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Abstract Freshwater fishes are among the most threatened taxa worldwide owing to changes in land use, species introductions, and climate change. Although more than half of the freshwater fishes in the Chilean Mediterranean ecoregion are considered vulnerable or endangered, still little is known about their biogeography. Fishes of the family Perciliidae are endemic of this region and ideal cases to study potential implications of global warming given their endangered conservation status, small size, restricted range, and limited dispersal capacity in fragmented habitats. Here, we model the spatial distribution of habitats for Percilia irwini and P. gillissi under current (1970–2000) and future (2050–2080) climatic scenarios (SSP245, SSP585). We implement maximum entropy (MaxEnt) models adapted for stream networks using high-resolution datasets of selected geophysical and climatic variables. At present, both species inhabit relatively low-quality habitats. In the future (SSP585), suitable habitats for P. irwini are predicted to be reduced drastically (99%) with potential local extirpations in its northern range. Similarly, up to 62% of suitable habitats for P. gillissi would also be reduced in the future. Our study provides insights about assessing future threats and vulnerability of endemic, endangered, range-restricted, and small-bodied freshwater species in this region and elsewhere.

Abstract Fish invasions threaten native freshwater ecosystems worldwide, yet methods to map biodiversity in data-deficient regions are scarce. Rainbow trout (Oncorhynchus mykiss) and brown trout (Salmo trutta fario) have been introduced to the Himalayan ecoregion where they are sympatric with vulnerable native snow trout Schizothorax plagiostomus and Schizothorax richardsonii. We aim to evaluate potential habitat overlap among snow trout and non-native trout in the Indus and Ganges River basins, Himalayan ecoregion. We transferred maximum entropy (MaxEnt) models developed with spatially continuous freshwater-specific environmental variables to map the distribution of potentially suitable habitats for rainbow and brown trout in the Himalayas. We adopted a similar procedure to map suitable habitats for snow trout species. There were substantial habitat overlaps (up to 96%) among snow trout and non-native trout. Yet, the physiography of receiving basins could play a role minimizing the impacts of each non-native trout on native snow trout. We generate high-resolution classified stream suitability maps as decision support tools to help managers in habitat allocation and policy formation to balance recreational fisheries with conservation of snow trout. Our workflow can be transferred to other basins and species for mapping freshwater biodiversity patterns in species-rich yet data-poor regions of the world.

Paracetamol is a commonly used analgesic and antipyretic drug, but at a high dose level, it leads to deleterious side effects. The need to investigate new hepatoprotective drugs is driven by the lack of safety and efficiency of existing medications. A newly synthesized compound 2′, 3′-dihydroxybenzylidene (DHB) was evaluated in the present study for its antioxidant, hepatoprotective and nephroprotective potential compared to ascorbic acid in paracetamol intoxicated rats. DHB and ascorbic acid were evaluated against 2, 2-diphenyl-1-picrylhydrazyl (DPPH) for assessment of the antioxidant potential. Male albino rats (n = 20) were categorized into 5 groups with 4 rats each and the test compounds were administered for 14 days consecutively. On day 15th, the rats were anesthetized, and blood was collected through heart puncture for the evaluation of hematological and serological parameters. Subsequently, the rats were dissected for the histopathology of liver and kidney. Alanine Transaminase (ALT), Alkaline Phosphatase (ALP), Serum Bilirubin (SBR), Cholesterol level and Renal Function Tests (RFTs) showed a substantial increase in the paracetamol treated group. Healing in liver and kidney tissues was observed in the DHB treated groups compared to paracetamol intoxicated group. The hemoglobin (HB), mean corpuscular hemoglobin (MCH), RBCs and mean corpuscular hemoglobin concentration (MCHC) were found significantly elevated while the total leukocytes count (TLC), platelets (PLT) and neutrophils significantly decreased in the DHB treated group compared to the paracetamol intoxicated group. It is concluded that DHB possesses antioxidant, hepatoprotective, nephroprotective, and anti-inflammatory potential against paracetamol induced hepatotoxicity and nephrotoxicity in rats.

The natural territory disturbance, losses, and degradation are real and alarming threats to the ecosystem. The population of butterflies remains arbitrary in prairie residuals and linear range habitats. Such environments are low, isolated, and sub-quality than intact prairies - biodiversity losses associated with ecosystems regulating services and supporting services. Therefore, the present study was conducted on environmental variables and soil gradient and its effects on butterfly colonies in tehsil Tangi, Charsadda, Khyber Pakhtunkhwa, Pakistan. A total of 506 specimens of butterflies and soil samples were collected from different localities randomly. Butterflies were collected with aerial nets, searching, and picking method, and taken to the laboratory for identification and recording concerning each location every two weeks from August 2014 to May 2015. The similarity index among individuals was 246 (47%), while among species 45.5 (8.62%) and Catopsilia pyranthe were at (35/122; 14/30; 7/14; 6.91/24.11) position, similarly in dissimilarity index, Catopsilia ponoma was at (58/122; 19/30; 9/14; 11.460/24.11) position. The density revealed that the Danauas chrysippus was the most abundant species 122/506. Similarly, among environmental gradients, silt associated considerably with pH, wilting point (Wp), field capacity (Fc), bulk density (Bd), saturated hydraulic conductivity (Shy) and available water (Aw) (p≈0.000), sand with pH, Wp, Fc and Bd (p≈0.000), pH with Wp, Fc and Bd (p≈0.000), Wp with Fc, Bd, and Aw (p≈0.000), Fc with Bd and Aw (p≈0.000). We concluded that low latitude and altitude, excessive amounts of insecticides and pesticides show a significant impact on butterflies' diversity.

Purpose: To evaluate the acetabular cup and graft survival in patients who underwent total hip arthroplasty (THA) with the diagnosis of dysplastic hip osteoarthritis and received a femoral head autograft due to acetabular coverage deficiency. Methods: Between January 2005 and December 2016, 83 hip prostheses of 80 patients who underwent THA using femoral head autografts and were followed up for at least 2 years were retrospectively evaluated. Seventy-four hips of the remaining 71 patients (57 female (80%)) were included. Mean patient age at surgery was 51 ± 16 (range 18–76) years. The mean follow-up duration was 76 ± 25 (range 25–161) months. Acetabular inclination and graft thickness, contact length, percentage of coverage, and graft resorption were examined on postoperative and final follow-up radiographs. The presence of a radiolucent area around the acetabular and femoral components indicating loosening was also evaluated. Results: The mean postoperative acetabular component inclination was 44 ± 5.1° (range 30–48°) with mean graft coverage of 34 ± 4.8% (range 24–46%). In all patients, autograft union with the pelvis was seen and the lateral overflow was remodeled. Fifteen patients (20%) underwent revision surgery due to aseptic acetabular component loosening in four, nontraumatic recurrent dislocations in eight, periprosthetic infection in one, acetabular component protrusion in one, and traumatic hip dislocation in one. Conclusion: In patients with osteoarthritis secondary to developmental hip dysplasia, the use of femoral head autografts to eliminate acetabular coverage deficiency during THA achieves acceptable midterm postoperative radiological outcomes. Increased acetabular bone stock may be beneficial in possible future revision surgeries.

Purpose: To evaluate the short-term clinical and radiological outcomes with degenerative changes in patients over 40 years old following isolated vertical medial meniscal tear repair. Methods: Between 2007 and 2015, 438 patients underwent arthroscopic meniscal repair. Thirty-three patients aged over 40 years with isolated vertical medial meniscal repair (23 males and 10 females, mean age 46.1 ± 7.0; range 40–67) were included in the study. Preoperative and postoperative physical examination findings, Lysholm knee score, the International Knee Documentation Committee score, magnetic resonance imaging findings, and Kellgren–Lawrence osteoarthritis stage were evaluated. Results: The mean follow-up period was 31.1 months ± 20.1 (range 12–100 months). There was statistically significant improvement in functional scores ( p < 0.05) and physical examination findings. In 22 patients (66.7%), improvement in the clinical and radiological results was detected ( p < 0.05). However, no correlation was found between clinical and radiological outcomes. There was also no significant change in osteoarthritis stages at the last follow-up visit. No significant difference was found between smokers and nonsmokers regarding clinical outcomes. Conclusion: Successful clinical and radiological outcomes can be obtained following isolated vertical medial meniscal tear repair in patients older than 40 years. Age is not the sole criterion for the success of meniscal repair; rather, the functional capacity of the patient, the location of the tear, the grade of knee joint arthritis, and the quality of the meniscal tissue should be taken into consideration.

Abstract Background Chronic rhinosinusitis with nasal polyposis (CRSwNP) often coexists with lower airway disease. With the overlap between upper and lower airway disease, optimal management of the upper airways is undertaken in conjunction with that of the lower airways. Biologic therapy with targeted activity within the Type 2 inflammatory pathway can improve the clinical signs and symptoms of both upper and lower airway diseases. Knowledge gaps nevertheless exist in how best to approach patient care as a whole. There have been sixteen randomized, double-blind, placebo-controlled trails performed for CRSwNP targeted components of the Type 2 inflammatory pathway, notably interleukin (IL)-4, IL-5 and IL-13, IL- 5R, IL-33, and immunoglobulin (Ig)E. This white paper considers the perspectives of experts in various disciplines such as rhinology, allergy, and respirology across Canada, all of whom have unique and valuable insights to contribute on how to best approach patients with upper airway disease from a multidisciplinary perspective. Methods A Delphi Method process was utilized involving three rounds of questionnaires in which the first two were completed individually online and the third was discussed on a virtual platform with all the panelists. A national multidisciplinary expert panel of 34 certified specialists was created, composed of 16 rhinologists, 7 allergists, and 11 respirologists who evaluated the 20 original statements on a scale of 1–9 and provided comments. All ratings were quantitively reviewed by mean, median, mode, range, standard deviation and inter-rater reliability. Consensus was defined by relative interrater reliability measures—kappa coefficient ( $$\kappa$$ κ ) value > 0.61. Results After three rounds, a total of 22 statements achieved consensus. This white paper only contains the final agreed upon statements and clear rationale and support for the statements regarding the use of biologics in patients with upper airway disease. Conclusion This white paper provides guidance to Canadian physicians on the use of biologic therapy for the management of upper airway disease from a multidisciplinary perspective, but the medical and surgical regimen should ultimately be individualized to the patient. As more biologics become available and additional trials are published we will provide updated versions of this white paper every few years. Graphical abstract

The purpose of this study was to see the effect of the outdoor learning method on student motivation in the Museology course of the History Education Study Program at the IKIP PGRI Pontianak. This research method used is experimental, with a research design that is Quasi experimental. The experimental class is A and the control class is B. The location is on the IKIP PGRI Pontianak campus. Data collection techniques with learning motivation questionnaires, observation sheets and documentation. Data analysis techniques used descriptive statistics, parametric statistical tests, and used the Effect Size formula. The results of this study are 1. The average learning motivation of students who are not taught using the History Education laboratory is 66.33 which is classified as sufficient. 2. The average learning motivation of students who are taught or the experimental class using the outdoor learning method is 77.42 which is classified as good. 3. There is a significant difference in the average learning motivation of students in the control class and students in the experimental class. 4. Based on the calculation using the effect size obtained Es 80, or Es = 0.55, it can be concluded that the use of the outdoor learning method on learning motivation in Museology courses is classified as moderate.

Abstract Objectives Many experts feel that in the absence of well-defined goals for success, they have an easier time identifying failure. As success ought to not be defined only by absence of failure, we aimed to define optimal outcomes for endoscopic sinus surgery (ESS) in chronic rhinosinusitis (CRS) by obtaining expert surgeon perspectives. Methods A total of 12 surgeons participated in this targeted consultation. Face to face semi-structured interviews were performed with expert surgeons in the field of CRS and ESS. General impressions and personal definitions of acceptable operative success and optimal operative outcomes were compiled and summarized. Results According to an expert survey, patients’ main objectives are an improvement in their chief complain, a general improvement in quality of life (QoL), and a better overall symptomatic control. The most important aspects of endoscopy for defining a successful intervention were an adequate mucus circulation, a healthy mucosa, minimal edema, and patency of all explored cavities or ostia. In the assessment of surgical outcomes, it was determined that both objective and patient reported data must be carefully examined, with more attention given to subjective outcomes. Conclusions According to data gathered from a Canadian expert consultation, a definition of success must be based on both subjective data and nasal endoscopy. We propose to define an acceptable outcome as either a subjective improvement of at least the minimal clinically improvement difference of a validated patient reported outcome questionnaire, along with a satisfactory endoscopic result (1) or a complete subjective resolution with a sub-optimal endoscopy (2). Graphical abstract

Abstract Healthcare services in many countries have been partially or completely disrupted by the Coronavirus (COVID-19) pandemic since its onset in the end of 2019. Amongst the most impacted are the elective medical and surgical services in order to conserve resources to care for COVID-19 patients. As the number of infected patients decrease across Canada, elective surgeries are being restarted in a staged manner. Since Otolaryngologists – Head & Neck Surgeons manage surgical diseases of the upper aerodigestive tract where the highest viral load reside, it is imperative that these surgeries resume in a safe manner. The aim of this document is to compile the current best evidence available and provide expert consensus on the safe restart of rhinologic and skull base surgeries while discussing the pre-operative, intra-operative, and post-operative care and tips. Risk assessment, patient selection, case triage, and pre-operative COVID-19 testing will be analyzed and discussed. These guidelines will also consider the optimal use of personal protective equipment for specific cases, general and specific operative room precautions, and practical tips of intra-operative maneuvers to optimize patient and provider safety. Given that the literature surrounding COVID-19 is rapidly evolving, these recommendations will serve to start our specialty back into elective rhinologic surgeries over the next months and they may change as we learn more about this disease.

Abstract Background Inverted papilloma (IP) is an unusual type of benign tumor that has high recurrence rates and the potential to transform into squamous cell carcinomas (SCC). The mechanism of the transformation process from IP to IP-SCC is uncertain and there is no consensus regarding the best practice for IP-SCC detection. The goal of this study is to identify the best clinical methods to detect for IP-SCC. Methods An evidence-based review was performed using Medline and Ovid to obtain all articles up to October 10th, 2019 pertaining to identification of IP malignant transformation. All manuscripts discussing clinical methods or biomarkers were included. Results Based on clinical research studies, convoluted cerebriform pattern and apparent diffusion coefficient values on Magnetic Resonance Imaging (MRI) can help differentiate benign IP from SCC and increased SUVmax on PET/CT is associated with higher probability of malignancy although not as specific. No consensus about the best biomarker for IP-SCC has been reached among researchers and continues to be exploratory. Conclusion Endoscopy with biopsy is the gold standard practice to identify IP-SCC; however, MRI is the preferred imaging modality to recognize malignant transformation in cases where biopsy is difficult. Multiple biomarkers have shown positive results, but no single indicator with clinical significance for monitoring malignant transformation process has been found.

Abstract Background Depression and chronic pain are debilitating disorders that co-exist with many chronic diseases. Chronic rhinosinusitis (CRS) is no exception. Nonetheless, little is known about the association between these co-related conditions and the treatment of CRS. The objective of this study is to measure outcomes following endoscopic sinus surgery (ESS) in CRS patients reporting significant pre-operative depression and pain. Methods This is a prospective longitudinal cohort study examining patients with CRS who had failed maximal medical therapy and subsequently underwent ESS. Participants completed a several patient-reported outcome (PRO) instruments pre-operatively and 6 months post-operatively. The PROs included the Sinonasal Outcome Test-22 (SNOT-22), the Patient Health Questionnaire (PHQ-9) measuring symptoms of depression and an assessment of chronic pain using the pain intensity (P), interference with enjoyment of life (E) and general (G) activity instrument, the PEG instrument. Results The study had 142 participants complete their pre-operative and post-operative surveys. The participation rate was 40.1% among eligible patients. The prevalence of at least moderate depression was 22 patients (15.5%) among participants. Compared with non-depressed participants, the pre-operative sino-nasal disease burden and pain scores were higher among depressed participants (p

Introduction Chronic rhinosinusitis (CRS) is common, with a Canadian prevalence of 5%, and associated with significant morbidity. Understandably, CRS impairs workplace productivity but that productivity substantially increases following surgical treatment. CRS with nasal polyps (CRSwNP), the most common type of CRS, is usually treated with a combination of medications and endoscopic sinus surgery (ESS). Historically, surgical treatment has only been performed in the operating room at a cost of about $C3500. However, recent studies have shown that a de-escalated procedure, endoscopic polypectomy performed in clinic (EPIC), can provide an improvement in patient symptoms to levels equal to those for ESS. Moreover, EPIC has additional proposed advantages including shorter recovery time, significantly lower cost to the healthcare system and shorter wait time for the patient. There is currently insufficient evidence to draw conclusions about the superiority of polypectomy or ESS for the management of CRSwNP.Methods and analysis We designed a multicentre, open-label, randomised controlled trial to evaluate whether EPIC was non-inferior to the current clinical standard, ESS for the treatment of CRSwNP. The primary outcome is the Sinonasal Outcome Test-22 score measured at baseline and at 3 months after surgery. Other outcomes include peak nasal inspiratory flow, quality of life measured by the EuroQoL 5 Dimensions 5 Levels questionnaire and work impairment using the Work Productivity and Activity Impairment Questionnaire.We aim to recruit 140 patients from sites across Canada. Participants will be randomly assigned to EPIC or ESS and followed up for 3 months in clinic after the procedure. Additionally, participants will enter a 5-year long-term follow-up period.Ethics and dissemination This study was approved by the Ottawa Health Sciences Network Research Ethics Board for all sites in Ontario, Canada (study number CTO0801). Sites located outside of Ontario obtained approval from their local/institutional research ethics board.Trial registration number NCT02975310.

Abstract Background Patients with Chronic Rhinosinusitis (CRS) can suffer from a significant decline in their quality of life. CRS patients have a high prevalence of comorbid conditions and it is important to understand the impact of these conditions on their CRS-related quality of life. This study measures the impacts of chronic pulmonary comorbidities on quality of life, pain, and depression scores among patients with CRS awaiting Endoscopic Sinus Surgery (ESS). Methods This study is based on cross-sectional analysis of prospectively collected patient-reported outcome data collected pre-operatively from patients waiting for ESS. Surveys were administered to patients to assess sino-nasal morbidity (SNOT-22), depression and pain. The impact of pulmonary comorbidity on SNOT-22 scores, pain and depression was measured. Results Two hundred fifthy-three patients were included in the study, 91 with chronic pulmonary comorbidity. The mean SNOT-22 scores were significantly higher among patients with chronic pulmonary comorbidities than among patients without (37 and 48, respectively). This difference is large enough to be clinically significant. Patients with chronic pulmonary comorbidities reported slightly higher depression scores than those without. Conclusions This study found that among CRS patients waiting for ESS, chronic pulmonary comorbidities are strongly associated with significantly higher symptom burden.

Masalah dalam penelitian ini adalah bagaimana penggunaan pendekatan Cooperative Learning dengan Strategi Games Competition dapat meningkatkan aktivitas belajar siswa pada Mata Pelajaran IPS Terpadu Materi Sejarah kelas VIII SMP Negeri 2 Sungai Raya?. Metode penelitian yang digunakan adalah penelitian tindakan kelas. Subyek dalam Penelitian Tindakan Kelas ini adalah siswa kelas VIII SMP Negeri 2 Sungai Raya tahun pelajaran 2015/2016. Alat pengumpulan data yang digunakan dalam penelitian ini adalah angket, panduan observasi, panduan wawancara, dan dokumentasi. Teknik analisis data dalam penellitian ini adalah Analisis hasil penelitian digambarkan dengan cara menggunakan triangulasi data. Indikator keberhasilan didasarkan dari kisi-kisi pengamatan aktivitas siswa yang meliputi :1) semangat siswa untuk mengikuti pembelajaran, 2) keaktifan dalam menyelesaikan tugas membuat pertanyaan dan jawaban, 3) keaktifan dalam menjawab pertanyaan, 4) keaktifan dalam menanggapi atas pertanyaan dari kelompok lain, 5) kerjasama dalam kelompok dalam menyelesaikan tugas berkompetisi dengan kelompok lain.Kesimpulan penelitian bahwa Pembelajaran IPS menggunakan pendekatan cooperative learning dengan strategi Games Competition dapat meningkatkan aktivitas belajar siswa kela VIII SMP Negeri 2 Sungai Raya, yaitu peningkatan aktifitas belajar siswa secara klasikal yaitu pada siklus I sebesar 65 % dan pada Siklus II sebesar 85 %, hal ini berarti ada peningkatan sebesar 20%. Pembelajaran dengan menggunakan pendekatan cooperative learning dengan strategi Games Competition dapat memberikan kesempatan kepada siswa untuk aktif dalam mengungkapkan pendapat, menghargai pendapat orang lain,berani bertanya, menanggapi, belajar berkompetisi secara jujur, serta mampu menumbuhkan rasa solidaritas siswa.