Predicting species dominance shifts across elevation gradients in mountain forests in Greece under a warmer and drier climate

The Mediterranean Basin is expected to face warmer and drier conditions in the future, following projected increases in temperature and declines in precipitation. The aim of this study is to explore how forests dominated by Abies borisii-regis, Abies cephalonica, Fagus sylvatica, Pinus nigra and Quercus frainetto will respond under such conditions. We combined an individual-based model (GREFOS), with a novel tree ring data set in order to constrain tree diameter growth and to account for inter- and intraspecific growth variability. We used wood density data to infer tree longevity, taking into account inter- and intraspecific variability. The model was applied at three 500-m-wide elevation gradients at Taygetos in Peloponnese, at Agrafa on Southern Pindos and at Valia Kalda on Northern Pindos in Greece. Simulations adequately represented species distribution and abundance across the elevation gradients under current climate. We subsequently used the model to estimate species and functional trait shifts under warmer and drier future conditions based on the IPCC A1B scenario. In all three sites, a retreat of less drought-tolerant species and an upward shift of more drought-tolerant species were simulated. These shifts were also associated with changes in two key functional traits, in particular maximum radial growth rate and wood density. Drought-tolerant species presented an increase in their average maximal growth and decrease in their average wood density, in contrast to less drought-tolerant species

Skin Ulcer: A Long-Term Complication After Massive Liquid Silicone Oil Infiltration

Despite scientific literature replete with stories of disastrous results and disfigurement, illicit subcutaneous injections of highly viscous fluids in massive quantities still are performed, often by unqualified persons. The authors present a devastating long-term outcome from a massive volume of silicone oil injected subcutaneously into the buttocks of a 48-year-old transsexual patient and its ulceration treated only through regular medications. The therapeutic protocol consisted of wound disinfection with iodopovidone, washing with saline solution, disinfection with sodium hypochlorite 0.05 %, and application of ointment containing Vibrio alginolyticus collagenase and hyaluronan. The follow-up evaluation was at 1 and 2 weeks and then at 1, 2, and 3 months. Weekly photographs were taken, and measurements of the lesion and evolution were estimated every 7 days. After 3 months of regular medications, the authors succeeded in closing the ulcer, avoiding invasive therapeutic options. In the presence of the cutaneous ulceration above a massively infiltrated area, if the removal of all the injected oil is surgically definitely impossible, other conservative procedures should be considered. Our experience demonstrated how it is possible to manage a so prickly a case with a noninvasive approach such as periodic medications. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266