Biotic soil crusts of Oregon's shrub steppe

This research examines the community composition of biotic soil crusts at nine sites in central and eastern Oregon, U.S.A. At each site, data were collected in one pair of livestock-grazed and excluded transects. Variables recorded included: cover of biotic soil crusts and vascular plant species, soil surface pH, electrical conductivity, soil surface roughness, surface rock, gravel, bare ground, organic litter, and cowpies. Using Non-metric Multidimensional Scaling, we extracted the primary environmental gradients controlling biotic crust community composition among sites. The strongest gradient was related to soil chemistry. Total crust cover, lichen cover, and bryophyte cover were inversely related to soil pH, electrical conductivity, and CIV (Calcareous Index Value; site scores on a scale representing relative soil calcium carbonate content). Total crust cover was also positively associated with temperature, and inversely related to elevation. Biotic crust composition was related to moisture and aspect; cooler, north-facing slopes with greater precipitation and Festuca idahoensis cover were compositionally distinct from flat sites with greater heat exposure. The weakest pattern in these data appears to represent a disturbance gradient, with bare ground inversely related to exclosure age. Transect scores on this gradient were different between currently grazed and exclosure transects ( p = 0.01, blocked MRPP). On average, bare ground was greater in the grazed transects, while total crust cover, cover of nitrogen-fixing lichens, biotic soil surface roughness, and species richness were greater within the exclosures (p 5 0.02 for all, two-tailed paired t-tests). Differences in vascular plant cover, richness, and composition were not detected. CIV was one of the strongest variables related to biotic crust composition. CIV is based on a calcareous index that uses the presence of certain lichen species as indicators of calcareous soils. Using weighted averaging and the abundances of these indicators in our data, we revised this index, incorporating new indicators and removing poor ones. We conclude that 1) biotic soil crusts are sensitive indicators of disturbance, 2) there are strong compositional differences in shrub steppe crust communities of Oregon, which are related to regional soil and climate differences, and 3) lichens can be used as sensitive indicators of soil chemistry

Il Percorso Diagnostico Terapeutico Assistenziale del paziente con melanoma metastatico presso l\u2019Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone di Palermo come strumento applicativo della clinical governance

L\u2019evoluzione dello scenario internazionale relativo alla sanit\ue0 identifica cinque specifiche dimensioni come driver del cambiamento: il sistema, la finanza, le persone, i processi e la tecnologia. In linea con tali elementi, il patto per la salute 2014-2016 esplicita la necessit\ue0 di una rivisitazione a tutti i livelli del sistema salute, sia organizzativo che gestionale, con l\u2019intento di aumentare l\u2019efficienza e l\u2019efficacia, sviluppando nuovi modelli assistenziali, anche nella logica delle reti cliniche, dove tra gli \u201cstrumenti\u201d viene identificata l\u2019attivazione di Percorsi Diagnostico Terapeutico Assistenziali (PDTA). I percorsi condivisi e codificati per i vari stadi di patologia, con un sistema di raccolta dei dati clinici che possa generare gli indicatori di processo e di esito, sono ritenuti indispensabili per innescare il miglioramento della qualit\ue0 e valutare l\u2019efficacia e l\u2019efficienza. Tenendo conto di queste premesse, nell\u2019ambito dell\u2019Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone di Palermo \ue8 stata sviluppata una progettualit\ue0 al fine di formalizzare e studiare il PDTA del paziente con melanoma metastatico, identificando il percorso ideale e descrivendo il percorso applicabile con le relative leve del cambiamento. Il progetto ha reso evidente come la gestione consapevole del \u201cprofondo cambiamento\u201d in essere nelle organizzazioni clinico assistenziali pu\uf2 essere \u201cgovernata\u201d grazie anche alla \u201cdocumentazione\u201d del proprio modo di operare in riferimento alle Linee Guida di riferimento e alle relative raccomandazioni. Il progetto ha reso evidente inoltre come la sostenibilit\ue0 dei percorsi passa anche attraverso la definizione di opportuni indicatori, correlati alle diverse fasi ed attivit\ue0 chiave, da poter monitorare nella \u201cvita corrente dell\u2019organizzazione\u201d

Current therapeutic strategies for advanced pancreatic cancer: A review for clinicians

Pancreatic cancer (PC) would become the second leading cause of cancer death in the near future, despite representing only 3% of new cancer diagnosis. Survival improvement will come from a better knowledge of risk factors, earlier diagnosis, better integration of locoregional and systemic therapies, as well as the development of more efficacious drugs rising from a deeper understanding of disease biology. For patients with unresectable, non-metastatic disease, combined strategies encompassing primary chemotherapy and radiation seems to be promising. In fit patients, new polychemotherapy regimens can lead to better outcomes in terms of slight but significant survival improvement associated with a positive impact on quality of life. The upfront use of these regimes can also increase the rate of radical resections in borderline resectable and locally advanced PC. Second line treatments showed to positively affect both overall survival and quality of life in fit patients affected by metastatic disease. At present, oxaliplatin-based regimens are the most extensively studied. Nonetheless, other promising drugs are currently under evaluation. Presently, in addition to surgery and conventional radiation therapy, new locoregional treatment techniques are emerging as alternative options in the multimodal approach to patients or diseases not suitable for radical surgery. As of today, in contrast with other types of cancer, targeted therapies failed to show relevant activity either alone or in combination with chemotherapy and, thus, current clinical practice does not include them. Up to now, despite the fact of extremely promising results in different tumors, also immunotherapy is not in the actual therapeutic armamentarium for PC. In the present paper, we provide a comprehensive review of the current state of the art of clinical practice and research in PC aiming to offer a guide for clinicians on the most relevant topics in the management of this disease

Asymmetric Organocatalysis Accelerated via Self-Assembled Minimal Structures

Self-assembling minimalistic peptides embedded with an organocatalytic moiety were designed. By controlling the formation of fibrils via external intervention, it was shown that the activation is accelerated when the organocatalyst is in its supramolecular state. The effect of the accelerated catalysis was demonstrated in a Michael benchmark reaction

Functional polymorphisms within the inflammatory pathway regulate expression of extracellular matrix components in a genetic risk dependent model for anterior cruciate ligament injuries

Objectives: To investigate the functional effect of genetic polymorphisms of the inflammatory pathway on structural extracellular matrix components (ECM) and the susceptibility to an anterior cruciate ligament (ACL) injury. Design: Laboratory study, case–control study. Methods: Eight healthy participants were genotyped for interleukin (IL)1B rs16944 C > T and IL6 rs1800795 G > C and

Efficacy and safety of subcutaneous trastuzumab and intravenous trastuzumab as part of adjuvant therapy for HER2-positive early breast cancer: final analysis of the randomised, two-cohort PrefHer study

Aim To assess efficacy (event-free survival, EFS) and safety in patients followed up for 3 years in the PrefHer study (NCT01401166). Patients and methods Post surgery and post chemotherapy in the (neo)adjuvant setting, patients with human epidermal growth factor receptor 2 (HER2)-positive early breast cancer were randomised to receive four cycles of the subcutaneous form of trastuzumab (Herceptin ® SC [H SC] via single-use injection device [Cohort 1] or delivery via a hand-held syringe from an SC Vial [Cohort 2]; 600 mg fixed dose) followed by four of the intravenous form of trastuzumab (Herceptin ® [H IV]; 8 mg/kg loading, 6 mg/kg maintenance doses) in the adjuvant setting or vice versa every 3 weeks. Patients could have received H before randomisation. H was then continued to complete a total of 18 cycles, including any cycles received before randomisation. Results A total of 488 patients were randomised across both cohorts. After median follow-up of 36.1 months, 3-year EFS across both groups in the evaluable intention-to-treat population (467 patients) was 90.6% overall, 89.9% in Cohort 1, and 91.1% in Cohort 2. No new safety signals were identified during long-term follow-up, with only one cardiac serious adverse event in the safety population (483 patients). Conclusions Three-year EFS data following H SC and H IV treatment are consistent with those reported by previous trials for H in the adjuvant setting. The overall safety profile during adjuvant treatment was as expected

Correlates of loneliness among university students

Background The purpose of this study was to investigate level of loneliness, essential needs during university education, and relationships between loneliness, essential needs, and characteristics of university students. A sample comprising 721 students participated in the study. The mean age was 21.58 (SD = 1.73) with a range from 18 to 25. The majority of the students were female (70.6%) and were living in students' dormitory (67.5%) with low (87.8%) income, away from their parents. Methods The UCLA-R loneliness scale and sociodemographic questionnaire which includes an open-ended question on essential needs during university education were administered. Pearson-Product-Moment correlations were used to explore the relationships between participants' loneliness, needs, and characteristics. Results It was found that 60.2% of the participants experienced loneliness. Economical support (81.6%), social interaction (46.9%) and psychosocial support (35%) were the essential needs during university education reported by the participants. The study findings indicate that there were significant relationships between the needs of economical support, social interaction, and loneliness level of university students. Results also show that there were significant relationships among romantic relationship, parents' status and loneliness. Participants' loneliness levels were relatively higher who had not any romantic relationship and were not from married families. Conclusion The findings of this study provided essential information, about Turkish university students, concerning: level of loneliness and relationships that exist among loneliness, needs and sociodemographic characteristics. The findings also suggest implications for psychosocial practice. Because of the mean of loneliness were found to be high (45.49 ± 10.07), for this study, professionals need to pay attention to Turkish university students' psychosocial state, and need to empower them in establishing social relations

Parental health limitations, caregiving and loneliness among women with widowed parents: longitudinal eveidence from France

We investigate how daughters’ feelings of loneliness are impacted when widowed parents develop health limitations, and when daughters take on personal care tasks in response. Using longitudinal data from daughters of widowed parents drawn from the French Family and Intergenerational Relationships Study (ERFI, 1485 observations nested in 557 daughters), we assess (a) whether health limitations of widowed parents are associated with daughters’ feelings of loneliness regardless of whether or not daughters provide personal care and (b) whether there is an effect of care provision on loneliness that cannot be explained by parental health limitations. Fixed effect regression analyses show that widowed parents’ health limitations were associated with raised feelings of loneliness among their daughters. No significant additional effect of providing personal care to a widowed parent was found. Prior research on the impact of health limitations of older parents on the lives of their adult–children has focused mostly on issues related to informal caregiving. Our findings suggest that more attention to the psychosocial impact of parental health limitations—net of actual caregiving—on adult children’s lives is warranted