Impact of infestation by parasitic weeds on rice farmers' productivity and technical efficiency in sub-Saharan Africa

Rice production is crucial for food security and income generation in sub-Saharan Africa. However, productivity and technical efficiency levels in rice production systems are severely constrained by biotic constraints such as parasitic weeds. This paper assesses the impact of infestation by parasitic weeds on rice farmers’ technical efficiency and examines the potential role of managerial factors in improving technical efficiency. Household and field survey data were collected from rice farmers in Cote d’Ivoire and Benin in West Africa. A stochastic frontier production function was estimated, which allows for identifying the levels of exogenous factors that prevent farmers from improving technical efficiency levels. The results suggest that farmers cope with parasitic weeds through learning from experiencing infestations by parasitic weed. The results will assist national extension in designing segmented training programmes that are better tailored to rice farmers’ needs and preventing food security from being jeopardized by parasitic weeds

Reducing risks of human exposure to antimicrobial resistance originating from livestock supply chains

Antimicrobial resistance is one of the biggest health threats for both humans and animals. This justifies the need for a conceptual framework that provides an integrated assessment of the measures and strategies that can be applied within livestock supply chains to reduce the risks of human exposure to resistant pathogens. The aim of this study is therefore to provide a comprehensive supply chain-based conceptualisation that describes the main measures and strategies to Rev. Sci. Tech. Off. Int. Epiz., 39 (3) 2 2/26 reduce the risks of human exposure to resistant pathogens. The conceptual framework presented in this study makes a distinction between on-farm and beyond-farm decision-making contexts. The on-farm decision-making context focuses on the strategies that can reduce antimicrobial use. The beyond-farm decision-making context focuses on the prevalence of (pathogenic) microorganisms. The focus of this framework is on Western European food production systems. A panel consisting of Dutch policy makers on antimicrobial issues assessed various aspects of the framework, including correctness, completeness and consistency. It is concluded that the conceptual framework provides a sound theoretical basis for economic decision-support for policy makers to reduce the risks of human exposure to resistant pathogens originating from livestock supply chains

Extracorporeal Membrane Oxygenation in Patients With COVID-19: An International Multicenter Cohort Study

Background:To report and compare the characteristics and outcomes of COVID-19 patients on extracorporeal membrane oxygenation (ECMO) to non-COVID-19 acute respiratory distress syndrome (ARDS) patients on ECMO.Methods:We performed an international retrospective study of COVID-19 patients on ECMO from 13 intensive care units from March 1 to April 30, 2020. Demographic data, ECMO characteristics and clinical outcomes were collected. The primary outcome was to assess the complication rate and 28-day mortality; the secondary outcome was to compare patient and ECMO characteristics between COVID-19 patients on ECMO and non-COVID-19 related ARDS patients on ECMO (non-COVID-19; January 1, 2018 until July 31, 2019).Results:During the study period 71 COVID-19 patients received ECMO, mostly veno-venous, for a median duration of 13 days (IQR 7-20). ECMO was initiated at 5 days (IQR 3-10) following invasive mechanical ventilation. Median PaO2/FiO(2) ratio prior to initiation of ECMO was similar in COVID-19 patients (58 mmHg [IQR 46-76]) and non-COVID-19 patients (53 mmHg [IQR 44-66]), the latter consisting of 48 patients. 28-day mortality was 37% in COVID-19 patients and 27% in non-COVID-19 patients. However, Kaplan-Meier curves showed that after a 100-day follow-up this non-significant difference resolves. Non-surviving COVID-19 patients were more acidotic prior to initiation ECMO, had a shorter ECMO run and fewer received muscle paralysis compared to survivors.Conclusions:No significant differences in outcomes were found between COVID-19 patients on ECMO and non-COVID-19 ARDS patients on ECMO. This suggests that ECMO could be considered as a supportive therapy in case of refractory respiratory failure in COVID-19

Extracorporeal Membrane Oxygenation in Patients With COVID-19: An International Multicenter Cohort Study

Background:To report and compare the characteristics and outcomes of COVID-19 patients on extracorporeal membrane oxygenation (ECMO) to non-COVID-19 acute respiratory distress syndrome (ARDS) patients on ECMO.Methods:We performed an international retrospective study of COVID-19 patients on ECMO from 13 intensive care units from March 1 to April 30, 2020. Demographic data, ECMO characteristics and clinical outcomes were collected. The primary outcome was to assess the complication rate and 28-day mortality; the secondary outcome was to compare patient and ECMO characteristics between COVID-19 patients on ECMO and non-COVID-19 related ARDS patients on ECMO (non-COVID-19; January 1, 2018 until July 31, 2019).Results:During the study period 71 COVID-19 patients received ECMO, mostly veno-venous, for a median duration of 13 days (IQR 7-20). ECMO was initiated at 5 days (IQR 3-10) following invasive mechanical ventilation. Median PaO2/FiO(2) ratio prior to initiation of ECMO was similar in COVID-19 patients (58 mmHg [IQR 46-76]) and non-COVID-19 patients (53 mmHg [IQR 44-66]), the latter consisting of 48 patients. 28-day mortality was 37% in COVID-19 patients and 27% in non-COVID-19 patients. However, Kaplan-Meier curves showed that after a 100-day follow-up this non-significant difference resolves. Non-surviving COVID-19 patients were more acidotic prior to initiation ECMO, had a shorter ECMO run and fewer received muscle paralysis compared to survivors.Conclusions:No significant differences in outcomes were found between COVID-19 patients on ECMO and non-COVID-19 ARDS patients on ECMO. This suggests that ECMO could be considered as a supportive therapy in case of refractory respiratory failure in COVID-19

Cost-effectiveness in extracorporeal life support in critically ill adults in the Netherlands

Intensive Car

Conventional Versus Alternative Pig Production Assessed By Multicriteria Decision Analysis

Differentiated quality and respect for the environment seem to be linked implicitly, but there is no demonstration of this concept for pig production. Pig production takes on different forms. Conventional pig production occurs side by side with some productions of “differentiated qualities” that are encouraged by the European Union as well as by nations. At the same time, the EU and nations are imposing environmental limitations concerning, for instance, the management of nitrogen and respect for neighbours. Here, we compared environmental impacts of 3 types of production: conventional production, organic production and free-range production. We took into account the process performances of 21 farms in the Walloon Region, Belgium. We compared the global process performances by multicriteria analysis. A jury of 16 experts was questioned to assign a relative importance to the emissions of ammonia, greenhouse gases, molecular nitrogen, odour and nitrogen to effluents. We found that the highest weighting was assigned to the N content of effluents, then to odour diffusion, the emission of ammonia, the emissions of greenhouse gas and finally, the emission of molecular nitrogen got a weak weighting. Our results showed that the relative ordering obtained was: (1) free-range production, (2) organic production and (3) conventional production. Nevertheless, within every sample a significant variability in the performances was observed. The same method applied within every sample enabled the creation of sub-groups. After reordering, we found that the most effective farms of every system of production were classified as top of the class. Thus, our original approach showed that on average the production of differentiated qualities was more environmentally effective than the conventional production. However, the variability of the performances within a system of production was high and it was quite possible for the conventional farms to reach results comparable with those of the best organic and free-range operations

How do people respond to congestion mitigation policies? A multivariate probit model of the individual consideration of three travel-related strategy bundles

Multivariate probit, Congestion response, Travel behavior,

RBC Transfusion in Venovenous Extracorporeal Membrane Oxygenation: A Multicenter Cohort Study

OBJECTIVES: In the general critical care patient population, restrictive transfusion regimen of RBCs has been shown to be safe and is yet implemented worldwide. However, in patients on venovenous extracorporeal membrane oxygenation, guidelines suggest liberal thresholds, and a clear overview of RBC transfusion practice is lacking. This study aims to create an overview of RBC transfusion in venovenous extracorporeal membrane oxygenation. DESIGN: Mixed method approach combining multicenter retrospective study and survey. SETTING: Sixteen ICUs worldwide. PATIENTS: Patients receiving venovenous extracorporeal membrane oxygenation between January 2018 and July 2019. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The primary outcome was the proportion receiving RBC, the amount of RBC units given daily and in total. Furthermore, the course of hemoglobin over time during extracorporeal membrane oxygenation was assessed. Demographics, extracorporeal membrane oxygenation characteristics, and patient outcome were collected. Two-hundred eight patients received venovenous extracorporeal membrane oxygenation, 63% male, with an age of 55 years (45-62 yr), mainly for acute respiratory distress syndrome. Extracorporeal membrane oxygenation duration was 9 days (5-14 d). Prior to extracorporeal membrane oxygenation, hemoglobin was 10.8 g/dL (8.9-13.0 g/dL), decreasing to 8.7 g/dL (7.7-9.8 g/dL) during extracorporeal membrane oxygenation. Nadir hemoglobin was lower on days when a transfusion was administered (8.1 g/dL [7.4-9.3 g/dL]). A vast majority of 88% patients received greater than or equal to 1 RBC transfusion, consisting of 1.6 U (1.3-2.3 U) on transfusion days. This high transfusion occurrence rate was also found in nonbleeding patients (81%). Patients with a liberal transfusion threshold (hemoglobin > 9 g/dL) received more RBC in total per transfusion day and extracorporeal membrane oxygenation day. No differences in survival, hemorrhagic and thrombotic complication rates were found between different transfusion thresholds. Also, 28-day mortality was equal in transfused and nontransfused patients. CONCLUSIONS: Transfusion of RBC has a high occurrence rate in patients on venovenous extracorporeal membrane oxygenation, even in nonbleeding patients. There is a need for future studies to find optimal transfusion thresholds and triggers in patients on extracorporeal membrane oxygenation