Preliminary economic assessment of water resources of the Pangani River Basin, Tanzania: economic values and incentives

River basinsEconomic analysisDomestic waterIrrigated farmingLivestockPolicyWater supplyFinancing

Preliminary economic assessment of water resources of the Pangani River Basin, Tanzania

River basin managementWater useWater allocationEconomic evaluationDomestic waterIrrigation waterLivestockWater power

THE ROLE OF ESTUARIES IN SOUTH AFRICAN FISHERIES: ECONOMIC IMPORTANCE AND MANAGEMENT IMPLICATIONS

Existing catch data for 129 of 255 functional estuaries on the South African coastline were reviewed and the relationships between fish catch and estuary size, type and biogeographical region analysed using simple and multivariate models. The best predictive models were obtained by analysing data separately for each biogeographical region. Estuary size alone explained >80&#37 of the variation in catch in the warm temperate region and >90&#37 of the variation in catch in the cool temperate and subtropical region. Further analysis of the two main estuary types, i.e. permanently open and temporarily open/closed estuaries revealed a steeper regression slope and therefore greater productivity for the permanently open systems. Estuary size (ha) and type (five) were used to explain catches within the warm temperate and subtropical regions using general linear models. The models were able to explain 82 and 98&#37 of the variance in catches for the two regions respectively, and both were significant (p &#60 0.001). These models were applied to estuary type and size data for all 246 estuaries in the two regions and a total catch of 1 840 tons per year was estimated. Including the cool temperate region the total estuarine catch in South Africa was estimated at 2 480 tons per year. In all, 50&#37 of the estuarine catch was attributed to commercial seine and gillnet fisheries, 46&#37 to recreational angling and 4&#37 to traditional trap and spear fisheries. Total catch value was R433 million per year, of which 99&#37 could be attributed to recreational angling. Estuarine contribution to the inshore marine fisheries was estimated at approximately R490 million per year, estuarydependent species constituting 83&#37of the catch of the recreational shore and commercial seine and gillnet fisheries and only 7&#37 of the catch of the recreational spearfishery and commercial and recreational boat fisheries. In 2002, the total value of estuarine and estuary-dependent fisheries was estimated to be R1.251 billion.Afr. J. mar. Sci. 25: 131–15

Technical guidelines for economic valuation of inland small-scale fisheries in developing countries

These ôTechnical Guidelines for Economic Valuation of Inland Small-scale Fisheries in Developing Countriesö are one of the outputs of the project on ôFood security and poverty alleviation through improved valuation and governance of river fisheries in Africaö. The guidelines draw upon research results and experience gained during the course of the project. The project was coordinated and implemented by the WorldFish Center and was carried out in cooperation with the National Agricultural Research Institutes (NARs) from the participating countries: the Nigeria Institute for Freshwater Fisheries Research, the Departments of Fishery of Niger, Malawi and Zambia, and the Cameroonian MinistΦre de lÆElevage, des PΩches et de lÆIndustrie Animale; and three advanced research institutes (ARIs): the Leibniz University of Hannover in Germany, the Institute for Sustainable Development and Aquatic Resources in UK, and the University of Cape Town in South Africa.Rural development, Sustainable development, Livelihoods, Economic analysis, Research, Artisanal fishing

Heart failure and cognitive impairment: Challenges and opportunities

As populations age, heart failure (HF) is becoming increasingly common, and in addition to a high burden of morbidity and mortality, HF has an enormous financial impact. Though disproportionately affected by HF, the elderly are less likely to receive recommended therapies, in part because clinical trials of HF therapy have ignored outcomes of importance to this population, including impaired cognitive function (ICF). HF is associated with ICF, manifested primarily as delirium in hospitalized patients, or as mild cognitive impairment or dementia in otherwise stable outpatients. This association is likely the result of shared risk factors, as well as perfusion and rheological abnormalities that occur in patients with HF. Evidence suggests that these abnormalities may be partially reversible with standard HF therapy. The clinical consequences of ICF in HF patients are significant. Clinicians should consider becoming familiar with screening instruments for ICF, including delirium and dementia, in order to identify patients at risk of nonadherence to HF therapy and related adverse consequences. Preliminary evidence suggests that optimal HF therapy in elderly patients may preserve or even improve cognitive function, though the impact on related outcomes remains to be determined

Book Reviews

Reviews of the following books: Mount Hope Cemetery of Bangor, Maine: The Complete History by Trudy Irene Scee; The Reverend Jacob Bailey, Maine Loyalist: For God, King, Country and for Self by James S. Leamon; The Barns of Maine: Our History, Our Stories by Don Perkins; Gateway to Vacationland: The Making of Portland, Maine by John F. Bauman; Maine: The Wilder Half of New England by William David Berry; The Cross of War: Christian Nationalism and U.S. Expansion in the Spanish-American War by Matthew McCullough; Omaha Beach: The Life and Military Service of a Penobscot Indian Elder by Charles Norman Shay

Outcomes Associated With Oral Anticoagulants Plus Antiplatelets in Patients With Newly Diagnosed Atrial Fibrillation.

Importance: Patients with nonvalvular atrial fibrillation at risk of stroke should receive oral anticoagulants (OAC). However, approximately 1 in 8 patients in the Global Anticoagulant Registry in the Field (GARFIELD-AF) registry are treated with antiplatelet (AP) drugs in addition to OAC, with or without documented vascular disease or other indications for AP therapy. Objective: To investigate baseline characteristics and outcomes of patients who were prescribed OAC plus AP therapy vs OAC alone. Design, Setting, and Participants: Prospective cohort study of the GARFIELD-AF registry, an international, multicenter, observational study of adults aged 18 years and older with recently diagnosed nonvalvular atrial fibrillation and at least 1 risk factor for stroke enrolled between March 2010 and August 2016. Data were extracted for analysis in October 2017 and analyzed from April 2018 to June 2019. Exposure: Participants received either OAC plus AP or OAC alone. Main Outcomes and Measures: Clinical outcomes were measured over 3 and 12 months. Outcomes were adjusted for 40 covariates, including baseline conditions and medications. Results: A total of 24 436 patients (13 438 [55.0%] male; median [interquartile range] age, 71 [64-78] years) were analyzed. Among eligible patients, those receiving OAC plus AP therapy had a greater prevalence of cardiovascular indications for AP, including acute coronary syndromes (22.0% vs 4.3%), coronary artery disease (39.1% vs 9.8%), and carotid occlusive disease (4.8% vs 2.0%). Over 1 year, patients treated with OAC plus AP had significantly higher incidence rates of stroke (adjusted hazard ratio [aHR], 1.49; 95% CI, 1.01-2.20) and any bleeding event (aHR, 1.41; 95% CI, 1.17-1.70) than those treated with OAC alone. These patients did not show evidence of reduced all-cause mortality (aHR, 1.22; 95% CI, 0.98-1.51). Risk of acute coronary syndrome was not reduced in patients taking OAC plus AP compared with OAC alone (aHR, 1.16; 95% CI, 0.70-1.94). Patients treated with OAC plus AP also had higher rates of all clinical outcomes than those treated with OAC alone over the short term (3 months). Conclusions and Relevance: This study challenges the practice of coprescribing OAC plus AP unless there is a clear indication for adding AP to OAC therapy in newly diagnosed atrial fibrillation

Molecular basis for effects of carcinogenic heavy metals on inducible gene expression.

Certain forms of the heavy metals arsenic and chromium are considered human carcinogens, although they are believed to act through very different mechanisms. Chromium(VI) is believed to act as a classic and mutagenic agent, and DNA/chromatin appears to be the principal target for its effects. In contrast, arsenic(III) is considered nongenotoxic, but is able to target specific cellular proteins, principally through sulfhydryl interactions. We had previously shown that various genotoxic chemical carcinogens, including chromium (VI), preferentially altered expression of several inducible genes but had little or no effect on constitutive gene expression. We were therefore interested in whether these carcinogenic heavy metals might target specific but distinct sites within cells, leading to alterations in gene expression that might contribute to the carcinogenic process. Arsenic(III) and chromium(VI) each significantly altered both basal and hormone-inducible expression of a model inducible gene, phosphoenolpyruvate carboxykinase (PEPCK), at nonovertly toxic doses in the chick embryo in vivo and rat hepatoma H411E cells in culture. We have recently developed two parallel cell culture approaches for examining the molecular basis for these effects. First, we are examining the effects of heavy metals on expression and activation of specific transcription factors known to be involved in regulation of susceptible inducible genes, and have recently observed significant but different effects of arsenic(III) and chromium(VI) on nuclear transcription factor binding. Second, we have developed cell lines with stably integrated PEPCK promoter-luciferase reporter gene constructs to examine effects of heavy metals on promoter function, and have also recently seen profound effects induced by both chromium(VI) and arsenic(III) in this system. These model systems should enable us to be able to identify the critical cis (DNA) and trans (protein) cellular targets of heavy metal exposure leading to alterations in expression of specific susceptible genes. It is anticipated that such information will provide valuable insight into the mechanistic basis for these effects as well as provide sensitive molecular biomarkers for evaluating human exposure

The association between patterns of atrial fibrillation, anticoagulation, and cardiovascular events.

AIMS: Guidelines do not recommend to take pattern of atrial fibrillation (AF) into account for the indication of anticoagulation (AC). We assessed AF pattern and the risk of cardiovascular events during 2-years of follow-up. METHODS AND RESULTS: We categorized AF as paroxysmal, persistent, or permanent in 29 181 patients enrolled (2010-15) in the Global Anticoagulant Registry In the FIELD of AF (GARFIELD-AF). We used multivariable Cox regression to assess the risks of stroke/systemic embolism (SE) and death across patterns of AF, and whether this changed with AC on outcomes. Atrial fibrillation pattern was paroxysmal in 14 344 (49.2%), persistent in 8064 (27.6%), and permanent 6773 (23.2%) patients. Median CHA2DS2-VASc, GARFIELD-AF, and HAS-BLED scores assessing the risk of stroke/SE and/or bleeding were similar across AF patterns, but the risk of death, as assessed by the GARFIELD-AF risk calculator, was higher in non-paroxysmal than in paroxysmal AF patterns. During 2-year follow-up, after adjustment, non-paroxysmal AF patterns were associated with significantly higher rates of all-cause death, stroke/SE, and new/worsening congestive heart failure (CHF) than paroxysmal AF in non-anticoagulated patients only. In anticoagulated patients, a significantly higher risk of death but not of stroke/SE and new/worsening CHF persisted in non-paroxysmal compared with paroxysmal AF patterns. CONCLUSION: In non-anticoagulated patients, non-paroxysmal AF patterns were associated with higher risks of stroke/SE, new/worsening HF and death than paroxysmal AF. In anticoagulated patients, the risk of stroke/SE and new/worsening HF was similar across all AF patterns. Thus AF pattern is no longer prognostic for stroke/SE when patients are treated with anticoagulants. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362