[Development and functioning of Multiprofessional Primary Care Practices in Rhône-Aipes region]. / Développement et fonctionnement des maisons de santé pluri-professionnelles dans la région Rhône-Alpes.

OBJECTIVE: The need to improve inter-professional cooperation encourages the grouping of primary care professionals in multi professional structures such as primary care practices. The objective of this study was to assess the implementation,organization and operation of primary care practices (PCP) in the French Rhone-Alpes region. METHODS: Cross-sectional survey by self-administered questionnaire of healthcare providers in charge of PCPs in RhOne-Alpes. RESULTS: The study included 35 PCPs across the 8 departments of the RhOne-Alpes region. Most (86%) had been operational since 2009. The number of professionals per PCP ranged from 6 to 30 with a median of 12. The most common~ represented occupations were nurses (125),general practitioners (105) and physical therapists(59). Inter-professional cooperation was based on multidisciplinary consultation meetings in 68% of PCPs and 74% share delectronic patient records. The majority of PCPs (54%) were located in areas with insufficient access to healthcare. Most PCPs(91%) were accessible to people with reduced mobility, 49% had opening hours of more than 60 hours per week, and 54% reported frequent use of third-party payment. CONCLUSION: Dynamic of implementation of PCPs appeared to reflect an attraction of health professionals to collective practices.This trend is consistent with French health care strategy.

A mechanohydraulic model supports a role for plasmodesmata in cotton fiber elongation.

Plant cell growth depends on turgor pressure, the cell hydrodynamic pressure, which drives expansion of the extracellular matrix (the cell wall). Turgor pressure regulation depends on several physical, chemical, and biological factors, including vacuolar invertases, which modulate osmotic pressure of the cell, aquaporins, which determine the permeability of the plasma membrane to water, cell wall remodeling factors, which determine cell wall extensibility (inverse of effective viscosity), and plasmodesmata, which are membrane-lined channels that allow free movement of water and solutes between cytoplasms of neighboring cells, like gap junctions in animals. Plasmodesmata permeability varies during plant development and experimental studies have correlated changes in the permeability of plasmodesmal channels to turgor pressure variations. Here, we study the role of plasmodesmal permeability in cotton fiber growth, a type of cell that increases in length by at least three orders of magnitude in a few weeks. We incorporated plasmodesma-dependent movement of water and solutes into a classical model of plant cell expansion. We performed a sensitivity analysis to changes in values of model parameters and found that plasmodesmal permeability is among the most important factors for building up turgor pressure and expanding cotton fibers. Moreover, we found that nonmonotonic behaviors of turgor pressure that have been reported previously in cotton fibers cannot be recovered without accounting for dynamic changes of the parameters used in the model. Altogether, our results suggest an important role for plasmodesmal permeability in the regulation of turgor pressure.

Minority cytotypes in European populations of the Gymnadenia conopsea complex (Orchidaceae) greatly increase intraspecific and intrapopulation diversity.

BACKGROUND AND AIMS: Patterns of ploidy variation among and within populations can provide valuable insights into the evolutionary mechanisms shaping the dynamics of plant systems showing ploidy diversity. Whereas data on majority ploidies are, by definition, often sufficiently extensive, much less is known about the incidence and evolutionary role of minority cytotypes. METHODS: Ploidy and proportions of endoreplicated genome were determined using DAPI (4',6-diamidino-2-phenylindole) flow cytometry in 6150 Gymnadenia plants (fragrant orchids) collected from 141 populations in 17 European countries. All widely recognized European species, and several taxa of less certain taxonomic status were sampled within Gymnadenia conopsea sensu lato. KEY RESULTS: Most Gymnadenia populations were taxonomically and/or ploidy heterogeneous. Two majority (2x and 4x) and three minority (3x, 5x and 6x) cytotypes were identified. Evolution largely proceeded at the diploid level, whereas tetraploids were much more geographically and taxonomically restricted. Although minority ploidies constituted <2 % of the individuals sampled, they were found in 35 % of populations across the entire area investigated. The amount of nuclear DNA, together with the level of progressively partial endoreplication, separated all Gymnadenia species currently widely recognized in Europe. CONCLUSIONS: Despite their low frequency, minority cytotypes substantially increase intraspecific and intrapopulation ploidy diversity estimates for fragrant orchids. The cytogenetic structure of Gymnadenia populations is remarkably dynamic and shaped by multiple evolutionary mechanisms, including both the ongoing production of unreduced gametes and heteroploid hybridization. Overall, it is likely that the level of ploidy heterogeneity experienced by most plant species/populations is currently underestimated; intensive sampling is necessary to obtain a holistic picture.