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Payments for environmental services (PES) are often viewed as a way to simultaneously improve conservation outcomes and the wellbeing of rural households who receive the payments. However, evidence for such win-win outcomes has been elusive. We add to the growing literature on conservation program impacts by using primary household survey data to evaluate the socioeconomic impacts of participation in Costa Rica's PES program. Despite the substantial cash transfers to voluntary participants in this program, we do not detect any evidence of impacts on their wealth or self-reported well-being using a quasi-experimental design. These results are consistent with the common claim that voluntary PES do not harm participants, but they beg the question of why landowners participate if they do not benefit. Landowners in our sample voluntarily renewed their contracts after five years in the program and thus are unlikely to have underestimated their costs of participation. They apparently did not invest additional income from the program in farm inputs such as cattle or hired labor, since both decreased as a result of participation. Nor do we find evidence that participation encouraged moves off-farm. Instead, semi-structured interviews suggest that participants joined the program to secure their property rights and contribute to the public good of forest conservation. Thus, in order to understand the social impacts of PES, we need to look beyond simple economic rationales and material outcomes.

The perspective of using live cells as lenses could open new revolutionary and intriguing scenarios in the future of biophotonics and biomedical sciences for endoscopic vision, local laser treatments via optical fibres and diagnostics. Here we show that a suspended red blood cell (RBC) behaves as an adaptive liquid-lens at microscale, thus demonstrating its imaging capability and tunable focal length. In fact, thanks to the intrinsic elastic properties, the RBC can swell up from disk volume of 90 fl up to a sphere reaching 150 fl, varying focal length from negative to positive values. These live optofluidic lenses can be fully controlled by triggering the liquid buffer’s chemistry. Real-time accurate measurement of tunable focus capability of RBCs is reported through dynamic wavefront characterization, showing agreement with numerical modelling. Moreover, in analogy to adaptive optics testing, blood diagnosis is demonstrated by screening abnormal cells through focal-spot analysis applied to an RBC ensemble as a microlens array. The shape of red blood cells is highly sensitive to surrounding liquid environment. Here, Miccio et al . make red blood cells into optofluidic lenses with fully controllable focal length at the microscale, which can be used for imaging and optical magnification in addition to blood diseases detection.

Manipulating and dispensing liquids on the micrometre- and nanoscale is important in biotechnology and combinatorial chemistry, and also for patterning inorganic, organic and biological inks. Several methods for dispensing liquids exist, but many require complicated electrodes and high-voltage circuits. Here, we show a simple way to draw attolitre liquid droplets from one or multiple sessile drops or liquid film reservoirs using a pyroelectrohydrodynamic dispenser. Local pyroelectric forces, which are activated by scanning a hot tip or an infrared laser beam over a lithium niobate substrate, draw liquid droplets from the reservoir below the substrate, and deposit them on the underside of the lithium niobate substrate. The shooting direction is altered by moving the hot tip or laser to form various patterns at different angles and locations. Our system does not require electrodes, nozzles or circuits, and is expected to have many applications in biochemical assays and various transport and mixing processes. Pyroelectric forces are used to transfer liquids between two substrates and create patterns without the use of nozzles, electrodes or complicated high-voltage circuits, opening up a new route for manipulating liquids.

A better understanding of the epidemiology and clinical features of invasive fungal infection (IFI) is integral to improving outcomes. We describe a novel case-finding methodology, reporting incidence, clinical features, and outcomes of IFI in a large US health care network. All available records in the Intermountain Healthcare Enterprise Data Warehouse from 2006 to 2015 were queried for clinical data associated with IFI. The resulting data were overlaid in 124 different combinations to identify high-probability IFI cases. The cohort was manually reviewed, and exclusions were applied. European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group Consensus Group definitions were adapted to categorize IFI in a broad patient population. Linear regression was used to model variation in incidence over time. A total of 3374 IFI episodes occurred in 3154 patients. The mean incidence was 27.2 cases/100 000 patients per year, and there was a mean annual increase of 0.24 cases/100 000 patients ( = .21). Candidiasis was the most common (55%). Dimorphic fungi, primarily spp., comprised 25.1% of cases, followed by spp. (8.9%). The median age was 55 years, and pediatric cases accounted for 13%; 26.1% of patients were on immunosuppression, 14.9% had autoimmunity or immunodeficiency, 13.3% had active malignancy, and 5.9% were transplant recipients. Lymphopenia preceded IFI in 22.1% of patients. Hospital admission occurred in 76.2%. The median length of stay was 16 days. All-cause mortality was 17.0% at 42 days and 28.8% at 1 year. Forty-two-day mortality was highest in spp. (27.5%), 20.5% for , and lowest for dimorphic fungi (7.5%). In this population, IFI was not uncommon, affected a broad spectrum of patients, and was associated with high crude mortality.

The PLOS ONE Collection \"Measuring forest conservation effectiveness\" brings together a series of studies that evaluate the effectiveness of tropical forest conservation policies and programs with the goal of measuring conservation success and associated co-benefits. This overview piece describes the geographic and methodological scope of these studies, as well as the policy instruments covered in the Collection as of June 2016. Focusing on forest cover change, we systematically compare the conservation effects estimated by the studies and discuss them in the light of previous findings in the literature. Nine studies estimated that annual conservation impacts on forest cover were below one percent, with two exceptions in Mexico and Indonesia. Differences in effect sizes are not only driven by the choice of conservation measures. One key lesson from the studies is the need to move beyond the current scientific focus of estimating average effects of undifferentiated conservation programs. The specific elements of the program design and the implementation context are equally important factors for understanding the effectiveness of conservation programs. Particularly critical will be a better understanding of the causal mechanisms through which conservation programs have impacts. To achieve this understanding we need advances in both theory and methods.

The measurement of relative displacements and deformations is important in many fields such as structural engineering, aerospace, geophysics, and nanotechnology. Optical-fiber sensors have become key tools for strain measurements, with sensitivity limits ranging between 10⁻⁹ and 10⁻⁶ε hertz (Hz)⁻¹/² (where ε is the fractional length change). We report on strain measurements at the 10⁻¹³ε-Hz⁻¹/² level using a fiber Bragg-grating resonator with a diode-laser source that is stabilized against a quartz-disciplined optical frequency comb, thus approaching detection limits set by thermodynamic phase fluctuations in the fiber. This scheme may provide a route to a new generation of strain sensors that is entirely based on fiber-optic systems, which are aimed at measuring fundamental physical quantities; for example, in gyroscopes, accelerometers, and gravity experiments.

Background In patients with acute respiratory distress syndrome (ARDS), low tidal volume ventilation has been associated with reduced mortality. Driving pressure (tidal volume normalized to respiratory system compliance) may be an even stronger predictor of ARDS survival than tidal volume. We sought to study whether these associations hold true in acute respiratory failure patients without ARDS. Methods This is a retrospectively cohort analysis of mechanically ventilated adult patients admitted to ICUs from 12 hospitals over 2 years. We used natural language processing of chest radiograph reports and data from the electronic medical record to identify patients who had ARDS. We used multivariable logistic regression and generalized linear models to estimate associations between tidal volume, driving pressure, and respiratory system compliance with adjusted 30-day mortality using covariates of Acute Physiology Score (APS), Charlson Comorbidity Index (CCI), age, and PaO 2 /FiO 2 ratio. Results We studied 2641 patients; 48% had ARDS ( n  = 1273). Patients with ARDS had higher mean APS (25 vs. 23, p  < .001) but similar CCI (4 vs. 3, p  = 0.6) scores. For non-ARDS patients, tidal volume was associated with increased adjusted mortality (OR 1.18 per 1 mL/kg PBW increase in tidal volume, CI 1.04 to 1.35, p  = 0.010). We observed no association between driving pressure or respiratory compliance and mortality in patients without ARDS. In ARDS patients, both ΔP (OR1.1, CI 1.06–1.14, p  < 0.001) and tidal volume (OR 1.17, CI 1.04–1.31, p  = 0.007) were associated with mortality. Conclusions In a large retrospective analysis of critically ill non-ARDS patients receiving mechanical ventilation, we found that tidal volume was associated with 30-day mortality, while driving pressure was not.

. Microplastics (MP) have gained enormous attention in the last years as they are among the major contaminants of soil and oceans, able to insert themselves in the food chain and cause severe damage to plants life, fauna and human health. Many techniques have been proposed to analyze the abundance, concentration and presence of such material in water, but data are still incomplete. Here, we propose digital holography (DH) as a non-invasive technique to search for and reconstruct the shape of different types of MP. We prove DH is a suitable tool for identifying MP also in the presence of other objects in water, such as diatoms.

Background:The kidney plays an essential role in the regulatory system for bone and mineral metabolism. During the post renal-transplant period, a significant loss in bone strength, characterized by high rates of osteopenia and osteoporosis occurs with consequent higher susceptibility to fracture. The clinical management of bone diseases in transplant patients is complex due to both, the frequent persistence of Chronic Renal Disease (CKD) and the normal aging process, leading to a continuous need for regular bone status monitoring.Objectives:The aim of the present study is to assess the diagnostic accuracy of the non-ionizing method, Radiofrequency Echographic Multi Spectrometry (REMS) for the detection of impaired bone status of kidney transplant recipients (KTR) fractured and non-fractured in comparison to conventional dual-energy X-ray absorptiometry (DXA).Methods:A cohort of 39 male and women Caucasian patients undergoing kidney transplantation was enrolled in the study. All enrolled patients underwent a lumbar spine (LS) examination both with REMS and with DXA. Because of renal impairment, KTR patients experience substantial bone loss which is associated to a reduced T-score and consequent susceptibility to fragility fractures. On the basis of the history of fragility fractures collected from each participant, the cohort was stratified into two groups, fractured and non-fractured patients, and the bone health status was evaluated using both techniques. From a total of 39 lumbar scans, 9 and 30 scans encompassed patients with and without a fracture history, respectively.Results:As expected, the fractured group yielded a lower spinal T-score values compared to the non-fractured ones with both REMS and DXA techniques (Table 1). The measurements differed significantly between the two technologies. In particular, considering the whole cohort of fractured and non-fractured patients, the mean BMD at the lumbar spine obtained with REMS was 0.866 ± 0.104 g/cm2, which was significantly lower than the corresponding DXA ones (0.929 ± 0.191 g/cm2; p<0.05). Similarly, significant differences were found on the corresponding T- and Z-score values between the two technologies (p<0.05). Moreover, in the non-fractured group, significant differences were found between the REMS-measured BMD, T- and Z-score versus DXA-measured values (all with p<0.001). Indeed, in these patients while a T-score of -1.0 ± 1.6 was measured by DXA, the REMS-measured T-score yielded a lower value of -1.8 ± 0.9. Analogously, the Z-score measured at the spine was -0.1 ± 1.3 with DXA and -0.8 ± 0.7 with REMS.Table 1. Bone health assessment of fractured and non-fractured patients for lumbar spine. Results are reported as average value ± SD and p-value are obtained using Wilcoxon paired test.*p<0.05 on the BMD, T-score and Z-score of the total cohort between DXA and REMS;**p<0.001 on the BMD, T-score and Z-score of non-fractured patients between DXA and REMS.Conclusion:These findings show that REMS is suitable to evaluate the bone mass in kidney transplant recipients patients. REMS technology is able to automatically discard bone artefacts, as aortic calcifications, typically reported in these patients, that could influence DXA diagnosis. Therefore, REMS may represent a valuable strategy for early identification and stratification of high-risk individuals susceptible to fracture following kidney transplantation. The difference betwewn dxa and REMS t score values in non fractured KTR patients can be due to the pathology itself. Further studies are required to elucidate whether the REMS outcome in non-fractured patients indeed translates into a clinically significant enhanced ability to identify bone damage in this specific setting.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of Interests:None declared.

Background:Data on the effectiveness of denosumab on osteoporosis after kidney transplantation are limited. We investigated the long-term bone mineral density (BMD) changes in kidney transplant recipients (KTRs) treated with denosumab compared to untreated KTRs.Objectives:For these reasons, we performed a quasi-experimental study to investigate the long-term BMD changes over four years in KTRs receiving treatment with denosumab compared to a cohort of age and sex-matched untreated KTRs.Methods:we enrolled KTRs treated with denosumab 60 mg/six months for four years. An untreated group of sex and age-matched KTRs with a 1:1 ratio was included. The primary outcome was BMD changes assessed by Dual-energy X-ray Absorptiometry over four years. Data on serum creatinine, alkaline phosphatase (ALP), parathyroid hormone, and 25-hydroxyvitamin D were collected. All patients received oral cholecalciferol and calcium supplementationResults:23 denosumab-treated KTRs were enrolled, and 23 untreated KTRs (Table 1). The median time from transplant to the start of denosumab was 4 years (range 0;24). The denosumab group showed a significant increase from baseline in BMD at the lumbar spine (LS) (9.0±10.7%, p<0.001), and total hip (TH) (3.8±7.9%, p=0.041). The untreated group showed a significant decrease at all sites (−3.0±7%, p=0.041 at the LS; −6.3±9.2%, p=0.003 at the TH; −6.7±9.3%, p=0.003 at the FN) (Figure 1, panel A and B). The between-group differences in percent BMD changes were statistically significant at all sites. Similar results were found for the respective Z-scores.The ALP serum levels significantly decreased from baseline only in the denosumab group, with a significant between-group difference (p=0.032). No significant differences in serum creatinine, hypocalcaemic events or acute graft rejection rates were observed.Conclusion:four years of denosumab therapy were associated with increased BMD in KTRs, while untreated KTRs showed significant BMD losses at all sites.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of Interests:None declared.