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Background: Acute mesenteric ischaemia (AMI) is a condition with high mortality. This survey assesses current attitudes and practices to manage AMI worldwide.Methods: A questionnaire survey about the practices of diagnosing and managing AMI, endorsed by several specialist societies, was sent to different medical specialists and hospitals worldwide. Data from individual health care professionals and from medical teams were collected.Results: We collected 493 individual forms from 71 countries and 94 team forms from 34 countries. Almost half of respondents were surgeons, and most of the responding teams (70%) were led by surgeons. Most of the respondents indicated that diagnosis of AMI is often delayed but rarely missed. Emergency revascularisation is often considered for patients with AMI but rarely in cases of transmural ischaemia (intestinal infarction). Responses from team hospitals with a dedicated special unit (14 team forms) indicated more aggressive revascularisation. Abdominopelvic CT-scan with intravenous contrast was suggested as the most useful diagnostic test, indicated by approximately 90% of respondents. Medical history and risk factors were thought to be more important in diagnosis of AMI without transmural ischaemia, whereas for intestinal infarction, plasma lactate concentrations and surgical exploration were considered more useful. In elderly patients, a palliative approach is often chosen over extensive bowel resection. There was a large variability in anticoagulant treatment, as well as in timing of surgery to restore bowel continuity.Conclusions: Delayed diagnosis of AMI is common despite wide availability of an adequate imaging modality, i.e. CT-scan. Large variability in treatment approaches exists, indicating the need for updated guidelines. Increased awareness and knowledge of AMI may improve current practice until more robust evidence becomes available. Adherence to the existing guidelines may help in improving differences in treatment and outcomes. Background: Acute mesenteric ischaemia (AMI) is a condition with high mortality. This survey assesses current attitudes and practices to manage AMI worldwide.Methods: A questionnaire survey about the practices of diagnosing and managing AMI, endorsed by several specialist societies, was sent to different medical specialists and hospitals worldwide. Data from individual health care professionals and from medical teams were collected.Results: We collected 493 individual forms from 71 countries and 94 team forms from 34 countries. Almost half of respondents were surgeons, and most of the responding teams (70%) were led by surgeons. Most of the respondents indicated that diagnosis of AMI is often delayed but rarely missed. Emergency revascularisation is often considered for patients with AMI but rarely in cases of transmural ischaemia (intestinal infarction). Responses from team hospitals with a dedicated special unit (14 team forms) indicated more aggressive revascularisation. Abdominopelvic CT-scan with intravenous contrast was suggested as the most useful diagnostic test, indicated by approximately 90% of respondents. Medical history and risk factors were thought to be more important in diagnosis of AMI without transmural ischaemia, whereas for intestinal infarction, plasma lactate concentrations and surgical exploration were considered more useful. In elderly patients, a palliative approach is often chosen over extensive bowel resection. There was a large variability in anticoagulant treatment, as well as in timing of surgery to restore bowel continuity.Conclusions: Delayed diagnosis of AMI is common despite wide availability of an adequate imaging modality, i.e. CT-scan. Large variability in treatment approaches exists, indicating the need for updated guidelines. Increased awareness and knowledge of AMI may improve current practice until more robust evidence becomes available. Adherence to the existing guidelines may help in improving differences in treatment and outcomes.

Accurate prediction of rut depth caused by military vehicles trafficking is crucial for the success of their mission. In addition to the operational aspect of trafficability and mobility, military vehicle traffic can lead to severe degradation of soil functions. The objective of this study was (i) to examine rut depth formation and bulk density changes after one and repeated passages of a military vehicle on different soils and land uses, and (ii) to assess the ability of an analytical soil compaction model to predict these changes. The wheeling tests were carried out with a 7 Mg military truck at seven sites in Estonia covering soil textures from sand to clay and a peat soil. Rut depths and bulk density at various depths were measured after one and ten vehicle passes. Undisturbed soil samples were collected next to the tracks for determination of initial soil compressive properties used for parameterisation of the model. The smallest rut depths were measured on arable soils, both after one and ten vehicle passes. The largest rut depth after one pass was obtained on the peat soil, while the largest rut depths after ten passes were measured on the grassland soils. The model overestimated rut depths on the peat soil, and underestimated the increase in rut depth from the first to the tenth pass on the grassland soils, while predictions for the arable soils were adequate. We identify a need for studies on the mechanical behaviour of peat soils during wheeling and for better quantitative description of multi pass effects, especially on soft soils.

Following the new ESPEN Standard Operating Procedures, the previous guidelines to provide best medical nutritional therapy to critically ill patients have been updated. These guidelines define who are the patients at risk, how to assess nutritional status of an ICU patient, how to define the amount of energy to provide, the route to choose and how to adapt according to various clinical conditions. When to start and how to progress in the administration of adequate provision of nutrients is also described. The best determination of amount and nature of carbohydrates, fat and protein are suggested. Special attention is given to glutamine and omega-3 fatty acids. Particular conditions frequently observed in intensive care such as patients with dysphagia, frail patients, multiple trauma patients, abdominal surgery, sepsis, and obesity are discussed to guide the practitioner toward the best evidence based therapy. Monitoring of this nutritional therapy is discussed in a separate document.

Purpose: To assess whether the combination of intra-abdominal hypertension (IAH, intra-abdominal pressure >_ 12 mmHg) and hypoxic respiratory failure (HRF, PaO2/FiO2 ratio < 300 mmHg) in patients receiving invasive ventilation is an independent risk factor for 90-and 28-day mortality as well as ICU-and ventilation-free days. Methods: Mechanically ventilated patients who had blood gas analyses performed and intra-abdominal pressure measured, were included from a prospective cohort. Subgroups were defined by the absence (Group 1) or the presence of either IAH (Group 2) or HRF (Group 3) or both (Group 4). Mixed-effects regression analysis was performed. Results: Ninety-day mortality increased from 16% (Group 1, n = 50) to 30% (Group 2, n = 20) and 27% (Group 3, n = 100) to 49% (Group 4, n = 142), log-rank test p < 0.001. The combination of IAH and HRF was associated with increased 90-and 28-day mortality as well as with fewer ICU-and ventilation-free days. The association with 90-day mortality was no longer present after adjustment for independent variables. However, the association with 28-day mortality, ICU-and ventilation-free days persisted after adjusting for independent variables. Conclusions: In our sub-analysis, the combination of IAH and HRF was not independently associated with 90-day mortality but independently increased the odds of 28-day mortality, and reduced the number of ICU-and ventilation-free days. (c) 2021 Elsevier Inc. All rights reserved.

In this paper we present effects of four paired agricultural management practices (organic matter (OM) addition versus no organic matter input, no-tillage (NT) versus conventional tillage, crop rotation versus monoculture, and organic agriculture versus conventional agriculture) on five key soil quality indicators, i.e., soil organic matter (SOM) content, pH, aggregate stability, earthworms (numbers) and crop yield. We have considered organic matter addition, no-tillage, crop rotation and organic agriculture as “promising practices”; no organic matter input, conventional tillage, monoculture and conventional farming were taken as the respective references or “standard practice” (baseline). Relative effects were analysed through indicator response ratio (RR) under each paired practice. For this we considered data of 30 long-term experiments collected from 13 case study sites in Europe and China as collated in the framework of the EU-China funded iSQAPER project. These were complemented with data from 42 long-term experiments across China and 402 observations of long-term trials published in the literature. Out of these, we only considered experiments covering at least five years. The results show that OM addition favourably affected all the indicators under consideration. The most favourable effect was reported on earthworm numbers, followed by yield, SOM content and soil aggregate stability. For pH, effects depended on soil type; OM input favourably affected the pH of acidic soils, whereas no clear trend was observed under NT. NT generally led to increased aggregate stability and greater SOM content in upper soil horizons. However, the magnitude of the relative effects varied, e.g. with soil texture. No-tillage practices enhanced earthworm populations, but not where herbicides or pesticides were applied to combat weeds and pests. Overall, in this review, yield slightly decreased under NT. Crop rotation had a positive effect on SOM content and yield; rotation with ley very positively influenced earthworms’ numbers. Overall, crop rotation had little impact on soil pH and aggregate stability − depending on the type of intercrop; alternatively, rotation of arable crops only resulted in adverse effects. A clear positive trend was observed for earthworm abundance under organic agriculture. Further, organic agriculture generally resulted in increased aggregate stability and greater SOM content. Overall, no clear trend was found for pH; a decrease in yield was observed under organic agriculture in this review.

A study was carried out to assess if the visual soil assessment method (VSA) would allow recognizing differences between soils receiving organic matter (OM) amendments and similar control soils, by the observation of visual soil quality indicators’ score. 36 practices were identified across 8 pedoclimatic zones. These fields/plots were paired with nearby control fields/plots, without OM amendments, sharing similar farming features. A survey, comprising a VSA of the soil structure status, surface ponding, signs of erosion, earthworm counts and soil stability (slake test), complemented by measurements of soil organic matter (SOM) and permanganate oxidizable organic carbon (LOC) content, soil pH, penetration resistance and texture, on soils of both management system groups (OM addition and Control), was performed in 2016. Correlations of the visual soil quality indicators’ score with SOM, LOC, other soil properties and climate variables and indices were calculated within each group; the correlations between soil properties, and between soil properties (SOM and LOC) and climate variables were also calculated. A statistically significantly higher proportion of soils of the OM group had a good score for “soil structure and consistency” and “soil porosity”. These differences are not directly explained by non-inherent soil properties. No statistically significant Spearman’s correlation coefficients were observed between “soil structure and consistency” and either soil properties or climate variables; concerning “soil porosity”, distinct statistically significant correlations were observed between the two groups with different climate variables and indices. Correlations between the scores of the visual soil quality indicators and climate variables were found to follow the same directions of correlations of LOC content with the same climate variables, although the latter correlations were weak. Mean SOM and LOC content, were slightly higher in the OM group, although differences were not statistically significant. A high linear correlation between LOC (mg/g) and SOM (%) (r = 0.65, n = 26) exists within the Control group, but not within the OM group (r = 0.20 and n = 26). When the relationship of SOM and LOC content with visual soil quality indicators’ score was studied, statistically significant correlations were only observed between SOM and “earthworm count” within the Control group (rs = 0.44), and between LOC and “soil colour” within the OM group (rs=-0.52). Both LOC content and LOC status (ranked as a function of LOC content and soil texture), had only negative statistically significant correlations with visual soil quality indicators’ score, questioning their worth as stand-alone soil quality indicators.

Deep ruts in soil hinder the movement of off-road vehicles and harm drastically the soil environment. The aim of this study was to determine the most suitable cone and remoulding index based methods for rut depth estimation for single and repeated military vehicle passage in typical Estonian soils. Cone index based sinkage models – US Army ERDC, Maclaurin (1990) and Willoughby and Turnage sinkage models applicable for military vehicles were tested, using different critical layers (0–15 cm, 7.5–23 cm or 15–30 cm). The test vehicles were a 7 Mg truck and a 23 Mg armoured personnel carrier. At eight experimental sites covering mechanically very variable soil conditions (from peat to clay soil), rut depth was measured after one and ten vehicle passes, cone penetration tests were conducted in situ, and samples were collected for determination of bulk density, organic carbon content, texture, gravimetric water content, plastic and liquid limits of the topsoil and subsoil. According to average RMSD values for military truck the Willoughby and Turnage model was the most accurate prediction method. For one pass and 10 passes the rating cone index values from the 7.5–23 cm and 15–30 cm soil layer, respectively, produced the lowest RMSD values.

Soil bulk density (D b ) is an important indicator of soil quality, site productivity and soil compaction and is widely used as an input variable for various models. However, D b is often not determined during actual soil surveys, and many attempts have been made to predict it from other more easily and routinely measured variables. The aim of this study was to develop a predictive model for D b estimation for the humus horizon of arable soils. In addition, we hypothesised that the mixed model approach would enable more accurate predictions than the multiple regression model. Estonian National Soil Monitoring data (1983–2008) were used for D b modelling. The dataset contains 17,293 entries for the humus horizon of Estonian arable soils. Mixed model methodology and linear multiple regression analysis were used to develop prediction models. Soil sampling depth, soil organic carbon and water content had the greatest effects on D b estimation. D b is determined through interactions of explanatory variables, and their contribution to D b variation in mixed model differs from variable contribution indicated by the simple regression model. We found that the regression model overestimates the importance of SOC. The mixed model prediction was an improvement compared to multiple regression models (MSE = 0.009 compared to MSE = 0.014). In addition, the predicted values in the mixed model showed good agreement with observed values, while the multiple regression model underestimated D b values above 1.6 g cm −3 and overestimated D b values below 1.2 g cm −3 . We conclude that the mixed model approach enables higher prediction accuracy than multiple regression analysis. We propose a mixed model with 20 variables as a prediction model for the humus horizon of Estonian arable soils. The methodology is also applicable for other soil conditions.

Formation of soil organic matter in three quarry detritus areas was investigated at Sirgala, north-east Estonia (27°47′E, 59°19′N). The sites were afforested in 1965–1970 with 2-years-old seedlings of Scots pine. During the first decade after planting, forest floor (ground litter) had not formed. In 1988, ground litter occurred as a single layer. After 29–34 years, a brownish black (10YR2/2) A-horizon and a very dark greyish-brown (10YR3/2) AC-horizon had developed to a depth of 20–25 cm. Falling litter (litterfall) and ground litter of a Moder-type had also formed. Organic matter of the ground litter was rich in carbon but poor in nitrogen. A large accumulation of organic carbon and nitrogen in the mineral topsoil, a high C:N ratio, and significant amount of humus accumulation were characteristics of these young soils. As a result of pedogenesis, part of the residual oil-shale (kukersite) in detritus was humified as insoluble fraction. Organic carbon (14.4–19.7 g kg−1) of kukersite, contained in the quarry detritus were subtracted from the measured values to calculate the amount of organic matter of plant origin. Sesquioxides–humic–fulvic humus was rich in substances bound with mineral content of the detritus, but poor in free fulvic acids and Ca–humates. Highly productive forest ecosystems with the formation of Calcaric Regosols have developed on pure skeletal quarry detritus within about three decades.

Brain-derived neurotrophic factor (BDNF) supports the survival of a specific set of neurons in the vertebrate nervous system. Here we show that the rat BDNF gene consists of four short 5' exons and one 3' exon encoding the mature BDNF protein. Eight different BDNF mRNAs with four different 5' ends and two alternative polyadenylation sites are transcribed from this gene. BDNF mRNAs containing exons I, II, and III are expressed predominantly in the brain, whereas exon IV transcripts predominate in the lung and heart. mRNAs containing exons I, II, and III increase markedly in the brain after kainic acid-induced seizures, whereas exon IV mRNA increases only slightly. Several transcription initiation sites were mapped upstream of the four 5' exons, and transfection of promoter-reporter gene constructs confirmed that these sequences act as promoters. Combined, the data demonstrate that alternative usage of four promoters within the BDNF gene and differential splicing control tissue-specific and seizure-induced expression of BDNF mRNA.