Climate Change Effects on Avian Migration

Siirretty Doriast

Benign biliary strictures treated with biodegradable stents in patients with surgically altered anatomy using double balloon enteroscopy

Objectives Surgically altered anatomy complicates endoscopical procedures of pancreatobiliary tree. Biliary or hepaticojejunal anastomosis strictures have been managed using percutaneous transhepatic or double balloon enteroscopy (DBE) techniques with multiple plastic stents, or fully covered self-expandable metal stents. We report the first seven cases with surgically altered anatomy treated with biodegradable stents with DBE. Materials and methods Seven cases with altered anatomy, all with Roux-en-Y hepaticojejunostomy (HJ), were treated for HJ anastomosis strictures (3 cases) and intrahepatic biliary stricture (4 cases). Fujifilm DB enteroscope with a 200 cm long and 3.2 mm wide working channel was used. Balloon dilatations were first performed and then 1-3 biodegradable stents were deployed with a pusher over a guidewire. Results Two patients had HJ due to liver resections, one due to biliary injury in cholecystectomy and four due to liver transplantation because of primary sclerosing cholangitis (PSC). Median duration of the procedures was 56 min. Deployment of the stents took less than 20 min per patient. There were no stent or cholangiography related adverse events, but one patient required endotracheal intubation for nose bleeding caused by the placement of nasopharyngeal tube. Two PSC patients had recurrent cholangitis in the follow up. There was one stent migration in 90 day follow up. With all the HJ anastomotic strictures resolution of strictures seemed to be achieved. Conclusions Treatment of biliary or anastomosis strictures in altered anatomy is complex and time consuming. The biodegradable stent, which can be passed through working channel of a long enteroscope, seems promising in the treatment of these strictures. The benefit is that no stent removal is needed.Peer reviewe

Diclofenac does not reduce the risk of acute pancreatitis in patients with primary sclerosing cholangitis after endoscopic retrograde cholangiography

Background The European Society of Gastrointestinal Endoscopy recommends rectal indomethacin or diclofenac before endoscopic retrograde cholangiopancreatography (ERCP) to prevent post-ERCP pancreatitis. However, data on the prophylactic effect in patients with primary sclerosing cholangitis (PSC) are lacking. Methods This was a retrospective case-control study. In 2009-2018, a total of 2000 ERCPs were performed in 931 patients with PSC. Case procedures (N = 1000 after November 2013) were performed after administration of rectal diclofenac. Control procedures (N = 1000 before November 2013) were performed with the same indication but without diclofenac. Acute post-ERCP pancreatitis and other ERCP-related adverse events (AEs) were evaluated. Results Post-ERCP pancreatitis developed in 49 (4.9%) procedures in the diclofenac group and 62 (6.2%) procedures in the control group (p = 0.241). No difference existed between the groups in terms of the severity of pancreatitis or any other acute AEs. The risk of pancreatitis was elevated in patients with native papilla: 11.4% in the diclofenac group and 8.7% in the control group (p = 0.294). In adjusted logistic regression, diclofenac did not reduce the risk of pancreatitis (odds ratio (OR) = 1.074, 95% confidence interval 0.708-1.629, p = 0.737). However, in generalised estimation equations with the advanced model, diclofenac seemed to diminish the risk of pancreatitis (OR = 0.503) but not significantly (p = 0.110). Conclusion In this large patient cohort in a low-risk unit, diclofenac does not seem to reduce the risk of post-ERCP pancreatitis in patients with PSC. The trend in the pancreatitis rate after ERCP is decreasing. The evaluation of the benefits of diclofenac among PSC patients warrants a randomised controlled study targeted to high-risk patients and procedures.Peer reviewe

Occupational radiation dose from gastrointestinal endoscopy procedures with special emphasis on eye lens doses in endoscopic retrograde cholangiopancreatography

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Risk in the circular food economy: Glyphosate-based herbicide residues in manure fertilizers decrease crop yield

Glyphosate-based herbicides (GBHs) are the most frequently used herbicides globally. They were launched as a safe solution for weed control, but recently, an increasing number of studies have shown the existence of GBH residues and highlighted the associated risks they pose throughout ecosystems. Conventional agricultural practices often include the use of GBHs, and the use of glyphosate-resistant genetically modified crops is largely based on the application of glyphosate, which increases the likelihood of its residues ending up in animal feed. These residues persist throughout the digestive process of production animals and accumulate in their excretion products. The poultry industry, in particular, is rapidly growing, and excreted products are used as plant fertilizers in line with circular food economy practices. We studied the potential effects of unintentional glyphosate contamination on an agronomically important forage grass, meadow fescue (Festuca pratensis) and a horticulturally important strawberry (Fragaria x vescana) using glyphosate residues containing poultry manure as a plant fertilizer in a common garden experiment. Glyphosate in the manure decreased plant growth in both species and vegetative reproduction in F. x vescana. Furthermore, our results indicate that glyphosate residues in organic fertilizers might have indirect effects on sexual reproduction in F. pratensis and herbivory in F. x vescana because they positively correlate with plant size. Our results highlight that glyphosate can be unintentionally spread via organic fertilizer, counteracting its ability to promote plant growth.</p

Hyvä yliopisto-opettajuus – kysymyksiä ja vastauksia yliopistopedagogisen koulutusvuoden varrelta

Hyvä yliopisto-opettajuus – kysymyksiä ja vastauksia yliopistopedagogisen koulutusvuoden varrelta on julkaisu, joka kuvaa Aalto-yliopiston yliopistopedagogiselle kurssille vuonna 2014 osallistuneiden pedagogisen osaamisen kehittymistä. Oppimisprosessi oli vuoden mittainen ja perustui yhteisölliseen ja tutkivaan oppimiseen. Näin heterogeenisestä osallistujaryhmästä kehittyi yhdessä toimiva oppimis- ja tutkimusryhmä. He kiinnostuivat oman ja työyhteisönsä reflektiivisestä opetuksen kehittämisestä. Julkaisussa Opettaja kehittäjänä –kurssin osallistujat kuvaavat ja avaavat ilmiötä hyvä yliopisto-opettajuus monelta eri näkökulmalta. Kurssin ohjaajat jäsentävät kurssin toteutusta ja arvioivat sen onnistumista pohtien miten tämän tyyppinen kurssi, jonka sisältöjä ei ole ennalta suunniteltu pystyy vastaamaan osallistujien erilaisiin odotuksiin ja osaamistarpeisiin. Julkaisu tarjoaa näkökulmia opetusosaamisen ja opetuksen kehittämiseen. Teos sopii kaikille yliopisto-opetuksesta ja sen kehittämisestä kiinnostuneille. Part of the publication is in English (pages 76-175, title "Integrating transferable skills into teaching at Aalto University"

Globally, functional traits are weak predictors of juvenile tree growth, and we do not know why

1. Plant functional traits, in particular specific leaf area (SLA), wood density and seed mass, are often good predictors of individual tree growth rates within communities. Individuals and species with high SLA, low wood density and small seeds tend to have faster growth rates. 2. If community-level relationships between traits and growth have general predictive value, then similar relationships should also be observed in analyses that integrate across taxa, biogeographic regions and environments. Such global consistency would imply that traits could serve as valuable proxies for the complex suite of factors that determine growth rate, and, therefore, could underpin a new generation of robust dynamic vegetation models. Alternatively, growth rates may depend more strongly on the local environment or growth–trait relationships may vary along environmental gradients. 3. We tested these alternative hypotheses using data on 27 352 juvenile trees, representing 278 species from 27 sites on all forested continents, and extensive functional trait data, 38% of which were obtained at the same sites at which growth was assessed. Data on potential evapotranspiration (PET), which summarizes the joint ecological effects of temperature and precipitation, were obtained from a global data base. 4. We estimated size-standardized relative height growth rates (SGR) for all species, then related them to functional traits and PET using mixed-effect models for the fastest growing species and for all species together. 5. Both the mean and 95th percentile SGR were more strongly associated with functional traits than with PET. PET was unrelated to SGR at the global scale. SGR increased with increasing SLA and decreased with increasing wood density and seed mass, but these traits explained only 3.1% of the variation in SGR. SGR–trait relationships were consistently weak across families and biogeographic zones, and over a range of tree statures. Thus, the most widely studied functional traits in plant ecology were poor predictors of tree growth over large scales. 6. Synthesis. We conclude that these functional traits alone may be unsuitable for predicting growth of trees over broad scales. Determining the functional traits that predict vital rates under specific environmental conditions may generate more insight than a monolithic global relationship can offer

Species and abundance of ectoparasitic flies (Diptera) in pied flycatcher nests in Fennoscandia

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