Association of severe hypertension with pneumonia in elderly patients with acute ischemic stroke

Pneumonia is one of the most frequent complications in elderly patients with acute ischemic stroke. Although severe hypertension is often observed in the early phase of acute stroke, there are few studies of acute hypertension as a factor influencing the incidence of stroke-associated pneumonia (SAP) in elderly subjects with acute ischemic stroke. To assess the association of acute phase blood-pressure elevation with the incidence of SAP, we compared 10 elderly patients with acute ischemic stroke complicated with severe hypertension (⩾200/120 mm Hg) with 43 patients with moderate hypertension (160–199/100–119 mm Hg), as well as with 65 control normotensive or mildly hypertensive (<160/100 mm Hg) controls on admission. Data were collected on known risk factors, type of ischemic stroke and underlying chronic conditions. The significance of differences in risk factors was analyzed using univariate and multivariate comparisons of 38 SAP cases and others, 8 SAP death cases and others, and 28 patients with poor outcome associated with in-hospital death or artificial feeding at discharge and others. After adjustment for potential confounding factors, the relative risk estimates for SAP, SAP death and poor outcome were 2.83 (95% confidence interval 1.14–7.05), 5.20 (1.01–26.8) and 6.84 (1.32–35.4), respectively, for severe hypertension relative to normotensive or mildly hypertensive controls. We conclude that severe hypertension on admission is an independent predictive factor for SAP in elderly patients with acute ischemic stroke

Comparison of vegetation changes along grazing gradients with different numbers of livestock

The objective of this study was to clarify whether the changes in percent cover of plant functional types (i.e., life forms and growth forms) along a grazing gradient reflect the livestock number, which would reinforce the reliability of using a grazing gradient design and improve the management of rangeland. We selected two livestock camps that for many years have had different numbers of livestock, with approximately six times more sheep-equivalents at site 1 than at site 2. Vegetation was sampled in 10 quadrats on five transects along the grazing gradient at each site. In each quadrat, we recorded percent cover of each plant species. Our findings suggested that vegetation changes along the grazing gradient under different livestock numbers were characterized by changes in the cover of life forms: perennial species were replaced by annual species near the camps (10–50 m). However, we did not find growth form change that reflected the difference in the number of livestock

Improving Access to HIV and Sexual Reproductive Health Services for Key Populations along Nigeria’s Transport Corridors: The STOP Project.

Background: Despite high HIV prevalence amongst key populations in strategic travel corridors in Nigeria, there is still very low access to HIV and Sexual Reproductive Health (SRH) services. Targeting men-who-have-sex-with-men, females who sell sex, long distance truck drivers and those who live along the country’s transport corridors is vital for effective control of the HIV epidemic in Nigeria. Excellence and Friends Management Consult (EFMC) partnered with the Nigerian National Agency for the Control of AIDS (NACA) to improve access to HIV, SRH services educate and test for HIV, and offer referral/treatment to HIV-infected individuals. We report on the need, process and outcome of this project. Methods: The Strategic Travelers Outreach Program (STOP) took place between February and August 2016 in Sagamu/Ogere and Obollo-Afor travel corridors. Through community advocacy and outreach, house-to-house, door-to-door and community/office testing, key populations were provided with targeted HIV, SRH and referral services. Results: Over 50,000 people were contacted with HIV and SRH education/counselling. 19,275 (M: 10,965, 56.9%; F: 8,310, 43.1%) were tested with all receiving their results same day. General positivity rate was 1.3%: female (1.9%). Brothel-based female sex workers had higher positivity rate (3.2%). The study also revealed prostitutes did not use condoms with their husbands or long-term boyfriends and that knowledge of HIV was poor. Conclusion: The results highlight an urgent need to mobilize educational and healthcare resources to mitigate HIV transmission along these corridors. A socio-anthropological approach is required to alter long-held beliefs and change risk-seeking behavior

A water acquisition strategy may regulate the biomass and distribution of winter forage species in cold Asian rangeland

Aboveground biomass is often restricted by water availability; therefore, water acquisition strategies have important roles in determining biomass volume and distribution under arid conditions. In cold Asian rangelands, the large tussock grass Achnatherum splendens is the most important forage for maintaining livestock under severe winter conditions. However, A. splendens distribution is restricted to the middle of the slopes of ephemeral streams, making it difficult to manage winter foraging. To understand the mechanisms behind the specific distribution and maintenance of a large A. splendens biomass under arid conditions, we established four typical vegetative plots along a riverside slope with different A. splendens density levels and elevations: river bottom with no A. splendens , riverbank with a large A. splendens community, upper slope with an isolated A. splendens community, and flat plain with no A. splendens . We measured the soil pH and electric conductivity (EC ) of the plots and investigated the vertical biomass and root distribution of A. splendens . We also investigated the water source for the A. splendens communities using isotope techniques. The soil pH was not different among plots, while the soil EC was significantly higher in the river bottom because of salt accumulation. However, low soil EC levels were found under the A. splendens communities. In the ground below the A. splendens communities, plant stems were buried deeply. The belowground biomass and buried stem depths decreased at the sites of the isolated A. splendens communities in the upper slope. The aboveground biomass of A. splendens increased as the stem burial depths and, therefore, the adventitious roots depths increased. The water source of A. splendens was estimated to be at a depth of more than 30 cm. Thus, A. splendens prefers a habitat with a low level of soil salinity and a high level of water availability, which may increase with the sand burial depth because of the increasing accessibility of a substantial water source in the deeper soil layer. Sand burial may affect the water acquisition strategy and maintenance of large biomasses of tussock grass species that act as important winter forage in cold Asian rangelands