The study focuses on economic and food security implications of projected climate change on Malian agriculture sector. Climate change projections made by two global circulation models are considered. The analysis focuses on the effects on crops, forages, and livestock and the resultant effects on sectoral economics and risk of hunger in Mali. Results show that under climate change, crop yield changes are in the range of minus 17% to plus 6% at national level. Simultaneously, forage yields fall by 5 to 36% and livestock animal weights are reduced by 14 to 16%. The resultant economic losses range between 70 to $142 million, with producers gaining, but consumers losing. The percentage of population found to be at risk of hunger rises from a current estimate of 34% to an after climate change level of 64% to 72%. A number of policy and land management strategies can be employed to mitigate the effects of climate change. In particular, we investigate the development of heat resistant cultivars, the adoption of existing improved cultivars, migration of cropping pattern, and expansion of cropland finding that they effectively reduce climate change impacts lowering the risk of hunger to as low as 28%.

Though rare, pulmonary vascular complications after lung transplantation carry high mortality. In our opinion, early identification and intervention improves outcome. Intraoperative assessment by pressure gradient measurement and transoesophageal echocardiography is recommended. Despite this, mortality remains high and prevention is better than cure.

No abstract

OBJECTIVES: Availability of donor lungs suitable for transplant falls short of current demand and contributes to waiting list mortality. Ex vivo lung perfusion (EVLP) offers the opportunity to objectively assess and recondition organs unsuitable for immediate transplant. Identifying robust biomarkers that can stratify donor lungs during EVLP to use or non-use or for specific interventions could further improve its clinical impact. METHODS: In this pilot study, 16 consecutive donor lungs unsuitable for immediate transplant were assessed by EVLP. Key inflammatory mediators and tissue injury markers were measured in serial perfusate samples collected hourly and in bronchoalveolar lavage fluid (BALF) collected before and after EVLP. Levels were compared between donor lungs that met criteria for transplant and those that did not. RESULTS: Seven of the 16 donor lungs (44%) improved during EVLP and were transplanted with uniformly good outcomes. Tissue and vascular injury markers lactate dehydrogenase, HMGB-1 and Syndecan-1 were significantly lower in perfusate from transplanted lungs. A model combining IL-1β and IL-8 concentrations in perfusate could predict final EVLP outcome after 2 h assessment. In addition, perfusate IL-1β concentrations showed an inverse correlation to recipient oxygenation 24 h post-transplant. CONCLUSIONS: This study confirms the feasibility of using inflammation and tissue injury markers in perfusate and BALF to identify donor lungs most likely to improve for successful transplant during clinical EVLP. These results support examining this issue in a larger study.

No abstract

This study was undertaken to assess the potential impacts of climate change on agriculture in the Sikasso region of southern Mali, as part of an effort by the U.S. Agency for International Development (USAID) to integrate climate change adaptation considerations into their development projects. The region is considered to be the breadbasket of Mali, providing a substantial amount of the country's food supplies as well as cotton for exchange earnings. The project had two components: modeling how climate change could affect production of cereal and cash crops in southern Mali; and conducting a stakeholder-driven vulnerability and adaptation assessment to identify potential options for addressing current and projected risks to agriculture from climate change. Projected changes in crop yields were based on a previous analysis that was extended for the purposes of this study. The projections suggested that the sensitivity of maize to changing weather conditions is relatively small (generally less than 10% change) under both dry and wet scenarios in 2030 and 2060. White (Irish) potatoes, the primary cash crop, are the most sensitive to changing weather conditions, with yields decreasing under both dry and wet conditions; yields could decrease by about 25%

We report a 91% live birth rate post-cardiac transplantation. Meticulous individualized care with frequent monitoring of CNI levels and LV function is necessary to optimize the maternal and fetal outcomes.

The Mali agricultural sector and the country's food security are potentially vulnerable to climate change. Policies may be able to mitigate some of the climate change vulnerability. This article investigates several policy changes that may reduce vulnerability, including climate-specific and other policies. The policy set includes migration of cropping patterns, development of high-temperature-resistant cultivars, reduction in soil productivity loss, cropland expansion, adoption of improved cultivars, and changes in trade patterns. When all policies are considered together, results under climate change show an annual gain of $252 million in economic benefits as opposed to a $161 million loss without policy adjustment. Simultaneously, undernourishment is reduced to 17% of the Malian population as compared with 64% without policy adjustment. We also find tradeoffs in cases between economic benefits and undernourishment. Policies are also studied individually and collectively. Overall, the results indicate that policy can play an important role in reducing climate change vulnerability in Mali.