A document by Faruk Yazıcı. Click on the document to view its contents.

A document by Abrar Alameri. Click on the document to view its contents.

Title: Exudative pleural effusion in a woman with granulosa cell tumorAuthors: Muhammad Anees, MBBS1, Kevin Chiu, MD2, Stephen Goertzen, DO3, Carlos Jimenez3, MD, Saadia Faiz, MD3Institutional Affiliations: 1Division of Pulmonary, Critical Care, and Sleep Medicine, McGovern Medical School at UTHealth, Houston, TX, United States, 2Department of Internal Medicine, McGovern Medical School at UTHealth, Houston, TX, United States, 3Department of Pulmonary Medicine, The University of Texas at MD Anderson Cancer Center, Houston, TX, United States.Corresponding Author: Saadia A. Faiz, MD, Department of Pulmonary Medicine, Unit 1462, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Houston, TX 77030-1402; Tel: (713)792-6238; Fax: (713) 794-4922; email: safaiz@mdanderson.orgConflicts of Interest: The author declares that no conflicts of interest existAuthor Contributions: MA, KC, SG, CJ, SF: conception and design, drafting the article, critical revision of intellectual content, final approval of the version to be publishedKey words: exudate, malignant pleural effusion, serositis, docetaxelPatient consent: The authors should confirm that written informed consent was obtained from the patient to publish this report in accordance with the journal’s patient consent policy.Word count: 939; Figures: 2; Tables: 1;Abstract word count: 183Abstract: Pleural effusions are common in cancer patients, and their development may signal progressive malignant disease. Drug-induced effusions are rare and often overlooked cause of exudative pleural effusions. We describe a 50-year-old woman with recurrent granulosa cell tumor of the ovary who developed bilateral pleural and pericardial effusions after 10 cycles of docetaxel and bevacizumab. Imaging showed stable pelvic disease without thoracic metastases. Pleural fluid analysis revealed exudates with negative cytology and cultures. Pleuroscopy demonstrated normal pleura, and biopsies confirmed reactive mesothelial hyperplasia without malignancy. Bilateral indwelling pleural catheters were placed. After discontinuation of docetaxel, effusions resolved, and indwelling pleural catheters were removed. Docetaxel causes fluid retention, typically generalized, but isolated serositis is uncommon. In our case, the temporal association with docetaxel, absence of malignant pleural involvement, and resolution after drug cessation support a diagnosis of docetaxel-induced serositis. This highlights the importance of considering non-malignant etiologies in patients with cancer with new effusions. Further multidisciplinary evaluation in these cases is paramount. Drug-induced serositis should be considered in patients receiving docetaxel who develop pleural effusions, particularly when imaging shows stable disease and cytology is negative.Key clinical message: Pleural effusions in cancer patients may signal progressive malignant disease, but therapy-related effusion may also occur. In cases of exudative effusion of unclear etiology, diagnostic intervention may be needed. Drug-induced serositis may occur in patients receiving docetaxel, particularly when imaging shows stable disease and cytology is negative.Introduction: Pleural effusions commonly occur in patients with cancer, and they may emerge due to a myriad of etiologies. Pleural fluid analysis is central to diagnostic evaluation(1). Although most malignant pleural effusions are exudates by Light’s criteria, transudates may also occur. Diagnostic sensitivity of pleural fluid cytology may vary based on tumor type(2). We describe a challenging case of bilateral effusions in a woman with granulosa cell tumor of the ovary.Case History/Examination: A 50-year-old woman with granulosa cell tumor of the ovary underwent a total laparoscopic hysterectomy with bilateral salpingo-oophorectomy. Three years later, she developed recurrent disease with both perirectal and peritoneal metastases. She underwent laparotomy with debulking and subsequently received carboplatin/paclitaxel. Repeat imaging showed persistent pelvic disease without chest metastases, along with subcutaneous metastases, and she was then started on docetaxel and bevacizumab. After 10 cycles of docetaxel and bevacizumab, she presented with dyspnea with exertion and orthopnea. On physical exam, vital signs were as follows: blood pressure 134/96 mmHg, heart rate 107 beats per minute, temperature 98.1 F, respiratory rate 21 times per minute, body mass index 46.3 kg/m2. She had decreased bibasilar breath sounds, mild peripheral edema, but could not appreciate jugular venous distention or ascites given body habitus. Laboratory data was normal including N-terminal pro-B-type natriuretic peptide 74 pg/ml (<= 125 pg/ml), creatinine 0.59 mg/dl (0.51-0.95 mg/dl), serum albumin 3.5 gm/dl (3.5-5.2 gm/dl). Imaging demonstrated improving response in the measurable malignant disease but increased pericardial and bilateral pleural effusions had developed (Figure 1). The echocardiogram revealed normal left and right ventricular function and a small to moderate pericardial effusion, without signs of tamponade. Abdominal ultrasound did not show ascites. Bilateral thoracenteses improved her symptoms, and pleural fluid analysis (Table 1) revealed exudates. Cytology was negative. Two weeks later, she had recurrent symptoms with reaccumulation of bilateral pleural and stable pericardial effusions on imaging. Given unclear etiology of pleural effusions, pleuoroscopy with pleural catheter placement on her left hemithorax and placement of indwelling pleural catheter (IPC) on the right hemithorax was performed. Pleuroscopy reviewed no discrete lesions on the parietal pleura, and biopsies revealed reactive mesothelial hyperplasia without malignancy (Figure 2). Serum tumor markers were stable. After multidisciplinary discussion, docetaxel was held with subsequent cycles of chemotherapy.

A document by Mohammed Deeb Zakkor. Click on the document to view its contents.

Case ReportTitle: Impacted drug-packet in the sigmoid colon: a case report in a resource- constrained setting.

Background: Left uterine displacement (LUD) during caesarean delivery (CD) is widely recommended to prevent aortocaval compression and improve maternal haemodynamic and neonatal outcomes. However, prior Cochrane review conducted a decade ago found limited evidence supporting LUD’s efficacy. Objective: To evaluate the impact of LUD on maternal haemodynamic state, vasopressor requirements, and neonatal outcomes during CD Search Strategy: MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled trials (CENTRAL) from January 1966 to August 2025. Selection Criteria: Randomized controlled trials comparing LUD + supine versus supine position during CD. No language restrictions. Data Collection and Analysis: Using PRISMA guidelines two reviewers independently screened studies, extracted data and assessed risk of bias. A random effects model was used for meta-analysis to estimate pooled odds ratios with 95 % confidence intervals. The protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023408564). Main Results: Seven studies (666 patients) met inclusion criteria. Pooled data showed no significant differences between LUD + supine versus supine groups for the primary outcome of the incidence of hypotension (OR 0.51, 95% CI: 0.24 to 1.06) or umbilical artery pH (MD (95%CI): 0.01 (-0.01 to 0.02). Maternal systolic or mean blood pressure, incidence of nausea/vomiting or vasopressor requirements did not show significant differences nor did any other neonatal outcomes, including APGAR scores. Conclusion: Left uterine displacement does not significantly impact maternal haemodynamic state, vasopressor use, or neonatal outcomes in the current obstetric anaesthesia practice. Routine LUD application during CD should be reconsidered.

Single Dose Amoxicillin Challenge for Suspected Serum Sickness-Like ReactionsAuthors : Nikhil A. Crain, MD1, Kirstin D. Carel, MD2, Sean T. O’Leary, MD, MPH3, Laura A. Wang, MD, MPH21 Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA2 Department of Pediatrics, Section of Allergy & Immunology, University of Colorado School of Medicine, Aurora, CO, USA3 Department of Pediatrics, Section of Infectious Disease, University of Colorado School of Medicine, Aurora, CO, USARunning Title: Single Dose Amoxicillin Challenge SSLRCorrespondence : Laura Ann Wang, MD, Children’s Hospital Colorado Anschutz Medical Campus, 13123 East 16th Ave, Aurora, CO, USA 80045, T: 720-777-1234, F: 720-848-1947Word Count: 844Tables : 1Figures : noneConflicts of Interest: noneFunding source: noneKey Words: Serum sickness-like reactions, amoxicillin, penicillin allergy, single dose drug challenge, drug allergy labelsTo the Editor:Serum sickness–like reactions (SSLRs) are delayed adverse reactions triggered by viral infections and medications.1 SSLRs associated with penicillin-based antibiotics are generally uncommon and mild, and a prior study suggests that graded oral challenges may be used to differentiate between beta-lactam-induced SSLRs and viral exanthems.2 Nevertheless, tolerance of a challenge does not preclude SSLR recurrence with future antibiotic exposure.1 While allergy practice parameters endorse direct drug challenges for low-risk benign cutaneous reactions, there is no consensus regarding SSLR challenge protocols—namely, whether to use single-dose, multi-dose, or graded approaches.3 In this retrospective study, we share outcomes of children who underwent direct single-dose amoxicillin challenges after being referred for symptoms concerning for SSLR by primary care providers.We reviewed electronic medical records (EMR) of patients who completed a direct single dose amoxicillin challenge in the outpatient allergy clinic at Children’s Hospital Colorado between 2020 and 2025. Patients received a single dose of oral amoxicillin (45 mg/kg, up to 1 g) followed by a one-hour observation period. Children were classified as having SSLR if they met the following criteria: 1) rash or hives with swelling, arthritis, or arthralgia, or 2) clinical suspicion for SSLR (e.g., swollen hands). Due to its variability in presentation, fever was not a requirement for inclusion, although its presence or absence was noted. Data were collected on patient demographics, index reaction characteristics, and labeling outcomes at the time of chart review. Summary statistics were generated to describe the demographic and clinical outcomes of patients. Our institution investigational research board (IRB) approved this study for exemption and determined consent was not required (IRB #23-1190).A total of 867 children underwent single-dose amoxicillin challenge. Seventy-four (9%) patients had index reaction symptoms consistent with SSLR (Table 1 ). Half of patients were male (50%), 32% were 2 to <6 years, 31% were 6 to <11 years, and 37% were either <2 years or ≥11 years. Index reaction was on average 4.2 years prior to allergist visit. Over half (54%) had no atopic history. Fifty-six (76%) patients had reports of swelling (e.g., “swelling”, “edema”, “puffiness”), 13 (18%) had fever, and 11 (15%) had arthritis/arthralgia (e.g., “joint pain”, “pain with walking”); nearly all (92%) presented with concurrent rash or hives. Amoxicillin was the index reaction antibiotic for most patients (91%). Most symptoms occurred after the second day of antibiotic course (57%). All patients (100%) passed a single dose amoxicillin challenge with a 1-hour observation period and were sent home following the challenge. Two patients developed late symptoms after the initial challenge (rash and joint swelling, ranging from 7 hours to 3 days after the challenge dose).There was documentation that 11 (16%) patients had exposure to a penicillin-based antibiotic course after passing the challenge. Of these, one had a documented reaction (diffuse rash with some swelling on hands, ears and face approximately three days into amoxicillin course) that occurred five years after the initial challenge. There was no documented reaction among the other patients with penicillin-based antibiotic exposure. The remaining 62 (84%) patients did not have documentation of subsequent penicillin class exposure or reaction.This retrospective study is among the first to describe children with clinical presentations concerning for SSLR who underwent a single dose amoxicillin challenge. Of note, all patients passed the direct oral challenge without immediate symptoms concerning for anaphylaxis or requiring emergency care. Among the 867 total patients in our overall cohort, about 10% had symptoms (e.g., swelling, fever, arthralgia/arthritis) consistent with SSLR, warranting closer assessment by an allergist. Amoxicillin has been reported as the most common antibiotic associated with serum sickness or SSLR reactions, which was the primary index reaction drug among penicillin-based antibiotics in our study.4 The prevalence of amoxicillin-induced SSLRs is challenging to discern due to symptom overlap and diagnostic uncertainty, with reports of the prevalence of amoxicillin-related SSLR ranging from 4 to 87%.5,6Fernandez et al. recently reported findings that children may unpredictably develop SSLR symptoms upon subsequent exposure to culprit antibiotics – often in the setting of concurrent illness – despite passing drug challenges.7 Their research highlights the difficulty of predicting SSLR and the complex immune interplay between antibiotics and infection.8,9 Average length of follow up from drug challenge to chart review in our cohort was 1.6 years (range 0.5-5.1 years). Research that incorporates longitudinal follow-up and identifies patient, drug, or illness factors associated with SSLR recurrence is warranted.This study has several limitations. First, the smaller sample size, coupled with a predominantly white cohort, may limit generalizability to populations outside our state. Second, as a retrospective review, findings were reliant on information available in our institution’s electronic medical record, and events occurring outside the system may not be captured. Third, our broad inclusion criteria may have included patients that did not truly have an SSLR. Diagnostic clarity and consensus criteria around SSLR would enhance future surveillance of outcomes.8In conclusion, this study supports the feasibility and safety of single dose amoxicillin challenges for children with suspected SSLR. Future collaboration among allergists and researchers should focus on defining optimal challenge protocols and developing approaches to potentially risk-stratify patients for future SSLR reactions.Nikhil A. Crain, MD, Kirstin D. Carel, MD, Sean T. O’Leary, MD, MPH, Laura A. Wang, MD, MPH, University of Colorado School of Medicine, Aurora, CO, USAAcknowledgements : NoneKey Message: This research supports the feasibility of single-dose amoxicillin challenges in children who were referred for symptoms concerning for SSLR by primary care providers.

Background: In 2023-24, 33% of labours were induced in England. The prostaglandin dinoprostone is commonly used, but evidence is increasing that misoprostol may be a better alternative. Objectives: Compare the efficacy and safety of vaginal dinoprostone with vaginal misoprostol for labour induction. Search Strategy: Electronic databases (Medline, Scopus, CINAHL, Cochrane Central Register) were searched in 2025. Selection Criteria: Randomised controlled trials comparing singleton, term inductions with vaginal dinoprostone or misoprostol published after 2000. Primary outcome was vaginal births within 24 hours. Secondary outcomes included birth mode, induction to birth interval, oxytocin augmentation, uterine hyperstimulation and adverse maternal or neonatal outcomes. Data Collection and Analysis: Data extraction used a standardised proforma including the Cochrane Risk of Bias. A random effects meta-analysis was performed using R. Main Results: From 8,529 records, 44 papers reported 7,040 participants induced with vaginal misoprostol and 6,604 with dinoprostone. Risk of bias was moderate. Participants given misoprostol were 48% (OR 1.48 95% CI 1.20, 1.84) more likely to achieve vaginal birth within 24 hours compared with those given dinoprostone, although heterogeneity was high. The rates of the above-mentioned secondary outcomes were comparable. In the misoprostol group, fewer patients required augmentation with oxytocin (OR 0.51 95% CI 0.40, 0.65). Conclusion: Induction of labour with vaginal misoprostol seems to improve the rate of vaginal birth within 24 hours when compared to dinoprostone without increasing the incidence of adverse events with fewer patients requiring oxytocin augmentation. We encourage consideration of vaginal misoprostol as a first-line agent for labour induction.

The objective was to analyze the reliability, internal structure, invariance, and sex-based network of the scores of Mexican university students on the Depression, Anxiety, and Stress Scale (DASS-21). The sample consisted of 773 participants from a public university in Mexico. We analyzed factorial, convergent, discriminant, and predictive validity using Confirmatory Factor Analysis, Average Variance Extracted (AVE), the Fornell–Larcker discriminant analysis, Heterotrait–Monotrait Correlation Relationships (HTMT), and Linear Regression Analysis, respectively. The reliability of the scale was analyzed using McDonald’s Omega coefficient. Using Multigroup Confirmatory Factor Analysis, Mean Analysis, and Network Analysis, we compared the scale scores of participants grouped by gender. Evidence of reliability and validity was found for the scores of Mexican university students on the Depression, Anxiety, and Stress Scale (DASS-21). Likewise, significant differences were found between men and women in symptoms of Depression, Anxiety, and Stress, and an internal structure was identified that assumes a higher-order factor called General Psychological Distress, which explains the factors of Depression, Anxiety, and Stress. Thus, a reliable and valid instrument to evaluate and address the mental health of university students in Mexico from a preventive approach.

The evolutionary history of Ephedra L. has over time proved to be a very difficult phylogenetic problem, something which is probably best reflected by the incongruent phylogenetic relationships demonstrated in and among previous studies. Low number of phylogenetically informative sites and different rooting strategies have been suggested as explanations, but the role of gene tree discordance and its underlying causes and influence on phylogenetic reconstruction in Ephedra has largely remained unexplored. In the present study we address the phylogeny of Ephedra using information from a large set of nuclear low-copy genes obtained with a specifically designed bait set. We explore the potential effect of putative paralogy, intra-locus recombination and chimeric sequences on phylogenic estimation in Ephedra, while striving at minimizing the risk for gene tree error. Our results indicate that recombination and putatively paralogous sequences have limited influence on phylogenetic results, although handling of putative paralogs and recombinants did improve overall species tree resolution and statistics. A robust Ephedra species phylogeny was obtained by analyzing gene trees in which orthologous clades were inferred from data composed of orthologous and putative paralogous sequences. The results support the division of Ephedra into three geographically defined clades, with the American clade as sister to the Mediterranean clade and the Asian clade. Relationships among species within these three clades were relatively consistent among our analytical approaches, but our results highlighted moderate to strong signals of gene tree discordance at many nodes. ILS is a possible explanation for this discord for many nodes, but hybridization/introgression are also commonly indicated.

IntroductionAirway stenosis due to hilar and mediastinal lymph node metastases of renal cell carcinoma (RCC) is rare. Because RCC is a highly vascular tumor, endobronchial or intrapulmonary metastases may cause hemoptysis and carry a high risk of asphyxiation. Although chemotherapy and radiotherapy are generally used for treatment, airway stenting can provide rapid relief in cases of airway stenosis,1 as it restores airway patency and improves respiratory status, activities of daily living (ADL), and quality of life (QOL) before definitive therapies are effective. Bronchial arterial embolization (BAE) is another effective modality for managing hemoptysis and airway obstruction. Rigid bronchoscopic intervention for metastasis of renal cell carcinoma requires sufficient preparation for massive intraoperative bleeding for safer treatment.2 We report a case in which BAE followed by airway hybrid stent placement successfully improved the outcome of a patient with airway stenosis caused by pulmonary metastasis of RCC.

A document by Parul Issar. Click on the document to view its contents.

IntroductionHereditary angioedema (HAE) is a rare genetic disorder caused by dysregulation of the kallikrein–kinin system, resulting in excessive bradykinin production and recurrent episodes of angioedema(1). Clinical manifestations include swelling of the skin, gastrointestinal tract, and upper airway, leading to abdominal pain, vomiting, and potentially life-threatening laryngeal edema. Attacks often occur unpredictably, and identifiable triggers are absent in many cases(2).However, invasive procedures involving mechanical or mucosal stimulation, such as tracheal intubation and endoscopic interventions, are well-recognized precipitants of angioedema attacks, particularly those affecting the upper airway(3). Given the risk of fatal airway obstruction, international guidelines, including those of the World Allergy Organization/European Academy of Allergy and Clinical Immunology (WAO/EAACI)(4), recommend short-term prophylaxis for patients with HAE undergoing invasive procedures.Short-term prophylaxis with a plasma-derived C1 inhibitor concentrate (C1-INH) is recommended for patients with HAE undergoing invasive procedures(4-6). Recently, lanadelumab, a monoclonal antibody targeting plasma kallikrein, has been introduced as an effective long-term prophylactic therapy, substantially reducing the HAE attack frequency and disease burden(7). However, evidence regarding perioperative management strategies for patients receiving lanadelumab remains limited, and optimal approaches for integrating long-term prophylaxis with procedure-specific risk management have not yet been established(8, 9).Herein, we report a patient with type I HAE receiving long-term lanadelumab prophylaxis who successfully underwent two invasive procedures with different levels of invasiveness: endoscopic retrograde cholangiopancreatography (ERCP) under conscious sedation and laparoscopic cholecystectomy under general anesthesia with tracheal intubation. This case highlights the practical considerations for perioperative management in the era of long-term prophylaxis, emphasizing the importance of tailored short-term prophylaxis and multidisciplinary collaboration in patient management.

Participatory approaches to decision making which involve the potential beneficiaries ensure that the decisions are acceptable and interventions effective. However, in cultures where adolescents and young women (AGYW) are marginalized, they lack access to decision-making processes- even when the decisions affect them. This is more so for undocumented AGYW who work in the informal artisanal mining sector. This paper reports on an approach that meaningfully engaged AGYW, from Uganda and Uganda, in a participatory decision making with regards to their health, and economic well being. The nominal group discussion technique supported AGYWs to identify the relevant priorities at the community, district and national levels. The AGYW identified the top priority interventions, which were validated by district and national level stakeholders. The provision of information and training if participants supported the AGYW to identify priorities which resonated with the decision makers. The process empowered the AGYW to advocate for the priority interventions. The participatory approach empowered the AGYW, and enabled them to meaningfully engage in priority setting and to advocate for themselves. The approaches used in this study are useful to researchers and decision makers who are interested in including vulnerable populations in decision making and programming.

Mobile EEG has become popular in investigating brain dynamics during gait in recent years. Within this development, new preprocessing pipelines have been introduced and improvised. The diversity of approaches, however, complicates comparisons across studies. To provide clarity, we reviewed studies combining mobile EEG with gait measurements to map the preprocessing pipelines employed in the field. Our analysis identified substantial heterogeneity in pipeline steps, their order, combinations, and the level of reporting detail. We visualized this heterogeneity as a map, tracing pathways from raw data to outcomes such as Power spectral density (PSD), Event-related spectral perturbations (ERSP), Event-related (de)-synchronization (ERD/ERS), and Corticomuscular coherence (CMC), along with a subsequent analysis highlighting unique pipelines. Notably, artifact rejection varied across studies in both the tools used and reporting practices. While differences in experimental paradigms can justify this variability, this challenges comparability across findings. These results emphasize the need for transparent reporting standards and jointly developed guidelines within the mobile EEG community.

not-yet-known not-yet-known not-yet-known unknown Introduction : Direct oral anticoagulants (DOAC) are widely used by elderly populations that are often exposed to polypharmacy. Pharmacodynamic drug interactions (PD-DDI) may increase the risk of haemorrhage in patients on DOAC. Methods : A case-cross over and cohort study designs were used to assess the risk of haemorrhage (gastrointestinal and intracranial haemorrhage) due to PD-DDI on patients exposed to DOAC and concomitantly to nonsteroidal anti-inflammatory drugs (NSAIDs), antiplatelet agents, corticosteroids and antidepressants inhibiting serotonin reuptake. Using the Health Research and Innovation Data Analysis Programme (PADRIS) of the Health Department of the Government of Catalonia, Spain a conditional logistic regression analysis showing the odds ratio (OR) and 95% confidence interval (95%) in the case-crossover design and a propensity score match (PSM) in the case of the cohort design were run. Results : Case-crossover design: A total of 2,422 patients were on DOAC and experienced a haemorrhagic event. PD-DDI risk of haemorrhage for NSAID showed an OR 2.89 (05% CI 1.91 - 4.37), a OR 1.95 (95% CI 1.30 - 2.93) for antiplatelets and OR 1.88 (95% CI 1.30 - 2.72) for corticosteroids. There were no associations with intracranial haemorrhage. Cohort design: After PSM the cohort of 43,892 patients on a DOAC showed 21,943 exposed to a PD-DDI. NSAIDs PD-DDI showed a threefold risk of haemorrhage (OR 2.75, 95% CI 1.22 - 6.18) and gastrointestinal specific too (OR 3.6, 95% CI 1.34 - 9.70), with no risk of intracranial haemorrhage. Conclusions : DOAC have increased risk of haemorrhage when concomitantly exposed to drugs that also show risk of haemorrhage (PD-DDI). Clinicians may need to personalize according to the PD-DDI risk of haemorrhage in high-risk patients, this is according to their personal history and need of concomitant used other medications.

The timing of migratory departure represents a critical behavioural decision in the annual cycle of long-distance migrants; however, the proximate environmental cues underlying this process remain poorly resolved for many species. We aimed to examine the environmental factors affecting the migratory departure of Dark-bellied Brent Geese (Branta bernicla bernicla) from the German Wadden Sea, as the species’ principal pre-breeding staging area along the East Atlantic Flyway. We analysed high-resolution GPS tracking data from 61 Dark-bellied Brent Geese during spring migration. Departures occurred within a narrow seasonal window between 14 May and 6 June (mean = 26 May), with a pronounced preference for late-afternoon and evening hours. Hourly ERA5 reanalysis data, as gridded global weather information produced by the European Centre for Medium-Range Weather Forecasts, were linked to each bird’s pre-departure period and analysed using Cox proportional hazard models. Wind assistance emerged as the dominant predictor of departure probability, with geese showing a markedly higher likelihood of departing under strong tailwinds and a reduced likelihood under humid conditions, indicating a preference for dry, supportive airflow. Time-varying analyses further revealed that the influence of wind assistance was strongest early in the migration window and gradually weakened towards its end, suggesting increasing migratory urgency over time. Other meteorological variables, including temperature, cloud cover, and air pressure, showed negligible effects. These findings demonstrate that Brent Geese fine-tune the onset of spring migration to exploit transient atmospheric opportunities. The pronounced sensitivity to wind assistance highlights the importance of short-term weather dynamics in shaping migration timing and highlights potential vulnerability to changing wind regimes in an increasingly human-modified atmosphere.

A document by Xiaojing Zhang. Click on the document to view its contents.