Langzeit-Systemvergleiche in Kenia und Indien: Konventionelle und biologische Erträge aus dem ersten Umstellungsjahr

Organic agriculture is more and more perceived as a promising approach to increase food security in developing countries. However, only few attempts have been made so far to assess agronomic and economic performance of organic agriculture in these^regions in a systematic way. This article reports the first year’s results of two long-term farming systems comparison field trials in Kenya and India. In sub-humid Central Kenya, on a high potential site in Meru South District (Chuka), there were no differences between yields of conventional and organic systems for the first maize and brassica crops. In contrast, organic yields were 14 to 60% lower than conventional yields on a trial site in a medium potential zone in Maragua District (Thika). It is assumed that the organic crops in Chuka could benefit from N and P mobilisation from the soil. In Thika, where N and P were less available, the crop depended on the easily soluble nutrients applied in the conventional treatments. In the semi-arid cotton belt of^Central India, biodynamic, organic, conventional and genetically modified (GM) cotton are compared. Soya and wheat are also part of the crop rotation under study. Biodynamic and organic cotton and wheat yields were 30% lower than conventional and GM yields. Soya yields did not differ between the treatments. It is suggested that yield in organic farming systems in conversion depends on initial inherent soil fertility and crop

Business opportunities analysis using GIS: the retail distribution sector

[EN] The retail distribution sector is facing a difficult time as the current landscape is characterized by ever-increasing competition. In these conditions, the search for an appropriate location strategy has the potential to become a differentiating and competitive factor. Although, in theory, an increasing level of importance is placed on geography because of its key role in understanding the success of a business, this is not the case in practice. For this reason, the process outlined in this paper has been specifically developed to detect new business locations. The methodology consists of a range of analyzes with Geographical Information Systems (GISs) from a marketing point of view. This new approach is called geomarketing. First, geodemand and geocompetition are located on two separate digital maps using spatial and non-spatial databases. Second, a third map is obtained by matching this information with the demand not dealt with properly by the current commercial offer. Third, the Kernel density allows users to visualize results, thus facilitating decision-making by managers, regardless of their professional background. The advantage of this methodology is the capacity of GIS to handle large amounts of information, both spatial and non-spatial. A practical application is performed in Murcia (Spain) with 100 supermarkets and data at a city block level, which is the highest possible level of detail. This detection process can be used in any commercial distribution company, so it can be generalized and considered a global solution for retailers.Roig Tierno, H.; Baviera-Puig, A.; Buitrago Vera, JM. (2013). Business opportunities analysis using GIS: the retail distribution sector. Global Business Perspectives. 1(3):226-238. doi:10.1007/s40196-013-0015-6S22623813Alarcón, S. (2011). The trade credit in the Spanish agrofood industry. Mediterranean Journal of Economics, Agriculture and Environment (New Medit), 10(2), 51–57.Alcaide, J. 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Changing methods of location planning for retail companies. GeoJournal, 45, 289–298.Clarkson, R. M., Clarke-Hill, C. M., & Robinson, T. (1996). UK supermarket location assessment. International Journal of Retail and Distribution Management, 24(6), 22–33.Davis, P. (2006). Spatial competition in retail markets: Movie theaters. The RAND Journal of Economics, 37(4), 964–982.Ghosh, A., & McLafferty, S. L. (1982). Locating stores in uncertain environments: A scenario planning approach. Journal of Retailing, 58(4), 5–22.Härdle, W. (1991). Smoothing techniques with implementation in S. Nueva York, NY: Springer.Harris, B., & Batty, M. (1993). Locational models, geographical information, and planning support systems. Journal of Planning Education and Research, 12, 184–198.Hernandez, T. (2007). Enhancing retail location decision support: The development and application of geovisualization. Journal of Retailing and Consumer Services, 14, 249–258.Hernandez, T., & Bennison, D. (2000). The art and science of retail location decisions. International Journal of Retail and Distribution Management, 28(8), 357–367.Huff, D. (1963). Defining and estimating a trade area. Journal of Marketing, 28, 34–38.Instituto Nacional de Estadística (INE). (2011). Padrón de habitantes 2011. http://www.ine.es . Accessed 9 Oct 2012.Kelly, J. P., Freeman, D. C., & Emlen, J. M. (1993). Competitive impact model for site selection: The impact of competition, sales generators and own store cannibalization. The International Review of Retail, Distribution and Consumer Research, 3, 237–259.Latour, P., & Le Floc’h, J. (2001). Géomarketing: Principes, méthodes et applications. París: Éditions d’Organisation.Mendes, A. B., & Themido, I. H. (2004). Multi-outlet retail site location assessment. International Transactions in Operational Research, 11, 1–18.Moreno, A. (1991). Modelización cartográfica de densidades mediante estimadores Kernel. Treballs de la Societat Catalana de Geografia, 6(30), 155–170.Moreno, A. (2007). Obtención de capas raster de densidad. In A. Moreno (Coord.), Sistemas y Análisis de la información Geográfica. Manual de autoaprendizaje con ArcGIS (pp. 685–691). Madrid: Editorial RA-MA.Murad, A. A. (2003). Creating a GIS application for retail centers in Jeddah City. International Journal of Applied Earth Observation and Geoinformation, 4, 329–338.Murad, A. A. (2007). Using GIS for retail planning in Jeddah City. American Journal of Applied Sciences, 4(10), 820–826.Musyoka, S. M., Mutyauvyu, S. M., Kiema, J. B. K., Karanja, F. N., & Siriba, D. N. (2007). Market segmentation using geographic information systems (GIS). A case study of the soft drink industry in Kenya. Marketing Intelligence and Planning, 25(6), 632–642.Nielsen Database. (2012). Retailers Database. http://www.nielsen.com/global/en.html . Accessed 12 Oct 2012.Ozimec, A. M., Natter, M., & Reutterer, T. (2010). 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Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Cross-sectional study of drivers of animal-source food consumption in low-income urban areas of Nairobi, Kenya

Background Malnutrition, including undernutrition and micronutrient deficiencies is a chronic problem in most developing countries. Animal-source foods (ASFs) provide essential sources of proteins and micronutrients, yet little is known about ASF consumption patterns or household preferences towards animal-source products among low-income populations. This is particularly critical for malnourished children for whom even small increases in consumption could help improve nutrition and health outcomes. This study analysed both the demand as well as the drivers and barriers for ASF consumption among households in two low-income areas in Nairobi, Kenya. Methods Data on ASF expenditures and quantities purchased in the previous week, and reasons for consuming or not consuming ASFs were collected in a cross-sectional study from 205 randomly selected households in Korogocho and Dagoretti settlements. Self-reported reasons for consuming or not-consuming ASFs were described. Demand for ASFs was estimated using the Almost Ideal Demand System to provide measures of demand elasticity for changes in food prices and expenditures. Results On average households purchased 48 grams of ASFs, including fresh milk, per week per household member. Expenditure on ASFs counted for 38% (520 Kenyan Schillings) of the overall food expenditure of which, on average, 48% was spent on fresh milk. Price was the most commonly self-reported barrier for consumption, while taste was reported as the main driver for consumption. The perceived nutritional value was an important driver for consuming more commonly purchased ASFs (beef, eggs, fish and milk). For less commonly purchased ASFs (pork, sausages, sheep and goat meat, offal) taste, access and tradition were given as main reasons for not consuming. Estimated demand elasticities indicated that increases in total food expenditure would lead to greatest increase in the demand for beef meat. Price reductions would increase the demand relatively more for fish, other meats and dairy. Conclusions For most ASFs better affordability would be a clear driver to increase the consumption. However, to increase the variety and quantity of ASFs eaten, other policies targeting improvements in physical access, food safety and consumer education on nutritional values and cooking methods should be considered

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Anti-HIV-1 integrase potency of methylgallate from Alchornea cordifolia using in vitro and in silico approaches:

According to the 2018 report of the United Nations Programme on HIV/AIDS (UNAIDS), acquired immune deficiency syndrome (AIDS), a disease caused by the human immunodeficiency virus (HIV), remains a significant public health problem. The non-existence of a cure or effective vaccine for the disease and the associated emergence of resistant viral strains imply an urgent need for the discovery of novel anti-HIV drug candidates. The current study aimed to identify potential anti-retroviral compounds from Alchornea cordifolia

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Siah2-deficient mice show impaired skin wound repair

Hypoxia is associated with the dermal wound healing process and hypoxia signaling is presumed to be crucial for normal wound repair. The Siah2 ubiquitin ligase controls the abundance of hypoxia-inducible factor-1 alpha, and loss of Siah2 results in destabilization of hypoxia-inducible factor-1 alpha under hypoxia. Utilizing Siah2-/- mice we demonstrate that cutaneous wound healing is impaired in these mice.Wounds in Siah2-/- mice heal slower and are associated with delayed induction of myofibroblast infiltration and reduced collagen deposition. This coincides with delayed angiogenesis and reduced macrophage infiltration into the wounds of Siah2-/- mice. We furthermore demonstrate that primary Siah2-/- dermal fibroblasts have reduced migratory capacities and produce less collagen than wild-type fibroblasts. Additionally, Siah2-/- fibroblasts showed conserved responses to transforming growth factor-b at the receptor level (pSmad 2C activation) but reduced responses downstream. Together, our data show, for the first time, that Siah2 is involved as a positive regulator in the wound healing response. Understanding the role of hypoxia signaling in tissue repair and fibrosis and interference with the hypoxia signaling pathway via regulation of Siah2 may provide new targets for clinical regulation of fibrosis and scarring