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Improving crop productivity is crucial to food security and rural livelihoods in southern Africa. However, agricultural intensification at irrigation schemes may place greater demands on water resources, even where water use efficiency (WUE) is improved, due to the paradox of irrigation efficiency. We analysed trends in water use efficiency (WUE), Gross Primary Productivity (GPP), evapotranspiration (ET), evaporation (E), and transpiration (T) at six irrigation schemes which received technological and social interventions. GPP was decoupled from ET at some schemes. For example, at the Landela sub-block of the Silalatshani irrigation scheme in Zimbabwe, GPP and T increased at 4.8% and 4.6% per year, respectively. Conversely, E decreased at 13.5% per year, giving a 3.6% decrease in ET per year from 2013 to 2021. This suggests that crop production can be decoupled from water consumption at southern African irrigation schemes, meaning it is possible to produce more food with less water. [Display omitted] • Water use efficiency was estimated with remote sensing for smallholder irrigation schemes in southern Africa. • Gross primary productivity (GPP) was decoupled from evapotranspiration (ET) at some schemes. This means more crops have been grown with less water. • Decoupling was not observed at all irrigation schemes and is likely to be context dependent. [ABSTRACT FROM AUTHOR]

• We propose a threshold-based framework for vegetation drought impact forecasting. • The lead time between threshold soil moisture and subsequent vegetation impact events was typically two to four weeks. • The optimal soil moisture integration depth for forecasting vegetation conditions varied between ecosystems, probably in response to rooting depth. Timely and skilful forecasts of vegetation drought impacts should enable more proactive drought preparedness, management, and mitigation. Numerous previous studies found a temporal correlation between soil moisture and vegetation condition. However, a correlation across the full range of soil moisture and vegetation condition does not automatically translate into skill in forecasting infrequent events such as agricultural droughts. Here, we develop a threshold- or impact-based forecasting framework to assess early warning capability (EWC). We analysed the skill and lead time achieved using soil moisture observations at multiple depths as predictors of subsequent vegetation drought impacts inferred from MODIS satellite observations at 93 sites across the United States. Forecast thresholds were expressed in terms of seasonally-adjusted standardised anomalies (z-scores) to distinguish climate-related impacts from any seasonal vegetation cycle. Different combinations of soil moisture integration depth, satellite vegetation indices and threshold levels were tested. Near-Infrared Reflectance of vegetation (NIRv) yielded a marginally better EWC than other indicators of vegetation drought impact. The optimal soil moisture integration depth varied between land cover types, from 0 to 10 cm for cropping systems to 0–100 cm for grassland and savanna. The greatest skill improvements were achieved using similar z-score threshold values for the soil moisture trigger and vegetation impact, producing typical lead times of two to four weeks. Further research is recommended to combine the framework developed here with spatially continuous soil moisture analyses or forecasts available from remote sensing and land surface models. [ABSTRACT FROM AUTHOR]

This study compared surface soil moisture from 11 separate remote sensing and modelled products across Australia in a common framework. The comparison was based on a correlation analysis between soil moisture products and in situ data collated from three separate ground-based networks: OzFlux, OzNet and CosmOz. The correlation analysis was performed using both original data sets and temporal anomalies, and was supported by examination of the time series plots. The interrelationships between the products were also explored using cluster analyses. The products considered in this study include: Soil Moisture Ocean Salinity (SMOS; both Land Parameter Retrieval Model (LPRM) and L-band Microwave Emission of the Biosphere (LMEB) algorithms), Advanced Microwave Scanning Radiometer 2 (AMSR2; both LPRM and Japan Aerospace Exploration Agency (JAXA) algorithms) and Advanced Scatterometer (ASCAT) satellite-based products, and WaterDyn, Australian Water Resource Assessment Landscape (AWRA-L), Antecedent Precipitation Index (API), Keetch-Byram Drought Index (KBDI), Mount's Soil Dryness Index (MSDI) and CABLE/BIOS2 model-based products. The comparison of the satellite and model data sets showed variation in their ability to reflect in situ soil moisture conditions across Australia owing to individual product characteristics. The comparison showed the satellite products yielded similar ranges of correlation coefficients, with the possible exception of AMSR2_JAXA. SMOS (both algorithms) achieved slightly better agreement with in situ measurements than the alternative satellite products overall. Among the models, WaterDyn yielded the highest correlation most consistently across the different locations and climate zones considered. All products displayed a weaker performance in estimating soil moisture anomalies than the original data sets ( i.e. the absolute values), showing all products to be more effective in detecting interannual and seasonal soil moisture dynamics rather than individual events. Using cluster analysis we found satellite products generally grouped together, whereas models were more similar to other models. SMOS (based on LMEB algorithm and ascending overpass) and ASCAT (descending overpass) were found to be very similar to each other in terms of their temporal soil moisture dynamics, whereas AMSR2 (based on LPRM algorithm and descending overpass) and AMSR2 (based on JAXA algorithm and ascending overpass) were dissimilar. Of the model products, WaterDyn and CABLE were similar to each other, as were the API/AWRA-L and KBDI/MSDI pairs. The clustering suggests systematic commonalities in error structure and duplication of information may exist between products. This evaluation has highlighted relative strengths, weaknesses, and complementarities between products, so the drawbacks of each may be minimised through a more informed assessment of fitness for purpose by end users. [ABSTRACT FROM AUTHOR]

In 2009, the National Institutes of Health recognized the need to expand knowledge of lesbian, gay, bisexual, and transgender (LGBT) health and commissioned the Institute of Medicine to report on the health of these populations in the United States. The resulting Institute of Medicine publication called for more knowledge of the health of LGBT populations, as well as improved methodologies to reach them, more LGBT-focused research, and enhanced training programs and cultural competency of physicians and researchers. Several of the National Institutes of Health-funded HIV/AIDS clinical trials networks, including the Adolescent Medicine Trials Network for HIV/AIDS Interventions, HIV Prevention Trials Network, HIV Vaccine Trials Network, and Microbicide Trials Network, have focused attention on engaging transgender (TG) individuals in research. They have identified issues that transcend the nature of research (ie, treatment or prevention, adult or adolescent) and have adopted various approaches to effectively engage the TG community. Each network has recognized the importance of developing partnerships to build trust with and seek input from TG individuals on research plans and policies. They have established standing advisory groups and convened consultations for this purpose. To ensure that trial data are reflective of the participants they are seeking to enroll, they have reviewed and revised data collection forms to incorporate the 2-step method of collecting sex at birth and gender identity as 2 independent variables, and some have also revised research protocol templates and policies for concept development to ensure that they are appropriate for the inclusion of TG participants. The networks have also initiated trainings to enhance cultural sensitivity and developed a range of materials and resources for network and clinical research site staff. They continue to identify TG-specific research needs in an effort to be more responsive to and improve the health of TG individuals, particularly related to HIV/AIDS. [ABSTRACT FROM AUTHOR]

Background: We investigated whether chronotype is associated with glycemic control, antidiabetic treatment, and risk of developing complications in patients with type 2 diabetes (T2DM)., Methods: The diabetologists filled out an online questionnaire on the Google Form platform to collect the following parameters of subjects with T2DM: body mass index (BMI), fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), diabetes history, antidiabetic treatment, diabetic complications, and chronotype categories., Results: We enrolled 106 subjects with T2DM (M/F: 58/48; age: 63.3 ± 10.4 years; BMI: 28.8 ± 4.9 kg/m 2 ). Thirty-five point eight% of the subjects showed a morning chronotype (MC), 47.2% an intermediate chronotype (IC), and 17% an evening chronotype (EC). EC subjects reported significantly higher HbA1c ( p < 0.001) and FPG ( p = 0.004) values, and higher prevalence of cardiovascular complications (CVC) ( p = 0.028) and of subjects taking basal ( p < 0.001) and rapid insulin ( p = 0.01) compared to MC subjects. EC subjects reported significantly higher HbA1c ( p < 0.001) and FPG ( p = 0.015) than IC subjects. An inverse association was found between chronotype score, HbA1c (r = -0.459; p < 0.001), and FPG (r = -0.269; p = 0.05), remaining significant also after adjustment for BMI, age, and disease duration., Conclusions: EC is associated with higher prevalence of CVC and poorer glycemic control independently of BMI and disease duration in subjects with T2DM.

We developed and tested an innovative physical training method in older adults that embeds the gym program into everyday life in the most conservative way possible. Physical training was included in the activities of local parishes where older women from Southern Italy spend most of their free time and was delivered by trained physical therapists with the support of an ICT tool known as CoCo. 113 older women (aged 72.0 [69.0-75.0] years) noncompliant to conventional exercise programs participated to the study. 57 of them underwent the final anthropometric assessment and 50 the final physical tests. In study completers handgrip strength and physical performance evaluated with the chair-stand, the two minutes step and the chair-sit and -reach tests significantly improved. Quality of life as evaluated with the EuroQol-5dimension (EQ-5D) questionnaire improved as well. In conclusion, a training program designed to minimally impact on life habits of older people is effective in improving fitness in patients noncompliant to other to physical exercise programs.

Multiple endocrine neoplasia syndromes have since been classified as types 1 and 2, each with specific phenotypic patterns. MEN1 is usually associated with pituitary, parathyroid and paraneoplastic neuroendocrine tumours. The hallmark of MEN2 is a very high lifetime risk of developing medullary thyroid carcinoma (MTC) more than 95% in untreated patients. Three clinical subtypesdMEN2A, MEN2B, and familial MTC (FMTC) have been defined based on the risk of pheochromocytoma, hyperparathyroidism, and the presence or absence of characteristic physical features). MEN2 occurs as a result of germline activating missense mutations of the RET (REarranged during Transfection) proto-oncogene. MEN2-associated mutations are almost always located in exons 10, 11, or 13 through 16. Strong genotype-phenotype correlations exist with respect to clinical subtype, age at onset, and aggressiveness of MTC in MEN2. These are used to determine the age at which prophylactic thyroidectomy should occur and whether screening for pheochromocytoma or hyperparathyroidism is necessary. Specific RET mutations can also impact management in patients presenting with apparently sporadic MTC. Therefore, genetic testing should be performed before surgical intervention in all patients diagnosed with MTC. Recently, Pellegata et al. have reported that germline mutations in CDKN1B can predispose to the development of multiple endocrine tumours in both rats and humans and this new MEN syndrome is named MENX and MEN4, respectively. CDKN1B. A recent report showed that in sporadic MTC, CDKN1B V109G polymorphism correlates with a more favorable disease progression than the wild-type allele and might be considered a new promising prognostic marker. New insights on MEN syndrome pathogenesis and related inherited endocrine disorders are of particular interest for an adequate surgical and therapeutic approach.