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Sudden aspen decline (SAD), present in many parts of North America, is the sudden dieback of branches, crown loss, and rapid mortality of aspen (Populus tremuloides Michx.). We surveyed 21 plots in southwestern Colorado and categorized each plot by the mean percentage of recent crown loss (RCL) into three SAD levels: low SAD (0%-25% RCL), moderate SAD (25.1%-50% RCL), and high SAD (50.1%-100% RCL). Our research quantified the effects of SAD on microclimate and understory vegetation at the individual species and community level. Mean day surface, day subsurface, and night subsurface temperatures were warmer in high SAD stands than in low ones. High SAD stands had lower soil moisture, lower litter and duff depth, higher bare soil cover, higher photosynthetically active radiation, higher arbuscular mycorrhizal propagule densities, and higher grass biomass. Indicator plant species were uniquely associated with low and high SAD. Our study illustrates that SAD has multiple ecological effects on aspen understories, including a potential positive feedback in which warmer temperatures and decreased soil moisture, consequences of SAD, may lead to increased branch dieback and tree mortality, which would alter microclimatemaking conditions more favorable to SAD and escalate the effects of SAD on understory vegetation. Key words: climate change, dieback, community composition, mortality, mycorrhizae, plant biomass, San Juan Mountains. Le declin soudain du peuplier (DSP), present dans plusieurs parties de l'Amerique du Nord, se manifeste par le deperissement des branches, la reduction de la cime et la mort rapide du peuplier faux-tremble (Populus tremuloides Michx.). Nous avons inventorie 21 placettes dans le sud-ouest du Colorado et nous les avons regroupees en trois categories de DSP en fonction du pourcentage moyen de reduction recente de la cime (RRC): faible (0-25 % RRC), modere (25,1-50 % RRC) et severe (50,1-100 % RRC). Nous avons quantifie les effets du DSP sur le microclimat et la vegetation de sous-bois a l'echelle de l'espece et de la communaute. Les temperatures moyennes diurnes en surface et sous la surface ainsi que nocturnes sous la surface etaient plus chaudes dans les peuplements oU le DSP etait severe comparativement aux peuplements oU le DSP etait faible. Les peuplements oU le DSP etait severe etaient caracterises par une teneur en eau du sol plus faible, une litiere et un humus moins epais, un couvert de sol nu plus important, un rayonnement photosynthetiquement actif plus eleve, une plus forte densite de propagules mycorhyziennes a arbuscules et une biomasse herbacee plus importante. Les especes de plantes indicatrices etaient uniquement associees au DSP faible et severe. Notre etude montre que le DSP a de multiples effets ecologiques sur le sous-bois du peuplier faux-tremble, incluant une retroaction positive potentielle la oU des temperatures plus chaudes et une teneur en eau du sol reduite, resultant du DSP, peuvent causer une augmentation du deperissement des branches et de la mortalite des arbres. En modifiant le microclimat, cette augmentation cree des conditions plus favorables au DSP et intensifie les effets du DSP sur la vegetation de sous-bois. [Traduit par la Redaction] Mots-cles : changements climatiques, deperissement, composition de la communaute, mortalite, mycorhizes, biomasse vegetale, monts San Juan., Introduction Temperate forest ecosystems are characterized by complex histories of natural and human disturbances. Combined disturbances tend to have complex influences on vegetation community dynamics (Kulakowski et al. 2012). Disturbances [...]

Infantile myofibromatosis (IM) comprises a wide clinical spectrum, ranging from solitary or multicentric lesions to generalized life-threatening forms. IM is mostly linked to germline or somatic heterozygous mutations in the PDGFRβ tyrosine kinase, encoded by the PDGFRB gene. Treatments for IM range from wait and see approach to systemic chemotherapy, according to the clinical context. Targeted therapies, such as tyrosine kinase inhibitors (TKIs) like Imatinib, show promise in treating IM lesions with PDGFRB gain-of-function mutations. Here, we report the first evidence of two sporadic, multifocal IM with PDGFRB gene fusions. RNA sequencing analysis revealed two novel fusion transcripts involving the protein kinase domain of PDGFRB, with UBE2I and FN1 genes, respectively. Although gene fusions are frequent and potent oncogenic drivers in soft-tissue neoplasia, fusion genes involving PDGFRB have not previously been linked to IM. DNA-based NGS panel testing may not detect chromosomal rearrangements, such as translocations, emphasizing the critical role of comprehensive molecular profiling, including RNA sequencing, in diagnosing and managing children with IM., (© 2025 Wiley Periodicals LLC.)

Conservation scientists work in diverse settings, sometimes requiring them to exist in spaces where they do not feel safe, included, or accepted. This is often the case for the LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, and others) community, which is frequently marginalized in conservation spaces. We conducted an anonymous, semistructured, online survey of members and nonmembers of the LGBTQIA+ community of conservation students and professionals in North America to explore participants' lived experiences in conservation. Our 737 responses (response rate 26.8%) included 10% who identified as genderqueer, gender nonconforming, questioning, nonspecific, genderfluid, transgender woman, agender, transgender man, 2-spirit Indigenous, or intersex (gender expansive), and 29% as bisexual, queer, lesbian, gay, asexual, pansexual, omnisexual, questioning, or nonheterosexual (queer+). We found that non-LGBTQIA+ respondents overestimated the degree to which LGBTQIA+ respondents felt included in the field of conservation by 5% (sexual orientation) and 18% (gender identity). Respondents' feelings of safety and belonging were up to 50% lower in most work settings compared with non-LGBTQIA respondents; the lowest frequencies were reported by gender expansive respondents (40.9-64.4%). Contextual responses indicated that the lack of safety and belonging related to direct experiences of bullying (23 long-form descriptions out of 73 gender expansive respondents and 15 of 217 queer+ respondents), concerns around safety in rural settings (4 of 73 gender expansive respondents and 20 of 217 queer+ respondents), and concerns around not being able to express their authentic selves (7 of 73 gender expansive respondents and 5 of 217 queer+ respondents). The intersection between gender identity and race also played a role in feelings of safety, belonging, and disclosure of sexual orientation (1 of 73 gender expansive respondents, 6 of 217 queer+ respondents). The most frequent support resources used by LGBTQIA+ conservation scientists included one-on-one support from peers, mentors and external collaborators, support group, and wellness and counseling services outside of work., (© 2024 The Author(s). Conservation Biology published by Wiley Periodicals LLC on behalf of Society for Conservation Biology.)

Outdoor field experiences have not historically been welcoming to marginalized communities. Recent calls to address the lack of diversity in outdoor field experiences have accelerated efforts to make programs more inclusive for multiple marginalized identity groups. Despite these efforts, many cultural and procedural changes are still needed to support the Lesbian, Gay, Bisexual, Transgender, Queer or Questioning (LGBTQ+) community when participating in outdoor field experiences. Here we use results from a survey of leaders from 17 outdoor programs and expertise gained from our own experiences cultivating inclusion in field programs to outline strategies that outdoor field experience providers can use to foster greater support for the LGBTQ+ community. We define key terminology to increase awareness of LGBTQ+ identities and pronouns. We then highlight important actions that field experience leaders can take to make their internships, education programs, and trips more accessible and inclusive for the LGBTQ+ community. We use results from our survey of outdoor programs to highlight practices currently being used to support LGBTQ+ inclusion and accessibility and synthesize how current practice aligns with our overall recommendations. The LGBTQ+ community deserves to be welcomed into outdoor field experiences and to participate fully as students, researchers, educators, recreators, and professionals., (© 2022 The Authors. Ecological Applications published by Wiley Periodicals LLC on behalf of The Ecological Society of America.)

Objectives: To present the functional and oncological outcomes after ≥1 year of follow-up, following an experience of >1000 robot-assisted radical prostatectomies (RARPs) with our standardised total anatomical reconstruction (TAR) technique. To evaluate which factors influence postoperative continence recovery in order to obtain a nomogram to predict the risk of postoperative urinary incontinence (UI)., Patients and Methods: The enrolment phase began in June 2013 and ended in May 2017. Patients were prospectively included in the study with the following inclusion criteria: (i) localised prostate cancer (clinical stages cT1-3, cN0, cM0); (ii) indication for RP; and (iii) preoperative multiparametric prostate magnetic resonance imaging. All patients underwent RARP with the TAR technique done at the end of the demolitive phase. The continence rates were assessed at 24 h, and 1, 4, 12, 24 and 48 weeks after catheter removal. Patients were defined as continent if they answered 'zero pad' or 'one safety pad' per day. A logistic regression model was used to evaluate the potential impact of some pre- and intraoperative factors on postoperative urinary continence recovery. Model discrimination was assessed using an area under (AUC) the receiver operating characteristic (ROC) curve. A nomogram to predict the risk of postoperative UI after RARP with the TAR technique was generated based on the logistic model., Results: In all, 1008 patients were enrolled in our study. At 24 h, and 1, 4, 12, 24 and 48 weeks after catheter removal, 621 (61.61%), 594 (58.93%), 803 (79.66%), 912 (90.48%), 950 (94.25%) and 956 (94.84%) patients were continent, respectively. In the logistic regression model, the variables analysed had a higher impact on continence recovery at 4 and 12 weeks. At 4 weeks, the postoperative odds of urinary continence recovery increased with the absence of diabetes [odds ratio (OR) 2.76, 95% confidence interval (CI) 1.41-5.41] and D'Amico low vs high risk (OR 2.01, 95% CI 1.01-3.99). At 12 weeks, urinary continence increased with the absence of diabetes (OR 3.01, 95% CI 1.23-7.35), D'Amico low vs high risk (OR 4.04, 95% CI 1.56-10.47), and D'Amico intermediate vs high risk (OR 3.33, 95% CI 1.66-6.70). ROC curves were drawn and an AUC value of 61.9% (95% CI 57.49-66.36) at 4 weeks and 63.8% (95% CI 58.03-69.65) at 12 weeks were computed. Based on these parameters, two nomograms (at 4 and 12 weeks postoperatively) were generated., Conclusion: The TAR technique conferred excellent results in the early recovery of urinary continence. Two nomograms were created, to predict preoperatively the postoperative odds of urinary continence recovery at 4 and 12 weeks after RARP by integrating the presence of diabetes and D'Amico risk classification., (© 2019 The Authors BJU International © 2019 BJU International Published by John Wiley & Sons Ltd.)

Purpose: To report the 4-year outcomes of a consecutive series of anal cancer patients treated with concurrent chemo-radiation delivered with intensity-modulated radiotherapy (IMRT), employing a simultaneous integrated boost (SIB) approach., Methods: A consecutive series of 54 patients was enrolled between 2007 and 2013. Treatment schedule consisted of 50.4 Gy/28 fractions (1.8 Gy daily) to the gross tumor volume, while the elective nodal volumes were prescribed 42 Gy/28 fractions (1.5 Gy/daily) for patients having a cT2N0 disease. Patients with cT3-T4/N0-N3 tumors were prescribed 54 (T3) or 60 (T4) Gy/30 fractions (1.8-2 Gy daily) to the gross tumor volume; gross nodal volumes were prescribed 50.4 Gy/30 fr (1.68 Gy daily) if sized ≤ 3 cm or 54 Gy/30 fr (1.8 Gy daily) if > 3 cm; elective nodal regions were given 45 Gy/30 fractions (1.5 Gy daily). Chemotherapy was administered concurrently according to the Nigro's regimen. Primary endpoint was colostomy-free survival (CFS). Secondary endpoints were local control (LC), disease-free survival (DFS), cancer-specific survival (CSS), overall survival (OS), and toxicity profile., Results: Median follow up was 32.6 months (range 12-84). The actuarial probability of being alive at 4 years without a colostomy (CFS) was 68.9% (95% CI: 50.3%-84.7%). Actuarial 4-year OS, CSS, DFS, and LC were 77.7% (95% CI: 60.7-88.1%), 81.5% (95% CI: 64%-91%), 65.5% (95% CI: 47.7%-78.5%), and 84.6% (95% CI: 71.6%-92%). Actuarial 4-year metastasis-free survival was 74.4% (95% CI: 55.5%-86.2%). Maximum detected acute toxicities were as follows: dermatologic -G3: 13%; GI-G3: 8%; GU-G3: 2%; anemia-G3: 2%; neutropenia-G3:11%; G4: 2%; thrombocytopenia- G3:2%. Four-year G2 chronic toxicity rates were 2.5% (95% CI: 3.6-16.4) for GU, 14.4% (95% CI: 7.1-28) for GI, 3.9% (95% CI: 1%-14.5%) for skin, and 4.2% (95% CI: 1.1-15.9) for genitalia., Conclusions: Our study shows the feasibility of IMRT in the combined modality treatment of anal cancer, with comparable results to the literature with respect to LC, sphincter preservation and survival. Acute toxicity is lower if compared to series employing standard techniques. Our results support the use of IMRT on a routine basis for the treatment of anal cancer.

Aims and Background: Glioblastoma multiforme (GBM) is the most frequent primary central nervous system malignancy in adults, accounting for 50% of all primary intracranial malignancies. GBM mostly arises within the cerebral hemispheres and frequently affects patients in the fifth and sixth decades of life. Conversely, primary cerebellar GBM is a rather infrequent occurrence in the adult population, accounting for 1%-2.2% of all GBMs. Here we report a case of cerebellar GBM in an adult woman and provide an extensive review of the literature., Methods: A 42-year-old woman was referred to our hospital for occipital constrictive headache, dizziness and gait disturbance. Multimodality imaging including computed tomography and magnetic resonance imaging (MRI) showed a right cerebellar mass. Gross total resection was performed. Histological examination showed grade IV GBM according to the World Health Organization classification, with a synchronous component of low-grade glioma. Immunohistochemistry showed positivity for p53 and negativity for epidermal growth factor receptor (EGFR). After surgical tumor excision, the patient underwent adjuvant radiation to the posterior fossa with an intensity-modulated approach for a total dose of 60 Gy in 30 fractions. In addition, she received concurrent and adjuvant chemotherapy with temozolomide., Results: Treatment was well tolerated, with mild acute toxicity. There was no evidence of recurrence on brain and spinal gadolinium-enhanced MRI scans 4, 8 and 12 months after primary surgery. No late side effects were recorded., Conclusion: Our patient had several immunohistochemical characteristics of secondary glioblastoma such as p53 positivity, EGFR negativity and the presence of a low-grade glioma component. Intensity-modulated radiation therapy allowed us to safely deliver full-dose radiation with sparing of critical structures.

Aims and Background: Adult sarcomas of the head and neck region (HNSs) are considered a rare clinicopathological entity. They account for only 2-15% of all adult sarcomas and for less than 1% of all head and neck malignancies. The preferred initial treatment option is wide surgical excision. Whenever surgery is considered infeasible, a frontline combined-modality approach including radiotherapy and chemotherapy might be proposed. We here report on a case of localized sarcoma of the maxillary sinus treated with induction chemotherapy and subsequent intensity-modulated radiation therapy (IMRT), achieving a persistent complete remission status., Methods: A 66-year-old man was referred to our institution hospital for left-sided facial pain with swollen left cheek and ipsilateral facial palsy. Magnetic resonance imaging showed a mass within the left maxillary sinus extending to the orbital floor and adjacent alveolar bones. Histological examination of the biopsy specimen demonstrated a myxofibrosarcoma. The patient underwent induction chemotherapy with gemcitabine 900 mg/m2 (days 1-8) and taxotere 80 mg/m2 every 3 weeks for 3 cycles and sequential simultaneous integrated boost (SIB) IMRT up to a total dose of 70 Gy/35 fractions to the macroscopic disease with 59.5 Gy/35 fractions to the level IB-II lymph nodes in the left neck., Results: Treatment was well tolerated with mild acute toxicity. Complete remission was achieved at restaging MRI 6 months after the end of the combined modality approach. The patient remains in complete, unmaintained clinical and instrumental complete remission 18 months after treatment, with no late side effects., Conclusion: Combination therapy with induction chemotherapy and sequential SIB-IMRT could therefore be a promising modality for head and neck sarcomas, allowing for simultaneous tumor control and normal tissue sparing.

We examined how climate-mediated forest dieback regulates zoonotic disease prevalence using the relationship between sudden aspen decline (SAD) and Sin Nombre virus (SNV) as a model system. We compared understory plant community structure, small mammal community composition, and SNV prevalence on 12 study sites within aspen forests experiencing levels of SAD ranging from <10.0% crown fade to >95.0% crown fade. Our results show that sites with the highest levels of SAD had reduced canopy cover, stand density, and basal area, and these differences were reflected by reductions in understory vegetation cover. Conversely, sites with the highest levels of SAD had greater understory standing biomass, suggesting that vegetation on these sites was highly clustered. Changes in forest and understory vegetation structure likely resulted in shifts in small mammal community composition across the SAD gradient, as we found reduced species diversity and higher densities of deer mice, the primary host for SNV, on sites with the highest levels of SAD. Sites with the highest levels of SAD also had significantly greater SNV prevalence compared to sites with lower levels of SAD, which is likely a result of their abundance of deer mice. Collectively, results of our research provide strong evidence to show SAD has considerable impacts on vegetation community structure, small mammal density and biodiversity and the prevalence of SNV.

Background: There are few studies investigating the factors which may affect different biochemical presentations of Hashimoto's thyroiditis (HT) and these are frequently based on limited pediatric populations., Aims: (1) To assess the frequency of thyroid function patterns at HT diagnosis in 608 children and adolescents, and (2) to analyze the factors that affect thyroid status at diagnosis., Results: At presentation, test results showed euthyroidism in 52.1% of patients (subgroup A), overt or subclinical hypothyroidism in 41.4%, and overt or subclinical hyperthyroidism in 6.5%. The mean age of patients with thyroid dysfunctions (subgroup B) was significantly lower than that of subgroup A, and the rate of children below 10 years of age was significantly greater in subgroup B. Other variables related to thyroid function patterns were prepubertal status; association with either Down or Turner syndromes, which correlated with increased risk of thyroid dysfunctions, and association with other autoimmune diseases, which correlated with decreased risk of thyroid dysfunctions. None of the remaining factors analyzed were associated with increased risk of thyroid dysfunctions., Conclusions: Biochemical thyroid function patterns at HT presentation in childhood and adolescence are mainly conditioned by patients' age., (Copyright © 2012 S. Karger AG, Basel.)

Background: Well-differentiated neuroendocrine carcinomas are highly vascularized and may be sensitive to drugs administered on a metronomic schedule that has shown antiangiogenic properties. A phase II study was designed to test the activity of protracted 5-fluorouracil (5FU) infusion plus long-acting release (LAR) octreotide in patients with neuroendocrine carcinoma., Methods: Twenty-nine patients with metastatic or locally advanced well-differentiated neuroendocrine carcinoma were treated with protracted 5FU intravenous infusion (200 mg/m2 daily) plus LAR octreotide (20 mg monthly). Patients were followed for toxicity, objective response, symptomatic and biochemical response, time to progression and survival., Results: Assessment by Response Evaluation Criteria in Solid Tumors (RECIST) criteria showed partial response in 7 (24.1%), stable disease in 20 (69.0%), and disease progression in 2 patients. Response did not significantly differ when patients were stratified by primary tumor site and proliferative activity. A biochemical (chromogranin A) response was observed in 12/25 assessable patients (48.0%); symptom relief was obtained in 9/15 symptomatic patients (60.0%). There was non significant decrease in circulating vascular epithelial growth factor (VEGF) over time. Median time to progression was 22.6 months (range, 2.7-68.5); median overall survival was not reached yet. Toxicity was mild and manageable., Conclusion: Continuous/metronomic 5FU infusion plus LAR octreotide is well tolerated and shows activity in patients with well-differentiated neuroendocrine carcinoma. The potential synergism between metronomic chemotherapy and antiangiogenic drugs provides a rationale for exploring this association in the future., Trial Registration: NCT00953394.

Unlabelled: The aims of this study were to: (1) retrospectively investigate the birth length and weight of our patients with congenital adrenal hyperplasia (CAH); (2) compare these parameters with standards for birth length and weight recently assessed in an Italian control population; (3) evaluate whether neonatal auxological data may change depending on the different clinical forms of CAH. Birth length and weight were retrospectively evaluated in 101 children with different clinical forms of CAH and compared with standards for birth length and weight assessed in an Italian control population. In both sexes the average birth length of patients with classical CAH was greater than the mean birth length of the controls, and both length and weight were greater in children with classical CAH than in those with the non-classical form. Among the patients with classical CAH, those with the salt-wasting form were longer but also weighed less than those with the simple-virilizing form., Conclusions: (1) fetal length velocity in patients with CAH may be increased only in those infants with classical forms of the syndrome, while it is unaffected in those with the non-classical form; (2) the greater the enzymatic activity impairment, the longer the birth length of newborns with CAH.

Background: Lung cancer is the leading cause of cancer death in men worldwide; most cases are not suitable for radical surgery at diagnosis and palliative treatment remains the primary goal of therapy. Cisplatin and gemcitabine are among the most active cytotoxic agents for the treatment of non-small cell lung cancer (NSCLC): they have non-overlapping toxicity and preclinical studies have demonstrated their potential synergistic interaction., Patients and Methods: The aims of the present study were to assess the activity and tolerability of cisplatin 80 mg/m2 on day 1, combined with gemcitabine 1000 mg/m2 on days 1 and 8, administered every 3 weeks. A total of 46 consecutive patients with advanced NSCLC entered this study; all of them were evaluable for toxicity and for activity., Results: According to an intent-to-treat analysis, 15 patients attained a partial response (33%), 9 (20%) obtained a disease stabilisation and 22 (47%) progressed. This regimen appeared to be modestly toxic, with grades 3-4 leukopenia and thrombocytopenia observed in 10% and 6% of cases respectively; grade 3 vomiting appeared in 12 patients (26%) and grade 3 mucositis in 1 patient. The median time-to-progression and overall survival were 200 and 400 days, respectively., Conclusion: Our study of gemicitabine + cisplatin on stage IV NSCLC patients achieved favourable results in terms of toxicity and overall survival.