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Purpose To evaluate and assess the current knowledge about apexification and regenerative techniques as a meaningful treatment modality and to map the scientific evidence for the efficacy of both methods for the management of traumatised immature teeth with pulp necrosis and apical periodontitis. Methods This systematic review searched five databases: PubMed, Web of Science, Cochrane Library, Ovid (Medline), and Embase. Published articles written in English were considered for inclusion. The following keywords were used: Regenerative endodontic treatment OR regenerat* OR revital* OR endodontic regeneration OR regenerative endodontics OR pulp revascularization OR revasculari* OR ‘traumatized immature teeth’. Only peer-reviewed studies with a study size of at least 20 cases followed up for 24 months were included. Eligibility assessment was performed independently in a blinded manner by three reviewers and disagreements were resolved by consensus. Subgroup analyses were performed on three clinical outcomes: survival, success, and continued root development. Results Seven full texts out of 1359 citations were included and conventional content analysis was performed. Most of the identified citations were case reports and case series. Conclusions In the present systematic review, the qualitative analysis revealed that both regenerative and apexification techniques had equal rates of success and survival and proved to be effective in the treatment of immature necrotic permanent teeth. Endodontic regenerative techniques appear to be superior to apexification techniques in terms of stimulation of root maturation, i.e. root wall thickening and root lengthening. Knowledge gaps were identified regarding the treatment and follow-up protocols for both techniques.

In small-scale fishery, information provided by fishers has been useful to complement current and past lack of knowledge on species and environment. Through interviews, 82 fishers from the largest fishing communities on the north and south borders of a Brazilian northeastern coastal state provided estimates of the catch per unit effort (CPUE) and rank of species abundance of their main target fishes for three time points: current year (2013 at the time of the research), 10, and 20 years past. This information was contrasted to other available data sources: scientific sampling of fish landing (2013), governmental statistics (2003), and information provided by expert fishers (1993), respectively. Fishers were more accurate when reporting information about their maximum CPUE for 2013, but except for three species, which they estimated accurately, fishers overestimated their mean CPUE per species. Fishers were also accurate at establishing ranks of abundance of their main target species for all periods. Fishers' beliefs that fish abundance has not changed over the last 10 years (2003-2013) were corroborated by governmental and scientific landing data. The comparison between official and formal landing records and fishers' perceptions revealed that fishers are accurate when reporting maximum CPUE, but not when reporting mean CPUE. Moreover, fishers are less precise the less common a species is in their catches, suggesting that they could provide better information for management purposes on their current target species.

Breast-conserving surgery for palpable breast cancer is associated with tumour-involved margins in up to 41% of cases and excessively large excision volumes. Ultrasound-guided surgery has the potential to resolve both of these problems, thereby improving surgical accuracy for palpable breast cancer. We aimed to compare ultrasound-guided surgery with the standard for palpable breast cancer—palpation-guided surgery—with respect to margin status and extent of healthy breast tissue resection. In this randomised controlled trial, patients with palpable T1–T2 invasive breast cancer were recruited from six medical centres in the Netherlands between October, 2010, and March, 2012. Eligible participants were randomly assigned to either ultrasound-guided surgery or palpation-guided surgery in a 1:1 ratio via a computer-generated random sequence and were stratified by study centre. Patients and investigators were aware of treatment assignments. Primary outcomes were surgical margin involvement, need for additional treatment, and excess healthy tissue resection (defined with a calculated resection ratio derived from excision volume and tumour diameter). Data were analysed by intention to treat. This trial is registered at http://www.TrialRegister.nl, number NTR2579. 134 patients were eligible for random allocation. Two (3%) of 65 patients allocated ultrasound-guided surgery had tumour-involved margins compared with 12 (17%) of 69 who were assigned palpation-guided surgery (difference 14%, 95% CI 4–25; p=0·0093). Seven (11%) patients who received ultrasound-guided surgery and 19 (28%) of those who received palpation-guided surgery required additional treatment (17%, 3–30; p=0·015). Ultrasound-guided surgery also resulted in smaller excision volumes (38 [SD 26] vs 57 [41] cm3; difference 19 cm3, 95% CI 7–31; p=0·002) and a reduced calculated resection ratio (1·0 [SD 0·5] vs 1·7 [1·2]; difference 0·7, 95% CI 0·4–1·0; p=0·0001) compared with palpation-guided surgery. Compared with palpation-guided surgery, ultrasound-guided surgery can significantly lower the proportion of tumour-involved resection margins, thus reducing the need for re-excision, mastectomy, and radiotherapy boost. By achieving optimum resection volumes, ultrasound-guided surgery reduces unnecessary resection of healthy breast tissue and could contribute to improved cosmetic results and quality of life. Dutch Pink Ribbon Foundation, Osinga-Kluis Foundation, Toshiba Medical Systems.

The list of threatened species (Red List), established by the International Union for Conservation of Nature (IUCN), aims to provide global assessments on the extinction risk of species. However, protecting vulnerable populations requires establishing threat criteria at sub-global scales, e.g., national Red Lists. In data-poor contexts, typical of many developing countries, assessing threat status by applying IUCN criteria constitutes a major challenge, which may be one reason for mismatches between national and global Red List assessments. Despite the intense harvesting of threatened elasmobranchs species in Brazilian waters, Brazilian fisheries monitoring has ceased to exist for nearly a decade. This jeopardizes accurate assessment of species’ conservation status at a local scale. In the absence of fisheries records, local ecological knowledge (LEK) provides an alternative option to obtain reliable information on targeted species. We interviewed 186 fishers from four Brazilian Northeastern states, whose recollections spanned six decades and documented catches or sightings of 19 shark species. For eight species with sufficient data, temporal trends in maximum length of sharks caught by fishers of different age-classes were statistically tested. Four species’ maximum length declined over time, while four were primarily captured by elderly fishers, with few or no recent catches reported. Of these species, one is classified more conservatively in the national Red List vs. IUCN Red List, which is supported by LEK results. Contrastingly, two species are classified less conservatively at the national level than by IUCN, such that upgrading and matching IUCN’s conservation criteria is warranted. We suggest that LEK provides support for conservation status listing in data-poor contexts.

Despite its relevance, the economic contribution of small-scale fisheries to poverty alleviation is still poorly understood. This study investigates why some fishers perform economically better in fisheries than others under similar conditions and whether these variations in performance were due to individual adaptive strategies related to fishing technology and effort. A pairwise comparison between fishers’ income from the Brazilian equatorial region in 1994 and 2014 was performed while modeling individual changes related to the fishing activity (Generalized Linear Model, GLM) and the factors that would explain why fishers became richer or poorer over time (Proportional odds model). Fisher’s geographical region, the use of motorized boats and the adoption of hookah compressors explained income in 1994, whereas having larger boats and fishing with hook and line explained it in 2014. Fishers were slightly more likely to gain income if they changed their type of boat. Some fishers are trapped in poverty, and the changes they made were either not enough to leave this condition or made it worse. Escaping poverty traps in fisheries may require efforts beyond those available to the individuals, especially as stocks become increasingly overfished.

Information on the distribution and habitat preferences of ecologically and commercially important species is essential for their management and protection. This is especially important as climate change, pollution, and overfishing change the structure and functioning of pelagic ecosystems. In this study, we used Bayesian hierarchical spatial-temporal models to map the Essential Fish Habitats of the Yellowfin tuna (Thunnus albacares) in the waters around Isla del Coco National Park, Pacific Costa Rica, based on independent underwater observations from 1993 to 2013. We assessed if observed changes in the distribution and abundance of this species are related with habitat characteristics, fishing intensity or more extreme climatic events, including the El Niño Southern Oscillation, and changes on the average sea surface temperature. Yellowfin tuna showed a decreasing abundance trend in the sampled period, whereas higher abundances were found in shallow and warmer waters, with high concentration of chlorophyll-a, and in surrounding seamounts. In addition, El Niño Southern Oscillation events did not seem to affect Yellowfin tuna distribution and abundance. Understanding the habitat preferences of this species, using approaches as the one developed here, may help design integrated programs for more efficient management of vulnerable species.

Purpose The aim of this study was to analyze the relationship between adiposity, cardiometabolic risk and cardiorespiratory fitness (CRF) according to different groups of adiponectin concentration. Methods 255 adolescents of both sexes, aged 11–17 years old, participated. Anthropometric and biochemical parameters such as body mass, height, abdominal circumference (AC), waist circumference (WC), fat mass, fat-free mass, total cholesterol (TC), high-density lipoprotein (HDL-c), low-density lipoprotein (LDL-c), triglycerides (TG), glucose, insulin, adiponectin, blood pressure, peak oxygen consumption (VO 2peak ) were measured. Body mass index (BMI), z-score BMI (BMI-z), triponderal mass index (TMI), waist-to-height ratio (WHtR), homeostasis model to assessment insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) were calculated. Adiponectin was categorized: low adiponectin concentration (LAC  ≤ 5.18 µg/mL −1 ), intermediate (IAC = 5.18 and 7.63 µg/mL −1 ) and high (HAC ≥ 7.63 µg/ml −1 ). Results LAC showed higher BMI, BMI-z and TMI than the other groups ( p  < 0.05) and higher AC, WC and WHtR that the HAC ( p  < 0.05). IAC showed lower values of TC, LDL-c and TG, and the LAC presented the highest values of insulin, HOMA-IR and QUICKI ( p  < 0.05) to the IAC and HAC. HAC presented the lower VO 2peak than the other groups ( p  < 0.01). BMI, TMI, glucose, insulin, HOMA-IR showed inverse, and QUICKI a direct and weak correlation with adiponectin ( p  < 0.05). No significant association was found between adiponectin and VO 2peak ( p  > 0.05). Conclusion The LAC group had higher means in the anthropometric variables and the worst results related to insulin resistance and sensitivity. Thus, adiponectin may play an important role in obesity and reduced concentration may be a factor in the development of obesity-associated morbidities.

Background Ultrasound-guided breast-conserving surgery (USS) results in a significant reduction in both margin involvement and excision volumes (COBALT trial). Objective The aim of the present study was to determine whether USS also leads to improvements in cosmetic outcome and patient satisfaction when compared with standard palpation-guided surgery (PGS). Methods A total of 134 patients with T1–T2 invasive breast cancer were included in the COBALT trial (NTR2579) and randomized to either USS (65 patients) or PGS (69 patients). Cosmetic outcomes were assessed by a three-member panel using computerized software Breast Cancer Conservative Treatment cosmetic results (BCCT.core) and by patient self-evaluation, including patient satisfaction. Time points for follow-up were 3, 6, and 12 months after surgery. Overall cosmetic outcome and patient satisfaction were scored on a 4-point Likert scale (excellent, good, fair, or poor), and outcomes were analyzed using a multilevel, mixed effect, proportional odds model for ordinal responses. Results Ultrasound-guided breast-conserving surgery achieved better cosmetic outcomes, with 20 % excellence overall and only 6 % rated as poor, whereas 14 % of PGS outcomes were rated excellent and 13 % as poor. USS also had consistently lower odds for worse cosmetic outcomes (odds ratio 0.55, p  = 0.067) than PGS. The chance of having a worse outcome was significantly increased by a larger lumpectomy volume ( p trend  = 0.002); a volume >40 cc showed odds 2.78-fold higher for a worse outcome than a volume ≤40 cc. USS resulted in higher patient satisfaction compared with PGS. Conclusion Ultrasound-guided breast-conserving surgery achieved better overall cosmetic outcomes and patient satisfaction than PGS. Lumpectomy volumes >40 cc resulted in significantly worse cosmetic outcomes.

The Southwest Atlantic Ocean (SWAO) is a globally important region, where diverse water masses converge and mix, regulating the Earth’s climate while supporting productive fisheries and high marine biodiversity. Ecological connectivity is also substantial, with multiple species and ecosystems shared across multiple jurisdictions and international borders. However, despite historical efforts and more recent calls for regional management, the SWAO is one of the few large oceanic regions with no dedicated ocean governance body covering all shared resources. This disconnect is particularly alarming in the face of climate change, which is altering the distribution and abundance of fish stocks, shifting species ranges poleward, and intensifying uncertainty in marine resource management. A collaborative regional framework, rooted in ecosystem-based management, is urgently needed to foster sustainable management as well as bolster resilience to the impacts of climate change. As Brazil hosts a series of United Nations meetings on environmental topics, the region faces a decisive moment: either to remain reactive to external governance structures or to proactively design frameworks that reflect regional priorities, balance sovereignty concerns, and better integrate scientific evidence into decision-making. Thus, we invite decision makers, managers and scientists to take advantage of the political momentum in Latin America to advance integrated and multi-scale ocean governance, while strengthening ocean science diplomacy in the SWAO. This is a call to help navigate an uncertain future by addressing shared challenges and prioritizing ocean sustainability in the SWAO.

Background Groupers are a vulnerable but economically important group of fish, especially for small-scale fisheries. We investigated catches and local ecological knowledge (LEK) of diet, habitat, and past fishing experiences. Methods Landings, prices, interviews, and restaurants demand for two species, Epinephelus marginatus (dusky grouper) and Epinephelus morio (red grouper), were registered. Results We visited 74 markets and 79 sites on the coast of Brazil in 2017–2018, and we interviewed 71 fishers: Bahia (NE), Rio de Janeiro and São Paulo (SE), and Santa Catarina (S). The landings sampled of dusky grouper (2016–2017) in Rio de Janeiro were: n  = 222, size 38–109 cm, weight 1–24 kg, average 3.84 kg; in São Paulo, São Sebastião were: n  = 47, size 39–106 cm, weight 2–8 kg, average of 2.77 kg; and at Santos: n  = 80, 26–120 cm, weight 0.36–15 kg, average 2.72 kg. Red grouper was observed in markets in the northeastern Brazil. We did not observe Epinephelus marginatus from Bahia northward; a maximum size of 200 cm was reported south of the Bahia, besides Rio de Janeiro and São Paulo coasts, 20 years ago (or longer) by 12 fishers. Local knowledge of fishers was important for grouper data of habitat and diet; the reproduction period was identified by fishers as September to March. Conclusions Groupers can be considered as a cultural and ecological keystone species. We suggest protective measures: 1) fishing zoning, 2) islands (MPAs) with the surveillance of fishers, 3) late Spring and early Summer as key periods for management (grouper reproduction), 4) studies on grouper larvae, 5) mapping of fishing spots, 6) studies on local knowledge. Collaboration with small-scale fishers and local knowledge could contribute to low-conflict management measures. In that regard, integrative models of management from Latin America, by using local knowledge and citizen science, could produce successful grouper management for Brazilian data-poor fisheries, a contrasting reality to the Mediterranean areas. Finally, the distribution of E. marginatus in Brazil leave us with questions: a) Have dusky groupers disappeared from Bahia because of a decline in the population? b) Was it uncommon in Northeast Brazil? c) Did changes in water temperatures forced a movement southward?