Understanding the economic impact of BXW and its management practices in East and Central Africa

Banana Xanthomonas wilt (BXW) is a widespread banana disease in East and Central Africa (ECA). It has the ability to cause up to 100% yield loss, severely compromising food security and livelihoods for banana-based farming households. There are no BXW-resistant varieties, and cultural management practices offer the only means of control. However, adoption of these practices by farmers has been lower than expected, mainly because of their high cost and labour-intensiveness. There are also other actors, both in public and private sectors, playing an important role in the disease management and facing different costs related to it. Our literature review reveals that a cost analysis of the banana value chain as a whole is missing. By this we mean consideration of not only farmers, who have to sustain the cost of management practices, but also other stakeholders involved, as national and local governments, research institutions and agricultural extensionists. In this study we identify economic actors involved in the banana value chain together with their costs related to the disease management and propose a cost analysis conceptual framework. Further, we review determinants of adoption of the BXW management practices and finally relate them to the estimates of costs of inaction (losses due to BXW spread). In this way, we present a comprehensive picture of costs of BXW spread vis-a-vis the costs of management practices and indicate possible ways to tip the balance in favour of the disease eradication. Ongoing research needs to carry out ex-post analyses on different costs sustained by the stakeholders of banana value chain, and ex ante analyses to predict future scenarios which represent possible alternatives, depending on whether and how the disease will be managed in the coming years. Those results will better inform decision-makers at national, regional, and international levels and provide support in designing strategies to cope with the BXW spread across the ECA region

Severe Aortic Stenosis and Myocardial Function: Diagnostic and Prognostic Usefulness of Ultrasonic Integrated Backscatter Analysis

Background— The aim of this study was to assess the myocardial reflectivity pattern in severe aortic valve stenosis through the use of integrated backscatter (IBS) analysis. Patients with aortic stenosis (AS) were carefully selected in the Department of Cardiology. Methods and Results— Thirty-five subjects (AS: valve orifice ≤1 cm2; 12 female; mean age, 71.8±6.2 years) and 25 healthy subjects were studied. All subjects of the study had conventional 2D-Doppler echocardiography and IBS. Backscatter signal was sampled at the septum and posterior wall levels. Patients with AS were divided into 2 groups: 16 patients with initial signs of congestive heart failure and a depressed left ventricular systolic function (DSF) (ejection fraction [EF] range, 35% to 50%) and 19 asymptomatic patients with normal left ventricular systolic function (NSF) (EF >50%). Myocardial echo intensity (pericardium related) was significantly higher at the septum and posterior wall levels in DSF than in NSF and in control subjects. IBS variation, as an expression of variation of the signal, appeared to be significantly lower in AS with DSF than in NSF and in control subjects, at both the septum and posterior wall levels. Patients with DSF underwent aortic valve replacement, and, during surgical intervention, a septal myocardial biopsy was made for evaluation of myocardium/fibrosis ratio. Abnormally increased echo intensity was detected in left ventricular pressure overload by severe aortic stenosis and correlated with increase of myocardial collagen content (operating biopsy). Conclusions— One year after aortic valve replacement, we observed a significant reduction of left ventricular mass, and, only if pericardial indexed IBS value (reduction of interstitial fibrosis) decreased, it was possible to observe an improvement of EF and of IBS variation

Aortic stiffness is associated with cardiac function and cerebral small vessel disease in patients with type 1 diabetes mellitus: assessment by magnetic resonance imaging

To evaluate, with the use of magnetic resonance imaging (MRI), whether aortic pulse wave velocity (PWV) is associated with cardiac left ventricular (LV) function and mass as well as with cerebral small vessel disease in patients with type 1 diabetes mellitus (DM). We included 86 consecutive type 1 DM patients (49 male, mean age 46.9 +/- 11.7 years) in a prospective, cross-sectional study. Exclusion criteria included aortic/heart disease and general MRI contra-indications. MRI of the aorta, heart and brain was performed for assessment of aortic PWV, as a marker of aortic stiffness, systolic LV function and mass, as well as for the presence of cerebral white matter hyperintensities (WMHs), microbleeds and lacunar infarcts. Multivariate linear or logistic regression was performed to analyse the association between aortic PWV and outcome parameters, with covariates defined as age, gender, mean arterial pressure, heart rate, BMI, smoking, DM duration and hypertension. Mean aortic PWV was 7.1 +/- 2.5 m/s. Aortic PWV was independently associated with LV ejection fraction ( = -0.406, P = 0.006), LV stroke volume ( = -0.407, P = 0.001), LV cardiac output ( = -0.458, P = 0.001), and with cerebral WMHs (P < 0.05). There were no independent associations between aortic stiffness and LV mass, cerebral microbleeds or lacunar infarcts. Aortic stiffness is independently associated with systolic LV function and cerebral WMHs in patients with type 1 DM.Neuro Imaging Researc

Symptomatic acute myocardial infarction in a cardiac transplant recipient successfully treated with primary coronary angioplasty: Evidence of prognostic importance of chest pain after cardiac transplantation

Accelerated coronary artery disease remains the limiting factor in the long-term survival of heart transplant (HT) recipients and occurs in approximately 50% of patients by 5 years after transplantation. Sequelae of graft arteriosclerosis include congestive heart failure (due to acute or chronic ischemia), graft loss, and death. Unfortunately, as a consequence of cardiac denervation, symptoms are often atypical or completely absent, and thus presentation with an acute coronary syndrome is extremely uncommon. We describe the case of an HT recipient with a typical clinical picture of an acute myocardial infarction (MI), who presented to our hospital 2 hours after the. onset of symptoms and was successfully treated with primary percutaneous transluminal coronary angioplasty (PTCA)

Moral foundations and willingness to pay for non-wood forest products: A study in three european countries

Non-Wood Forest Products (NWFPs) provide social and cultural services related to e.g., the tradition and social role of collecting berries, mushrooms and herbs. These services can be ranked among intangible outputs as a part of the recreational function of forests. However, their social value is only partially captured in non-forest activities. We used a Choice Experiment to explore individuals’ preferences towards NWFPs and associated services in Italy, Sweden, and Czechia. We estimated the individual marginal willingness to pay for the supply and maintenance of NWFPs. In addition, we analysed the determinants of people’s choices using the framework of the Moral Foundations Theory (MFT). The results show that people collect NWFPs mostly for self-consumption and recreation, rather than for livelihood or to sell them on the market. Despite this, they are willing to pay for sustainable forest management practices that favour NWFPs supply, as well as for forest conservation. Additionally, Care and Fairness traits in the MFT determine people’s willingness to pay for NWFPs. The results from this study highlight the value of the social component of non-wood forests products and the expenses related to picking. This is a first step towards a value chain analysis of the NWFPs

Public and private investments for banana Xanthomonas Wilt control in Uganda: The economic feasibility for smallholder farmers

Banana Xanthomonas Wilt (BXW) poses a serious threat to livelihoods and food security for millions of households in Africa. Despite considerable investments in Uganda by the Government and other national and international stakeholders, the disease persists in the country after periods of significant resurgence. Building on the Agricultural Innovation Systems framework, this paper reviews the role of the major stakeholders involved in controlling the disease in Uganda. Next, using household survey data, it analyzes economic costs and benefits of adopting an integrated BXW control package for the Ugandan smallholder farmers. After 2015, there has been a significant reduction in both public and private investments in BXW management, which may contribute to future disease resurgence. Our analysis reveals a high level of partial adoption of BXW recommended practices, and just a third of farmers adopting a full control package. This means significant economic losses for non-adopters, as indicated by our findings that households adopting the full package registered a net balance of US$65 per acre higher than non-adopters. We find that disproportionally large costs need to be borne at the beginning of the process, while the benefits are distributed over time, which may present a barrier to adoption by resource-poor smallholders