Towards durable multistakeholder-generated solutions: The pilot application of a problem-oriented policy learning protocol to legality verification and community rights in Peru

This paper reports and reflects on the pilot application of an 11-step policy learning protocol that was developed by Cashore and Lupberger (2015) based on several years of Cashore’s multi-author collaborations. The protocol was applied for the first time in Peru in 2015 and 2016 by the IUFRO Working Party on Forest Policy Learning Architectures (hereinafter referred to as the project team). The protocol integrates insights from policy learning scholarship (Hall 1993, Sabatier 1999) with Bernstein and Cashore’s (2000, 2012) four pathways of influence framework. The pilot implementation in Peru focused on how global timber legality verification interventions might be harnessed to promote local land rights. Legality verification focuses attention on the checking and auditing of forest management units in order to verify that timber is harvested and traded in compliance with the law. We specifically asked: How can community legal ownership of, and access to, forestland and forest resources be enhanced? The protocol was designed as a dynamic tool, the implementation of which fosters iterative rather than linear processes. It directly integrated two objectives: 1) identifying the causal processes through which global governance initiatives might be harnessed to produce durable results ‘on the ground’; 2) generating insights and strategies in collaboration with relevant stakeholders. This paper reviews and critically evaluates our work in designing and piloting the protocol. We assess what seemed to work well and suggest modifications, including an original diagnostic framework for nurturing durable change. We also assess the implications of the pilot application of the protocol for policy implementation that works to enhance the influence of existing international policy instruments, rather than contributing to fragmentation and incoherence by creating new ones

The surgical treatment of pituitary adenomas in the eighth decade

BACKGROUND The surgical treatment of pituitary adenomas in elderly patients (i.e., over 70 years of age) is a special problem because of the increased rate of perioperative complications and the reduced tolerance of postoperative fluid and electrolyte imbalance. Therefore, the unquestionable progress in the pharmacological and radiotherapy may not allow these patients the option of radical surgical treatment, We report our experience with the transsphenoidal procedure for pituitary adenomas in aged patients in an attempt to contribute to a better definition of the actual role of surgery. METHODS Transsphenoidal surgery was performed in 11 patients over 70 years of age affected by various histological types of pituitary micro- and macroadenomas, ranging from Hardy Grade I through IIIc, Special care was dedicated to the postoperative treatment, in particular to water and electrolyte balances, and to the immediate treatment of any pathological variation of these parameters. RESULTS We had no mortality and no postoperative adjunctive morbidity, All the patients recovered well from the operation with an average hospital stay of 20 days. The tumor removal was complete in six cases and partial in the remaining five. With an average follow-up of 2 years, we did observe only one case of symptomatic recurrence of the disease. CONCLUSIONS Transsphenoidal surgery in the elderly is feasible and quite safe in the hands of an experienced team, if special care is devoted to the preoperative selection of patients and to the postoperative treatment of fluid and electrolyte imbalanc

A regional-scale conceptual and numerical groundwater flow model in fluvio-glacial sediments for the Milan Metropolitan area (Northern Italy)

Study region: The Milan metropolitan area lies on one of the most important aquifer in Italy, heavily exploited for public and industrial water supply. The area, covering 3135 km2 in the Po Plain (Northern Italy) with a continental climate, is bounded by the Po, the Adda and the Ticino rivers and by the prealpine foothills. Regional hydrology is characterised by a network of natural and man-made elements, and lowland springs. The sedimentary sequence, from bottom to top, is formed by meandering river plain deposits, the distal fringe of the glacial outwash plains and proximal braid-plain deposits. Study focus: This study proposes a general approach for aquifer geometry reconstruction and hydrodynamic parametrization of hydrofacies in fluvio-glacial deposits, and their implementation into a 3D regional groundwater flow model. This approach is based on sedimentologically-defined lithofacies/hydrofacies and their correlation in space to obtain nearly homogeneous subunits starting from available data (i.e. 8628 borehole logs, grain size distributions, well tests) and sedimentological knowledge. New hydrological insights for the region: The calibrated 3D FEM groundwater model allows quantifying the main components of the hydrogeological budget at the regional scale, and the fluxes among the different hydro-stratigraphic units. A sensitivity analysis of groundwater levels to the main recharge components suggests importance of anthropogenic disturbances with respect to natural recharge, and that land-use change may impact water resources more than climate change

Lung penetration, bronchopulmonary pharmacokinetic/pharmacodynamic profile and safety of 3 g of ceftolozane/tazobactam administered to ventilated, critically ill patients with pneumonia

Objectives: Ceftolozane/tazobactam is approved for hospital-acquired/ventilator-associated bacterial pneumonia at double the dose (i.e. 2 g/1 g) recommended for other indications. We evaluated the bronchopulmonary pharmacokinetic/pharmacodynamic profile of this 3 g ceftolozane/tazobactam regimen in ventilated pneumonia patients. Methods: This was an open-label, multicentre, Phase 1 trial (clinicaltrials.gov: NCT02387372). Mechanically ventilated patients with proven/suspected pneumonia received four to six doses of 3 g of ceftolozane/tazobactam (adjusted for renal function) q8h. Serial plasma samples were collected after the first and last doses. One bronchoalveolar lavage sample per patient was collected at 1, 2, 4, 6 or 8 h after the last dose and epithelial lining fluid (ELF) drug concentrations were determined. Pharmacokinetic parameters were estimated by noncompartmental analysis and pharmacodynamic analyses were conducted to graphically evaluate achievement of target exposures (plasma and ELF ceftolozane concentrations >4 mg/L and tazobactam concentrations >1 mg/L; target in plasma: similar to 30% and similar to 20% of the dosing interval, respectively). Results: Twenty-six patients received four to six doses of study drug; 22 were included in the ELF analyses. Ceftolozane and tazobactam T-max (6 and 2 h, respectively) were delayed in ELF compared with plasma (1h). Lung penetration, expressed as the ratio of mean drug exposure (AUC) in ELF to plasma, was 50% (ceftolozane) and 62% (tazobactam). Mean ceftolozane and tazobactam ELF concentrations remained >4 mg/L and >1mg/L, respectively, for 100% of the dosing interval. Therewere no deaths or adverse event-related study discontinuations. Conclusions: In ventilated pneumonia patients, 3 g of ceftolozane/tazobactam q8h yielded ELF exposures considered adequate to cover ceftolozane/tazobactam-susceptible respiratory pathogens

Torre Alfina Deep Geothermal Reservoir

The Castel Giorgio-Torre Alfina (CG-TA, central Italy) is a geothermal reservoir whose fluids are hosted in a carbonate formation at temperatures ranging between 120°C and 210°C. Data from deep wells suggest the existence of convective flow. We present the 3D numerical model of the CG-TA to simulate the undisturbed natural geothermal field and investigate the impacts of the exploitation process. The open source finite-element code OpenGeoSys is applied to solve the coupled systems of partial differential equations. The commercial software FEFLOW® is also used as additional numerical constraint. Calculated pressure and temperature have been calibrated against data from geothermal wells. The flow field displays multicellular convective patterns that cover the entire geothermal reservoir. The resulting thermal plumes protrude vertically over 3 km at Darcy velocity of about  m/s. The analysis of the exploitation process demonstrated the sustainability of a geothermal doublet for the development of a 5 MW pilot plant. The buoyant circulation within the geothermal system allows the reservoir to sustain a 50-year production at a flow rate of 1050 t/h. The distance of 2 km, between the production and reinjection wells, is sufficient to prevent any thermal breakthrough within the estimated operational lifetime. OGS and FELFOW results are qualitatively very similar with differences in peak velocities and temperatures. The case study provides valuable guidelines for future exploitation of the CG-TA deep geothermal reservoir

Phasing diffuse scattering. Application of the SIR2002 algorithm to the non-crystallographic phase problem

A new phasing algorithm has been used to determine the phases of diffuse elastic X-ray scattering from a non-periodic array of gold balls of 50 nm diameter. Two-dimensional real-space images, showing the charge-density distribution of the balls, have been reconstructed at 50 nm resolution from transmission diffraction patterns recorded at 550 eV energy. The reconstructed image fits well with scanning electron microscope (SEM) image of the same sample. The algorithm, which uses only the density modification portion of the SIR2002 program, is compared with the results obtained via the Gerchberg-Saxton-Fienup HIO algorithm. In this way the relationship between density modification in crystallography and the HiO algorithm used in signal and image processing is elucidated.Comment: 7 pages, 12 figure

Theory of Room Temperature Ferromagnet V(TCNE)_x (1.5 < x < 2): Role of Hidden Flat Bands

Theoretical studies on the possible origin of room temperature ferromagnetism (ferromagnetic once crystallized) in the molecular transition metal complex, V(TCNE)_x (1.5<x<2) have been carried out. For this family, there have been no definite understanding of crystal structure so far because of sample quality, though the effective valence of V is known to be close to +2. Proposing a new crystal structure for the stoichiometric case of x=2, where the valence of each TCNE molecule is -1 and resistivity shows insulating behavior, exchange interaction among d-electrons on adjacent V atoms has been estimated based on the cluster with 3 vanadium atoms and one TCNE molecule. It turns out that Hund's coupling among d orbitals within the same V atoms and antiferromagnetic coupling between d oribitals and LUMO of TCNE (bridging V atoms) due to hybridization result in overall ferromagnetism (to be precise, ferrimagnetism). This view based on localized electrons is supplemented by the band picture, which indicates the existence of a flat band expected to lead to ferromagnetism as well consistent with the localized view. The off-stoichiometric cases (x<2), which still show ferromagnetism but semiconducting transport properties, have been analyzed as due to Anderson localization.Comment: Accepted for publication in J. Phys. Soc. Jpn. Vol.79 (2010), No. 3 (March issue), in press; 6 pages, 8 figure

Impediments to mixing classical and quantum dynamics

The dynamics of systems composed of a classical sector plus a quantum sector is studied. We show that, even in the simplest cases, (i) the existence of a consistent canonical description for such mixed systems is incompatible with very basic requirements related to the time evolution of the two sectors when they are decoupled. (ii) The classical sector cannot inherit quantum fluctuations from the quantum sector. And, (iii) a coupling among the two sectors is incompatible with the requirement of physical positivity of the theory, i.e., there would be positive observables with a non positive expectation value.Comment: RevTex, 21 pages. Title slightly modified and summary section adde

MSH3 protein expression and nodal status in MLH1-deficient colorectal cancers.

View the MathML source: Colorectal tumors manifesting high-frequency microsatellite instability (MSI-H) develop genetically as a consequence of mutations in genes harboring repetitive DNA sequences. The activin type 2 receptor (ACVR2), possessing 2 polyadenine coding sequences, was identified as a mutational target, but it is not clear if expression is abrogated. Here, we analyzed MSI-H colorectal cancers for ACVR2 mutation and expression to assess if biallelic inactivation occurs. View the MathML source: All 54 MSI-H colon cancers and 20 random microsatellite stable (MSS) tumors from a population-based cohort of 503 patients were analyzed for mutations in 2 A8 tracts (exon 3 and 10) of ACVR2 and the A10 tract of transforming growth factor \u3b2 receptor 2 (TGFBR2). Additionally, we sequenced exon 10 of ACVR2 in select cancers. ACVR2 expression was determined by immunohistochemistry using an antibody targeting an epitope beyond the predicted truncated protein. View the MathML source: Forty-five of 54 MSI-H cancers (83%) showed mutation (A8 to A7) in the polyadenine tract of exon 10 compared with no MSS tumors. Of tumors with mutant ACVR2, 62% lacked protein expression but all MSS and MSI-H tumors with wild-type ACVR2 expressed protein. We found no evidence of loss of heterozygosity at the ACVR2 locus in MSS tumors. Comparatively, 69% of MSI-H cancers had frameshift mutation in TGFBR2. View the MathML source:ACVR2 mutations are highly frequent in MSI-H colon cancers and in most cases cause loss of ACVR2 expression, indicating biallelic inactivation of the gene. Loss of activin signaling through mutation of ACVR2, similar to observations with TGFBR2, may be important in the genesis of MSI-H colorectal cancer

The Patterson deconvolution method for the<i>ab-initio</i>structure solution of large proteins

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