Precipitation controls on nutrient budgets in subtropical and tropical forests and the implications under changing climate

Biological, geological and hydrological drivers collectively control forest biogeochemical cycling. However, based on a close examination of recent literature, we argue that the role of hydrological control particularly precipitation on nutrient budgets is significantly underestimated in subtropical and tropical forests, hindering our predictions of future forest nutrient status under a changing climate in these systems. To test this hypothesis, we analyzed two decades of monthly nutrient input and output data in precipitation and streamwater from a subtropical forested watershed in Taiwan, one of the few sites that has long-term nutrient input-output data in the tropics and subtropics. The results showed that monthly input and output of all ions and budgets (output – input) of most ions were positively correlated with precipitation quantity and there was a surprisingly greater net ion export during the wet growing season, indicating strong precipitation control on the nutrient budget. The strong precipitation control is also supported by the divergence of acidic precipitation and near neutral acidity of streamwater, with the former being independent from precipitation quantity but the latter being positively related to precipitation quantity. An additional synthesis of annual precipitation quantity and nutrient budgets of 32 forests across the globe showed a strong correlation between precipitation quantity and nutrient output-input budget, indicating that strong precipitation control is ubiquitous at the global scale and is particularly important in the humid tropical and subtropical forests. Our results imply that climate change could directly affect ecosystem nutrient cycling in the tropics through changes in precipitation pattern and amount

Microstructural differences in white matter tracts across middle to late adulthood : a diffusion MRI study on 7167 UK Biobank participants

Acknowledgements This research was approved by the UK Biobank (application number: 24089) and was supported by the Roland Sutton Academic Trust (grant number: 0039/R/16) and Taiwan National Health Research Institute (NHRI-EX109-10928NI). We acknowledge the valuable contributions of members of the UK Biobank Imaging Working Group and the UK Biobank coordinating center. The UK Biobank (including the imaging enhancement) was supported by the UK Medical Research Council and the Wellcome Trust. The authors are grateful for the provision of simultaneous multislice (multiband) pulse sequence and reconstruction algorithms by the Center for Magnetic Resonance Research, University of Minnesota. Finally, the authors are extremely grateful to all UK Biobank study participants, who have generously donated their time to make this resource possible. This article was edited by Wallace Academic Editing.Peer reviewedPostprin

Pharmacologic interventions for Kawasaki disease in children:A network meta-analysis of 56 randomized controlled trials

Background: Although the current consensus recommends a standard treatment of high-dose intravenous immunoglobulin with high-dose aspirin to manage Kawasaki disease (KD), the use of different adjunctive therapies remains controversial. The aim of the current network meta-analysis (NMA) was to compare the efficacy and tolerability of different existing interventions for the initial and refractory stages of KD. Methods: An NMA of randomised controlled trials (RCTs) was conducted using the frequentist model applied after electronic searches in PubMed, Embase, ScienceDirect, ProQuest, ClinicalTrials.gov, ClinicalKey, Cochrane CENTRAL, and Web of Science. The main outcomes were reduced fever duration/diminished severity of fever subsided. The initial stage of KD was defined as the first stage to treat patients with KD; the refractory stage of KD represents KD patients who failed to respond to standard KD treatment. The cut-off points for intravenous immunoglobulin (IVIG) were low (100–400 mg), medium (1 g), and high (at least 2 g). Findings: A total of fifty-six RCTs with 6486 participants were included. NMA demonstrated that the medium-dosage IVIG + aspirin + infliximab [mean difference=−1.76 days (95% confidence intervals (95% CIs): −3.65 to 0.13 days) compared to high-dosage IVIG + aspirin] exhibited the shortest fever duration; likewise, the medium-dosage IVIG + aspirin + infliximab [odds ratio (OR)=0.50, 95% CIs: 0.18–1.37 compared to high-dosage IVIG + aspirin] exhibited the smallest incidence of coronary artery lesion (CAL) in the initial-stage KD. In the refractory-stage KD, the high-dosage IVIG + pulse steroid therapy (OR=0.04, 95% CIs: 0.00–0.43 compared to the high-dosage IVIG only) had the best rate of decline of fever; likewise, the high-dosage IVIG + ciclosporin [OR=0.05 (95% CIs: 0.00–1.21) compared to the high-dosage IVIG only] exhibited the smallest incidence of CAL. Infliximab significantly improved resolution compared to the high-dosage IVIG only group (OR=0.20, 95%CIs: 0.07–0.62) in refractory-stage KD. Interpretation: The NMA demonstrated that the combination therapy with the standard therapy of IVIG and aspirin might have an additional effect on shortening the duration of fever and lowering the CAL incidence rate in patients with acute KD. Moreover, the combination therapy with high-dose IVIG and pulse steroid therapy or cyclosporine therapy might have an additional effect on improving the rate of decline of fever and lowering the incidence rate of CAL in children with refractory KD. Because some of the findings of this NMA should be considered hypothesis-generating rather than confirmatory, further evidence from de novo randomised trials is needed to support our results. Funding: None.</p

Early Improvement in Interstitial Fluid Flow in Patients With Severe Carotid Stenosis After Angioplasty and Stenting

Background and Purpose This study aimed to investigate early changes in interstitial fluid (ISF) flow in patients with severe carotid stenosis after carotid angioplasty and stenting (CAS). Methods We prospectively recruited participants with carotid stenosis ≥80% undergoing CAS at our institute between October 2019 and March 2023. Magnetic resonance imaging (MRI), including diffusion tensor imaging (DTI), and the Mini-Mental State Examination (MMSE) were performed 3 days before CAS. MRI with DTI and MMSE were conducted within 24 hours and 2 months after CAS, respectively. The diffusion tensor image analysis along the perivascular space (DTI-ALPS) index was calculated from the DTI data to determine the ISF status. Increments were defined as the ratio of the difference between post- and preprocedural values to preprocedural values. Results In total, 102 participants (age: 67.1±8.9 years; stenosis: 89.5%±5.7%) with longitudinal data were evaluated. The DTI-ALPS index increased after CAS (0.85±0.15; 0.85 [0.22] vs. 0.86±0.14; 0.86 [0.21]; P=0.022), as did the MMSE score (25.9±3.7; 24.0 [4.0] vs. 26.9±3.4; 26.0 [3.0]; P<0.001). Positive correlations between increments in the DTI-ALPS index and MMSE score were found in all patients (rs=0.468; P<0.001). Conclusion An increased 24-hour post-CAS DTI-ALPS index suggests early improvement in ISF flow efficiency. The positive correlation between the 24-hour DTI-ALPS index and 2-month MMSE score increments suggests that early ISF flow improvement may contribute to long-term cognitive improvement after CAS

Monsoon hydrography and productivity changes in the East China Sea during the past 100,000 years : Okinawa Trough evidence (MD012404)

Author Posting. © American Geophysical Union, 2009. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Paleoceanography 24 (2009): PA3208, doi:10.1029/2007PA001577.We analyzed the high-resolution foraminifer isotope records, total organic carbon (TOC), and opal content from an Okinawa Trough core MD012404 in order to estimate the monsoon hydrography and productivity changes in the East China Sea (ECS) of the tropical western Pacific over the past 100,000 years. The variability shown in the records on orbital time scales indicates that high TOC intervals coincide with the increases of boreal May–September insolation driven by precession cycles (∼21 ka), implying a strong connection to the variations in monsoons. We also observed possibly nearly synchronous, millennial-scale changes of the ECS surface hydrography (mainly driven by salinity changes but also by temperature effects) and productivity coincident with monsoon events in the Hulu/Dongge stalagmite isotope records. We found that increased freshening and high productivity correlate with high monsoon intensity in interstadials. This study suggests that the millennial-scale changes in monsoon hydrography and productivity in the ECS are remarkable and persistent features over the past 100,000 years.Y.Y.’s work was partly supported by Global Environmental Research Fund (RF-081) and JSPS Kakenhi (21674003)

Comparison of Human and Soil Candida tropicalis Isolates with Reduced Susceptibility to Fluconazole

Infections caused by treatment-resistant non-albicans Candida species, such as C. tropicalis, has increased, which is an emerging challenge in the management of fungal infections. Genetically related diploid sequence type (DST) strains of C. tropicalis exhibiting reduced susceptibility to fluconazole circulated widely in Taiwan. To identify the potential source of these wildly distributed DST strains, we investigated the possibility of the presence in soil of such C. tropicalis strains by pulsed field gel electrophoresis (PFGE) and DST typing methods. A total of 56 C. tropicalis isolates were recovered from 26 out of 477 soil samples. Among the 18 isolates with reduced susceptibility to fluconazole, 9 belonged to DST149 and 3 belonged to DST140. Both DSTs have been recovered from our previous studies on clinical isolates from the Taiwan Surveillance of Antimicrobial Resistance of Yeasts (TSARY) program. Furthermore, these isolates were more resistant to agricultural azoles. We have found genetically related C. tropicalis exhibiting reduced susceptibility to fluconazole from the human hosts and environmental samples. Therefore, to prevent patients from acquiring C. tropicalis with reduced susceptibility to azoles, prudent use of azoles in both clinical and agricultural settings is advocated

Management of ulcerative colitis in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023

Ulcerative colitis (UC) is a chronic inflammation of the gastrointestinal tract and is characterized by alternating periods of inflammation and remission. Although UC incidence is lower in Taiwan than in Western countries, its impact remains considerable, demanding updated guidelines for addressing local healthcare challenges and patient needs. The revised guidelines employ international standards and recent research, emphasizing practical implementation within the Taiwanese healthcare system. Since the inception of the guidelines in 2017, the Taiwan Society of Inflammatory Bowel Disease has acknowledged the need for ongoing revisions to incorporate emerging therapeutic options and evolving disease management practices. This updated guideline aims to align UC management with local contexts, ensuring comprehensive and context-specific recommendations, thereby raising the standard of care for UC patients in Taiwan. By adapting and optimizing international protocols for local relevance, these efforts seek to enhance health outcomes for patients with UC

Management of Crohn’s disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023

Crohn’s disease (CD) is a chronic, fluctuating inflammatory condition that primarily affects the gastrointestinal tract. Although the incidence of CD in Taiwan is lower than that in Western countries, the severity of CD presentation appears to be similar between Asia and the West. This observation indicates the urgency for devising revised guidelines tailored to the unique reimbursement system, and patient requirements in Taiwan. The core objectives of these updated guidelines include the updated treatment choices and the integration of the treat-to-target strategy into CD management, promoting the achievement of deep remission to mitigate complications and enhance the overall quality of life. Given the diversity in disease prevalence, severity, insurance policies, and access to medical treatments in Taiwan, a customized approach is imperative for formulating these guidelines. Such tailored strategies ensure that international standards are not only adapted but also optimized to local contexts. Since the inception of its initial guidelines in 2017, the Taiwan Society of Inflammatory Bowel Disease (TSIBD) has acknowledged the importance of continuous revisions for incorporating new therapeutic options and evolving disease management practices. The latest update leverages international standards and recent research findings focused on practical implementation within the Taiwanese healthcare system