Analysis on the effect of medical resource reallocation in the relocation project of a tertiary hospital / 中华医院管理杂志

Objective:To analyze the impact created by the reallocation of a tertiary hospital on the neurosurgery inpatients volume in the functional core area of Beijing as the capital city, for reference to improve the healthcare resource reallocation policy.Methods:The data were obtained from the data sheet of discharged patients and the monthly report of medical statistics in Beijing. The study analyzed the average monthly neurosurgery inpatients volume, surgical beds and bed utilization rate of secondary or higher level hospitals from the core area, a tertiary hospital(hospital A), and as well as three tertiary hospitals(hospitals B, C and D)within 5 kilometers of Hospital A original location before and after the reallocation of Hospitls A. Periods of November 2017 to August 2018 and November 2018 to August 2019 respectively serve as the time frame before and after the relocation of Hospital A.Results:After the reallocation, the average monthly total inpatients volume, inpatients volume from other places, and local inpatients volume of neurosurgery at secondary or higher level hospitals in the core area decreased from 2 238, 1 610 and 628 to 1 526, 996 and 530 respectively. The inpatients volume changes were all statistically different( P<0.001). The number of neurosurgery inpatients in Hospital A and Hospital B increased from 983 and 659 to 1 316 and 934 respectively, as well as the number of neurosurgery inpatients in Hospital C and Hospital D did not change much. After the relocation of Hospital A, the number of surgical beds in secondary or higher level hospitals in the core area was reduced from 5 213 to 4 782, while that of Hospital A increased from 557 to 750, while the other three tertiary hospitals remained unchanged. The changes of bed utilization rate of the 4 hosptials were all less than 7.00%. Conclusions:After the reallocation Hospital A, the neurosurgery inpatient volume in the core area decreased, which was mainly contributed by the decrease of patients from other places, suggesting a positive outcome by the reallocation of healthcare resources in Beijing. On the other hand, it is necessary to study the influence of alternative medical resources on the reallocation effect.

Changes of NCCa-ATP Channels in Core Area During Focal Cerebral Ischemia and Reperfusion in Rats / 昆明医科大学学报

Objective To study the changes of SUR1-regulated NCCa-ATP channels in core area during focal cerebral ischemia and reperfusion in rats, and to explore the therapeutic window of focal cerebral ischemia. Methods Adult male Wistar rats were rendered to undergo 120 minutes of the left middle cerebral artery occlusion (MCAO) by the intraluminal thread technique before reperfusion. The core area of the left hemisphere cortex ischemia/reperfusion at different times (reperfusion:R3 h, 6 h, 8 h, 12 h and 24 h) was taken to be tested the level of mRNA and protein expression of sulfonylurea receptor 1 (SUR1) using RT-PCR and Western-blot techniques. SUR1 of the ischemic brain microvascular endothelial cells were observed by immunofluorescence double staining at the peak expressing time point of SUR1. Results We found the up-regulation of SUR1 mRNA and SUR1 protein in ischemic infarcts tissues for R3 h, 6 h, 8 h and 12 h, peaked at R8 h, compared with the sham-operation group ( <0.05) . However, SUR1 expression increased was observed at R12 h by double immunofluorescence in microvascular endothelium. Conclusion SUR1-regulated NCCa-ATP channel may take part in cerebral ischemic damage during focal cerebral ischemia and reperfusion. The expressions of SUR1 mRNA and SUR1 protein were up-regulated in ischemic infarcts tissues. The data suggested that the best time to apply SUR1 inhibitor is within 8-12 hours after ischemia and reperfusion.

Forest structure of artificial islands in the Tucuruí dam reservoir in northern Brazil: a test core-area model / Estrutura da floresta em ilhas artificiais no reservatório da usina hidrelétrica de Tucuruí, Brasil: um teste do modelo de área nuclear

Construction of hydroelectric dams in tropical regions has been contributing significantly to forest fragmentation. Alterations at edges of forest fragments impact plant communities that suffer increases in tree damage and dead, and decreases in seedling recruitment. This study aimed to test the core-area model in a fragmented landscape caused by construction of a hydroelectric power plant in the Brazilian Amazon. We studied variations in forest structure between the margin and interiors of 17 islands of 8-100 hectares in the Tucuruí dam reservoir, in two plots (30 and >100m from the margin) per island. Mean tree density, basal area, seedling density and forest cover did not significantly differ between marginal and interior island plots. Also, no significant differences were found in liana density, dead tree or damage for margin and interior plots. The peculiar topographic conditions associated with the matrix habitat and shapes of the island seem to extend edge effects to the islands' centers independently of the island size, giving the interior similar physical microclimatic conditions as at the edges. We propose a protocol for assessing the ecological impacts of edge effects in fragments of natural habitat surrounded by induced (artificial) edges. The protocol involves three steps: (1) identification of focal taxa of particular conservation or management interest, (2) measurement of an "edge function" that describes the response of these taxa to induced edges, and (3) use of a "Core-Area Model" to extrapolate edge function parameters to existing or novel situations.

A construção de usinas hidrelétricas em regiões tropicais tem contribuído significativamente para a fragmentação da floresta. As alterações nas bordas de fragmentos florestais causam profundos impactos na comunidade de plantas, tais como, o aumento em de árvores mortas ou danificadas e a diminuição do recrutamento de plântulas. Este estudo tem como objetivo testar o modelo de área nuclear (core-area model) em uma paisagem de floresta fragmentada resultante da formação do lago da Usina Hidrelétrica de Tucucui na Amazônia. Foram medidas as variações na estrutura em 17 ilhas, com tamanhos variando de 8 a 100 hectares. Em cada ilha foram colocadas duas parcelas, a 1ª parcela a 30 metros da margem e a 2ª parcela a mais de 100 metros da margem da ilha. A densidade e a área basal de árvores, a densidade da regeneração natural e a cobertura do dossel da floresta não foram significativamente diferentes entre as parcelas da borda e do interior das ilhas. Também não foram encontradas diferenças significativas na densidade de lianas, no número de troncos mortos ou árvores danificadas entre as parcelas da borda e do interior das ilhas. A grande declividade do terreno das ilhas, a matriz circundante (água) e a forma irregular da ilhas podem ser os fatores responsáveis me provocar a extensão do efeito de borda em todas as ilhas analisadas, independente do tamanho e grau de isolamento. Nós propomos um novo protocolo para avaliar os impactos ecológicos dos efeitos de borda em fragmentos de habitat criados artificialmente. Este protocolo envolve três etapas: (1) identificação dos táxons biológicos de particular interesse de conservação ou de gestão (2) medição das das variáveis responsaveis pela resposta dos táxons induzidas pelo efeito de borda e (3) Usar o modelo de área nuclear (core area model) na extrapolação das variáveis medidas em situacões novas ou existentes.

Habitat use and home range of brown-nosed coati, Nasua nasua (Carnivora: Procyonidae) in the Brazilian Cerrado biome

The brown-nosed coati (Nasua nasua) is a carnivorous species found in all the Brazilian biomes, some of which are endangered areas. The aim of this work was to determine the habitat use and selection, home range and core area of N. nasua in the Cerrado biome, central region of Tocantins, Brazil. The study was carried out in an area of approximately 20 000ha from May 2000 to July 2002. A total of seven box traps were placed in the area for 13 months, three of 11 captured animals were followed and monitored by radio-tracking during 13 months. The monitoring was conducted once a day, three times a week using a car and walking through the study area (radio-tracking and visual contact). The results demonstrate that these three males used more frequently the gallery forest formation, followed by cerrado and wetlands. The use of gallery forest by these animals indicated an habitat selection (Proportion test, z=12.98, p< 0.01). Besides, adult males used the gallery forest more frequently (Fisher’s exact test, p<0.01) and wetlands less frequently (Fisher’s exact test, p<0.01) than juvenile males, without significant differences between animal ages for cerrado percentage of habitat use. Besides, results also showed a gallery forest selection by adult (Proportion test z= 13.62, p<0.01) and juvenile (Proportion test z=2.68, p<0.01) males, and a wetland selection by the juvenile male (Proportion test z=3.90, p<0.01). The home ranges varied from 2.20 to 7.55km² for the Minimum Convex Polygon 100% (MCP 100%) and from 4.38 to 13.32km² for the Harmonic Mean 95% (HM 95%). The smallest home range overlap occurred between the adult males (Nm1 and Nm3), and the greatest between the juvenile Njm2 and the adult Nm1. The average of the core area (HM 75%) for the three monitored animals represented 21.29% of the home range calculated with HM 95%. No overlap between core areas was observed for adult males, but, it was an overlap between the core area of the juvenile male and its band with that of the two adult males. The present study provides new data on core area size and frequency habitat use by adult and juvenile males of N. nasua in the Brazilian Cerrado, that may support conservation efforts. Rev. Biol. Trop. 58 (3): 1069-1077. Epub 2010 September 01.

El coatí Nasua nasua es una especie de prociónido que se distribuye en todos los biomas brasileños, algunos de los cuales son zonas amenazadas. Sin embargo, hay pocos estudios sobre el uso de hábitat, área de acción y centro de esta especie. En el bioma Cerrado de la región central de Tocantins, Brasil se determinó el uso y selección de hábitat, área de acción y centro de N. nasua. El estudio se llevó a cabo en un área de aproximadamente 20 000 has de mayo 2000 a Julio 2002. Durante 13 meses se colocaron en la zona siete trampas, tres de 11 animales capturados fueron seguidos y controlados por radio-seguimiento por un periodo de 13 meses. El monitoreo se llevó a cabo una vez al día, tres veces por semana, caminando por el área de estudio o en carro (radio-seguimiento y contacto visual). Los resultados del estudio demostraron que los tres individuos ocuparon más frecuentemente las formaciones de bosque de galería, seguido por cerrado y bosque húmedo. Las áreas de acción variaron entre 2.20 y 7.55km² para el polígono mínimo convexo (PMC), y de 4.38 a 13.32 para la media harmónica MH 95%. El área centro (MH 75%) fue equivalente a 21.29% del área de acción calculada para la media harmónica MH 95%. Este estudio provee información útil para los esfuerzos de conservación de la especie en el Cerrado brasileño, ya que proporciona nueva información sobre el tamaño del área centro y la frecuencia de uso de hábitat de dos machos adultos y un jóven de N. nasua.