Search

Introduction: Extracorporeal life support is an increasingly used technique for respiratory and cardiocirculatory support. Besides primary organ dysfunction, an excessive systemic hyperinflammatory response can be the underlying cause for acute organ failure necessitating extracorporeal life support therapy, or it may be associated with the extracorporeal life support itself. Controlling this overwhelming inflammatory response using CytoSorb® hemoadsorption has been shown to be associated with improved hemodynamics and restored metabolic balance resulting in preserved organ functions. Methods: In this retrospective case series, we describe 23 patients undergoing extracorporeal life support therapy and CytoSorb hemoadsorption. Cytokine levels were monitored, hemodynamic and metabolic variables were recorded, and outcome measures such as duration of organ support, intensive care unit mortality, and hospital mortality were noted. Results: CytoSorb treatment was associated with a trend toward a reduction in plasma cytokine levels (first treatment median interleukin-6 pre 595 vs post 350 pg/mL (n.s.); second treatment median interleukin-6 317 vs 108 pg/mL, p Conclusion: Hemoadsorption may offer a potentially promising therapeutic option for critically ill patients undergoing extracorporeal life support therapy, with cytokine reduction and a consecutively mitigated inflammatory response, decreased vasoplegia, and improved organ function as seen in our patients.

Food and nutrition security has been a persistent major challenge to human societies and this challenge continues into the 21st century, especially taking into consideration the targets set by the UN Sustainable Development Goals, which call for eradicating hunger (goal 2), ending poverty (goal 1), sustainably managing and using natural resources and ecosystems (goal 15), and combating climate change (goal 13). The way food is consumed and produced affects the human well-being as well as the environment. Avoiding food losses and adopting a balanced healthy diet is also an important step towards sustainability. Promoting dietary standards and monitoring their adoption is a potentially important policy tool for mitigating environmental impacts of food production as well as monitoring food security and nutrition. There is relatively little research to measure nutritional adequacy of food intake according to dietary standards, and to explore the relationship with health outcomes. In this study we choose the well-established WHO global level dietary recommendations as a reference to quantify nutritional adequacy by developing an energy and macronutrient intake index (ENI), and to assess its relation to indicators of hunger and undernutrition. We find strong negative association between nutritional adequacy of dietary intake and prevalence of undernutrition at the national level, and we illustrate that ENI could be an effective tool to inform national food security strategies. Under different future socioeconomic development scenarios, almost all sub-Saharan African countries achieve an adequate per capita energy intake level but their nutritional status varies with many countries deviating from recommended levels because of the unbalanced development of macronutrient intake levels; more improvement exists in fat and energy intake levels and less agreement in fruit vegetable and animal protein intake levels. Scenario application proves that the relationship between ENI and undernutrition could readily be applied in future scenarios generated by integrated assessment models to provide insights into the impacts of various climate change scenarios, socioeconomic development pathways and alternative global trade policies on global hunger and undernutrition status.

This study presents the development of a new bottom-up large-scale hydroeconomic model, Extended Continental-scale Hydroeconomic Optimization (ECHO), that works at a subbasin scale over a continent. The strength of ECHO stems from the integration of a detailed representation of local hydrological and technological constraints with regional and global policies, while accounting for the feedbacks between water, energy, and agricultural sectors. In this study, ECHO has been applied over Africa as a case study with the aim of demonstrating the benefits of this integrated hydroeconomic modeling framework. Results of this framework are overall consistent with previous findings evaluating the cost of water supply and adaptation to global changes in Africa. Moreover, results provide critical assessments of future investment needs in both supply- and demand-side water management options, economic implications of contrasting future socioeconomic and climate change scenarios, and the potential trade-offs among economic and environmental objectives. Overall, this study demonstrates the capacity of ECHO to address challenging research questions examining the sustainability of water supply and the impacts of water management on energy and food sectors and vice versa. As such, we propose ECHO as useful tool for water-related scenario analysis and management options evaluation.

With the wages for migrant workers increasing dramatically in China since 2003, the size of the agricultural labour forces has been shrinking rapidly. Intensively substituting agricultural machinery for the shrinking farm labour force is hardly possible for croplands in the mountainous regions of China where mechanization is difficult to achieve due to small field size and rough terrain. This has eventually led to cropland abandonment in these regions. Considering the high pressure for food security in China, cropland abandonment in the mountainous regions should not be ignored. By employing a novel method, this study estimates the extent of recently abandoned croplands (period 2000-2010) and the changes that can be expected in the future in China's mountainous areas. The results show that the total extent of abandoned croplands in Chinese mountainous counties during the period 2000 to 2010 is estimated at 147 million mu (1 mu=666.67m2); in total, about 28% of croplands in mountainous counties was abandoned, including croplands converted in the Grain for Green Programme (GGP). With three scenario assumptions, a sizeable extent, 114 to 203 million mu, of croplands may be abandoned from 2010 to 2030 with the rapid decrease and aging of projected farm labour forces. This could exacerbate the future challenges of maintaining China's food security. A substantial increase in agricultural project investments, including land consolidation and agricultural productive fixed assets, especially micro-tillage machines, could help mitigate the risk of cropland abandonment. Additionally, land-use and environmental policymaking should take into account the expanding cropland abandonment in mountainous regions.

Introduction Infective endocarditis is a serious disease condition. Depending on the causative microorganism and clinical symptoms, cardiac surgery and valve replacement may be needed, posing additional risks to patients who may simultaneously suffer from septic shock. The combination of surgery bacterial spreadout and artificial cardiopulmonary bypass (CPB) surfaces results in a release of key inflammatory mediators leading to an overshooting systemic hyperinflammatory state frequently associated with compromised hemodynamic and organ function. Hemoadsorption might represent a potential approach to control the hyperinflammatory systemic reaction associated with the procedure itself and subsequent clinical conditions by reducing a broad range of immuno-regulatory mediators. Methods We describe 39 cardiac surgery patients with proven acute infective endocarditis obtaining valve replacement during CPB surgery in combination with intraoperative CytoSorb hemoadsorption. In comparison, we evaluated a historical group of 28 patients with infective endocarditis undergoing CPB surgery without intraoperative hemoadsorption. Results CytoSorb treatment was associated with a mitigated postoperative response of key cytokines and clinical metabolic parameters. Moreover, patients showed hemodynamic stability during and after the operation while the need for vasopressors was less pronounced within hours after completion of the procedure, which possibly could be attributed to the additional CytoSorb treatment. Intraoperative hemoperfusion treatment was well tolerated and safe without the occurrence of any CytoSorb device-related adverse event. Conclusions Thus, this interventional approach may open up potentially promising therapeutic options for critically-ill patients with acute infective endocarditis during and after cardiac surgery, with cytokine reduction, improved hemodynamic stability and organ function as seen in our patients.

Extracorporeal life support is an increasingly used technique for respiratory and cardiocirculatory support. Besides primary organ dysfunction, an excessive systemic hyperinflammatory response can be the underlying cause for acute organ failure necessitating extracorporeal life support therapy, or it may be associated with the extracorporeal life support itself. Controlling this overwhelming inflammatory response using CytoSorbIn this retrospective case series, we describe 23 patients undergoing extracorporeal life support therapy and CytoSorb hemoadsorption. Cytokine levels were monitored, hemodynamic and metabolic variables were recorded, and outcome measures such as duration of organ support, intensive care unit mortality, and hospital mortality were noted.CytoSorb treatment was associated with a trend toward a reduction in plasma cytokine levels (first treatment median interleukin-6 pre 595 vs post 350 pg/mL (n.s.); second treatment median interleukin-6 317 vs 108 pg/mL, p 0.05), a reduced vasoplegic response resulting in a reduction in vasopressor requirements (first treatment median norepinephrine pre 0.15 vs post 0.02 µg/kg/min (n.s.); second treatment median norepinephrine 0.1 vs 0.02 µg/kg/min, p 0.05) as well as rebalancing of deranged metabolic parameters (first treatment median lactate pre-treatment 6 vs post-treatment median lactate 2 mmol/L, p 0.05). The hemoperfusion treatment was well tolerated and safe, without the occurrence of any CytoSorb device-related adverse events.Hemoadsorption may offer a potentially promising therapeutic option for critically ill patients undergoing extracorporeal life support therapy, with cytokine reduction and a consecutively mitigated inflammatory response, decreased vasoplegia, and improved organ function as seen in our patients.

Unsustainable overexploitation of groundwater for agricultural irrigation has led to rapid groundwater depletion and severe environmental damage in the semi-arid Hebei Plain of China. Field experiments have recommended annual winter fallowing (i.e., forgoing winter wheat production) as the most effective way to replenish groundwater. However, adopting the recommendation across the Hebei Plain would lead to a significant reduction in total wheat production. This research aims to find the most favorable water-sustainable cropping systems for different localities in the Hebei Plain, which at the regional aggregation level maintains the uppermost overall levels of wheat and grain production respectively. Our simulations indicate that in the Hebei Plain, an optimal allocation of a wheat-early maize relay intercropping system and an early maize-winter fallow cropping system across the Hebei Plain could lead to significant water savings while minimizing grain production losses to around 11%. Compared to the prevailing wheat and summer maize cropping system, to prevent a drop in the water table, 39% of the current wheat cropping land would need to be fallowed in winter, reducing irrigation water use by 2639 × 106 m3. Replacing the prevailing wheat and summer maize cropping system with our optimized allocation system could lead to a 36% increase in total maize production and 39% decrease in total wheat production, resulting in total agricultural irrigation water savings of 2322 × 106 m3 and a total grain production reduction by 11%. The findings indicate the potential benefits of our cropping system adaptation method to meet the challenge of recovering local groundwater level with the least possible reduction of wheat and total grain production in the Hebei Plain.

Water scarcity has become a crucial environmental issue worldwide. It has increased substantially in the last decades in many parts of the world, and it is expected to further exacerbate in the future driven by socio-economic and climatic changes. Several solution options could be implemented to address this growing water scarcity, including supply and demand-side management options that span the water, energy, and agricultural sectors. However, these options involve tradeoffs among various societal objectives, especially when the interactions between these objectives are not properly considered. This paper provides a review of the impending water scarcity challenges and suggests assessing water scarcity solution options using a nexus modeling framework that links well-established sectoral-oriented models.

To sustain growing food demand and increasing standard of living, global water use increased by nearly 6 times during the last 100 years, and continues to grow. As water demands get closer and closer to the water availability in many regions, each drop of water becomes increasingly valuable and water must be managed more efficiently and intensively. However, soaring water use worsens water scarcity conditions already prevalent in semi-arid and arid regions, increasing uncertainty for sustainable food production and economic development. Planning for future development and investments requires that we prepare water projections for the future. However, estimations are complicated because the future of the world's waters will be influenced by a combination of environmental, social, economic, and political factors, and there is only limited knowledge and data available about freshwater resources and how they are being used. The Water Futures and Solutions (WFaS) initiative coordinates its work with other ongoing scenario efforts for the sake of establishing a consistent set of new global water scenarios based on the shared socio-economic pathways (SSPs) and the representative concentration pathways (RCPs). The WFaS "fast-track" assessment uses three global water models, namely H08, PCR-GLOBWB, and WaterGAP. This study assesses the state of the art for estimating and projecting water use regionally and globally in a consistent manner. It provides an overview of different approaches, the uncertainty, strengths and weaknesses of the various estimation methods, types of management and policy decisions for which the current estimation methods are useful. We also discuss additional information most needed to be able to improve water use estimates and be able to assess a greater range of management options across the water–energy–climate nexus.

The serious water scarcity and groundwater over-exploitation problems of the North China Plain (NCP) have aroused worldwide concerns. Achieving a reduction in agricultural water use is critical, because agriculture is the largest water consumer in the NCP. New solutions to these problems may lie in changes in the area sown to winter wheat across the NCP. In this study, the water footprint (WF) was applied as an aggregative indicator to evaluate the impact of the changing area sown to winter wheat. A Chinese version of the AEZ model, the China-AEZ model, was used for the evaluation. The results showed: (1) Green water plays a more significant role in winter wheat production in the southern part of the NCP than in the north; about a half of the water requirements for winter wheat are met by green water in the southern part of the NCP, compared to only a third in the north. (2) As a result of the north-south shift in the area sown to winter wheat during the period 1998-2011, the WF, the green water footprint (WFgreen) and the surface water footprint (WFblues) for winter wheat increased, respectively, by 459 X 10(6) m(3) yr(-1) (0.9%), by 973 x 10(6) m(3) yr(-1) (4.2%) and by 47 X 106 m(3) yr(-1) (0.5%), whereas the groundwater footprint (WFblueg) diminished by 561 x 10(6) m(3) yr(-1) (3.4%). The contribution of green water also increased, from 46.3% in 1998 to 47.8% in 2011, concurrent with the changes in the area sown to winter wheat. (3) The Hebei Plain, in the northern part of the NCP, conserved 1856 X 10(6) m(3) yr(-1) of blue water footprint (Whim) for winter wheat during the period 1998-2011, equivalent to about one third of the total amount of water supplied by the Middle Route of the South-to-North Water Transfer Project (MRP) in 2010. By comparison, WF and its components all increased in the southern provinces of the NCP. The diminishing requirement for groundwater and the increasing role of green water in winter wheat production encourage policies aimed at the further optimization of agricultural land use and the achievement of integrated blue-green water management in the NCP. (C) 2015 Elsevier Ltd. All rights reserved.

There have been increasing concerns on risks and uncertainty posed by climate change to China's future crop production. The existing assessments using popular process-based and site-specific crop growing models highlight the significant extent of climate-induced yield reduction, and thus suggest a scary downward risk for China's future food production. Surprisingly, much less attention has been paid to exploring the potential gains that may also be brought by climate change. To address this imbalance, we develop an integrated agro-climatic and ecological assessment tool that is capable of detecting the shifts of multicropping opportunities under different climate change scenarios. The application of this tool to the context of China reveals significant extension of multicropping opportunities brought in by climate change. We argue for an active adaptation to such emerging opportunities through both market and policy incentives, because the aggregate gain of such adaptation is sufficient to outweig...

Land, energy and water are our most precious resources, but the manner and extent to which they are exploited contributes to climate change. Meanwhile, the systems that provide these resources are themselves highly vulnerable to changes in climate. Efficient resource management is therefore of great importance, both for mitigation and for adaptation purposes. We postulate that the lack of integration in resource assessments and policy-making leads to inconsistent strategies and inefficient use of resources. We present CLEWs (climate, land-use, energy and water strategies), a new paradigm for resource assessments that we believe can help to remedy some of these shortcomings.

This study establishes a procedure to couple Decision Support System for Agrotechnology Transfer (DSSAT) and China Agro-ecological Zone model (AEZ-China). This procedure enables us to quantify the effects of two natural adaptation measures on soybean production in China, concern on which has been growing owing to the rapidly rising demand for soybean and the foreseen global climate change. The parameters calibration and mode verification are based on the observation records of soybean growth at 13 agro-meteorological observation stations in Northeast China and Huang-Huai-Hai Plain over 1981–2011. The calibration of eco-physiological parameters is based on the algorithms of DSSAT that simulate the dynamic bio-physiological processes of crop growth in daily time-step. The effects of shifts in planting day and changes in the length of growth cycle (LGC) are evaluated by the speedy algorithms of AEZ. Results indicate that without adaptation, climate change from the baseline 1961-1990 to the climate of 2050s as specified in the Providing REgional Climate for Impacts Studies-A1B would decrease the potential yield of soybean. By contrast, simulations of DSSAT using AEZ-recommended cultivars with adaptive LGC and also the corresponding adaptive planting dates show that the risk of yield loss could be fully or partially mitigated across majority of grid-cells in the major soybean growing areas.

The use of cardiopulmonary bypass (CPB) in cardiothoracic surgery results in a well-known activation of the immunologic response. In some cases, however, this triggered immunologic response may be excessive, leading to a severe systemic inflammatory response syndrome (SIRS) and induced organ dysfunction. For example, patients frequently develop hemodynamic instability with hypotension and low systemic vascular resistance. To date, different therapeutic approaches, such as steroids, have been tried to control this maladaptive postoperative SIRS response, yet definitive proof of clinical efficacy is missing. A new cytokine adsorber device (CytoSorb; CytoSorbents) may be a useful approach to control hyperinflammatory systemic reactions by reducing a broad range of proinflammatory cytokines and other inflammatory mediators. This may, in turn, help to reestablish a physiologic immune response and help to restore deranged clinical parameters in these patients. In this retrospective case series study, we describe 16 cardiac surgery patients following prolonged CPB with post-CPB SIRS and subsequent acute kidney injury, who were then treated with hemoadsorption using CytoSorb in combination with continuous renal replacement therapy (CRRT). Treatment of patients with CytoSorb who presented with severe post-CPB SIRS resulted in a reduction of elevated cytokine levels, which was associated with a clear stabilization of deranged hemodynamic, metabolic, and organ function parameters. Treatment was well tolerated and safe, with no device-related adverse events occurring. CytoSorb therapy combined with CRRT is a potentially promising new treatment approach to achieve hemodynamic stability, cytokine reduction, and improved organ function in cardiac surgery patients who develop post-CPB SIRS.

This paper summarizes the main characteristics of the RCP8.5 scenario. The RCP8.5 combines assumptions about high population and relatively slow income growth with modest rates of technological change and energy intensity improvements, leading in the long term to high energy demand and GHG emissions in absence of climate change policies. Compared to the total set of Representative Concentration Pathways (RCPs), RCP8.5 thus corresponds to the pathway with the highest greenhouse gas emissions. Using the IIASA Integrated Assessment Framework and the MESSAGE model for the development of the RCP8.5, we focus in this paper on two important extensions compared to earlier scenarios: 1) the development of spatially explicit air pollution projections, and 2) enhancements in the land-use and land-cover change projections. In addition, we explore scenario variants that use RCP8.5 as a baseline, and assume different degrees of greenhouse gas mitigation policies to reduce radiative forcing. Based on our modeling framework, we find it technically possible to limit forcing from RCP8.5 to lower levels comparable to the other RCPs (2.6 to 6 W/m2). Our scenario analysis further indicates that climate policy-induced changes of global energy supply and demand may lead to significant co-benefits for other policy priorities, such as local air pollution.

This paper measures the economic impacts of climate change on China's agriculture based on the Ricardian model. By using county-level cross-sectional data on agricultural net revenue, climate, and other economic and geographical data for 1275 agriculture dominated counties, we find that under most climate change scenarios both higher temperature and more precipitation would have an overall positive impact on China's agriculture. However, the impacts vary seasonally and regionally. Autumn effect is the most positive, but spring effect is the most negative. Applying the model to five climate scenarios in the year 2050 shows that the East, the Central part, the South, the northern part of the Northeast, and the Plateau would benefit from climate change, but the Southwest, the Northwest and the southern part of the Northeast may be negatively affected. In the North, most scenarios show that they may benefit from climate change. In summary, all of China would benefit from climate change in most scenarios.

The relationship between peaks of G-CSF serum concentrations and respiratory burst activity of polymorphonuclear cells (PMN) was investigated in patients with postoperative or post-traumatic severe sepsis and septic shock. Over a 12 month period, a longitudinal analysis of G-CSF, TNF-alpha and IFN-gamma serum concentrations, burst activity of PMN, and expression of CD64 on the surface of PMN, were performed by ELISA technique and flow cytometric analysis, respectively, in 58 patients admitted to the intensive care unit (ICU) on a daily basis until discharge from the ICU or death. Out of these 58 patients, 27 with proven infections were in septic shock for at least 4 days' duration. Seventeen of these patients survived, whereas ten died. In 15 out of these 27 patients, 26 episodes of G-CSF peaks were observed, which were followed in most patients (13/15) by an increase in PMN burst activity, from 28% up to 540% (median 188%). Following the G-CSF peaks, CD64 expression on PMN remained at an increased level, followed by a marked decline 3 days later. TNF-alpha serum concentrations were elevated in most episodes (22/26), whereas IFN-gamma serum concentrations were below the detection level in 23/26 episodes. Taken together, peaks in G-CSF serum concentrations are followed by enhanced CD64 expression and increased burst activity of PMN in most patients with severe sepsis and septic shock. Thus, endogenous G-CSF increases neutrophil function in patients with severe sepsis and septic shock, necessary for resolution of bacterial infections in these patients.

Tee impacts of climate change on China’s agriculture are measured based on Ricardian model. By using county-level cross-sectional data on agricultural net revenue, climate, and other economic and geographical data for 1275 agriculture-dominated counties in the period of 1985–1991, we find that both higher temperature and more precipitation will have overall positive impact on China’s agriculture. However, the impacts vary seasonally and regionally. Higher temperature in all seasons except spring increases agricultural net revenue while more precipitation is beneficial in winter but is harmful in summer. Applying the model to five climate scenarios in the 2020s and 2050s shows that the North, the Northeast, the Northwest, and the Qinghai-Tibet Plateau would always benefit from climate change while the South and the Southwest may be negatively affected. For the East and the Central China, most scenarios show that they may benefit from climate change. In conclusion, climate change would be beneficial to the whole China.

Over a 6 month period, in 192 patients admitted to the intensive care unit (ICU), a longitudinal analysis of whole blood lipopolysaccharide (LPS)-induced ex vivo cytokine production was performed on a daily basis until discharge from the ICU or death. Twenty-one patients with proven infections were in septic shock for the first time and for at least 3 days' duration. Ex vivo LPS-inducible release of granulocyte colony-stimulating factor (G-CSF) was upregulated and that of TNF-alpha was downregulated in patients with septic shock, regardless whether they survived or died. In conclusion, LPS-induced ex vivo TNF-alpha and G-CSF cytokine release by monocytes is regulated differentially in patients with septic shock. Since upregulation of LPS-induced production of G-CSF occurred earlier in survivors than in non-survivors, rapidly elevated and sustained G-CSF responsiveness may contribute to survival in septic shock.

We have used site-directed mutagenesis in conjunction with homologous recombination to generate two mouse lines carrying point mutations in the glycine binding site of the NMDAR1 subunit (Grin1). Glycine concentration–response curves from acutely dissociated hippocampal neurons revealed a 5- and 86-fold reduction in receptor glycine affinity in mice carryingGrin1D481NandGrin1K483Qmutations, respectively, whereas receptor glutamate affinity remained unaffected. Homozygous mutantGrin1D481Nanimals are viable and fertile and appear to develop normally. However, homozygous mutantGrin1K483Qanimals are significantly lighter at birth, do not feed, and die within a few days. No gross abnormalities in CNS anatomy were detected in eitherGrin1D481NorGrin1K483Qmice. Interestingly,in situhybridization and Western blot analysis revealed changes in the expression levels of NMDA receptor subunits inGrin1D481Nmice relative to wild type that may represent a compensatory response to the reduction in receptor glycine affinity.Grin1D481Nmice exhibited deficits in hippocampal theta burst-induced long-term potentiation (LTP) and spatial learning and also a reduction in sensitivity to NMDA-induced seizures relative to wild-type controls, consistent with a reduced activation of NMDA receptors. Mutant mice exhibited normal prepulse inhibition but showed increased startle reactivity. Preliminary analysis indicated that the mice exhibit a decreased natural aversion to an exposed environment. The lethal phenotype ofGrin1K483Qanimals confirms the critical role of NMDA receptor activation in neonatal survival. A milder reduction in receptor glycine affinity results in an impairment of LTP and spatial learning and alterations in anxiety-related behavior, providing further evidence for the role of NMDA receptor activation in these processes.

The productivity of important agricultural crops is drastically reduced when they experience short episodes of high temperatures during the reproductive period. Crop heat stress was acknowledged in the IPCC 4th Assessment Report as an important threat to global food supply. We produce a first spatial assessment of heat stress risk at a global level for four key crops, wheat, maize, rice and soybean, using the FAO/IIASA Global Agro-Ecological Zones Model (GAEZ). A high risk of yield damage was found for continental lands at high latitudes, particularly in the Northern Hemisphere between 40 and 60°N. Central and Eastern Asia, Central North America and the Northern part of the Indian subcontinent have large suitable cropping areas under heat stress risk. Globally, this ranged from less than 5 Mha of suitable lands for maize for the baseline climate (1971–2000) to more than 120 Mha for wetland rice for a future climate change condition (2071–2100) assuming the A1B emission scenario. For most crops and regions, the intensity, frequency and relative damage due to heat stress increased from the baseline to the A1B scenario. However for wheat and rice crops, GAEZ selection of different crop types and sowing dates in response to A1B seasonal climate caused a reduction in heat stress impacts in some regions, which suggests that adaptive measures considering these management options may partially mitigate heat stress at local level. Our results indicate that temperate and sub-tropical agricultural areas might bear substantial crop yield losses due to extreme temperature episodes and they highlight the need to develop adaptation strategies and agricultural policies able to mitigate heat stress impacts on global food supply.

Surface ozone (O 3 ) is a potent phytotoxic air pollutant that reduces the productivity of agricultural crops. Growing use of fossil fuel and climate change are increasing O 3 concentrations to levels that threaten food supply. Historically, farmers have successfully adapted agricultural practices to cope with changing environments. However, high O 3 concentrations are a new threat to food production and possibilities for adaptation are not well understood. We simulate the impact of ozone damage on four key crops (wheat, maize, rice and soybean) on a global scale and assess the effectiveness of adaptation of agricultural practices to minimize ozone damage. As O 3 concentrations have a strong seasonal and regional pattern, the adaptation options assessed refer to shifting crop calendars through changing sowing dates, applying irrigation and using crop varieties with different growth cycles. Results show that China, India and the United States are currently by far the most affected countries, bearing more than half of all global losses and threatened areas. Irrigation largely affects ozone exposure but local impacts depend on the seasonality of emissions and climate. Shifting crop calendars can reduce regional O 3 damage for specific crop-location combinations (e.g. up to 25% for rain-fed soybean in India) but has little implication at the global level. Considering the limited benefits of adaptation, mitigation of O 3 precursors remains the main option to secure regional and global food production.

The developing countries would need to achieve an increase in their agricultural output by more than threefold during the next century to keep up with increasing demand, stemming from growth in population, incomes and urbanization. There is an urgent need for each country to quantify its long-term food and agricultural requirements and assess them against the possibilities of sustainable production from its own land resources. The extent to which physical resources of soil, climate, terrain and water can be utilized to produce food and agricultural products is limited. The ecological limits to production are set by soil and climatic conditions as well as by specific production inputs and management applied. Any 'mining ' of land resources beyond these ecological limits will, in the long run, only result in degradation and ever-decreasing productivity of land and of outputs, unless attention is paid to the management, conservation and enhancement of the natural resource base. The United Nations Food and Agricultural Organization agro-ecological zone (AEZ) methodology is concerned with the quantification of land resources and their potential agricultural productivity and population supporting capacity for development planning. The AEZ Kenya country methodology is described.

The present study was performed to clarify the time course of the expression of CD64, the Fc gamma receptor type I (FcgammaR1), and membrane-bound CD14 (mCD14), one of the major receptors for endotoxin, on polymorphonuclear leukocytes (PMN) and monocytes in 22 postoperative/post-traumatic patients with septic shock. Therefore, the expression of CD64 and mCD14, and serum concentrations of granulocyte colony-stimulating factor (G-CSF) and interferon-gamma (IFN-gamma) were determined by flow cytometric analysis and enzyme-linked immunosorbent assay (ELISA), respectively, from the first day of septic shock onwards over a period of 14 days. When compared to the values of 12 healthy controls, CD64 expression was elevated significantly on PMN and monocytes of the patients, whereas the expression of mCD14 was decreased significantly at all days. The initially increased expression of CD64 on PMN and monocytes decreased within the first days of septic shock. The already initially decreased mCD14 expression decreased further on PMN, but not on monocytes. Serum concentrations of G-CSF and IFN-gamma during the study period were significantly higher than those of the control group. The differences in the kinetics of CD64 and mCD14 expression in patients with septic shock may be explained by different regulatory effects of cytokines, such as G-CSF and IFN-gamma.

Objective: To clarify the changes in total leukocyte counts, CD64 neutrophil receptor expression and serum granulocyte colony-stimulating factor (G-CSF) concentrations in critically ill patients without infection and sepsis and in patients with septic shock. Design: Prospective study. Setting: Intensive care unit (ICU) and research laboratory of a university hospital. Patients: Eleven critically ill patients without infections and 22 patients with proven infections in septic shock for the first time and of at least 3 days' duration. Measurements and results: Over a 6month period, a longitudinal analysis of expression of the monomeric Fc receptor type I (CD64, FcγRI) on neutrophils was performed by flow cytometric analysis on a daily basis in all postoperative/post-traumatic patients admitted to the ICU until discharge from the ICU or death. Out of 273 patients, 11 patients without sepsis had organ failure and 22 patients with proven infections had septic shock for the first time and of at least 3 days' duration. Ten out of the 22 patients survived, 12 died. CD64 expression was greater in patients with septic shock than in patients without sepsis. Moreover, CD64 expression was only initially and transiently elevated in most survivors (9/10) and non-survivors (8/12) of septic shock. In survivors, G-CSF serum concentrations were markedly decreased in the 2nd week. Conclusions: Decreased neutrophil CD64 expression in an acutely ill population with septic shock may reflect the development of a non-responsive state as well as the early downregulation of neutrophil activation prior to the resolution of an ongoing infection.