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1. Vulnerability of mineral-associated soil organic carbon to climate across global drylands

Author

Díaz-Martínez, Paloma, Maestre, Fernando T., Moreno-Jiménez, Eduardo, Delgado-Baquerizo, Manuel, Eldridge, David J., Saiz, Hugo, Gross, Nicolas, Le Bagousse-Pinguet, Yoann, Gozalo, Beatriz, Ochoa, Victoria, Guirado, Emilio, García-Gómez, Miguel, Valencia, Enrique, Asensio, Sergio, Berdugo, Miguel, Martínez-Valderrama, Jaime, Mendoza, Betty J., García-Gil, Juan C., Zaccone, Claudio, Panettieri, Marco, García-Palacios, Pablo, Fan, Wei, Benavente-Ferraces, Iria, Rey, Ana, Eisenhauer, Nico, Cesarz, Simone, Abedi, Mehdi, Ahumada, Rodrigo J., Alcántara, Julio M., Amghar, Fateh, Aramayo, Valeria, Arroyo, Antonio I., Bahalkeh, Khadijeh, Ben Salem, Farah, Blaum, Niels, Boldgiv, Bazartseren, Bowker, Matthew A., Bran, Donaldo, Branquinho, Cristina, Bu, Chongfeng, Cáceres, Yonatan, Canessa, Rafaella, Castillo-Monroy, Andrea P., Castro, Ignacio, Castro-Quezada, Patricio, Chibani, Roukaya, Conceição, Abel A., Currier, Courtney M., Darrouzet-Nardi, Anthony, Deák, Balázs, Dickman, Christopher R., Donoso, David A., Dougill, Andrew J., Durán, Jorge, Ejtehadi, Hamid, Espinosa, Carlos, Fajardo, Alex, Farzam, Mohammad, Ferrante, Daniela, Fraser, Lauchlan H., Gaitán, Juan J., Gusman Montalván, Elizabeth, Hernández-Hernández, Rosa M., von Hessberg, Andreas, Hölzel, Norbert, Huber-Sannwald, Elisabeth, Hughes, Frederic M., Jadán-Maza, Oswaldo, Geissler, Katja, Jentsch, Anke, Ju, Mengchen, Kaseke, Kudzai F., Kindermann, Liana, Koopman, Jessica E., Le Roux, Peter C., Liancourt, Pierre, Linstädter, Anja, Liu, Jushan, Louw, Michelle A., Maggs-Kölling, Gillian, Makhalanyane, Thulani P., Issa, Oumarou Malam, Marais, Eugene, Margerie, Pierre, Mazaneda, Antonio J., McClaran, Mitchel P., Messeder, João Vitor S., Mora, Juan P., Moreno, Gerardo, Munson, Seth M., Nunes, Alice, Oliva, Gabriel, Oñatibia, Gastón R., Osborne, Brooke, Peter, Guadalupe, Pueyo, Yolanda, Quiroga, R. Emiliano, Reed, Sasha C., Reyes, Victor M., Rodríguez, Alexandra, Ruppert, Jan C., Sala, Osvaldo, Salah, Ayman, Sebei, Julius, Sloan, Michael, Solongo, Shijirbaatar, Stavi, Ilan, Stephens, Colton R. A., Teixido, Alberto L., Thomas, Andrew D., Throop, Heather L., Tielbörger, Katja, Travers, Samantha, Val, James, Valko, Orsolya, van den Brink, Liesbeth, Velbert, Frederike, Wamiti, Wanyoike, Wang, Deli, Wang, Lixin, Wardle, Glenda M., Yahdjian, Laura, Zaady, Eli, Zeberio, Juan M., Zhang, Yuanming, Zhou, Xiaobing, and Plaza, César

Abstract

Mineral-associated organic carbon (MAOC) constitutes a major fraction of global soil carbon and is assumed less sensitive to climate than particulate organic carbon (POC) due to protection by minerals. Despite its importance for long-term carbon storage, the response of MAOC to changing climates in drylands, which cover more than 40% of the global land area, remains unexplored. Here we assess topsoil organic carbon fractions across global drylands using a standardized field survey in 326 plots from 25 countries and 6 continents. We find that soil biogeochemistry explained the majority of variation in both MAOC and POC. Both carbon fractions decreased with increases in mean annual temperature and reductions in precipitation, with MAOC responding similarly to POC. Therefore, our results suggest that ongoing climate warming and aridification may result in unforeseen carbon losses across global drylands, and that the protective role of minerals may not dampen these effects.

Published
2024
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2. Unforeseen plant phenotypic diversity in a dry and grazed world

Author

Gross, Nicolas, Maestre, Fernando T., Liancourt, Pierre, Berdugo, Miguel, Martin, Raphaël, Gozalo, Beatriz, Ochoa, Victoria, Delgado-Baquerizo, Manuel, Maire, Vincent, Saiz, Hugo, Soliveres, Santiago, Valencia, Enrique, Eldridge, David J., Guirado, Emilio, Jabot, Franck, Asensio, Sergio, Gaitán, Juan J., García-Gómez, Miguel, Martínez, Paloma, Martínez-Valderrama, Jaime, Mendoza, Betty J., Moreno-Jiménez, Eduardo, Pescador, David S., Plaza, César, Pijuan, Ivan Santaolaria, Abedi, Mehdi, Ahumada, Rodrigo J., Amghar, Fateh, Arroyo, Antonio I., Bahalkeh, Khadijeh, Bailey, Lydia, Ben Salem, Farah, Blaum, Niels, Boldgiv, Bazartseren, Bowker, Matthew A., Branquinho, Cristina, van den Brink, Liesbeth, Bu, Chongfeng, Canessa, Rafaella, Castillo-Monroy, Andrea del P., Castro, Helena, Castro, Patricio, Chibani, Roukaya, Conceição, Abel Augusto, Darrouzet-Nardi, Anthony, Davila, Yvonne C., Deák, Balázs, Donoso, David A., Durán, Jorge, Espinosa, Carlos, Fajardo, Alex, Farzam, Mohammad, Ferrante, Daniela, Franzese, Jorgelina, Fraser, Lauchlan, Gonzalez, Sofía, Gusman-Montalvan, Elizabeth, Hernández-Hernández, Rosa Mary, Hölzel, Norbert, Huber-Sannwald, Elisabeth, Jadan, Oswaldo, Jeltsch, Florian, Jentsch, Anke, Ju, Mengchen, Kaseke, Kudzai F., Kindermann, Liana, le Roux, Peter, Linstädter, Anja, Louw, Michelle A., Mabaso, Mancha, Maggs-Kölling, Gillian, Makhalanyane, Thulani P., Issa, Oumarou Malam, Manzaneda, Antonio J., Marais, Eugene, Margerie, Pierre, Hughes, Frederic Mendes, Messeder, João Vitor S., Mora, Juan P., Moreno, Gerardo, Munson, Seth M., Nunes, Alice, Oliva, Gabriel, Oñatibia, Gaston R., Peter, Guadalupe, Pueyo, Yolanda, Quiroga, R. Emiliano, Ramírez-Iglesias, Elizabeth, Reed, Sasha C., Rey, Pedro J., Reyes Gómez, Víctor M., Rodríguez, Alexandra, Rolo, Victor, Rubalcaba, Juan G., Ruppert, Jan C., Sala, Osvaldo, Salah, Ayman, Sebei, Phokgedi Julius, Stavi, Ilan, Stephens, Colton, Teixido, Alberto L., Thomas, Andrew D., Throop, Heather L., Tielbörger, Katja, Travers, Samantha, Undrakhbold, Sainbileg, Val, James, Valkó, Orsolya, Velbert, Frederike, Wamiti, Wanyoike, Wang, Lixin, Wang, Deli, Wardle, Glenda M., Wolff, Peter, Yahdjian, Laura, Yari, Reza, Zaady, Eli, Zeberio, Juan Manuel, Zhang, Yuanling, Zhou, Xiaobing, and Le Bagousse-Pinguet, Yoann

Abstract

Earth harbours an extraordinary plant phenotypic diversity1that is at risk from ongoing global changes2,3. However, it remains unknown how increasing aridity and livestock grazing pressure—two major drivers of global change4–6—shape the trait covariation that underlies plant phenotypic diversity1,7. Here we assessed how covariation among 20 chemical and morphological traits responds to aridity and grazing pressure within global drylands. Our analysis involved 133,769 trait measurements spanning 1,347 observations of 301 perennial plant species surveyed across 326 plots from 6 continents. Crossing an aridity threshold of approximately 0.7 (close to the transition between semi-arid and arid zones) led to an unexpected 88% increase in trait diversity. This threshold appeared in the presence of grazers, and moved toward lower aridity levels with increasing grazing pressure. Moreover, 57% of observed trait diversity occurred only in the most arid and grazed drylands, highlighting the phenotypic uniqueness of these extreme environments. Our work indicates that drylands act as a global reservoir of plant phenotypic diversity and challenge the pervasive view that harsh environmental conditions reduce plant trait diversity8–10. They also highlight that many alternative strategies may enable plants to cope with increases in environmental stress induced by climate change and land-use intensification.

Published
2024
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3. Hotspots of biogeochemical activity linked to aridity and plant traits across global drylands

Author

Eldridge, David J., Ding, Jingyi, Dorrough, Josh, Delgado-Baquerizo, Manuel, Sala, Osvaldo, Gross, Nicolas, Le Bagousse-Pinguet, Yoann, Mallen-Cooper, Max, Saiz, Hugo, Asensio, Sergio, Ochoa, Victoria, Gozalo, Beatriz, Guirado, Emilio, García-Gómez, Miguel, Valencia, Enrique, Martínez-Valderrama, Jaime, Plaza, César, Abedi, Mehdi, Ahmadian, Negar, Ahumada, Rodrigo J., Alcántara, Julio M., Amghar, Fateh, Azevedo, Luísa, Ben Salem, Farah, Berdugo, Miguel, Blaum, Niels, Boldgiv, Bazartseren, Bowker, Matthew, Bran, Donaldo, Bu, Chongfeng, Canessa, Rafaella, Castillo-Monroy, Andrea P., Castro, Ignacio, Castro-Quezada, Patricio, Cesarz, Simone, Chibani, Roukaya, Conceição, Abel Augusto, Darrouzet-Nardi, Anthony, Davila, Yvonne C., Deák, Balázs, Díaz-Martínez, Paloma, Donoso, David A., Dougill, Andrew David, Durán, Jorge, Eisenhauer, Nico, Ejtehadi, Hamid, Espinosa, Carlos Ivan, Fajardo, Alex, Farzam, Mohammad, Foronda, Ana, Franzese, Jorgelina, Fraser, Lauchlan H., Gaitán, Juan, Geissler, Katja, Gonzalez, Sofía Laura, Gusman-Montalvan, Elizabeth, Hernández, Rosa Mary, Hölzel, Norbert, Hughes, Frederic Mendes, Jadan, Oswaldo, Jentsch, Anke, Ju, Mengchen, Kaseke, Kudzai F., Köbel, Melanie, Lehmann, Anika, Liancourt, Pierre, Linstädter, Anja, Louw, Michelle A., Ma, Quanhui, Mabaso, Mancha, Maggs-Kölling, Gillian, Makhalanyane, Thulani P., Issa, Oumarou Malam, Marais, Eugene, McClaran, Mitchel, Mendoza, Betty, Mokoka, Vincent, Mora, Juan P., Moreno, Gerardo, Munson, Seth, Nunes, Alice, Oliva, Gabriel, Oñatibia, Gastón R., Osborne, Brooke, Peter, Guadalupe, Pierre, Margerie, Pueyo, Yolanda, Emiliano Quiroga, R., Reed, Sasha, Rey, Ana, Rey, Pedro, Gómez, Víctor Manuel Reyes, Rolo, Víctor, Rillig, Matthias C., le Roux, Peter C., Ruppert, Jan Christian, Salah, Ayman, Sebei, Phokgedi Julius, Sharkhuu, Anarmaa, Stavi, Ilan, Stephens, Colton, Teixido, Alberto L., Thomas, Andrew David, Tielbörger, Katja, Robles, Silvia Torres, Travers, Samantha, Valkó, Orsolya, van den Brink, Liesbeth, Velbert, Frederike, von Heßberg, Andreas, Wamiti, Wanyoike, Wang, Deli, Wang, Lixin, Wardle, Glenda M., Yahdjian, Laura, Zaady, Eli, Zhang, Yuanming, Zhou, Xiaobing, and Maestre, Fernando T.

Abstract

Perennial plants create productive and biodiverse hotspots, known as fertile islands, beneath their canopies. These hotspots largely determine the structure and functioning of drylands worldwide. Despite their ubiquity, the factors controlling fertile islands under conditions of contrasting grazing by livestock, the most prevalent land use in drylands, remain virtually unknown. Here we evaluated the relative importance of grazing pressure and herbivore type, climate and plant functional traits on 24 soil physical and chemical attributes that represent proxies of key ecosystem services related to decomposition, soil fertility, and soil and water conservation. To do this, we conducted a standardized global survey of 288 plots at 88 sites in 25 countries worldwide. We show that aridity and plant traits are the major factors associated with the magnitude of plant effects on fertile islands in grazed drylands worldwide. Grazing pressure had little influence on the capacity of plants to support fertile islands. Taller and wider shrubs and grasses supported stronger island effects. Stable and functional soils tended to be linked to species-rich sites with taller plants. Together, our findings dispel the notion that grazing pressure or herbivore type are linked to the formation or intensification of fertile islands in drylands. Rather, our study suggests that changes in aridity, and processes that alter island identity and therefore plant traits, will have marked effects on how perennial plants support and maintain the functioning of drylands in a more arid and grazed world.

Published
2024
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4. Author Correction: Hotspots of biogeochemical activity linked to aridity and plant traits across global drylands

Author

Eldridge, David J., Ding, Jingyi, Dorrough, Josh, Delgado-Baquerizo, Manuel, Sala, Osvaldo, Gross, Nicolas, Le Bagousse-Pinguet, Yoann, Mallen-Cooper, Max, Saiz, Hugo, Asensio, Sergio, Ochoa, Victoria, Gozalo, Beatriz, Guirado, Emilio, García-Gómez, Miguel, Valencia, Enrique, Martínez-Valderrama, Jaime, Plaza, César, Abedi, Mehdi, Ahmadian, Negar, Ahumada, Rodrigo J., Alcántara, Julio M., Amghar, Fateh, Azevedo, Luísa, Ben Salem, Farah, Berdugo, Miguel, Blaum, Niels, Boldgiv, Bazartseren, Bowker, Matthew, Bran, Donaldo, Bu, Chongfeng, Canessa, Rafaella, Castillo-Monroy, Andrea P., Castro, Ignacio, Castro-Quezada, Patricio, Cesarz, Simone, Chibani, Roukaya, Conceição, Abel Augusto, Darrouzet-Nardi, Anthony, Davila, Yvonne C., Deák, Balázs, Díaz-Martínez, Paloma, Donoso, David A., Dougill, Andrew David, Durán, Jorge, Eisenhauer, Nico, Ejtehadi, Hamid, Espinosa, Carlos Ivan, Fajardo, Alex, Farzam, Mohammad, Foronda, Ana, Franzese, Jorgelina, Fraser, Lauchlan H., Gaitán, Juan, Geissler, Katja, Gonzalez, Sofía Laura, Gusman-Montalvan, Elizabeth, Hernández, Rosa Mary, Hölzel, Norbert, Hughes, Frederic Mendes, Jadan, Oswaldo, Jentsch, Anke, Ju, Mengchen, Kaseke, Kudzai F., Köbel, Melanie, Lehmann, Anika, Liancourt, Pierre, Linstädter, Anja, Louw, Michelle A., Ma, Quanhui, Mabaso, Mancha, Maggs-Kölling, Gillian, Makhalanyane, Thulani P., Issa, Oumarou Malam, Marais, Eugene, McClaran, Mitchel, Mendoza, Betty, Mokoka, Vincent, Mora, Juan P., Moreno, Gerardo, Munson, Seth, Nunes, Alice, Oliva, Gabriel, Oñatibia, Gastón R., Osborne, Brooke, Peter, Guadalupe, Pierre, Margerie, Pueyo, Yolanda, Emiliano Quiroga, R., Reed, Sasha, Rey, Ana, Rey, Pedro, Gómez, Víctor Manuel Reyes, Rolo, Víctor, Rillig, Matthias C., le Roux, Peter C., Ruppert, Jan Christian, Salah, Ayman, Sebei, Phokgedi Julius, Sharkhuu, Anarmaa, Stavi, Ilan, Stephens, Colton, Teixido, Alberto L., Thomas, Andrew David, Tielbörger, Katja, Robles, Silvia Torres, Travers, Samantha, Valkó, Orsolya, van den Brink, Liesbeth, Velbert, Frederike, von Heßberg, Andreas, Wamiti, Wanyoike, Wang, Deli, Wang, Lixin, Wardle, Glenda M., Yahdjian, Laura, Zaady, Eli, Zhang, Yuanming, Zhou, Xiaobing, and Maestre, Fernando T.

Published
2024
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5. Response of soil carbon and plant diversity to grazing and precipitation in High Nature Value farmlands.

Author

Deosaran, Rishi, Carvalho, Fabio, Nunes, Alice, Köbel, Melanie, Serafim, João, Hooda, Peter S., Waller, Martyn, Branquinho, Cristina, and Brown, Kerry A.

Subjects
PLANT diversity, VALUATION of farms, PLANT phenology, GRAZING, CARBON in soils, PLANT life cycles
Abstract

Mediterranean oak-dominated agro-silvo-pastoral systems of southwestern Europe (called montado in Portugal and dehesa in Spain) are semi-natural, savannah-style High Nature Value farmlands (HNVfs) shaped by centuries of anthropogenic (e.g., cultivation, grazing) and natural (e.g., drought) disturbances. Therefore, changes in grazing and precipitation may alter their vegetation composition and ecosystem properties and impact upon their long-term viability. We quantified the responses of soil organic carbon (SOC) and plant taxonomic and functional trait diversities to cattle grazing and inter-annual changes in precipitation across three open-woodland sites within the montado landscape in Alentejo, southern Portugal. The sites are characterised by the presence or absence of cattle grazing and different amounts of mean annual precipitation (ranging from semiarid to dry subhumid). Three different precipitation periods were used: a shorter autumn-to-spring period and longer 12- and 18-month periods before sampling. Specific leaf area, plant height and seed mass were used to estimate single-trait community weighted means and a multi-trait measure of community functional diversity (Rao's Q). SOC and plant species richness responded negatively to the presence of cattle grazing but positively to increase in precipitation (and its interaction with cattle grazing), while trait-based measures were largely unresponsive to cattle grazing and precipitation (though RLQ analysis revealed strong controls of the environmental variables on plant life cycle, growth form, leaf phenology and dispersal strategies). SOC was most responsive to longer-term (18-month) changes in precipitation, whereas plant species richness was most responsive to shorter-term (autumn-to-spring) changes in precipitation. These results suggest that different components of plant diversity respond differently to external drivers in montado HNVfs, while the response time of soil properties may be longer than that of plant taxonomic diversity. • We assessed three sites in oak woodlands under different amounts of precipitation. • Taxonomic and functional diversity respond differently to grazing and precipitation. • Plant species richness is most responsive to autumn-to-spring precipitation. • Soil organic carbon is most responsive to 18-month changes in precipitation. • Soil organic carbon responds negatively to grazing but positively to precipitation. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Comparison of Heart Transplantation Outcomes: Adult Congenital Heart Disease vs Matched Cardiac Patients in a Quaternary Reference Centre

Author

Kinsella, Aisling, Alba, Ana C., Alvarez, Juglans S., Nunes, Alice, Ribeiro, Roberto V., Yu, Frank, Lafreniere-Roula, Myriam, Manlhiot, Cedric, Heggie, Jane, and Rao, Vivek

Abstract

The number of transplantations performed for adult congenital heart disease (ACHD) patients is increasing. We sought to compare survival and post-transplantation complications, including graft failure, rejection, dialysis, and use of a right ventricular assist device, between ACHD and a cohort of dilated (DCM) and ischemic (ICM) cardiomyopathy patients matched by age and year of transplantation.

Published
2020
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7. Seed removal decrease by invasive Argentine ants in a high Nature Value farmland.

Author

Frasconi Wendt, Clara, Nunes, Alice, Lobo Dias, Sara, Verble, Robin, Branquinho, Cristina, and Boieiro, Mário

Subjects
BIOLOGICAL invasions, VALUATION of farms, ANTS, MILK thistle, SEED dispersal, BIOTIC communities, SEEDS
Abstract

• Collapse of seed removal in the Argentine ant invaded site. • Seed removal is maintained by key seed-dispersing native ants in non-invaded site. • Interspecific differences in removal rates were determined by seed/elaiosome characteristics. • The invasion by the Argentine ant has severe implications for ecosystem functioning. • Importance to monitor key indicators to prevent biotic homogenization of HNV farmlands. Seed dispersal by ants is an important ecological process that maintains the structure and diversity of natural communities, however, it is vulnerable to biological invasions. Argentine ants are one of the worst invasive ant species and cause severe changes in ecosystem processes and native ant biodiversity declines in invaded sites. Here, we studied seed removal by ants combining observations and a cafeteria experiment with seeds of four myrmecochorous plant species (Centaurea sphaerocephala, Rosmarinus officinalis , Silybum marianum , and Ulex australis) in two sites (invaded and uninvaded) located in the Mediterranean Montado ecosystem and classified as High Nature Value farmland (HNV). Significant differences in daily seed removal rates were found between the two study sites. In uninvaded sites, several native ant species were attracted to the seeds, resulting in all seeds being removed rapidly. The majority of seed removal events were carried out by two key seed disperses Pheidole pallidula (71%) and Aphaenogaster iberica (26%) with a clear preference for diaspored with larger and heavier elaiosome (i.e., C. sphaerocephala , S. marianum). By contrast, while the Argentine ant showed some interest (68% of seeds were interacted with), no seed removal events were observed. The extirpation of the local ant fauna by the Argentine ant and its inability to ensure seed dispersal services may lead to the interference and eventually to the collapse of seed dispersal of the four studied myrmecochorous plants in the invaded site in the future. We argue that these discrete but severe consequences of an invasive species on a key ecological process may strongly affect the functioning of the Montado ecosystem. [ABSTRACT FROM AUTHOR]

Published
2022
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8. Framing the application of Adaptation Pathways for agroforestry in Mediterranean drylands.

Author

Vizinho, André, Avelar, David, Fonseca, Ana Lúcia, Carvalho, Silvia, Sucena-Paiva, Leonor, Pinho, Pedro, Nunes, Alice, Branquinho, Cristina, Vasconcelos, Ana Cátia, Santos, Filipe Duarte, Roxo, Maria José, and Penha-Lopes, Gil

Subjects
AGROFORESTRY, ARID regions, NATURAL resources management, FILM adaptations, CLIMATE change, FORESTS & forestry
Abstract

Adaptation Pathways is a decision support tool designed to create adaptation policies under different climate change scenarios. This tool has been used successfully in several sectors and contexts such as coastal and river adaptation, urban heat waves, floods and rural livelihoods but its use in natural resource management, has faced several challenges and limitations. In the sector of agroforestry its use has seldom been done or documented and one of the reasons for this may due to some of its specific challenges. In this study, these challenges were addressed when using the Adaptation Pathways for the adaptation planning of three case studies in the semi-arid Alentejo region, a Mediterranean dryland of southern Portugal. This tool was integrated in a participatory approach combined with the Scenario Workshop method, to plan the adaptation of the agriculture and forestry sector of one municipality (Mértola) and two agroforestry farms (221 ha and 1000 ha). The methodology included, for each case study, 20 interviews, two workshops, literature review, expert analysis and the use of indicators of efficacy of adaptation measures, to define tipping points. The adaptation process and the resulting adaptation plans were evaluated by questionnaire and expert review. This combination of methods has supported the choice of effective adaptation measures for the case studies and when combined with several adaptation pathways and a landscape approach it supported the creation of integrated climate change adaptation plans that are now in implementation. We discuss how this combination of methods deals with limitation to Adaptation Pathways identified in the literature, conclude that the method was able to create adaptation plans that are now under implementation and present avenues for future research. • There is a growing need for climate adaptation planning and decision making support tools. • Participatory adaptation planning in the field of agroforestry has rarely been done or documented. • Adaptation Pathways approach was successfully used in three case studies. • Limitations of Adaptation Pathways were addressed and discussed. [ABSTRACT FROM AUTHOR]

Published
2021
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9. PERSONAL ETHICAL DILEMMA: IS THE PATIENT COMPETENT?

Author

Nunes, Alice

Abstract

The article offers the author's insights regarding the issue of handling the dental treatment of an elderly patient who seems incompetent to make better decisions for his own dental health. According to the author, dentists need to avoid possible risks that may cause injury to a patient. The author says that a dentist has a right to intervene to a patient's decision if the latter shows poor judgments and refuses to have the right treatment needed.

Published
2011

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