Soil erosion after forest fires: evaluation of mitigation measures applied to drainage channels in the northwest of Portugal

The development and implementation of measures which promote the reduction of the impacts of forest fires on soils is imperative and should be part of any strategy for forest and soil preservation and recovery, especially considering the actual scenario of continuous growth in the number of fires and burnt area. Consequently, with the dendrocaustologic reality that has characterized the Portuguese mainland in recent decades, a research project promoted by the Center for the Study of Geography and Spatial Planning (CEGOT) was implemented with the objective of applying several erosion mitigation measures in a burned area of the Peneda-Geres National Park in NW Portugal. This paper therefore seeks to present the measures applied in the study area within the project Soil Protec, relating to triggered channel processes and the results of preliminary observations concerning the evaluation of the effectiveness of erosion mitigation measures implemented, as well as their cost/benefit ratio.

Sensing, uptake and response to c4-dicarboxylic acids in pseudomonas aeruginosa pao1

C4-dicarboxylates are one of the preferred carbon and energy sources for the growth of P. aeruginosa, a ubiquitous and metabolically versatile bacterium. However, despite their importance, C4-dicarboxylates sensing and uptake systems were poorly understood in P. aeruginosa and only little information was available in the literature. In our work, the C4-dicarboxylate transport (Dct) system in P. aeruginosa was found to be composed of a novel two-component system, called DctB/DctD, regulating together with the sigma factor RpoN the expression of two newly identified C4-dicarboxylate transporters: DctA and DctPQM. Inactivation of the dct A, dctB or dctD gene caused a growth defect of the strain in minimal media supplemented with succinate, fumarate or malate, indicating their major role in Dct. However, residual growth of the dctA mutant in these media suggested the presence of redundant C4-dicarboxylate transporter(s). Tn5 insertion mutagenesis of the kdctA mutant, combined with a screening for growth on succinate, led to the identification of a second Dct system, the DctPQM transporter, belonging to the tripartite ATP-independent periplasmic (TRAP) family of carriers. AdctAAdctPQM double mutant showed no growth on malate and fumarate albeit residual growth on succinate suggested that additional transporters for succinate are present. Competition experiments demonstrated that the DctPQM carrier was more efficient than the DctA carrier for the utilization of succinate at μΜ concentrations, whereas DctA was the major transporter at mM concentrations. For the first time, high- and low-affinity uptake systems for succinate (DctA and DctPQM) are reported to function co-ordinately to transport C4- dicarboxylates. Most probably, the presence of redundant uptake systems contributes to the versatility of this bacterium. Next, the regulation of the Dct system was investigated. While performing a parallel study about the carbon catabolite repression (CCR) phenomenon in P. aeruginosa, a link between the CCR cascade (CbrAB/CrcZ/Crc) and the Dct system was observed. Crc is a translational repressor acting when preferred carbon sources (like C4-dicarboxylates) are present. CrcZ is a small RNA acting as a functional antagonist of Crc and induced by the CbrA/CbrB two-component system when non preferred carbon sources (like mannitol) are utilized. Novel targets of the CbrAB/CrcZ/Crc system in P. aeruginosa were identified using transcriptome analysis; among them dctA and dctPQM were detected. CCR is regulating the dct transporter genes expression depending on the succinate concentrations in the medium of growth; this modulation of CCR is possible because, at the same time, succinate concentrations tune CCR. In a medium containing high succinate concentrations, CrcZ levels were low and therefore Crc inhibited the translation of mRNA targets. Whereas in a medium containing low succinate concentrations, the subsequent increase of CrcZ levels sequestered Crc, inhibiting its activity. This model shows for the first time that CCR possesses a feedback-based circuitry, a very important type of regulatory loop that confers the best adaptive response under changing environmental conditions. The expression of the dct transporter genes is also found to be regulated by the RNA chaperone protein Hfq. Hfq has the same post-transcriptional effect than Crc at high concentration of succinate, i.e. inhibiting dctP and dctR and indirectly favouring dctA expression. Moreover, an additional indirect positive regulation of dctP expression by Hfq was found. Finally, a metabolome approach was performed to investigate the internal signals modulating CCR via induction of CbrA activity in P. aeruginosa PAOl and P. putida KT2442. The results of the analysis are currently under study in the laboratory. - Les acides C4-dicarboxyliques font partie des sources de carbone et d'énergie préférés de P. aeruginosa, une bactérie versatile et ubiquitaire. Néanmoins, malgré leur importance, comment la présence des acides C4-dicarboxyliques dans le milieu est sentie par la bactérie et comment ils sont transportés dans la cellule chez P. aeruginosa n'étaient pas connus. De plus, peu d'informations sur ces procédés ont été répertoriées dans la littérature. Grace à notre travail, le système de transport des acides C4-dicarboxyliques (Dct) chez P. aeruginosa a pu être caractérisé. En effet, il est composé d'un nouveau système à deux composants, nommé DctB/DctD, qui régule, en combinaison avec le facteur sigma alternatif RpoN, l'expression des deux nouveaux transporteurs des acides C4-dicarboxyliques: DctA et DctPQM. L'inactivation des gènes dctA, dctB or dctD cause un défaut de croissance des souches mutantes dans un milieu minimum contenant du succinate, fumarate ou malate; confirmation de leur rôle dans le Dct. Cependant, une croissance résiduelle du mutant dctA dans ces milieux suggérerait une redondance des transporteurs d'acides Grdicarboxyliques. Une expérience de mutagenèse dans la souche AdctA, utilisant le transposon Tn5, combiné avec un criblage génétique sur la croissance dans le succinate, nous a permis d'identifier le deuxième transporteur DctPQM. DctPQM appartient à la famille des transporteurs TRAP (tripartite ATP-independent periplasmic). Un double mutant AdctAAdctPQM ne pousse pas dans du malate ou fumarate mais par contre présente une croissance résiduelle dans le succinate suggérant l'existence de transporteurs supplémentaires pour le succinate. En réalisant des expériences de compétitions nous avons démontré que le transporteur DctPQM est plus efficace que le transporteur DctA pour l'utilisation de succinate à une concentration de l'ordre du μΜ. Par contre, DctA est le transporteur le plus important pour une concentration de succinate de l'ordre du raM. Pour la première fois, deux systèmes de transport, un avec une forte- et un avec une faible-affinité (DctA et DctPQM) pour le succinate, sont coordonnés dans leur activité de transport des acides C4- dicarboxyliques, probablement contribuant à la versatilité de la bactérie. Ensuite, nous avons étudié la régulation du system Dct. En effectuant, en parallèle, une étude sur le phénomène de la répression catabolique (RC) chez P. aeruginosa, un lien entre la RC et le système Dct a été observé. La cascade des régulateurs formant la RC est composée de CbrA/CbrB, CrcZ et Crc. Crc est un répresseur traductionnel qui agit quand des sources de carbone préférées (comme les acides C4-dicarboxyliques) sont présentes dans le milieu. CrcZ est un petit ARN non-codant qui agit comme antagoniste de Crc. L'expression de CrcZ est induite par le système à deux composants CbrA/CbrB lorsque une source de carbone non-préférée est utilisée (comme le mannitol). Des nouvelles cibles du système CbrAB/CrcZ/Crc chez P. aeruginosa ont été identifiées grâce à une analyse du transcriptome des souches mutantes des régulateurs de la cascade. Parmi les cibles identifiées, les gènes dctA et dctPQM étaient présents. La RC régule l'expression des transporteurs dct en fonction de la concentration de succinate dans le milieu de croissance. Cette régulation est possible parce que, en même temps, les acides C4- dicarboxyliques régulent la RC. Dans un milieu contenant une grande concentration du succinate, le niveau d'expression de CrcZ est faible, donc Crc peut inhiber l'expression de ces ARN messagers cibles. Par contre, dans un milieu avec une faible concentration de succinate, l'augmentation de l'expression de CrcZ titre Crc et inhibe son activité. Ce modèle de régulation rétroactive est très important pour le phénomène de la RC, parce qu'il permet à la bactérie d'accorder une meilleure réponse à un changement environnemental. L'expression des gènes codant pour les transporteurs dct sont aussi régulés par la protéine chaperonne d'ARN Hfq. Hfq semble avoir le même effet traductionnelle que Crc, lorsqu'il y a une forte concentration de succinate. Nous avons ainsi observé une régulation négative de l'expression du gène dct Ρ et dctR, qui code pour un répresseur de la transcription de dctA. Nous avons aussi observé une régulation positive de la transcription de dctP par Hfq, probablement de façon indirecte. Enfin, une analyse du metabolome a était utilisée pour chercher les signaux internes modulant la RC et, en particulier, l'activité de la protéine senseur CbrA chez P. aeruginosa PAOl et P. putida KT2442. Les résultats de l'analyse sont en cours d'étude dans le laboratoire.

Meta-analysis of the effects of MI training on clinicians' behavior.

MI-based interventions are widely used with a number of different clinical populations and their efficacy has been well established. However, the clinicians' training has not traditionally been the focus of empirical investigations. We conducted a meta-analytic review of clinicians' MI-training and MI-skills findings. Fifteen studies were included, involving 715 clinicians. Pre-post training effect sizes were calculated (13 studies) as well as group contrast effect sizes (7 studies). Pre-post training comparisons showed medium to large ES of MI training, which are maintained over a short period of time. When compared to a control group, our results also suggested higher MI proficiency in the professionals trained in MI than in nontrained ones (medium ES). However, this estimate of ES may be affected by a publication bias and therefore, should be considered with caution. Methodological limitations and potential sources of heterogeneity of the studies included in this meta-analysis are discussed.

Linking bees and flowers: How do floral communities structure pollinator communities?

Pollinators provide essential ecosystem services, and declines in some pollinator communities around the world have been reported. Understanding the fundamental components defining these communities is essential if conservation and restoration are to be successful. We examined the structure of plant-pollinator communities in a dynamic Mediterranean landscape, comprising a mosaic of post-fire regenerating habitats, and which is a recognized global hotspot for bee diversity. Each community was characterized by a highly skewed species abundance distribution, with a few dominant and many rare bee species, and was consistent with a log series model indicating that a few environmental factors govern the community. Floral community composition, the quantity and quality of forage resources present, and the geographic locality organized bee communities at various levels: (1) The overall structure of the bee community (116 species), as revealed through ordination, was dependent upon nectar resource diversity (defined as the variety of nectar volume-concentration combinations available), the ratio of pollen to nectar energy, floral diversity, floral abundance, and post-fire age. (2) Bee diversity, measured as species richness, was closely linked to floral diversity (especially of annuals), nectar resource diversity, and post-fire age of the habitat. (3) The abundance of the most common species was primarily related to post-fire age, grazing intensity, and nesting substrate availability. Ordination models based on age-characteristic post-fire floral community structure explained 39-50% of overall variation observed in bee community structure. Cluster analysis showed that all the communities shared a high degree of similarity in their species composition (27-59%); however, the geographical location of sites also contributed a smaller but significant component to bee community structure. We conclude that floral resources act in specific and previously unexplored ways to modulate the diversity of the local geographic species pool, with specific disturbance factors, superimposed upon these patterns, mainly affecting the dominant species.

Role of nesting resources in organising diverse bee communities in a Mediterranean landscape

1. The habitat components determining the structure of bee communities are well known when considering foraging resources; however, there is little data with respect to the role of nesting resources. 2. As a model system this study uses 21 diverse bee communities in a Mediterranean landscape comprising a variety of habitats regenerating after fire. The findings clearly demonstrate that a variety of nesting substrates and nest building materials have key roles in organising the composition of bee communities. 3. The availability of bare ground and potential nesting cavities were the two primary factors influencing the structure of the entire bee community, the composition of guilds, and also the relative abundance of the dominant species. Other nesting resources shown to be important include availability of steep and sloping ground, abundance of plant species providing pithy stems, and the occurrence of pre-existing burrows. 4. Nesting resource availability and guild structure varied markedly across habitats in different stages of post-fire regeneration; however, in all cases, nest sites and nesting resources were important determinants of bee community structure.

Improved simulation of fire–vegetation interactions in the Land surface Processes and eXchanges dynamic global vegetation model (LPX-Mv1)

The Land surface Processes and eXchanges (LPX) model is a fire-enabled dynamic global vegetation model that performs well globally but has problems representing fire regimes and vegetative mix in savannas. Here we focus on improving the fire module. To improve the representation of ignitions, we introduced a reatment of lightning that allows the fraction of ground strikes to vary spatially and seasonally, realistically partitions strike distribution between wet and dry days, and varies the number of dry days with strikes. Fuel availability and moisture content were improved by implementing decomposition rates specific to individual plant functional types and litter classes, and litter drying rates driven by atmospheric water content. To improve water extraction by grasses, we use realistic plant-specific treatments of deep roots. To improve fire responses, we introduced adaptive bark thickness and post-fire resprouting for tropical and temperate broadleaf trees. All improvements are based on extensive analyses of relevant observational data sets. We test model performance for Australia, first evaluating parameterisations separately and then measuring overall behaviour against standard benchmarks. Changes to the lightning parameterisation produce a more realistic simulation of fires in southeastern and central Australia. Implementation of PFT-specific decomposition rates enhances performance in central Australia. Changes in fuel drying improve fire in northern Australia, while changes in rooting depth produce a more realistic simulation of fuel availability and structure in central and northern Australia. The introduction of adaptive bark thickness and resprouting produces more realistic fire regimes in Australian savannas. We also show that the model simulates biomass recovery rates consistent with observations from several different regions of the world characterised by resprouting vegetation. The new model (LPX-Mv1) produces an improved simulation of observed vegetation composition and mean annual burnt area, by 33 and 18% respectively compared to LPX.

A cross-country study on trade credit supply and financial crisis

O objetivo deste trabalho de pesquisa é investigar a oferta de crédito comercial durante períodos de crise financeira em seis países diferentes: Brasil, França, Alemanha, Itália, Espanha e Reino Unido, foram utilizadas informações de empresas de capital aberto entre 2000 e 2011. A literatura internacional documenta que durante o pico de crises financeiras a oferta de crédito comercial aumenta pois as companhias usam o crédito comercial como substituto e/ou complemento ao crédito bancário, apesar de após o momento de pico esta oferta diminui significantemente porque as empresas enfrentam problemas de liquidez causado por escassez de crédito. Mesmo que somente existam evidências pontuais de que a oferta de crédito comercial aumentou durante a crise financeira global de 2008, o efeito pós-crise é perceptível durante a crise Europeia de 2011, pois as empresas europeias diminuíram a oferta de crédito comercial, também evidenciando que estas companhias estavam confrontando problemas de administração de liquidez. Em relação ao uso de crédito comercial como ferramenta de transmissão de capital, nenhuma evidência foi encontrada para provar sua existência em tempo de crise financeira.

Acquisition of suture skills during medical graduation by instructor-directed training: A randomized controlled study comparing senior medical students and faculty surgeons

Due to shortage of time and limited availability of faculty surgeons to teach basic surgical skills during medical graduation, the search for alternative ways of simulated training with feedback is needed. The purpose of this study was to compare the simulated teaching of suture skills to novice medical students by senior medical students and by experienced faculty surgeons. Forty-eight novice medical students were randomly assigned to three practice conditions on bench model (n = 16): self-directed suture training (control), senior medical student-directed suture skills' training, or experienced faculty surgeon-directed suture skills' training. Pre- and post-tests were applied. Global Rating Scale with blinded evaluation and self-perceived confidence based on Likert scale were used to assess all suture performances in pre- and post-training. Effect size was also calculated. The analysis made after training showed that the students who received feedback from the instructors had better performance based on the Global Rating Scale (all p < 0.0000) and felt more confident to carry out sutures (all p < 0.0000) when compared to the control. There was no significant difference (all p > 0.05) between the student-directed teaching and faculty-directed teaching groups. The magnitude of the effect (instructor-directed training suture) was considered large (>0.80) in all measurements. The acquisition of suture skills after student-directed training was similar to the training supervised by faculty surgeon, and the increase in suture performances of trainees that received instructor administered training was superior to self-directed learning. © 2013 Springer-Verlag Italia.

Efeito da concentração subinibitória de amoxicilina e ciprofloxacino sobre alguns fatores relacionados à virulência de Staphylococcus aureus

Pós-graduação em Biociências e Biotecnologia Aplicadas à Farmácia - FCFAR

Efeitos do fogo recorrente na serrapilheira: consequências para artrópodes, decomposição e mineralização de carbono e nitrogênio em uma floresta de transição da Amazônia

Os artrópodes possuem uma importante função no ecossistema, pois participam da ciclagem de nutrientes, decomposição, trituração e mistura da serrapilheira. Os incêndios florestais, cada vez mais freqüentes na Amazônia, destroem a camada de serrapilheira e os artrópodes que nela vivem. O objetivo desta tese é investigar como o fogo recorrente atua sobre este processo, investigando a abundância e densidade de artrópodes de serrapilheira e as taxas de decomposição da matéria orgânica e a mineralização de C e N em uma floresta de transição da Amazônia no município de Querência, estado do Mato Grosso. Para tanto, uma parcela de 50 ha de floresta primária (500 x 1000 m) foi queimada experimentalmente a cada ano a partir de 2004, e outra área de mesmo tamanho foi mantida intacta para controle. Os artrópodes foram coletados aleatoriamente em 40 pontos distribuídos dentro da parcela, por meio de armadilhas de solo (“pitfalls”) e em 40 pontos sendo extraídos da serrapilhaira através de funis de Berlese. As coletas foram realizadas em fevereiro, abril (estação chuvosa), junho e agosto (estação seca) de 2007, após a terceira queima experimental anual. Os artrópodes foram analisados até o nível taxonômico de ordem e as formigas foram identificadas até gênero. O estudo de decomposição foi feito com 480 bolsas se serrapilheira distribuídas aleatoriamente, com 240 em cada parcela, quatro meses após a última queimada. As bolsas foram confeccionadas com malhas de nylon com aberturas de 2 mm (malha fina), e em metade delas foram feitos três orifícios de 1 cm² de cada lado, permitindo a entrada de macroartrópodes (malha grossa). Em cada bolsa foi inserido cerca de 10 g de folhas secas. A cada dois meses 30 bolsas de cada tipo de malha foi retirada de cada parcela, totalizando duas retiradas na estação seca e duas na estação chuvosa. As bolsas foram secas em estufa e pesadas novamente. A diferença entre peso seco inicial e final representou a taxa de decomposição. A cada retirada de um lote de bolsas de cada tipo de malha e de cada parcela, uma subamostra (10) destas bolsas foram selecionadas aleatoriamente para análises de análise de C e N das folhas. Os artrópodes apresentaram fortes diferenças sazonais. Na estação seca os colêmbolas ocorreram em menor abundância e as formigas ocorreram em maior abundância. Concomitantemente aos efeitos de sazonalidade, os artrópodes apresentaram diversas respostas ao fogo, com alguns grupos apresentando aumento e outros redução em abundância e densidade em diferentes datas pós-fogo, em comparação a floresta controle. Os ortópteros se destacaram por terem apresentado maior abundância em todas as datas pós-fogo em comparação a floresta controle. Em geral os macropredadores freduziram sua abundância e densidade após o fogo (formigas, besouros, dentre outros) e os engenheiros de ecossistema e decompositores foram mais abundantes (baratas, ácaros, dentre outros) em relação à floresta controle. As formigas também apresentaram diferenças entre as parcelas: maior diversidade e modificações na composição de gêneros durante a estação seca, pois o fogo favoreceu o aumento em abundância de formigas generalistas. As taxas de decomposição na parcela queimada foram menores do que na parcela controle, e as bolsas de malha fina com menores taxas de decomposição do que as bolsas de malha grossa. As taxas de C e N também foram diferentes entre as parcelas, e a razão C/N, na parcela queimada se manteve estável em todas as datas pós-fogo, enquanto na parcela controle houve declínio gradual durante o experimento seguindo as estações. Estes resultados indicam que o fogo modifica a fauna de serrapilheira, reduzindo diversas populações de artrópodes e modificando a composição deste grupo. As bolsas de malha fina indicam que a exclusão de macroartrópodes reduzem a taxa de decomposição da matéria orgânica e que os microartrópodes são mais prejudicados. O fogo também reduz o processo de mineralização de C e N já que a razão C/N se manteve estável na parcela queimada. Este estudo demonstra que o fogo recorrente tem forte efeito sobre artrópodes de serrapilheira e ciclagem de nutrientes em florestas de transição da Amazônia.

Efeitos do fogo sobre comunidades de aves no Pantanal Mato-Grossense

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

T-3 Rapidly Increases SLC2A4 Gene Expression and GLUT4 Trafficking to the Plasma Membrane in Skeletal Muscle of Rat and Improves Glucose Homeostasis

Background: Glucose transporter 4 (GLUT4) is highly expressed in muscle and fat tissue, where triiodothyronine (T-3) induces solute carrier family 2 facilitated glucose transporter member 4 (SLC2A4) gene transcription. T-3 was also shown to rapidly increase glucose uptake in myocytes exposed to cycloheximide, indicating that it might act nongenomically to regulate GLUT4 availability. We tested this hypothesis by evaluating, in thyroidectomized rats (Tx rats), the acute and/or chronic T-3 effects on GLUT4 mRNA expression and polyadenylation, protein content, and trafficking to the plasma membrane (PM) in skeletal muscle, as well as on blood glucose disappearance rate (kITT) after insulin administration. Methods: Rats were surgically thyroidectomized and treated with T-3 (0.3 to 100 mu g/100 g body weight) from 10 minutes to 5 days, and killed thereafter. Sham-operated (SO) rats were used as controls. Total RNA was extracted from the skeletal muscles (soleus [SOL] and extensorum digitalis longus [EDL]) and subjected to Northern blotting analysis using rat GLUT4 cDNA probe. Total protein was extracted and subjected to specific centrifugations for subcellular fractionation, and PM as well as microsomal (M) fractions were subjected to Western blotting analysis, using anti-GLUT4 antiserum as a probe. GLUT4 mRNA polyadenylation was examined by a rapid amplification of cDNA ends-poly(A) test (RACE-PAT). Results: Thyroidectomy reduced skeletal muscle GLUT4 mRNA, mRNA poly(A) tail length, protein content, and trafficking to the PM, as well as the kITT. The acute T-3 treatment rapidly (30 minutes) increased all these parameters compared with Tx rats. The 5-day T-3 treatment increased GLUT4 mRNA and protein expression, and restored GLUT4 trafficking to the PM and kITT to SO values. Conclusions: The results presented here show for the first time that, in parallel to its transcriptional action on the SLC2A4 gene, T-3 exerts a rapid post-transcriptional effect on GLUT4 mRNA polyadenylation, which might increase transcript stability and translation efficiency, leading to the increased GLUT4 content and availability to skeletal muscle, as well as on GLUT4 translocation to the PM, improving the insulin sensitivity, as shown by the kITT.

Local targeting of malignant gliomas by the diffusible peptidic vector 1,4,7,10-tetraazacyclododecane-1-glutaric acid-4,7,10-triacetic acid-substance p

PURPOSE: Malignant glial brain tumors consistently overexpress neurokinin type 1 receptors. In classic seed-based brachytherapy, one to several rigid (125)I seeds are inserted, mainly for the treatment of small low-grade gliomas. The complex geometry of rapidly proliferating high-grade gliomas requires a diffusible system targeting tumor-associated surface structures to saturate the tumor, including its margins. EXPERIMENTAL DESIGN: We developed a new targeting vector by conjugating the chelator 1,4,7,10-tetraazacyclododecane-1-glutaric acid-4,7,10-triacetic acid to Arg(1) of substance P, generating a radiopharmaceutical with a molecular weight of 1,806 Da and an IC(50) of 0.88 +/- 0.34 nmol/L. Cell biological studies were done with glioblastoma cell lines. neurokinin type-1 receptor (NK1R) autoradiography was done with 58 tumor biopsies. For labeling, (90)Y was mostly used. To reduce the "cross-fire effect" in critically located tumors, (177)Lut and (213)Bi were used instead. In a pilot study, we assessed feasibility, biodistribution, and early and long-term toxicity following i.t. injection of radiolabeled 1,4,7,10-tetraazacyclododecane-1-glutaric acid-4,7,10-triacetic acid substance P in 14 glioblastoma and six glioma patients of WHO grades 2 to 3. RESULTS: Autoradiography disclosed overexpression of NK1R in 55 of 58 gliomas of WHO grades 2 to 4. Internalization of the peptidic vector was found to be specific. Clinically, the radiopharmeutical was distributed according to tumor geometry. Only transient toxicity was seen as symptomatic radiogenic edema in one patient (observation period, 7-66 months). Disease stabilization and/or improved neurologic status was observed in 13 of 20 patients. Secondary resection disclosed widespread radiation necrosis with improved demarcation. CONCLUSIONS: Targeted radiotherapy using diffusible peptidic vectors represents an innovative strategy for local control of malignant gliomas, which will be further assessed as a neoadjuvant approach.

The influence of dosing schedules and cerebrospinal fluid bactericidal activity on the therapy of bacterial meningitis

Bacterial meningitis represents an infection in an area of impaired host defence. Optimal therapy of meningitis requires attaining bactericidal activity within cerebrospinal fluid (CSF). Studies in experimental animal models of meningitis suggest that maximal rates of bacterial killing in vivo and optimal cure rates are achieved when CSF antibiotic concentrations exceed the MBC of the test strain by greater than or equal to ten-fold. The results of clinical trials support this conclusion. In addition, a variable post-antibiotic effect occurs in-vivo after short periods of exposure to antimicrobial activity, thus maintaining therapeutic efficacy with intermittent dosage regimens. These basic principles of therapy are outlined in this review and serve as a basis for rational treatment regimens. For most antibiotics, the optimal dose, dosage interval, and duration of therapy for bacterial meningitis remain to be established.

Efficacy of psychological interventions for sexual dysfunction: a systematic review and meta-analysis

Sexual dysfunction is highly prevalent in the general population and associated with psychological distress and impaired sexual satisfaction. Psychological interventions are promising treatment options, as sexual dysfunction is frequently caused by and deteriorates because of psychological factors. However, research into the efficacy of psychological interventions is rather scarce and an up-to-date review of outcome studies is currently lacking. Therefore, we conducted a systematic review and meta-analysis of all available studies from 1980 to 2009 to examine the efficacy of psychological interventions for patients with sexual dysfunction. A total of 20 randomized controlled studies comparing a psychological intervention with a wait-list were included in the meta-analysis. The overall post-treatment effect size for symptom severity was d = 0.58 (95% CI: 0.40 to 0.77) and for sexual satisfaction d = 0.47 (95% CI: 0.27 to 0.70). Psychological interventions were shown to especially improve symptom severity for women with Hypoactive Sexual Desire Disorder and orgasmic disorder. Our systematic review of 14 studies comparing at least two active interventions head-to-head revealed that very few comparative studies are available with large variability in effect sizes across studies (d between -0.69 and 2.29 for symptom severity and -0.56 and 14.02 for sexual satisfaction). In conclusion, psychological interventions are effective treatment options for sexual dysfunction. However, evidence varies considerably across single disorders. Good evidence exists to date for female hypoactive sexual desire disorder and female orgasmic disorder. Further research is needed on psychological interventions for other sexual dysfunctions, their long-term and comparative effects.