Elementary School Education in Rainforest Conservation and Reforestation in Mindanao, Philippines

A series of four interactive interdisciplinary (but based on science books0 for grades two through five were created to provide educational materials on tropical rainforests for elementary schools in the Philippines. The books were produced in conjunction with Philippine and American teachers, administrators, and science education consultants. They were then used and assessed for a year in actual classrooms in a variety of six Philippine schools in Mindanao. Comparative tests before and after using the materials were given to both teachers and students in participating schools. We observed highly significant measurable learning and improvements in understanding about rainforests. There was much variability in outcomes among the different schools. A highly significant general trend among students however, was for greater improvement (gain) for students who had lower pretest scores. That trend for individual students extended to the schools, which reduced the discrepancies between public rural mountain schools and schools in urban or city settings including a private city school

Indumento y tricomas en la caracterización de un grupo de nueve especies del género Mortoniodendron (Tiliaceae)

The indument and trichome morphology in leaves and endocarp for 9 species of Mortoniodendron (Tiliaceae) were studied. The distribution and the type of trichomes were established according to their form, symmetry, size, and density using scanning electron and optical microscopy. Two categories for the distribution of trichomes were defi ned in the leaves and the endocarp. In the case of the leaves, 7 species have axillar indument and it is glabrescent in 9, while in the endocarp 5 species show glabrescent and others glabrous. Four types of trichomes were recognized: acicular with a single arm, fasciculate with 2-5 arms, stellate with 3-18 arms, and uni or multicellular capitate. Acicular and fasciculate trichomes prevail in M. costaricense, M. hirsutum and M. vestitum. Stellate trichomes are present in all the species, but 4 categories are distinguished according to size and number of arms. Only M. palaciosii and M. ruizii possess capitate trichomes. In the endocarp stellate trichomes prevail, except for M. vestitum with long fasciculate trichomes. The taxonomic usefulness of the results is discussed and a key to identify the species is provided.Se estudió el indumento y la morfología de los tricomas del envés de las hojas y del endocarpo de 9 especies del género Mortoniodendron (Tiliaceae). Se establece el tipo de indumento y de tricomas según la forma, simetría, tamaño y densidad, mediante microscopía electrónica de barrido y óptica. En las hojas y endocarpo se defi nen 2 categorías para el tipo de indumento. Para las hojas, el axilar se presenta en 7 especies y glabrescente en 9 y para el endocarpo glabrescente en 5 especies y el resto glabras. Con relación a la forma, simetría y tamaño se reconocen 4 tipos de tricomas: simples de un brazo, fasciculados de 2 a 5 brazos, estrellados de 3 a 18 brazos y capitados uni y multicelulares. Los tricomas simples y fasciculados predominan en M. costaricense, M. hirsutum y M. vestitum. Los estrellados están presentes en todas las especies y se distinguen 4 categorías según el tamaño y número de brazos. Sólo en M. palaciosii y M. ruizii se encuentran tricomas capitados. En el endocarpo predominan los tricomas estrellados, excepto en M. vestitum con tricomas fasciculados largos. Se discute la importancia taxonómica de los resultados y se elabora una clave para identifi car las especies

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk