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PACs (polycylic aromatic compounds) are air pollutants formed in incomplete combustion, e.g., in vehicle en-gines. Vegetation can potentially remove substantial amounts and act as bioindicators of these pollutants. Increased knowledge of the pollutant removal efficiencies of different tree species is essential for understanding the potential benefits trees can provide urban residents. We investigated the leaf/needle content of the two PAC groups, polycyclic aromatic hydrocarbons (PAHs, 32 compounds) and dibenzothiophenes (DBTs, 6 compounds) in seven broadleaved and four conifer tree species in an arboretum of South-West Sweden. PAHs were grouped into low-molecular (L-PAHs, largely gaseous), medium-molecular (M-PAHs, both gaseous and particle-bound) and high-molecular mass (H-PAHs, largely particle-bound) PAHs. DBTs are organosulphur compounds with two benzene rings. In general, conifer needles were stronger accumulators of PACs than leaves of broadleaved trees. Comparing three-year-old and one-year-old needles showed that evergreen conifers accumulated L-PAHs, M-PAHs, H-PAHs and DBTs over several years. In deciduous trees, L-PAHs and DBTs declined from June to September, M-PAHs had no significant net change, but for H-PAHs, there was a significant net accumulation. Conifers had a similar or lower net average annual accumulation of H-PAHs than broadleaved trees, except the deciduous conifer Larix, which had the highest uptake rate of this toxicologically important PAH category. Our results suggest that L-PAH accumulation depends on leaf/needle mass or volume, while for H-PAHs leaf/needle area is more important. This explains why conifers represented a stronger sink for L-PAHs and M-PAHs. DBT accumulation in leaves/needles was similar to that of L-PAHs. An important conclusion is that tree leaves/ needles accumulate substantial amounts of PAC with strong and complex contrasts between tree species and PAC groups. Another implication of our data is that conifer needles are useful as bioindicators for PAC pollution since they accumulate all PAC categories over several years.

Tropical forests store 40–50 per cent of terrestrial vegetation carbon 1. However, spatial variations in aboveground live tree biomass carbon (AGC) stocks remain poorly understood, in particular in tropical montane forests 2. Owing to climatic and soil changes with increasing elevation 3, AGC stocks are lower in tropical montane forests compared with lowland forests 2. Here we assemble and analyse a dataset of structurally intact old-growth forests (AfriMont) spanning 44 montane sites in 12 African countries. We find that montane sites in the AfriMont plot network have a mean AGC stock of 149.4 megagrams of carbon per hectare (95% confidence interval 137.1–164.2), which is comparable to lowland forests in the African Tropical Rainforest Observation Network 4 and about 70 per cent and 32 per cent higher than averages from plot networks in montane 2,5,6 and lowland 7 forests in the Neotropics, respectively. Notably, our results are two-thirds higher than the Intergovernmental Panel on Climate Change default values for these forests in Africa 8. We find that the low stem density and high abundance of large trees of African lowland forests4 is mirrored in the montane forests sampled. This carbon store is endangered: we estimate that 0.8 million hectares of old-growth African montane forest have been lost since 2000. We provide country-specific montane forest AGC stock estimates modelled from our plot network to help to guide forest conservation and reforestation interventions. Our findings highlight the need for conserving these biodiverse 9,10 and carbon-rich ecosystems.

The role of18F-FDG PET in patients with variable grades of neuroendocrine tumors (NETs) prior to peptide receptor radionuclide therapy (PRRT) has not been adequately elucidated. We aimed to evaluate the impact of18F-FDG PET status on disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) in neuroendocrine tumor (NET) patients receiving PRRT. We searched the MEDLINE, Embase, Cochrane Library, and Web of Science databases up to July 2020 and used the Newcastle-Ottawa scale (NOS) criteria to assess quality/risk of bias. A total of 5091 articles were screened. In 12 studies, 1492 unique patients with NETs of different origins were included. The DCR for patients with negative18F-FDG PET status prior to PRRT initiation was 91.9%, compared to 74.2% in patients with positive18F-FDG PET status (random effects odds ratio (OR): 4.85; 95% CI: 2.27–10.36). Adjusted analysis of pooled hazard ratios (HRs) confirmed longer PFS and OS in NET patients receiving PRRT with negative18F-FDG PET (random effects HR:2.45; 95%CIs: 1.48–4.04 and HR:2.25; 95% CIs:1.55–3.28, respectively). In conclusion,18F-FDG PET imaging prior to PRRT administration appears to be a useful tool in NET patients to predict tumor response and survival outcomes and a negative FDG uptake of the tumor is associated with prolonged PFS and OS. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

A broad spectrum of novel targeted therapies with prime antitumor activity and/or ample control of hormonal symptoms together with an overall acceptable safety profile have emerged for patients with metastatic neuroendocrine neoplasms (NENs). In this systematic review and quantitative meta-analysis, the PubMed, EMBASE, Cochrane Central Register of Controlled Trials and clinicaltrials.gov databases were searched to assess and compare the safety profile of NEN treatments with special focus on the cardiovascular adverse effects of biotherapy and molecular targeted therapies (MTTs). Quality/risk of bias were assessed using GRADE criteria. Placebocontrolled randomized clinical trials (RCTs) in patients with metastatic NENs, including medullary thyroid cancer (MTC) were included. A total of 3695 articles and 122 clinical trials registered in clinicaltrials.gov were screened. We included sixteen relevant RCTs comprising 3408 unique patients assigned to different treatments compared with placebo. All the included studies had a low risk of bias. We identified four drug therapies for NENs with eligible placebo-controlled RCTs: somatostatin analogs (SSAs), tryptophan hydroxylase (TPH) inhibitors, mTOR inhibitors and tyrosine kinase inhibitors (TKI). Grade 3 and 4 adverse effects (AE) were more often encountered in patients treated with mTOR inhibitors and TKI (odds ratio [OR]: 2.42, 95% CI: 1.87–3.12 and OR: 3.41, 95% CI: 1.46–7.96, respectively) as compared to SSAs (OR:0.77, 95% CI: 0.47–1.27) and TPH inhibitors (OR:0.77, 95% CI: 0.35–1.69). MTOR inhibitors had the highest risk for serious cardiac AE (OR:3.28, 95% CI: 1.66–6.48) followed by TKIs (OR:1.51, 95% CI: 0.59–3.83). Serious vascular AE were more often encountered in NEN patients treated with mTOR inhibitors (OR: 1.72, 95% CI: 0.64–4.64) and TKIs (OR:1.64, 95% CI: 0.35–7.78). Finally, patients on TKIs were at higher risk for new-onset or exacerbation of pre-existing hypertension (OR:3.31, 95% CI: 1.87–5.86). In conclusion, SSAs and TPH inhibitors appear to be safer as compared to mTOR inhibitors and TKIs with regards to their overall toxicity profile, and cardiovascular toxicities in particular. Special consideration should be given to a patient-tailored approach with anticipated toxicities of targeted NEN treatments together with assessment of cardiovascular comorbidities, assisting clinicians in treatment selection and early recognition/management of cardiovascular toxicities. This approach could improve patient compliance and preserve cardiovascular health and overall quality of life. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

The role of primary tumor resection in patients with pancreatic neuroendocrine neoplasms (PanNENs) and unresectable distant metastases remains controversial. We aimed to evaluate the effect of palliative primary tumor resection (PPTR) on overall survival (OS) in this setting. We searched the MEDLINE, Embase, Cochrane Library, Web of Science and SCOPUS databases up to January 2020 and used the Newcastle–Ottawa scale (NOS) criteria to assess quality/risk of bias. A total of 5661 articles were screened. In 10 studies, 5551 unique patients with stage IV PanNEN and unresectable metastases were included. The five-year OS for PanNEN patients undergoing PPTR in stage IV was 56.6% vs. 23.9% in the non-surgically treated patients (random effects relative risk (RR): 1.70; 95% CI: 1.53–1.89). Adjusted analysis of pooled hazard ratios (HR) confirmed longer OS in PanNEN patients undergoing PPTR (random effects HR: 2.67; 95% CI: 2.24–3.18). Cumulative OS analysis confirmed an attenuated survival benefit over time. The complication rate of PPTR was as high as 27%. In conclusion, PPTR may exert a survival benefit in stage IV PanNEN. However, the included studies were subject to selection bias, and special consideration should be given to PPTR anchored to a multimodal treatment strategy. Further longitudinal studies are warranted, with long-term follow-up addressing the survival outcomes associated with surgery in stage IV disease. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

Mesenteric fibrosis (MF) constitutes an underrecognized sequela in patients with small intestinal neuroendocrine neoplasms (SI-NENs), often complicating the disease clinical course. The aim of the present systematic review, carried out by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, is to provide an update in evolving aspects of MF pathogenesis and its clinical management in SI-NENs. Complex and dynamic interactions are present in the microenvironment of tumor deposits in the mesentery. Serotonin, as well as the signaling pathways of certain growth factors play a pivotal, yet not fully elucidated role in the pathogenesis of MF. Clinically, MF often results in significant morbidity by causing either acute complications, such as intestinal obstruction and/or acute ischemia or more chronic conditions involving abdominal pain, venous stasis, malabsorption and malnutrition. Surgical resection in patients with locoregional disease only or symptomatic distant stage disease, as well as palliative minimally invasive interventions in advanced inoperable cases seem clinically meaningful, whereas currently available systemic and/or targeted treatments do not unequivocally affect the development of MF in SI-NENs. Increased awareness and improved understanding of the molecular pathogenesis of MF in SI-NENs may provide better diagnostic and predictive tools for its timely recognition and intervention and also facilitates the development of agents targeting MF. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

Tropical forest soils are a significant source for the greenhouse gas N2O as well as for NO, a precursor of tropospheric ozone. However, current estimates are uncertain due to the limited number of field measurements. Furthermore, there is considerable spatial and temporal variability of N2O and NO emissions due to the variation of environmental conditions such as soil properties, vegetation characteristics and meteorology. In this study we used a process-based model (ForestDNDC-tropica) to estimate N2O and NO emissions from tropical highland forest (Nyungwe) soils in southwestern Rwanda. To extend the model inputs to regional scale, ForestDNDC-tropica was linked to an exceptionally large legacy soil dataset. There was agreement between N2O and NO measurements and the model predictions though the ForestDNDC-tropica resulted in considerable lower emissions for few sites. Low similarity was specifically found for acidic soil with high clay content and reduced metals, indicating that chemo-denitrification processes on acidic soils might be under-represented in the current ForestDNDC-tropica model. The results showed that soil bulk density and pH are the most influential factors driving spatial variations in soil N2O and NO emissions for tropical forest soils. The area investigated (1113 km2) was estimated to emit ca. 439 ± 50 t N2O-N yr−1 (2.8–5.5 kg N2O-N ha−1 yr−1) and 244 ± 16 t NO-N yr−1 (0.8–5.1 kg N ha−1 yr−1). Consistent with less detailed studies, we confirm that tropical highland rainforest soils are a major source of atmospheric N2O and NO.

Tree and soil interactions may result in changes in soil carbon and nutrient contents. Forest plantations made up of monodominant stands of 17 different species, some native and some exotic to Rwanda, as well as a stand with mixed native tree species were investigated. Biosequential sampling was used followed by basic soil chemical analyses. Results revealed that the plantation species composition influenced the soil chemical properties. Total soil C and N, C: N ratio, available P, pH, and cation exchange capacity (CEC) differed significantly between plantation stands of different species (P < 0.001, N = 54). Increases in the levels of soil C, total N, CEC and base saturation (BS) were observed mainly in mixed native species (MNS), Polyscia fulva, Casuarina equisetifolia and Eucalyptus saligna. The pH declined slightly in soil beneath some Eucalyptus species treatments and increased in others. The high nutrient uptake by fast-growing trees and the acidic parent material were involved in the acidification process. The findings suggest that the species used in afforestation maintain soil fertility and protect the environment. It is recommended that afforestation of abandoned and less productive lands in Rwanda should utilize fast growing Eucalyptus species in combination with agroforestry and native species in order to maintain or improve soil chemical properties.Key words: Afforestation, base saturation (BS), cation exchange capacity (CEC), forest plantation, soil carbon, total N, Rwanda.