60 research outputs found
Mosaic fungal individuals have the potential to evolve within a single generation
Although cells of mushroom-producing fungi typically contain paired haploid nuclei (n + n), most Armillaria gallica vegetative cells are uninucleate. As vegetative nuclei are produced by fusions of paired haploid nuclei, they are thought to be diploid (2n). Here we report finding haploid vegetative nuclei in A. gallica at multiple sites in southeastern Massachusetts, USA. Sequencing multiple clones of a single-copy gene isolated from single hyphal filaments revealed nuclear heterogeneity both among and within hyphae. Cytoplasmic bridges connected hyphae in field-collected and cultured samples, and we propose nuclear migration through bridges maintains this nuclear heterogeneity. Growth studies demonstrate among- and within-hypha phenotypic variation for growth in response to gallic acid, a plant-produced antifungal compound. The existence of both genetic and phenotypic variation within vegetative hyphae suggests that fungal individuals have the potential to evolve within a single generation in response to environmental variation over time and space
Potential Unintended Consequences Due to Medicareβs βNo Pay for Errors Ruleβ? A Randomized Controlled Trial of an Educational Intervention with Internal Medicine Residents
Medicare has selected 10 hospital-acquired conditions for which it will not reimburse hospitals unless the condition was documented as βpresent on admission.β This βno pay for errorsβ rule may have a profound effect on the clinical practice of physicians.
To determine how physicians might change their behavior after learning about the Medicare rule.
We conducted a randomized trial of a brief educational intervention embedded in an online survey, using clinical vignettes to estimate behavioral changes.
At a university-based internal medicine residency program, 168 internal medicine residents were eligible to participate.
Residents were randomized to receive a one-page description of Medicareβs βno pay for errorsβ rule with pre-vignette reminders (intervention group) or no information (control group). Residents responded to five clinical vignettes in which βno pay for errorsβ conditions might be present on admission.
Primary outcome was selection of the single most clinically appropriate option from three clinical practice choices presented for each clinical vignette.
Survey administered from December 2008 to March 2009. There were 119 responses (71%). In four of five vignettes, the intervention group was less likely to select the most clinically appropriate response. This was statistically significant in two of the cases. Most residents were aware of the rule but not its impact and specifics. Residents acknowledged responsibility to know Medicare documentation rules but felt poorly trained to do so. Residents educated about the Medicareβs βno pay for errorsβ were less likely to select the most clinically appropriate responses to clinical vignettes. Such choices, if implemented in practice, have the potential for causing patient harm through unnecessary tests, procedures, and other interventions
Acquisition and Evolution of Plant PathogenesisβAssociated Gene Clusters and Candidate Determinants of Tissue-Specificity in Xanthomonas
is a large genus of plant-associated and plant-pathogenic bacteria. Collectively, members cause diseases on over 392 plant species. Individually, they exhibit marked host- and tissue-specificity. The determinants of this specificity are unknown. lineage. genome and indicate that differentiation with respect to host- and tissue-specificity involved not major modifications or wholesale exchange of clusters, but subtle changes in a small number of genes or in non-coding sequences, and/or differences outside the clusters, potentially among regulatory targets or secretory substrates
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