Forest growth in Europe shows diverging large regional trends.

Forests cover about one-third of Europe's surface and their growth is essential for climate protection through carbon sequestration and many other economic, environmental, and sociocultural ecosystem services. However, reports on how climate change affects forest growth are contradictory, even for same regions. We used 415 unique long-term experiments including 642 plots across Europe covering seven tree species and surveys from 1878 to 2016, and showed that on average forest growth strongly accelerated since the earliest surveys. Based on a subset of 189 plots in Scots pine (the most widespread tree species in Europe) and high-resolution climate data, we identified clear large-regional differences; growth is strongly increasing in Northern Europe and decreasing in the Southwest. A less pronounced increase, which is probably not mainly driven by climate, prevails on large areas of Western, Central and Eastern Europe. The identified regional growth trends suggest adaptive management on regional level for achieving climate-smart forests.

Thermal aerial culling for the control of vertebrate pest populations.

Helicopter-based shooting is an effective management tool for large vertebrate pest animals. However, animals in low-density populations and/or dense habitat can be difficult to locate visually. Thermal-imaging technology can increase detections in these conditions. We used thermal-imaging equipment with a specific helicopter crew configuration to assist in aerial culling for feral pigs (Sus scrofa) and fallow deer (Dama dama) in South Australia in 2021. Seventy-two percent of pigs and 53% of deer were first detected in dense canopy/tall forest habitat. Median time from the first impact shot to incapacitation was < 12 s. The culling rate (animals hour-1) doubled compared to visual shoots over the same populations and the wounding rate was zero resulting in a incapacitation efficiency of 100%. The crew configuration gave the shooter a wide field of view and the thermal operator behind the shooter provided essential support to find new and escaping animals, and to confirm species identification and successful removal. The crew configuration allowed for successful target acquisition and tracking, with reduced target escape. The approach can increase the efficiency of aerial culling, has the potential to increase the success of programs where eradication is a viable option, and can improve animal welfare outcomes by reducing wounding rates and the escape of target animals.

Does A History of Malignancy Lead to Worse Outcomes in a Single-center Burn Unit?

A history of malignancy is associated with worse outcomes in cardiac disease and trauma. Our objective was to determine if a past medical history or comorbid condition of cancer portends an increased morbidity or mortality in burns or skin-sloughing disorders at our institution. Patients were identified using our Institutional Burn Center registry and linked to the clinical and administrative data. All patients admitted between January 1, 2014 and June 30, 2021 were eligible for inclusion. Demographics, length of stay, comorbid conditions and mortality were evaluated. Statistical analysis was performed with Kruskal-Wallis, chi-square, and Fisher's exact tests. Seven thousand three hundred seventy-two patients were admitted during this time period. Three hundred eighty-six patients had a history of cancer (5%). Patients with a history of cancer were older (56 vs 44 years, P < .0001). They had a significantly longer length of stay (16 vs 10 days, P < .0001). They also had larger burns and higher hospital costs ($147,021 versus $83,788, P < .0001), were more likely to be male and more likely to have a skin-sloughing disorder. A history of cancer was not associated with increased odds of burn mortality. Thus, a history of cancer is associated with increased lengths of stay and costs in patients admitted for burn injury or skin-sloughing disorders, but not associated with increased mortality. Further study is warranted to investigate and mitigate what aspects of their care could be adjusted to improve outcomes.

Driving performance and turning reaction time following hip arthroscopy for FAIS: does capsular repair matter?

PURPOSE: (1) To compare the pre- and postoperative driving performance in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS); (2) to examine the differences in driving performance between patients with versus without capsular repair. METHODS: Patients who underwent arthroscopic hip surgery for FAIS were included. Driving performance of participating patients was collected using a driving simulator preoperatively and at 2 weeks, 4-6 weeks and 8-12 weeks postoperatively. Data collected included demographics, surgery laterality, intraoperative procedures, left and right turn reaction time, total turn reaction time, gas off time (GOF), and break reaction time (BRT). Repeated measures analysis of variance (ANOVA) was used for statistical analysis. RESULTS: 21 subjects (9 males, 12 females) with a mean age of 30 ± 9 years were included and 57.1% of the subjects had right-sided surgery. There was no difference between the mean preoperative and the 2-week postoperative left (0.72 seconds and 0.75 seconds, respectively) right (0.77 seconds and 0.75 seconds, respectively), and total (0.74 seconds and 0.75 seconds, respectively) turn reaction times as well as GOF (0.62 seconds and 0.60 seconds, respectively) and BRT (0.92 seconds and 0.93 seconds, respectively), indicating that the patients' driving performance returned to the preoperative level as early as 2 weeks following hip arthroscopy for FAIS. There was no significant difference amongst any of the driving variables between patients who underwent capsular repair (50%) and those who did not. There was no significant difference amongst any of the driving variable s between patients who underwent left versus right hip arthroscopy. CONCLUSIONS: Patients' driving performance returns to the preoperative level as early as 2 weeks after hip arthroscopy for FAIS. Surgery laterality nor capsular repair make any significant difference in the time for driving abilities to return to baseline. The impact of intraoperative procedures performed, and the analgesic medications used postoperatively on the driving ability of patients undergoing hip arthroscopy warrants further investigation in larger patient populations.

The Cost of Mental Health Comorbid Conditions in Burn Patients: A Single-site Experience.

Many burn survivors suffer from psychiatric sequelae long after their physical injuries have healed. This may even be more pronounced in individuals who have a history of mental health disorders prior to admission. The aim of this study was to explore the clinical outcomes of patients with previously diagnosed mental health disorders who were admitted to our Burn Center. This was a single-site, retrospective review using our institutional Burn Center registry. All adult patients (18 years or older) admitted to our Burn Center between January 1, 2014 and June 30, 2021 with burn injury or inhalation injury were included in this study. Variables of interest included demographics and burn mechanism. Outcomes of interests were length of stay, cost of hospitalization, and mortality. A P-value of < .05 was considered statistically significant for all analyses. There were 4958 patients included in this study, with 35% of these patients having a previous diagnosis of mental health disorders. Patients with mental health disorders were younger, with larger burns, P < .05. They had significantly longer lengths of stay and significantly higher costs (P < .00001). Mortality for those with a mental health disorder history was 2% and 3% for those without (P = .04). Patients with pre-existing mental health disorders had decreased odds of mortality. However, they do have extended lengths of stay, which may exhaust current sparse staff and burn bed resources.

Outcomes of COPD Patients with Flame Burn and Inhalation Injuries at a Single Institution.

The presence of any comorbid condition may lead to worse outcomes after burn injury. Chronic obstructive pulmonary disease (COPD) is a condition with significant morbidity and mortality. In 2018, about 16 million adults in the United States reported a diagnosis of COPD based on data from the American Lung Association. The objective of this study was to explore the outcomes of patients with COPD admitted to our Burn Center with flame burns and/or inhalation injury. Patients were identified using our Institutional Burn Center registry and linked to the clinical and administrative data. All adult flame-injured and/or inhalation injury-only patients admitted to our burn center between July 1, 2011 and June 30, 2020 were included. Demographics, length of stay, burn, and patient characteristics and outcomes, including mortality, were evaluated. Four thousand three hundred ninety-seven patients were included in the study. Patients were divided into two populations, those with COPD (n = 515) and those without a diagnosis of COPD (n = 3882). Patients with COPD were older, more likely to be white and male, and had smaller sized burns, p < .001. Patients with COPD were more likely to be smokers and have comorbid conditions. There was no statistically significant difference between the incidence of inhalation injury, lengths of stay, or number of ventilator days. Burn size and inhalation injury increased mortality risk regardless of COPD severity, as did age among those not on home oxygen. More studies are needed to determine the genomic or proteomic changes in patients with COPD that lead to worse outcomes after flame injury, and/or inhalation injury alone.

Improved Cervical Lymph Node Characterization among Patients with Head and Neck Squamous Cell Carcinoma Using MR Texture Analysis Compared to Traditional FDG-PET/MR Features Alone.

Accurate differentiation of benign and malignant cervical lymph nodes is important for prognosis and treatment planning in patients with head and neck squamous cell carcinoma. We evaluated the diagnostic performance of magnetic resonance image (MRI) texture analysis and traditional 18F-deoxyglucose positron emission tomography (FDG-PET) features. This retrospective study included 21 patients with head and neck squamous cell carcinoma. We used texture analysis of MRI and FDG-PET features to evaluate 109 histologically confirmed cervical lymph nodes (41 metastatic, 68 benign). Predictive models were evaluated using area under the curve (AUC). Significant differences were observed between benign and malignant cervical lymph nodes for 36 of 41 texture features (p < 0.05). A combination of 22 MRI texture features discriminated benign and malignant nodal disease with AUC, sensitivity, and specificity of 0.952, 92.7%, and 86.7%, which was comparable to maximum short-axis diameter, lymph node morphology, and maximum standard uptake value (SUVmax). The addition of MRI texture features to traditional FDG-PET features differentiated these groups with the greatest AUC, sensitivity, and specificity (0.989, 97.5%, and 94.1%). The addition of the MRI texture feature to lymph node morphology improved nodal assessment specificity from 70.6% to 88.2% among FDG-PET indeterminate lymph nodes. Texture features are useful for differentiating benign and malignant cervical lymph nodes in patients with head and neck squamous cell carcinoma. Lymph node morphology and SUVmax remain accurate tools. Specificity is improved by the addition of MRI texture features among FDG-PET indeterminate lymph nodes. This approach is useful for differentiating benign and malignant cervical lymph nodes.

Extensive Nonsegmental Pulmonary Perfusion Defects on SPECT/CT as an Early Sign of COVID-19 Infection.

We describe a hospitalized patient with confirmed coronavirus disease 2019 in whom the initial chest computed tomography (CT) was negative, while subsequent perfusion single-photon emission computed tomography/computed tomography imaging revealed extensive nonsegmental perfusion defects in addition to newly developing parenchymal densities. Possible reasons for these findings and their relationship to the multisystem severe acute respiratory syndrome coronavirus 2 infection are discussed in this article.

"Low Dose MR" Dixon Technique for Imaging FDG PET-MR Lymphoma.

Introduction Hybrid PET-MR is a relatively new imaging modality with its major strength being the MR component offering superior soft tissue contrast. While PET/MRI offers the inherent advantage of reduced radiation dose, it has been shown to result in a markedly prolonged examination time becoming a challenge in children and sick patients. "Low dose MRI" is a term used in the nuclear medicine community to describe fast acquired PET-MR scan protocols that rely heavily on PET images for diagnosis. In this study, we sought to determine if the Dixon sequences obtained for attenuation correction could be used as a diagnostic sequence for interpreting PET-MRI lymphoma cases, potentially reducing scan time. Materials and Methods We retrospectively identified 40 patients who underwent 88 FDG PET-MR body imaging studies for staging or restaging lymphoma. A radiologist and nuclear medicine physician initially reviewed top of the head to mid thigh PET images, attenuation correction coronal Dixon MRI sequences, and PET-MR fusion with Dixon sequence. The same physicians reviewed the PET images, multi-sequence MR including the attenuation correction Dixon, and multi-sequence PET-MR fusion images The lesions were further characterized based on their imaging characteristics, size, SUVmax, and malignant potency. A consensus read followed. Results All patients were adults with an average study age of 43.8 years. Our study consisted of 40 females and 48 males out of which 7 were for staging and 81 were for re-staging. All patients had systemic lymphoma. Thirty-seven of the studies had active lymph nodes on Dixon PET-MR that agreed with multi-sequence PET-MR which identified 33 positive cases (89.1%) having an average SUV 10.2 ± 7.74 SD. Four Dixon PET-MR cases did not detect lesions, with an average SUV 2.3 ± 0.55 SD, which was read as minimal residual activity. Multi-sequence MR identified 11 patients with enlarged lymph nodes without FDG uptake, which were not seen on Dixon MR. All 5 studies with bones lesions were detected by Dixon PET-MR as well as 2 soft tissue organ lesions. Multi-sequence MR identified 1 patient with non-active, healed bone lesion. Fifty-five of these studies were true negatives. Compared to multi-sequence PET-MR, Dixon PET-MR demonstrated 89.2% sensitivity, 100% specificity with no false positive studies. Conclusion The present study investigated the diagnostic potential of a fast protocol for integrated PET/MRI used for dedicated tumor staging of patients with lymphoma. In this retrospective study, Dixon PET-MR was shown to be sensitive and specific compared to multi-sequence PET-MR in the detection of lymphoma. The low number of these cases not detected had minimally active lymph nodes that resolved on subsequent imaging and probably were not clinically important.

Comment on "Bayesian additional evidence for decision making under small sample uncertainty".

We examine the concept of Bayesian Additional Evidence (BAE) recently proposed by Sondhi et al. We derive simple closed-form expressions for BAE and compare its properties with other methods for assessing findings in the light of new evidence. We find that while BAE is easy to apply, it lacks both a compelling rationale and clarity of use needed for reliable decision-making.

Reverse-Bayes methods for evidence assessment and research synthesis.

It is now widely accepted that the standard inferential toolkit used by the scientific research community-null-hypothesis significance testing (NHST)-is not fit for purpose. Yet despite the threat posed to the scientific enterprise, there is no agreement concerning alternative approaches for evidence assessment. This lack of consensus reflects long-standing issues concerning Bayesian methods, the principal alternative to NHST. We report on recent work that builds on an approach to inference put forward over 70 years ago to address the well-known "Problem of Priors" in Bayesian analysis, by reversing the conventional prior-likelihood-posterior ("forward") use of Bayes' theorem. Such Reverse-Bayes analysis allows priors to be deduced from the likelihood by requiring that the posterior achieve a specified level of credibility. We summarise the technical underpinning of this approach, and show how it opens up new approaches to common inferential challenges, such as assessing the credibility of scientific findings, setting them in appropriate context, estimating the probability of successful replications, and extracting more insight from NHST while reducing the risk of misinterpretation. We argue that Reverse-Bayes methods have a key role to play in making Bayesian methods more accessible and attractive for evidence assessment and research synthesis. As a running example we consider a recently published meta-analysis from several randomised controlled trials (RCTs) investigating the association between corticosteroids and mortality in hospitalised patients with COVID-19.

Bioeconomy and green recovery in a post-COVID-19 era.

The spread of the COVID-19 pandemic has generated a health crisis and repetitive lockdowns that disrupted different economic and societal segments. As the world has placed hope on the vaccination progress to bring back the socio-economic "normal," this article explores how the bioeconomy can enhance the resilience and sustainability of bio-based, food, and energy systems in the post-COVID-19 era. The proposed recovery approach integrates technological innovations, environment, ecosystem services, "biocities," food, rural economies, and tourism. The importance of integrating culture, arts, and the fashion industry as part of the recovery is underlined towards building a better bioeconomy that, together with environmental safeguards, promotes socio-cultural and economic innovations. This integration could be achieved supporting communities and stakeholders to diversify their activities by combining sustainable production with decarbonization, stimulating private investments in this direction and monitoring the resulting impact of mitigation measures. Food systems should become more resilient in order to allow adapting rapidly to severe crises and future shocks, while it is important to increase circularity towards the valorization of waste, the integration of different processes within the biorefinery concept and the production of bio-based products and biofuels.

Fluorodeoxyglucose positron-emission tomography-magnetic resonance hybrid imaging: An emerging tool for staging of cancer of the uterine cervix.

Positron-emission tomography-magnetic resonance imaging (PET-MRI) is an emerging hybrid imaging modality that utilizes the superior soft tissue resolution of MR with the metabolic data from PET. In this study, we sought to assess the clinical value of fluorodeoxyglucose (FDG) PET-MRI with dedicated pelvic PET-MR in the initial staging of cervical cancer. In this institutional-approved study, we identified 23 adult females who underwent FDG PET-MRI on hybrid camera for staging of primary uterine cervical cancer that included a dedicated PET-MR of the pelvis. A nuclear medicine physician and a radiologist reviewed the PET, MRI, and fusion-body and pelvis images alone and then with consensus read characterizing PET and MR abnormal findings. There were 23 patients who underwent FDG PET-MRI for initial staging of cervical cancer with an average age of 52.2 ± 14.0 years. A total of 23 suspected lymph nodes in eight different patients were detected within the pelvis with increased metabolic activity on PET. Both the dedicated pelvis and whole-body PET imaging detected the same corresponding pelvic lymph nodes, although the pelvic PET imaging had better lymph node uptake delineation due to longer acquisition time. Using a 10-mm short-axis criterion, MRI identified only 43.5% of the FDG avid lymph nodes. The average SUVmax on the pelvis PET sequences was higher with SUV 8.9 ± 5.2 compared to the whole-body PET with SUV 7.8 ± 5.4 but was not statistically significant (P > 0.05). Primary cervical cancer was identified in 18 patients on both PET imaging and MRI with dedicated MR pelvis providing better characterization. Based on our results of the patients with cervical cancer evaluated for initial staging, combining dedicated pelvic PET-MRI with whole-body PET/MR provides the most complete status of malignant disease in reference to delineation of primary tumor, involvement of surrounding tissues, and regional lymph nodes.

Hot stuff in the bushes: Thermal imagers and the detection of burrows in vegetated sites.

Thermal imaging technology is a developing field in wildlife management. Most thermal imaging work in wildlife science has been limited to larger ungulates and surface-dwelling mammals. Little work has been undertaken on the use of thermal imagers to detect fossorial animals and/or their burrows. Survey methods such as white-light spotlighting can fail to detect the presence of burrows (and therefore the animals within), particularly in areas where vegetation obscures burrows. Thermal imagers offer an opportunity to detect the radiant heat from these burrows, and therefore the presence of the animal, particularly in vegetated areas. Thermal imaging technology has become increasingly available through the provision of smaller, more cost-effective units. Their integration with drone technology provides opportunities for researchers and land managers to utilize this technology in their research/management practices.We investigated the ability of both consumer (AUD$65,000) mounted on drones to detect rabbit burrows (warrens) and entrances in the landscape as compared to visual assessment.Thermal imagery and visual inspection detected active rabbit warrens when vegetation was scarce. The presence of vegetation was a significant factor in detecting entrances (p < .001, α = 0.05). The consumer imager did not detect as many warren entrances as either the professional imager or visual inspection (p = .009, α = 0.05). Active warren entrances obscured by vegetation could not be accurately identified on exported imagery from the consumer imager and several false-positive detections occurred when reviewing this footage.We suggest that the exportable frame rate (Hz) was the key factor in image quality and subsequent false-positive detections. This feature should be considered when selecting imagers and suggest that a minimum export rate of 30 Hz is required. Thermal imagers are a useful additional tool to aid in identification of entrances for active warrens and professional imagers detected more warrens and entrances than either consumer imagers or visual inspection.