Advancing human nutrition without degrading land resources through modeling cropping systems in the Ethiopian highlands

Food shortage in sub-Saharan Africa is generally considered a function of limited access to food, with little thought to nutritional quality. Analyzing household production of nutrients across farming systems could be valuable in guiding the improvement of those systems. An optimization model was employed to analyze the scenario of human nutrition and cropland allocation in enset (Enset ventricosum)/root crop-based and cereal-based systems of the Ethiopian Highlands. The type and amount of nutrients produced in each system were analyzed, and an optimization model was used to analyze which cropping strategies might improve the nutritional quality of the household using existing resources. Both production systems were in food deficit, in terms of quantity and quality of nutrients, except for iron. The energy supply of resource-poor households in the enset/root crop-based system was only 75% of the recommended daily dietary allowance (RDA) of the World Health Organization (WHO), whereas resource-rich farmers were able to meet their energy, protein, zinc, and thiamine demands. Extremely high deficiency was found in zinc, calcium, vitamin A, and vitamin C, which provided only 26.5%, 34%, 1.78%, and 12%, of the RDA, respectively. The RDA could be satisfied if the land area occupied by enset, kale, and beans were expanded by about 20%, 10%, and 40%, respectively, at the expense of maize and sweet potato. The cereal-based system also had critical nutrient deficits in calcium, vitamin A, and vitamin C, which provided 30%, 2.5%, and 2% of the RDA, respectively. In the cereal system, the RDA could be fully satisfied by reducing cropland allocated to barley by about 50% and expanding the land area occupied by faba beans, kale, and enset. A shift from the cereal/root crop-dominated system to a perennial-enset dominated system would decrease soil erosion by improving the crop factor by about 45%. This shift would also have a very strong positive impact on soil fertility management. However, any policy suggestions for change in cropland allocation should be done through negotiations with households, communities, and district stakeholders

Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality

Background and purpose: Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. Conclusions: During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT

Global impact of COVID-19 on stroke care and IV thrombolysis

Objective To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. Methods We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. Results There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] -11.7 to -11.3, p < 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI -13.8 to -12.7, p < 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI -13.7 to -10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2-9.8, p < 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. Conclusions The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months.Paroxysmal Cerebral Disorder

Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality.

BACKGROUND AND PURPOSE: Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. METHODS: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). RESULTS: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. CONCLUSIONS: During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT

Biomembrane stabilization and antiulcerogenic properties of aqueous leaf extract of Gossypium barbadense L. (Malvaceae)

Gossypium spp. belong to a class of botanicals with global therapeutic applications against a number of disorders including ulcers. This study evaluated the membrane stabilization and detoxification potential of aqueous leaf extract of Gossypium barbadense L. (Malvaceae) in indomethacin-induced oxidative gastric ulceration in Wistar rats. The ulcerated rats were orally pretreated with the extract and esomeprazole for 4 weeks. Gastric function and antioxidative parameters were thereafter evaluated. The indomethacin-mediated significant elevations in the ulcer index, gastric volume, pepsin activity and mucosal level of malondialdehyde were dosedependently attenuated in the extract-treated animals. The extract also significantly modulated and improved the pH, mucin content, glutathione (reduced) as well as gastric activities of superoxide dismutase and catalase in the ulcerated rats. These improvements may be ascribed to the antioxidant and membrane stabilization activities of the extract which are attributable to its active metabolites as revealed by the analytical chromatogram. The observed effects compared favorably with that of esomeprazole and are suggestive of the capability of the extract to prevent mucosal damage and preserve gastric functions as evidently supported by the macroscopical appearance of the stomachs and the % ulcer inhibitory values. Conclusively, the overall data from the present findings suggest that the aqueous leaf extract of G. barbadense could prevent indomethacin-mediated oxidative gastric ulceration via fortification of antioxidant defense mechanisms. Keywords: Esomeprazole, Gossypium barbadense, Indomethacin, Mucosal damage, Oxidative stres

An East African perspective for paradigm shift on maritime security in the Indian Ocean Region

© 2015 Indian Ocean Research Group. This paper advances the view that the meaning of maritime security should be considered based on lessons of history and requirements of human well-being. It challenges the tendency to separately view maritime security from the political, economic and social structures of the East African littoral states. Based on a critical reading of the history of the development of violent colonial structures in the region, the paper shows that most security discourses in relation to East Africa advance a paradigm that legitimises the control and management of the region's maritime domain under the surveillance of foreign powers. The framing of poverty and conflicts as internally caused and economically motivated power struggles within fragile states contributes to this paradigm. This paper argues that the East African maritime domain is an integral part of the hinterland, and maritime security should be understood from a perspective that addresses structural violence in the regio