Ecosystem resilience despite large-scale altered hydroclimatic conditions

Climate change is predicted to increase both drought frequency and duration, and when coupled with substantial warming, will establish a new hydroclimatological model for many regions. Large-scale, warm droughts have recently occurred in North America, Africa, Europe, Amazonia and Australia, resulting in major effects on terrestrial ecosystems, carbon balance and food security. Here we compare the functional response of above-ground net primary production to contrasting hydroclimatic periods in the late twentieth century (1975-1998), and drier, warmer conditions in the early twenty-first century (2000-2009) in the Northern and Southern Hemispheres. We find a common ecosystem water-use efficiency (WUE e: Above-ground net primary production/ evapotranspiration) across biomes ranging from grassland to forest that indicates an intrinsic system sensitivity to water availability across rainfall regimes, regardless of hydroclimatic conditions. We found higher WUE e in drier years that increased significantly with drought to a maximum WUE e across all biomes; and a minimum native state in wetter years that was common across hydroclimatic periods. This indicates biome-scale resilience to the interannual variability associated with the early twenty-first century drought - that is, the capacity to tolerate low, annual precipitation and to respond to subsequent periods of favourable water balance. These findings provide a conceptual model of ecosystem properties at the decadal scale applicable to the widespread altered hydroclimatic conditions that are predicted for later this century. Understanding the hydroclimatic threshold that will break down ecosystem resilience and alter maximum WUE e may allow us to predict land-surface consequences as large regions become more arid, starting with water-limited, low-productivity grasslands. © 2013 Macmillan Publishers Limited. All rights reserved

On Spanish Dvandva and its restrictions

As noted by Bauer, real dvandva compounds –that is, coordinative compounds that properly express the aggregation of two different entities, not the intersection of properties in one entity– are extremely rare in English or Spanish. This article explores the empirical domain of dvandva compounding in Spanish, and notes that they are productive when not used as heads within their phrases. We propose that the explanation for this is that Spanish can only productively build dvandva compounds using flat structures without internal hierarchy. This causes the compound to look externally for a head noun that defines the interpretation of the relation established between the two members of the dvandva. The proposal also explains why proper names is preferred in dvandva compounding, given that they do not denote properties

Memorable tourism experiences and their consequences : An interaction ritual (IR) theory approach

Tourism experiences, memories thereof, and their consequences tend to be analysed separately, often focusing on the individual’s perspective. This paper introduces Collins’ (2004) interaction ritual (IR) theory to develop a micro-sociological interpretation of these phenomena as interconnected elements of IR chains. A longitudinal qualitative study of a multi-cultural festival held in Italy, the Mondiali Antirazzisti (Anti-racist World Cup), is used to show how emotional experiences and patterns of collective action are reproduced by the returning attendees in their home communities through the trans-local appropriation of the event’s format. Findings lead to a revised model of IR chains to explain the trans-local dimension of transformational event tourism. The implications for wider application of IR theory within tourism are discussed

The Somatic Genomic Landscape of Chromophobe Renal Cell Carcinoma

We describe the landscape of somatic genomic alterations of 66 chromophobe renal cell carcinomas (ChRCCs) based on multidimensional and comprehensive characterization, including mitochondrial DNA (mtDNA) and whole genome sequencing. The result is consistent that ChRCC originates from the distal nephron compared to other kidney cancers with more proximal origins. Combined mtDNA and gene expression analysis implicates changes in mitochondrial function as a component of the disease biology, while suggesting alternative roles for mtDNA mutations in cancers relying on oxidative phosphorylation. Genomic rearrangements lead to recurrent structural breakpoints within TERT promoter region, which correlates with highly elevated TERT expression and manifestation of kataegis, representing a mechanism of TERT up-regulation in cancer distinct from previously-observed amplifications and point mutations

Multiplatform Analysis of 12 Cancer Types Reveals Molecular Classification within and across Tissues of Origin

Recent genomic analyses of pathologically-defined tumor types identify “within-a-tissue” disease subtypes. However, the extent to which genomic signatures are shared across tissues is still unclear. We performed an integrative analysis using five genome-wide platforms and one proteomic platform on 3,527 specimens from 12 cancer types, revealing a unified classification into 11 major subtypes. Five subtypes were nearly identical to their tissue-of-origin counterparts, but several distinct cancer types were found to converge into common subtypes. Lung squamous, head & neck, and a subset of bladder cancers coalesced into one subtype typified by TP53 alterations, TP63 amplifications, and high expression of immune and proliferation pathway genes. Of note, bladder cancers split into three pan-cancer subtypes. The multi-platform classification, while correlated with tissue-of-origin, provides independent information for predicting clinical outcomes. All datasets are available for data-mining from a unified resource to support further biological discoveries and insights into novel therapeutic strategies

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Evaluation of Amendments to Control Phosphorus Losses in Runoff from Pig Slurry Applications to Land

peer-reviewedIf spread in excess of crop requirements, incidental phosphorus (P) losses from agriculture can lead to eutrophication of receiving waters. The use of amendments in targeted areas may help reduce the possibility of surface runoff of nutrients. The aim of this study was to identify amendments which may be effective in reducing incidental dissolved reactive phosphorus (DRP) losses in surface runoff from land applied pig slurry. For this purpose, the DRP losses under simulated conditions across the surface of intact grassland soil cores, loaded with unamended and amended slurry at a rate equivalent to 19 kg P ha−1, were determined over a 30 h period. The effectiveness of the amendments at reducing DRP in overlying water were (in decreasing order): alum (86%), flue gas desulfurization by-product (FGD) (74%), poly-aluminum (Al) chloride (PAC) (73%), ferric chloride (71%), fly ash (58%), and lime (54%). FGD was the most costly of all the treatments (€7.64/m3 for 74% removal). Ranked in terms of feasibility, which takes into account effectiveness, cost, and other potential impediments to use, they were: alum, ferric chloride, PAC, fly ash, lime, and FGD.Irish Research Ccouncil (EMBARK Scholarship

Knowledge, Attitudes and Practices of East Tennessee Medical Providers towards Transgender Patients

Introduction: Transgender is an identity term used to describe people with diverse gender identities and expressions that differ from their sex assigned at birth. People who identify as transgender have worse health outcomes than the cisgender or non-transgender populations. Limited healthcare access and chronic stress from discrimination all contribute to worsening health outcomes for this population. However, research regarding this population is limited, particularly in the rural southern United States. The purpose of this study was to assess physicians’, nurse practitioners’, and physician assistants’ experience with, attitude towards, and knowledge of transgender healthcare in the Northeast Tennessee region. Methods: Medical providers, including NPs, PAs, DOs and MDs from Family Medicine, Emergency Medicine, Internal Medicine, Pediatrics, and Obstetrics and Gynecology in both academic and community settings were surveyed regarding their attitudes toward, knowledge of, and experiences with gender, sexual orientation, and sexuality as they relate to healthcare. All potential participants were informed that participation was voluntary. Limited demographics were gathered and surveys were collected in a confidential manner. Data were analyzed for statistical significance. Results: Initial analyses showed the majority of providers had not received training in transgender healthcare and perceived they had few to no trans-identified patients. Over half of all respondents felt competent in providing healthcare to trans people and the majority felt comfortable treating this population. Providers indicated it is important to know their patients’ sexual practices, gender identity and sexual orientation; however, the majority of providers do not ask patients their gender identity, sexuality, or desired pronouns. Respondents were unsure whether gender confirmation surgery is covered by insurance and widely accessible. In assessing clinical knowledge of providers, there were a wide variety of responses suggesting varying level of competence amongst providers. Responses were split regarding whether access to healthcare is the same for the transgender population as it is for the general population. Pediatric providers were asked about comfort in prescribing hormones, knowledge of mental health support in the area, referrals and discussing gender identity with patients. These responses fell along a normal distribution, indicating a variety of training, experiences, and opinion regarding trans healthcare for the adolescent population. Conclusions: Overall results from the preliminary data demonstrate a contradiction between ideology and practice. With most participants responding they felt comfortable and competent providing care to the transgender population, yet their responses indicated a lack of training and absence of inclusivity in their health care practices. This suggests that education is needed within the healthcare community on transgender healthcare

Transgender Medicine Integrated Grand Rounds: Are Medical Students Receiving Enough Education to Competently Care for our Patients?

Transgender individuals are defined as those whose gender does not match the sex they were assigned at birth. Healthcare providers receive inadequate training in transgender medicine, which could lead to provider stigma and lower health outcomes and higher health disparities. The purpose of our study was to assess the effect of an educational intervention on first and second year ETSU medical students’ knowledge and attitudes regarding transgender healthcare. A transgender healthcare-centered Integrated Grand Rounds (IGR) was used as a setting to conduct a 9-item survey regarding definitions, medical management, and attitudes/comfort levels with transgender care. First and second year medical students (n=140) who participated in the intervention had the option to complete pre and post surveys on paper before and after IGR. Of the 140 participants, 138 (98.6%) completed the pretest and posttest measures. The participants’ attitudes about transgender patients and their comfort in treating transgender patients significantly improved between pre and posttest surveys (

Knowledge, Attitudes and Practices of East Tennessee Medical Providers towards Transgender Patients

One-third of transgender individuals report having at least one negative health care experience related to being transgender and nearly a quarter report that they have delayed seeking health care due to fear of being mistreated. Objective: To assess medical providers’ experiences with, attitudes towards, and knowledge of transgender health care in the Northeast Tennessee region. Study Design: Cross-sectional survey. Setting: Academic and community health care clinics in Northeast Tennessee. Participants: Physicians, nurse practitioners, and physician assistants practicing emergency medicine, family medicine, internal medicine, obstetrics & gynecology, or pediatrics (n=154). Main and Secondary Outcome Measures: Descriptive statistics and multiple regression models were used to determine relationships between provider characteristics and three sets of dependent variables (practices, attitudes, and knowledge). Results: The majority of providers (65%) had not received training in transgender healthcare. Over 90% perceived they had treated fewer than five trans-identified patients in the last year. The majority of respondents (69.3%) felt comfortable providing health care to transgender patients, yet only 38% felt competent treating this population. Providers indicated it was important to know their patients’ sexual practices, gender identity and sexual orientation; however, the majority of providers never or rarely asked patients their gender identity (75.4%), sexuality (57.2%), or desired pronouns (84.4%). Having formal training in transgender health was the only significant predictor of knowledge, sexual orientation and gender history taking, and competence/comfort with transgender patient care. Conclusions: Results demonstrate a contradiction between ideology and practice. Most participants responded they felt comfortable providing care to the transgender population, yet their responses indicated a lack of training and absence of inclusivity in their health care practices. As formal training was the only significant predictor of outcomes, this suggests that additional medical education and training is needed on transgender health care