Applied science facilitates the large-scale expansion of protected areas in an Amazonian hot spot.

Meeting international commitments to protect 17% of terrestrial ecosystems worldwide will require >3 million square kilometers of new protected areas and strategies to create those areas in a way that respects local communities and land use. In 2000-2016, biological and social scientists worked to increase the protected proportion of Peru's largest department via 14 interdisciplinary inventories covering >9 million hectares of this megadiverse corner of the Amazon basin. In each landscape, the strategy was the same: convene diverse partners, identify biological and sociocultural assets, document residents' use of natural resources, and tailor the findings to the needs of decision-makers. Nine of the 14 landscapes have since been protected (5.7 million hectares of new protected areas), contributing to a quadrupling of conservation coverage in Loreto (from 6 to 23%). We outline the methods and enabling conditions most crucial for successfully applying similar campaigns elsewhere on Earth.

Carbon-nanotube-polymer nanocomposites for field-emission cathodes.

The electron field-emission (FE) characteristics of functionalized single-walled carbon-nanotube (CNT)-polymer composites produced by solution processing are reported. It is shown that excellent electron emission can be obtained by using as little as 0.7% volume fraction of nanotubes in the composite. Furthermore by tailoring the nanotube concentration and type of polymer, improvements in the charge transfer through the composite can be obtained. The synthesis of well-dispersed randomly oriented nanotube-polymer composites by solution processing allows the development of CNT-based large area cathodes produced using a scalable technology. The relative insensitivity of the cathode's FE characteristics to the electrical conductivity of the composite is also discussed.

Randomized, prospective, and controlled clinical trial of pulsed electromagnetic field stimulation for cervical fusion.

BACKGROUND CONTEXT: Multilevel fusions, the use of allograft bone, and smoking have been associated with an increased risk of nonunion after anterior cervical discectomy and fusion (ACDF) procedures. Pulsed electromagnetic field (PEMF) stimulation has been shown to increase arthrodesis rates after lumbar spine fusion surgery, but there are minimal data concerning the effect of PEMF stimulation on cervical spine fusion. PURPOSE: To determine the efficacy and safety of PEMF stimulation as an adjunct to arthrodesis after ACDF in patients with potential risk factors for nonunion. STUDY DESIGN: A randomized, controlled, prospective multicenter clinical trial. PATIENT SAMPLE: Three hundred and twenty-three patients with radiographic evidence (computed tomography-myelogram [CT-myelo] or magnetic resonance imaging [MRI]) of a compressed cervical nerve root and symptomatic radiculopathy appropriate to the compressed root that had failed to respond to nonoperative management were enrolled in the study. The patients were either smokers (more than one pack per day) and/or were undergoing multilevel fusions. All patients underwent ACDF using the Smith-Robinson technique. Allograft bone and an anterior cervical plate were used in all cases. OUTCOME MEASURES: Measurements were obtained preoperatively and at each postoperative interval and included neurologic assessment, visual analog scale (VAS) scores for shoulder/arm pain at rest and with activity, SF-12 scores, the neck disability index (NDI), and radiographs (anteroposterior, lateral, and flexion-extension views). Two orthopedic surgeons not otherwise affiliated with the study and blinded to treatment group evaluated the radiographs, as did a blinded radiologist. Adverse events were reported by all patients throughout the study to determine device safety. METHODS: Patients were randomly assigned to one of two groups: those receiving PEMF stimulation after surgery (PEMF group, 163 patients) and those not receiving PEMF stimulation (control group, 160 patients). Postoperative care was otherwise identical. Follow-up was carried out at 1, 2, 3, 6, and 12 months postoperatively. RESULTS: The PEMF and control groups were comparable with regard to age, gender, race, past medical history, smoking status, and litigation status. Both groups were also comparable in terms of baseline diagnosis (herniated disc, spondylosis, or both) and number of levels operated (one, two, three, or four). At 6 months postoperatively, the PEMF group had a significantly higher fusion rate than the control group (83.6% vs. 68.6%, p=.0065). At 12 months after surgery, the stimulated group had a fusion rate of 92.8% compared with 86.7% for the control group (p=.1129). There were no significant differences between the PEMF and control groups with regard to VAS pain scores, NDI, or SF-12 scores at 6 or 12 months. No significant differences were found in the incidence of adverse events in the groups. CONCLUSIONS: This is the first randomized, controlled trial that analyzes the effects of PEMF stimulation on cervical spine fusion. PEMF stimulation significantly improved the fusion rate at 6 months postoperatively in patients undergoing ACDF with an allograft and an anterior cervical plate, the eligibility criteria being patients who were smokers or had undergone multilevel cervical fusion. At 12 months postoperatively, however, the fusion rate for PEMF patients was not significantly different from that of the control group. There were no differences in the incidence of adverse events in the two groups, indicating that the use of PEMF stimulation is safe in this clinical setting.

Land-use allocation protects the Peruvian Amazon.

Disturbance and deforestation have profound ecological and socioeconomic effects on tropical forests, but their diffuse patterns are difficult to detect and quantify at regional scales. We expanded the Carnegie forest damage detection system to show that, between 1999 and 2005, disturbance and deforestation rates throughout the Peruvian Amazon averaged 632 square kilometers per year and 645 square kilometers per year, respectively. However, only 1 to 2% occurred within natural protected areas, indigenous territories contained only 11% of the forest disturbances and 9% of the deforestation, and recent forest concessions effectively protected against clear-cutting. Although the region shows recent increases in disturbance and deforestation rates and leakage into forests surrounding concession areas, land-use policy and remoteness are serving to protect the Peruvian Amazon.

Intraoperative neuromonitoring detects thrombotic occlusion of the left common iliac arterial bifurcation after anterior lumbar interbody fusion: case report.

Prompt recognition of acute or delayed vascular insults during anterior spinal reconstructive surgery of the lower lumbar levels is paramount for successful intervention and prevention of sequelae. Although surgical exposure of the lower lumbar levels requires mindful dissection and cautious retraction of abdominal vessels, ischemic insult due to partial or complete occlusion of the iliac arteries may go undetected without adequate surgical monitoring. We present a case of progressive thrombotic occlusion of the left common iliac artery detected by intraoperative spinal cord monitoring using somatosenory evoked potentials (SSEPs) at the peripheral and central levels. Surgical monitoring using palpation of vessels and pulse oximetry of the great toe were initially proposed as simple and relatively inexpensive modalities for routine surgical monitoring. Subsequently, monitoring cortical SSEPs were combined with great toe pulse oximetry to advance continuous routine surgical monitoring. However, using only cortical SSEPs predisposes such protocols to an inherently higher risk of false positives. Neuromonitoring protocols should rely heavily on the replication of waveforms recorded at multiple sites along the neural pathway.