Intensive Management Research Articles

Managing Forests for Biodiversity Conservation and Climate Change Mitigation.

We include biodiversity impacts in forest management decision making by incorporating the countryside species area relationship model into the partial equilibrium model GLOBIOM-Forest. We tested three forest management intensities (low, medium, and high) and limited biodiversity loss via an additional constraint on regional species loss. We analyzed two scenarios for climate change mitigation. RCP1.9, the higher mitigation scenario, has more biodiversity loss than the reference RCP7.0, suggesting a trade-off between climate change mitigation, with increased bioenergy use, and biodiversity conservation in forests. This trade-off can be alleviated with biodiversity-conscious forest management by (1) shifting biomass production destined to bioenergy from forests to energy crops, (2) increasing areas under unmanaged secondary forest, (3) reducing forest management intensity, and (4) reallocating biomass production between and within regions. With these mechanisms, it is possible to reduce potential global biodiversity loss by 10% with minor changes in economic outcomes. The global aggregated reduction in biodiversity impacts does not imply that biodiversity impacts are reduced in each ecoregion. We exemplify how to connect an ecologic and an economic model to identify trade-offs, challenges, and possibilities for improved decisions. We acknowledge the limitations of this approach, especially of measuring and projecting biodiversity loss.

Mapping the dynamics of intensive forage acreage during 2008–2022 in Google Earth Engine using time series Landsat images and a phenology-based algorithm

The increasing demand for livestock feed in China has led to a remarkable increase in forage acreage, particularly in forage fields under intensive agricultural management. However, there are no maps currently available to demonstrate and document the spatial and temporal patterns of the continuous expansion of intensive forage. Here we proposed a pixel- and phenology-based approach to map intensive forage by utilizing time series Landsat images and the Google Earth Engine platform. Given the challenge of accurately identifying intensive forage fields in diverse regions using fixed multi-temporal Landsat data, along with the distinct phenological characteristics of intensive forage fields that undergo multiple annual harvests, we proposed an innovative data mining approach based on dynamic monthly composite images (DMCI). This approach aims to enhance the algorithm’s efficiency and precision in identifying intensive forage. As a pilot study, we analyzed all available Landsat images (1732 scenes) from 2008 to 2022 in a county located in the farming-pastoral ecotone of northern China and tracked the historical dynamics of intensive forage expansion over five epochs at three-year intervals. The accuracy assessment of the intensive forage maps for the five epochs using validation sample points showed that the overall accuracy and Mathews correlation coefficient ranged from 97.1 % to 98.9 % and 0.93 to 0.98 respectively. The intensive forage acreage in the study area exhibited a dramatic expansion from 2008 to 2022, particularly after the 2012s. This study demonstrates the potential of our DMCI- and phenology-based algorithm and time series Landsat images for tracking the dynamics of intensive forage acreage at 30-m resolution in temperate single-cropping regions.

Assessing landscape-level effects of permanent grassland management and landscape configuration on open-land butterflies based on national monitoring data

AbstractHalting and reversing the ongoing insect decline requires in-depth knowledge on key drivers. Due to their sensitivity to habitat quality, butterflies are valuable indicators for grassland management intensity, including mowing. However, most studies examining mowing regime impacts on butterflies are limited to small spatial extents. Here, we tested the potential of citizen science butterfly monitoring data for assessing landscape-level effects of mowing regimes (number of mowing events and timing of the first event) and edge density (density of boundaries between different land-cover types) on butterfly richness, abundance, and community composition. We used generalised linear mixed-effects models to relate nationwide data from the German Butterfly Monitoring Scheme (DEBMS) to high-resolution satellite imagery on mowing events in permanent grasslands (grasslands excluded from crop rotation). As butterfly transects may not consistently be located within grasslands, we ran our models for different thresholds from 0 to 50%, representing increasing shares of the transect route situated within permanent grasslands (10% intervals). We did not find significant associations between mowing regimes and butterflies when focussing on species richness and abundance of all species inhabiting open land. However, we found strong positive associations of delayed mowing with the abundance of grassland specialists with increasing grassland shares per transect. Further, we found negative associations of delayed mowing with the annual number of generations and of more frequent mowing with the abundance of specialists, depending on the share of grassland per transect. Edge density had a positive association with species richness and abundance of species inhabiting open land, as well as abundance of grassland indicator species and grassland specialists in landscapes with a low grassland share per transect. Our findings underscore the importance of low-intensity managed permanent grasslands at the landscape scale for specialised butterflies. Additionally, we highlight the importance of a high density of boundaries for open-land and specialised butterflies, particularly in landscapes with highly fragmented permanent grasslands. To improve future analyses of grassland management impacts, we recommend expanding DEBMS monitoring sites to cover a larger grassland management intensity gradient and to place more transects within grasslands.

Rapid Initiation of Injection Naltrexone for Opioid Use Disorder

Injectable extended-release (XR)-naltrexone is an effective treatment option for opioid use disorder (OUD), but the need to withdraw patients from opioid treatment prior to initiation is a barrier to implementation. To compare the effectiveness of the standard procedure (SP) with the rapid procedure (RP) for XR-naltrexone initiation. The Surmounting Withdrawal to Initiate Fast Treatment with Naltrexone study was an optimized stepped-wedge cluster randomized trial conducted at 6 community-based inpatient addiction treatment units. Units using the SP were randomly assigned at 14-week intervals to implement the RP. Participants admitted with OUD received the procedure the unit was delivering at the time of their admission. Participant recruitment took place between March 16, 2021, and July 18, 2022. The last visit was September 21, 2022. Standard procedure, based on the XR-naltrexone package insert (approximately 5-day buprenorphine taper followed by a 7- to 10-day opioid-free period and RP, defined as 1 day of buprenorphine at minimum necessary dose, 1 opioid-free day, and ascending low doses of oral naltrexone and adjunctive medications (eg, clonidine, clonazepam, antiemetics) for opioid withdrawal. Receipt of XR-naltrexone injection prior to inpatient discharge (primary outcome). Secondary outcomes included opioid withdrawal scores and targeted safety events and serious adverse events. All analyses were intention-to-treat. A total of 415 participants with OUD were enrolled (mean [SD] age, 33.6 [8.48] years; 205 [49.4%] identified sex as male); 54 [13.0%] individuals identified as Black, 91 [21.9%] as Hispanic, 290 [69.9%] as White, and 22 [5.3%] as multiracial. Rates of successful initiation of XR-naltrexone among the RP group (141 of 225 [62.7%]) were noninferior to those of the SP group (68 of 190 [35.8%]) (odds ratio [OR], 3.60; 95% CI, 2.12-6.10). Withdrawal did not differ significantly between conditions (proportion of days with a moderate or greater maximum Clinical Opiate Withdrawal Scale score (>12) for RP vs SP: OR, 1.25; 95% CI, 0.62-2.50). Targeted safety events (RP: 12 [5.3%]; SP: 4 [2.1%]) and serious adverse events (RP: 15 [6.7%]; SP: 3 [1.6%]) were infrequent but occurred more often with RP than SP. In this trial, the RP of XR-naltrexone initiation was noninferior to the standard approach and saved time, although it required more intensive medical management and safety monitoring. The results of this trial suggest that rapid initiation could make XR-naltrexone a more viable treatment for patients with OUD. ClinicalTrials.gov Identifier: NCT04762537.

Interventional Intensive Care in Postoperative Period of Gastric Surgical Repair Due to Perforated Peptic Ulcer Disease : A Case Report

Introduction: Perforated peptic ulcer is the most common indication for emergency gastric surgery. good management of postoperative peptic ulcer perforation patients in the ICU will reduce patient mortality rates. Case presentation A 76-year-old male patient presented with a major complaint of pain throughout the abdomen that had worsened since 1 day, the abdominal pain had been felt for 4 days before admission. The patient had a history of painkiller drug consumption routinely for 3 years. The patient’s vital signs were normal, with a qSOFA score 1 and a VAS score 5. Abdominal physical examination showed the abdominal distended, no visible contour and no visible peristaltic, decreased bowel sound, and there is tenderness and rebound tenderness at the whole abdomen Patient was taken up for emergency laparostomy, then the patient underwent diagnostic laparoscopic in an elective setting with intraoperative findings of gastric perforation, then patient continued with the gastric repair. In the postoperative period, the patient was treated in the ICU of Dr. M. Djamil General Hospital. Conclusion: Intensive care management for post-gastric repair surgery patients is generally the same as for other abdominal surgery patients. The intensive care management needs comprehensive treatment, starting from oxygen therapy, monitoring, analgesia, fluid therapy, antibiotic therapy, glycemic control, and nasogastric tube nutrition.

Seasonal shifts in the habitat selection patterns of male American Marten (Martes americana) at a fine spatial scale

Abstract Old-growth forests harbor a large amount of complex structural features that result in a wide array of wildlife habitats. However, intensive forest management is gradually converting old-growth forest into younger, even-aged stands, reducing structural complexity and threatening the persistence of old-growth-dependent species. Maintaining elements of complex stand structure is critical to the conservation of old-growth forest specialists that use different habitat components at different periods of their annual cycle, and it requires a comprehensive understanding of seasonal variation in the habitat needs of these species. However, difficulties in observing free-ranging animals have sometimes limited our ability to assess such variations in habitat requirements, especially for small, elusive species. To address this, we used GPS telemetry collars to describe fine-scale habitat selection patterns of 6 male American Martens (Martes americana) during 2 contrasting periods of the year (snow-free, from mid-April to mid-November; snow-covered, from mid-November to mid-April), an objective formerly hard to achieve using conventional VHF telemetry. We used resource selection functions conducted at the fourth order of selection to compare habitat characteristics found at the sites used by martens (GPS locations, n = 100) to those found on an equal number of available sites (random points, n = 100) within each individual seasonal home range. We conducted vegetation surveys on these 200 sites to describe habitat and built candidate models representing different concurrent hypotheses. Our results showed that proxies of prey availability, predator avoidance, and thermal constraints were the primary factors influencing marten habitat selection during both periods, although their respective importance differed between periods. Martens selected sites with a high density of large-diameter snags (≥30·ha−1), high conifer canopy closure (≥53%), and a dense lateral cover (≥81%) during the snow-free period, but selected sites with a high volume of coarse woody debris (≥64 m3·ha−1) and high conifer canopy closure (≥48%) during the snow-covered period. Our results highlight the importance of contrasting seasonal changes in habitat selection patterns of small carnivores and may help maintain structural attributes in the landscape that are suitable for male American Martens.

Prevalence, geographic distribution and risk factors of Eimeria species on commercial broiler farms in Guangdong, China

BackgroundCoccidiosis is one of the most frequently reported diseases in chickens, causing a significant economic impact on the poultry industry. However, there have been no previous studies evaluating the prevalence of this disease in broiler farms in Guangdong province. Therefore, this study aims to conduct an epidemiological investigation into the occurrence of Eimeria species and associated risk factors in intensive management conditions across four regions in Guangdong province, China. A total of 394 fecal samples were collected from 89 broiler farms in Guangdong province. The prevalence of Eimeria species infection was determined using PCR, and the occurrence of Clostridium perfringens type A was assessed using quantitative real-time PCR.ResultsThe results showed an overall prevalence of 98.88% (88/89) at the farm level and 87.06% (343/394) at the flock level. All seven Eimeria species were identified, with E. acervulina (72.53%; 64/89), E. tenella (68.54%; 61/89), and E. mitis (66.29%; 59/89) at the farm level, and E. acervulina (36.55%; 144/394), E. mitis (35.28%; 139/394), and E. tenella (34.01%; 134/394) at the flock level. The predominant species combination observed was a co-infection of all seven Eimeria species (6.74%; 6/89), followed by a combination of E. acervulina, E. tenella, E. mitis, E. necatrix, E. brunetti, and E. maxima (5.62%, 5/89). A combination of E. acervulina, E. tenella, E. mitis, E. necatrix, E. brunetti, and E. praecox (4.49%; 4/89) was also observed at the farm level. Furthermore, the study identified several potential risk factors associated with the prevalence of Eimeria species, including farm location, chicken age, drinking water source, control strategy, and the presence of C. perfringens type A were identified as potential risk factors associated with prevalence of Eimeria species. Univariate and multivariate analyses revealed a significant association between E. necatrix infection and both grower chickens (OR = 10.86; 95% CI: 1.92–61.36; p < 0.05) and adult chickens (OR = 24.97; 95% CI: 4.29–145.15; p < 0.001) compared to starter chickens at the farm level. Additionally, farms that used groundwater (OR = 0.27; 95% CI: 0.08–0.94; p < 0.05) were less likely to have E. maxima compared to those that used running water. At the flock level, the prevalence of E. tenella was significantly higher in the Pearl River Delta (OR = 2.48; 95% CI: 1.0–6.15; p = 0.05) compared to eastern Guangdong. Interestingly, flocks with indigenous birds were less likely to have E. brunetti (OR = 0.48; 95% CI: 0.26–0.89; p < 0.05) compared to flocks with indigenous crossbred birds. Furthermore, flocks that used anticoccidial drugs (OR = 0.09; 95% CI: 0.03–0.31; p < 0.001) or a combination of vaccines and anticoccidial drugs (OR = 0.06; 95% CI: 0.01–0.25; p < 0.001) were less likely to be positive for E. tenella compared to flocks that only used vaccines. Finally, flocks with C. perfringens type A infection were significantly more likely to have E. necatrix (OR = 3.26; 95% CI: 1.96–5.43; p < 0.001), E. tenella (OR = 2.14; 95% CI: 1.36–3.36; p < 0.001), E. brunetti (OR = 2.48; 95% CI: 1.45–4.23; p < 0.001), and E. acervulina (OR = 2.62; 95% CI: 1.69–4.06; p < 0.001) compared to flocks without C. perfringens type A.ConclusionsThis study conducted an investigation on the prevalence, distribution, and risk factors associated with Eimeria species infection in broiler chickens in Guangdong. The farm-level prevalence of Eimeria species was higher than the previous prevalence figures for other areas and countries. E. brunetti was identified at higher prevalence in Guangdong than previously survived prevalence in different regions in China. Farm location, chicken age, drinking water source, control strategy, and the presence of C. perfringens type A were considered as potential risk factors associated with prevalence of Eimeria species. It is imperative to underscore the necessity for further surveys to delve deeper into the occurrence of Eimeria species under intensive management conditions for different flock purposes.

Application of BIM+GIS Integration Technology in the Construction of Urban Intelligent Water Informatization

Urban intelligent water informatization is the process of managing and operating urban water systems with the use of contemporary information and communication technology in order to increase productivity, security, and sustainability. Establishing the appropriate infrastructure is the initial stage in building an intelligent water system so that management can choose wisely how to manage and operate the water system. Building information modeling (BIM) is a digital depiction of a building's or infrastructure's structural and functional details. In most metropolitan regions, a fast development phase is predicted to cause several water issues, including water resource shortages, floods, poor drainage, and water resource contamination. As a result, a practical approach is required for urban intelligent water information technology with the help of artificial intelligence techniques. Intelligent water systems may be built using Building Information Modeling (BIM) software to increase the system's effectiveness, stability, and durability. By offering a potent tool for storing and analyzing geographical data connected to the water distribution system, a geographic information system (GIS) can play a crucial role in the development of urban intelligent water informatization using ArcGIS mapping Software. The Internet of Things (IoT) system is used to implement intelligent water informatization, hardware implementation using ESP32, and software development using MQTT Broker and Node-Red. As a result, we recommended utilizing BIM+GIS integration technology for building urban intelligent water informatization. The suggested system is evaluated using management efficiency, urban flood control, innovative Construction, intensive management, and computation cost. In this research, the main objective is to identify where there are water leaks broken pipes and early warning system and monitoring system for flash flood disasters in urban areas. The result findings show that the integration of BIM and GIS provides a comprehensive platform for managing complex water informatization infrastructure projects and maximizes efficiency and sustainability.

Abstract PO5-20-11: Synchronous Breast Cancer and Pheochromocytoma: A Case Series

Abstract Background: Pheochromocytomas are rare, although literature suggests a rising incidence due to the widespread use of sensitive imaging modalities. Synchronous presentation of breast cancer with a pheochromocytoma is exceedingly rare with only one case documented in the literature. We present two cases of malignancy in the breast in which pheochromocytomas were incidentally detected during workup and management with vastly different presentations. Case Presentation: Two patients presented with breast cancer and were secondarily diagnosed with pheochromocytoma. Patient 1 is a 48-year-old postmenopausal female with a history of intraductal papilloma four years prior, who presented with right breast nipple discharge. Diagnostic mammogram showed a right breast mass and biopsy confirmed an intraductal papilloma with intermediate-grade DCIS, ER+/PR-. She had no family history of cancer or PGL/PPC. During a scheduled lumpectomy, she developed hypoxia, hypotension, and flash pulmonary edema requiring intubation and ECMO with prolonged ICU stay and long recovery with tracheostomy for four months. Contrast-enhanced CT of her abdomen showed a 9 cm right adrenal mass. Serum and urine metanephrines were markedly elevated, and it was determined that she had an adrenal crisis secondary to undiagnosed pheochromocytoma. She completed treatment for DCIS with lumpectomy and radiation and is currently on adjuvant anastrozole. She additionally had an adrenalectomy for pheochromocytoma, which was found to be stage PASS 2. Subsequent genetic testing confirmed the absence of germline mutations associated with hereditary PGL/PPC or breast cancer. Patient 2 is a 57-year-old female presenting with a history of left breast mass she first noted a year ago, with newly found nipple retraction and skin changes. Biopsy showed invasive ductal carcinoma of the breast, G3, Stage IIIA, pT3N2aM0, ER 95%/PR-/Her2- (IHC 0). Staging PET scan showed a 3.4 cm hypermetabolic left adrenal mass in addition to the breast mass and left axillary adenopathy. Serum and urine metanephrines were elevated, and pheochromocytoma was diagnosed. Family history was positive only for pancreatic cancer in a maternal aunt. Comprehensive genotype testing was negative for hereditary breast cancer and PGL/PCC syndromes. She was concomitantly treated with a radical mastectomy for breast cancer and a left adrenalectomy and tolerated the procedure well as she received perioperative alpha-adrenergic blockade with doxazosin. She has received chemotherapy and radiation for breast cancer treatment and is currently on adjuvant anastrozole. The adrenal mass was confirmed to be a pheochromocytoma PASS 2-3. Discussion: We present two unique cases of breast cancer and pheochromocytomas discovered in tandem with variable clinical manifestations. It is extremely uncommon to have a presentation of primary breast malignancy concomitantly with pheochromocytoma, and we demonstrate two cases that occurred within months of one another at our facility. During the first case, metastatic workup was not indicated for DCIS. However, during the seemingly benign lumpectomy procedure, the patient experienced significant complications, leading to intense ICU management, intubation, and tracheostomy. In the second case, a metastatic workup was completed due to locally advanced breast cancer where the adrenal mass was detected and a pheochromocytoma was diagnosed prior to surgery. This allowed both cancers to be resected simultaneously and safely. This series demonstrates the importance of keeping pheochromocytomas in the differential during the workup of adrenal masses prior to surgical interventions. Additionally, they demonstrate how the usual workup and management of breast cancer does not take into account these rare but significant diagnoses, and that can result in fatal consequences. Citation Format: Nikita Dahake, Abhimanyu Tushir, Aruna Padmanabhan. Synchronous Breast Cancer and Pheochromocytoma: A Case Series [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-20-11.

Re-Expansion Pulmonary Edema as a Life-Threatening Complication in Massive, Long-Standing Pneumothorax: A Case Series and Literature Review.

Re-expansion pulmonary edema is a rare and potentially life-threatening complication that can occur after the rapid re-expansion of a collapsed lung due to pneumothorax or pleural effusion. It has a multifactorial pathogenesis, and risk factors for re-expansion pulmonary edema, such as chronic lung collapse, rapid re-expansion, and changes in pulmonary vascular permeability, have been identified. Clinical manifestations vary, ranging from almost asymptomatic to a rapidly fatal condition, and its incidence may be more common and less fatal than previously believed. The literature emphasizes the importance of early recognition and management to ensure favorable outcomes. However, there is ongoing debate regarding the indications for ventilatory support and the timing of non-invasive or invasive ventilation. Herein, we report a case series of three paradigmatic examples of massive re-expansion pulmonary edema occurring over a period of 10 years in our institution among a population of 815 patients with spontaneous pneumothorax. We also conducted a literature review on re-expansion pulmonary edema, with a particular focus on diagnosis and management. In each case, despite initially normal clinical parameters, severe respiratory distress developed following the insertion of a thoracic drainage tube for a massive spontaneous pneumothorax. Two patients required High-Flow Nasal Oxygen, and one was addressed to intensive management, including CPAP. In all cases, the patient's outcome was optimal.

Management and liming-induced changes in organo-Al/Fe complexes and amorphous mineral-associated organic carbon: Implications for carbon sequestration in volcanic soils

Amorphous mineral-associated organic carbon (AMAOC) and organo-Al/Fe complexes (Cp) play crucial roles in soil carbon (C) sequestration in volcanic soils. This study investigated the effects of land use management and liming on the C sequestration capacity of a young allophanic Andisol and old halloysitic-kaolinitic volcanic Ultisol sampled at 0–10 and 10–20 cm depth. This study was designed to test two hypotheses: (1) management and liming affect the C sequestration capacity of Andisol by reducing Cp and increasing AMAOC to offset Cp losses, and (2) they do not significantly affect the carbon sequestration capacity of Ultisol because of its more crystalline mineral forms and reduced amount of Cp. This study was conducted using a selective dissolution technique and density fractionation with agricultural soils and forests as control soils. After 43 years of intensive management and liming, the soil organic carbon (SOC) content decreased by 32% in the topsoil compared to the original native forest soil (178 ± 2 g kg−1 soil), mainly in the particulate organic matter (POM) fraction, which decreased by 74% compared to the native forest soil (61 ± 9 g kg−1 soil). However, Cp decreased only by 40% compared to the forest soil (62 ± 1 g kg−1 soil) from pHKCl 4.8–5.0, and AMAOC increased in 17% in the topsoil and 64% in the subsoil, supporting the first hypothesis of this study. In the cultivated Ultisol, SOC decreased by 35% due to the POM fraction, and mineral-associated organic C (MAOC) decreased by 37% compared to the forest soil (38 ± 7 g kg−1 soil). These results partially support the second hypothesis because the crystalline clay minerals from which MAOC originated remained unchanged and were strongly correlated with SOC. The mass balance of both soils indicated that the stable C losses from native forest soils were < 14%. These results highlight the importance of different C sequestration mechanisms to compensate for SOC losses in the young allophanic Andisol and old volcanic Ultisol. Our findings imply that both mechanisms can be used to estimate the C sequestration capcity in similar soil types.

Comparison between in-person, telehealth, and combination visits among veterans treated in a pharmacist-led diabetes management clinic

The Veterans Affairs San Diego Healthcare System converted its pharmacist-run Diabetes Intense Medical Management (DIMM) Clinic to telehealth during the COVID-19 pandemic. Previous studies suggested that in-person DIMM visits improved glycemic control, medication adherence, and patient satisfaction. To explore if these benefits apply to telehealth, we compared glycemic control in veterans with post-COVID-19 telehealth DIMM visits and pre-pandemic in-person DIMM visits. The primary study objective was to evaluate the mean hemoglobin (A1c) change from baseline in cohorts who received telehealth visits, traditional visits, or a combination of both after 12 months of intervention. Secondary objectives included evaluation of all-cause mortality and the average time to mortality (days). A retrospective multi-arm historical cohort control study was conducted to compare 12-month glycemic control among veterans with type 2 diabetes who initiated DIMM care via audio-only telehealth, in-person, or combination between August 2018 and November 2021. Primary endpoint was the 12-month change in A1c from baseline; secondary measures included all-cause mortality and the average time to mortality (days). A total of 44 veterans were included for analysis. At 12 months, the average decrease in A1c from baseline were -0.90% (95% CI: -2.82, 1.01), -1.73% (95% CI: -3.33, -0.14), and -1.42% (95% CI: -2.67, -0.18) for the In-Person, Telehealth, and Combination groups, respectively. No differences in quarterly HbA1c rate of change were reported across the groups. All-cause mortality was highest in the In-person group (15.4%) compared to the Telehealth (4.6%) and the Combination (0.0%) groups; however, these differences were not statistically significant. Lastly, there were no significant differences in average time to death between the groups. Telehealth may be an alternative method of access to pharmacist-led diabetes care that is slowly making its way into our healthcare systems as a permanent fixture.

SEIZURE CONTROL IN PATIENTS WITH ANTI-NMDAR ENCEPHALITIS : CASE SERIES

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Anti N-methyl-D-aspartate Receptor (anti-NMDAR) encephalitis is a rare, yet has had increasing number of cases. Patients often require airway protection, mechanical ventilation and intensive care because the patients’ complex symptoms accompanied by seizures that are difficult to control. Here, we present two related case reports that discuss intensive care management and focus on the administered sedation/anesthesia methods and their outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case illustration: &lt;/strong&gt;Male patients, 19 and 21 years old, presented with neuropsychiatric symptoms, seizures, dyskinesia. Both require airway protection and mechanical ventilation as well as Intensive Care Unit (ICU) care. Radiodiagnostic head Computed Tomography (CT) scan and head Magnetic Resonance Imagng (MRI) showed no cerebral abnormalities. Cerebrospinal Fluid (CSF) examination showed positive NMDAR antibodies. First patient had failed to improve clinically even with multiple anti-convulsants, ketamine, dexmedetomidine, immunotherapy, and chemotherapy. Second patient clinically improved with benzodiazepine (midazolam) and propofol as anti-convulsants followed by plasma exchange immunotherapy. The two cases had different outcomes. The first case deceased from septic shock, while the second case was treated by outpatient procedure.&lt;/p&gt;&lt;strong&gt;Conclusion : &lt;/strong&gt;Our presented cases suggest that midazolam, propofol, dextemedetomidine, ketamine do not provide satisfying results for seizure control in patients with anti-NMDAR encephalitis, unless immunotherapy is carried out as early as possible and optimally.&lt;strong&gt;&lt;em&gt;&lt;/em&gt;&lt;/strong&gt;&lt;strong&gt;&lt;/strong&gt;&lt;p&gt;&lt;strong&gt; &lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt; &lt;/strong&gt;&lt;/p&gt;

Varying degrees of human-animal interaction elicit weak evidence of a temporally stable behavioral trait in rangeland breeding ewes.

Coherent patterns of inter-related behaviors that occur across time and contexts, also known as personality or consistent individual differences (CIDs), are important to identify among livestock as they carry valuable information for selective breeding purposes. Repeated testing is necessary to reveal behavioral patterns, yet temporal stability of behavioral traits is often assumed. In this study, three human-animal interaction (HAI) tests were employed within a flock of sheep maintained in the Sierra-Nevada foothills to assess intra-individual consistency and inter- relatedness of behavioral responses. Groups of five (four or six when needed) ewes were placed in three HAI tests (restrained Human Contact, unrestrained Human Presence and unrestrained Human Approach) at the time of post-breeding, gestation and weaning (3 x per year; over 2 years). PCs were created using principal component analysis (PCA) of behaviors from the unrestrained Human Presence test and were compared to the behaviors from the two other HAI tests to evaluate cross-contextual relationships. Frequency of ‘environmental vigilance’ (EV), ‘investigating fence’ (IF) and duration of ‘head down’ (HD) were the only variables to achieve a moderate repeatability estimate [EV: 0.32 ± 0.09, [CI (0.21, 0.48])]; IF: 0.29 ± 0.13, [CI (0.14, 0.48)]; HD: 0.44 ± 0.15, [CI (0.22, 0.68)]. PCA revealed a single component in all Human Presence tests that was characterized by loadings (>0.45) for duration of ‘grazing’ and ‘environmental vigilance’. Spearman’s rank order analysis revealed no significant correlations between PC1 of each replicate. There was also no significant inter-relatedness identified between behaviors of each HAI test. Taken together, it is suggested that the rangeland ewes of this study exhibited consistency of some individual behaviors within the Human Contact and Human Presence test, however, did not demonstrate a temporally stable trait that can be generalized across multiple contexts. Future work should evaluate the influence of extensive versus intensive management styles on the development and maintenance of human-oriented behavioral traits.

Carbon density and sequestration in the temperate forests of northern Patagonia, Argentina

IntroductionForests are a crucial part of the global carbon cycle and their proper management is of high relevance for mitigating climate change. There is an urgent need to compile for each region reference data on the carbon (C) stock density and C sequestration rate of its principal forest types to support evidence-based conservation and management decisions in terms of climate change mitigation and adaptation. In the Andean Mountains of northern Patagonia, extensive areas of temperate forest have developed after massive anthropogenic fires since the beginning of the last century.MethodsWe used a plot design along belt transects to determine reference values of carbon storage and annual C sequestration in total live (above- and belowground biomass) and deadwood mass, as well as in the soil organic layer and mineral soil (to 20 cm depth) in different forest types dominated by Nothofagus spp. and Austrocedrus chilensis.ResultsAverage total carbon stock densities and C sequestration rates range from a minimum of 187 Mg.ha−1 and 0.7 Mg.ha−1.year−1 in pure and mixed N. antarctica shrublands through pure and mixed A. chilensis forests taller than 7 m and pure N. pumilio forests to a maximum in pure N. dombeyi forests with 339 Mg.ha−1 and 2.2 Mg.ha−1.year−1, respectively. Deadwood C represents between 20 and 33% of total wood mass C and is related to the amount of live biomass, especially for the coarse woody debris component. The topsoil contains between 33 and 57% of the total estimated ecosystem carbon in the tall forests and more than 65% in the shrublands, equaling C stocks of around 100–130 Mg.ha−1 in the different forest types.ConclusionWe conclude that the northern Patagonian temperate forests actually store fairly high carbon stocks, which must be interpreted in relation to their natural post-fire development and relatively low management intensity. However, the current high stand densities of these forests may well affect their future carbon storage capacity in a warming climate, and they represent a growing threat of high-intensity fires with the risk of a further extension of burned areas in the future.

Design principles for multi‐species productive grasslands: Quantifying effects of diversity beyond richness

Abstract Productive grasslands in temperate regions have relied strongly on low plant diversity with high management intensity and fertiliser inputs. Increasing plant diversity can provide high yields of digestible forage for livestock production with lower environmental impacts, and thus represents a diversity‐dependent nature‐based solution that can deliver multiple ecosystem functions. Sharing lessons from the design of managed, productive grassland communities, we address the following questions: how can we identify combinations of plant species that best deliver a selected function or multiple functions? and; when is community composition more important than species richness? We describe approaches that separate plant diversity into its underlying components: species richness, composition and relative abundance. Disentangling these three components facilitates a more nuanced understanding of how diversity can contribute to the design of diversity‐dependent nature‐based solutions.

A case of Gloriosa superba poisoning

A case of <i>Gloriosa superba</i> poisoning

Evaluating machine learning models and identifying key factors influencing spatial maize yield predictions in data intensive farm management

Understanding the relationships between crop yields, soil properties, weather patterns and input applications is important for optimizing agricultural production. Data variation analysis using statistical and machine learning (ML) approaches can help identify and understand the practices that optimize yield. The objectives of this study were (i) to evaluate the predictive accuracy of selected ML models for estimating grain yields in on-farm maize (Zea mays L.) trials with different combinations of seeding and fertilizer rates in a commercial field, and (ii) to investigate the ability of ML models to assist in identifying yield-limiting factors in the same field. Multiple linear regression, multilayer perceptron, decision tree, and random forest (RF) ML models were trained and tested using crop management and soil from a data-intensive farm management (DIFM) trial and remotely sensed data. The dataset consisted of multiple subplot treatment observations of crop management, soil properties and normalized difference vegetation index (NDVI), linked to final grain yield for the 2019/2020 and 2020/2021 seasons. The RF had the best combination of high correlation (R2 = 0.69 and 0.80) and low error (MAPE = 5.4 and 8.4% and RMSE = 0.69 and 0.95 t ha−1) when compared to other models for both seasons. Feature importance analysis revealed that urea application was consistently the most critical variable and explained yield variations to the greatest extent, whereas soil phosphorus (P), plant population, and sodium in 2020, and soil P, soil pH, clay content, and plant population in 2021 emerged as the most influential factors for explaining yields. This study concluded that the RF model was the best for spatial yield predictions using DIFM trial datasets. There was also variability between seasons in yield limiting factors resulting from temporal variations in growing conditions. To effectively apply insights from yield prediction models, it is crucial that the variables incorporated into these models have a significant connection to yield and the findings can be translated into actionable management decisions. The DIFM trials combined with ML can play an important role in advancing the field of precision agriculture by providing valuable insights into the complex interactions between crops, soils, and management practices, and identifying new opportunities for improving crop yields and environmental sustainability.

Pregnant women with COVID-19 ARDS on the intensive care unit

Pregnant women with coronavirus disease 2019 (COVID-19) are at increased risk of severe disease progression. Comorbidities, such as chronic arterial hypertension, diabetes mellitus, advanced maternal age and high body mass index, may predispose to severe disease. The management of pregnant COVID-19patients on the intensive care unit (ICU) is challenging and requires careful consideration of maternal, fetal and ethical issues. Description and discussion of intensive care treatment strategies and perinatal anesthesiological management in patients with COVID-19 acute respiratory distress syndrome (CARDS). We analyzed the demographic data, maternal medical history, clinical intensive care management, complications, indications and management of extracorporeal membrane oxygenation (ECMO) and infant survival of all pregnant patients treated for severe CARDS in the anesthesiological ICU of aGerman university hospital between March and November 2021. The cohort included 9 patients with amean age of 30.3 years (range 26-40years). The gestational age ranged from 21 + 3 weeks to 37 + 2 weeks. None of the patients had been vaccinated against SARS-CoV‑2. Of the nine patients seven were immigrants and communication was hampered by inadequate Central European language skills. Of the patients five had aPaO2/FiO2 index < 150 mm Hg despite escalated invasive ventilation (FiO2 > 0.9 and a positive end-expiratory pressure [PEEP] of 14 mbar) and were therefore treated with repeated prolonged prone positioning maneuvers (5-14 prone positions for 16 h each, atotal of 47prone positioning treatments) and 2 required treatment with inhaled nitric oxide and venovenous ECMO. The most common complications were bacterial superinfection of the lungs, urinary tract infection and delirium. All the women and five neonates survived. All newborns were delivered by cesarean section, two patients were discharged home with an intact pregnancy and two intrauterine fetal deaths were observed. None of the newborns tested positive for SARS-CoV‑2 at birth. High survival rates are possible in pregnant patients with CARDS. The peripartum management of pregnant women with CARDS requires close interdisciplinary collaboration and should prioritize maternal survival in early pregnancy. In our experience, prolonged prone positioning, an essential evidence-based cornerstone in the treatment of ARDS, can also be safely used in advanced stages of pregnancy. Inhaled nitric oxide (iNO) and ECMO should be considered as life-saving treatment options for carefully selected patients. For cesarean section, neuraxial anesthesia can be safely performed in patients with mild CARDS if well planned but the therapeutic anticoagulation recommended for COVID-19 may increase the risk of bleeding complications, making general anesthesia amore viable alternative, especially in severe disease.

Agricultural insect pests as models for studying stress-induced evolutionary processes.

Agricultural insect pests (AIPs) are widely successful in adapting to natural and anthropogenic stressors, repeatedly overcoming population bottlenecks and acquiring resistance to intensive management practices. Although they have been largely overlooked in evolutionary studies, AIPs are ideal systems for understanding rapid adaptation under novel environmental conditions. Researchers have identified several genomic mechanisms that likely contribute to adaptive stress responses, including positive selection on de novo mutations, polygenic selection on standing allelic variation and phenotypic plasticity (e.g., hormesis). However, new theory suggests that stress itself may induce epigenetic modifications, which may confer heritable physiological changes (i.e., stress-resistant phenotypes). In this perspective, we discuss how environmental stress from agricultural management generates the epigenetic and genetic modifications that are associated with rapid adaptation in AIPs. We summarise existing evidence for stress-induced evolutionary processes in the context of insecticide resistance. Ultimately, we propose that studying AIPs offers new opportunities and resources for advancing our knowledge of stress-induced evolution.