Homeostatic Response to Three Years of Experimental Warming Suggests High Intrinsic Natural Resistance in the Páramos to Warming in the Short Term

Páramos, tropical alpine ecosystems, host one of the world s most diverse alpine floras, account for the largest water reservoirs in the Andes, and some of the largest soil carbon pools worldwide. It is of global importance to understand the future of this extremely carbon-rich ecosystem in a warmer world and its role on global climate feedbacks. This study presents the result of the first in situ warming experiment in two Colombian páramos using Open-Top Chambers. We evaluated the response to warming of several ecosystem carbon balance-related processes, including decomposition, soil respiration, photosynthesis, plant productivity, and vegetation structure after 3 years of warming. We found that OTCs are an efficient warming method in the páramo, increasing mean air temperature by 1.7°C and mean daytime temperature by 3.4°C. The maximum air temperature differences between OTC and control was 23.1°C. Soil temperature increased only by 0.1°C. After 3 years of warming using 20 OTC (10 per páramo) in a randomized block design, we found no evidence that warming increased CO2 emissions from soil respiration, nor did it increase decomposition rate, photosynthesis or productivity in the two páramos studied. However, total C and N in the soil and vegetation structure are slowly changing as result of warming and changes are site dependent. In Sumapaz, shrubs, and graminoids cover increased in response to warming while in Matarredonda we observed an increase in lichen cover. Whether this change in vegetation might influence the carbon sequestration potential of the páramo needs to be further evaluated. Our results suggest that páramos ecosystems can resist an increase in temperature with no significant alteration of ecosystem carbon balance related processes in the short term. However, the long-term effect of warming could depend on the vegetation changes and how these changes alter the microbial soil composition and soil processes. The differential response among páramos suggest that the response to warming could be highly dependent on the initial conditions and therefore we urgently need more warming experiments in páramos to understand how specific site characteristics will affect their response to warming and their role in global climate feedbacks. © Copyright © 2021 Lasso, Matheus-Arbeláez, Gallery, Garzón-López, Cruz, Leon-Garcia, Aragón, Ayarza-Páez and Curiel Yuste.Special thanks to David Campos, Fabian Salgado, Luis Fernando Rojas, Ewen Dano, Jorge Acosta, Juliana Portilla, and Michelle Guevara that helped with field and lab work. We would like to thank the Sabogal family for allowing the establishment of the OTC and collection of samples in the p?ramo ?Parque Ecol?gico Matarredonda? and to the Lieutenant Colonel Edgar Riveira, Commander of the High Mountain Battalion No. 1 in Sumapaz and all the commanders that follow him and who provided us with accommodation and food in the battalion as well as logistic support in all our field campaigns. Thanks to all the soldiers who always enthusiastically helped us in the field work in Sumapaz. This research was also supported by the Basque Government through the BERC 2018?2021 program, and by the Spanish Ministry of Science, Innovation and Universities through the BC3 Mar?a de Maeztu excellence accreditation (MDM-2017-0714). Funding. Funding for this research comes from the ?Patrimonio Aut?nomo Fondo Nacional de Financiamiento para la Ciencia, la Tecnolog?a y la Innovaci?n Francisco Jos? de Caldas?Colciencias,? grant number 120471451294, granted by Colciencias (today?s Colombian Ministry of Science, Technology and Innovation), from Eloisa Lasso?s FAPA (Fondo de Apoyo para Profesores Asistentes) grant number P12.160422.001 from the Universidad de los Andes, and from the Research Fund to support faculty programs at the Faculty of Sciences at the Universidad de los Andes grant number INV-2019-84-1805

The value of the continuous genotyping of multi-drug resistant tuberculosis over 20 years in Spain

Molecular epidemiology of circulating clinical isolates is crucial to improve prevention strategies. The Spanish Working Group on multidrug resistant tuberculosis (MDR-TB) is a network that monitors the MDR-TB isolates in Spain since 1998. The aim of this study was to present the study of the MDR-TB and extensively drug-resistant tuberculosis (XDR-TB) patterns in Spain using the different recommended genotyping methods over time by a national coordinated system. Based on the proposed genotyping methods in the European Union until 2018, the preservation of one method, MIRU-VNTR, applied to selected clustered strains permitted to maintain our study open for 20 years. The distribution of demographic, clinical and epidemiological characteristics of clustered and non-clustered cases of MDR/XDR tuberculosis with proportion differences as assessed by Pearson’s chi-squared or Fisher’s exact test was compared. The differences in the quantitative variables using the Student's-t test and the Mann–Whitney U test were evaluated. The results obtained showed a total of 48.4% of the cases grouped in 77 clusters. Younger age groups, having a known TB case contact (10.2% vs 4.7%) and XDR-TB (16.5% vs 1.8%) were significantly associated with clustering. The largest cluster corresponded to a Mycobacterium bovis strain mainly spread during the nineties. A total of 68.4% of the clusters detected were distributed among the different Spanish regions and six clusters involving 104 cases were grouped in 17 and 18 years. Comparison of the genotypes obtained with those European genotypes included in The European Surveillance System (TESSy) showed that 87 cases had become part of 20 European clusters. The continuity of MDR strain genotyping in time has offered a widespread picture of the situation that allows better management of this public health problem. It also shows the advantage of maintaining one genotyping method over time, which allowed the comparison between ancient, present and future samples

International eDelphi Study to Reach Consensus on the Methotrexate Dosing Regimen in Patients With Psoriasis

Abstract Importance: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide. Objective: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics. Design, setting, and participants: Between September 2020 and March 2021, a survey study with a modified eDelphi procedure that was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants worldwide (55 [30.6%] resided in non-Western countries) was conducted in 3 rounds. The proposals on which no consensus was reached were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 neither agree nor disagree, 7-9 agree) and were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (97 [53.9%]) and were experienced in treating patients with psoriasis with methotrexate (163 [91.6%] had more than 10 years of experience). Main outcomes and measures: In a survey with eDelphi procedure, we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree. Results: Of 251 participants, 180 (71.7%) completed all 3 survey rounds, and 58 participants (23.1%) joined the conference meeting. Consensus was achieved on 11 proposals in round 1, 3 proposals in round 2, and 2 proposals in round 3. In the consensus meeting, consensus was achieved on 4 proposals. More research is needed, especially for the proposals on folic acid and the dosing of methotrexate for treating subpopulations such as children and vulnerable patients. Conclusions and relevance: In this eDelphi consensus study, consensus was reached on 20 of 21 proposals involving methotrexate dosing in patients with psoriasis. This consensus may potentially be used to harmonize the treatment with methotrexate in patients with psoriasis