Correlations in abnormal synergies between the upper and lower extremities across various phases of stroke

BACKGROUND AND OBJECTIVES

The flexion synergy and extension synergy are a representative consequence of a stroke and appear in the upper extremity and lower extremity. Since the ipsilesional corticospinal tract (CST) is the most influential neural pathway for both extremities in motor execution, damage by a stroke to this tract could lead to similar motor pathological features (e.g., abnormal synergies) in both extremities. However, less attention has been paid to the inter-limb correlations in the flexion synergy and extension synergy across different recovery phases of a stroke.

METHODS

We used results of the Fugl-Meyer assessment (FMA) to characterize those correlations in a total of 512 participants with hemiparesis post stroke from the acute phase to 1 year. The FMA provides indirect indicators of the degrees of the flexion synergy and extension synergy post stroke.

RESULTS

We found that generally, strong inter-limb correlations (r>0.65 with all p-values<0.0001) between the flexion synergy and extension synergy appeared in the acute-to-subacute phase (<90 days). But correlations of lower-extremity extension synergy with upper-extremity flexion synergy and extension synergy decreased (down to r=0.38) around 360 days after stroke (p<0.05).

DISCUSSION

These results suggest that preferential use of alternative neural pathways after damage by a stroke to the CST enhances inter-limb correlations between the flexion synergy and extension but a recovery of the CST functional and the fragmentation (remodeling) of the alternative neural substrates in the chronic phase contribute to diversity in neural pathways in motor execution, eventually leading to reduced inter-limb correlations.

Long-Term Effects of Ecological Restoration Projects on Ecosystem Services and Their Spatial Interactions: A Case Study of Hainan Tropical Forest Park in China

Ecological restoration projects aim to comprehensively intervene in damaged or deteriorating ecosystems, restore them, improve the provision of ecosystem services, and achieve harmonious coexistence between humans and nature. Implementing ecological restoration projects leads to continuous changes in land use/land cover. Studying the long-term changes in land use/land cover and their impacts on ecosystem services, as well as the trade-off and synergy between these services, helps evaluate the long-term effectiveness of ecological restoration projects in restoring ecosystems. Therefore, this study analyzes the land use/land cover, and ecosystem services of the Hainan Tropical Forest Park in China to address this. Since 2000, the area has undergone multiple ecological restoration projects, divided roughly into two stages: 2003-2013 and 2013-2021. The InVEST model is used to quantify three essential ecosystem services in mountainous regions (water yield, carbon storage, and soil conservation), and redundancy analysis identifies the primary driving factors influencing their changes. We conducted spatial autocorrelation analysis to examine the interplay among ecosystem services under long-term land use/land cover change. The results indicate a decrease in the total supply of water yield (-5.14%) and carbon storage (-3.21%) in the first phase. However, the second phase shows an improvement in ecosystem services, with an increase in the total supply of water yield (11.45%), carbon storage (27.58%), and soil conservation (21.95%). The redundancy analysis results reveal that land use/land cover are the primary driving factors influencing the changes in ecosystem services. Furthermore, there is a shift in the trade-off and synergy between ecosystem services at different stages, with significant differences in spatial distribution. The findings of this study provide more spatially targeted suggestions for the restoration and management of tropical montane rainforests in the future.

Multifunctionality and provision of ecosystem services by livestock species and breeds at global level

Beyond providing food, livestock species are linked to a wide range of uses and ecosystem services (ESs). Based on information reported by 41 countries on 3 361 national breed populations to the Domestic Animal Diversity Information System of the Food and Agriculture Organization of the United Nations, we investigated how factors such as species, region, breed adaptedness, or management system associate with the recognition of provision of a set of 52 ESs. Among species, a greater number of cultural ESs were reported for horses (2.47 for horses vs 0.75 on average across all species), while the major ruminant species (cattle, goats and sheep) were on average associated with more provisioning ESs (2.99 vs 2.39), and more regulating and maintenance ESs (1.86 vs 1.32). Compared to European breeds, African livestock contribute more provisioning ES (3.95 vs 1.88). Native breeds and, to a lesser extent, locally adapted breeds, were linked to more ESs than were exotic breeds (5.97 and 4.10 vs 2.90, respectively), regardless of the ES category considered. The total number of ES reported was greater for breeds primarily kept under Back Yard/Farm Yard and extensive management systems than in other production environments. Different "bundles" of ES were identified in relation to the interdependence among themselves, or according to species or regional specificities. Overall, our results highlight that native and locally adapted breeds, which tend to be raised in less specialized production systems than exotic breeds, are reported to play multiple roles contributing to rural community livelihoods and environmental sustainability of food systems.

Plant bioactive compounds alleviate photoinduced retinal damage and asthenopia: Mechanisms, synergies, and bioavailability

The retina, an important tissue of the eye, is essential in visual transmission and sustaining adequate eyesight. However, oxidative stress and inflammatory reactions can harm retinal structure and function. Recent studies have demonstrated that exposure to light can induce oxidative stress and inflammatory reactions in retinal cells, thereby facilitating the progression of retinal damage-related diseases and asthenopia. Plant bioactive compounds such as anthocyanin, curcumin, resveratrol, lutein, zeaxanthin, epigallocatechin gallate, and quercetin are effective in alleviating retinal damage and asthenopia. Their strong oxidation resistance and unique chemical structure can prevent the retina from producing reactive oxygen species and regulating eye muscle relaxation, thus alleviating retinal damage and asthenopia. Additionally, the combination of these active ingredients produces a stronger antioxidant effect. Consequently, understanding the mechanism of retinal damage caused by light and the regulation mechanism of bioactive compounds can better protect the retina and reduce asthenopia.

Spatial Responses of Ecosystem Service Trade-offs and Synergies to Impact Factors in Liaoning Province

Global ecosystem services (ESs) are experiencing a significant decline, necessitating the development of robust environmental governance policies. To address the lack of integrated planning with heavy industry as the research object and a lack of knowledge of ES trade-offs and synergies in China's ecological and environmental governance. In this study, the spatial and temporal variations of four ESs (water yield (WY), soil conservation (SC), carbon storage (CS), and habitat quality (HQ)) were determined in the study area of Liaoning Province. Explore the mechanisms that shape ecosystem service trade-offs and synergies and the factors that influence them. Spearman's correlation and difference analyses were proposed to determine the spatial and temporal distributions of trade-offs and synergistic relationships among ESs. In addition, we constructed a multiscale geo-weighted regression (MGWR) model to investigate driver spatial heterogeneity affecting trade-offs and synergies. The results revealed that (1) In the study area, ESs were on the rise in Liaoning Province. (2) Temporally, ESs were overwhelmingly dominated by synergies; at the spatial scale, ESs were dominated by trade-offs of varying degrees, with the area of synergy between WY and SC being the highest. (3) ESs demonstrated spatial heterogeneity in intensity and were more impacted by natural factors such as vegetation cover, elevation, and precipitation than by characteristics related to human activity. This study helps improve understanding of the interactions and dependencies among ESs and can provide a reference for ecological governance and improvements in Liaoning Province.

Economic-ecological services and their trade-offs or synergies of agricultural landscapes in Xiangxi, central China

The scarcity of agricultural ecosystem services (ESs) caused by land use changes has become increasingly prominent, and the negative effects of agricultural production on ecosystems have been a constant concern. In this work, the geographic information system mapping method, the agricultural product supply (AS) model and InVEST model were applied to assess the economic and ecological services of agricultural landscapes. The interlinkages among them in Xiangxi were explored, a mountainous area in central China. The major conclusions drawn were as follows.1) From 2000 to 2020, the economic services (ESs1) of agricultural landscapes in Xiangxi increased by 96.6667%, and those of grain yield per ha (X1), cash crop output value per ha (X2), forestry output value per ha (X3), meat production per capita in rural areas (X4), and fishery output per ha (X5) were 39.0405%, 510.8462%, 297.6807%, 64.5947%, and 194.0348%, respectively. The spatial distribution of X1, X2, X3, X4, and X5 changed considerably, and the major influencing factors were human elements. 2) Ecological services (ESs2) increased by 5.13%, and those of carbon storage (CS, X6), water conservation (WC, X7), and N content in water (X8) were 1.0897%, 13.5808%, and -0.7406%, respectively. The distribution of X6, X7, and X8 was nearly unchanged and primarily influenced by natural factors 3) The relationship between ESs1 and ESs2 was not ideal. The dominant relationships between AS and CS were trade-offs, those between AS and WC were synergies, and those between AS and water purification were trade-offs. 4) The following suggestions are proposed: promote afforestation and vegetation protection policies, implement the best agricultural policies, increase investment in water conservation projects, adjust agricultural scale, and control the usage of agricultural chemicals. For the surrounding areas of more developed regions, strict environmental measures and agricultural policies are necessary. The methods used in this study are novel and can provide methodological references for similar studies. Moreover, it may offer useful suggestions for agricultural resource management and contribute to ecological civilization construction.

Effective synergies in indium oxide loaded with zirconia mixed with silicoaluminophosphate molecular sieve number 34 catalysts for carbon dioxide hydrogenation to lower olefins

Tandem catalysts consisting of metal oxides and zeolites have been widely studied for catalytic carbon dioxide (CO₂) hydrogenation to lower olefins, while the synergies of two components and their influence on the catalytic performance are still unclear. In this study, the composite catalysts composed of indium oxide loaded with zirconia (In₂O₃/ZrO₂) and silicoaluminophosphate molecular sieve number 34 (SAPO-34) are developed. Performance results indicate that the synergies between these two components can promote CO₂ hydrogenation. Further characterizations reveal that the chabazite (CHA) structure and acid sites in the SAPO-34 are destroyed when preparing In-Zr/SAPO by powder milling (In-Zr/SAPO-M) because of the excessive proximity of two components, which inhibits the activation of CO₂ and hydrogen (H₂), thus resulting in much higher methane selectivity than the catalysts prepared by granule stacking (In-Zr/SAPO-G). Proper granule integration manner promotes tandem reaction, thus enhancing CO₂ hydrogenation to lower olefins, which can provide a practicable strategy to improve catalytic performance and the selectivity of the target products.

Assessing synergies and trade-offs of diverging Paris-compliant mitigation strategies with long-term SDG objectives

The Sustainable Development Goals (SDGs) and the Paris Agreement are the two transformative agendas, which set the benchmarks for nations to address urgent social, economic and environmental challenges. Aside from setting long-term goals, the pathways followed by nations will involve a series of synergies and trade-offs both between and within these agendas. Since it will not be possible to optimise across the 17 SDGs while simultaneously transitioning to low-carbon societies, it will be necessary to implement policies to address the most critical aspects of the agendas and understand the implications for the other dimensions. Here, we rely on a modelling exercise to analyse the long-term implications of a variety of Paris-compliant mitigation strategies suggested in the recent scientific literature on multiple dimensions of the SDG Agenda. The strategies included rely on technological solutions such as renewable energy deployment or carbon capture and storage, nature-based solutions such as afforestation and behavioural changes in the demand side. Results for a selection of energy-environment SDGs suggest that some mitigation pathways could have negative implications on food and water prices, forest cover and increase pressure on water resources depending on the strategy followed, while renewable energy shares, household energy costs, ambient air pollution and yield impacts could be improved simultaneously while reducing greenhouse gas emissions. Overall, results indicate that promoting changes in the demand side could be beneficial to limit potential trade-offs.

A spatialized assessment of ecosystem service relationships in a multifunctional agroforestry landscape of Senegal

Agroforestry systems are an integral part of Sub-Saharan agricultural landscapes. Studies conducted at tree or plot scales on the supply of ecosystem services (ES) suggest that agroforestry practices are a promising way to build multifunctional agricultural landscapes. However, the current characterization and understanding of how multiple ES are associated across such heterogeneous agricultural landscapes are still limited. This study provides the first characterization of the multiple ESs supplied by a Sahelian Faidherbia albida agroforestry parkland and their relationships. Relying on field data for 11 ES indicators, recent advances in remote sensing-derived information, and blending different ES mapping approaches, we first assessed the spatial heterogeneity of the supply of each ES. We found that the majority of ES indicators remained below ES potential values over the study area by 25 % to 50 %, revealing that there is a considerable scope for increasing the ES supply in the F. albida parkland. Then, using a scoring approach, we analyzed the supply of multiple ESs. We observed a large number of hotspots and a clear effect of the proximity of F. albida trees fostering the supply of multiple ESs in their vicinity. Finally, we mapped and analyzed the dominant relationships - trade-offs, synergies or losses - between ESs from a cooccurrence spatial approach. We showed that significant trade-offs and losses (58 % of the area) between ESs can exist in the F. albida parkland. Interestingly, we also showed that synergies occurred mainly up to 10 m from the F. albida trees, suggesting that synergies need to be increased beyond this threshold. By adopting an original ES valuation framework, we provided basic insights into ESs and their relationships. The different maps and information generated can support public debates and target new policies fostering the multifunctionality of F. albida parklands as well as in various other parklands of West Africa.

More synergies or more trade-offs? The interaction among multiple assessment indicators in sustainable urban development in Guangzhou, China

To achieve sustainable development, local governments are under enormous pressure to simultaneously achieve the three assessment tasks (TATs) of energy saving, CO₂ reduction, and pollution reduction. However, the TATs are often managed by different authorities and have three types of measures (TTMs) that correspond to them. The lack of adequate cooperation between these authorities has led to the inefficient investment of policy resources and even to policy conflicts, and the interactions among the TTMs are not yet known. To this end, this paper uses the MCEE model to assess the interactions among the TTMs quantitatively using Guangzhou, China, as a case study. The results showed the following. (1) According to the current development trend, if the authorities managing the TATs continue to work alone, they will not be able to fulfill the corresponding assessment tasks in the future. (2) The TTMs have interactions with each other, and their synergies are far greater than their trade-offs. From 2015 to 2035, it is expected that energy-saving measures can accomplish 54.39% of the CO₂ reduction tasks and 32.74% of the pollution reduction tasks indirectly, and low-carbon measures can accomplish 55.53% of the energy saving tasks and 27.20% of the pollution reduction tasks indirectly, However, environmental-protection measures will cause fewer trade-offs (energy demand and CO₂ emissions increase by 3.76% and 2.88%, respectively). (3) In some years, the contribution of interactions among the TTMs are even higher than their direct contribution to the TATs. Our findings suggest that intensive cooperation between authorities is necessary, and that the benefits of such cooperation will outweigh the disadvantages.

Increasing health system synergies in low-income settings: Lessons learned from a qualitative case study of Rwanda

Building synergies is seen as an effective strategy to address and decrease existing fragmentation in health systems of low-and middle-income countries (LMICs). To that end, different programmes, such as the Sector Wide Approach, have been adopted to increase health system synergies. Despite these efforts, fragmentation remains an enduring problem, hampering health system performance in LMICs. This study is part of the Lancet Commission on synergies between Universal Health Coverage, Health Security, and Health Promotion; we aimed to document synergising strategies adopted by Rwanda. Data for this paper came from a qualitative study including in-depth interviews of 15 key informants and a document review. A thematic analysis embracing deductive and inductive approaches was used to analyse the data. We found that Rwanda adopted three main strategies to increase health system synergies: (1) alignment of health programmes with national health policies and strategies, (2) increased coordination across national health institutions, and (3) effective monitoring and evaluation frameworks. Achieving synergies in a low-resource country is challenging but not impossible. To meet the target of global health agendas such as the Sustainable Development Goals and the prevention of future global pandemics, efforts to increase health system synergies in LMICs need to be strengthened.

A fast method to evaluate in a combinatorial manner the synergistic effect of different biostimulants for promoting growth or tolerance against abiotic stress

BACKGROUND

According to the most popular definition, a biostimulant is any substance or microorganism applied to plants with the aim to enhance nutrition efficiency, abiotic stress tolerance and/or crop quality traits, regardless of its nutrient content. Therefore, a biostimulant can help crops to withstand abiotic stress, while maintaining or even increasing productivity. We have previously designed a sequential system, based on two different model organisms, the baker's yeast Saccharomyces cerevisiae and the plant Arabidopsis thaliana, to evaluate the potential of different natural extracts as biostimulants employing a blind-test strategy.

RESULTS

In this report, we further expand this concept to evaluate different biostimulants in a combinatorial approach to reveal the potential additive, synergistic or antagonistic effects of different combinations of biostimulants in order to design new formulations with enhanced effects on plant growth or tolerance to abiotic stress. The method is based on yeast assays (growth tests in solid medium, and continuous growth in liquid cultures) and plant assays (mass accumulation in hydroponic culture) to assess effects on early growth.

CONCLUSIONS

With this novel approach, we have designed new formulations and quantified the ability to enhance growth and promote biomass accumulation under normal conditions and in the presence of abiotic stresses, such as drought, salinity or cold. This method enables a fast screen of many different products in a combinatorial manner, in order to design novel formulations of natural extracts with biostimulant potential.

Unraveling nonlinear and interaction effects of various determinants on bus gaseous emissions

Urban transit buses equipped with large-displacement engines operate on circular routes several times throughout the day, emitting large amounts of environmentally hazardous exhaust. Hence, understanding the intricate associations between bus emissions and multiple contributors is beneficial for creating sustainable transportation systems, while previous studies focusing on statistical methods fail to unravel them. This paper innovatively leverages the bagged decision tree approach to delineate such complex relationships based on the data collected from CNG-fueled and diesel-powered buses. Relative importance indicates that velocity appears to be the primary factor and is therefore selected as the research objective. Results suggest that the effects of different contributors on bus emissions present nonlinear patterns. More specifically, the influence of speed on CO, CO₂, and NOx exhaust generally reveals an increasing-stabilizing tendency while that of HC represents a decreasing-stabilizing mode. Besides, the phenomenon of synergies between determinants is also prevalent, for instance, buses within high-speed and large-slope conditions tend to produce more emissions. These findings can provide nuanced guidance for policy-making and bus route planning issues in consideration of environmental protection and pollution mitigation.

Public health preparedness and response synergies between institutional authorities and the community: a qualitative case study of emerging tick-borne diseases in Spain and the Netherlands

BACKGROUND

Communities affected by infectious disease outbreaks are increasingly recognised as partners with a significant role to play during public health emergencies. This paper reports on a qualitative case study of the interactions between affected communities and public health institutions prior to, during, and after two emerging tick-borne disease events in 2016: Crimean-Congo Haemorrhagic Fever in Spain, and Tick-Borne Encephalitis in the Netherlands. The aim of the paper is to identify pre-existing and emergent synergies between communities and authorities, and to highlight areas where synergies could be facilitated and enhanced in future outbreaks.

METHODS

Documentary material provided background for a set of semi-structured interviews with experts working in both health and relevant non-health official institutions (13 and 21 individuals respectively in Spain and the Netherlands), and focus group discussions with representatives of affected communities (15 and 10 individuals respectively). Data from all sources were combined and analysed thematically, initially independently for each country and then for both countries together.

RESULTS

Strong synergies were identified in tick surveillance activities in both countries, and the value of pre-existing networks of interest groups for preparedness and response activities was recognised. However, authorities also noted that there were hard-to-reach and potentially vulnerable groups, such as hikers, foreign tourists, and volunteers working in green areas. While the general population received preventive information about the two events, risk communication or other community engagement efforts were not seen as necessary specifically for these sub-groups. Post-event evaluations of community engagement activities during the two events were limited, so lessons learned were not well documented.

CONCLUSIONS

A set of good practices emerged from this study, that could be applied in these and other settings. They included the potential value of conducting stakeholder analyses of community actors with a stake in tick-borne or other zoonotic diseases; of utilising pre-existing stakeholder networks for information dissemination; and of monitoring community perceptions of any public health incident, including through social media. Efforts in the two countries to build on the community engagement activities that are already in place could contribute to better preparedness planning and more efficient and timely responses in future outbreaks.

Towards food systems transformation-five paradigm shifts for healthy, inclusive and sustainable food systems

Food systems must serve different societal, public health and individual nutrition, and environmental objectives and therefore face numerous challenges. Considering the integrated performances of food systems, this paper highlights five fundamental paradigm shifts that are required to overcome trade-offs and build synergies between health and nutrition, inclusive livelihoods, environmental sustainability and food system resilience. We focus on the challenges to raise policy ambitions, to harmonize production and consumption goals, to improve connectivity between them, to strengthen food system performance and to anchor the governance of food systems in inclusive policies and participatory institutions. Taken together, these shifts in paradigms shape a new discourse for food system transformation that will be capable to respond to current and future policy challenges.

Are synergies continuously present in cyclical movements? An example with the basketball dribble task

In human movement, synergies occur when two or more variables co-vary to stabilize a performance goal. The concept of motor redundancy is associated with the existence of several strategies to complete the same task, which enables a movement system to adapt to an ever-changing environment. This feature provides the system with the ability of being flexible enough to produce adaptive movements, but also stable enough to produce acceptable outputs which is a key issue in motor performance. In a kinetic chain of movement, two proximal joints might reciprocally compensate to stabilize an end-effector (i.e., the most distal segment in the limb that interacts with the environment). End-effector variables are 'controlled', and directly linked to performance, whereas the task relevant elements are allowed by the system to have high variability, providing adaptability. In basketball dribbling, we hypothesized that shoulder and elbow variability contributes to stabilize the dribble height as an end-effector performance variable. A specific computational procedure based on the UCM (i.e., Uncontrolled Manifold) notion was used to capture synergies in two groups according to the experience level: amateurs and professionals. Results identified synergy presence during the basketball dribbling, which only occurred when the wrist reached its peak height. The control of the wrist peak height is achieved due to a reciprocal compensation between shoulder and elbow which stabilizes the dribbling height.

Interactions between two existential threats: COVID-19 and climate change

The COVID-19 pandemic and climate change are complex existential threats, unpredictable in many ways and unprecedented in modern times. There are parallels between the scale and scope of their impacts and responses. Understanding shared drivers, coupled vulnerabilities, and criteria for effective responses will help societies worldwide prepare for the simultaneous threats of climate change and future pandemics. We summarize some shared characteristics of COVID-19 and climate change impacts and interventions and discuss key policy implications and recommendations.

Synergies and fragmentation in country level policy and program agenda setting, formulation and implementation for Global Health agendas: a case study of health security, universal health coverage, and health promotion in Ghana and Sierra Leone

Background

Global health agendas have in common the goal of contributing to population health outcome improvement. In theory therefore, whenever possible, country level policy and program agenda setting, formulation and implementation towards their attainment should be synergistic such that efforts towards one agenda promote efforts towards the other agendas. Observation suggests that this is not what happens in practice. Potential synergies are often unrealized and fragmentation is not uncommon. In this paper we present findings from an exploration of how and why synergies and fragmentation occur in country level policy and program agenda setting, formulation and implementation for the global health agendas of Universal Health Coverage (UHC), Health Security (HS) and Health Promotion (HP) in Ghana and Sierra Leone. Our study design was a two country case study. Data collection involved document reviews and Key Informant interviews with national and sub-national level decision makers in both countries between July and December 2019. Additionally, in Ghana a stakeholder workshop in December 2019 was used to validate the draft analysis and conclusions.

Results

National and global context, country health systems leadership and structure including resources were drivers of synergies and fragmentation. How global as well as country level actors mobilized power and exercised agency in policy and program agenda setting and implementation processes within country were also important drivers.

Conclusions

There is potential in both countries to pull towards synergies and push against fragmentation in agenda setting, formulation and implementation of global health agendas despite the resource and other structural constraints. It however requires political and bureaucratic prioritization of synergies, as well as skilled leadership. It also requires considerable mobilization of country level actor exercise of agency to counter sometimes daunting contextual, systems and structural constraints.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06500-6.

Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia

BACKGROUND

Evidence exists about synergies among universal health coverage, health security and health promotion. Uniting these three global agendas has brought success to the country's health sector. This study aimed to document the efforts Ethiopia has made to apply nationally synergistic approaches uniting these three global health agendas. Our study is part of the Lancet Commission on synergies between these global agendas.

METHODS

We employed a case study design to describe the synergistic process in the Ethiopian health system based on a review of national strategies and policy documents, and key informant interviews with current and former policymakers, and academics. We analyzed the "hardware" (using the World Health Organization's building blocks) and the "software" (ideas, interests, and power relations) of the Ethiopian health system according to the aforementioned three global agendas.

RESULTS

Fragmentation of health system primarily manifested as inequities in access to health services, low health workforce and limited capacity to implementation guidelines. Donor driven vertical programs, multiple modalities of health financing, and inadequate multisectoral collaborations were also found to be key features of fragmentation. Several approaches were found to be instrumental in fostering synergies within the global health agenda. These included strong political and technical leadership within the government, transparent coordination, and engagement of stakeholders in the process of priority setting and annual resource mapping. Furthermore, harmonization and alignment of the national strategic plan with international commitments, joint financial arrangements with stakeholders and standing partnership platforms facilitated efforts for synergy.

CONCLUSIONS

Ethiopia has implemented multiple approaches to overcome fragmentation. Such synergistic efforts of the primary global health agendas have made significant contributions to the improvement of the country's health indicators and may promote sustained functionality of the health system.

Model-based optimisation of agricultural profitability and nutrient management: a practical approach for dealing with issues of scale

To manage agricultural landscapes more sustainably, we must understand and quantify the synergies and trade-offs between environmental impact, production, and other ecosystem services. Models play an important role in this type of analysis as generally it is infeasible to test multiple scenarios by experiment. These models can be linked with algorithms that optimise for multiple objectives by searching a space of allowable management interventions (the control variables). Optimisation of landscapes for multiple objectives can be computationally challenging, however, particularly if the scale of management is typically smaller (e.g. field scale) than the scale at which the objective is quantified (landscape scale) resulting in a large number of control variables whose impacts do not necessarily scale linearly. In this paper, we explore some practical solutions to this problem through a case study. In our case study, we link a relatively detailed, agricultural landscape model with a multiple-objective optimisation algorithm to determine solutions that both maximise profitability and minimise greenhouse gas emissions in response to management. The optimisation algorithm combines a non-dominated sorting routine with differential evolution, whereby a 'population' of 100 solutions evolves over time to a Pareto optimal front. We show the advantages of using a hierarchical approach to the optimisation, whereby it is applied to finer-scale units first (i.e. fields), and then the solutions from each optimisation are combined in a second step to produce landscape-scale outcomes. We show that if there is no interaction between units, then the solution derived using such an approach will be the same as the one obtained if the landscape is optimised in one step. However, if there is spatial interaction, or if there are constraints on the allowable sets of solutions, then outcomes can be quite different. In these cases, other approaches to increase the efficiency of the optimisation may be more appropriate-such as initialising the control variables for half of the population of solutions with values expected to be near optimal. Our analysis shows the importance of aligning a policy or management recommendation with the appropriate scale.

'It's far too complicated': why fragmentation persists in global health

Background

Despite many efforts to achieve better coordination, fragmentation is an enduring feature of the global health landscape that undermines the effectiveness of health programmes and threatens the attainment of the health-related Sustainable Development Goals. In this paper we identify and describe the multiple causes of fragmentation in development assistant for health at the global level. The study is of particular relevance since the emergence of new global health problems such as COVID-19 heightens the need for global health actors to work in coordinated ways. Our study is part of the Lancet Commission on Synergies between Universal Health Coverage, Health Security and Health Promotion.

Methods

We used a mixed methods approach. This consisted of a non-systematic literature review of published papers in scientific journals, reports, books and websites. We also carried out twenty semi-structured expert interviews with individuals from bilateral and multilateral organisations, governments and academic and research institutions between April 2019 and December 2019.

Results

We identified five distinct yet interconnected sets of factors causing fragmentation: proliferation of global health actors; problems of global leadership; divergent interests; problems of accountability; problems of power relations. We explain why global health actors struggle to harmonise their approaches and priorities, fail to align their work with low- and middle-income countries’ needs and why they continue to embrace funding instruments that create fragmentation.

Conclusions

Many global actors are genuinely committed to addressing the problems of fragmentation, despite their complexity and interconnected nature. This paper aims to raise awareness and understanding of the causes of fragmentation and to help guide actors’ efforts in addressing the problems and moving to more synergistic approaches.

Linking Tensegrity to Sports Team Collective Behaviors: Towards the Group-Tensegrity Hypothesis

Collective behaviors in sports teams emerge from the coordination between players formed from their perception of shared affordances. Recent studies based on the theoretical framework of ecological dynamics reported new analytical tools to capture collective behavior variables that describe team synergies. Here, we introduce a novel hypothesis based on the principles of tensegrity to describe collective behavior. Tensegrity principles operate in the human body at different size scales, from molecular to organism levels, in structures connected physically (biotensegrity). Thus, we propose that a group of individuals connected by information can exhibit synergies based on the same principles (group-tensegrity), and we provide an empirical example based on the dynamics of a volleyball team sub-phase of defense.

Methodology for assessment of public health emergency preparedness and response synergies between institutional authorities and communities

BACKGROUND

This paper describes a participatory methodology that supports investigation of the synergistic collaboration between communities affected by infectious disease outbreak events and relevant official institutions. The core principle underlying the methodology is the recognition that synergistic relationships, characterised by mutual trust and respect, between affected communities and official institutions provide the most effective means of addressing outbreak situations.

METHODS

The methodological approach and lessons learned were derived from four qualitative case studies including (i) two tick-borne disease events (Crimean-Congo haemorrhagic fever in Spain, 2016, and tick-borne encephalitis in the Netherlands, 2016); and (ii) two outbreaks of acute gastroenteritis (norovirus in Iceland, 2017, and verocytotoxin-producing Escherichia coli [VTEC] in Ireland, 2018). An after-event qualitative case study approach was taken using mixed methods. The studies were conducted in collaboration with the respective national public health authorities in the affected countries by the European Centre for Disease Prevention and Control (ECDC). The analysis focused on the specific actions undertaken by the participating countries' public health and other authorities in relation to community engagement, as well as the view from the perspective of affected communities.

RESULTS

Lessons highlight the critical importance of collaborating with ECDC National Focal Points during preparation and planning and with anthropological experts. Field work for each case study was conducted over one working week, which although limiting the number of individuals and institutions involved, still allowed for rich data collection due to the close collaboration with local authorities. The methodology enabled efficient extraction of synergies between authorities and communities. Implementing the methodology required a reflexivity among fieldworkers that ackowledges that different versions of reality can co-exist in the social domain. The method allowed for potential generalisability across studies. Issues of extra attention included insider-outsider perspectives, politically sensitivity of findings, and how to deal with ethical and language issues.

CONCLUSIONS

The overall objective of the assessment is to identify synergies between institutional decision-making bodies and community actors and networks before, during and after an outbreak response to a given public health emergency. The methodology is generic and could be applied to a range of public health emergencies, zoonotic or otherwise.

Diagnosis of circular economy in the forest sector in southern Brazil

This paper analyzes how the forest sector in Lages region of Santa Catarina State (SC), Brazil, performs materials and energy synergies between its companies, striving for a circular economic model that encourages reduction in the use of virgin resources and waste generation. Therefore, 23 companies from the forest sector were visited and divided in: primary processing (PP), primary and secondary processing (PSP), primary, secondary and tertiary processing (PSTP), panels (Pa), pulp and paper (P&P), recycling (Re) and production of energy (PE). The sector consumes 83.6% of its input from virgin materials, 91.3% of its wastes go to energy recovery, and 83.2% of the energy consumed comes from the steam generated from these wastes. Through a dendrogram obtained by grouping the companies in five clusters, based on their similarities in circularity, and by a circularity map, it was observed that the use of forestry wastes in obtaining steam and electricity is the main circular characteristic of the sector. Also, the transformation yield of inputs in products increase from 60% in PP and PSP to almost 100% in companies that operate at the closure of the sector circularity, Re and PE. This provides high exploitation of the materials, reduces the need for the extraction of virgin resources, returns nutrients to the soil, provides clean renewable energy, and reduced the need for landfill. It was observed that the existence of an industrial arrangement favors the application of a Circular Economic model in the forest sector in Lages.

In vitro activity of ceftaroline in combination with other antimicrobials active against Staphylococcus spp

INTRODUCTION

We evaluated the in vitro activity of the combination of ceftaroline with daptomycin, linezolid and vancomycin against methicillin-resistant Staphylococcus aureus and coagulase-negative Staphylococcus (CNS).

MATERIAL AND METHODS

We analysed 70 staphylococcal strains (31 S. aureus and 39 CNS) with the Etest using the MIC:MIC ratio method and calculation of fractional inhibitory concentration indexes.

RESULTS

The combination of ceftaroline with daptomycin showed an additive effect (53.2%) and synergy (6.6%) against methicillin-susceptible S. aureus, and an additive effect (81.2%) against methicillin-resistant S. aureus (MRSA). This combination also showed an additive effect against 33% of linezolid-susceptible CNS and was not synergistic against linezolid-resistant CNS. The combination of ceftaroline with vancomycin was synergistic (87%) and ceftaroline with linezolid was additive (37%) against MRSA.

CONCLUSIONS

The combinations of ceftaroline with daptomycin, vancomycin or linezolid showed additive and/or synergistic effects against methicillin-resistant Staphylococcus.

Stroke survivors exhibit stronger lower extremity synergies in more challenging walking conditions

The aim of this study was to examine how kinematic synergies are utilised as compensatory movements to stabilise foot positions under different walking task constraints in people with stroke. Ten (Males = 6, Females = 4) hemiplegic chronic stroke survivors volunteered to participate in this study, recruited from a rehabilitation centre. They completed a consent form and participated in treadmill walking tasks; flat, uphill, and crossing over a moving obstacle. The uncontrolled manifold method was used to quantify kinematic synergies in the paretic and non-paretic legs during their swing phase. The results of this study showed the strength of synergies was significantly greater in the obstacle task than in the uphill walking tasks at mid and terminal swing phases. In conclusion, the results suggest that walking in the challenging situations caused people with stroke to control step stability with greater compensation between lower extremity joints. Participants adapted to the increased challenge by increasing the amount of 'good variability', which could be a strategy to reduce the risks of falling.

Hierarchical biomimetic BiVO4 for the treatment of pharmaceutical wastewater in visible-light photocatalytic ozonation

Photocatalytic ozonation is an attractive advanced oxidation process for wastewater treatment, but highly active catalysts with strong response to visible light are urgently needed to push forward its practical application. In this study, a hierarchical biomimetic monoclinic bismuth vanadate (BiVO₄) with leaves morphology was synthesized by a hydrothermal method, and employed as catalyst for oxalic acid and penicillin degradation in photocatalytic ozonation. The results show that the organics degradation was more efficient using leaves shaped BiVO₄ as catalyst than the bulk shaped one in photocatalytic ozonation and the synergy index is ranged from 2.8 to 3.3, indicating a superior positive synergistic effect between photocatalysis and ozonation. The higher activity of the leaves shaped BiVO₄ was probably attributed to the distinctive biomimetic morphology and preferable band structure with more negative CB potential. Mechanism studies suggested that the main reactive species were h⁺ and OH for the degradation of persistent oxalic acid in photocatalytic ozonation. In addition, the effect of ozone concentration and inorganic ions and reusability of the material were also intensively investigated.

Life cycle assessment of a bioelectrochemical system as a new technological platform for biosuccinic acid production from waste

Waste management is a key environmental and socio-economic issue. Environmental concerns are encouraging the use of alternative resources and lower emissions to air, water and soil. Innovative technologies to deal with waste recovery that produce marketable bioproducts are emerging. Bioelectrochemical synthesis systems (BESs) are based on the primary principle of transforming organic waste into added-value products using microorganisms to catalyse chemical reactions. This technology is at the core of a research project called BIORARE (BIoelectrosynthesis for ORganic wAste bioREfinery), an interdisciplinary project that aims to use anaerobic digestion as a supply chain to feed a BES and produce target biomolecules. This technology needs to be driven by environmental strategies. Life Cycle Assessment (LCA) was used to evaluate the BIORARE concept based on expert opinion and prior experiments for the production of biosuccinic acid and waste management. A multidisciplinary approach based on biochemistry and process engineering expertise was used to collect the inventory data. The BES design and the two-step anaerobic digestion process have many potential impacts on air pollution or ecotoxicity-related categories. The comparison of the BIORARE concept with conventional fermentation processes and a water-fed BES technology demonstrated the environmental benefit resulting from the use of both the BES technology and a waste-based substrate as input thus supporting the BIORARE concept. Some trade-offs among the impact categories were identified but led to options to improve the concept. BES design and synergy management may improve the environmental performance of the BIORARE concept.

Merged plantarflexor muscle activity is predictive of poor walking performance in post-stroke hemiparetic subjects

Stroke is the leading cause of long-term disability and individuals post-stroke often experience impaired walking ability. The plantarflexor (PF) muscles are critical to walking through their contributions to the ground reaction forces and body segment energetics. Previous studies have shown muscle activity during walking can be grouped into co-excited muscle sets, or modules. Improper co-activation, or merging of modules, is a common impairment in individuals post-stroke. The purpose of this study was to determine the influence of merged PF modules on walking performance in individuals post stroke by examining balance control, body support and propulsion, and walking symmetry. Muscle modules were identified using non-negative matrix factorization to classify subjects as having an independent or merged PF module. The merged group had decreased balance control with a significantly higher frontal plane whole-body angular momentum than both the independent and control groups, while the independent and control groups were not significantly different. The merged group also had higher paretic braking and nonparetic propulsion than both the independent and control groups. These results remained when comparisons were limited to subjects who had the same number of modules, indicating this was not a general effect due to subjects with merged PF having fewer modules. It is likely that a merged PF module is indicative of general PF dysfunction even when some activation occurs at the appropriate time. These results suggest an independent PF module is critical to walking performance, and thus obtaining an independent PF module should be a crucial aim of stroke rehabilitation.

Effect of environmental constraints on multi-segment coordination patterns during the tennis service in expert performers

The aims of this study were to examine the effect of different environmental constraints on kinematic multi-segment coordination patterns during the service and its coordination with service time variability. Ten expert tennis players (Age: 34.1 ± 5.3) volunteered to take part in this study. Participants served 30 times in 3 different conditions: control, target and opposition. The order of conditions was counterbalanced between participants. A wireless 3D motion capture system (STT Co, Spain) was used to measure 7 joint motions, with a 17 degrees of freedom biomechanical model created to capture the entire service action. Results of the principal component analysis showed that 4 synergies were created; however, their roles were changed relative to the perception of the environment. The results of repeated-measures analysis of variance did not show any significant difference on total variance and individual principal components between conditions; however, one synergy pattern significantly predicted the service time variability in both control and opposition conditions. In conclusion, the findings demonstrated that expert performers reduce the joint dimensionality by creating functional synergies in different phases of service and adapt the service action according to the perception of the environment.

EARLY DIALOGUE IN EUROPE: PERSPECTIVES ON VALUE, CHALLENGES, AND CONTINUING EVOLUTION

OBJECTIVES

This study aims to assess participants' views on previous experiences, the current situation and future perspectives for early dialogue between the pharmaceutical industry, a regulatory agency and health technology assessment bodies (HTABs) in Europe.

METHODS

Eleven semi-structured interviews were arranged purposively with experienced people from the pharmaceutical industry, the European Medicines Agency, and an expert in Health Economics. The interview questions focused on the value of early dialogue, the challenges faced during the process of early dialogue, the best time to start an early dialogue, the kind of products most suitable for early dialogue, the current situation, and future perspectives for the early dialogue process. The interviews were recorded and then transcribed for open and axial coding to summarize the findings.

RESULTS

All interviewees agreed that early dialogue is a valuable process that helps to inform the development program and accordingly provide patients with faster access to new medicines. However, at this stage, the pharmaceutical industry acknowledged certain challenges: (i) Finding resources within pharmaceutical companies and HTABs to support early dialogues (ii) Requirements between regulators and HTABs in different countries diverge.

CONCLUSIONS

This study revealed that people from the pharmaceutical industry perceive early dialogue as a valuable tool that can bring medicines to patients faster by streamlining development. However, the challenges mentioned above need to be mitigated to build a sustainable mechanism for early dialogue.

Co-evolutionary dynamics of the human-environment system in the Heihe River basin in the past 2000years

There is limited quantitative understanding of interactions between human and environmental systems over the millennial scale. We aim to reveal the co-evolutionary dynamics of the human-environment system in a river basin by simulating the water use and net primary production (NPP) allocation for human and environmental systems over the last 2000years in Heihe River basin (HRB) in northwest China. We partition the catchment total evapotranspiration (ET) into ET for human and environmental systems with a social-hydrological framework and estimate the NPP for human and environmental systems using the Box-Lieth model, then classify the co-evolutionary processes of the human-environment system into distinct phases using the rate of changes of NPP over time, and discover the trade-offs or synergies relationships between them based on the elasticity of change of the NPP for humans to the change of NPP for environment. The co-evolutionary dynamics of human-environment system in the HRB can be divided into four periods, including: Phase I (Han Dynasty-Yuan Dynasty): predevelopment characterized by nearly no trade-offs between human and environment; Phase II (Yuan Dynasty-RC): slow agricultural development: characterized by a small human win due to small trade-offs between human and environment; Phase III (RC-2000): rapid agricultural development: characterized by a large human win due to large trade-offs between human and environment, and Phase IV (2000-2010): a rebalance characterized by large human wins with a small-environment win due to synergies, although these occurred very occasionally. This study provides a quantitative approach to describe the co-evolution of the human-environment system from the perspective of trade-offs and synergies in the millennial scale for the first time. The relationships between humans and environment changed from trade-off to synergy with the implementation of the water reallocation scheme in 2000. These findings improve the understanding of how humans influence environmental systems and responses to environmental stresses.

Can we spread the risk? A demand-share perspective to sustained hamstring health. Practical examples

This short practical paper gives examples of exercises of synergists that assist the biceps femoris long head, the most commonly injured hamstring muscle in repeated sprint field sports (soccer, rugby) with the aim of reducing risk of or recurrence of injury. It is a companion to the theoretical piece of the same name.

Trade-offs and synergies between yield, labor, profit, and risk in Malawian maize-based cropping systems

Land degradation, population growth, and chronic poverty in Eastern and Southern Africa challenge the sustainability of livelihoods for smallholder farmers. These farmers often manage soils depleted of nutrients, apply limited amounts of mineral fertilizer, and take decisions about their cropping systems that involve multiple trade-offs. The rotation of cereals with legumes bears agronomic and ecological merit; however, the socio-economic implications of the cereal-legume rotation require a deeper understanding. This study explores the yield, labor, profit, and risk implications of different legume and mineral fertilizer practices in maize-based cropping systems in central Malawi. Our method involves coupling crop modeling and an agricultural household survey with a socio-economic analysis. We use a process-based cropping systems model to simulate the yield effects of integrating legumes into maize monocultures and applying mineral fertilizer over multiple seasons. We combine the simulated yields with socio-economic data from an agricultural household survey to calculate indicators of cropping-system performance. Our results show that a maize-groundnut rotation increases average economic profits by 75% compared with maize monoculture that uses more mineral fertilizer than in the rotation. The maize-groundnut rotation increases the stability of profits, reduces the likelihood of negative profits, and increases risk-adjusted profits. In contrast, the maize-groundnut rotation has a 54% lower average caloric yield and uses more labor than the maize monoculture with mineral fertilization. By comparing labor requirements with labor supply at the household scale, we show for the first time that the additional labor requirements of the maize-groundnut rotation can increase the likelihood of experiencing a labor shortage, if this rotation is undertaken by farm households in central Malawi. We demonstrate that risk and labor factors can be important when examining trade-offs among alternative cropping systems.

Inter-joint coordination changes during and after muscle fatigue

People produce multi-joint movements by organizing many degrees of freedom into a few major covarying relationships, indicating a high level of inter-joint coordination. These relationships can be identified using data decomposition analyses (e.g. principal components analysis, non-negative matrix factorization). The purpose of this study was to determine how movement coordination changes during muscle fatigue by analyzing the covariance structure of multi-joint movements. Sixteen (16) healthy adults completed a continuous, timed ratcheting task with the right arm for three 1-min intervals before, during, and after an intermittent shoulder fatigue protocol. Joint angles from the right arm and trunk were tracked for subsequent principal components analysis. Principal component waveforms were constructed from the original joint angles, and changes in the waveforms during fatigue were assessed using cross-correlations. The variance explained by the first four principal components reached a maximum of 90.5% in the second minute of the pre-test and decreased to a minimum of 86.0% in the last minute of fatigue (p = .033). In the last minute of the post-test, explained variance (87.1%) did not differ from any other pre, fatigue, or post-test time point (p > .23). These results suggest that inter-joint coordination decreased during fatigue. Changes in the movement patterns and principal component waveforms suggest that subjects adopted a more rigid movement strategy when fatigued. However, the rigid movement strategy was not observed during the post-test. The results suggest that people adopted a new pattern of inter-joint coordination while using novel kinematics.

Groundwater and human development: synergies and trade-offs within the context of the sustainable development goals

This article argues that groundwater-accounting for 98% of all fresh water on earth-is central to human development. Drawing upon studies at the regional and sub-regional level, this review article explores synergies and trade-offs between groundwater development and human development. On one hand, groundwater exploitation may enhance human development. Groundwater's "untapped potential" related to various aspects of human development involves (a) water supply for irrigation and domestic purposes; (b) climate change adaptation and hydrological resilience; (c) hydrogeological storage of CO2; and (d) access to (renewable) energy. On the other hand, human development may come at the expense of quality deterioration or depletion of groundwater. The review concludes that achieving a sound understanding of local groundwater characteristics and human impact on groundwater resources across scales is paramount to implementing the sustainable development goals in an integrated manner.

Effects of force detecting sense organs on muscle synergies are correlated with their response properties

Sense organs that monitor forces in legs can contribute to activation of muscles as synergist groups. Previous studies in cockroaches and stick insects showed that campaniform sensilla, receptors that encode forces via exoskeletal strains, enhance muscle synergies in substrate grip. However synergist activation was mediated by different groups of receptors in cockroaches (trochanteral sensilla) and stick insects (femoral sensilla). The factors underlying the differential effects are unclear as the responses of femoral campaniform sensilla have not previously been characterized. The present study characterized the structure and response properties (via extracellular recording) of the femoral sensilla in both insects. The cockroach trochantero-femoral (TrF) joint is mobile and the joint membrane acts as an elastic antagonist to the reductor muscle. Cockroach femoral campaniform sensilla show weak discharges to forces in the coxo-trochanteral (CTr) joint plane (in which forces are generated by coxal muscles) but instead encode forces directed posteriorly (TrF joint plane). In stick insects, the TrF joint is fused and femoral campaniform sensilla discharge both to forces directed posteriorly and forces in the CTr joint plane. These findings support the idea that receptors that enhance synergies encode forces in the plane of action of leg muscles used in support and propulsion.

Toxicity mechanisms and synergies of silver nanoparticles in 2,4-dichlorophenol degradation by Phanerochaete chrysosporium

Mechanisms of silver nanoparticles-mediated toxicity to Phanerochaete chrysosporium and the influence of silver nanoparticles (AgNPs) on the biodegradation of 2,4-dichlorophenol (2,4-DCP) have been systematically investigated. AgNPs at low doses (0-60μM) have greatly enhanced the degradation ability of P. chrysosporium to 2,4-DCP with the maximum degradation rates of more than 94%, exhibiting excellent synergies between AgNPs and P. chrysosporium in the degradation of 2,4-DCP. Meanwhile, removal of total Ag was also at high levels and highly pH dependent. However, significant inhibition was highlighted on 2,4-DCP biodegradation and Ag removal upon treatment with AgNPs at high doses and AgNO₃ at low-level exposure. Results also suggested that AgNPs-induced cytotoxicity could arise from the "Trojan-horse" mechanism executing particle effects, ion effects, or both, ruling out extracellularly released Ag⁺. Moreover, under relatively low concentrations of AgNPs exposure, 2,4-DCP was broken into linear chain organics, and eventually turned into CO₂ and H₂O through reductive dechlorination and reaction with hydroxyl radicals. FTIR analysis showed that amino, carboxyl, carbonyl, and sulfur-containing functional groups played crucial roles in Ag transportation and the reduction of Ag⁺ to Ag⁰.

Policy coherence to achieve the SDGs: using integrated simulation models to assess effective policies

Coherently addressing the 17 Sustainable Development Goals requires planning tools that guide policy makers. Given the integrative nature of the SDGs, we believe that integrative modelling techniques are especially useful for this purpose. In this paper, we present and demonstrate the use of the new System Dynamics based iSDG family of models. We use a national model for Tanzania to analyse impacts of substantial investments in photovoltaic capacity. Our focus is on the impacts on three SDGs: SDG 3 on healthy lives and well-being, SDG 4 on education, and SDG 7 on energy. In our simulations, the investments in photovoltaics positively affect life expectancy, years of schooling and access to electricity. More importantly, the progress on these dimensions synergizes and leads to broader system-wide impacts. While this one national example illustrates the anticipated impact of an intervention in one specific area on several SDGs, the iSDG model can be used to support similar analyses for policies related to all the 17 SDGs, both individually and concurrently. We believe that integrated models such as the iSDG model can bring interlinks to the forefront and facilitate a shift to a discussion on development grounded in systems thinking.

Ecosystem services capacity across heterogeneous forest types: understanding the interactions and suggesting pathways for sustaining multiple ecosystem services

As ecosystem services supply from tropical forests is declining due to deforestation and forest degradation, much effort is essential to sustain ecosystem services supply from tropical forested landscapes, because tropical forests provide the largest flow of multiple ecosystem services among the terrestrial ecosystems. In order to sustain multiple ecosystem services, understanding ecosystem services capacity across heterogeneous forest types and identifying certain ecosystem services that could be managed to leverage positive effects across the wider bundle of ecosystem services are required. We sampled three forest types, tropical rainforests, sclerophyll forests, and rehabilitated plantation forests, over an area of 32,000m(2) from Wet Tropics bioregion, Australia, aiming to compare supply and evaluate interactions and patterns of eight ecosystem services (global climate regulation, air quality regulation, erosion regulation, nutrient regulation, cyclone protection, habitat provision, energy provision, and timber provision). On average, multiple ecosystem services were highest in the rainforests, lowest in sclerophyll forests, and intermediate in rehabilitated plantation forests. However, a wide variation was apparent among the plots across the three forest types. Global climate regulation service had a synergistic impact on the supply of multiple ecosystem services, while nutrient regulation service was found to have a trade-off impact. Considering multiple ecosystem services, most of the rehabilitated plantation forest plots shared the same ordination space with rainforest plots in the ordination analysis, indicating that rehabilitated plantation forests may supply certain ecosystem services nearly equivalent to rainforests. Two synergy groups and one trade-off group were identified. Apart from conserving rainforests and sclerophyll forests, our findings suggest two additional integrated pathways to sustain the supply of multiple ecosystem services from a heterogeneous tropical forest landscape: (i) rehabilitation of degraded forests aiming to provide global climate regulation and habitat provision ecosystem services and (ii) management intervention to sustain global climate regulation and habitat provision ecosystem services.

Robot-aided assessment of lower extremity functions: a review

The assessment of sensorimotor functions is extremely important to understand the health status of a patient and its change over time. Assessments are necessary to plan and adjust the therapy in order to maximize the chances of individual recovery. Nowadays, however, assessments are seldom used in clinical practice due to administrative constraints or to inadequate validity, reliability and responsiveness. In clinical trials, more sensitive and reliable measurement scales could unmask changes in physiological variables that would not be visible with existing clinical scores.In the last decades robotic devices have become available for neurorehabilitation training in clinical centers. Besides training, robotic devices can overcome some of the limitations in traditional clinical assessments by providing more objective, sensitive, reliable and time-efficient measurements. However, it is necessary to understand the clinical needs to be able to develop novel robot-aided assessment methods that can be integrated in clinical practice.This paper aims at providing researchers and developers in the field of robotic neurorehabilitation with a comprehensive review of assessment methods for the lower extremities. Among the ICF domains, we included those related to lower extremities sensorimotor functions and walking; for each chapter we present and discuss existing assessments used in routine clinical practice and contrast those to state-of-the-art instrumented and robot-aided technologies. Based on the shortcomings of current assessments, on the identified clinical needs and on the opportunities offered by robotic devices, we propose future directions for research in rehabilitation robotics. The review and recommendations provided in this paper aim to guide the design of the next generation of robot-aided functional assessments, their validation and their translation to clinical practice.

Determination of the modes of action and synergies of xylanases by analysis of xylooligosaccharide profiles over time using fluorescence-assisted carbohydrate electrophoresis

The structure of xylan, which has a 1,4-linked β-xylose backbone with various substituents, is much more heterogeneous and complex than that of cellulose. Because of this, complete degradation of xylan needs a large number of enzymes that includes GH10, GH11, and GH3 family xylanases together with auxiliary enzymes. Fluorescence-assisted carbohydrate electrophoresis (FACE) is able to accurately differentiate unsubstituted and substituted xylooligosaccharides (XOS) in the heterogeneous products generated by different xylanases and allows changes in concentrations of specific XOS to be analyzed quantitatively. Based on a quantitative analysis of XOS profiles over time using FACE, we have demonstrated that GH10 and GH11 family xylanases immediately degrade xylan into sizeable XOS, which are converted into smaller XOS in a much lower speed. The shortest substituted XOS produced by hydrolysis of the substituted xylan backbone by GH10 and GH11 family xylanases were MeGlcA(2) Xyl3 and MeGlcA(2) Xyl4 , respectively. The unsubstituted xylan backbone was degraded into xylose, xylobiose, and xylotriose by both GH10 and GH11 family xylanases; the product profiles are not family-specific but, instead, depend on different subsite binding affinities in the active sites of individual enzymes. Synergystic action between xylanases and β-xylosidase degraded MeGlcA(2) Xyl4 into xylose and MeGlcA(2) Xyl3 but further degradation of MeGlcA(2) Xyl3 required additional enzymes. Synergy between xylanases and β-xylosidase was also found to significantly accelerate the conversion of XOS into xylose.

Force feedback reinforces muscle synergies in insect legs

The nervous system solves complex biomechanical problems by activating muscles in modular, synergist groups. We have studied how force feedback in substrate grip is integrated with effects of sense organs that monitor support and propulsion in insects. Campaniform sensilla are mechanoreceptors that encode forces as cuticular strains. We tested the hypothesis that integration of force feedback from receptors of different leg segments during grip occurs through activation of specific muscle synergies. We characterized the effects of campaniform sensilla of the feet (tarsi) and proximal segments (trochanter and femur) on activities of leg muscles in stick insects and cockroaches. In both species, mechanical stimulation of tarsal sensilla activated the leg muscle that generates substrate grip (retractor unguis), as well as proximal leg muscles that produce inward pull (tibial flexor) and support/propulsion (trochanteral depressor). Stimulation of campaniform sensilla on proximal leg segments activated the same synergistic group of muscles. In stick insects, the effects of proximal receptors on distal leg muscles changed and were greatly enhanced when animals made active searching movements. In insects, the task-specific reinforcement of muscle synergies can ensure that substrate adhesion is rapidly established after substrate contact to provide a stable point for force generation.

Interactions of propofol and remifentanil on bispectral index under 66% N(2)O: analysis by dose-effect curve, isobologram, and combination index

Background

Propofol and remifentanil are usually co-administered and have shown synergistic effect for anesthesia. However, the synergistic effect of the two drugs on hypnosis measured by bispectral index (BIS) was controversial in previous studies. The aim of this study was to identify the interaction of propofol and remifentanil on BIS and the optimal dose combinations for hypnosis under 66% N₂O during surgery.

Methods

Patients (age 55-75 and American Society of Anesthesiologists [ASA] 1-2) undergoing gastrectomy were enrolled in this study. Propofol and remifentanil were co-administered incrementally at 1 : 1 potent ratio (the P1R1 group), at 1 : 2 potent ratio (the P1R2 group), or at 2 : 1 potent ratio (the P2R1 group) using effect site target-controlled infusion and BIS was measured. 66% N₂O was concomitantly administered to all groups. The dose-effect curves, the 90% effective dose (EC₉₀) for adequate hypnosis (BIS 40), isobolograms and combination index were obtained by Calcusyn program (Biosoft) to reveal the interaction of propofol and remifentanil.

Results

The P2R1 group showed synergistic action on BIS. However, the other groups needed larger amount of each drug than the doses of additive action. The EC₉₀ of the P2R1 group was propofol, 3.34 µg/ml and remifentanil, 2.41 ng/ml under 66% of N₂O.

Conclusions

Propofol dominant co-administration is needed for dose reduction in BIS guided hypnosis.