Interactions of moisture and light drive lichen growth and the response to climate change scenarios: experimental evidence for Lobaria pulmonaria.

BACKGROUND AND AIMS: There is growing interest in the functional ecology of poikilohydric non-vascular photoautotrophs (NVPs), including 'cryptogamic' bryophytes and lichens. These organisms are structurally important in many ecosystems, contributing substantially to ecosystem function and services, while also being sensitive to climate change. Previous research has quantified the climate change response of poikilohydric NVPs using predictive bioclimatic models with standard climate variables including precipitation totals and temperature averages. This study aimed for an improved functional understanding of their climate change response based on their growth rate sensitivity to moisture and light. METHODS: We conducted a 24-month experiment to monitor lichen hydration and growth. We accounted for two well-known features in the ecology of poikilohydric NVPs, and exemplified here for a structurally dominant lichen epiphyte, Lobaria pulmonaria: (1) sensitivity to multiple sources of atmospheric moisture including rain, condensed dew-formation and water vapour; and (2) growth determined by the amount of time hydrated in the light, driving photosynthesis, referred to as the Iwet hypothesis. KEY RESULTS: First, we found that even within an oceanic high-rainfall environment, lichen hydration was better explained by vapour pressure deficit than precipitation totals. Second, growth at a monthly resolution was positively related to the amount of time spent hydrated in the light, and negatively related to the amount of time spent hydrated in the dark. CONCLUSIONS: Using multimodel averaging to project growth models for an ensemble of future climate change scenarios, we demonstrated reduced net growth for L. pulmonaria by the late 21st century, explained by extended climate dryness and lichen desiccation for periods when there is otherwise sufficient light to drive photosynthesis. The results further emphasize a key issue of photoperiodism when constructing functionally relevant models to understand the risk of climate change, especially for poikilohydric NVPs.

A research agenda for nonvascular photoautotrophs under climate change.

Nonvascular photoautotrophs (NVP), including bryophytes, lichens, terrestrial algae, and cyanobacteria, are increasingly recognized as being essential to ecosystem functioning in many regions of the world. Current research suggests that climate change may pose a substantial threat to NVP, but the extent to which this will affect the associated ecosystem functions and services is highly uncertain. Here, we propose a research agenda to address this urgent question, focusing on physiological and ecological processes that link NVP to ecosystem functions while also taking into account the substantial taxonomic diversity across multiple ecosystem types. Accordingly, we developed a new categorization scheme, based on microclimatic gradients, which simplifies the high physiological and morphological diversity of NVP and world-wide distribution with respect to several broad habitat types. We found that habitat-specific ecosystem functions of NVP will likely be substantially affected by climate change, and more quantitative process understanding is required on: (1) potential for acclimation; (2) response to elevated CO2 ; (3) role of the microbiome; and (4) feedback to (micro)climate. We suggest an integrative approach of innovative, multimethod laboratory and field experiments and ecophysiological modelling, for which sustained scientific collaboration on NVP research will be essential.

Microclimates hold the key to spatial forest planning under climate change: Cyanolichens in temperate rainforest.

There is deepening interest in how microclimatic refugia can reduce species threat, if suitable climatic conditions are maintained locally, despite global climate change. Microclimates are a particularly important consideration in topographically heterogeneous landscapes, while in some habitats, such as forests and woodlands, microclimates are also extremely labile and affected by management practices that could consequently be used to offset climate change impact. This study explored a conservation priority guild-cyanolichen epiphytes in temperate rainforest-quantifying the niche response to macroclimate, and landscape or woodland stand structures that determine the microclimate. Based on epiphyte survey in a core region of European temperate rainforest (western Scotland), a 'random forest' machine-learning model confirmed a strong cyanolichen response to summer dryness, as well as the effects of distance to running water, topographic heatload and tree species identity, which modify the local moisture regime and/or lichen growth rates. By quantifying this response to macroclimate, landscape and stand structures, it was possible to estimate an extent to which woodland may be expanded in the future, to offset a negative effect of increasing summer dryness projected through to the 2080s. Using current policy as a yardstick, sufficient woodland expansion could be delivered relatively quickly for median impacted sites, but with times to woodland delivery extending over 10, 20 and 25 years for sites at the 75th, 90th and 95th percentiles of cyanolichen decline. Furthermore, the extent of new woodland required, and delivery times, increase almost threefold on average, as new woodland becomes distributed over wider riparian zones. These contrasting implications emphasize an urgent need for afforestation that achieves targeted spatial planning responsive to microclimates as refugia.

Alkaline air: changing perspectives on nitrogen and air pollution in an ammonia-rich world.

Ammonia and ammonium have received less attention than other forms of air pollution, with limited progress in controlling emissions at UK, European and global scales. By contrast, these compounds have been of significant past interest to science and society, the recollection of which can inform future strategies. Sal ammoniac (nushadir, nao sha) is found to have been extremely valuable in long-distance trade (ca AD 600-1150) from Egypt and China, where 6-8 kg N could purchase a human life, while air pollution associated with nushadir collection was attributed to this nitrogen form. Ammonia was one of the keys to alchemy-seen as an early experimental mesocosm to understand the world-and later became of interest as 'alkaline air' within the eighteenth century development of pneumatic chemistry. The same economic, chemical and environmental properties are found to make ammonia and ammonium of huge relevance today. Successful control of acidifying SO2 and NOx emissions leaves atmospheric NH3 in excess in many areas, contributing to particulate matter (PM2.5) formation, while leading to a new significance of alkaline air, with adverse impacts on natural ecosystems. Investigations of epiphytic lichens and bog ecosystems show how the alkalinity effect of NH3 may explain its having three to five times the adverse effect of ammonium and nitrate, respectively. It is concluded that future air pollution policy should no longer neglect ammonia. Progress is likely to be mobilized by emphasizing the lost economic value of global N emissions ($200 billion yr-1), as part of developing the circular economy for sustainable nitrogen management. This article is part of a discussion meeting issue 'Air quality, past present and future'.

Using Animation to Improve Recovery from Acute Coronary Syndrome: A Randomized Trial.

UNLABELLED: Background: Recovery from myocardial infarction has been associated with patients' perceptions of damage to their heart. New technologies offer a way to show patients animations that may foster more accurate perceptions and encourage medication adherence, increased exercise and faster return to activities. PURPOSE: The purpose of this study was to investigate the effects of a brief animated intervention delivered at the patients' bedside on perceptions and recovery in acute coronary syndrome patients. METHODS: Seventy acute coronary syndrome patients were randomly assigned to the intervention or standard care alone. Illness perceptions, medication beliefs and recovery outcomes were measured. RESULTS: Post-intervention, the intervention group had significantly increased treatment control perceptions and decreased medication harm beliefs and concerns. Seven weeks later, intervention participants had significantly increased treatment control and timeline beliefs, decreased symptoms, lower cardiac avoidance, greater exercise and faster return to normal activities compared to control patients. CONCLUSIONS: A brief animated intervention may be clinically effective for acute coronary syndrome patients (Trial-ID: ACTRN12614000440628).

Archaeobotanical evidence for climate as a driver of ecological community change across the anthropocene boundary.

The biodiversity response to climate change is a major focus in conservation research and policy. Predictive models that are used to project the impact of climate change scenarios - such as bioclimatic envelope models - are widely applied and have come under severe scrutiny. Criticisms of such models have focussed on at least two problems. First, there is an assumption that climate is the primary driver of observed species distributions ('climatic equilibrium'), when other biogeographical controls are often reliably established. Second, a species' sensitivity to macroclimate may become less relevant when impacts are down-scaled to a local level, incorporating a modifying effect of species interactions structuring communities. This article examines the role of different drivers (climate, pollution and landscape habitat structure) in explaining spatial community variation for a widely applied bioindicator group: lichen epiphytes. To provide an analysis free of 'legacy effects' (e.g. formerly higher pollution loads), the study focused on hazel stems as a relatively short-lived and recently colonized substratum. For communities during the present day, climate is shown to interact with stem size/age as the most likely explanation of community composition, thus coupling a macroclimatic and community-scale effect. The position of present-day communities was projected into ordination space for eight sites in England and compared to the position of historical epiphyte communities from the same sites, reconstructed using preserved hazel wattles dating mainly to the 16th Century. This comparison of community structure for the late- to post-Mediaeval period, with the post-Industrial period, demonstrated a consistent shift among independent sites towards warmer and drier conditions, concurrent with the end of the Little Ice Age. Long-term temporal sensitivity of epiphyte communities to climate variation thus complements spatial community patterns. If more widely applied, preserved lichen epiphytes have potential to generate new baseline conditions of environment and biodiversity for preindustrial lowland Europe.

Genotypic variation in a foundation tree (Populus tremula L.) explains community structure of associated epiphytes.

Community genetics hypothesizes that within a foundation species, the genotype of an individual significantly influences the assemblage of dependent organisms. To assess whether these intra-specific genetic effects are ecologically important, it is required to compare their impact on dependent organisms with that attributable to environmental variation experienced over relevant spatial scales. We assessed bark epiphytes on 27 aspen (Populus tremula L.) genotypes grown in a randomized experimental array at two contrasting sites spanning the environmental conditions from which the aspen genotypes were collected. We found that variation in aspen genotype significantly influenced bark epiphyte community composition, and to the same degree as environmental variation between the test sites. We conclude that maintaining genotypic diversity of foundation species may be crucial for conservation of associated biodiversity.

Acute coronary syndrome care across Australia and New Zealand: the SNAPSHOT ACS study.

OBJECTIVES: To characterise management of suspected acute coronary syndrome (ACS) in Australia and New Zealand, and to assess the application of recommended therapies according to published guidelines. DESIGN, SETTING AND PATIENTS: All patients hospitalised with suspected or confirmed ACS between 14 and 27 May 2012 were enrolled from participating sites in Australia and New Zealand, which were identified through public records and health networks. Descriptive and logistic regression analysis was performed. MAIN OUTCOME MEASURES: Rates of guideline-recommended investigations and therapies, and inhospital clinical events (death, new or recurrent myocardial infarction [MI], stroke, cardiac arrest and worsening congestive heart failure). RESULTS: Of 478 sites that gained ethics approval to participate, 286 sites provided data on 4398 patients with suspected or confirmed ACS. Patients' mean age was 67 2013s (SD, 15 2013s), 40% were women, and the median Global Registry of Acute Coronary Events (GRACE) risk score was 119 (interquartile range, 96-144). Most patients (66%) presented to principal referral hospitals. MI was diagnosed in 1436 patients (33%), unstable angina or likely ischaemic chest pain in 929 (21%), unlikely ischaemic chest pain in 1196 (27%), and 837 patients (19%) had other diagnoses not due to ACS. Of the patients with MI, 1019 (71%) were treated with angiography, 610 (43%) with percutaneous coronary intervention and 116 (8%) with coronary artery bypass grafting. Invasive management was less likely with increasing patient risk (GRACE score < 100, 90.1% v 101-150, 81.3% v 151-200, 49.4% v > 200, 36.1%; P < 0.001). The inhospital mortality rate was 4.5% and recurrent MI rate was 5.1%. After adjusting for patient risk and other variables, significant variations in care and outcomes by hospital classification and jurisdiction were evident. CONCLUSION: This first comprehensive combined Australia and New Zealand audit of ACS care identified variations in the application of the ACS evidence base and varying rates of inhospital clinical events. A focus on integrated clinical service delivery may provide greater translation of evidence to practice and improve ACS outcomes in Australia and New Zealand.

Lichens as spatially transferable bioindicators for monitoring nitrogen pollution.

Excess nitrogen is a pollutant and global problem that harms ecosystems and can severely affect human health. Pollutant nitrogen is becoming more widespread and intensifying in the tropics. There is thus a requirement to develop nitrogen biomonitoring for spatial mapping and trend analysis of tropical biodiversity and ecosystems. In temperate and boreal zones, multiple bioindicators for nitrogen pollution have been developed, with lichen epiphytes among the most sensitive and widely applied. However, the state of our current knowledge on bioindicators is geographically biased, with extensive research effort focused on bioindicators in the temperate and boreal zones. The development of lichen bioindicators in the tropics is further weakened by incomplete taxonomic and ecological knowledge. In this study we performed a literature review and meta-analysis, attempting to identify characteristics of lichens that offer transferability of bioindication into tropical regions. This transferability must overcome the different species pools between source information - drawing on extensive research effort in the temperate and boreal zone - and tropical ecosystems. Focussing on ammonia concentration as the nitrogen pollutant, we identify a set of morphological traits and taxonomic relationships that cause lichen epiphytes to be more sensitive, or more resistant to this excess nitrogen. We perform an independent test of our bioindicator scheme and offer recommendations for its application and future research in the tropics.

Archaeobotanical evidence for a massive loss of epiphyte species richness during industrialization in southern England.

This paper describes a novel archaeological resource--preserved epiphytes on the timber structure of vernacular buildings--used, to our knowledge, for the first time to quantify a loss of biodiversity between pre-industrial and post-industrial landscapes. By matching the confirmed occurrence of epiphyte species for the pre-industrial period, with a statistical likelihood for their absence in the present-day landscape (post-1960), we robustly identified species that have been extirpated across three contrasting regions in southern England. First, the scale of biodiversity loss observed--up to 80 per cent of epiphytes--severely challenges biodiversity targets and environmental baselines that have been developed using reference points in the post-industrial period. Second, we examined sensitivity in the present-day distribution of extirpated species, explained by three environmental drivers: (i) pollution regime, (ii) extent of ancient woodland, and (iii) climatic setting. Results point to an interacting effect between the pollution regime (sulphur dioxide) and changed woodland structure, leading to distinctive regional signatures in biodiversity loss.

DNA barcoding of lichenized fungi demonstrates high identification success in a floristic context.

• Efforts are currently underway to establish a standard DNA barcode region for fungi; we tested the utility of the internal transcribed spacer (ITS) of nuclear ribosomal DNA for DNA barcoding in lichen-forming fungi by sampling diverse species across eight orders. • Amplification of the ITS region (ITS1-5.8S-ITS2) was conducted for 351 samples, encompassing 107, 55 and 28 species, genera and families, respectively, of lichenized fungi. We assessed the ability of the entire ITS vs the ITS2 alone to discriminate between species in a taxonomic dataset (members of the genus Usnea) and a floristic dataset. • In the floristic dataset, 96.3% of sequenced samples could be assigned to the correct species using ITS or ITS2; a barcode gap for ITS is present in 92.1% of species. Although fewer species have a barcode gap in the taxonomic dataset (73.3% with ITS and 68.8% with ITS2), up to 94.1% of samples were assigned to the correct species using BLAST. • While discrimination between the most closely related species will remain challenging, our results demonstrate the potential to identify a high percentage of specimens to the correct species, and the remainder to the correct genus, when using DNA barcoding in a floristic context.

Functional Traits in Lichen Ecology: A Review of Challenge and Opportunity.

Community ecology has experienced a major transition, from a focus on patterns in taxonomic composition, to revealing the processes underlying community assembly through the analysis of species functional traits. The power of the functional trait approach is its generality, predictive capacity such as with respect to environmental change, and, through linkage of response and effect traits, the synthesis of community assembly with ecosystem function and services. Lichens are a potentially rich source of information about how traits govern community structure and function, thereby creating opportunity to better integrate lichens into 'mainstream' ecological studies, while lichen ecology and conservation can also benefit from using the trait approach as an investigative tool. This paper brings together a range of author perspectives to review the use of traits in lichenology, particularly with respect to European ecosystems from the Mediterranean to the Arctic-Alpine. It emphasizes the types of traits that lichenologists have used in their studies, both response and effect, the bundling of traits towards the evolution of life-history strategies, and the critical importance of scale (both spatial and temporal) in functional trait ecology.

Communication in the time of COVID.

The risk of infection precluded normal visiting by relatives of COVID-19 patients in an intensive therapy unit (ITU). Instead, a team of medical students and retired consultants telephoned next of kin with a daily update. A categorised selection of the students' reflections on their experiences is presented and discussed.

Psychological responses to cardiac diagnosis: changes in illness representations immediately following coronary angiography.

OBJECTIVE: Coronary angiography is a commonly used diagnostic test for ischemic heart disease. Little is known, however, about how undergoing the procedure impacts on the ways in which individuals perceive their illness. We sought to explore patients' reactions to an angiogram in terms of changes in symptom appraisal, perceived consequences of their condition, and patients' illness concern and emotional response to their condition after the receiving diagnostic results. METHODS: The Brief IPQ was administered to patients undergoing a diagnostic coronary angiogram (N=57) before and immediately following the procedure. Changes in illness representations were then compared between patients diagnosed with diseased arteries and patients with normal arteries. RESULTS: We found that the number of symptoms patients associated with their condition, illness consequences, and illness emotion decreased for patients receiving normal results but remained unchanged for patients receiving results showing diseased arteries. Illness concern decreased significantly for both patient groups. CONCLUSIONS: The results demonstrate that diagnostic results can have clear and immediate effects on how patients' view and emotionally respond to their symptoms. The results also suggest that patients cognitively prepare themselves to receive an unfavorable diagnosis and the pattern suggests those receiving normal results modify their perceptions in a positive direction rather than those receiving an unfavorable diagnosis.

Climate-woodland effects on population genetics for two congeneric lichens with contrasting reproductive strategies.

Genetic variation is expected to be influenced by the interaction between reproductive mode and dispersal traits on the one hand and environmental and habitat setting affecting establishment success on the other. We evaluated how environmental/habitat setting affects population genetic variation (i.e. variation in genetic diversity and structure) when regulated by contrasting dispersal traits. We used fungus-specific microsatellite markers to examine genetic diversity and structure of two closely related epiphytic lichen fungi that differ in their primary reproductive mode: Nephroma laevigatum (sexually reproducing, n = 191, 10 microsatellites) and N. parile (asexually reproducing, n = 182, 12 microsatellites), along a steep climatic gradient in Scotland. Despite their reproductive differences, we found a high proportion of clones in both species and a background pattern of genetic structure related to climatic gradients. We also demonstrated that woodland connectivity, rather than geographic distance, explained genetic diversity in both species. Environmental/habitat setting, modulated by the reproductive mode of the species, affects genetic diversity and structure, but the putative dissimilarity in their reproductive mode is less important than has been previously assumed. We reinforce the importance of protecting highly connected populations, positioned along a gradient capturing the segregation of gene pool differences in response to climatic variation.

Changes in patient drawings of the heart identify slow recovery after myocardial infarction.

OBJECTIVE: The objective of this study was to investigate how changes in heart attack patients' drawings of their heart over the recovery period relate to psychological and functional recovery. METHODS: Sixty-nine inpatients admitted for acute myocardial infarction at the coronary care unit at a metropolitan hospital completed questionnaires at discharge, including a drawing of what they thought had happened to their heart after their heart attack. Fifty-six patients returned follow-up questionnaires at 3 and 6 months, including heart drawings, cardiac anxiety, time to return to work, changes in exercise frequency, and healthcare use. RESULTS: Increases in the size of the heart drawn at the 3-month follow-up relative to discharge were related to slower return to work (r = 0.48, p < .01), higher cardiac anxiety (r = 0.35, p < .05), and more phone calls to health services (r = 0.37, p < .05) as well as increases in worry about another myocardial infarction (r = 0.39, p < .01), increased activity restriction (r = 0.34, p < .05), higher use of alternative medicines (r = 0.40, p < .05), and less frequent exercise (r = -0.39, p < .05) relative to before the myocardial infarction. CONCLUSIONS: Drawings of the heart may be useful in identifying patients who have experienced heart attacks who are likely to develop greater heart-focused anxiety, complaints of ill health, and higher use of health care. Increases in the size of the patient's drawing of the heart may reflect increases in the extent to which their heart condition plays on their mind and directs their daily activities.

Does the early feedback of results improve reassurance following diagnostic testing? A randomized controlled trial in patients undergoing cardiac investigation.

OBJECTIVE: Providing reassurance is often a critical component of the medical consultation. An important area that has not been addressed in the literature is how delay in providing the results of medical tests affects patient reassurance. In this study we investigated whether the early provision of a normal diagnostic result immediately following medical testing improves patient reassurance compared to results provided 4 weeks later. METHOD: We conducted a longitudinal randomized controlled trial and 1-month follow-up. Fifty-one cardiology outpatients with no known cardiac pathology referred for an echocardiogram test were randomized following normal test results to receive their test results from a cardiologist either immediately following testing or 4 weeks later. Measures of symptoms, anxiety, and health perceptions were taken prior to diagnostic testing. Reassurance was assessed immediately after the results were provided and 1 month later. RESULTS: Data analysis showed that the provision of early results had no impact on patient reassurance. Cardiac anxiety was strongly associated with lower reassurance; patients who were more anxious about their heart were significantly less reassured by a normal test result, both immediately following feedback and 1 month later. CONCLUSIONS: The early provision of test results had no impact on patient reassurance. The study suggests the identification and targeting of patients high in cardiac anxiety may be a better method for improving reassurance than reducing the waiting time for results following medical testing.

Microsatellite loci in two epiphytic lichens with contrasting dispersal modes: Nephroma laevigatum and N. parile (Nephromataceae).

PREMISE OF THE STUDY: Microsatellite markers were characterized for two epiphytic cyanolichens, Nephroma laevigatum and N. parile (Nephromataceae), and will be used to investigate population structure and estimate gene flow among populations of these two closely related species with contrasting dispersal modes. • METHODS AND RESULTS: Twelve and 14 microsatellite loci were characterized for N. laevigatum and N. parile, respectively. Allele number in N. laevigatum ranged from three to 13 per locus, while in N. parile there were from two to six alleles per locus. As expected, the sexually reproducing N. laevigatum had higher genetic diversity than the predominantly asexual N. parile. • CONCLUSIONS: This new set of markers is suitable for studying population structure and providing insights into gene flow among populations and for understanding processes of diversification. Compared between the species, they will facilitate an understanding of the influence of contrasting reproductive strategies on population and community structure.