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Hereditary Angioedema (HAE) is a rare disease and for this reason proper diagnosis and appropriate therapy are often unknown or not available for physicians and other health care providers. For this reason we convened a group of specialists that focus upon HAE from around the world to develop not only a consensus on diagnosis and management of HAE, but to also provide evidence based grades, strength of evidence and classification for the consensus. Since both consensus and evidence grading were adhered to the document meets criteria as a guideline. The outcome of the guideline is to improve diagnosis and management of patients with HAE throughout the world and to help initiate uniform care and availability of therapies to all with the diagnosis no matter where the residence of the individual with HAE exists.
Seit 1890 wird die aus dem westlichen Nordamerika stammende Fabacee Lupinus polyphyllus Lindl. (Stauden-Lupine) in Deutschland beobachtet. Ihre großflächigsten Vorkommen in Deutschland finden sich derzeit in der Hohen Rhön im Gebiet Leitgraben/Elsgellen (407 ha: 1998 10,6 % Lupinus-Bedeckung). Dort werden fast alle Wiesen mit Auflagen des Bayerischen Vertragsnaturschutzprogramms bewirtschaftet. Dies bedeutet, zeitlich gestaffelte Pflegetermine zwischen 10. Juli und 31. Oktober (Abschluss der Pflegearbeiten), die den Zeitraum der Samenbildung von Lupinus vollständig erschließen. Nachweisbar ist, dass dort, wo innerhalb der Vertragsnaturschutzflächen Heugewinnung die primäre Motivation für die Nutzung ist - dies bedeutet Nutzung zum frühest möglichen Zeitpunkt - keine Lupinus-Etablierung nachweisbar ist! Neben rechtzeitiger Mahd ist Beweidung mit (Rhön-)Schafen geeignet, die Ver- und Ausbreitung von Lupinus einzudämmen. Auch dafür gilt, dass sie vor der Samenreife (ab Anfang Juli) von Lupinus durchzuführen ist, da reife Lupinus-Samen durch Schafe endozooisch ausgebreitet werden. Vegetationsaufnahmen von Kleinseggenrieden (Caricetum fuscae), Borstgrasrasen (Polygalu-Nardetum) und Goldhaferwiesen (Geranio-Trisetetum), in denen Lupinus polyphyllus mit höheren Deckungsgraden (> 25 %) vorkommt, belegen, dass die niedrigwüchsigen Arten der Krautschicht zurückgedrängt werden. Parallel dazu nehmen die kräftige Horste ausbildenden Gräser Poa chaixii und Deschampsia cespitosa zu. Eine Trennartengruppe mit den Ruderalarten Cerastium glomeratum, Galium aparine agg., Galeopsis tetrahit, Cirsium arvense und Urtica dioica charakterisiert die Lupinus-Fazies. Die Konkurrenzkraft der Dominanzbestände mit Lupinus erklärt sich über die Biomasseverteilung in Form einer umgekehrten Pyramide, die über Bestandeshöhe (zwischen 70 und 110 cm) und dichte Belaubung stark beschattend auf tiefere Vegetationsschichten (< 30 cm) wirkt, so dass deren Arten ausdünnen, wenn sie nicht die ausreichende Plastizität im Höhenwachstum besitzen, um mit Lupinus mitzuhalten. Auch andere Dominanzbestände-aufbauende Arten wie Impatiens glandulifera, Heracleum mantegazzianum und Reynoutria ssp. besitzen diese Eigenschaft und können aufgrund ihrer Wuchshöhe sogar die Funktion einer fehlenden Strauchschicht übernehmen.
In Borstgrasrasen (Nardetalia) des Werra-Meißner-Gebietes (Nordhessen, Südniedersachsen) wurden 2012 nach 25 Jahren auf möglichst gleichen Untersuchungsflächen (quasi-Dauerflächen) Wiederholungsaufnahmen angefertigt, um den gegenwärtigen Zustand bzw. Veränderungen in diesem prioritären FFH-Lebensraumtyp zu erfassen. Es wurden insgesamt 61 Flächen untersucht. Neben der Artenzusammensetzung wurden auch Bodenparameter (pH, C/N-Verhältnis, Mächtigkeit der organischen Auflage) und die Nutzung erfasst.
Bei der Wiederholungsaufnahme 2012 waren, abgesehen von einer Aufforstungsfläche, noch auf allen Flächen Arten der Borstgrasrasen vorhanden. Die Flächen wurden 2012 überwiegend genutzt oder gepflegt, während 1986/87 Brachflächen noch bei weitem dominierten. Eine Düngung der Flächen erfolgte nicht. Trotz dieser generell günstigen Nutzungssituation lässt sich ein genereller Trend zur Eutrophierung feststellen, der sich hinsichtlich Artenzahl und Deckung in einer Zunahme von Arten des Wirtschaftsgrünlandes (Molinio-Arrhenatheretea) bei gleichzeitiger Abnahme der Borstgrasrasen-Kennarten äußert. Auch die Artenzahlen der übrigen Magerkeitszeiger nahmen im Mittel ab, während Verbrachungszeiger im Allgemeinen zunahmen. Eine Veränderung der Gesamtartenzahl war nicht festzustellen. Die mittleren Zeigerwerte spiegeln die Verschiebungen im Arteninventar durch erhöhte mittlere Reaktions- und Stickstoffzahlen wider. Strukturell hat in den vergangenen 25 Jahren vor allem eine generelle Zunahme der Moosschichtdeckung und eine Ausbreitung der Sträucher auf Brachflächen stattgefunden. Bei den Bodenparametern waren 2012 eine signifikante Erhöhung der pH-Werte, eine Einengung der C/N-Verhältnisse und eine Abnahme der Mächtigkeit der organischen Auflage (Of) feststellbar. Regressionsmodelle zeigen, dass dabei die Zunahme von Arten des Wirtschaftsgrünlandes direkt mit den ansteigenden pH-Werten zusammen hing, während die Veränderungen bei den Kennarten eher vom Ausgangs-C/N-Verhältnis, teilweise auch von der Entwicklung der organischen Auflage und der Nutzung abhängig waren. Die vorgefundenen Veränderungen werden vor dem Hintergrund möglicher Gefährdungsszenarien (Brache, Eutrophierung, Bodenversauerung, Klimawandel) diskutiert. Angesichts des unerwarteten Befundes einer Eutrophierung bei gleichzeitig nachlassender Bodenversauerung, wird die Hypothese aufgestellt, dass der seit den 1990er-Jahren erfolgte Rückgang der Schwefeldepositionen mit nachfolgender Erholung der Boden-pH-Werte und nachlassender Stressbelastung, z. B. durch Ammonium-Toxizität, die Veränderungen ausgelöst haben könnte. Außerdem deuten die Ergebnisse auf eine zumindest teilweise zu geringe Nutzungs- bzw. Pflegeintensität bzw. zu späte Nutzungstermine. Möglicherweise führt der erhöhte Eutrophierungsdruck hier auch zu verstärkten Anforderungen an das Management der Flächen. Eindeutige Indizien für klimabedingte Veränderungen im Arteninventar ließen sich nicht finden. Indirekte Effekte über eine erwärmungsbedingte Förderung der Mineralisationsraten oder ein ursächlicher Zusammenhang zwischen höheren Wintertemperaturen und der Zunahme der Moosdeckung lassen sich jedoch nicht ausschließen.
Between 1996 and 2006 the vegetation succession in drift sands and in blown-out gravel-rich depressions, located in the nature reserve Hulshorsterzand in the central Netherlands, was studied. Within this Natura 2000 habitat (type 2330: inland dunes with open Corynephorus and Agrostis grasslands) so-called lichen steppes are included, famous for their biodiversity, both in flora (cryptogams), and in fauna. With multivariate analysis, the relation between the primary succession, the species composition of the vegetation and the soil quality was studied in three different biotopes i.e. 1. drift sand, 2. blownout gravel-rich depressions and 3. drift sand after management. With a total of up to 34 species, lichen diversity in the study area appeared to be high. Biotope 1, i.e. the pioneer vegetation with Corynephorus canescens on blowing sand, is rather scarce in lichens. Between 1996 and 2006 green algae, C. canescens and Polytrichum piliferum appeared, with the result that much of the former open drift sand area was covered by pioneer stages of the Spergulo-Corynephoretum. If sand stopped blowing in, a combination of P. piliferum with the neophyte Campylopus introflexus occurred. The terminal stages of lichen succession on drift sand, a vegetation with mainly Festuca ovina s.l., Deschampsia flexuosa and reindeer lichens (Cladonia subgen. Cladina), proved to be rather stable. Since 1996 the lichen steppes occurring in biotope 2 were increasingly grass-encroached. Where some sand was still blowing in, lichen diversity did not change much, but gradually C. introflexus increased. However, without sand blowingin, a decreasing lichen cover and loss of some Red List lichens occurred. In general, in this grass-rich vegetation Calluna vulgaris will germinate and gradually a dry heath might develop. However, where dynamics had stopped and Pinus sylvestris seedlings established, succession to a young forest started. Vegetation change from open sand to lichen-rich vegetation is clearly related to a decrease in pH, an increase in organic matter, in % total N and in % total P. The lichen composition is clearly related to this gradient. The applied restoration measures on steep sand dunes in the eastern area, both of cutting pine trees and removing topsoil down to the mineral soil layer, proved to be successful. The sand kept drifting and the pioneer community thriving, including the lichen Stereocaulon condensatum characteristic of pioneer conditions, while the neophytic moss hardly increased between 1996 and 2006.
Compared to other grassland types across Slovakia, dry grasslands harbour species-rich and specialised ant communities. High diversity and species richness of ants may be seen as a consequence of (i) the specific structure of dry grassland vegetation, (ii) long-term ecological stability, and (iii) currently low or absent management-induced disturbance. With special regard to dry grasslands, we report on structural characteristics of vegetation and low-disturbance regime, which contribute to ant assemblage structure. Our study was carried out in the Štiavnické Vrchy Mts. (Central Slovakia), a region with a historically well-developed grassland area. We established a set of 25 research plots within southorientated grassland habitats representing five different grassland types: wet managed and wet abandoned grasslands, mesic managed and mesic abandoned grasslands (Arrhenatherion elatioris), and dry abandoned grassland habitats (Asplenio-Festucion glaucae). Each habitat type was represented by five plots. At each plot, a set of ten pitfall traps was used to sample ground-foraging ant assemblages. Around each trap, structural characteristics of vegetation and microhabitat were assessed. Dry grasslands were shown to have a specific microhabitat structure, characterised by the presence of a well-developed moss and lichen layer, exposed bedrock, bare soil, and significantly lower, although species-rich vege - tation. Besides the specific microhabitat structure, the absence of management may have contributed to the distinctiveness of these ant assemblages compared to those associated with other grassland categories. Ant assemblages were more species-rich, and the activity of ants was higher in recently abandoned grassland habitats. The effect of abandonment was quite opposite for plants, whose species-richness was, contrary to ants, higher within managed sites.
Understanding the diverging opinions of academic experts, stakeholders and the public is important for effective conservation management. This is especially so when a consensus is needed for action to minimize future risks but the knowledge upon which to base this action is uncertain or missing. How to manage non-native, invasive species (NIS) is an interesting case in point: the issue has long been controversial among stakeholders, but publicly visible, major disagreement among experts is recent. To characterize the multitude of experts’ understanding and valuation of non-native, NIS we performed structured qualitative interviews with 26 academic experts, 13 of whom were invasion biologists and 13 landscape experts. Within both groups, thinking varied widely, not only about basic concepts (e.g., non-native, invasive) but also about their valuation of effects of NIS. The divergent opinions among experts, regarding both the overall severity of the problem in Europe and its importance for ecosystem services, contrasted strongly with the apparent consensus that emerges from scientific synthesis articles and policy documents. We postulate that the observed heterogeneity of expert judgments is related to three major factors: (1) diverging conceptual understandings, (2) lack of empirical information and high scientific uncertainties due to complexities and contingencies of invasion processes, and (3) missing deliberation of values. Based on theory from science studies, we interpret the notion of an NIS as a boundary object, i.e., concepts that have a similar but not identical meaning to different groups of experts and stakeholders. This interpretative flexibility of a concept can facilitate interaction across diverse groups but bears the risk of introducing misunderstandings. An alternative to seeking consensus on exact definitions and risk assessments would be for invasive species experts to acknowledge uncertainties and engage transparently with stakeholders and the public in deliberations about conflicting opinions, taking the role of honest brokers of policy alternatives rather than of issue advocates.
Ambrosia artemisiifolia is an invasive annual herb infamous for the high allergenicity of its pollen, which is related to increasing medical costs. Additionally, it can cause serious yield losses as agricultural weed. Common ragweed seeds accumulate in the soil and can remain therein viable for decades, which poses a problem for the sustainable management of these populations. A long term management should thus target a reduction of the soil seed bank. We observed the influence of four different mowing regimes on the ragweed soil seed bank at six roadside populations in eastern Austria. The mowing regimes were based on methods from common roadside management practice and specifically adapted to reduce seed production. After three years of application, the soil seed bank was indeed reduced by 45 to 80 percent through three of the four mowing regimes tested. Therefore, we suggest that the best mowing regime for the most effective reduction of the size of the soil seed bank is the one consisting of one cut just after the beginning of female flowering (around the 3rd week of August in Eastern Central Europe), followed by a second cut 2–3 weeks later.
Members of the balloon vine genus, Cardiospermum, have been extensively moved around the globe as medicinal and horticultural species, two of which are now widespread invasive species; C. grandiflorum and C. halicacabum. A third species, C. corindum, may also have significant invasion potential. However, in some regions the native status of these species is not clear, hampering management. For example, in South Africa it is unknown whether C. halicacabum and C. corindum are native, and this is a major constraint to on-going biological control programmes against invasive C. grandiflorum. We review the geography, biology and ecology of selected members of the genus with an emphasis on the two most widespread invaders, C. halicacabum and C. grandiflorum. Specifically, we use molecular data to reconstruct a phylogeny of the group in order to shed light on the native ranges of C. halicacabum and C. corindum in southern Africa. Phylogenetic analyses indicate that southern African accessions of these species are closely related to South American taxa indicating human-mediated introduction and/or natural long distance dispersal. Then, on a global scale we use species distribution modelling to predict potential suitable climate regions where these species are currently absent. Native range data were used to test the accuracy with which bioclimatic modelling can identify the known invasive ranges of these species. Results show that Cardiospermum species have potential to spread further in already invaded or introduced regions in Australia, Africa and Asia, underlining the importance of resolving taxonomic uncertainties for future management efforts. Bioclimatic modelling predicts Australia to have highly favourable environmental conditions for C. corindum and therefore vigilance against this species should be high. Species distribution modelling showed that native range data over fit predicted suitable ranges, and that factors other than climate influence establishment potential. This review opens the door to better understand the global biogeography of the genus Cardiospermum, with direct implications for management, while also highlighting gaps in current research.
We performed a survey of grassland communities in the Ukrainian Carpathians with the aim of: (1) syntaxonomically classifying the meso- and subxerophilous grassland vegetation; (2) analysing the main gradients in their species composition; (3) estimating the effect of selected environmental factors on grassland species composition; (4) assessing the species richness of vascular plants and bryophytes in relation to the measured environmental variables. We collected 46 phytosociological relevés during the growing seasons of 2010 and 2011. Species composition and species richness were studied at two spatial scales (1 m² and 16 m²) in relation to soil parameters (soil depth, pH (KCl), content of P, K, Mg, N and C), management regime (mowing, grazing, ploughing in the past and burning), and other factors (altitude, litter cover, open soil, inclination, solar radiation and animal excrement). Seven grassland types were distinguished belonging to 3 classes and 4 alliances, namely the Nardetea strictae including the Violion caninae (mesic pastures at altitudes of 400–600 m mostly on moderate slopes) and the Nardo strictae-Agrostion tenuis (grasslands on moderate slopes at altitudes of 700–900 m usually managed by mowing and grazing the aftermath); the Molinio-Arrhenatheretea, including the Arrhenatherion elatioris (submontane grasslands originated mostly on former fields after their abandonment in the past) and the Cynosurion cristati (intensive pastures); and the Festuco-Brometea including the Cirsio-Brachypodion pinnati (abandoned grasslands dominated by Brachypodium pinnatum and Inula salicina). Detrended correspondence analysis indicated that the major compositional turnover was related to altitude and soil reaction. A canonical correspondence analysis confirmed that altitude had the strongest effect on species composition in the analysed dataset, followed by management treatments (former ploughing, grazing intensity). For vascular plant species richness, regression tree analysis identified grazing intensity as the most important predictor at the 1 m² scale. At the 16 m² scale, soil humus content was evaluated as the most important predictor of vascular plant species richness, followed by litter cover and grazing intensity. The number of bryophytes was not determined by the studied environmental factors at either of the two spatial scales. Although the number of analysed relevés in this study was limited, our results significantly contribute to the understanding of submontane grasslands in the Ukrainian Carpathians.
Introduction: In patients with severe pelvic ring injuries, exsanguination still is the leading cause of death in the early post-injury phase. While mechanical pelvic ring stabilization and pre-peritoneal pelvic packing are mainly addressing venous bleeding, angio-embolization aims to control arterial bleeding. The goal of the present study was to evaluate the rate of postoperative angio-embolization after mechanical pelvic ring injury stabilization and pre-peritoneal pelvic packing. Bleeding sources detected in the angiography and the patient's outcome were investigated. Patients and Methods: Retrospective observational cohort study at a single academic level I trauma center, reviewing all patients with pelvic ring injuries admitted from 01/2010 to 12/2019. Patients with emergent mechanical pelvic ring stabilization (supraacetabular external fixator and/or pelvic C-clamp) and direct pre-peritoneal pelvic packing were further analyzed. Patients that underwent postoperative angio-embolization were compared with those that did not. All postoperative angio-embolizations were evaluated with regards to bleeding sources and type of embolization. Results: During the study period, a total of 39 patients required immediate mechanical pelvic stabilization and direct pre-peritoneal pelvic packing. Of these, 12 patients (30.8%) underwent a postoperative angio-embolization. The following vessels were identified as bleeding sources: superior gluteal artery (n = 6), obturator artery (n = 2), internal pudendal artery (n = 2), unnamed branches of the internal iliac artery (n = 3). A selective embolization was successful in 11 patients; in 1 patient, an unilateral complete occlusion of the internal iliac artery was performed to control the bleeding. Mean time from hospital admission to the surgical procedure was 52.8 ± 14.7 min and the mean time from admission to angio-embolization was 189.1 ± 55.5 min. The in-hospital mortality rate of patients with angio-embolization was 25.0% (n = 3). Of these, 2 patients died due to multiple organ failure and 1 patient due to severe head injury. Conclusion: Secondary angio-embolization after external pelvic fixation and pre-peritoneal pelvic packing was effective in controlling ongoing bleeding. The most frequently detected bleeding vessel was the superior gluteal artery, which is difficult to surgically address, further highlighting the importance of angio-embolization in the management algorithm.