Advances in arboreal mammal research techniques for tropical rainforest canopy exploration.

Techniques for mammal research in the rainforest canopy  presents a number of challenges; including difficulties accessing and maneuvering within the three-dimensional study area and thereby acquiring an adequate sample size. In addition, rainforest mammals are not evenly distributed in the canopy, resulting in stratification of species within the three dimensional environment (Grelle 2003), and all non-volant mammals are limited to the architecture of the forest.Las técnicas para la investigación de mamíferos en el dosel de la selva tropical presentan una serie de desafíos; incluyendo dificultades para acceder y maniobrar dentro del área de estudio tridimensional y, por lo tanto, adquirir un tamaño de muestra adecuado. Además, los mamíferos de la selva tropical no están distribuidos uniformemente en el dosel, lo que resulta en la estratificación de especies dentro del entorno tridimensional (Grelle 2003), y todos los mamíferos no volátiles están limitados a la arquitectura del bosque

Adipose tissue stromal vascular fraction in facial surgery

Fat grafting is the surgical technique of transplantation of adipose tissue to restore volume loss in patients due to oncological resections, congenital abnormalities, lipoatrophy, aging or trauma. Adipose tissue is harvested from the abdomen, inner knee or thigh by liposuction and can then be injected to an acceptor site such as the face. Adipose tissue does not only consist of adipocytes, but also consists of a heterogenous mesenchymal cell population called stromal vascular fraction cells that are embedded in the extracellular matrix. This tissue-like stromal vascular fraction (tSVF), which is embedded in its native extracellular matrix is researched because of its pro-regenerative properties. In vitro research has shown pro-angiogenic and immunomodulatory effects of SVF and therefore translation into various clinical applications is investigated at this moment. The aim of our research was to investigate the methods to obtain tSVF, the in vitro properties, and the clinical efficacy of tSVF in various clinical applications in facial surgery

Early mobilisation versus plaster immobilisation of simple elbow dislocations: Results of the FuncSiE multicentre randomised clinical trial

Background/aim To compare outcome of early mobilisation and plaster immobilisation in patients with a simple elbow dislocation. We hypothesised that early mobilisation would result in earlier functional recovery. Methods From August 2009 to September 2012, 100 adult patients with a simple elbow dislocation were enrolled in this multicentre randomised controlled trial. Patients were randomised to early mobilisation (n=48) or 3 weeks plaster immobilisation (n=52). Primary outcome measure was the Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score. Secondary outcomes were the Oxford Elbow Score, Mayo Elbow Performance Index, pain, range of motion, complications and activity resumption. Patients were followed for 1 year. Results Quick-DASH scores at 1 year were 4.0 (95% CI 0.9 to 7.1) points in the early mobilisation group versus 4.2 (95% CI 1.2 to 7.2) in the plaster immobilisation group. At 6 weeks, early mobilised patients reported less disability (Quick-DASH 12 (95% CI 9 to 15) points vs 19 (95% CI 16 to 22); p<0.05) and had a larger arc of flexion and extension (121° (95% CI 115° to 127°) vs 102° (95% CI 96° to 108°); p<0.05). Patients returned to work sooner after early mobilisation (10 vs 18 days; p=0.020). Complications occurred in 12 patients; this was unrelated to treatment. No recurrent dislocations occurred. Conclusions Early active mobilisation is a safe and effective treatment for simple elbow dislocations. Patients recovered faster and returned to work earlier without increasing the complication rate. No evidence was found supporting treatment benefit at 1 year

Deliverable 3.6 zoning plan of case studies : evaluation of spatial management options for the case studies

Within MESMA, nine case studies (CS) represent discrete marine European spatial entities, at different spatial scales, where a spatial marine management framework is in place, under development or considered. These CS (described in more details below) are chosen in such a way (MESMA D. 3.1 ) that they encompass the complexity of accommodating the various user functions of the marine landscape in various regions of the European marine waters. While human activities at sea are competing for space, there is also growing awareness of the possible negative effects of these human activities on the marine ecosystem. As such, system specific management options are required, satisfying current and future sectoral needs, while safeguarding the marine ecosystem from further detoriation. This integrated management approach is embedded in the concept of ecosystem based management (EBM). The goal of marine EBM is to maintain marine ecosystems in a healthy, productive and resilient condition, making it possible that they sustain human use and provide the goods and services required by society (McLeod et al. 2005). Therefore EBM is an environmental mangagement approach that recognises the interactions within a marine ecosystem, including humans. Hence, EBM does not consider single issues, species or ecosystems good and services in isolation. Operationalisation of EBM can be done through place-based or spatial management approaches (Lackey 1998), such as marine spatial planning (MSP). MSP is a public process of analysing and allocating the spatial and temporal distribution of human activities aiming at achieving ecological, economic and social objectives. These objectives are usually formulated through political processes (Douvere et al. 2007, Douvere 2008). Within MESMA, a spatially managed area (SMA) is then defined as “a geographical area within which marine spatial planning initiatives exist in the real world”. Marine spatial planning initiatives refer to existing management measures actually in place within a defined area, or in any stage of a process of putting management in place, e.g. plans or recommendations for a particular area. Management can include management for marine protection (e.g. in MPAs), or management for sectoral objectives (e.g. building a wind farm to meet renewable energy objectives). Within MESMA, SMAs can have different spatial scales. A SMA can be a small, specific area that is managed/planned to be managed for one specific purpose, but it can also be a larger area within which lots of plans or ‘usage zones’ exist. This definition is different from the definition mentioned in the DoW (page 60). The original definition was adapted during a CS leader workshop (2-4 May 2012 in Gent, Belgium) and formally accepted by the MESMA ExB during the ExB meeting in Cork (29-30 May 2012). MSP should result in a marine spatial management plan that will produce the desired future trough explicit decisions about the location and timing of human activities. Ehler & Douvere (2009) consider this spatial management as a beginning toward the the implementation of desired goals and objectives. They describe the spatial management plan as a comprehensive, strategic document that provides the framework and direction for marine spatial management decisions. The plan should identify when, where and how goals and objectives will be met. Zoning (the development of zoning plans) is often an important management measure to implement spatial management plans. The purpose of a zoning plan (Ehler & Douvere 2009) is: To provide protection for biologically and ecologically important habitats, ecosystems, and ecological processes. To seperate conflicting human activities, or to combine compatible activities. To protect the natural values of the marine management area (in MESMA terminology: the SMA) while allowing reasonable human uses of the area. To allocate areas for reasonable human uses while minimising the effects of these human uses on each other, and nature. To preserve some areas of the SMA in their natural state undisturbed by humans except for scientific and educational purposes.peer-reviewe

Klinische Symptome und intensivmedizinische Versorgung bei akuten Intoxikationen: Analyse einer Patientenstichprobe der internistischen Intensivtherapiestation der Universitätsmedizin Rostock aus den Jahren 2004 bis 2011 unter Verwendung des Poisoning Severity Scores und des Therapeutic Intervention Scoring Systems

Akute Intoxikationen machen ca. 7% der Fälle auf einer internistischen Intensivstation aus. Häufigste Auslöser sind Arzneimittelüberdosierungen und Alkoholintoxikationen. Der Poisoning Severity Score (PSS) ist ein geeignetes Werkzeug zur Charakterisierung von Intoxikationen im Bereich der Intensivmedizin. Nach dem PSS waren 33,1% der Fälle als leichte, 40,1% der Fälle als mittelschwere und 21,2% der Fälle als schwere Intoxikationen zu klassifizieren. Die Mortalität betrug 1%. Der Schweregrad korreliert mit dem anhand des TISS-28 quantifizierten intensivmedizinischen Therapieaufwand

Nationwide comprehensive gastro-intestinal cancer cohorts: the 3P initiative

Background: The increasing sub-classification of cancer patients due to more detailed molecular classification of tumors, and limitations of current trial designs, require innovative research designs. We present the design, governance and current standing of three comprehensive nationwide cohorts including pancreatic, esophageal/gastric, and colorectal cancer patients (NCT02070146). Multidisciplinary collection of clinical data, tumor tissue, blood samples, and patient-reported outcome (PRO) measures with a nationwide coverage, provides the infrastructure for future and novel trial designs and facilitates research to improve outcomes of gastrointestinal cancer patients. Material and methods: All patients aged ≥18 years with pancreatic, esophageal/gastric or colorectal cancer are eligible. Patients provide informed consent for: (1) reuse of clinical data; (2) biobanking of primary tumor tissue; (3) collection of blood samples; (4) to be informed about relevant newly identified genomic aberrations; (5) collection of longitudinal PROs; and (6) to receive information on new interventional studies and possible participation in cohort multiple randomized controlled trials (cmRCT) in the future. Results: In 2015, clinical data of 21,758 newly diagnosed patients were collected in the Netherlands Cancer Registry. Additional clinical data on the surgical procedures were registered in surgical audits for 13,845 patients. Within the first two years, tumor tissue and blood samples were obtained from 1507 patients; during this period, 1180 patients were included in the PRO registry. Response rate for PROs was 90%. The consent rate to receive information on new interventional studies and possible participation in cmRCTs in the future was >85%. The number of hospitals participating in the cohorts is steadily increasing. Conclusion: A comprehensive nationwide multidisciplinary gastrointestinal cancer cohort is feasible and surpasses the limitations of classical study designs. With this initiative, novel and innovative studies can be performed in an efficient, safe, and comprehensive setting

Efficacy of immediate patient feedback in emergency psychiatry:a randomized controlled trial in a crisis intervention &amp; brief therapy team

Background: This study looks at the effect of immediate session-by-session feedback using short questionnaires for evaluating outcome of and alliance in the therapy. Research data strongly suggests that using this feedback informed treatment improves the outcome of therapy. However, until now, this method of Miller and Duncan has only been examined in clients (generally students) with mild problems and in partner counselling. The question addressed by this study is whether immediate feedback is also effective when applied during crisis intervention and subsequent brief therapy in a psychiatric patient population in emergency situations. It also looks at whether 'feedback- informed treatment' affects the quality of the alliance. Method/Design: To test the hypotheses, all patients seeking help from the Crisis Intervention & Brief Therapy Team over a two-year period will be followed throughout their treatment up to a maximum of six months and a follow-up period of three months after ending the treatment. Patients are randomly assigned to two conditions: treatment without feedback and treatment with immediate feedback for each session. The therapists all operate in both conditions and so they deliver both treatments. An estimated total of 180 patients, aged 18 years and over, will be included in the study. Discussion: The aim of this study is to make clear whether, and to what extent, systematic feedback from the patient in this target group during therapy determines the course and outcomes of therapy. We also look at whether, and to what extent, the quality of the alliance and the motivation of the person delivering treatment with respect to the instruments play a role

A long term inventory of medium and large mammals with camera-traps in Las Tablas Protected Zone, Costa Rica.

Large mammals are a critical component of tropical ecosystems, especially for the tropics (Terborgh 1988, Cardillo et al. 2005). Nevertheless, is not until recently that with the emergence and widespread use of non-invasive techniques such as camera-traps, that we are getting a large amount ofinformation on medium and large-size mammal assemblages.Los mamíferos grandes son un componente crítico de los ecosistemas tropicales, especialmente para los trópicos (Terborgh 1988, Cardillo et al. 2005). Sin embargo, no es hasta hace poco que con la aparición y el uso generalizado de técnicas no invasivas como las trampas de cámara, estamos obteniendo una gran cantidad de información en ensamblajes de mamíferos de tamaño mediano y grande