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Background Adrenal tumors are quite common. If malignancy is suspected, the question arises whether the adrenal tumor is the primary or a secondary (= metastasis) malignancy. Surgery on adrenal metastases is generally considered to be of limited value if other distant metastases exist. We present a case of laryngeal squamous cell cancer that subsequently developed a large adrenal metastasis and multiple lymph node metastases treated successfully with surgery and immunotherapy. Case presentation The white male patient in his 60s was treated 20 months earlier with radiochemotherapy owing to laryngeal squamous cell cancer and considered to be in complete remission. He was now under investigation owing to macroscopic hematuria. Computed tomography showed an unrelated large left adrenal mass and periadrenal enlarged lymph nodes. A primary adrenal neoplasm with locoregional lymph node metastases was suspected. The patient underwent open adrenalectomy including removal of the locoregional lymph nodes. Histology surprisingly revealed that the large adrenal tumor was a metastasis of the laryngeal squamous cell cancer. In addition, three out of five lymph nodes removed also contained metastases of the same type of squamous cell cancer. Additional lymph node metastases (para-aortic, mediastinum, and right axilla) were subsequently diagnosed, and the patient was treated with immunotherapy. About 6 months later, the patient was in complete remission. Immunotherapy was continued and eventually discontinued after the completion of a 2-year treatment. A total of 3 years after the adrenal surgery, the patient is still considered to be in complete remission. Conclusion Despite the overall bad prognosis of metastasized laryngeal squamous cell carcinoma, multidisciplinary and multimodal treatment can lead to complete remission for several years.

Dams are obstructing rivers worldwide, impairing habitat and migration opportunities for many freshwater fish species; however, global data linking dam and fish distributions have been limited. Here, we quantify dam obstruction at the biogeographic scale of freshwater ecoregion, which provides the spatial framework necessary to assess the risk of fish species loss due to dams and allows us to identify both ecoregions and genera at risk. Nearly 50% of the 397 assessed freshwater ecoregions are obstructed by large- and medium-size dams, and approximately 27% face additional downstream obstruction. A synthesis of obstruction data and fish traits indicates that taxa such as lampreys (Lampetra spp.), eels (Anguilla spp.), and shads (Alosa spp.) are at particular risk of species loss. Threatened ecoregions with heavy dam obstruction and above-average counts of total, diadromous, or endemic species are found on all continents and include the Murray—Darling Province, Southern Italy, the Lower and Middle Indus Basin, West Korea, the South Atlantic region of the United States, the Upper Paraná, and Mobile Bay ecoregions.

Despite the recognized importance of reservoirs and dams, global datasets describing their characteristics and geographical distribution are largely incomplete. To enable advanced assessments of the role and effects of dams within the global river network and to support strategies for mitigating ecohydrological and socioeconomic costs, we introduce here the spatially explicit and hydrologically linked Global Reservoir and Dam database (GRanD). As of early 2011, GRanD contains information regarding 6862 dams and their associated reservoirs, with a total storage capacity of 6197 km 3 . On the basis of these records, we estimate that about 16.7 million reservoirs larger than 0.01 ha - with a combined storage capacity of approximately 8070 km 3 - may exist worldwide, increasing Earth's terrestrial surface water area by more than 305 000 km 2 . We find that 575 900 river kilometers, or 7.6%% of the world's rivers with average flows above 1 cubic meter per second (m 3 s −1 ), are affected by a cumulative upstream reservoir capacity that exceeds 2%% of their annual flow; the impact is highest for large rivers with average flows above 1000 m 3 s −1 , of which 46.7%% are affected. Finally, a sensitivity analysis suggests that smaller reservoirs have substantial impacts on the spatial extent of flow alterations despite their minor role in total reservoir capacity.

A major difference in the revised diagnostic criteria for Alzheimer's disease (AD) is the incorporation of biomarkers to support a clinical diagnosis and allow the identification of preclinical AD due to AD neuropathological processes. However, AD-specific fluid biomarkers which specifically distinguish clinical AD dementia from other dementia disorders are still missing. Here we aimed to evaluate the disease-specificity of increased YKL-40 levels in cerebrospinal fluid (CSF) from AD patients with mild to moderate dementia (n = 49) versus Parkinson's disease (PD) (n = 61) and dementia with Lewy bodies (DLB) patients (n = 36), and non-demented controls (n = 44). Second we aimed to investigate whether altered YKL-40 levels are associated with CSF levels of other inflammation-associated molecules. When correcting for age, AD patients exhibited 21.3%, 27.7% and 38.8% higher YKL-40 levels compared to non-demented controls (p = 0.0283), DLB (p = 0.0027) and PD patients (p<0.0001). The AD-associated increase in YKL-40 was not associated with CSF P-tau, T-tau or Aβ42. No relationship between increased YKL-40 and levels of the astrocytic marker glial-fibrillary acidic protein (GFAP), interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1) and interferon gamma-induced protein 10 (IP-10) could be identified. Our results confirm previous reports of an age-associated increased in CSF YKL-40 levels and further demonstrate increased CSF YKL-40 in AD patients versus non-demented controls and patients with DLB or PD. The increase in YKL-40 levels in the AD patients was unrelated to the established CSF AD biomarkers and the inflammatory markers GFAP, MCP-1, IP-10 and IL-8, proposing YKL-40 as a marker of yet to be identified AD-related pathological processes.

Understanding and predicting ecosystem responses to multiple environmental pressures is a long‐standing interest in ecology and environmental management. However, few studies have examined how the functional features of freshwater biological communities vary along multiple gradients of environmental stress. Furthermore, modelling these functional features for a whole river network constitutes a strong potential basis to improve ecosystem management. We explored how functional redundancy of biological communities (FR, a functional feature related to the stability, resistance and resilience of ecosystems) responds to single and multiple environmental filters. We compared these responses with those of functional richness, evenness and divergence. We used riparian vegetation of a Mediterranean basin, and three of the main environmental filters affecting freshwater communities in such regions, that is drought, flow regulation and agricultural intensity, thus considering the potential effect of natural environmental variability. We also assessed the predictability of FR and estimated it for the entire river network. We found that all functional measures decreased with increasing environmental filter intensity. However, FR was more sensitive to single and multiple environmental filters compared to other functional measures. The best‐fitting model explained 59% of the FR variability and included agriculture, drought and flow regulation and the pairwise interactions of agriculture with drought and flow regulation. The parameters of the FR models differed from null model expectations reflecting a non‐random decline along stress gradients. Synthesis and applications. We found non‐random detrimental effects along environmental filters' gradients for riparian functional redundancy (the most sensitive functional index), meaning that increased stress could jeopardize stability, resistance and resilience of these systems. In general, agriculture caused the greatest impact on functional redundancy and functional diversity measures, being the most important stressor for riparian functionality in the study area. Temporary streams flowing through an agricultural, regulated basin had reduced values of functional redundancy, whereas the free‐flowing medium‐sized, perennial water courses flowing through unaltered sub‐basins displayed higher values of functional redundancy and potentially greater stability against human impacts. All these findings along with the predicted basin‐wide variation of functional redundancy can assist environmental managers in improving monitoring and ecosystem management.

Neurofilaments are structural components of neurons and are particularly abundant in highly myelinated axons. The levels of neurofilament light chain (NfL) in both cerebrospinal fluid (CSF) and plasma have been related to degeneration in several neurodegenerative conditions including frontotemporal dementia (FTD) and NfL is currently considered as the most promising diagnostic and prognostic fluid biomarker in FTD. Although the location and function of filaments in the healthy nervous system suggests a link between increased NfL and white matter degeneration, such a claim has not been fully elucidated in vivo, especially in the context of FTD. The present study provides evidence of an association between the plasma levels of NfL and white matter involvement in behavioral variant FTD (bvFTD) by relating plasma concentration of NfL to diffusion tensor imaging (DTI) metrics in a group of 20 bvFTD patients. The results of both voxel-wise and tract specific analysis showed that increased plasma NfL concentration is associated with a reduction in fractional anisotropy (FA) in a widespread set of white matter tracts including the superior longitudinal fasciculus, the fronto-occipital fasciculus the anterior thalamic radiation and the dorsal cingulum bundle. Plasma NfL concentration also correlated with cortical thinning in a portion of the right medial prefrontal cortex and of the right lateral orbitofrontal cortex. These results support the hypothesis that blood NfL levels reflect the global level of neurodegeneration in bvFTD and help to advance our understanding of the association between this blood biomarker for FTD and the disease process.

QUESTIONS: The order of plant species arrival can affect recruitment and subsequent plant community development via priority effects, but is often overlooked. Priority effects occur when early‐colonizing plant species affect the establishment of later‐arriving species, and are hypothesized to depend on species identity and habitat conditions. In riparian ecosystems on the banks of rivers, a strong moisture gradient induces a zonation of plant species with different degrees of adaptation to soil moisture. Further, riparian zones receive seeds during floods and later in the season via wind dispersal. As such, we questioned if recruitment in riparian zones is primarily affected by (1) environmental conditions (i.e. soil moisture), (2) arrival order, and (3) species identity, or an interaction between these factors. LOCATION: Riparian zones of tributaries in the Vindel River catchment, northern Sweden. METHOD: We designed a controlled greenhouse experiment and a large‐scale field experiment where we sowed five plant species representing different dispersal events and habitat moisture preferences. We sowed seeds in three arrival order treatments (all species simultaneously, species group A phased 3 wk before group B, and vice versa) and under different soil moisture treatments in the greenhouse (dry, dry‐after‐wet and wet) and under a range of moisture conditions in the field. RESULTS: We found strong priority effects as early‐arriving species grew bigger and often produced higher seedling densities compared to later‐arriving species, both in the greenhouse and after two growing seasons in the field. Priority effects in the greenhouse were strongest in the dry and dry‐after‐wet treatments and weaker under wet conditions. Consistent but weaker patterns were observed in the field after the first growing season. The relative abundance of species in plant communities assembled without phased arrival interacted with soil moisture and species identity. Priority effects were strongest for species with a low relative abundance (i.e. less competitive species). CONCLUSIONS: Our findings that priority effects influenced recruitment and interacted with soil moisture suggest that priority effects should be considered when addressing riparian vegetation changes after shifts in flooding regimes. This is especially important because floods will not only affect habitat conditions, but also the phasing of seed arrival.

Neurosin is a protease that in vitro degrades α-synuclein, the main constituent of Lewy bodies found in brains of patients with synucleinopathy including Parkinson's disease (PD) and dementia with Lewy bodies (DLB). Several studies have reported reduced cerebrospinal fluid (CSF) levels of α-synuclein in synucleinopathy patients and recent data also proposes a significant role of α-synuclein in the pathophysiology of Alzheimer's disease (AD). To investigate potential links between neurosin and its substrate α-synuclein in vivo we used a commercially available sandwich ELISA and an in-house developed direct ELISA to quantify CSF levels of α-synuclein and neurosin in patients diagnosed with DLB, PD and PD dementia (PDD) versus AD patients and non-demented controls. We found that patients with synucleinopathy displayed lower CSF levels of neurosin and α-synuclein compared to controls and AD patients. In contrast, AD patients demonstrated significantly increased CSF α-synuclein but similar neurosin levels compared to non-demented controls. Further, CSF neurosin and α-synuclein concentrations were positively associated in controls, PD and PDD patients and both proteins were highly correlated to CSF levels of phosphorylated tau in all investigated groups. We observed no effect of gender or presence of the apolipoprotein Eε4 allele on neither neurosin or α-synuclein CSF levels. In concordance with the current literature our study demonstrates decreased CSF levels of α-synuclein in synucleinopathy patients versus AD patients and controls. Importantly, decreased α-synuclein levels in patients with synucleinopathy appear linked to low levels of the α-synuclein cleaving enzyme neurosin. In contrast, elevated levels of α-synuclein in AD patients were not related to any altered CSF neurosin levels. Thus, altered CSF levels of α-synuclein and neurosin in patients with synucleinopathy versus AD may not only mirror disease-specific neuropathological mechanisms but may also serve as fit candidates for future biomarker studies aiming at identifying specific markers of synucleinopathy.

Arctic and subarctic (i.e., [sub]arctic) ecosystems are predicted to be particularly susceptible to climate change. The area of tundra is expected to decrease and temperate climates will extend further north, affecting species inhabiting northern environments. Consequently, species at high latitudes should be especially susceptible to climate change, likely experiencing significant range contractions. Contrary to these expectations, our modelling of species distributions suggests that predicted climate change up to 2080 will favour most mammals presently inhabiting (sub)arctic Europe. Assuming full dispersal ability, most species will benefit from climate change, except for a few cold-climate specialists. However, most resident species will contract their ranges if they are not able to track their climatic niches, but no species is predicted to go extinct. If climate would change far beyond current predictions, however, species might disappear. The reason for the relative stability of mammalian presence might be that arctic regions have experienced large climatic shifts in the past, filtering out sensitive and range-restricted taxa. We also provide evidence that for most (sub)arctic mammals it is not climate change per se that will threaten them, but possible constraints on their dispersal ability and changes in community composition. Such impacts of future changes in species communities should receive more attention in literature.