Renewable Resource Management with Stock Externalities: Coastal Aquifers and Submarine Groundwater Discharge

This paper develops a hydrologic-ecologic-economic model of groundwater use. Particularly, we model coastal groundwater management and its effects on submarine groundwater discharge, nearshore marine water quality, and marine biota. We show that incorporating the external effects on nearshore resources increases the optimal sustainable steady-state head level. Numerical simulations are illustrated using data from the Kuki’o region on the island of Hawaii. Two different approaches for incorporating the nearshore resource are examined. Including algae’s market value in the objective function results in only slightly lower rates of extraction. When a minimum constraint is placed on the stock of the keystone species, however, greater conservation may be indicated. The constraint also results in non-monotonic paths of water extraction, head level, and water price in the optimal solution.groundwater management, marine ecology, dynamic optimization, safe minimum standard, sustainability science

Optimal Management of a Hawaiian Coastal Aquifer with Near-Shore Marine Ecological Interactions

We optimize groundwater management in the presence of marine consequences of submarine groundwater discharge (SGD). Concern for marine biota increases the optimal steady-state head level of the aquifer. The model is discussed in general terms for any coastal groundwater resource where SGD has a positive impact on valuable near-shore resources. Our application focuses of the Kona Coast of Hawai’i, where SGD is being actively studied and where both near-shore ecology and groundwater resources are serious sociopolitical issues. To incorporate the consequences of water extraction on nearshore resources, we impose a safe minimum standard for the quantity of SGD. Efficient pumping rates fluctuate according to various growth requirements on the keystone marine algae and different assumptions regarding recharge rates. Desalination is required under average recharge conditions and a strict minimum standard, and under low recharge conditions regardless of minimum standards of growth.groundwater management, marine ecology, dynamic optimization, safe minimum standard, sustainability science.

SÍNDROME GENITURINÁRIA DA MENOPAUSA: CONCEITO, ATUAIS POSSIBILIDADES E NOVAS PERSPECTIVAS DO TRATAMENTO

A mulher brasileira vive atualmente cerca de um terço da sua vida após a menopausa, dessa forma os sintomas advindos da queda de estrogênio no organismo configuram queixa ginecológica frequente. As mudanças relacionadas à atrofia do epitélio vulvovaginal constituem a síndrome geniturinária, que se destaca por exercer impacto negativo na qualidade de vida de até 50% das mulheres que vivem nessa fase. Por se tratar de um tema de grande relevância para a formação médica, este trabalho visa elucidar o conceito de síndrome geniturinária, abordar as possibilidades e novas perspectivas de tratamento dessa condição. Através de uma revisão de literatura, foram selecionados doze artigos e constatou-se que o tratamento padrão utilizado ainda se baseia no uso de estrogênio tópico em baixas doses. Entretanto, este tratamento pode ser contraindicado em algumas situações, além de ser associado à má adesão e persistência dos sintomas. Em sintomas leves e contraindicações de uso hormonal, o emprego de lubrificantes e hidratantes vaginais de longa duração pode ser considerado. O uso de lasers de CO2, Erbium: YAG e os sistemas de radiofrequência emergem como novos recursos terapêuticos sendo validados para substituição do tratamento convencional, opção para pacientes com contraindicações ao uso de estrogênio ou para uso em associação com esse. Entretanto, essas alternativas ainda levantam alguns questionamentos como efeitos colaterais e técnicas de aplicação carecendo, portanto, de mais estudos para aprimoramento e expansão do uso. Melhores hábitos de vida e manutenção de atividade sexual contribuem para redução da sintomatologia. Palavras-Chave: “Atrofia genital”; “Síndrome geniturinária”; “tratamento

Physician-patient communication about genomic tumor testing: perceptions of oncology providers

Background: • Genomic tumor testing (GTT) is a new technology and a cornerstone of the “precision medicine” movement in cancer care. • GTT uses next-generation genome sequencing technology to identify somatic variants in tumor cells. • By identifying somatic variants that predict responses to cancer therapies, GTT can help tailor therapy to individual patients, making them more effective. • However, due to the fact that GTT also detects many variants of uncertain significance, its clinical value is currently unproven. • When using GTT, physicians counsel patients about both its benefits and its limitations, but the ideal goals and content of these physician-patient discussions have not been clearly defined

Co-creating nutrition-sensitive development pathways with aquatic foods: Consulting local food systems partners in Baucau and Lautem municipalities, Timor-Leste

On 23 June 2022, WorldFish held a consultation workshop in Baucau Vila to introduce its planned action research program (Box 1) in Baucau and Lautem municipalities to its diverse partners, including national, municipal and local government representatives, community members, and local and international NGOs. This brief provides a summary of the workshop and demonstrates the first steps towards co-developing a municipality-level food systems coalition for sustainable and nutrition-sensitive transformation that includes aquatic foods

Salivary levels of inflammatory and anti-inflammatory biomarkers in periodontitis patients with and without acute myocardial infarction: implications for cardiovascular risk assessment.

BACKGROUND Periodontitis is initiated by a dysbiotic activity and furthermore leads to a chronic inflammatory response. The presence of pro-inflammatory markers plays an important role in the inflammatory load. Macrophage inflammatory protein-1 alpha (MIP-1α) and C-reactive protein (CRP) are pro- inflammatory biomarkers that quantify clinical and subclinical inflammation in cardiac ischemia in cardiac inflammation and disease. Adiponectin is an anti-inflammatory marker associated with good health. The susceptibility of periodontitis patients to cardiovascular events needs to be evaluated. OBJECTIVE This study aims to assess the levels of biomarkers in periodontitis patients with and without acute myocardial infarction (AMI) compared to controls. MATERIAL AND METHODS Pro-inflammatory and anti-inflammatory analytes were examined by collecting unstimulated saliva from three groups (n = 20/each): healthy individuals, individuals with stage III periodontitis, and post-myocardial infarction patients with stage III periodontitis. The samples were collected within 48 h of AMI. RESULTS Adiponectin levels were significantly lower in patients with periodontitis with and without AMI compared to controls, while CRP and MIP-1α were significantly higher in patients with periodontitis with and without AMI compared to controls. The highest titers for MIP-1α and CRP were detected among patients with periodontitis with and AMI. CONCLUSION Our study provides possible evidence of the association between periodontitis and salivary analytes that occur in tandem with cardiovascular disease. The lower levels of Adiponectin and higher levels of CRP and MIP-1α in patients with periodontitis indicate that this condition is a potential risk factor for cardiovascular disease. The findings emphasize the importance of early detection and intervention for periodontitis patients to prevent cardiovascular events

Community oncology clinicians’ knowledge, beliefs, and attitudes regarding genomic tumor testing

Introduction: Genomic tumor testing (GTT) is a new technology that promises to make cancer treatment more precise. However, little is known about clinicians’ knowledge, beliefs, and attitudes regarding GTT, particularly in community oncology settings

Salivary levels of inflammatory and anti-inflammatory biomarkers in periodontitis patients with and without acute myocardial infarction: implications for cardiovascular risk assessment

BackgroundPeriodontitis is initiated by a dysbiotic activity and furthermore leads to a chronic inflammatory response. The presence of pro-inflammatory markers plays an important role in the inflammatory load. Macrophage inflammatory protein-1 alpha (MIP-1α) and C-reactive protein (CRP) are pro- inflammatory biomarkers that quantify clinical and subclinical inflammation in cardiac ischemia in cardiac inflammation and disease. Adiponectin is an anti-inflammatory marker associated with good health. The susceptibility of periodontitis patients to cardiovascular events needs to be evaluated.ObjectiveThis study aims to assess the levels of biomarkers in periodontitis patients with and without acute myocardial infarction (AMI) compared to controls.Material and methodsPro-inflammatory and anti-inflammatory analytes were examined by collecting unstimulated saliva from three groups (n = 20/each): healthy individuals, individuals with stage III periodontitis, and post-myocardial infarction patients with stage III periodontitis. The samples were collected within 48 h of AMI.ResultsAdiponectin levels were significantly lower in patients with periodontitis with and without AMI compared to controls, while CRP and MIP-1α were significantly higher in patients with periodontitis with and without AMI compared to controls. The highest titers for MIP-1α and CRP were detected among patients with periodontitis with and AMI.ConclusionOur study provides possible evidence of the association between periodontitis and salivary analytes that occur in tandem with cardiovascular disease. The lower levels of Adiponectin and higher levels of CRP and MIP-1α in patients with periodontitis indicate that this condition is a potential risk factor for cardiovascular disease. The findings emphasize the importance of early detection and intervention for periodontitis patients to prevent cardiovascular events

Pronóstico y supervivencia en pacientes con Neuroblastoma

RESUMEN:   Los tumores malignos en edad pediátrica continúan siendo un problema de salud en la población infantil a nivel mundial. El neuroblastoma es el tumor sólido extracraneal más frecuente en el primer año de vida.  Representa el 8% de los tumores sólidos de la infancia. Este tipo de tumor se diagnostica en el lactante como hallazgo incidental, en estos casos con una supervivencia de más del 90%, o debuta con metástasis, en estadios avanzados de la enfermedad, con muy poca supervivencia. El neuroblastoma, al igual que el resto de los tumores abdominales en la infancia, frecuentemente pasa desapercibido y el diagnóstico, así como el tratamiento, es tardío, con un pronóstico desfavorable para la mayoría de los pacientes. Se considera una verdadera urgencia relativa por el rápido crecimiento de este tumor y la producción de metástasis.  A pesar del tratamiento multidisciplinario entre oncólogos, cirujanos, pediatras y radioterapeutas, así como de la aplicación de las modalidades de tratamientos actuales, la supervivencia es variable. Se trazó como objetivo caracterizar el Neuroblastoma según las tendencias médicas actuales, la supervivencia y pronóstico de esta enfermedad. Se realizó búsqueda y revisión bibliográfica en Scopus a través de Hinari y, adicionalmente, en Medline/Medline Plus a través de PubMed, con los descriptores Neuroblastoma, tumor abdominal, cirugía y oncología.  Como resultado de la bibliografía consultada, se constató que un aspecto fundamental para obtener un pronóstico y sobrevida favorables en estos pacientes es el diagnóstico y tratamiento oportuno. &nbsp