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Marine and coastal ecosystems are among the most productive environments in the world and their stocks of natural capital offer a bundle of vital ecosystem services. Anthropogenic pressure seriously threatens health and long-term sustainability of marine environments. For these reasons, integrated approaches capable of combining ecological and socio-economic aspects are needed to achieve nature conservation and sustainability targets. In this study, the value of natural capital of the Egadi Islands Marine Protected Area (EI-MPA) was assessed through a biophysical and trophodynamic environmental accounting model. The emergy value of both autotrophic and heterotrophic natural capital stocks was calculated for the main habitats of the EI-MPA. Eventually, the emergy value of natural capital was converted into monetary units to better communicate its importance to local managers and policy-makers. The total value of natural capital in the EI-MPA resulted in 1.12·10 21 sej, equivalent to about 1.17 billion of euros. In addition, using Marxan software, the results of the environmental accounting were integrated with spatial data on main human uses. This integration took into account the trade-offs between conservation measures and human exploitation by means of two different scenarios, with and without considering human uses in the EI-MPA. The comparison between the scenarios highlighted the importance of taking into account human activities in marine spatial planning (MSP), allowing the identification of key areas for natural capital conservation. In conclusion, this study showed the importance of integrating environmental accounting with conservation planning to support effective strategies for ecological protection and sustainable management of human activities. The results of this study represent a first benchmark useful to explore alternative nature conservation strategies in the EI-MPA, and, more in general, in Mediterranean MPAs. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy and tolerability of flunisolide given once-daily in patients with persistent asthma versus other inhaled corticosteroids given in standard multidose regimens. Patients and Methods: A total of 515 patients aged 16 to 75 years with mild to moderate asthma stabilised on multidose regimens of various inhaled corticosteroids were enrolled in an 8-week, open-label, multicentre, randomised, parallel-group study. Patients were randomised in a 4:1 ratio to receive either once-daily flunisolide (1000µg at 6pm increased if necessary up to 2000µg; n = 416) administered via AeroChamber or their previous corticosteroid regimens (triamcinolone, beclomethasone or fluticasone propionate; n = 99), which were continued on a 2- to 4-times daily basis at the previously established dosages. The transfer to once-daily flunisolide from the previous regimen was made directly without a run-in period. Results: The treatment ‘success rate’ [percentage of patients whose forced expiratory volume in 1 second (FEV) values at the study end-point were at least 90% of baseline values] was 85.7% in both treatment groups. Other efficacy parameters, including percentage predicted FEV, morning and evening peak expiratory flow rate (PEFR) values, asthma symptom scores, salbutamol (albuterol) usage, nocturnal awakenings, quality-of-life scores and global rating of change were also similar in the two groups. The incidence of drug-related adverse events such as headache, increased cough, pharyngitis, nausea and oral candidiasis were low in both groups (≤1.7% with flunisolide), and there were no notable changes in vital signs or physical examination variables in either group. The majority of patients expressed a preference for the once-daily flunisolide dosage regimen. Conclusions: Once-daily flunisolide provided asthma therapy that was at least as effective and as well tolerated as the patients' previous inhaled corticosteroid medication, indicating that individuals with mild to moderate asthma can be directly transferred to once-daily flunisolide therapy without compromising efficacy and tolerability. [ABSTRACT FROM AUTHOR]

Purpose Gambling disorder has been recently reclassified under the category "substance-related and addictive disorders". Recent studies performed through functional MRI (fMRI) have shown that the perseverance of some behaviors can alter brain activation [1,2]. In this work we aim at investigating functional connectivity changes in pathological gamblers (PGs) in comparison to healthy controls (HCs) by means of resting state functional Magnetic Resonance Imaging (rs-fMRI). Methods and materials Thirteen HCs and fourteen PGs were recruited (all right handed males; drugs free; mean age 36 ± 10 yrs). All acquisitions were performed through a 1,5 T MRI scanner using a 8-channels phased-array head coil. Multi-session temporal concatenated Independent Component Analysis (concat-ICA) was carried out to achieve activations information on functionally linked brain regions. The resulted components were then matched and compared between groups. Correction for multiple comparisons across space was applied assuming an overall significance of p < 0.05 using permutation testing and threshold-free cluster enhancement. Results Functional connectivity was found to be increased in PGs, compared to HCs, in several networks including: anterior cingulate cortex, accumbens nucleus, head of the caudate nucleus, middle left temporal gyrus, right insula, right cerebellar hemisphere cortex and cerebellar vermis. Conclusion We can conclude that an hyperconnectivity together with an overactivation of specific regions is observed in PGs. The persistent activation of specific functional networks during gambling tasks might represent the neurofunctional basis of PGs state-reduced triggering threshold to gaming underlying the clinical features of gambling disorder. These preliminary results confirms the crucial role of fMRI studies to investigate brain networks and their changes in specific clinical functional disorders. [ABSTRACT FROM AUTHOR]

Marine Protected Areas (MPAs) are playing a central role in the achievement of ocean sustainability and, since 2000, their global coverage has increased over ten times. The success of MPAs, and therefore the delivery of their potential outcomes for human well-being and global sustainability, requires multi-disciplinary, holistic, and comprehensive approaches for its achievement. In this study, the global scientific literature on MPAs was quantitatively reviewed through bibliometrics approaches, investigating patterns and trends in its development over time. In particular, bibliometric network and citation burst analyses of keywords were performed using VOSviewer and CiteSpace software. The bibliographic search on the Scopus and Web of Science databases resulted in a total number of 5908 and 6036 scientific documents published on MPAs. The network analysis of the keywords co-occurrence produced four main clusters whose connections and overlapping showed a multidisciplinary structure of MPA science, in which the ecological, social, and economic domains of research are strongly interlinked. Temporal analyses showed a recent focus on topics related to the social-ecological systems theory (e.g., ecosystem services, marine spatial planning, governance, and small-scale fisheries) suggesting that newer research lines recognize the importance of integrating the "human dimension" in conservation and sustainability studies. Overall, the results of both the performed bibliometric analyses pointed out the evolution of MPA science from the conventional concept of "marine reserves" to a broader scope integrating ecological, economic, and social aspects. In conclusion, MPA research is timely responding to the identification of MPAs as ocean sustainability tools, opening MPA science to multi-disciplinary research lines by linking the ecological and socio-economic dimensions of sustainability. MPA research is expected to play a crucial role in generating the interdisciplinary scientific knowledge needed to fully contribute to global ocean sustainability and human well-being. Unlabelled Image • Scientific research on MPAs is highly interdisciplinary. • MPA research evolved over time encompassing ecological and socio-economic aspects. • Over the years, human-related keywords increased in MPA scientific literature. • The human dimension plays a central role in marine conservation. • MPA research is responding to international commitments for ocean sustainability. [ABSTRACT FROM AUTHOR]

Characterized by interlinked social, economic, and ecological dynamics, Marine Protected Areas (MPAs) are a management tool for achieving sustainability goals in social-ecological systems. The recent increase in their establishment worldwide, fostered by international policies, highlights the need for comprehensive and integrated assessment frameworks able to address the evaluation of their social-ecological effectiveness and management performance, which is of fundamental importance for their adaptive management and decision making processes. Although several indicators and methodologies exist to assess MPAs ecological or social performances, no comprehensive assessment framework currently captures their broad range of objectives, encompassing the ecological, socio-cultural, and economic spheres. In this study, we present a novel quantitative framework (named MPAs Overall Success Evaluation – MOSE) able to assess the overall effectiveness and management performance of MPAs under the perspective of social-ecological systems. The multicriteria framework includes indicators linked to nature conservation, socio-cultural, socio-economic, and management objectives, integrating the multidisciplinary knowledge on MPAs in a single but comprehensive approach. The proposed framework was applied to the case study of Cerbère-Banyuls Natural Marine Reserve (France), the first MPA included in the IUCN Green List. Results showed that a high level of management effort is applied to the investigated MPA, generating several social-ecological benefits. This study showed the applicability of the MOSE framework and its potential usefulness as a tool to inform managers and decision-makers in charge for developing adaptive management strategies. Image 1 • The MPAs Overall Success Evaluation (MOSE) framework is presented. • The framework is applied to the Cerbère-Banyuls Natural Marine Reserve (France). • Results show the MPA management effort and generated social-ecological benefits. • The framework represents a useful tool for adaptive management. • Future applications will target a wide variety of MPAs at different scales. [ABSTRACT FROM AUTHOR]