The impact of phosphorus on projected Sub-Saharan Africa food security futures

Sub-Saharan Africa must urgently improve food security. Phosphorus availability is one of the major barriers to this due to low historical agricultural use. Shared socioeconomic pathways (SSPs) indicate that only a sustainable (SSP1) or a fossil fuelled future (SSP5) can improve food security (in terms of price, availability, and risk of hunger) whilst nationalistic (SSP3) and unequal (SSP4) pathways worsen food security. Furthermore, sustainable SSP1 requires limited cropland expansion and low phosphorus use whilst the nationalistic SSP3 is as environmentally damaging as the fossil fuelled pathway. The middle of the road future (SSP2) maintains today’s inadequate food security levels only by using approximately 440 million tonnes of phosphate rock. Whilst this is within the current global reserve estimates the market price alone for a commonly used fertiliser (DAP) would cost US$ 130 ± 25 billion for agriculture over the period 2020 to 2050 and the farmgate price could be two to five times higher due to additional costs (e.g. transport, taxation etc.). Thus, to improve food security, economic growth within a sustainability context (SSP1) and the avoidance of nationalist ideology (SSP3) should be prioritised

Soil chemistry aspects of predicting future phosphorus requirements in Sub-Saharan Africa

Phosphorus (P) is a finite resource and critical to plant growth and therefore food security. Regional‐ and continental‐scale studies propose how much P would be required to feed the world by 2050. These indicate that sub‐Saharan Africa soils have the highest soil P deficit globally. However, the spatial heterogeneity of the P deficit caused by heterogeneous soil chemistry in the continental scale has never been addressed. We provide a combination of a broadly adopted P‐sorption model that is integrated into a highly influential, large‐scale soil phosphorus cycling model. As a result, we show significant differences between the model outputs in both the soil‐P concentrations and total P required to produce future crops for the same predicted scenarios. These results indicate the importance of soil chemistry for soil‐nutrient modelling and highlight that previous influential studies may have overestimated P required. This is particularly the case in Somalia where conventional modelling predicts twice as much P required to 2050 as our new proposed model. Plain language summary Improving food security in Sub‐Saharan Africa over the coming decades requires a dramatic increase in agricultural yields. Global yield increase has been driven by, amongst other factors, the widespread use of fertilisers including phosphorus. The use of fertilisers in Sub‐Saharan Africa is often prohibitively expensive and thus the most efficient use of phosphorus should be targeted. Soil chemistry largely controls phosphorus efficiency in agriculture, for example iron and aluminium which exist naturally in soil reduce the availability of phosphate to plants. Yet soil chemistry has not been included in several influential large‐scale modelling studies which estimate phosphorus requirements in Sub‐Saharan Africa to 2050. In this study we show that predictions of phosphorus requirement to feed the population of Sub‐Saharan Africa to 2050 can significantly change if soil chemistry is included (e.g. Somalia with up to 50% difference). Our findings are a new step towards making predictive decision‐making tool for phosphorus fertiliser management in Sub‐Saharan Africa considering the variability of soil chemistry

Impact of a pharmaceutical care programme on health-related quality of life among women with epilepsy: a randomised controlled trial (IPHIWWE study)

This paper was presented in part at the II Congreso Colombiano de Atención Farmacéutica, Medellín, Colombia, September 27, 2013.Background: Epilepsy is a complex chronic disorder which affects health-related quality of life (HRQOL), especially in women. Pharmaceutical care (PC) allows direct intervention between the pharmacist, the patient and the other healthcare team members to optimise treatments in order to reduce negative outcomes related to medication and contribute to improving HRQOL. The aim of the study was to establish the impact of the application of a pharmaceutical care programme on the HRQOL of women with epilepsy.Methods: This study is a pragmatic randomised controlled trial involving women with epilepsy (WWE) over 18 years of age. The intervention group (IG) received a pharmaceutical care programme consisting of medication review follow-up according to Dáder’s method, health education and therapeutic drug monitoring of anticonvulsants. The impact was assessed by changes in seizure frequency, in the self-administered questionnaires (the QOLIE-31, Liverpool AEP, CES-D, Haynes-Sackett test and Moriski-Green test) and between the first interview and the one at the end of six months of follow-up. A Student’s t-test was performed to compare the final QOLIE-31 score between groups and a paired Student’s t-test was used to determine the change in each group between the start and the end of follow-up.Results: One hundred eighty-two WWE entered the study and 144 (79.1%) completed it. The t-test for comparing the final QOLIE-31 scores between groups yielded a t = −2.166 and confidence interval (CI) (95%): −10.125; −0.4625, p-value =0.0319. The change (Δ) in the QOLIE-31 score for the IG was 12.45 points (p-value <0.001) and for the control group it was 2.61 (p-value =0.072). With 10.7 as the minimally important change we found a relative risk of 2.17 (CI: 1.37; 3.43) and a number needed to treat (NNT) of 3.5.Conclusions: The study demonstrated that the application of a pharmaceutical care programme significantly improves HRQOL in WWE. The NNT we found allows a recommendation to implement the PC programme for the additional benefit that would be obtained in patients’ HRQOL.This study was funded by a competitive investigator grant award from the Universidad Nacional de Colombia (Colombia) - Research Division of Bogotá (ref: 202010011419 Quipu Code)

Efficiency of phosphorus resource use in Africa as defined by soil chemistry and the impact on crop production

By 2050 the global population will be 9.7 billion, placing an unprecedented burden on the world’s soils to produce extremely high food yields. Phosphorus (P) is crucial to plant growth and mineral fertilizer is added to soil to maintain P concentrations, however this is a finite resource, thus efficient use is critical. Plants primarily uptake P from a labile (available) P pool and not from the stable solid phase; transfer between these pools limits bioavailability. Transfer is controlled by soil properties which vary between soil types. The dynamic phosphorus pool simulator (DPPS) quantifies crop production and soil P relationships by utilising the transfer. This approach effectively models crop uptake from soil inputs, but it does not quantify the efficiency use. This study incorporates geochemical techniques within DPPS to quantify the efficiency of fertilizer-P use based on soil chemistry

Visual Event-Related Potentials in Mild Cognitive Impairment and Alzheimer's Disease: A Literature Review

BACKGROUND: Cognitive deficits are correlated with increasing age and become more pronounced for people with mild cognitive impairment (MCI) and dementia caused by Alzheimer's disease (AD). Conventional methods to diagnose cognitive decline (i.e., neuropsychological testing and clinical judgment) can lead to false positives. Tools such as electroencephalography (EEG) offer more refined, objective measures that index electrophysiological changes associated with healthy aging, MCI, and AD. OBJECTIVE: We sought to review the EEG literature to determine whether visual event-related potentials (ERPs) can distinguish between healthy aging, MCI, and AD. METHOD: We searched Medline and PyscInfo for articles published between January 2005 and April 2018. Articles were considered for review if they included participants aged 60+ who were healthy older adults or people with MCI and AD, and examined at least one visually elicited ERP component. RESULTS: Our search revealed 880 records, of which 34 satisfied the inclusion criteria. All studies compared cognitive function between at least two of the three groups (healthy older adults, MCI, and AD). The most consistent finding

Ewing’s Sarcoma of Mandible: Practical Approach to a Challenging Case

As a rare entity, sarcomas of the head and neck are challenging cases. In this paper, we represent a unique case of Ewing sarcoma of mandible, serving as an example of multidisciplinary team importance in a developing country

Paneth cells promote angiogenesis and regulate portal hypertension in response to microbial signals.

BACKGROUND & AIMS Paneth cells (PCs) synthesize and secrete antimicrobial peptides that are key mediators of host-microbe interactions, establishing a balance between intestinal microflora and enteric pathogens. We observed that their number increases in experimental portal hypertension and aimed to investigate the mechanisms by which these cells can contribute to the regulation of portal pressure. METHODS We first treated Math1Lox/LoxVilcreERT2 mice with tamoxifen to induce the complete depletion of intestinal PCs. Subsequently, we performed partial portal vein or bile duct ligation. We then studied the effects of these interventions on hemodynamic parameters, proliferation of blood vessels and the expression of genes regulating angiogenesis. Intestinal organoids were cultured and exposed to different microbial products to study the composition of their secreted products (by proteomics) and their effects on the proliferation and tube formation of endothelial cells (ECs). In vivo confocal laser endomicroscopy was used to confirm the findings on blood vessel proliferation. RESULTS Portal hypertension was significantly attenuated in PC-depleted mice compared to control mice and was associated with a decrease in portosystemic shunts. Depletion of PCs also resulted in a significantly decreased density of blood vessels in the intestinal wall and mesentery. Furthermore, we observed reduced expression of intestinal genes regulating angiogenesis in Paneth cell depleted mice using arrays and next generation sequencing. Tube formation and wound healing responses were significantly decreased in ECs treated with conditioned media from PC-depleted intestinal organoids exposed to intestinal microbiota-derived products. Proteomic analysis of conditioned media in the presence of PCs revealed an increase in factors regulating angiogenesis and additional metabolic processes. In vivo endomicroscopy showed decreased vascular proliferation in the absence of PCs. CONCLUSIONS These results suggest that in response to intestinal flora and microbiota-derived factors, PCs secrete not only antimicrobial peptides, but also pro-angiogenic signaling molecules, thereby promoting intestinal and mesenteric angiogenesis and regulating portal hypertension. LAY SUMMARY Paneth cells are present in the lining of the small intestine. They prevent the passage of bacteria from the intestine into the blood circulation by secreting substances to fight bacteria. In this paper, we discovered that these substances not only act against bacteria, but also increase the quantity of blood vessels in the intestine and blood pressure in the portal vein. This is important, because high blood pressure in the portal vein may result in several complications which could be targeted with novel approaches