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A ten-year-long examination of macroinvertebrate community recovery was conducted following a catastrophic spill of highly alkaline red sludge (pH >13) into lowland streams. Our primary objective was to compare recovery patterns after coarse- and fine-grain disturbances, focusing on two aspects: i) trend analysis to reveal long-term changes of six community parameters, and ii) variation analyses to assess parameter changes over time. We conducted statistical analysis on long-term data series of macroinvertebrates obtained from quantitative samples collected at four sections with varying degrees of disturbance along the impacted stream sections. We developed a comprehensive theoretical framework comprising a series of sequential phases: Ramp-up, Overshoot, and Oscillation Phases. i) A trend analysis revealed that disturbances show a gradual recovery pattern, while variance analyses showed an asymptotic convergence to an equilibrium. ii) Evaluating these trends across phases unveiled that the initial recovery phase exhibited a steep trajectory, lasting 4-9 months, irrespective of disturbance severity. Coarse-grain disturbances induced a remarkable Overshoot phenomenon across all community metrics. The more severe the disturbance, the greater the height and duration of the Overshoot. Our results suggest that the presence or absence of Overshoot can serve as an indicator for coarse-grain disturbances in the context of large and infrequent disturbances (LID). The entire recovery process lasts for 2.5-3 years irrespective of the severity of the LID. In conclusion, a minimum survey duration of two and half years is deemed imperative to capture the phases of recovery, and changes associated with LID are not expected to extend beyond the three-year threshold. The theoretical framework, including Overshoot parameters, may assist future studies in comparing recovery patterns of different LID types. Furthermore, our theoretical framework is likely to be applicable to other groups of organisms given a sufficiently long monitoring of recovery, influenced also by the length of reproductive cycles.
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Desastres , Invertebrados , Animales , Aguas del Alcantarillado , Hungría , Ríos/química , EcosistemaRESUMEN
Purpose: The current study aimed to analyze the changes in heart rate variability (HRV) 24h, 48h and 72h after exercise sessions in breast cancer survivors. Methods: Sixteen survivors who had undergone chemotherapy and radiotherapy were included. Participants trained resistance and cardiovascular components 3 times per week. The intervention was supervised and delivered online for 4 weeks. In this period, patients measured their HRV daily obtaining the lnrMSSD and lnSDNN values of: day 0 (the morning of the training sessions), 24h, 48h and 72h after exercise. Results: Significant changes in lnrMSSD (p=0.015) and lnSDNN (p=0.031) during recovery times and lnSDNN during the weeks were found (p=0.015). The most prominent differences were identified between the baseline measurement taken on day 0 and 24h after exercise (p=0.007 and p=0.048, respectively) and between measurements obtained 24h and 48h after the training session (p=0.019 and p=0.026, respectively). Conclusion: Our study suggests that patients may decrease their lnrMSSD and lnSDNN values 24h after exercise and they were close to recover 48h after the sessions. In this regard, HRV may be an useful tool to monitor their recovery and exercise tolerance.
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U.S. wildfire activity has increased over the past several decades, disrupting the systems and infrastructure that support community health and resilience. As the cumulative burden of wildfire damage is projected to increase, understanding an effective community recovery process is critically important. Through qualitative interviews with leaders of long-term recovery organizations (LTROs), a key component of wildfire recovery, we explored barriers and facilitators to LTROs' ability to support post-wildfire needs among rural communities. Between February-May 2022, we conducted surveys and semi-structured interviews with 18 leaders from six LTROs serving rural communities in Washington, Oregon, and California impacted by wildfires between 2015-2020. The Robert Wood Johnson Foundation's Culture of Health Framework informed the semi-structured interview guide and a priori codebook, to examine LTROs' ability to address post-wildfire community needs from a health equity perspective. Additional codes were added through an inductive approach, and emerging themes were identified. Our findings indicate that LTROs face many barriers in addressing community needs post-wildfire, including the policies governing access to and the slow arrival of recovery resources, the intertwined nature of community economic health and built environment restoration, and the challenge of forming a functional LTRO structure. However, participants also identified facilitators of LTROs' work, including the ability of LTROs and their government partners to adapt policies and procedures, and close collaboration with other community organizations. Factors both internal and external to the community and LTROs' organizational characteristics influence their ability to address community needs, essential to health, post-wildfire. This study's findings suggest the need for policy improvements to promote more equitable recovery resource access, that economic recovery should be a core LTRO function, and that recovery planning should be incorporated into community disaster preparedness activities. Future research should focus on LTROs' role in other contexts and in response to other disasters.
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BACKGROUND: The COVID-19 pandemic has been associated with an unprecedented number of critical care survivors. Their experiences through illness and recovery are likely to be complex, but little is known about how best to support them. AIM: This study aimed to explore experiences of illness and recovery from the perspective of survivors, their relatives and professionals involved in their care. STUDY DESIGN: In-depth qualitative interviews were conducted with three stakeholder groups during the first wave of the pandemic. A total of 23 participants (12 professionals, 6 survivors and 5 relatives) were recruited from 5 acute hospitals in England and interviewed by telephone or video call. Data analysis followed the principles of Reflexive Thematic Analysis. FINDINGS: Three themes were generated from their interview data: (1) Deteriorating fast-a downhill journey from symptom onset to critical care; (2) Facing a new virus in a hospital-a remote place; and (3) Returning home as a survivor, maintaining normality and recovering slowly. CONCLUSIONS: Our findings highlight challenges in accessing care and communication between patients, hospital staff and relatives. Following hospital discharge, patients adopted a reframed 'survivor identity' to cope with their experience of illness and slow recovery process. The concept of survivorship in this patient group may be beneficial to promote and explore further. RELEVANCE TO CLINICAL PRACTICE: All efforts should be made to continue to improve communication between patients, relatives and health professionals during critical care admissions, particularly while hospital visits are restricted. Adapting to life after critical illness may be more challenging while health services are restricted by the impacts of the pandemic. It may be beneficial to promote the concept of survivorship, following admission to critical care due to severe COVID-19.
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COVID-19 , Cuidadores , Humanos , Pandemias , Investigación Cualitativa , Personal de SaludRESUMEN
Background: The long-term implications of COVID-19 attract global attention in the post-COVID-19 pandemic era. Impaired lung function is the main sequelae in adults' survivors of SARS-CoV-2 infection. Methods and Results: The plasma proteomic pattern provides novel evidence on multiple biological domains relevant to monitoring lung function and targeting the clinical application in adults with acute respiratory distress syndrome (ARDS) secondary to SARS-CoV-2 infection (SARS-CoV-2-ARDS). Preliminary studies support the evidence of pulmonary function tests (PFT) and computed tomography (CT) scan as routine follow-up tools. Combining the early fibrotic indicators and D-dimer levels could prove the validity and reliability of the proactive management of lung function assessment during the long-term recovery in SARS-CoV-2 infection. Conclusion: In summary, protocolized PFT and CT scan and effective biomarkers for early fibrotic changes should be applied to clinical practice during the long follow-up in patients with severe COVID-19.
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BACKGROUND: Opioid use disorder (OUD) seriously impacts public health in the United States. However, few investigations of long-term outcomes following treatment with medication for OUD exist. Additionally, these studies have prioritized opioid use and treatment utilization outcomes, and a gap in knowledge regarding long-term, multidimensional trajectories of OUD recovery exists. This study investigated a diverse array of outcomes for individuals with OUD at an average of 4.2 years post clinical trial participation. METHODS: Individuals who previously participated in long-acting buprenorphine subcutaneous injection clinical trials (NCT023579011; NCT025100142; NCT02896296) and enrolled in The Remission from Chronic Opioid Use-Studying Environmental and SocioEconomic Factors on Recovery (RECOVER; NCT03604861) Study participated in a follow up assessment (n = 216). Substance use, psychosocial, opioid dependence, and delay discounting outcomes were assessed. Regression analyses were conducted to determine significant associations between psychosocial/opioid dependence variables and both recent opioid use and delay discounting. RESULTS: The majority of participants reported abstinence from opioids since the last RECOVER study assessment (mean 2.26 years; 55%) and in the past 30 days (69%). Participants reported low levels of depression and psychological distress. Positive associations between depression and opioid craving with past 30-day opioid misuse and delay discounting, and negative associations between quality of life and treatment effectiveness with these outcomes were observed. CONCLUSIONS: This study examined longer term OUD recovery outcomes. Participants reported high levels of abstinence from opioids and psychosocial functioning. These encouraging results highlight the multidimensional nature of recovery from OUD, and further support the effectiveness of buprenorphine as an OUD treatment.
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Buprenorfina , Trastornos Relacionados con Opioides , Analgésicos Opioides/uso terapéutico , Buprenorfina/uso terapéutico , Ensayos Clínicos como Asunto , Humanos , Tratamiento de Sustitución de Opiáceos , Trastornos Relacionados con Opioides/tratamiento farmacológico , Trastornos Relacionados con Opioides/psicología , Calidad de Vida , Factores Socioeconómicos , Estados UnidosRESUMEN
Most children have a mild course of acute COVID-19. Only few mainly non-controlled studies with small sample size have evaluated long-term recovery from SARS-CoV-2 infection in children. The aim of this study was to evaluate symptoms and duration of 'long COVID' in children. A nationwide cohort study of 37,522 children aged 0-17 years with RT-PCR verified SARS-CoV-2 infection (response rate 44.9%) and a control group of 78,037 children (response rate 21.3%). An electronic questionnaire was sent to all children from March 24th until May 9th, 2021. Symptoms lasting > 4 weeks were common among both SARS-CoV-2 children and controls. However, SARS-CoV-2 children aged 6-17 years reported symptoms more frequently than the control group (percent difference 0.8%). The most reported symptoms among pre-school children were fatigue Risk Difference (RD) 0.05 (CI 0.04-0.06), loss of smell RD 0.01 (CI 0.01-0.01), loss of taste RD 0.01 (CI 0.01-0.02) and muscle weakness RD 0.01 (CI 0.00-0.01). Among school children the most significant symptoms were loss of smell RD 0.12 (CI 0.12-0.13), loss of taste RD 0.10 (CI 0.09-0.10), fatigue RD 0.05 (CI 0.05-0.06), respiratory problems RD 0.03 (CI 0.03-0.04), dizziness RD 0.02 (CI 0.02-0.03), muscle weakness RD 0.02 (CI 0.01-0.02) and chest pain RD 0.01 (CI 0.01-0.01). Children in the control group experienced significantly more concentration difficulties, headache, muscle and joint pain, cough, nausea, diarrhea and fever than SARS-CoV-2 infected. In most children 'long COVID' symptoms resolved within 1-5 months. CONCLUSIONS: Long COVID in children is rare and mainly of short duration. WHAT IS KNOWN: ⢠There are increasing reports on 'long COVID' in adults. ⢠Only few studies have evaluated the long-term recovery from COVID-19 in children, and common for all studies is a small sample size (median number of children included 330), and most lack a control group. WHAT IS NEW: ⢠0.8% of SARS-CoV-2 positive children reported symptoms lasting >4 weeks ('long COVID'), when compared to a control group. ⢠The most common 'long COVID' symptoms were fatigue, loss of smell and loss of taste, dizziness, muscle weakness, chest pain and respiratory problems. ⢠These 'long COVID' symptoms cannot be assigned to psychological sequelae of social restrictions. ⢠Symptoms such as concentration difficulties, headache, muscle- and joint pain as well as nausea are not 'long COVID' symptoms. ⢠In most cases 'long COVID' symptoms resolve within 1-5 months.
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COVID-19 , Adolescente , Adulto , COVID-19/complicaciones , Niño , Preescolar , Estudios de Cohortes , Cefalea/etiología , Humanos , Lactante , Recién Nacido , SARS-CoV-2 , Síndrome Post Agudo de COVID-19RESUMEN
Clinical evaluations of long-term outcomes in the early-stage spinal cord injury (SCI) focus on macroscopic motor performance and are limited in their prognostic precision. This study was designed to investigate the sensitivity of the magnetic resonance imaging (MRI) indexes to the data-driven gait process after SCI. Ten adult female rhesus monkeys were subjected to thoracic SCI. Kinematics-based gait examinations were performed at 1 (early stage) and 12 (chronic stage) months post-SCI. The proportion of stepping (PS) and gait stability (GS) were calculated as the outcome measures. MRI metrics, which were derived from structural imaging (spinal cord cross-sectional area, SCA) and diffusion tensor imaging (fractional anisotropy, FA; axial diffusivity, λ//), were acquired in the early stage and compared with functional outcomes by using correlation analysis and stepwise multivariable linear regression. Residual tissue SCA at the injury epicenter and residual tissue FA/remote normal-like tissue FA were correlated with the early-stage PS and GS. The extent of lesion site λ///residual tissue λ// in the early stage after SCI was correlated with the chronic-stage GS. The ratios of lesion site λ// to residual tissue λ// and early-stage GS were predictive of the improvement in the PS at follow-up. Similarly, the ratios of lesion site λ// to residual tissue λ// and early-stage PS best predicted chronic GS recovery. Our findings demonstrate the predictive power of MRI combined with the early data-driven gait indexes for long-term outcomes. Such an approach may help clinicians to predict functional recovery accurately.
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Imagen de Difusión Tensora , Traumatismos de la Médula Espinal , Animales , Benchmarking , Imagen de Difusión Tensora/métodos , Femenino , Macaca mulatta , Imagen por Resonancia Magnética/métodos , Médula Espinal/diagnóstico por imagen , Médula Espinal/patología , Traumatismos de la Médula Espinal/patologíaRESUMEN
Background: It remains widely accepted that spontaneous recovery from aphasia is largely limited to the first related factors. This has direct implications for acute and chronic interventions for aphasia. few months following stroke. A few recent studies challenge this view, revealing that some individuals' language abilities improve even during the chronic stage. Aims: To identify prognostic indicators of long-term aphasia recovery. Methods & Procedures: Eighteen people with aphasia initially evaluated in the chronic stage were retested at least one year later. The Western Aphasia Battery-Revised (WAB-R) Aphasia Quotient (AQ) was used to quantify changes in language impairment. Prognostic factors included those related to the patient (demographic, psychosocial), stroke (lesion volume and location), and treatment (medical, rehabilitative). Outcomes & Results: Twelve participants improved and 6 remained stable or declined. Linear regression analysis revealed that lesion volume predicted long-term language gains, with smaller lesions yielding greater improvements. Individuals who did not improve were more likely to have lesions encompassing critical frontal and temporoparietal cortical regions and interconnecting white matter pathways. Exploratory regression analysis of psychosocial and treatment-related factors revealed a positive relationship between improvement and satisfaction with life participation, and a negative relationship between improvement and perceived impairment severity. Critically, psychosocial and treatment-related factors significantly improved model fit over lesion volume, suggesting that these factors add predictive value to determining long-term aphasia prognosis. Conclusions: Long-term aphasia recovery is multidetermined by a combination of stroke-, psychosocial-, and treatment-related factors. This has direct implications for acute and chronic interventions for aphasia.
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OBJECTIVES: Ischemic stroke (IS) is the main cause of homonymous visual field defects (HVFDs) in adults. Some reports suggest recovery even in late-phase strokes, but data is sparse. This study examines the frequency of long-term recovery from HVFDs in patients with posterior circulation infarction (POCI) and evaluates whether demographic or clinical characteristics are prognostic factors of perimetric recovery. MATERIALS AND METHODS: Our study included patients with HVFDS due to POCI who had undergone 2 or more kinetic perimetric evaluations at least 6 months after the index IS. Clinical and imaging data were systematically reviewed and we performed univariate and multivariate logistic regression analyses to determine whether demographic, stroke etiology (TOAST classification), and initial perimetric patterns were prognostic factors of visual recovery occurring 6 months and beyond from POCI. RESULTS: One hundred one patients with POCI were included. Median subject age was 60 years and 54.4% were female. After a median perimetric follow-up time of 13.5 months, spontaneous visual improvement was observed in 15.8% of patients. Prognostic factors for visual improvement were age < 50 years (OR 4.6; P = 0.093), POCI associated with hypercoagulable states (OR 12.3; P = 0.048), and vertebral artery dissection (OR 12.6; P = 0.048), while the presence of complete homonymous hemianopia was a negative predictor of recovery (OR 0.2; P = 0.048). CONCLUSION: Partial visual recovery in HVFDs is observed even 6 months and beyond POCI. Age < 50 years and stroke etiology were predictors of recovery.
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Infarto Encefálico/fisiopatología , Hemianopsia/fisiopatología , Accidente Cerebrovascular Isquémico/fisiopatología , Campos Visuales , Adulto , Factores de Edad , Anciano , Infarto Encefálico/diagnóstico , Infarto Encefálico/etiología , Femenino , Hemianopsia/diagnóstico , Hemianopsia/etiología , Humanos , Accidente Cerebrovascular Isquémico/diagnóstico , Accidente Cerebrovascular Isquémico/etiología , Masculino , Persona de Mediana Edad , Pronóstico , Recuperación de la Función , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Pruebas del Campo VisualRESUMEN
In the United States, approximately 292,000 adults (>18 years old) per year suffer an in-hospital cardiac arrest (IHCA). Survival rates have increased over the last decade and many survivors return to their communities. IHCA has been recognized as a unique disease entity because the arrest happens in a medical care setting and survivors often have more medical co-morbidities. Although more individuals are surviving IHCA, very little is known about their long-term recovery experiences. Semi-structured interviews with 19 IHCA survivors were conducted to better understand their recovery experiences and identify strategies of adaptation that they felt aided their recovery. Thematic analysis indicated that IHCA survivors experience ongoing challenges to recovery. Reconceptualization of independence was necessary for some participants to re-engage in social and physical activities and a few were able to engage in new activities. Our findings suggest that IHCA survivors often develop their own strategies for adaptation in order to continue participation in their social lives and that their recovery experiences are ongoing. Intervention programs and follow-up care should continuously ask survivors what is important to them and identify resources that will support their goals. Questions should include physical, cognitive, psychological and social goals that extend beyond those specifically related to IHCA since our findings indicate that the effects of IHCA are long-lasting and encompass all aspects of survivors' lives.
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This study performed a comparative analysis of changes in the operating status of initial surviving disaster-stricken businesses and non-disaster-stricken businesses in Lushan County, China, after a devastating earthquake on 20 April 2013. It used a logistic regression model to explore the key factors associated with 'post-disaster continued business operation' in the long term. Field data were collected from 1,078 businesses and questionnaire data from 263 small businesses between 2013 and 2017. The results indicate that a higher proportion of initial surviving disaster-stricken businesses than non-disaster-stricken businesses managed to remain operational in each observation period. The continued operation of disaster-stricken businesses after the earthquake was positively associated with the owner's age, previous disaster experience, pre-disaster financial conditions, closure duration, and borrowing money from family or friends. A negative association was found with the size of the business. The findings serve as a vital reference for strategies to promote post-disaster continued business operation.
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Comercio/economía , Comercio/organización & administración , Planificación en Desastres , Terremotos/economía , China , Femenino , Humanos , Masculino , Encuestas y CuestionariosRESUMEN
Previous studies examining life after traumatic brain injury (TBI) have taken a predominantly short-term and quantitative perspective, with generally narrow focus, and have not specifically investigated changes in experience over time post-injury to gain a uniquely long-term perspective. This study therefore aimed to qualitatively explore the broad long-term experience of living for 10 years or more with TBI. Thirty participants completed semi-structured interviews investigating the impact of TBI on various life domains, the rehabilitation experience and support received, and overall perspectives of the long-term journey after TBI. Results demonstrated that: (a) although some participants reported full recovery, several experienced persistent physical, cognitive and emotional problems that impacted their independence, employment and interpersonal relationships; (b) early rehabilitation was very helpful, but some participants experienced difficulties accessing ongoing services; (c) family and social support were important to recovery; (d) most participants drew upon inner strength to find positives in their experience. These findings have identified factors that facilitate and impede long-term recovery from TBI, which may inform better support and care for injured individuals over the years after injury to improve their quality of life.
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Lesiones Traumáticas del Encéfalo , Epidemias , Lesiones Traumáticas del Encéfalo/complicaciones , Humanos , Estudios Longitudinales , Calidad de Vida , Apoyo SocialRESUMEN
Nowadays, the great majority of toxicological studies have focused on immediate cardiovascular effects of simultaneous exposure to long-term or short-term PM2.5; yet, whether the persistent vascular fibrosis will be induced after short-term PM2.5 exposure and its related underlying mechanisms remain unclear. In this study, we adopted SD rats treated with PM2.5 for 1â¯month and followed by 12â¯months and 18â¯months recovery. Results from Doppler ultrasonography and histopathological analysis found that PM2.5-evoked vascular fibrosis was comprised of structural injury, including thickening of aortic media and carotid intima media thickness (CIMT), narrow left common carotid artery (LCCA), collagen deposition, impaired elasticity and functional alterations in aortal stiffness during long-term recovery. The protein expression levels of collagen I, collagen III, proliferating cell nuclear antigen (PNCA), TGF-ß and osteopontin (OPN) remained elevated trends in PM2.5-treated groups for the related period than in control groups. Additionally, PM2.5 upregulated the protein expression levels of superoxide dismutase 2 (SOD2), mitochondrial fission related proteins (Drp1 and Fis1), while downregulated the protein expression levels of mitochondrial fusion related proteins (Mfn2 and OPA1). Moreover, PM2.5 significantly activated the mitophagy-related protein expression, including LC3, p62, PINK, Parkin. In summary, our results demonstrated that short-term PM2.5 exposure could trigger mitophagy, further lead to mitochondrial dysfunction which regulated persistent vascular fibrosis during long-term recovery.
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Grosor Intima-Media Carotídeo , Material Particulado , Animales , Fibrosis , Mitocondrias , Ratas , Ratas Sprague-DawleyRESUMEN
Seminatural grasslands are important biodiversity hotspots, but they are increasingly degraded by intensive agriculture. Grassland restoration is considered to be promising in halting the ongoing loss of biodiversity, but this evaluation is mostly based on plant communities. Insect herbivores contribute substantially to grassland biodiversity and to the provisioning of a variety of ecosystem functions. However, it is unclear how they respond to different measures that are commonly used to restore seminatural grasslands from intensively used agricultural land. We studied the long-term success of different restoration techniques, which were originally targeted at reestablishing seminatural grassland plant communities, for herbivorous insect communities on taxonomic as well as functional level. Therefore, we sampled insect communities 22 yr after the establishment of restoration measures. These measures ranged from harvest and removal of biomass to removal of the topsoil layer and subsequent seeding of plant propagules. We found that insect communities in restored grasslands had higher taxonomic and functional diversity compared to intensively managed agricultural grasslands and were more similar in composition to target grasslands. Restoration measures including topsoil removal proved to be more effective, in particular in restoring species characterized by functional traits susceptible to intensive agriculture (e.g., large-bodied species). Our study shows that long-term success in the restoration of herbivorous insect communities of seminatural grasslands can be achieved by different restoration measures and that more invasive approaches that involve the removal of the topsoil layer are more effective. We attribute these restoration successes to accompanying changes in the plant community, resulting in bottom-up control of the herbivore community. Our results are of critical importance for management decisions aiming to restore multi-trophic communities, their functional composition and consequently the proliferation of ecosystem functions.
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Pradera , Herbivoria , Animales , Biodiversidad , Ecosistema , InsectosRESUMEN
What is the long-term trajectory of semantic memory deficits in patients who have suffered structural brain damage? Memory is, per definition, a changing faculty. The traditional view is that after an initial recovery period, the mature human brain has little capacity to repair or reorganize. More recently, it has been suggested that the central nervous system may be more plastic with the ability to change in neural structure, connectivity, and function. The latter observations are, however, largely based on normal learning in healthy subjects. Here, we report a patient who suffered bilateral ventro-medial damage after presumed herpes encephalitis in 1971. He was seen regularly in the eighties, and we recently had the opportunity to re-assess his semantic memory deficits. On semantic category fluency, he showed a very clear category-specific deficit performing better that control data on non-living categories and significantly worse on living items. Recent testing showed that his impairments have remained unchanged for more than 40 years. We suggest cautiousness when extrapolating the concept of brain plasticity, as observed during normal learning, to plasticity in the context of structural brain damage.
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Lenguaje , Trastornos de la Memoria/diagnóstico , Recuerdo Mental/fisiología , Plasticidad Neuronal/fisiología , Lesiones Encefálicas/fisiopatología , Estudios de Seguimiento , Humanos , Masculino , Semántica , Adulto JovenRESUMEN
Background: Studies investigating the subjective experiences of long-term recovery from substance use disorder are scarce. Particularly, functional and social factors have received little attention. Objectives: To investigate what long-term recovered service users found to build recovery from substance use disorder. Material and Methods: The study was designed as a phenomenological investigation subjected to thematic analysis. We interviewed 30 long-term recovered adult service users. Results: Our thematic analysis resulted in five themes and several subthemes: 1) paranoia, ambivalence and drug cravings: extreme barriers to ending use; 2) submitting to treatment: a struggle to balance rigid treatment structures with a need for autonomy; 3) surrendering to trust and love: building a whole person; 4) a life more ordinary: surrendering to mainstream social responsibilities; and 5) taking on personal responsibility and gaining autonomy: it has to be me, it cannot be you. Conclusions: Our study sample described long-term recovery as a developmental process from dependency and reactivity to personal autonomy and self-agency. The flux of surrendering to and differentiating from authority appeared to be a driving force in recovery progression. Participants called for treatment to focus on early social readjustment.
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Efforts are still needed regarding the research of therapeutics for ischemic stroke. While in experimental studies the protective effect of pharmacological agents is often highlighted by a reduction of the lesion size evaluated in the short term (days), in clinical studies a functional recovery of patients suffering from stroke is expected on the long-term (months and years). Long-term functional preclinical studies are highly recommended to evaluate potential neuroprotective agents for stroke, rather than an assessment of the infarction size at a short time point. The present study thus aimed to select among various behavioral tests those able to highlight long-term deficits (3 months) after cerebral ischemia in mice. Permanent focal cerebral ischemia was carried out in male Swiss mice by intraluminal occlusion of the left middle cerebral artery (MCA). Fourteen behavioral tests were assessed from 7 days to 90 days after ischemia (locomotor activity, neurological score, exit circle test, grip and string tests, chimney test, adhesive removal test, pole test, beam-walking tests, elevated plus maze, marble burying test, forced swimming test, novel object recognition test). The present study clearly identified a battery of behavioral tests able to highlight deficits up to 3 months in our mouse model of permanent MCA occlusion (locomotor activity, neurological score, adhesive removal test, pole test, beam-walking tests, elevated plus maze, marble burying test, forced swimming test and novel object recognition test). This battery of behavioral tests highlighting long-term deficits is useful to study future neuroprotective strategies for stroke treatment.
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Isquemia Encefálica/complicaciones , Trastornos Mentales/diagnóstico , Trastornos Mentales/etiología , Animales , Isquemia Encefálica/tratamiento farmacológico , Modelos Animales de Enfermedad , Conducta Exploratoria/fisiología , Locomoción/fisiología , Masculino , Aprendizaje por Laberinto/fisiología , Ratones , Examen Neurológico , Oxígeno/uso terapéutico , Desempeño Psicomotor , Estadísticas no Paramétricas , NataciónRESUMEN
Drought-induced wildfires have increased in frequency and extent over the tropics. Yet, the long-term (greater than 10 years) responses of Amazonian lowland forests to fire disturbance are poorly known. To understand post-fire forest biomass dynamics, and to assess the time required for fire-affected forests to recover to pre-disturbance levels, we combined 16 single with 182 multiple forest census into a unique large-scale and long-term dataset across the Brazilian Amazonia. We quantified biomass, mortality and wood productivity of burned plots along a chronosequence of up to 31 years post-fire and compared to surrounding unburned plots measured simultaneously. Stem mortality and growth were assessed among functional groups. At the plot level, we found that fire-affected forests have biomass levels 24.8 ± 6.9% below the biomass value of unburned control plots after 31 years. This lower biomass state results from the elevated levels of biomass loss through mortality, which is not sufficiently compensated for by wood productivity (incremental growth + recruitment). At the stem level, we found major changes in mortality and growth rates up to 11 years post-fire. The post-fire stem mortality rates exceeded unburned control plots by 680% (i.e. greater than 40 cm diameter at breast height (DBH); 5-8 years since last fire) and 315% (i.e. greater than 0.7 g cm-3 wood density; 0.75-4 years since last fire). Our findings indicate that wildfires in humid tropical forests can significantly reduce forest biomass for decades by enhancing mortality rates of all trees, including large and high wood density trees, which store the largest amount of biomass in old-growth forests. This assessment of stem dynamics, therefore, demonstrates that wildfires slow down or stall the post-fire recovery of Amazonian forests.This article is part of a discussion meeting issue 'The impact of the 2015/2016 El Niño on the terrestrial tropical carbon cycle: patterns, mechanisms and implications'.