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In the context of climate change, chestnut fertilization is receiving great attention in the Mediterranean basin, due to the increase in the unpredictability of the pluviometric regime which makes it difficult to determine the optimal timing of fertilizer applications. The purpose of this work was to assess the suitability of fertilizers with mechanisms for nutrient protection on the increase of tree nutritional status and crop productivity. Four fertilizers with restricted nutrient solubility were tested: Bioscape 5:14:7 (32.8% organic matter (OM)); Humix 13:3:5 (80.1% OM); Exactyon AG 6:15:8 (37.7% N and 33.1% P encapsulated); and Exactyon AG 18:5:13 (47% N encapsulated, 28.8% N as urea coated with ammonium sulfate). The trials were carried out for four years in Moimenta and Meixedo, NE Portugal, which also received a non-fertilized control. In Moimenta the ground was managed by tillage and in Meixedo by a cover of natural vegetation. Exactyon AG 18:5:13, being the most concentrated in N and B, gave significantly higher cumulative (2015–2018) nut yields (146.6 kg tree−1) than the control (52.3 kg tree−1) in the Moimenta trial. The results were explained by the increase in leaf N and B levels, which in the control treatment were in the deficiency range. In Meixedo there were not found significant differences among treatments, likely due to the competition by cover crop for resources. The results showed that the response of the trees to the fertilizers relied mainly in their content in nutrients limiting to the agroecosystem and less in the mechanisms of nutrient protection.

Zusammenfassung.Hintergrund:Im Rahmen einer Versorgungsstudie zur besseren Vermittlung von Kindern und Jugendlichen nach Missbrauch, Misshandlung oder Vernachlässigung in eine evidenzbasierte Therapie wurde ein migrationsspezifisches Angebot, das unter anderem einen eintägigen kultur- und migrationsspezifischen Workshop beinhaltete, eingeführt und evaluiert. Zentrale Themen waren die Vermittlung von Informationen zu Migration und Akkulturation, Trauma und psychische Gesundheit bei Familien mit Migrationshintergrund sowie Übungen zur interkulturellen Kompetenz und kultursensiblen Arbeit. Methodik:Durch eine Onlinebefragung einer Teilgruppe der im Projekt tätigen Case Manager (Fachkräfte der Kinder- und Jugendhilfe) wurden gegen Projektende Erfahrungen und Einschätzungen zur Arbeit mit Familien mit Migrationshintergrund eingeholt. Um die praktische Relevanz der Workshopinhalte zu illustrieren, werden in diesem Artikel zwei Fallbeispiele der interkulturellen Case-Management-Arbeit vorgestellt. Ergebnisse:Insgesamt wurde der Workshop gut bewertet. Nach Angaben der Case Manager müssen insbesondere sprachliche und kulturelle Besonderheiten in der Arbeit mit Familien mit Migrationshintergrund beachtet werden. Die Fallbeispiele zeigen, dass der Workshop die Case Manager beispielsweise im Umgang mit differierenden Krankheitsverständnissen, kultursensiblen Erhebungsmethoden oder der Arbeit mit Sprachmittlern sensibilisierte und somit unterstützte. Schlussfolgerungen:In der Case-Management-Arbeit wurden Grenzen des psychosozialen Versorgungssystems sichtbar und auf Basis der Erfahrungswerte kann sich der bestehenden Forderung nach weiterem Ausbau interkultureller Bildungsmaßnahmen angeschlossen werden.

Die Strategien zur Therapie des Rektumkarzinoms haben sich in den vergangenen beiden Jahrzehnten erheblich gewandelt. Dies betrifft vor allem das lokal fortgeschrittene Karzinom im mittleren und unteren Rektumdrittel. Hier ist die hochauflösende Magnetresonanztomographie von zentraler Bedeutung für die Therapieplanung. Die chirurgische Resektion des Primarius mit onkologischer Lymphadenektomie bleibt integraler Bestandteil der multimodalen Therapie, wobei die Ergebnisse der minimal-invasiven Techniken (laparoskopisch sowie robotisch assistiert) mit denen der offen-chirurgischen Resektion vergleichbar sind. Aktuelle Weiterentwicklungen sind vor allem das Konzept der sogenannten totalen neoadjuvanten Therapie, also die Ergänzung der neoadjuvanten Radiochemotherapie bzw. Radiotherapie um eine zusätzliche neoadjuvante Chemotherapie, sowie die sogenannte organerhaltende Watch-and-wait-Strategie, also der Verzicht auf eine radikale chirurgische Resektion im Falle einer klinischen Komplettremission nach neoadjuvanter Therapie.

In acute coronary syndromes (ACS), the optimal revascularization strategy for unprotected left main coronary artery (ULMCA) culprit lesion has been under-investigated. Therefore, we compared clinical characteristics and short- and medium-term outcomes of percutaneous and surgical revascularization in ACS.

Die Insuffizienz gastrointestinaler Anastomosen stellt für die betroffenen Patient*innen ein relevantes Morbiditäts- und Mortalitätsrisiko dar. Die Perfusionsqualität der Darmenden ist der entscheidende Parameter zur Gewährleistung einer suffizienten Anastomosenheilung. Zur Beurteilung der Gewebeperfusion findet in der modernen Viszeralchirurgie vor der Anfertigung gastrointestinaler Anastomosen zunehmend die intraoperative fluoreszenzgestützte Perfusionsmessung mit Indocyaningrün Anwendung. Mit dieser Technik kann zwischen adäquat und inadäquat perfundiertem Gewebe unterschieden werden und somit die Anastomose in einem möglichst optimal durchbluteten Bereich angelegt werden. Die Chirurgie verfügt damit über ein Messinstrument, dass es erlaubt, additiv zur rein subjektiven makroskopisch-visuellen Einschätzung der Perfusionsqualität, eine objektivierbare Beurteilung des Gewebes vorzunehmen und somit ein besseres funktionelles Ergebnis für die Patient*innen zu erzielen. Aktuell ist der Stellenwert dieser Technik jedoch noch nicht abschließend geklärt. Ziel des vorliegenden Leitthemenbeitrags ist es, den Nutzen der intraoperativen fluoreszenzgestützten Perfusionsmessung näher zu charakterisieren und hinsichtlich seiner Bedeutung für den klinischen Alltag einzuordnen.

Supplemental Digital Content is available in the text.

The paper analyses the progression of technology as an enabler in the mutual fund industries of the five emerging economies, i.e., Brazil, Russia, India, China, and South Africa. The paper discusses the growth in terms of their FinTech adoption, total asset size, number of funds and average size for each industry. It compares the percentage of total assets under management in terms of global market, their equity mutual funds as a percentage of total market value, market concentration, technology as an enabler to facilitate transactions, and the distribution channels. The paper finds China as the biggest contributor among BRICS to the global mutual fund industry. Their direct digital distribution channels hold more than 80% of the sales. Following China is India, with their direct channels contributing almost 50% of the sales. While traditional channels are the norm in Brazil, South Africa and Russia, predictions indicate a digital future for them.

Background:Recruitment of participants into research studies, especially individuals from minority groups, is challenging; lack of diversity may lead to biased findings. Aim:To explore beliefs about research participation among individuals who were approached and eligible for the GRADE study. Methods:In-depth qualitative telephone interviews with randomized participants (n = 25) and eligible individuals who declined to enroll (n = 26). Results:Refusers and consenters differed in trust and perceptions of risk, benefits and burden of participation. Few participants understood how comparative effectiveness research differed from other types of trials; however, some features of comparative effectiveness research were perceived as lower risk. Conclusion:We identified facilitators and addressable barriers to participation in research studies.

Defining post-infarct ventricular arrhythmic substrate is challenging with voltage mapping alone, though may be improved in combination with an activation map. Omnipolar Technology on the EnSite X system displays activation as vectors that can be superimposed onto a voltage map.

The bactericidal effects of silver nanoparticles (Ag NPs) against infectious strains of multiresistant bacteria is a well‐studied phenomenon, highly relevant for many researchers and clinicians battling bacterial infections. However, little is known about the uptake of the Ag NPs into the bacteria, the related uptake mechanisms, and how they are connected to antimicrobial activity. Even less information is available on AgAu alloy NPs uptake. In this work, the interactions between colloidal silver–gold alloy nanoparticles (AgAu NPs) and Staphylococcus aureus(S. aureus) using advanced electron microscopy methods are studied. The localization of the nanoparticles is monitored on the membrane and inside the bacterial cells and the elemental compositions of intra‐ and extracellular nanoparticle species. The findings reveal the formation of pure silver nanoparticles with diameters smaller than 10 nm inside the bacteria, even though those particles are not present in the original colloid. This finding is explained by a local RElease PEnetration Reduction (REPER) mechanism of silver cations emitted from the AgAu nanoparticles, emphasized by the localization of the AgAu nanoparticles on the bacterial membrane by aptamer targeting ligands. These findings can deepen the understanding of the antimicrobial effect of nanosilver, where the microbes are defusing the attacking silver ions via their reduction, and aid in the development of suitable therapeutic approaches. This study uses targeting silver‐gold alloy nanoparticles to show that silver nanoparticles found inside bacteria follow a RElease‐PEnetration‐Reduction (REPER) mechanism of the emitted silver cations, with the microbes thereby potentially defusing the therapeutic effect related to silver ions.

Poisoning from lead fishing tackle has been identified as the leading cause of mortality in adult common loons (Gavia immer). As a K‐selected species, adult survival is a critical component in the population demography of loons, but the population‐level effects of mortality from ingested lead tackle on loons have not been quantified. We used a long‐term dataset (1989–2012) on common loon mortality in New Hampshire, USA, to describe the types of lead tackle ingested by loons, investigate methods of ingestion of lead tackle, document the number and rate of adult mortalities resulting from lead tackle, and test for a population‐level effect of lead tackle on the loon population in New Hampshire. Nearly half (48.6%) of collected adult mortalities resulted from lead toxicosis from ingested lead fishing tackle, representing an adjusted annual mortality rate of 1.7 ± 0.6% (SD) of the statewide population. Jigs accounted for 52.6% and sinkers for 38.8% of the archived lead tackle objects removed from loons, a higher proportion of jigs than has been reported in previous studies. The timing of lead tackle mortalities and a high incidence of accompanying non‐lead associated fishing gear (hooks, fishing line, leaders, swivels, wire), which peaked in July and August, suggest that loons obtain the majority of lead tackle from current fishing activity rather than from a reservoir of lead tackle on lake bottoms. To project the statewide loon population in the absence of lead fishing tackle as a stressor, we constructed a retrospective population model, which re‐inserted loons that died from lead tackle into the population, and used linear regression to test for a population‐level effect. We defined a population‐level effect as a difference in the population growth rate (λ). We estimated that lead tackle mortality reduced the population growth rate (λ) by 1.4% and the statewide population by 43% during the years of the study. This study suggests that replacing lead fishing sinkers and jigs weighing ≤28.4 g with non‐toxic alternatives would result in an immediate benefit to the loon population in New Hampshire. © 2017 The Wildlife Society. We used a 24‐year dataset to document that ingested lead fishing tackle is the leading known cause of death for adult common loons in New Hampshire, much of it likely acquired as a result of current fishing activity rather than from a reservoir of lost tackle on lake substrates. Population modeling indicated a significant population‐level effect from this mortality, and this study suggests that the replacement of lead fishing tackle weighing ≤28.4 g with non‐toxic alternatives would benefit loon populations.

Radiofrequency ablation (RFA) is more cost-effective than stereotactic body radiation therapy (SBRT) for initial treatment of inoperable, localized hepatocellular carcinoma despite the high local control of SBRT shown in studies to date; however, SBRT is cost-effective relative to RFA to salvage locally recurrent tumors after RFA.

For the long-term management of high- and intermediate-level radioactive waste and/or spent fuel, many countries prefer disposal in a geological repository. In Belgium, Switzerland and France, argillaceous formations are being explored as potential host formations for this purpose. In this context, knowledge of the diffusion coefficient of He is relevant within two research areas: first, diffusion coefficients are used in safety calculations to evaluate the balance between gas generation (mainly H2) and gas dissipation; and, second, the diffusion coefficients of He and Ar are needed in the diffusion models of natural tracers. Owing to the lack of data on the diffusion coefficients of He and Ar for the different clay host formations, diffusion experiments with dissolved He and Ar were performed on Boom Clay, Opalinus Clay and Callovo-Oxfordian Clay. Samples were confined in a diffusion cell, and diffusion coefficients were measured by using the double through-diffusion technique. The diffusion coefficients (Dpor Dpore) for He in Boom Clay, Callovo-Oxfordian Clay and Opalinus Clay are 12.6×10−10, 4.51×10−10and 7.13×10−10m2s−1, respectively. The diffusion coefficients for Ar in Boom Clay, Callovo-Oxfordian Clay and Opalinus Clay are 18.6×10−11, 4.06×10−11and 3.65×10−11m2s−1, respectively.

The ability of the adult mammalian brain to compensate for neuronal loss caused by injury or disease is very limited. Transplantation aims to replace lost neurons, but the extent to which new neurons can integrate into existing circuits is unknown. Here, using chronic in vivo two-photon imaging, we show that embryonic neurons transplanted into the visual cortex of adult mice mature into bona fide pyramidal cells with selective pruning of basal dendrites, achieving adult-like densities of dendritic spines and axonal boutons within 4–8 weeks. Monosynaptic tracing experiments reveal that grafted neurons receive area-specific, afferent inputs matching those of pyramidal neurons in the normal visual cortex, including topographically organized geniculo-cortical connections. Furthermore, stimulus-selective responses refine over the course of many weeks and finally become indistinguishable from those of host neurons. Thus, grafted neurons can integrate with great specificity into neocortical circuits that normally never incorporate new neurons in the adult brain.

Implant-associated infections still pose serious problems in modern medicine. The development of fabrication processes to generate functional surfaces, which inhibit bacterial attachment, is of major importance. Sharklet™-like as well as grooves and grid micro-structures having similar dimensions were fabricated on the common implant material titanium by ultra-short pulsed laser ablation. Investigations on the biofilm formation of Staphylococcus aureusfor up to 24 h revealed similarly reduced bacterial surface coverage on all micro-structures investigated compared to smooth titanium surfaces. This study is a prove-of-principle and could serve as basis for further investigations towards a structure-based biofilm-inhibiting implant.

Cellular differentiation is accompanied by dramatic changes in chromatin structure which direct the activation of lineage‐specific transcriptional programs. Structure‐specific recognition protein‐1 (SSRP1) is a histone chaperone which is important for chromatin‐associated processes such as transcription, DNA replication and repair. Since the function of SSRP1 during cell differentiation remains unclear, we investigated its potential role in controlling lineage determination. Depletion of SSRP1 in human mesenchymal stem cells elicited lineage‐specific effects by increasing expression of adipocyte‐specific genes and decreasing the expression of osteoblast‐specific genes. Consistent with a role in controlling lineage specification, transcriptome‐wide RNA‐sequencing following SSRP1 depletion and the induction of osteoblast differentiation revealed a specific decrease in the expression of genes involved in biological processes related to osteoblast differentiation. Importantly, we observed a specific downregulation of target genes of the canonical Wnt signaling pathway, which was accompanied by decreased nuclear localization of active β‐catenin. Together our data uncover a previously unknown role for SSRP1 in promoting the activation of the Wnt signaling pathway activity during cellular differentiation. StemCells2016;34:1369–1376

The poem “House in the Snow" by Nathaniel U. is presented. First Line: The house; Last Line: the next day.

Developed to decrease unnecessary thoracic computed tomography use in adult blunt trauma patients, the National Emergency X-Radiography Utilization Study (NEXUS) Chest clinical decision instrument does not include the extended Focused Assessment with Sonography in Trauma (eFAST). We assessed whether eFAST improves the NEXUS Chest clinical decision instrument’s diagnostic performance and may replace the chest radiograph (CXR) as a predictor variable.

Introduction: Reperfusion therapy is generally recommended in acute high-risk pulmonary embolism (HR-PE), but several population-based studies report that it is underused. Data on epidemiology, management and outcomes of HR-PE in Portugal are scarce.

IMPORTANCE: The most appropriate dose fractionation for whole-breast irradiation (WBI) remains uncertain. OBJECTIVE: To assess acute and 6-month toxic effects and quality of life (QOL) with conventionally fractionated WBI (CF-WBI) vs hypofractionated WBI (HF-WBI). DESIGN, SETTING, AND PARTICIPANTS: Unblinded randomized trial of CF-WBI (n = 149; 50.00 Gy/25 fractions + boost [10.00-14.00 Gy/5-7 fractions]) vs HF-WBI (n = 138; 42.56 Gy/16 fractions + boost [10.00-12.50 Gy/4-5 fractions]) following breast-conserving surgery administered in community-based and academic cancer centers to 287 women 40 years or older with stage 0 to II breast cancer for whom WBI without addition of a third field was recommended; 76% of study participants (n = 217) were overweight or obese. Patients were enrolled from February 2011 through February 2014 and observed for a minimum of 6 months. INTERVENTIONS: Administration of CF-WBI or HF-WBI. MAIN OUTCOMES AND MEASURES: Physician-reported acute and 6-month toxic effects using National Cancer Institute Common Toxicity Criteria, and patient-reported QOL using the Functional Assessment of Cancer Therapy for Patients with Breast Cancer (FACT-B). All analyses were intention to treat, with outcomes compared using the χ2 test, Cochran-Armitage test, and ordinal logistic regression. RESULTS: Of 287 participants, 149 were randomized to CF-WBI and 138 to HF-WBI. Treatment arms were well matched for baseline characteristics, including FACT-B total score (HF-WBI, 120.1 vs CF-WBI, 118.8; P = .46) and individual QOL items such as somewhat or more lack of energy (HF-WBI, 38% vs CF-WBI, 39%; P = .86) and somewhat or more trouble meeting family needs (HF-WBI, 10% vs CF-WBI, 14%; P = .54). Maximum physician-reported acute dermatitis (36% vs 69%; P < .001), pruritus (54% vs 81%; P < .001), breast pain (55% vs 74%; P = .001), hyperpigmentation (9% vs 20%; P = .002), and fatigue (9% vs 17%; P = .02) during irradiation were lower in patients randomized to HF-WBI. The rate of overall grade 2 or higher acute toxic effects was less with HF-WBI than with CF-WBI (47% vs 78%; P < .001). Six months after irradiation, physicians reported less fatigue in patients randomized to HF-WBI (0% vs 6%; P = .01), and patients randomized to HF-WBI reported less lack of energy (23% vs 39%; P < .001) and less trouble meeting family needs (3% vs 9%; P = .01). Multivariable regression confirmed the superiority of HF-WBI in terms of patient-reported lack of energy (odds ratio [OR], 0.39; 95% CI, 0.24-0.63) and trouble meeting family needs (OR, 0.34; 95% CI, 0.16-0.75). CONCLUSIONS AND RELEVANCE: Treatment with HF-WBI appears to yield lower rates of acute toxic effects than CF-WBI as well as less fatigue and less trouble meeting family needs 6 months after completing radiation therapy. These findings should be communicated to patients as part of shared decision making. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01266642