Testing native species response to fire – a first step towards building fire resilient native plant communities at Hawai’i Volcanoes National Park

Reports were scanned in black and white at a resolution of 600 dots per inch and were converted to text using Adobe Paper Capture Plug-in.Wildfires, fueled by fire-adapted alien grasses, result in the loss of native tree and shrub species in the dry and seasonally dry communities of Hawai‘i Volcanoes National Park. Future wildfires and further loss of native plant diversity is expected given the prevalence of alien grasses in the area. Fire-tolerance, defined in this paper as the ability to survive or colonize after fire, was evaluated in seven controlled burns. Seed germination in response to oven heating was tested in laboratory experiments. Fourteen of 19 native species showed some capacity to survive or colonize after fire. Seedlings of eleven species were able to establish from seeds placed in the field prior to or immediately following controlled burns (Argemone glauca, Bidens hawaiensis, Canavalia hawaiiensis, Dodonaea viscosa, Myoporum sandwicense, Osteomeles anthyllidifolia, Santalum paniculatum, Scaevola kilaueae, Sida fallax, Sophora chrysophylla, Sesbania tomentosa). Seven species survived beyond the first year including six that reached reproductive maturity (Argemone glauca, Bidens hawaiensis, Canavalia hawaiiensis, Dodonaea viscosa, Sida fallax, Sophora chrysophylla). Seeds of ten species tested in oven-heating experiments showed either a positive or neutral germination response to mild heating (90 ºC), among these were three species (Myrsine lanaiensis, Rhus sandwicensis, Senna gaudichaudii) not tested in the field. Testing species response to fire is the first step toward building resilient native plant communities in the new fire regime established by alien grasses at HAVO

Treatment of Nongenital Warts

Topical salicylic acid, cryotherapy, and topical fluorouracil are effective for treating nongenital warts. (Strength of Recommendation [SOR]: A, based on a systematic review of randomized controlled trials [RCTs].) Fluorouracil is more expensive than salicylic acid and produces more adverse effects, such as pain and blisters. The combination of salicylic acid and cryotherapy may be better than either treatment alone, although salicylic acid may be more cost-effective than cryotherapy. Bleomycin and interferons should not be used to treat nongenital warts. (SOR: A, based on a meta-analysis.

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

Racism as Experienced by Physicians of Color in the Health Care Setting.

BACKGROUND AND OBJECTIVES: The purpose of this study was to examine the impact of racism experienced by physicians of color in the workplace. METHODS: We utilized a mixed-methods, cross-sectional, survey design. Seventy-one participants provided qualitative responses describing instances of racism from patients, colleagues, and their institutions. These responses were then coded in order to identify key domains and categories. Participants also completed quantitative measures of their professional quality of life and the incidence of microaggressions experienced while at work. RESULTS: We found that physicians of color were routinely exposed to instances of racism and discrimination while at work. Twenty-three percent of participants reported that a patient had directly refused their care specifically due to their race. Microaggressions experienced at work and symptoms of secondary traumatic stress were significantly correlated. The qualitative data revealed that a majority of participants experienced significant racism from their patients, colleagues, and institutions. Their ideas for improving diversity and inclusion in the workplace included providing spaces to openly discuss diversity work, constructing institutional policies that promote diversity, and creating intentional hiring practices that emphasize a more diverse workforce. CONCLUSIONS: Physicians of color are likely to experience significant racism while providing health care in their workplace settings, and they are likely to feel unsupported by their institutions when these experiences occur. Institutions seeking a more equitable workplace environment should intentionally include diversity and inclusion as part of their effort

Concrete and abstract visualizations in history learning tasks

Background: History learning requires that students understand historical phenomena, abstract concepts and the relations between them. Students have problems grasping, using and relating complex historical developments and structures. Aims: A study was conducted to determine the effects of tasks with abstract and/or concrete visualizations on the learning of historical developments and structures. The hypothesis was that students receiving visualizations would learn and retain more historical knowledge and concepts than those not receiving visualizations. Sample: First-year pupils in vocational middle school (N = 104) worked in randomly assigned pairs. Methods: After reading a text, the pairs were given a learning task in one of four conditions: Textual, Concrete visualized, Abstract visualized, and Combined. Results: Post-test and retention test results showed no significant differences. There were some significant differences on the evaluation questionnaire. Conclusions: Combining text and different types of visualizations in learning tasks does not necessarily enhance history learning. Possible explanations given are the ecological setting, the semiotics of the domain of history – that are not defined clearly – and the difficulty of unequivocally visualizing historical concepts