The unruptured intracranial aneurysm treatment score: a multidisciplinary consensus.

OBJECTIVE We endeavored to develop an unruptured intracranial aneurysm (UIA) treatment score (UIATS) model that includes and quantifies key factors involved in clinical decision-making in the management of UIAs and to assess agreement for this model among specialists in UIA management and research. METHODS An international multidisciplinary (neurosurgery, neuroradiology, neurology, clinical epidemiology) group of 69 specialists was convened to develop and validate the UIATS model using a Delphi consensus. For internal (39 panel members involved in identification of relevant features) and external validation (30 independent external reviewers), 30 selected UIA cases were used to analyze agreement with UIATS management recommendations based on a 5-point Likert scale (5 indicating strong agreement). Interrater agreement (IRA) was assessed with standardized coefficients of dispersion (vr*) (vr* = 0 indicating excellent agreement and vr* = 1 indicating poor agreement). RESULTS The UIATS accounts for 29 key factors in UIA management. Agreement with UIATS (mean Likert scores) was 4.2 (95% confidence interval [CI] 4.1-4.3) per reviewer for both reviewer cohorts; agreement per case was 4.3 (95% CI 4.1-4.4) for panel members and 4.5 (95% CI 4.3-4.6) for external reviewers (p = 0.017). Mean Likert scores were 4.2 (95% CI 4.1-4.3) for interventional reviewers (n = 56) and 4.1 (95% CI 3.9-4.4) for noninterventional reviewers (n = 12) (p = 0.290). Overall IRA (vr*) for both cohorts was 0.026 (95% CI 0.019-0.033). CONCLUSIONS This novel UIA decision guidance study captures an excellent consensus among highly informed individuals on UIA management, irrespective of their underlying specialty. Clinicians can use the UIATS as a comprehensive mechanism for indicating how a large group of specialists might manage an individual patient with a UIA.

Plant diversity effects on grassland productivity are robust to both nutrient enrichment and drought

Global change drivers are rapidly altering resource availability and biodiversity. While there is consensus that greater biodiversity increases the functioning of ecosystems, the extent to which biodiversity buffers ecosystem productivity in response to changes in resource availability remains unclear. We use data from 16 grassland experiments across North America and Europe that manipulated plant species richness and one of two essential resources—soil nutrients or water—to assess the direction and strength of the interaction between plant diversity and resource alteration on above-ground productivity and net biodiversity, complementarity, and selection effects. Despite strong increases in productivity with nutrient addition and decreases in productivity with drought, we found that resource alterations did not alter biodiversity–ecosystem functioning relationships. Our results suggest that these relationships are largely determined by increases in complementarity effects along plant species richness gradients. Although nutrient addition reduced complementarity effects at high diversity, this appears to be due to high biomass in monocultures under nutrient enrichment. Our results indicate that diversity and the complementarity of species are important regulators of grassland ecosystem productivity, regardless of changes in other drivers of ecosystem function.

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 379 - Autograph für das Deutsche Stammbuch

u.a.: "Aut credere, aut philosophari, aut degere pecudum ritu, ventri obedientium - utique mori";

Calcareous nannofossils and planktic foraminiferal assemblages of ODP Hole 198-1210A

Calcareous nannofossil and planktic foraminiferal assemblages from ODP Hole 1210A in the northwestern Pacific Ocean were used to reconstruct surface-water conditions for the past 500 kyr. Stratigraphic control was provided by calcareous nannofossil events that are thought to be synchronous over a broad range of latitudes. Calcareous nannofossil and planktic foraminiferal assemblages and abundance patterns indicate the unlikelihood of long term (Milankovitch-scale) latitudinal shifts of the Kuroshio Extension over the last 500 kyr and illustrate two successive surface water-mass states, one that prevailed prior to 300 ka and one that existed after 300 ka. The relative abundance of very small placoliths and the absolute abundance of the upper photic zone (UPZ) coccolith species decrease abruptly at approximately 300 ka. The relative abundance of the lower photic zone (LPZ) species Florisphaera profunda greatly increases at the same time, although intervals during which the relative abundance of this taxon is very low or absent also occur prior to 300 ka. The absolute abundance of planktic foraminifera gradually increased after the 300-ka boundary, including peaks of Globoconella inflata. These assemblage and abundance changes suggest significant modifications to the surface water-mass structure. Surface water was weakly stratified prior to 300 ka, but alternated between intensely stratified and vertically mixed after 300 ka. Changes in the surface water-mass structure suggest an intensification of the East Asian summer and winter monsoon after 300 ka.

REE, Ba, and Sr abundances and Sr, Nd, and Ce isotope ratos of ODP Hole 110-504B basalts

Abundances of rare earth elements (REE), Ba, and Sr and isotopic ratios of Sr, Nd, and Ce were determined for six samples of basalts drilled at Hole 504B on Leg 111 of the Ocean Drilling Program. Analyses found that these basalts are the most depleted in Sr, Ba, and light REE among mid-ocean ridge basalts (MORB); Ba depletion is especially notable. On the other hand, Sr, Nd, and Ce isotopic ratios for basalts from Hole 504B are within the range of typical MORB values.