The fertilization process in Lithocarpus dealbatus (Fagaceae) and its implication on the sexual reproduction evolution of Fagales.

MAIN CONCLUSION: The pistillate flowers of Lithocarpus dealbatus show two pollen tube (PT) arresting sites (the style-joining and micropyle) within the pistil during the postpollination-prezygotic stage. The PT, arrested at the pre-ovule stage, enhanced PT competition allowing the most compatible PTs to enter the ovary to ensure the highest fertilization success. During the shift from animal pollination to wind pollination, plants require a series of changes in reproductive traits. The mode of pollination is striking labile in Fagaceae. Lithocarpus is insect pollinated and is closely related to wind-pollinated Quercus. Little is known about the sexual reproduction of Lithocarpus. This study aimed to reveal the sexual reproduction of Lithocarpus dealbatus and to explore the evolutionary pattern of the key sexual reproduction traits to better understand their possible role in labile pollination. We found that after pollination, L. dealbatus PTs grew slowly in the style reaching style-joining in mid-January of the second year; then PT growth was arrested at style-joining for four months. Only two to three PTs resumed growth in mid-May to reach the micropyle, where PT growth ceased for one month before one PT resumed growth and passed through the micropyle to the embryo sac. Fagaceae showed a generalized mating system. Vast pollen production, small-sized pollen grains, long stigmatic receptive time, and reduced perianth were compatible with beetle pollination syndrome, representing the plesiomorphic status in Fagaceae. A large stigmatic surface and dry pollen grains linked to wind pollination might be independently derived several times in fagaceous lineages. Beetle pollination syndrome can cope with the uncertainty of pollinators to ensure conspecific pollen capture, which represents pre-adaptation status and has a selective advantage when conditions change, favouring wind pollination. The arrest of the PT at style-joining is a unique mechanism in later derived fagaceous lineages to enhance PT competition and promote outcrossing.

Morphological characteristics of seed starch granules of Fagaceae in South China and their implication in paleodiet.

Nut fruits likely played a significant role before and during the origin of agriculture; however, relatively little research conducted on the morphological characteristics and statistical comparisons of nut fruit starch granule hinders the progress of paleodietary analysis of prehistorical society. For better species identification of starch granule remaining on tools discovered at archaeological sites, it is desirable to develop a more abundant morphology database of modern nut fruit starch granules as well as the establishment of relevant identification standards. Therefore, nuts from 40 species in four genera (Quercus, Lithocarpus, Castanea, and Castanopsis) of Fagaceae were collected from South China for statistical measurement and comparative analysis. Starch granules are highly accumulated in 34 species except for 6 species, whose shapes involve oval, subcircular, drop-shaped, rounded triangle, polygonal, spherical caps, and bell-shaped types, or a combination of several types, and the average length is between 10 and 20 µm. According to research on Quercus phylogeny relationships, it was found that the species in the same infragenious section produce similar morphological characteristics of starch granules. The result was applied in the identification of starch granules extracted from stone tools from the 20 to 10 ka cultural layer of Xiaodong Rockshelter, and some starch granules can be recognized to species level, revealing that nuts from Quercus and Lithocarpus were gathered and exploited by ancient people. This expansion of modern starch presentation and comparison of nuts helps to improve the accuracy of the identification of ancient starch and deepen the understanding of plant utilization of ancient humans.

The complete chloroplast genome sequence of Lithocarpus longinux (Fagaceae).

Lithocarpus longinux (Hu) Chun ex Y.C.Hsu & H.Wei Jen is a Critically Endangered tree distributed in Ma-li-po county in the Southeastern Yunnan Province China. Less than ten individuals have been found since the species was established 70 years ago. In this study, we assembled and annotated the complete chloroplast genome of L. longinux. The complete chloroplast genome of the species is 161,420 bp in length and has a GC content of 36.8%, including one large single-copy region (LSC, 90,409 bp), one small single-copy region (SSC, 19,255 bp), and two copies of inverted repeat regions (IRs, 25,878 bp). A total of 112 unique genes were detected, including 81 protein-coding genes, 29 tRNA genes, and 4 rRNA genes. Phylogenetic analysis of 31 representative chloroplast genomes of the Fagales suggests Lithocarpus is monophyletic with strong bootstrap support and that L. longinux is closely related to L. balansae.

Development of Quercus acutissima (Fagaceae) pollen tubes inside pistils during the sexual reproduction process.

MAIN CONCLUSION: Extensive histology of pistillate flowers revealed two pollen tube arresting sites (the style-joining and micropyle) within the pistil of Quercus acutissima during the postpollination-prezygotic stage, which reflects a unique female and male gametophyte recognition/selection mechanism. Sexual reproduction is among the most delicate and essential stages in plant life cycles and involves a series of precise interactions between pistils and male gametophytes. Quercus is a woody genus that dominates Northern Hemisphere forests and is notorious for interspecific hybridization, but its sexual reproduction is poorly understood, especially its pollen tube (PT) growth dynamics within pistils. This study used microtome techniques and scanning electron microscopy to observe the postpollination-prezygotic process in the biennially fruiting oak Quercus acutissima. Many pollen grains germinated at anthesis instantly, and PTs penetrated stigmatic surfaces and elongated through the stylar transmitting tissue, then arrested at style-joining for about 12-13 months. Few PTs resumed growth along the compitum in the upper ovarian locule wall in the subsequent April, concurrent with the rapid growth of rudimentary ovules. PTs arrived in the micropyle, and upper septum during megaspore mother cell meiosis, then arrested again for 7-10 days waiting for the embryo sac maturation. Fertilization occurred one week later. Our study shows a clear female dominant crosstalk growth pattern between PT and the ovule. The intermittent PT growth might reflect a unique male gametophyte recognition/selection mechanism to avoid self-pollination and enhance PT competition while increasing interspecific hybridization.

Unilateral vs Bilateral Hybrid Approaches for Upper Limb Rehabilitation in Chronic Stroke: A Randomized Controlled Trial.

OBJECTIVE: To investigate the effects of unilateral hybrid therapy (UHT) and bilateral hybrid therapy (BHT) compared with robot-assisted therapy (RT) alone in patients with chronic stroke. DESIGN: A single-blind, randomized controlled trial. SETTING: Four hospitals. PARTICIPANTS: Outpatients with chronic stroke and mild to moderate motor impairment (N=44). INTERVENTION: UHT combined unilateral RT (URT) and modified constraint-induced therapy. BHT combined bilateral RT (BRT) and bilateral arm training. The RT group received URT and BRT. The intervention frequency for the 3 groups was 90 min/d 3 d/wk for 6 weeks. MAIN OUTCOME MEASURES: Fugl-Meyer Assessment (FMA, divided into the proximal and distal subscale) and Stroke Impact Scale (SIS) version 3.0 scores before, immediately after, and 3 months after treatment and Wolf Motor Function Test (WMFT) and Nottingham Extended Activities of Daily Living (NEADL) scale scores before and immediately after treatment. RESULTS: The results favored BHT over UHT on the FMA total score and distal score at the posttest (P=.03 and .04) and follow-up (P=.01 and .047) assessment and BHT over RT on the follow-up FMA distal scores (P=.03). At the posttest assessment, the WMFT and SIS scores of the 3 groups improved significantly without between-group differences, and the RT group showed significantly greater improvement in the mobility domain of NEADL compared with the BHT group (P<.01). CONCLUSIONS: BHT was more effective for improving upper extremity motor function, particularly distal motor function at follow-up, and individuals in the RT group demonstrated improved functional ambulation post intervention.

Hybrid Rehabilitation Therapies on Upper-Limb Function and Goal Attainment in Chronic Stroke.

This study examined the treatment effects between unilateral hybrid therapy (UHT; unilateral robot-assisted therapy [RT] + modified constraint-induced movement therapy) and bilateral hybrid therapy (BHT; bilateral RT + bilateral arm training) compared with RT. Thirty patients with chronic stroke were randomized to UHT, BHT, or RT groups. Preliminary efficacy was assessed using the Fugl-Meyer Assessment (FMA), the Chedoke Arm and Hand Activity Inventory (CAHAI), and the goal attainment scaling (GAS). Possible adverse effects of abnormal muscle tone, pain, and fatigue were recorded. All groups showed large improvements in motor recovery and individual goals. Significant between-group differences were found on GAS favoring the hybrid groups but not on FMA and CAHAI. No adverse effects were reported. Hybrid therapies are safe and applicable interventions for chronic stroke and favorable for improving individual functional goals. Treatment effects on motor recovery and functional activity might be similar among the three groups.

Quality of Work Life, Nurses' Intention to Leave the Profession, and Nurses Leaving the Profession: A One-Year Prospective Survey.

PURPOSE: To examine the associations among quality of work life, nurses' intention to leave the profession, and nurses leaving the profession. DESIGN: A prospective study design was used. METHODS: Participants were 1,283 hospital nurses with a purposive sampling in Taiwan. The self-reported questionnaire consisted of three questionnaires: the Chinese version of the Quality of Nursing Work Life scale, an intention-to-leave profession questionnaire, and a demographic questionnaire. Records of nurses leaving the profession were surveyed 1 year later. Data were analyzed by descriptive statistics and inferential statistics. FINDINGS: As many as 720 nurses (56.1%) had tendencies to leave their profession. However, only 31 nurses (2.5%) left their profession 1 year later. Nurses' intention to leave the profession mediated the relationship between the milieu of respect and autonomy, quality of work life, and nurses leaving the profession. CONCLUSIONS: The milieu of respect and autonomy describing the quality of work life predicts the nurses' intention to leave the profession, and together these predict nurses leaving the profession. CLINICAL RELEVANCE: This study illustrates that nurse managers could provide effective interventions to ameliorate the milieu of respect and autonomy aspect of quality of work life to prevent nurses from leaving their profession.

Validity of EQ-5D in general population of Taiwan: results of the 2009 National Health Interview and Drug Abuse Survey of Taiwan.

PURPOSE: The aim of this study was to examine the validity of the EuroQOL five dimensions questionnaire (EQ-5D) using a nationally representative data from the National Health Interview Survey (NHIS) through comparison with short-form 36 (SF-36). METHODS: Data for this study came from the 2009 NHIS in Taiwan. The study sample was the 4007 participants aged 20-64 years who completed the survey. We used SUDAAN 10.0 (SAS-Callable) to carry out weighed estimation and statistical inference. The EQ index was estimated using norm values from a Taiwanese study as well as from Japan and the United Kingdom (UK). The SF-36 score was standardized using American norm values. RESULTS: In terms of concurrent validity, the EQ-5D met the five hypotheses. The results did not fulfill hypothesis that women would have lower visual analogue scale (EQ-VAS) scores. In terms of discriminant validity, the EQ-5D fulfilled two hypotheses. Our results approached but did not fulfill hypothesis that there would be a weak association between the physical and psychological dimensions of the EQ-5D and the mental component summary score of the SF-36. Results were comparable regardless of whether the Japanese or UK norm value sets were used. CONCLUSIONS: We were able to fulfill many, not all of our validity hypotheses regardless of whether the established Japanese or UK norm value sets or the Taiwanese norm values were used. The EQ-5D is an effective and simple instrument for assessing health-related quality of life of general population in Taiwan.

Development of two Barthel Index-based Supplementary Scales for patients with stroke.

BACKGROUND: The Barthel Index (BI) assesses actual performance of activities of daily living (ADL). However, comprehensive assessment of ADL functions should include two other constructs: self-perceived difficulty and ability. OBJECTIVE: The aims of this study were to develop two BI-based Supplementary Scales (BI-SS), namely, the Self-perceived Difficulty Scale and the Ability Scale, and to examine the construct validity of the BI-SS in patients with stroke. METHOD: The BI-SS was first developed by consultation with experts and then tested on patients to confirm the clarity and feasibility of administration. A total of 306 participants participated in the construct validity study. Construct validity was investigated using Mokken scale analysis and analyzing associations between scales. The agreement between each pair of the scales' scores was further examined. RESULTS: The Self-perceived Difficulty Scale consisted of 10 items, and the Ability Scale included 8 items (excluding both bladder and bowel control items). Items in each individual scale were unidimensional (H ≥ 0.5). The scores of the Self-perceived Difficulty and Ability Scales were highly correlated with those of the BI (rho = 0.78 and 0.90, respectively). The scores of the two BI-SS scales and BI were significantly different from each other (p<.001). These results indicate that both BI-SS scales assessed unique constructs. CONCLUSIONS: The BI-SS had overall good construct validity in patients with stroke. The BI-SS can be used as supplementary scales for the BI to comprehensively assess patients' ADL functions in order to identify patients' difficulties in performing ADL tasks, plan intervention strategies, and assess outcomes.

The Cerebral Palsy Quality of Life for Children (CP QOL-Child): evidence of construct validity.

The Cerebral Palsy Quality of Life for Children (CP QOL-Child) is the first health condition-specific questionnaire designed for measuring QOL in children with cerebral palsy (CP). However, its construct validity has not yet been confirmed by confirmatory factor analysis (CFA). Hence, this study assessed the construct validity of the caregiver proxy-report version of the Chinese version of the CP QOL-Child in children with CP using CFA. A total of 312 children with CP (mean age: 8.59 years, SD: 2.52 years) and their caregivers participated in this study. The Chinese version of the CP QOL-Child was completed by the caregivers of children with CP. Then, CFA was applied to evaluate the seven-factor measurement structure of the CP QOL-Child. The seven-factor CFA model had an adequate fit to our data as judged by χ(2) statistic and various goodness-of-fit (GOF) indices, including the root mean square error of approximation (RMSEA). This study provided empirical evidence of the construct validity of the CP QOL-Child to support its use with children with CP in the Chinese speaking society.

Are hip-specific items useful in a quality of life questionnaire for patients with hip fractures?

Researchers measure the significance of hip fracture by the patient's impairment. The patient's quality of life (QOL) is usually also substantially affected. However, there is no specific quality of life (QOL) questionnaire for patients with hip fractures. This study was designed to determine whether adding a new set of specific questions about hip fracture to the World Health Organization Quality of Life Questionnaire would be helpful for patients with hip fractures. Three hundred and fifty-two patients were interviewed over the telephone. Three of the four initial items were chosen for statistical analysis. The Cronbach's alpha of the four domains (physical, psychological, social, and environmental) ranged from 0.84 to 0.92 (P<0.01), and that of the new physical domain (PD) (adding the three new items) was 0.94 (P<0.01). Test-retest correlations of the three new items and all domains exceeded 0.66 (P<0.01). Criteria-related validity of the three new items ranged from 0.52 to 0.65 (P<0.05). The correlations between the new PD and the overall QOL and general health (0.70-0.78) were slightly lower than those (0.72-0.80) between the standard PD and the new items. A four-factor model was confirmed after factor analysis was conducted. In conclusion, adding three new items to the questionnaire led to only limited improvement in reliability and validity. The World Health Organization Quality of Life Questionnaire is sufficient for measuring QOL in patients with hip fractures.

Selection of appropriate Chinese terms to represent intensity and types of physical activity terms for use in the Taiwan version of IPAQ.

In order to analyze the health risks of insufficient activity by international comparisons, the first author obtained the permission to translate and develop a Taiwan version of the International Physical Activity Questionnaire (IPAQ). The objective was to determine culturally sensitive Chinese translations for the terms "moderate", "vigorous" and "physical activity" as well as to identify representative types of physical activity for Taiwanese. This study used discussions by 12 expert focus groups, 6 expert audits, a scale survey, field study, Cognitive Aspect Survey Methodology (CASM), dual independent translation and back-translation to establish a consensus on physical activity-related concepts, terminologies and types that define the intensity of common activities of Taiwanese by integrating both local and foreign studies. The Chinese terms "fei li", "zhong deng fei li" and "shen ti huo dong", respectively, were identified as suitable and adequate translations for the English terms "vigorous", "moderate" and "physical activity". The common Taiwanese activities were accurately categorized and listed in questionnaires, forming culturally sensitive scales. Taiwan versions of IPAQ's self-administered long version (SL), self-administered short version (SS), and telephone interview short version (TS) were developed. Their content validity indices were .992, .994, and .980, as well as .994, .992, and .994 for language equivalence and meaning similarity between the English and Chinese versions of the IPAQ-LS, IPAQ-SS, and IPAQ-TS, respectively. Consistency values for the English and Chinese versions in terms of intraclass correlation coefficients were .945, .704, and .894, respectively. The IPAQ-Taiwan is not only a sensitive and precise tool, but also shows the effectiveness of the methodology (CASM) used in tool development. Subjects who did not regularly exercise and had an education less than a junior high school level underestimated the moderate-intensity physical activity.