Coastal wetlands can be saved from sea level rise by recreating past tidal regimes

Climate change driven Sea Level Rise (SLR) is creating a major global environmental crisis in coastal ecosystems, however, limited practical solutions are provided to prevent or mitigate the impacts. Here, we propose a novel eco-engineering solution to protect highly valued vegetated intertidal ecosystems. The new ‘Tidal Replicate Method’ involves the creation of a synthetic tidal regime that mimics the desired hydroperiod for intertidal wetlands. This synthetic tidal regime can then be applied via automated tidal control systems, “SmartGates”, at suitable locations. As a proof of concept study, this method was applied at an intertidal wetland with the aim of restabilising saltmarsh vegetation at a location representative of SLR. Results from aerial drone surveys and on-ground vegetation sampling indicated that the Tidal Replicate Method effectively established saltmarsh onsite over a 3-year period of post-restoration, showing the method is able to protect endangered intertidal ecosystems from submersion. If applied globally, this method can protect high value coastal wetlands with similar environmental settings, including over 1,184,000 ha of Ramsar coastal wetlands. This equates to a saving of US$230 billion in ecosystem services per year. This solution can play an important role in the global effort to conserve coastal wetlands under accelerating SLR

Reducing outcome measures in mental health: a systematic review of the methods

Economic and Social Research Council (ESRC) Grant number ES/J500057/1 and South London and Maudsley NHS Trust

Complex innovations in agriculture, environment, and health – the perceptions of rice farmers in the Jequetepeque Valley, Peru

The increased use of water in irrigated rice monocultures in the Jequetepeque Valley, on the northern coast of Peru, has exacerbated environmental, socioeconomic and health problems. The Alternate Wetting and Drying (AWD) irrigation technique aims to increase water management efficiency in rice cultivation. The objective of the present article is to understand farmers’ perceptions about the benefits and risks of implementing AWD. Data from interviews with 319 farmers showed that they recognise nine interactions between AWD's economic, environmental and health aspects but prioritise economic factors when assessing its benefits. We also identified the main channels and spaces of communication and debate on issues related to agriculture and health that are likely to be effective in promoting the diffusion of AWD. The study demonstrated the relevance of integrated actions to encourage the adoption of agricultural innovations which consider the interactions between environmental sustainability, health issues, and producers' economic priorities.The increased use of water in irrigated rice monocultures in the Jequetepeque Valley, on the northern coast of Peru, has exacerbated environmental, socioeconomic and health problems. The Alternate Wetting and Drying (AWD) irrigation technique aims to increase water management efficiency in rice cultivation. The objective of the present article is to understand farmers’ perceptions about the benefits and risks of implementing AWD. Data from interviews with 319 farmers showed that they recognise nine interactions between AWD's economic, environmental and health aspects but prioritise economic factors when assessing its benefits. We also identified the main channels and spaces of communication and debate on issues related to agriculture and health that are likely to be effective in promoting the diffusion of AWD. The study demonstrated the relevance of integrated actions to encourage the adoption of agricultural innovations which consider the interactions between environmental sustainability, health issues, and producers' economic priorities.The increased use of water in irrigated rice monocultures in the Jequetepeque Valley, on the northern coast of Peru, has exacerbated environmental, socioeconomic and health problems. The Alternate Wetting and Drying (AWD) irrigation technique aims to increase water management efficiency in rice cultivation. The objective of the present article is to understand farmers’ perceptions about the benefits and risks of implementing AWD. Data from interviews with 319 farmers showed that they recognise nine interactions between AWD's economic, environmental and health aspects but prioritise economic factors when assessing its benefits. We also identified the main channels and spaces of communication and debate on issues related to agriculture and health that are likely to be effective in promoting the diffusion of AWD. The study demonstrated the relevance of integrated actions to encourage the adoption of agricultural innovations which consider the interactions between environmental sustainability, health issues, and producers' economic priorities.The increased use of water in irrigated rice monocultures in the Jequetepeque Valley, on the northern coast of Peru, has exacerbated environmental, socioeconomic and health problems. The Alternate Wetting and Drying (AWD) irrigation technique aims to increase water management efficiency in rice cultivation. The objective of the present article is to understand farmers’ perceptions about the benefits and risks of implementing AWD. Data from interviews with 319 farmers showed that they recognise nine interactions between AWD's economic, environmental and health aspects but prioritise economic factors when assessing its benefits. We also identified the main channels and spaces of communication and debate on issues related to agriculture and health that are likely to be effective in promoting the diffusion of AWD. The study demonstrated the relevance of integrated actions to encourage the adoption of agricultural innovations which consider the interactions between environmental sustainability, health issues, and producers' economic priorities

The complex influence of ENSO on droughts in Ecuador

48 Pags.- 1 Tabl.- 18 Figs. The definitive version is available at: http://link.springer.com/journal/382In this study, we analyzed the influence of El Niño–Southern Oscillation (ENSO) on the spatio-temporal variability of droughts in Ecuador for a 48-year period (1965–2012). Droughts were quantified from 22 high-quality and homogenized time series of precipitation and air temperature by means of the Standardized Precipitation Evapotranspiration Index. In addition, the propagation of two different ENSO indices (El Niño 3.4 and El Niño 1 + 2 indices) and other atmospheric circulation processes (e.g., vertical velocity) on different time-scales of drought severity were investigated. The results showed a very complex influence of ENSO on drought behavior across Ecuador, with two regional patterns in the evolution of droughts: (1) the Andean chain with no changes in drought severity, and (2) the Western plains with less severe and frequent droughts. We also detected that drought variability in the Andes mountains is explained by the El Niño 3.4 index [sea surface temperature (SST) anomalies in the central Pacific], whereas the Western plains are much more driven by El Niño 1 + 2 index (SST anomalies in the eastern Pacific). Moreover, it was also observed that El Niño and La Niña phases enhance droughts in the Andes and Western plains regions, respectively. The results of this work could be crucial for predicting and monitoring drought variability and intensity in Ecuador.This work was supported by the EPhysLab (UVIGO-CSIC Associated Unit) and the research projects I-COOP H2O 2013CD0006: “Test multisectorial y actividades demostrativa sobre el potencial desarrollo de sistemas de monitorización de sequías en tiempo real en la región del oeste de Sudamérica” financed by the Spanish National Research Council, CGL2011-27574-CO2-02, CGL2014-52135-C03-01 and Red de variabilidad y cambio climático RECLIM (CGL2014-517221-REDT), financed by the Spanish Commission of Science and Technology and FEDER, and “LIFE12 ENV/ES/000536-Demonstration and validation of innovative methodology for regional climate change adaptation in the Mediterranean area (LIFE MEDACC)” financed by the LIFE programme of the European Commission. Cesar Azorin-Molina was supported by the JCI-2011-10263 Grant. Arturo Sanchez-Lorenzo was supported by the JCI-2012-12508 Grant. Miquel Tomas-Burguera was supported by a doctoral grant by the Ministry of Economy and Competitiveness and Natalia Martin-Hernandez was supported by a doctoral grant by the Aragón Regional Government. E. Aguilar was funded by the Grant CCI-009-ATN/OC-12439-RG-2012 from the Banco Iberoamericano de Desarrollo.Peer reviewe

Priorities for health economic methodological research: Results of an expert consultation

Background: The importance of economic evaluation in decision making is growing with increasing budgetary pressures on health systems. Diverse economic evidence is available for a range of interventions across national contexts within Europe, but little attention has been given to identifying evidence gaps that, if filled, could contribute to more efficient allocation of resources. One objective of the Research Agenda for Health Economic Evaluation project is to determine the most important methodological evidence gaps for the ten highest burden conditions in the European Union (EU), and to suggest ways of filling these gaps. Methods: The highest burden conditions in the EU by Disability Adjusted Life Years were determined using the Global Burden of Disease study. Clinical interventions were identified for each condition based on published guidelines, and economic evaluations indexed in MEDLINE were mapped to each intervention. A panel of public health and health economics experts discussed the evidence during a workshop and identified evidence gaps. Results: The literature analysis contributed to identifying cross-cutting methodological and technical issues, which were considered by the expert panel to derive methodological research priorities. Conclusions: The panel suggests a research agenda for health economics which incorporates the use of real-world evidence in the assessment of new and existing interventions; increased understanding of cost-effectiveness according to patient characteristics beyond the “-omics” approach to inform both investment and disinvestment decisions; methods for assessment of complex interventions; improved cross-talk between economic evaluations from health and other sectors; early health technology assessment; and standardized, transferable approaches to economic modeling

ISPOR Code of Ethics 2017 (4th Edition)

As the leading health economics and outcomes research (HEOR) professional society, ISPOR has a responsibility to establish a uniform, harmonized international code for ethical conduct. ISPOR has updated its 2008 Code of Ethics to reflect the current research environment. This code addresses what is acceptable and unacceptable in research, from inception to the dissemination of its results. There are nine chapters: 1 – Introduction; 2 – Ethical Principles respect, beneficence and justice with reference to a non-exhaustive compilation of international, regional, and country-specific guidelines and standards; 3 – Scope HEOR definitions and how HEOR and the Code relate to other research fields; 4 – Research Design Considerations primary and secondary data related issues, e.g., participant recruitment, population and research setting, sample size/site selection, incentive/honorarium, administration databases, registration of retrospective observational studies and modeling studies; 5 – Data Considerations privacy and data protection, combining, verification and transparency of research data, scientific misconduct, etc.; 6 – Sponsorship and Relationships with Others (roles of researchers, sponsors, key opinion leaders and advisory board members, research participants and institutional review boards (IRBs) / independent ethics committees (IECs) approval and responsibilities); 7 – Patient Centricity and Patient Engagement new addition, with explanation and guidance; 8 – Publication and Dissemination; and 9 – Conclusion and Limitations

L'équipe-projet HeKA

This article describe the Inria, Inserm, Univ. de Paris project team HeKA.International audienceHeKA est une équipe-projet de recherche commune à Inria, l’Inserm et l’Université de Paris. Plus précisément, HeKA, dépend du Centre de Recherche des Cordeliers et du Centre Inria de Paris. En plus de deux chercheurs Inria et Inserm, HeKA est composé de chercheurs hospitalo-universitaires de l’AP-HP associés à des services de l’Hôpital Européen Georges Pompidou, l’Hôpital Necker et de l’Institut Imagine. Les thèmes de recherche de l’équipe sont l’informatique médicale, les biostatistiques et les mathématiques appliquées pour l’aide à la décision clinique. Le terme HeKA est à la fois une référence à la divité égyptienne de la médecine et un acronyme pour Health data- and model- driven Knowledge Acquisition.L’équipe HeKA fait suite à l’équipe 22 (Information Sciences to support Personalized Medicine) dirigée par Anita Burgun au Centre de Recherche des Corderliers (Inserm, Université de Paris). La responsable de HeKA est Sarah Zohar, elle est secondée par Adrien Coulet

Predictors of length of stay in psychiatry: analyses of electronic medical records

The article processing charge was funded by the German Research Foundation (DFG) and the Albert-Ludwigs-University Freiburg in the funding programme Open Access Publishing

Molecular Epidemiology of HIV-1 Subtypes in India: Origin and Evolutionary History of the Predominant Subtype C

This thesis describes the translational genomics of HIV-1subtype C in India from its origin to therapeutic response with the aim to improve our knowledge for better therapeutic and preventive strategies to combat HIV/AIDS. In a systemic approach, we identified the molecular phylogeny of HIV-1 subtypes circulating in India and the time to most recent common ancestors (tMRCA) of predominant HIV-1 subtype C strains. Additionally, this thesis also studied drug resistance mutations in children, adolescents and adults, the role of host factors in evolution of drug resistance, and population dynamics of viremia and viral co-receptor tropism in perinatal transmission. Finally, the long term therapeutic responses on Indian national first-line antiretroviral therapy were also studied. In Paper I, we reported an increase in the HIV-1 recombinant forms in the HIV-1 epidemiology using a robust subtyping methodology. While the study confirmed HIV- 1 subtype C as a dominant subtype, its origin was dated back to the early 1970s from a single or few genetically related strains from South Africa, whereafter, it has evolved independently. In Paper II, the lethal hypermutations due to the activity of human apolipoprotein B mRNA-editing enzyme catalytic polypeptide-like 3G (hA3G) was significantly associated with antiretroviral therapy (ART) failure in Indian HIV-1 subtype C patients. The presence of M184I and M230I mutations were observed due to the editing of hA3G in the proviral compartment but stop codons were also found in the open reading frames and the same drug resistance mutations were absent in plasma virus. Therefore, it is unlikely that the viral variants which exhibit hypermutated sequences and M184I and/or M230I will mature and expand in vivo and hence are unlikely to have any clinical significance. The high concordance of drug resistance genotyping in the plasma and proviral compartments in therapy-naïve patients, gives weight to the idea of using whole blood for surveillance of drug resistance mutations which precludes logistic challenges of cold chain transport. In Papers III and IV, we identified a substantial proportion of HIV-1 subtype C perinatally-infected older children who had a high burden of plasma viremia but also had high CD4+ T-cell counts. In addition, older children with HIV-1 subtype C infection presented a high prevalence of predicted X4 and R5/X4 tropic strains which indicates that HIV-1 subtype C strains required longer duration of infection and greater disease progression to co-receptor transition from R5- to X4-tropic strains (IV). Our studies also indicate that transmitted drug resistance is low among Indian HIV-1 infected children, adolescents (III) and adults (II). In Paper V, in a longitudinal cohort study, a good long-term response to the Indian national first-line therapy for a median of nearly four years with 2.8% viral failure, indicating the overall success of the Indian ART program. Our study also showed that three immunologically well patients with virological rebound and major viral drug resistance mutations (M184V, K103N and Y181C) during one study visit had undetectable viral load at their next visit. These findings suggest that use of multiple parameters like patients’ immunological (CD4+ T-cell count), virological (viral load) and drug resistance data should all be used to optimize the treatment switch to second line therapy. In conclusion, this translational genomics study enhances our knowledge about the HIV-1 subtype C strains circulating in India which are genetically distinct from prototype African subtype C strains. Considerably more research using appropriate models need to be performed to understand the phenotypic and biological characteristics of these strains to guide efficient disease intervention and management strategies