Global financial donors have invested billions of dollars in "Sustainable Forest Management" to conserve forests and the ecosystem services they provide. A major contributing mechanism, community ...forest management (CFM), aims to provide global environmental benefits (reduce deforestation, maintain biodiversity), while also improving local human welfare (alleviate poverty). We have systematically reviewed available evidence of CFM effectiveness and consider the implications of our findings for future investment in CFM programs. There is evidence of CFM being associated with greater tree density and basal area but not with other indicators of global environmental benefits. We found no data on local human welfare amenable to meta-analysis. Poor study design, variable reporting of study methodology or context, and lack of common indicators make evidence synthesis difficult. Given the policy interest in and the planned donor expenditure on CFM, evaluation must be improved so that informed decisions can be made about appropriate investment in this approach.
Decision-makers need readily accessible tools to understand the potential impacts of alternative policies on forest cover and greenhouse gas (GHG) emissions and to develop effective policies to meet ...national and international targets for biodiversity conservation, sustainable development and climate change mitigation. Land change modelling can support policy decisions by demonstrating potential impacts of policies on future deforestation and GHG emissions. We modelled land change to explore the potential impacts of expert-informed scenarios on deforestation and GHG emissions, specifically CO2 emissions, in the Ankeniheny–Zahamena Corridor in eastern Madagascar. We considered four scenarios: business as usual; effective conservation of protected areas; investment in infrastructure; and agricultural intensification. Our results highlight that effective forest conservation could deliver substantial emissions reductions, while infrastructure development will likely cause forest loss in new areas. Agricultural intensification could prevent additional forest loss if it reduced the need to clear more land while improving food security. Our study demonstrates how available land change modelling tools and scenario analyses can inform land-use policies, helping countries reconcile economic development with forest conservation and climate change mitigation commitments.
We sought to investigate the role of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) in preventing the new onset of type 2 diabetes mellitus.
Diabetes is a ...public health problem of epidemic proportions and its prevalence is on the rise. The typical American born today has a one in three chance of developing type 2 diabetes. This diagnosis is associated with an adverse cardiovascular prognosis and is considered the risk equivalent of established coronary disease. Even in high-risk individuals, diabetes is a preventable disease. Several studies have shown that ACE inhibitors and ARBs decrease the incidence of new-onset type 2 diabetes. However, the exact role of these agents in diabetes prevention has not yet been fully elucidated.
We conducted a meta-analysis of 12 randomized controlled clinical trials of ACE inhibitors or ARBs, identified through a MEDLINE search and a review of reports from scientific meetings, to study the efficacy of these medications in diabetes prevention.
This showed that ACE inhibitors and ARBs were associated with reductions in the incidence of newly diagnosed diabetes by 27% and 23%, respectively, and by 25% in the pooled analysis.
The use of an ACE inhibitor or ARB should be considered in patients with pre-diabetic conditions such as metabolic syndrome, hypertension, impaired fasting glucose, family history of diabetes, obesity, congestive heart failure, or coronary heart disease.
Acetylcholine mediates its effects through both the nicotinic acetylcholine receptors (ligand-gated ion channels) and the G protein-coupled muscarinic receptors. It plays pivotal roles in a diverse ...array of physiological processes and its activity is controlled through enzymatic degradation by acetylcholinesterase. The effects of receptor agonists and enzyme inhibitors, collectively termed cholinomimetics, in antinociception/analgesia are well established. These compounds successfully inhibit pain signaling in both humans and animals and are efficacious in a number of different preclinical and clinical pain models, suggesting a broad therapeutic potential. In this review we examine and discuss the evidence for the therapeutic exploitation of the cholinergic system as an approach to treat pain.
In order to develop novel anticancer HDAC/tubulin dual inhibitors, a novel series of α-phthalimido-substituted chalcones-based hybrids was synthesized and characterized by IR,
H NMR,
C NMR, mass ...spectroscopy and X-ray analysis.
All the synthesized compounds were evaluated for their in vitro anticancer activity against MCF-7 and HepG2 human cancer cell lines using MTT assay. To explore the mechanism of action of the synthesized compounds, in vitro
-tubulin polymerization and HDAC 1 and 2 inhibitory activity were measured for the most potent anticancer hybrids. Further, cell cycle analysis was also evaluated.
The trimethoxy derivative
showed the most potent anticancer activity, possessed the most potent
-tubulin polymerase and HDAC 1 and 2 inhibitory activity and efficiently induced cell cycle arrest at both G2/M and preG1phases in the MCF-7 cell line.
Quantifying guideline-directed medical therapy (GDMT) intensity is foundational for improving heart failure (HF) care. Existing measures discount dose intensity or use inconsistent weighting.
The ...Kansas City Medical Optimization (KCMO) score is the average of total daily to target dose percentages for eligible GDMT, reflecting the percentage of optimal GDMT prescribed (range, 0-100). In Change the Management of Patients With HF, we computed KCMO, HF collaboratory (0-7), and modified HF Collaboratory (0-100) scores for each patient at baseline and for 1-year change in established GDMT at the time (mineralocorticoid receptor antagonist, β-blocker, ACE angiotensin-converting enzyme inhibitor/angiotensin receptor blocker/angiotensin receptor neprilysin inhibitor). We compared baseline and 1-year change distributions and the coefficient of variation (SD/mean) across scores.
Among 4532 patients at baseline, mean KCMO, HF collaboratory, and modified HF Collaboratory scores were 38.8 (SD, 25.7), 3.4 (1.7), and 42.2 (22.2), respectively. The mean 1-year change (n=4061) for KCMO was -1.94 (17.8); HF collaborator, -0.11 (1.32); and modified HF Collaboratory, -1.35 (19.8). KCMO had the highest coefficient of variation (0.66), indicating greater variability around the mean than the HF collaboratory (0.49) and modified HF Collaboratory (0.53) scores, reflecting higher resolution of the variability in GDMT intensity across patients.
KCMO measures GDMT intensity by incorporating dosing and treatment eligibility, provides more granularity than existing methods, is easily interpretable (percentage of ideal GDMT), and can be adapted as performance measures evolve. Further study of its association with outcomes and its usefulness for quality assessment and improvement is needed.
The binding motifs found in the crystal structures of protein−carbohydrate complexes have been successfully mimicked with simple acyclic pyridine- and pyrimidine-based receptors. A full discussion of ...the recognition motifs observed in the crystal structures of complexes of receptors 1 and 3 with glucopyranosides 4a and 4b is provided. A remarkable similarity of these motifs to those observed in the crystal structures of sugar-binding proteins and those found by molecular modeling is shown. In addition, the recognition properties of the new pyrimidine receptor 3 toward monosaccharides 4−6 are described. This molecule has been established as a highly effective receptor for β-glucopyranosides.
1. The abundance and distribution of a species are affected by processes which operate at multiple scales. Large-scale dynamics are increasingly recognized in conservation responses such as ...metapopulation management, transfrontier protected areas and softening the agricultural matrix. Landscape-scale monitoring is needed both to inform and judge their efficacy. In this Special Profile we address some of the challenges presented by monitoring at the landscape scale, how models of species distribution can be used to inform policy, and we discuss how monitoring at the global-scale could be approached. 2. Collecting data over a large area is inherently costly, so methods which can provide robust information at low-cost are particularly valuable. We present two papers which test low-cost approaches against more data-hungry methods (indices of abundance vs. direct density estimates, and species distribution models built from presence-only vs. presence/absence data). 3. Occupancy modelling is a useful approach for landscape-scale monitoring due to the relatively low-cost of collecting detection/non-detection data. We discuss challenges, such as non-random sampling locations and periodical unavailability for detection, in using detection/non-detection data for monitoring species distribution. Such data can also provide estimates of abundance and we show how existing models have been modified to allow the abundance of multiple species to be estimated simultaneously. 4. Models of species distribution can be used to project likely future scenarios and thus inform conservation planning where distributions are likely to change because of climate change or changing disturbance patterns. We also discuss how an optimization framework can be used to make efficient management decisions for invasive species management in the light of imperfect information. 5. Synthesis and applications. Monitoring is needed for many purposes including auditing past management decisions and informing future choices. Much monitoring data are collected at the site scale, although management authorities increasingly recognize landscape-scale dynamics. Recent global targets for conservation require monitoring which can report trends at the global-scale. Integrating data collected at a variety of scales to draw robust inference at the scale required is a challenge which deserves more attention from applied ecologists.
Health Status Identifies Heart Failure Outpatients at Risk for Hospitalization or Death
Paul A. Heidenreich, John A. Spertus, Philip G. Jones, William S. Weintraub, John S. Rumsfeld, Saif S. Rathore, ...Eric D. Peterson, Frederick A. Masoudi, Harlan M. Krumholz, Edward P. Havranek, Mark W. Conard, Randall E. Williams, for the Cardiovascular Outcomes Research Consortium
To test the hypothesis that the Kansas City Cardiomyopathy Questionnaire (KCCQ) provides prognostic information independent of other clinical data, we evaluated 505 heart failure (HF) patients who had an ejection fraction <40%. At 12 months, among patients with a KCCQ score <25, 37% had been admitted for HF and 20% had died, compared with 7% (admissions) and 5% (death) of those with a KCCQ score ≥75 (p < 0.0001 for both comparisons). In sequential multivariable models adjusting for clinical variables, six-minute walk, and B-type natriuretic peptide levels, the KCCQ score remained significantly associated with survival free of HF hospitalization.
We tested the hypothesis that one health status measure, the Kansas City Cardiomyopathy Questionnaire (KCCQ), provides prognostic information independent of other clinical data in outpatients with heart failure (HF).
Health status measures are used to describe a patient’s clinical condition and have been shown to predict mortality in some populations. Their prognostic value may be particularly useful among patients with HF for identifying candidates for disease management in whom increased care may reduce hospitalizations and prevent death.
We evaluated 505 HF patients from 13 outpatient clinics who had an ejection fraction <40% using the KCCQ summary score. Proportional hazards regression was used to evaluate the association between the KCCQ summary score (range, 0 to 100; higher scores indicate better health status) and the primary outcome of death or HF admission, adjusting for baseline patient characteristics, 6-min walk distance, and B-type natriuretic peptide (BNP).
The mean age was 61 years, 76% of patients were male, 51% had an ischemic HF etiology, and 5% were New York Heart Association functional class IV. At 12 months, among the 9% of patients with a KCCQ score <25, 37% had been admitted for HF and 20% had died, compared with 7% (HF admissions) and 5% (death) of those with a KCCQ score ≥75 (33% of patients, p < 0.0001 for both comparisons). In sequential multivariable models adjusting for clinical variables, 6-min walk, and BNP levels, the KCCQ score remained significantly associated with survival free of HF hospitalization.
A low KCCQ score is an independent predictor of poor prognosis in outpatients with HF.
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