Isolated populations of a rare alpine plant show high genetic diversity and considerable population differentiation

Background and Aims Gene flow and genetic variability within and among alpine plant populations can be greatly influenced by the steep environmental gradients and heterogeneous topography of alpine landscapes. In this study, the effects are examined of natural isolation of alpine habitats on genetic diversity and geographic structure in populations of C. thyrsoides, a rare and isolated European Alpine monocarpic perennial with limited seed dispersal capacity. Methods Molecular diversity was analysed for 736 individuals from 32 populations in the Swiss Alps and adjacent Jura mountains using five polymorphic microsatellite loci. Pollen flow was estimated using pollen grain-sized fluorescent powder. In addition, individual-based Bayesian approaches were applied to examine population structure. Key Results High within-population genetic diversity (HE = 0·76) and a relatively low inbreeding coefficient (FIS = 0·022) were found. Genetic differentiation among populations measured with a standardized measure was considerable (G′ST = 0·53). A significant isolation-by-distance relationship was found (r = 0·62, P < 0·001) and a significant geographic sub-structure, coinciding with proposed postglacial migration patterns. Altitudinal location and size of populations did not influence molecular variation. Direct measures of pollen flow revealed that insect-mediated pollen dispersal was restricted to short distances within a population. Conclusions The natural isolation of suitable habitats for C. thyrsoides restricts gene flow among the populations as expected for a monocarpic species with very limited seed dispersal capacities. The observed high within-population genetic diversity in this rare monocarpic perennial is best explained by its outcrossing behaviour, long-lived individuals and overlapping generations. Despite the high within-population genetic diversity, the considerable genetic differentiation and the clear western-eastern differentiation in this species merits consideration in future conservation effort

International Governance in the Arctic - The Development of Cooperation, Challenges and Division of Opinions

In this thesis the development of governance and cooperation in the Arctic is discussed. The main goal is to provide an overview of the current and future challenges in terms of governance in the realm of International Relation theories and globalization. This is of great importance today as the Arctic is going through turbulent times in terms of governance and many have discussed the need to strengthen the regulatory frameworks. The thesis consists of two parts. In the latter part a study conducted in the spring 2015 is presented. A questionnaire was sent out to participants of the Arctic Biodiversity Congress 2014. The aim of the study was to outline the division of opinions and attitudes towards Arctic governance discussed in the former part. The results from the study confirm that opinions and attitudes towards international governance in the Arctic are very divided. Using multiple indicators to create a composite variable showed that attitude towards Arctic governance was slightly more negative than positive. The thesis concludes that the development has been towards cooperation and that conflict is unlikely in the Arctic. However there are many conflicting opinions, producing great challenges for the future of international governance in the Arctic

Availability and costs of medicines for the treatment of tuberculosis in Europe

Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved. Funding Information: CLa provided consultation service to INSMED and received speaker's honoraria from INSMED, GILEAD, and JANSSEN, outside of the scope of this work. The other authors declare that they have no conflicts of interest. CLa is supported by the German Center for Infection Research (DZIF). All other authors have no funding source in the context of this manuscript. Publisher Copyright: © 2022 The Author(s)OBJECTIVES: To evaluate the access to comprehensive diagnostics and novel antituberculosis medicines in European countries. METHODS: We investigated the access to genotypic and phenotypic Mycobacterium tuberculosis drug susceptibility testing and the availability of antituberculosis drugs and calculated the cost of drugs and treatment regimens at major tuberculosis treatment centres in countries of the WHO European region where rates of drug-resistant tuberculosis are the highest among all WHO regions. Results were stratified by middle-income and high-income countries. RESULTS: Overall, 43 treatment centres from 43 countries participated in the study. For WHO group A drugs, the frequency of countries with the availability of phenotypic drug susceptibility testing was as follows: (a) 75% (30/40) for levofloxacin, (b) 82% (33/40) for moxifloxacin, (c) 48% (19/40) for bedaquiline, and (d) 72% (29/40) for linezolid. Overall, of the 43 countries, 36 (84%) and 24 (56%) countries had access to bedaquiline and delamanid, respectively, whereas only 6 (14%) countries had access to rifapentine. The treatment of patients with extensively drug-resistant tuberculosis with a regimen including a carbapenem was available only in 17 (40%) of the 43 countries. The median cost of regimens for drug-susceptible tuberculosis, multidrug-resistant/rifampicin-resistant tuberculosis (shorter regimen, including bedaquiline for 6 months), and extensively drug-resistant tuberculosis (including bedaquiline, delamanid, and a carbapenem) were €44 (minimum-maximum, €15-152), €764 (minimum-maximum, €542-15152), and €8709 (minimum-maximum, €7965-11759) in middle-income countries (n = 12) and €280 (minimum-maximum, €78-1084), €29765 (minimum-maximum, €11116-40584), and €217591 (minimum-maximum, €82827-320146) in high-income countries (n = 29), respectively. DISCUSSION: In countries of the WHO European region, there is a widespread lack of drug susceptibility testing capacity to new and repurposed antituberculosis drugs, lack of access to essential medications in several countries, and a high cost for the treatment of drug-resistant tuberculosis.Peer reviewe

Adaptation of the Critical Care Family Need Inventory to the Turkish population and its psychometric properties

In the complex environment of intensive care units, needs of patients’ relatives might be seen as the lowest priority. On the other hand, because of their patients’ critical and often uncertain conditions, stress levels of relatives are quite high. This study aims to adapt the Critical Care Family Need Inventory, which assesses the needs of patients’ relatives, for use with the Turkish-speaking population and to assess psychometric properties of the resulting inventory. The study was conducted in a state hospital with the participation of 191 critical care patient relatives. Content validity was assessed by expert opinions, and construct validity was examined by exploratory factor analysis (EFA). Cronbach’s alpha coefficient was used to determine internal consistency. The translated inventory has a content validity ratio higher than the minimum acceptable level. Its construct validity was established by the EFA. Cronbach’s alpha coefficient for the entire scale was 0.93 and higher than 0.80 for subscales, thus demonstrating the translated version’s reliability. The Turkish adaptation appropriately reflects all dimensions of needs in the original CCFNI, and its psychometric properties were acceptable. The revised tool could be useful for helping critical care healthcare workers provide services in a holistic approach and for policymakers to improve quality of service

Tuberculosis incidence in foreign-born people residing in European countries in 2020.

BackgroundEuropean-specific policies for tuberculosis (TB) elimination require identification of key populations that benefit from TB screening.AimWe aimed to identify groups of foreign-born individuals residing in European countries that benefit most from targeted TB prevention screening.MethodsThe Tuberculosis Network European Trials group collected, by cross-sectional survey, numbers of foreign-born TB patients residing in European Union (EU) countries, Iceland, Norway, Switzerland and the United Kingdom (UK) in 2020 from the 10 highest ranked countries of origin in terms of TB cases in each country of residence. Tuberculosis incidence rates (IRs) in countries of residence were compared with countries of origin.ResultsData on 9,116 foreign-born TB patients in 30 countries of residence were collected. Main countries of origin were Eritrea, India, Pakistan, Morocco, Romania and Somalia. Tuberculosis IRs were highest in patients of Eritrean and Somali origin in Greece and Malta (both > 1,000/100,000) and lowest among Ukrainian patients in Poland (3.6/100,000). They were mainly lower in countries of residence than countries of origin. However, IRs among Eritreans and Somalis in Greece and Malta were five times higher than in Eritrea and Somalia. Similarly, IRs among Eritreans in Germany, the Netherlands and the UK were four times higher than in Eritrea.ConclusionsCountry of origin TB IR is an insufficient indicator when targeting foreign-born populations for active case finding or TB prevention policies in the countries covered here. Elimination strategies should be informed by regularly collected country-specific data to address rapidly changing epidemiology and associated risks

Rifapentine access in Europe: growing concerns over key tuberculosis treatment component

[No abstract available]Support statement: C. Lange is supported by the German Center of Infection Research (DZIF). All other authors have no funding to declare for this study. Funding information for this article has been deposited with the Crossref Funder Registry

Artificial Intelligence-based methods in head and neck cancer diagnosis : an overview

Background This paper reviews recent literature employing Artificial Intelligence/Machine Learning (AI/ML) methods for diagnostic evaluation of head and neck cancers (HNC) using automated image analysis. Methods Electronic database searches using MEDLINE via OVID, EMBASE and Google Scholar were conducted to retrieve articles using AI/ML for diagnostic evaluation of HNC (2009–2020). No restrictions were placed on the AI/ML method or imaging modality used. Results In total, 32 articles were identified. HNC sites included oral cavity (n = 16), nasopharynx (n = 3), oropharynx (n = 3), larynx (n = 2), salivary glands (n = 2), sinonasal (n = 1) and in five studies multiple sites were studied. Imaging modalities included histological (n = 9), radiological (n = 8), hyperspectral (n = 6), endoscopic/clinical (n = 5), infrared thermal (n = 1) and optical (n = 1). Clinicopathologic/genomic data were used in two studies. Traditional ML methods were employed in 22 studies (69%), deep learning (DL) in eight studies (25%) and a combination of these methods in two studies (6%). Conclusions There is an increasing volume of studies exploring the role of AI/ML to aid HNC detection using a range of imaging modalities. These methods can achieve high degrees of accuracy that can exceed the abilities of human judgement in making data predictions. Large-scale multi-centric prospective studies are required to aid deployment into clinical practice

Plant reproduction in the alpine landscape : reproductive ecology, genetic diversity and gene flow of the rare monocarpic "Campanula thyrsoides" in the Swiss Alps

Aims & Objectives The work presented in this thesis forms part of a larger project “How patchy habitat and isolation affect alpine plant life: genetic diversity, gene flow and mating systems”, which includes the PhD studies of Patrick Kuss and the author under the supervision of Professor Jürg Stöcklin. This doctoral thesis investigates the consequences of the natural fragmentation and patchiness of alpine landscapes on the life of alpine plant populations. The central focus of the thesis is on the mating system, the role of inbreeding and/or outbreeding depression, genetic diversity and geographic structure within and among populations of the rare Alpine monocarpic perennial Campanula thyrsoides. The main objectives and research questions addressed are: • Is Campanula thyrsoides self-compatible (SI) and if not, does the SI system break down with flower age? Do inbred C. thyrsoides offspring in the common garden suffer from inbreeding depression? • Do we find a distance related inbreeding depression (poorer reproducive output) or outbreeding depression (increased reproductive output) in field populations of C. thyrsoides following crosses of different crossing distances (selfing, 1m, 10m, 100m and among distant populations)? • How much genetic diversity exists within populations of C. thyrsoides and how does it relate to population size and altitude? Has the natural habitat fragmentation let to strong genetic differentiation and restricted gene flow among populations of C. thyrsoides resulting in a pronounced geographic structure? Study species In order to seek answers to our research questions, we choose to study a yellow bellflower; Campanula thyrsoides. The choice was based on the information that C. thyrsoides is a rare plant species, which is only found on calcarious soils within the European Alps and adjacent mountain ranges (Aeschimann et al. 2005). The plants selectiveness for carbonate bearing soils together with the fact that its seeds are not adapted to long-distance dispersal (Tackenberg 2003) are the main reasons for the isolation and small sizes of many of its populations. These population characteristics, therefore, made C. thyrsoides a suitable study species. Another important characteristic of C. thyrsoides, and one of the main reasons for its inclusion in the study is because it is a monocarpic perennial which flowers once and subsequently dies (Jäger 2000). Monocarpic plants species, which are more commonly found in subtropical and tropical mountain systems (e.g. the giant rosettes of Puya spp, Espeletia spp., Echium spp. etc., Smith & Young 1987; Young & Augspurger 1991) are rare amidst the temperate alpine flora (for the Alps, see Aeschimann et al. 2005). Monocarpy can promote genetic differentiation between populations by reducing the effective population size due to a shorter generation time and lower density of populations (Loveless & Hamrick 1984; Vitalis et al. 2004). When studying the effects of population isolation and habitat fragmentation on plant reproduction (e.g. mating system and inbreeding depression), it is, moreover, ideal to study a Campanula species. Although most Campanula species are selfincompatible and allogamous (Nyman 1993), both a break-down in the SI system with flower age (Vogler et al. 1998) and an evolution towards complete self-compatibility (Ægisdóttir & Thórhallsdóttir 2006) have been recorded. Design We studied the reproductive ecology and genetic diversity of Campanula thyrsoides by firstly setting up pollination experiments in the common garden and in the field and secondly by sampling leaf material in 32 field populations in Switzerland. In the common garden study, we set up a pollination experiment in order to study the breeding system of C. thyrsoides, including the consequences of selfing, half-sibling crossings and outcrossing on reproductive output and seedling performance. Moreover, field experiments in four populations were set up in the Swiss Alps in order to study the effect of different crossing distances on reproduction in C. thyrsoides and to see if evidence would be found of hidden inbreeding depression or outbreeding depression following large-distance crossings compared to within-population crossings. In addition, we studied the genetic diversity, gene flow and geographical structure within and among 32 field populations of C. thyrsoides in Switzerland, covering both large geographical and altitudinal ranges. The genetic study was conducted using 5 co-dominant microsatellite markers. In addition, we studied the genetic diversity in C. thyrsoides and two other alpine plants using random amplified polymorphic DNA (RAPD) marker as well as studing the evolutionary demography of C. thyrsoides