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Schizophyllum commune is an environmental basidiomycetous fungus, causing occasional, predominantly respiratory, infections in humans. Although S. commune is considered an emerging pathogen, some authors pointed out the possibility that the increase in the diagnosed cases may be also due to recent advances in diagnostic technologies now allowing a more prompt and precise identification at the species level. Here we describe the first Italian case of chronic non-invasive fungal rhinosinusitis due to S. commune in an immunocompetent subject and update the literature review on S. commune sinusitis published between 2012–2019. A timely diagnosis is important to avoid local and systemic complications due to infection with this fungus. In our case, prompt identification at species level was only possible with the use of MALDI-TOF mass spectrometry and confirmed by sequence analysis of ribosomal DNA ITS regions, due to the difficulty in achieving a correct and rapid identification using routine morphological analysis. [ABSTRACT FROM AUTHOR]

Values held in agricultural extension systems determine which extension goals can be reached. Globally changing socio-ecological contexts require a paradigm shift in agricultural extension systems from a top-down approach dominated by instrumental values to achieve the primary goal of increasing yields, to a more site-specific relational and participatory approach that induces locally adaptive use of sustainable agricultural practices. A literature review was conducted to understand how relational values in farmer-to-farmer extension align with participatory agricultural extension systems. Relevance, trust, and place attachment are the main relational values expressed in farmer-to-farmer extension where participatory processes incorporate farmers' livelihood outcomes in the transformational goals of agricultural extension. Recognizing and strengthening the relational values in farmer-to-farmer extension, based on different contexts, will likely support the development of locally adapted knowledge and innovations, and provide a basic rationale for building communication strategies, colearning, and supporting behavioral change of all agricultural extension actors. • Farmer-to-farmer extension prioritizes rural livelihoods over yield increase. • Relevance, trust, and place attachment strengthen farmer-to-farmer extension. • Relational values support adaptive capacity of connected farming communities. • Strengthened relational values support the use of best-fit agricultural innovations. [ABSTRACT FROM AUTHOR]

Exophiala dermatitidis is a dematiaceous fungus with yeast-like and hyphal growth states that may cause cutaneous and visceral infections. Recently, E. dermatitidis has been linked to central line associated blood stream infection (CLABSI), probably due to its ability to produce extracellular polysaccharides and grow as biofilm. We describe an E. dermatitidis CLASBI. The strain was identified by morphological and molecular methods. E. dermatitidis CLASBI is highly uncommon, but seems to be increasing. [ABSTRACT FROM AUTHOR]

Abstract The concept of land degradation neutrality (LDN) is a new approach receiving considerable interest because of its potential to address land degradation. Implementing LDN presents a number of challenges primarily concerned with the choice of scales of operation at which to apply it and then, monitoring and assessing degradation status and trends at these scales. In the absence of studies that apply the concept to local scales and engage local stakeholders, our study was undertaken in the Gilgel-Abay watershed of northwest Ethiopia using sites that equate to a local landscape scale (10–1000 km2) at which decisions about land use are made. Combining participatory mapping, farmer interviews and a field survey of soil erosion prevalence, our objectives were to: (i) understand local perceptions of land degradation and restoration activities; (ii) assess their implications for LDN, and (iii) explore the utility of engaging local land users in the assessment of land degradation and restoration activities. Our findings demonstrate that engaging land users can provide a comprehensive overview of land degradation and restoration activities at local scales; that land users may not share the same priorities, in terms of where, when and how to address degradation, as one another, or with other actors involved in restoration initiatives, which implies a need for negotiation; and that the impacts of restoration activities are likely to be socially differentiated. This makes it important to understand how livelihoods interact with different restoration interventions and to take measures to ensure that striving for LDN does not disadvantage the most vulnerable people. Based on these findings, we propose three guiding strategies for implementing LDN at local scales: negotiate priorities and incentivize action; match options to context; and, co-produce knowledge and indicators. [ABSTRACT FROM AUTHOR]

Objective The purposes of this study were to report our experience with endoscopic treatment of choanal atresia (CA), to illustrate our surgical technique and analyse the different factors that may affect outcomes. Material and methods A retrospective review was performed of patients affected by congenital CA and treated between June 1996 and November 2013 at three referral centres which follow a uniform policy. Results Eighty-four patients with CA (55 unilateral and 29 bilateral), aged between one day and 76 years (mean, 13 years) were included. Associated malformations were present in 28 patients. The overall success rate was 93%, with 96.3% and 86.2% success rates for unilateral and bilateral CA respectively. Six patients (7%) required revision surgery for early symptomatic restenosis. Statistical analysis revealed that outcomes were not influenced by sex, previous surgeries, unilateral versus bilateral atresia or associated anomalies. However, age seemed to be a prognostic risk factor for patients under one year-old. Conclusion The endoscopic endonasal approach is safe and effective, with a very high success rate and low morbidity. The removal of the vomer and the use of mucoperiosteal flaps are the main keys to avoiding postoperative stenosis. The use of stents or Mitomycin C is therefore not mandatory. [ABSTRACT FROM AUTHOR]

One of the main causes of tropical forest loss is conversion to agriculture, which is constantly increasing as a dominant land cover in the tropics. The loss of forests greatly affects biodiversity and ecosystem services. This paper assesses the economic return from increasing tree cover in agricultural landscapes in two tropical locations, West Java, Indonesia and eastern Bangladesh. Agroforestry systems are compared with subsistence seasonal food-crop-based agricultural systems. Data were collected through rapid rural appraisal, field observation, focus groups and semi-structured interviews of farm households. The inclusion of agroforestry tree crops in seasonal agriculture improved the systems’ overall economic performance (net present value), even when it reduced understorey crop production. However, seasonal agriculture has higher income per unit of land area used for crop cultivation compared with the tree establishment and development phase of agroforestry farms. Thus, there is a trade-off between short-term loss of agricultural income and longer-term economic gain from planting trees in farmland. For resource-poor farmers to implement this change, institutional support is needed to improve their knowledge and skills with this unfamiliar form of land management, sufficient capital for the initial investment, and an increase in the security of land tenure. [ABSTRACT FROM AUTHOR]

Background This paper describes our experience in the management of acute and chronic invasive fungal rhinosinusitis (IFRS) in adults. Methods Medical files of all patients aged >18 years treated in our institutions for IFRS from 2002 to 2013 were retrospectively reviewed. Results A total of 18 cases (10 acute and 8 chronic) were recorded. In acute form, haematological malignancies represented the principal comorbidity (100%), while in chronic form this was diabetes mellitus (87.5%). All patients received systemic antifungal agents. Endoscopic sinus surgery was performed in 16/18 patients (88.9%). Among patients with an acute IFRS, 4/10 died of fungal infection (40%), on the other side 2/8 patients with chronic IFRS died of the evolution of the mycosis (25%). Conclusions Acute and chronic IFRS are different entities: in acute form, prognosis is poor, so therapy should be promptly performed, although host immune status and evolution of the haematological disease are key factors for the outcome. In chronic form, a wide surgical excision of the disease is recommended in order to obtain a complete removal of fungal infection. In both forms, early clinical findings are non-specific and ambiguous, so diagnosis depends on a high index of suspicion, taking into account predisposing factors. [ABSTRACT FROM AUTHOR]

Abstract: This paper introduces a GIS framework (Polyscape) designed to explore spatially explicit synergies and trade-offs amongst ecosystem services to support landscape management (from individual fields through to catchments of ca 10,000km2 scale). Algorithms are described and results presented from a case study application within an upland Welsh catchment (Pontbren). Polyscape currently includes algorithms to explore the impacts of land cover change on flood risk, habitat connectivity, erosion and associated sediment delivery to receptors, carbon sequestration and agricultural productivity. Algorithms to trade these single-criteria landscape valuations against each other are also provided, identifying where multiple service synergies exist or could be established. Changes in land management can be input to the tool and “traffic light” coded impact maps produced, allowing visualisation of the impact of different decisions. Polyscape hence offers a means for prioritising existing feature preservation and identifying opportunities for landscape change. The basic algorithms can be applied using widely available national scale digital elevation, land use and soil data. Enhanced output is possible where higher resolution data are available (e.g., LIDAR, detailed land use or soil surveys). Deficiencies in the data are reduced by incorporating local stakeholder knowledge (increasing stakeholder participation in the negotiation process). [Copyright &y& Elsevier]

Objectives: To evaluate the role of nasal endoscopy for early clinical diagnosis of hereditary hemorrhagic telangiectasia (HHT) in children and to investigate the characteristics of epistaxis and mucocutaneous telangiectases in our pediatric population.Study Design: From May 2016 to December 2019, a cross-sectional observational study was conducted, recruiting children aged 2-18 years with a parent affected by HHT. To identify the Curaçao criteria, all children underwent collection of clinical history, mucocutaneous examination, and nasal endoscopy. The clinical data were then compared with the genetic data acquired subsequently.Results: Seventy children (median age, 10.8 years) were included. All underwent nasal endoscopy without complications. Forty-six children were positive by genetic testing; of these, 26 % had skin and oral telangiectases and 91 % had nasal telangiectases. The diagnostic sensitivity of the Curaçao criteria increased from 28 % (95 % CI, 16%-43 %) to 85 % (95 % CI, 71%-94 %; P < .0001) when the nasal telangiectases were included.Conclusions: The magnified and complete endoscopic view of the nasal cavities proved useful in increasing the diagnostic sensitivity of the Curaçao criteria. Such an examination turned out to be feasible and safe. For this reason, we believe that nasal endoscopy should be included in the diagnostic assessment of pediatric patients with suspected HHT. [ABSTRACT FROM AUTHOR]

• Increasing tree cover on agricultural land is a way to enhance ecosystem services. • The benefits, costs and effects on beneficiaries of increasing tree cover is uneven. • Land-sparing can increase regulating benefits but reduces provisioning benefits. • Land-sharing can increase regulating benefits and maintain provisioning benefits. Increasing tree cover on agricultural land is recognised as a potential mechanism to enhance ecosystem services. In this case study, we assessed and mapped the impacts on ecosystem services and dis-services of different land-sparing and land-sharing strategies for tree cover expansion on grassland and arable land in the Welsh uplands. In addition, we modelled the impacts of widespread adoption of these strategies on grassland and arable land on the total basket of ecosystem services derived from the Welsh uplands. Our modelling over a 120-year period suggests land-sharing strategies (agroforestry options) could lead to the greatest potential increase in ecosystem service benefits (+£2.62 billion for the Agroforestry – in field trees option). Such land-sharing strategies deliver a basket of ecosystem services primarily focused on private provisioning benefits, with only modest increases in public regulation and maintenance benefits. In contrast, land-sparing strategies (full afforestation options) deliver the highest level of public regulation and maintenance benefits (£7.60 billion), but at the cost of provisioning benefits (−£17.13 billion). Land-sharing strategies (agroforestry options) provide the highest level of in-situ ecosystem service benefits. Land-sparing strategies (full afforestation options) primarily provide ex-situ ecosystem service benefits and are likely to require livelihood shifts for private landowners and occupants. [ABSTRACT FROM AUTHOR]

• Humans derive multiple benefits and costs from upland land use in Wales. • The economic value of these benefits and costs is currently uncaptured. • The contribution of different land uses to these benefits is unbalanced. • Upland agriculture in Wales provides the highest economic value of benefits per hectare. • There is however scope to increase the public benefits of upland agricultural land use. Upland land use in Wales has high potential value in relation to the delivery of ecosystem services which is currently uncaptured. In this study we assessed the ecosystem services and dis-services generated by the two dominant land uses (forestry and agricultural) in the uplands of Wales in qualitative and monetary units. We also mapped the distribution of ecosystem services and dis-services across the two dominant land uses. Our results provide an initial baseline estimate of the supply and economic value of ecosystem services and dis-services from upland forestry and agricultural land use in Wales. The qualitative assessment showed the highest levels of ecosystem service supply were derived from forestry land use and the highest levels of ecosystem dis-services were derived from agricultural land use. The economic value of ecosystem service benefits from upland land use in Wales is £1,472.25 million year−1 and the total costs of ecosystem dis-services are £101.54 million year−1 using 2018 values. When an economic weighting is applied the per hectare economic value of ecosystem service benefits from agriculture at £1,434.02 ha−1 year−1 is higher than that of forestry at £1,261.09 ha−1 year−1 and the per hectare costs of ecosystem dis-services from agriculture at £96.10 ha−1 year−1 was marginally lower than that of forestry at £98.58 ha−1 year−1. Overall our results highlight an imbalance in the current delivery of ecosystem services from upland land use in Wales with the majority of benefits coming in the form of private benefits through provisioning services. By using systematic qualitative and economic assessment tools this study has highlighted critical data gaps and provides a basis for rebalancing ecosystem service delivery and increasing levels of public benefits through expansion of tree cover within the Welsh uplands. Our mapping highlights where land use adaption and transformation may be approached to address the imbalance in ecosystem service supply. [ABSTRACT FROM AUTHOR]

Introduction: A new bio-degradable synthetic membrane was recently introduced to treat second degree burns in adults and pediatric patients.Objective: To assess complications and outcomes using this absorbable synthetic membrane to treat second degree burns.Methods: 229 burn patients, 138 pediatric, with superficial and deep second -degree wounds, treated with the absorbable synthetic membrane (Suprathel®, Polymedics, Denkendorf, Germany) were included in this study. Patients were treated under anesthesia or moderate sedation. The wound bed was prepared by using either rough debridement or dermabrasion excision. After hemostasis, the membrane was applied to the wound with an outer layer dressing of fatty gauze, bridal veil, absorptive gauze and an ACE® wrap. The outer dressing was removed every one to four days, depending on exudate, in order to closely follow the wound through the translucent membrane and fatty gauze layers. After complete epithelialization, the dressing separated and could be removed. The study focused on the need for subsequent grafting, healing time, patient pain level, hypertrophic scarring and rate of infection.Results: All wounds in this study that were treated with Suprathel® healed without grafting. The average TBSA (Total Body Surface Area) was 8.9% (1%-60%). Average time to healing was 13.7 days for ≥ 90% epithelialization with 11.9 days for pediatric patients versus 14.7 days for adults. Throughout the treatment period, the average pain level was 1.9 on a 10-point scale. 27 patients developed hypertrophic scarring in some areas (11.7%). Average Length of stay (LOS) was 6.9 days. The rate of infection was 3.8% (8/229). Failure or progression to full thickness in part of the wounds was 5.2% (12/229).Conclusion: In treating second degree burn wounds, this membrane provides a simple, effective solution alternative with good outcomes and less pain than conventional and previously studied treatment options in the same institution. Fewer dressing changes and easier overall management of the wounds contribute to its favorable profile. [ABSTRACT FROM AUTHOR]