Net Gains from 'Net Purchases? Farmers' Preferences for Online and Local Input Purchases

E-commerce represents both threats to and opportunities for rural communities. This study addresses one element of the issue: farmers' willingness to substitute online merchants or national farm input stores for local businesses. Results of a conjoint analysis of contingent choice experiments suggest that farmers are willing to purchase from online or national stores outside their communities if compensated with lower prices or greater services. Results also demonstrate that the context of the input purchase, such as time constraints, was very important not only in valuing these services, but, more broadly, in terms of the farmer's loyalty to a local merchant.e-commerce, farm input purchase, willingness to pay, contingent choice, rural communities, Farm Management, Marketing,

Willingness to pay for locally produced foods: A customer intercept study of direct market and grocery store shoppers

Increasingly, grocery stores are marketing foods differentiated as locally produced. Freshness and taste are obvious reasons for consumer preference for these goods, but also important may be home-bias. Whatever the motive, there is substantial evidence that some consumers are willing to pay premium prices for food characterized as locally produced. A customer-intercept survey and a choice experiment of food shoppers in direct markets and traditional grocery stores was analyzed using Conjoint methods to evaluate WTP for characteristics related to locally grown fresh strawberries. Our results suggest that consumers are willing to pay more for locally produced berries: Customers intercepted in grocery stores would pay an average of 64 cents more per quart, while those intercepted at direct markets would pay nearly $1.17 more per carton of strawberries that was grown locally rather than berries identified simply as "produced in the U.S." These conclusions provide a solid rationale for the existence of niche market potential for local berry producers.Consumer/Household Economics,

On the role of Eurasian autumn snow cover in dynamical seasonal predictions

Seasonal predictions leverage on predictable or persistent components of the Earth system that can modify the state of the atmosphere. The land surface provides predictability through various mechanisms, including snow cover, with particular reference to Autumn snow cover over the Eurasian continent. The snow cover alters the energy exchange between surface and atmosphere and induces a diabatic cooling that in turn can affect the atmosphere locally and remotely. Lagged relationships between snow cover in Eurasia and atmospheric modes of variability in the Northern Hemisphere have been documented but are deemed to be non-stationary and climate models typically do not reproduce observed relationships with consensus. The role of the snow in recent dynamical seasonal forecasts is therefore unclear. Here we assess the role of Autumn Eurasian snow cover in a set of five operational seasonal forecasts with large ensemble size and high resolution and with the help of targeted idealised simulations. Forecast systems reproduce realistically regional changes of the surface energy balance. Retrospective forecasts and idealised sensitivity experiments identify a coherent change of the circulation in the Northern Hemisphere. The main features of the atmospheric response are a wave-train downstream over the Pacific and North America and a signal in the Arctic. The latter does not emerge in reanalysis data but is compatible with a lagged but weak and fast feedback from the snow to the Arctic Oscillation

El Niño teleconnection to the Euro-Mediterranean late-winter: the role of extratropical Pacific modulation

El Niño Southern Oscillation (ENSO) represents the major driver of interannual climate variability at global scale. Observational and model-based studies have fostered a long-standing debate on the shape and intensity of the ENSO influence over the Euro-Mediterranean sector. Indeed, the detection of this signal is strongly affected by the large internal variability that characterizes the atmospheric circulation in the North Atlantic–European (NAE) region. This study explores if and how the low-frequency variability of North Pacific sea surface temperature (SST) may impact the El Niño-NAE teleconnection in late winter, which consists of a dipolar pattern between middle and high latitudes. A set of idealized atmosphere-only experiments, prescribing different phases of the anomalous SST linked to the Pacific Decadal Oscillation (PDO) superimposed onto an El Niño-like forcing in the tropical Pacific, has been performed in a multi-model framework, in order to assess the potential modulation of the positive ENSO signal. The modelling results suggest, in agreement with observational estimates, that the PDO negative phase (PDO−) may enhance the amplitude of the El Niño-NAE teleconnection, while the dynamics involved appear to be unaltered. On the other hand, the modulating role of the PDO positive phase (PDO+) is not reliable across models. This finding is consistent with the atmospheric response to the PDO itself, which is robust and statistically significant only for PDO−. Its modulation seems to rely on the enhanced meridional SST gradient and the related turbulent heat-flux released along the Kuroshio–Oyashio extension. PDO− weakens the North Pacific jet, whereby favoring more poleward propagation of wave activity, strengthening the El Niño-forced Rossby wave-train. These results imply that there might be conditional predictability for the interannual Euro-Mediterranean climate variability depending on the background state

Acute kidney injury in hospitalized children with sickle cell anemia

Background: Children with sickle cell anemia (SCA) are at increased risk of acute kidney injury (AKI) that may lead to death or chronic kidney disease. This study evaluated AKI prevalence and risk factors in children with SCA hospitalized with a vaso-occlusive crisis (VOC) in a low-resource setting. Further, we evaluated whether modifcations to the Kidney Disease: Improving Global Outcomes (KDIGO) defnition would infuence clinical outcomes of AKI in children with SCA hospitalized with a VOC. Methods: We prospectively enrolled 185 children from 2 – 18 years of age with SCA (Hemoglobin SS) hospitalized with a VOC at a tertiary hospital in Uganda. Kidney function was assessed on admission, 24–48 h of hospitalization, and day 7 or discharge. Creatinine was measured enzymatically using an isotype-dilution mass spectrometry traceable method. AKI was defned using the original-KDIGO defnition as≥1.5-fold change in creatinine within seven days or an absolute change of≥0.3 mg/dl within 48 h. The SCA modifed-KDIGO (sKDIGO) defnition excluded children with a 1.5-fold change in creatinine from 0.2 mg/dL to 0.3 mg/dL. Results: Using KDIGO, 90/185 (48.7%) children had AKI with 61/185 (33.0%) AKI cases present on admission, and 29/124 (23.4%) cases of incident AKI. Overall, 23 children with AKI had a 1.5-fold increase in creatinine from 0.2 mg/ dL to 0.3 m/dL. Using the sKDIGO-defnition, 67/185 (36.2%) children had AKI with 43/185 (23.2%) cases on admission, and 24/142 (16.9%) cases of incident AKI. The sKDIGO defnition, but not the original-KDIGO defnition, was associated with increased mortality (0.9% vs. 7.5%, p=0.024). Using logistic regression, AKI risk factors included age (aOR, 1.10, 95% CI 1.10, 1.20), hypovolemia (aOR, 2.98, 95% CI 1.08, 8.23), tender hepatomegaly (aOR, 2.46, 95% CI 1.05, 5.81), and infection (aOR, 2.63, 95% CI 1.19, 5.81) (p\u3c0.05). Conclusion: These results demonstrate that AKI is a common complication in children with SCA admitted with VOC. The sKDIGO defnition of AKI in children with SCA was a better predictor of clinical outcomes in children. There is need for promotion of targeted interventions to ensure early identifcation and treatment of AKI in children with SCA

Cerebrospinal fluid biomarkers provide evidence for kidney-brain axis involvement in cerebral malaria pathogenesis

Introduction: Cerebral malaria is one of the most severe manifestations of malaria and is a leading cause of acquired neurodisability in African children. Recent studies suggest acute kidney injury (AKI) is a risk factor for brain injury in cerebral malaria. The present study evaluates potential mechanisms of brain injury in cerebral malaria by evaluating changes in cerebrospinal fluid measures of brain injury with respect to severe malaria complications. Specifically, we attempt to delineate mechanisms of injury focusing on blood-brain-barrier integrity and acute metabolic changes that may underlie kidney-brain crosstalk in severe malaria. Methods: We evaluated 30 cerebrospinal fluid (CSF) markers of inflammation, oxidative stress, and brain injury in 168 Ugandan children aged 18 months to 12 years hospitalized with cerebral malaria. Eligible children were infected with Plasmodium falciparum and had unexplained coma. Acute kidney injury (AKI) on admission was defined using the Kidney Disease: Improving Global Outcomes criteria. We further evaluated blood-brain-barrier integrity and malaria retinopathy, and electrolyte and metabolic complications in serum. Results: The mean age of children was 3.8 years (SD, 1.9) and 40.5% were female. The prevalence of AKI was 46.3% and multi-organ dysfunction was common with 76.2% of children having at least one organ system affected in addition to coma. AKI and elevated blood urea nitrogen, but not other measures of disease severity (severe coma, seizures, jaundice, acidosis), were associated with increases in CSF markers of impaired blood-brain-barrier function, neuronal injury (neuronspecific enolase, tau), excitatory neurotransmission (kynurenine), as well as altered nitric oxide bioavailability and oxidative stress (p \u3c 0.05 after adjustment for multiple testing). Further evaluation of potential mechanisms suggested that AKI may mediate or be associated with CSF changes through blood-brainbarrier disruption (p = 0.0014), ischemic injury seen by indirect ophthalmoscopy (p \u3c 0.05), altered osmolality (p = 0.0006) and through alterations in the amino acids transported into the brain

Autoantibody levels are associated with acute kidney injury, anemia and post-discharge morbidity and mortality in Ugandan children with severe malaria

Autoantibodies targeting host antigens contribute to autoimmune disorders, frequently occur during and after infections and have been proposed to contribute to malaria-induced anemia. We measured anti-phosphatidylserine (PS) and anti-DNA antibody levels in 382 Ugandan children prospectively recruited in a study of severe malaria (SM). High antibody levels were defined as antibody levels greater than the mean plus 3 standard deviations of community children (CC). We observed increases in median levels of anti-PS and anti-DNA antibodies in children with SM compared to CC (p < 0.0001 for both). Children with severe malarial anemia were more likely to have high anti-PS antibodies than children with cerebral malaria (16.4% vs. 7.4%), p = 0.02. Increases in anti-PS and anti-DNA antibodies were associated with decreased hemoglobin (p < 0.05). A one-unit increase in anti-DNA antibodies was associated with a 2.99 (95% CI, 1.68, 5.31) increase odds of acute kidney injury (AKI) (p < 0.0001). Elevated anti-PS and anti-DNA antibodies were associated with post-discharge mortality (p = 0.031 and p = 0.042, respectively). Children with high anti-PS antibodies were more likely to have multiple hospital readmissions compared to children with normal anti-PS antibody levels (p < 0.05). SM is associated with increased autoantibodies against PS and DNA. Autoantibodies were associated with anemia, AKI, post-discharge mortality, and hospital readmission

Working group 3: What are and how do we measure the pros and cons of existing approaches?

WG3 discussed both the pros and cons of existing schemes as well as metrics to measure relative advantages and disadvantages. We first provide a list of the current operational techniques and their respective advantages and disadvantages that were discussed in the WG. We do not claim that the list is complete, and we note that the pros and cons are neither exhaustive nor quantitative. Nevertheless, it may be useful to note the WG’s consensus on the general advantages and disadvantages of the most commonly-used schemes. We then list our recommendations for evaluating model uncertainty schemes. At the end is a short list pertaining to recommendations for further development of methods to represent model uncertainty

Association between Blood Pressure and HIV Status in Rural Uganda: Results of Cross-Sectional Analysis.

Introduction: The association between HIV status and hypertension is not well described within sub-Saharan Africa. We examined prevalence and risk factors for hypertension among HIV positive and negative individuals living in a rural district of Uganda. Methods: We conducted a cross-sectional analysis in two concurrent cohorts of 600 HIV negative and 721 HIV seropositive individuals aged ≥35 years. Results: Of the 721 HIV positive participants, 59.8% were women and the median age was 44.3 years, while for HIV negative individuals, 55% were women and the median age was 47.8 years. Over 90% of HIV positive individuals were on antiretroviral treatment. The prevalence of hypertension (≥140/≥90 mmHg) was 33.5% in HIV negative individuals and 23.9% in HIV positive individuals. Age (adjusted OR = 1.05, 95% CI 1.03 to 1.06) and BMI (adjusted OR = 1.08, 95% CI 1.05 to 1.12) were associated with higher odds of hypertension. Having HIV was associated with lower odds of hypertension (adjusted OR = 0.66, 95% CI 0.50 to 0.88), lower systolic blood pressure (-5.1 mmHg, 95% CI: -7.4 to -2.4) and lower diastolic blood pressure (-4.0 mmHg, 95% CI: -5.6 to -2.5). We did not observe differences in the odds of hypertension by CD4 count, viral load or ART among HIV positive individuals in this sample. Conclusions: Hypertension was prevalent in one third of HIV negative individuals and in one fourth of HIV positive patients. While access to health information among individuals attending HIV clinics may explain observed differences, more research is needed to understand plausible biological and social mechanisms that could explain lower blood pressure among people living with HIV in Uganda