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1. Mutualistic networks are highly dynamic, characterized by high temporal turnover of species and interactions. Yet, we have a limited understanding of how the internal structure of these networks and the roles species play in them vary through time. selleck chemical 2. We used six years of observation data and a novel statistical method (dynamic stochastic block models) to assess how network structure and species' structural position within the network change throughout subseasons of the flowering season and across years in a quantitative plant-pollinator network from a dryland ecosystem in Argentina. 3. Our analyses revealed a core-periphery structure persistent through subseasons and years. Yet, species structural position as core or peripheral was highly dynamic virtually all species that were at the core in some subseasons were also peripheral in other subseasons, while many other species remained always peripheral. 4. Our results illuminate our understanding of the dynamics of mutualistic networks and have important implications for ecosystem management and conservation. This article is protected by copyright. All rights reserved.BACKGROUND Vacuum and forceps assisted vaginal deliveries are reported to increase the incidence of postpartum infections and maternal readmission to hospital compared to spontaneous vaginal delivery. Prophylactic antibiotics may be prescribed to prevent these infections. However, the benefit of antibiotic prophylaxis for operative vaginal deliveries is still unclear. This is an update of a review last published in 2017. OBJECTIVES To assess the effectiveness and safety of antibiotic prophylaxis in reducing infectious puerperal morbidities in women undergoing operative vaginal deliveries including vacuum or forceps delivery, or both. SEARCH METHODS For this update, we searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (5 July 2019), and reference lists of retrieved studies. SELECTION CRITERIA All randomised controlled trials comparing any prophylactic antibiotic regimens with placebo or no treatment in women undergoterms of superficial and deep perineal wound infection or serious infectious complications in women undergoing operative vaginal deliveries without clinical indications for antibiotic administration after delivery. Prophylactic antibiotics slightly improve perineal pain and health consequences of perineal pain, probably reduce the costs, and may slightly reduce the maternal hospital re-admission and health-related quality of life. However, the effect on reduction of endometritis, organ or space perineal wound infection, maternal adverse reactions and maternal length of stay is unclear due to low-certainty evidence. As the evidence was mainly derived from a single multi-centre study conducted in a high-income setting, future well-designed randomised trials in other settings, particularly in low- and middle-income settings, are required to confirm the effect of antibiotic prophylaxis for operative vaginal delivery. Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.Enteric fistulas are among the most dreaded surgical complications. Controlling fistula effluent and protecting the surrounding tissue is a difficult long-term endeavor that can consume significant clinical resources. This article describes novel, one-piece compressible isolation devices that can be used to manage the body surface around an enteric fistula, stoma, or drain tube to seal and protect the patient from effluent. The described devices and methods are the result of an innovative partnership between an abdominal reconstructive surgeon and a Certified Wound Ostomy Nurse (CWON) to deliver improved patient outcomes.The demographics of total knee arthroplasty (TKA) patients are changing. Individuals are more active, younger, and more obese. These changing demographics and a higher demand for longevity creates a new challenge for reliable and long-term implant fixation. Historically, cemented fixation has remained the gold standard, as cementless design and techniques from the 1980s and 1990s did not obtain long-term positive outcomes due to a failure of ingrowth onto the implants. Advances in the modern-day cementless TKA designs appear to have overcome their initial challenges, indicating the dependence of cementless TKA on implant design. However, there remains the perception that cementless total knee arthroplasty are inferior to cemented TKA. This review discusses the longer-term survivorship data for recent systems, which has shown the potential advantages of cementless fixation.Median sternotomy is the most common access for cardiac surgery. Deep surgical wound infection (DSWI) and mediastinitis after median sternotomy remain significant clinical problems after cardiac surgery in terms of mortality, morbidity and healthcare-associated costs. Despite recent advances in medical management and consensus papers, their incidence ranges from 1% to 5%, and the associated mortality ranges from 20% to 50%. Recent studies in this field are providing excellent outcomes with promising results for the near future. The choice of sternal closure technique plays a crucial role in the prevention of DSWI and mediastinitis and should be tailored to the patient's characteristics, as clinical judgement and experience play a pivotal role. Early aggressive surgical debridement, vacuum-assisted closure (VAC) therapy, muscle flap and newer technologies are revolutionizing the paradigm of treatment of DSWI. Also, recent advances in tissue engineering have been refining potential approaches to tissue regeneration or substitution for enhanced wound repair. This editorial aims to briefly summarize the current and future techniques in DSWI prevention and treatment after cardiac surgery.in English, German HINTERGRUND  Der schnelle Fortschritt in der onkologischen Forschung bedingt eine Vielzahl neuer wissenschaftlicher Publikationen. Dieser Beitrag möchte daher einen Überblick über den aktuellen Wissensstand bezüglich der Kriterien-basierten Bildgebung und Responsebeurteilung bei Lymphomen liefern. So sind gemeinsame Kriterien in der Auswertung von Daten, insbesondere der bildgebenden Responseevaluation, für die Vergleichbarkeit der Studien essenziell. Während Kriterien-basierte Klassifikationen für solide Tumoren bereits länger etabliert sind, gibt es nun zunehmend auch Klassifikationen für Lymphomerkrankungen. Als Ziel dieser Übersichtsarbeit soll die Entwicklung der Kriterien-basierten Auswertung von Lymphomerkrankungen mit besonderem Schwerpunkt auf die Bildgebung bis hin zu den derzeit gültigen Leitlinien beschrieben werden. METHODE  Die Literaturrecherche erfolgte in PubMed in den Sprachen Englisch und Deutsch. Dieser Übersichtsartikel enthält die wichtigsten Kriterien-basierten Responseevaluationen von Lymphomerkrankungen, die von Januar 1999 bis Juli 2019 publiziert wurden.
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