Vulnerability of marine megafauna to global at‐sea anthropogenic threats

Abstract Marine megafauna species are affected by a wide range of anthropogenic threats. To evaluate the risk of such threats, species’ vulnerability to each threat must first be determined. We build on the existing threats classification scheme and ranking system of the International Union for Conservation of Nature (IUCN) Red List of Threatened Species by assessing the vulnerability of 256 marine megafauna species to 23 at‐sea threats. The threats we considered included individual fishing gear types, climate‐change‐related subthreats not previously assessed, and threats associated with coastal impacts and maritime disturbances. Our ratings resulted in 70 species having high vulnerability ( v  > 0.778 out of 1) to at least 1 threat, primarily drifting longlines, temperature extremes, or fixed gear. These 3 threats were also considered to have the most severe effects (i.e., steepest population declines). Overall, temperature extremes and plastics and other solid waste were rated as affecting the largest proportion of populations. Penguins, pinnipeds, and polar bears had the highest vulnerability to temperature extremes. Bony fishes had the highest vulnerability to drifting longlines and plastics and other solid waste; pelagic cetaceans to 4 maritime disturbance threats; elasmobranchs to 5 fishing threats; and flying birds to drifting longlines and 2 maritime disturbance threats. Sirenians and turtles had the highest vulnerability to at least one threat from all 4 categories. Despite not necessarily having severe effects for most taxonomic groups, temperature extremes were rated among the top threats for all taxa except bony fishes. The vulnerability scores we provide are an important first step in estimating the risk of threats to marine megafauna. Importantly, they help differentiate scope from severity, which is key to identifying threats that should be prioritized for mitigation.

Sulphites: Hidden Allergens in Epoxy Resin Products?

Surgeon preferences and practice patterns in rectopexy: Results of an international survey

Abstract Aim Rectopexy is the preferred abdominal intervention for rectal prolapse. Despite similar procedural steps – rectal mobilisation, prolapse reduction, and fixation – techniques vary widely, and onsensus on the optimal approach is lacking. This study aimed to assess global surgeon preferences and practices in rectopexy. Methods An international 28‐item online survey was distributed between November 2023 and March 2024 through professional networks and social media. Questions addressed surgeon demographics, perioperative strategies, and technical approaches to rectopexy. Responses were analysed descriptively and stratified by region and specialty. Results A total of 226 surgeons from 36 countries across four continents completed the survey. Most respondents (79.6%) administered preoperative intravenous antibiotics, and 80.5% used some form of mechanical bowel preparation. Minimally invasive approaches predominated (81%), with laparoscopy being most common. Posterior dissection was preferred by 61.5%, while 38.5% favoured ventral (anterior) dissection. Two‐thirds (68.1%) routinely used mesh, predominantly synthetic. Only 15% performed rectopexy as a day‐case procedure. Regional and specialty‐related variations were evident in approach, mesh type, and perioperative protocols. Conclusion This international survey reveals marked variability in rectopexy practice worldwide. Despite common principles, surgeon preference and regional factors strongly influence decision‐making. The findings emphasise the need for updated international guidelines to harmonise technique selection and perioperative management in rectal prolapse surgery.

Optimizing treatment strategies for early‐onset mucinous adenocarcinoma of the colon: A SEER database analysis

Abstract Background Colorectal mucinous adenocarcinoma (MAC) is challenging due to its unique pathophysiology and increasing incidence in younger populations. Treatment guidelines for early‐onset MAC remain unclear, with clinical decisions often based on extrapolated data from classical adenocarcinoma. We aimed to assess the association between the extent of surgical resection and systemic therapy in patients with early‐onset colonic MAC and survival. Methods Retrospective cohort analysis of patients aged 20–50 with stage II–III colonic MAC using the SEER database (2000–2020). We evaluated overall survival (OS) and cancer‐specific survival (CSS) based on surgical resection (segmental vs. extended) and systemic therapy, using Kaplan–Meier and Cox regression analyses. Results The cohort included 2553 patients (58.5% male; mean age 42.7 years). Segmental resection was performed in 27.6%. Extended resection was more commonly performed in right‐sided and stage III disease. Systemic therapy was administered to 62.1%, predominantly for stage III disease with unfavourable tumour features. Systemic therapy was associated with improved restricted mean 5‐year CSS (51.7 vs. 47.8 months, p  = 0.041) and OS (51.1 vs. 45.9 months, p  = 0.008) in stage III, but not stage II, disease. Extended resection was associated with a modest survival benefit for CSS (56.5 vs. 54.3 months, p  = 0.027) and OS (56.0 vs. 53.3 months, p  = 0.007) in stage II, but not stage III, disease. Conclusion Systemic therapy was associated with a significant survival benefit in patients with stage III early‐onset MAC, supporting its role as a cornerstone of treatment despite the histology's presumed chemoresistance.

Gracilis transposition for faecal incontinence after damage control surgery for blunt perineal trauma: A video vignette

Do We Appeal to the Knowledge of Our Political Rivals?

Abstract Categorical explanations involve the use of labels to account for various properties of the explanandum. Prior research shows that the degree to which a label is perceived to be entrenched in society impacts the judged quality of the categorical explanation that invokes it regardless of how informative the explanation actually is. The aim of the present paper is to investigate whether the label entrenchment effect persists even when the label is said to be entrenched only in a particular community (rather than in society at large) and whether one's relationship to the entrenching community mediates the effect. Across five online behavioral experiments, we show that US partisans (Democrats and Republicans) rated the informativeness of a circular categorical explanation as higher when the label it invokes is entrenched in their own political community than when it is entrenched in the rival political community. However, being entrenched in the rival political community led to higher informativeness judgments than not being entrenched at all. Finally, we show that the effect does not occur when the label is entrenched in an epistemically suspect community, the Flat Earth Society.

Getting ahead of the crises: Developing an avian malaria disease management plan for Hawaiian forest birds

Abstract Avian malaria is an existential threat to a majority of native Hawaiian forest birds. Climate change is facilitating the spread of malaria to historically disease‐free areas, and despite the risk of native Hawaiian forest bird extinctions from malaria outbreaks, no comprehensive disease management plans exist for forest bird conservation areas. Hakalau Forest National Wildlife Refuge, Hawai‘i, supports a thriving bird community in a historically disease‐free area that is now vulnerable to malaria incursion. Drawing on the expertise of land managers and research scientists, we developed an approach that could be used to proactively address the risk of expanding malaria into the Refuge. The plan lays out a multi‐level approach that includes options for monitoring and management actions depending on defined threat levels: Vigilant, High Alert, Disease Outbreak, and Crisis levels. Initial Vigilant and High Alert levels monitor bird populations, climate conditions, and mosquito occurrence for signs of possible disease outbreaks, with higher levels shifting toward more direct management responses. While specific actions will change as new tools become available, the proactive approach can help Refuge managers better respond to changing malaria levels in the future and provide a model for managing disease here in Hawai‘i and elsewhere.

PrEP Use in Solid Organ Transplant Recipients: A Single‐Center Experience

Martin C. Mihm, Jr. and Dermatopathology Education at Harvard Medical School

Colloid Bodies in Cutaneous Basal Cell Carcinoma: Clinical and Histologic Correlates—An Analysis of 405 Cases

ABSTRACT Background Colloid bodies (CB), also known as Civatte bodies, are commonly seen in inflammatory dermatoses and are thought to represent cell degeneration. No studies have investigated the incidence and clinical associations of CB in cutaneous basal cell carcinoma (BCC). The aim of this study is to assess the incidence of CB in BCC lesions and analyze their clinical associations. Methods Four hundred and five sequential cases of cutaneous BCC from 396 patients diagnosed from 1/1/2023 to 12/31/2023 in our institution were studied for the presence of CB. Only cases of BCC with a single growth pattern were included. BCC subtype, patient age, location of the lesion, history of previous BCC at other site, smoking history, and allergy history were collected. Cases with and without CB were compared for each parameter using the paired t‐test for age and the Chi‐square test for categorical data. Results Patients were grouped based on the presence of CB into a study group (57 cases) and control group with no CB (348 cases). CB were identified in 14% (57/405) of BCCs. 19% (54/281) of nodular, 12.5% (1/8) of infiltrative, and 1.7% (2/116) of superficial type BCCs had CB. BCC with CB were more common on the face/scalp than other sites (66.7% vs. 34.2%, p  < 0.001). Patients with CB were older (median 72 vs. 68 years ±12, p  = 0.04), predominantly male (63% vs. 47%, p  = 0.02), more frequently had a prior BCC (0.61% vs. 0.38%, p  = 0.012), and did not differ in smoking history compared to the control cohort. Conclusions We identified CB in 14% of BCCs studied, most commonly in nodular, followed by infiltrative, and least often superficial type. After cohort matching, significant clinical associations of CB in BCC were sun‐exposed location and personal history of one or more prior BCC at other site(s). Their pathogenesis is not known, however their presence suggests tumor regression, which may potentially be exploited for new therapies in a subset of patients.