Regulation of nitrate emission from agriculture to aquatic environments in Denmark currently depend on general rules for nutrient application and associated farm-level reporting schemes. Similar or comparable centralized regulation instruments dedicated to controlling and limiting rather than focusing and improving N application practices exist in large parts of the OECD. Recent policy debates have exposed an array of problems relating to this type of regulation. Problems include issues of appropriate scale, transparency and failures to adapt intervention and regulation to relevant geo-ecological variations in contexts where general rules are being imposed on varied agro-ecosystems. Therefore it has been proposed to rescale regulation to better fit relevant socio-political and agro-environmental processes including the scale of farmers' decision making, the scale of relevant hydrological systems and the scale of key agro-ecological conditions such as soil characteristics and drainage. However, the challenge of shifting the regulation to a more local scale raises a number of questions. These include (1) How information produced locally can be integrated with national scale data? (2) In what way integrated datasets can used to model environmental effects of current and possible land use patterns? (3) In what way data and estimates of consequences of land use changes are best made available in decision making processes? To address these questions this article reports on ongoing work in Denmark to develop a decision support tool for N-management at the scale of agricultural landscapes, which are areas where a similar pattern of land use is repeated across the land surface, reflecting a specific mode of adapting agriculture to natural conditions. The aim of the article is to evaluate the design of a decision support tool aiming at enabling strategic N-management at landscape scales by linking decision support at the scale of individual farms with decision support targeted at groups of farms where a coordinated effort to solve common problems may be more efficient. Design targets for the tool were established empirically based on evidence from exploratory workshops with farmers and other stakeholders in 6 case areas across Denmark. On this basis a prototype GIS-tool for capturing, storing, editing, displaying and modelling landscape scale farming practices and associated emission consequences was developed. The tool was designed to integrate locally held knowledge with national scale datasets in live scenario situations through the implementation of a flexible, uniform and editable data model for land use data - the dNmark landscape model. Based on input data that is corrected and co-authored by workshop participants, the tool estimates the effect of potential land use scenarios on nutrient emissions. The tool was tested in 5 scenario workshops in case areas in Denmark in 2016, on the basis of which its design is evaluated and discussed in this article.
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http://dx.doi.org/10.1016/j.jenvman.2019.05.107 | DOI Listing |
Infect Dis Ther
January 2025
ViiV Healthcare, Madrid, Spain.
Introduction: Dolutegravir (DTG) + lamivudine (3TC) demonstrated high rates of virologic suppression (VS) and low rates of virologic failure (VF), discontinuation, and drug resistance in randomized trials. Real-world evidence can support treatment effectiveness, safety, and tolerability in clinical practice and aid in treatment decisions.
Methods: A systematic literature review (SLR) was conducted to identify studies using DTG + 3TC (January 2013-March 2024).
Drugs Aging
January 2025
Program for the Care and Study of the Aging Heart, Department of Medicine, Weill Cornell Medicine, 420 East 70th St, New York, NY, LH-36510063, USA.
There are several pharmacologic agents that have been touted as guideline-directed medical therapy for heart failure with preserved ejection fraction (HFpEF). However, it is important to recognize that older adults with HFpEF also contend with an increased risk for adverse effects from medications due to age-related changes in pharmacokinetics and pharmacodynamics of medications, as well as the concurrence of geriatric conditions such as polypharmacy and frailty. With this review, we discuss the underlying evidence for the benefits of various treatments in HFpEF and incorporate key considerations for older adults, a subpopulation that may be at higher risk for adverse drug events.
View Article and Find Full Text PDFJ Clin Monit Comput
January 2025
Department of Anaesthesiology and Intensive Care, Bicetre hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Le Kremlin Bicetre, France.
Intravenous fluid is administered during high-risk surgery to optimize stroke volume (SV). To assess ongoing need for fluids, the hemodynamic response to a fluid bolus is evaluated using a fluid challenge technique. The Acumen Assisted Fluid Management (AFM) system is a decision support tool designed to ease the application of fluid challenges and thus improve fluid administration during high-risk surgery.
View Article and Find Full Text PDFArch Dermatol Res
January 2025
Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
We have recently shown that fluoxetine (FX) suppressed polyinosinic-polycytidylic acid-induced inflammatory response and endothelin release in human epidermal keratinocytes, via the indirect inhibition of the phosphoinositide 3-kinase (PI3K)-pathway. Because PI3K-signaling is a positive regulator of the proliferation, in the current, highly focused follow-up study, we assessed the effects of FX (14 µM) on the proliferation and differentiation of human epidermal keratinocytes. We found that FX exerted anti-proliferative actions in 2D cultures (HaCaT and primary human epidermal keratinocytes [NHEKs]; 48- and 72-h; CyQUANT-assay) as well as in 3D reconstructed epidermal equivalents (48-h; Ki-67 immunohistochemistry).
View Article and Find Full Text PDFPediatr Cardiol
January 2025
Department of Infectious Disease, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, No. 1678 Dongfang Road, Pudong New Area, Shanghai, 200127, China.
Kawasaki disease (KD) is a febrile vasculitis disorder, with coronary artery lesions (CALs) being the most severe complication. Early detection of CALs is challenging due to limitations in echocardiographic equipment (UCG). This study aimed to develop and validate an artificial intelligence algorithm to distinguish CALs in KD patients and support diagnostic decision-making at admission.
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