Antiteuchus tripterus (Fabricius, 1787) (Heteroptera: Pentatomidae): First Record of This Native Stink Bug Damaging the Threatened Araucaria angustifolia in Brazil

This is the first report of Antiteuchus tripterus (Fabricius, 1787) (Heteroptera: Pentatomidae) damaging Araucaria angustifolia (Bertol.) Kuntze, 1898 (Pinales: Araucariaceae) plants in Brazil. This bug, native to the neotropical region, damaged this plant on fragments of mixed rain forest in Bueno Brandão, Minas Gerais state, Brazil. Araucaria angustifolia, native and with ecological and economic values, was widely used in the lumber market and, therefore, threatened with extinction. Nymphs and adults of A. tripterus were observed in March and April with a population reduction until June 2022. The bioecology and damage caused by A. tripterus on A. angustifolia are not known.

Understanding for whom, under what conditions, and how an integrated approach to atrial fibrillation service delivery works: a realist review

AIMS

To understand for whom, under what conditions, and how an integrated approach to atrial fibrillation (AF) service delivery works (or does not work).

METHODS AND RESULTS

A realist review of integrated approaches to AF service delivery for adult populations aged ≥18 years. An expert panel developed an initial programme theory, searched and screened literature from four databases until October 2022, extracted and synthesized data using realist techniques to create context-mechanism-outcome configurations for integrated approaches to AF service, and developed an integrated approach refined programme theory. A total of 5433 documents were screened and 39 included. The refined programme theory included five context-mechanism-outcome configurations for how clinical and system-wide outcomes are affected by the way integrated approaches to AF service delivery are designed and delivered. This review identifies core mechanisms underpinning the already known fundamental components of integrated care. This includes having a central coordinator responsible for service organization to provide continuity of care across primary and secondary care ensuring services are patient centred. Additionally, a fifth pillar, lifestyle and risk factor reduction, should be recognized within an AF care pathway.

CONCLUSION

It is evident from our provisional theory that numerous factors need to interlink and interact over time to generate a successfully integrated model of care in AF. Stakeholders should embrace this complexity and acknowledge that the learnings from this review are integral to shaping future service delivery in the face of an aging population and increased prevalence of AF.

Integrated soil-fruit-climate management system to improve apple production stability

Unstable agricultural systems, such as unreliable fruit production, threaten global food security and could negatively impact human nutrition. However, methods of maintaining a stable fruit supply have received little attention. Therefore, this study explored the impact of a systematic service model on the establishment of an integrated soil-fruit-climate management (ISM) approach and stabilization of apple yield based on a fixed-effects model using sample data from Fuji apple farmers in China for six consecutive years (2016-2021). The results showed that the systematic service model dramatically improved the adoption of ISM-based technology. By 2021, the rate of ISM technology adoption among farmers reached 84.4 %, especially pendulous branch-fruiting technology and Osmia pollination, which increased by 82.2 % and 37.8 %, respectively, compared to that in 2016. With the adoption of the ISM approach, apple yields and tree loadings stabilized over time. For example, the yield change rate and tree loading change rate were 14.8 % and 7.3 % lower, respectively, in 2021 than in 2016. We demonstrated through a fixed-effects analysis that the ISM approach exerts a fully mediated effect on the mechanism of action of service measure quantity disclosure, which positively impacted the rate of change in yield and tree loadings. This finding indicated that the six-in-one systematic service model of soil testing, pest and disease diagnosis, course training, meteorological monitoring, on-site guidance, and experimental demonstration established by the Science and Technology Backyard model resolved the information, goal, and hardware gaps that limited the adoption of this technology by farmers and promoted the construction of an integrated soil-fruit-climate management approach, which in turn has stabilized the apple production system.

Update on the state of research to manage Fusarium head blight

Fusarium head blight (FHB) is one of the most devastating diseases of cereal crops, causing severe reduction in yield and quality of grain worldwide. In the United States, the major causal agent of FHB is the mycotoxigenic fungus, Fusarium graminearum. The contamination of grain with mycotoxins, including deoxynivalenol and zearalenone, is a particularly serious concern due to its impact on the health of humans and livestock. For the past few decades, multidisciplinary studies have been conducted on management strategies designed to reduce the losses caused by FHB. However, effective management is still challenging due to the emergence of fungicide-tolerant strains of F. graminearum and the lack of highly resistant wheat and barley cultivars. This review presents multidisciplinary approaches that incorporate advances in genomics, genetic-engineering, new fungicide chemistries, applied biocontrol, and consideration of the disease cycle for management of FHB.

Tech-economic modeling and analysis of agricultural photovoltaic-water systems for irrigation in arid areas

Affected by the shortage of water resources and land degradation, the sustainable development of agriculture in more and more arid areas will face serious obstacles. The combinations of agricultural photovoltaic, water transportation and irrigation systems are considered as a potential choice to solve above problem. This study aims to investigate the competitiveness of various system configurations to transport water from water resource to agricultural irrigation systems driven by the output power of agricultural photovoltaic. Including the levelized cost of electricity and net present value, a comprehensive techno-economic assessment model is proposed to analyze the agricultural photovoltaic and irrigation systems in arid areas for six scenarios. The applicability of the proposed model in managing regional water and renewable energy nexus systems was tested through application to a real-world case study in the Gansu province, China. Assuming that the baseline transportation distance is 50 km, the results show that exporting water to farmland through electric water trucks shows the best economic performance with the net present value of 13.71 MU$, and every 10 km increase in the transportation distance can decrease the net present value by 1.32 MU$. An important finding is that when the transportation distance was greater than 100 km, pipeline transportation mode was more economical than electric water truck transportation mode. Finally, a sensitivity analysis was carried out to analyze the electricity and water prices, farmland size, photovoltaic efficiency on the economic performance of these systems. Results show that only when the electricity price was greater than 0.08 $/kWh, pipeline transport mode yielded positive benefits, and every 0.1$/m³ increase in the water price can increase the net present value by 0.2 MU$.

[Integrated management during the perinatal period for total anomalous pulmonary venous connection]

OBJECTIVES

To evaluate the clinical effectiveness of integrated management during the perinatal period for fetuses diagnosed with total anomalous pulmonary venous connection (TAPVC) by prenatal echocardiography.

METHODS

Clinical data of 64 cases of TAPVC fetuses diagnosed by prenatal echocardiography and managed with integrated perinatal care in Qingdao Women and Children's Hospital from January 2017 to December 2021 were retrospectively analyzed. Integrated perinatal care included multidisciplinary collaboration among obstetrics, fetal medicine, ultrasound, pediatric cardiology, pediatric anesthesia, and neonatology.

RESULTS

Among the 64 TAPVC fetuses, there were 29 cases of supracardiac type, 27 cases of intracardiac type, 2 cases of infracardiac type, and 6 cases of mixed type. Chromosomal analysis was performed in 42 cases, and no obvious abnormalities were found. Among the 64 TAPVC fetuses, 37 were induced labor, and 27 were followed up until term birth. Among the 27 TAPVC cases, 2 cases accepted palliative care, 2 cases were referred to another hospital for treatment and lost to follow-up, while the remaining 23 cases underwent primary repair surgery. One case died within 6 months after the operation due to low cardiac output syndrome, while the other 22 cases were followed up for (2.1±0.3) years with good outcomes (2 cases underwent a second surgery within 1 year after the first operation due to anastomotic stenosis or pulmonary vein stenosis).

CONCLUSIONS

TAPVC fetuses can achieve good outcomes with integrated management during the perinatal period.

Environmental performance of phytosanitary control techniques on soybean crop estimated by life cycle assessment (LCA)

Phytosanitary control is essential to ensure agricultural productivity and quality. However, approaches based on scheduled use of pesticides, overuse of harmful molecules produce impacts on different types of living organisms. Integrated Pest and Disease Management (IPM-IDM) may significantly reduce the burden of pesticides in the environment. Plant resistance may also be included in the IPM-IDM and even in conventional management due to little requirement of additional knowledge and changes in agricultural practices. Robust environmental assessments using methodology of universal use, life cycle assessment (LCA), may estimate the impacts of specific pesticides that cause major damages, including remarkable category impacts. Therefore the objective of this study was to determine the impacts and (eco)toxicological effects of phytosanitary strategies (IPM-IDM including or not lepidopteran resistant transgenic cultivars) vs. the scheduled approach. Two inventory modeling methods were also applied to gather information on the use and applicability of these methods. Life cycle assessment (LCA) was applied using two inventory modeling methods: 100%Soil and PestLCI (Consensus) using data from Brazilian croplands under tropical conditions, by combining phytosanitary approaches (IPM-IDM, IPM-IDM + transgenic cultivar, conventional, conventional + transgenic cultivar) and modeling methods. Hence, eight soybean production scenarios were established. The IPM-IDM was efficient to reduce the (eco)toxicity impacts of soybean production mainly for freshwater ecotoxicity category. Due to the dynamic character of IPM-IDM approaches, the inclusion of recently introduced strategies (plant resistant and biological control to stink bugs and plant fungal diseases) may diminish even more the principal impacting substances throughout the Brazilian croplands. The PestLCI Consensus method, although its development is yet in progress, to date can be suggested to estimate the agriculture environmental impacts more properly under tropical conditions.

Public authorities for transformative change: integration principle in public funding

Although science widely supports moving towards transformative change through integrating biodiversity into decision-making, and arguing for the essential role of public authorities, it falls short on suggesting specific means to that end. This article considers the EU's approach to fostering the green transition as part of its post-pandemic recovery while exploring how the integration of biodiversity considerations could be integrated into decision-making. The rationale and implementation of the EU's do no harm principle is examined, which functioned as a condition for public funds. The analysis shows the mentioned EU policy innovation has a very limited impact. The role of do no harm has been limited to validating, rather than initiating policy measures. It has failed to influence the design of measures such that they would benefit biodiversity and not encouraged synergies between the climate and biodiversity goals. Based on the experience with do no harm as well as the more focussed regulatory action directed at the goal of climate neutrality, the article lists key steps for fostering biodiversity integration in policy planning and policy implementation. These steps encompass substantive and procedural approaches and aim for deliberation, target-setting, tracking, verification and screening. There is considerable scope for robust regulation to play a role in support of the biodiversity goals alongside transformative bottom-up initiatives.

Water-climate change extended nexus contribution to social welfare and environment-related sustainable development goals in China

Climate change exacerbates uncertainties in water resource management, water supply, and treatment that are energy intensive and then exert great pressure on climate change mitigation; hence, interrelated and contradictory characteristics within the water-climate change (WC) nexus system are needed to be studied. The nexus thinking and coordination of WC would impact many realistic practices and assist in sustainable socioeconomic development since traditional single-target policies have sometimes been out of function. Hence, the ability to direct water production and use as well as climate change mitigation has become a hotspot recently. Furthermore, we find that there has been no complete research on reviewing the impacts of the WC nexus in different areas on the Sustainable Development Goals (SDGs). Hence, this paper builds a core nexus of WC and then analyzes those effects on social and environmental aspects in many areas, including sewage treatment, energy transition, waste treatment, land management, and ocean management. This paper discusses how WC interlinkages are utilized to realize SDGs in those areas. Moreover, uncertainties derived from exogenous hydrology, climate change, and anthropogenic endogenous systems for realistic problems appeal to gradually increasing concern. Finally, implications offer valuable guidelines for integrated management of water and carbon emissions, as well as sustainable socioeconomic development in the future.

Effects of different management practices on soil microbial community structure and function in alpine grassland

Management practices, such as grazing exclusion and reseeding, have been implemented to mitigate the degradation of grassland. Low grazing intensities and reseeding increase grass production. Nevertheless, few studies have investigated the effects of these measures on the soil microbial community structure and function in the Qinghai Tibetan Plateau (QTP). To reveal the effects of management practices on soil microbes and give a reference to assess and improve ecosystems functions, we here evaluated the impact of various types of grazing (exclusion, seasonal, and traditional), reseeding (annual oat (Avena fatua) grassland (RO) and perennial artificial grassland cultivated >10 y), and integrated restoration (weed control and no-tillage reseeding) measures on soil microbial community structure and function in the QTP. The Shannon-Wiener diversity indices were highest for prokaryotes under RO and for fungi under integrated grassland restoration. Relative Actinobacteria abundance was higher under seasonal grazing than that under integrated grassland restoration. The latter had relatively higher abundances of Betaproteobacteria, Alphaproteobacteria, and Deltaproteobacteria and comparatively lower abundance of Thermoleophilia. There were significantly higher abundances of plant pathogens under seasonal grazing than those under other managements. There were significantly high proportions of pathotrophs and saprotrophs (10.0%) under seasonal and traditional grazing, respectively. The proportion of pathotrophs under integrated restoration (10.0%) was about seven-fold greater than that under grazing exclusion (1.5%). The relative differences among treatments in terms of soil water content, plant biomass, and soil C:N partially explained the differences in their prokaryotic community compositions. Increases in soil organic carbon and C:N may explain the observed changes in the soil fungal communities. The management practices affected soil microorganisms mainly by altering the soil nutrient profile. Grazing attracted specific pathotrophs and saprotrophs while repelling certain plant pathogens. Hence, modulations in soil microbial community structure and function must be considered in the process of planning for the implementation of grassland degradation management measures.

Challenges in Providing Care for Patients with Chronic Diseases during Disasters: A Qualitative Study with Focus on Diabetes and Chronic Respiratory Diseases in Iran

Background

Non-communicable diseases are of the major health challenges and the leading cause of death in Iran and at the global level. Moreover, Iran is a disaster-prone country and considering the exacerbation of diabetes and chronic respiratory diseases in natural disasters, its healthcare system is facing challenges. This study was designed to explore challenges in providing healthcare services to patients with diabetes and chronic respiratory diseases during disasters in Iran.

Materials and Methods

The conventional content analysis is used in this qualitative study. Participants included 46 patients with diabetes and chronic respiratory diseases, and 36 of stakeholders were experienced and had theoretical knowledge. Participants' selection started by means of purposive sampling and continued to the point of data saturation. Data collection was carried out employing semi-structured interviews. Data analysis was performed using Graneheim and Lundman method.

Results

Based on participants' experiences, four major challenges in providing care to patients with diabetes and chronic respiratory diseases during natural disasters include integrated management (with three subcategories: control and supervision, patient data management, volunteer management), physical, psychosocial health (with three subcategories: psychological impacts, exacerbation of signs and symptoms, special patient characteristics), health literacy and the behavior (with three subcategories: risk perception, values and beliefs, education and awareness) and barriers to healthcare delivery (with three subcategories: facilities and human resources, financial and living problems and insurances, accessibilities and geographic access).

Conclusion

Developing countermeasures against medical monitoring system shutdown in order to detect medical needs and problems faced by chronic disease patients including those with diabetes and chronic obstructive pulmonary disease (COPD), is essential in preparedness for future disasters. Developing effective solutions may result in improved preparedness and better planning of diabetic and COPD patients for disasters, and potentially promote health outcomes during and after disasters.

Adaptive management of environmental challenges in West African coastal lagoons

Human activities in coastal lagoons over several decades have had a significant impact on their ecology and the valuable ecosystem services they provide. Although there are several management approaches to mitigate the problem, they are unable to link human needs and activities with changes in the state of the environment. This research provides this link via assessment of eleven lagoons in Ghana with a socio-ecological framework (Drivers (D), Activities (A), Pressure (P), State (S), Impact (I) on welfare (W), and Response (R) as a Measure (M); DAPSI(W)R(M)). Data were systematically obtained from relevant publications, previously conducted research, and national reports on the subject and were analyzed using this socio-ecological framework. Results show that basic biological and physiological needs such as food and shelter, social status and dominance, financial self-reliance, and self-actualization are the drivers of fishing, farming, settlements, salt mining, mangrove harvesting, industries, among others. These activities have contributed to pressures of selective extraction of fish and mangroves species, the introduction of heavy metals, organic materials, and smothering of substrates, consequently altering the environment by decreasing the oxygen rate and increasing the biochemical oxygen demand, organic matter, nutrients and pathogens, and reduction in lagoon areas and biodiversity. Thus, ultimately impacting human welfare, such as loss of revenue, employment, and seafood provision. Management options, including addressing the building and fuelwood material sources, afforestation and community ownership of lagoons, the prohibition of construction activities, and research-led management that can support decision-makers to improve the sustainability of these ecosystems, are highlighted. The findings have global implications for guiding local planners and state regulators in the applications of such integrated environmental management.

Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry

BACKGROUND

Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The 'Atrial fibrillation Better Care' (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We aim to determine the impact of ABC pathway in a contemporary cohort of clinically complex AF patients.

METHODS

From the ESC-EHRA EORP-AF General Long-Term Registry, we analysed clinically complex AF patients, defined as the presence of frailty, multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on major outcomes was analysed through Cox-regression analyses and delay of event (DoE) analyses.

RESULTS

Among 9966 AF patients included, 8289 (83.1%) were clinically complex. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.72, 95%CI 0.58-0.91), major adverse cardiovascular events (MACEs; aHR: 0.68, 95%CI 0.52-0.87) and composite outcome (aHR: 0.70, 95%CI: 0.58-0.85). Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.74, 95%CI 0.56-0.98) and composite outcome (aHR: 0.76, 95%CI 0.60-0.96) also in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all the outcomes investigated in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the number needed to treat for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome.

CONCLUSIONS

An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes among clinically complex AF patients.

Heterorhabditis amazonensis to Control Euschistus heros (Hemiptera: Pentatomidae) in Laboratory and Field Conditions

This study evaluated the potential of entomopathogenic nematodes (EPNs) to control Euschistus heros (Fabricius) under laboratory and field conditions. Eight isolates of the species Heterorhabditis amazonensis were evaluated on field-collected and laboratory-reared insect populations. The isolates that performed best in the virulence test were evaluated for in vivo production on Galleria mellonella Fabricius larvae. Then, these were evaluated in field conditions on E. heros from the laboratory and field populations. The isolates IBCB-n46, NEPET11, and IBCB-n40 caused the highest mortality in adult E. heros from laboratory rearing (100, 94, and 80%, respectively), and IBCB-n46 and NEPET11 were the best against the field population (71 and 47% mortality, respectively). In the assay to evaluate production, the isolate IBCB-n46 achieved the best result (3.4 × 10⁵ IJs/g per larvae), followed by isolates UEPN05 (1.4 × 10⁵ IJs/g per larvae) finally NEPET11 (7.5 × 10⁴ IJs/g per larvae). In the assay in field conditions, all treatments differed from the control treatment, no significant differences were observed in the evaluated factors (isolates and insect populations), and the highest percentage of mortality was obtained by the UEPN05 isolate when applied to insects from the laboratory (18.57% mortality).

Safeguarding marine life: conservation of biodiversity and ecosystems

Marine ecosystems and their associated biodiversity sustain life on Earth and hold intrinsic value. Critical marine ecosystem services include maintenance of global oxygen and carbon cycles, production of food and energy, and sustenance of human wellbeing. However marine ecosystems are swiftly being degraded due to the unsustainable use of marine environments and a rapidly changing climate. The fundamental challenge for the future is therefore to safeguard marine ecosystem biodiversity, function, and adaptive capacity whilst continuing to provide vital resources for the global population. Here, we use foresighting/hindcasting to consider two plausible futures towards 2030: a business-as-usual trajectory (i.e. continuation of current trends), and a more sustainable but technically achievable future in line with the UN Sustainable Development Goals. We identify key drivers that differentiate these alternative futures and use these to develop an action pathway towards the desirable, more sustainable future. Key to achieving the more sustainable future will be establishing integrative (i.e. across jurisdictions and sectors), adaptive management that supports equitable and sustainable stewardship of marine environments. Conserving marine ecosystems will require recalibrating our social, financial, and industrial relationships with the marine environment. While a sustainable future requires long-term planning and commitment beyond 2030, immediate action is needed to avoid tipping points and avert trajectories of ecosystem decline. By acting now to optimise management and protection of marine ecosystems, building upon existing technologies, and conserving the remaining biodiversity, we can create the best opportunity for a sustainable future in 2030 and beyond.

Safeguarding marine life: conservation of biodiversity and ecosystems

Marine ecosystems and their associated biodiversity sustain life on Earth and hold intrinsic value. Critical marine ecosystem services include maintenance of global oxygen and carbon cycles, production of food and energy, and sustenance of human wellbeing. However marine ecosystems are swiftly being degraded due to the unsustainable use of marine environments and a rapidly changing climate. The fundamental challenge for the future is therefore to safeguard marine ecosystem biodiversity, function, and adaptive capacity whilst continuing to provide vital resources for the global population. Here, we use foresighting/hindcasting to consider two plausible futures towards 2030: a business-as-usual trajectory (i.e. continuation of current trends), and a more sustainable but technically achievable future in line with the UN Sustainable Development Goals. We identify key drivers that differentiate these alternative futures and use these to develop an action pathway towards the desirable, more sustainable future. Key to achieving the more sustainable future will be establishing integrative (i.e. across jurisdictions and sectors), adaptive management that supports equitable and sustainable stewardship of marine environments. Conserving marine ecosystems will require recalibrating our social, financial, and industrial relationships with the marine environment. While a sustainable future requires long-term planning and commitment beyond 2030, immediate action is needed to avoid tipping points and avert trajectories of ecosystem decline. By acting now to optimise management and protection of marine ecosystems, building upon existing technologies, and conserving the remaining biodiversity, we can create the best opportunity for a sustainable future in 2030 and beyond.

Screening and mitigating major threats of regional development to water ecosystems using ecosystem services as endpoints

Coordinating the coercion of human activities to the ecosystem is a continuous strategic concern. A practical way to conceptualize socioeconomic development and link it to ecosystem response is urgently needed. This study proposed a two-staged method to reveal the threats concealed in socioeconomic development and show the return of water ecosystem services to regulation measures. Eight threat indexes referring to scale, structure and efficiencies of industrial, agriculture and domestic sectors were designed to assess the threats caused by unsustainable development features, while four indexes for evaluating water supply, habitat provision, regulation and quality purification service of ecosystem were set up. For each threat index, the evaluation result is a relative value derived from comparison with a reasonable level. The major threats could be screened out by ranking threat indexes, so that unreasonable development dimension could be identified and subsequent regulation scheme be prepared. On this basis, with the targeted adjustment of socioeconomic development, corresponding improvements in water ecosystem could be expected and quantified. In the case study of Beijing-Tianjin-Hebei District, the most remarkable threats include production inefficiency of the industrial sector and oversized population, of which degrees of deviation from reasonable levels exceed 70%. When all development dimensions were dragged to the suggested levels, the habitat provision and water supply service would witness the largest progress among four services, with the values rising from 0.49 to nearly 1. This method helps discover the critical defect of socioeconomic development in terms of ecosystem response and facilitate the decision maker to establish more sustainable initiatives.

Effect of Ayurveda intervention in the integrated management of essential hypertension- a retrospective observational study

BACKGROUND

A study titled 'Integration of AYUSH (Ayurveda) with National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS)' implemented in India in three districts of three states, namely Bhilwara (Rajasthan), Gaya (Bihar), and Surendranagar (Gujarat) since 2015 for the management of various non-communicable diseases (NCDs) through integrated approach.

OBJECTIVE(S)

To evaluate the effect of Ayurveda medication, lifestyle modification, and Yoga in integration with standard care for the management of essential hypertension.

MATERIAL AND METHODS

A retrospective analysis of the demographic and clinical records available from NPCDCS-AYUSH Integration Project was done. The data of participants with Essential Hypertension (EHTN), aged between 30 and 60 years, who had completed six months integrated management as per the treatment protocol of the NPCDCS-AYUSH Integration project between July 2018 and March 2019 were taken and distributed in two groups based on their intervention. Those advised for lifestyle modification and Yoga in addition to standard care with any of the five medicines/combinations i.e. Amlodipine or Atenolol or Amlodipine + Atenolol or Losartan or Telmisartan were assigned Group I and those who were given Ayurveda medication, lifestyle modification and Yoga in addition to standard care were assigned to Group II. The change in blood pressure was analysed and dose reduction/discontinuation of conventional medications was also observed.

RESULTS

Data of 1938 participants who had completed treatment under the NPCDCS program was analysed. At the 6th month, systolic and diastolic blood pressure was significantly reduced (P < 0.01) in all categories of Group I and Group II from baseline. Further, the dose of conventional medicine was reduced in 33.1% of participants of Group I and in 30.4% participants of Group II when compared to 0 day while conventional medicines were discontinued in 15.1% of Group I and 36.7% of Group II participants.

CONCLUSION

Ayurveda medication along with lifestyle management and Yoga effectively controls systolic and diastolic blood pressure and further helps in reducing/discontinuation of dose of conventional medicines in EHTN participants.

Integration of biophysical connectivity in the spatial optimization of coastal ecosystem services

Ecological connectivity in coastal oceanic waters is mediated by dispersion of the early life stages of marine organisms and conditions the structure of biological communities and the provision of ecosystem services. Integrated management strategies aimed at ensuring long-term service provision to society do not currently consider the importance of dispersal and larval connectivity. A spatial optimization model is introduced to maximise the potential provision of ecosystem services in coastal areas by accounting for the role of dispersal and larval connectivity. The approach combines a validated coastal circulation model that reproduces realistic patterns of larval transport along the coast, which ultimately conditions the biological connectivity and productivity of an area, with additional spatial layers describing potential ecosystem services. The spatial optimization exercise was tested along the coast of Central Chile, a highly productive area dominated by the Humboldt Current. Results show it is unnecessary to relocate existing management areas, as increasing no-take areas by 10% could maximise ecosystem service provision, while improving the spatial representativeness of protected areas and minimizing social conflicts. The location of protected areas was underrepresented in some sections of the study domain, principally due to the restriction of the model to rocky subtidal habitats. Future model developments should encompass the diversity of coastal ecosystems and human activities to inform integrative spatial management. Nevertheless, the spatial optimization model is innovative not only for its integrated ecosystem perspective, but also because it demonstrates that it is possible to incorporate time-varying biophysical connectivity within the optimization problem, thereby linking the dynamics of exploited populations produced by the spatial management regime.

Social-ecological assessment of Lake Manyara basin, Tanzania: A mixed method approach

The social-ecological system of the Lake Manyara basin (Northern Tanzania), a UNESCO Biosphere reserve (BR) suffers from social-economic and environmental problems due to decreasing water levels, erosion and land and water use conflicts. We propose an integrated assessment of the social-ecological interactions of the area to support future sustainable management. Within the Drivers-Pressures-State-Impact-Response (DPSIR) framework an integrated literature review and several methods of knowledge collection were combined to identify future management priorities and challenges. During focus groups with farmers and pastoralists, stakeholders confirmed the role played by land use changes as driver and pressure in the landscape, e.g. through increased erosion rates and siltation of the lake. Moreover, economic and social issues were identified as prominent factors being influenced by, or influencing these processes. These statements match the scientific literature. During participatory mapping exercises different spatial and resource allocation perceptions appeared amongst pastoralists and farmers. The multidisciplinary approach proved to be useful to acquire an integrated and comprehensive understanding of the state, challenges and opportunities of Lake Manyara BR, to feed into a decision support system in service of an integrated management plan. Our assessment suggests that improved water governance in a multi-actor approach (with a focus on distribution of benefits, rights, and a specific role of the water authorities) should be a priority for future integrated management strategies. Also, awareness raising amongst decision makers, scientists and local communities is needed to demonstrate the advantages of an integrated approach. And finally, visible and fair mechanisms to share conservation revenues should be designed in a way that local benefits can be obtained together with incentive mechanisms for co-management and conservation.

Telemedicine for parkinsonism: A two-step model based on the COVID-19 experience in Milan, Italy

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Telehealth keeps patients with parkinsonism safe from traveling to in-person care site during the COVID-19 mitigation phase.

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During the COVID-19 crisis, a telemedicine program for patients with parkinsonism was boosted in Milan, Italy.

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This two-step model integrates a telenursing forward triage followed by video-consultations by experienced neurologists.

Using Socioenvironmental Report Cards as a Tool for Transdisciplinary Collaboration

The process of developing a socioenvironmental report card through transdisciplinary collaboration can be used in any system and can provide the foundation for collaborative solutions for sustainable resource management by creating a holistic assessment that balances environmental, economic, and social concerns that incorporates multiple perspectives from multisectoral actors. We demonstrated this in the Mississippi River watershed, USA with the ultimate goal of promoting holistic management of the region's natural resources. But working at the scale of the Mississippi River watershed presents the challenge of working across geographical, organizational, and disciplinary boundaries. The development of a socioenvironmental report card served as the focus for efforts to foster a shared vision among diverse stakeholders in the watershed and to promote transdisciplinary collaboration. The process engaged more than 700 participants from environment, flood control, transportation, water supply, economy, and recreation sectors, from more than 400 organizations representing local, state, and federal government agencies, businesses and trade associations, and private, nonprofit, and academic institutions. This broad engagement in the selection of important themes, indicators, measures, and assessment methods as part of the cocreation of boundary objects aimed to foster social and mutual learning and to develop common understanding and shared visioning among stakeholders with differing perspectives. The process was facilitated by boundary-spanning organizations, creating an atmosphere of trust by utilizing "third places" for knowledge exchange and integration. This transdisciplinary process also led to collective action through collaboration and selection of restoration and management activities that could improve conditions for multiple sectors simultaneously and/or recognize potential tradeoffs for informed decision making. Integr Environ Assess Manag 2020;16:494-507. © 2020 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Recovery of in-sewer dosed iron from digested sludge at downstream treatment plants and its reuse potential

Iron-based coagulants are dosed in enormous amounts and play an essential role in various segments of our urban water infrastructure. In order for the water industry to become circular, a closed-loop management strategy for iron needs to be developed. In this study, we have demonstrated for the first time that in-sewer dosed iron, either in the form of FeCl₃ or ferric-based drinking water sludge (Fe-DWS) as a means to combat sewer corrosion and odour, can be recovered in the form of vivianite in digested sludge in down-stream wastewater treatment plants. Importantly, about 92 ± 2% of the in-sewer dosed Fe was estimated to be bound in vivianite in digested sludge. A simple insertion of Neodymium magnet allowed to recover 11 ± 0.2% and 15.3 ± 0.08% of the vivianite formed in the digested sludge of the in-sewer dosed iron in the form of FeCl₃ and Fe-DWS, respectively. The purity of recovered vivianite ranged between 70 ± 5% and 49 ± 3% for in-sewer dosed FeCl₃ and Fe-DWS, respectively. Almost complete (i.e. 98 ± 0.3%) separation of Fe in the form of ferrihydrite was achieved from vivianite after alkaline washing. Subsequent batch experiments demonstrated that the recovered ferrihydrite can be directly reused for efficient sulfide control in sewers. At a ferrihydrite-Fe:S molar ratio of 1.2:1, sewage dissolved sulfide concentrations was reduced from 15 mgS/L to below 0.5 mgS/L within 1 h of reaction. Overall, the results obtained in our study flag a first step for utilities towards a closed-loop iron-based coagulant management approach.

Ectoparasites of Cattle

Diverse groups of ectoparasitic arthropods cause significant morbidity and mortality in most of the approximately 1.49 billion head of cattle worldwide. Hematophagous ectoparasites (ie, blood-feeding flies, myiasis-causing flies, lice, mites, ticks) are the most important in cattle. Intense use of ectoparasiticides to treat infestations can result in ectoparasite populations becoming resistant to this treatment method. Approaches integrating the use of different technologies are required to manage cattle ectoparasites effectively while addressing societal expectations regarding food safety and environmental health. Assessing the status of coparasitism with ectoparasites and endoparasites in cattle across agroecosystems is critical in advancing integrated parasite management.

Effect of essential oils of Mentha spicata L. and Melaleuca alternifolia Cheel on the midgut of Podisus nigrispinus (Dallas) (Hemiptera: Pentatomidae)

Agricultural pest control is a popular research topic, and essential oils are widely studied because they represent a promising alternative to synthetic insecticides. However, despite the increase in studies on pests, little work has been done on pesticide contamination of the predators feeding on insecticide-affected prey. Therefore, the objective of this study was to evaluate the effects of Lethal Dose 50 (LD₅₀) from the essential oils of Mentha spicata L. and Melaleuca alternifolia Cheel on the histology, including histochemistry (from protein and carbohydrate analysis) and immunohistochemistry (from the evaluation of cellular apoptosis), of the midgut of fifth instar nymphs of Podisus nigrispinus (stinkbug) (Dallas). The periods of analysis were 12, 24, and 48 h after ingestion of Alabama argillacea Hübner caterpillars treated with the respective oils. The oil from M. spicata did not cause histological alterations or apoptosis in the insect. However, there was a reduction in the level of carbohydrates within the 48-h period. After 24 h, the oil of M. alternifolia caused an elongation of digestive cells and, after 48 h, cell lysis with the release of material into the lumen, suggesting tissue necrosis. The immunohistochemical study revealed no apoptotic process. There was a reduction in the neutral carbohydrate levels in the 24- and 48-h periods and in the number of regenerative cells, when compared to the control, after the period of 48 h. These results demonstrate that M. spicata oil has potential for use in cotton fields because it does not affect the vital characteristics of P. nigrispinus. However, the essential oil of M. alternifolia is not suitable for use as a pesticide because it is extremely toxic to predators.

Opportunities for reducing coagulants usage in urban water management: The Oxley Creek Sewage Collection and Treatment System as an example

Iron and aluminium based coagulants are used in enormous amounts and play an essential role in urban water management globally. They are dosed at drinking water production facilities for the removal of natural organic matter. Iron salts are also dosed to sewers for corrosion and odour control, and at wastewater treatment plants (WWTPs) for phosphate removal from wastewater and hydrogen sulfide removal from biogas. A recent laboratory study revealed that iron dosed to sewers is available for phosphate and hydrogen sulfide removal in the downstream WWTP. This study demonstrates for the first time under real-life conditions the practical feasibility and effectiveness of the strategy through a year-long full-scale investigation. Over a period of 5 months, alum dosing at ∼190 kg Al/day to the bioreactor in a full-scale WWTP was stopped, while FeCl₂ dosing at ∼160 kg Fe/day in the upstream network was commenced. Extensive sampling campaigns were conducted over the baseline, trial and recovery periods to investigate sulfide control in sewers and its flow-on effects on phosphate in WWTP effluent, H₂S in biogas, as well as on the WWTP effluent hypochlorite disinfection process. A plant-wide mass balance analysis showed that the Fe²⁺ dosed upstream was effectively used for P removal in the activated sludge tanks, with an effluent phosphate concentration comparable to that in the baseline period (i.e. with alum dosing to the bioreactor). Simultaneously, hydrogen sulfide concentration in biogas decreased ∼43%, from 495 ± 10 to 283 ± 4 ppm. No effects on biological nitrogen removal and disinfection processes were observed. Both effluent phosphate and H₂S in biogas increased in the recovery period, when in-sewer dosing of FeCl₂ was stopped. X-ray diffraction failed to reveal the presence of vivianite in the digested sludge, providing strong evidence that thermal hydrolysis prevented the formation of vivianite during anaerobic digestion. The latter limits the potential for selective recovery of Fe and P through magnetic separation. Overall, our study clearly demonstrates the multiple beneficial reuse of iron in a real urban wastewater system and urges water utilities to adopt an integrated approach to coagulant use in urban water management.

Multi-host disease management: the why and the how to include wildlife

In recent years, outbreaks caused by multi-host pathogens (MHP) have posed a serious challenge to public and animal health authorities. The frequent implication of wildlife in such disease systems and a lack of guidelines for mitigating these diseases within wild animal populations partially explain why the outbreaks are particularly challenging. To face these challenges, the French Ministry of Agriculture launched a multi-disciplinary group of experts that set out to discuss the main wildlife specific concepts in the management of MHP disease outbreaks and how to integrate wildlife in the disease management process.

This position paper structures the primary specific concepts of wildlife disease management, as identified by the working group. It is designed to lay out these concepts for a wide audience of public and/or animal health officers who are not necessarily familiar with wildlife diseases. The group’s discussions generated a possible roadmap for the management of MHP diseases. This roadmap is presented as a cycle for which the main successive step are: step 1-descriptive studies and monitoring; step 2-risk assessment; step 3-management goals; step 4-management actions and step 5-assessment of the management plan. In order to help choose the most adapted management actions for all involved epidemiological units, we integrated a decision-making framework (presented as a spreadsheet). This tool and the corresponding guidelines for disease management are designed to be used by public and health authorities when facing MHP disease outbreaks. These proposals are meant as an initial step towards a harmonized transboundary outbreak response framework that integrates current scientific understanding adapted to practical intervention.

A Petri net modeling approach to explore the temporal dynamics of the provision of multiple ecosystem services

The representation of the temporal dynamics of ecosystem services (ES) is a crucial research frontier in the field of ES modeling. In fact, most current ES models focus on static ES assessments, that need to be repeated with different inputs per time step to explore potential changes in ES. Here, we present a new approach for the dynamic modeling of multiple ES, based on the Petri Net modeling framework. The key features are: (i) multiple ES are modeled together as a single network, using a social-ecological systems (SES) perspective; (ii) the model accounts for the interactions occurring among ES, by distinguishing between the ES whose provision is mediated by some type of human input, which can produce some side-effects on the system, and those that are generated directly through ecosystem functions and do not generate side-effects; (iii) the model can reproduce the effects of changing drivers on the elements of the SES. These features allow to use the model to explore how ES can evolve over time under different "what-if" scenarios. The importance of considering the ES interactions is tested, showing that failing to include them in the model remarkably affects the results. Due to its complexity, the model should be used as an exploratory tool, focusing on the analysis of the general trends of multiple ES provision, rather than on the generation of quantitative projections. A first conceptual application to the Venice lagoon, Italy, is presented, in which the trends of 13 different ES are simulated. This application shows the potential of the model in exploring the development produced by climate change and socio-economic pressures, and the effects of a set of possible management actions. This modeling approach can contribute to generate new perspectives on the dynamic modeling of multiple ES and on the integrated management of SES.

A new method to evaluate the vulnerability of watersheds facing several stressors: A case study in mediterranean Chile

Freshwater systems are subjected to multiple anthropogenic stressors and natural disturbances that act as debilitating agents and modifiers of river systems, causing cumulative and synergistic effects that deteriorate their health and result in watershed vulnerability. This study proposes an easy-to-apply spatial method of watershed vulnerability evaluation using Geographic Information Systems (GIS) in the Andalién River watershed, located in the Chilean mediterranean. A watershed vulnerability index (WVI) based on three sub-indices - anthropogenic stressors, environmental fragility and natural disturbances - was developed. To determine the index grouping weights, expert surveys were carried out using the Delphi method. We subsequently normalized and integrated the factors of each sub-index with relative weights. The ranges of each thematic layer were re-classified to establish vulnerability scores. The watershed was divided into three sections: headwaters zone, transfer zone and depositional zone. The watershed vulnerability index showed that 41% of the watershed had very low vulnerability and 42% had medium vulnerability, while only 1% - in the depositional zone - had high vulnerability. A one-way ANOVA was carried out to analyze the vulnerability differences among the three sections of the watershed; it showed significant differences (F (2, 16) = 8.15: p < 0.05). The a posteriori test showed differences between the headwaters and depositional zones (Tukey test, p = 0.005) and between the transfer and depositional zones (Tukey test, p = 0.014). To validate the WVI, water quality was measured at 16 stations in the watershed; there was a significant correlation between vulnerability level and NO₂^- levels (r = 0.8; p = 0.87; α = 0.05) and pH (r = 0.8; p = 0.80; α = 0.05). The WVI showed the cumulative effects of multiple stressors in the depositional zone of the watershed. This is the first study to evaluate and validate non-regulated watershed vulnerability with GIS using multiple anthropogenic and natural stressors.

Land aptitude for horticultural crops and water requirement determination under unsustainable water resources condition

Droughts and pressure on soil and water resources in arid climatic condition call for integrated managements of existing resources. In this research, the sustainability of water resources was analyzed and an agricultural land potential assessment and water demand determination model were proposed. The capabilities of the model were illustrated with sample results for basins at the Kurdistan Province, Iran. The long-term meteorological, climate, hydrometric, and synoptic data were analyzed. The climate zones and annual water potential at each basin were derived. Appropriate maps were extracted in GIS environment to assess the agricultural land capability and crop adaption. The data from synoptic stations was used to obtain crop water requirement by CROPWAT software and FAO guidelines. The results showed that the rainfall and runoff in the study area were affected by climate changes, and in some basins, result shows severe drop. The results of proposed model indicated that diversity and quality of lands with the potential for development in the study area were substantial, and the agricultural lands can be expanded hugely. Considering the unsustainability in water resources, the annual water rate of the basins cannot meet the water demands of land development. The proposed model provides an integrated framework for the application of water management strategies in integrated water resources management.

Oviposition deterrent activity of basil plants and their essentials oils against Tuta absoluta (Lepidoptera: Gelechiidae)

The leafminer Tuta absoluta Meyrick (Lepidoptera: Gelechiidae) is one of the most important pests of tomato, reducing crop yields by up to 100% in greenhouses and fields, in several countries globally. Because synthetic insecticides lead to resistance and have adverse effects on natural enemies and the health of producers, alternative control methods are needed. In this study, we assessed the oviposition-deterring effect of basil plants, Ocimum gratissimum L. and O. basilicum L. (Lamiaceae), using dual-choice behavioural assays performed in flight tunnels. We found that both plants significantly reduced T. absoluta oviposition behaviour on a tomato plant located nearby. To evaluate the potential effect of basil volatile organic compounds, we formulated essential oils of both plant species in paraffin oil, and observed a similar oviposition-deterring effect. Gas chromatography analyses detected 18 constituents in these essential oils which the major constituents included thymol (33.3%), p-cymene (20.4%), γ-terpinene (16.9%), myrcene (3.9%) in O. gratissimum and estragol (73.8%), linalool (8.6%), β-elemene (2.9%) and E-β-ocimene (2.6%) in O. basilicum. Twenty and 33 compounds were identified of the volatiles collected on O. gratissimum and O. basilicum plants, respectively. The main components include the following: p-cymene (33.5%), γ-terpinene (23.6%), α-terpinene (7.2%), α-thujene (6.7%) and E-α-bergamotene (38.9%) in O. gratissimum, and methyl eugenol (26.1%), E-β-ocimene (17.7%), and linalool (9.4%) in O. basilicum. Four compounds (α-pinene, β-pinene, Myrcene, Limonene) were common in essential oils and plants. Our results suggest the valuable potential of basil and associated essential oils as a component of integrated management strategies against the tomato leafminer.

Outcomes of integrated management versus specialized care for patients with type 2 diabetes: An observational study

AIMS

To compare type 2 diabetes (T2D) patients included in a Diabetes Integrated Management (DIM) program with those followed in Diabetes Specialized Care (DSC), investigating differences in general characteristics, changes in clinical outcomes, and factors related with the inclusion in the DIM program.

METHODS

T2D patients living in the ASLTO3 district and included into the DIM program, a shared disease management between general practitioners and diabetes specialists, from 2008 to 2014 were compared with T2D patients living in the same district and in charge of the local DSC. Demographic, anthropometric and clinical data for both groups of patients were obtained from the electronic records of DSC.

RESULTS

1326 DIM patients were compared with 3494 DSC patients. A higher proportion of females was observed among DIM patients than among DSC patients. DIM patients were older, more frequently in therapy with diet only or with oral hypoglycemic, and had HbA1c and creatinine lower than DSC patients. The analyses of changes in clinical parameters during the study period showed a good and statistically significant improvement of most parameters, independently of the inclusion in DIM or DSC, with the exception of creatinine level.

CONCLUSIONS

Integrated Management is an efficient and effective way to achieve good long-term clinical outcomes for patients with diabetes.

Community involvement works where enforcement fails: conservation success through community-based management of Amazon river turtle nests

Law enforcement is widely regarded as a cornerstone to effective natural resource management. Practical guidelines for the optimal use of enforcement measures are lacking particularly in areas protected under sustainable and/or mixed use management regimes and where legal institution are weak. Focusing on the yellow-spotted river turtles (Podocnemis unifilis) along 33 km of river that runs between two sustainable–use reserves in the Brazilian Amazon as an illustrative example, we show that two years of patrols to enforce lawful protection regulations had no effect on nest harvesting. In contrast, during one year when community-based management approaches were enacted harvest levels dropped nearly threefold to a rate (26%) that is likely sufficient for river turtle population recovery. Our findings support previous studies that show how community participation, if appropriately implemented, can facilitate effective natural resource management where law enforcement is limited or ineffective.

Multidisciplinary management of patients with coexisting inflammatory bowel disease and spondyloarthritis: A Delphi consensus among Italian experts

BACKGROUND

Treatment of patients with coexisting spondyloarthritis (SpA) and inflammatory bowel disease (IBD) often requires multidisciplinary collaboration between gastroenterologists and rheumatologists.

AIM

To describe the results of the first Delphi consensus to define shared therapeutic strategies for the best management of patients with coexisting SpA and IBD.

METHODS

A scientific steering committee of 10 Italian experts in the field of SpA and IBD developed 27 statements on 5 possible clinical scenarios and selected 40 specialists from across Italy, both gastroenterologists and rheumatologists, to vote them using a Delphi method. Each participant expressed a level of agreement on each statement using a 5-point scale (1="absolutely disagree"; 5="absolutely agree"). Total cumulative agreement was defined as the sum of the percentage of responses to items 4 ("agree") and 5 ("absolutely agree"). Total cumulative agreement ≥70% defined consensus for each statement.

RESULTS

After the first round, positive consensus was reached for 22 statements. Statements without consensus were discussed in a plenary session before the second vote. Positive consensus was then reached in all statements, with final total cumulative agreement ranging from 80% to 100%.

CONCLUSION

This is the first Delphi consensus defining specific treatment algorithms for patients with coexisting SpA and IBD.

Evaluation of three adjuvants with respect to both adverse effects and the efficacy of antibody production to the Bm86 protein

Cattle tick infestations remain an important burden for farmers in tropical area like in New Caledonia. With the development of acaricide resistance, tick vaccines should be an attractive alternative to control ticks but their efficacy needs to be improved. In this study three adjuvants were studied in an experimental tick vaccine with a Bm86 protein to assess their performance in terms of antibody productions and adverse reactions following vaccinations. The water-in-oil adjuvant ISA 61 VG led to higher antibody titers compared to a water-in-oil-in-water adjuvant ISA 201 VG and an aqueous polymeric adjuvant Montanide Gel 01. Vaccinations with these three adjuvants did not produce severe general reaction but an increase in skin thickness was observed especially with both oil-based emulsions. These results indicated that the water-in-oil adjuvant is the most interesting to use for this vaccine but local adverse reactions remain an issue.

"And DPSIR begat DAPSI(W)R(M)!" - A unifying framework for marine environmental management

The marine environment is a complex system formed by interactions between ecological structure and functioning, physico-chemical processes and socio-economic systems. An increase in competing marine uses and users requires a holistic approach to marine management which considers the environmental, economic and societal impacts of all activities. If managed sustainably, the marine environment will deliver a range of ecosystem services which lead to benefits for society. In order to understand the complexity of the system, the DPSIR (Driver-Pressure-State-Impact-Response) approach has long been a valuable problem-structuring framework used to assess the causes, consequences and responses to change in a holistic way. Despite DPSIR being used for a long time, there is still confusion over the definition of its terms and so to be appropriate for current marine management, we contend that this confusion needs to be addressed. Our viewpoint advocates that DPSIR should be extended to DAPSI(W)R(M) (pronounced dap-see-worm) in which Drivers of basic human needs require Activities which lead to Pressures. The Pressures are the mechanisms of State change on the natural system which then leads to Impacts (on human Welfare). Those then require Responses (as Measures). Furthermore, because of the complexity of any managed sea area in terms of multiple Activities, there is the need for a linked-DAPSI(W)R(M) framework, and then the connectivity between marine ecosystems and ecosystems in the catchment and further at sea, requires an interlinked, nested-DAPSI(W)R(M) framework to reflect the continuum between adjacent ecosystems. Finally, the unifying framework for integrated marine management is completed by encompassing ecosystem structure and functioning, ecosystem services and societal benefits. Hence, DAPSI(W)R(M) links the socio-ecological system of the effects of changes to the natural system on the human uses and benefits of the marine system. However, to deliver these sustainably in the light of human activities requires a Risk Assessment and Risk Management framework; the ISO-compliant Bow-Tie method is used here as an example. Finally, to secure ecosystem health and economic benefits such as Blue Growth, successful, adaptive and sustainable marine management Responses (as Measures) are delivered using the 10-tenets, a set of facets covering all management disciplines and approaches.

Towards understanding the integrative approach of the water, energy and food nexus

The water, energy and food nexus (WEF nexus) is currently quite popular in environmental management. The concept found a fertile ground in science and policymaking, but there is no consistent view on the meaning of integration within the nexus. Here, a wealth of publications is reviewed in an endeavour to: (1) reveal the lines of justification for the need of the WEF nexus debate and (2) identify the range of tools for analysing the interdependent resource issues of the nexus using an integrated framework of science and policy. There are three drivers behind the emergence of the nexus thinking. These are a) increasing resource interlinks due to growing scarcities, b) recent resource supply crises, and c) failures of sector-driven management strategies. Evaluation of the WEF nexus integrative debate can be carried out using four key criteria, namely ability to change current policy debates, issue and thinking novelty, practicability and measurability, and clearness and implementation roadmap. It is clear that, although the nexus has been quite successful in changing policy debates, issue prioritization is missing and seems to be left to specific case studies and policymakers' choices. There is a high need for 'incorporation' and 'cross-linking' of issues between the three resources. In this regard, nexus governance is the missing link in the nexus debate.

Transitions of Care Between Acute and Chronic Heart Failure: Critical Steps in the Design of a Multidisciplinary Care Model for the Prevention of Rehospitalization

Despite advances in the treatment of heart failure, mortality, the number of readmissions, and their associated health care costs are very high. Heart failure care models inspired by the chronic care model, also known as heart failure programs or heart failure units, have shown clinical benefits in high-risk patients. However, while traditional heart failure units have focused on patients detected in the outpatient phase, the increasing pressure from hospital admissions is shifting the focus of interest toward multidisciplinary programs that concentrate on transitions of care, particularly between the acute phase and the postdischarge phase. These new integrated care models for heart failure revolve around interventions at the time of transitions of care. They are multidisciplinary and patient-centered, designed to ensure continuity of care, and have been demonstrated to reduce potentially avoidable hospital admissions. Key components of these models are early intervention during the inpatient phase, discharge planning, early postdischarge review and structured follow-up, advanced transition planning, and the involvement of physicians and nurses specialized in heart failure. It is hoped that such models will be progressively implemented across the country.

Persistence of fipronil residues in Eucalyptus seedlings and its concentration in the insecticide solution after treatment in the nursery

Eucalyptus seedlings are normally protected from underground termites (Isoptera: Termitidae) by immersing them in insecticide solutions. Fipronil (phenylpyrazole) is the most frequently used product to protect seedlings in the field for up to 6 months after application. This is performed just prior to planting. However, the persistence of this product in seedlings that are treated and subjected to irrigation several days prior to planting has not yet been evaluated. This study aims to quantify the fipronil concentration in the substratum and roots of the seedlings treated and subjected to irrigation for up to 56 days prior to planting and to quantify this insecticide concentration in the solutions, without continuous stirring, for 120 min. The quantitative determination of fipronil in the seedlings and in the insecticide solution was done by high-performance liquid chromatography (HPLC) with an ultraviolet (UV) detector. It was found that irrigation up to 56 days, performed in the nurseries, did not decrease the fipronil concentration in the seedlings. The absence of stirring reduced the fipronil concentration in the insecticide solution, necessitating a homogenization system to maintain the recommended concentration of this product, to effectively treat the eucalyptus seedlings. The seedling treatment with fipronil can be conducted strictly in the nursery, reducing cost and environmental risks.

The 'Toolbox' of strategies for managing Haemonchus contortus in goats: What's in and what's out

A dynamic and innovative approach to managing the blood-consuming nematode Haemonchus contortus in goats is critical to crack dependence on veterinary anthelmintics. H. contortus management strategies have been the subject of intense research for decades, and must be selected to create a tailored, individualized program for goat farms. Through the selection and combination of strategies from the Toolbox, an effective management program for H. contortus can be designed according to the unique conditions of each particular farm. This Toolbox investigates strategies including vaccines, bioactive forages, pasture/grazing management, behavioural management, natural immunity, FAMACHA, Refugia and strategic drenching, mineral/vitamin supplementation, copper Oxide Wire Particles (COWPs), breeding and selection/selecting resistant and resilient individuals, biological control and anthelmintic drugs. Barbervax(®), the ground-breaking Haemonchus vaccine developed and currently commercially available on a pilot scale for sheep, is prime for trialling in goats and would be an invaluable inclusion to this Toolbox. The specialised behaviours of goats, specifically their preferences to browse a variety of plants and accompanying physiological adaptations to the consumption of secondary compounds contained in browse, have long been unappreciated and thus overlooked as a valuable, sustainable strategy for Haemonchus management. These strategies are discussed in this review as to their value for inclusion into the 'Toolbox' currently, and the future implications of ongoing research for goat producers. Combining and manipulating strategies such as browsing behaviour, pasture management, bioactive forages and identifying and treating individual animals for haemonchosis, in addition to continuous evaluation of strategy effectiveness, is conducted using a model farm scenario. Selecting strategies from the Toolbox, with regard to their current availability, feasibility, economical cost and potential ease of implementation depending on the systems of production and their complementary nature, is the future of managing H. contortus in farmed goats internationally and maintaining the remaining efficacy of veterinary anthelmintics.

Water resource management: a comparative evaluation of Brazil, Rio de Janeiro, the European Union, and Portugal

This paper presents an overview of water resource management in Brazil, in particular the state of Rio de Janeiro, and in the European Union, with an emphasis on member country Portugal. The study examines the primary laws, governing bodies and water resource plans. The paper describes the concerns and interests of the scientific community and other sectors of society with regard to water resource management. The paper also draws attention to challenges and opportunities concerning the main objective of water resource management, which is to ensure the availability of water of high quality and sustainable quantity. Additionally, it also mentions good and poor management practices. Among the concerns highlighted are integrated water resource management and water resource monitoring. The objective of this study was to contribute to water resource management processes. The primary reasons for this study are the growing scarcity of freshwater in the world, recurrent problems in managing this resource and a desire to contribute to the improvement of the current situation. The study of water management in different contexts allows for a greater understanding of the subject, thereby assisting the decision-making of managers and society in general with regard to environmental quality and ecological and human health. There is an increasing interest in efficient water resource management, which creates a demand for information on the subject. Both Brazil and the European Union are facing problems related to quantity and quality of water. Problems like scarcity of freshwater, contamination, salinization, and floods. This makes the realities of them quite close, despite the physical distance between them. In general, Brazil, Rio de Janeiro, the European Union and Portugal have similar water resource management requirements. If these regions are to supply a consistent quantity of high-quality water to present and future generations, then they need effective laws and plans, efficient managing agencies, political interest and economic resources. Investments in research and developing water resource management plans are inefficient measures if they are not implemented with special emphasis on monitoring and inspection.

Feasibility of sulfide control in sewers by reuse of iron rich drinking water treatment sludge

Dosage of iron salt is the most commonly used method for sulfide control in sewer networks but incurs high chemical costs. In this study, we experimentally investigate the feasibility of using iron rich drinking water treatment sludge for sulfide control in sewers. A lab-scale rising main sewer biofilm reactor was used. The sulfide concentration in the effluent decreased from 15.5 to 19.8 mgS/L (without dosing) to below 0.7-2.3 mgS/L at a sludge dosing rate achieving an iron to total dissolved inorganic sulfur molar ratio (Fe:S) of 1:1, with further removal of sulfide possible by prolonging the reaction time. In fact, batch tests revealed an Fe consumption to sulfide removal ratio of 0.5 ± 0.02 (mole:mole), suggesting the possible occurrence of other reactions involving the removal of sulfide. Modelling revealed that the reaction between iron in sludge and sulfide has reaction orders of 0.65 ± 0.01 and 0.77 ± 0.02 with respect to the Fe and sulfide concentrations, respectively. The addition of sludge slightly increased the total chemical oxidation demand (tCOD) concentration (by approximately 12%) as expected, but decreased the soluble chemical oxidation demand (sCOD) concentration and methane formation by 7% and 20%, respectively. Some phosphate removal (13%) was also observed at the sludge dosing rate of 1:1 (Fe:S), which is beneficial to nutrient removal from the wastewater. Overall, this study suggests that dosing iron-rich drinking water sludge to sewers could be an effective strategy for sulfide removal in sewer systems, which would also reduce the sludge disposal costs for drinking water treatment works. However, its potential side-effects on sewer sedimentation and on the wastewater treatment plant effluent remain to be investigated.

Integrating the provision of ecosystem services and trawl fisheries for the management of the marine environment

The species interaction and their biological traits (BT) determine the function of benthic communities and, hence, the delivery of ecosystem services. Therefore, disturbance of benthic communities by trawling may compromise ecosystem service delivery, including fisheries' catches. In this work, we explore 1) the impact of trawling activities on benthic functional components (after the BTA approach) and 2) how trawling impact may affect the ecosystem services delivered by benthic communities. To this aim, we assessed the provision of ecosystem services by adopting the concept of Ecosystem Service Providers (ESP), i.e. ecological units that perform ecosystem functions that will ultimately deliver ecosystem services. We studied thirteen sites subjected to different levels of fishing effort in the Mediterranean. From a range of environmental variables included in the study, we found ESPs to be mainly affected by fishing effort and grain size. Our results suggested that habitat type has significant effects on the distribution of ESPs and this natural variability influences ESP response to trawling at a specific site. In order to summarize the complex relationships between human uses, ecosystem components and the demand for ecosystem services in trawling grounds, we adapted a DPSIR (Drivers-Pressures-State Change-Impact-Response) framework to the study area, emphasizing the role of society as Drivers of change and actors demanding management Responses. This integrative framework aims to inform managers about the interactions between all the elements involved in the management of trawling grounds, highlighting the need for an integrated approach in order to ensure ecosystem service provision.

Integrated options for the management of black root rot of strawberry caused by Rhizoctonia solani Kuhn

An investigation was made to manage strawberry black root rot caused by Rhizoctonia solani (R. solani) through the integration of Trichoderma harzianum (T. harzianum) isolate STA7, mustard oil cake and Provax 200. A series of preliminary experiments were conducted to select a virulent isolate of R. solani, an effective isolate of T. harzianum, a suitable organic amendment, and a suitable fungicide before setting the experiment for integration. The pathogenicity of the selected four isolates of R. solani was evaluated against strawberry and isolate SR1 was selected as the test pathogen due to its highest virulent (95.47% mortality) characteristics. Among the 20 isolates of T. harzianum, isolate STA7 showed maximum inhibition (71.97%) against the test pathogen (R. solani). Among the fungicides, Provax-200 was found to be more effective at lowest concentration (100 ppm) and highly compatible with Trichoderma isolates STA7. In the case of organic amendments, maximum inhibition (59.66%) of R. solani was obtained through mustard oil cake at the highest concentration (3%), which was significantly superior to other amendments. Minimum percentages of diseased roots were obtained with pathogen (R. solani)+Trichoderma+mustard oil cake+Provax-200 treatment, while the highest was observed with healthy seedlings with a pathogen-inoculated soil. In the case of leaf and fruit rot diseases, significantly lowest infected leaves as well as fruit rot were observed with a pathogen+Trichoderma+mustard oil cake+Provax-200 treatment in comparison with the control. A similar trend of high effectiveness was observed by the integration of Trichoderma, fungicide and organic amendments in controlling root rot and fruit diseases of strawberry. Single application of Trichoderma isolate STA7, Provax 200 or mustard oil cake did not show satisfactory performance in terms of disease-free plants, but when they were applied in combination, the number of healthy plants increased significantly. The result of the current study suggests the superiority of our integrated approach to control the sclerotia forming pathogen R. solani compared to the individual treatment either by an antagonist or by a fungicide or by mustard oil cake.

Restoration of eutrophic freshwater by managing internal nutrient loads. A review

Eutrophication has become the primary water quality issue for most of the freshwater and coastal marine ecosystems in the world. It is one of the most visible examples of biosphere's alteration due to human activities affecting aquatic ecosystems from the Arctic to the Antarctic. As eutrophication becomes frequent and many eutrophic ecosystems have difficulties meeting the EU Water Framework Directive (WFD) criteria the removal of phosphate and/or ammonium gains great importance, in water treatment. The objective of this paper is to review the restoration methods of eutrophic ecosystems, emphasizing remediation methods of internal nutrient release budget as a major factor to control eutrophication. The use of phosphate inactivation agents as a restoration tool, their capacity and application methods, as well as the individual results (in water quality, algal blooms, flora and fauna) in areas that have been implemented were also examined. Moreover, a conceptual model was conducted as a process to determine remediation technique, highlighting the need of an integrated approach to eutrophication management. The chemical lake restoration methods are not a panacea and their implementation should consist a targeted management approach as a part of an integrated management plan. The longevity of the treatment effectiveness using P-inactivation agents is reduced if not given the necessary importance in managing the external nutrient loads. The successful implementation of internal P management measures requires a site-specific study of a range of factors affecting viability of the method used, in connection with an assessment of the potential adverse effects on humans, livestock, biotic and abiotic factors.

Italian Expert Panel on the management of patients with coexisting spondyloarthritis and inflammatory bowel disease

Spondyloarthritis (SpA) is a group of diseases with similar clinical, radiologic and serologic features, including SpA associated with inflammatory bowel disease (IBD-associated SpA). Several studies have estimated the occurrence of SpA in IBD patients as ranging from 17% to 39%, confirming that SpA is the most frequent extra-intestinal manifestation in patients with IBD. In this paper, the expert panel presents some red flags to guide clinicians - both rheumatologists and gastroenterologists - to make a correct diagnosis of IBD-associated SpA in clinical practice. IBD-associated SpA classification, clinical presentation and diagnostic work-up are also presented. From the therapeutic point of view, only separate recommendations/guidelines are currently available for the treatment of Crohn's disease, ulcerative colitis and for both axial and peripheral SpA. However, when IBD and SpA coexist, the therapeutic strategy should be modulated to take into account the variable manifestations of IBD in terms of intestinal and extra-intestinal features, and the clinical manifestations of SpA, with particular attention to peripheral enthesitis, dactylitis and anterior uveitis. To our knowledge, this is the first attempt to define therapeutic algorithms for the integrated management of different IBD-associated SpA clinical scenarios.