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Objective: Management of follow-up protocols after endovascular aortic repair (EVAR), vary significantly between centres and is not standardized according to the sac regression. By designing an international expert-based Delphi consensus, the study aimed to create recommendations on follow-up after EVAR according to sac evolution. Methods: Eight facilitators created appropriate statements regarding the study topic that were voted, using a 4-point Likert scale, by a selected panel of international experts using a three-round modified Delphi consensus process. Based on the experts' responses, only those statements reaching a Grade A (full agreement ≥75%) or B (overall agreement ≥80% and full disagreement <5%) were included in the final document. Results: One-hundred and seventy-four participants were included in the final analysis, and each voted the initial 29 statements related to the definition of sac regression (Q1-Q9), EVAR follow-up (Q10-Q14), and the assessment and role of sac regression during follow-up (Q15-Q29). At the end of the process, 2 statements (6.9%) were rejected, 9 statements (31%) received a grade B consensus strength, and 18 (62.1%) reached a grade A consensus strength. Out of twenty-seven final statements, fifteen statements (55.6%) were classified as grade I, while twelve (44.4%) were classified as grade II. Experts agreed that sac regression should be considered an important indicator of EVAR success and always be assessed during follow-up after EVAR. Conclusions: Based on the elevated strength and high consistency of this international expert-based Delphi consensus, most of the statements might guide current clinical management of follow-up after EVAR according to the sac regression. Future studies are needed to clarify debated issues.

[EN] Chemical communication in terrestrial vertebrates is often built on complex blends, where semiochemical and structural compounds may form an integrated functional unit. In lizards, many species have specialized epidermal glands whose secretions are waxy, homogeneous blends of lipids and proteins, both active in communication. The intimate co-occurrence of such compounds allows us to hypothesize that they should undergo a certain degree of covariation, considering both their semiochemical role and the support-to-lipid function hypothesized for the protein fraction. In order to assess the occurrence and level of protein–lipid covariation, we compared the composition and complexity of the two fractions in the femoral gland secretions of 36 lizard species, combining phylogenetically-informed analysis with tandem mass spectrometry. We found the composition and complexity of the two fractions to be strongly correlated. The composition of the protein fraction was mostly influenced by the relative proportion of cholestanol, provitamin D 3 , stigmasterol, and tocopherol, while the complexity of the protein pattern increased with that of lipids. Additionally, two identified proteins (carbonic anhydrase and protein disulfide isomerase) increased their concentration as provitamin D 3 became more abundant. Although our approach does not allow us to decrypt the functional relations between the proteinaceous and lipid components, nor under the semiochemical or struc- tural hypothesis, the finding that the proteins involved in this association were enzymes opens up to new perspectives about protein role: They may confer dynamic properties to the blend, making it able to compensate predictable variation of the envi- ronmental conditions. This may expand the view about proteins in the support-to-lipid hypothesis, from being a passive and inert component of the secretions to become an active and dynamic one, thus providing cues for future research., [IT] La comunicazione chimica nei vertebrati terrestri èspesso costituita da miscele complesse, in cui com- posti semiochimici e strutturali possono formare un“unitàfunzionaleintegrata. Nelle lucertole, molte specie hanno ghiandole epidermiche specializzate le cui secrezioni sono miscele cerose e omogenee di lipidi e proteine, entrambe attive nella comu- nicazione. L”intima coesistenza di tali composti lascia ipotizzare che essi debbano subire un certo grado di co-variazione, sia considerando il loro ruolo semiochimico, sia la funzione di supporto ai lipidi ipotizzata per la frazione proteica. Per valutare la presenza e il livello di covariazione proteine-lipidi, abbiamo confrontato la composizione e la complessitàdelle due frazioni nelle secrezioni della ghiandola femorale di 36 specie di lucertole, combinando l“analisi filogenetica comparativa con la spet- trometria di massa. Abbiamo riscontrato una forte correlazione tra la composizione e la complessitàdelle due frazioni. La composizione della frazione proteica èstata influenzata soprattutto dalla proporzione relativa di colestanolo, provitamina D 3 , stigmasterolo e tocoferolo, mentre la complessitàdelpattern proteico èaumentata con quella dei lipidi. Inoltre, due proteine identificate (anidrasi carbonica e disolfuro isomerasi) hanno aumentato la loro concentrazione al crescere dell’abbondanza della provitamina D 3 . Sebbene il nostro approccio non consenta di decifrare le relazioni funzionali tra le componenti proteiche e lipidiche, nésecondo l”ipotesi semiochimica nésecondo quella strutturale, la scoperta che le proteine coinvolte in questa asso- ciazione sono enzimi apre a nuove prospettive sul ruolo delle proteine stesse: esse potrebbero conferire proprietàdinamichealla miscela, rendendola capace di compensare le prevedibili variazioni delle condizioni ambientali. Questo puòampliare la visione delle proteine nell’ipotesi che esse siano di supporto ai lipidi, da componente passiva e inerte delle secrezioni a, [ES] La comunicación química en los vertebrados terrestres se basa a menudo en mezclas complejas, donde los compuestos semioquímicos y estructurales pueden formar una unidad funcional integrada. En los lagartos y lagartijas, muchas especies tienen glándulas epidérmicas especializadas cuyas secreciones son mezclas cerosas y homogéneas de lípidos y proteínas, siendo ambos compuestos activos en la comunicación. La co-ocurrencia estrecha de tales compuestos permite plantear la hipótesis de que debería existir un cierto grado de covariación, considerando los posibles papeles de la fracción proteica tanto como semioquímicos y como apoyo a la función de los lípidos. Con el fin de evaluar la ocurrencia y el nivel de covariación entre proteínas y lípidos, comparamos la composición y complejidad de estas dos fracciones en las secreciones de la glándula femoral de 36 especies de lagartos y lagartijas, combinando análisis filogenéticos con espectrometría de masas en tándem. Encontramos que la composición y la complejidad de las dos fracciones estaban fuertemente correlacionadas. La com- posición de la fracción proteica estuvo influenciada principalmente por la proporción relativa de colestanol, provitamina D 3 , estigmasterol y tocoferol, mientras que la complejidad del patrón proteico aumentócon el de los líp idos. Además, dos proteínas identificadas (anhidrasa carbónica y proteína disulfuro isomerasa) aumentaban su concentración a medida que la provitamina D 3 era más abundante. Aunque nuestro enfoque no permite descifrar las relaciones funcionales entre los componentes pro- teináceos y lipídicos, ni bajo la hipótesis semioquímica, ni bajo la estructural, el hallazgo de que las proteínas involucradas en esta asociación serían enzimas abre nuevas perspectivas sobre el papel de las proteínas. Estas podrían conferir propiedades dinámicas a la mezcla, haciéndola capaz de compensar la variación esperada debida a las condiciones ambientales. Estos resul- tados pueden ampliar la vis

Objective: Aberrant subclavian artery (ASA) and Kommerell's diverticulum (KD) are rare vascular anomalies that may be associated with lifestyle-limiting and life-threatening complications. The aim of this study is to report contemporary outcomes after invasive treatment of ASA/KD using a large international dataset. Methods: Patients who underwent treatment for ASA/KD (2000-2020) were identified through the Vascular Low Frequency Disease Consortium, a multi-institutional collaboration to investigate uncommon vascular disorders. We report the early and mid-term clinical outcomes including stroke and mortality, technical success, and other operative outcomes including reintervention rates, patency, and endoleak. Results: Overall, 285 patients were identified during the study period. The mean patient age was 57 years; 47% were female and 68% presented with symptoms. A right-sided arch was present in 23%. The mean KD diameter was 47.4 mm (range, 13.0-108.0 mm). The most common indication for treatment was symptoms (59%), followed by aneurysm size (38%). The most common symptom reported was dysphagia (44%). A ruptured KD was treated in 4.2% of cases, with a mean diameter of 43.9 mm (range, 18.0-100.0 mm). An open procedure was performed in 101 cases (36%); the most common approach was ASA ligation with subclavian transposition. An endovascular or hybrid approach was performed in 184 patients (64%); the most common approach was thoracic endograft and carotid-subclavian bypass. A staged operative strategy was employed more often than single setting repair (55% vs 45%). Compared with endovascular or hybrid approach, those in the open procedure group were more likely to be younger (49 years vs 61 years; P < .0001), female (64% vs 36%; P < .0001), and symptomatic (85% vs 59%; P < .0001). Complete or partial symptomatic relief at 1 year after intervention was 82.6%. There was no association between modality of treatment and symptom r

Accurate measures of species abundance are essential to identify conservation strategies. N-mixture models are increasingly used to estimate abundance on the basis of species counts. In this study we tested whether abundance estimates obtained using N-mixture models provide consistent results with more traditional approaches requiring capture (capture-mark recapture and removal sampling). We focused on endemic, threatened species of amphibians and reptiles in Italy, for which accurate abundance data are needed for conservation assessments: The Lanza's Alpine salamander Salamandra lanzai, the Ambrosi's cave salamander Hydromantes ambrosii and the Aeolian wall lizard Podarcis raffonei. In visual counts, detection probability was variable among species, ranging between 0.14 (Alpine salamanders) and 0.60 (cave salamanders). For all the species, abundance estimates obtained using N-mixture models showed limited differences with the ones obtained through capture-mark-recapture or removal sampling. The match was particularly accurate for cave salamanders in sites with limited abundance and for lizards, nevertheless non-incorporating heterogeneity of detection probability increased bias. N-mixture models provide reliable abundance estimates that are comparable with the ones of more traditional approaches, and offer additional advantages such as a smaller sampling effort and no need of manipulating individuals, which in turn reduces the risk of harming animals and spreading diseases.

The evolution of sexual dimorphism is an important topic of evolutionary biology, but few studies have investigated the determinants of sexual dimorphism over broad phylogenetic scales. The number of vertebrae is a discrete character influencing multiple traits of individuals, and is particularly suitable to analyze processes determining morphological variation. We evaluated the support of multiple hypotheses concerning evolutionary processes that may cause sexual dimorphism in the number of caudal vertebrae in Urodela (tailed amphibians). We obtained counts of caudal vertebrae from >2,000 individuals representing 27 species of salamanders and newts from Europe and the Near East, and integrated these data with a molecular phylogeny and multiple information on species natural history. Per each species, we estimated sexual dimorphism in caudal vertebrae number. We then used phylogenetic least squares to relate this sexual dimorphism to natural history features (courtship complexity, body size dimorphism, sexual ornamentation, aquatic phenology) representing alternative hypotheses on processes that may explain sexual dimorphism. In 18 % of species, males had significantly more caudal vertebrae than females, while in no species did females have significantly more caudal vertebrae. Dimorphism was highest in species where males have more complex courtship behaviours, while the support of other candidate mechanisms was weak. In many species, males use the tail during courtship displays, and sexual selection probably favours tails with more vertebrae. Dimorphism for the number of tail vertebrae was unrelated to other forms of dimorphism, such as sexual ornamentation or body size differences. Multiple sexually dimorphic features may evolve independently because of the interplay between sexual selection, fecundity and natural selection.

Background: This project by the ICVR (International Consortium of Vascular Registries), a collaboration of 11 vascular surgical quality registries, was designed to evaluate international variation in the contemporary management of abdominal aortic aneurysm (AAA) with relation to recommended treatment guidelines from the Society for Vascular Surgery and the European Society for Vascular Surgery. Methods: Registry data for open and endovascular AAA repair (EVAR) during 2010 to 2013 were collected from 11 countries. Variations in patient selection and treatment were compared across countries and across centers within countries. Results: Among 51 153 patients, 86% were treated for intact AAA (iAAA) and 14% for ruptured AAA. Women constituted 18% of the entire cohort (range, 12% in Switzerland–21% in the United States; P<0.01). Intact AAAs were repaired at diameters smaller than recommended by guidelines in 31% of men (<5.5 cm; range, 6% in Iceland–41% in Germany; P<0.01) and 12% of women with iAAA (<5 cm; range, 0% in Iceland–16% in the United States; P<0.01). Overall, use of EVAR for iAAA varied from 28% in Hungary to 79% in the United States (P<0.01) and for ruptured AAA from 5% in Denmark to 52% in the United States (P<0.01). In addition to the between-country variations, significant variations were present between centers in each country in terms of EVAR use and rate of small AAA repair. Countries that more frequently treated small AAAs tended to use EVAR more frequently (trend: correlation coefficient, 0.51; P=0.14). Octogenarians made up 23% of all patients, ranging from 12% in Hungary to 29% in Australia (P<0.01). In countries with a fee-for-service reimbursement system (Australia, Germany, Switzerland, and the United States), the proportions of small AAA (33%) and octogenarians undergoing iAAA repair (25%) were higher compared with countries with a population-based reimbursement model (small AAA repair, 16%; octogenarians, 18%; P<0.01)

Despite the recognition that some species might quickly adapt to new conditions under climate change, demonstrating and predicting such a fundamental response is challenging. Morphological variations in response to climate may be caused by evolutionary changes or phenotypic plasticity, or both, but teasing apart these processes is difficult. Here, we built on the number of thoracic vertebrae (NTV) in ectothermic vertebrates, a known genetically based feature, to establish a link with body size and evaluate how climate change might affect the future morphological response of this group of species. First, we show that in old-world salamanders, NTV variation is strongly related to changes in body size. Secondly, using 22 salamander species as a case study, we found support for relationships between the spatial variation in selected bioclimatic variables and NTV for most of species. For 44% of species, precipitation and aridity were the predominant drivers of geographical variation of the NTV. Temperature features were dominant for 31% of species, while for 19% temperature and precipitation played a comparable role. This two-step analysis demonstrates that ectothermic vertebrates may evolve in response to climate change by modifying the number of thoracic vertebrae. These findings allow to develop scenarios for potential morphological evolution under future climate change and to identify areas and species in which the most marked evolutionary responses are expected. Resistance to climate change estimated from species distribution models was positively related to present-day species morphological response, suggesting that the ability of morphological evolution may play a role for species' persistence under climate change. The possibility that present-day capacity for local adaptation might help the resistance response to climate change can be integrated into analyses of the impact of global changes and should also be considered when planning management actions favouring

Body size is influenced by the interaction of multiple forces, whose effects can determine the occurrence of sexual size dimorphism (SSD). Rensch's rule is the increase of SSD with body size in taxa where males are the largest sex, and the opposite pattern in female-biased SSD taxa. This pattern was detected in many animal groups, but contrasting results were also highlighted. This study evaluated the existence of Rensch's patterns for body size and for the number of caudal vertebrae in salamandrid caudate amphibians. Furthermore, we tested the support of alternative hypotheses on processes that may determine allometric patterns: sexual selection, fecundity selection and constraining selection by performing separate analyses on species with male- and female-biased SSD. We used the literature and original data to gather information on body size and number of caudal vertebrae in 52 species of salamandrids over four continents. We then tested the support of the three hypotheses using a phylogenetic approach. Rensch's rule was valid for body size in salamanders only for species with male-biased dimorphism. No allometric relationships were detected by analyses on all the species, or by analyses on female-biased SSD species. Analyses performed on the number of caudal vertebrae showed no significant patterns. Our study supports the role of sexual selection in promoting positive allometry for body size in male-biased SSD species, whereas the alternative hypotheses were not supported by our data. These results highlight the importance of distinguishing male- and female-biased species as different evolutionary pressures and constraints may be at the basis of evolution of SSD in these groups. © 2014 The Zoological Society of London.

Aim Ecogeographical variation of body size in vertebrates (e.g. Bergmann’s rule) has long been recognized. However, the patterns and causes of intra-specific ecogeographical variation of body size in ectotherms, and in amphibians in particular, are strongly debated. We identified the relationship between bioclimatic variables and body size predicted a priori by alternative hypotheses (heat balance, endurance, seasonality, starvation resistance, water availability, primary productivity, parental investment) proposed to explain ecogeographical patterns of body size in ectotherms, and we evaluated the relative support of these hypotheses in explaining variation in body size of the Italian crested newt, Triturus carnifex. Location Twenty-three populations covering the whole range of T. carnifex (Austria, Croatia, Italy and Slovenia). Methods We obtained data on body size (snout–vent length, SVL) of 2639 adult newts from direct measurements and the literature; we obtained high-resolution environmental data for the sampled localities. We used an information-theoretic approach to evaluate the support of the data for the different hypotheses.We also integrated information on population genetics in our models. Results We observed strong geographical variation of body size. The best Akaike information criterion (AIC) models showed that populations with larger body size are associated with cold climates and secondarily with high primary productivity. Furthermore, sexual dimorphism increases in cold climates, as the increase in body size was stronger for females.When taking into account population genetics,we did not find support for relationships with the other variables. Main conclusion Our results are consistent with three hypotheses proposed to explain ecogeographical variation in amphibians: heat balance, increased parental investment of females and productivity. Information theory provides the framework for comparing hypotheses rather than looking for patterns. We suggest