TRY plant trait database – enhanced coverage and open access

Plant traits—the morphological, anatomical, physiological, biochemical and phenological characteristics of plants—determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait‐based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits—almost complete coverage for ‘plant growth form’. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait–environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives

Early-TIPS improves survival in high-risk variceal bleeders. Results of a multicenter variceal bleeding observational study

Background: Despite gold standard therapy, about 20% of patients with acute variceal bleeding (AVB) die during the first 6 weeks. Early-TIPS (placed within 72 hours from admission) has been shown to improve survival in patients with AVB and high risk of treatment failure (defined as Child C-Pugh score up to 13 (CP-C) or Child B plus active bleeding at endoscopy (CPB-AB)). However, studies evaluating its benefit included a relatively small number of patients. In addition, how much CPB-AB are really high-risk has been questioned. The present study aimed to evaluate the role of early TIPS in a large number of CP-C and CPB-AB patients with AVB admitted to referral centers worldwide. Methods: Multicenter, international, observational study including 2168 patients from 34 centers between April 2013 and April 2015. Patient\u2019s data were recorded and centralized on ReDCap (Research Electronic Data Capture) and centralized by the study-coordinating center. Patients were managed according to current guidelines. Placement of early-TIPS was based on individual center policy. Patients were followed up to 1 year, death or liver transplantation. Multiple excellence control procedures were used to optimize data quality. Additionally, data were regularly monitored by a data validation committee for detection of inconsistencies or errors followed by queries to local investigators requiring resolution; and further validated all reported outcomes. Results: 671/2168 patients (30.9%) were high-risk and had no exclusion criteria (HCC beyond Milan, age >75, creatinine 653mg/dl, PVT or Child>13); 434 (65%) CP-C <14 points and 237 (35%) CPB-AB. 589 patients were treated with pharmacological + endoscopic therapy (Drug+Endo) and 82 with Early-TIPS. There were no major differences among groups. The 6-week and 1-year actuarial probabilities of remaining free of rebleeding were significantly higher in the Early-TIPS than in the Drug+Endo group (93% vs 81%, and 87% vs 68%; P=0.002). The benefit of early-TIPS was observed in CPB-AB and CPC. Survival was also Higher in the early-TIPS group (6w-survival: 87% vs 77%; 1-y: 70% vs 62%; P=0.08). However, a survival benefit was only observed in CP-C (6w: 85% vs 69%; 1y: 66% vs 53%; P=0.034), not in the CPB-AB group. These results were confirmed using models adjusted for baseline covariates as well as propensity score. Conclusions: The present study confirms in a large group of high-risk patients that the use of early-TIPS reduces rebleeding risk. Early-TIPS also improves survival in Child C patients

Association Between Portosystemic Shunts and Increased Complications and Mortality in Patients With Cirrhosis

Background &amp; Aims: Spontaneous portosystemic shunts (SPSS) have been associated with hepatic encephalopathy (HE). Little is known about their prevalence among patients with cirrhosis or clinical effects. We investigated the prevalence and characteristics of SPSS in patients with cirrhosis and their outcomes. Methods: We performed a retrospective study of 1729 patients with cirrhosis who underwent abdominal computed tomography or magnetic resonance imaging analysis from 2010 through 2015 at 14 centers in Canada and Europe. We collected data on demographic features, etiology of liver disease, comorbidities, complications, treatments, laboratory and clinical parameters, Model for End-Stage Liver Disease (MELD) score, and endoscopy findings. Abdominal images were reviewed by a radiologist (or a hepatologist trained by a radiologist) and searched for the presence of SPSS, defined as spontaneous communications between the portal venous system or splanchnic veins and the systemic venous system, excluding gastroesophageal varices. Patients were assigned to groups with large SPSS (L-SPSS, 658 mm), small SPSS (S-SPSS, &lt;8 mm), or without SPSS (W-SPSS). The main outcomes were the incidence of complications of cirrhosis and mortality according to the presence of SPSS. Secondary measurements were the prevalence of SPSS in patients with cirrhosis and their radiologic features. Results: L-SPSS were identified in 488 (28%) patients, S-SPSS in 548 (32%) patients, and no shunt (W-SPSS) in 693 (40%) patients. The most common L-SPSS was splenorenal (46% of L-SPSS). The presence and size of SPSS increased with liver dysfunction: among patients with MELD scores of 6\u20139, 14% had L-SPSS and 28% had S-SPSS; among patients with MELD scores of 10\u201313, 30% had L-SPSS and 34% had S-SPSS; among patients with MELD scores of 14 or higher, 40% had L-SPSS and 32% had S-SPSS (P &lt;.001 for multiple comparison among MELD groups). HE was reported in 48% of patients with L-SPSS, 34% of patients with S-SPSS, and 20% of patients W-SPSS (P &lt;.001 for multiple comparison among SPSS groups). Recurrent or persistent HE was reported in 52% of patients with L-SPSS, 44% of patients with S-SPSS, and 37% of patients W-SPSS (P =.007 for multiple comparison among SPSS groups). Patients with SPSS also had a larger number of portal hypertension-related complications (bleeding or ascites) than those W-SPSS. Quality of life and transplantation-free survival were lower in patients with SPSS vs without. SPSS were an independent factor associated with death or liver transplantation (hazard ratio, 1.26; 95% confidence interval, 1.06\u20131.49) (P =.008) in multivariate analysis. When patients were stratified by MELD score, SPSS were associated with HE independently of liver function: among patients with MELD scores of 6\u20139, HE was reported in 23% with L-SPSS, 12% with S-SPSS, and 5% with W-SPSS (P &lt;.001 for multiple comparison among SPSS groups); among those with MELD scores of 10\u201313, HE was reported in 48% with L-SPSS, 33% with S-SPSS, and 23% with W-SPSS (P &lt;.001 for multiple comparison among SPSS groups); among patients with MELD scores of 14 or more, HE was reported in 59% with L-SPSS, 57% with S-SPSS, and 48% with W-SPSS (P =.043 for multiple comparison among SPSS groups). Patients with SPSS and MELD scores of 6\u20139 were at higher risk for ascites (40.5% vs 23%; P &lt;.001) and bleeding (15% vs 9%; P =.038) than patients W-SPSS and had lower odds of transplant-free survival (hazard ratio 1.71; 95% confidence interval, 1.16\u20132.51) (P =.006). Conclusions: In a retrospective analysis of almost 2000 patients, we found 60% to have SPSS; prevalence increases with deterioration of liver function. SPSS increase risk for HE and with a chronic course. In patients with preserved liver function, SPSS increase risk for complications and death. ClinicalTrials.gov ID NCT02692430

TRY plant trait database, enhanced coverage and open access

Plant traits-the morphological, ahawnatomical, physiological, biochemical and phenological characteristics of plants-determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait-based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits-almost complete coverage for 'plant growth form'. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait-environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives