Extensive global wetland loss over the past three centuries.

Wetlands have long been drained for human use, thereby strongly affecting greenhouse gas fluxes, flood control, nutrient cycling and biodiversity1,2. Nevertheless, the global extent of natural wetland loss remains remarkably uncertain3. Here, we reconstruct the spatial distribution and timing of wetland loss through conversion to seven human land uses between 1700 and 2020, by combining national and subnational records of drainage and conversion with land-use maps and simulated wetland extents. We estimate that 3.4 million km2 (confidence interval 2.9-3.8) of inland wetlands have been lost since 1700, primarily for conversion to croplands. This net loss of 21% (confidence interval 16-23%) of global wetland area is lower than that suggested previously by extrapolations of data disproportionately from high-loss regions. Wetland loss has been concentrated in Europe, the United States and China, and rapidly expanded during the mid-twentieth century. Our reconstruction elucidates the timing and land-use drivers of global wetland losses, providing an improved historical baseline to guide assessment of wetland loss impact on Earth system processes, conservation planning to protect remaining wetlands and prioritization of sites for wetland restoration4.

A synopsis of global frontiers in fertility preservation.

Since 2007, the Oncofertility Consortium Annual Conference has brought together a diverse network of individuals from a wide range of backgrounds and professional levels to disseminate emerging basic and clinical research findings in fertility preservation. This network also developed enduring educational materials to accelerate the pace and quality of field-wide scientific communication. Between 2007 and 2019, the Oncofertility Consortium Annual Conference was held as an in-person event in Chicago, IL. The conference attracted approximately 250 attendees each year representing 20 countries around the world. In 2020, however, the COVID-19 pandemic disrupted this paradigm and precluded an in-person meeting. Nevertheless, there remained an undeniable demand for the oncofertility community to convene. To maintain the momentum of the field, the Oncofertility Consortium hosted a day-long virtual meeting on March 5, 2021, with the theme of "Oncofertility Around the Globe" to highlight the diversity of clinical care and translational research that is ongoing around the world in this discipline. This virtual meeting was hosted using the vFairs ® conference platform and allowed over 700 people to participate, many of whom were first-time conference attendees. The agenda featured concurrent sessions from presenters in six continents which provided attendees a complete overview of the field and furthered our mission to create a global community of oncofertility practice. This paper provides a synopsis of talks delivered at this event and highlights the new advances and frontiers in the fields of oncofertility and fertility preservation around the globe from clinical practice and patient-centered efforts to translational research.

Exploring the Multiple Meanings of Adaptive Management: A Case Study of the Lachlan Catchment in the Murray-Darling Basin.

Managing rivers and sharing their benefits is largely dependent on stakeholder values and knowledge, expressed through policy, governance and institutions. Adaptive management is essentially a social learning process, which can provide a tool to navigate the 'wickedness' of contemporary social-ecological challenges. This research applied an interpretive, qualitative approach to examine government intentions for adaptive management, as expressed in water policy documents, and practitioner experiences of learning through adaptive management in a case study of water management in the Lachlan catchment, Murray-Darling Basin, Australia. Data were created from content analysis of government water policy documents and interviews with key water managing and policy stakeholders. Interview participants attached divergent meanings to the concept of adaptive management. Five different 'styles' of adaptive management were found to coexist in the Lachlan catchment, which were associated with different levels of learning. While some learning was ad hoc, there was also promising evidence of more active adaptive management of environmental flows, which was resulting in higher-level learning. The findings highlight a disconnect between how adaptive management is understood in the academic literature, by practitioners, and how it is portrayed in Australian water policy, which is restricting opportunities for higher-level learning. Transformative learning was found to occur in response to crisis, rather than being linked to an intentional learning process.

Solvatochromism in perylene diimides; experiment and theory.

We report an experimental and computational investigation into the solvatochromism of a perylene diimide derivative. The alkyl swallowtail substituents allowed solubility in many solvents of widely differing polarity, with a complicated resultant behaviour, illustrating both negative and positive solvatochromism as a function of dielectric constant. Luminescence quantum yield and optical absorption linewidth displayed an inverse correlation, indicating varying degrees of intermolecular aggregation, and a remarkably similar trend was found between the peak absorption wavelength and the solvent boiling point, illustrating the dependency of aggregation on the solvent interactions. These outline trends may be parameterised by an empirically derived dimensionless quantity, as a tool to be used in more sophisticated future models of solvatochromism in small molecule chromophores.

Global CO2 emissions from dry inland waters share common drivers across ecosystems.

Many inland waters exhibit complete or partial desiccation, or have vanished due to global change, exposing sediments to the atmosphere. Yet, data on carbon dioxide (CO2) emissions from these sediments are too scarce to upscale emissions for global estimates or to understand their fundamental drivers. Here, we present the results of a global survey covering 196 dry inland waters across diverse ecosystem types and climate zones. We show that their CO2 emissions share fundamental drivers and constitute a substantial fraction of the carbon cycled by inland waters. CO2 emissions were consistent across ecosystem types and climate zones, with local characteristics explaining much of the variability. Accounting for such emissions increases global estimates of carbon emissions from inland waters by 6% (~0.12 Pg C y-1). Our results indicate that emissions from dry inland waters represent a significant and likely increasing component of the inland waters carbon cycle.

Extramural vascular invasion is an adverse prognostic indicator of survival in patients with colorectal cancer.

BACKGROUND/AIMS: Extramural vascular invasion (EVI) in colorectal cancer is reported to be a stage-independent adverse prognostic factor, and is a core item in the Royal College of Pathologists minimum data set for colorectal cancer histopathology reporting. The detection of EVI is also highly variable amongst pathologists. Our aims were to analyse both the frequency of EVI in colorectal cancer resections, and the effect of EVI on survival, in patients operated on over a 5-year period. METHOD: A retrospective analysis of patients having potentially curative surgery for colorectal cancer between January 1999 and December 2004. RESULTS: Over 5 years, 378 patients underwent a potentially curative resection. One-hundred seven (28.3%) cancers exhibited EVI, of which 104 (97%) were T3 and T4 tumours. Survival curves with and without EVI, unadjusted for nodal status and T stage, were significantly different (P = 0.0001) with 5-year survivals of 52% and 73% respectively. Survival curves for T3 and T4 tumours stratified with and without EVI also showed significantly different survival distributions (P = 0.007). A significant difference in frequency of EVI year on year was seen (P < 0.001), ranging from 8.5% to 46.7%, whereas the number of T3 and T4 tumours in each year was not significantly different (P = 0.677). CONCLUSIONS: EVI is an adverse prognostic indicator for survival in patients undergoing potentially curative resection of colorectal cancer, and the routine requirement of EVI in colorectal cancer histopathology reporting is justified. Optimal specimen preparation, meticulous histopathological analysis and regular auditing of EVI detection rates are essential for the accurate staging of colorectal cancer.

Interactions of native and non-native lady beetle species (Coleoptera: Coccinellidae) with aphid-tending ants in laboratory arenas.

Interactions between lady beetles and the European fire ant (Myrmica rubra L.) tending potato aphids [Macrosiphum euphorbiae (Thomas)] were compared in the laboratory. Lady beetle species native to North America (Coccinella trifasciata perplexa Mulsant, Coleomegilla maculata lengi Timberlake, Hippodamia convergens Guérin-Méneville) and non-native species of Palearctic origin [Coccinella septempunctata L., Harmonia axyridis (Pallas), Hippodamia variegata (Goeze), Propylea quatuordecimpunctata L.)] were evaluated. Harmonia axyridis consumed a significantly greater number of aphids compared with all other species but C. septempunctata. Ant stings affected H. variegata and C. septempunctata to a greater extent than other species. Ants showed a significantly greater amount of aggression toward H. convergens and H. variegata compared with P. quatuordecimpunctata. P. quatuordecimpunctata, C. trifasciata, and H. axyridis reacted significantly less to ants compared with H. variegata, H. convergens, C. maculata, and C. septempunctata. Differences in interactions with natural enemies may explain, in part, the successful establishment of some non-native coccinellids in new habitats.

Remote sensing and GIS for wetland inventory, mapping and change analysis.

A multiple purpose wetland inventory is being developed and promoted through partnerships and specific analyses at different scales in response to past uncertainties and gaps in inventory coverage. A partnership approach is being promoted through the Ramsar Convention on Wetlands to enable a global inventory database to be compiled from individual projects and analyses using remote sensing and GIS. Individual projects that are currently part of this global effort are described. They include an analysis of the Ramsar sites' database to map the distribution of Ramsar sites across global ecoregions and to identify regions and wetland types that are under-represented in the database. Given the extent of wetland degradation globally, largely due to agricultural activities, specific attention is directed towards the usefulness of Earth Observation in providing information that can be used to more effectively manage wetlands. As an example, a further project using satellite data and GIS to quantify the condition of wetlands along the western coastline of Sri Lanka is described and trends in land use due to changes in agriculture, sedimentation and settlement patterns are outlined. At a regional scale, a project to map and assess, using remote sensing, individual wetlands used for agriculture in eight countries in southern Africa is also described. Land cover and the extent of inundation at each site is being determined from a multi-temporal data set of images as a base for further assessment of land use change. Integrated fully within these analyses is the development of local capacity to plan and undertake such analyses and in particular to relate the outcomes to wetland management and to compile data on the distribution, extent and condition of wetlands globally.

The role of Earth Observation (EO) technologies in supporting implementation of the Ramsar Convention on Wetlands.

Over one hundred wetland specialists and Earth Observation experts from around the world gathered at the European Space Agency's 'GlobWetland Symposium: Looking at wetlands from space' in Frascati, Italy, from 19 to 20 October, 2006. The aim of the Symposium was to stimulate discussion between the two communities by reviewing the latest developments in Earth Observation (EO) for the inventory, assessment and monitoring of wetlands and identify key scientific, technical and policy-relevant challenges for the future. The results provide an overview of the key areas of current research in the use of EO for mapping and managing wetlands, while also pointing out gaps that could hinder global inventory, assessment and monitoring of wetlands. This paper provides a summary of the main outputs with a focus on the role of EO technologies in supporting the implementation of the Ramsar Convention on Wetlands. The summary contains a qualitative analysis of the state of the art and considers possible directions and priorities for future research, development and application of EO-based technologies in wetland management. In this context we: 1) highlight those applications where EO technologies are ready for wider uptake by wetland managers, and provide suggestions for supporting such uptake; 2) indicate where EO technologies and applications currently in the research and development stages could potentially be useful in wetland management; and 3) provide recommendations for new research and development of EO technologies, that can be utilized to address aspects of wetland management not covered by the range of current EO applications.

Use of Gonadotropin-Releasing Hormone Analogs in Children: Update by an International Consortium.

This update, written by authors designated by multiple pediatric endocrinology societies (see List of Participating Societies) from around the globe, concisely addresses topics related to changes in GnRHa usage in children and adolescents over the last decade. Topics related to the use of GnRHa in precocious puberty include diagnostic criteria, globally available formulations, considerations of benefit of treatment, monitoring of therapy, adverse events, and long-term outcome data. Additional sections review use in transgender individuals and other pediatric endocrine related conditions. Although there have been many significant changes in GnRHa usage, there is a definite paucity of evidence-based publications to support them. Therefore, this paper is explicitly not intended to evaluate what is recommended in terms of the best use of GnRHa, based on evidence and expert opinion, but rather to describe how these drugs are used, irrespective of any qualitative evaluation. Thus, this paper should be considered a narrative review on GnRHa utilization in precocious puberty and other clinical situations. These changes are reviewed not only to point out deficiencies in the literature but also to stimulate future studies and publications in this area.

Attitudes toward 'Disorders of Sex Development' nomenclature among physicians, genetic counselors, and mental health clinicians.

INTRODUCTION: In 2006, nomenclature referencing atypical sex development (i.e., 'intersex') was updated, and the term disorder of sex development (DSD) was formally introduced. Clinicians, patients, and parents, however, have not universally accepted the new terminology, and some continue to use different nomenclature. This inconsistency in terminology can lead to confusion among clinicians and patients, affect clinician-patient relationships, and interfere with the recommended multidisciplinary model for DSD care. OBJECTIVE: This study sought to (1) evaluate frequency of use and comfort with specific DSD terminology, (2) assess why clinicians are not using specific terms, and (3) determine what terms are being heard within the medical community and by the public in a sample of physicians, genetic counselors, and licensed mental health clinicians. STUDY DESIGN: A Web-based survey assessing the use of DSD terminology was distributed to endocrinologists, urologists, genetic counselors, and mental health clinicians. The survey assessed frequency of use and comfort with specific terms, negative experiences related to specific nomenclature use, and the context in which terms are used (e.g. case conference, literature, patient/parents, and media). A qualitative analysis of open-ended responses was conducted to characterize reasons for avoiding specific terms. RESULTS: The survey was completed by 286 clinicians. There were significant differences between specialties in comfort and frequency of use of specific terms, and significant differences were based on clinician gender, patient volume, length of time in practice, and practice setting. The study results also showed a difference in the nomenclature used within the medical community versus the media. DISCUSSION: Study findings are consistent with previous research exploring medical professionals' use of the new term: disorder of sex development. However, there continues to be inconsistency in the uptake of this new terminology. Words that have been purposed in the literature to replace disorder, such as difference and variation, would be accepted by clinicians, and the word divergent would not. This study expands on the existing literature documenting high uptake of disorder of sex development nomenclature among medical professionals. In addition, this study demonstrates that the most common diagnostic terms used by the medical community are not the same terms being presented to the public by the media. CONCLUSION: Medical professionals have varying preferences for terminology use when describing DSD, which can affect patient care. These results can be used in the future to compare with what patients and advocates prefer to develop a more universally accepted approach to nomenclature.

Slow light and chromatic temporal dispersion in photonic crystal waveguides using femtosecond time of flight.

We report time-of-flight experiments on photonic-crystal waveguide structures using optical Kerr gating of a femtosecond white-light supercontinuum. These photonic-crystal structures, based on engineered silicon-nitride slab waveguides, possess broadband low-loss guiding properties, allowing the group velocity dispersion of optical pulses to be directly tracked as a function of wavelength. This dispersion is shown to be radically disrupted by the spectral band gaps associated with the photonic-crystal periodicity. Increased time-of-flight effects, or "slowed light," are clearly observed at the edges of band gaps in agreement with two-dimensional plane-wave theoretical models of group velocity dispersion. A universal model for slow light in such photonic crystals is proposed, which shows that slow light is controlled predominantly by the detuning from, and the size of, the photonic band gaps. Slowed light observed up to time delays of approximately 1 ps, corresponds to anomalous dispersion of approximately 3.5 ps/nm per mm of the photonic crystal structure. From the decreasing intensity of time-gated slow light as a function of time delay, we estimate the characteristic losses of modes which are guided in the spectral proximity of the photonic band gaps.

Mechanised one-day fat clearance method to increase the lymph node yield in rectal cancer specimens.

The Royal College of Pathologists' guidelines for reporting colorectal cancer state that all lymph nodes in a colorectal cancer specimen should be sampled, regardless of site or size. The only means by which one can be certain that all nodes have been sampled is to clear the fat and visualise the lymph nodes. Methods of fat clearance have been available for many years, but few are acceptable in routine practice. Here, a simple, effective and economical solution to the problem is described, which should be amenable to any laboratory with a spare or back-up tissue-processing machine.

Radiographic evaluation of surgical clips is better than ultrasound for defining the lumpectomy cavity in breast boost treatment planning: a prospective clinical study.

PURPOSE: Breast radiotherapy (BrRT) often includes a "boost" to the lumpectomy bed. Selection of an appropriate electron energy and field size is based upon the dimensions and location of the surgical cavity. This study was performed to confirm our impression that ultrasound (US) inadequately defines the volume at risk compared to radiographic evaluation of surgical clips placed within the operative bed at the time of lumpectomy. METHODS AND MATERIALS Twenty-nine women treated with BrRT at our institution between 1996-1998 were prospectively identified as having surgical clips within the lumpectomy cavity. These patients underwent both US evaluation and radiographic evaluation of the clips to independently define two sets of transverse (T), longitudinal (L), and depth (D) measurements for each cavity. Volumes (V) were calculated for each method, assuming the cavity to be a box (V = T x L x D). Twenty-one women began BrRT following a median postoperative interval of 6 weeks (Group A), and 8 after 24 weeks (Group B) due to delivery of systemic therapy. RESULTS: Dimensions derived by US were smaller than the clip method in 22/29 of T, 25/29 of L, and 23/29 of D, or 80% of all linear measurements. A paired t-test demonstrated the difference between the methods to be statistically significant: T: p = 0.0004; L: p = 0.0001; D: p = 0.0004; and V: p = 0.0001. This underestimation by US did not fit any predictable pattern. Although the mean difference between methods (clips - US) was only 1.3, 1.9, and 1.1 cm for T, L, and D, respectively, differences ranged up to 5. 7, 9.2, and 5.5 cm for T, L, and D. The bias toward underestimation of V by US was significantly greater for Group B than Group A (p = 0. 03). CONCLUSIONS: US significantly underestimates all three dimensions of the lumpectomy cavity and hence the volume at risk compared to radiographic evaluation of surgical clips. Breast-conserving surgery should include placement of clips at the margins of the lumpectomy cavity (superior, inferior, medial, lateral, and posterior) to aid in radiotherapy treatment planning. US should not be utilized to guide the design of the boost field as it will result in inappropriate selection of lower electron energies and smaller field sizes (geographical miss), particularly among patients who receive chemotherapy prior to breast radiotherapy.

Ethanol impairs behavioral strategy use in naive rats but does not prevent spatial learning in the water maze in pretrained rats.

RATIONALE: Ethanol impairs performance in the water maze in rats. A detailed behavioral analysis is required to fully evaluate the nature of the impairment. OBJECTIVES: A detailed behavioral analysis was carried out to evaluate the effect of ethanol on performance in the water maze task in male hooded rats given 2.0 or 6.0 g/kg ethanol by gavage. Multiple measures of water maze strategies learning and spatial learning were studied. METHODS: Water maze trials were recorded on videotape and digitized for offline analysis. Some rats were naive at the start of spatial training, whereas other rats received water maze strategies pretraining prior to spatial training to familiarize them with the general behavioral strategies required in the task. RESULTS: Naive ethanol-treated rats exhibited both spatial learning and water maze behavioral strategies impairments. There was no evidence of a spatial learning impairment that was independent of an associated behavioral strategies impairment. Further, ethanol impaired the ability of naive rats to swim to a stable visible platform. Pretrained ethanol-treated rats performed significantly better than naive ethanol-treated rats on almost all measures, and were indistinguishable from controls on most measures. CONCLUSIONS: These results suggest that ethanol may impair water maze performance in naive rats by interfering with their ability to acquire and use required water maze behavioral strategies and generate adaptive swim paths. Ethanol does not prevent robust spatial learning in rats that are familiar with required water maze behavioral strategies.

Ultrasound can estimate the pathologic size of infiltrating ductal carcinoma.

HYPOTHESIS: Ultrasound (US) of the breast will accurately measure breast tumor size when compared with size as determined by pathologic examination. DESIGN: Retrospective case series. SETTING: University hospital-based breast center. PATIENTS: Thirty-five women with a diagnosis of breast cancer who had US as a component of their evaluation. MAIN OUTCOME MEASURE: Tumor size as measured by US compared with size measured by pathologic examination. RESULTS: Size measured by US ranged from 0.45 to 3.81 cm. Size measured by pathologic examination ranged from 0.5 to 5 cm. The mean difference of size measured by US vs pathologic size was 0.4 cm (P = .01). When only tumors with invasive ductal histology are evaluated, the mean difference in size is 0.33 cm (P = .008). The range of difference was -1.6 cm to +0.42 cm. Seventeen percent of invasive ductal tumors were underestimated by more than 1 cm; none were underestimated by more than 2 cm. CONCLUSIONS: This study demonstrates that, although US tends to underestimate the pathologic tumor size, 83% of invasive ductal tumors fall within a 1-cm and 100% fall within a 2-cm extension of the US-measured tumor size. Therefore, it is possible to use US to monitor the extent of treatment size when developing very localized therapeutic tools.

Can specific preoperative counseling increase the likelihood a woman will choose postmastectomy breast reconstruction?

BACKGROUND: Low reconstruction rates after mastectomy for breast cancer raise questions about the impact of preoperative education. This study determines whether counseling about reconstruction influences the decision about reconstruction. METHODS: The study was based on a prospectively collected database of breast cancer surgery. RESULTS: A total of 299 operations for breast cancer were performed. Of 127 mastectomies, 21 (16%) were not candidates. In all, 106 women were specifically educated about reconstruction; 40 (37%) women consulted with a plastic surgeon; and 22 (21%) women ultimately chose reconstruction. Forty women had the option of mastectomy or breast conservation. Twelve (30%) women accepted a consultation with a plastic surgeon. Six of these women (15%) ultimately chose reconstruction. Mastectomy was required in 66 women; 28 (42%) accepted a consultation with a plastic surgeon; 16 (24%) underwent reconstruction; 3 additional women are planning delayed reconstruction (28%). CONCLUSIONS: Reconstruction is more likely when mastectomy is required than when it is chosen. Low reconstruction rates reflect patient desire rather than access or education.

Intraoperative ultrasound does not improve detection of liver metastases in resectable pancreatic cancer.

BACKGROUND: In colorectal cancer, intraoperative ultrasound (IOUS) is superior to other imaging studies in characterizing hepatic metastases. The value of IOUS in detecting liver metastases from pancreatic cancer has not been evaluated previously. METHODS: Between 1990 and 1995, IOUS was prospectively employed to evaluate the liver for metastases in 32 patients with resectable pancreatic adenocarcinoma. Preoperatively, all patients had computed tomography (CT) and 22 patients had CT portography. RESULTS: At exploration, 5 of the 32 patients (15%) had extrapancreatic disease, 3 (9%) with liver implants. IOUS did not identify any additional hepatic metastases. Four preoperative studies were suspicious for metastatic disease in the liver. In these 4 patients, no hepatic metastases were identified by exploration or intraoperative ultrasound. CONCLUSIONS: We no longer routinely perform hepatic IOUS when evaluating patients with pancreatic adenocarcinoma for pancreaticoduodenectomy. When a preoperative study indicates possible hepatic involvement, IOUS can confirm the presence or absence of liver metastases.

Cost-effective management of gynecomastia.

BACKGROUND: Routine endocrine screening of idiopathic gynecomastia has been advocated, but may not be cost effective. We carried out a cost-benefit analysis of this approach. METHODS: A retrospective study (1992 to 1997) of 87 adult males with symptomatic gynecomastia was performed. RESULTS: Thirty-four (39%) patients had extrinsic causes; 53 (61%) were considered idiopathic. Forty-five idiopathic cases underwent endocrine testing: beta human chorionic gonadotropin alone, 16; and beta human chorionic gonadotropin, LH, estradiol, testosterone+/-testicular ultrasound, 29. One (2%) occult Leydig cell testicular tumor was detected. Forty-four patients had normal studies and remain well after local excision. CONCLUSION: Routine endocrine evaluation of idiopathic gynecomastia is rarely productive; such testing is best done selectively.