Search

The association between bariatric surgery and new onset of inflammatory bowel disease has so far only been sparsely studied and with conflicting results.To investigate the association between bariatric surgery and inflammatory bowel disease in a large population-based cohort.Nationwide in Sweden.This population-based retrospective cohort study included Swedish individuals registered in the Scandinavian Obesity Surgery Registry who underwent primary Roux-en-Y gastric bypass or sleeve gastrectomy during 2007-2018. Ten control individuals from the general population were matched according to age, sex, and region of residence at time of exposure. The study population was followed until 2019 with regard to the development of inflammatory bowel disease. Cox proportional hazards models were used to compare disease-free survival time between subgroups and control individuals for each outcome.The final cohort consisted of 64,188 exposed individuals with a total follow-up of 346,860 person-years and 634,530 controls with total follow-up of 3,444,186 person-years. Individuals who underwent Roux-en-Y-gastric bypass had an increased risk of later development of Crohn's disease (hazard ratio [HR] 1.8, 95% CI 1.5-2.2) and unclassified inflammatory bowel disease (HR 2.7, 95% CI 2.0-3.7) but not ulcerative colitis (HR .9, 95% CI .8-1.1) compared with control individuals, whereas individuals who underwent sleeve gastrectomy had an increased risk of ulcerative colitis (HR 1.8, 95% CI 1.1-3.1) but not Crohn's disease (HR .8, 95% CI .3-2.1) and unclassified inflammatory bowel disease (HR 2.5, 95% CI .8-7.8).Roux-en-Y gastric bypass was associated with increased risk of Crohn's disease and unclassified inflammatory bowel disease, whereas sleeve gastrectomy was associated with increased risk of ulcerative colitis only.

Many studies show that mixed species stands can have higher gross growth, or so-called overyielding, compared with monocultures. However, much less is known about mortality in mixed stands. Knowledge is lacking, for example, of how much of the gross growth is retained in the standing stock and how much is lost due to mortality. Here, we addressed this knowledge gap of mixed stand dynamics by evaluating 23 middle-aged, unthinned triplets of monospecific and mixed plots of Scots pine (Pinus sylvestris L.) and European beech (Fagus sylvatica L.) repeatedly surveyed over 6–8 years throughout Europe. For explanation of technical terms in this abstract see Box 1. First, mixed stands produced more gross growth (+10%) but less net growth (−28%) compared with the weighted mean growth of monospecific stands. In monospecific stands, 73% of the gross growth was accumulated in the standing stock, whereas only 48% was accumulated in mixed stands. The gross overyielding of pine (2%) was lower than that of beech (18%). However, the net overyielding of beech was still 10%, whereas low growth and dropout of pine caused a substantial reduction from gross to net growth. Second, the mortality rates, the self- and alien-thinning strength, and the stem volume dropout were higher in mixed stands than monospecific stands. The main reason was the lower survival of pine, whereas beech persisted more similarly in mixed compared with monospecific stands.Third, we found a 10% higher stand density in mixed stands compared with monospecific stands at the first survey. This superiority decreased to 5% in the second survey.Fourth, the mixing proportion of Scots pine decreased from 46% to 44% between the first and second survey. The more than doubling of the segregation index (S) calculated by Pielou index (S increased from 0.2 to 0.5), indicated a strong tendency towards demixing due to pine. Fifth, we showed that with increasing water supply the dropout fraction of the gross growth in the mixture slightly decreased for pine, strongly increased for beech, and also increased for the stand as a whole. We discuss how the reduction of inter-specific competition by thinning may enable a continuous benefit of diversity and overyielding of mixed compared with monospecific stands of Scots pine and European beech., The study received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No952314 and under the Marie Skłodowska-Curie grant agreement No 778322. The first author also wishes to thank the German ScienceFoundation (Deutsche Forschungsgemeinschaft) for funding the project “Structure and dynamics of mixed-species stands of Scots pine and European beech compared with monospecific stands; analysis along an ecological gradient through Europe” (# DFG PR 292/15-1). Felipe Bravo is grateful for Funds by the Junta de Castilla y León through the projects “CLU-2019-01 and CL-EI-2021-05 - iuFOR Institute Unit of Excellence” of the University of Valladolid and the co-financing by the European Regional Development Fund (ERDF “Europe drives our growth”). Miren del Río thanks for the support by the Spanish Ministerio de Ciencia e Innovación (# PID2021-126275OB-C21/C22). Dejan Stojanović thanks the Ministry of Education, Science and Technological Development of the Republic of Serbia for funding. Tzvetan Zlatanov thanks the Ministry of Education and Science of the Republic of Bulgaria (# DO1-405/18.12.2020 LTER-BG).

Quercus robur/Quercus petraea and Pinus sylvestris are widely distributed and economically important tree species in Europe co-occurring on mesotrophic, xeric and mesic sites. Increasing dry conditions may reduce their growth, but growth reductions may be modified by mixture, competition and site conditions. The annual diameter growth in monospecific and mixed stands along an ecological gradient with mean annual temperatures ranging from 5.5 °C to 11.5 °C was investigated in this study. On 36 triplets (108 plots), trees were cored and the year-ring series were cross-dated, resulting in year-ring series of 785 and 804 trees for Q. spp. and P. sylvestris, respectively. A generalized additive model with a logarithmic link was fit to the data with random effects for the intercept at the triplet, year and tree level and a random slope for the covariate age for each tree; the Tweedie-distribution was used. The final model explained 87 % of the total variation in diameter increment for both tree species. Significant covariates were age, climate variables (long-term mean, monthly), local competition variables, relative dbh, mixture, stand structure and interactions thereof. Tree growth declined with age and local density and increased with social position. It was positively influenced by mixture and structural diversity (Gini coefficient); mixture effects were significant for P. sylvestris only. The influence of potential evapotranspiration (PET) in spring and autumn on tree growth was positive and non-linear, whereas tree growth sharply decreased with increasing PET in June, which proved to be the most influential month on tree growth along the whole ecological gradient. Interactions of PET with tree social position (relative dbh) were significant in July and September for Q. spp. and in April for P. sylvestris. Interactions of climate with density or mixture were not significant. Climatic effects found agree well with previous results from intra-annual growth studies and indicate that the model captures the causal factors for tree growth well. Furthermore, the interaction between climate and relative dbh might indicate a longer growth duration for trees of higher social classes. Analysis of random effects across time and space showed highly dynamic patterns, with competitive advantages changing annually between species and spatial patterns showing no large-scale trends but pointing to the prevalence of local site factors. In mixed-species stands, the tree species have the same competitivity in the long-term, which is modified by climate each year. Climate warming will shift the competitive advantages, but the direction will be highly site-specific., The authors thank the European Union for funding the project “Mixed species forest management. Lowering risk, increasing resilience (REFORM)” under the framework of Sumforest ERA-NET. All contributors thank their national funding institutions to establish, measure and analyze data from the triplets. The Polish State Forests Enterprise also supported one of the Polish co-authors (Grant No: OR.271.3.15.2017). The Orléans site, OPTMix was installed thanks to ONF (National Forest Service, France), belongs to research infrastructure ANAEE-F; it is also included in the SOERE TEMPO, ZAL (LTSER Zone Atelier Loire) and the GIS oop network. This work was also supported by grant APVV-18-0347 (Slovakia). We acknowledge Institutional support MZE-RO0118 from the Ministry of Agriculture of the Czech Republic, partly funding the field measurements at Czech triplets.

Background/purpose Hirschsprung disease has previously been reported to be associated with inflammatory bowel disease (IBD). The aim was to clinically confirm the diagnosis and to describe characteristics among individuals with both conditions in a national populationbased cohort. Methods Nationwide, population-based cohort study, including all individuals with a Hirschsprung disease diagnosis and an IBD diagnosis registered between 1964 and 2016, in which clinical data were collected from the medical records of 18 validated cases with both Hirschsprung disease and IBD. The medical record of each individual in the study cohort was reviewed for age at IBD diagnosis, type of aganglionosis, type of surgical treatment, subtype of IBD, and treatment for IBD. Results Median age at follow up was 34 years (range 19–66), and 3 of 18 indivduals (17%) were females. Median age at first diagnosis of IBD was 21 years (range 10–46). Six patients had ulcerative colitis, ten had Crohn's disease and two had unclassified IBD. Most of the patients had pharmacological treatment for IBD and 5 (28%) individuals had surgical treatment. Conclusion Hirschsprung disease and IBD was clinically confirmed in 18 cases. Age at IBD onset and subtype of IBD is similar to IBD patients without Hirschsprung disease. Five individuals had undergone surgical treatment for IBD.

15 Pág. Ecological Modelling, Tree species mixing of oak (Quercus petraea (Matt.) Liebl./Quercus robur L.) and pine (Pinus sylvestris L.) has been shown to have positive effects on ecosystem service provision. From a management perspective, however, it is still uncertain which thinning regime provides the highest possible productivity of mixed oak–pine forests in the long term. Because of a lack of empirical studies dealing with thinning and species mixing effects on oak–pine forests, we simulated forest growth in order to test which thinning type and intensity may provide the highest productivity in the long-term. To achieve this, we simulated the growth of pure and mixed stands of oak and pine for 100 years in 23 triplets located on an ecological gradient across Europe. For this purpose, we applied four different growth simulators and compared their results: the distance-independent single-tree simulator PROGNAUS, the distance-dependent single-tree simulator SILVA, the gap model ForCEEPS, and the process-based simulator 3D-CMCC-FEM. We investigated the effects of species mixing and thinning from the upper (thinning from above) and lower tail (thinning from below) of the diameter distribution by reducing the stand basal area to 50 and 80% of the maximum basal area. We compared simulated results of the relative volume productivity of mixed versus pure stands and of thinned versus unthinned stands to empirical results previously obtained on the same set of triplets. Simulated relative volume productivity ranged between 61 and 156%, although extremes of 10% and of 300% could be observed. We found the relative volume productivity to be influenced by stand age, but not by stand density, except for PROGNAUS. Relative volume productivity did not increase with the site water supply of the triplet location. Highest long-term productivity for oak, pine and oak–pine stands can be expected in consequence of thinning from above, but the effect of thinning intensity differed between simulators. Thinning effects were positively affected by stand density, but not by stand age, except for thinning from above predicted by PROGNAUS. Predicted thinning effects showed good approximation of results from thinning experiments for oak, but not for pine stands. We hypothesize the results might be caused by the insufficient simulator representation of climate and its interaction with other site variables and stand structure. Further work is needed to reduce the revealed limitations of the existing growth models, as we currently see no alternative to such kind of studies and simulators., The authors thank the European Union for funding the project “Mixed species forest management. Lowering risk, increasing resilience (REFORM)” under the framework of Sumforest ERA-NET. The authors from Austria also thank the Austrian Federal Ministry for Sustainability and Tourism for supporting the establishment of the Austrian triplet plots and for covering the work expenses of Markus Engel within the project ”Forstwirtschaft mit Mischwäldern – geringes Risiko, hohe Widerstandskraft – REFORM” under the grant number 101199. All contributors thank their national funding institutions to establish, measure and analyze data from the triplets. Maude Toïgo and Xavier Morin thank François de Coligny and Nicolas Beudez for their help in the development of the ForCEEPS model. Antonio Tomao, Carlo Trotta and Anna Barbati thank Alessio Collalti for his support and suggestions about the simulations with the 3D-CMCC-FEM model.

Purpose Hirschsprung disease (HSCR) is a multifactorial disease. Maternal intake of selective serotonin reuptake inhibitors (SSRI) during early pregnancy has previously been associated with increased risk for HSCR. The aim of this study was to assess the risk for HSCR in newborns after maternal intake of SSRI in a population-based Swedish cohort. Methods This was a Swedish nationwide, population-based, case–control cohort study containing all children born in Sweden between 1/12006 and 31/122012. The cases were identified in the Swedish National Patient Register and the controls (five age- and sex-matched controls per case) were randomly selected among children without HSCR in the cohort. Data on maternal SSRI use during pregnancy were collected from the Swedish Prescribed Drug Register. Results Out of 775,024 born children during the study period, 150 cases of HSCR (112 males) and 750 controls (560 males) were included. Five (3.3%) mothers of newborns with HSCR had used SSRI during pregnancy compared to 16 (2.1%) mothers of the controls (p = 0.372). The mean age was similar in mothers who had used SSRI compared to those who had not (30.9 (SD +/− 5.1) versus 30.6 (SD +/− 5.0), p = 0.81). Conclusions There was no increased risk of HSCR owing to maternal intake of SSRI in this cohort. Level of evidence: Level I.

Purpose Hirschsprung disease (HSCR) has previously been associated with increased need of special education services despite normal intelligence. The aim of this study was to assess the risk of attention deficit hyperactivity disorders (ADHD) in individuals with HSCR in a population-based cohort. Methods This was a nationwide, population-based cohort study. The study exposure was HSCR and the study outcome was ADHD. The cohort included all individuals with HSCR registered in the Swedish National Patient Register between 1964 and 2013 and ten age- and sex-matched controls per patient, randomly selected from the Population Register. Results The cohort comprised 739 individuals with HSCR and 7390 controls. Twenty-six of the 739 individuals with HSCR and 202 of the 7390 controls were diagnosed with ADHD, Odds ratio (OR) 1.30, Confidence interval (CI) 95% 0.84–1.93, indicating no difference in risk for ADHD. The mean age at diagnosis of ADHD was not different between the groups; 18.1 years (SD 8.4) vs 16.7 years (SD 7.8), p = 0.39. Down syndrome did not affect the risk for ADHD, OR 2.26 (CI 95% 0.68–5.53). Female gender decreased the risk for ADHD, OR 0.58 (CI 95% 0.40–0.83). Conclusions There is no increased risk of ADHD in patients with Hirschsprung disease. Level of evidence. Prognosis study, level of evidence: Level I.

The scale of opportunity to implement forest restoration exceeds billions of ha worldwide, and a part of this area in northern temperate regions includes formerly oak ( Quercus spp.)-dominated ecosystems. The cost of achieving restoration is often high, and tends to increase with severity of ecosystem degradation. Therefore, it is important to develop cost-efficient regeneration practices to support forest restoration. Direct seeding of acorns, one of the earliest artificial forest regeneration techniques developed, offers several benefits including costs that can be about a third of planting oak seedlings. However, direct seeding is presently a more uncertain practice for establishing oak forests and woodlands than is planting seedlings. Much of this uncertainty can be a result of acorn depredation by rodents even though other factors may also limit oak establishment. This review provides a synthesis of foundational knowledge, particularly from Europe and North America, pertaining to the biology and ecology of acorn production, acorn germination, early seedling growth, and acorn depredation by granivorous rodents. We build on this knowledge to review research on operational direct seeding practices and four basic strategies for acorn depredation control (chemical, ecological, physical and silvicultural). We suggest that environmentally sound approaches to minimize acorn depredation and increase seedling establishment currently exists. For example, seeding operations probably hold higher chances for success if scheduled during years of high masting, if applied on open sites (areas with little shrub and tree cover), and if acorn lots are sized and sown at an appropriate depth. Several gaps in our knowledge limit the development of improved operational practices for broader success. We lack information on basic acorn biology and proper handling and storage practices for many of the oaks around the world. And, we need research to support development of new techniques or combinations of strategies and techniques that minimize acorn depredation under a wide range of site conditions. Nevertheless, our synthesis suggests that direct seeding will remain a cost-effective and environmentally sound practice for oak forest and woodland establishment, and it will likely gain expanded use as future research informs innovation that increases seed availability, decreases acorn depredation, and raises predictability of oak seedling establishment.

Wind is a natural disturbance factor in boreal and temperate forests having large ecological and economic consequences. We investigated recovery processes in forests severely damaged by windthrow, by conducting a systematic quantitative literature review of 34 case studies. We addressed three questions on forest ecosystem recovery: (1) Which forest regeneration processes dominate forest recovery after windthrow? (2) Which structures and processes enhance or impede forest recovery after windthrow? (3) Does salvage logging after windthrow influence forest recovery? Our analyses showed that the main focus of the reviewed studies was on post storm seedling regeneration and survival. Advanced regeneration from suppressed seedlings or saplings also played an important role in the studies, especially for shade tolerant species and in the boreal biome. Pits and mounds and coarse woody debris played an important role for the establishment of Picea sp., especially in the studies from the boreal biome, whereas in the temperate biome game interference and competition from ground vegetation seemed to be the most important influencing processes. Salvage logging mostly acted as a subsequent disturbance after the windthrow, pushing the forest ecosystem towards an earlier successional stage, hereby impeding recovery. In none of the studies however, did the windthrow nor the consequent salvaging halt recovery completely, confirming the resilience of forests as the dominant vegetation type in these biomes. Based on our results forest management implications are discussed.

Many tree species worldwide are suffering from slow or failed natural regeneration with dramatic consequences for biodiversity and ecosystem services. However, it is difficult to disentangle the complex effects of factors influencing regeneration processes on long-lived tree species at large scales. In this study, we use long-term data from the Swedish National Forest Inventory (1953–2015) combined with deer hunting data (1960–2015) to reveal experimentally-intractable processes impeding oak (Quercus spp.) regeneration in southern Sweden. Oak-dominated ecosystems are widespread in northern temperate regions, where oaks are foundation species with disproportionate importance for biodiversity and ecosystem functions. Our study reveals that during the last six decades, oak tree numbers and standing volume have continuously increased, while natural regeneration of oak declined steeply after the early 1980s. We connect this decline to denser and darker forests, combined with increased abundance of deer. Land use changes during the six decades, such as abandonment of traditional practices and large-scale introduction of forest management oriented towards high volume production, led to continuously denser forests and thereby reduced the oak regeneration niche. In addition, the impact of changed game management was evident. This was particularly clear from a natural experiment on Gotland, a large island free of deer until roe deer were introduced in the late 20th century, at which point oak regeneration began a steep decline. At the stand level, natural oak regeneration could be expected to mainly occur in pulses after disturbance events, followed by a period of low regeneration success as the cohort ages. However, at a landscape scale one would expect a mix of successional stages that would even out such demographic patterns. A prolonged period of low regeneration at a landscape scale will eventually lead to a large gap in the oak size distribution as was observed in this study. This could eventually hurt the many species dependent on old and large oak trees. Active management to restore the oak regeneration niche, i.e. forest habitats with more light and less browsing pressure, therefore seems essential. The latter includes developing strategies that manage both deer populations and their available food across landscapes. Our study is the first to link oak regeneration failure to long-term changes in land use and increased deer populations at a landscape scale in this region. Furthermore, our study show how historical data can clarify confounded processes impacting long-lived forest species.

Objective To evaluate the associations of parent-reported sleep-disordered breathing (SDB) and device-assessed sleep behaviors with behavioral and emotional functioning in pediatric patients with overweight/obesity. Study design A total of 109 children with overweight/obesity (mean age, 10.0 +/- 1.1 years) were included in this cross-sectional study. We used the Spanish version of the Pediatric Sleep Questionnaire (PSQ) to assess SDB and its subscales (ie, snoring, daytime sleepiness, and inattention/hyperactivity). Device-assessed sleep behaviors (ie, wake time, sleep onset time, total time in bed, total sleep time, and waking after sleep onset) were estimated using wrist-worn accelerometers. We used the Behavior Assessment System for Children, second edition to assess behavioral and emotional functioning (ie, clinical scale: aggressiveness, hyperactivity, behavior problems, attention problems, atypicality, depression, anxiety, retreat, and somatization; adaptive scale: adaptability, social skills, and leadership). Results SDB was positively associated with all clinical scale variables (all beta > 0.197, P 0.196, P .045) and lower adaptability (beta = -0.246, P = .011). The inattention/hyperactivity subscale was significantly associated with the entire clinical and adaptive scales (all beta > vertical bar 0.192 vertical bar, P, Spanish Government, European Commission DEP2013-47540 DEP2016-79512-R DEP2017-91544-EXP RYC-2011-09011, Spanish Government FPU17/04802 FJC2018-037925-I FPU15/02645, University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence, Scientific Excellence Unit on Exercise and Health, Consejeria de Conocimiento, Investigacion y Universidades, European Commission B-CTS-355-UGR18 SOMM17/6107/UGR, SAMID III network, RETICS - PNI + D + I 2017-2021 (Spain), ISCIII Sub-Directorate General for Research Assessment and Promotion, EXERNET Research Network on Exercise and Health DEP2005-00046/ACTI 09/UPB/19 45/UPB/20 27/UPB/21, European Commission 667302, HL-PIVOT network Healthy Living for Pandemic Event Protection, Andalusian Operational Programme, Junta de Andalucia

Background: There is a paucity of data from low- and middle-income countries on sedentary behaviour (SB) levels and patterns during early childhood. The purpose of this study was to examine how device-measured SB in young children differed across geographically, economically, and socio-demographically diverse populations, in an international sample. Methods: This multinational, cross-sectional pilot study included data from 1071 3–5-year-old children from 19 countries, collected between 2018 and 2020 (pre-COIVID). SB was measured for three consecutive days using activPAL accelerometers. Sedentary time, sedentary fragmentation and seated transport duration were calculated using PAL Analysis Algorithms and a custom-made analysis program. Linear mixed models were used to examine the differences in SB variables between sex, country-level income groups, caregiver education levels, urban/rural settings, and population density. Findings: Children spent 56% (7.4 hrs) of their waking time sedentary, and 42% accrued at least one sedentary bout/day lasting ≥60 min. The longest average bout duration was 81.1±45.4 min, and an average of 61.1±50.1 min/day was spent in seated transport. Children from upper-middle-income and high-income countries spent a greater proportion of the day sedentary, accrued more sedentary bouts, had shorter breaks between sedentary bouts, and spent significantly more time in seated transport, than children from low- and lower-middle-income countries. Few differences were found in SB patterns between urban/rural settings and caregiver education levels within each country-level income group, while multiple significant differences were found when comparing between country-level income groups. Higher population density was correlated with several higher SB measures. Interpretation: These data advance our understanding of young children’s SB patterns globally and the influences of country income, urban/rural setting, caregiver education levels, and population density. Country income levels and population density appear to be stronger drivers of the observed differences, than sex, rural or urban residential setting or caregiver educational attainment. Funding: American Council on Exercise, USA Beijing Health System High Level Talents Training Project, China 13 Biomedical Research Foundation, Dhaka, Bangladesh Canadian Institutes of Health Research Planning and Dissemination Grant Conselho Nacional de Pesquisa e Desenvolvimento Cientifico e Tecnologico - CNPq Research Department of National Planning and Monitoring, PNG Government Early Start, University of Wollongong, Australia Faculty of Health Sciences at the University of the Witwatersrand, Johannesburg, South Africa Global Challenges Program, University of Wollongong, Australia Harry Crossley Foundation, South Africa National Health and Medical Research Council, Australia NIH - International Research Training Grant Pham Ngoc Thach University of Medicine, Vietnam Research University Grant (GUP), Universiti Kebangsaan Malaysia Sasakawa Sports Research Grant, Sasakawa Sports Foundation, Japan Stella de Silva Research Grant, Sri Lanka College of Paediatricians, Sri Lanka The DST-NRF Centre for Excellence in Human Development at the University of Witwatersrand, Johannesburg, South Africa The International Society of Behavioral Nutrition and Physical Activity, Pioneers Program Declaration of Interest: The authors have no competing financial or personal interests to declare. Ethical Approval: Ethical approval was obtained from the University of Wollongong, Australia (ref: 2018/044) and the appropriate ethics committee(s) in each country.

International audience; Just as the aboveground tree organs represent the interface between trees and the atmosphere, roots act as the interface between trees and the soil. In this function, roots take-up water and nutrients, facilitate interactions with soil microflora, anchor trees, and also contribute to the gross primary production of forests. However, in comparison to aboveground plant organs, the biomass of roots is much more difficult to study. In this study, we analyzed 19 European datasets on above- and belowground biomass of juvenile trees of 14 species to identify generalizable estimators of root biomass based on tree sapling dimensions (e.g. height, diameter, aboveground biomass). Such estimations are essential growth and sequestration modelling. In addition, the intention was to study the effect of sapling dimension and light availability on biomass allocation to roots. All aboveground variables were significant predictors for root biomass. But, among aboveground predictors of root biomass plant height performed poorest. When comparing conifer and broadleaf species, the latter tended to have a higher root biomass at a given dimension. Also, with increasing size, the share of belowground biomass tended to increase for the sapling dimensions considered. In most species, there was a trend of increasing relative belowground biomass with increasing light availability. Finally, the height to diameter ratio (H/D) was negatively correlated to relative belowground biomass. This indicates that trees with a high H/D are not only more unstable owing to the unfavorable bending stress resistance, but also because they are comparatively less well anchored in the ground. Thus, single tree stability may be improved through increasing light availability to increase the share of belowground biomass.