Exploring payments for ecosystem services in the context of native tree planting in Lebanon

From local governance regimes to policies and markets, diverse institutions are crucial for ensuring effective natural resource management. Payments for Ecosystems Services (PES) are being adopted globally as a potential strategy for protecting and increasing forests by paying for environmental goods and services not captured in the market. Large-scale reforestation efforts have also increased globally, but are mostly aimed at increasing forest cover rather than ensuring resilient ecosystems. Many have argued that such incentivised reforestation schemes could lead to plantations of limited species diversity. Enhancing tree species diversity simultaneously with other forest ecosystem services (e.g. carbon sequestration) in reforestation therefore remains a challenge. Since many land managers are reluctant to voluntarily plant trees of little market or use value, PES may offer a strategy for enhancing tree diversity if stakeholders’ perceptions were understood. I therefore explored how PES should be designed to deliver biodiversity-enhancing reforestation. Empirical research was carried out in mountainous villages within Lebanon’s newly designated Important Plant Areas (IPAs). Semi-structured interviews were conducted with local authorities and key informants in 48 villages within nine IPAs exposing numerous socio-institutional and biophysical constraints to reforestation on municipal lands. I then set out to gauge landowners’ perceptions of PES schemes with varying levels of conditionality. In this mixed-methods study, I found that private landowners are very diverse in their preferences and attitudes towards PES schemes expressed through their discussions about risks and reward. I later surveyed national stakeholders’ preferences for native species to be used in reforestation. Similarly, these stakeholders (and potential PES buyers) also exhibit preference heterogeneity when prioritising native species for reforestation. Finally, I estimate a production possibility frontier from a choice experiment conducted with landowners in the Bcharre-Ehden IPA. My results indicated that real trade-offs do exist between the extent of forest cover and diversity of species used in reforestation. However, while limited in scope, it is possible for reforesting private lands with diverse native forest species cost-effectively through identifying and targeting willing suppliers (i.e. landowners). Increasing participation requires further research to investigate whether absentee residents, with landholdings not tied to commercial farming, would be willing to accept low-cost payments for biodiversity-enhancing reforestation. My thesis provides insights from empirical studies that will contribute to both research and policy in designing PES for achieving multiple objectives cost-effectively

Modifikasi Model Power Soccer Wheelchair (Kursi Roda Elektronik Power Soccer) sebagai Alat Latihan Olahraga Power Soccer Bagi Atlet Tuna Daksa

The purpose of this research is to create an electronic wheelchair sport designed for power soccer. The authors try modify Wheelchair Power Soccer (Electronic Power Wheel Chair Soccer) as a Tool of Power Soccer Sports Exercise for disable Athletes. The system is a solution and that the author gave innovation and contribute to the problem using the physically disabled football is still manual. We innovate to create electronic wheelchair as a tool for physically disable soccer athletes.Performance results wheelchair soccer power tools (electronic power wheelchair soccer) is driven in accordance with the commands sent by a joystick control that will be received by the control circuit ATmega8535 microcontroller and the output is the motion that moved by motor stepper. The tool is able to browse for a maximum of 32 minutes on flat roads with power supply of 6V 4.5 Ah. Optimal video radius of less than 5 meters

Megakaryocytes Enhance Mesenchymal Stromal Cells Proliferation and Inhibit Differentiation

Megakaryocytes (MKs) can induce proliferation of calvarial osteoblasts [Ciovacco et al., 2009], but this same phenomenon has not been reported for bone marrow stromal populations from long bones. Bone marrow contains several types of progenitor cells which can be induced to differentiate into multiple cell types. Herein, we examined mesenchymal stromal cell proliferation and osteoblastic differentiation when rabbit or mouse MK were cultured with i) rabbit bone marrow stromal cells, ii) rabbit dental pulp stromal cells, or iii) mouse bone marrow stromal cells. Our results demonstrated that rabbit and mouse stromal cells co-cultured with rabbit MK or mouse MK, have significant increases in proliferation on day 7 by 52%, 46%, and 24%, respectively, compared to cultures without MK. Conversely, alkaline phosphatase (ALP) activity was lower at various time points in these cells when cultures contain MK. Similarly, calcium deposition observed at day 14 rabbit bone marrow and dental pulp stromal cells and day 21 mouse bone marrow stromal cells was 63%, 69%, and 30% lower respectively, when co-cultured with MK. Gene expression studies reveal transcriptional changes broadly consistent with increased proliferation and decreased differentiation. Transcript levels of c-fos (associated with cell proliferation) trended higher after 3, 7, and 14 days in culture. Also, expression of alkaline phosphatase, osteonectin, osterix, and osteopontin, which are markers for osteoblast differentiation, showed MK-induced decreases in a cell type and time dependent manner. Taken together, these data suggest that MK play a role in stromal cell proliferation and differentiation, from multiple sites/locations in multiple species

A fast-degrading thiol–acrylate based hydrogel for cranial regeneration

Successful regeneration of the cranium in patients suffering from cranial bone defects is an integral step to restore craniofacial function. However, restoration of craniofacial structure has been challenging due to its complex geometry, limited donor site availability, and poor graft integration. To address these problems, we investigated the use of a thiol–acrylate hydrogel as a cell carrier to facilitate cranial regeneration. Thiol–acrylate hydrogels were formulated with 5–15 wt% poly(ethylene glycol)-diacrylate (PEGDA) and 1–9 mm dithiothreitol (DTT). The degradation rate, swelling ratio, and shear modulus of the resulting hydrogel were first characterized. Then, pre-osteoblast-like cells (MC3T3-E1) were encapsulated in the hydrogel and cultured for up to 21 d. Our results demonstrate that compared to samples formulated from 15 wt% PEGDA, 5 wt% PEGDA samples showed lower storage modulus at day 10 (0.7 kPa versus 8.3 kPa), 62.7% higher in weight change after soaking for 10 d. While the 5 wt% PEGDA group showed an 85% weight loss between day 10 and 21, the 15 wt% PEGDA group showed a 5% weight gain in the same time period. Cell viability with 15 wt% PEGDA and 5 mm DTT hydrogel decreased by 41.3% compared to 5 wt% PEGDA and 5mM DTT gel at day 7. However, histological analysis of cells after 21 d in culture revealed that they had pericellular mineral deposition indicating that the cells were differentiating into osteoblasts lineage in all experimental groups. This study shows that thiol–acrylate hydrogels can be tailored to achieve different degradation rates, in order to enhance cell viability and differentiation. Thus, the findings of this study provide a fundamental understanding for the application of thiol–acrylate hydrogels in cranial bone regeneration

The Prevention of Delirium and Complications Associated with Surgical Treatments (PODCAST) study: protocol for an international multicentre randomised controlled trial

Introduction: Postoperative delirium is one of the most common complications of major surgery, affecting 10–70% of surgical patients 60 years and older. Delirium is an acute change in cognition that manifests as poor attention and illogical thinking and is associated with longer intensive care unit (ICU) and hospital stay, long-lasting cognitive deterioration and increased mortality. Ketamine has been used as an anaesthetic drug for over 50 years and has an established safety record. Recent research suggests that, in addition to preventing acute postoperative pain, a subanaesthetic dose of intraoperative ketamine could decrease the incidence of postoperative delirium as well as other neurological and psychiatric outcomes. However, these proposed benefits of ketamine have not been tested in a large clinical trial. Methods: The Prevention of Delirium and Complications Associated with Surgical Treatments (PODCAST) study is an international, multicentre, randomised controlled trial. 600 cardiac and major non-cardiac surgery patients will be randomised to receive ketamine (0.5 or 1 mg/kg) or placebo following anaesthetic induction and prior to surgical incision. For the primary outcome, blinded observers will assess delirium on the day of surgery (postoperative day 0) and twice daily from postoperative days 1–3 using the Confusion Assessment Method or the Confusion Assessment Method for the ICU. For the secondary outcomes, blinded observers will estimate pain using the Behavioral Pain Scale or the Behavioral Pain Scale for Non-Intubated Patients and patient self-report. Ethics and dissemination The PODCAST trial has been approved by the ethics boards of five participating institutions; approval is ongoing at other sites. Recruitment began in February 2014 and will continue until the end of 2016. Dissemination plans include presentations at scientific conferences, scientific publications, stakeholder engagement and popular media. Registration details The study is registered at clinicaltrials.gov, NCT01690988 (last updated March 2014). The PODCAST trial is being conducted under the auspices of the Neurological Outcomes Network for Surgery (NEURONS). Trial registration number NCT01690988 (last updated December 2013)

Cost-Effectiveness of Peer-Delivered Interventions for Cocaine and Alcohol Abuse among Women: A Randomized Controlled Trial

<div><h3>Aims</h3><p>To determine whether the additional interventions to standard care are cost-effective in addressing cocaine and alcohol abuse at 4 months (4 M) and 12 months (12 M) from baseline.</p> <h3>Method</h3><p>We conducted a cost-effectiveness analysis of a randomized controlled trial with three arms: (1) NIDA's Standard intervention (SI); (2) SI plus a Well Woman Exam (WWE); and, (3) SI, WWE, plus four Educational Sessions (4ES).</p> <h3>Results</h3><p>To obtain an additional cocaine abstainer, WWE compared to SI cost $7,223 at 4 M and$3,611 at 12 M. Per additional alcohol abstainer, WWE compared to SI cost $3,611 and$7,223 at 4 M and 12 M, respectively. At 12 M, 4ES was dominated (more costly and less effective) by WWE for abstinence outcomes.</p> <h3>Conclusions</h3><p>To our knowledge, this is the first cost-effectiveness analysis simultaneously examining cocaine and alcohol abuse in women. Depending on primary outcomes sought and priorities of policy makers, peer-delivered interventions can be a cost-effective way to address the needs of this growing, underserved population.</p> <h3>Trial Registration</h3><p>ClinicalTrials.gov <a href="http://www.clinicaltrials.gov/ct2/show/NCT01235091">NCT01235091</a></p> </div

Influence of calcium aluminate cement (CAC) on alkaline activation of red clay brick waste (RCBW)

In this paper, the effect of calcium aluminate cement (CAC) additions on the alkali activation of red clay brick waste (RCBW) was studied at room temperature and at 65 C. RCBW was partially replaced with CAC (0e50 wt.%) and blends were activated with NaOH and sodium silicate solutions. The compressive strength evolution was tested on mortars and the nature of the reaction products was analysed by infrared spectroscopy, X-ray diffraction, thermogravimetric analysis, microscopic studies and pH measurements. The results show that the use of CAC accelerates the activation process of RCBW so that 50 MPa were obtained in the blended mortars containing 40 wt.% CAC cured for 3 days at room temperature. CAC did not undergo normal hydration and only the C3AH6 phase was identified in the pastes blended with more than 30 wt.% CAC and cured at 65 C, while the main reaction product was a cementitious gel containing Ca and Al from CAC.The authors are grateful to the Spanish Ministry of Science and Innovation for supporting this study through Project GEOCEDEM BIA 2011-26947, and to FEDER funding.Reig Cerdá, L.; Soriano Martínez, L.; Borrachero Rosado, MV.; Monzó Balbuena, JM.; Paya Bernabeu, JJ. (2016). Influence of calcium aluminate cement (CAC) on alkaline activation of red clay brick waste (RCBW). Cement and Concrete Composites. 65:177-185. https://doi.org/10.1016/j.cemconcomp.2015.10.021S1771856

Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial

Background: The EMPA KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. Methods: EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. Findings: Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5–2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62–0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16–1·59), representing a 50% (42–58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all &gt;0·1). Interpretation: In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. Funding: Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council