Effect of Left Subclavian Artery Revascularisation in Thoracic Endovascular Aortic Repair: A Systematic Review and Meta-analysis.

OBJECTIVE/BACKGROUND: Thoracic endovascular aortic repair (TEVAR) is an emerging therapy for thoracic aortic pathologies. However, the role of left subclavian artery (LSA) revascularisation in patients with LSA coverage in TEVAR has not been established. A systematic review and meta-analysis was done to investigate the effect of LSA revascularisation in TEVAR when the LSA was covered. METHODS: PubMed, Embase, and the Cochrane Library were searched to find relevant randomised controlled trials (RCTs) and cohort studies. The Cochrane Risk of Bias Tool and Newcastle-Ottawa Scale was used to evaluate the methodological quality of RCTs and cohort studies respectively. Relative risks (RRs) with 95% confidence intervals (CIs) were calculated to express differences for dichotomous outcomes. Random effects models were used to combine outcomes for studies with I2 > 50%; otherwise, fixed effects models were used. Subgroup analyses and sensitivity analyses were performed to further validate the results. RESULTS: Sixteen cohort studies with a total of 2591 patients were included in this systematic review and meta-analysis. The average score of the included studies was 7.56. Of the included patients, the peri-operative stroke rate was 6.8% (n = 176/2591). The peri-operative stroke rates of the with and without LSA revascularisation groups were 5.4% and 7.8%, respectively. Compared with no LSA revascularisation, patients with LSA revascularisation had a significantly lower peri-operative stroke rate (RR 0.61; 95% CI 0.45-0.82; I2 = 20%) and peri-operative spinal cord ischaemia (SCI) rate (RR 0.59; 95% CI 0.39-0.90; I2 = 0). No significant difference was found between the with and without LSA revascularisation groups with respect to peri-operative mortality (RR 0.86; 95% CI 0.60-1.21; I2 = 35%) and peri-operative paraplegia (RR 0.81; 95% CI 0.45-1.44; I2 = 17%). CONCLUSION: The results of this review reveal that LSA revascularisation was associated with significantly lower peri-operative stroke and SCI rates. LSA revascularisation should be recommended for patients with LSA coverage in TEVAR. High quality RCTs are needed to further validate the conclusion.

Ants contribute significantly to the pollination of a biodiesel plant, Jatropha curcas.

Ants are the most abundant visitors to the flowers of Jatropha curcas L., but it is not clear how much they contribute to the pollination of this plant. In this study, we observed floral visitor assemblage and foraging behavior of ants, measured pollen loads carried by ants and deposited on stigmas, and determined the contribution of ants to the female reproductive success of J. curcas through exclusion experiments. Ants were the most abundant pollinators, accounting for 71.03 and 78.17% of total visits at two study sites. Among different ant species, Tapinoma melanocephalum (F.) is always the most abundant and the only common ant species at two study sites, which might suggest its important role in the pollination of J. curcas. Pollen loads carried by ants were significantly different among different species at two study sites. Pollen loads carried by ants increased with increased body length. Although the flowers exposed only to the ants produced less fruit than those exposed only to the winged visitors, ants alone resulted in almost 60% fruit set. Thus, ants could play a major role in the pollination of J. curcas if winged insects are absent.

Contribution of diurnal and nocturnal insects to the pollination of Jatropha curcas (Euphorbiaceae) in southwestern China.

Jatropha curcas L. (Euphorbiaceae) is being increasingly planted worldwide, but questions remain regarding its pollination biology. This study examined the contribution of diurnal and nocturnal insects to the pollination of monoecious J. curcas, through its floral biology, pollination ecology, and foraging behavior of potential pollinators. Nectar production of both male and female flowers peaked in the morning, declined in the afternoon, and rapidly bottomed during the night in all of their anthesis days. The diurnal visitors to the flowers of J. curcas are bees and flies, and the nocturnal visitors are moths. Flowers received significantly more visits by diurnal insects than by nocturnal insects. Through bagging flowers during night or day or both or exclusion, we compared fruit and seed production caused by diurnal and nocturnal pollinators. Both nocturnal and diurnal visitors were successful pollinators. However, flowers exposed only to nocturnal visitors produced less fruits than those exposed only to diurnal visitors. Thus, diurnal pollinators contribute more to seed production by J. curcas at the study site.