation and first results from 15 emergency departments with focus on Federal Joint Committee's guidelines on acuity assessment]

Hintergrund

Die Notfallversorgung befindet sich im Umbruch. In Notaufnahmen werden Patienten ausgehend von Symptomen und Dringlichkeit versorgt; dies bildet sich jedoch in den etablierten Routinedaten der gesetzlichen Sozialversicherung nicht ab. Ziel des AKTIN-Projekts war der Aufbau einer datenschutzkonformen Registerinfrastruktur zur Nutzung von klinischen Routinedaten aus Notaufnahmen.

Methoden

Über eine standardisierte Schnittstelle werden aus den verschiedenen Dokumentationssystemen kontinuierlich Daten der Notaufnahmebehandlung in ein lokales Data Warehouse exportiert. Dort stehen sie sowohl für lokale Nutzungen, wie interne Berichte und Qualitätsmanagement, als auch gleichzeitig datenschutzkonform für multizentrische Auswertungen zur Verfügung.

Anhand der Registerpopulation wird die Ersteinschätzung sowie die Erhebung von Vitalparametern in Abhängigkeit von Vorstellungsgründen für einen 12-Monats-Zeitraum analysiert.

Ergebnisse

Für den Zeitraum 04/2018 bis 03/2019 wurden 436.149 gültige Fälle aus 15 Notaufnahmen übermittelt. In 86,0 % der Fälle ist eine Ersteinschätzung dokumentiert.

Diese fand in 70,5 % innerhalb von 10 min nach Ankunft des Patienten statt. In 10 Kliniken wird regelhaft (82,3 %) ein Vorstellungsgrund erfasst. Die Erfassung von Vitalparametern variiert plausibel zwischen den Vorstellungsgründen.

Schlussfolgerung

Das AKTIN-Notaufnahmeregister bietet einen zeitnahen Einblick in das Versorgungsgeschehen der Notaufnahmen ohne zusätzlichen Dokumentationsaufwand und unabhängig vom primären IT-System, Kostenträger, Fallart und Abrechnungsmodus. Die Vorgaben des Gemeinsamen Bundesausschusses zur Ersteinschätzung werden weitgehend umgesetzt. Durch die Etablierung von standardisierten Vorstellungsgründen werden symptombasierte Analysen und Gesundheitssurveillance ermöglicht.

Zusatzmaterial online

Die Onlineversion dieses Beitrags (10.1007/s00063-020-00764-2) enthält die Abb. S1 und S2. Beitrag und Zusatzmaterial stehen Ihnen auf www.springermedizin.de zur Verfügung. Bitte geben Sie dort den Beitragstitel in die Suche ein, das Zusatzmaterial finden Sie beim Beitrag unter „Ergänzende Inhalte“.

Nuevos xenófitos de La Palma (Islas Canarias, España), con énfasis en las especies naturalizadas y (potencialmente) invasoras. Parte 3

Varios meses de trabajos de campo en La Palma (Islas Canarias occidentales) han posibilitado el descubrimiento de nuevas plantas vasculares no nativas. Alstroemeria aurea, A. ligtu, Anacyclus radiatus subsp. Radiatus, Chenopodium album subsp. borbasii, Cotyledon orbiculata, Cucurbita ficifolia, Cynodon nlemfuensis, Datura stramonium subsp. tatula, Digitaria ciliaris var. rhachiseta, D. ischaemum, Diplotaxis tenuifolia, Egeria densa, Eugenia uniflora, Galinsoga quadriradiata, Glebionis segetum, Kalanchoe laetivirens, Lemna minuta, Ligustrum lucidum, Lotus broussonetii, Oenothera fallax, Paspalum notatum, Passiflora caerulea, P. manicata × tarminiana, P. tarminiana, Pelargonium capitatum, Phaseolus lunatus, Portulaca trituberculata, Pyracantha angustifolia, Sedum mexicanum, Trifolium lappaceum, Urochloa mutica, U. subquadripara y Volutaria tubuliflora son xenófitos naturalizados o (potencialmente) invasores o de especial interés florístico, que se citan por primera vez para las Islas Canarias o para la isla de La Palma. Tres táxones adicionales, probablemente casuales, se dan a conocer por primera vez de las Islas Canarias, y siete táxones de la isla de La Palma.

Laparoscopic therapy of the coeliac artery compression syndrome: a critical analysis of the current standard procedure

INTRODUCTION

Median arcuate ligament syndrome has been known anatomically for approximately 100 years and results from a compression of the coeliac axis by fibrous attachment of the diaphragmatic crura. Owing to the rarity of the disease and limited available data, many aspects of treatment are controversial. Currently, laparoscopic decompression is considered by several authors as standard surgical procedure. We present an analysis of the clinical routine of MALS therapy.

METHODS

We conducted a prospective observational trial in patients with MALS between March 2016 and August 2018, in which clinical symptoms, diagnostic evaluation, procedures with complication analysis and follow-up data were recorded.

RESULTS

A total of 18 patients (12 female, 6 male) with MALS, aged between 15 and 65 years, were included in this study. All patients presented with long-standing abdominal pain. Preoperative Doppler ultrasonography showed a flow velocity of the coeliac artery averaging 289.9cm/second in mid-position of the diaphragm, 285.9cm/second in expiration and 199.0cm/second in inspiration. All operated patients underwent laparoscopic decompression; two patients received an angiographic intervention. Postoperatively, a significant decrease of the flow velocity in mid-position of the diaphragm was detected (P = 0.018). At follow-up after 5.2 months, 50.0% of the patients were pain-free, 37.5% reported symptomatic relief and 12.5% showed evidence for a recurrence.

CONCLUSION

MALS is challenging both diagnostically and therapeutically. Laparoscopy with release of the median arcuate ligament is an essential part of the therapy and can be confirmed by Doppler ultrasonography. Disease outcome is also influenced by several predictive factors.

[Gender-specific differences of the early postoperative and oncosurgical long-term outcome in rectal cancer-data obtained in a prospective multicenter observational study]

BACKGROUND

Gender-specific aspects have been increasingly considered in clinical medicine, also in oncological surgery.

AIM

To analyze gender-specific differences of early postoperative and oncological outcomes after rectal cancer resection based on data obtained in a prospective multicenter observational study.

PATIENTS AND METHODS

As part of the multicenter prospective observational study "Quality assurance in primary rectal cancer", data on tumor site, exogenic and endogenic risk factors, neoadjuvant treatment, surgical procedures, tumor stage, intraoperative and postoperative complications of patients with the histological diagnosis of rectal cancer were registered. Data from the years 2005-2006 and 2010-2011 were investigated with respect to gender-specific differences of postoperative morbidity, hospital mortality, local recurrency rate, disease-free and overall survival by univariable and multivariable analyses.

RESULTS

Overall, data from 10,657 patients were evaluated: 60.9% of the patients were male, who were significantly younger (p < 0.001). Men had a significantly higher rate of alcohol (p < 0.001) and nicotine abuse (p < 0.001) as well as a trend to a higher body mass index (BMI) compared with women. Although, there was no significant difference in the distribution of various tumor stages comparing men and women, neoadjuvant radiochemotherapy was used significantly more often in male patients (p < 0.001). In addition, male patients underwent an abdominoperineal rectum exstirpation more often, whereas creation of an enterostoma and Hartmann's procedure were more frequently used in women (p < 0.001 each). Multivariate analysis revealed that male patients developed a higher overall morbidity (odds ratio, OR: 1.5; p < 0.001) during both study periods and from 2010-2011 a higher hospital mortality (OR: 1.8; p < 0.001). After a median follow-up period of 36 months, gender did not have a significant impact on overall survival, disease-free survival or on the local tumor recurrency. The 5‑year overall survival was 60.5%, disease-free survival 63.8% and local recurrency rate was 5%.

CONCLUSION

Independent of other variables, gender differences were found with respect to early postoperative outcome but not to oncological long-term results after surgery of rectal cancer.

Minimally invasive video-assisted thyroidectomy: a critical analysis of long-term cosmetic results using a validated tool

INTRODUCTION

Since its first publication in 1997, minimally invasive video-assisted thyroidectomy (MIVAT) has developed into the predominant minimally invasive surgery of the thyroid. A major advantage over conventional thyroid surgery is the superior cosmetic result. However, there are still few data comparing the long-term cosmetic results of the two methods. This paper compares the long-term cosmetic results of the two methods, based on follow-up assessments.

METHODS

Between 2004 and 2011, 143 preselected patients underwent a MIVAT in our department. Additionally, 134 patients underwent a conventional thyroidectomy in our hospital in 2011. A total of 117 patients from the MIVAT group and 102 patients from the conventional thyroidectomy group received follow-up assessments after 23.1 and 23.6 months, respectively, using the patient and observer scar assessment scale.

RESULTS

The measurable cervical scar length averaged 1.9 cm in the MIVAT group and 3.9 cm in the conventional group (P < 0.001). Some 11.1% of the patients in the MIVAT group and 7.1% of the patients in the conventional group had developed keloid (P = 0.391). The patient scar assessment score was 10.4 for the MIVAT group compared with 9.9 for the conventional thyroidectomy group (P = 0.691) and the observer scare assessment score was 8.6 for MIVAT compared with 9.9 for conventional thyroidectomy (P = 0.011).

CONCLUSION

In the patient assessment instrument, conventional thyroidectomy had a small advantage over MIVAT in the cosmetic long-term results. This difference between the two groups was, however, not significant. Our result contradicts short-term cosmetic results of published randomized studies with improvement for MIVAT. The Observer Score demonstrates a significant advantage of the MIVAT.

Investigation of a New Version of the Liquid Embolic Agent PHIL with Extra-Low-Viscosity in an Endovascular Embolization Model

BACKGROUND AND PURPOSE

The type and composition of an embolic agent have a relevant influence on the performance of endovascular embolization. The aim of this study was to investigate a new version of the liquid embolic agent precipitating hydrophobic injectable liquid (PHIL) with extra-low-viscosity in an in vivo embolization model.

MATERIALS AND METHODS

Twenty-four embolization procedures were performed in the porcine rete mirabile. Eight embolizations were performed with PHIL 25% low viscosity, Squid 12, and standard PHIL 25%, respectively. Procedure time, required volume of embolic agent, visibility of the embolic agent, embolization control, embolization extent (ie, penetration of the rete mirabile), amount of reflux, and degree of embolization distal to the rete mirabile were assessed.

RESULTS

All embolic agents were adequately visible. The embolization extent was not significantly different among the 3 investigated agents; however, there was a tendency toward a higher embolization extent for PHIL 25% low viscosity (median embolization extent: 88% [PHIL 25% low viscosity]; 65% [Squid 12]; 60% [PHIL 25%]; P = .146). The amount of reflux was significantly lower for the extra-low-viscosity agents PHIL 25% low viscosity and Squid 12 compared with the standard PHIL 25% (median reflux distance: 8 mm [PHIL 25% low viscosity]; 6 mm [Squid 12]; 17 mm [PHIL 25%]; P = .011). All other embolization features did not differ among agents.

CONCLUSIONS

PHIL 25% low viscosity is a promising liquid embolic agent for endovascular embolization, featuring effective distal penetration, adequate visibility, a low amount of reflux, and good flow control.

Nuevos xenófitos de La Palma (Islas Canarias, España), con énfasis en las especies naturalizadas y (potencialmente) invasoras. Parte 2

Varios meses de trabajos de campo en La Palma (Islas Canarias occidentales) han posibilitado el descubrimiento de nuevas plantas vasculares no nativas. Abutilon theophrasti, Agrostis xfouilladeana, Alternanthera brasiliana, Bupleurum salicifolium subsp. salicifolium, Callisia fragrans, Emilia coccinea, Hyparrhenia sinaica, Ipomoea purpurea, Jasminum polyanthum, Macfadyena unguis-cati, Malvastrum coromandelianum subsp. coromandelianum, Misopates calycinum, Nephrolepis cordifolia, Opuntia microdasys, Passiflora subpeltata, Plantago lanceolata, Polygonum aviculare subsp. rurivagum, Pseudogynoxys chenopodioides, Psidium littorale, Robinia pseudoacacia, Rosa micrantha, Rumex bucephalophorus subsp. gallicus, Sorghum bicolor subsp. verticilliflorum, Sphagneticola trilobata, Syzygium jambos, Thunbergia alata y Youngia japonica subsp. japonica son xenófitos naturalizados o (potencialmente) invasores, se citan por primera vez para las Islas Canarias o para La Palma. Se dan a conocer por primera vez 14 t·axones adicionales, probablemente casuales, de las Islas Canarias y 15 taxones de la isla de La Palma.

Nuevos xenófitos de La Palma (Islas Canarias, España), con énfasis en las especies naturalizadas y (potencialmente) invasoras

Varios años de trabajos de campo en La Palma (Islas Canarias occidentales) han posibilitado el descubrimiento de nuevas plantas vasculares no nativas. Amaranthus blitoides, A. deflexus, Aptenia cordifolia, Argemone ochroleuca, Begonia schmidtiana, Capsella rubella, Cardamine hamiltonii, Centratherum punctatum, Cerastium fontanum subsp. vulgare, Chasmanthe floribunda (ampliamente confundida con C. aethiopica y Crocosmia xcrocosmiiflora en Macaronesia), Chenopodium probstii, Commelina latifolia var. latifolia, Dichondra micrantha, Dysphania anthelmintica, Epilobium ciliatum, Erigeron sumatrensis, Erodium neuradifolium, Eucalyptus globulus, Euphorbia hypericifolia, E. maculata, Gamochaeta antillana, Geranium pyrenaicum, Hedychium coronarium, Hypochaeris radicata, Kalanchoe daigremontiana, K. delagoensis, K. xhoughtonii, Kickxia commutata subsp. graeca, K. spuria subsp. integrifolia, Lactuca viminea subsp. ramosissima, Landoltia punctata, Malvastrum coromandelianum subsp. capitatospicatum, Oenothera jamesii, Orobanche nana, Oxalis latifolia, Papaver hybridum, P. setigerum, Pilea microphylla, Podranea ricasoliana, Polygonum arenastrum, Portulaca granulatostellulata, P. nicaraguensis, P. nitida, P. papillatostellulata, Rumex crispus subsp. crispus, R. pulcher subsp. pulcher, R. xpratensis, Sechium edule, Sida spinosa var. angustifolia, Silene nocturna, Solanum abutiloides, S. alatum, S. decipiens, Sonchus tenerrimus, Spergularia marina, Stellaria pallida, Tragopogon porrifolius subsp. australis, Tribulus terrestris y Trifolium repens subsp. repens son xenófitos naturalizados o (potencialmente) invasores, que se citan por primera vez para las Islas Canarias o para la isla de La Palma. 37 táxones adicionales, probablemente casuales, se dan a conocer por primera vez de las Islas Canarias, y 56 táxones de la isla de La Palma.

Bioclimatic and vegetation mapping of a topographically complex oceanic island applying different interpolation techniques

Different spatial interpolation techniques have been applied to construct objective bioclimatic maps of La Palma, Canary Islands. Interpolation of climatic data on this topographically complex island with strong elevation and climatic gradients represents a challenge. Furthermore, meteorological stations are not evenly distributed over the island, with few stations at high elevations. We carried out spatial interpolations of the compensated thermicity index (Itc) and the annual ombrothermic Index (Io), in order to obtain appropriate bioclimatic maps by using automatic interpolation procedures, and to establish their relation to potential vegetation units for constructing a climatophilous potential natural vegetation map (CPNV). For this purpose, we used five interpolation techniques implemented in a GIS: inverse distance weighting (IDW), ordinary kriging (OK), ordinary cokriging (OCK), multiple linear regression (MLR) and MLR followed by ordinary kriging of the regression residuals. Two topographic variables (elevation and aspect), derived from a high-resolution digital elevation model (DEM), were included in OCK and MLR. The accuracy of the interpolation techniques was examined by the results of the error statistics of test data derived from comparison of the predicted and measured values. Best results for both bioclimatic indices were obtained with the MLR method with interpolation of the residuals showing the highest R2 of the regression between observed and predicted values and lowest values of root mean square errors. MLR with correction of interpolated residuals is an attractive interpolation method for bioclimatic mapping on this oceanic island since it permits one to fully account for easily available geographic information but also takes into account local variation of climatic data.

[Iatrogenic splenic injuries in surgery of colorectal carcinoma: impact on the oncological long-term of outcome]

INTRODUCTION

Iatrogenic lesions of the spleen during surgery of colorectal carcinoma is considered a significant risk factor for a worse early postoperative outcome. With regard to the impact of iatrogenic splenic lesions particularly associated with splenectomy on the oncological long-term outcome, only limited valid data are available.

METHODS

Data obtained in a prospective multicenter observational study were analyzed. The study enrolled 45,265 patients with surgery for colorectal carcinoma in curative and palliative intentions during the study period from 01 January 2000 to 31 December 2004, with regard to the impact of iatrogenic splenic lesions on survival rates.

RESULTS AND CONCLUSION

Follow-up data with corresponding informed consent were obtained from 564 patients with iatrogenic splenic lesions, resulting in a follow-up rate of 99.8 %. The median follow-up period was 50.2 months. The median 5-year overall survival was 4.8 years in group I (splenic lesion with splenectomy) and in group II (splenic lesion with organ preservation) 8.0 years (p = 0.009). Between group II (splenic lesion with organ preservation) and group III (control group with no splenic lesion) there were no significant differences with regard to long-term survival. Using multivariate Cox regression analysis, iatrogenic splenic lesions with splenectomy were identified as an independent risk factor for a worse oncological long-term outcome.

The anagenetic world of spore-producing land plants

A fundamental challenge to our understanding of biodiversity is to explain why some groups of species diversify, whereas others do not. On islands, the gradual evolution of a new species from a founder event has been called 'anagenetic speciation'. This process does not lead to rapid and extensive speciation within lineages and has received little attention. Based on a survey of the endemic bryophyte, pteridophyte and spermatophyte floras of nine oceanic archipelagos, we show that anagenesis, as measured by the proportion of genera with single endemic species within a genus, is much higher in bryophytes (73%) and pteridophytes (65%) than in spermatophytes (55%). Anagenesis contributed 49% of bryophyte and 40% of endemic pteridophyte species, but only 17% of spermatophytes. The vast majority of endemic bryophytes and pteridophytes are restricted to subtropical evergreen laurel forests and failed to diversify in more open environments, in contrast with the pattern exhibited by spermatophytes. We propose that the dominance of anagenesis in island bryophytes and pteridophytes is a result of a mixture of intrinsic factors, notably their strong preference for (sub)tropical forest environments, and extrinsic factors, including the long-term macro-ecological stability of these habitats and the associated strong phylogenetic niche conservatism of their floras.

[Surgical treatment of carcinomas of the oesophagogastric junction - results achieved in multicentre studies]

BACKGROUND

Adenocarcinomas of the oesophagogastric junction are increasingly being considered as a separated tumour entity. The prognosis is rather poorer compared with that for distal gastric cancer. Data from a multicentre study as part of research on clinical care aim to reflect the current situation in surgical treatment after inauguration of neoadjuvant modalities.

PATIENTS AND METHOD

As part of the ongoing prospective multicentre observational study QCGC 2 (German Gastric Cancer Study 2), 544 adenocarcinomas of the oesophagogastric junction (AEG 1-3) were registered from 01/01/2007 to 12/31/2009.

RESULTS

Patients underwent surgical intervention in 108 (76.6 %) of the 141 surgical departments which provided data to the study. In 391 patients (82.5 %), R0 resection was achieved. Almost 60 % of the carcinomas of the oesophagogastric junction were approached in departments with no more than 10 of these tumour lesions through the whole study period (3 years). Endoscopic ultrasonography was performed in 283 cases (53 %); the rate of neoadjuvant treatment was 34.4 % (n = 187). Intraoperative fresh frozen section was only included in intraoperative decision-making in 242 patients (60.8 %). In the revealed heterogeneous spectrum of surgical interventions, a limited number of transthoracic approaches (20 %) and a mediastinal lymphadenectomy rate of only 47 % were found. Hospital lethality was 6.6 %. In the adenocarcinomas of the oesophagogastric junction, a significantly lower median survival (25 months) compared with distal gastric cancer (38 months) was observed depending on the tumour stage. In addition, 5-year survival rate of AEG patients (33.1 %) was distinctly lower than for patients with distal gastric cancer (41.4 %). There was no significantly better survival by neoadjuvant treatment in the group of investigated patients.

CONCLUSION

The results in the treatment of carcinomas of the oesophagogastric junction in the multicentre setting including surgical departments of each profile and region even after introduction of multimodal therapeutic concepts are not satisfying. In particular, modern diagnostic and surgical strategies need to be widely used or their percentage has to be increased. In this context, centralisation of the surgical care of this specific tumour entity appears reasonable.

Plasmid DNA in Streptococcus cremoris Wg2: Influence of pH on Selection in Chemostats of a Variant Lacking a Protease Plasmid

Cleared lysates of a proteolytic (Prt) strain and a naturally occurring non-proteolytic (Prt) variant of Streptococcus cremoris Wg2 contain equal amounts of covalently closed circular plasmid DNA. An analysis of this plasmid DNA by agarose gel electrophoresis revealed the presence of at least five different plasmid species in the Prt strain and only three plasmid species in the Prt variant. Curing studies with acriflavine indicated that a 16-megadalton plasmid determined proteolytic activity in the Prt strain. In energy-limited chemostats inoculated with both strains it was observed that the Prt strain was replaced by the Prt variant. This effect was most apparent when the pH of the culture was fixed at a value above 6.3. No selection for the Prt variant was observed at pH 5.9. Since the two types of organisms contain equal amounts of plasmid DNA, it was concluded that the energy gain of the Prt variants at pH values above 6.0 probably has to be found in protein synthesis rather than in plasmid DNA synthesis.