RESUMO
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.
Assuntos
Incêndios , Incêndios Florestais , Ecossistema , Retroalimentação , Florestas , ÁrvoresRESUMO
Both C3 and C4 photosynthetic pathways and smoke-released seed dormancy occur among grasses. C4 species evolved from C3 species as seasonality and fire frequency increased and might therefore imply that their smoke sensitivity increased. I searched the worldwide literature for reports on germination responses among grasses, whose photosynthetic pathway was known, to treatment by smoke. Data were obtained for 217 species and 126 genera. While subfamilies tended to be C3 (Pooideae), C4 (Chloridoideae) or a mixture (Panicoideae), a beneficial smoke response was independent of their photosynthetic pathway. The only exceptions were Danthonioideae (C3, non-smoke responsive) and Triodia (C4, smoke responsive). One third of both C3 and C4 genera were smoke responsive. Even within genera, 90% of species showed contrasting smoke responses, confirming that smoke sensitivity is rarely taxonomically constrained. Data on photosynthetic pathway, climate, fire regime and vegetation were compiled for 15 regions that formed four distinct groups: 1) In warm climates with aseasonal rainfall, C4 grasses are moderately better represented, with crown fires and limited smoke responses. 2) In cool regions, most species are C3, with surface-crown fires and lack smoke responses. 3) In warm regions with summer rain (savannas), most species are C4, with surface fires and lack smoke responses. 4) In Mediterranean-climate regions with summer drought, most species are C3, with crown fires and smoke-released dormancy. Thus, even though C3 and C4 grasses are equally capable of expressing smoke sensitivity, their response depends on the region's climate and fire regime that also dictate which photosynthetic pathway dominates.
Assuntos
Incêndios , Poaceae , Poaceae/fisiologia , Dormência de Plantas , Fumaça , Fotossíntese , ClimaRESUMO
Seed viability is routinely measured on seeds that fail to germinate at the end of an experiment. Together with the number of germinants, this is used to estimate viability of the seeds at start of the experiment (i.e., initial viability) and provides the comparative basis on which germination success is determined. The literature and recent data on the germination requirements of Leucadendron species were examined to determine if there was any evidence for a treatment effect on viability of ungerminated seeds at the end of the experiment. The survey showed that sometimes (perhaps often, as the problem has yet to be recognized or reported) prolonged duration in the treatment, especially the control where little germination occurs, lead to loss of viability during the experiment. This resulted in underestimation of initial viability if that treatment was used. I caution against the routine use of end-of-trial germination and viability of ungerminated seeds as an estimate of initial viability in determining germination success of various treatments. I explore ways to deal with the problem but the preference is for estimates of initial viability to be undertaken on a separate sample of seeds concurrently with the experiment as this avoids the risk of seed death during the trial.
Assuntos
Germinação , SementesRESUMO
BACKGROUND/OBJECTIVES: Dietary guidelines for the past 20 years have recommended that dietary fat should be minimized. In contrast, recent studies have suggested that there could be some potential benefits for reducing carbohydrate intake in favor of increased fat. It has also been suggested that low-carbohydrate diets be recommended for people with type 2 diabetes. However, whether such diets can improve glycemic control will likely depend on their ability to improve ß-cell function, which has not been studied. The objective of the study was to assess whether a low-carbohydrate and therefore high-fat diet (LCHFD) is beneficial for improving the endogenous insulin secretory response to glucose in prediabetic New Zealand Obese (NZO) mice. METHODS: NZO mice were maintained on either standard rodent chow or an LCHFD from 6 to 15 weeks of age. Body weight, food intake and blood glucose were assessed weekly. Blood glucose and insulin levels were also assessed after fasting and re-feeding and during an oral glucose tolerance test. The capacity of pancreatic ß-cells to secrete insulin was assessed in vivo with an intravenous glucose tolerance test. ß-Cell mass was assessed in histological sections of pancreata collected at the end of the study. RESULTS: In NZO mice, an LCHFD reduced plasma triglycerides (P=0.001) but increased weight gain (P<0.0001), adipose tissue mass (P=0.0015), high-density lipoprotein cholesterol (P=0.044) and exacerbated glucose intolerance (P=0.013). Although fasting insulin levels tended to be higher (P=0.08), insulin secretory function in LCHFD-fed mice was not improved (P=0.93) nor was ß-cell mass (P=0.75). CONCLUSIONS: An LCHFD is unlikely to be of benefit for preventing the decline in ß-cell function associated with the progression of hyperglycemia in type 2 diabetes.
Assuntos
Glicemia/metabolismo , Dieta com Restrição de Carboidratos , Dieta Hiperlipídica , Células Secretoras de Insulina/citologia , Insulina/metabolismo , Aumento de Peso , Tecido Adiposo/metabolismo , Animais , Colesterol/sangue , Diabetes Mellitus Tipo 2/sangue , Modelos Animais de Doenças , Intolerância à Glucose/sangue , Teste de Tolerância a Glucose , Hiperglicemia/sangue , Insulina/sangue , Secreção de Insulina , Masculino , Camundongos , Camundongos Endogâmicos , Camundongos Obesos , Triglicerídeos/sangueRESUMO
Resprouting as a response to disturbance is now widely recognized as a key functional trait among woody plants and as the basis for the persistence niche. However, the underlying mechanisms that define resprouting responses to disturbance are poorly conceptualized. Resprouting ability is constrained by the interaction of the disturbance regime that depletes the buds and resources needed to fund resprouting, and the environment that drives growth and resource allocation. We develop a buds-protection-resources (BPR) framework for understanding resprouting in fire-prone ecosystems, based on bud bank location, bud protection, and how buds are resourced. Using this framework we go beyond earlier emphases on basal resprouting and highlight the importance of apical, epicormic and below-ground resprouting to the persistence niche. The BPR framework provides insights into: resprouting typologies that include both fire resisters (i.e. survive fire but do not resprout) and fire resprouters; the methods by which buds escape fire effects, such as thick bark; and the predictability of community assembly of resprouting types in relation to site productivity, disturbance regime and competition. Furthermore, predicting the consequences of global change is enhanced by the BPR framework because it potentially forecasts the retention or loss of above-ground biomass.
Assuntos
Incêndios , Germinação , Desenvolvimento Vegetal , Fenômenos Fisiológicos Vegetais , Metabolismo dos Carboidratos , Carbono/metabolismo , Mudança Climática , Ecossistema , Raízes de Plantas/metabolismo , Raízes de Plantas/fisiologia , Caules de Planta/metabolismo , Caules de Planta/fisiologia , Plantas/metabolismo , Sementes/metabolismo , Sementes/fisiologia , Especificidade da Espécie , Madeira/metabolismo , Madeira/fisiologiaRESUMO
AIMS/HYPOTHESIS: Metformin is widely used for the treatment of type 2 diabetes. Although it reduces hepatic glucose production, clinical studies show that metformin may reduce plasma dipeptidyl peptidase-4 activity and increase circulating levels of glucagon-like peptide 1 (GLP-1). We examined whether metformin exerts glucoregulatory actions via modulation of the incretin axis. METHODS: Metformin action was assessed in Glp1r(-/-), Gipr(-/-), Glp1r:Gipr(-/-), Pparα (also known as Ppara)(-/-) and hyperglycaemic obese wild-type mice with or without the GLP-1 receptor (GLP1R) antagonist exendin(9-39). Experimental endpoints included glucose tolerance, plasma insulin levels, gastric emptying and food intake. Incretin receptor expression was assessed in isolated islets from metformin-treated wild-type and Pparα(-/-) mice, and in INS-1 832/3 beta cells with or without peroxisome proliferator-activated receptor (PPAR)-α or AMP-activated protein kinase (AMPK) antagonists. RESULTS: In wild-type mice, metformin acutely increased plasma levels of GLP-1, but not those of gastric inhibitory polypeptide or peptide YY; it also improved oral glucose tolerance and reduced gastric emptying. Metformin significantly improved oral glucose tolerance despite loss of incretin action in Glp1r(-/-), Gipr(-/-) and Glp1r(-/-) :Gipr(-/-) mice, and in wild-type mice fed a high-fat diet and treated with exendin(9-39). Levels of mRNA transcripts for Glp1r, Gipr and Pparα were significantly increased in islets from metformin-treated mice. Metformin directly increased Glp1r expression in INS-1 beta cells via a PPAR-α-dependent, AMPK-independent mechanism. Metformin failed to induce incretin receptor gene expression in islets from Pparα(-/-) mice. CONCLUSIONS/INTERPRETATION: As metformin modulates multiple components of the incretin axis, and enhances expression of the Glp1r and related insulinotropic islet receptors through a mechanism requiring PPAR-α, metformin may be mechanistically well suited for combination with incretin-based therapies.
Assuntos
Hipoglicemiantes/farmacologia , Metformina/farmacologia , PPAR alfa/metabolismo , Receptores dos Hormônios Gastrointestinais/metabolismo , Animais , Linhagem Celular , Diabetes Mellitus Tipo 2/tratamento farmacológico , Dipeptidil Peptidase 4/sangue , Ingestão de Alimentos/efeitos dos fármacos , Polipeptídeo Inibidor Gástrico/sangue , Peptídeo 1 Semelhante ao Glucagon/sangue , Receptor do Peptídeo Semelhante ao Glucagon 1 , Hipoglicemiantes/uso terapêutico , Masculino , Metformina/uso terapêutico , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Mutantes , PPAR alfa/genética , Fragmentos de Peptídeos/uso terapêutico , Receptores dos Hormônios Gastrointestinais/genética , Receptores de Glucagon/antagonistas & inibidores , Receptores de Glucagon/sangue , Transdução de Sinais/efeitos dos fármacosRESUMO
In plants, pollen- and seed-dispersal distributions are characteristically leptokurtic, with significant consequences for spatial genetic structure and nearest-neighbour mating. However, most studies to date have been on wind- or insect-pollinated species. Here, we assigned paternity to quantify effective pollen dispersal over 9 years of mating, contrasted this to seed dispersal and examined their effects on fine-scale spatial genetic structure, within the bird-pollinated shrub Banksia hookeriana (Proteaceae). We used 163 polymorphic amplified fragment length polymorphism markers to assess genetic structure and pollen dispersal in a spatially discrete population of 112 plants covering 0.56 ha. Spatial autocorrelation analysis detected spatial genetic structure in the smallest distance class of 0-5 m (r=0.025), with no significant structure beyond 8 m. Experimentally quantified seed-dispersal distances for 337 seedlings showed a leptokurtic distribution around a median of 5 m, reaching a distance of 36 m. In marked contrast, patterns of pollen dispersal for 274 seeds departed strikingly from typical near-neighbour pollination, with a distribution largely corresponding to the spatial distribution of plants. We found very high multiple paternity, very low correlated paternity and an equal probability of siring for the 50 closest potential mates. Extensive pollen carryover was demonstrated by multiple siring in 83 of 86 (96.5%) two-seeded fruits. Highly mobile nectar-feeding birds facilitate this promiscuity through observed movements that were effectively random. As the incidence of bird-pollination is markedly greater in the Southwest Australian Floristic Region than elsewhere, our results have broad and novel significance for the evolution and conservation for many species in Gondwanan lineages.
Assuntos
Aves/fisiologia , Pólen/genética , Polinização , Proteaceae/genética , Sementes/genética , Animais , Comportamento Animal , Pólen/fisiologia , Proteaceae/fisiologia , Sementes/fisiologiaRESUMO
Putative hybrids between Banksia hookeriana and B. prionotes were identified among 12 of 106 populations of B. hookeriana located at or near anthropogenically disturbed sites, mainly roadways, but none in 156 undisturbed populations. Morphometrics and AFLP markers confirmed that a hybrid swarm existed in a selected disturbed habitat, whereas no intermediates were present where the two species co-occurred in undisturbed vegetation. Individuals of both species in disturbed habitats at 12 sites were more vigorous, with greater size and more flower heads than their counterparts in undisturbed vegetation. These more fecund plants also showed a shift in season and duration of flowering. By promoting earlier flowering of B. hookeriana plants and prolonging flowering of B. prionotes, anthropogenic disturbance broke the phenological barrier between these two species. We conclude that anthropogenic disturbance promotes hybridization through increasing opportunities for gene flow by reducing interpopulation separation, increasing gamete production and, especially, promoting coflowering.
Assuntos
Flores , Hibridização Genética , Proteaceae/genética , Proteaceae/fisiologia , Adaptação Fisiológica , Reprodução , Estações do AnoRESUMO
AIMS/HYPOTHESIS: To study the secondary consequences of impaired suppression of endogenous glucose production (EGP) we have created a transgenic rat overexpressing the gluconeogenic enzyme phosphoenolpyruvate carboxykinase (PEPCK) in the kidney. The aim of this study was to determine whether peripheral insulin resistance develops in these transgenic rats. METHODS: Whole body rate of glucose disappearance (R(d)) and endogenous glucose production were measured basally and during a euglycaemic/hyperinsulinaemic clamp in phosphoenolpyruvate carboxykinase transgenic and control rats using [6-(3)H]-glucose. Glucose uptake into individual tissues was measured in vivo using 2-[1-(14)C]-deoxyglucose. RESULTS: Phosphoenolpyruvate carboxykinase transgenic rats were heavier and had increased gonadal and infrarenal fat pad weights. Under basal conditions, endogenous glucose production was similar in phosphoenolpyruvate carboxykinase transgenic and control rats (37.4+/-1.1 vs 34.6+/-2.6 micromol/kg/min). Moderate hyperinsulinaemia (810 pmol/l) completely suppressed EGP in control rats (-0.6+/-5.5 micromol/kg/min, p<0.05) while there was no suppression in phosphoenolpyruvate carboxykinase rats (45.2+/-7.9 micromol/kg/min). Basal R(d) was comparable between PEPCK transgenic and control rats (37.4+/-1.1 vs 34.6+/-2.6 micromol/kg/min) but under insulin-stimulated conditions the increase in R(d) was greater in control compared to phosphoenolpyruvate carboxykinase transgenic rats indicative of insulin resistance (73.4+/-11.2 vs 112.0+/-8.0 micromol/kg/min, p<0.05). Basal glucose uptake was reduced in white and brown adipose tissue, heart and soleus while insulin-stimulated transport was reduced in white and brown adipose tissue, white quadriceps, white gastrocnemius and soleus in phosphoenolpyruvate carboxykinase transgenic compared to control rats. The impairment in both white and brown adipose tissue glucose uptake in phosphoenolpyruvate carboxykinase transgenic rats was associated with a decrease in GLUT4 protein content. In contrast, muscle GLUT4 protein, triglyceride and long-chain acylCoA levels were comparable between PEPCK transgenic and control rats. CONCLUSIONS/INTERPRETATION: A primary defect in suppression of EGP caused adipose tissue and muscle insulin resistance.
Assuntos
Resistência à Insulina , Rim/enzimologia , Proteínas Musculares , Fosfoenolpiruvato Carboxiquinase (GTP)/metabolismo , Animais , Animais Geneticamente Modificados , Desoxiglucose/farmacocinética , Glucose/metabolismo , Transportador de Glucose Tipo 4 , Glicogênio/metabolismo , Proteínas de Transporte de Monossacarídeos/metabolismo , Músculo Esquelético/metabolismo , Fosfoenolpiruvato Carboxiquinase (GTP)/genética , RNA Mensageiro/metabolismo , Ratos , Triglicerídeos/metabolismoRESUMO
IL-6 expression in skeletal muscle is stimulated by contractions. We sought to examine whether hyperinsulinaemia increases IL-6 mRNA in skeletal muscle and whether any increase is modified in insulin resistant muscle. We hypothesized that intramuscular IL-6 mRNA would be increased in response to insulin, but such an affect would be unaffected by insulin resistance because the primary insulin sensitive signalling protein responsible for activating IL-6 functions normally in insulin resistant muscle. Transgenic rats over-expressing the gluconeogenic regulatory enzyme phosphoenolpyruvate carboxykinase (PEPCK) were studied. White gastrocnemius muscle samples were obtained under hyperinsulinaemic, euglycaemic clamp (4 mU kg(-1)min(-1) insulin, plasma glucose concentration 4-6 mmol L(-1)) and basal conditions in both PEPCK (basal n=4; insulin n=5) and wild-type (CON) (basal n=5; insulin n=4) rats, which were previously injected with a bolus of 2-[1-14C]deoxyglucose (2-DG) into the carotid artery. Muscle samples were assayed for 2-DG uptake and IL-6 mRNA. No differences in 2-DG uptake or IL-6 mRNA were observed when comparing groups under basal conditions. Under clamp conditions, 2-DG uptake was lower (P<0.05) in PEPCK compared with CON. Insulin stimulation in CON did not change IL-6 mRNA compared with basal levels. In contrast, there was an approximately 8-fold increase (P<0.05) in IL-6 mRNA in insulin-stimulated PEPCK compared with CON basal levels. Insulin stimulation increases IL-6 gene expression in insulin resistant, but not healthy, skeletal muscle, suggesting that IL-6 expression in skeletal muscle is sensitive to changes in insulin in circumstances of insulin resistance. It is likely that the differences observed when comparing healthy with insulin resistant muscle are due to the differential activation of insulin sensitive signalling proteins responsible for activating IL-6.
Assuntos
Resistência à Insulina/fisiologia , Insulina/farmacologia , Interleucina-6/genética , Interleucina-6/metabolismo , Músculo Esquelético/efeitos dos fármacos , Animais , Animais Geneticamente Modificados , Glicemia/metabolismo , Desoxiglucose/metabolismo , Humanos , Sistema de Sinalização das MAP Quinases/fisiologia , Contração Muscular/fisiologia , Músculo Esquelético/fisiologia , Proteínas Serina-Treonina Quinases/genética , Proteínas Serina-Treonina Quinases/metabolismo , RNA Mensageiro/metabolismo , RatosRESUMO
The role of dormancy, temperature and light in the regulation of seed germination of four annual Asteraceae from south-western Australia was investigated. The experiments aimed to identify after-ripening patterns, and to relate these to climatic conditions of the habitat in which the species occur. Seeds of all species were strongly dormant at maturity and maintained high levels of dormancy for time periods corresponding to the duration of summer in south-western Australia. Dry after-ripening was promoted best by temperatures lower than those prevailing in the dry season, although differences among storage temperatures were mostly insignificant. Germination percentages were highest at average winter temperatures (15 degrees C). A logistic model revealed significant differences in germinability among species, but not between incubation temperatures or light and dark treatments across species. Three species with seeds >0.5 mg germinated better in darkness than in light, whereas germination in darkness was almost inhibited in the species with the smallest seeds (0.14 mg). The course of dormancy loss, tested over a range of fluctuating incubation temperatures (7-30 degrees C), showed that seeds of three species came out of dormancy first at temperatures that prevail in south-western Australia during the winter (10-15 degrees C). Seeds from one species, introduced from South Africa, first lost dormancy at the lowest temperature (7 degrees C). All species showed after-ripening patterns of Type 1, typical of species growing in Mediterranean climates. The germination characteristics of the investigated species can be interpreted as ensuring that initial growth and establishment occur during the winter growing season, thereby avoiding the hot and dry summer conditions that follow seed dispersal.
Assuntos
Asteraceae/fisiologia , Sementes/fisiologia , Asteraceae/classificação , Asteraceae/efeitos da radiação , Austrália , Escuridão , Germinação/fisiologia , Germinação/efeitos da radiação , Luz , Sementes/crescimento & desenvolvimento , Sementes/efeitos da radiação , Especificidade da Espécie , TemperaturaRESUMO
The present study investigates the vasoreactivity of the brain in patients with large infarcts and dementia (multi-infarct dementia; MID) and in patients with microangiopathy, lacunes, white matter changes and dementia (lacunar dementia; LD) using positron emission tomography (PET) and 13NH3 as regional cerebral blood flow (rCBF) tracer. In the control group, an increase in rCBF ranging from 32 to 43% was found in all brain regions after intravenous acetazolamide administration. In both the MID group and the group with multiple infarcts without dementia, moderate loss of vasoreactivity was observed in the frontal, temporal and parietal cortex compared to the control values. Vasoreactivity was severely impaired in all cerebral regions of the LD group and restricted to the thalamus in the group with lacunes and white matter changes without dementia (lacunar stroke; LS). This suggests that global loss of vasoreactivity is not a determining factor in the occurrence of MID, but might be important in LD. The present study shows that loss of the vascular reserve leading to exhausted metabolic reserve of the whole brain is one of the possible mechanisms for the occurrence of vascular dementia.
Assuntos
Acetazolamida/farmacologia , Circulação Cerebrovascular/efeitos dos fármacos , Demência Vascular/diagnóstico por imagem , Tomografia Computadorizada de Emissão , Vasodilatadores/farmacologia , Sistema Vasomotor/efeitos dos fármacos , Idoso , Idoso de 80 Anos ou mais , Amônia , Isquemia Encefálica/complicações , Isquemia Encefálica/diagnóstico por imagem , Demência por Múltiplos Infartos/diagnóstico por imagem , Demência por Múltiplos Infartos/etiologia , Demência por Múltiplos Infartos/fisiopatologia , Demência Vascular/etiologia , Demência Vascular/fisiopatologia , Feminino , Humanos , Masculino , Microcirculação/efeitos dos fármacos , Pessoa de Meia-Idade , Radioisótopos de Nitrogênio , Fatores de Risco , Vasodilatação/efeitos dos fármacos , Sistema Vasomotor/fisiopatologiaRESUMO
OBJECTIVES: The authors assessed the feasibility and construct validity of the contingent valuation method for measuring the monetary value to healthy enrollees in a health maintenance organization of a new drug, filgrastim, as prophylaxis against febrile neutropenia after chemotherapy treatment for cancer. METHODS: A random sample of 220 enrollees from a closed-panel staff-model health maintenance organization who did not have cancer were interviewed. Chemotherapy, febrile neutropenia and filgrastim were described by video and decision board. Questions were asked in two different scenarios: (1) User-based: Assuming they were at the point of consumption and about to receive chemotherapy, what is the maximum they would be willing to pay to receive filgrastim? and (2) Insurance-based: Given they were at risk of cancer in the future, what is the maximum they would be willing to pay in additional monthly insurance premiums to add filgrastim to the plan? In a second insurance scenario where respondents were told that filgrastim was covered, what is the minimum reduction in premium that persons were willing to accept to relinquish coverage of the drug? A 2 x 2 factorial design was used to contrast two bidding algorithms to test for starting point bias and two 5-yearly prior risks of cancer, 1/200 versus 1/100. Main effects were tested by ANCOVA controlling for age, sex, health, and income. RESULTS: Demographics of experimental cells were similar. No evidence was found of significant starting point bias. For user-based questions, as expected, willingness-to-pay increases with febrile neutropenia risk reduction, but at a declining marginal rate. Despite careful presentation of information to respondents, willingness-to-pay for insurance was higher in the lower prior risk group. Consistent with previous contingent valuation studies, the authors of the present study found evidence that willingness-to-accept exceeds willingness-to-pay for coverage of the same benefit. CONCLUSIONS: An insurance-based contingent valuation study is feasible in a health maintenance organization. Construct validation evidence was encouraging, with the exception of the test for prior risk of cancer; however, this was a between-person contrast and may have been confounded by other factors.
Assuntos
Fator Estimulador de Colônias de Granulócitos/economia , Sistemas Pré-Pagos de Saúde/economia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adulto , Algoritmos , Análise de Variância , Atitude Frente a Saúde , Estudos de Viabilidade , Feminino , Febre/economia , Febre/prevenção & controle , Filgrastim , Financiamento Pessoal , Sistemas Pré-Pagos de Saúde/estatística & dados numéricos , Humanos , Masculino , Neutropenia/economia , Neutropenia/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Pennsylvania , Proteínas Recombinantes , Risco , Inquéritos e QuestionáriosRESUMO
A novel antifungal antibiotic GR135402 has been isolated from a fermentation broth of Graphium putredinis which inhibited protein synthesis in Candida albicans but not rabbit reticulocytes. The spectrum of activity included C. albicans and Cryptococcus neoformans but not some other Candida species or Aspergillus species. Therapeutic efficacy in a mouse model of systemic candidosis was attained following parenteral dosing.
Assuntos
Antifúngicos/química , Antifúngicos/isolamento & purificação , Fungos Mitospóricos/química , Compostos Policíclicos/química , Compostos Policíclicos/isolamento & purificação , Inibidores da Síntese de Proteínas/química , Inibidores da Síntese de Proteínas/isolamento & purificação , Animais , Antifúngicos/farmacologia , Aspergillus/efeitos dos fármacos , Candida albicans/efeitos dos fármacos , Fermentação , Camundongos , Testes de Sensibilidade Microbiana , Fungos Mitospóricos/classificação , Compostos Policíclicos/farmacologia , Inibidores da Síntese de Proteínas/farmacologiaRESUMO
We retrospectively collected data from one community managed care organization on all ambulatory care patients initially diagnosed with pneumonia or acute bronchitis from October, 1, 1992, to March 31, 1993, and from November 1, 1993, to January 31, 1994. We considered treatment to be successful when patients did not return for any related service within 15 days of initial diagnosis. We identified 2,490 episodes of illness, 85.7% which were acute bronchitis and 14.3% which were pneumonia. Overwhelmingly, physicians approached these conditions empirically (no diagnostic test); just 8.6% of patients had a diagnostic test during the 15-day episode of illness. Two-hundred twenty-nine of the episodes (9.2%) were apparently related to initial diagnoses, as they occurred during the 15-day period. More branded prescriptions (vs. generic) were dispensed during these related episodes. One patient was hospitalized and 19 patients used the emergency room either for first or subsequent visits. Empiric treatment is associated with effective diagnosis and therapy in ambulatory care patients with acute bronchitis and pneumonia. It remains unclear, however, if this strategy is the most cost-effective or if it leads to the most effective utilization of services.
Assuntos
Assistência Ambulatorial/normas , Bronquite/diagnóstico , Bronquite/tratamento farmacológico , Revisão de Uso de Medicamentos , Sistemas Pré-Pagos de Saúde/normas , Pneumonia/diagnóstico , Pneumonia/tratamento farmacológico , Doença Aguda , Adulto , Assistência Ambulatorial/estatística & dados numéricos , Antibacterianos/uso terapêutico , Criança , Cuidado Periódico , Sistemas Pré-Pagos de Saúde/estatística & dados numéricos , Pesquisa sobre Serviços de Saúde , Humanos , Pennsylvania , Padrões de Prática Médica , Estudos RetrospectivosRESUMO
The high plant diversity of mediterranean-climate regions has attracted much attention over the past few years. This review discusses patterns and determinants of local, differential and regional plant diversity in all five regions. Local diversity shows great variation within and between regions and explanations for these patterns invoke a wide range of hypotheses. Patterns of regional diversity are the result of differential speciation and extinction rates during the Quaternary. These rates have been influenced more by the incidence of fire and the severity of climate change than by environmental heterogeneity. All regions have a high number of rare and locally endemic taxa that survive as small populations, many of which are threatened by habitat transformation.
RESUMO
The objective of this study was to evaluate the clinical and economic effects of 2 clinical strategies for treating severe (grade II and above) erosive oesophagitis or poorly responsive gastro-oesophageal reflux disease. A single-blind, randomised controlled trial of up to 8 weeks' duration was undertaken comparing omeprazole with ranitidine plus metoclopramide in patients with severe and symptomatic erosive oesophagitis (endoscopic grade II and above). Two cost-effectiveness ratios were calculated: cost per healed patient and cost per symptom-free day. The study perspective was that of the payer or insurer of medical care. Healing rates were significantly higher among omeprazole-treated patients than among those who received ranitidine/metoclopramide at 4 weeks (68.5% vs 30.4%; p < 0.01) and overall (81.5% vs 45.7%; p < 0.01). Overall, mean gastrointestinal-related direct medical costs per healed patient were lower for the omeprazole group ($US189.60) than for the ranitidine/metoclopramide group ($US319.28). The incremental cost of an additional cure with omeprazole compared with ranitidine/metoclopramide was $US24.05. The overall average cost per symptom-free day was lower in the omeprazole group ($US7.88) than in the ranitidine/metoclopramide group ($US10.81). The incremental cost to obtain an additional symptom-free day with omeprazole, compared with ranitidine/metoclopramide, was $US1.41. In conclusion, superior efficacy at comparable cost is achieved by omeprazole compared with ranitidine/metoclopramide in the treatment of patients with severe erosive oesophagitis.
Assuntos
Antiulcerosos/economia , Antiulcerosos/uso terapêutico , Antieméticos/economia , Antieméticos/uso terapêutico , Esofagite/tratamento farmacológico , Esofagite/economia , Metoclopramida/economia , Metoclopramida/uso terapêutico , Omeprazol/economia , Omeprazol/uso terapêutico , Ranitidina/economia , Ranitidina/uso terapêutico , Análise Custo-Benefício , Método Duplo-Cego , Combinação de Medicamentos , Esofagoscopia , Humanos , Estudos ProspectivosRESUMO
OBJECTIVE: Changes in generic strategies in response to discontinuous environments have been relatively ignored in the management literature. This study reports an examination of the relationships between Porter's (1980) generic strategies, discontinuous environments, and performance. DATA SOURCES: Archival data for 1984 and 1988 were collected for 172 acute care hospitals in Florida in order to test these relationships. STUDY DESIGN: To examine fully the performance impact of changes in strategy in a discontinuous environment, a longitudinal research design that identified a firm's strategy at two points in time, 1984 and 1988, was used. PRINCIPAL FINDINGS: Results indicate that firms with a proper strategy environment fit performed the highest, firms that did not change their strategy had no change in performance, and firms that changed their strategy toward a proper strategy environment showed an increase in performance. CONCLUSION: Findings support the notion that hospitals with appropriate strategy-environment combinations will exhibit higher performance.