Balancing Sediment Connectivity and Energy Production via Optimized Reservoir Sediment Management Strategies

Sediment connectivity plays a fundamental role in sustaining ecosystem goods and services in fluvial systems, including hydropower production. Dams alter the natural processes of sediment transport by trapping sediment and reshaping downstream hydrology and geomorphology. Due to these processes' interconnected nature, dams' impacts extend in time and space beyond the dam site to the entire river system. System-scale approaches to reduce dam impacts commonly only consider dam siting, overlooking the potential of sediment management strategies integrated into the dam operations to offer more flexible solutions for mitigation. Herein, we contribute a sediment routing model (D-CASCADE) to assess the impacts of reservoirs and their management strategies on river sediment connectivity. D-CASCADE is applied to the 3S river system, a tributary of the Mekong River, a hotspot of potential dams in the Lower Mekong. We analyze three dam development portfolios. The effect of reservoir management is examined by assessing daily sediment delivery with specific dam release strategies. Model results predict sediment yield to the Mekong to reduce by 31%-60%. Finally, we explore trade-offs between hydropower generation and sediment connectivity across cascades of multiple reservoirs. Results show that repeated flushing operations during the early wet season could significantly increase sediment delivery with minimal (max 6%) hydropower losses. While poor trade-offs between sediment and hydropower have been locked-in in the Mekong, our results highlight the potential of including sediment connectivity models in multi-objective decision-making frameworks to devise integrated water and sediment management strategies that mitigate connectivity disruptions while minimizing losses in other sectors

Interstitial Lung Disease in Rheumatoid Arthritis in the Era of Biologics

Interstitial lung disease (ILD) represents a severe manifestation in connective tissue diseases (CTD), with an overall incidence of 15%, and it is still a challenge for clinicians evaluation and management. ILD is the most common manifestation of lung involvement in Rheumatoid Arthritis (RA), observed in up to 80% of biopsies, 50% of chest Computed Tomography (CT) and only 5% of chest radiographs. Histopatological patterns of ILD in RA may present with different patterns, such as: usual interstitial pneumonia, non specific interstitial pneumonia, desquamative interstitial pneumonia, organizing pneumonia, and eosinophilic infiltration. The incidence of ILD in RA patients is not only related to the disease itself, many drugs may be in fact associated with the development of pulmonary damage. Some reports suggest a causative role for TNFα inhibitors in RA-ILD development/worsening, anyway, no definitive statement can be drawn thus data are incomplete and affected by several variables. A tight control (pulmonary function tests and/or HRCT) is mandatory in patients with preexisting ILD, but it should be also performed in those presenting risk factors for ILD and mild respiratory symptoms. Biologic therapy should be interrupted, and, after excluding triggering infections, corticosteroids should be administered

Sporadic human prion diseases: molecular insights and diagnosis

Human prion diseases can be sporadic, inherited, or acquired by infection. Distinct clinical and pathological characteristics separate sporadic diseases into three phenotypes: Creutzfeldt-Jakob disease (CJD), fatal insomnia, and variably protease-sensitive prionopathy. CJD accounts for more than 90% of all cases of sporadic prion disease; it is commonly categorised into five subtypes that can be distinguished according to leading clinical signs, histological lesions, and molecular traits of the pathogenic prion protein. Three subtypes affect prominently cognitive functions whereas the other two impair cerebellar motor activities. An accurate and timely diagnosis depends on careful clinical examination and early performance and interpretation of diagnostic tests, including electroencephalography, quantitative assessment of the surrogate markers 14-3-3, tau, and of the prion protein in the CSF, and neuroimaging. The reliability of CSF tests is improved when these tests are interpreted alongside neuroimaging data

Espécies de patógenos invasores potenciais para plantios de pínus e eucalipto no Brasil

Sessão de Painéis

The COVID-19 Wellbeing Study: Examining perceived coercion and psychological wellbeing during the COVID-19 pandemic by means of an online survey, asynchronous virtual focus groups and individual interviews – a protocol

Introduction: The COVID-19 pandemic has resulted in many countries applying restrictive measures, such as lockdown, to contain and prevent further spread. The psychological impact of lockdown and working as a healthcare worker on the frontline has been chronicled in studies pertaining to previous infectious disease pandemics that have reported the presence of depressive symptoms, anxiety, insomnia, and post-traumatic stress symptoms. Potentially linked to psychological well-being and not yet studied is the possibility that lockdown and working on the frontline of the pandemic are associated with perceptions of coercion. Methods and analysis: The present study aimed to examine perceived coercion in those who have experienced COVID-19-related lockdown and/or worked as a frontline healthcare worker across three European countries. It aimed to describe how such perceptions may impact on psychological well-being, coping and posttraumatic growth. It will employ an explanatory mixedmethods research methodology consisting of an online survey and online asynchronous virtual focus groups (AVFGs) and individual interviews. χ2 tests and analyses of variance will be used to examine whether participants from different countries differ according to demographic factors, whether there are differences between cohorts on perceived coercion, depression, anxiety and post-traumatic growth scores. The relationship between coercion and symptoms of distress will be assessed using multiple regression. Both the AVFGs and the narrative interviews will be analysed using thematic narrative analysis. Ethics and dissemination: The study has been approved by University College London’s Research Ethics Committee under Project ID Number 7335/004. Results will be disseminated by means of peer-reviewed publications and at national and/or international conferences

Online information on medical cannabis is not always aligned with scientific evidence and may raise unrealistic expectations

There is a growing literature on the potential medical uses of Cannabis sativa and cannabinoid compounds. Although these have only been approved by regulatory agencies for a few indications, there is a hype about their possible benefits in a variety of conditions and a large market in the wellness industry. As in many cases patients search for information on cannabis products online, we have analyzed the information on medical cannabis available on the Internet. Therefore, this study aims at assessing the quality of the information available online on medical cannabis

Vasculitis and COVID-19: what do we have to know?

As the main title 'COVID-19 revolution: a new challenge for the internist' states, the global coronavirus infection disease 2019 (COVID-19) pandemic represented a new challenge for the internists. This paper is part of a series of articles written during the difficult period of the ongoing global pandemic and published all together in this fourth issue of the Italian Journal of Medicine, with the aim of sharing the direct experiences of those who were the first to face this severe emergency, expressing each point of view in the management of COVID-19 in relation to other diseases. Each article is therefore the result of many efforts and a joint collaboration between many colleagues from the Departments of Internal Medicine or Emergency Medicine of several Italian hospitals, engaged in the front line during the pandemic. These preliminary studies therefore cover diagnostic tools available to health care personnel, epidemiological reflections, possible new therapeutic approaches, discharge and reintegration procedures to daily life, the involvement of the disease not only in the lung, aspects related to various comorbidities, such as: coagulopathies, vasculitis, vitamin D deficiency, gender differences, etc.. The goal is to offer a perspective, as broad as possible, of everything that has been done to initially face the pandemic in its first phase and provide the tools for an increasingly better approach, in the hope of not arriving unprepared to a possible second wave. This paper in particular deals with vasculitis and COVID-19