Development of optical introscopy in medical engineering

The basic features of the process of development of medical optical introscopes are considered. Design characteristics of preproduction and production models of devices for diagnosis of the brain and the mammary gland are described.     

Reductions in emissions from deforestation from Indonesia’s moratorium on new oil palm,timber, and logging concessions

To reduce greenhouse gas emissions from deforestation, Indonesia instituted a nationwide moratorium on new license areas (“concessions”) for oil palm plantations, timber plantations, and logging activity on primary forests and peat lands after May 2011. Here we indirectly evaluate the effectiveness of this policy using annual nationwide data on deforestation, concession licenses, and potential agricultural revenue from the decade preceding the moratorium. We estimate that on average granting a concession for oil palm, timber, or logging in Indonesia increased site-level deforestation rates by 17–127%, 44–129%, or 3.1–11.1%, respectively, above what would have occurred otherwise. We further estimate that if Indonesia’s moratorium had been in place from 2000 to 2010, then nationwide emissions from deforestation over that decade would have been 241–615 MtCO₂e (2.8–7.2%) lower without leakage, or 213–545 MtCO₂e (2.5–6.4%) lower with leakage. As a benchmark, an equivalent reduction in emissions could have been achieved using a carbon price-based instrument at a carbon price of $3.30–7.50/tCO₂e (mandatory) or $12.95–19.45/tCO₂e (voluntary). For Indonesia to have achieved its target of reducing emissions by 26%, the geographic scope of the moratorium would have had to expand beyond new concessions (15.0% of emissions from deforestation and peat degradation) to also include existing concessions (21.1% of emissions) and address deforestation outside of concessions and protected areas (58.7% of emissions). Place-based policies, such as moratoria, may be best thought of as bridge strategies that can be implemented rapidly while the institutions necessary to enable carbon price-based instruments are developed.Reducing deforestation in Indonesia can contribute to climate-change mitigation at a globally significant scale. Estimates of annual greenhouse gas emissions from deforestation in Indonesia and the associated degradation of peat soils ranged from 0.32 to 1.91 GtCO₂e during 2000–2010 (1–6) (SI Appendix, Fig. S1) relative to a global total of 40–49 GtCO₂e from 2000 to 2010 (7). Deforestation in Indonesia is largely driven by the expansion of profitable and legally sanctioned oil palm and timber plantations and logging operations (5, 8–13). National and provincial governments zone areas of forest land to be logged or converted to plantation agriculture, and then district governments issue licenses to individual companies for these purposes (“concessions”) (14, 15). Substantial deforestation occurs outside of legally sanctioned concession areas as well.In May 2010, the national government of Indonesia announced a moratorium prohibiting district governments from granting new concession licenses (16, 17). The moratorium covered licenses for three types of activities: (i) conversion of primary forests and peat lands to oil palm plantations (oil palm concessions); (ii) conversion of primary forests and peat lands to fast-growing tree plantations for pulp and paper (timber concessions); and (iii) logging of commercially valuable tree species within forests (logging concessions). The moratorium was enacted in the context of a national strategy for reducing emissions from deforestation (REDD+) (18), a national target of reducing greenhouse gas emissions projected to 2020 by 26–41% while increasing gross domestic product by 7% per year (19), and a $1 billion bilateral cooperative agreement with Norway on reducing emissions from deforestation (20). The moratorium came into force in May 2011 (21) and was extended in May 2013 for an additional 2 y (22).The moratorium was conceived as both a stepping-stone to reforming Indonesia’s complex forest tenure system and a mechanism for reducing deforestation in its own right (23). The moratorium has been criticized for not covering secondary (i.e., logged) forests, for providing potential loopholes for food and energy security, for periodic downward revisions to the total moratorium area, for leaving a grace period between the announcement and the implementation of the moratorium during which licenses could still be obtained, and for not curtailing deforestation within existing concessions (24–27). Furthermore it has been noted that Indonesia’s deforestation rate has continued an upward trend from 2000 through 2012, even after the implementation of the moratorium in 2011 (28, 29). However, the effectiveness of the moratorium in reducing emissions from deforestation has yet to be quantified. Deforestation in recent years might have been even higher in the absence of a moratorium.Here we have evaluated the effectiveness of the moratorium policy by analyzing annual nationwide data on deforestation, the boundaries and license dates of concessions, and potential agricultural revenue from 2000 to 2010, the decade preceding the moratorium. The decade preceding the moratorium is ideal for scenario analysis because we can’t know where concessions would have been designated post-2011 without a moratorium, but we do know where pre-2010 concessions would not have been with a moratorium. Thus, we are able to construct a counterfactual scenario in which the moratorium policy in its current form was applied over the previous decade, and compare emissions under this simulated scenario to the emissions that actually occurred.We first answered the question: How much did the designation of a concession increase local (grid cell-level) deforestation above what would have occurred there without a concession? We used panel econometric techniques to control for potentially confounding geographic and time-variant factors and to construct upper and lower bounds around the magnitude of the treatment effect. Next, we answered the question: How much lower would Indonesia’s emissions from deforestation have been from 2000 to 2010 if no new concessions had been granted on primary forests and peat lands during that period? We aggregated estimates of local (grid cell-level) land-use change to the national level, accounted for geographic displacement of deforestation caused by market feedbacks (“leakage”), and applied grid cell-specific carbon emission factors for deforestation and peat degradation. Finally, we answered the question: At what carbon price would a price-based instrument have achieved an equivalent reduction in emissions over the same time period? We compared the estimated emission reductions from the place-based moratorium policy with the estimated emission reductions from a hypothetical carbon price-based instrument, adapting the Open Source Impacts of REDD+ Incentives Spreadsheet (OSIRIS) Indonesia model (4). We examined both a mandatory carbon price-based instrument (e.g., a cap-and-trade or symmetric tax-and-subsidy program) and a voluntary carbon price-based instrument (e.g., a project-level REDD+ program with business-as-usual reference levels).With this paper we contribute to several literatures. First, we expand the literature on quasi-experimental evaluation of the causal impact of conservation measures (30), such as protected areas (31–33), payment-for-ecosystem-services programs (33, 34), logging concessions (35), and clearing bans (36), to include agricultural concessions. Even though agricultural concessions are used to legally sanction deforestation on at least 150 million hectares of forest in at least 12 countries (37), and curtailing the expansion of such concessions represents a potentially promising policy for reducing emissions from deforestation, the effects of agricultural concessions on deforestation have only been estimated obliquely in econometric studies exploring other topics (4, 38, 39). Additionally, to our knowledge our paper is the first to transform area-based treatment effects to emissions-based treatment effects. Second, our paper is rare in that it uses panel data and techniques. Nearly all previous spatially explicit econometric studies of land-use change have necessarily relied upon cross-sectional analyses because of data availability constraints. In a meta-analysis of 117 such studies (40), only three have previously used panel methods (39, 41, 42). This paper is at the forefront of what is likely to be a proliferation of panel econometric analyses enabled by the recent availability of reliable, annual, globally consistent data on patterns of forest loss (28). Third, our paper is rare in that it calibrates the effect of land-use designations empirically. Nearly all previous land-use change scenario analyses have assumed idealized perfect effectiveness of conservation measures or complete conversion without such measures. A recent review of this literature found that only 1 of 71 peer-reviewed studies explicitly incorporated the difference in probable threat between reserved and nonreserved scenarios (43). Finally, our paper is to our knowledge the first to compare the effectiveness of place-based policies with alternative carbon price-based instruments for climate change mitigation within a landscape.     

Effects of hematopoietin-1 and interleukin 1 activities on early hematopoietic cells of the bone marrow

Hematopoietin-1 (H-1) was purified from the human cell line 5637 and two amino acid sequences were observed in the preparation. One sequence was identical to that of interleukin 1 alpha (IL 1 alpha) and the other to that of IL 1 beta. The action of recombinant IL 1 alpha and other hematopoietic growth factors was studied using (a) a high proliferative potential colony-forming cell assay that uses primitive hematopoietic precursors from bone marrow, and (b) a spleen colony-forming unit assay. The results indicate that the IL 1 alpha target cell population is different than the target cell populations of IL 3, granulocyte- macrophage colony-stimulating factor; that IL 1 alpha in combination with mononuclear phagocyte colony-stimulating factor provides a proliferative stimulus; and that IL 1 alpha has at least a survival- enhancing and possibly proliferation-inducing effect on primitive hematopoietic stem cells.     

预测急性脑卒中缺血半暗带的最优Tmax阈值

背景:挽救缺血半暗带对减少梗死范围有重要意义,一般以PWI与DWI的不匹配区域来评估半暗带.但PWI评估的低灌注范围可能会包括良性缺血区,从而使评估所得的半暗带体积大于实际值.为减少这种弊端,近来引入一新的参数:PWI的达峰时间(Tmax)阈值.Tmax为PWI成像信号强度-时间曲线中从对比剂开始出现到对比剂浓度达到峰值的时间.以对侧相应部位正常脑组织的Tmax为参考,脑组织中Tmax延迟超过阈值的区域即为PWI病灶区.     

In vivo evaluation of a vibration analysis technique for the per-operative monitoring of the fixation of hip prostheses

Background  

The per-operative assessment of primary stem stability may help to improve the performance of total hip replacement. Vibration analysis methods have been successfully used to assess dental implant stability, to monitor fracture healing and to measure bone mechanical properties. The objective of the present study was to evaluate in vivo a vibration analysis-based endpoint criterion for the insertion of the stem by successive surgeon-controlled hammer blows.     

Experience with over 1000 implanted ventricular assist devices

PURPOSE: The use of ventricular assist devices (VADs) in patients with chronic end-stage or acute heart failure has led to improved survival. We present our experience since 1987. SUBJECTS AND METHODS: Between July 1987 and December 2006, 1026 VADs were implanted in 970 patients. Most of them were men (81.9%). The indications were: cardiomyopathy (n = 708), postcardiotomy heart failure (n = 173), acute myocardial infarction (n = 36), acute graft failure (n = 45), a VAD problem (n = 6), and others (n = 2). Mean age was 46.1 (range 3 days to 78) years. In 50.5% of the patients the VAD implanted was left ventricular, in 47.9% biventricular, and in 1.5% right ventricular. There were 14 different types of VAD. A total artificial heart was implanted in 14 patients. RESULTS: Survival analysis showed higher early mortality (p < 0.05) in the postcardiotomy group (50.9%) than in patients with preoperative profound cardiogenic shock (31.1%) and patients with preoperative end-stage heart failure without severe shock (28.9%). A total of 270 patients were successfully bridged to heart transplantation (HTx). There were no significant differences in long-term survival after HTx among patients with and without previous VAD. In 76 patients the device could be explanted after myocardial recovery. In 72 patients the aim of implantation was permanent support. During the study period 114 patients were discharged home. Currently, 54 patients are on a device. CONCLUSIONS: VAD implantation may lead to recovery from secondary organ failure. Patients should be considered for VAD implantation before profound, possibly irreversible, cardiogenic shock occurs. In patients with postcardiotomy heart failure, a more efficient algorithm should be developed to improve survival. With increased experience, more VAD patients can participate in out-patient programs.     

Papilla Vateri restenoses after papillosphincterotomy

Biliary tract was investigated in 105 patients after endoscopic papillosphincterotomy for choledocholithiasis and papillostenosis. The follow-up revealed papillary restenosis in 8,6%, which occurred during first 2 years after the procedure. Short cut of the duodenal papilla and intramural part of the common bile duct and anamnestic papillostenosis and septic cholangitis proved to be the main reasons of the papillary restenosis.     

A survey on clinical presentation and nutritional status of infants with suspected cow' milk allergy

Background  

Cow's milk is the most common food allergen in infants and the diagnosis of cow's milk allergy is difficult, even with the use of several diagnostic tests. Therefore, elimination diets and challenge tests are essential for the diagnosis and treatment of this disorder. The aim of this study is to report the clinical presentation and nutritional status of children evaluated by pediatric gastroenterologists for the assessment of symptoms suggestive of cow's milk allergy.     

Efficacy of fixed low-dose isotretinoin (20 mg, alternate days) with topical clindamycin gel in moderately severe acne vulgaris

Background  In view of the potentially serious side-effects of standard isotretinoin (0.5–1.0 mg/kg per day) therapy for acne, we studied the safety and efficacy of low-fixed dose isotretinoin plus topical 1%clindamycin gel in the treatment of moderate grade of acne.
Methods  In this prospective, non-comparative study, 320 adult patients, with moderately severe acne were enrolled and treated with fixed-dose isotretinoin at 20 mg every alternate day (approximately 0.15 mg/kg/day to 0.28 mg/kg/day) for 6 months along with topical clindamycin gel. All female patients were assessed for polycystic ovarian disease. Patients were followed up for 6 months.
Results  A total of 305 patients completed the study. Overall, patients received a mean of 38.4 mg/kg cumulative dose of isotretinoin, and very good results were observed in 208 (68.20%), while good response was seen in 59 (19.34%) of patients. Failure of the treatment occurred in 38 (12.46%), while relapses occurred in 50 (16.39%) of patients. Relapses were commoner in females, and 37 of 43 (86.04%) patients had polycystic ovarian disease. Though mild chelitis (91%) and xerosis (43%) were common, laboratory abnormalities in the form of elevated hepatic enzymes (5%) and elevated serum lipids (6%) were rare.
Conclusion  Six months of treatment with fixed-dose, alternate-day isotretinoin (20 mg) plus topical 1%clindamycin gel was found to be effective in the treatment of moderate acne in adult patients, with a low incidence of side-effects.

Conflicts of interest

None declared