Aortic mural thrombus in a nonaneurysmal minimally atherosclerotic or normal aorta is a rare clinical entity and an uncommon cause of peripheral arterial embolization. Both anticoagulation therapy and aortic surgery are commonly used as primary treatment, but there are no consensuses or clinical guidelines to outline the best management strategy for this unusual problem. This systematic review compares the outcomes of these different strategies for the treatment of aortic mural thrombus.
The series of papers in this issue of AMBIO represent technical presentations made at the 7th International Phosphorus Workshop (IPW7), held in September, 2013 in Uppsala, Sweden. At that meeting, the 150 delegates were involved in round table discussions on major, predetermined themes facing the management of agricultural phosphorus (P) for optimum production goals with minimal water quality impairment. The six themes were (1) P management in a changing world; (2) transport pathways of P from soil to water; (3) monitoring, modeling, and communication; (4) importance of manure and agricultural production systems for P management; (5) identification of appropriate mitigation measures for reduction of P loss; and (6) implementation of mitigation strategies to reduce P loss. This paper details the major challenges and research needs that were identified for each theme and identifies a future roadmap for catchment management that cost-effectively minimizes P loss from agricultural activities.
This paper reports changes in behavioral outcomes related to the use of HIV testing service of a project that employed peer-based education strategies and integration of HIV voluntary counseling and testing (VCT) and Sexual and Reproductive Health (SRH) services targeting young people aged 15-24 across 5 provinces in Vietnam.
Two large cardiovascular outcome trials of canagliflozin, the CANVAS Program, will complete in early 2017: the CANagliflozin cardioVascular Assessment Study (CANVAS) and the CANagliflozin cardioVascular Assessment Study - Renal (CANVAS-R). Accruing data for the sodium-glucose co-transporter 2 inhibitor (SGLT2i) class has identified questions and opportunities that were not apparent when the trials were designed. Accordingly, a series of modifications have been made to the planned analyses. These updates will ensure that the data from the CANVAS Program will maximise advances in scientific knowledge and patient care. The specification of the analysis strategy prior to knowledge of the trial results, their design by the independent scientific trial Steering Committee, the detailed a priori definition of the analysis plans and the external review provided by the US Food and Drug Administration, all provide for a maximally efficient and robust utilisation of the data. The CANVAS Program should significantly advance our understanding of the effects of canagliflozin, and the broader SGLT2i class, on a range of important efficacy and safety outcomes.
Proper management of fecal sludge has significant positive health and environmental externalities. Most research on managing onsite sanitation so far either simulates the costs of, or the welfare effects from, managing sludge in situ in pit latrines. Thus, designing management strategies for onsite rural sanitation is challenging, because the actual costs of transporting sludge for treatment, and sources for financing these transport costs, are not well understood.
Economic saving is an elaborate behavior in which the goal of a reward in the future directs planning and decision-making in the present. Here, we measured neural activity while subjects formed simple economic saving strategies to accumulate rewards and then executed their strategies through choice sequences of self-defined lengths. Before the initiation of a choice sequence, prospective activations in the amygdala predicted subjects' internal saving plans and their value up to two minutes before a saving goal was achieved. The valuation component of this planning activity persisted during execution of the saving strategy and predicted subjects' economic behavior across different tasks and testing days. Functionally coupled amygdala and prefrontal cortex activities encoded distinct planning components that signaled the transition from saving strategy formation to execution and reflected individual differences in saving behavior. Our findings identify candidate neural mechanisms for economic saving in amygdala and prefrontal cortex and suggest a novel planning function for the human amygdala in directing strategic behavior toward self-determined future rewards.
Overexploitation and persecution of large carnivores resulting from conflict with humans comprise major causes of declines worldwide. Although little is known about the interplay between these mortality types, hunting of predators remains a common management strategy aimed at reducing predator-human conflict. Emerging theory and data, however, caution that such policy can alter the age structure of populations, triggering increased conflict in which conflict-prone juveniles are involved.
National and global dementia plans have focused on the research ambition to develop a cure or disease-modifying therapy by 2025, with the initial focus on investment in drug discovery approaches. We set out to develop complementary research ambitions in the areas of prevention, diagnosis, intervention, and care and strategies for achieving them.
Acute mesenteric ischemia (AMI) is an emergency with a high mortality rate; survivors have high rates of intestinal failure. We performed a prospective study to assess a multidisciplinary and multimodal management approach, focused on intestinal viability.
Successful watershed planning can be enhanced by stakeholder involvement in developing and implementing plans that reflect community goals and resource limitations. Community DECISIONS (Community Decision Support for Integrated, On-the-ground Nutrient Reduction Strategies) is a structured decision process to help stakeholders evaluate strategies that reduce watershed nutrient imbalances. A nutrient accounting algorithm and nutrient treatment database provide information on nutrient loadings and costs of alternative strategies to reduce loadings. Stakeholders were asked to formulate goals for the North Fork Shenandoah River Watershed in Virginia and select among strategies to achieve those goals. The Vector Analytic Hierarchy Process was used to rank strategies. Stakeholders preferred a Maximum strategy that included point source upgrades, riparian buffers, no-till corn silage, wheat cover, and bioretention filters in developed areas. Participants generally agreed that the process helped improve communication among stakeholders, was helpful for watershed planning, and should be used for TMDL (Total Maximum Daily Load) planning. Participants suggested more attention be paid to ensuring that all relevant issues are addressed and all information needed to make decisions is available. Watershed planning should provide stakeholders with clear scientific information about physical and socioeconomic processes. However, planning processes must give stakeholders adequate time to consider issues that may not have been addressed by existing scientific models and datasets.