Darwin's inflorescence syndrome is indeed associated with bee pollination.

KEY MESSAGE: A relationship between vertical acropetal inflorescences with protandrous flowers and bee pollination was hypothesized by Darwin back in 1877. Here we provide empirical evidence supporting this association across the angiosperms. Plant reproduction is not only determined by flower traits but also by the arrangement of flowers within inflorescences. Based on his observations of the orchid Spiranthes autumnalis, Darwin proposed in 1877 that bee-pollinated plants presenting protandrous flowers on vertical acropetal inflorescences, where proximal flowers open first, can exploit the stereotypical foraging behavior of their pollinators (i.e., upward movement through the inflorescence) to promote pollen exportation and reduce self-pollination. In these inflorescences, male-phase flowers lie spatially above female-phase flowers. To examine this untested hypothesis, we compiled literature information from 718 angiosperms species and evaluated the association between vertical acropetal inflorescences with protandrous flowers and bee pollination within a phylogenetic comparative framework. Results reveal that this type of inflorescence is indeed more common in species pollinated by bees. Moreover, this association does not seem to be weakened by the presence of alternative self-pollination avoidance mechanisms, like self-incompatibility, suggesting that this inflorescence type benefits mainly male rather than female fitness. Other inflorescence types placing male-phase flowers above female-phase flowers, e.g., vertical basipetal inflorescences with protogynous flowers, do not provide strong evidence of a differential association with pollination by bees. Female-biased nectar production in vertical acropetal inflorescences with protandrous flowers may reinforce the behavior of bees to fly upwards, rendering Darwin's configuration more adaptive than other inflorescence configurations.

Inundation and Fire Shape the Structure of Riparian Forests in the Pantanal, Brazil.

Inundation and fire can affect the structure of riparian vegetation in wetlands. Our aim was to verify if there are differences in richness, abundance, basal area, composition and topographic preference of woody species in riparian forests related to the fire history, flooding duration, or the interaction between both. The study was conducted in the riparian forests of the Paraguay River some of which were burned three times between 2001 and 2011. We sampled trees with a girth of at least 5 cm at breast height in 150 5 × 10 m plots (79 burned and 71 unburned). We also measured height of the flood mark and estimated the flooding duration of each plot. We performed Generalized Linear Mixed Models to verify differences in richness, basal area, and abundance of individuals associated to interaction of fire and inundation. We used an analysis of similarity (ANOSIM) and indicator species analysis to identify differences in composition of species and the association with burned and unburned area according to different levels of inundation. Finally, we used a hierarchical set of Generalized Linear Models (GLM), the so-called HOF models, to analyse each species' specific response to inundation based on topography and to determine their preferred optimal topographic position for both burned as well as unburned areas. Richness was positively associated with elevation only in burned areas while abundance was negatively influenced by inundation only in burned areas. Basal area was negatively associated with time of inundation independent of fire history. There were 15 species which were significant indicators for at least one combination of the studied factors. We found nine species in burned areas and 15 in unburned areas, with response curves in HOF models along the inundation gradient. From these, five species shifted their optimal position along the inundation gradient in burned areas. The interaction of fire and inundation did not appear to affect the basal area, but it did affect the richness, number of individuals, success of some species, and seemed to shape the boundary of these forests as shown by the difference in the positioning of these species along the inundation gradient.

Diagnosis and management of ureteral fibroepithelial polyps in children: a new treatment algorithm.

INTRODUCTION: Fibroepithelial polyps are benign mesenchymal tumors arising from the urinary tract. With the advent of endoscopy in the pediatric population, more reports of endoscopic diagnosis and treatment have appeared. OBJECTIVE: The present study reports experience with the diagnosis and treatment of fibroepithelial polyps of the upper urinary tract in the pediatric population. Incorporating past experience from literature, we propose an algorithm to guide the clinical diagnosis and treatment plan. STUDY DESIGN: Four pediatric patients undergoing pyeloplasty for ureteropelvic junction (UPJ) obstruction were diagnosed with ureteral polyps. Their demographics, radiologic, surgical and pathologic information were reviewed. In addition, a comprehensive literature search using the MEDLINE database yielded 37 reports containing 126 cases of ureteral polyps, including 5 series with 57 cases and 9 cases of synchronous bilateral ureteral polyps. RESULTS: Of 123 pediatric patients undergoing pyeloplasty from 2008 to 2013, four (3.3%) were found to have fibroepithelial polyps of the upper urinary tract. All patients were male and the mean age of presentation was 12 years. Ureteral polyps predominantly occurred unilaterally in the left ureter (75%) and one case of bilateral ureteral polyps was encountered. Along with three other recent case series [1-3], the combined incidence of ureteral polyps in patients undergoing evaluation for ureteral obstruction was 5.2%. Intraoperative retrograde pyelogram was used to identify filling defects in 4 of 5 affected ureters (see Figure). Ureterorenoscopy was performed in all three patients with filling defects for polyp mapping along the ureter and evaluation of the macroscopic polyp appearance. Based on ureteroscopic findings, Holmium laser polypectomy was performed in two patients with single, pedunculated polyps. Anderson-Hynes dismembered pyeloplasty was performed in three patients with broad based, multilobulated polyps too large for endoscopic treatment and in one patient for undiagnosed polyp prior to pyeloplasty. DISCUSSION: The present study finds that the 5.2% combined incidence of ureteral polyps in contemporary reports may be higher than previously described [4]. Retrograde pyelogram was an effective tool in diagnosing ureteral polyp and ureteroscopy can be employed if ureteral polyps are suspected for both diagnostic and therapeutic purposes. Although clinical experience is limited, endoscopic laser treatment seems to be effective for the single, pedunculated ureteral polyps, while dismembered pyeloplasty is required for the broad based, multilobulated polyps. The study was limited by the rarity of ureteral polyps. Future multi-institutional collaborative studies are required to validate the diagnostic and treatment algorithm proposed. CONCLUSION: Ureteral polyps cause approximately 5% of UPJ obstruction in the pediatric population. Diagnosis can be made in certain cases by intraoperative retrograde pyelogram. If a filling defect is encountered, ureteroscopy is indicated for polyp mapping. The treatment modality is dictated by the endoscopic appearance of the ureteral polyp.

[Evolution and weight and body composition determination after therapy for pathological obesity for measuring compliance in (re)-education]. / Evolution du poids et de la composition corporelle à moyen terme après une cure pour obésité pathologique selon la compliance à la (ré)-éducation.

Obesity, and its associated complications, is one of the most costly diseases in modern civilisations. Dieting alone rarely gives good long-term results. The effect of the combination of nutritional education and moderately intensive physical exercise on the evolution of weight and Body composition has been analysed by bio-impedancemetry over a one-year period. Patients could be divided into four groups: patients lost after the 3-week nutritional course, patients neither dieting nor exercising, patients dieting and patients both dieting and exercising. The results for the four groups were the following: undeterminably, 5% loss compared to initial weight (and nearly 10% compared to reported maximum weight). 10% loss and 15% loss over one year. In the last group, Body composition showed a relative increase in muscle mass, which explains the lack of a drop in basal metabolic rates seen in the diet-alone group. This maintained metabolic rate probably prevented patients from weight cycling (yo-yo phenomenon). This result can be compared to other life-style changing studies or pharmacological treatments (Orlistat, sibutramine) of obesity, which resulted in an approx. 10% weight reduction.

Creating and implementing guidelines on caring for difficult patients: a research utilization project.

Difficult patients challenge the resourcefulness of nurses. Considering the results of a focus group study, guidelines are designed for the care of difficult patients. Four case studies present the use of the guidelines, including interventions and outcomes.