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Corruption has found very fertile ground in the health sector. Many studies demonstrate the negative relationship between sustainability and corruption. However, relatively little is known at this time about how to prevent corruption in healthcare organizations (HCOs), and thus to recover the important sustainability of the entire healthcare system. After noticing this gap in the literature, the authors’ aim in undertaking this study was twofold: first, to analyze the current state of knowledge about how Italian HCOs adopt corruption prevention plans in compliance with the National Plan issued by the National Anti-Corruption Authority; second, to identify some clusters of HCOs which represent different adoption patterns of corruption prevention interventions and to classify these HCOs. For these purposes, the authors studied 68 HCOs along 13 dimensions that characterized the corruption prevention plans. The empirical results showed that the HCOs were not fully compliant with the anti-corruption legislation. At the same time, the authors identified three clusters of HCOs with different patterns of anti-corruption prevention interventions. The clusters that adopted some specific interventions seemed to be more sustainable than others.

The crucial role evaluation can play in the co-development of project design and its implementation will be addressed through the analysis of a case study, the Green Communities (GC) project, funded by the Italian Ministry of Environment within the EU Interregional Operational Program (2007-2013) "Renewable Energy and Energy Efficiency". The project's broader goals included an attempt to trigger a change in Italian local development strategies, especially for mountain and inland areas, which would be tailored to the real needs of communities, and based on a sustainable exploitation and management of the territorial assets. The goal was not achieved, and this paper addresses the issues of how GC could have been more effective in fostering a vision of change, and which design adaptations and evaluation procedures would have allowed the project to better cope with the unexpected consequences and resistances it encountered. The conclusions drawn are that projects should be conceived, designed and carried out as dynamic systems, inclusive of a dynamic and engaged evaluation enabling the generation of feedbacks loops, iteratively interpreting the narratives and dynamics unfolding within the project, and actively monitoring the potential of various relationships among project participants for generating positive social change.

Urea is the most common nitrogen (N) fertilizer in agriculture, due to its cheaper price and high N content. Although the reciprocal influence between NO3- and NH4+ nutrition are well known, urea (U) interactions with these N-inorganic forms are poorly studied. Here, the responses of two tomato genotypes to ammonium nitrate (AN), U alone or in combination were investigated. Significant differences in root and shoot biomass between genotypes were observed. Under AN+U supply, Linosa showed higher biomass compared to UC82, exhibiting also higher values for many root architectural traits. Linosa showed higher Nitrogen Uptake (NUpE) and Utilization Efficiency (NUtE) compared to UC82, under AN+U nutrition. Interestingly, Linosa exhibited also a significantly higher DUR3 transcript abundance. These results underline the beneficial effect of AN+U nutrition, highlighting new molecular and physiological strategies for selecting crops that can be used for more sustainable agriculture. The data suggest that translocation and utilization (NUtE) might be a more important component of NUE than uptake (NUpE) in tomato. Genetic variation could be a source for useful NUE traits in tomato; further experiments are needed to dissect the NUtE components that confer a higher ability to utilize N in Linosa.

BackgroundWe previously showed that, by activating innate immune receptors Toll‐like 4 (TLR4), adolescent intermittent ethanol (EtOH) exposure causes neuroinflammation, myelin damage, and behavioral dysfunctions. Recent findings reveal that clinically used opioid antagonists naltrexone (NT) and naloxone (NX) inhibit opioid‐induced TLR4 signaling and that NT, NX, and nalmefene (NF), the 6‐methylene derivative of NX, are able to reduce alcohol drinking escalation.MethodsNF (0.1 mg/kg, intraperitoneally) was injected 1 hour prior to EtOH (3 g/kg, intraperitoneally) following intermittent treatment in female (PND35) adolescent mice. Inflammatory molecules, myelin proteins, and apoptotic markers were assessed in the prefrontal cortex (PFC) and striatum/nucleus accumbens (STR/NAcc). The effect of NF on alcohol drinking preference was evaluated in both the wild‐type and TLR4 knockout (KO) adolescent mice. Using astroglial cells, the inhibitory potential of NT, NX, and NF on lipopolysaccharide (LPS), or the EtOH‐triggered TLR4 response, was compared.ResultsOur findings indicate that NF prevents the up‐regulation of cytokines (IL‐1β, IL‐17A, TNF‐α), chemokines (MCP‐1, MIP‐1, KC), and pro‐inflammatory mediators (iNOS, COX‐2), along with myelin damage and apoptotic events, in both PFC and STR/NAcc. NF also abolishes EtOH‐induced escalation of alcohol preference/consumption, but has no effect when administered to TLR4‐KO mice. In vitro experiments indicate that NX and NF inhibit TLR4 activation upon LPS or EtOH stimulation. Immunofluorescence studies and lipid rafts isolation show that NF is able to prevent TLR4 translocation to lipid rafts/caveolae in astrocytes.ConclusionsThese results suggest that NF prevents neuroinflammation and brain damage by blocking the TLR4 response and also support the role of central pro‐inflammatory immune signaling in the modulation of alcohol consumption/addiction.

AbstractThe co‐occurrence of chronic pain and alcohol use disorders (AUDs) involves complex interactions between genetic and neurophysiological aspects, and the research has reported mixed findings when they both co‐occur. There is also an indication of a gender‐dependent effect; males are more likely to use alcohol to cope with chronic pain problems than females. Recently, a new conceptualization has emerged, proposing that the negative affective component of pain drives and maintains alcohol‐related behaviors. We studied in a longitudinal fashion alterations in alcohol drinking patterns and pain thresholds in a mouse model of chronic neuropathic pain in a sex‐dependent manner. Following partial denervation (spared nerve injury [SNI]), stimulus‐evoked pain responses were measured before chronic alcohol consumption, during drinking, during a deprivation phase, and following an episode of excessive drinking. During the course of alcohol drinking, we observed pronounced sex differences in pain thresholds. Male mice showed a strong increase in pain thresholds, suggesting an analgesic effect induced by alcohol over time, an effect that was not observed in female mice. SNI mice did not differ from sham‐operated controls in baseline alcohol consumption. However, following a deprivation phase and the reintroduction of ethanol, male SNI mice but not female mice showed more pronounced excessive drinking than controls. Finally, we observed decreased central ethanol sensitivity in male SNI mice but not in females. Together with our finding, that ethanol is able to decrease a pain‐induced negative affective memory we come to following conclusion. We propose that a lower sensitivity to the intoxicating effects of alcohol together with the ability of alcohol to reduce the negative affective component of pain may explain the higher co‐occurrence of AUD in male chronic pain patients.

Global warming is enabling many plant species to expand their range to higher latitudes and altitudes, where they may suffer less from natural aboveground and belowground enemies. Reduced control by natural enemies can enable climate warming‐induced range expanders to gain an advantage in competition with natives and become disproportionally abundant in their new range. However, so far studies have only examined individual growth of range expanders, which have common congeneric plant species in their new range. Thus it is not known how general is this reduced effect of above‐ and belowground enemies and how it operates in communities, where multiple plant species also interact with each other. Here we show that range‐expanding plant species with and without congenerics in the invaded habitats differ in their ecological interactions in the new range. In a community‐level experiment, range‐expanding plant species, both with and without congenerics, suppressed the growth of a herbivore. However, only range expanders without congenerics reduced biomass production of the native plant species. In the present study, range expanders without congenerics allocated more biomass aboveground compared to native plant species, which can explain their competitive advantage. Competitive interaction and also biomass allocation of native plants and their congeneric range expanders were similar. Our results highlight that information about species phylogenetic relatedness with native flora can be crucial for improving predictions about the consequences of climate warming‐induced range expansions.

AbstractRising atmospheric [CO2] and associated climate change are expected to modify primary productivity across a range of ecosystems globally. Increasing aridity is predicted to reduce grassland productivity, although rising [CO2] and associated increases in plant water use efficiency may partially offset the effect of drying on growth. Difficulties arise in predicting the direction and magnitude of future changes in ecosystem productivity, due to limited field experimentation investigating climate and CO2 interactions. We use repeat near‐surface digital photography to quantify the effects of water availability and experimentally manipulated elevated [CO2] (eCO2) on understorey live foliage cover and biomass over three growing seasons in a temperate grassy woodland in south‐eastern Australia. We hypothesised that (i) understorey herbaceous productivity is dependent upon soil water availability, and (ii) that eCO2 will increase productivity, with greatest stimulation occurring under conditions of low water availability. Soil volumetric water content (VWC) determined foliage cover and growth rates over the length of the growing season (August to March), with low VWC (<0.1 m3 m−3) reducing productivity. However, eCO2 did not increase herbaceous cover and biomass over the duration of the experiment, or mitigate the effects of low water availability on understorey growth rates and cover. Our findings suggest that projected increases in aridity in temperate woodlands are likely to lead to reduced understorey productivity, with little scope for eCO2 to offset these changes.