Background and Aims: Epichloë endophytes inhabit aerial grass tissues but they can modify belowground processes that might affect host nutrient balance. We aimed to determine the effects of endophyte status (E+=endophyte-infected; E−=non-infected) and three Epichloë morphotypes (M1,M2,M3) on growth and nutrient content of a heterogeneous set of naturally infected asymptomatic plants of Lolium perenne. In addition, plant parameters were compared between asymptomatic E+ and plants with choke disease. Methods: A field experiment was conducted with 194 plants obtained from six natural populations (97E+, 97E−). For each E+ plant, the endophyte morphotype it hosted was known. Results: Endophyte-infected plants had significantly lower P, Ca, S, B, neutral detergent fiber and lignin contents, and higher Mn and digestibility than E−, independently of plant origin. Biomass production was affected by plant origin but not by endophytes. No effect of Epichloë morphotypes in any parameter was found. However, asymptomatic E+ and choke diseased plants differed in nutrients, fibers, and digestibility. Conclusions: An endophyte effect was detected in nutrient and fiber content, in spite of the heterogeneous constitution of the plant and fungal material used. The results obtained indicate that Epichloë may affect above and possibly underground processes involved in nutrient absorption, as well as plant quality, what may potentially affect litter decomposition processes.

BackgroundClinical Practice Guidelines recommend using peripheral blood pulse measuring as a screening test for Atrial Fibrillation. However, there is no adequate evidence supporting the efficacy of such procedure in primary care clinical practice. This paper describes a study protocol designed to verify whether early opportunistic screening for Atrial Fibrillation by measuring blood pulse is more effective than regular practice in subjects aged 65 years attending primary care centers.Methods/designAn cluster-randomized controlled trial conducted in Primary Care Centers of the Spanish National Health Service. A total of 269 physicians and nurses will be allocated to one of the two arms of the trial by stratified randomization with a 3:2 ratio (three practitioners will be assigned to the Control Group for every two practitioners assigned to the Experimental Group). As many as 12 870 patients aged 65 years or older and meeting eligibility criteria will be recruited (8 580 will be allocated to the Experimental Group and 4 290 to the Control Group). Randomization and allocation to trial groups will be carried out by a central computer system. The Experimental Group practitioners will conduct an opportunistic case finding for patients with Atrial Fibrillation, while the Control Group practitioners will follow the regular guidelines. The first step will be finding new Atrial Fibrillation cases. A descriptive inferential analysis will be performed (bivariate and multivariate by multilevel logistic regression analysis).DiscussionIf our hypothesis is confirmed, we expect Primary Care professionals to take a more proactive approach and adopt a new protocol when a patient meeting the established screening criteria is identified. Finally, we expect this measure to be incorporated into Clinical Practice Guidelines.Trial registrationThe study is registered as NCT01291953 (ClinicalTrials.gob)

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