Vegetation-fire feedbacks increase subtropical wildfire risk in scrubland and reduce it in forests.

Climate dictates wildfire activity around the world. But East and Southeast Asia are an apparent exception as fire-activity variation there is unrelated to climatic variables. In subtropical China, fire activity decreased by 80% between 2003 and 2020 amid increased fire risks globally. Here, we assessed the fire regime, vegetation structure, fuel flammability and their interactions across subtropical Hubei, China. We show that tree basal area (TBA) and fuel flammability explained 60% of fire-frequency variance. Fire frequency and fuel flammability, in turn, explained 90% of TBA variance. These results reveal a novel system of scrubland-forest stabilized by vegetation-fire feedbacks. Frequent fires promote the persistence of derelict scrubland through positive vegetation-fire feedbacks; in forest, vegetation-fire feedbacks are negative and suppress fire. Thus, we attribute the decrease in wildfire activity to reforestation programs that concurrently increase forest coverage and foster negative vegetation-fire feedbacks that suppress wildfire.

Heart Failure With Preserved Ejection Fraction: Current Status of Daily Clinical Practice in Indonesia.

Introduction Heart failure (HF) is a clinical syndrome with symptoms and/or signs caused by a structural and/or functional cardiac abnormality and corroborated by elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion. Among HF types, HF with preserved ejection fraction (HFpEF) is the commonest form. However, the diagnosis and management of HFpEF are challenging. In addition, the perception of healthcare professionals (HCPs) towards the diagnosis and management of HFpEF patients differs due to the existing gap between the guidelines and daily clinical practice. Therefore, an online survey was conducted to understand the HCPs' knowledge and practice gaps in the diagnosis, treatment, and management of patients with HFpEF. Methods A total of 160 respondents, i.e., cardiologists, internists, and cardiology residents from different community-based practices and hospitals across Indonesia participated in an online continuing medical education (CME) survey. A questionnaire was formulated to assess awareness, current practice patterns, challenges, and confidence of the HCPs related to the HFpEF. Results HCPs stated that diagnosis of HF is the prime responsibility of cardiologists and general physicians but not of general internists. According to the HCPs, reduction in mortality, reduction in hospitalization, and improved quality of life are the most important goals of HF treatment. The perceived prevalence of HFpEF is estimated to be 30-60% and mortality rates of HFpEF and HF with reduced ejection fraction (HFrEF) are similar. Further, mixed types of responses with different combinations of diagnosis, treatment, and prevention, were obtained when HCPs were asked about the challenges faced in HFpEF. Among the therapies, angiotensin-converting enzyme (ACE) inhibitors, mineralocorticoid receptor antagonists (MRA), beta-blockers, and diuretics are frequently used for the treatment of HF. Conclusion The perception of the HCPs toward the diagnosis and management of HFpEF may affect optimal care. Based on our findings, the cardiologists are well aware of the current situation of HF in Indonesia and treat patients with HFpEF effectively.

[Burkholderia cepacia isolation and characterization from hospital infections]. / Isolement et caractérisation de Burkholderia cepacia à l'origine d'infections hospitalières.

The evolution of reanimation and functional exploration techniques has led to and explosion of nosocomial infections. They are prevailing in Intensive Care and Neonatal Units. This study deals with B. cepacia strains isolated in 1996 in a pediatric hospital of the Dakar University Hospital Center, following the installation of tracheo-bronchial exhausters which are used for obstruction removal among children. The 44 B. cepacia strains examined come from 42 blood cultures done among 29 boys and 13 girls aged between 5 days and 7 years, and from 2 exhausters. After identification by API20 NE (bio Merieux), a standard antibiogram, a 3 characters biotyping (O.N.P.G., esculin, nitrate reductase) and a study of the polymorphism of the DNA enzymatic restriction profile obtained by an pulsed field electrophoresis are performed on the isolates. The contamination come from the exhausters. All the strains produce an orange-colored yellow pigment. Only an O.N.P.G. (+), nitrate reductase (+) biotype was identified. The antibiotic susceptibility profile is almost pathognomonic for the 44 tested strains: sensitivity (100%) to ceftriaxone, to ceftazidime, to aztreonam: to contrimoxazole (96%) and to chloramphenicol (91%). Search for widen spectrum beta-lactamses and antibiotics resistance plasmids was negative. However, those strains that are multiples resistant, discharge others 8.1. isofocal point beta-lactamases. The R.F.L.P. study demonstrated a unique profile. The B. cepacia transmission is the result of the installation of medical reanimation equipment that are not well taken care of. The nosocomial infections ascertained so far are ordinary bacteremias. Strain's phenotypical and genotypical identification shows the presence of only one clone. To overcome there nosocomial infections, hygienic measures have to be reinforced.