Specific diversity, structure and carbon stock of urban plant formations in southern Benin

The sustainable management of urban green spaces requires the monitoring of the structural parameters of theirs trees. This study, which was carried out in the cities of Abomey-Calavi, Allada and Cotonou in southern Benin, aimed to describe the dendrometric parameters and the rate of carbon stored by urban trees. The inventory of trees planted in two types of urban forests (greened public spaces and shade rows) was performed using the roving survey method at the level of each city. Then, presence and absence data of all trees, as well as diameter at breast height (DBH) >= 10 cm and height >= 2 m were measured. These data were analyzed using R 4.0.5 software. The calculated dendrometric parameters were subjected to variance tests to assess their significance. The different counts allowed us to identify 5128 individual trees. The density per hectare varied from 36.7 to 83.1 between cities and from 40.5 to 80.4 between types of green spaces. Basal area varied from 2.25 to 11.4 m²/ha within cities. In all three cities in the study, trees had an aggregative spatial distribution, but with low numbers of individuals per site. All of the trees studied have a carbon sequestration rate of 689 t/ha. It is therefore necessary to take precautions for the strengthening and preservation of urban trees and their diversity for a more sustainable urban ecological balance. Keywords: Benin, Biomass, Carbon storage, Tree structure, Urban forest

Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry

Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P\ua0 64 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P\ua0=\ua00.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P\ua075 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF 6445%

Distal Pancreatectomy for Body-pancreatic Ductal Adenocarcinoma: Is Splenectomy Necessary?

Purpose: The value of splenectomy during distal pancreatectomy (DP) for body-pancreatic ductal adenocarcinoma (B-PDAC) has not been evaluated. This study aimed to assess the impact of spleen preservation (SP+) on morbidity and oncological outcomes following DP for B-PDAC. Method: Single-center cohort study including patients who underwent DP with SP+ according to Warshaw’s technique and DP with splenectomy (SP-) for B-PDAC from 2008 to 2019. Exclusion criteria were: distance <5cm between tumor and spleen hilum and multi-organ resection. Primary endpoints were disease-free (DFS) and overall survival (OS). Secondary endpoints were 90-day morbi-mortality using comprehensive complication index (CCI) and ISGPS definitions. Results: 129 patients were enrolled including 59 (46%) SP+ and 70 (54%) with splenectomy (SP-). Median age and BMI were 68 years and 24 kg/m2. SP+ and SP- patients were comparable regarding preoperative variables including neoadjuvant treatment (overall=24%), and laparoscopic approach (overall=39%). There was no 90-day mortality. Hospital stay was shorter after SP+ (11 vs. 16 days; p<0.001). SP+ patients experienced a lower CCI (8.7 vs. 16.6; p=0.004) with lower rates of grade B/C POPF (14% vs. 29%; p= 0.039) and deep organ space abscess (5% vs. 19%; p=0.041). The rate of R0 margins was similar in SP+ and SP- patients (75% vs. 71%, respectively; p=0.840), as well as invaded/harvested node ratio (0.0% vs. 0.0%; p=0.246), and AJCC staging (p=0.200). After a median follow-up of 63 months (IC95%:52-96), 1- ,3- and 5-year DFS and OS were 77%, 50% and 43% and 91%, 63% and 47%, respectively. On multivariate analysis, after doubly-robust adjustments on preoperative data, SP+ was associated with a better DFS (HR=0.315 [IC95%: 0.146-0.678]; p=0.0032), and had no influence on OS (HR=0.664 [IC95%: 0.317-1.392]; p=0.2782). After doubly-robust adjustments on pathological data and perioperative treatment, SP+ had no negative impact on DFS (HR=0.58 [IC95%: 0.3-1.13]; p=0.111) or OS (HR=0.9 [IC95%: 0.47-1.71]; p=0.738). Conclusion: SP+ DP for B-PDAC is associated with less postoperative morbidity than splenectomy, without impairing oncological outcomes. This study provides a rational to evaluate SP+ DP as a potential new oncological standard in B-PDAC