The COVID-19 pandemic has had a significant impact on many aspects of head and neck cancer care.  The uncertainty and stress resulting from these changes has led many patients and caregivers to turn to head and neck cancer advocacy groups for guidance and support.  Here we outline some of the issues being faced by head and neck cancer patients during the current crisis and provide examples of programs being developed by advocacy groups to address them.  We also highlight the increased utilization of these organizations that has been observed as well as some of the challenges being faced by these not-for-profit groups as they work to serve the head and neck community. 

Unprecedented times call for extraordinary measures. While surgeons across the globe try to comprehend the evolving façade of the COVID 19 pandemic and improvise surgical practice to the best of their ability, the psychological impact of the stress on their own mental health and wellbeing has been underestimated. This paper aims to review the indirect and overt factors that may affect the mental health of a surgeon in the present circumstances. Furthermore, it will aim to highlight key coping mechanisms at individual and institutional level, so as to mitigate the negative psychological impact on surgeons.

Background: Otolaryngologists are amongst the highest risk for COVID-19 exposure.Methods: A cross-sectional, survey-based, national study evaluating academic otolaryngologists. Burnout, anxiety, distress, and depression were assessed by the single-item Mini-Z burnout assessment, 7-item Generalized Anxiety Disorder scale, 15-item Impact of Event Scale, and 2-item Patient Health Questionnaire, respectively.Results: 349 physicians completed the survey. 165 (47.3%) were residents and 212 (60.7%) were males. Anxiety, distress, burnout and depression were reported in 167 (47.9%), 210 (60.2%), 76 (21.8%) and 37 (10.6%) physicians respectively. Attendings had decreased burnout relative to residents (OR 0.28, CI [0.11-0.68]; p=0.005). Females had increased burnout (OR 1.93, CI [1.12.-3.32]; p=0.018), anxiety (OR 2.53, CI [1.59-4.02]; p<0.005), and distress (OR 2.68, CI [1.64-4.37]; p<0.005). Physicians in states with greater than 20,000 positive cases had increased distress (OR 2.01, CI [1.22-3.31]; p=0.006). Conclusion: During the COVID-19 pandemic, the prevalence of burnout, anxiety, and distress is high among academic otolaryngologists.

Background: As reported by increasing literature, a significant number of patients with SARS-CoV-2 infection developed smell/taste disorders.Aim of this study is to determine prevalence and severity of these symptoms among laboratory confirmed SARS-CoV-2 patients. Secondary objective is to determine their onset/recovery time.Methods: This cross-sectional study was conducted from March 10th to March 30th 2020 at Novara University Hospital during the COVID-19 Italian outbreak. The 355 enrolled patients answered a questionnaire at 14th (or more) days after proven infection.Results: The overall population prevalence of both smell/taste or one of the two disorders was 70%. They were first symptoms in 31 (8,7%) patients.Most patients reported a complete loss that in half of the cases (49.5%) was fully recovered after 14 days, with a median recovery time of 10 days.Conclusion: This study confirms high prevalence of smell/taste disorders in COVID-19 infection with self-recovery for half cases after about two weeks.

Diversity gradients are observed in various groups of organisms. For fishes in streams, the Water-Energy, Productivity and Temporal Heterogeneity hypotheses are considered the best combination to explain richness patterns. The relationship between species diversity and the variables that represent the hypotheses are generally considered linear and stationary, that is, there is equal relation of cause and effect along an entire geographical extension. The assumption of stationarity has not been tested or even observed in diversity gradients, thus producing imprecise models. Therefore, our goal is to quantify stationarity in the existing relationships between the ichthyofauna of streams and the Water-Energy, Productivity and Temporal Heterogeneity hypotheses using a Geographically Weighted Regression – GWR. In the proposed model, there is conspicuous absence of stationarity between fish species richness and the tested hypotheses. Furthermore, water-energy dynamics were observed as a possible metabolic restriction mechanism acting on the community structuring of stream fishes. This mechanism divides the fish fauna from the studied Brazilian watercourses in two regions: i) Amazonian, characterized by a stable climate and populations with little resistance to thermal variation; and ii) Central, featured by greater ranges of temperature and fish populations resistant to thermal variation.

Renal transplantation is the ultimate therapeutic option for end-stage renal failure. A major challenge that often leads to the loss of the renal graft is the immune-mediated organ rejection, of which there are three types; hyperacute, acute and chronic rejection. This necessitates a proper use of immunosuppressants in the form of short-term induction therapy, as prophylaxis against early acute rejection, and a life-long maintenance therapy against chronic rejection. However, the suppression of the immune system would also compromise the ability of the immune system to eradicate the pathogens and early cancer cells, which increases the risk for various types of serious infections and malignancies. Some of these drugs are also associated with hematologic, metabolic, cardiovascular and renal toxicities. This manuscript thoroughly reviews the available clinical data on the currently approved drugs that are used for both the induction and maintenance therapy, with some focus on their pharmacology. It also discusses the current guidelines and covers, in some details, the new drug classes that are still under clinical investigations.

Background: Obstructive sleep apnea (OSA) in children is characterized by repeated airway obstructions during sleep. The peak incidence for pediatric OSA is during early childhood, in particular, the period between 2 and 8 years of age Aims/Objectives: The aim of this study to evaluate the effect of adenotonsillectomy (AT) on the scholastic achievement of children with Obstructive Sleep Apnea (OSA) to put a plan for proper management of those children. Material and Methods: 50 children were selected from 150 children suspected with OSA who came to our unit complaining from symptoms of (OSA) and seeking for adenotonsillectomy. 50 children well diagnosed as OSA due to adenotonsillar hypertrophy confirmed by polysomnography. a full history was taken from parents, audiological evaluation and All 50 children underwent a battery of neurocognitive tests containing process-oriented intelligence scales(Stanford Binet Intelligence scale and Illinois Test of psycholinguistic ability) pre and post adenotonsillectomy to show the effect of Adenotonsillectomy(AT) on scholastic achievement of children with Obstructive Sleep Apnea (OSA). Results: Children with OSAS had lower scores in neurocognitive tests(Illinois test and Stanford Binet intelligent scale) and Percentage (%) of the child’s scores of his subjects (Academic performance) indicating impaired neurocognitive function and school performance, but 8 months after adenotonsillectomy, the children with OSAS demonstrated statistical highly significant differences were obtained between the preoperative and postoperative examination of the study group as regards the symptoms of OSA, IQ and Mental age, auditory perceptual assessment (APA), PLA of VSM (Visual sequential memory), AA (Auditory association) VA (Visual association), AC (Auditory closure), VC (Visual closure), GC (Grammatic closure) and SB (Sound Blending) (p<0.001). Conclusions: the school performance and neurocognitive functions improve after Adenotonsillectomy indicating that the impaired school performance and neurocognitive functions are mostly reversible, at least 8 months following adenotonsillectomy.

The role of animal feed as a vehicle for the transport and transmission of viral diseases was first identified during the porcine epidemic diarrhea virus (PEDV) epidemic in North America. Since that time, various feed additives have been evaluated at the laboratory level to measure their effect on viral viability and infectivity in contaminated feed using bioassay piglet models. While a valid first step, the conditions of these studies were not representative of commercial swine production. Therefore, the purpose of this study was to evaluate the ability of feed additives to mitigate the risk of virus-contaminated feed using a model based on real-world conditions. This new model used an “ice-block” challenge, containing equal concentrations of porcine reproductive and respiratory syndrome virus (PRRSV), Seneca-virus A (SVA) and PEDV, larger populations of pigs, representative commercial facilities and environments, along with realistic volumes of complete feed supplemented with selected additives. Following supplementation, the ice block was manually dropped into designated feed bins and pigs consumed feed by natural feeding behavior. After challenge, samples were collected at the pen level (feed troughs, oral fluids) and at the animal level (clinical signs, viral infection, growth rate, and mortality) across five independent experiments involving 15 additives. In 14 of the additives tested, pigs on supplemented diets had significantly greater average daily gain (ADG), significantly lower clinical signs and infection levels, and numerically lower mortality rates compared to non-supplemented controls. In conclusion, the majority of the additives evaluated mitigated the effects of PRRSV 174, PEDV, and SVA in contaminated feed, resulting in improved health and performance.

Labour induction with a cervical Foley catheter balloon is safer than pharmacological methods, particularly with previous caesarean section, fetal compromise or limited monitoring facilities. Amniotomy is associated with setting-specific risks. To extend balloon retention until labour is established thus avoiding pharmacological agents or amniotomy, we have developed a novel method of variable weighting of the balloon catheter according to the cervical status. When the cervix is too dilated to retain a single balloon, two Foley balloons are inserted side by side at the same level above the cervix.

Background: The hypothesis that early stimulation of the gut microbiota contributes to immune system balance has encouraged the use of probiotics to treat atopic dermatitis (AD), an immunological disorder characterized by chronic and relapsing skin inflammation, in several clinical studies. This study aimed to evaluate the clinical efficacy of a mixture of probiotics (Lactobacillus and Bifidobacterium) in children and adolescents with AD and the effects of probiotics on sensitization, inflammation, and immunological tolerance. Methods: In this double-blind, randomized, placebo-controlled clinical trial, children and adolescents (aged 2 to 19 years) received one gram (sachet) per day of probiotics or placebo for six months. SCOring of AD (SCORAD) index, serum IgE levels, skin prick test, tolerogenic and inflammatory cytokines were evaluated. Results: Forty patients were evaluated and clinical response was significantly better in the probiotic group as compared to the placebo group after treatment for six months; SCORAD decreased (95% CI, 2.44–52.94) even after adjustment for co-variables (95% CI, 5.52–59.13). Three months after the treatment was discontinued, improvement persisted in the probiotic group even after adjustment for co-variables (95% CI, 0.78– 27.70). IgE levels, skin prick test and cytokines did not differ between groups. Conclusions: AD children and adolescents treated with a mixture of probiotics (Lactobacillus rhamnosus, Lactobacillus acidophilus, Lactobacillus paracasei, and Bifidobacterium lactis) for six months presented a significate SCORAD reduction as compared to placebo group. This probiotics mixture did not affect SPT and IgE levels, as well as inflammatory or tolerogenic cytokines. ClinicalTrials.gov #NCT02519556.

Glycerol can be effectively converted to glyceric acid, a high value‐added pharmaceutical raw material, through its partial oxidation over an Au/Al2O3 catalyst under strongly basic conditions. The factors important for the highly selective production of glyceric acid were investigated experimentally. It was clarified that NaOH was involved in the glycerol activation step to a glycerol alkoxide intermediate (2, 3‐dihydroxypropoxide) in the liquid phase, then glyceric acid was formed by OOH species derived from O2 on an Au catalyst in the partial oxidation step. We have newly discovered the concerted effect of NaOH and O2 in different reaction steps.

In this report, oxidation of biomembrane lipids, phospholipid (LH) and cholesterol (ChH), were examined experimentally in the presence of vitamin E (VEH) by using a liposome system, which is used widely as a biomembrane model. A kinetic model was constructed by taking into account mechanisms of anti-oxidation and pro-oxidation by VEH to the co-oxidation mechanisms of biomembrane lipids reported previously. The model quantitatively described the oxidation behavior in the liposome system under various VEH addition conditions. The model also predicted the oxidation behavior in vivo under various oral ingestion conditions of VEH. The results suggest that ChH oxidation, which causes various diseases, can be suppressed effectively by taking a certain amount of VEH once a day to avoid a reduction in the VEH concentration present in the biomembrane. The proposed kinetic approach should be a useful tool for quantitatively characterizing complicated reaction systems, such as biomembrane oxidation.

Tick borne diseases impinge veterinary and public health, worldwide causing threat to nutritional security, mortality and huge economic losses. Crimean-Congo haemorrhagic fever (CCHF) and theileriosis are the two important tick-borne diseases in humans and animals respectively, risk the public health due to mortality and pose major threat to animal husbandry and livestock industries. Sero-epidemiological and genetic analysis are the key aspects in determining the prevalence of CCHF virus (CCHFV) circulation and molecular prevalence of theileriosis in region wise, which are overlooked in the India, where the country known for largest cattle population, globally. Thus, the present study aims to evaluate the prevalence of CCHFV in animals and genetic diversity of the prevailing Theileria annulata in Jabalpur, Madhya Pradesh. Systematically, livestock population was screened for presence of CCHFV antibodies and T. annulata through commercial IgG ELISA kits and PCR, respectively. Overall, 16% of samples (n=63/393) tested were positive for CCHFV-specific IgG antibodies and 15.9% (n-21/132) animals were positive for T. annulata infections, respectively. It indicates that, CCHFV is circulating in this region in an unnoticed hidden manner. It recommends that, screening of human cases showing hemorrhagic manifestations in health care setup and active surveillance of ticks as a preparedness to combat future outbreaks. Moreover, designing region wise preventive strategic plan may curb these emerging as well as economic tick-borne diseases.

Ovarian cancer (OC) is the most common reproductive system tumor threatening women’s health. Its incidence rate is increasing year by year. At present, the main treatment of ovarian cancer in the world is the combination of surgery and chemotherapy, and paclitaxel combined with platinum drugs is the first choice for chemotherapy. However, at the same time, studies have shown that platinum and paclitaxel drugs can lead to heart function damage, and serious cases can lead to heart failure. Two dimensional ultrasound and MRI have their own limitations, such as failure to detect lesions early, price and time-consuming, so they are not widely used, and three-dimensional speckle tracking imaging (3D-STE) technology has the advantages of convenience, rapidity, effectiveness and repeatability, which can early detect heart disease. In this paper, 3D-STE technology was used to compare the results of ovarian cancer patients and normal people in different chemotherapy cycles, and compared with the results of MRI. It will be confirmed that 3D-STE technology has more clinical application value than two-dimensional ultrasound and MRI, and provide basis for clinical diagnosis and application.

Understanding how soil microorganisms influence the direction and magnitude of soil carbon feedback to global warming is vital to predict future climate change. Although microbial activities are major contributors to soil respiration (RS) and its temperature sensitivity (Q10), the mechanisms underpinning microbial influence on RS and Q10 remain unclear. In this study, structural equation modeling (SEM) was conducted to illustrate that bacteria mainly affect RS by shifting beta diversity (denoted NMDS ordinations) instead of richness. In contrast, Q10 values are governed by the richness and NMDS ordinations of bacteria. We also found that soil water content (SWC) was the factor key to changing bacterial properties (P < 0.05, R2 ≥ 0.33). Network analysis demonstrated that only Proteobacteria were positively associated with RS (P < 0.05, R > 0.5). Illuminating the mechanisms underpinning the influence of soil microbes on RS and Q10 values is fundamental to understanding mechanistic soil-climate carbon cycles.

Insect herbivore has great impacts on biogeochemical cycling in forest ecosystem, but experimental tests on the herbivory-decomposability relationship at the inter-specific level are rare. We conducted a 400-day field decomposition experiment in a temperate mixed deciduous forest and measured mass remaining rate, decomposition constant, total loss of carbon (C) and nitrogen (N) of litter leaf with/without obvious damage by chewing insects for different tree species. We found that herbivory effect on initial litter quality (C: N ratio) varied with species, showing a markedly negative effect on M. alba (-5.78%) and positive effect on Q. acutissima (+5.35%). Herbivory damage increased decomposition constant for M. alba and L. formosana with higher special leaf area, but decreased it for D. kaki and Q. acutissima with lower special leaf area. The contrasting effects of insect herbivory on litter decomposition could be attributed to the variability of litter initial quality caused by herbivory. Our finding that herbivore damage showed inter-specific variability in both litter quality and decomposition rate suggests that herbivory induced feedbacks to nutrient cycling and ecosystem function should be estimated at the species level in multi-species mixed deciduous forest.

Just weeks following the fifth anniversary of the landmark Montgomery v Lanarkshire Health Board Supreme Court judgment, the Royal College of Obstetricians and Gynaecologists (RCOG) has delivered the fourth edition of its Green-top guideline on forceps and vacuum assisted births1. The irony of this is not lost on those who expected real change following last year’s peer review consultation (19 physicians and 6 maternity care organisations responded, including the first two signatories of this letter). The guideline opens with a fundamental question: Can assisted vaginal birth be avoided? The answers RCOG provides are solely in the context of labour (evidence on continuous support, epidural analgesia, positions adopted, delayed pushing), but a legal interpretation of Montgomery advises birth is “a situation that allows for significant advance planning and accordingly plans must be made.”2 The guideline concurs: women “should be informed about assisted vaginal birth in the antenatal period, especially during their first pregnancy [and] in advance of labour”. Nevertheless, while “lower rates in midwifery-led care settings” is included, ‘lower rates with planned caesarean’ is not, and there is no direct equivalent Green-top for this birth mode. The Montgomery judgment on consent specifically states that doctors are “under a duty to take reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment, and of any reasonable alternative or variant treatments.” It also emphasises that in any pregnancy, the “principal choice is between vaginal delivery and caesarean section.” RCOG may argue that referencing the “alternative choice of a caesarean section late in the second stage of labour” sufficiently addresses these points. However, a Queen’s Counsel who was involved in the Montgomery case reminds doctors that the mother “was not advised that an alternative to vaginal birth (i.e. caesarean section) was an option available to her… and there was an increased risk… should vaginal birth be attempted.”2 He warns, “Where the patient asks a question, it must be answered honestly and fully”, which suggests that planned caesarean birth omission from this Green-top could have serious legal consequences, and there is every chance the Montgomery case could reoccur.Despite aiming “to provide evidence-based recommendations”, RCOG does not include pelvic organ prolapse as an adverse outcome. Instead, it says women who “achieve an assisted vaginal birth rather than have a caesarean birth… are far more likely to have an uncomplicated vaginal birth in subsequent pregnancies”, and that “much of the pelvic floor morbidity reported… may not be causally related to the procedure.” Furthermore, the stated aim of RCOG’s clinical Green-tops is to identify “good practice and desired outcomes”, which will be “used globally.”4 This is relevant because many countries define this as low caesarean birth rates. In the UK, the National Institute for Health and Care Excellence (NICE) does not advocate targets, and recommends support for prophylactic caesarean birth requests.3 Yet decades of promoting vaginal birth rather than informed choice has obstructed autonomy and contributed substantially to rising litigation costs.5The truth is, the NHS simply cannot afford to keep repeating the same communication and consent mistakes, and in our view, this NICE accredited Green-top guideline clearly demonstrates that lessons from Montgomery have still not been learned.Pauline M Hull, Founder, Caesarean BirthKim Thomas, CEO, Birth Trauma OrganisationDr. Elizabeth Skinner, Faculty of Medicine, University of SydneyAmy Dawes, Co-founder and CEO, Australasian Birth Trauma AssociationPenny Christensen, Executive Director, Birth Trauma Canada

The Krakatau volcano erupted in 1883 and created a unique ecosystem where the surrounding islands were completely sterilised. While volcanic activity and plant succession have been extensively studied in the Krakatau islands, the soils received less attention. As the age of the parent material is known precisely, and the islands are isolated, soils of Krakatau islands could provide insights on the first stages of weathering in tropical volcanic regions. This study aims to characterize soils from the Krakatau islands. In 2015, ten sampling sites were selected from Mt. Anak Krakatau, Rakata, Panjang, and Sebesi islands, all making part of the Krakatau island complex. Field morphology was observed from representative profiles on each island. Soil samples were collected and analysed for physical and chemical properties. The geochemical analysis was carried out using the X-ray fluorescence (XRF). Linear discriminant analysis was used to separate materials from the four islands based on their chemical and geochemical concentrations. While the four islands were nearby and influenced by the 1883 eruption of Mt. Krakatau, the analysis showed that the chemical and geochemical characteristics of volcanic ash for each island are distinct. Discriminant analysis of chemical and geochemical properties differentiated soils of Anak Krakatau as the youngest ones, and soils of Sebesi are the most developed ones. The following sequence of the soil weathering degree was established: Sebesi > Rakata > Panjang > Anak Krakatau.

African swine fever (ASF) is a fatal disease in swine. Concentration of cases over summer and outbreaks in farms with high levels of biosecurity might support the hypothesis of ASF virus transmission via insects. A total of 28,718 insects were collected from 14 pig farms affected by ASF in the Republic of Korea. The insects collected were flies (N = 27,310, 95.1%), mosquitoes (N = 1,198, 4.2%), and cockroaches (N = 24, 0.1%). The remaining 0.6% (N = 186) could not be taxonomically classified. All the insects collected showed no trace of ASF Virus-DNA was detected by laboratory analysis. It is premature to conclude on the role of insects in the transmission of ASFV. However, the possibility of the virus spreading via insects should not be overlooked.

Introduction: To know whether cardiac pacemaker implantations improve the functional capacity (FC) and affect the prognosis. Methods and Results: We prospectively enrolled 621 de-novo pacemaker recipients (age 76±9 years, 50.7% male) between April 2015 and September 2016. The FC was assessed by the metabolic equivalents (METs) during the implantation and periodically thereafter. The patients were a priori classified into a poor FC (<2 METs, n=40 [6.4%]), moderate FC (24 METs, n=342 [55.1%]). Three months after the pacemaker implantation, poor FC or moderate FC patients improved to a good FC by 43%. The distribution of the three FCs remained at those levels by the end of the follow-up (p=0.18). During a median follow-up of 2.4 years, 71 patients (11%) had cardiovascular hospitalizations and 35 (5.6%) all-cause death. A multivariate Cox analysis revealed that a poor FC at baseline was an independent predictor of both a cardiovascular hospitalization (hazard ratio [HR] 2.494, 95% confidence interval [CI] 1.227-5.070, p=0.012) and all-cause death (HR 3.338, 95% CI 1.254-8.886, p=0.016). One year after the pacemaker implantation, the 19 patients whose poor FC improved to a good FC did not die, however, the 8 who remained with a poor FC had a high mortality rate of 37.5% (p<0.01). Conclusion: Approximately half of the poor or moderate FC patients improved to a good FC 3 months after the pacemaker implantation. The baseline FC predicted the prognosis, and patients with an improved FC after the pacemaker implantation had a better prognosis.

Background: Improved catheter stability is associated with decreased arrhythmia recurrence after atrial fibrillation (AF) ablation. Recently, atrial voltage mapping in AF was demonstrated to correlate better with scar as compared to mapping in sinus rhythm (SR). However, it is unknown whether ablation of persistent AF in sinus rhythm with atrial pacing or in atrial fibrillation with ventricular pacing results in differences in catheter stability or arrhythmia recurrence. Methods: We analyzed 53 consecutive patients undergoing first-time persistent AF ablation with pulmonary vein and posterior wall isolation: 27 were cardioverted, mapped, and ablated in sinus rhythm with atrial pacing, and 26 were mapped and ablated in AF with ventricular pacing. Ablation data was extracted from the mapping system and analyzed using custom MATLAB software to determine high-frequency (60Hz) catheter excursion as a novel metric for catheter spatial stability. Results: There was no difference in catheter stability as assessed by maximal catheter excursion, mean catheter excursion, or contact force variability between the atrial-paced and ventricular-paced patients. Ventricular-paced patients did have significantly greater mean contact forces compared to atrial-paced patients. One year arrhythmia-free survival was similar between the atrial paced and ventricular paced patients (78% vs 67%, p = 0.31). Conclusion: For patients with persistent AF, ablation in AF with ventricular pacing results in similar catheter stability and arrhythmia recurrence as compared to cardioversion and ablation in sinus rhythm with atrial pacing. Given the improved fidelity of mapping in AF, mapping and ablating during AF with ventricular pacing may be preferred.

1. Anthropogenic effects, such as nitrogen (N) enrichment and mowing, are constantly changing the function and structure of grassland ecosystems. In order to test whether the magnitude and frequency of N addition, as well as occurrence of mowing, affects gross N turnover. We designed a long-term field experiment which included 5 levels of N addition (0, 2, 10, 20, and 50 g N m-2 yr-1) and mowing in a typical grassland of northern China. 2. To test the effects of N addition frequency, the amount of N applied was separated evenly by two times (twice a year, low frequency) or twelve times (monthly, high frequency) that results were compared against a control site where none of the treatments were applied. Mowing effects were also considered at each N treatment levels. 3. Our results showed that the N level, the frequency of N addition, and mowing significantly influenced gross ammonification (GA) and nitrification (GN) rates. Specifically, the effect of N addition frequency was significantly different under the highest N addition level (50 g N m-2 yr-1), lower frequency (twice a year) significantly increased N turnover rates. Mowing significantly increased the GA rate, while decreased GN rate both under the highest N addition level (50 g N m-2 yr-1) and lower N addition frequency. Further long-term study of the effects of the interactions between N addition and mowing on N turnover will be needed for understanding the mechanisms by which nutrient cycling in typical grassland ecosystems may change in the future.

Enemy-risk effects, often referred to as non-consumptive effects (NCEs), are an important feature of predator-prey ecology, but their significance has had little impact on the conceptual underpinning or practice of biological control. We provide an overview of enemy-risk effects in predator-prey interactions, discuss ways in which risk effects may impact biocontrol programs, and suggest avenues for further integration of natural enemy ecology and integrated pest management. Enemy-risk effects can have important influences on different stages of biological control programs, including natural enemy selection, efficacy testing, and quantification of non-target impacts. Enemy-risk effects can also shape the interactions of biological control with other pest management practices. Biocontrol systems also provide community ecologists with some of the richest examples of behaviorally-mediated trophic cascades and demonstrations of how enemy-risk effects play out among species with no shared evolutionary history, important topics for invasion biology and conservation.  We conclude that the longstanding use of ecological theory by biocontrol practitioners should be expanded to incorporate enemy-risk effects, and that community ecologists will find many opportunities to study enemy risk effects in biocontrol settings.

Why have ecological targets for the majority of water bodies in Europe not been met despite decades of water protection programs? We hypothesize that restoration strategies have not adequately accounted for whole-river network perspectives, including interactions between stream orders, spatial patterns of pollutant sources, and ecoregion-dependent susceptibility. We used high-resolution data from Germany to identify relationships between urban wastewater-river discharge fraction (UDF), agricultural land use fraction (ALF), and ecological status by stream order across three ecoregions. We found ecological status of good or better in less than 8% of all river sections with the highest proportions in low-order streams and complete disappearance at higher orders. Increasing ALF impaired the ecological status for river reaches across all stream orders. In contrast, relationships between UDF and ecological status impairment were significant only in low-order streams, independent from ecoregion. Concentrating integrative restoration efforts in low-order streams would maximize the potential to mitigate anthropogenic impacts.