A strategic framework for improving food security in Arab countries

In 2007 and the first half of 2008, a sharp rise in agricultural commodity and food prices triggered grave concerns about food security, malnutrition and increased poverty. While the threat of a prolonged food-price shock receded in the second half of 2008, many factors underlying the price volatility are likely to persist, and will require careful management if future food-price shocks are to be avoided. This paper suggests three strategies that, together, could reduce vulnerability to price shocks: (1) strengthen safety nets, improve access to family planning services, and promote education; (2) enhance domestic food production and improve rural livelihoods through increased investment in research and development to increase productivity; and (3) reduce exposure to market volatility through more efficient supply chains and better use of financial instruments to hedge risk. The challenge of food security will require a global response, involving governments, international and regional funding and lending institutions, United Nations agencies, non-governmental organizations, civil society, and the private sector

Different techniques of surgical left atrial appendage closure and their efficacy. a systematic review

Background: Atrial fibrillation has been identified as an independent risk factor for thromboembolic events. Since 1948 different surgical techniques have described the feasibility and the rationale of left atrial surgical appendage closure. The aim of this systematic review is to evaluate the reported patency rates of different surgical techniques. Methods: This systematic review was conducted according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Two independent investigators searched the PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, and OVID & REG; (Wolters Kluwer, Alphen aan den Rijn, Netherlands) to identify relevant studies. Consecutively, a PICO (Population, Intervention, Comparison and Outcomes) strategy assessment of literature was performed to search eventual other relevant studies that may have been ignored. Results: A total of 42 studies were included in our analysis. The total number of patients who underwent surgical left atrial appendage closure was 5671, and in 61.2% an imaging follow up was performed, mostly with transesophageal echocardiographic evaluation. Success rate for the different techniques was: Clip deployment 98%; Lariat procedure 88%; Surgical amputation 91%; Endocardial suture 74.3%, Epicardial suture 65%; Left atrial appendage closure (LAAC) ligation 60.9%; Stapler technique with excision of left atrial appendage (LAA) 100%; Stapler without excision 70%. Conclusions: To date, data on surgical left atrial appendage closure are poor and not standardized, even if reported rates are acceptable and comparable to transcatheter procedures. If validated on large-scale non-retrospective and multicentric studies, these promising developments may offer a valuable alternative for patients with atrial fibrillation (AF) and ineligible for oral anticoagulation therapy

Embodied GHG emissions of buildings – The hidden challenge for effective climate change mitigation

Buildings are major sources of greenhouse gas (GHG) emissions and contributors to the climate crisis. To meet climate-change mitigation needs, one must go beyond operational energy consumption and related GHG emissions of buildings and address their full life cycle. This study investigates the global trends of GHG emissions arising across the life cycle of buildings by systematically compiling and analysing more than 650 life cycle assessment (LCA) case studies. The results, presented for different energy performance classes based on a final sample of 238 cases, show a clear reduction trend in life cycle GHG emissions due to improved operational energy performance. However, the analysis reveals an increase in relative and absolute contributions of so‐called ‘embodied’ GHG emissions, i.e., emissions arising from manufacturing and processing of building materials. While the average share of embodied GHG emissions from buildings following current energy performance regulations is approximately 20–25% of life cycle GHG emissions, this figure escalates to 45–50% for highly energy-efficient buildings and surpasses 90% in extreme cases. Furthermore, this study analyses GHG emissions at time of occurrence, highlighting the ‘carbon spike’ from building production. Relating the results to existing benchmarks for buildings’ GHG emissions in the Swiss SIA energy efficiency path shows that most cases exceed the target of 11.0 kgCO$^{2}$eq/m$^{2}$a. Considering global GHG reduction targets, these results emphasize the urgent need to reduce GHG emissions of buildings by optimizing both operational and embodied impacts. The analysis further confirmed a need for improving transparency and comparability of LCA studies

Embodied GHG emissions of buildings - Critical reflection of benchmark comparison and in-depth analysis of drivers

In the face of the unfolding climate crisis, the role and importance of reducing Greenhouse gas (GHG) emissions from the building sector is increasing. This study investigates the global trends of GHG emissions occurring across the life cycle of buildings by systematically compiling life cycle assessment (LCA) studies and analysing more than 650 building cases. Based on the data extracted from these LCA studies, the influence of features related to LCA methodology and building design is analysed. Results show that embodied GHG emissions, which mainly arise from manufacturing and processing of building materials, are dominating life cycle emissions of new, advanced buildings. Analysis of GHG emissions at the time of occurrence, shows the upfront \u27carbon spike\u27 and emphasises the need to address and reduce the GHG \u27investment\u27 for new buildings. Comparing the results with existing life cycle-related benchmarks, we find only a small number of cases meeting the benchmark. Critically reflecting on the benchmark comparison, an in-depth analysis reveals different reasons for cases achieving the benchmark. While one would expect that different building design strategies and material choices lead to high or low embodied GHG emissions, the results mainly correlate with decisions related to LCA methodology, i.e. the scope of the assessments. The results emphasize the strong need for transparency in the reporting of LCA studies as well as need for consistency when applying environmental benchmarks. Furthermore, the paper opens up the discussion on the potential of utilizing big data and machine learning for analysis and prediction of environmental performance of buildings

Randomized Trials of Retosiban Versus Placebo or Atosiban in Spontaneous Preterm Labor.

OBJECTIVE:  The aim of this study is to assess the efficacy and safety of retosiban in spontaneous preterm labor (sPTL). STUDY DESIGN:  Two multicenter, randomized, and double-blind trials compared retosiban with placebo and retosiban with atosiban in women with a singleton pregnancy and intact membranes in sPTL at 24 to 336/7 weeks' gestation. Coprimary endpoints in the placebo-controlled trial were time to delivery (TTD) or treatment failure (whichever occurred first) and neonatal composite morbidity and mortality. The primary endpoint of the atosiban comparator trial was TTD. RESULTS:  The trials were terminated early because of slow recruitment. The placebo-controlled trial enrolled 23 participants (February 2016-July 2017; 2.6% of target);the atosiban-comparator trial enrolled 97 (March 2015-August 2017; 29% of target). Baseline participant characteristics were similar between treatments. In the placebo-controlled trial, mean gestational ages at randomization were 30.8 (retosiban, n = 10) and 30.5 weeks (placebo, n = 13), and mean times to delivery/treatment failure were 18.9 days (retosiban) and 11.1 days (placebo). Two and four neonates in the retosiban and placebo groups, respectively, had ≥1 component of the neonatal composite endpoint. In the atosiban-comparator trial, mean gestational age at randomization was 31.5 weeks (for both retosiban, n = 47, and atosiban, n = 50), and adjusted mean TTDs were 32.51 days (retosiban) and 33.71 days (atosiban; p > 0.05). Adverse events were no more common with retosiban than placebo or atosiban. CONCLUSION:  Despite considerable efforts to conduct two adequate and well-controlled studies in patients with sPTL, both studies were unable to recruit effectively and consequently terminated prematurely. Key factors negatively affecting participation were patient and physician resistance to use of a placebo comparator, lack of investigator consensus on diagnostic criteria and acceptance of protocol procedures, and ethics committee decisions. Meaningful cooperation between pharmaceutical companies, regulatory authorities, and the obstetric community is essential for future development of drugs to treat sPTL

Polyisoprene Nanoparticles Prepared by Polymerization in Microemulsion

Batch polymerization of isoprene was carried out at 25∘C in a normal microemulsion stabilized with sodium dodecyl sulfate and initiated with the redox couple tert-butyl hydroperoxide/tetraethylene-pentamine. Characterization by transmission electronic microscopy showed that polyisoprene nanoparticles with number-average diameter close to 20 nm were obtained. The low molecular weights obtained, as determined by gel permeation chromatography, were probably due to chain scission as inferred from the oxidative ambient at which polymerization was carried out. Microstructure calculated from infrared spectroscopy data indicates that the obtained polyisoprene contains around 80% total 1,4 units, which is in accordance with its glass transition temperature (-60.8∘C) determined by differential scanning calorimetry

Establishment of diagnostic reference levels in cardiac computed tomography

The aim of this study was to determine diagnostic reference levels (DRLs) for cardiac computed tomography (CCT) in Jordan. Volume computed tomography dose index (CTDIvol) and dose–length product (DLP) were collected from 228 CCTs performed at seven Jordanian hospitals specialized in cardiac CT. DRLs for cardiac CT were defined at the 75th percentile of CTDIvol and DLP. CTDIvol and DLP were collected from 30 successive cardiac CT in each center except for one center (18 scans). The 75th percentile of the CTDIvol and the DLP of the centers calculated from mixed retrospective and prospective gated modes were 47.74 milligray (mGy) and 1035 mGy/cm, respectively. This study demonstrated wide dose variations among the surveyed hospitals for cardiac CT scans; there was a 5.1-fold difference between the highest and lowest median DLP with a range of 223.2–1146.7 mGy/cm. Differences were associated with variations in the mAs and kVp. This study confirmed large variability in CTDIvol and DLP for cardiac CT scans; variation was associated with acquisition protocols and highlights the need for dose optimization. DRLs are proposed for CCT; there remains substantial potential for optimization of cardiac CT examinations for adults in Jordan

Spectral Theory of Sparse Non-Hermitian Random Matrices

Sparse non-Hermitian random matrices arise in the study of disordered physical systems with asymmetric local interactions, and have applications ranging from neural networks to ecosystem dynamics. The spectral characteristics of these matrices provide crucial information on system stability and susceptibility, however, their study is greatly complicated by the twin challenges of a lack of symmetry and a sparse interaction structure. In this review we provide a concise and systematic introduction to the main tools and results in this field. We show how the spectra of sparse non-Hermitian matrices can be computed via an analogy with infinite dimensional operators obeying certain recursion relations. With reference to three illustrative examples --- adjacency matrices of regular oriented graphs, adjacency matrices of oriented Erd\H{o}s-R\'{e}nyi graphs, and adjacency matrices of weighted oriented Erd\H{o}s-R\'{e}nyi graphs --- we demonstrate the use of these methods to obtain both analytic and numerical results for the spectrum, the spectral distribution, the location of outlier eigenvalues, and the statistical properties of eigenvectors.Comment: 60 pages, 10 figure

Toll-like receptor signaling adapter proteins govern spread of neuropathic pain and recovery following nerve injury in male mice.

BackgroundSpinal Toll-like receptors (TLRs) and signaling intermediaries have been implicated in persistent pain states. We examined the roles of two major TLR signaling pathways and selected TLRs in a mononeuropathic allodynia.MethodsL5 spinal nerve ligation (SNL) was performed in wild type (WT, C57BL/6) male and female mice and in male Tlr2-/-Tlr3-/-, Tlr4-/-, Tlr5-/-, Myd88-/-, Triflps2, Myd88/Triflps2, Tnf-/-, and Ifnar1-/- mice. We also examined L5 ligation in Tlr4-/- female mice. We examined tactile allodynia using von Frey hairs. Iba-1 (microglia) and GFAP (astrocytes) were assessed in spinal cords by immunostaining. Tactile thresholds were analyzed by 1- and 2-way ANOVA and the Bonferroni post hoc test was used.ResultsIn WT male and female mice, SNL lesions resulted in a persistent and robust ipsilateral, tactile allodynia. In males with TLR2, 3, 4, or 5 deficiencies, tactile allodynia was significantly, but incompletely, reversed (approximately 50%) as compared to WT. This effect was not seen in female Tlr4-/- mice. Increases in ipsilateral lumbar Iba-1 and GFAP were seen in mutant and WT mice. Mice deficient in MyD88, or MyD88 and TRIF, showed an approximately 50% reduction in withdrawal thresholds and reduced ipsilateral Iba-1. In contrast, TRIF and interferon receptor null mice developed a profound ipsilateral and contralateral tactile allodynia. In lumbar sections of the spinal cords, we observed a greater increase in Iba-1 immunoreactivity in the TRIF-signaling deficient mice as compared to WT, but no significant increase in GFAP. Removing MyD88 abrogated the contralateral allodynia in the TRIF signaling-deficient mice. Conversely, IFNβ, released downstream to TRIF signaling, administered intrathecally, temporarily reversed the tactile allodynia.ConclusionsThese observations suggest a critical role for the MyD88 pathway in initiating neuropathic pain, but a distinct role for the TRIF pathway and interferon in regulating neuropathic pain phenotypes in male mice