bluuebunny/crossref_metadata_2025_split huggingface dataset:
Signal Enhancement and Enhancement Kinetics of Gadobutrol, Gadoteridol, and Gadoterate Meglumine in Various Body Regions
Authors: Knobloch Gesine , Frenzel Thomas , Pietsch Hubertus , Jost Gregor 
Published: January 2020

Objectives
The signal enhancement (SE) and enhancement kinetics of gadolinium-based contrast agents (GBCAs) in T1-weighted magnetic resonance (MR) images depend on the relaxivity of the GBCA and its pharmacokinetic profile. This in vivo study systematically compared the SE (technical efficacy) and the enhancement kinetics of the 3 macrocyclic GBCAs gadobutrol, gadoteridol, and gadoterate meglumine in various body regions.

Materials and Methods
A total of 15 healthy male white New Zealand rabbits were randomly divided into 3 groups (n = 5/group). The GBCAs were injected intravenously (0.1 mmol/kg body weight) and signal intensities from multiphase T1-weighted MR images (1.5 T; volumetric interpolated breath-hold examination (VIBE); repetition time/echo time/α: 4.74 milliseconds/2.38 milliseconds/10°) before and up to approximately 23 minutes after contrast injection were determined in the brain, tongue, submandibular gland, liver, spleen, prostate, muscle, and blood/aorta). Thirty minutes after injection, the animals were sacrificed and Gadolinium (Gd) concentrations were determined in the above-mentioned tissue samples by inductively coupled plasma optical emission spectrometry. Gadolinium tissue concentrations were correlated with the respective SE measurements in each tissue.

Results
The time course of SE, representing the pharmacokinetic profile of the GBCA, was similar for all 3 agents in all tissues. The magnitude of SE was, however, tissue dependent and consistently higher for gadobutrol (P < 0.05 in all tissues but brain). No significant difference in the magnitude of SE was found between gadoteridol and gadoterate meglumine. The inductively coupled plasma optical emission spectrometry analysis revealed no differences in Gd-tissue concentrations between the GBCAs. A linear correlation was observed between SE and the respective Gd concentrations for all 3 GBCAs. A significantly higher enhancement efficacy, that is, SE per Gd concentration, was observed for gadobutrol.

Conclusions
Gadobutrol-enhanced MR imaging showed greater SE compared with gadoteridol and gadoterate meglumine, whereas the SE kinetics were similar among the 3 GBCAs. For all 3 GBCAs, the SE was independent of the body region.
The Charles Procedure as Part of the Modern Armamentarium Against Lymphedema
Authors: Hassan Kareem , Chang David W. 
Published: January 2020

Background
Over the past 2 decades, the surgical treatment of lymphedema has advanced considerably with lymphovenous bypass and vascularized lymph node transfer. Despite these advances, some patients can only be treated with a radical debulking procedure, commonly known as Charles procedure. However, the Charles procedure is not a commonly performed procedure and can have significant risks such as fluid shifts, blood loss and wound infections. In this article, we present our experience with Charles procedure and share pearls to perform this procedure expediently while avoiding potential pitfalls.

Methods
Patients with severe lymphedema who were treated by the senior author with Charles procedure were evaluated. The medical record was queried for their pertinent medical history, including cause of lymphedema, prior treatments for the condition, medical comorbidities and preoperative and postoperative course. The surgical technique and lessons learned from each case are described.

Results
Three patients were identified within the study period who underwent treatment with the Charles procedure. All patients had secondary lower extremity lymphedema. All patients had single-stage direct excision and skin grafting. One patient required postoperative ICU stay due to significant fluid shifts and blood loss, another suffered from a wound infection. All 3 patients ultimately recovered to exceed their preoperative activity levels with satisfactory outcomes.

Conclusions
The Charles procedure continues to have clinical utility in modern lymphedema treatment. Despite potential risks, it can be done successfully with proper planning and careful attention to technical details; it can be life changing for patients suffering from most extreme lymphedema.
Optimization of the Parameters of Different Purification Techniques and Comparison of Their Purification Efficiency and Their Effects on the Metabolic Activity of Adipose Tissue in Autologous Fat Transplantation
Authors: Li Yilin , Lu Haibing , Yang Xiaonan , Jin Xiaolei , Qi Zuoliang 
Published: January 2020

Abstract
There is still no unified standardized or optimal procedure for lipoaspirate purification and we explored the optimal parameters of 3 purification techniques and compared their efficiencies and effects on the metabolic activity of adipose tissue. The purification efficiency of each technique was compared by analyzing the composition ratio of the processed compounds. The effects of the purification techniques on the dynamic metabolic activity of adipose tissue were evaluated in vitro using the glucose transfer assay. We found that the cotton pad adsorption technique displayed the greatest ability to remove aqueous and oil fractions, followed by centrifugation and sedimentation techniques (P < 0.01). The in vitro metabolic activity of adipose tissue peaked at 4 hours. The glucose transfer rates in the cotton pad group and the sedimentation group were significantly higher (P < 0.05) than that of the centrifugation group, and the centrifugation method exerted the greatest effect on the metabolic activity of adipose tissue. To sum up, the optimal processing parameters were the following: sedimentation technique, 30 minutes of sedimentation; centrifugation technique, 3 to 5 minutes of centrifugation and centrifugation force of 200 g; and cotton pad adsorption technique, contact area of 5 cm2/mL and contact time of 5 minutes. The cotton pad adsorption technique yielded the best purification of the aqueous and oil fractions, followed by the centrifugation technique, whereas the sedimentation technique exhibited the lowest efficiency. The in vitro metabolic activity of adipose tissue peaked at 4 hours, and the cotton pad and sedimentation technique exerted decreased effects on metabolic activity than the centrifugation technique.
Midline Intranasal Dermoid Cyst With Intracranial Extension: Technical Details of a Multidisciplinary Approach to a Rare Condition
Authors: Davis Matthew J. , Abu-Ghname Amjed , Davies Lesley W. , Xue Amy S. , Masoumy Mohamad , Lam Sandi , Buchanan Edward P. 
Published: January 2020

Abstract
Dermoid cysts are rare, benign neoplasms that develop when ectodermal tissue is ectopically included during neural tube closure. Only 0.7% to 1.8% of dermoid cysts occur intracranially, and these make up only 0.3% of all intracranial tumors. Definitive management of intracranial dermoid cysts is achieved with surgical excision, with the primary goal being removal of the lesion before rupture or infection occurs. The authors report the multidisciplinary management of a 6-month-old patient with a midline intranasal dermoid cyst with intracranial involvement successfully treated with surgical resection. The surgical approach included Neurosurgical access with a bifrontal approach to remove the intracranial portion, then Plastic Surgery accessed and removed the intranasal portion through a transcolumellar and infracartilaginous dissection. The entire cyst was successfully removed without rupture. The patient's postoperative course was without complication.
Timely preoperative imaging and diagnosis were crucial to the success of this operation. When considering the possibility of a midline dermoid cyst with intracranial extension, it is essential to obtain proper imaging to distinguish between lesions on the differential diagnosis and to define extent of extension. Once diagnosed, surgical planning requires a multidisciplinary approach. Considerations for the optimal surgical approach to intracranial, intranasal dermoids include maximizing surgical exposure and ensuring an aesthetically pleasing reconstructive outcome.
Sequential Cohort Analysis After Liver Transplantation Shows de Novo Extended Release Tacrolimus Is Safe, Efficacious, and Minimizes Renal Dysfunction
Authors: Lim Tiong Yeng , McPhail Mark J. , Shah Amar , Mahgoub Sara , Nayagam Jeremy , Cramp Matthew , Bernal William , Menon Krish , Jassem Wayel , Joshi Deepak , Heneghan Michael A. , Agarwal Kosh , Heaton Nigel D. , Suddle Abid , O’Grady John G. , Aluvihare Varuna R. 
Published: January 2020

Background.
The use of once-daily extended-release tacrolimus (ERT) is associated with improved long-term graft and patient survival when compared with twice-daily tacrolimus (BDT), but the underlying reasons for differential survival are unclear. The aim of the study was to compare clinical outcomes known to impact on posttransplant survival for de novo BDT and ERT in liver transplantation (LT) recipients.

Methods.
We conducted a single-center, prospective sequential cohort analysis of adult patients undergoing LT during a change in protocol from de novo BDT to ERT, with a 6-month post-LT follow-up.

Results.
A total of 160 transplanted patients were evaluated; 82 were in the BDT group and 78 were in the ERT group. The cohorts were matched for standard variables and a similar proportion in each group received induction interleukin-2 receptor antibody (36% and 31%). There were no significant differences in the measured outcomes of patient and graft survival, biopsy-proven acute rejection episodes, post LT diabetes, and toxicity. A significantly lower number of patients developed chronic kidney disease Stage3–4 in the ERT cohort compared with BDT cohort. In patients with pre-LT renal dysfunction who received antibody induction, estimated glomerular filtration rate decreased significantly in the BDT but not the ERT group.

Conclusions.
We show that once-daily ERT is as safe and efficacious as BDT in de novo LT but optimally conserves renal function post-LT.
Safe and Successful Treatment of Acute Cellular Rejection of an Intestine and Abdominal Wall Transplant With Vedolizumab
Authors: Trentadue Guido , Kats-Ugurlu Gursah , Blokzijl Tjasso , Diercks Gilles FH , Haveman Jan Willem , Faber Klaas Nico , Dijkstra Gerard 
Published: January 2020

Background.
Graft survival rates after intestinal transplantation (ITx) are still the lowest in comparison to other solid organ transplants. One of the main reasons is the frequent occurrence of acute cellular rejection (ACR). Vedolizumab is an antibody against α4β7+ integrin involved in gut-homing of T cells which has been approved for inflammatory bowel diseases (IBD). We report its off-label use to treat ACR after ITx.

Methods.
Following abdominal wall transplantation (AWTx) and ITx, clinical course was followed biochemically. Sequential small intestinal biopsies were taken preceding, during, and after ACR treatment with vedolizumab, following the standard therapy regime for IBD. Rejection was diagnosed histologically, and proinflammatory (α4β7+, interleukin-17+) and regulatory (FoxP3+) T cells were analyzed by immunohistochemistry.

Results.
ACR in both the ITx and AWTx resolved upon vedolizumab treatment, which was safe, evidenced by clearing an astrovirus and primary cytomegalovirus infection. Only a slight reduction of α4β7+ cells in the mucosa was observed, and α4β7+ and regulatory T cells could still move into the lamina propria upon infection.

Conclusions.
Vedolizumab is a safe treatment option for ACR after ITx but its mechanism is probably not only based on inhibition of gut-selective T-cell homing.
Climate change and ecosystems: threats, opportunities and solutions
Authors: Malhi Yadvinder , Franklin Janet , Seddon Nathalie , Solan Martin , Turner Monica G. , Field Christopher B. , Knowlton Nancy 
Published: January 2020

The rapid anthropogenic climate change that is being experienced in the early twenty-first century is intimately entwined with the health and functioning of the biosphere. Climate change is impacting ecosystems through changes in mean conditions and in climate variability, coupled with other associated changes such as increased ocean acidification and atmospheric carbon dioxide concentrations. It also interacts with other pressures on ecosystems, including degradation, defaunation and fragmentation. There is a need to understand the ecological dynamics of these climate impacts, to identify hotspots of vulnerability and resilience and to identify management interventions that may assist biosphere resilience to climate change. At the same time, ecosystems can also assist in the mitigation of, and adaptation to, climate change. The mechanisms, potential and limits of such nature-based solutions to climate change need to be explored and quantified. This paper introduces a thematic issue dedicated to the interaction between climate change and the biosphere. It explores novel perspectives on how ecosystems respond to climate change, how ecosystem resilience can be enhanced and how ecosystems can assist in addressing the challenge of a changing climate. It draws on a Royal Society-National Academy of Sciences Forum held in Washington DC in November 2018, where these themes and issues were discussed. We conclude by identifying some priorities for academic research and practical implementation, in order to maximize the potential for maintaining a diverse, resilient and well-functioning biosphere under the challenging conditions of the twenty-first century.
This article is part of the theme issue ‘Climate change and ecosystems: threats, opportunities and solutions’.
Plant community diversity will decline more than increase under climatic warming
Authors: Harrison Susan 
Published: January 2020

Regions and localities may lose many species to extinction under rapid climate change and may gain other species that colonize from nearby warmer environments. Here, it is argued that warming-induced species losses will generally exceed gains and there will be more net declines than net increases in plant community richness. Declines in richness are especially likely in water-limited climates where intensifying aridity will increasingly exceed plant tolerances, but also in colder temperature-limited climates where steep climatic gradients are lacking, and therefore, large pools of appropriate species are not immediately adjacent. The selectivity of warming-induced losses may lead to declines in functional and phylogenetic diversity as well as in species richness, especially in water-limited climates. Our current understanding of climate-caused diversity trends may be overly influenced by numerous studies coming from north-temperate alpine mountaintops, where conditions are unusually favourable for increases—possibly temporary—in local species richness.
This article is part of the theme issue ‘Climate change and ecosystems: threats, opportunities and solutions’.
Benthic-based contributions to climate change mitigation and adaptation
Authors: Solan Martin , Bennett Elena M. , Mumby Peter J. , Leyland Julian , Godbold Jasmin A. 
Published: January 2020

Innovative solutions to improve the condition and resilience of ecosystems are needed to address societal challenges and pave the way towards a climate-resilient future. Nature-based solutions offer the potential to protect, sustainably manage and restore natural or modified ecosystems while providing multiple other benefits for health, the economy, society and the environment. However, the implementation of nature-based solutions stems from a discourse that is almost exclusively derived from a terrestrial and urban context and assumes that risk reduction is resolved locally. We argue that this position ignores the importance of complex ecological interactions across a range of temporal and spatial scales and misses the substantive contribution from marine ecosystems, which are notably absent from most climate mitigation and adaptation strategies that extend beyond coastal disaster management. Here, we consider the potential of sediment-dwelling fauna and flora to inform and support nature-based solutions, and how the ecology of benthic environments can enhance adaptation plans. We illustrate our thesis with examples of practice that are generating, or have the potential to deliver, transformative change and discuss where further innovation might be applied. Finally, we take a reflective look at the realized and potential capacity of benthic-based solutions to contribute to adaptation plans and offer our perspectives on the suitability and shortcomings of past achievements and the prospective rewards from sensible prioritization of future research.
This article is part of the theme issue ‘Climate change and ecosystems: threats, opportunities and solutions'.
Soil microbial community responses to climate extremes: resistance, resilience and transitions to alternative states
Authors: Bardgett Richard D. , Caruso Tancredi 
Published: January 2020

A major challenge for advancing our understanding of the functional role of soil microbial communities is to link changes in their structure and function under climate change. To address this challenge requires new understanding of the mechanisms that underlie the capacity of soil microbial communities to resist and recover from climate extremes. Here, we synthesize emerging understanding of the intrinsic and extrinsic factors that influence the resistance and resilience of soil microbial communities to climate extremes, with a focus on drought, and identify drivers that might trigger abrupt changes to alternative states. We highlight research challenges and propose a path for advancing our understanding of the resistance and resilience of soil microbial communities to climate extremes, and of their vulnerability to transitions to alternative states, including the use of trait-based approaches. We identify a need for new approaches to quantify resistance and resilience of soil microbial communities, and to identify thresholds for transitions to alternative states. We show how high-resolution time series coupled with gradient designs will enable detecting response patterns to interacting drivers. Finally, to account for extrinsic factors, we suggest that future studies should use environmental gradients to track soil microbial community responses to climate extremes in space and time.
This article is part of the theme issue ‘Climate change and ecosystems: threats, opportunities and solutions’.
If the trees burn, is the forest lost? Past dynamics in temperate forests help inform management strategies
Authors: Iglesias Virginia , Whitlock Cathy 
Published: January 2020

Forest dynamics are driven by top-down changes in climate and bottom-up positive (destabilizing) and negative (stabilizing) biophysical feedbacks involving disturbance and biotic interactions. When positive feedbacks prevail, the resulting self-propagating changes can potentially shift the system into a new state, even in the absence of climate change. Conversely, negative feedbacks help maintain a dynamic equilibrium that allows communities to recover their pre-disturbance characteristics. We examine palaeoenvironmental records from temperate forests to assess the nature of long-term stability and regime shifts under a broader range of environmental forcings than can be observed at present. Forest histories from northwestern USA, Patagonia, Tasmania and New Zealand show long-term trajectories that were governed by (i) the biophysical template, (ii) characteristics of climate and disturbance, (iii) historical legacies that condition the ecological capacity to respond to subsequent disturbances, and (iv) thresholds that act as irreversible barriers. Attention only to current forest conditions overlooks the significance of history in creating path dependency, the importance of individual extreme events, and the inherent feedbacks that force an ecosystem into reorganization. A long-time perspective on ecological resilience helps guide conservation strategies that focus on environmental preservation as well as identify vulnerable species and ecosystems to future climate change.
This article is part of the theme issue ‘Climate change and ecosystems: threats, opportunities and solutions’.
Climatic and local stressor interactions threaten tropical forests and coral reefs
Authors: França Filipe M. , Benkwitt Cassandra E. , Peralta Guadalupe , Robinson James P. W. , Graham Nicholas A. J. , Tylianakis Jason M. , Berenguer Erika , Lees Alexander C. , Ferreira Joice , Louzada Júlio , Barlow Jos 
Published: January 2020

Tropical forests and coral reefs host a disproportionately large share of global biodiversity and provide ecosystem functions and services used by millions of people. Yet, ongoing climate change is leading to an increase in frequency and magnitude of extreme climatic events in the tropics, which, in combination with other local human disturbances, is leading to unprecedented negative ecological consequences for tropical forests and coral reefs. Here, we provide an overview of how and where climate extremes are affecting the most biodiverse ecosystems on Earth and summarize how interactions between global, regional and local stressors are affecting tropical forest and coral reef systems through impacts on biodiversity and ecosystem resilience. We also discuss some key challenges and opportunities to promote mitigation and adaptation to a changing climate at local and global scales.
This article is part of the theme issue ‘Climate change and ecosystems: threats, opportunities and solutions'.
Pleistocene Arctic megafaunal ecological engineering as a natural climate solution?
Authors: Macias-Fauria Marc , Jepson Paul , Zimov Nikita , Malhi Yadvinder 
Published: January 2020

Natural climate solutions (NCS) in the Arctic hold the potential to be implemented at a scale able to substantially affect the global climate. The strong feedbacks between carbon-rich permafrost, climate and herbivory suggest an NCS consisting of reverting the current wet/moist moss and shrub-dominated tundra and the sparse forest–tundra ecotone to grassland through a guild of large herbivores. Grassland-dominated systems might delay permafrost thaw and reduce carbon emissions—especially in Yedoma regions, while increasing carbon capture through increased productivity and grass and forb deep root systems. Here we review the environmental context of megafaunal ecological engineering in the Arctic; explore the mechanisms through which it can help mitigate climate change; and estimate its potential—based on bison and horse, with the aim of evaluating the feasibility of generating an ecosystem shift that is economically viable in terms of carbon benefits and of sufficient scale to play a significant role in global climate change mitigation. Assuming a megafaunal-driven ecosystem shift we find support for a megafauna-based arctic NCS yielding substantial income in carbon markets. However, scaling up such projects to have a significant effect on the global climate is challenging given the large number of animals required over a short period of time. A first-cut business plan is presented based on practical information—costs and infrastructure—from Pleistocene Park (northeastern Yakutia, Russia). A 10 yr experimental phase incorporating three separate introductions of herds of approximately 1000 individuals each is costed at US$114 million, with potential returns of approximately 0.3–0.4% yr−1towards the end of the period, and greater than 1% yr−1after it. Institutional friction and the potential role of new technologies in the reintroductions are discussed.This article is part of the theme issue ‘Climate change and ecosystems: threats, opportunities and solutions'.