Life Cycle Thinking for the environmental and financial assessment of rice management systems in the Senegal River Valley

Rice is a staple food in Senegal, which however imports more than 70% of the rice consumed annually to meet its domestic demand. Despite governmental efforts to increase rice self-sufficiency, both rice supply and yields remain low. Senegalese farmers face challenges related to irrigation infrastructure and fertiliser access, besides those derived from climate change. This study applies Life Cycle Assessment (LCA) combined with financial Life Cycle Costing (LCC) to evaluate alternative scenarios for rice management in the Senegal River Valley and identify sustainability hotspots and potential improvements. Specifically, rice cultivation in Ross Béthio (Saint Louis, Senegal) is assessed based on the observed agricultural practices during the dry seasons of 2016 and 2017. Two scenarios capturing conventional (CONV) and intensive (INT) practices are compared to two reference scenarios (SAED scenarios) according to the recommendations of the official agricultural advisory service. The INT scenario generates the lowest impacts per kg of paddy rice in seven out of thirteen impact categories, including climate change, freshwater and marine eutrophication, ozone depletion and water scarcity. This is due to the higher yields (7.4 t ha^-1) relative to CONV (4.8 t ha^-1) and the two reference SAED scenarios (6.0 t ha^-1). The two latter scenarios show the lowest values in the remaining categories, although they also generate slightly lower profits than INT (138 € t^-1 vs. 149 € t^-1) due to increased labour costs for additional fertilisation treatments. The results from both LCA and LCC underline the importance of increasing yields to decrease environmental impacts and production costs of rice when estimated per kg of product. Well-designed fertiliser application doses and timing and increased mechanisation can deliver further environmental benefits. Additional improvements (e.g. in irrigation, crop rotations, straw management) could be considered to promote the long-term sustainability and profitability of rice production in Senegal. LCA in combination with financial LCC is identified as a decision-support tool for evaluating the sustainability of alternative crop management practices. Life Cycle Thinking can still benefit from experiential learning based on information exchange between farmers, researchers and extension agents to contribute to a sustainable agriculture and ultimately to food security in Africa.

Characteristics and Outcomes of COVID-19 in Patients on Left Ventricular Assist Device Support

Supplemental Digital Content is available in the text.

Background:

The coronavirus disease 2019 (COVID-19) pandemic continues to afflict millions of people worldwide. Patients with end-stage heart failure and left ventricular assist devices (LVADs) may be at risk for severe COVID-19 given a high prevalence of complex comorbidities and functional impaired immunity. The objective of this study is to describe the clinical characteristics and outcomes of COVID-19 in patients with end-stage heart failure and durable LVADs.

Methods:

The Trans-CoV-VAD registry is a multi-center registry of LVAD and cardiac transplant patients in the United States with confirmed COVID-19. Patient characteristics, exposure history, presentation, laboratory data, course, and clinical outcomes were collected by participating institutions and reviewed by a central data repository. This report represents the participation of the first 9 centers to report LVAD data into the registry.

Results:

A total of 40 patients were included in this cohort. The median age was 56 years (interquartile range, 46–68), 14 (35%) were women, and 21 (52%) were Black. Among the most common presenting symptoms were cough (41%), fever, and fatigue (both 38%). A total of 18% were asymptomatic at diagnosis. Only 43% of the patients reported either subjective or measured fever during the entire course of illness. Over half (60%) required hospitalization, and 8 patients (20%) died, often after lengthy hospitalizations.

Conclusions:

We present the largest case series of LVAD patients with COVID-19 to date. Understanding these characteristics is essential in an effort to improve the outcome of this complex patient population.

A Mayan founder mutation is a common cause of deafness in Guatemala

Over 5% of the world's population has varying degrees of hearing loss. Mutations in GJB2 are the most common cause of autosomal recessive non-syndromic hearing loss (ARNHL) in many populations. The frequency and type of mutations are influenced by ethnicity. Guatemala is a multi-ethnic country with four major populations: Maya, Ladino, Xinca, and Garifuna. To determine the mutation profile of GJB2 in a ARNHL population from Guatemala, we sequenced both exons of GJB2 in 133 unrelated families. A total of six pathogenic variants were detected. The most frequent pathogenic variant is c.131G>A (p.Trp44*) detected in 21 of 266 alleles. We show that c.131G>A is associated with a conserved haplotype in Guatemala suggesting a single founder. The majority of Mayan population lives in the west region of the country from where all c.131G>A carriers originated. Further analysis of genome-wide variation of individuals carrying the c.131G>A mutation compared with those of Native American, European, and African populations shows a close match with the Mayan population.

Metoprolol for action tremor following intracerebral hemorrhage

Tremor has been rarely described as a manifestation of stroke. A 21-year-old left-handed man developed severe action tremor of his distal left upper extremity and hand following a right parieto-occipital intracerebral hemorrhage. Strength of the left upper extremity improved gradually during a 3-month period but a severe action tremor developed. The patient was treated with the cardioselective beta-blocking agent, metoprolol, initially for elevated blood pressure and tachycardia at 25 mg twice daily for approximately 2 months. Metoprolol was then increased at weekly intervals by 25mg twice daily to a total of 100mg twice daily. Tremor intensity decreased clinically and graphically as monitored by a trace test by having the patient attempt to trace a horizontal and vertical axis and scoring the errors. The scores declined weekly from the first week (4,347), second week (3,786), third week (1,088), to the fourth week (484). No adverse cognitive or cardiopulmonary effects were noted. Action tremor should be considered as one of the movement disorders caused by hemorrhagic cerebral infarction. This case responded well to treatment with metoprolol.

Purification of testosterone-oestradiol-binding globulins from mammalian sera by anion-exchange high performance liquid chromatography

Testosterone-oestradiol-binding globulin (TeBG) has been isolated from serum or plasma of several species using procedures that yielded highly purified protein, but which required multiple and tedious chromatographic steps. In this report we describe a procedure for the isolation of TeBG which involves two chromatographic steps: androgen affinity chromatography followed by anion-exchange high performance liquid chromatography (anion-exchange HPLC). The purity of the final product was confirmed by silver staining following fractionation on sodium dodecyl sulphate-containing polyacrylamide gels. The size heterogeneity and specific binding activity of TeBGs purified from human, rabbit, or bull serum (or plasma) by this technique was indistinguishable from preparations obtained by conventional chromatography. The present technique shortened the entire purification procedure to about 5 working days and yielded milligram quantities of highly purified protein. Bases on our experience with serum or plasma from the human, rabbit, and bull, this approach should be suitable for isolation of TeBG from a wide range of species.

Nuclear translocation of estradiol receptors by the in vivo administration of norethisterone: an alternate mechanism for gonadotropin inhibition

In order to investigate the anti-gonadotropic effect of norethisterone (NET) in long-term ovariectomized rats, we studied the interaction of this synthetic progestin with intracellular steroid receptors in the anterior pituitary by a nuclear exchange assay. The results demonstrated that the administration of NET to long-term ovariectomized rats resulted in nuclear translocation of estradiol cytosol receptors in the pituitary and uterus with a rate of accumulation and nuclear retention being similar in both tissues. Accumulation of nuclear estradiol receptors in the pituitary was in agreement with the rate of LH inhibition in NET-treated rats. The results presented in this communication may explain the anti-gonadotropic activity of NET in long-term ovariectomized rats in addition to its well known progestational activity.

Interaction of medroxyprogesterone acetate with cytosol androgen receptors in the rat hypothalamus and pituitary

The binding of medroxyprogesterone acetate (MPA) with cytosol androgen receptors from rat pituitary and hypothalamus was studied. The pituitary and hypothalamic cytosol androgen receptors from adult castrated female rats were in vitro labeled using 3H natural (testosterone (T) and 5 alpha-dihydrotestosterone (DHT] and [3H]synthetic (methyltrienolone) androgens as radioligands. The [3H]androgen-receptor complexes sedimented with a coefficient of 8S in linear sucrose gradients. When incubated with an excess of radioinert MPA, specific binding was abolished indicating interaction of MPA with androgen receptors. Furthermore specific [3H]MPA-androgen cytosol receptor complexes could be identified in these neuroendocrine tissues when a post-gradient receptor labeling technique was used in the absence or presence of radioinert MPA, DHT, and triamcinolone acetonide. A study of binding kinetics disclosed that the equilibrium dissociation constant and saturation binding capacity for the MPA binder, were similar to those exhibited by DHT binding to androgen receptors in both studied tissues under identical experimental conditions. The overall results were interpreted as demonstrating that MPA interacts with cytosol steroid receptors other than those of progesterone in the rat hypothalamus and anterior pituitary. The data are consistent with MPA binding to androgen receptors.

Clinical and endocrine spectrum in patients with the 45,X/46,XY karyotype

Cytogenetic and endocrine studies were performed in five unrelated 45,X/46,XY individuals in an attempt to correlate them with their clinical expression and gonadal morphology. A lack of a consistent pattern between cytogenetic findings and phenotype was observed. Endocrine studies revealed a wide spectrum of hypothalamic, pituitary, and gonadal hormone production as assessed by the base line levels of LH, FSH, T, and delta 4-A and their responses to appropriate exogenous stimulation (LH-RH and HCG). An adequate correlation between endocrine findings with gonadal morphology and phenotype could be established; thus demonstrating that patients with this particular chromosome complement have a functional integrity of the gonadotropin hypothalamic pituitary activity modulated accordingly with the gonadal function of each particular case.

Induction of ovulation in a true hermaphrodite with male phenotype

Ovulation was induced in a 16-yr-old 46 XX/47 XXY true hermaphrodite with a male phenotype. The presence of testicular tissue was assessed by a normal androgen response to hCG. Administration of FSH and LH for 8 consecutive days, followed by a single dose of hCG, induced a biphasic serum profile of 17 beta-estradiol and progesterone similar to that observed in normal menstrual cycles. In addition, a significant rise in serum testosterone was noticed during the luteal phase. Laparotomy revealed the presence of a uterus, with evidence of endometrial bleeding and absence of a vagina. These results demonstrated that gonadotropins were able to induce follicular maturation, ovulation, and endometrial bleeding in a true hermaphrodite resembling a normal ovulatory cycle. Gonadotropin administration can be used as a diagnostic tool for establishing the presence of ovarian tissue in this gonadal development abnormality.