Plant species' range shifts in mountainous areas—all uphill from here?

Species from many different habitats are responding to recent climate change. Mountainous areas are of particular interest as they provide pronounced gradients and have experienced above-average temperature increases. Data from the beginning of the 20th century of both the upper and lower range limits of plants of the European Alps were updated a century later and analyzed in order to identify common trends and deviating patterns of shifts at opposing ends of species' ranges. At the upper limit, there was a strong trend towards an increase in species richness per summit, including 33 species that were recorded for the first time on any of the investigated summit areas. The species experienced a consistent upward shift exceeding 100 elevational meters, and 49 out of the 125 investigated species shifted upwards to a present altitude which is higher than any reported occurrence in the region one century ago. The response at the lower range limit was more heterogeneous and suggests species-specific differences in responsiveness and response patterns. With this approach of the combined analysis of upper and lower range limits along elevational gradients, it is possible to identify candidate species that might not keep pace with climate change, and thus, might face an increased risk of extinction with continued global warmin

Diffuse swelling of the buccal mucosa and palate as first and only manifestation of an extranodal non-Hodgkin ‘double-hit' lymphoma: report of a case

Background: Most of the lymphomas arising in the oral cavity are of B-cell origin. Among these, diffuse large B-cell lymphomas are the most common. Diffuse large B-cell lymphomas may exhibit more than one chromosomal rearrangement and are then referred to as ‘double-hit' or ‘triple-hit' lymphomas. Case report: We present a case of an intraoral ‘double-hit' lymphoma in a 76-year-old male who had been referred by an oral surgeon in private practice. Intraoral examination exhibited a firm, exophytic lesion in the region of the right hard palate and buccal mucosa with extension to the soft palate. Radiographic examination exhibited a massive thickening of the right sinus membrane, and arrosion of the lateral and basal cortical sinus walls in the right maxilla. After diagnosis of the lesion, the patient was treated with six cycles of chemotherapy. Discussion: Lymphomas arising within the oral cavity account for less than 5% of all oral malignancies and typically affect the palatine tonsils and the palate. ‘Double-hit' lymphomas are associated with older age, usually present with an advanced stage of disease, and show an aggressive clinical behaviour. They normally have a poor prognosis, even when treated with intensive chemotherapy regimens. Nevertheless, in the case presented, the patient was free of symptoms 1year after initial diagnosi

Additive Effect of Enterococcus faecium on Enterococcal Bloodstream Infections: A 14-Year Study in a Swiss Tertiary Hospital

We investigated whether an increase in enterococcal bloodstream infections (BSIs) depends on the emergence of Enterococcus faecium in an area with low vancomycin-resistant enterococci prevalence. From 1999 to 2012, a linear increase in E. faecium BSI rates (0.009 per 1,000 patient-days per year; P<.001) was noted. Enterococcus faecalis BSI rates remained stabl

Divergent selection in low and high elevation populations of a perennial herb in the Swiss Alps

Mountain plant species with wide elevational ranges are expected to be exposed to different selection pressures at low and high elevation. Estimating the extent of genetic population differentiation contributes to our understanding of selective forces shaping phenotypic variation of plants in response to changing climate conditions. Using a common garden experiment, we measured narrow-sense heritability (h 2) and quantitative trait differentiation (Q ST) in several growth-related, reproductive and phenological traits among low and high elevation populations of the semi-dry grassland species Ranunculus bulbosus from the Swiss Alps. Q ST values were compared to neutral genetic differentiation (F ST) based on AFLP markers and indicated divergent selection in most traits among all populations as well as among low and high elevation populations separately. Furthermore, pairwise Q ST and F ST estimates were not correlated suggesting that neutral marker differentiation is not a valuable proxy for quantitative trait differentiation. Neutral molecular differentiation increased with geographical distance whereas quantitative genetic differentiation did not followan isolation by distance pattern. Plant traits did mostly not differ among low and high populations and pairwise Q ST-F ST comparisons indicated no divergent selection between the two elevations. Differing levels of trait differentiation in low and high elevation populations, however, indicated that different selective forces acted on plants at contrasting elevations suggesting that selection regimes might alter under climate warming

The effect of longitudinal sleep monitoring on clinician agreement in obstructive sleep apnea diagnosis: The ELSA study

There is strong evidence for clinically relevant night‐to‐night variability of respiratory events in patients with suspected obstructive sleep apnea. Sleep experts retrospectively evaluated diagnostic data in 56 patients with suspected obstructive sleep apnea. Experts were blinded to the fact that they were diagnosing the same case twice, once based on a short report of a single in‐laboratory respiratory polygraphy and once with the additional information of 14 nights of pulse oximetry at home. All experts (n = 22) were highly qualified, 13 experts (59.1%) treated > 100 patients with suspected obstructive sleep apnea per year. In 12 patients, the apnea–hypopnea index in the respiratory polygraphy was  100 per year compared with 0–29 patients per year (Coef. [95% confidence interval] −0.63 [−1.22/−0.04] and −0.61 [−1.07/−0.15], respectively). Experts found already a high level of consensus regarding obstructive sleep apnea diagnosis, severity and continuous positive airway pressure recommendation after a single respiratory polygraphy. However, longitudinal sleep monitoring could help increase consensus in selected patients with diagnostic uncertainty

Inclusion of postdoctoral trainees in a translational science training TL1 program was associated with greater diversification of research across the translational science continuum: a bibliometric analysis of TL1 trainee publications

The NIH National Center for Advancing Translational Science (NCATS) was established to support translational research that spans the entire TS Continuum, with the goal of bridging the gap between preclinical biomedical research and real-world applications to advance treatments to patients more quickly. In 2018, the Translational Science Training (TST) TL1 Program at the University of Texas Health Science Center at San Antonio implemented new strategies to better include and encourage research more broadly across the TS Continuum, including the addition of postdoctoral scientists and a clinically trained Program Co-Director, expansion of team science and community engagement programming, and targeted trainee recruitment from schools of nursing, dentistry, and allied health, in addition to medicine. The objective of this bibliometric analysis was to determine if the program exhibited a more diverse mix of T-types after the adjustments made in 2018. The TST/TL1 Program experienced a shift in T-type, from mostly T0 (preclinical) to more T3/T4 (clinical implementation/public health) research, after new strategies were implemented. This supports the conclusion that strategic programmatic adjustments by an NCATS-funded predoctoral training program resulted in outcomes that better align with NCATS priorities to develop Trainees who contribute across the entire TS Continuum

Plant traits poorly predict winner and loser shrub species in a warming tundra biome

Climate change is leading to species redistributions. In the tundra biome, shrubs are generally expanding, but not all tundra shrub species will benefit from warming. Winner and loser species, and the characteristics that may determine success or failure, have not yet been fully identified. Here, we investigate whether past abundance changes, current range sizes and projected range shifts derived from species distribution models are related to plant trait values and intraspecific trait variation. We combined 17,921 trait records with observed past and modelled future distributions from 62 tundra shrub species across three continents. We found that species with greater variation in seed mass and specific leaf area had larger projected range shifts, and projected winner species had greater seed mass values. However, trait values and variation were not consistently related to current and projected ranges, nor to past abundance change. Overall, our findings indicate that abundance change and range shifts will not lead to directional modifications in shrub trait composition, since winner and loser species share relatively similar trait spaces

The tundra phenology database: more than two decades of tundra phenology responses to climate change

Observations of changes in phenology have provided some of the strongest signals of the effects of climate change on terrestrial ecosystems. The International Tundra Experiment (ITEX), initiated in the early 1990s, established a common protocol to measure plant phenology in tundra study areas across the globe. Today, this valuable collection of phenology measurements depicts the responses of plants at the colder extremes of our planet to experimental and ambient changes in temperature over the past decades. The database contains 150 434 phenology observations of 278 plant species taken at 28 study areas for periods of 1\u201326 years. Here we describe the full data set to increase the visibility and use of these data in global analyses and to invite phenology data contributions from underrepresented tundra locations. Portions of this tundra phenology database have been used in three recent syntheses, some data sets are expanded, others are from entirely new study areas, and the entirety of these data are now available at the Polar Data Catalogue (https://doi.org/10.21963/13215)

Mentoring programs for medical students - a review of the PubMed literature 2000 - 2008

Abstract Background Although mentoring is acknowledged as a key to successful and satisfying careers in medicine, formal mentoring programs for medical students are lacking in most countries. Within the framework of planning a mentoring program for medical students at Zurich University, an investigation was carried out into what types of programs exist, what the objectives pursued by such programs are, and what effects are reported. Methods A PubMed literature search was conducted for 2000 - 2008 using the following keywords or their combinations: mentoring, mentoring program, medical student, mentor, mentee, protégé, mentorship. Although a total of 438 publications were identified, only 25 papers met the selection criteria for structured programs and student mentoring surveys. Results The mentoring programs reported in 14 papers aim to provide career counseling, develop professionalism, increase students' interest in research, and support them in their personal growth. There are both one-to-one and group mentorships, established in the first two years of medical school and continuing through graduation. The personal student-faculty relationship is important in that it helps students to feel that they are benefiting from individual advice and encourages them to give more thought to their career choices. Other benefits are an increase in research productivity and improved medical school performance in general. Mentored students also rate their overall well-being as higher. - The 11 surveys address the requirements for being an effective mentor as well as a successful mentee. A mentor should empower and encourage the mentee, be a role model, build a professional network, and assist in the mentee's personal development. A mentee should set agendas, follow through, accept criticism, and be able to assess performance and the benefits derived from the mentoring relationship. Conclusion Mentoring is obviously an important career advancement tool for medical students. In Europe, more mentoring programs should be developed, but would need to be rigorously assessed based on evidence of their value in terms of both their impact on the career paths of juniors and their benefit for the mentors. Medical schools could then be monitored with respect to the provision of mentorships as a quality characteristic.</p