Conservation agriculture and climate change

This chapter review aims at developing a clear understanding of the impacts and benefits of conservation agriculture (CA) with respect to climate change, and examining if there are any misleading findings at present in the scientific literature. Most of the world’s agricultural soils have been depleted of organic matter and soil health over the years under tillage-based agriculture (TA), compared with their state under natural vegetation. This degradation process can be reversed and this chapter identifies the conditions that can lead to increase in soil organic matter content and improvement in soil health under CA practices which involve minimum soil disturbance, maintenance of soil cover, and crop diversity. The chapter also discusses the need to refer to specific carbon pools when addressing carbon sequestration, as each carbon category has a different turnover rate. With respect to greenhouse gas emissions, sustainable agricultural systems based on CA principles are described which result in lower emissions from farm operations as well as from machinery manufacturing processes, and that also help to reduce fertilizer use. This chapter describes that terrestrial carbon sequestration efficiently be achieved by changing the management of agricultural lands from high soil disturbance, as TA practices to low disturbance, as CA practices, and by adopting effective nitrogen management practices to provide a positive nitrogen balance for carbon sequestration. However, full advantages of CA in terms of carbon sequestration can usually be observed only in the medium to longer term when CA practices and associated carbon sequestration processes in the soil are well established

Ezetimibe added to statin therapy after acute coronary syndromes

BACKGROUND: Statin therapy reduces low-density lipoprotein (LDL) cholesterol levels and the risk of cardiovascular events, but whether the addition of ezetimibe, a nonstatin drug that reduces intestinal cholesterol absorption, can reduce the rate of cardiovascular events further is not known. METHODS: We conducted a double-blind, randomized trial involving 18,144 patients who had been hospitalized for an acute coronary syndrome within the preceding 10 days and had LDL cholesterol levels of 50 to 100 mg per deciliter (1.3 to 2.6 mmol per liter) if they were receiving lipid-lowering therapy or 50 to 125 mg per deciliter (1.3 to 3.2 mmol per liter) if they were not receiving lipid-lowering therapy. The combination of simvastatin (40 mg) and ezetimibe (10 mg) (simvastatin-ezetimibe) was compared with simvastatin (40 mg) and placebo (simvastatin monotherapy). The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary revascularization ( 6530 days after randomization), or nonfatal stroke. The median follow-up was 6 years. RESULTS: The median time-weighted average LDL cholesterol level during the study was 53.7 mg per deciliter (1.4 mmol per liter) in the simvastatin-ezetimibe group, as compared with 69.5 mg per deciliter (1.8 mmol per liter) in the simvastatin-monotherapy group (P<0.001). The Kaplan-Meier event rate for the primary end point at 7 years was 32.7% in the simvastatin-ezetimibe group, as compared with 34.7% in the simvastatin-monotherapy group (absolute risk difference, 2.0 percentage points; hazard ratio, 0.936; 95% confidence interval, 0.89 to 0.99; P = 0.016). Rates of pre-specified muscle, gallbladder, and hepatic adverse effects and cancer were similar in the two groups. CONCLUSIONS: When added to statin therapy, ezetimibe resulted in incremental lowering of LDL cholesterol levels and improved cardiovascular outcomes. Moreover, lowering LDL cholesterol to levels below previous targets provided additional benefit