The impact of El Niño-Southern Oscillation on the Canadian climate

The quasi-periodic El Niño -Southern Oscillation (ENSO) phenomenon in the tropical Pacific Ocean produces the largest interannual variation in the cold season climate of Canada. The diabatic heating in the eastern tropical Pacific, associated with the warm phase of ENSO (El Niño), triggers Rossby waves which in turn gives rise to the Pacific-North American teleconnection (PNA) over the North American sector. The strongest cell of the PNA pattern lies over western Canada. In most of southern Canada, mean winter temperature distribution is shifted towards warmer values, and precipitation is below normal. The presence of El Niño provides the best opportunity to make skillful long-range winter forecast for Canada. A strong El Niño event, while bringing respite from the otherwise cold winter in Canada, can be expected to cost the Canadian economy two to five billion dollars

Storage stability of potato variety Lady Rosetta under comparative temperature regimes

Potatoes are usually stored under low temperatures for sprout prevention and to ensure their continuous supply. Low temperature sweetening in potato is the major temperature related disorder being faced by the growers and is also known to be associated with variety specific storage temperature. The present study aimed at identifying the appropriate storage temperature for the premium potato variety Lady Rosetta with special reference to the changes in its quality attributes, that is weight loss, total sugars, starch, ascorbic acids, total phenolic contents, radical scavenging activity, enzymatic activities and potato chip color. The selected potato variety was stored under different temperature (5, 15 and 25oC) regimes to identify appropriate storage temperature. Our results showed significant variations in the tested quality attributes in response to different storage temperatures. Storage at 5oC maintained tuber dormancy up to 126 days, however, found associated with increased sugar accumulation (2.32 g/100 g), rapid starch depletion (13.25 g/100 g) and poor post processing performance (L-value, 52.00). In contrast, potato storage at 15oC retained lower sugar contents (1.33 g/100g) and superior chip color (L-value, 59.33) till the end of storage. However, they were found associated with the increased polyphenol oxidase (38.47 U/g f.w) and peroxidase (15.25 U/100 g f.w) activities as compare to those potatoes stored at 5oC during the same storage period. Storage life of potato tubers at 25oC was significantly reduced due to dormancy break on 84th day and subsequent starch degradation (15.29 g/100 g) increased sugar accumulation (1.32 g/100 g) and increased polyphenol oxidase (79.89 U/g f.w) and peroxidase activities (40.69 U/100 g f.w). Our results showed that potato variety Lady Rosetta is cold sensitive and requires specific temperature for prolonged storage and best post processing performance

Technical Change, Efficiency, and Capital-labour Substitution in Pakistan's Large-scale Manufacturing Sector

Pakistan's manufacturing sector is characterised by relatively high capital intensity and the level of absorption of labour in industry is low. This paper estimates the elasticities of substitution in Pakistan's large-scale manufacturing sector to determine the potential for switching to relatively more labour-intensive production techniques. Data for the years 1960 to 1986 have been used and a total of seventeen industry groups have been analysed. This involved the aggregation of data from the Census of Manufacturing Industries (CMI). Industry groups were aggregated while keeping in mind the structural and economic similarities within the groups. The functional form used for the estimation is the CES production function and direct estimation procedures have been used. Industries in Pakistan are generally considered to be characterised by low substitution between capital and labour, near-constant returns to scale, high capital intensity, and low exogenous technical change. The results of this study bear this out with a few exceptions and the policy implications are interesting. The level of capital intensity in the manufacturing sector is not commensurate with the relative factor endowments, and there is a need to redirect the industries towards greater use of labour-intensive technology. In the short term, there appears to be little scope for altering the capital-labour ratios in the manufacturing sector. In the long run, however, measures aimed at the gradual replacement of capital with labour in production techniques may come to fruition.

Strengthening integration of chronic care in Africa: protocol for the qualitative process evaluation of integrated HIV, diabetes and hypertension care in a cluster randomised controlled trial in Tanzania and Uganda

Introduction: In sub-Saharan Africa, the burden of non-communicable diseases (NCDs), particularly diabetes mellitus (DM) and hypertension, has increased rapidly in recent years, although HIV infection remains a leading cause of death among young-middle-aged adults. Health service coverage for NCDs remains very low in contrast to HIV, despite the increasing prevalence of comorbidity of NCDs with HIV. There is an urgent need to expand healthcare capacity to provide integrated services to address these chronic conditions. Methods and analysis: This protocol describes procedures for a qualitative process evaluation of INTE-AFRICA, a cluster randomised trial comparing integrated health service provision for HIV infection, DM and hypertension, to the current stand-alone vertical care. Interviews, focus group discussions and observations of consultations and other care processes in two clinics (in Tanzania, Uganda) will be used to explore the experiences of stakeholders. These stakeholders will include health service users, policy-makers, healthcare providers, community leaders and members, researchers, non-governmental and international organisations. The exploration will be carried out during the implementation of the project, alongside an understanding of the impact of broader structural and contextual factors. Ethics and dissemination: Ethical approval was granted by the Liverpool School of Tropical Medicine (UK), the National Institute of Medical Research (Tanzania) and TASO Research Ethics Committee (Uganda) in 2020. The evaluation will provide the opportunity to document the implementation of integration over several timepoints (6, 12 and 18 months) and refine integrated service provision prior to scale up. This synergistic approach to evaluate, understand and respond will support service integration and inform monitoring, policy and practice development efforts to involve and educate communities in Tanzania and Uganda. It will create a model of care and a platform of good practices and lessons learnt for other countries implementing integrated and decentralised community health services

Community-based interventions to improve and sustain antiretroviral therapy adherence, retention in HIV care and clinical outcomes in low- and middle-income countries for achieving the UNAIDS 90-90-90 targets

Little is known about the effect of community versus health facility-based interventions to improve and sustain antiretroviral therapy (ART) adherence, virologic suppression, and retention in care among HIV-infected individuals in low- and middle-income countries (LMICs). We systematically searched four electronic databases for all available randomized controlled trials (RCTs) and comparative cohort studies in LMICs comparing community versus health facility-based interventions. Relative risks (RRs) for pre-defined adherence, treatment engagement (linkage and retention in care), and relevant clinical outcomes were pooled using random effect models. Eleven cohort studies and eleven RCTs (N = 97,657) were included. Meta-analysis of the included RCTs comparing community- versus health facility-based interventions found comparable outcomes in terms of ART adherence (RR = 1.02, 95 % CI 0.99 to 1.04), virologic suppression (RR = 1.00, 95 % CI 0.98 to 1.03), and all-cause mortality (RR = 0.93, 95 % CI 0.73 to 1.18). The result of pooled analysis from the RCTs (RR = 1.03, 95 % CI 1.01 to 1.06) and cohort studies (RR  = 1.09, 95 % CI 1.03 to 1.15) found that participants assigned to community-based interventions had statistically significantly higher rates of treatment engagement. Two studies found community-based ART delivery model either cost-saving or cost-effective. Community- versus facility-based models of ART delivery resulted in at least comparable outcomes for clinically stable HIV-infected patients on treatment in LMICs and are likely to be cost-effective

Relationships Between Pacific and Atlantic Ocean Sea Surface Temperatures and U.S. Streamflow Variability

An evaluation of Pacific and Atlantic Ocean sea surface temperatures (SSTs) and continental U.S. streamflow was performed to identify coupled regions of SST and continental U.S. streamflow variability. Both SSTs and streamflow displayed temporal variability when applying the singular value decomposition (SVD) statistical method. Initially, an extended temporal evaluation was performed using the entire period of record (i.e., all years from 1951 to 2002). This was followed by an interdecadal-temporal evaluation for the Pacific (Atlantic) Ocean based on the phase of the Pacific Decadal Oscillation (PDO) (Atlantic Multidecadal Oscillation (AMO)). Finally, an extended temporal evaluation was performed using detrended SST and streamflow data. A lead time approach was assessed in which the previous year\u27s spring-summer season Pacific Ocean (Atlantic Ocean) SSTs were evaluated with the current water year continental U.S. streamflow. During the cold phase of the PDO, Pacific Ocean SSTs influenced streamflow regions (southeast, northwest, southwest, and northeast United States) most often associated with El Niño–Southern Oscillation (ENSO), while during the warm phase of the PDO, Pacific Ocean SSTs influenced non-ENSO streamflow regions (Upper Colorado River basin and middle Atlantic United States). ENSO and the PDO were identified by the Pacific Ocean SST SVD first temporal expansion series as climatic influences for the PDO cold phase, PDO warm phase, and the all years analysis. Additionally, the phase of the AMO resulted in continental U.S. streamflow variability when evaluating Atlantic Ocean SSTs. During the cold phase of the AMO, Atlantic Ocean SSTs influenced middle Atlantic and central U.S. streamflow, while during the warm phase of the AMO, Atlantic Ocean SSTs influenced upper Mississippi River basin, peninsular Florida, and northwest U.S. streamflow. The AMO signal was identified in the Atlantic Ocean SST SVD first temporal expansion series. Applying SVD, first temporal expansions series were developed for Pacific and Atlantic Ocean SSTs and continental U.S. streamflow. The first temporal expansion series of SSTs and streamflow were strongly correlated, which could result in improved streamflow predictability

Sex and area differences in the association between adiposity and lipid profile in Malawi.

BACKGROUND: Evidence from high-income countries shows that higher adiposity results in an adverse lipid profile, but it is unclear whether this association is similar in Sub-Saharan African (SSA) populations. This study aimed to assess the association between total and central adiposity measures and lipid profile in Malawi, exploring differences by sex and area of residence (rural/urban). METHODS: In this cross-sectional study, data from 12 096 rural and 12 847 urban Malawian residents were used. The associations of body mass index (BMI) and waist to hip ratio (WHR) with fasting lipids (total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C) and triglycerides (TG)) were assessed by area and sex. RESULTS: After adjusting for potential confounders, higher BMI and WHR were linearly associated with increased TC, LDL-C and TG and reduced HDL-C. BMI was more strongly related to fasting lipids than was WHR. The associations of adiposity with adverse lipid profile were stronger in rural compared with urban residents. For instance, one SD increase in BMI was associated with 0.23 mmol/L (95% CI 0.19 to 0.26) increase in TC in rural women and 0.13 mmol/L (95% CI 0.11 to 0.15) in urban women. Sex differences in the associations between adiposity and lipids were less evident. CONCLUSIONS: The consistent associations observed of higher adiposity with adverse lipid profiles in men and women living in rural and urban areas of Malawi highlight the emerging adverse cardio-metabolic epidemic in this poor population. Our findings underline the potential utility of BMI in estimating cardiovascular risk and highlight the need for greater investment to understand the long-term health outcomes of obesity and adverse lipid profiles and the extent to which lifestyle changes and treatments effectively prevent and modify adverse cardio-metabolic outcomes

A comparison of the associations between adiposity and lipids in Malawi and the United Kingdom.

BACKGROUND: The prevalence of excess adiposity, as measured by elevated body mass index (BMI) and waist-hip ratio (WHR), is increasing in sub-Saharan African (SSA) populations. This could add a considerable burden of cardiovascular and metabolic diseases for which these populations are currently ill-prepared. Evidence from white, European origin populations shows that higher adiposity leads to an adverse lipid profile; whether these associations are similar in all SSA populations requires further exploration. This study compared the association of BMI and WHR with lipid profile in urban Malawi with a contemporary cohort with contrasting socioeconomic, demographic, and ethnic characteristics in the United Kingdom (UK). METHODS: We used data from 1248 adolescents (mean 18.7 years) and 2277 Malawian adults (mean 49.8 years), all urban-dwelling, and from 3201 adolescents (mean 17.8 years) and 6323 adults (mean 49.7 years) resident in the UK. Adiposity measures and fasting lipids were assessed in both settings, and the associations of BMI and WHR with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) were assessed by sex and age groups in both studies. RESULTS: Malawian female adults were more adipose and had more adverse lipid profiles than their UK counterparts. In contrast, Malawian adolescent and adult males were leaner and had more favourable lipid profiles than in the UK. Higher BMI and WHR were associated with increased TC, LDL-C and TG and reduced HDL-C in both settings. The magnitude of the associations of BMI and WHR with lipids was mostly similar or slightly weaker in the Malawian compared with the UK cohort in both adolescents and adults. One exception was the stronger association between increasing adiposity and elevated TC and LDL-C in Malawian compared to UK men. CONCLUSIONS: Malawian adult women have greater adiposity and more adverse lipid profiles compared with their UK counterparts. Similar associations of adiposity with adverse lipid profiles were observed for Malawian and UK adults in most age and sex groups studied. Sustained efforts are urgently needed to address the excess adiposity and adverse lipid profiles in Malawi to mitigate a future epidemic of cardio-metabolic disease among the poorest populations