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Objective: To compare the efficacy and safety of percutaneous polidocanol sclerotherapy and laparoscopic deroofing in the management of pediatric symptomatic simple renal cysts. Methods: Forty-six ...

There is growing evidence that engaging in extra-pair copulations may be a strategy by which females can modify their initial mate choice if they are constrained by primary choice of the social mate. Several factors such as genetic similarity and adult phenotypic traits can affect extra-pair paternity (EPP) patterns, but the relative importance of these factors may vary among species. Moreover, interactive effects of male and female characteristics have rarely been considered. Here, we aimed to study how multiple parameters characterizing a breeding pair (i.e. genetic similarity between mates, partners' age and laying date) predict the occurrence of EPP at the brood level. The study uses 4 years of data from a wild population of Blue Tits Cyanistes caeruleus. Contrary to predictions of the inbreeding avoidance hypothesis, we did not find a positive relationship between the occurrence of EPP and the relatedness of social mates. We also found that the probability of EPP was unrelated to laying date. However, EPP was predicted by an interaction of social partners' ages. Specifically, EPP was less likely when old females were paired with old males in comparison to old females paired to young males. Our study suggests that the occurrence of EPP may be the result of behavioural interactions in which both male and female age are important for determining the outcome. Our results confirm the importance of considering the interactions of male and female characteristics in studies investigating EPP patterns.

We assess the estimation accuracy for two static baselines (350 m and 8 km) with NavIC L5 double-differenced (DD) pseudoranges using weighted and recursive least-square techniques for a day. Additi...

Background: In the treatment of idiopathic pulmonary fibrosis (IPF), nintedanib and pirfenidone, with their different mechanisms of action, lead to a reduction in the rate of progression of the fibrosis process measured by the reduction of functional decline, and, in particular, the decrease in forced vital capacity (FVC) and of the diffusion capacity of the lungs for carbon monoxide (DLCO). The objective of this study was to analyze real-life adherence, persistence and efficacy in the use of pirfenidone and nintedanib in the treatment of IPF. Methods: A non-interventional multicenter retrospective observational pharmacological study in real-life treat-ment at 1 and 2 years was conducted. Furthermore, we analyzed the levels of FVC and DLCO at 6 and 12 months, respectively, from the start of treatment. Results: We identified 144 patients in the period between January 2013 and April 2019. From the point of view of adherence, there is no difference between the two drugs, even though patients who used pirfenidone had increasingly higher values: 0.90 vs 0.89, in the first year, and 0.91 vs 0.84, in the second year. In the first year of treatment, the percentage of persistent patients was 67% and 76%, while in the second year, it dropped to 47% and 53% for pirfenidone and nintedanib, respectively. Conclusion: The stratification of the adherence values as a function of the response to treatment in terms of FVC at 12 months for both study drugs showed that patients with optimal response scored adherence of more than 90%.

Reduction of car use is one of the most effective ways to tackle congestion‐related problems. Using positive incentives to stimulate bicycle use is one possibility to reduce car use. Cycling is a sustainable transport mode that uses little space and is healthy. There is evidence that positive incentives may be more effective than punishing travellers for undesirable behaviour, and the emergence of mobile applications for delivering interventions has opened up new opportunities for influencing travellers. So far, few studies have focused on exploring the effectiveness of positive incentives on long‐term behavioural change. We used the SMART app to deliver positive incentives to more than 6000 travellers in the Dutch region of Twente. The app automatically tracks users and provides incentives such as challenges with rewards, feedback, and messages. This study covers the period from March 2017 to June 2018, in which more than 1000 SMART users participated in monthly challenges. We evaluated the effects of the challenges and rewards and found that the challenges did encourage cycling and reduced car use in the short term. There is also some evidence for behavioural change over a longer time period.

Although much knowledge and debates about residential satisfaction exist, there is little evidence regarding its fluid nature and its influencing factors. Therefore, we suggest an analytical framew...

The use of therapeutic agents in medicine has lead to the development of resistant strains of many pathogens. As an alternative medicine, many herbal formulations were introduced. From ancient times, various medicinal plants have been used as a treatment agent for various diseases due to their alarming herbal properties. Turmeric, a rhizome of curcumin long a is one among them which has anti-infective and anti-inflammatory properties. Due to its novel properties, it is used in various treatments options for oral health and systemic health. Curcumin, due to its complex interaction between inflammation, immunity and oxidative stress, it was used in various oral and neck pathologies also apart from general health benefits. Curcumin suppresses pro-inflammatory cytokines in head and neck pathologies showing various changes in salivary Ph and salivary stress biomarkers. In dentistry, curcumin has been proved to have antiplaque efficiency in various studies, but long term study is required to substantiate its properties. Recently nanostructured lipid carrier containing curcumin was used in dentistry to bring about bone regeneration. This article depicts various properties, applications of curcumin in healthcare and its pharmacological action for systemic and oral health.

Study on the corrosivity of mild steel in coastal area was carried out to understand the influence of corrosion factors on mild steel in long-term analysis. Two sites (A1 and A2) were selected based on soil geotechnical and physico chemical properties. Soil corrosion is a very slow process, so methodological approach was planned for a period of 3 years. Soil physico chemical composition, texture, moisture content are related to the corrosion rate. The results revealed that the corrosion rate of coupons buried in soil increases with moisture content and chloride content. Weight loss trend was in good agreement with PDP and impedance analysis. The surface morphology examined by SEM/EDAX, optical microscopy.

In this paper, we reflect on the evolution of place-based governance from a long-term (15 year) study of rural development initiatives undertaken in a region of Poland as part of its accession to the European Union. We decompose the recursive process of institutional learning arising from initiatives for heritage preservation and rural economic development. In our analysis, we elaborate a typology of unavoidable development dilemmas that must be explicitly managed in order to allow place-based governance to effectively harness the cultural value, social context, and developmental needs of certain locales or landscapes. Although creating and sustaining local value remain contingent on broader realities of governance, proactive management of these dilemmas can help prevent many of the usual contestations around goals and identity from becoming intractable in later periods. Our proposed approach to enabling place-based governance emphasizes conflict recognition and engagement as important complements to more common prescriptive models of governance.

Background/Aim: To compare the intra-operative video overlay guided enlargement of Area of ILM peeled (AIP) more than three Disc Diameter (DD) versus the inverted flap technique in large (>400 µm ) Full Thickness Macular Holes (FTMH). Methods: Retrospectively, 127 cases of large FTMHs divided into two groups (i) Group A ( n = 62)—intra-operative video-overlay guided enlargement of AIP > 3DD performed and (ii) Group B ( n = 65)—Inverted flap technique was done. Mean Best Corrected Visual Acuity (BCVA), hole closure rate and postoperative foveal anatomy were noted on Optical Coherence Tomography (OCT). Results: Mean Minimal Diameter of Macular Hole (MDMH) were 632.05 ± 146.62 µm (A) and 677.24 ± 152.08 µm (B). Hole closure rate were 93.55% (A) and 96.92% (B). Mean preoperative BCVA was 1.07 ± 0.37 Log MAR (A) and 0.94 ± 0.23 Log MAR (B). Mean postoperative BCVA at 3 months were 0.73 ± 0.22 Log MAR (A) and 0.83 ± 0.24 Log MAR (B). One-way ANOVA test showed statistically better visual improvement in Group A at 3 months ( p = 0.02), 6 months ( p = 0.045), 12 months ( p = 0.002), and 24 months ( p = 0.011). Chi square test revealed Type I pattern of hole closure was statistically more in Group B ( p Conclusion: Anatomically, macular hole closure rate as well as closure pattern was better in Group B. But functional improvement was better in Group A.

Research targeting desirable difficulties has provided researchers and educators with a deeper understanding of the methods of study that benefit long-term learning. This literature has also provided important insights about why students do not always prefer practice methods that result in long term learning gains. Research targeting the interaction of motivation and cognition can provide additional insights into the factors underlying students’ self-regulatory learning behaviors. The current paper discusses research on the role of motivation derived from our past achievement experiences, which can enrich our understanding of the factors that influence student's achievement choices. For example, memories of prior academic experiences influence student motivation and serve as the basis for task specific expectancies and values, which are reflected in the amount of effort and the strategies learners deploy on learning and problem-solving tasks. The paper highlights findings from the literatures on achievement motivation and judgment and decision making in an effort to broaden and enrich the discussion of the application of desirable difficulties to multidimensional educational contexts.

Study abroad (SA) has recently become an increasingly popular option for language learners who wish to engage in an immersive educational experience while living in a different culture, but not all...

Nine dogs with hemophilia A were treated with adeno-associated viral (AAV) gene therapy and followed for up to 10 years. Administration of AAV8 or AAV9 vectors expressing canine factor VIII (AAV-cFVIII) corrected the FVIII deficiency to 1.9-11.3% of normal FVIII levels. In two of nine dogs, levels of FVIII activity increased gradually starting about 4 years after treatment. None of the dogs showed evidence of tumors or altered liver function. Analysis of integration sites in liver samples from six treated dogs identified 1,741 unique AAV integration events in genomic DNA and expanded cell clones in five dogs, with 44% of the integrations near genes involved in cell growth. All recovered integrated vectors were partially deleted and/or rearranged. Our data suggest that the increase in FVIII protein expression in two dogs may have been due to clonal expansion of cells harboring integrated vectors. These results support the clinical development of liver-directed AAV gene therapy for hemophilia A, while emphasizing the importance of long-term monitoring for potential genotoxicity.

Objective To evaluate whether quarterly or monthly administration of fremanezumab for migraine prevention exhibits a pattern of decreased efficacy toward the end of the dosing interval (wearing-off effect). Background The main goals of migraine preventive treatment are to reduce the frequency, severity, and duration of migraine attacks, and migraine-associated disability. Wearing-off refers to the phenomenon whereby clinical symptoms return or worsen before the next dose of a drug is due and has been reported previously with migraine preventive medications. Design and methods This was a long-term, 12-month, multicenter, randomized, double-blind, parallel-group phase 3 study (NCT02638103) that included chronic (CM) and episodic migraine (EM) patients who rolled over from the 12-week phase 3 HALO CM (NCT02621931) and EM trials (NCT02629861), as well as an additional subset of 312 new patients. Patients with CM or EM received fremanezumab either monthly or quarterly. In this post hoc analysis, for selected months, the difference in the average number of migraine days between weeks 1-2 and weeks 3-4, between weeks 1-3 and week 4, and between weeks 1-2 and weeks 11-12 were calculated. Results A total of 1890 patients (CM, 1110; EM, 780) were enrolled. At months 3, 6, 9, and 15, there were no substantial differences in mean weekly migraine days between weeks 1-2 and weeks 3-4 or between weeks 1-3 and week 4 with quarterly or monthly fremanezumab in the CM or EM subgroups. There were no substantial increases in mean weekly migraine days between weeks 1-2 and weeks 11-12 during the first quarter of treatment (months 1-3) or the second quarter of treatment (months 4-6) with quarterly or monthly fremanezumab in the CM or EM subgroups. Across both dosing subgroups in CM and EM patients, the mean weekly number of migraine days decreased substantially (30%-42%) during the first 2 weeks; decreases in weekly migraine days remained steady during the last 2 weeks of the first quarter, with a similar maintenance of response during the second quarter. Conclusions This analysis of data from a long-term, phase 3 study showed that patients receiving quarterly fremanezumab or monthly fremanezumab did not experience a wearing-off effect toward the end of the dosing interval.

BACKGROUND/AIM This study evaluated marginal soft tissue recession at implants with simultaneous lateral guided bone regeneration (GBR), at least five years after prosthetic loading. MATERIAL AND METHODS Patients treated with GBR at the time of implant placement and adherent to supportive periodontal therapy (SPT) program with at least 5 years of follow-up were re-examined in 5 clinical centers. At the last follow-up, clinical and radiographic data on peri-implant hard and soft tissue were collected. Multilevel analysis considering center, patient, and implant (brand, length, diameter, position) was performed. RESULTS A total of 96 patients and 195 augmented implants were included. The mean duration of SPT was 8.3 ± 3.1 years, while mean recall frequency was 4.5 ± 1.3 months. Sixty-five (33%) implants received soft tissue graft before prosthetic delivery. Twenty-one (11%) implants developed biological complications during the follow-up. No implant failure was reported. Mean difference in bone levels (ΔBL) was -0.7 ± 0.9 mm, while mean difference in keratinized tissue (ΔKT) was -0.4 ± 0.9 mm. Eighty-five (44%) implants showed recession (REC) of soft tissue margin (mean 0.6 ± 0.8 mm). The presence of REC was associated with use of non-resorbable membrane (p

The breeding biology and population dynamics of the Pied Flycatcher Ficedula hypoleuca in pine, mixed and deciduous forests in Skibotn, Northern Norway (69°20’N, 20°20’E), was studied during 33 years (1987–2019; in total 1775 completed first clutches). It was a period during which summer temperatures remained relatively stable, but late spring (May) temperatures tended to become warmer. The number of breeding pairs declined over the study period but varied less than in populations living in more harsh subalpine environments. In spite of the northern location, females started to lay eggs in a relatively late phenological phase of the environment and in relatively warm weather. The date of birch leafing and the date of egg-laying advanced during the study period, and they correlated with each other. Mean clutch size was 6.4 eggs, and mean number of fledglings/nest 4.6. Date of egg-laying was earlier and clutch size larger in deciduous forests than in pine and mixed forests, but this did not translate into better fledgling productivity. The main causes of nesting failure were predation by small mustelids and starvation in warm and dry summers. However, in the long run the population seemed to be able to maintain itself without immigration, i.e., act as a source population. The possibility that during warm climate periods of the past, breeding biology and population dynamics of Pied Flycatchers over large geographical areas might have resembled those in Skibotn is discussed. Cover photo: “Mummified” Pied Flycatcher nestling (age about 10 days) starved to death in Skibotn in the warm and dry summer of 1988. Photo: Antero Järvinen.

In this paper, we present a systematic analysis of large-scale human mobility patterns obtained from a passive Wi-Fi tracking system, deployed across different location typologies. We have deployed a system to cover urban areas served by public transportation systems as well as very isolated and rural areas. Over 4 years, we collected 572 million data points from a total of 82 routers covering an area of 2.8 km2. In this paper we provide a systematic analysis of the data and discuss how our low-cost approach can be used to help communities and policymakers to make decisions to improve people’s mobility at high temporal and spatial resolution by inferring presence characteristics against several sources of ground truth. Also, we present an automatic classification technique that can identify location types based on collected data.

The paper considers non-spherical objects with low gravitational attraction, such as asteroids, satellites of the planet and comets. We considered possibility of a mission to small bodies of the solar system of irregular shape on the example of the asteroid Apophis. The authors of the article suggest using a nanoclass spacecraft with an electric rocket propulsion system for a long mission to study Apophis. The purpose of this work is to determine the necessary costs of the working body for all stages of the mission, which includes reaching the asteroid, forming and maintaining a given orbit relative to it. The gravity of the Earth, Sun, and asteroid is taken into account when modeling the controlled movement of the spacecraft. When a spacecraft is moving relative to an asteroid, its gravitational field is described as a superposition of the gravitational fields of two rotating massive points. In this paper, it is proposed to divide the mission into two sections for preliminary ballistic design. The first optimal speed heliocentric flight Earth-asteroid Apophis with the alignment of the speed of the spacecraft and the asteroid. The second is the movement in the vicinity of the asteroid, which includes the optimal speed maneuver for forming the working orbit and maintaining the working orbit for a given time.

Canine demodicosis is a common skin disorder with multiple risk factors, including age and breed predisposition. There is relatively limited information about the risk factors for canine demodicosis in large canine populations. This retrospective case-control study was conducted by searching the electronic records of dogs with skin lesions for the presence of Demodex mites in skin scrapings. Diagnosis of demodicosis was based on the presence of skin lesions and mites in skin scrapings. Multivariate analysis was conducted using logistic regression analysis to estimate the relative risk and odds ratio of variables hypothesized to influence the risk of canine demodicosis, such as age, sex, breed, season, and parasitic infection. The results of multivariate logistic regression analysis showed a positive correlation between the dogs' age and demodicosis. Dogs older than three years, as well as puppies, had a high risk of demodicosis (P0.05). Breeds with the greatest association (odds ratio) with demodicosis included the American Staffordshire Terrier (OR=0.9) and Moscow Watchdog (OR=0.2). The presence of intestinal parasites, such as Diphyllobothrium latum, was significantly associated with demodicosis.

Purpose: To report the characteristics of non-proliferative fellow eyes in patients with unilateral proliferative macular telangiectasia type 2 (MacTel). Methods: This was a multicenter, retrospective study and included fellow eyes of eyes with subretinal neovascular membrane (SRNVM). Multimodal imaging including fundus photography, optical coherence tomography (OCT), and OCT angiography (OCTA) was performed. OCT and OCTA measurements included central macular thickness (CMT), subfoveal choroidal thickness (SFCT), foveal avascular zone (FAZ) area and qualitative parameters such as distortion or enlargement of FAZ, increased inter-vascular spacing, dilated, tortuous vessel at margin of FAZ, crowding of vessel, and loss of choriocapillaris (CC). Results: Thirteen fellow eyes of 13 patients with mean age of 63.6 ± 12.0 years were included. Fellow eyes had various stages of the diseases – stage 2 (four eyes), 3 (six eyes), and 4 (three eyes). OCTA showed increased intervascular spacing (8; 61.5%), dilated (11; 84.6%), and elongated vessels (8; 61.5%) at the margin of the FAZ, crowding of vessels (6; 46.2%), capillary non-perfusion areas outside the FAZ (4; 30.8%), and areas of CC loss (4; 30.8%). Mean follow-up was 9.1 ± 12.9 months. Out of six eyes with follow-up of ⩾12 months, two developed SRNVM at 18 and 33 months with OCTA showing crowding and entanglement of dilated retinal vessels in deep capillary plexus at baseline which corresponded to the area affected by SRNVM. Conclusion: Fellow eyes of proliferative MacTel showed established disease stages on OCTA with progressive capillary crowding and entanglement of vessels likely corresponding to the future site of SRNVM.

There is increasing evidence that zoos and aquariums do, as intended, educate their visitors. However, even though most zoos offer a wide array of educational experiences, few studies have consider...

This study explores prospective primary school teachers’ misconceptions concerning basic concepts in chemistry. The data was gathered during the years 2012–2016 among first-year primary school teac...

The aim of this study was to investigate the frequency and intraoperative difficulties associated with pseudoexfoliation (PXF) syndrome at a tertiary eye care center in Garhwal Himalayan region. Methods: This study included patients scheduled for cataract surgery who were diagnosed with PXF syndrome. All patients had gone through a complete ophthalmologic evaluation, including slit-lamp examination, tonometry, gonioscopy, and ophthalmoscopy prior to the surgery. Cataract surgeries were done by a single surgeon who reported the intra-operative difficulties. Results: In total, 424 phakic eyes of 934 patients were evaluated, 126 of whom (22.1%) were diagnosed with PXF syndrome. Most eyes (n = 81, 35.8%) with PXF syndrome were ≥81 years old. Eighty-six eyes (38.1%) had bilateral involvement, whereas 70 (30.9%) had right or left eye involvement. Further, PXF material was distributed on the iris, pupil, and lens in 70 eyes (30.9%) and on the pupillary margin in 36 eyes (15.9%). The mean pupillary dilation was 5.1 (±1.4) mm in patients with PXF syndrome compared with 7.2 (±1.6) mm in those without it (P = 0.03). Grade VI cataract was observed in 93 eyes (41.2%) and hypermature cataract was the most commonly observed cataract stage. Twenty-one eyes (9.3%) had increased intraocular pressure. Intraoperative difficulties were encountered in 62 eyes (27.4%) with poor pupillary dilation being the most common problem (32 eyes, 14.2%), followed by zonular dehiscence (18 eyes, 8%). Conclusion: This hospital-based study showed that PXF syndrome is common in rural population of Garhwal region and that the intraoperative complication rate in these patients is high. Surgeons should be aware of the potential complications of cataract procedures in patients with PEX. Caution should be taken at every stage of the surgery to prevent these complications, and surgeons should be knowledgeable and skilful in complication management should they arise.

The advent of dermal regeneration templates has fostered major advances in the treatment of acute burns and their sequelae, in the last three decades. Both data on morphological aspects of the newly-formed tissue, and clinical trials comparing different templates, are few. The goal of this study was to prospectively analyze the outcome of randomized patients treated with two of the existing templates, followed by thin skin autograft. They are both 2 mm-thick bovine collagen templates (Matriderm® and Integra®), the latter includes a superficial silicone layer. Surgery was performed on patients with impaired mobility resulting from burn sequelae (n = 12 per template) in a two-step procedure. Negative pressure therapy was applied after surgery; patients were monitored for 12 months. No intra or postoperative complications were observed. Data on scar skin quality (Vancouver scar scale), rate of mobility recovery, and graft contraction were recorded; as well as morphological analyses at light microscopical level. Improvement in mobility and skin quality were demonstrated along with graft contraction, in all patients. The double layer template showed the best performance in retraction rate, skin quality and mobility recovery. The subepidermal newly-formed connective tissue showed no histoarchitectural differences between the templates. The double layer template was not absorbed up to 12 months after placement.

Objectives: To assess are there learning-related improvements in the speech reception thresholds (SRTs) for the Finnish matrix sentence test (FMST) and the Finnish digit triplet test (FDTT) in repe...

Recombinant human erythropoietin(rHuEPO) has emerged as a newrenoprotectiveagent against variousacutekidney injuries. ExperiencewithrHuEPO in chronic kidney injuriesis so far limited and conflictingresultswere obtained. In the presentstudy,we addressed to evaluate thelong-termrenal effects of rHuEPO indiabeticnephropathy (DN) of rats inrelationto novel hypoxia theory andendogenousEPO secretion. WecomparedrHuEPO to a standarddrug,losartan (LSR), and the possibilityof add-on therapy was alsotested.Thirty-four male SpragueDawleyrats were randomly dividedintofive groups: control-naive group,untreateddiabetic group, EPO- treated diabetic group (150 U/kg,S.C., TIW), LSR-treated diabeticgroup (5 mg/kg/day), and EPO-LSRtreateddiabetic group. Drug treatmentwas started one week afterstreptozotocin(STZ) injection andcontinuedfor twenty-eight weeks.STZ-treateddiabetic rats developedprogressivealbuminuria, renal dysfunction,and significant glomerularchange28 weeks after induction ofdiabetes.Chronic administration ofrHuEPOalone or in combination withLSRto the STZ-induced diabetic ratdidnot show beneficial effect on DNevolution,inspite of improving diabetic-renalhypoxia. The best beneficialeffect on DN evolution was obtainedby LSR sole therapy based onrenalfunction evaluation, albuminu- ria, and renal histopathology. Interestingly,administration of LSR eitheraloneor in combination with rHuEPOinSTZ-induced diabetic rats significantlyabolished increased plasmaendogenousEPO. In conclusion, thisstudyhas questioned the renoprotectiverole of low-dose rHuEPO inthesetting of DN and confirmed thatthislow-dose rHuEPO used had adverseeffects on blood pressure andincreasedhematocrit level.

Purpose: To evaluate the effect of continuous tooth eruption on the outcomes of single-implant-supported restorations in the anterior maxilla of adults. Materials and Methods: Seventy-six patients (age: 21 to 78 years) treated with single-implant-supported restorations in the esthetic zone were included. Radiographs obtained at crown placement and follow-up examinations from 1 to 15 years postloading were analyzed with regard to vertical incisal plane changes of the implant-supported crown relative to adjacent teeth. Results: Infraocclusion increased over time by 0.08 ± 0.02 mm/year. Infraocclusion was more pronounced (P =.04) for delayed (0.09 mm/year) versus immediate implant placement (0.06 mm/year) and for younger versus older adults (0.0013 mm/year per additional year of age; P =.014). No statistically significant association between infraocclusion and sex, ethnicity, implant site, timing of implant temporization, surgical protocol, and type of restoration was found. Conclusion: Infraocclusion of single-implant-supported maxillary anterior restorations may result in esthetic concerns over time. Greater infraocclusion occurs in delayed implant placement and in younger individuals.

For scholars and policy-makers alike, deeper learning has been a promising paradigm for fostering students’ interest in and mastery of science, technology, engineering, and mathematics (STEM). Deep...

Objective Our aim was to study the quality of medical care in patients with systemic lupus erythematosus (SLE) to understand gaps and to analyze the association with outcome of the disease. Methods Information on demographics and medical care was assessed by self-reported questionnaires among SLE patients (LuLa cohort, 2011, n = 580). In total, 21 aspects of medical care were analyzed. Univariate analysis selected 10 predictor variables for further analysis: (1) urine examination and (2) blood test in the previous year, (3) taking antimalarials, (4) taking vitamin D and calcium if the dosage of prednisolone was greater than 7.5 mg/day, counseling regarding (5) lipid metabolism, (6) vaccination, and (7) blood pressure, and treatment of the comorbidities (8) hypertension, (9) osteoporosis and (10) lipid metabolism disorder. The association of these 10 items with the outcome of the disease, assessed in 2015, was analyzed by linear regression analysis, adjusted for age, disease duration and sex. Results On average six of the 10 items were met (±1.7). Receiving more clinical care in 2013 was predictive for low disease activity (SLAQ, p = 0.024, β = –0.104, corr. R2 = 0.048), low progress in disease-related damage (Delta Brief Index of Lupus Questionnaire, p = 0.048, β = –0.132, corr. R2 = 0.036) and high health-related quality of life (SF-12 physical, p = 0.035, β = 0.100, corr. R2 = 0.091) in 2015. Conclusion Our study illustrates a link between the quality of care and the SLE outcome parameters disease activity, disease-related damage and quality of life. Consistent considerations of these care parameters, which are recommended in several management guidelines, could therefore be a good approach to improve the outcome of patients with SLE.

The carbon sequestration of plants through photosynthesis is responsible for removal of a substantial amount of the man-made CO2 emissions to the atmosphere. In recent years this so-called land-sink has removed about 30% of the man-made emissions to the atmosphere, with forests being the most important sinks. The land-sink is, however, vulnerable to changes in the environment, such as the atmospheric composition, climate change, and extreme events like storms and droughts. It is therefore important to study the effects of such change on terrestrial ecosystems to provide the basis for predicting the future of the sink.We here report the results of continuous CO2 flux measurements over a Danish beech forest during the years 1996–2019. Over the years the forest acted as a sink of CO2 with a net carbon sequestration ranging from about zero to 400 g C m–2 yr−1. We found significant trends in net ecosystem exchange (NEE) (increasing in absolute terms with 15 g C m–2 yr2), gross ecosystem exchange (GEE) (increasing with 25 g C m–2 yr–2), and ecosystem respiration (RE) (increasing with 10 g C m–2 yr–2). A prolonged growing season explained 73% of the increase in NEE. The increasing CO2 concentration in the atmosphere and a subsequent increase in photosynthetic capacity together with warming are the most likely main causes of the increased carbon uptake. The severe drought in the summer of 2018 resulted in a reduction of the annual NEE of 25%.

Background/Objectives Seasonal variation in body mass is a model for the study of body mass regulation. Here a long-term study is presented on body mass, body composition, and activity-induced energy expenditure in a subject with a large seasonal variation in body mass of about 3.0 kg. Subject/Methods Body mass was assessed daily over >20 consecutive years. Daily assessment of activity-induced energy expenditure was performed over the last 10 years. Body composition was assessed monthly for 1 year in the middle and at the end of the observation interval. Additionally, data were compared with data on body composition, resting energy expenditure, and total daily energy expenditure of the same subject as a participant in published studies. Results Body mass showed a pronounced seasonal variation, associated with a synchronous variation in physical activity. Body mass peaked in the cold winter months when physical activity reached the lowest annual value and decreased to the lowest value in mid-summer when daily physical activity peaked. The seasonal variation in body mass consisted mainly of body fat. Longitudinally, over the past 8 years of the observation interval, average fat-free mass showed a decrease of 1.0 kg and fat mass increased 0.8 kg. Conclusions In a subject with a pronounced seasonal variation in physical activity, activity-induced variation in energy requirement was covered by an annual variation in body mass, mainly as fat. Maintenance of activity-induced energy expenditure did not protect against loss of fat-free body mass with advancing age.

The pelagic / anoxic hypolimnion population of Spirostomum teres was investigated as a part of the long-term ciliates’ monitoring (2003–2016) in an oligo- to mesotrophic monomictic hyposaline crater lake Alchichica (Puebla / Veracruz, Mexico), including an analysis of picoplankton (both heterotrophic, HPP and autotrophic, APP) and inorganic compounds of nitrogen (ammonium, nitrite, nitrate), phosphorus (dissolved reactive phosphorus, DRP) and silicon. Additionally, detailed studies of the ciliate vertical distribution and feeding activity measured upon fluorescently labelled APP (picocyanobacteria) were carried out. The results were compared with those from a neighbour freshwater crater lake La Preciosa and with a meromictic karstic lake La Cruz (Cuenca, Spain). The ciliate vertical distribution within the water column was very well defined: During the first decade, the benthic population was frequently found throughout a developing stratification of the lake. The established stratification of the lake turned the conditions favourable for the formation of an oxycline / hypolimnion population, typically, several meters below the deep chlorophyll maximum (formed basically by diatoms); the population preferred the layers without detectable dissolved oxygen. However, an observed gradient of light (PAR) could support both oxygenic and anoxygenic photosynthesis. Late stratification after deepening of the thermocline reduced the layers with S. teres population to a minimum apparently due to the drastic change in physicochemical conditions within a metalimnion, coupled with an oxycline, and limited to 1 to 2 meters; microstratification was found. Last years, the very bottom population disappeared or it was reduced and the late stratification S. teres peaks were smaller or did not appeared. Generally, S. teres oxycline / anoxic hypolimnion population was observed from June through November. Optimum picoplankton numbers in conditions that supported the ciliate growth were found: The ciliate was peaking at APP of 0.6 to 1 × 105 cells mL–1; the optimum of HPP was observed round 1.4 × 106 cells mL–1. S. teres was efficiently feeding upon picocyanobacteria in numbers of 105 cells mL–1 reaching the clearance rate of 2000 nL cell–1h–1, which represented in average 130 to 210 cells cell–1h–1 ingested. Feeding upon purple sulphur bacteria was observed but only during the end of the lake stable stratification when the ciliate population was already dropping. On the other hand, the volume specific clearance of S. teres upon picocyanobacteria (103 h–1) did not support the hypothesis that they could serve as a sole prey. Feeding upon eukaryote phytoplankton (chlorophytes Monoraphidium minutum, diatoms Cyclotella choc tawhatcheeana) could be of higher importance that previously supposed. Additionally, a use of ingested and retained photosynthetic prokaryotes is hypothesized.