Wild Red Deer Benefit the Conservation of European Semi-Natural Open Habitats

Traditional land use practices have shaped European landscapes for millennia. Agricultural intensification and declining popularity of pastoral farming in the past century have resulted in a tremendous loss of extensively used open landscapes and associated biodiversity. Today, conservation management needs to prevent secondary succession of many open habitats. Large or inaccessible target areas unsuitable for conventional conservation measures might benefit from grazing by wild herbivores, which do not require fencing nor regular welfare monitoring. In a military training area in Germany, we studied the quantitative and qualitative effects of wild red deer in two protected open habitat types (lowland hay meadows and European dry heaths) based on grazing exclusion experiments over three years. Using movable exclusion cages, we showed that the amount of biomass annually removed by red deer was similar to the forage removal in livestock-based conservation grazing systems. Mown grasslands were particularly attractive to red deer owing to enhanced productivity and forage quality, suggesting that red deer grazing activities can be influenced by mowing. In addition, we compared the vegetation development in grasslands and heathlands with and without red deer grazing using open and permanently fenced plots. Grassland plant diversity decreased in fenced plots. In both habitat types, different structural vegetation characteristics, e.g. increasing sward and litter height, indicated successional developments when red deer grazing was excluded. Our results substantiate that allowing red deer access to open landscapes could not only alleviate potential conflicts with forestry, but can also promote open vegetation structure and diversity, thus providing a valuable contribution to the conservation management of semi-natural habitats

Association of Perioperative Regional Analgesia with Postoperative Patient-Reported Pain Outcomes and Opioid Requirements: Comparing 22 Different Surgical Groups in 23,911 Patients from the QUIPS Registry

(1) Background: In many surgical procedures, regional analgesia (RA) techniques are associated with improved postoperative analgesia compared to systemic pain treatment. As continuous RA requires time and experienced staff, it would be helpful to identify settings in which continuous RA has the largest benefit. (2) Methods: On the basis of 23,911 data sets from 179 German and Austrian hospitals, we analyzed the association of perioperative RA with patient-reported pain intensity, functional impairment of movement, nausea and opioid use for different surgeries. Regression analyses adjusted for age, sex and preoperative pain were performed for each surgery and the following groups: patients receiving continuous RA (surgery and ward; RA++), RA for surgery only (RA+−) and patients receiving no RA (RA−−). (3) Results: Lower pain scores in the RA++ compared to the RA−− group were observed in 13 out of 22 surgeries. There was no surgery where pain scores for RA++ were higher than for RA−−. If maximal pain, function and side effects were combined, the largest benefit of continuous RA (RA++) was observed in laparoscopic colon and sigmoid surgery, ankle joint arthrodesis, revision (but not primary) surgery of hip replacement, open nephrectomy and shoulder surgery. The benefit of RA+− was lower than that of RA++. (4) Discussion: The additional benefit of RA for the mentioned surgeries is larger than in many other surgeries in clinical routine. The decision to use RA in a given surgery should be based on the expected pain intensity without RA and its additional benefits

Accuracy of standard clinical 3T prostate MRI for pelvic lymph node staging: Comparison to 68Ga-PSMA PET-CT

The aim was to assess the performance of prostate 3T MRI for pelvic lymph node (LN) staging in prostate cancer (PCa), in comparison to 68Gallium-prostate specific membrane antigen PET-CT (68Ga-PSMA PET-CT) as reference standard for LN detection. 130 patients with PCa underwent non-contrast-enhanced multiparametric prostate 3T MRI and 68Ga-PSMA-PET-CT within 180 days at our institution. Overall, 187 LN metastases (n = 43 patients) detected by 68Ga-PSMA-PET-CT were characterized by calculating maximum standardized uptake value (SUVmax), area, diameter and anatomical location including iliac, obturator, presacral and inguinal region. MRI achieved an overall sensitivity, specificity, positive and negative predictive value of 81.6% (CI 71.1-88.9%), 98.6% (CI 97.6-99.2%), 73.5% (CI 52.1-87.6%) and 99.5% (CI 98.8-99.8%), respectively. On a region-based analysis, detection rates differed non-significantly (ps > 0.12) in the anatomical regions. On a size-dependent analysis, detection of LN > 10 mm did not differ significantly (ps > 0.09) from LN ≤ 10 mm. In comparison to single T1 sequence evaluation, additional use of the T2 weighted sequences did not improve the overall performance significantly (p > 0.05). 3T prostate MRI represented an accurate tool for the detection of LN compared to 68Ga-PSMA-PET-CT. Especially for LN metastases smaller than 10 mm, MRI was less accurate compared to 68Ga-PSMA-PET-CT

Desire to Receive More Pain Treatment: A Relevant Patient-Reported Outcome Measure to Assess Quality of Post-Operative Pain Management? Results From 79,996 Patients Enrolled in the Pain Registry QUIPS from 2016 to 2019

Acute postoperative pain is frequently evaluated by pain intensity scores. However, interpretation of the results is difficult and thresholds requiring treatment are notwell defined. Additional patientreported outcome measures (PROMs) might be helpful to better understand individual pain experience and quality of pain management after surgery.We used data from the QUIPS pain registry for a cross-sectional study in order to investigate associations between the desire to receive more pain treatment (D2RMPT) with pain intensity ratings and other PROMs. Responses from 79,996 patientswere analyzed, of whom 10.7% reported D2RMPT. A generalized estimating equation Poisson model showed that women had a lower risk ratio (RR) to answer this question with “yes” (RR: .92, P < .001). Factors that increased the risk most were “maximal pain intensity ≥ 6/10 on a numerical rating scale” (RR: 2.48, P < .001) and “any pain interference” (RR: 2.48, P < .001). The largest reduction in risk was observed if patients were “allowed to participate in pain treatment decisions” (RR: .41, P < .001) and if they felt that they “received sufficient treatment information” (RR: .58, P < .001). Our results indicate that the (easily assessed) question D2RMPT gives additional information to other PROMs like pain intensity. The small proportion of patients with D2RMPT (even for high pain scores) opens the discussion about clinicians’ understanding of over- und under-treatment and questions the exclusive use of pain intensity as quality indicator. Future studies need to investigatewhether asking about D2RMPT in clinical routine can improve postoperative pain outcome. Perspective: This article presents characteristics of the patient-reported outcome measure “Desire to receive more pain treatment.” This measure could be used to apply pain treatment in a more individualized way and lead to improved treatment strategies and quality

Red Deer Browsing Decelerates Shrub Regrowth Despite Increasing Wolf Presence

Semi-natural open habitats in Europe have been shaped by traditional land use practices, such as extensive mowing or livestock grazing. However, socio-economic transformations have led to the abandonment of many grassland and heathland areas and conservation management is now required to maintain these biodiverse habitats. Grazing by wild red deer (Cervus elaphus) can be a convenient alternative to laborious mechanical management or livestock grazing. Yet it remains unclear if free-ranging ungulates can counteract shrub growth sufficiently to maintain open habitats—especially with natural predators, i.e. wolves (Canis lupus), recolonizing Europe. To assess red deer effects on shrub regrowth after clearance, we installed a cohort of open and fenced plots (17 pairs) in 2016, when wolf presence in our study area (Grafenwöhr military training area, DE) was negligible. When wolf presence had become frequent in 2020, we set up a second cohort (41 paired plots). For both cohorts, the vegetation in the shrub and herb layer was significantly higher in fenced than open plots already after one year. Shrub height increased continuously and dead herbaceous biomass accumulated under red deer exclusion. Consequently, wild red deer can slow down shrub succession in open habitats even under increasing predation pressure. Regardless of wolf presence, a wildlife management that enables red deer to forage in open landscapes could thus reduce the required frequency of conservation management interventions

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

The Quality of Postoperative Pain Therapy in German Hospitals.

BACKGROUND Many patients in German hospitals complain of inadequate treatment of their postoperative pain. Hospital-related structural and procedural variables may affect pain perception and patient satisfaction. We studied the association of individual variables with outcome quality. METHODS Data from the years 2011 to 2014 from the world's largest acute pain registry (QUIPS) were evaluated. The analysis was performed with mixed linear regression models. RESULTS We studied registry data from 138 German hospitals concerning four commonly performed types of operations (total number of operations, 21 114) and found that the intensity of pain, functional impairment, and satisfaction with postoperative pain therapy were all highly variable from one hospital to another. Patients in university hospitals complained more often than those in standard care facilities of highly intense pain (odds ratio [OR] 2.44; 95% con - fidence interval [CI] [1.18; 5.04]) and dissatisfaction (OR 3.58 [1.85; 6.93]). In specialized centers as well, pain intensity (OR 1.39 [1.06; 1.83]) and dissatisfaction (OR 1.59 [1.25; 2.02]) were higher. Pain-related limitation of movement was also reported more commonly in university hospitals (OR 2.12 [0.87; 5.16]) and specialized centers (OR 1.87 [1.33; 2.65]) than in standard care facilities. Less pain-related limitation of movement and higher satisfaction were reported in hospitals in which pain was documented in the patients' charts and the patients felt adequately informed about the treatment options. CONCLUSION The current state of postoperative pain therapy leaves much room for improvement. Quality indicators in the field of acute pain medicine might help improve patient care

Abstraction of Process Relevant Information from Geotechnical Standards and Regulations

The paper presents the abstraction of process relevant information in order to enable the workflow management based on semantic data. It is shown for three examples, how the standards define the information needed to perform a certain planning activity. Abstraction of process relevant information is discussed for different granularities of the underlying process-model. As one possible application ProMiSE is introduced, which uses process relevant data in individual tokens in a petri-net based process-model