Northern Eurasia Future Initiative (NEFI): facing the challenges and pathways of global change in the 21st century

During the past several decades, the Earth system has changed significantly, especially across Northern Eurasia. Changes in the socio-economic conditions of the larger countries in the region have also resulted in a variety of regional environmental changes that can have global consequences. The Northern Eurasia Future Initiative (NEFI) has been designed as an essential continuation of the Northern Eurasia Earth Science Partnership Initiative (NEESPI), which was launched in 2004. NEESPI sought to elucidate all aspects of ongoing environmental change, to inform societies and, thus, to better prepare societies for future developments. A key principle of NEFI is that these developments must now be secured through science-based strategies co-designed with regional decision makers to lead their societies to prosperity in the face of environmental and institutional challenges. NEESPI scientific research, data, and models have created a solid knowledge base to support the NEFI program. This paper presents the NEFI research vision consensus based on that knowledge. It provides the reader with samples of recent accomplishments in regional studies and formulates new NEFI science questions. To address these questions, nine research foci are identified and their selections are briefly justified. These foci include: warming of the Arctic; changing frequency, pattern, and intensity of extreme and inclement environmental conditions; retreat of the cryosphere; changes in terrestrial water cycles; changes in the biosphere; pressures on land-use; changes in infrastructure; societal actions in response to environmental change; and quantification of Northern Eurasia's role in the global Earth system. Powerful feedbacks between the Earth and human systems in Northern Eurasia (e.g., mega-fires, droughts, depletion of the cryosphere essential for water supply, retreat of sea ice) result from past and current human activities (e.g., large scale water withdrawals, land use and governance change) and potentially restrict or provide new opportunities for future human activities. Therefore, we propose that Integrated Assessment Models are needed as the final stage of global change assessment. The overarching goal of this NEFI modeling effort will enable evaluation of economic decisions in response to changing environmental conditions and justification of mitigation and adaptation efforts

A case of brain abscess mimicking cystic brain tumor and showing intraoperative 5-aminolevulinic acid fluorescence: case report .

Intraoperative fluorescence diagnostics is proved highly sensitive and specific for surgery of highly malignant brain gliomas, meningiomas and metastases. The greatest capability of accumulating 5-ALA was found in oligodendrogliomas, piloid astrocytomas and gliomas with cystic components. In some cases, making the differential diagnosis between a cerebral cystic tumor and a brain abscess can be difficult due to the similarity of clinical and neuroimaging data. A 37 year old male was hospitalized in a local neurological hospital. On admission, he presented with headaches, nausea, episodic vomiting, and weakness in the left extremities. In the last few months the patient suffered from recurrent episods of sinusitis. Contrast-enhanced brain CT scans revealed a right parietal lobe lesion of irregular shape (70x35 mm) with perilesional contrast enhancement. Contrast-enhanced MRI showed a mass lesion, which was hypointense on T1 with a marked contrast accumulation at the periphery. To the differential diagnosis between the suspected abscess and malignant tumor, we used the method of intraoperative metabolic navigation with 5-ALA. To relive the severe tension of the brain tissue, a ultrasound-guided cyst puncture was carried out. As a result, a thick yellow purulent discharge (~30 mL) was drained. Microbiological analysis of cyst contents revealed the presence of the pathogenic Streptococcus alactolyticus in the abscess’s content. The 5-ALA-induced fluorescence can be successfully used in neurosurgery for the differential diagnosis between a intracerebral tumor cyst and an abscess in the brain

Right ventricular dysfunction following continuous flow left ventriccular assist device placement in 51 patients: predicators and outcomes

<p>Abstract</p> <p>Background</p> <p>Right ventricular (RV) dysfunction following implantation of a left ventricular assist device (LVAD) is a serious condition and is associated with increased mortality.</p> <p>Methods</p> <p>The aim of the study is to investigate the significance of pre-existing RV dysfunction, tricuspid valve (TV) insufficiency, and the severity of septal deviation following LVAD implantation on RV dysfunction, as well as the outcome and short-term complications in 51 patients from June 2006 to August 2010. Student <it>t</it> test was used to compare the data and estimate the p value.</p> <p>Results</p> <p>Mean age was 55.1 ± 13, with a male to female ratio of 3.25. The 30-day mortality was 13.7% (7/51 patients), and the overall mortality was 23.5% (12/51 patients). Meanwhile, 21 patients (21/51; 41.2%) have undergone orthotopic heart transplantation. The mean time of support was 314.5±235 days with a median of 240 days at the time of closing this study. Echocardiographic evaluation of RV function pre- and post-implantation of an LVAD demonstrated septal deviation towards the left ventricle in immediate postoperative phase, which correlated with acute RV dysfunction (<it>p</it> = 0.002). Preoperative RV dysfunction was a significant predictor of postoperative right heart dysfunction following implantation of an LVAD (<it>p</it> = 0.001).</p> <p>Conclusion</p> <p>Preoperative RV dysfunction is a predictor of RV failure in LVAD patients. The adjustment of septal deviation through gradual increase of the LVAD flow can prevent the acute RV dysfunction following LVAD placement.</p