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Seed dispersal is an essential ecological process for plant (re)colonization, especially in intensively human-altered habitats such as old-fields (i.e. abandoned farmlands) where seed arrival is often limited. Assessment of spatial patterns of mammal-generated seed rain and their matching with the spatial distribution of adult plants provides essential information on the patterns and pace of the (re)colonization processes. For instance, increased seedling survival far from adult plants could indicate density-dependent mortality (Janzen-Connell) effects whereas increased survival close to adult plants could suggest facilitative effects. Here, we characterized during two dispersal seasons the spatial distribution of feces from four frugivorous mammals and quantified its spatial association with the distribution of adult plants of the pioneer Mediterranean dwarf palm (Chamaerops humilis) in two old-fields in southwestern Spain. We also estimated the dispersal kernels of both emerged and surviving seedlings and assessed potential evidence for Janzen-Connell and/or facilitative effects. Using a spatially explicit approach, we revealed strong differences between study sites in the strength and scale of spatial associations between mammal feces with C. humilis seeds and adult dwarf palms, being strongly positive at small scales in one site and slightly positive at larger scales in the other one. Further, we found some evidence of both Janzen-Connell and facilitative effects depending on the study site. Altogether, our results emphasize the central role as seed disperser of the Eurasian badger (Meles meles) in the natural (re)colonization of Mediterranean old-fields and the spatial variations of the underlying mechanisms and demographic consequences for plant populations., This work was supported by the Portuguese Foundation for Science and Technology to PJG (SFRH/BD/130527/2017) and ARC (SFRH/BPD/115781/2016); and by a grant of the Spanish Ministry of Science and Innovation to JMF (PGC2018-094808-B-I00). Logistic and technical support was provided by ICTS-RBD.

Este artículo se encuentra disponible en la siguiente URL: https://www.sciencedirect.com/science/article/pii/S246878122200056X Background: The central component of person-centred care is in having a therapeutic realtionship. Furthermore, the empathy of the physiotherapist is one of the most important attributes in achieving a successful therapeutic alliance. Objective: The aim of the research was to determine the association between the constructs of empathy and therapeutic alliance in Spanish physical therapists and the possible influence of socio-professional variables on them. Design: Cross-sectional research. Methods: An electronic survey including the Working Alliance Inventory-Short Form, the Interpersonal Reactivity Index and sociodemographic data with 473 Spanish physiotherapists. A descriptive, bivariate and simple lineal regression analysis was carried out. Results: Work experience has a positive influence on bonding and the agreement on objectives and tasks (0.04 < B > 0.06; p < 0.01). The perspective taking dimensions and empathic concern positively influence the agreement on achievement (0.14 < B > 0.19; p < 0.001). Personal distress inversely influences bonding and the agreement on achievements and tasks (􀀀 0.13 < B > 􀀀 0.09; p < 0.01). Conclusions: The dimensions of perspective taking and empathic concern seem to facilitate successful shared decision making in terms of treating objectives. Furthermore, the physiotherapist’s personal distress acts as an obstacle to the development of the three subcomponents of the therapeutic alliance analysed.

Objetivos LSD1 e LSD2 codificam enzimas desmetilases que primariamente regulam a transcricao genica por desmetilar a histona 3, mas que tambem podem diretamente desmetilar proteinas especificas, que possuem importante impacto oncogenico, como p53, E2F, HIF, STAT3 e DNMT1. De fato, a desregulacao de LSD1 e LSD2 tem sido associada ao desenvolvimento de diversos tipos de câncer. Neste estudo tivemos como objetivo avaliar a expressao e o impacto prognostico de LSD1 e LSD2 na LLC. Materiais e metodos Utilizamos amostras de 55 pacientes com LLC, atendidos no Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto-USP. Apos diagnostico, determinamos por Citometria de fluxo a expressao de ZAP-70 e o padrao cariotipico dos pacientes por exame citogenetico (Bandeamento G). A expressao de LSD1 e LSD2 foi determinada por PCR em tempo real e comparada com celulas B-saudaveis. Resultados Nao detectamos alteracao nos niveis transcricionais de LSD1 ao compararmos as amostras de LLC e celulas B controle. Entretanto, os pacientes com LLC apresentaram expressao reduzida do transcrito LSD2 (p = 0,001). Considerando o padrao heterogeneo de expressao de LSD1 e LSD2 na LLC, as amostras foram dicotomizadas em “alta”e “baixa”expressao, seguindo a mediana de expressao dos genes. E interessante, pois as amostras com expressao reduzida de LSD1 e LSD2 apresentaram leucometria elevada (p = 0,007 e p = 0,01, respectivamente). Adicionalmente, a expressao reduzida dos transcritos LSD1 e LSD2 tambem esta associada com a presenca de tres ou mais alteracoes citogeneticas (p = 0,009 e p = 0,0006, respectivamente) e presenca de alteracoes citogeneticas de prognostico desfavoravel (p = 0,008 e p = 0,001). Discussao dados reportados na literatura indicam que LSD1 e LSD2 podem ter um papel na proliferacao e sobrevida celular. Alem disso, foi demonstrado que a inibicao dessas enzimas afeta a segregacao e o correto alinhamento cromossomico alem do processo de imprinting genomico. Nossa hipotese e que LSD1 e LSD2 tenham papel de supressor tumoral na LLC, em que a baixa expressao dessas enzimas pode favorecer a sobrevida das celulas leucemicas. Conclusao Encontramos uma associacao entre a baixa expressao dos genes e fatores prognosticos, no entanto, estudos adicionais sao necessarios em coortes independentes para confirmar o papel prognostico de LSD1 e LSD2 e para descrever molecularmente o impacto dessas enzimas na sobrevida e instabilidade genomica da LLC.

Introduction: Metabolic Associated Fatty Liver Disease (MAFLD) is a clinic-pathological condition commonly associated with metabolic syndrome (MS) and this association is frequently found in severely obese. Objective: To compare clinical and histological characteristics of MAFLD in obese with and without MS. Methodology: Cross-sectional study with severely obese patients diagnosed with MAFLD between Sep/2014 and May/2015. MAFLD was diagnosed by liver biopsy during bariatric surgery. MS diagnosis was based on the International Diabetes Federation criteria. Statistical analyses were performed using chi-square and t tests. P

Psychological theories of emotion often highlight the dynamic quality of the affective experience, yet neuroimaging studies of affect have traditionally relied on static stimuli that lack ecological validity. Consequently, the brain regions that represent emotions and feelings as they unfold remain unclear. Recently, dynamic, model-free analytical techniques have been employed with naturalistic stimuli to better capture time-varying patterns of activity in the brain; yet, few studies have focused on relating these patterns to changes in subjective feelings. Here, we address this gap, using intersubject correlation and phase synchronization to assess how stimulus-driven changes in brain activity and connectivity are related to two aspects of emotional experience: emotional intensity and enjoyment. During fMRI scanning, healthy volunteers listened to a full-length piece of music selected to induce sadness. After scanning, participants listened to the piece twice while simultaneously rating the intensity of felt sadness or felt enjoyment. Activity in the auditory cortex, insula, and inferior frontal gyrus was significantly synchronized across participants. Synchronization in auditory, visual, and prefrontal regions was significantly greater in participants with higher measures of a subscale of trait empathy related to feeling emotions in response to music. When assessed dynamically, continuous enjoyment ratings positively predicted a moment-to-moment measure of intersubject synchronization in auditory, default mode, and striatal networks, as well as the orbitofrontal cortex, whereas sadness predicted intersubject synchronization in limbic and striatal networks. The results suggest that stimulus-driven patterns of neural communication in emotional processing and high-level cortical regions carry meaningful information with regards to our feeling in response to a naturalistic stimulus.

Objective The objective of this study was to perform a cross-cultural adaption and psychometric evaluation of the Spanish version of the Satisfaction with Epilepsy Care (SEC) questionnaire and analyze patient satisfaction with epilepsy care. Methods Transcultural adaptation and validation of the SEC were carried out using translation and back-translation with pilot testing and an expert panel. The SEC-E (Spanish) was analyzed in 213 patients with epilepsy to examine construct and criterion validity and internal consistency. Results The SEC-E achieved conceptual, semantic, and content equivalence with the original version. For content validity, one question was eliminated from the original questionnaire as it has little relevance in our cultural setting. Positive correlations for criterion validity were obtained using the gold standard measure (Satisfaction in Hospitalized Patients scale). Construct validity replicated the three dimensions of the original questionnaire. The scale showed adequate reliability through internal consistency (Cronbach's α of 0.94) and temporal stability on retest (n = 85). Patients scored (0 to 100) 77.5 [standard deviation (SD): 19.9] for satisfaction with communication, 76.9 (SD: 17) for organization, and 67.2 (SD: 22.1) for information. Significance The SEC-E is a valid and reliable tool for the assessment of educational interventions aiming to improve the quality of care in patients with epilepsy in Spanish clinical practice. The results showed a good level of patient satisfaction with epilepsy care.

Objective To report a diagnosis of hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome following initial presentation with multiple cutaneous lesions. Design Case report. Design classification N/A. Setting Academic tertiary care center. Patient(s) 27-year-old nulligravid woman who presented with multiple red-brown lesions on her skin found to have cutaneous and uterine leiomyoma. Intervention(s) Biopsy of cutaneous lesions and fertility sparing robot-assisted laparoscopic myomectomy (RALM). Main outcome measures(s) Histological assessment of uterine leiomyoma. Results(s) Pathologic examination of uterine leiomyoma revealed diffuse atypia and fumarate hydratase loss phenotype concerning for genetic syndrome. Follow-up DNA sequencing via Sanger sequencing confirmed a pathogenetic R2333H mutation consistent with HLRCC. Conclusion(s) Consideration of HLRCC on differential diagnosis when patients present with cutaneous nodules and atypical or early onset uterine leiomyoma provides opportunity for early surveillance, family member testing, and more thoughtful surgical planning. Precis 27-year-old woman with multiple cutaneous lesions is found to have uterine leiomyomas and undergoes robotic myomectomy. Genetic testing of uterine leiomyomas reveals mutation in fumarate hydratase, etiologic in hereditary leiomyomatosis and renal cell cancer (HLRCC)., Highlights • Atypical skin findings and fibroids warrant consideration of HLRCC on the differential diagnosis. • Consider similar genetic testing and management as those with Lynch syndrome associated endometrial cancer. • Pre-operative planning should take HLRCC into consideration when considering tissue containment and removal strategies.

Understanding the mechanisms underlying the recolonization of old-fields is critical to promote the recovery of the ecosystem functioning, particularly in regions where agricultural abandonment has increased in the last 60 years. Given that seed arrival and seedling survival often limit the recolonization process by woody species in many Mediterranean habitats, the ‘perching’ and ‘nursing’ effects exerted by some pioneer species could be crucial for the restoration of such abandoned lands. We examined the role of an endemic Mediterranean palm (Chamaerops humilis) on the recolonization of old-fields by woody species in southern Iberian Peninsula. We chose three independent old-fields differing in their shrub encroachment levels. To identify potential facilitation by C. humilis, we used a spatially-explicit approach and analyzed its spatial associations with ten common woody species (e.g. Asparagus spp., Daphne gnidium, Olea europaea var. sylvestris, Pyrus bourgaeana). We detected positive spatial associations between C. humilis and woody species at small-scale (1–5 m) in the three plots. Most of such small-scale associations were linked to the bird-dispersal of woody species. Nonetheless, there were marked differences among plots in spatial associations between C. humilis and woody plants, being Asparagus spp. the only species positively associated with C. humilis within the three studied old-fields. These species-specific differences were likely related to variations among old-fields in encroachment level and the legacy of human management. Such small-scales spatial associations between C. humilis and woody species across Iberian old-fields were linked to the perching and nursing effects exerted by the palm. We emphasize the strong potential of this pioneer Mediterranean palm for the restoration of native ecosystems and the recovery of ecosystems services., This work was supported by the Portuguese Foundation for Science and Technology, PJG (SFRH/BD/130527/2017), ARC (SFRH/BPD/ 115781/2016) and JMF (IF/00728/2013).

Purpose To study the significance of ‘therapeutic relationship’ between nurses and patients within the context of a psychiatric hospital. Method Narrative literature review. Content analysis. Findings The significance of the therapeutic relationship is quite similar for both nurses and patients in psychiatric hospital units. Nevertheless, several factors may separate the two positions: the time available for the relationship, the negative perceptions on the part of both parties, and the insecurity of the setting. Practice implications Increased knowledge and understanding of the significance of the therapeutic relationship from the perspective of nurses and patients would allow the strengthening of areas of mutual interest.