Macrosystems ecology: Understanding ecological patterns and processes at continental scales

Macrosystems ecology is the study of diverse ecological phenomena at the scale of regions to continents and their interactions with phenomena at other scales. This emerging subdiscipline addresses ecological questions and environmental problems at these broad scales. Here, we describe this new field, show how it relates to modern ecological study, and highlight opportunities that stem from taking a macrosystems perspective. We present a hierarchical framework for investigating macrosystems at any level of ecological organization and in relation to broader and finer scales. Building on well-established theory and concepts from other subdisciplines of ecology, we identify feedbacks, linkages among distant regions, and interactions that cross scales of space and time as the most likely sources of unexpected and novel behaviors in macrosystems. We present three examples that highlight the importance of this multiscaled systems perspective for understanding the ecology of regions to continents

Elderly persons in a situation of dependence: informal caregiver stress and coping

Objective: Study the relationship between psychological (stress) and psychological (coping) of the informal caregiver of the elderly in a situation of dependence. Methods: Cross-sectional study involving a sample selected by convenience, of 110 informal caregivers of "Conselho de Faro", Portugal. Data was collected in the homes by application of four instruments to these caregivers (sociodemographic data, assessment of stress intensity; abbreviated scale of coping and Barthel's dependence assessment. Results: The coping strategies centered on the problem (Chi-square = 10.243, p <= 0.037) and on the medium (Chi-square = 9.574, p <= 0.048) were used by the informal caregivers of the more dependent elderly. However, strategies centered on the caregiver were those that generated less stress (beta = -0.378, p <= 0.000). Conclusion: The "coping strategies centered on the caregiver" are those that generate less perception of stress in the informal caregivers

Antimicrobial photodynamic therapy compared to systemic antibiotic therapy in non-surgical treatment of periodontitis: Systematic review and meta-analysis.

BACKGROUND: Periodontitis is one of the most prevalent inflammatory diseases in humans. It is associated with the presence of bacteria and is mediated by the host's immune response This study represents a systematic review and meta-analysis trying to answer the following question: "What is the effect of antimicrobial photodynamic therapy (aPDT) as an adjunct to scaling and root planing (SRP) compared to systemic antibiotic therapy with amoxicillin plus metronidazole (AMX+MTZ) on the non-surgical treatment of periodontitis?". METHODS: Clinical studies comparing aPDT with systemic use of AMX+MTZ were searched until January of 2020 using the databases: PubMed, MEDLINE, SCOPUS, EMBASE, Cochrane Central, Web of Science and Scielo, as well manual searches in related journals. Periodontal clinical parameters such as probing depth (PD), clinical attachment level (CAL) and bleeding on probing (BOP) were statistically analyzed. RESULTS: Five randomized clinical studies (RCTs) were included within the eligibility criteria, and served as a basis for qualitative and quantitative analyzes. All the studies reported an improvement in the clinical parameters with both therapies, although in a direct comparison, our analyzes did not find statistical differences that indicate the superiority of one supporting treatment in relation to the other. CONCLUSION: Although the limited number of RCTs and the great heterogeneity between them, it can conclude that aPDT presents similar clinical results compared to antibiotic therapy with AMX+MTZ as adjuvants in the non-surgical treatment of periodontitis

Miltefosine in the Treatment of Cutaneous Leishmaniasis Caused by Leishmania braziliensis in Brazil: A Randomized and Controlled Trial

Cutaneous leishmaniasis (CL) is characterized by skin ulcerations and occurs in rural poor areas of developing countries. It is treated with daily injections of antimony for 20 days, which is associated with irregular use and increasingly lower cure rates. Miltefosine is an oral medication with activity against the agent of CL (Leishmania). We have studied the efficacy and safety of miltefosine compared with antimony in patients with CL caused by Leishmania braziliensis in Bahia, Brazil. A total of 90 patients participated; 60 received miltefosine and 30 were treated with antimony. Six months after treatment, 75% of patients treated with miltefosine were cured, compared with 53% of the patients in the antimony group, a difference considered significant (p = 0.04). We also found that miltefosine was more effective than antimony in adults than in children. The incidence of side effects was similar with both drugs (76.7% vs. 78.3%), but all patients were able to finish the treatments. Our study shows that miltefosine is more effective than antimony for the treatment of CL in Bahia, Brazil and can contribute to the control of this disease due to its activity and easier administration

Irinotecan in patients with relapsed or cisplatin-refractory germ cell cancer: a phase II study of the German Testicular Cancer Study Group

Despite generally high cure rates in patients with metastatic germ cell cancer, patients with progressive disease on first-line cisplatin-based chemotherapy or with relapsed disease following high-dose salvage therapy exhibit a very poor prognosis. Irinotecan has shown antitumour activity in human testicular tumour xenografts in nude mice. We have performed a phase II study examining the single agent activity of irinotecan in patients with metastatic relapsed or cisplatin-refractory germ cell cancer. Refractory disease was defined as progression or relapse within 4 weeks after cisplatin-based chemotherapy or relapse after salvage high-dose chemotherapy with autologous stem cell support. Irinotecan was administered at a dose of 300 (−350) mg m−2 every 3 weeks. Response was evaluated every 4 weeks. Fifteen patients have been enrolled. Median age was 35 (19–53) years. Primary tumour localisation was gonadal/mediastinal in 12/3 patients. Patients had been pretreated with a median of six (4–12) cisplatin-containing cycles and 13 out of 15 patients had previously failed high-dose chemotherapy with blood stem cell support. Median number of irinotecan applications was two (1–3). Fourteen patients are assessable for response and all for toxicity. In one patient, no adequate response evaluation was performed. Toxicity was generally acceptable and consisted mainly of haematological side effects with common toxicity criteria 3° anaemia (two patients), common toxicity criteria 3° leukocytopenia (one patient) and common toxicity criteria 3° thrombocytopenia (three patients). Common toxicity criteria 3/4° non-haematological toxicity occurred in five patients (33%): 1×diarrhoea, 2×alopecia, 1×fever and in one patient worsening of pre-existing peripheral polyneuropathy from 1° to 4°. No response was observed to irinotecan therapy. Currently, 13 patients have died of the disease and two patients are alive with the disease. The patients included in our study exhibit similar prognostic characteristics as patients treated in previous trials evaluating new drugs in this setting. Irinotecan at a dose of 300–350 mg m−2 every 3 weeks appears to have no antitumour activity in patients with cisplatin-refractory germ cell cancer and, thus, further investigation in this disease is not justified

Effective Rheology of Bubbles Moving in a Capillary Tube

We calculate the average volumetric flux versus pressure drop of bubbles moving in a single capillary tube with varying diameter, finding a square-root relation from mapping the flow equations onto that of a driven overdamped pendulum. The calculation is based on a derivation of the equation of motion of a bubble train from considering the capillary forces and the entropy production associated with the viscous flow. We also calculate the configurational probability of the positions of the bubbles.Comment: 4 pages, 1 figur