Mapping and characterizing social-ecological land systems of South America

Humans place strong pressure on land and have modified around 75% of Earth’s terrestrial surface. In this context, ecoregions and biomes, merely defined on the basis of their biophysical features, are incomplete characterizations of the territory. Land system science requires classification schemes that incorporate both social and biophysical dimensions. In this study, we generated spatially explicit social-ecological land system (SELS) typologies for South America with a hybrid methodology that combined data-driven spatial analysis with a knowledge-based evaluation by an interdisciplinary group of regional specialists. Our approach embraced a holistic consideration of the social-ecological land systems, gathering a dataset of 26 variables spanning across 7 dimensions: physical, biological, land cover, economic, demographic, political, and cultural. We identified 13 SELS nested in 5 larger social-ecological regions (SER). Each SELS was discussed and described by specific groups of specialists. Although 4 environmental and 1 socioeconomic variable explained most of the distribution of the coarse SER classification, a diversity of 15 other variables were shown to be essential for defining several SELS, highlighting specific features that differentiate them. The SELS spatial classification presented is a systematic and operative characterization of South American social-ecological land systems. We propose its use can contribute as a reference framework for a wide range of applications such as analyzing observations within larger contexts, designing system-specific solutions for sustainable development, and structuring hypothesis testing and comparisons across space. Similar efforts could be done elsewhere in the world

Primary cardiac osteosarcoma in a 42-year-old woman

We describe here a 42-year-old woman who was admitted to hospital with a pedunculated mass in her left atrium. She was diagnosed with a primary cardiac osteosarcoma with special immunohistochemical characteristics. Echocardiography and computed tomography can be used to differentiate cardiac osteosarcomas from routine intracardiac tumors. The patient was treated by surgical removal of the mass. Two years later, she has shown no evidence of disease recurrence. We discuss primary osteosarcomas in the cardiac cavity and their management

Water seepage beneath dams on soluble evaporite deposits: a laboratory and field study (Caspe Dam, Spain)

The paper presents analytical methods and results for assessing the variation in the concentration of sulphate (and other ions) over space and time in groundwater flowing through a soluble evaporite terrain beneath a dam. The influence of effective porosity, groundwater flow velocity and the specific rate of dissolution (K′) are considered. The theoretical analysis was tested in a scale model simulating a dam constructed on heavily karstified bedrock. A simple and useful method for assessing how much material is lost through dissolution and how the rate of dissolution changes over time is considered in the context of the Caspe Dam, Spain

Cardiothoracic CT: one-stop-shop procedure? Impact on the management of acute pulmonary embolism

In the treatment of pulmonary embolism (PE) two groups of patients are traditionally identified, namely the hemodynamically stable and instable groups. However, in the large group of normotensive patients with PE, there seems to be a subgroup of patients with an increased risk of an adverse outcome, which might benefit from more aggressive therapy than the current standard therapy with anticoagulants. Risk stratification is a commonly used method to define subgroups of patients with either a high or low risk of an adverse outcome. In this review the clinical parameters and biomarkers of myocardial injury and right ventricular dysfunction (RVD) that have been suggested to play an important role in the risk stratification of PE are described first. Secondly, the use of more direct imaging techniques like echocardiography and CT in the assessment of RVD are discussed, followed by a brief outline of new imaging techniques. Finally, two risk stratification models are proposed, combining the markers of RVD with cardiac biomarkers of ischemia to define whether patients should be admitted to the intensive care unit (ICU) and/or be given thrombolysis, admitted to the medical ward, or be safely treated at home with anticoagulant therapy

Serological Evaluation of Mycobacterium ulcerans Antigens Identified by Comparative Genomics

A specific and sensitive serodiagnostic test for Mycobacterium ulcerans infection would greatly assist the diagnosis of Buruli ulcer and would also facilitate seroepidemiological surveys. By comparative genomics, we identified 45 potential M. ulcerans specific proteins, of which we were able to express and purify 33 in E. coli. Sera from 30 confirmed Buruli ulcer patients, 24 healthy controls from the same endemic region and 30 healthy controls from a non-endemic region in Benin were screened for antibody responses to these specific proteins by ELISA. Serum IgG responses of Buruli ulcer patients were highly variable, however, seven proteins (MUP045, MUP057, MUL_0513, Hsp65, and the polyketide synthase domains ER, AT propionate, and KR A) showed a significant difference between patient and non-endemic control antibody responses. However, when sera from the healthy control subjects living in the same Buruli ulcer endemic area as the patients were examined, none of the proteins were able to discriminate between these two groups. Nevertheless, six of the seven proteins showed an ability to distinguish people living in an endemic area from those in a non-endemic area with an average sensitivity of 69% and specificity of 88%, suggesting exposure to M. ulcerans. Further validation of these six proteins is now underway to assess their suitability for use in Buruli ulcer seroepidemiological studies. Such studies are urgently needed to assist efforts to uncover environmental reservoirs and understand transmission pathways of the M. ulcerans

Lay Perceptions of Type 2 Diabetes in Scotland: Bringing Health Services Back In.

The growing prevalence of type 2 diabetes is placing Scottish health services under considerable strain. Consequently, diabetes services are undergoing a major process of reorganisation, including the devolvement of routine diabetes care/diabetic review from secondary to primary healthcare settings. This qualitative study was devised to explore newly diagnosed type 2 diabetes patients' perceptions of their disease and the health services they receive at a time when this restructuring of services is taking place. The sample comprised 40 patients resident in Lothian, Scotland, who had diverse experiences of services, some receiving GP-based care only, others having varying contact with hospital diabetes clinics. In-depth interviews were undertaken with patients, three times at six monthly intervals over 1 year, enabling their experiences to be tracked at critical junctures during the post-diagnostic period. Disease perceptions and health service delivery were found to be mutually informing and effecting. Not only did (different types of) health service delivery influence the ways in which patients thought about and self-managed their disease, over time patients? disease perceptions also informed their expectations of, and preferences for, diabetes services. We thus argue that there is a need for a reconceptualisation within the medical social sciences to take into account the context of healthcare and the economic/policy factors that inform health service delivery when looking at patients? disease perceptions. We also discuss the logistical and ethical challenges of drawing upon patients? perspectives, preferences and views in the design and delivery of future health services

An open-source optimization tool for solar home systems: A case study in Namibia

Solar home systems (SHSs) represent a viable technical solution for providing electricity to households and improving standard of living conditions in areas not reached by the national grid or local grids. For this reason, several rural electrification programmes in developing countries, including Namibia, have been relying on SHSs to electrify rural off-grid communities. However, the limited technical know-how of service providers, often resulting in over- or under-sized SHSs, is an issue that has to be solved to avoid dissatisfaction of SHSs’ users. The solution presented here is to develop an open-source software that service providers can use to optimally design SHSs components based on the specific electricity requirements of the end-user. The aim of this study is to develop and validate an optimization model written in MS Excel-VBA which calculates the optimal SHSs components capacities guaranteeing the minimum costs and the maximum system reliability. The results obtained with the developed tool showed good agreement with a commercial software and a computational code used in research activities. When applying the developed optimization tool to existing systems, the results identified that several components were incorrectly sized. The tool has thus the potentials of improving future SHSs installations, contributing to increasing satisfaction of end-users