Ideal Scenario Research Articles

Evaluating the viability of a Tram-Train system. A case study from Salento (Italy)

Tram-Train (TT) combines features of railway and tramway systems by mean of tailored light railway vehicles. Although TT systems offer several benefits such as efficiency, effectiveness, and quality, they also incur some issues (e.g., rolling-stock design) that might discourage city administrations from implementation. Further, whilst this system is quite well-known, the related literature is still scarce and relegated to presenting qualitative descriptions of general features, technical issues, and experiments with some TT components. Detailed viability analyses of TT systems implementation in metropolitan areas and evaluation of their economic feasibility have been poorly investigated.This case study addresses previous gaps by a two-tier framework. The first - a context analysis - focuses on a city’s features and applies an analytical hierarchy process resulting in a weighted global score to assess the suitability of the specific context for a TT system. If the city achieves a positive evaluation for implementation (according to the score), then the second tier brings a cost-benefit analysis (CBA) into play to assess the project’s economic sustainability.Analysis of the Salento (Italy) metropolitan area proved to be a peculiar case study, as it presented uncommon features for TT system employment compared to ideal scenarios from the literature. Nevertheless, by the context analysis, the area resulted viable for such an innovative and interoperable transport system. Indeed, the results highlighted that resource availability and political strategies were far more relevant in the analysis than the spatial and technical features, as well as the need for improving connections. Next, two TT project alternatives were compared through the CBA, and both resulted in economically sustainable, being the net present value positive, the internal rate of return larger than the discount rate and the benefit-cost ratio larger than one. In addition, a sensitivity analysis was applied for the best alternative. It showed that TT investment costs, the marginal cost of accidents, and the demand shifted from the suburban bus and car, respectively, were reported as critical variables. Nonetheless, no switching values were registered that could realistically threaten the assessment of the economic profitability of the TT project. As far as the authors know, these results provide the first empirical evidence of the TT system’s viability and its economic feasibility in a mid-sized city based on the development of previous literature recommendations. Hence, this case study may provide a benchmark tool for policymakers, transit experts and the scientific community to assess TT projects.

Investigation of beam delivery time for synchrotron-based proton pencil beam scanning system with novel scanning mode

Objective. To investigate synchrotron-based proton pencil beam scanning (PBS) beam delivery time (BDT) using novel continuous scanning mode. Approach. A BDT calculation model was developed for the Hitachi particle therapy system. The model was validated against the measured BDT of 36 representative clinical proton PBS plans with discrete spot scanning (DSS) in the current Hitachi proton therapy system. BDTs were calculated with the next generation using Mayo Clinic Florida system operating parameters for conventional DSS, and novel dose driven continuous scanning (DDCS). BDTs of DDCS with and without Break Spots were investigated. Main results. For DDCS without Break Spots, the use of Stop Ratio to control the transit dose largely reduced the beam intensity and consequently, severely prolonged the BDT. DDCS with Break Spots was able to maintain a sufficiently high beam intensity while controlling transit dose. In DDCS with Break Spots, tradeoffs were made between beam intensity and number of Break Spots. Therefore, BDT decreased with increased beam intensity but reached a plateau for beam intensity larger than 10 MU s−1. Averaging over all clinical plans, BDT was reduced by 10% for DDCS with Break Spots compared to DSS. Significance. DDCS with Break Spots reduced BDT. DDCS has the potential to further reduce BDT under the ideal scenario which requests both stable beam intensity extraction and accurately modelling the transit dose. Further investigation is warranted.

Rugosity and blocking indices of artificial reefs and their correlations with wake volume

Like aquatic habitats in nature, artificial reefs (ARs) have been investigated to determine whether their complexity affects species diversity. Moreover, studies have been carried out to investigate wake regions of ARs, which provide a shelter, feeding ground, rest area, and temporary stopover for marine species; however, few have examined the correlation between the complexity of the AR and characteristics of the wake region. In this study, we first modelled three ideal scenarios and six real ARs, all designed with different degrees of rugosity and/or water-blocking effects. Second, we obtained the wake volumes of the target structures using the element-based finite volume method and investigated their correlations with the rugosity index (RI), blocking index (BI), and rugosity-blocking index (RBI). Our results showed that for securing a large wake region, it is necessary to implement not only a large upper surface with a certain degree of rugosity (e.g. 2.0 for a tunnel- or arch-type AR) but also a large front surface area with sufficient water-blocking effects (e.g. 0.5 for a cube- or box-type AR). Overall, the RI, BI, and RBI were useful for distinguishing the characteristics of the upper and front surfaces, and accordingly to estimate wake volumes.

A theoretical understanding of ionic current through a nanochannel driven by a viscosity gradient

HypothesisDifferent thermodynamic forces owing to the gradient of temperature, electrical potential, or concentration can drive ionic current through charged membranes. It has been recently shown that a viscosity gradient can drive an electrical current through a negatively charged nanochannel (Wiener and Stein, arXiv: 1807.09106). A model description of this phenomenon, based on the Maxwell–Stefan equation will help unravel the dominating physical mechanisms in so-called visco-migration. TheoryTo understand the physical mechanisms underlying this phenomenon, we employed the Maxwell–Stefan equation to develop a 1D model and obtain a relation between the flux of solvents and the driving forces. Viscosity gradients are known to drive transport, but the development of an electrical current has not been theoretically described prior to this work. FindingsOur 1D model shows that the ionic current depends on the ideality of the solvent, though both ideal and non-ideal scenarios demonstrated good agreement with experimental data. We employed the model to understand the impact of solution bulk ionic strength and pH on the drift of ionic species with same reservoirs solution properties. Our modeling results unveiled the significant impact of bulk solution properties on the drift of ions which is in agreement with the experiments. Moreover, we have shown that the diffusion gradient along the nanochannel contributes significantly into driving ionic species if we even apply a small ionic concentration gradient to both reservoirs. Our modeling results may pave the way for finding novel applications for drift of ions in a diffusion gradient, which can be induced by connecting reservoirs of different viscosity fluids.

Estimated Impacts of Alcohol Control Policies on NCD Premature Deaths in Thailand.

Background: This study aimed to assess the impacts of achieving a 10% alcohol reduction target and different alcohol policy interventions on NCD premature deaths during 2010–2025 in Thailand. Methods: The researchers estimated the impacts on three main NCDs: cancers, cardiovascular diseases, and diabetes. These represent two ideal scenarios, which are the target reduction and five intervention scenarios. These intervention scenarios comprise taxation with 50% price increases, a total ban on advertisements, availability restriction by shortening sales times, early psychological intervention, and combined interventions. Consumption data and mortality trends were obtained from available national data. Relative risks and intervention effects were derived from the literature. Results: Achieving a 10% reduction target would lead to 3903–7997 avoidable NCD deaths. Taxation was the most effective intervention, with the highest number of avoidable NCD deaths, followed by early psychological intervention, availability restriction, and an advertisement ban. A combination of these four interventions would reduce 13,286 NCD deaths among men and 4994 NCD deaths among women, accounting for 46.8% of the NCD mortality target. Conclusion: This study suggests using Thailand as an example for low- and middle-income countries to enhance implementation and enforcement of the recommended effective alcohol policies for achieving the global targets.

18 Politically relevant solar geoengineering scenarios

Solar geoengineering, also known as Solar Radiation Modification (SRM), has been proposed to alter Earth’s radiative balance to reduce the effects of anthropogenic climate change. SRM has been identified as a research priority, as it has been shown to effectively reduce surface temperatures, while substantial uncertainties remain around side effects and impacts. Global modeling studies of SRM have often relied on idealized scenarios to understand the physical processes of interventions and their widespread impacts. These extreme or idealized scenarios are not directly policy-relevant and are often physically implausible (such as imposing global solar reduction to counter the warming of an instantaneous quadrupling of CO2). The climatic and ecological impacts of politically relevant and potentially plausible SRM approaches have rarely been modeled and assessed. Nevertheless, commentators and policymakers often falsely assume that idealized or extreme scenarios are proposed solutions to climate change. This paper proposes 18 scenarios that appear to be broadly plausible from political and Earth System perspectives and encompass futures that could be both warnings or perhaps desirable. We place these scenarios into four groups following broader strategic contexts: (1) Global Management; (2) Regional Emergencies; (3) Coordinated Regional Interventions; and (4) Reactive Global Interventions. For each scenario, relevant model experiments are proposed. Some may be performed with existing setups of global climate models, while others require further specification. Developing and performing these model experiments – and assessing likely resulting impacts on society and ecosystems – would be essential to inform public debate and policymakers on the real-world issues surrounding SRM.

A mapping approach to assess the evolution of pores during dehydration

Shrinkage and collapse phenomena are the two mechanisms involved in the evolution of pores within food products during dehydration. These phenomena can be mathematically represented by shrinkage and collapse functions, which can be derived from theoretical models of porosity, bulk density, or volume reduction coefficient. In this contribution, these two functions were simplified to capture four extreme scenarios of dehydration, which consist in the combination of total or no shrinkage with total or no collapse. The four simplified equations were used to generate theoretical maps characterized by three distinct zones that are associated with pore evolution. Each of these zones represents a key dehydration situation. By superimposing experimental data of porosity, bulk density, or volume reduction coefficient on these theoretical maps, it is possible to assess dehydration processes, i.e., drying technologies and/or dehydration conditions, in terms of pore formation and evolution over time. These theoretical maps can be constructed for each food product before starting the dehydration processes. Therefore, when the experimental data is available, the suggested mapping approach is a simple, fast, and reliable tool to: (i) assess the performance of a given dehydration process versus specific cases of pore formation, and (ii) compare different dehydration processes in terms of their ability to promote pore formation. This practical tool can be used by the industry and academia to quantitatively evaluate how far a drying technology and/or its dehydration conditions are from the ideal scenario in terms of pore formation. This gap quantification will provide a basis for converging towards the ideal scenario by fine-tuning the dehydration conditions or choosing the appropriate drying technology.

Joint Fairness and Power Optimization Under User Priority in NOMA Networks for IoT Applications

Nonorthogonal multiple access (NOMA) has been recently proposed as an enabling technique for future cellular networks. The main purpose of NOMA is assigning every resource block (RB), such as a time slot, subcarrier, or spreading code to multiple users. Increasing the number of supported users for each RB makes NOMA an efficient technique for sixth-generation (6G) and Internet of Things (IoT) networks. It also can lead to a higher total network rate, spectrum efficiency (SE), and fairness compared to orthogonal multiple access (OMA) networks. In this article, optimizing fairness and power by satisfying the new user priority approach in NOMA networks is investigated. The user priority approach guarantees the independent Quality of Service (QoS) and makes the problem more practical for applications such as IoT. In this article, theoretical and simulation results support the optimum solutions under both ideal and nonideal scenarios.

Perceptions on the effectiveness of environmental education programs as environmental licensing tools for port-related enterprise in Brazil.

Environmental Education Programs (EEPs) are considered environmental management tools in Brazilian environmental licensing processes, within the scope of mitigatory and compensatory measures to the social, environmental, and economic impacts caused by development projects or new enterprises. Here, we assess the perceptions and expectations regarding environmental education programs of three groups of actors (communities, environmental managers, and environmental agency technicians) involved in the licensing processes of port activities in the region of Paranaguá, in the State of Paraná, Brazil. Paranaguá is the largest coastal municipality of the state of Paraná, in the southern region of Brazil, and is home to Brazil`s second largest port. Since this is environmental conservation area, the conflicts between the port activities, environmental protection and needs of the local communities require efficient environmental management practices, with EEPs as one of their main implementation tools. The evaluation was based on semi-structured interviews which were analyzed using the methods of content analysis and discourse of the collective subject. The actors understand that environmental education is a potentially effective tool to promote the mitigation or compensation of environmental impacts generated by port developments undergoing licensing processes. The groups considered that the continuity, promotion of social organization, and correlation with the actual environmental impacts related to each enterprise are essential qualities for good EEPs. The evaluated perceptions were complementary and indicate a complex but effective ideal scenario for EEPs in the region.

The role of nitric oxide in sepsis-associated kidney injury.

Sepsis is one of the leading causes of acute kidney injury (AKI), and several mechanisms including microcirculatory alterations, oxidative stress, and endothelial cell dysfunction are involved. Nitric oxide (NO) is one of the common elements to all these mechanisms. Although all three nitric oxide synthase (NOS) isoforms are constitutively expressed within the kidneys, they contribute in different ways to nitrergic signaling. While the endothelial (eNOS) and neuronal (nNOS) isoforms are likely to be the main sources of NO under basal conditions and participate in the regulation of renal hemodynamics, the inducible isoform (iNOS) is dramatically increased in conditions such as sepsis. The overexpression of iNOS in the renal cortex causes a shunting of blood to this region, with consequent medullary ischemia in sepsis. Differences in the vascular reactivity among different vascular beds may also help to explain renal failure in this condition. While most of the vessels present vasoplegia and do not respond to vasoconstrictors, renal microcirculation behaves differently from nonrenal vascular beds, displaying similar constrictor responses in control and septic conditions. The selective inhibition of iNOS, without affecting other isoforms, has been described as the ideal scenario. However, iNOS is also constitutively expressed in the kidneys and the NO produced by this isoform is important for immune defense. In this sense, instead of a direct iNOS inhibition, targeting the NO effectors such as guanylate cyclase, potassium channels, peroxynitrite, and S-nitrosothiols, may be a more interesting approach in sepsis-AKI and further investigation is warranted.

Determination of Two Homogeneous Materials in a Bar with Solid-Solid Interface

In this work, a bar fully insulated on its lateral surface. composed by two different unknown materials is considered. For the analytical solution, it is assumed a perfectly assembly solid-solid interface, so no heat loss due to friction is present. This is an ideal scenario, so this loss and possible measurement errors are included by simulating noisy data for the estimation of the thermal conductivity of the unknown materials. A stationary heat transfer process along the bar is considered where a Dirichlet condition is imposed at the left that represents a source of constant temperature. At the other end of the bar, a Robin condition that models heat dissipation by convection, is assumed. The constant thermal conductivity coefficients of both solids are determined under two different situations: a) two noisy temperature measurements are available, one at the interface and the other at the right boundary; b) a temperature measurement at the interface and a heat flow measurement at the right edge of the bar are given. The bounds for the errors in the identification of the unknown coefficients are obtained based on the data measurements, the room temperature and temperature values at the boundary and interface. Numerical examples are given to illustrate the ideas used for the parameter identification and elasticity analysis is carried out to measure the dependence of the data on the estimated parameters.

Soil erosion in Qilian Mountain National Park: Dynamics and driving mechanisms

Study regionQilian Mountain National Park (QLMNP) in northwestern China. Study focusThe risk of soil erosion has increased noticeably at the global scale. In China, several ecological projects have been conducted to minimize the side effect of soil erosion in recent decades. Assessing soil erosion and identifying driving mechanisms are necessary due to the increased risk of ecological security in QLMNP. Here, we employed the Revised Universal Soil Loss Equation (RUSLE) to assess the soil erosion rate in QLMNP from 1982 to 2020. The driving mechanism was detected through the differences between the realistic scenario and four idealized scenarios with different fixed RUSLE input parameters. The contributions of different driving factors (soil type, digital elevation model, slope, extreme precipitation frequency and intensity, precipitation, vegetation coverage, and land use/cover change (LUCC)) were assessed through the geodetector model. New hydrological insights for the regionThe soil erosion rate averaged over QLMNP increased at 0.13 t ha-1 yr-1 from 1982 to 2020, despite the slightly decrease shown in the majority (62.62%) area. Anthropic LUCC in eco-conservation measures tends to prevent soil erosion in QLMNP, but extreme precipitation has the opposite effect. The coupled impacts of extreme precipitation and LUCC dominate the soil erosion dynamics in this area. Our results indicate that ecological projects are effective to mitigate the soil erosion caused by climate change.

Molecular detection of Leishmania infantum in rats and sand flies in the urban sewers of Barcelona, Spain

BackgroundClassically, dogs have been considered to be the only reservoir of leishmaniasis in urban areas. However, in a previous study, we found a 33.3% prevalence of Leishmania infantum in the spleens of Norway rats (Rattus norvegicus) sampled in the underground sewer system of the city of Barcelona (Spain). The aim of the present study was to verify, using molecular methods, the potential reservoir role of these rats in the same sewer system.MethodsA sensitive real-time PCR (qPCR) assay, DNA sequencing and phylogenetic analysis were carried out to identify and quantify the presence of L. infantum DNA in sand fly individuals captured in the same underground sewer system of Barcelona as in our previous study and in the spleens and ears of rats captured in the same sewer system.ResultsLeishmania infantum DNA was found in 14 of the 27 (51.9%) sand flies identified as Phlebotomus perniciosus, and 10 of the 24 (41.7%) rats studied were infected. Leishmania infantum was found in the spleens (70%) and in the ears (40%) of the infected rats. Quantitative results revealed the presence of high loads of L. infantum in the rats studied (> 3 × 106 parasites/g ear tissue) and among the sand flies (> 34 × 106 parasites in 1 individual).ConclusionsThe molecular methods used in this study demonstrated a high prevalence of L. infantum in the underground sewer populations of both R. norvegicus and P. perniciosus. These results suggest that sewer rats, in addition to dogs, are likely to act as reservoirs of leishmaniasis in cities, where sewer systems seem to offer the ideal scenario for the transmission of leishmaniasis. Therefore, to achieve the WHO 2030 target on the elimination of leishmaniasis as a public health problem successfully, an efficient control strategy against leishmaniasis in rats and sand flies should be implemented, particularly in the sewer systems of urban areas of endemic countries.Graphical

CO2-Foam Monitoring using Resistivity and Pressure Measurements

This paper focuses on combining resistivity and pressure measurements to determine the effectiveness of foam as a mobility control method. It presents a theoretical framework to describe the expected resistivity changes during CO2-foam displacements. With this objective, we first provide equations to estimate the resistivity for CO2-foam systems and then utilize two distinct foam models to quantify these effects. Using analytical solutions based on the fractional flow theory, we present resistivity and mobility distributions for ideal and non-ideal reservoir displacement scenarios. Additionally, assuming pressure measurements only, we examine the inter-dependency between various foam parameters. Our results suggest that the combination of pressure and resistivity measurements in time-lapse mode could be deployed as an effective monitoring tool in field applications of the (CO2) foam processes. The proposed method is novel as it could be employed to predict under-performing CO2-foam floods and improve oil recovery and CO2 storage.

Semi-supervised fault diagnosis of machinery using LPS-DGAT under speed fluctuation and extremely low labeled rates

Recent research in semi-supervised fault diagnosis of machinery based on graph neural networks (GNNs) still has some problems, such as insufficient label information mining, static feature extraction of neighbor nodes, and relatively ideal diagnosis scenarios. In engineering practice, machinery often runs under speed fluctuation such as start-stop process, and labeling samples becomes increasingly expensive. To deal with the above challenges, a new semi-supervised fault diagnosis method called label propagation strategy and dynamic graph attention network (LPS-DGAT) is proposed in this paper. The designed LPS can take full advantage of the label co-dependency between samples, so as to realize the full utilization of the limited label information. The constructed DGAT by dynamic attention can effectively extract feature information of the different neighbor nodes under speed fluctuation. The proposed method is used to analyze the vibration signals of bearing and gear under speed fluctuation, and the comparison results show that even in the extreme situations where the labeled rates are no more than 1%, the proposed method can still accurately extract discriminative features and diagnose different fault modes, which is better than other GNNs.

Coronavirus Disease 2019 Vaccination for Cancer Patients: Risk or Benefit?

The aim of the present study is to list the published clinical trials on coronavirus disease 2019 (COVID-19) vaccines, to describe the mechanism of action of the identified vaccines, and to identify protocols regarding safety, status, and prioritization of cancer patients for vaccination. This is a systematic review with a limited literature search conducted by an information specialist; key resources such as PubMed and websites of major cancer organizations were searched. The main search terms were COVID-19, vaccination, cancer, and breast and gynecological cancers. Cancer patients infected with the new coronavirus are at high risk of complications and death, but we still know little about the risks and benefits of vaccination for COVID-19 in these patients. In an ideal scenario, all cancer patients should have their immunization status updated before beginning treatment, but this is not always possible. Patients with breast or gynecological cancers who are receiving treatment or are in the 5-year posttreatment period should be included in the priority group for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccination.

My Journey Through a Kidney Transplant Procedure.

My Journey Through a Kidney Transplant Procedure James Moran Polycystic Kidney Disease is hereditary. My grandmother died at home before dialysis was readily available. My mother, uncle, and great aunt all had dialysis treatments for extended periods of time and eventually died. My uncle was most fortunate in that he had a heart attack while on dialysis. My mother and great aunt suffered through the disease before it consumed them. The magic age for adult onset PKD requiring dialysis is in the early fifties. First diagnosed at age 25, I watched my creatinine levels increase over the years and knew what awaited me. I was 52 when my nephrologist said it was time for me to have the surgical procedure to attach a vein to an artery in my left arm. This arteriovenous fistula is the access point for dialysis. He said that I would probably need dialysis within about three months. It was about one year more before I really needed it. Even though it was an eventuality we had expected for over 25 years, my wife said: “I thought we had more time.” I considered myself fortunate to have dialysis available and so close. The center was about ten minutes from my house. The 5:30 AM appointment time was not my first choice, but it did enable me to continue working and still have evenings at home with my family. The initial few months are called the “honeymoon” period. Things were going well, I was tolerating the treatments, and I felt better. Why would I need a transplant? I attended a pre-transplant session at a hospital at my wife’s insistence. I really had reservations about the process. Except for the out-patient AV fistula surgery, I had not been “under the knife” and never had a hospital stay. A pre-transplant session at a different hospital was even more graphic and made me less enthusiastic. Eventually, dialysis became more difficult and I felt more fatigued. It was more disruptive and vacations always created scheduling issues. Both hospitals as well as the dialysis team, encouraged me to look for a live donor. They suggested that I contact family members and friends to tell them I was in need of a kidney donor. My oldest son who was 21 at the time offered immediately without being asked. Personally, I felt reluctant to put someone else at risk for me even though they assured me that the donor would remain safe and my outcome would be better. I reluctantly placed myself on the transplant list and received dialysis for about four years before a cadaver kidney became available. The story of the call from the transplant clinic was interesting. My transplant surgeon had told me that I would need a bilateral nephrectomy because my polycystic kidneys were large and infected. He said that they needed to be removed before the transplant, but the removal should be delayed until I was closer to the top of the transplant list as it would add extra stress on my body. After about three years on dialysis, I received my first call. I declined the kidney and scheduled the nephrectomy. This surgery was difficult and I was in a lot of pain. The following year was brutal while I waited for the next call. Without my native kidneys, I was no longer producing urine and I had severe limitations on fluid intake. This was most unbearable during hot summer days. The long wait between the first and second calls was exacerbated by a nearby transplant center being closed as people transferred their wait time to the center on which I was listed. In the ideal scenario, I would have received a call soon after the nephrectomy had healed. The second call came while I was on a Boy Scout camping trip. I had been involved in Boy Scouts for 25 years in varying capacities but many as Scout-master and frequently camping. I probably spent several hundred nights in a tent. On this trip, I had no cell signal inside the camp. My wife received the call at home and, after failing to reach me, drove to our camp and walked...

Effect of early breast feeding on pain perception in women undergoing spinal anaesthesia for caesarean delivery: a comparative study

BackgroundPostoperative pain reduction is a key priority after caesarean delivery. Current recommendations are to breastfeed the baby as soon as possible after birth, including after caesarean section. However, analgesics can transfer into breast milk, and hence an ideal scenario is a postoperative period free from analgesics and pain. The aim of this study was to determine the effect of early breastfeeding on pain perception after caesarean delivery with spinal anaesthesia in the Gaza Strip. MethodsData for the comparative study were collected by research nurses at the Al Helal Al Emirati Hospital, Rafah, Gaza Strip, occupied Palestinian territory, from May to October, 2019. All women who had delivered at the hospital were encouraged to breastfeed as early as possible after caesarean delivery. Women who underwent caesarean delivery with spinal anaesthesia were assigned to one of two groups. Group 1 were women who breastfed in the first hour after caesarean delivery. Group 2 were women who were unable to breastfeed early (within 24 h) owing to maternal morbidity or neonatal causes such as admission to the neonatal intensive care units or a stillborn baby. A pain assessment scale (PAS; range 1–5, in which 1=no pain and 5=worst pain imaginable) was used to record the pain 1 h after the end of the caesarean delivery and then at 6 h, 12 h, 18 h, and 24 h. The time from the end of the caesarean delivery to the first demand for other analgesia and the total amounts and types of analgesics used in 24 h were recorded. The study was approved by the Palestinian Ministry of Health and the Helsinki Committee, Gaza Strip. Women provided verbal informed consent before participation. FindingsIn the period of the study there were approximately 590 women who delivered by caesarean section at Al Helal Al Emirati hospital, of whom 149 received spinal anaesthesia. Data from these 149 patients (mean age 30·85 years [SD 6·29]) were investigated: 111 (75%) in group 1 and 38 (26%) in group 2. The reported pain was lower in the first and 12th hour in group 1 than in group 2 (first hour, PAS 1·35 for group 1 vs 1·87 for group 2, p=0·004; 12th hour, PAS 1·35 for group 1 vs 1·73 for group 2, p=0·015). In group 1, 40 (36%) of 111 women needed analgesics after caesarean delivery, compared with 22 (58%) of 38 women in group 2 (p=0·018). Of the women who needed additional analgesia, 33 (83%) of 40 took only one analgesic and five (13%) of 40 took two analgesics in group 1, compared with 15 (68%) of 22 who took one analgesic and six (27%) of 22 who took two analgesics in group 2 (p=0·345 for group 1 vs group 2). The mean time to needing other analgesic drugs was longer in group 1 than in group 2 (10·54 h [SD 1·25] vs 6·40 h [SD 1·43]; p=0·035). InterpretationBreastfeeding within 1 h after caesarean delivery with spinal anaesthesia was associated with better pain reduction than no breastfeeding within 24 h. A multicentre study over a longer period post delivery, with a larger study population to include more types of delivery, would be of great benefit. FundingNone.

Coexistence in Times of Climate Crisis: A Participatory Mapping to Understanding Conservation Conflicts in the Central Andes of Chile

PurposeHuman-wildlife conflicts worldwide are arising, representing significant challenges for conservation biologists, decision-makers, and agropastoralist communities. Extreme climatic events, disease outbreaks, and land-use change could be intensifying these conflicts. The multi-species and mountainous landscapes seem prone to conflicts due to a lack of territory planning. These complex, dynamic, and multi-layered conflicts require a multidimensional approach. Currently, in Chile, mountainous landscapes have several threats, such as a lack of territory planning, mega-mining projects, and recently (last 10 years) the effects of the Mega-drought. Many transhumant agropastoralists have been forced to quit their livelihoods while increasing livestock-wildlife conflicts. We aim to build territorial planning within a holistic approach to strengthening the agropastoralists' competence to coexist with local wildlife (puma, condor, and guanaco) in Central Chile's Andes mountains.MethodologyWe conducted participatory mapping workshops with two agropastoralist communities in 2020. They were randomly divided into 4 to 7 people groups and told to draw a map representing their territory, including four elements: (1) natural and human components of the landscape, (2) natural wildlife conflict areas, (3) active grazing areas, and (4) their ideal future scenario, regarding their activity.FindingsResults showed different spatial perceptions of the natural and human components of the territory. All agropastoralists (100%) indicated similar wildlife conflict areas: focusing in the Summerlands. All agreed that Mega-drought was the primary threat to their production, increasing the conflict with wildlife. Summerland areas are identified as suitable areas for working in conflict with wildlife.Research Limitations/ImplicationsThis study highlights the need for a multidimensional approach to conflict and territory planning to address conservation conflicts. The study's implications show that agropastoralists decided to reduce Summerland use and improve Winterland planning to increase livestock productivity and reduce conflict with wildlife. Participatory mapping could help to prioritize areas to mitigate conflicts with wildlife.Originality/ValueThis study is the first in the Aconcagua valley to conduct a transdisciplinary & participatory approach toward coexistence between transhumant agropastoralists and wildlife. It also provides a baseline for similar schemes in semi-arid and mountainous landscapes worldwide facing rapid climate shifts and increasing human-wildlife conflict.

Geografías para un buen nacer: una aproximación geo(corpo)gráfica del parto en domicilio en Chile

Home birth has added a layer of complexity to the epistemology of birth, raising questions about its institutional aspects. From this standpoint, this article stems from an interest in the narratives that Chilean women ascribe to the scenario of home birth. Thirty women were interviewed between October 2018 and January 2019 using elements of body mapping. A central category emerged in thematic analysis: geo(corpo)graphies of home birth, which involves the deployment of the material/symbolic body in a manner that allows birth to occur. Three subcategories also emerged: creating the ideal setting for childbirth, which has to do with imagining and defining the ideal space for childbirth; the best place to give birth letting instincts flow, which is constructed by feeling and listening to the body; and resignifying the ideal scenario, which implies attributing a new meaning to the home in order to give birth. These geo(corpo)graphic narratives of home birth recognize corporality and its disposition in space, allowing birth to be collectively socialized, blurring the boundaries between the public and the private.