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Estuaries receive and process a large amount of particulate organic carbon (POC) prior to its export into coastal waters. Studying the origin of this POC is key to understanding the fate of POC and the role of estuaries in the global carbon cycle. Here, we evaluated the concentrations of POC, as well as particulate organic nitrogen (PON), and used stable carbon and nitrogen isotopes to assess their sources across 13 contrasting British estuaries during five different sampling campaigns over 1 year. We found a high variability in POC and PON concentrations across the salinity gradient, reflecting inputs, and losses of organic material within the estuaries. Catchment land cover appeared to influence the contribution of POC to the total organic carbon flux from the estuary to coastal waters, with POC contributions >36% in estuaries draining catchments with a high percentage of urban/suburban land, and

Dissolved inorganic carbon (DIC) fluxes from the land to ocean have been quantified for many rivers globally. However, CO2 fluxes to the atmosphere from inland waters are quantitatively significant components of the global carbon cycle that are currently poorly constrained. Understanding, the relative contributions of natural and human-impacted processes on the DIC cycle within catchments may provide a basis for developing improved management strategies to mitigate free CO2 concentrations in rivers and subsequent evasion to the atmosphere. Here, a large, internally consistent dataset collected from 41 catchments across Great Britain (GB), accounting for ∼36% of land area (∼83,997 km2) and representative of national land cover, was used to investigate catchment controls on riverine dissolved inorganic carbon (DIC), bicarbonate (HCO3−) and free CO2 concentrations, fluxes to the coastal sea and annual yields per unit area of catchment. Estimated DIC flux to sea for the survey catchments was 647 kt DIC yr−1 which represented 69% of the total dissolved carbon flux from these catchments. Generally, those catchments with large proportions of carbonate and sedimentary sandstone were found to deliver greater DIC and HCO3− to the ocean. The calculated mean free CO2 yield for survey catchments (i.e. potential CO2 emission to the atmosphere) was 0.56 t C km−2 yr−1. Regression models demonstrated that whilst river DIC (R2 = 0.77) and HCO3− (R2 = 0.77) concentrations are largely explained by the geology of the landmass, along with a negative correlation to annual precipitation, free CO2 concentrations were strongly linked to catchment macronutrient status. Overall, DIC dominates dissolved C inputs to coastal waters, meaning that estuarine carbon dynamics are sensitive to underlying geology and therefore are likely to be reasonably constant. In contrast, potential losses of carbon to the atmosphere via dissolved CO2, which likely constitute a significant fraction of net terrestrial ecosystem production and hence the national carbon budget, may be amenable to greater direct management via altering patterns of land use.

Zooplankton form an integral component of epi- and mesopelagic ecosystems, and there is a need to better understand their role in ocean biogeochemistry. The export and remineralisation of particulate organic matter at depth plays an important role in controlling atmospheric CO2 concentrations. Pelagic mesozooplankton and micronekton communities may influence the fate of organic matter in a number of ways, including: the consumption of primary producers and export of this material as fast-sinking faecal pellets, and the active flux of carbon by animals undertaking diel vertical migration (DVM) into the mesopelagic. We present day and night vertical biomass profiles of mesozooplankton and micronekton communities in the upper 500 m during three visits to an ocean observatory station (P3) to the NW of South Georgia (Scotia Sea, South Atlantic) in austral spring, alongside estimates of their daily rates of ingestion and respiration throughout the water column. Day and night community biomass estimates were dominated by copepods >330 μm, including the lipid-rich species, Calanoides acutus and Rhincalanus gigas. We found little evidence of synchronised DVM, with only Metridia spp. and Salpa thompsoni showing patterns consistent with migratory behaviour. At depths below 250 m, estimated community carbon ingestion rates exceeded those of metabolic costs, supporting the understanding that food quality in the mesopelagic is relatively poor, and organisms have to consume a large amount of food in order to fulfil their nutritional requirements. By contrast, estimated community rates of ingestion and metabolic costs at shallower depths were approximately balanced, but only when we assumed that the animals were predominantly catabolising lipids (i.e. respiratory quotient = 0.7) and had relatively high absorption efficiencies. Our work demonstrates that it is possible to balance the metabolic budgets of mesopelagic animals to within observational uncertainties, but highlights the need for a better understanding of the physiology of lipid-storing animals and how it influences carbon budgeting in the pelagic.

Major changes in North Atlantic zooplankton communities in recent decades have been linked to climate change but the roles of environmental drivers are often complex. High temporal resolution data is required to disentangle the natural seasonal drivers from additional sources of variability in highly heterogeneous marine systems. Here, physical and plankton abundance data spanning 2003–2017 from a weekly long-term monitoring site on the west coast of Scotland were used to investigate the cause of an increasing decline to approximately -80± 5% in annual average total zooplankton abundance from 2011 to 2017. Generalized additive mixed models (GAMMs), with an autoregressive correlation structure, were used to examine seasonal and inter-annual trends in zooplankton abundance and their relationship with environmental variables. Substantial declines were detected across all dominant taxa, with ∼ 30–70% of the declines in abundance explained by a concurrent negative trend in salinity, alongside the seasonal cycle, with the additional significance of food availability found for some taxa. Temperature was found to drive seasonal variation but not the long-term trends in the zooplankton community. The reduction in salinity had the largest effect on several important taxa. Salinity changes could partly be explained by locally higher freshwater run-off driven by precipitation as well as potential links to changes in offshore water masses. The results highlight that changes in salinity, caused by either freshwater input (expected from climate predictions) or fresher offshore water masses, may adversely impact coastal zooplankton communities and the predators that depend on them.

Calanoid copepods comprise around 90% of Arctic zooplankton biomass and are fundamental to the ecological and biogeochemical functioning of high-latitude pelagic ecosystems. They accumulate lipid reserves during the productive months and represent an energy-rich food source for higher trophic levels. Rapidly changing climate in the Arctic may alter the quantity and composition of the food environment for one of the key copepod species, Calanus finmarchicus, with as yet unquantified effects on its production. Here we present rates of feeding and egg production in female C. finmarchicus exposed to the range of feeding conditions encountered across the Fram Strait in May/June 2018. Carbon (C) budgets were constructed and used to examine the relationship between feeding and growth (= egg production) in these animals. C-specific ingestion rates (mean ± standard deviation) were highly variable, ranging from 0.015 ± 0.004 to 0.645 ± 0.017 day-1 (mean = 0.295 ± 0.223 day-1), and were positively correlated with food availability. C-specific egg production rates ranged from 0.00 to 0.049 day-1 (mean = 0.012 ± 0.011) and were not correlated with either food availability or ingestion rate. Calculated gross growth efficiencies (GGE: growth/ingestion) were low, 0.12 ± 0.13 (range = 0.01 to 0.39). The assembled C budgets indicate that the average fraction of ingested food that was surplus to the requirements for egg production, respiration and losses to faecal pellets was 0.17 ± 0.42. We suggest that this excess occurred, at least in part, because many of the incubated females were still undergoing the energetically (C-) expensive process of gonad maturation at the time of sampling, an assertion that is supported by the relatively high C:N (nitrogen) ratios of the incubated females, the typically low egg production rates, and gonad maturation status. Ontogenetic development may thus explain the large variability seen in the relationship between egg production and ingestion. The apparently excessive ingestion rates may additionally indicate that recently moulted females must acquire additional N via ingestion to complete the maturation process and begin spawning. Our results highlight the need for improved fundamental understanding of the physiology of high-latitude copepods and its response to environmental change.

Animals and plants are shifting the timing of key life events in response to climate change, yet despite recent documentation of escalating phenological change, scientists lack a full understanding of how and why phenological responses vary across space and among species. Here, we used over 7 million community-contributed bird observations to derive species-specific, spatially explicit estimates of annual spring migration phenology for 56 bird species across eastern North America. We show that changes in the spring arrival of migratory birds are coarsely synchronized with fluctuations in vegetation green-up and that the sensitivity of birds to plant phenology varied extensively. Bird arrival responded more synchronously with vegetation green-up at higher latitudes, where phenological shifts over time are also greater. Critically, species’ migratory traits explained variation in sensitivity to green-up, with species that migrate more slowly, arrive earlier and overwinter further north showing greater responsiveness to earlier springs. Identifying how and why species vary in their ability to shift phenological events is fundamental to predicting species’ vulnerability to climate change. Such variation in sensitivity across taxa, with long-distance neotropical migrants exhibiting reduced synchrony, may help to explain substantial declines in these species over the last several decades. Citizen-science data on bird observations from eastern North America show that the timing of spring arrival of migratory birds is broadly correlated with fluctuations in vegetation green-up but that the varying sensitivity of different bird species to this phenological event is linked to their different migratory strategies.

Resumen Introduccion Existe muy poca literatura espanola que compare resultados oncologicos tras prostatectomia radical (PR) segun la via de abordaje y la metodologia es inadecuada. Objetivo Comparar los resultados oncologicos en cuanto a margenes quirurgicos (MQ) y recidiva bioquimica (RB) entre PR abierta (PRA) y laparoscopica (PRL). Material y metodos Comparacion de 2 cohortes (307 con PRA y 194 con PRL) entre 2007 y 2015. El estado de los MQ se clasificaron como positivos o negativos y la RB como la elevacion del PSA despues de la PR > 0,4 ng/ml. Para el contraste de variables cualitativas se utilizo el test Chi-cuadrado y ANOVA para las cuantitativas. Para evaluar los factores predictores de los MQ se ha realizado un analisis multivariante mediante regresion logistica. Para evaluar los factores predictores de RB se ha realizado un analisis multivariable mediante regresion de Cox. Resultados El 43,5% de pacientes tuvieron un Gleason 7 (3 + 4) en la pieza quirurgica y un 31,7% MQ positivos siendo el estadio patologico mas frecuente pT2c en el 61,9%. No existieron diferencias significativas entre ambos grupos, excepto la afectacion extracapsular (p = 0,001), mas frecuente en la PRL. La mediana de seguimiento fue de 49 meses, evidenciando RB en el 23% de pacientes, sin diferencias significativas entre cohortes. En el analisis multivariable solo el grupo de riesgo D’Amico se comporto como factor predictor independiente de MQ positivos y el score de Gleason y los MQ positivos como factores predictores independientes de RB. Conclusion La via de abordaje no influyo en el estado de MQ ni en la RB.

Lipid-storing copepods are fundamental to the functioning of marine ecosystems, transferring energy from primary producers to higher trophic levels and sequestering atmospheric carbon (C) in the deep ocean. Quantifying trophic transfer and biogeochemical cycling by copepods requires improved understanding of copepod metabolic rates in both surface waters and during lipid-fueled metabolism over winter. Here we present new biomass turnover rates of C and nitrogen (N) inCalanoides acutus,Calanoides natalis,Calanus glacialisandCalanus hyperboreusalongside published data forCalanus finmarchicusandCalanus pacificus. Turnover rates in metabolically active animals, normalised to 10°C, ranged between 0.007 – 0.105 d-1and 0.004 – 0.065 d-1for C and N, respectively. Turnover rates of C were typically faster than those for N, supporting the understanding that non-protein C, e.g. lipid, is catabolised faster than protein. Re-analysis of published data indicates that inactive, overwinteringC. finmarchicusturn over wax ester lipids at a rate of 0.0016 d-1. These and other basal rate data will facilitate the mechanistic representation of copepod physiology in global biogeochemical models, thereby reducing uncertainties in our predictions of future ocean ecosystem functioning and C sequestration.

Kidney procurement procedure must be carried out following a standardized technique in order to optimize kidney grafts for their subsequent implantation.Review of the available literature on kidney procurement procedure.Narrative review of the available evidence on deceased donor kidney procurement technique after a search of relevant manuscripts indexed in PubMed, EMBASE and Scielo written in English and Spanish.Deceased donor kidney procurement can be divided into two groups, donation after brain death (DBD) and donation after circulatory death (DCD). Kidney procurement in DBD frequently includes other chest and/or abdominal organs, requiring multidisciplinary surgical coordination. During the harvesting procedure, the renal vascular pedicle must remain intact for subsequent implantation and reduced ischemia time.Adequate execution and perfect knowledge of the technique for surgical removal and anatomy reduces the rate of graft losses associated to inadequate harvesting techniques.

Resumen Objetivo Analizar la supervivencia de los pacientes con cancer de prostata (CP) con factores pronosticos desfavorables (FPD) tratados con PR y radioterapia de rescate (RTR) tras recidiva bioquimica (RB) y persistencia bioquimica (PB). Material y metodo Analisis retrospectivo de 446 pacientes con al menos uno de los siguientes FPD: score de Gleason ≥ 8, estadio patologico ≥ pT3 y/o margenes quirurgicos positivos (MQ + ). El criterio de RB fue la elevacion del PSA por encima de 0,4 ng/ml. Evaluacion de supervivencia mediante Kaplan-Meier y log-rank. Para identificar factores de riesgo con posible influencia en la respuesta a RTR y la supervivencia causa-especifica (SCE) se uso analisis uni y multivariable (regresion de Cox). Resultados Mediana de seguimiento: 72 (rango 37-122) meses, mediana de tiempo hasta RB: 42 (rango 20-112) meses. El 36,3% presentaron RB. Presentaron respuesta bioquimica a la RTR 121 (74,7%) pacientes. La supervivencia libre de recaida (SLR) despues de la RTR a los 3, 5, 8 y 10 anos fue del 95,7, del 92,3, del 87,9 y del 85%, la SG a los 5, 10 y 15 anos fue del 95,6, del 86,5 y del 73,5%. La SCE a los 5, 10 y 15 anos fue del 99,1, del 98,1 y del 96,6%, respectivamente. Solo el tiempo hasta la RB Conclusiones La PR solo consigue control de la enfermedad a los 10 anos en aproximadamente la mitad de los casos. El tratamiento multimodal secuencial (PR + RTR cuando precise) aumenta este control bioquimico hasta > 87%, lograndose una larga SCE. Los pacientes con un tiempo hasta recidiva > 24 meses respondieron mejor al tratamiento de rescate.

Objective Survival analysis of patients with prostate cancer (PCa) with adverse prognostic factors (APF) treated with radical prostatectomy (RP) and salvage radiotherapy (SRT) after biochemical recurrence (BR) or biochemical persistence (BP). Materials and methods Retrospective analysis of 446 patients with at least one of the following APF: Gleason score ≥8, pathologic stage ≥pT3 and/or positive surgical margins. BR criteria used was PSA level over 0.4 ng/ml. A survival analysis using Kaplan–Meier was performed to compare the different variable categories with log-rank test. In order to identify risk factors for SRT response and cancer specific survival (CSS) we performed univariate and multivariate analyses using Cox regression. Results Mean follow up: 72 (IQR 27–122) months, mean time to BR: 42 (IQR 20–112) months, mean PSA level at BR: 0.56 (IQR 0.42–0.96). BR was present in 36.3% of the patients. Biochemical response to SRT was observed in 121 (75.7%) patients. Recurrence-free survival (RFS) rates after SRT at 3, 5, 8 and 10 years were 95.7%, 92.3%, 87.9%, and 85%; overall survival (OS) rates after 5, 10 and 15 years was 95.6%, 86.5% and 73.5%, respectively. CSS rates at 5, 10 and 15 years were 99.1%, 98.1% and 96.6%. Only time to BR Conclusions In these patients, RP only controls the disease in approximately half of the cases. Multimodal sequential treatment (RP + SRT when needed) increases this control, achieving high CSS rates and biochemical control in over 87% of the patients. Patients with time to recurrence >24 months responded better to rescue treatment.

Introduction Recurrence trends after renal cell cancer (RCC) nephrectomy are not clearly defined. Objective To evaluate recurrence trends according to recurrence risk groups (RRG). Methods Retrospective analysis of 696 patients with RCC treated with nephrectomy between 1990−2010. Three RRG were defined according to the presence of anatomopathological variables (pTpN stage, nuclear grade, tumor necrosis (TN), sarcomatoid differentiation (SD), positive resection margin (RM)): - Low RG (LRG):pT1pNx-0 G1–4, pT2pNx-0 G1–2; no TN, SD and/or RM(+) - Intermediate RG (IRG):pT2pNx-0 G3–4;pT3–4pNx-0 G1–2; LRG with TN. - High RG (HRG):pT3–4pNx-0 G3–4;pT1–4pN+;IRG with TN and/or SD; LRG with SD and/or RM (+). The Kaplan-Meier method has been used to evaluate recurrence-free survival as a function of RRG. The log-rank test was used to evaluate differences between survival curves. Results The median follow-up was 105 (IQR 63–148) months. Of the total series, 177 (25.4%) patients presented recurrence: distant 15.9%, local 4.9% and 4.6% distant and local. The recurrence rate varied according to the RRG with values of 72.9% for HRG, 16.9% for IRG and 10.2% for LRG (P = .0001). Most cases in LRG presented single organ recurrence (72.2%) (P = .006). The LRG experienced recurrence as single metastasis in 50% of cases, compared to 30% and 18.6% in IRG and HRG, respectively (P = .009). The most common sites of recurrence were lung and abdomen. Lung recurrence predominated in the HRG (72.9%) (P = .0001) and abdominal, in the LRG (83.3%) with a tendency to significance (P = .15). Conclusions Recurrence rates (especially bone and lung) increase with higher RG. Single organ recurrences and single metastases are more frequent in LRG.

Resumen Introduccion No estan claramente definidos los patrones de recurrencia tras nefrectomia por cancer renal. Objetivo Evaluar patrones de recidiva en funcion del grupo de riesgo de recurrencia (GRR). Material y metodo Analisis retrospectivo de 696 pacientes con carcinoma de celulas renales tratados con nefrectomia entre 1990-2010. Se definieron tres GRR segun la presencia de variables anatomopatologicas (estadio pTpN, grado nuclear, necrosis tumoral [NT], diferenciacion sarcomatoide [DS], margen de reseccion positivo [MR]): -GR bajo (GRB): pT1pNx-0 G1-4, pT2pNx-0 G1-2; no NT, DS y/o MR (+). -GR intermedio (GRI): pT2pNx-0 G3-4;pT3-4pNx-0 G1-2; GRB con NT. -GR alto (GRA): pT3-4pNx-0 G3-4; pT1-4pN + ; GRI con NT y/o DS; GRB con DS y/o MR (+). Para el contraste de variables cualitativas se utilizo el test de la Chi cuadrado. El metodo de Kaplan-Meier se ha utilizado para evaluar la supervivencia libre de recidiva en funcion de los GRR. Para evaluar diferencias entre las curvas de supervivencia se ha utilizado el test de log-rank. Resultados La mediana de seguimiento fue de 105 (IQR 63-148) meses. Del total de la serie recidivaron 177 (25,4%) pacientes: 15,9% a distancia, 4,9% local y 4,6% a distancia y local. La tasa de recurrencia vario segun el grupo de riesgo con tasas del 72,9% en GRA, 16,9% en GRI y 10,2% en GRB (p = 0,0001). La recurrencia en organo unico fue mayoritaria en el GRB (72,2%) (p = 0,006). El GRB presento recidiva en forma de metastasis unica en el 50% de los casos, frente al 30% y 18,6% en GRI y GRA, respectivamente (p = 0,009). Las localizaciones de recurrencia mas habituales fueron pulmon y abdomen. La localizacion pulmonar predomino en el GRA (72,9%) (p = 0,0001) y la abdominal en el GRB (83,3%) con una tendencia a la significacion (p = 0,15). Conclusiones A medida que aumenta el grupo de riesgo aumentan las recurrencias, sobre todo oseas y pulmonares. En el GRB son mas frecuentes las metastasis unicas y en organo unico.

Mesopelagic fish are an important component of marine ecosystems, and their contribution to marine biogeochemical cycles is becoming increasingly recognized. However, major uncertainties remain in the rates at which they remineralize organic matter. We present respiration rate estimates of mesopelagic fish from two oceanographically contrasting regions: the Scotia Sea and the Benguela Current. Respiration rates were estimated by measuring the enzyme activities of the electron transport system. Regression analysis of respiration with wet mass highlights regional and inter-specific differences. The mean respiration rates of all mesopelagic fish sampled were 593.6 and 354.9 µl O2 individual−1 h−1 in the Scotia Sea and Benguela Current, respectively. Global allometric models performed poorly in colder regions compared with our observations, underestimating respiratory flux in the Scotia Sea by 67–88%. This may reflect that most data used to fit such models are derived from temperate and subtropical regions. We recommend caution when applying globally derived allometric models to regional data, particularly in cold (

The changing Arctic environment is affecting zooplankton that support its abundant wildlife. We examined how these changes are influencing a key zooplankton species, Calanus finmarchicus, principally found in the North Atlantic but expatriated to the Arctic. Close to the ice-edge in the Fram Strait, we identified areas that, since the 1980s, are increasingly favourable to C. finmarchicus. Field-sampling revealed part of the population there to be capable of amassing enough reserves to overwinter. Early developmental stages were also present in early summer, suggesting successful local recruitment. This extension to suitable C. finmarchicus habitat is most likely facilitated by the long-term retreat of the ice-edge, allowing phytoplankton to bloom earlier and for longer and through higher temperatures increasing copepod developmental rates. The increased capacity for this species to complete its life-cycle and prosper in the Fram Strait can change community structure, with large consequences to regional food-webs.

Demersal fisheries trawling is widely acknowledged as one of the most intense forms of widespread benthic disturbance, resuspending extensive plumes of sediments and dissolved nutrients. However, difficulties associated with sampling within trawl plumes have hitherto limited our quantitative understanding of these widespread phenomena. This lack of knowledge hinders our ability to understand the broader consequences of demersal trawling and the development of new fishing gears to limit benthic disturbance. Here we present data from a series of novel in situ experiments using a specially designed trawl sled to quantitatively examine how trawl gear-induced drag and pressure influence the height and concentrations of resuspended sediments and nutrients within a trawl plume. Our data demonstrate that the composition of resuspended particles and sampled nutrients are both influenced by sampling height above the seafloor and the amount of drag exerted by the trawl gear (p < 0.001 in all cases), although the relative importance of these factors differed between the response variables examined. These differences likely reflect that sediment particles are more influenced by gravity than dissolved nutrients are. Our results demonstrate that trawl gear specification strongly influences the amount of dissolved and particulate material resuspended, suggesting that their design could be modified to reduce impacts on benthic ecosystems.

The flux of terrigenous organic carbon through estuaries is an important and changing, yet poorly understood, component of the global carbon cycle. Using dissolved organic carbon (DOC) and fluorescence data from 13 British estuaries draining catchments with highly variable land uses, we show that land use strongly influences the fate of DOC across the land ocean transition via its influence on the composition and lability of the constituent dissolved organic matter (DOM). In estuaries draining peatland-dominated catchments, DOC was highly correlated with biologically refractory “humic-like” terrigenous material which tended to be conservatively transported along the salinity gradient. In contrast, there was a weaker correlation between DOC and DOM components within estuaries draining catchments with a high degree of human impact, that is, relatively larger percentage of arable and (sub)urban land uses. These arable and (sub)urban estuaries contain a high fraction of bioavailable “protein-like” material that behaved nonconservatively, with both DOC removals and additions occurring. In general, estuaries draining catchments with a high percentage of peatland (≥18%) have higher area-specific estuarine exports of DOC (>13 g C m−2 yr−1) compared to those estuaries draining catchments with a high percentage (≥46%) of arable and (sub)urban land uses (

The traditional separation between primary producers (autotrophs) and consumers (heterotrophs) at the base of the marine food web is being increasingly replaced by the paradigm that mixoplankton, planktonic protists with the nutritional ability to use both phago(hetero)trophy and photo(auto)trophy to access energy are widespread globally. Thus, many ‘phytoplankton’ eat, while 50% of ‘protozooplankton’ also perform photosynthesis. Mixotrophy may enhance primary production, biomass transfer to higher trophic levels and the efficiency of the biological pump to sequester atmospheric CO2 into the deep ocean. Although this view is gaining traction, science lacks a tool to quantify the relative contributions of autotrophy and heterotrophy in planktonic protists. This hinders our understanding of their impacts on carbon cycling within marine pelagic ecosystems. It has been shown that the hydrogen (H) isotopic signature of lipids is uniquely sensitive to heterotrophy relative to autotrophy in plants and bacteria. Here, we explored whether it is also sensitive to the trophic status in protists. The new understanding of H isotope signature of lipid biomarkers suggests it offers great potential as a novel tool for quantifying the prevalence of mixotrophy in diverse marine microorganisms and thus for investigating the implications of the ‘mixoplankton’ paradigm.

Comparative analysis of postoperative complications and survival between laparoscopic partial nephrectomy (PN) and radical nephrectomy (RN) in cT1 renal cell carcinoma (RCC).Retrospective study of patients with two kidneys and single renal tumor cT1 treated in our center between 2005 and 2018 by laparoscopic PN or RN.372 patients met the inclusion criteria for the study. RN was performed in 156 (41.9%) patients and PN in 216 (58.1%). Clavien Dindo III-V complications were observed in 10 (4,6%) PN and 6 (3,9%) RN patients (p = 0.75). The comorbidity Charlson index (CCI) was identified as an independent predictor variable of complications (p = 0.02) and surgical approach did not affect multivariate analysis. Estimated overall survival (OS) was 81.2% and 56.8% at 5 and 10 years in the RN group and 90.2% and 75.7% in the PN group, respectively (p = 0.0001). Obesity (HR 2.77, p = 0.01), CCI ≥ 3 (HR 3.69, p = 0.001) and glomerular filtration rate (GFR)60 mL/min/1.73 mLaparoscopic PN is not inferior to RN in terms of oncologic and surgical safety in cT1 RCC. Nephrectomy approach did not influence patient OS, however, obesity, CCI ≥ 3 and GFR60 mL/min/1.73 m

Resumen Introduccion El objetivo es comparar el rendimiento de la secuencia resonancia magnetica (RM) y biopsia transrectal «cognitiva» (BTRCog) frente a la biopsia transrectal clasica (BTRCl) en pacientes con al menos una biopsia de prostata (BP) negativa. Material y metodo Analisis retrospectivo de 205 pacientes con al menos una BP negativa. A 144 (70,2%) pacientes se les realizo antes de la biopsia una RM y a 61 (29,8%) no. Los nodulos se clasificaron segun la clasificacion PI-RADS v2 agrupando pZa, pZpl y pZpm como zona periferica (ZP), Tza, Tzp y CZ como zona transicional (ZT) y areas AS como zona anterior (ZA). A los pacientes con RM se les realizo BTRCog. A los pacientes sin RM se les realizo una BTRCl de la ZP y de la ZT. Comparacion de variables cualitativas con test de la chi2 y de cuantitativas con t de Student. Analisis multivariante (regresion logistica) para identificar variables predictoras. Resultados La mediana de edad fue 68 (IQR 62-72%) anos, de PSA 8,3 (IQR 6,2-11,7) ng/ml y del numero de biopsias previas fue 1 (IQR 1-2). En 169 (82,4%) el tacto rectal (TR) fue normal, mientras que en 36 (17,6%) sospechoso (cT2a-b en 34 y cT2c en 2). La mediana del volumen prostatico (VP) fue de 48 (IQR 38-65) cc. Existio diferencia en el PSAD (p = 0,03) entre ambos grupos. En la ETR se identifico nodulo hipoecoico en 8 (13,1%) pacientes con BTRCl y en 62(43,1%) (p = 0,0001) con BTRCog. La mediana de cilindros extraidos en BTRCl fue 10 (IQR 10-10) y en el grupo BTRCog fue 11 (IQR 9-13) (p = 0,75). Se diagnostico cancer en 74 (36,1%) pacientes. En BTRCl 10 (16,4%) y en BTRCog 64 (44,4%) (p = 0,0001). Los tumores diagnosticados fueron clasificados: ISUP-1: 34 (45,9%), ISUP-2: 21 (28,4%), ISUP-3: 9 (12,2%), ISUP-4: 7 (9,5%), ISUP-5: 3 (4,1%). No existieron diferencias (p = 0,89). La mediana de cilindros afectados en BTRCl fue 1 (IQR 1-5) frente a 2 (IQR 1-4) en el grupo BTRCog (p = 0,93). Variables predictoras independientes de cancer: edad (OR = 12,05, p = 0,049). TR sospechoso (OR = 2,64, p = 0,04), nodulo hipoecoico en ecografia (OR = 2,20, p = 0,03) y la secuencia RM + BTRCog (OR = 3,49, p = 0,003). Conclusiones La secuencia RMNmp + BTRCog en pacientes con al menos una BP previa negativa multiplica casi por 3,5 (OR = 3,49) la probabilidad de diagnosticar un cancer frente a la BTRCl.

espanolIntroduccion y objetivo Una de las caracteristicas inherentes a los tumores renales es la capacidad de extenderse al interior del sistema venoso como trombos tumorales. El objetivo de este estudio es evaluar en los pacientes con cancer renal en un estadio pT3apN0cM0 si la existencia de afectacion tumoral venosa influye en la recidiva tumoral. Materiales y metodos Analisis retrospectivo de pacientes con cancer renal en estadio pT3apN0cM0 tratados con nefrectomia radical entre 1990-2015. Analisis univariante y multivariante mediante regresion de Cox para identificar variables predictoras y variables predictoras independientes relacionadas con la recidiva. Resultados Se analizaron los resultados de 153 pacientes. La mediana de seguimiento fue de 82 (IQR 36-117) meses. La supervivencia libre de recidiva a los 5 anos fue del 58,9% con una mediana de 97 (IC95% 49,9-144,1) meses. Recidivaron 77 (50,3%) pacientes. En 70 (90,9%) casos las metastasis fueron a distancia, en 17 (14,2%) de estos pacientes se objetivo recurrencia local en el lecho de nefrectomia sincronica. En el analisis multivariable se identificaron como variables predictoras independientes de recidiva tumoral la necrosis tumoral (p=0,0001) y la invasion microvascular (p=0,001). Conclusiones La existencia de extension tumoral venosa no se ha relacionado, en nuestra serie y tras la realizacion del analisis multivariable, con la recidiva. La necrosis tumoral y la infiltracion microvascular si se comportaron como factores predictores independientes de recidiva tumoral. EnglishIntroduction and objective One of the inherent features of kidney tumours is the capacity to spread inside the venous system as tumour thrombi. The aim of this study was to assess in patients with stage pT3apN0cM0 kidney cancer whether venous tumour involvement influenced tumour recurrence. Materials and methods A retrospective analysis of patients with stage pT3apN0cM0 kidney cancer treated with radical nephrectomy between 1990-2015. Univariate and multivariate Cox regression analysis to identify predictive variables and independent predictive variables relating to recurrence. Results The results of 153 patients were studied. The median follow-up was 82 (IQR 36-117) months. Recurrence-free survival at 5 years was 58.9% with a median of 97 (95% CI 49.9-144.1) months. Seventy-seven (50.3%) patients recurred. Seventy cases 70 (90.9%) had distant metastases, 17 (14.2%) of these patients had local recurrence in the bed of nephrectomy. Tumour necrosis (p=.0001), and microvascular invasion (p=.001) were identified as independent predictors of tumour recurrence in the multivariable analysis. Conclusions In our series, after multivariable analysis, venous tumour extension was not related to recurrence. Tumour necrosis and microvascular infiltration did behave as independent predictive factors of tumour recurrence.

Introduction and objective One of the inherent features of kidney tumours is the capacity to spread inside the venous system as tumour thrombi. The aim of this study was to assess in patients with stage pT3apN0cM0 kidney cancer whether venous tumour involvement influenced tumour recurrence. Materials and methods A retrospective analysis of patients with stage pT3apN0cM0 kidney cancer treated with radical nephrectomy between 1990 and 2015. Univariate and multivariate Cox regression analysis to identify predictive variables and independent predictive variables relating to recurrence. Results The results of 153 patients were studied. The median follow-up was 82 (IQR 36–117) months. Recurrence-free survival at 5 years was 58.9% with a median of 97 (95% CI 49.9–144.1) months. Seventy-seven (50.3%) patients recurred. Seventy cases 70 (90.9%) had distant metastases, 17 (14.2%) of these patients had local recurrence in the bed of nephrectomy. Tumour necrosis (p = 0.0001), and microvascular invasion (p = 0.001) were identified as independent predictors of tumour recurrence in the multivariable analysis. Conclusions In our series, after multivariable analysis, venous tumour extension was not related to recurrence. Tumour necrosis and microvascular infiltration did behave as independent predictive factors of tumour recurrence.

Resumen Introduccion Evaluacion de la efectividad de la biopsia cognitiva (BC) en los pacientes con sospecha clinica de cancer de prostata (caP) y al menos una biopsia negativa (BTR). Material y metodo Analisis retrospectivo de 144 pacientes con al menos una BTR y una resonancia magnetica nuclear (RMN) previa. Los nodulos de la RMN se clasificaron segun la clasificacion PI-RADS v2 agrupando pZa, pZpl y pZpm como zona periferica (ZP), Tza, Tzp y CZ como zona transicional (ZT) y areas AS como zona anterior (ZA). Se indico biopsia en nodulos ≥ PI-RADS 3. Se llevo a cabo analisis uni y multivariante (regresion logistica) tratando de identificar variables relacionadas con tumor en biopsia de PI-RADS 3. Resultados La mediana de edad fue de 67 (IQR: 62-72) anos, la de PSA 8,2 (IQR: 6,2-12) ng/ml. Se identifico nodulo en la RMN en la ZP en 97 (67,4%) casos, en la ZT en 29 (20,1%) casos y en ZA en 41 (28,5%) casos. Se diagnostico caP en la biopsia en 64 (44%) pacientes. En PI-RADS 3 se obtuvo un 17,5% (7/40) de cancer, PI-RADS 4 un 47,3% (35/73) y en los PI-RADS 5 un 73,3% (22/29) (p = 0,0001). Analisis multivariable con variables que pudieran influir en el resultado de la biopsia en pacientes con PI-RADS 3: ninguno (edad, PSA, numero de biopsias previas, tacto rectal, PSAD, volumen prostatico ni numero de cilindros extraidos) se comporto como factor predictor independiente de tumor. Conclusiones El rendimiento diagnostico de la BC en pacientes con al menos una biopsia previa negativa fue del 44% incrementandose segun el grado de PI-RADS, siendo en PI-RADS 3 bajo. No se identifico ninguna variable clinica predictora de caP en pacientes con PI-RADS 3.

Introduction Evaluation of the effectiveness of cognitive biopsy (CB) in patients with clinical suspicion of prostate cancer (PC), and at least one negative biopsy (TRB). Material and method Retrospective study of 144 patients with at least one previous TRB and magnetic resonance imaging (MRI). The MRI nodules were classified based on PI-RADS v2 grouping pZa, pZpl and pZpm as the peripheral zone (PZ), Tza, Tzp and CZ as the transitional zone (TZ), and the AS zones as the anterior zone (AZ). A biopsy was indicated for nodules ≥PI-RADS 3. Uni and multivariate analysis was undertaken (logistic regression) to identify variables relating to a PI-RADS 3 tumour on biopsy. Results The median age was 67 (IQR: 62–72) years, the median PSA was 8.2 (IQR: 6.2–12) ng/ml. A nodule was identified on MRI in the PZ in 97 (67.4%) cases, in the TZ in 29 (20.1%), and in the AZ in 41 (28.5%). PC was diagnosed on biopsy in 64 (44%) patients. The cancer rate in the PI-RADS 3 lesions was 17.5% (7/40), in the PI-RADS 4 47.3% (35/73), and in the PI-RADS 5 lesions it was 73.3% (22/29) (p = 0.0001). Multivariable analysis with variables that could influence the biopsy result in patients with PI-RADS 3: none (age, PSA, number of previous biopsies, rectal examination, PSAD, prostate volume or number of extracted cylinders) behaved as an independent tumour predictor. Conclusions The diagnostic performance of CB in patients with at least one previous negative biopsy was 44%, increasing according to the PI-RADS grade, and low in PI-RADS 3. No clinical variable predictive of cancer was found in patients with PI-RADS 3.

This paper reviews trends in the academic literature on cumulative effects assessment (CEA) of disturbance on forest ecosystems to advance research in the broader context of impact assessments. Disturbance is any distinct spatiotemporal event that disrupts the structure and composition of an ecosystem affecting resource availability. We developed a Python package to automate search term selection, write search strategies, reduce bias and improve the efficient and effective selection of articles from academic databases and grey literature. We identified 148 peer-reviewed literature published between 1986 and 2022 and conducted an inductive and deductive thematic analysis of the results. Our findings revealed that CEA studies are concentrated in the global north, with most publications from authors affiliated with government agencies in the USA and Canada. Methodological and analytical approaches are less interdisciplinary but mainly quantitative and expert-driven, involving modeling the impacts of disturbances on biophysical valued components. Furthermore, the assessment of socioeconomic valued components, including the effects of disturbance on Indigenous wellbeing connected to forests, has received less attention. Even though there is a high preference for regional assessment, challenges with data access, quality, and analysis, especially baseline data over long periods, are hampering effective CEA. Few articles examined CEA - policy/management nexus. Of the few studies, challenges such as the inadequate implementation of CEA mitigation strategies due to policy drawbacks and resource constraints, the high cost of monitoring multiple indicators, and poor connections between scenarios/modeling and management actions were paramount. Future CEA research is needed to broaden our understanding of how multiple disturbance affects forests in the global south and coupled social and ecological systems and their implications for sustainable forest management.

Land-ocean dissolved organic matter (DOM) transport is a significant and changing term in global biogeochemical cycles which is increasing as a result of human perturbation, including land-use change. Knowledge of the behavior and fate of transported DOM is lacking, particularly in the tropics and subtropics where land-use change is occurring rapidly. We used Parallel Factor (PARAFAC) Analysis to investigate how land-use influenced the composition of the DOM pool along a subtropical land-use gradient (from near-pristine broadleaf forest to agri-urban settings) in Belize, Central America. Three humic-like and two protein-like components were identified, each of which was present across land uses and environments. Land-use mapping identified a strong (R2 = 0.81) negative correlation between broadleaf forest and agri-urban land. All PARAFAC components were positively associated with agri-urban land-use classes (cropland, grassland, and/or urban land), indicating that land-use change from forested to agri-urban exerts influence on the composition of the DOM pool. Humic-like DOM exhibited linear accumulation with distance downstream and behaved conservatively in the coastal zone whilst protein-like DOM exhibited nonlinear accumulation within the main river and nonconservative mixing in coastal waters, indicative of differences in reactivity. We used a hydrodynamic model to explore the potential of conservative humics to reach the region's environmentally and economically valuable coral reefs. We find that offshore corals experience short exposures (10 ± 11 days yr−1) to large (∼120%) terrigenous DOM increases, whilst nearshore corals experience prolonged exposure (113 ± 24 days yr−1) to relatively small (∼30%) terrigenous DOM increases.

The dynamics of Amazonian rainforest over long timescales connect closely to its rich biodiversity. While palaeoecological studies have suggested its stability through the Pleistocene, palaeontological evidence indicates the past existence of major expansions of savannah and grassland. Here we present integrated modelling evidence for a grassier Neotropics during the Last Glacial Maximum, congruent with palaeoecological and biological studies. Vegetation reconstructions were generated using the land processes and exchanges model, driven by model reconstructions of Last Glacial Maximum climate, and compared with palynological data. A factorial experiment was performed to quantify the impacts of fire and low CO2 on vegetation and model–data agreement. Fire and low CO2 both individually and interactively induced widespread expansion of savannah and grassland biomes while improving model–data agreement. The interactive effects of fire and low CO2 induced the greatest ‘savannafication’ of the Neotropics, providing integrated evidence for a number of biogeographically relevant open vegetation formations, including two dry corridors (paths of savannah and grassland through and around Amazonia that facilitated major dispersal and evolutionary diversification events). Our results show a bimodality in tree cover that was driven by fire and further enhanced by ‘CO2 deprivation’, which suggests biome instability in this region of climate space. Lower CO2 and more-frequent fires may have supported grassland expansion in the Amazon during the Last Glacial Maximum, according to vegetation modelling using a range of boundary conditions tested against existing pollen records.

Understanding what limits the growth of marine copepods is important for modeling food web dynamics and biogeochemical cycles in the ocean. We use a state‐of‐the‐art stoichiometric model that explicitly represents metabolic physiology to examine the roles of food quantity vs. quality in limiting the growth of these animals. The model predicts that the crossover from C‐ to N‐limitation occurs at food C : N 7.3–11.5 mol C mol N−1, depending on food quantity. Thus, despite significant losses of N in metabolism, copepods should be limited by C when consuming food at Redfield C : N (6.625). We nevertheless suggest that copepods do not seek C‐rich diets per se. Rather, results indicate limitation by food quantity as growth increases with organic matter intake, regardless of its elemental composition. Our work highlights the benefit of developing mechanistic representations of zooplankton metabolism in order to increase confidence in the predictions of biogeochemical models.

Copepods can feed on, and may regulate, the blooms of harmful algae (HA), and may also facilitate dinoflagellate blooms by inducing toxin production and through selective grazing. However, exposure to HA may also cause mortality and reproductive impairment in copepods, with detrimental effects at the population-scale. Here we present the toxin profile of the dinoflagellate, Alexandrium catenella (formerly Alexandrium tamarense), and examine how it affects the survival and reproduction of the cosmopolitan marine copepod, Acartia tonsa. Healthy adult copepods were exposed to mono-specific diets of toxic and non-toxic strains of A. catenella (1119/27 and 1119/19, respectively) and non-toxic Rhodomonas sp. for 10 days alongside unfed controls to examine how their survival was influenced by likely HA bloom conditions. Additional 2-day experiments examined how their egg production rate and hatching success were affected by food deprivation, toxic A. catenella, a non-toxic alternative and a mixture of toxic and non-toxic prey, at high and low concentrations. Survival of A. tonsa declined over the 10-day experiment in all treatments but was not significantly lower in the toxic A. catenella treatment; mortality was only significantly enhanced in the unfed animals, which showed 100% mortality after 9 days. Egg production rates and hatching success from females in the unfed and toxic A. catenella treatments were all significantly lower than values observed in females fed Rhodomonas sp. or non-toxic A. catenella. Animals offered 1,000 μg C L–1 of Rhodomonas sp. and a 50:50 mixture of toxic A. catenella and Rhodomonas sp. produced significantly more eggs than animals fed toxic A. catenella alone. These results were not apparent at prey concentrations of 100 μg C L–1. The percentages of eggs to successfully hatch from females offered mono-specific diets of toxic A. catenella were always close to zero. Collectively, our results indicate that adult female A. tonsa can acquire sufficient energy from toxic A. catenella to survive, but suffer reproductive impairment when feeding on this prey alone.