Pluvials, droughts, the Mongol Empire, and modern Mongolia

Although many studies have associated the demise of complex societies with deteriorating climate, few have investigated the connection between an ameliorating environment, surplus resources, energy, and the rise of empires. The 13th-century Mongol Empire was the largest contiguous land empire in world history. Although drought has been proposed as one factor that spurred these conquests, no high-resolution moisture data are available during the rapid development of the Mongol Empire. Here we present a 1,112-y tree-ring reconstruction of warm-season water balance derived from Siberian pine (Pinus sibirica) trees in central Mongolia. Our reconstruction accounts for 56% of the variability in the regional water balance and is significantly correlated with steppe productivity across central Mongolia. In combination with a gridded temperature reconstruction, our results indicate that the regional climate during the conquests of Chinggis Khan’s (Genghis Khan’s) 13th-century Mongol Empire was warm and persistently wet. This period, characterized by 15 consecutive years of above-average moisture in central Mongolia and coinciding with the rise of Chinggis Khan, is unprecedented over the last 1,112 y. We propose that these climate conditions promoted high grassland productivity and favored the formation of Mongol political and military power. Tree-ring and meteorological data also suggest that the early 21st-century drought in central Mongolia was the hottest drought in the last 1,112 y, consistent with projections of warming over Inner Asia. Future warming may overwhelm increases in precipitation leading to similar heat droughts, with potentially severe consequences for modern Mongolia

Prevention and treatment of infectious complications after urogenital prosthesis surgery

Prostheses are widely used in urogenital surgery for many decades and have gained a fundamental role in the management of multiple diseases with good results in terms of functionality, aesthetic outcomes and patients\u2019 satisfaction. It is remarkable that prosthetic device vary in term of mechanical sophistication, costs and surgical implantation techniques ranging from simple device widely used in urological practice like testicular prosthesis to highly sophisticated devices as Inflatable Penile Prosthesis (IPP) and Artificial Urinary Sphincter (AUS). Despite continuous implementations of the devices and improvements of surgical implantation techniques infective complications are still fearful and not uncommon events. Risk of infection depends on patients\u2019 individual features, perioperative strategies, implantation techniques and prosthetic devices. Prevent these complications is imperative because the management of prosthesis infection requires removal of the device in most cases. Centres that plan prosthetic implantations should based on these strategies protocols in order to prevent as far as possible infective complications

Integrating Herbivore Population Dynamics Into a Global Land Biosphere Model: Plugging Animals Into the Earth System

Mammalian herbivores are an essential component of grassland and savanna ecosystems, and with feedbacks to the climate system. To date, the response and feedbacks of mammalian herbivores to changes in both abiotic and biotic factors are poorly quantified and not adequately represented in the current global land surface modeling framework. In this study, we coupled herbivore population dynamics in a global land model (the Dynamic Land Ecosystem Model, DLEM 3.0) to simulate populations of horses, cattle, sheep, and goats, and their responses to changes in multiple environmental factors at the site level across different continents during 1980–2010. Simulated results show that the model is capable of reproducing observed herbivore population dynamics across all sites for these animal groups. Our simulation results also indicate that during this period, climate extremes led to a maximum mortality of 27% of the total herbivores in Mongolia. Across all sites, herbivores reduced aboveground net primary productivity (ANPP) and heterotrophic respiration (Rh) by 14% and 15%, respectively (p \u3c 0.05). With adequate parameterization, the model can be used for historical assessment and future prediction of mammalian herbivore populations and their relevant impacts on biogeochemical cycles. Our simulation results demonstrate a strong coupling between primary producers and consumers, indicating that inclusion of herbivores into the global land modeling framework is essential to better understand the potentially large effect of herbivores on carbon cycles in grassland and savanna ecosystems

The Eldgjá eruption: timing, long-range impacts and influence on the Christianisation of Iceland.

The Eldgjá lava flood is considered Iceland's largest volcanic eruption of the Common Era. While it is well established that it occurred after the Settlement of Iceland (circa 874 CE), the date of this great event has remained uncertain. This has hampered investigation of the eruption's impacts, if any, on climate and society. Here, we use high-temporal resolution glaciochemical records from Greenland to show that the eruption began in spring 939 CE and continued, at least episodically, until at least autumn 940 CE. Contemporary chronicles identify the spread of a remarkable haze in 939 CE, and tree ring-based reconstructions reveal pronounced northern hemisphere summer cooling in 940 CE, consistent with the eruption's high yield of sulphur to the atmosphere. Consecutive severe winters and privations may also be associated with climatic effects of the volcanic aerosol veil. Iceland's formal conversion to Christianity dates to 999/1000 CE, within two generations or so of the Eldgjá eruption. The end of the pagan pantheon is foretold in Iceland's renowned medieval poem, Vǫluspá ('the prophecy of the seeress'). Several lines of the poem describe dramatic eruptive activity and attendant meteorological effects in an allusion to the fiery terminus of the pagan gods. We suggest that they draw on first-hand experiences of the Eldgjá eruption and that this retrospection of harrowing volcanic events in the poem was intentional, with the purpose of stimulating Iceland's Christianisation over the latter half of the tenth century

Intraoperative ultrasound in robot-assisted partial nephrectomy: State of the art

Introduction: Nephron-sparing surgery (NSS) is of one of the most studied fields in urology due to the balancing between renal function preservation and oncological safety of the procedure. Aim of this short review is to report the state of the art of intra-operative ultrasound as an operative tool to improve localization of small renal masses partially or completely endophytic during robotassisted partial nephrectomy (RAPN). Material and methods: We performed a literature review by electronic database on Pubmed about the use of intra-operative US in RAPN to evaluate the usefulness and the feasibility of this procedure. Results: Several studies analyzed the use of different US probes during RAPN. Among them some focused on using contrastenhanced ultra sonography (CEUS) for improving the dynamic evaluation of microvascular structure allowing the reduction of ischemia time (IT). We reported that nowaday the use of intraoperative US during RAPN could be helpful to improve the preservation of renal tissue without compromising oncological safety. Moreover, during RAPN there is no need for assistant to hand the US probe increasing surgeon autonomy. Conclusions: The use of a robotic ultrasound probe during partial nephrectomy allows the surgeon to optimize tumor identification with maximal autonomy, and to benefit from the precision and articulation of the robotic instrument during this key step of the partial nephrectomy procedure. Moreover US could be useful to reduce ischemia time (IT). The advantages of nephron-sparing surgery over radical nephrectomy is well established with a pool of data providing strong evidence of oncological and survival equivalency. With the progressive growth of robot-assisted partial nephrectomy (RAPN) techniques, the use of several tools has been progressively developed to help the surgeon in the identification of masses and its vascular net. In this short review we tried to analyze the current use of intra-operative ultrasound as an operative tool to improve localization of small renal masses partially or completely endophytic during RAPN

Variability in genes regulating vitamin D metabolism is associated with vitamin D levels in type 2 diabetes

Mortality rate is increased in type 2 diabetes (T2D). Low vitamin D levels are associated with increased mortality risk in T2D. In the general population, genetic variants affecting vitamin D metabolism (DHCR7 rs12785878, CYP2R1 rs10741657, GC rs4588) have been associated with serum vitamin D. We studied the association of these variants with serum vitamin D in 2163 patients with T2D from the "Sapienza University Mortality and Morbidity Event Rate (SUMMER) study in diabetes". Measurements of serum vitamin D were centralised. Genotypes were obtained by Eco™ Real-Time PCR. Data were adjusted for gender, age, BMI, HbA1c, T2D therapy and sampling season. DHCR7 rs12785878 (p = 1 x 10-4) and GC rs4588 (p = 1 x 10-6) but not CYP2R1 rs10741657 (p = 0.31) were significantly associated with vitamin D levels. One unit of a weighted genotype risk score (GRS) was strongly associated with vitamin D levels (p = 1.1 x 10-11) and insufficiency (<30 ng/ml) (OR, 95%CI = 1.28, 1.16-1.41, p = 1.1 x 10-7). In conclusion, DHCR7 rs12785878 and GC rs4588, but not CYP2R1 rs10741657, are significantly associated with vitamin D levels. When the 3 variants were considered together as GRS, a strong association with vitamin D levels and vitamin D insufficiency was observed, thus providing robust evidence that genes involved in vitamin D metabolism modulate serum vitamin D in T2D

Changes in renal function after nephroureterectomy for upper urinary tract carcinoma: analysis of a large multicenter cohort (Radical Nephroureterectomy Outcomes (RaNeO) Research Consortium)

Purpose To investigate prevalence and predictors of renal function variation in a multicenter cohort treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). Methods Patients from 17 tertiary centers were included. Renal function variation was evaluated at postoperative day (POD)-1, 6 and 12 months. Timepoints differences were Delta 1 = POD-1 eGFR - baseline eGFR; Delta 2 = 6 months eGFR - POD-1 eGFR; Delta 3 = 12 months eGFR - 6 months eGFR. We defined POD-1 acute kidney injury (AKI) as an increase in serum creatinine by >= 0.3 mg/dl or a 1.5 1.9-fold from baseline. Additionally, a cutoff of 60 ml/min in eGFR was considered to define renal function decline at 6 and 12 months. Logistic regression (LR) and linear mixed (LM) models were used to evaluate the association between clinical factors and eGFR decline and their interaction with follow-up. Results A total of 576 were included, of these 409(71.0%) and 403(70.0%) had an eGFR < 60 ml/min at 6 and 12 months, respectively, and 239(41.5%) developed POD-1 AKI. In multivariable LR analysis, age (Odds Ratio, OR 1.05, p < 0.001), male gender (OR 0.44, p = 0.003), POD-1 AKI (OR 2.88, p < 0.001) and preoperative eGFR < 60 ml/min (OR 7.58, p < 0.001) were predictors of renal function decline at 6 months. Age (OR 1.06, p < 0.001), coronary artery disease (OR 2.68, p = 0.007), POD-1 AKI (OR 1.83, p = 0.02), and preoperative eGFR < 60 ml/min (OR 7.80, p < 0.001) were predictors of renal function decline at 12 months. In LM models, age (p = 0.019), hydronephrosis (p < 0.001), POD-1 AKI (p < 0.001) and pT-stage (p = 0.001) influenced renal function variation (ss 9.2 +/- 0.7, p < 0.001) during follow-up. Conclusion Age, preoperative eGFR and POD-1 AKI are independent predictors of 6 and 12 months renal function decline after RNU for UTUC

Fucans, but Not Fucomannoglucuronans, Determine the Biological Activities of Sulfated Polysaccharides from Laminaria saccharina Brown Seaweed

Sulfated polysaccharides from Laminaria saccharina (new name: Saccharina latissima) brown seaweed show promising activity for the treatment of inflammation, thrombosis, and cancer; yet the molecular mechanisms underlying these properties remain poorly understood. The aim of this work was to characterize, using in vitro and in vivo strategies, the anti-inflammatory, anti-coagulant, anti-angiogenic, and anti-tumor activities of two main sulfated polysaccharide fractions obtained from L. saccharina: a) L.s.-1.0 fraction mainly consisting of O-sulfated mannoglucuronofucans and b) L.s.-1.25 fraction mainly composed of sulfated fucans. Both fractions inhibited leukocyte recruitment in a model of inflammation in rats, although L.s.-1.25 appeared to be more active than L.s.-1.0. Also, these fractions inhibited neutrophil adhesion to platelets under flow. Only fraction L.s.-1.25, but not L.s.-1.0, displayed anticoagulant activity as measured by the activated partial thromboplastin time. Investigation of these fractions in angiogenesis settings revealed that only L.s.-1.25 strongly inhibited fetal bovine serum (FBS) induced in vitro tubulogenesis. This effect correlated with a reduction in plasminogen activator inhibitor-1 (PAI-1) levels in L.s.-1.25-treated endothelial cells. Furthermore, only parent sulfated polysaccharides from L. saccharina (L.s.-P) and its fraction L.s.-1.25 were powerful inhibitors of basic fibroblast growth factor (bFGF) induced pathways. Consistently, the L.s.-1.25 fraction as well as L.s.-P successfully interfered with fibroblast binding to human bFGF. The incorporation of L.s.-P or L.s.-1.25, but not L.s.-1.0 into Matrigel plugs containing melanoma cells induced a significant reduction in hemoglobin content as well in the frequency of tumor-associated blood vessels. Moreover, i.p. administrations of L.s.-1.25, as well as L.s.-P, but not L.s.-1.0, resulted in a significant reduction of tumor growth when inoculated into syngeneic mice. Finally, L.s.-1.25 markedly inhibited breast cancer cell adhesion to human platelet-coated surfaces. Thus, sulfated fucans are mainly responsible for the anti-inflammatory, anticoagulant, antiangiogenic, and antitumor activities of sulfated polysaccharides from L. saccharina brown seaweed