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Rezension von: Moser, Rudolph Friedrich von (1845): Beschreibung des Oberamts Welzheim. Mit einer Karte des Oberamts, einer Ansicht von Welzheim und vier Tabellen. Stuttgart, Tübingen: Cotta (Beschreibung des Königreichs Württemberg, 22). Fromm, Christian Ludwig (1847): Beschreibung des Oberamts Gerabronn. Mit einer Karte des Oberamts, einer Ansicht von Kirchberg u. vier Tabellen. Stuttgart, Tübingen: Cotta (Beschreibung des Königreichs Württemberg, 24). Moser, Rudolph Friedrich von (1847): Beschreibung des Oberamts Hall. Mit einer Karte des Oberamts, einer Ansicht von Hall und vier Tabellen. Stuttgart, Tübingen: Cotta (Beschreibung des Königreichs Württemberg, 23). Moser, Rudolph Friedrich von (1852): Beschreibung des Oberamts Gaildorf. Mit drei Tabellen und einer Karte des Oberamts, nebst Titelbild und einem Holzschnitt. Stuttgart: Müller (Beschreibung des Königreichs Württemberg, 31).Paulus, Eduard (1853): Beschreibung des Oberamts Besigheim. Mit drei Tabellen und einer Karte des Oberamts, nebst Titelbild und vier Holzschnitten. Stuttgart: Müller (Beschreibung des Königreichs Württemberg, 32). Bauer, Hermann (1854): Beschreibung des Oberamts Aalen. Mit drei Tabellen und einer Karte des Oberamts, nebst Titelbild. Stuttgart: Müller (Beschreibung des Königreichs Württemberg, 33). Dillenius, Ferdinand Ludwig Jakob (1861): Beschreibung des Oberamts Weinsberg. Mit drei Tabellen, einer Karte des Oberamts, zwei Ansichten und einem Holzschnitt. Stuttgart: Aue (Beschreibung des Königreichs Württemberg, 43). Titot, Heinrich (1865): Beschreibung des Oberamts Heilbronn. Mit drei Tabellen, einer Karte des Oberamts und zwei Ansichten. Stuttgart: Lindemann (Beschreibung des Königreichs Württemberg, 45). Paulus, Eduard; Boger, Ernst (1865): Beschreibung des Oberamts Oehringen. Mit drei Tabellen, einer Karte des Oberamts und zwei Ansichten. Stuttgart: Lindemann (Beschreibung des Königreichs Württemberg, 46). Paulus, Eduard (1866): Beschreibung des Oberamts Marbach. Mit drei Tabellen, einer Karte des Oberamts und zwei Ansichten. Stuttgart: Lindemann (Beschreibung des Königreichs Württemberg, 48).

PURPOSE Consensus molecular subtypes (CMSs) were evaluated as prognostic and predictive biomarkers of patients with RAS wild-type metastatic colorectal cancer (mCRC) receiving fluorouracil and folinic acid (FU/FA) with or without panitumumab (Pmab) after Pmab + mFOLFOX6 induction within the randomized phase II PanaMa trial. METHODS CMSs were determined in the safety set (ie, patients that received induction) and full analysis set (FAS; ie, randomly assigned patients who received maintenance) and correlated with median progression-free survival (PFS) and overall survival (OS) since the start of induction or maintenance treatment and objective response rates (ORRs). Hazard ratios (HRs) and 95% CI were calculated by univariate/multivariate Cox regression analyses. RESULTS Of 377 patients of the safety set, 296 (78.5%) had available CMS data: CMS1/2/3/4: 29 (9.8%)/122 (41.2%)/33 (11.2%)/112 (37.8%) and unclassifiable: 17 (5.7%). The CMSs were prognostic biomarkers in terms of PFS ( P < .0001), OS ( P < .0001), and ORR ( P = .02) since the start of induction treatment. In FAS patients (n = 196), with CMS2/4 tumors, the addition of Pmab to FU/FA maintenance therapy was associated with longer PFS (CMS2: HR, 0.58 [95% CI, 0.36 to 0.95], P = .03; CMS4: HR, 0.63 [95% CI, 0.38 to 1.03], P = .07) and OS (CMS2: HR, 0.88 [95% CI, 0.52 to 1.52], P = .66; CMS4: HR, 0.54 [95% CI, 0.30 to 0.96], P = .04). The CMS interacted significantly with treatment in terms of PFS (CMS2 v CMS1/3: P = .02; CMS4 v CMS1/3: P = .03) and OS (CMS2 v CMS1/3: P = .03; CMS4 v CMS1/3: P < .001). CONCLUSION The CMS had a prognostic impact on PFS, OS, and ORR in RAS wild-type mCRC. In PanaMa, Pmab + FU/FA maintenance was associated with beneficial outcomes in CMS2/4, whereas no benefit was observed in CMS1/3 tumors.

In the post-pandemic COVID-19 period, human activities have returned to normal and COVID-19 cases are usually mild. However, patients with multiple myeloma (MM) present an increased risk for breakthrough infections and severe COVID-19 outcomes, including hospitalization and death. The European Myeloma Network has provided an expert consensus to guide patient management in this era. Vaccination with variant-specific booster vaccines, such as the bivalent vaccine for the ancestral Wuhan strain and the Omicron BA.4/5 strains, is essential as novel strains emerge and become dominant in the community. Boosters should be administered every 6–12 months after the last vaccine shot or documented COVID-19 infection (hybrid immunity). Booster shots seem to overcome the negative effect of anti-CD38 monoclonal antibodies on humoral responses; however, anti-BCMA treatment remains an adverse predictive factor for humoral immune response. Evaluation of the immune response after vaccination may identify a particularly vulnerable subset of patients who may need additional boosters, prophylactic therapies and prevention measures. Pre-exposure prophylaxis with tixagevimab/cilgavimab is not effective against the new dominant variants and thus is no longer recommended. Oral antivirals (nirmatrelvir/ritonavir and molnupiravir) and remdesivir are effective against Omicron subvariants BA.2.12.1, BA.4, BA.5, BQ.1.1 and/or XBB.1.5 and should be administered in MM patients at the time of a positive COVID-19 test or within 5 days post symptoms onset. Convalescent plasma seems to have low value in the post-pandemic era. Prevention measures during SARS-CoV-2 outbreaks, including mask wearing and avoiding crowded places, seem prudent to continue for MM patients.

Our study demonstrates that with aging, female C57BL/6N mice exhibit higher in vivo aortic stiffness, reduced modulus of elasticity, aortic wall structural and extracellular matrix remodeling, and elevations in systemic inflammation. These changes are largely reflective of those that occur with aging in women. Thus, female C57BL/6N mice are a viable model of human aortic aging and the utility of these animals should be considered in future biomedical investigations.

Right ventricular dysfunction (RVD), as expressed by right ventricular to pulmonary artery coupling, has recently been identified as a strong outcome predictor in patients undergoing mitral valve edge-to-edge repair (M-TEER) for secondary mitral regurgitation (MR). The aim of this study was to define RVD in patients undergoing M-TEER for primary MR (PMR) and to evaluate its impact on procedural MR reduction, symptomatic development and 2-year all-cause mortality.This multicentre study included patients undergoing M-TEER for symptomatic PMR at nine international centres. The study cohort was divided into a derivation (DC) and validation cohort (VC) for calculation and validation of the best discriminatory value for RVD. A total of 648 PMR patients were included in the study. DC and VC were comparable regarding procedural success and outcomes at follow-up. Sensitivity analysis identified RVD as an independent predictor for 2-year mortality in the DC (hazard ratio [HR] 2.37, 95% confidence interval [CI] 1.47-3.81, p 0.001), which was confirmed in the VC (HR 2.06, 95% CI 1.36-3.13, p 0.001). Procedural success (MR ≤2+) and symptomatic improvement at follow-up (New York Heart Association [NYHA] class ≤II) were lower in PMR patients with RVD (MR ≤2+: 82% vs. 93%, p = 0.002; NYHA class ≤II: 57.3% vs. 66.5%, p = 0.09 for with vs. without RVD). In all PMR patients, the presence of RVD significantly impaired 2-year survival after M-TEER (HR 2.23, 95% CI 1.63-3.05, p 0.001).Mitral valve edge-to-edge repair is an effective treatment option for PMR patients. The presence of RVD is associated with less MR reduction, less symptomatic improvement and increased 2-year mortality. Accordingly, RVD might be included into pre-procedural prognostic considerations.

Laboratory-based diffraction contrast tomography (LabDCT) is a novel technique used to resolve grain orientations and shapes in three dimensions at the micrometre scale using laboratory X-ray sources, allowing the user to overcome the constraint of limited access to synchrotron facilities. To foster the development of this technique, the implementation of LabDCT is illustrated in detail using a conventional laboratory-based X-ray tomography setup, and it is shown that such implementation is possible with the two most common types of detectors: CCD and flat panel. As a benchmark, LabDCT projections were acquired on an AlCu alloy sample using the two types of detectors at different exposure times. Grain maps were subsequently reconstructed using the open-source grain reconstruction method reported in the authors' previous work. To characterize the detection limit and the spatial resolution for the current implementation, the reconstructed LabDCT grain maps were compared with the map obtained from a synchrotron measurement, which is considered as ground truth. The results show that the final grain maps from measurements by the CCD and flat panel detector are similar and show comparable quality, while the CCD gives a much better contrast-to-noise ratio than the flat panel. The analysis of the grain maps reconstructed from measurements with different exposure times suggests that a grain map of comparable quality could be obtained in less than 1 h total acquisition time without a significant loss of grain reconstruction quality and indicates a clear potential for time-lapse LabDCT experiments. The current implementation is suggested to promote the generic use of the LabDCT technique for grain mapping on conventional tomography setups.

Patients with peritoneal metastases (PM) of colorectal cancer have a very poor outcome. Intraperitoneal delivery of chemotherapy is the preferred route for PM treatment. The main limitation of the treatment options is the short residence time of the cytostatic, with subsequent short exposure of the cancer cells. To address this, a supramolecular hydrogel has been developed that allows both local and slow release of its encapsulated drug, mitomycin C (MMC) or cholesterol-conjugated MMC (cMMC), respectively. This experimental study investigates if drug delivery using this hydrogel improves the therapeutic efficacy against PM. PM was induced in WAG/Rij rats (n = 72) by intraperitoneally injecting syngeneic colon carcinoma cells (CC531) expressing luciferase. After seven days, animals received a single intraperitoneal injection with saline (n = 8), unloaded hydrogel (n = 12), free MMC (n = 13), free cMMC (n = 13), MMC-loaded hydrogel (n = 13), or cMMC-loaded hydrogel (n = 13). Primary outcome was overall survival with a maximum follow-up of 120 days. Intraperitoneal tumor development was non-invasive monitored via bioluminescence imaging. Sixty-one rats successfully underwent all study procedures and were included to assess therapeutic efficacy. After 120 days, the overall survival in the MMC-loaded hydrogel and free MMC group was 78% and 38%, respectively. A trend toward significance was found when comparing the survival curves of the MMC-loaded hydrogel and free MMC (p = 0.087). No survival benefit was found for the cMMC-loaded hydrogel compared to free cMMC. Treating PM with our MMC-loaded hydrogel, exhibiting prolonged MMC exposure, seems effective in improving survival compared to treatment with free MMC.

BackgroundLoneliness is a concern for patients with schizophrenia (SCZ). However, the correlates of loneliness in SCZ are unclear; thus, the aim of the study is to investigate neuro- and social cognitive (SC) mechanisms associated with loneliness in SCZ.MethodsData for the study were pooled from two cross-national samples (Poland/USA) and included 147 SCZ and 103 healthy controls (HC) overall. Data from clinical, neurocognitive, and SC assessments were examined as potential predictors of loneliness in HC and SCZ samples pooled across two sites. Furthermore, Latent Class Analysis (LCA) was used to cluster patients based on SC capacity. Next, the relationship between SC and loneliness was explored in each cluster of SCZ.ResultsSCZ reported higher levels of loneliness than HC. Loneliness was linked to increased negative and affective symptoms in patients. A negative association between loneliness and mentalizing and emotion recognition abilities was found in the patients with social-cognitive impairments, but not in those who performed at normative levels.ConclusionsWe have elucidated a novel mechanism which may explain previous inconsistent findings regarding the correlates of loneliness in SCZ. As decreased SC capacity may be linked with loneliness only in patients with observable SC impairments, SC heterogeneity in SCZ needs to be recognized while planning psychosocial interventions targeting loneliness in this group.

Vitamin D, besides its classical effect on mineral homeostasis and bone remodeling, can also modulate apoptosis. A special form of apoptosis termed eryptosis appears in erythrocytes. Eryptosis is characterized by cell shrinkage, membrane blebbing, and cell membrane phospholipid disorganization and associated with diseases such as sepsis, malaria or iron deficiency, and impaired microcirculation. To our knowledge, this is the first study that linked vitamin D with eryptosis in humans. This exploratory cross-sectional trial investigated the association between the vitamin D status assessed by the concentration of plasma 25-hydroxyvitamin D (25(OH)D) and eryptosis. Plasma 25(OH)D was analyzed by LC–MS/MS, and eryptosis was estimated from annexin V-FITC-binding erythrocytes by FACS analysis in 2074 blood samples from participants of the German National Cohort Study. We observed a weak but clear correlation between low vitamin D status and increased eryptosis (r = − 0.15; 95% CI [− 0.19, − 0.10]). There were no differences in plasma concentrations of 25(OH)D and eryptosis between male and female subjects. This finding raises questions of the importance of vitamin D status for eryptosis in terms of increased risk for anemia or cardiovascular events.

Background: The oral cavity is a potential source of infectious complications in patients treated with myelosuppressive chemotherapy (CT). Pre-chemotherapy oral examination to identify foci of infection is recommended, but it is unclear whether this should include panoramic radiography. The present study aimed to evaluate the additional diagnostic merit of panoramic radiography as part of pre-CT oral screening. Methods: Patients with solid tumors scheduled to receive a myelosuppressive CT were eligible. The foci definition followed the guidelines of the Dutch Association of Maxillofacial Surgery. Oral foci assessed by clinical evaluation and panoramic radiography were compared. Results: In 33 out of 93 patients (35.5%), one or more foci were identified by clinical examination, whereas in 49.5% of patients, panoramic radiography showed pathology. In 19 patients, an oral focus was missed by clinical examination only, whereas in 11 patients, panoramic radiography indicated periodontal bone loss, but advanced periodontitis was not substantiated by clinical examination. Conclusions: Panoramic radiographs complement clinical examinations and have additional diagnostic value. Nevertheless, the additional merit seems small, and the clinical relevance may vary depending on the anticipated risk of developing oral complications and the need for detailed diagnosis and rigorous elimination of oral foci prior to the start of cancer therapy.

Radiation oncology clinical trials lack full representation of the ethnic and racial diversity present in the general United States and in the cancer patient population. There are low rates of both recruitment and enrollment of individuals from underrepresented ethnic and racial backgrounds, especially Black and Hispanic patients, people with disabilities, and patients from underrepresented sexual and gender groups. Even if approached for enrollment, barriers such as mistrust in medical research stemming from historical abuse and contemporary biased systems, low socioeconomic status, and lack of awareness prohibit historically marginalized populations from participating in clinical trials. In this paper, we reflect on these specific barriers and detail approaches to increase diversity of the patient population in radiation oncology clinical trials to better reflect the communities we serve. We hope that implementation of these approaches will increase the diversity of clinical trials patient populations in not only radiation oncology but also other medical specialties.

N-Nitrosamines (also referred to as nitrosamines) are a class of substances, many of which are highly potent mutagenic agents which have been classified as probable human carcinogens. Nitrosamine impurities have been a concern within the pharmaceutical industry and by regulatory authorities worldwide since June 2018, when regulators were informed of the presence of N-nitrosodimethylamine (NDMA) in the angiotensin-II receptor blocker (ARB) medicine, valsartan. Since that time, regulatory authorities have collaborated to share information and knowledge on issues related to nitrosamines with a goal of promoting convergence on technical issues and reducing and mitigating patient exposure to harmful nitrosamine impurities in human drug products. This paper shares current scientific information from a quality perspective on risk factors and potential root causes for nitrosamine impurities, as well as recommendations for risk mitigation and control strategies.

For patients with newly diagnosed breast cancer, information regarding hereditary predisposition can influence treatment decisions. From a surgical standpoint, patients with known germline mutations may alter decisions of local therapy to reduce the risk of second breast primaries. This information may also be considered in the choice of adjuvant therapies or eligibility for clinical trials. In recent years, the criteria for the consideration of germline testing in patients with breast cancer has expanded. Additionally, studies have shown a similar prevalence of pathogenic mutations in those patients outside of these traditional criteria, prompting calls for genetic testing for all patients with a history of breast cancer. While data confirms the benefit of counseling by certified genetics professionals, the capacity of genetic counselors may no longer meet the needs of these growing numbers of patients. National societies assert that counseling and testing can be performed by providers with training and experience in genetics. Breast surgeons are well positioned to offer this service, as they receive formal genetics training during their fellowship, manage these patients daily in their practices, and are often the first providers to see patients after their cancer diagnosis.

The use of biomarkers in spinal cord injury (SCI) research has evolved rapidly in recent years whereby most studies focused on the acute post-injury phase. Since SCI is characterized by persisting neurological impairments, the question arises whether blood biomarkers remain altered during the subacute post-injury time. Sample collection in the subacute phase might provide a better insight in the ongoing SCI specific molecular mechanism with fewer confounding factors compared with the acute phase where, amongst other complications, individuals receive a substantial amount of medication. This study aimed to determine if the temporal dynamics of serum biomarkers of neurodegeneration differ between individuals depending on their extent of neurological recovery in the transition phase between acute and chronic SCI. We performed a secondary analysis of biomarkers in patients with SCI (

We provide a simple framework connecting the distribution of excess savings across households to the dynamics of aggregate demand. Deficit-financed fiscal transfers generate excess savings. The poorest households with the highest marginal propensities to consume (MPCs) spend down their excess savings the fastest, increasing other households' incomes and their excess savings. This leads to a long-lasting increase in aggregate demand until, ultimately, excess savings have “trickled up” to the richest savers with the lowest MPCs, raising wealth inequality.

Objetivo: Analisar as evidências científicas disponíveis na literatura sobre indicadores que subsidiam a avaliação dos serviços de atendimento pré-hospitalar de urgência e emergência. Método: Revisão integrativa conduzida nas bases LILACS, CINAHL, SCOPUS, National Library of Medicine (via PubMed) e Web of Science. Utilizados estudos disponíveis na íntegra de domínio público ou privado, sem limite de idioma, não delimitando data de publicação. Resultados: Foram elencados quatro estudos para amostra final, os quais os indicadores de avaliação dos serviços de atendimento pré-hospitalar de urgência e emergência estavam relacionados à satisfação do paciente, os tempos despendidos durante o atendimento, o desenvolvimento de indicadores de qualidade (estrutura, processo e resultados) e os índices de avaliação dos serviços. Conclusão: Os achados contribuem no campo prático dos serviços de atendimento pré-hospitalar de urgência e emergência, com a finalidade de proporcionar uma reflexão entre os gestores e profissionais de saúde.

Introduction This systematic review and network meta-analysis assessed via direct and indirect comparison the occurrence and magnitude of effects following different nutritional supplementation strategies and exercise interventions on acute and chronic rowing performance and its surrogates. Methods PubMed, Web of Science, PsycNET and SPORTDiscus searches were conducted until March 2022 to identify studies that met the following inclusion criteria: (a) controlled trials, (b) rowing performance and its surrogate parameters as outcomes, and (c) peer-reviewed and published in English. Frequentist network meta-analytical approaches were calculated based on standardized mean differences (SMD) using random effects models. Results 71 studies with 1229 healthy rowers (aged 21.5 ± 3.0 years) were included and two main networks (acute and chronic) with each two subnetworks for nutrition and exercise have been created. Both networks revealed low heterogeneity and non-significant inconsistency (I2 ≤ 35.0% and Q statistics: p ≥ 0.12). Based on P-score rankings, while caffeine (P-score 84%; SMD 0.43) revealed relevantly favorable effects in terms of acute rowing performance enhancement, whilst prior weight reduction (P-score 10%; SMD − 0.48) and extensive preload (P-score 18%; SMD − 0.34) impaired acute rowing performance. Chronic blood flow restriction training (P-score 96%; SMD 1.26) and the combination of β-hydroxy-β-methylbutyrate and creatine (P-score 91%; SMD 1.04) induced remarkably large positive effects, while chronic spirulina (P-score 7%; SMD − 1.05) and black currant (P-score 9%; SMD − 0.88) supplementation revealed impairment effects. Conclusion Homogeneous and consistent findings from numerous studies indicate that the choice of nutritional supplementation strategy and exercise training regimen are vital for acute and chronic performance enhancement in rowing.

Ovarian vein thrombosis (OVT) is a rare thromboembolic condition. It involves the right ovarian vein in 70–80% of cases. The risk factors for the development of OVT are pregnancy or puerperium, hormone therapy with estrogen, recent surgery or hospitalization, malignancy, pelvic inflammatory diseases, thrombophilia and idiopathic OVT. We present a rare case of left OVT in a young, non-pregnant woman in her 30 s. A high degree of suspicion is necessitated in patients with the triad of young-middle-aged female, pain abdomen in lower quadrant and hematuria to diagnose OVT. Contrast enhanced computer tomography (CT-venography) is the diagnostic modality of choice. The patient was initially treated with low molecular weight heparin and then switched to direct oral anticoagulants. At 6-monthsfollow-up the patient was free from any symptoms.

International audience; Ice losses from the Greenland and Antarctic ice sheets have accelerated since the 1990s, accounting for a significant increase in the global mean sea level. Here, we present a new 29-year record of ice sheet mass balance from 1992 to 2020 from the Ice Sheet Mass Balance Inter-comparison Exercise (IMBIE). We compare and combine 50 independent estimates of ice sheet mass balance derived from satellite observations of temporal changes in ice sheet flow, in ice sheet volume, and in Earth's gravity field. Between 1992 and 2020, the ice sheets contributed 21.0±1.9 mm to global mean sea level, with the rate of mass loss rising from 105 Gt yr−1 between 1992 and 1996 to 372 Gt yr−1 between 2016 and 2020. In Greenland, the rate of mass loss is 169±9 Gt yr−1 between 1992 and 2020, but there are large inter-annual variations in mass balance, with mass loss ranging from 86 Gt yr−1 in 2017 to 444 Gt yr−1 in 2019 due to large variability in surface mass balance. In Antarctica, ice losses continue to be dominated by mass loss from West Antarctica (82±9 Gt yr−1) and, to a lesser extent, from the Antarctic Peninsula (13±5 Gt yr−1). East Antarctica remains close to a state of balance, with a small gain of 3±15 Gt yr−1, but is the most uncertain component of Antarctica's mass balance. The dataset is publicly available at https://doi.org/10.5285/77B64C55-7166-4A06-9DEF-2E400398E452 (IMBIE Team, 2021).

Purpose: Developing new therapeutics for any of the more than 100 sarcoma subtypes presents a challenge. After progression from standard therapies, patients with sarcoma may be referred for enrollment in early-phase trials. This study aimed to investigate whether enrollment in biomarker-matched early-phase clinical trials leads to better outcomes for patients with advanced sarcoma. Experimental Design: In this retrospective analysis, investigational treatment characteristics and longitudinal survival outcomes were analyzed in patients with biopsy-confirmed sarcoma enrolled in early-phase trials at MD Anderson Cancer Center from May 2006 to July 2021. Results: Five hundred eighty-seven patients were included [405 soft tissue, 122 bone, 60 gastrointestinal stromal tumor (GIST); median of three prior lines of therapy]. Most common subtypes were leiomyosarcoma (17.2%), liposarcoma (14.0%), and GIST (10.2%). Molecular testing was available for 511 patients (87.1%); 221 patients (37.6%) were treated in matched trials. Overall response rate was 13.1% matched compared with 4.9% in unmatched (P < 0.001); the clinical benefit rate at 6 months was 43.9% vs. 19.9% (P < 0.001). Progression-free survival was longer for patients in matched trials (median, 5.5 vs. 2.4 months; P < 0.001), and overall survival was also superior for patients in matched trials (median, 21.5 vs. 12.3 months; P < 0.001). The benefit of enrollment in matched trials was maintained when patients with GIST were excluded from the analysis. Conclusions: Enrollment in biomarker-matched early-phase trials is associated with improved outcomes in heavily pretreated patients with metastatic sarcoma. Molecular testing of tumors from patients with advanced sarcoma and enrollment in matched trials is a reasonable therapeutic strategy.

The Eastern North Pacific gray whale (Eschrichtius robustus) is one population of large cetacean that has recovered from depletion resulting from commercial harvest in the mid- to late-1800s. It is believed that this population may be approaching, or possibly exceeding its carrying capacity as suggested by recent increases in mortality of all age and sex classes. Research on the breeding biology and phenology of gray whales that spend the winter in the coastal waters and lagoons of Baja California, Mexico has been conducted for many years. These studies contribute valuable information on the reproductive biology of this species, and the importance of their coastal lagoon habitats to their reproductive success. This paper reviews and summarises historical exploitation, conservation measures, the findings of research conducted on gray whales in their winter breeding range, potential natural and anthropogenic threats to this population, and makes recommendations for future research and monitoring. This review concentrates on the findings of research conducted since the mid-1970s.

Eastern boundary upwelling systems (EBUS) contribute a disproportionate fraction of the global fish catch relative to their size and are especially susceptible to global environmental change. Here we present the evolution of communities over 50 d in an in situ mesocosm 6 km offshore of Callao, Peru, and in the nearby unenclosed coastal Pacific Ocean. The communities were monitored using multi-marker environmental DNA (eDNA) metabarcoding and flow cytometry. DNA extracted from weekly water samples were subjected to amplicon sequencing for four genetic loci: (1) the V1–V2 region of the 16S rRNA gene for photosynthetic eukaryotes (via their chloroplasts) and bacteria; (2) the V9 region of the 18S rRNA gene for exploration of eukaryotes but targeting phytoplankton; (3) cytochrome oxidase I (COI) for exploration of eukaryotic taxa but targeting invertebrates; and (4) the 12S rRNA gene, targeting vertebrates. The multi-marker approach showed a divergence of communities (from microbes to fish) between the mesocosm and the unenclosed ocean. Together with the environmental information, the genetic data furthered our mechanistic understanding of the processes that are shaping EBUS communities in a changing ocean. The unenclosed ocean experienced significant variability over the course of the 50 d experiment, with temporal shifts in community composition, but remained dominated by organisms that are characteristic of high-nutrient upwelling conditions (e.g., diatoms, copepods, anchovies). A large directional change was found in the mesocosm community. The mesocosm community that developed was characteristic of upwelling regions when upwelling relaxes and waters stratify (e.g., dinoflagellates, nanoflagellates). The selection of dinoflagellates under the salinity-driven experimentally stratified conditions in the mesocosm, as well as the warm conditions brought about by the coastal El Niño, may be an indication of how EBUS will respond under the global environmental changes (i.e., increases in surface temperature and freshwater input, leading to increased stratification) forecast by the IPCC.

Objective: Describe how dietary intake patterns of US young adults align with the EAT-Lancet Planetary Health Diet (PHD) sustainable diet goals and identify personal, behavioural, and socio-environmental correlates of sustainable intake. Design: Data on past-year dietary intake were captured using a FFQ. The PHD was applied to specific food groups, and a total PHD score was calculated. Linear regression models were used to identify associations between personal, behavioural and socio-environmental factors and PHD scores. Setting: This cross-sectional analysis uses data from the second wave of EAT 2010–2018 (Eating and Activity over Time), a population-based longitudinal study recruited in Minnesota. Participants: Ethnically/racially diverse group of participants (n 1308) with a mean age of 22·1 (sd 2·0) years. Results: The mean PHD score was 4·1 (sd 1·4) on a scale of 0–14, with 14 representing the most sustainable. On average, participants consumed fewer whole grains, fish, legumes, soya, and nuts than ideal for a sustainable diet, and an excess of eggs, added sugar, and meat. The PHD score was higher for participants with higher socio-economic status (SES) and greater educational attainment. Higher home availability of healthy food (β = 0·24, P < 0·001) and less frequent fast-food consumption (β = –0·26, P < 0·001) were the strongest correlates of PHD scores. Conclusions: Results suggest that a high percentage of participants may not be achieving the sustainable diet goals defined by the PHD. Reductions in meat consumption and increases in plant-based foods are necessary to increase the sustainability of US young adults’ diets.

Risk of inflammatory bowel disease (IBD) under isotretinoin is a scope of a long-standing controversy. The burden of isotretinoin-related irritable bowel syndrome (IBS) has not been investigated.To evaluate the risk of Crohn`s disease (CD), ulcerative colitis (UC), and IBS in patients with acne starting isotretinoin versus oral antibiotics treatment.A global population-based retrospective cohort study assigned two groups of patients with acne initiating isotretinoin (n=77,005) and oral antibiotics (n=77,005). Comprehensive propensity-score matching was conducted.The lifetime risk of CD (hazard ratio [HR], 1.05; 95% confidence interval [CI], 0.89-1.24; P=0.583) and UC (HR, 1.13; 95% CI, 0.95-1.34; P=0.162) was comparable between study groups, whereas the lifetime risk of IBS was lower in isotretinoin-prescribed patients (HR, 0.82; 95% CI, 0.76-0.89; P0.001). In time-stratified analysis, isotretinoin-related risk of UC was significantly increased during the first 6 months following drug initiation (HR, 1.93; 95% CI, 1.29-2.88; P=0.001), but decreased afterward to level the risk of the comparator group. The absolute risk difference within the first 6 months was clinically marginal (5.0 additional UC cases/10,000 patients starting isotretinoin; 95% CI, 2.5-7.7).Retrospective data collection.Isotretinoin does not confer an elevated risk of CD, whilst it might be associated with a slight and transient increase in UC risk.

This study aims to quantify surgical site complications (SSC) after isolated salvage neck dissection (ND) compared with primary ND.Between 1997 and 2017 in the Netherlands Cancer Institute - Antoni van Leeuwenhoek, a total of 323 isolated NDs were performed in 308 patients: primary ND (n = 144), post-radiotherapy (RT) ND (n = 53) and post-chemoradiotherapy (CRT) ND (n = 126). Patient, tumor and therapy characteristics were recorded. SSCs were scored according to the Clavien-Dindo Classification (CDC).101 NDs (31%) were complicated by at least one SSC. In total, 189 different SSCs occurred. Translated to CDC, 45 complications were grade 2, 25 grade 3a and 31 grade 3b. No significant difference in occurrence of SSC (CDC1) was found between all groups. However, post-CRT, selective (SND) and modified radical ND and radical ND (MRND/RND) (p = 0.005), resection of sternocleidomastoid muscle (SCM) (p = 0.039) and duration of super selective ND surgery (p = 0.048) were significantly associated with more SSC. SCM muscle removal was associated with more surgical site infection (p = 0.045) and necrosis (p = 0.036). From week 10 post-RT/CRT, no difference in complication frequency with primary ND was seen.Post-CRT SND, MRND/RND and SCM muscle resection were associated with an increased incidence of SSCs. If oncologically possible, limit the extent of ND and when an MRND is inevitable, preserve the SCM muscle for optimal prevention of SSC. Concerning SSC, optimal timing of salvage ND is minimal 10 weeks after RT/CRT.

Spatial networks are known to be informative about the spatiotemporal transmission dynamics of COVID-19. Using district-level panel data from Germany that cover the first 22 weeks of 2020, we show that mobility, commuter and social networks all predict the spatiotemporal propagation of the epidemic. The main innovation of our approach is that it incorporates the whole network and updated information on case numbers across districts over time. We find that when disease incidence increases in network neighbouring regions, case numbers in the home district surge one week later. The magnitude of these network transmission effects is comparable to within-district transmission, illustrating the importance of networks as drivers of local disease dynamics. After the introduction of containment policies in mid-March, network transmission intensity drops substantially. Our analysis suggests that this reduction is primarily due to a change in quality—not quantity—of interregional movements. This implies that blanket mobility restrictions are not a prerequisite for containing the interregional spread of COVID-19.