Skin and diabetes mellitus: what do we know?

Diabetes mellitus (DM) is becoming increasingly prevalent worldwide. Although major complications of this condition involve kidney, retina and peripheral nerves, the skin of diabetic patients is also frequently injured. Hence, interest is mounting in the definition of the structural and molecular profile of non-complicated diabetic skin, i.e., before injuries occur. Most of the available knowledge in this area has been obtained relatively recently and, in part, derives from various diabetic animal models. These include both insulin-dependent and insulin-resistant models. Structural work in human diabetic skin has also been carried out by means of tissue samples or of non-invasive methods. Indications have indeed been found for molecular/structural changes in diabetic skin. However, the overall picture that emerges is heterogeneous, incomplete and often contradictory and many questions remain unanswered. This review aims to detail, as much as possible, the various pieces of current knowledge in a systematic and synoptic manner. This should aid the identification of areas in which key questions are still open and more research is needed. A comprehensive understanding of this field could help in determining molecular targets for the prevention and treatment of skin injuries in DM and markers for the monitoring of cutaneous and systemic aspects of the disease. Additionally, with the increasing development of non-invasive optics-based deep-tissue-imaging diagnostic technologies, precise knowledge of cutaneous texture and molecular structure becomes an important pre-requisite for the use of such methods in diabetic patients.     

UV radiation: what we know and do we protect ourselves adequately?

Chronic sun exposure causes degenerative changes in the skin that are recognized as photoaging, immunosuppression and photocarcinogenesis. Sun is necessary for life, so total sun avoidance is impossible. Sun exposure during the first 15 years of life and blistering sunburns before age 20 have been linked to an increased risk of melanoma. Individuals who have outdoor lifestyles, live in sunny climates, and are lightly pigmented will experience the greatest degree of photoaging. In our study, performed four years ago, we have shown the knowledge of more than 4000 people about the effects of UV rays on the skin. The results show us that sun exposure is still exaggerated and uncontrolled due to the lack of knowledge about this topic. Encouraging photoprotection and improving the awareness of the general public about the harmful effects of too much sun exposure must be the leading preventative health strategy.     

Dying with dementia: what do we know about it?

Death with dementia is increasingly common, yet research on end of life with dementia and end-of-life care for such patients has been sparse. This article reviews recent studies in this area, most of which were done in US nursing homes. Research focused on five domains: prognosis, decision making, treatment, patient's health and suffering, and family's circumstances and satisfaction with care. Prognostication focused on developing risk scores for mortality within 6 months or a year, and while decision making was usually studied qualitatively, the other three domains were largely covered by a series of small, retrospective studies. Future direction in research is discussed, including the ongoing CASCADE project in Boston and the Dutch End of Life with Dementia Study (DEOLD). Both of these prospective studies in nursing home residents assess decision making, as well as factors associated with family's satisfaction and patient suffering. These studies will provide insight into interventions that are most likely to improve end of life care of patients with dementia in the respective countries and elsewhere.     

Mechanisms of tolerance to herbivore damage:what do we know?

Identifying mechanisms of tolerance to herbivore damage will facilitate attempts to understand the role of tolerance in the evolutionary and ecological dynamics of plants and herbivores. Investigations of the physiological and morphological changes that occur in plants in response to herbivore damage have identified several potential mechanisms of tolerance. However, it is unlikely that all physiological changes that occur following damage are tolerance mechanisms. Few studies have made direct comparisons between the expression of tolerance and the relative expression of putative mechanisms. I briefly review empirical evidence for some of the better-studied potential mechanisms, including increased photosynthetic activity, compensatory growth, utilization of stored reserves, and phenological delays. For each of these mechanisms I discuss reasons why the relationship between tolerance and these characters may be more complicated than it first appears. I conclude by discussing several empirical approaches, including herbivore manipulations, quantitative trait loci (QTL) analysis, and selection experiments, that will further our understanding of tolerance mechanisms. This revised version was published online in July 2006 with corrections to the Cover Date.     

Microplastics and freshwater microalgae: what do we know so far?

The constant entry of microplastics in several environmental matrices has been of great concern to the scientific community and to society in general, mainly due to the mysteries that surround the implications of this pollutant in the environment. Freshwater ecosystems are resources especially susceptible to variations in environmental quality, and the lack of data on the impacts caused by plastic fragments exacerbates the vulnerability of this environment. Considering the results of other studies, which demonstrate the increasing entry of polymeric fragments in the aquatic environment can lead to algae growth inhibition, an investigation was carried out to determine the current state of research on the interaction between microplastics and freshwater microalgae. In total, 20 scientific articles were analyzed. Different species were subjected to toxicological tests under controlled conditions in the laboratory with small microplastics (size range between 0.1 and 1000 µm), primary and secondary microplastics of different types of polymer. Four toxicity class of indicators were chosen to assess the microalgae response to exposure to microplastic in the selected studies: growth inhibition; photosynthetic activity; pigment analysis; and enzymatic activity and oxidative stress. In this review, a critical analysis is made on the effects of the shape, size, concentration, and duration of exposure to microplastics and research gaps are identified to guide future research priorities in this area of study.

     

Sexual selection and environmental change:what do we know and what comes next?

Anthropogenic environmental change is the most significant threat to biodiversity in the 21st century.Animal populations are experi-encing rapid changes in thei...     

The molecular ecology of biological invasions: what do we know about non-additive genotypic effects and invasion success?

Recent research suggests that non-additive genotypic effects may play an important role in the establishment success of invasive species. However, most empirical data for these inferences come from greenhouse experiments. Only recently has researchers tested non-additive genotypic effects and establishment success of invasive alien species under field conditions. Here we give a brief overview of this research and also carefully consider data from the first publication, to our knowledge, to report on non-additive genotypic effects on invasion success under field conditions. We identify some shortcomings in this important study and make suggestions for future research aimed at better understanding the contributions of non-additive genotypic effects to establishment success and invasion.     

Spatial dynamics in model plant communities: what do we really know?

A variety of models have shown that spatial dynamics and small-scale endogenous heterogeneity (e.g., forest gaps or local resource depletion zones) can change the rate and outcome of competition in communities of plants or other sessile organisms. However, the theory appears complicated and hard to connect to real systems. We synthesize results from three different kinds of models: interacting particle systems, moment equations for spatial point processes, and metapopulation or patch models. Studies using all three frameworks agree that spatial dynamics need not enhance coexistence nor slow down dynamics; their effects depend on the underlying competitive interactions in the community. When similar species would coexist in a nonspatial habitat, endogenous spatial structure inhibits coexistence and slows dynamics. When a dominant species disperses poorly and the weaker species has higher fecundity or better dispersal, competition-colonization trade-offs enhance coexistence. Even when species have equal dispersal and per-generation fecundity, spatial successional niches where the weaker and faster-growing species can rapidly exploit ephemeral local resources can enhance coexistence. When interspecific competition is strong, spatial dynamics reduce founder control at large scales and short dispersal becomes advantageous. We describe a series of empirical tests to detect and distinguish among the suggested scenarios.     

Habitat fragmentation and large-scale conservation: what do we know for sure?

We review the ecological effects of habitat fragmentation, comparing the theoretical approaches that have been taken to understanding it with the existing evidence from empirical studies. Theory has emphasized the spatial aspects of fragmentation and the role of dispersal among patches, and has generated interesting predictions such as a nonlinear relationship between the amount of remaining habitat and the probability of species persistence. However, while the few available large-scale empirical studies of fragmentation all tend to show that it has major effects, these documented effects tend to be relatively simple ones such as the degradation of habitat quality within fragments. There is good reason to be cautious of any claim that corridors or the spatial configuration of remaining habitat can compensate for the overall loss of habitat.
This is an invited Minireview on the occasion of the 50th anniversary of the Nordic Ecological Society Oikos.     

Measures to reduce population fragmentation by roads: what has worked and how do we know?

Roads impede animal movement, which decreases habitat accessibility and reduces gene flow. Ecopassages have been built to mitigate this but there is little research with which to evaluate their effectiveness, owing to the difficulty in accessing results of existing research; the lack of scientific rigor in these studies; and the low priority of connectivity planning in road projects. In this article, we suggest that the imperative for improving studies of ecopassage effectiveness is that road ecology research should be included from the earliest stages of road projects onwards. This would enable before-after-control-impact (BACI) design research, producing useful information for the particular road project as well as rigorous results for use in future road mitigation. Well-designed studies on ecopassage effectiveness could help improve landscape connectivity even with the increasing number and use by traffic of roads.     

Managing ecosystem services: what do we need to know about their ecology?

Human domination of the biosphere has greatly altered ecosystems, often overwhelming their capacity to provide ecosystem services critical to our survival. Yet ecological understanding of ecosystem services is quite limited. Previous work maps the supply and demand for services, assesses threats to them, and estimates economic values, but does not measure the underlying role of biodiversity in providing services. In contrast, experimental studies of biodiversity-function examine communities whose structures often differ markedly from those providing services in real landscapes. A bridge is needed between these two approaches. To develop this research agenda, I discuss critical questions and key approaches in four areas: (1) identifying the important 'ecosystem service providers'; (2) determining the various aspects of community structure that influence function in real landscapes, especially compensatory community responses that stabilize function, or non-random extinction sequences that rapidly erode it; (3) assessing key environmental factors influencing provision of services, and (4) measuring the spatio-temporal scale over which providers and services operate. I show how this research agenda can assist in developing environmental policy and natural resource management plans.     

From monkeys to humans: what do we now know about brain homologies?

Different primate species, including humans, have evolved by a repeated branching of lineages, some of which have become extinct. The problem of determining the relationships among cortical areas within the brains of the surviving branches (e.g. humans, macaque monkeys, owl monkeys) is difficult for several reasons. First, evolutionary intermediates are missing, second, measurement techniques are different in different primate species, third, species differ in body size, and fourth, brain areas can duplicate, fuse, or reorganize between and within lineages.     

Physician prescribing practices: What do we know? Where do we go? How do we get there?

Although drug prescribing is one of the most important components of medical care, little is known about how prescribing practices are determined and how they can be influenced. Enhancing the quality and effectiveness of drug prescribing requires research and better dissemination of information to physicians and other decision-makers. This requires a collaborative effort and a coordinated action plan. Participants at the Physician Prescribing Practices Workshop, held in Ottawa in October 1995, addressed issues and made recommendations in three areas: current knowledge and issues for research in the field of prescribing practices, and the capacity of Canadian databases to study these issues, strategies for disseminating and implementing knowledge and research findings to enhance the quality of prescribing; and the formation of a network to foster collaboration among stakeholders.