Estimating cultural benefits from surface water status improvements in freshwater wetland ecosystems

Freshwater wetlands provide crucial ecosystem services, though are subject to anthropogenic/natural stressors that provoke negative impacts on these ecosystems, services and values. The European Union Water Framework Directive aims to achieve good status of surface waters by 2015, through implementation of Catchment Management Plans. Implementation of Catchment Management Plans is costly, though associated benefits from improvements in surface water status are less well known. This paper establishes a functional relationship between surface water status and cultural ecosystem service values of freshwater systems. Hence, we develop a bio-economic valuation approach in which we relate ecological status and chemical status of surface waters (based on local physio-chemical and benthic macro-invertebrates survey data) to willingness-to-pay (using benefit-function transfer). Results for the Pateira de Fermentelos freshwater wetland (Portugal) show that the current status of surface waters is good from a chemical though only moderate from an ecological perspective. The current cultural ecosystem service value of the wetland is estimated at 1.54 m€/yr- increasing to 2.02 m€/yr in case good status of surface waters is obtained. Taking into account ecosystem services and values in decision making is essential to avoid costs from externalities and capture benefits from spill-overs--leading to more equitable, effective and efficient water resources management.

Alcohol and Youth in Portugal: An Intervention Through the Triangle Project

<p><strong>Keywords: </strong>Adolescent; Alcohol Drinking; Portugal.</p>

Tuberculosis is associated with non-tuberculosis-related deaths among HIV/AIDS patients in Rio de Janeiro

SETTING

Human immunodeficiency virus (HIV) infected patients followed in a large cohort in Rio de Janeiro, Brazil.

OBJECTIVE

To evaluate the association of tuberculosis (TB) and other covariables with non-TB-related (NTR) causes of death (CODs).

DESIGN

Patients aged >18 years were followed from 1997 to 2009, until death or 31 December 2009, whichever was earlier. CODs were ascertained using a standardised algorithm. TB diagnosis and prophylaxis followed Brazilian guidelines. Poisson models were used to calculate adjusted rate ratios (aRRs).

RESULTS

Of 2887 patients included in the study, 761 had TB (26.4%). NTR death rates were twice as high among patients with TB (4/100 vs. 2.09/100 patient-years). TB was associated with NTR deaths (aRR 1.4, 95%CI 1.05-1.86, P = 0.01). Highly active antiretroviral treatment (HAART) was protective against NTR (aRR 0.46, 95%CI 0.34-0.61, P < 0.001). Among patients who had never had active TB, prophylaxis was also protective against NTR (aRR 0.45, P = 0.04). The CD4 cell count increase was very modest for both TB and NTR CODs compared to those who did not die (0 vs. 249 cells, P < 0.001).

CONCLUSIONS

TB was significantly associated with increased NTR CODs, indicating rapid progression of disease and increased long-term risk of mortality, probably related to persistent immunodeficiency or incomplete immune recovery. Our results confirm the benefits of HAART and TB prophylaxis.

Current pain education within undergraduate medical studies across Europe: Advancing the Provision of Pain Education and Learning (APPEAL) study

OBJECTIVES

Unrelieved pain is a substantial public health concern necessitating improvements in medical education. The Advancing the Provision of Pain Education and Learning (APPEAL) study aimed to determine current levels and methods of undergraduate pain medicine education in Europe.

DESIGN AND METHODS

Using a cross-sectional design, publicly available curriculum information was sought from all medical schools in 15 representative European countries in 2012-2013. Descriptive analyses were performed on: the provision of pain teaching in dedicated pain modules, other modules or within the broader curriculum; whether pain teaching was compulsory or elective; the number of hours/credits spent teaching pain; pain topics; and teaching and assessment methods.

RESULTS

Curriculum elements were publicly available from 242 of 249 identified schools (97%). In 55% (133/242) of schools, pain was taught only within compulsory non-pain-specific modules. The next most common approaches were for pain teaching to be provided wholly or in part via a dedicated pain module (74/242; 31%) or via a vertical or integrated approach to teaching through the broader curriculum, rather than within any specific module (17/242; 7%). The curricula of 17/242 schools (7%) showed no evidence of any pain teaching. Dedicated pain modules were most common in France (27/31 schools; 87%). Excluding France, only 22% (47/211 schools) provided a dedicated pain module and in only 9% (18/211) was this compulsory. Overall, the median number of hours spent teaching pain was 12.0 (range 4-56.0 h; IQR: 12.0) for compulsory dedicated pain modules and 9.0 (range 1.0-60.0 h; IQR: 10.5) for other compulsory (non-pain specific) modules. Pain medicine was principally taught in classrooms and assessed by conventional examinations. There was substantial international variation throughout.

CONCLUSIONS

Documented pain teaching in many European medical schools falls far short of what might be expected given the prevalence and public health burden of pain.

Quasi-polaritons in Bose-Einstein condensates induced by Casimir-Polder interaction with graphene

We consider the mechanical coupling between a two-dimensional Bose-Einstein condensate and a graphene sheet via the vacuum fluctuations of the electromagnetic field which are at the origin of the so-called Casimir-Polder potential. By deriving a self-consistent set of equations governing the dynamics of the condensate and the flexural (out-of-plane) modes of the graphene, we can show the formation of a new type of purely acoustic quasi-particle excitation, a quasi-polariton resulting from the coherent superposition of quanta of flexural and Bogoliubov modes.

D2 dopamine receptor regulation of learning, sleep and plasticity

Dopamine and sleep have been independently linked with hippocampus-dependent learning. Since D2 dopaminergic transmission is required for the occurrence of rapid-eye-movement (REM) sleep, it is possible that dopamine affects learning by way of changes in post-acquisition REM sleep. To investigate this hypothesis, we first assessed whether D2 dopaminergic modulation in mice affects novel object preference, a hippocampus-dependent task. Animals trained in the dark period, when sleep is reduced, did not improve significantly in performance when tested 24h after training. In contrast, animals trained in the sleep-rich light period showed significant learning after 24h. When injected with the D2 inverse agonist haloperidol immediately after the exploration of novel objects, animals trained in the light period showed reduced novelty preference upon retesting 24h later. Next we investigated whether haloperidol affected the protein levels of plasticity factors shown to be up-regulated in an experience-dependent manner during REM sleep. Haloperidol decreased post-exploration hippocampal protein levels at 3h, 6h and 12h for phosphorylated Ca(2+)/calmodulin-dependent protein kinase II, at 6h for Zif-268; and at 12h for the brain-derived neurotrophic factor. Electrophysiological and kinematic recordings showed a significant decrease in the amount of REM sleep following haloperidol injection, while slow-wave sleep remained unaltered. Importantly, REM sleep decrease across animals was strongly correlated with deficits in novelty preference (Rho=0.56, p=0.012). Altogether, the results suggest that the dopaminergic regulation of REM sleep affects learning by modulating post-training levels of calcium-dependent plasticity factors.

TLR4 and TLR9 Polymorphisms Effect on Inflammatory Response in End-Stage Renal Disease Patients

Toll-like receptors (TLRs) play a key role in the response of innate and adaptive immune system to microbial and endogenous ligands. Inflammation is a common feature in end-stage renal disease (ESRD) patients; however, the mechanisms/factors triggering the inflammatory process are still poorly clarified. Our aim was to analyze the impact of the c.-1486T>C and c.896A>G polymorphisms in TLR9 and TLR4 genes, respectively, on the inflammatory response of ESRD patients. Clinical and laboratory evaluation was carried out on 184 ESRD patients. Polymerase chain reaction followed by restriction fragmens length polymorphisms (PCR-RFLP) was employed for genotyping of TLR-4 c.896A>G and TLR-9 c.-1486T>C polymorphisms. The prevalence of AA and AG of TLR4 c.896A>G polymorphism in ESRD patients was 97.8% and 2.2%, respectively. None of the individuals showed a homozygous TLR4 polymorphism. Concerning the TLR9 c.-1486T>C polymorphism, we found that ESRD patients showed a prevalence of TC and CC genotypes of 57.1% and 20.6%, respectively. We found that the heterozygous patients for the TLR4 c.896A>G polymorphism presented an increased level in lymphocyte count, a decrease in neutrophil/lymphocyte ratio and in serum levels of hepcidin. Regarding the TLR9 c.-1486T>C polymorphism, we found that it is associated with decreased white blood cell and neutrophil counts, ferritin and CRP serum levels, and with an increase in serum levels of creatinine. Our data suggest that the presence of the studied polymorphisms is associated with a decreased inflammatory response in ESRD patients under hemodialysis, and, thus its presence might have beneficial effects in ESRD patients. Moreover, our data provide new insights in the role of TLR polymorphisms in renal disease, which might have impact in the near future for the development of innovative therapies.

Uncommon aetiologies of chylothorax: superior vena cava syndrome and thoracic aortic aneurysm

BACKGROUND

Chylothorax, an uncommon cause of pleural effusion, results from the accumulation of lymph in the pleural space due to damage or obstruction of the thoracic duct. The high content of triglycerides and the presence of chylomicrons in the pleural fluid sets the diagnosis.

OBJECTIVE

To present a case report of a chylothorax due to superior vena cava compression or a thoracic aortic aneurysm, discuss the particularities, the investigation of chylothorax as well as its treatment options.

METHODS

A review of the literature on chylothorax was performed using PubMed to assess the different aetiologies, investigation and treatments usually performed.

CONCLUSION

Chylothorax is usually secondary to malignancy, trauma, congenital diseases and infections. However, less common causes are also described, as the ones described in our case report. The gold standard for diagnosis is the identification of chylomicrons in the pleural fluid. Conservative management is recommended in most cases of chylothorax.