Clinical Management of Endometriosis in Menopause: A Narrative Review.

Endometriosis, an inflammatory disease primarily affecting the pelvis and peritoneum, manifests with pelvic pain, dysmenorrhea, dyschezia, dyspareunia, and infertility. Despite its ubiquity, the management of endometriosis is challenging due to its heterogeneous presentation, limitations in diagnostic methods, variable therapeutic responses, and personal and socio-cultural impact on quality of life. This review attempts to consolidate the current literature on endometriosis occurring during and beyond menopause, and to present details regarding management strategies that take into account individual outcomes and goals when managing this condition.

Internet and Telephone Support for Discontinuing Long-Term Antidepressants: The REDUCE Cluster Randomized Trial.

Importance: There is significant concern regarding increasing long-term antidepressant treatment for depression beyond an evidence-based duration.

Objective: To determine whether adding internet and telephone support to a family practitioner review to consider discontinuing long-term antidepressant treatment is safe and more effective than a practitioner review alone.

Design, Setting, And Participants: In this cluster randomized clinical trial, 131 UK family practices were randomized between December 1, 2018, and March 31, 2022, with remote computerized allocation and 12 months of follow-up.

Patient-reported outcome measures for monitoring primary care patients with depression: the PROMDEP cluster RCT and economic evaluation.

Background: Guidelines on the management of depression recommend that practitioners use patient-reported outcome measures for the follow-up monitoring of symptoms, but there is a lack of evidence of benefit in terms of patient outcomes.

Objective: To test using the Patient Health Questionnaire-9 questionnaire as a patient-reported outcome measure for monitoring depression, training practitioners in interpreting scores and giving patients feedback.

Design: Parallel-group, cluster-randomised superiority trial; 1 : 1 allocation to intervention and control.

Depression follow-up monitoring with the PHQ-9: an open cluster-randomised controlled trial.

Background: Outcome monitoring of depression treatment is recommended but there is a lack of evidence on patient benefit in primary care.

Aim: To test monitoring depression using the Patient Health Questionnaire (PHQ-9) with patient feedback.

Design And Setting: An open cluster-randomised controlled trial was undertaken in 141 group practices.

Coupled social and ecological change drove the historical extinction of the California grizzly bear ().

Large carnivores (order Carnivora) are among the world's most threatened mammals due to a confluence of ecological and social forces that have unfolded over centuries. Combining specimens from natural history collections with documents from archival records, we reconstructed the factors surrounding the extinction of the California grizzly bear (), a once-abundant brown bear subspecies last seen in 1924. Historical documents portrayed California grizzlies as massive hypercarnivores that endangered public safety.

Effects of ocean acidification on growth and photophysiology of two tropical reef macroalgae.

Macroalgae can modify coral reef community structure and ecosystem function through a variety of mechanisms, including mediation of biogeochemistry through photosynthesis and the associated production of dissolved organic carbon (DOC). Ocean acidification has the potential to fuel macroalgal growth and photosynthesis and alter DOC production, but responses across taxa and regions are widely varied and difficult to predict. Focusing on algal taxa from two different functional groups on Caribbean coral reefs, we exposed fleshy (Dictyota spp.

Comparative uptake, translocation, and plant mediated transport of Tc-99, Cs-133, Np-237, and U-238 in Savannah River Site soil columns for the grass species Andropogon virginicus.

This study examines the ability of the grass species Andropogon virginicus to alter the subsurface transport and redistribution of a suite of radionuclides (Tc, Cs (stable analog for Cs and Cs), Np, U) with varying chemical behaviors in a Savannah River Site soil via the use of vegetated and unvegetated soil columns. After an acclimation period, a small volume of solution containing all radionuclides was introduced into the columns via Rhizon© pore water sampling tubes. Plants were grown for an additional 4 weeks before shoots were harvested, and columns were prepared for sampling.

Interprofessional collaboration among first responder students in a simulated disaster exercise.

Introduction: Interprofessional disaster simulation exercises provide an opportunity for first responder students to learn about disaster response and recovery, to practice their roles and to learn to collaborate with other first responders. With the move to virtual education during the COVID-19 pandemic, a table-top disaster exercise is an alternative format to inperson exercises. To date, most disaster simulation exercises for students have focused on the roles of healthcare providers.

Influence of offshore oil and gas structures on seascape ecological connectivity.

Offshore platforms, subsea pipelines, wells and related fixed structures supporting the oil and gas (O&G) industry are prevalent in oceans across the globe, with many approaching the end of their operational life and requiring decommissioning. Although structures can possess high ecological diversity and productivity, information on how they interact with broader ecological processes remains unclear. Here, we review the current state of knowledge on the role of O&G infrastructure in maintaining, altering or enhancing ecological connectivity with natural marine habitats.

Diet of a threatened endemic fox reveals variation in sandy beach resource use on California Channel Islands.

The coastal zone provides foraging opportunities for insular populations of terrestrial mammals, allowing for expanded habitat use, increased dietary breadth, and locally higher population densities. We examined the use of sandy beach resources by the threatened island fox (Urocyon littoralis) on the California Channel Islands using scat analysis, surveys of potential prey, beach habitat attributes, and stable isotope analysis. Consumption of beach invertebrates, primarily intertidal talitrid amphipods (Megalorchestia spp.

Are small airplanes safe with regards to COVID-19 transmission?

Social distancing is impossible in small aircrafts but there is a specific, highly effective ventilation system. Measurements proved that there is no crossflow between pilot, copilot and backseaters. Terefore the risk of infection should be very low.

Multiple climate change-driven tipping points for coastal systems.

As the climate evolves over the next century, the interaction of accelerating sea level rise (SLR) and storms, combined with confining development and infrastructure, will place greater stresses on physical, ecological, and human systems along the ocean-land margin. Many of these valued coastal systems could reach "tipping points," at which hazard exposure substantially increases and threatens the present-day form, function, and viability of communities, infrastructure, and ecosystems. Determining the timing and nature of these tipping points is essential for effective climate adaptation planning.

Placing the suspect at a PC: A preliminary study involving fingerprints on keyboards and mice.

Digital devices now play an important role in the lives of many in society. Whilst they are used predominantly for legitimate purposes, instances of digital crime are witnessed, where determining their usage is important to any criminal investigation. Typically, when determining who has used a digital device, digital forensic analysis is utilised, however, biological trace evidence or fingerprints residing on its surfaces may also be of value.

Ocean acidification disrupts the orientation of postlarval Caribbean spiny lobsters.

Anthropogenic inputs into coastal ecosystems are causing more frequent environmental fluctuations and reducing seawater pH. One such ecosystem is Florida Bay, an important nursery for the Caribbean spiny lobster, Panulirus argus. Although adult crustaceans are often resilient to reduced seawater pH, earlier ontogenetic stages can be physiologically limited in their tolerance to ocean acidification on shorter time scales.

A feasibility randomised control trial of individual cognitive stimulation therapy for dementia: impact on cognition, quality of life and positive psychology.

Objectives: This study aimed to evaluate the feasibility of a 14-session programme of individual Cognitive Stimulation Therapy (iCST) for people with dementia (PWD). It addressed potential limitations in previous literature of iCST and evaluated possible impact on cognition, quality of life (QoL) and positive psychology.

Method: The 14-session iCST programme was developed using existing manuals for group and individual CST and consultation with experts in the field.

Sea urchins mediate the availability of kelp detritus to benthic consumers.

Detritus can fundamentally shape and sustain food webs, and shredders can facilitate its availability. Most of the biomass of the highly productive giant kelp, Macrocystis pyrifera, becomes detritus that is exported or falls to the seafloor as litter. We hypothesized that sea urchins process kelp litter through shredding, sloppy feeding and egestion, making kelp litter more available to benthic consumers.

A review of quality procedures in the UK forensic sciences: What can the field of digital forensics learn?

With a reliance on the various forms of forensic science evidence in complex criminal investigations, the measures for ensuring its quality are facing increasing scrutiny. Improvements to quality management systems, to ensure both the robust application of scientific principles and the accurate interpretation and reporting of results, have arisen as a consequence of high-profile rebuttals of forensic science evidence, combined with process improvements driven by evaluation of current practice. These improvements are crucial to ensure validity of results as well as providing assurance for all those involved in the Criminal Justice System.

Underlying mechanisms and ecological context of variation in exploratory behavior of the Argentine ant, .

Uncovering how and why animals explore their environment is fundamental for understanding population dynamics, the spread of invasive species, species interactions, etc. In social animals, individuals within a group can vary in their exploratory behavior, and the behavioral composition of the group can determine its collective success. Workers of the invasive Argentine ant () exhibit individual variation in exploratory behavior, which affects the colony's collective nest selection behavior.

Retrosplenial and postsubicular head direction cells compared during visual landmark discrimination.

Background: Visual landmarks are used by head direction (HD) cells to establish and help update the animal's representation of head direction, for use in orientation and navigation. Two cortical regions that are connected to primary visual areas, postsubiculum (PoS) and retrosplenial cortex (RSC), possess HD cells: we investigated whether they differ in how they process visual landmarks.

Methods: We compared PoS and RSC HD cell activity from tetrode-implanted rats exploring an arena in which correct HD orientation required discrimination of two opposing landmarks having high, moderate or low discriminability.

Landmark-Based Updating of the Head Direction System by Retrosplenial Cortex: A Computational Model.

Maintaining a sense of direction is fundamental to navigation, and is achieved in the brain by a network of head direction (HD) cells, which update their signal using stable environmental landmarks. How landmarks are detected and their stability determined is still unknown. Recently we reported a new class of cells (Jacob et al.

Taking the metabolic pulse of the world's coral reefs.

Worldwide, coral reef ecosystems are experiencing increasing pressure from a variety of anthropogenic perturbations including ocean warming and acidification, increased sedimentation, eutrophication, and overfishing, which could shift reefs to a condition of net calcium carbonate (CaCO3) dissolution and erosion. Herein, we determine the net calcification potential and the relative balance of net organic carbon metabolism (net community production; NCP) and net inorganic carbon metabolism (net community calcification; NCC) within 23 coral reef locations across the globe. In light of these results, we consider the suitability of using these two metrics developed from total alkalinity (TA) and dissolved inorganic carbon (DIC) measurements collected on different spatiotemporal scales to monitor coral reef biogeochemistry under anthropogenic change.

A speed-accurate self-sustaining head direction cell path integration model without recurrent excitation.

The head direction (HD) system signals HD in an allocentric frame of reference. The system is able to update firing based on internally derived information about self-motion, a process known as path integration. Of particular interest is how path integration might maintain concordance between true HD and internally represented HD.

A dual-axis rotation rule for updating the head direction cell reference frame during movement in three dimensions.

In the mammalian brain, allocentric (Earth-referenced) head direction, called azimuth, is encoded by head direction (HD) cells, which fire according to the facing direction of the animal's head. On a horizontal surface, rotations of the head around the dorsoventral (D-V) axis, called yaw, correspond to changes in azimuth and elicit appropriate updating of the HD "compass" signal to enable large-scale navigation. However, if the animal moves through three-dimensional (3D) space then there is no longer a simple relationship between yaw rotations and azimuth changes, and so processing of 3D rotations is needed.