Ecological stress caused by climate change, invasive species and anthropogenic disturbance is driving global environmental change, but how these stressors interact to impact native species are poorly understood. We used a field experiment to test how two stressors (drought and plant invasion by Imperata cylindrica) interacted to determine the effects of a third stressor (fire) on a foundation tree species (Pinus palustris). The invasion combined with prolonged drought resulted in shorter trees than invasion alone. The invasion also resulted in 65% greater fuel loads, four times taller flames, greater maximum temperatures and longer heating duration. Consequently, nearly all tree mortality occurred due to a synergistic interaction between the drought + invasion treatment and fire, where invasion caused taller flames that impacted trees that were shorter due to drought. These findings demonstrate that synergy amongst ecological stressors can dramatically impact native species, with significant implications for forecasting the effects of multiple stressors under global change.

Hyaluronic acid (HA) is an effective dermal filler for facial rejuvenation. This study aimed to observe the clinical efficacy of HA injection for lip augmentation in Chinese patients.

From May 2019 to April 2020, 70 patients with lip fullness scale (LPS) ≤3 underwent local HA injection using the „three-point“ injection technique. All patients were followed up to observe the clinical efficacy, LPS, adverse events, and complications.

All 70 patients were followed up for 12months. Statistically significant improvements were observed in the height of lips within 6-9months post-treatment (p<0.05). The LFS improved significantly at follow-up compared with baseline (p<0.05). Local redness occurred in two patients, and serious swelling occurred in three patients. These adverse events were generally tolerated and disappeared gradually within 1week. No other serious adverse events and complications were reported in the remaining patients.

Hyaluronic acid injection can be used for lip augmentation in the Chinese population. The „three-point“ technique is simple, safe, and effective and does not cause serious complications.

Hyaluronic acid injection can be used for lip augmentation in the Chinese population. The „three-point“ technique is simple, safe, and effective and does not cause serious complications.

Formative assessment with emphasis on feedback has been linked to developmental purposes of assessment, whilst summative assessment is assumed to focus on judgemental and quality assurance purposes. This dichotomy is questioned but designs to blend formative and summative assessments in constructive ways are rare in health care education.

We have designed an assessment model blending formative and summative assessments. In the formative assessment at the end of a course, students‘ responses to real-life scenarios with questions demanding responses at the relational level of understanding were assessed at three levels of understanding (incorrect, descriptive and relational) modified after the SOLO taxonomy. Students were presented with individual feedback for each response. At the summative assessment of a subsequent course, the students‘ new responses were assessed underpinning a final judgement of students‘ performance. The assessment model was justified across three student cohorts.

Both formative ande importance of developing and assessing cognitive complexity.“My favorite science outreach activity is meeting with young people at science fairs to answer the questions they have about the world around them (not always easy to answer but often inspiring) … I chose chemistry as a career because you transform and model matter at the scale of the molecule, a scale imperceptible to human beings until very recently in our history. …“ Find out more about Morgan Donnard in his Introducing … Profile.

Although overall survival of ALF has improved, neurological restoration after recovery from ALF may not always be satisfactory. The purpose of this study was to investigate the occurrence and possible causes of NI in children with ALF following LT.

We retrospectively examined all children younger than 16years old with ALF who subsequently underwent LT at our center between January 2005 and December 2016. NI was assessed in December 2016 using the six-point Pediatric Cerebral Performance Category score and was defined as any increase in the score.

There were 62 children with median age 10months (quartile range 5-34). The etiology of ALF was indeterminate in 47 children (75.8%). The median duration from admission to LT was 5.5days (quartile range 4-7), and 96.8% (60/62) received living donor LT. The overall survival was 83.9% (52/62) in a median follow-up period of 4.2years. Mild-to-moderate NI was observed in 23.1% (12/52) of the survivors. Possible causes of NI were underlying systemic disease (n=3), perioperative brain lesion (n=2), and unclassified (n=7). All seven patients with unclassified NI were less than 12months old. The unclassified NI causes were presumed to be ALF, its perioperative care, and the vulnerable infant brain.

NI in children with ALF following LT was not rare and should be prevented. Further investigations are required to clarify the characteristics of the patients with unclassified NI.

NI in children with ALF following LT was not rare and should be prevented. Further investigations are required to clarify the characteristics of the patients with unclassified NI.Synthesis and reactivity of disilicon(0) complexes are of fundamental and application importance. Herein, we report the development of an N-heterocyclic imino-substituted silylene (1), which has strong σ-donating ability and is significantly sterically hindered. The one-pot reaction of this silylene with [IPr→SiCl2 ] (IPr=1,3-bis(2,6-diisopropylphenyl)-imidazol-2-ylidene) and KC8 (2 equiv) in THF at -30 °C leads to a silylene-ligated disilicon(0) complex (2), isolated as red crystals in 60 % yield. Characterization data and DFT calculations show that the trans-bent Si4 skeleton in 2 features a Si0 =Si0 double bond with significant π-π bonding and one lone pair of electrons on each of these two Si0 atoms. Complex 2 reacts readily with phenylacetylene, producing a structurally intriguing silatricyclic complex 6,8-diaza-1,2,5-trisilatricyclo-[3.2.1.02,7 ]-oct-3-ene (3), and revealing new aspects of low-valent silicon chemistry.There is a debate in the literature regarding the level of contribution of executive functions (EF) to reading comprehension (RC), in the context of the simple view of reading (SVR) model. The current study aims to create sub-profiles of reading and cognitive abilities based on a measure traditionally used for evaluating EF, that is, the Stroop task, and specifically, Stroop time. Ninety-seven adults with and without reading difficulties performed reading and cognitive tasks, including the Stroop tests. Four groups were created based on Stroop performance time and a reading profile was created for each group. A mediation analysis was conducted to determine if reading accuracy and linguistic abilities predict RC mediated by Stroop time. Participants with a shorter Stroop time demonstrated better reading abilities, whereas those with longer Stroop time showed decreased reading performance. Stroop time was also negatively associated with better performance in additional cognitive abilities. A mediation analysis suggested that decoding ability and linguistic ability predict RC through EF. Our findings support the SVR model and the involvement of EF in reading proficiency and might be used for designing EF-based interventions for reading and RC difficulties.

To determine nurses‘ perceived barriers to the delivery of person-centred care to complex patients with multiple chronic conditions in acute care settings.

Complex patients have multiple physical and mental health problems, and their life is also greatly affected by sociocultural and economic determinants of health. Selleck ESI-09 These patients require person-centred care, but nurses often find it challenging to provide effective care to these patients due to their complex health needs.

A descriptive qualitative design was used. The COREQ guidelines were followed for reporting.

Semi-structured interviews were conducted with a purposive sample of 19 nurses in two hospitals. Data were analysed using deductive thematic analysis guided by the Theoretical Domains Framework, which entails 14 domains about factors affecting behaviours.

The key barriers were identified under environmental context and resources, social influences, emotions, knowledge and skills domains. Deep-rooted social issues delay patients‘ health-sees, and organisational barriers is essential. Nurses could focus on their self-awareness and collaborative skills to address emotional and interprofessional conflicts.

Designing implementation facilitation teams, organising person-centred care grand rounds, and allocation of stress management resources to address hostility, social-cultural influences, and organisational barriers is essential. Nurses could focus on their self-awareness and collaborative skills to address emotional and interprofessional conflicts.The Quantikine® ELISA detects tissue factor in cell lysates and culture supernatants containing extracellular vesicles from tissue factor-expressing cell lines but does not detect low levels of tissue factor antigen in plasma.

The availability of chest computed tomography (CT) imaging can help diagnose comorbidities associated with chronic obstructive pulmonary disease (COPD). Their systematic identification and relationship with all-cause mortality have not been explored. Furthermore, whether their CT-detected prevalence differs from clinical diagnosis is unknown.

The prevalence of 10 CT-assessed comorbidities was retrospectively determined at baseline in 379 patients (71% men) with mild to severe COPD attending pulmonary clinics. Anthropometrics, smoking history, dyspnoea, lung function, exercise capacity, BODE (BMI, Obstruction, Dyspnoea and Exercise capacity) index and exacerbations rate were recorded. The prevalence of CT-determined comorbidities was compared with that recorded clinically. Over a median of 78 months of observation, the independent association with all-cause mortality was analysed. A ‚CT-comorbidome‘ graphically expressed the strength of their association with mortality risk.

Coronary artery calcification, emphysema and bronchiectasis were the most prevalent comorbidities (79.8%, 62.7% and 33.9%, respectively). All were underdiagnosed before CT. Coronary artery calcium (hazard ratio [HR] 2.09; 95% CI 1.03-4.26, p= 0.042), bronchiectasis (HR 2.12; 95% CI 1.05-4.26, p= 0.036) and low psoas muscle density (HR 2.61; 95% CI 1.23-5.57, p= 0.010) were independently associated with all-cause mortality and helped define the ‚CT-comorbidome‘.

This study of COPD patients shows that systematic detection of 10 CT-diagnosed comorbidities, most of which were not detected clinically, provides information of potential use to patients and clinicians caring for them.

This study of COPD patients shows that systematic detection of 10 CT-diagnosed comorbidities, most of which were not detected clinically, provides information of potential use to patients and clinicians caring for them.