Emotional, informational, and decision-making support needs among people seeking abortion in the US: perspectives from All-Options Talkline callers.

People seeking abortion may need or want emotional or informational support before, during, and after their abortion. Feeling supported and affirmed contributes to perceptions of quality care. The All-Options Talkline offers free, telephone-based, peer counselling to callers anywhere in the United States. This study aimed to explore the types of support received through the Talkline and the ways it supplemented other forms of support received by people who obtained an abortion. Between May 2021 and February 2022, we conducted 30 interviews via telephone or Zoom with callers recruited through the Talkline. We coded the interviews and conducted thematic analysis, focusing on themes related to gaps of support from family, friends, and healthcare professionals, as well as types of support received through the Talkline. We identified four key motivations for calling the Talkline, including the need for (1) decision-making support and validation, (2) a neutral perspective, (3) emotional support to discuss negative or complex feelings, and (4) information about the abortion process. Participants indicated that interactions with family, friends, and healthcare professionals ranged from unsupportive and negative, to substantially supportive. Access to the Talkline was particularly useful prior to clinical interactions and in the weeks or months after an abortion. We found that the All-Options Talkline provided person-centred, remote support for callers, filling gaps or supplementing support from one's community or healthcare professionals. Abortion support from non-medically trained support people contributes to high-quality abortion care, especially in a time of increasing abortion restrictions and use of remote abortion services.

Abdominal wound dehiscence and incisional hernia prevention in midline laparotomy: a systematic review and network meta-analysis.

BACKGROUND: Incisional hernia (IH) is the main complication after laparotomy. In an attempt to reduce this complication, mesh techniques and studies in which the closure technique is modified have been proposed. Both types are characterized by comparison with the closure described as standard or conventional: 1 × 1, mass, and continuous closure. For this study, modified closure techniques (MCTs) were considered as those techniques in which an extra suture is placed (reinforced tension line (RTL), retention), the closure point is modified in distance (small bites) or shape (CLDC, Smead Jones, interrupted, Cardiff point) and which aim to reduce these complications. The objective of this network meta-analysis (NMA) was to evaluate the effectiveness of MCTs for reducing the incidence of IH and abdominal wound dehiscence (AWD) to provide objective support for their recommendation. METHODS: An NMA was performed according to the PRISMA-NMA guidelines. The primary objective was to determine the incidence of IH and AWD, and the secondary objective was to determine the incidence of postoperative complications. Only published clinical trials were included. The risk of bias was analyzed, and the random-effects model was used to determine statistical significance. RESULTS: Twelve studies comparing 3540 patients were included. The incidence of HI was lower in RTL, retention suture, and small bites, these techniques showed statistical differences with pooled ORs (95% CI) of 0.28 (0.09-0.83), 0.28 (0.13-0.62), and 0.44 (0.31-0.62), respectively. Associated complications, including hematoma, seroma, and postoperative pain, could not be analyzed; however, MCTs did not increase the risk of surgical site infection. CONCLUSION: Small bites, RTL, and retention sutures decreased the prevalence of IH. RTL and retention suture decreased the prevalence of AWD. RTL was the best technique as it reduced both complications (IH and AWD) and had the best SUCRA and P-scores, and the number needed to treat (NNT) for net effect was 3. REGISTRATION: This study was prospectively registered in the PROSPERO database under registration number CRD42021231107.

Incorporating Ecosystem Services into Water Resources Management-Tools, Policies, Promising Pathways.

Ecosystems provide a range of services, including water purification, erosion prevention, and flood risk mitigation, that are important to water resource managers. But as a sector, water resources management has been slow to incorporate ecosystem protection and restoration, for a variety of reasons, although related concepts such as nature-based solutions and green infrastructure are gaining traction. We explain some of the existing challenges to wider uptake of the ecosystem services concept in water resources management and introduce some promising avenues for research and practice, elaborated in more detail through 12 papers, spanning five continents and a variety of contexts, which make up a Special Issue on "Incorporating Ecosystem Services into Water Resources Management". Cross-cutting themes include (A) ecosystem services as a flexible concept to communicate with stakeholders; (B) participatory processes to involve stakeholders in research; (C) multiple values, and valuation methods, of water-related services; and (D) applications of decision-support tools. We conclude with a summary of research gaps and emphasize the importance of co-producing knowledge with decision makers and other stakeholders, in order to improve water resources management through the integration of ecosystem services.

Identifying Spatial Patterns and Ecosystem Service Delivery of Nature-Based Solutions.

Compared to technical infrastructure, nature-based solutions, NBS, strive to work with nature and to move beyond business-as-usual practices in order to address societal challenges such as flood risks. This research aims to spatially identify possible NBS areas and evaluate the areas capacity to provide selected ecosystem services, ES, for the Lahn river landscape in Germany. The research follows the functional landscape approach using hydromorphological landscape units, HLU, based on specific biophysical spatial criteria, such as slope, to then identify locations which may be considered suitable for NBS. The current ES delivery of these possible NBS areas is then evaluated. The three ES assessed are carbon storage, nutrient retention and recreation. We then undertake a geospatial comparison analysis to show the spatial relationships and patterns that emerge in regards to the ES configuration of the distinct NBS apt areas. Results show the HLU method serves to delineate and identify areas where NBS may exist or be implemented. The data depicts a distinct spatial pattern for each possible NBS space and complementary ES delivery. This explorative method is a useful spatial approach that can support NBS implementation and serve to investigate the multiple benefits NBS provide. The use of ecosystem services to compare and understand NBS is a viable prospect that must, however, be cautiously, locally and scientifically approached. Noticeable limitations regarding ES assessment remain, as available methods are often insufficiently inclusive of natural ecosystem processes and functions. Further research should assess a broader spectrum of NBS and their delivery of ES.

Advancing Sustainable Development Goals with localised nature-based solutions: Opportunity spaces in the Lahn river landscape, Germany.

Nature-based solutions (NBS) are recognized as promising actions to alleviate societal challenges and achieve the United Nation's Sustainable Development Goals (SDGs). One scientific challenge to implement NBS in practice is to locate areas suitable for an effective implementation of NBS (opportunity spaces). Opportunity spaces either already host NBS that need to be safeguarded or restored, or provide the socio-ecological conditions for establishing new NBS. Complex methods have been proposed to model potential locations of selected NBS, but they are often too data and resource intensive to be applied in practice for landscape planning. The aim of this article is to put forward a pragmatic method for identifying NBS opportunity spaces that contribute to advance multiple SDGs, and to test its application in a participatory, extended peer-review process in the Lahn river landscape, Germany. Our method includes: (i) synthesizing a generic catalogue of NBS in river landscapes, (ii) estimating the potential of NBS to achieve simultaneously Lahn development goals (LDGs) and SDGs, and (iii) applying key spatial indicators and best available data to explore opportunity spaces for selected NBS. The generic catalogue provides a systematic overview of 650 individual NBS for river landscapes and their respective potentials for addressing LDGs and SDGs. The NBS Renaturalising floodplains through land use changes, Revitalising historic floodplains, and Creating buffer strips are those actions contributing to the greatest number of local SDGs (locally adapted SDGs that include LDGs). Results of the spatial analysis in the Lahn river landscape showed about 4739 ha of areas where NBS were already in place and need to be safeguarded and additional 1323 ha with opportunities for further NBS creation. The proposed method presents a robust and transferable approach that facilitates spatial mapping of NBS to local SDGs for planning practitioners facing time and resource constraints.

Methamphetamine Compromises the Adaptive B Cell-Mediated Immunity to Antigenic Challenge in C57BL/6 Mice.

Methamphetamine (METH) is a substance of abuse that causes dysregulation of the innate and adaptive immunity in users. B cells are involved in the humoral component of the adaptive immunity by producing and secreting antibodies (Abs). METH modifies Ab production, although limited information on the impact of this psychostimulant on antigen (Ag)-specific humoral immune responses is available. Since T cell-dependent and T cell-independent Ags are involved in the activation of B lymphocytes, we explored the role of METH on humoral immunity to ovalbumin (OVA; T cell-dependent) and bacterial lipopolysaccharide (LPS; T cell-independent) in C57BL/6 mice. We demonstrated that METH extends the infiltration of B cells into pulmonary and splenic tissues 7 days post-Ag challenge. METH impairs Ab responses in the blood of animals challenged with OVA and LPS. Furthermore, METH diminishes the expression and distribution of IgM on B cell surface, suggesting a possible detrimental impact on users' humoral immunity to infection or autoimmunity.

Planning nature-based solutions: Principles, steps, and insights.

Nature-based solutions (NBS) find increasing attention as actions to address societal challenges through harnessing ecological processes, yet knowledge gaps exist regarding approaches to landscape planning with NBS. This paper aims to provide suggestions of how planning NBS can be conceptualized and applied in practice. We develop a framework for planning NBS by merging insights from literature and a case study in the Lahn river landscape, Germany. Our framework relates to three key criteria that define NBS, and consists of six steps of planning: Co-define setting, Understand challenges, Create visions and scenarios, Assess potential impacts, Develop solution strategies, and Realize and monitor. Its implementation is guided by five principles, namely Place-specificity, Evidence base, Integration, Equity, and Transdisciplinarity. Drawing on the empirical insights from the case study, we suggest suitable methods and a checklist of supportive procedures for applying the framework in practice. Taken together, our framework can facilitate planning NBS and provides further steps towards mainstreaming.

Effect of dental restorative materials surface roughness on the in vitro biofilm formation of Streptococcus mutans biofilm.

PURPOSE: To evaluate Streptococcus mutans biofilm formation over different restorative dental materials. METHODS: Using a bioreactor over 72 hours, four commercially available ceramics were evaluated: IPS E-max Press, IPS E-max CAD, Lava Ultimate CAD-CAM, Vita Enamic and two resin composites (SR Nexco Paste and Brilliant NG). The results were evaluated using atomic force microscopy and confocal microscopy, the biofilm was stained and the arbitrary fluorescence units (AFU) quantified. RESULTS: The results showed that IPS E-max CAD had the lowest roughness values (4.29±1.79 nm), while the highest values were observed for Vita Enamic discs ( (77.13±17.35 nm). Analysis of S. mutans biofilm formation by AFU revealed lower values for IPS E-max CAD (6.77±1.67 nm); the highest values were found for Lava Ultimate (79.99±22.23 nm). Regarding the composite groups, SR Nexco Paste showed roughness values of 15.07±2.77 nm and lower arbitrary fluorescence units of 30.92±12.01 nm than Brilliant NT. There was a correlation between the surface roughness of ceramics and composite with S. mutans biofilm formation. CLINICAL SIGNIFICANCE: The adhesion of oral bacteria to restorative dental materials plays a key role in the success of dental treatment; the surface roughness influences the S. mutans biofilm formation.

Síndrome de Sjögren primario y enfermedad quística pulmonar: reporte de un caso / Primary Sjögren syndrome and pulmonary cysts disease: case report

El síndrome de Sjögren (SS) es una enfermedad inflamatoria, autoinmunitaria crónica de etiología desconocida, caracterizada por infiltración del tejido glandular y extraglandular por linfocitos y células plasmáticas. Presenta manifestaciones glandulares (xeroftalmia y xerostomía) y extraglandulares (50%); v.gr.: pulmonares (11%) ­las más comunes son la enfermedad intersticial linfocítica y la enfermedad quística pulmonar (25%)­; las manifestaciones extraglandulares preceden, muchas veces, a las manifestaciones glandulares; por este motivo su diagnóstico se confunde o se retrasa. Caso clínico: paciente de sexo femenino, 71 años de edad, con antecedentes de hipertensión arterial e hipotiroidismo. Hospitalizada por astenia, tos seca y disnea de medianos esfuerzos. Revisión de aparatos y sistemas: xeroftalmia y xerostomía. Exámenes complementarios: Rx tórax: opacidades difusas redondeadas en ambos campos pulmonares; tomografía simple de tórax: múltiples lesiones quísticas predominantes en los lóbulos inferiores y calcificaciones nodulares. Se amplían los estudios para determinar la etiología: exámenes inmunoquímicos: anti SSA/Ro 200 U/ml (< 20 UE/ ml), anti SSB/La 84,4U/ml (< 20 UE/ml), anticuerpos antinucleares 1/160 (≤ 1/40), factor reumatoideo 49,9UI/ml (< 20 UI/ml). Se sospecha síndrome de Sjogren y realiza sialografía de parótidas que evidencia obstrucción y procesos inflamatorios de los conductos parotídeos. Biopsia de labio inferior: mucosa revestida por epitelio escamoso, edema intercelular y exocitosis linfocitaria. El estroma contiene infiltrado linfomononuclear disperso característico del SS. Una vez confirmado el diagnóstico, se trata con corticoides y tratamiento específico del ojo y boca seca.

Context: Sjögren's syndrome (SS) is an inflammatory, chronic autoimmune disease of unknown etiology, which is characterized by infiltration of glandular and extraglandular tissue by lymphocytes and plasma cells. It presents glandu-lar manifestations (xerophthalmia and xerostomia), as extraglandular (50%). Within these, there are pulmonary manifestations (11%), the most common manifestation being lymphocytic interstitial disease followed by cystic lung dis-ease (25%). Its manifestations often precede the glandular manifestations so that the diagnosis of it is confused or delayed. Case presentation: A 71-year-old female patient with a history of high blood pressure and hypothyroidism. Hospitalized for presenting asthenia, dry cough and dyspnea to the medium efforts. In the review of all systems, she referred xerophthalmia and xerostomia. The following exams were carried out: Rx thor-ax: rounded diffuse opacities in both pulmonary fields, is complemented with simple chest Tomography: Multiple pre-dominant cystic lesions in lower lobes and nodular calcifications. It was decided to expand the studies to determine etiology and see if it is related to its xerophthalmia and xerostomia characteris-tic of SS. Immunochemical tests were performed. The results: anti-SSA / Ro 200 U / mL (< 20 EU / mL); anti SSB / 84.4U / mL (< 20 EU / mL); antinuclear antibodies with fine granular pattern 1/160 (≤ 1/40) Rheumatoid factor 49.9UI / mL (< 20 IU / mL). With the suspicion of Sjogren's syndrome, parotid sialog-raphy is performed, obstruction is evidenced and chronic inflammatory pro-cesses of parotid ducts. Lower lip biopsy: Mucosa lined by squamous epitheli-um with intercellular edema and exocytosis of small lymphocytes. The stroma contains mild scattered lymphomononuclear infiltrate characteristic of SS. Con-firmed diagnosis of SS managed with corticosteroids and specific treatment of eye and dry mouth.