This paper provides a comparative perspective on infrastructure provision in developing Asia's three largest countries: China, India, and Indonesia. It discusses their achievements and shortfalls in providing network infrastructure (energy, transport, water, and telecommunications) over the past two decades. It documents how three quite distinct development paths—and very different levels of national saving and investment—were manifested in different trajectories of infrastructure provision. The paper then describes the institutional, economic, and policy factors that enabled or hindered progress in providing infrastructure. Here, contrasting levels of centralization of planning played a key role, as did countries’ differing abilities to mobilize infrastructure-related revenue streams such as user charges and land value capture. The paper then assesses future challenges for the three countries in providing infrastructure in a more integrated and sustainable way, and links these challenges with the global development agenda to which the three countries have committed. The concluding recommendations hope to provide a platform for further policy and research dialogue.
Objective: To evaluate the clinical and radiographic results and complications of arthroscopic subcapital realignment osteotomy for the treatment of chronic and stable proximal femoral epiphysiolysis (PFE) in an initial series of patients. According to the literature review, the study presents the first description of an arthroscopic technique of this type of osteotomy. Methods: Between June 2012 and December 2014, seven patients underwent arthroscopic subcapital realignment osteotomy for the treatment of chronic, stable PFE. The mean age of the patients was 11 years and four months. Minimum follow-up ranged from 6 to 36 months (mean, 16.5 months). Patients were clinically evaluated according to the Harris Hip Score modified by Byrd and radiographically according to Southwick’s quantitative classification and the epiphyseal-diaphyseal angle. Postoperative complications were analyzed. Results: With regard to the evaluation of the Harris Hip Score Modified by Byrd clinical score, a preoperative mean of 35.8 points and a postoperative mean of 97.5 points were observed (p < 0.05). Radiographically, five patients were classified as Southwick grade II and two as grade III. A mean correction of the epiphyseal-diaphyseal angle of 40° was observed. There were no immediate postoperative complications. One patient developed avascular necrosis of the femoral head, without collapse or chondrolysis at the last follow-up (22 months). Conclusion: The arthroscopic technique presented by the authors for the treatment of chronic, stable PFE resulted in clinical and radiographic improvement of the patients in this initial series.
Multiple myeloma (MM) is a hematologic cancer characterized by clonal proliferation of plasma cells within the bone marrow. It is the most serious form of plasma cell dyscrasias, whose complications—hypercalcemia, renal failure, anemia, and lytic bone lesions—are severe and justify the therapeutic management. Imaging of bone lesions is a cardinal element in the diagnosis, staging, study of response to therapy, and prognostic evaluation of patients with MM. Historically, the skeletal radiographic workup (SRW), covering the entire axial skeleton, has been used to detect bone lesions. Over time, new imaging techniques that are more powerful than SRW have been evaluated. Low-dose and whole-body computed tomography (CT) supplants SRW for the detection of bone involvement, but is of limited value in assessing therapeutic response. Bone marrow MRI, initially studying the axial pelvic-spinal skeleton and more recently the whole body, is an attractive alternative. Beyond its non-irradiating character, its sensitivity for the detection of marrow damage, its capacity to evaluate the therapeutic response and its prognostic value has been demonstrated. This well-established technique has been incorporated into disease staging systems by many health systems and scientific authorities. Along with positron emission tomography (PET)-18 fluorodeoxyglucose CT, it constitutes the current imaging of choice for MM. This article illustrates the progress of the MRI technique over the past three decades and situates its role in the management of patients with MM.
The human brain has been described as a complex system. Its study by means of neurophysiological signals has revealed the presence of linear and nonlinear interactions. In this context, entropy metrics have been used to uncover brain behavior in the presence and absence of neurological disturbances. Entropy mapping is of great interest for the study of progressive neurodegenerative diseases such as Alzheimer’s disease. The aim of this study was to characterize the dynamics of brain oscillations in such disease by means of entropy and amplitude of low frequency oscillations from Bold signals of the default network and the executive control network in Alzheimer’s patients and healthy individuals, using a database extracted from the Open Access Imaging Studies series. The results revealed higher discriminative power of entropy by permutations compared to low-frequency fluctuation amplitude and fractional amplitude of low-frequency fluctuations. Increased entropy by permutations was obtained in regions of the default network and the executive control network in patients. The posterior cingulate cortex and the precuneus showed differential characteristics when assessing entropy by permutations in both groups. There were no findings when correlating metrics with clinical scales. The results demonstrated that entropy by permutations allows characterizing brain function in Alzheimer’s patients, and also reveals information about nonlinear interactions complementary to the characteristics obtained by calculating the amplitude of low frequency oscillations.
Introduction: In Colombia, the last oral health study showed that about 70% of the population has partial edentulism while 5.2% will have lost all their teeth between the age of 65 and 79. Rehabilitation with implants is an increasingly used option, which requires clinical and radiographic follow-up. Panoramic radiography is a low-cost option, in which it is possible to observe areas of bone loss, mesiodistal angulation of the implant, relationship with anatomical structures and lesions suggestive of peri-implantitis. Reports and analysis of relevant data on radiographic findings associated with dental implants are required to determine the risk factors for their success in patients who use them. Objective: To determine the prevalence and characterize the findings associated with osseointegration implants in panoramic radiographs. Methods: A descriptive cross-sectional observational study was carried out with 10,000 digital panoramic radiographs selected by convenience from radiological centers in the city of Bogota, Colombia, of which 543 corresponded to the sample analyzed for the presence of implants. The following were evaluated for each implant: location, position, angulation and distances to adjacent structures, using the Clínicalview® program (Orthopantomograph OP200D, Instrumentarium, USA). Results: The frequency of radiographs with implants was 5.43% with a total of 1,791 implants, with an average of 3.2 per radiograph. They were found in greater proportion in the upper jaw with a supracrestal location and an angulation of 10.3 degrees. 32% had implant/tooth or implant/implant distances that were less than optimal. 40.9% were restored and 1.2% showed lesions compatible with periimplantitis. Conclusions: A high percentage of the implants reviewed have a risk factor that affects their long-term viability, either due to angulation, supracrestal or crestal position, proximity to teeth or other implants, or because they are not restorable.
Cardiovascular imaging analysis is a useful tool for the diagnosis, treatment and monitoring of cardiovascular diseases. Imaging techniques allow non-invasive quantitative assessment of cardiac function, providing morphological, functional and dynamic information. Recent technological advances in ultrasound have made it possible to improve the quality of patient treatment, thanks to the use of modern image processing and analysis techniques. However, the acquisition of these dynamic three-dimensional (3D) images leads to the production of large volumes of data to process, from which cardiac structures must be extracted and analyzed during the cardiac cycle. Extraction, three-dimensional visualization, and qualification tools are currently used within the clinical routine, but unfortunately require significant interaction with the physician. These elements justify the development of new efficient and robust algorithms for structure extraction and cardiac motion estimation from three-dimensional images. As a result, making available to clinicians new means to accurately assess cardiac anatomy and function from three-dimensional images represents a definite advance in the investigation of a complete description of the heart from a single examination. The aim of this article is to show what advances have been made in 3D cardiac imaging by ultrasound and additionally to observe which areas have been studied under this imaging modality.
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