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Introduction â Clinical guidelines recommend anticoagulation therapy for the treatment of cancer-Associated venous thromboembolism (VTE), but little is known about preferences. Therefore, the objective of this discrete choice experiment (DCE) was to elucidate patient preferences regarding anticoagulation convenience attributes. Methods â Adult patients with cancer-Associated VTE who switched to direct oral anticoagulants were included in a single-Arm study (COSIMO). Patients were asked to decide between hypothetical treatment options based on a combination of the following attributes: route of administration (injection/tablet), frequency of intake (once/twice daily), need for regular controls of the international normalized ratio (INR) at least every 3 to 4 weeks (yes/no), interactions with food/alcohol (yes/no), and distance to treating physician (1 vs. 20 km) as an additional neutral attribute. DCE data were collected by structured telephone interviews and analyzed based on a conditional logit regression. Results â Overall, 163 patients (mean age 63.7 years, 49.1% female) were included. They strongly preferred oral administration compared with self-injections (importance of this attribute for overall treatment decisions: 73.8%), and a treatment without dietary restrictions (11.8%). Even if these attributes were less important (7.2% and 6.5%, respectively), patients indicated a preference for a shorter distance to the treating physician and once-daily dosing compared with twice-daily intake. Need for regular controls of INR at least every 3 to 4 weeks showed no significant impact on the treatment decision (0.7%). Conclusion â This study showed that treatment-related decision making in cancer-Associated VTE, assuming comparable effectiveness and safety of anticoagulant treatments, is predominantly driven by route of administration, with patients strongly preferring oral administration.

Die Flussauen zählen in Europa zu den komplexesten und artenreichsten ökologischen Systemen. Der Mensch hat diese Lebensräume durch massive Eingriffe in das hydrologische Regime von Flüssen, strukturelle Änderungen und zunehmende Nähr- und Schadstoffbelastung erheblich verändert oder zerstört. Mit Nachdruck wird deshalb schon seit Jahren der ökologisch verträgliche Umgang mit Auen gefordert. Diese gesellschaftliche Zielsetzung erfordert es, die ökologischen Auswirkungen von Eingriffen, insbesondere von Nutzungsänderungen und flussbaulichen Maßnahmen, hinreichend sicher abschätzen zu können.Leipzig ist die einzige deutsche Großstadt, in der großflächige Hartholz-Auenwälder entlang von Weißer Elster, Pleiße und Luppe erhalten geblieben sind. Momentan stellen Austrocknung und fehlende Hydrodynamik durch Entkoppelung von Fluss und Aue, verursacht durch den technischen Ausbau der Gewässerlandschaft im 19ten und 20igsten Jahrhundert um Hochwasser möglichst schnell aus der Flusslandschaft zu bringen, die größten Herausforderungen für den Erhalt der Auenlandschaft dar. Um das Leipziger Auensystem wieder in einen funktionierenden Auenraum zu entwickeln, muss darüber hinaus dem weiteren Verlust von Lebensräumen, wie z.B. naturraumtypischen Fließgewässern und artenreichem Auengrünland, entgegen gewirkt werden. Mit der Wiederherstellung auentypischer Wasserverhältnisse und Lebensräume lassen sich mittelfristig Biodiversität und zahlreiche Ökosystemleistungen nachhaltig sichern.

Die Flussauen zählen in Europa zu den komplexesten und artenreichsten ökologischen Systemen. Der Mensch hat diese Lebensräume durch massive Eingriffe in das hydrologische Regime von Flüssen, strukturelle Änderungen und zunehmende Nähr- und Schadstoffbelastung erheblich verändert oder zerstört. Mit Nachdruck wird deshalb schon seit Jahren der ökologisch verträgliche Umgang mit Auen gefordert. Diese gesellschaftliche Zielsetzung erfordert es, die ökologischen Auswirkungen von Eingriffen, insbesondere von Nutzungsänderungen und flussbaulichen Maßnahmen, hinreichend sicher abschätzen zu können.Leipzig ist die einzige deutsche Großstadt, in der großflächige Hartholz-Auenwälder entlang von Weißer Elster, Pleiße und Luppe erhalten geblieben sind. Momentan stellen Austrocknung und fehlende Hydrodynamik durch Entkoppelung von Fluss und Aue, verursacht durch den technischen Ausbau der Gewässerlandschaft im 19ten und 20igsten Jahrhundert um Hochwasser möglichst schnell aus der Flusslandschaft zu bringen, die größten Herausforderungen für den Erhalt der Auenlandschaft dar. Um das Leipziger Auensystem wieder in einen funktionierenden Auenraum zu entwickeln, muss darüber hinaus dem weiteren Verlust von Lebensräumen, wie z.B. naturraumtypischen Fließgewässern und artenreichem Auengrünland, entgegen gewirkt werden. Mit der Wiederherstellung auentypischer Wasserverhältnisse und Lebensräume lassen sich mittelfristig Biodiversität und zahlreiche Ökosystemleistungen nachhaltig sichern.

Background: Osteoporosis (OP) and its associated fractures have a significant impact on patients' quality of life and are impacting their morbidity and mortality. For OP patients at high risk of fracture, guidelines recommend a pharmacological OP treatment. The aim of this study was to describe the real-world medication treatment of postmenopausal women with severe OP at high risk of fracture, their risk to experience a new fracture after having at least one previous fracture, and to assess the associated healthcare resource use (HCRU).Methods: This retrospective cohort study was based on anonymized German claims data (AOK PLUS). All included OP patients were female, >=55 years old, and had a vertebral and/or femoral fracture. We conducted a cross-sectional analysis in 2018 and a longitudinal analysis, starting with an incident vertebral/femoral fracture (after or simultaneously with the first observed OP diagnosis). In both analyses, patient characteristics, rate of new incident fractures, OP treatment patterns, and HCRU associated with the treatment of patients were investigated.Results: In the cross-sectional setting, 12,180 patients with a mean age of 83.59 years were observed. Of these patients, 14.30% sustained at least one new incident fracture and 34.54% received a pharmaceutical OP treatment during 2018. In this year, 58.50% of the patients had at least one OP-related outpatient visit, and 26.35% had a fracture-related visit. In 160 patients (1.31%), at least one OP-related hospitalization was documented, and in 1,293 patients (10.62%) a fracture-related hospitalization in 2018.In the longitudinal setting, 10,323 patients with a mean age of 83.22 years were included. Of these, 18.96% experienced at least one new incident fracture within the first 12 months after the index fracture, and in total 30.85% in the entire follow-up period (mean 2.03 years). During the 12-month baseline period, 22.12% of the patients received an OP treatment. Three months after the, Hintergrund: Osteoporose (OP) und die damit verbundenen Frakturen haben einen signifikanten Einfluss auf die Lebensqualität von OP-Patienten und beeinflussen ebenso deren Morbidität und Mortalität. Leitlinien empfehlen für OP-Patienten mit hohem Frakturrisiko eine spezifische medikamentöse Therapie. Das Ziel dieser Studie war es, die Behandlungspraxis und das Risiko erneuter Frakturen von postmenopausalen Frauen mit manifester OP mit deutlich erhöhtem Frakturrisiko zu beschreiben sowie die damit verbundenen Ressourcenverbräuche zu ermitteln.Methoden: Diese retrospektive Kohortenstudie basierte auf anonymen Krankenkassendaten (AOK PLUS). Sämtliche eingeschlossenen OP-Patienten waren weiblich, >=55 Jahre alt und erlitten bereits eine vertebrale oder femorale Fraktur. In der Studie wurden zwei verschiedene Analysen durchgeführt: eine Querschnittsanalyse für das Jahr 2018 und eine Längsschnittanalyse beginnend mit der Indexfraktur (nach erster beobachteter OP-Diagnose in 2015-2017). In beiden Analysen wurden die Patientencharakteristika, die Rate neuer Frakturen, die medikamentöse OP-Behandlung sowie die assoziierten Ressourcenverbräuche untersucht.Ergebnisse: In der Querschnittsanalyse wurden 12.180 Patientinnen mit einem durchschnittlichen Alter von 83,59 Jahren beobachtet. Von diesen Patientinnen erlitten in 2018 14,30% mindestens eine neue Fraktur und 34,54% erhielten eine medikamentöse OP-Behandlung. Im Beobachtungszeitraum besuchten 58,50% OP-bezogen einen ambulanten Arzt, 26,35% der Arztbesuche waren frakturbezogen. 160 (1,31%) bzw. 1.293 Patientinnen (10,62%) hatten 2018 einen stationären Aufenthalt mit OP- oder Fraktur-Bezug (primäre Diagnose).In die Längsschnittanalyse wurden 10.323 Patientinnen mit einem Durchschnittsalter von 83,22 Jahren eingeschlossen. Innerhalb der ersten 12 Monate nach der Indexfraktur erlitten 18,96% mindestens eine weitere neue Fraktur, im gesamten Beobachtungszeitraum (Mittelwert 2,03 Jahre) 30,85%. In den 12 Monaten vor der Indexfrak

Lake Ohrid (Republic of North Macedonia) is the oldest and most biodiverse freshwater lake in Europe. While the lake has recently been under severe anthropogenic pressure, historical impacts are poorly studied. We used paleolimnological information, particularly from cladoceran assemblages, to describe the long-term anthropogenic impacts that the lake has experienced over the last 6650 years. Multivariate analyses of cladoceran abundances together with selected environmental indicators were used to distinguish natural from human impacts and to track the direction and causes of observed changes. In addition, morphological analyses of planktonic Bosmina allowed us to assess the effects of fisheries and aquaculture on cladoceran phenotypic plasticity. Our findings reveal that the lake has been regularly exposed to anthropogenic impacts during the last millennia, including habitat deterioration, shifts in the food web and species introductions. Before 2400 cal yr BP, cladocerans showed the highest diversity values, and the relatively larger size of Bosmina longirostris indicated limited zooplanktivory. Since 2400 cal yr BP, coinciding with the foundation of the town of Ohrid and elevated erosion and deforestation, there has been a progressive loss of littoral taxa. Since 1700 cal yr BP, fish introductions have increased, inducing morphological changes in Bosmina, which resulted in a significant decrease in body size and antennule length and an increase in mucro and antennule angle. We also show that the present-day cladoceran community differs from the prehistoric community due to the invasion of Diaphanosoma. Overall, our results highlight the sensitivity of this unique ecosystem to human alterations, which began before the Anthropocene.

Intakte Flussauen sind Hotspots der biologischen Vielfalt und von Ökosystemleistungen für uns Menschen. Trotz der nationalen und europäischen Bedeutung der Biodiversität des Leipziger Auensystems, sind starke Beeinträchtigungen der Lebensräume in der Aue seit vie-len Jahren bekannt. Sie verstärken sich insbesondere in extremen Trockenjahren. Die heuti-gen Probleme der Flusslandschaft haben eine historische Dimension: Im 19. und der ersten Hälfte des 20. Jahrhunderts wurden mit dem Ausbau des Gewässernetzes große Teile der Aue vom Abflussregime der Flüsse entkoppelt. Dadurch fehlen dem Leipziger Auensystem seine drei zentralen Gestaltungselemente: Die hydrologische Dynamik, da die derzeitige Steuerung eine konstante Wasserführung anstrebt, die hydrologische Vernetzung der Le-bensräume, da die Hauptfließgewässer von ihren Auen getrennt wurden, und das Wasserdar-gebot, das durch die Entwässerung und fehlenden Überflutungen ohnehin gering ist.Damit wurden bereits viele aquatische und terrestrische Habitate zerstört oder degradiert. Aufgrund der anthropogen verursachten Tieflage von Elsterflutbett, Neuer Luppe und Nahle kam es zu einer fortschreitenden Austrocknung weiter Gebietsteile.Das Land Sachsen und die Region Leipzig stehen nun vor einer zweifachen Herausforde-rung: Die Revitalisierung des Auensystems, eine Aufgabe, für die in vielen anderen Flussre-gionen Deutschlands bereits Lösungen vorliegen oder umgesetzt sind, hat bis auf wenige räumlich eng begrenzte Projekte in der Fläche noch nicht begonnen. Während die Wiederher-stellung des Auensystems noch bevorsteht, kommt mit dem Klimawandel ein weiteres Prob-lem hinzu, das sich aktuell verschärft und für das wir noch keine erprobten Lösungen kennen. Bevor also die Aktivitäten für eine Verbesserung der Situation begonnen haben, befinden wir uns nun in einem Wettlauf gegen eine rapide Verschlechterung, nicht nur der biologischen Vielfalt, sondern der Ökosystemleistungen insgesamt und damit der Lebensbedingungen der Bü

Intakte Flussauen sind Hotspots der biologischen Vielfalt und von Ökosystemleistungen für uns Menschen. Trotz der nationalen und europäischen Bedeutung der Biodiversität des Leipziger Auensystems, sind starke Beeinträchtigungen der Lebensräume in der Aue seit vie-len Jahren bekannt. Sie verstärken sich insbesondere in extremen Trockenjahren. Die heuti-gen Probleme der Flusslandschaft haben eine historische Dimension: Im 19. und der ersten Hälfte des 20. Jahrhunderts wurden mit dem Ausbau des Gewässernetzes große Teile der Aue vom Abflussregime der Flüsse entkoppelt. Dadurch fehlen dem Leipziger Auensystem seine drei zentralen Gestaltungselemente: Die hydrologische Dynamik, da die derzeitige Steuerung eine konstante Wasserführung anstrebt, die hydrologische Vernetzung der Le-bensräume, da die Hauptfließgewässer von ihren Auen getrennt wurden, und das Wasserdar-gebot, das durch die Entwässerung und fehlenden Überflutungen ohnehin gering ist.Damit wurden bereits viele aquatische und terrestrische Habitate zerstört oder degradiert. Aufgrund der anthropogen verursachten Tieflage von Elsterflutbett, Neuer Luppe und Nahle kam es zu einer fortschreitenden Austrocknung weiter Gebietsteile.Das Land Sachsen und die Region Leipzig stehen nun vor einer zweifachen Herausforde-rung: Die Revitalisierung des Auensystems, eine Aufgabe, für die in vielen anderen Flussre-gionen Deutschlands bereits Lösungen vorliegen oder umgesetzt sind, hat bis auf wenige räumlich eng begrenzte Projekte in der Fläche noch nicht begonnen. Während die Wiederher-stellung des Auensystems noch bevorsteht, kommt mit dem Klimawandel ein weiteres Prob-lem hinzu, das sich aktuell verschärft und für das wir noch keine erprobten Lösungen kennen. Bevor also die Aktivitäten für eine Verbesserung der Situation begonnen haben, befinden wir uns nun in einem Wettlauf gegen eine rapide Verschlechterung, nicht nur der biologischen Vielfalt, sondern der Ökosystemleistungen insgesamt und damit der Lebensbedingungen der Bü

Lake Ohrid (Republic of North Macedonia) is the oldest and most biodiverse freshwater lake in Europe. While the lake has recently been under severe anthropogenic pressure, historical impacts are poorly studied. We used paleolimnological information, particularly from cladoceran assemblages, to describe the long-term anthropogenic impacts that the lake has experienced over the last 6650 years. Multivariate analyses of cladoceran abundances together with selected environmental indicators were used to distinguish natural from human impacts and to track the direction and causes of observed changes. In addition, morphological analyses of planktonic Bosmina allowed us to assess the effects of fisheries and aquaculture on cladoceran phenotypic plasticity. Our findings reveal that the lake has been regularly exposed to anthropogenic impacts during the last millennia, including habitat deterioration, shifts in the food web and species introductions. Before 2400 cal yr BP, cladocerans showed the highest diversity values, and the relatively larger size of Bosmina longirostris indicated limited zooplanktivory. Since 2400 cal yr BP, coinciding with the foundation of the town of Ohrid and elevated erosion and deforestation, there has been a progressive loss of littoral taxa. Since 1700 cal yr BP, fish introductions have increased, inducing morphological changes in Bosmina, which resulted in a significant decrease in body size and antennule length and an increase in mucro and antennule angle. We also show that the present-day cladoceran community differs from the prehistoric community due to the invasion of Diaphanosoma. Overall, our results highlight the sensitivity of this unique ecosystem to human alterations, which began before the Anthropocene.

Aim: Elevated biodiversity is the result of the cradle, museum or sink functions. The contributions of these three functions to species accumulation and their changes through time remain unknown for glacial refugia. Additionally, our understanding of the role these functions played during pre‐glacial periods is limited. We test for changes in contributions of functions through time leading to the current diversity patterns using a model refugium and taxo

The Caspian Sea has been a highly dynamic environment throughout the Quaternary and witnessed major oscillations in lake level, which were associated with changes in salinity and habitat availability. Such environmental pressures are considered to drive strong phylogeographic structures in species by forcing populations into suitable refugia. However, little is actually known on the effect of lake-level fluctuations in the Caspian Sea on its aquatic biota. We compared the phylogeographic patterns of the aquatic Neritidae snail genus Theodoxus across the Pontocaspian region with refugial populations in southern Iran. Three gene fragments were used to determine relationships and divergence times between the sampled populations in both groups. A dated phylogeny and statistical haplotype networks were generated in conjunction with the analyses of molecular variance and calculations of isolation by distance using distance-based redundancy analyses. Extended Bayesian skyline plots were constructed to assess demographic history. Compared with the southern Iranian populations, we found little phylogeographic structure for the Pontocaspian Theodoxus group, with more recent diversification, homogeneity of haplotypes across the Pontocaspian region and a relatively stable demographic history since the Middle Pleistocene. Our results argue against a strong influence of Caspian Sea low stands on the population structure post the early Pleistocene, whereas high stands may have increased the dispersal possibilities and homogenization of haplotypes across the Pontocaspian region during this time. However, during the early Pleistocene, a more dramatic low stand in the Caspian Sea, around a million years ago, may have caused the reduction in Theodoxus diversity to a single lineage in the region. In addition, our results provide new insights into Theodoxus taxonomy and outlooks for regional conservation.

Defining and recording the loss of species diversity is a daunting task, especially if identities of species under threat are not fully resolved. An example is the Pontocaspian biota. The mostly endemic invertebrate faunas that evolved in the Black Sea – Caspian Sea – Aral Sea region and live under variable salinity conditions are undergoing strong change, yet within several groups species boundaries are not well established. Collection efforts in the past decade have failed to produce living material of various species groups whose taxonomic status is unclear. This lack of data precludes an integrated taxonomic assessment to clarify species identities and estimate species richness of Pontocaspian biota combining morphological, ecological, genetic, and distribution data. In this paper, we present an expert-working list of Pontocaspian and invasive mollusc species associated to Pontocaspian habitats. This list is based on published and unpublished data on morphology, ecology, anatomy, and molecular biology. It allows us to (1) document Pontocaspian mollusc species, (2) make species richness estimates, and (3) identify and discuss taxonomic uncertainties. The endemic Pontocaspian mollusc species richness is estimated between 55 and 99 species, but there are several groups that may harbour cryptic species. Even though the conservation status of most of the species is not assessed or data deficient, our observations point to deterioration for many of the Pontocaspian species.

Over the past decades, overall ecological conditions in the Caspian Sea have deteriorated. However, a comprehensive understanding of lake-wide spatial differences in anthropogenic pressures is lacking and the biological consequences of human impacts are poorly understood. This paper therefore aims at assessing the individual and combined effects of critical anthropogenic pressures on the Caspian Sea ecoregions. First, cumulative pressure scores were calculated with a cumulative environmental assessment (CEA) analysis. Then, the individual contribution of anthropogenic pressures was quantified. Finally, ecoregion-specific differences were assessed. The analyses show that both cumulative and individual pressure scores are unevenly distributed across the Caspian Sea. The most important individual pressures are invasive species, chemical pollution and poaching. This uneven distribution of pressure scores across Caspian Sea ecoregions creates new challenges for future conservation strategies, as different ecoregions usually require different conservation measures. Action: H2020-MSCA-ITN-2014, acronym: PRIDE, grant agreement No: 642973

Over the past decades, overall ecological conditions in the Caspian Sea have deteriorated. However, a comprehensive understanding of lake-wide spatial differences in anthropogenic pressures is lacking and the biological consequences of human impacts are poorly understood. This paper therefore aims at assessing the individual and combined effects of critical anthropogenic pressures on the Caspian Sea ecoregions. First, cumulative pressure scores were calculated with a cumulative environmental assessment (CEA) analysis. Then, the individual contribution of anthropogenic pressures was quantified. Finally, ecoregion-specific differences were assessed. The analyses show that both cumulative and individual pressure scores are unevenly distributed across the Caspian Sea. The most important individual pressures are invasive species, chemical pollution and poaching. This uneven distribution of pressure scores across Caspian Sea ecoregions creates new challenges for future conservation strategies, as different ecoregions usually require different conservation measures. Action: H2020-MSCA-ITN-2014, acronym: PRIDE, grant agreement No: 642973

The Caspian Sea has been a highly dynamic environment throughout the Quaternary and witnessed major oscillations in lake level, which were associated with changes in salinity and habitat availability. Such environmental pressures are considered to drive strong phylogeographic structures in species by forcing populations into suitable refugia. However, little is actually known on the effect of lake-level fluctuations in the Caspian Sea on its aquatic biota. We compared the phylogeographic patterns of the aquatic Neritidae snail genus Theodoxus across the Pontocaspian region with refugial populations in southern Iran. Three gene fragments were used to determine relationships and divergence times between the sampled populations in both groups. A dated phylogeny and statistical haplotype networks were generated in conjunction with the analyses of molecular variance and calculations of isolation by distance using distance-based redundancy analyses. Extended Bayesian skyline plots were constructed to assess demographic history. Compared with the southern Iranian populations, we found little phylogeographic structure for the Pontocaspian Theodoxus group, with more recent diversification, homogeneity of haplotypes across the Pontocaspian region and a relatively stable demographic history since the Middle Pleistocene. Our results argue against a strong influence of Caspian Sea low stands on the population structure post the early Pleistocene, whereas high stands may have increased the dispersal possibilities and homogenization of haplotypes across the Pontocaspian region during this time. However, during the early Pleistocene, a more dramatic low stand in the Caspian Sea, around a million years ago, may have caused the reduction in Theodoxus diversity to a single lineage in the region. In addition, our results provide new insights into Theodoxus taxonomy and outlooks for regional conservation.

Defining and recording the loss of species diversity is a daunting task, especially if identities of species under threat are not fully resolved. An example is the Pontocaspian biota. The mostly endemic invertebrate faunas that evolved in the Black Sea – Caspian Sea – Aral Sea region and live under variable salinity conditions are undergoing strong change, yet within several groups species boundaries are not well established. Collection efforts in the past decade have failed to produce living material of various species groups whose taxonomic status is unclear. This lack of data precludes an integrated taxonomic assessment to clarify species identities and estimate species richness of Pontocaspian biota combining morphological, ecological, genetic, and distribution data. In this paper, we present an expert-working list of Pontocaspian and invasive mollusc species associated to Pontocaspian habitats. This list is based on published and unpublished data on morphology, ecology, anatomy, and molecular biology. It allows us to (1) document Pontocaspian mollusc species, (2) make species richness estimates, and (3) identify and discuss taxonomic uncertainties. The endemic Pontocaspian mollusc species richness is estimated between 55 and 99 species, but there are several groups that may harbour cryptic species. Even though the conservation status of most of the species is not assessed or data deficient, our observations point to deterioration for many of the Pontocaspian species.

Aim: Elevated biodiversity is the result of the cradle, museum or sink functions. The contributions of these three functions to species accumulation and their changes through time remain unknown for glacial refugia. Additionally, our understanding of the role these functions played during pre‐glacial periods is limited. We test for changes in contributions of functions through time leading to the current diversity patterns using a model refugium and taxon. Location: Anatolia, Western Palaearctic. Taxon: Freshwater neritid snails (genus Theodoxus). Methods: Assessments were made to define molecular operational taxonomic units (MOTUs) for Theodoxus and reaffirm the genus as a suitable model taxon with elevated interspecific diversity in noted glacial refugia. Thereafter, we constructed a time‐calibrated multilocus Bayesian phylogeny of mtDNA and nDNA by using both fossil data and published substitution rates. Ancestral area estimation was performed on the phylogeny to define the contribution of the functions through time. Results: Accumulation of Theodoxus diversity in Anatolia over the Miocene–Pliocene transition is attributed to the museum function, but its contribution was small as only few divergence events occurred. The cradle function dominated during the Pliocene and Early Pleistocene, when most interspecific diversity built up and extant lineages in Anatolia were established. The sink function acted from the Middle Pleistocene to present‐day, but with only a small contribution to the total extant Anatolian interspecific diversity. Main conclusion: Our results do not entirely mitigate the role glacial cycles played in species accumulation, but highlight Ice Ages may have been less effective in forcing temperate aquatic interspecific diversity into more opportune areas. The elevated diversity in refugia may rather be the result of earlier in situ diversification. Elevated interspecific diversity attributed to the legacy of glacially forced retreats may need to b

Sclerochronological data from whole bivalve shells have been used extensively to derive palaeo-environmental information. However, little is known about the relevance of shell fragments more commonly preserved in the sediment record. Here, we investigate the oxygen and carbon isotope composition of Dreissena carinata fragments from a core recovered from Lake Dojran (FYRO Macedonia/Greece) to identify their relevance and efficacy as a proxy in palaeoenvironmental studies. We use a modern Dreissena shell to calibrate the relationship between the bivalve and its contemporary environment, which suggests their isotope composition is primarily a function of temperature and water balance. The range of fragment isotope data from the core overlaps with that of unbroken fossil shells, suggesting the fragments broadly record lakewater conditions across the time of deposition. A comparison of the isotope composition of shell fragments and endogenic carbonate shows an offset between the two sets of data, which is likely due to temperature differences between surface and bottom waters, the timing of carbonate precipitation, and productivity-controlled stratification of the dissolved inorganic carbon pool. Shell fragment isotope data seem to reflect the signal of environmental change recorded in other proxy data from the same core and may potentially be used (like endogenic carbonate) to provide information on past changes in lake level. (C) 2018 Elsevier Ltd. All rights reserved.

Sclerochronological data from whole bivalve shells have been used extensively to derive palaeoenvironmental information. However, little is known about the relevance of shell fragments more commonly preserved in the sediment record. Here, we investigate the oxygen and carbon isotope composition of Dreissena carinata fragments from a core recovered from Lake Dojran (FYRO Macedonia/Greece) to identify their relevance and efficacy as a proxy in palaeoenvironmental studies. We use a modern Dreissena shell to calibrate the relationship between the bivalve and its contemporary environment, which suggests their isotope composition is primarily a function of temperature and water balance. The range of fragment isotope data from the core overlaps with that of unbroken fossil shells, suggesting the fragments broadly record lakewater conditions across the time of deposition. A comparison of the isotope composition of shell fragments and endogenic carbonate shows an offset between the two sets of data, which is likely due to temperature differences between surface and bottom waters, the timing of carbonate precipitation, and productivity-controlled stratification of the dissolved inorganic carbon pool. Shell fragment isotope data seem to reflect the signal of environmental change recorded in other proxy data from the same core and may potentially be used (like endogenic carbonate) to provide information on past changes in lake level.

Sclerochronological data from whole bivalve shells have been used extensively to derive palaeo-environmental information. However, little is known about the relevance of shell fragments more commonly preserved in the sediment record. Here, we investigate the oxygen and carbon isotope composition of Dreissena carinata fragments from a core recovered from Lake Dojran (FYRO Macedonia/Greece) to identify their relevance and efficacy as a proxy in palaeoenvironmental studies. We use a modern Dreissena shell to calibrate the relationship between the bivalve and its contemporary environment, which suggests their isotope composition is primarily a function of temperature and water balance. The range of fragment isotope data from the core overlaps with that of unbroken fossil shells, suggesting the fragments broadly record lakewater conditions across the time of deposition. A comparison of the isotope composition of shell fragments and endogenic carbonate shows an offset between the two sets of data, which is likely due to temperature differences between surface and bottom waters, the timing of carbonate precipitation, and productivity-controlled stratification of the dissolved inorganic carbon pool. Shell fragment isotope data seem to reflect the signal of environmental change recorded in other proxy data from the same core and may potentially be used (like endogenic carbonate) to provide information on past changes in lake level. (C) 2018 Elsevier Ltd. All rights reserved.

Sclerochronological data from whole bivalve shells have been used extensively to derive palaeoenvironmental information. However, little is known about the relevance of shell fragments more commonly preserved in the sediment record. Here, we investigate the oxygen and carbon isotope composition of Dreissena carinata fragments from a core recovered from Lake Dojran (FYRO Macedonia/Greece) to identify their relevance and efficacy as a proxy in palaeoenvironmental studies. We use a modern Dreissena shell to calibrate the relationship between the bivalve and its contemporary environment, which suggests their isotope composition is primarily a function of temperature and water balance. The range of fragment isotope data from the core overlaps with that of unbroken fossil shells, suggesting the fragments broadly record lakewater conditions across the time of deposition. A comparison of the isotope composition of shell fragments and endogenic carbonate shows an offset between the two sets of data, which is likely due to temperature differences between surface and bottom waters, the timing of carbonate precipitation, and productivity-controlled stratification of the dissolved inorganic carbon pool. Shell fragment isotope data seem to reflect the signal of environmental change recorded in other proxy data from the same core and may potentially be used (like endogenic carbonate) to provide information on past changes in lake level.

Objectives : The aim of this study was to investigate the antiepileptic drug (AED) treatment of adults suffering from focal epilepsies (FE) in Germany. Of special interest was the number and percentage of the patients 16 years and older receiving no treatment with an AED, treatment with one AED (monotherapy), treatment with more than one AED, and treatment with a novel AED. The definition for "novel" was newly approved at the time of market entry since 2006 (last 10 years): eslicarbazepine (ESL), lacosamide (LCM), perampanel (PER), and retigabine (RTG). Methods: The analysis was based on a claims data set covering the years 2007 to 2014, provided by AOK PLUS, a German statutory health insurance. Two patient samples were defined: (1) prevalent patients suffering from FE (at least one in- or outpatient diagnosis of FE and at least one prescription of an AED), and (2) incident FE patients (first in- or outpatient diagnosis of FE without any previous diagnoses/AED prescriptions in the preceding 6 months). Patient observation started at date of first observed inpatient or outpatient focal epilepsy diagnosis within the analyzed period.Each patient was classified as a "no AED therapy", "AED monotherapy" or "more than one AED therapy". Patients were analyzed by number and type of concomitantly prescribed AEDs in yearly tranches (no, one, two, three, four, more than four AEDs; novel versus non-novel AEDs). Results: A total of 34,422 patients diagnosed with FE aged 16 year or older (mean age 59.6 years, 48.7% female) were identified. The mean follow-up period was 1,891 days (5.2 years) since first confirmed diagnosis. The percentage of prevalent patients diagnosed with FE who received one AED (monotherapy) was stable overall and ranged between a minimum of 66.2% (2007) and a maximum of 68.9% (2010). The percentage of patients who received two AEDs ranged from 23.6% (2012) to 25.8% (2007). The remaining patients received therapies with three (6.0% in 2010 to 6.7% in 2007), fou, Ziel: Das Ziel der vorliegenden Studie war die Beschreibung der medikamentösen Therapie von erwachsenen Patienten mit fokaler Epilepsie (FE) in Deutschland. Hierbei wurden insbesondere die Patienten analysiert, die 16 Jahre oder älter sind und keine antiepileptische Medikation, eine Monotherapie, eine Therapie mit mehr als einem Wirkstoff und/oder einem neuartigen Antiepileptikum erhielten. Für die Definition von "neuartig" wurde die Neuzulassung mit Zeitpunkt des Markteintrittes nach 2006 (in den letzten 10 Jahren) herangezogen: Eslicarbazepin (ESL), Lacosamid (LCM), Perampanel (PER) und Retigabin (RTG). Methoden: Basis für die vorliegende Studie waren anonymisierte Routinedaten aus den Jahren 2007 bis 2014 der AOK PLUS, einer deutschen gesetzlichen Krankenversicherung. Es wurden zwei Patientengruppen analysiert: (1) prävalente Patienten mit FE (mindestens eine ambulante oder stationäre Diagnose FE und mindestens eine Verordnung eines Antiepileptikums) und (2) inzidente Patienten mit FE (6 Monate vor der Erstdiagnose keine andere Epilepsiediagnose und keine Verordnung eines Antiepileptikums). Die jeweiligen Patienten wurden ab der ersten ambulanten oder stationären Diagnose mit FE innerhalb des Analysezeitraums beobachtet. Jeder Patient wurde in Hinblick auf folgende Behandlungsmuster analysiert: "keine antiepileptische Medikation", "Monotherapie" oder "Therapie mit mehr als einem antiepileptischen Wirkstoff". In der letztgenannten Gruppe wurden die Patienten nach der Anzahl und Art der verordneten antiepileptischen Wirkstoffe innerhalb eines Jahres weiter differenziert (zwei, drei, vier, mehr als vier Antiepileptika).Ergebnis: Insgesamt wurden 34.422 Patienten mit FE (Durchschnittsalter 59,6 Jahre; 48,7% weiblich) mit einer durchschnittlichen Beobachtungsdauer von 1.891 Tagen (5,2 Jahre) identifiziert. Der Anteil prävalenter Patienten, die eine Monotherapie erhielten, war über den Beobachtungszeitraum konstant mit einem Minimum von 66,2% (2007) und einem Maximum v

Most European cities have at least one river or lake crossing their urban landscape. Urbanisation has come at a cost to rivers and lakes, as they have been heavily degraded to enable development, carry waste, supply drinking water and facilitate transport and industry.

Most European cities have at least one river or lake crossing their urban landscape. Urbanisation has come at a cost to rivers and lakes, as they have been heavily degraded to enable development, carry waste, supply drinking water and facilitate transport and industry.

The 74 (75) ka Toba eruption in Sumatra, Indonesia, is considered to be one of the largest volcanic events during the Quaternary. Tephra from the Toba eruption has been found in many terrestrial and marine sedimentary deposits, and acidity peaks related to the eruption have been used to synchronize ice core records from Greenland and Antarctica. Seismic profiles and sedimentological data from Lake Prespa on the Balkan Peninsula, SE Europe, indicate a lake level lowstand at 73.6 ± 7.7 ka based on ESR dating of shells. Tephrostratigraphy, radiocarbon dating and tuning of the total organic carbon content with the NGRIP isotope record, corroborate that the lake level lowstand was a short-term event superimposed on the general cooling trend at the end of MIS 5, most likely at the onset of the Greenland Stadial GS-20. Acknowledging that tectonic events or karst processes could have triggered this lake level lowstand, the chronological correspondence between the lowstand and the Toba eruption is intriguing. Therefore a Toba-driven short-term shift to aridity in the Balkan region, leading to lake level changes and triggering spatial expansion events in one of the lake's most abundant benthic species, the carino mussel Dreissena presbensis, cannot be excluded.

The 74 (75) ka Toba eruption in Sumatra, Indonesia, is considered to be one of the largest volcanic events during the Quaternary. Tephra from the Toba eruption has been found in many terrestrial and marine sedimentary deposits, and acidity peaks related to the eruption have been used to synchronize ice core records from Greenland and Antarctica. Seismic profiles and sedimentological data from Lake Prespa on the Balkan Peninsula, SE Europe, indicate a lake level lowstand at 73.6 +/- 7.7 ka based on ESR dating of shells. Tephrostratigraphy, radiocarbon dating and tuning of the total organic carbon content with the NGRIP isotope record, corroborate that the lake level lowstand was a short-term event superimposed on the general cooling trend at the end of MIS 5, most likely at the onset of the Greenland Stadial GS-20. Acknowledging that tectonic events or karst processes could have triggered this lake level lowstand, the chronological correspondence between the lowstand and the Toba eruption is intriguing. Therefore a Toba-driven short-term shift to aridity in the Balkan region, leading to lake level changes and triggering spatial expansion events in one of the lake's most abundant benthic species, the carino mussel Dreissena presbensis, cannot be excluded.

The Scientific Collaboration on Past Speciation Conditions in Lake Ohrid (SCOPSCO) project is an international research initiative to study the influence of major geological and environmental events on the biological evolution of lake taxa. SCOPSCO drilling campaigns were carried out in 2011 and 2013. In 2011 we used gravity and piston coring at one of the five proposed drill sites, and in 2013 we undertook deep drilling with the Deep Lake Drilling System (DLDS) of Drilling, Observation and Sampling of the Earth's Continental Crust (DOSECC). In April and May 2013, a total of 2100 m sediments were recovered from four drill sites with water depths ranging from 125 to 260 m. The maximum drill depth was 569 m below the lake floor in the centre of the lake. By retrieving overlapping sediment sequences, 95% of the sediment succession was recovered. Initial data from borehole logging, core logging and geochemical measurements indicate that the sediment succession covers >1.2 million years (Ma) in a quasi-continuous sequence. These early findings suggest that the record from Lake Ohrid will substantially improve the knowledge of long-term environmental change and short-term geological events in the northeastern Mediterranean region, which forms the basis for improving understanding of the influence of major geological and environmental events on the biological evolution of endemic species.

The 74 (75) ka Toba eruption in Sumatra, Indonesia, is considered to be one of the largest volcanic events during the Quaternary. Tephra from the Toba eruption has been found in many terrestrial and marine sedimentary deposits, and acidity peaks related to the eruption have been used to synchronize ice core records from Greenland and Antarctica. Seismic profiles and sedimentological data from Lake Prespa on the Balkan Peninsula, SE Europe, indicate a lake level lowstand at 73.6 +/- 7.7 ka based on ESR dating of shells. Tephrostratigraphy, radiocarbon dating and tuning of the total organic carbon content with the NGRIP isotope record, corroborate that the lake level lowstand was a short-term event superimposed on the general cooling trend at the end of MIS 5, most likely at the onset of the Greenland Stadial GS-20. Acknowledging that tectonic events or karst processes could have triggered this lake level lowstand, the chronological correspondence between the lowstand and the Toba eruption is intriguing. Therefore a Toba-driven short-term shift to aridity in the Balkan region, leading to lake level changes and triggering spatial expansion events in one of the lake's most abundant benthic species, the carino mussel Dreissena presbensis, cannot be excluded.

The Scientific Collaboration on Past Speciation Conditions in Lake Ohrid (SCOPSCO) project is an international research initiative to study the influence of major geological and environmental events on the biological evolution of lake taxa. SCOPSCO drilling campaigns were carried out in 2011 and 2013. In 2011 we used gravity and piston coring at one of the five proposed drill sites, and in 2013 we undertook deep drilling with the Deep Lake Drilling System (DLDS) of Drilling, Observation and Sampling of the Earth's Continental Crust (DOSECC). In April and May 2013, a total of 2100 m sediments were recovered from four drill sites with water depths ranging from 125 to 260 m. The maximum drill depth was 569 m below the lake floor in the centre of the lake. By retrieving overlapping sediment sequences, 95% of the sediment succession was recovered. Initial data from borehole logging, core logging and geochemical measurements indicate that the sediment succession covers >1.2 million years (Ma) in a quasi-continuous sequence. These early findings suggest that the record from Lake Ohrid will substantially improve the knowledge of long-term environmental change and short-term geological events in the northeastern Mediterranean region, which forms the basis for improving understanding of the influence of major geological and environmental events on the biological evolution of endemic species.

The 74 (75) ka Toba eruption in Sumatra, Indonesia, is considered to be one of the largest volcanic events during the Quaternary. Tephra from the Toba eruption has been found in many terrestrial and marine sedimentary deposits, and acidity peaks related to the eruption have been used to synchronize ice core records from Greenland and Antarctica. Seismic profiles and sedimentological data from Lake Prespa on the Balkan Peninsula, SE Europe, indicate a lake level lowstand at 73.6 ± 7.7 ka based on ESR dating of shells. Tephrostratigraphy, radiocarbon dating and tuning of the total organic carbon content with the NGRIP isotope record, corroborate that the lake level lowstand was a short-term event superimposed on the general cooling trend at the end of MIS 5, most likely at the onset of the Greenland Stadial GS-20. Acknowledging that tectonic events or karst processes could have triggered this lake level lowstand, the chronological correspondence between the lowstand and the Toba eruption is intriguing. Therefore a Toba-driven short-term shift to aridity in the Balkan region, leading to lake level changes and triggering spatial expansion events in one of the lake's most abundant benthic species, the carino mussel Dreissena presbensis, cannot be excluded.

Report within SAFEGUARD work package 3.1, Final Version 2012-08-17