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The globalized coronavirus pandemic 2019 has kept us on our toes. Although confusion is widespread and there is a trend toward normalization of almost all human activities, outbreaks remain frequent. The majority of patients with COVID-19 have a trivial to moderate clinical course; a small group develops severe pneumonia and other life-threatening complications. Vaccination against this virus has contributed to better control of the pandemic, but there are no antiviral drugs that have demonstrated efficacy; therefore, the management of surgical patients confirmed or suspected of this disease is a challenge for health care workers, including the anesthesiologists, as well as the non-COVID-19 patients who at a given moment could become carriers or sick. General anesthesia produces aerosols and risks medical and technical personnel being infected, especially those who manage the airway. On the other hand, regional anesthesia has advantages over general anesthesia because the airway is not handled; however, its limited duration is the most important concern. It is reasonable that regional anesthesia occupies a preponderant place in the safe management of all patients, as long as the type of surgery allows it, the anesthesiologist has sufficient skills and patients accept the proposed technique. At this time of globalized crisis due to COVID-19, the intrapandemic anesthetic management of patients undergoing surgery continues to be a changing task, a challenge that has been solved as new data based on solid scientific evidence arise, besides the development of drugs, safer vaccines, equipment, and health prophylactic methods. There is a clear tendency to use regional anesthesia whenever this is possible.

The shoulder joint and clavicle are innervated by the brachial plexus, the cervical plexus, and nerves to muscles around the joint and clavicle. Regional anesthesia is aimed at producing optimal surgical conditions, prolonging postoperative analgesia, being free of complications, reducing costs, and minimizing hospital stay. Regional upper extremity anesthesia can be achieved by blocking the brachial plexus at different stages along the course of the trunks, divisions, cords, and terminal branches. The gold standard of regional anesthesia for shoulder surgery is interscalene brachial plexus block plus cervical plexus block, but it is associated with a high rate of neurological complications and phrenic nerve block. The interest of the anesthesiologist has been directed towards regional blocks avoiding these complications; techniques that approach nerves more distally than interscalene block have been described. These approaches include supraclavicular nerves, upper trunk, suprascapular nerve by anterior approach, axillary nerve block in the axillary fossa, clavipectoral fascia block. The objective of this chapter is to describe the anatomy, sonoanatomy, technique, and the clinical utility of these accesses.

Objective The main study objective was to determine how giant cell arteritis (GCA) is diagnosed in our clinical practice and whether the EULAR recommendations have influenced the diagnostic procedures used. Methods ARTEritis of the Rheumatology Spanish Society -Sociedad Española de Reumatología (ARTESER) is a multicentre observational retrospective study conducted in 26 hospitals with support from the Spanish Society of Rheumatology. All patients diagnosed with GCA between 1 June 2013 and 29 March 2019 were included. The gold standard for the diagnosis of GCA was the judgement of the physician in charge, according to clinical criteria, supported by data available from laboratory tests, imaging studies (ultrasound, positron emission tomography (PET) and MRI/CT angiography) and temporal artery biopsy (TAB) when available. Results We included 1675 patients with GCA (mean age±SD (76.9±8.1) years, 1178women (70.3%)). Of these, 776 patients had a positive TAB (46.3%), 503 (30.0%) positive ultrasound, 245 positive PET (14.6%) and 64 positive MRI/CT angiography (3.8%). These percentages changed substantially over the study. From 2013 to 2019, the use of ultrasound in diagnosis grew from 25.8% to 52.9% and PET from 12.3% to 19.6%, while use of TAB decreased from 50.3% to 33.3%. Conclusions Biopsy was the most widely used diagnostic test for confirming GCA, but use of imaging as a diagnostic tool has grown in recent years. Following publication of the 2018 EULAR recommendations, ultrasound has displaced biopsy as the first-line diagnostic test; TAB was performed in a third and PET in a fifth of cases. Funding: Roche contributes to the financial support of this study. Acknowledgements: To the Spanish Society of Rheumatology that has promoted and provided coverage for this study. To Roche for its financial contribution that made this epidemiological study possible

The survival of preterm newborn patients (PNB) depends in a great extent on the anesthetic technique used. Spinal anesthesia (SA) is considered the best-tolerated regional anesthetic method for highly unstable newborn infants (NB) with high risk of complications during the perioperative period. SA has been recommended for children at high risk for postoperative apnea due to general anesthetics or prematurity. Bronchopulmonary dysplasia (BPD) in the newborn is a disease that accompanies the patient to the operating room with a high incidence of mortality. SA in emergency surgery is a well-tolerated anesthetic procedure with proven effectiveness, with less hemodynamic and respiratory repercussions. At the same time, it produces greater protection against surgical stress in the NB weakened by the premature condition. Hemodynamic stability remains constant even in the newborn with heart disease.

Awassi dairy sheep farmers in the Middle East are facing high feed costs, particularly during the milk production season, along with large fluctuation in grain and straw prices. Incorporating agro-industrial byproducts into the diet of Awassi dairy sheep can help to balance diets and decrease costs. But it may affect milk quality through changes in the fatty acid profile. Six experimental diets were compared to a control diet in the research station of the International Center for Agricultural Research in the Dry Areas (ICARDA) in Tal Hadya, Syria. Milking Awassi ewes (n = 56) were used to test six experimental diets, in which supplements comprised molasses, sugar beet pulp, or cotton seed cake to a traditional control diet contained barley, wheat bran, and barley straw. Milk samples were collected on a weekly basis from April to June. The daily milk production and fat content were enhanced in diets containing urea-treated wheat straw (P

The purpose of non-governmental organizations is to support and help society by generating a non-profit community benefit. Generating a digital transformation of the Non-Governmental Organization (NGO)’s processes through the implementation of a technological platform will facilitate their common tasks, keeping their information accessible, understandable, and reliable. The objective of this work in progress is to visualize the way in which the Design Thinking methodology can improve the design process of a technological platform that benefits the NGO in the management of its processes.

Background The main risk factors for severe COVID-19 described are diabetes, hypertension, cardiovascular disease, obesity, chronic lung and renal disease. HIV infection has not been found to be an independent factor for severe COVID-19, however, only small case series of HIV and COVID-19 have been reported. The aim of this study is to describe clinical characteristics and outcomes of HIV positive patients with COVID-19 hospitalized in a tertiary care hospital in Mexico City. Methods A single-center review of HIV-infected patients diagnosed with COVID-19 was performed using medical records from March 1st, 2020 to May 20th, 2020. We describe the clinical characteristics and outcomes Results A total of 11 PLWH were diagnosed with COVID-19, only 9 were hospitalized and are described here. One died, 6 were discharged and 2 remain hospitalized (table 1). Overall, the median age was 46 years, all males and most (7/9) were on INSTI based ART regimen and undetectable HIV viral load (9/9), with a median of CD4 counts of 581 cell/mm3. The median days since onset of COVID19 symptoms was 7 days. 6/9 had at least one comorbidity: hypertension (3/9) and chronic kidney disease (3/9). 7/9 had body max index >25. 7/9 had moderate to severe lung disease, evidenced by computed tomography. 4/9 required invasive mechanical ventilation, and all were successfully extubated. Table 1. Characteristics and outcomes * Conclusion Most of the HIV patients who required hospitalization due to COVID19 had comorbidities. In spite of severe and critical presentations, most patients have recovered. Outcomes appear no different from those seen for non-HIV infected patients, however larger studies to determine the risk that HIV infection confers to COVID19 outcomes are needed. Disclosures All Authors: No reported disclosures

To generate information on animal fiber quality traits in Central Asia, as a prelude to genetic improvement, fiber samples of 495 cashmere goats from Kazakhstan and Uzbekistan, and 448 mohair goats from these two countries and Kyrgyzstan were characterized. Fixed effects involved location (geographical), animal age and coat color. Fiber traits included greasy down yield for cashmere (GDY, %) and clean yield (CY, %) for mohair; mean down diameter (MDD, μm) for cashmere and mean fiber diameter (MFD, μm) for mohair; coefficient of variation (CV, %) associated with MFD or MDD; comfort factor (CF, %); fiber curvature (Curv,°/mm) and staple length (SL, mm). Percentages of med, kemp and total medullation (TM) were also obtained for mohair samples. Residual phenotypic correlations between traits were calculated. Cashmere GDY, MDD, CV, CF, Curv and SL averaged respectively 26.8 ± 0.6%, 17.2 ± 0.1 μm, 21.0 ± 0.2%, 98.9 ± 0.2% 69.7 ± 0.5°/mm and 29.4 ± 0.7 mm. Location was a significant differentiating factor for all cashmere traits. Significant GDY decrease and MDD increase was observed with age. The SL was highly correlated with GDY, MDD and CF (0.63, 0.65 and −0.64, respectively), and so was GDY with MDD (0.78). Mohair CY, MFD, CV, CF, Curv and SL averaged respectively 76.7 ± 0.3%, 29.3 ± 0.2 μm, 29.5 ± 0.2%, 60.5 ± 1.0%, 48.5 ± 0.2°/mm, and 176.9 ± 1.9 mm, whereas med, kemp and TM averaged respectively 5.7 ± 0.3, 5.5 ± 0.3 and 11.2 ± 0.6%. Significant location differences were found for mohair CY, MFD, CF, Curv, SL, kemp and TM, along with a significant MFD increase and CF decrease with age. All variables, except CY, differentiated according to coat colors. CY was highly correlated with MFD (0.70), SL (0.80), CF (−0.72), Curv (−0.81) and kemp (−0.70). The mohair MFD was also highly correlated with CF (−0.99), Curv (−0.81), SL (0.70) and FM (0.64). The study detected important variability for fiber quality traits in view of (1) heterogeneity for all studied cashmere traits, except for CF, and in all studied mohair traits, and (2) significant location differences for most important quality traits in cashmere and mohair. This suggests that a good base for fiber quality improvement is in place in the region.

Many smallholder breeding programs in developing countries failed because of neglecting basic conditions, particularly the no involvement of farmers in a participatory manner from design to the implementation phase of the programs. Inadequate centralized breeding plans to improve local breeds and various plans prescribing crossbreeding with European highly producing breeds, failed. Though some nucleus breeding programs were successful and attained some sustainability if the farmers’ participation was considered, they still are vulnerable once the funding provided ends. An evolving approach, emerging from participatory research experiences, involves community-based breeding programs for smallholder farmers in low-input systems. These are being implemented in pilot research sites with promising results and already rendering lessons learned that merit consideration in relation with the sustainability of a program. The paper discusses important factors for the success of these programs. Farmers’ participation along with main issues for program implementation are highlighted in relation to site selection, the communication processes, recording schemes, role of scientists, the institutionalisation of cooperation and the enabling environment. Finally, ongoing case studies of successful community-based breeding programs are mentioned. Shortcomings in farmers’ participation require attention and institutional strengthening for effective application of participatory tools and knowledge exchange between farmers and researchers. But participatory research alone is not the sole prescription for success. No matter how participatory the plans will be, they will always depend on technical support and institutional support for data collection, analysis and feedback. This is hindered because of the short-term projection of funding for research projects. An important issue relates to the out scaling of successful experiences at project level that benefits only a limited number of farmers. The only avenue to guarantee sustainability is that government priorities (local or national) emphasize community-based breeding as a viable alternative for smallholder improvement on a long-term basis, and development and appropriate policies provide the enabling environment for realization and adoption at a large scale. Under these conditions research will have an advisory and facilitating role whereas ownership of the program will go to the community-level.

Several less researched forages from various Mediterranean plants may be superior, or at least equivalent, in forage value to barley (Hordeum vulgare) straw. These include lentil (Lens culinaris) straw, vetch (Vicia sativa) hay, dried olive (Olea europea L) leaves, and saltbush (Atriplex halimus). Using in vitro, in sacco and in vivo methods, we tested (i) the nutritional composition, (ii) digestibility and metabolizable energy, and (iii) intake and nitrogen balance in fat-tailed Awassi lambs of these feeds or diets prepared with these feeds. In vivo, the forages were fed in proportions of about 3/4 of the total diet to 30 animals allocated to five groups in a randomized complete block design. Diets, balanced for nitrogen, included concentrate (280 g/kg) and were offered at 1.1 kg dry matter (DM)/day with ad libitum access to water. Test forages had large differences in content (g/kg DM) of organic matter (OM; 690-916, Atriplex leaves vs. barley straw), crude protein (CP; 43-169, barley straw vs. vetch hay) and neutral detergent fiber (258-672, Atriplex leaves vs. barley straw). Olive leaves contained the highest phenol and ether extract levels (63 and 32 g/kg DM, respectively). Atriplex leaves were particularly rich in Na (94 g/kg) and K (39 g/kg). Atriplex leaf OM had the highest digestibility (0.68), but its low level reduced the metabolizable energy (ME; 6-7 MJ/kg DM) to that of barley straw. Its limited palatability caused significant refusals as well. Vetch hay, olive leaves, and lentil straw had superior OM digestibility to that of barley straw (the latter not significant). Olive leaf CP had limited ruminal degradability and total tract digestibility. None of the forages significantly affected body N retention, while olive leaves significantly reduced rumen microbial efficiency. The different models used to estimate ME ranked vetch hay first (9 MJ/kg DM), followed by olive leaves and lentil straw (6.5-8 MJ/kg DM). Overall, vetch hay was the most valuable forage in terms of energy and protein supply. Lentil straw and olive leaves were similar or slightly superior to barley straw, although they presented a different ruminal degradation pattern. Atriplex leaves, if fed restrictedly, could be used to replace barley straw when access to water is ad libitum.

Livestock husbandry in the dry areas of the Mediterranean basin is facing scarcity and fluctuation of feed supply and feed prices. At the same time the local agro-food industry is expanding and its by-products might be used as alternatives to traditional feed resources, but their nutritional value is not well known. Therefore, four by-products typical for the Mediterranean area were tested in vitro (n = 3 per diet or feed), in sacco (n = 6) and in vivo (n = 6) either individually or in a proportion of 0.34 of the total diet. The test feeds (broken lentils, sugar beet pulp, tomato pomace and crude olive cake) were compared to a barley–wheat bran mixture (control). Forage (barley straw) made up proportionately 0.5 of the diet. For all experiments either rumen canulated or intact castrated male Awassi sheep were employed. The thirty sheep used in the in vivo experiment weighed on average 42 kg. The animals were fed 1.1 kg dry matter (DM)/day and had free access to water. Large compositional differences (g/kg DM) between the batches of test feeds used in the present study were found in crude protein (from 79 to 245; for olive cake and broken lentils), neutral detergent fiber (aNDFom; from 283 to 584; for broken lentils and olive cake) and non-fiber carbohydrates (from 109 to 436 for tomato pomace and olive cake and to broken lentils). Two feeds (tomato pomace and olive cake) were rich in ether extract; sugar beet pulp was rich in calcium. Broken lentils had the highest effective degradabilities (ED). Olive cake was lowest in ED of OM and aNDFom (0.39 and 0.32, respectively). Olive cake caused refusals of concentrate (lower proportionate concentrate intake compared with the control, P

High feed-cost constraints are currently threatening the livelihoods of farmers fattening lambs in developing Middle Eastern countries. Reduced-cost feeds and adequate management alternatives are needed for more efficient lamb-fattening systems. Therefore lamb fattening performances of different Awassi sheep genotypes, on different diets and fattening environments, were therefore evaluated. Two trials were conducted. The first trial was conducted on-farm in northern Syria to assess the fattening performance of Syrian Awassi, and Turkish × Syrian Awassi crossbred lambs, and the suitability of 2 cost-reducing feeding diets compared to the traditional spring fattening diet of grazing green barley with supplementation (C): intensive feeding based only on concentrate and barley straw (D1) and semi-intensive grazing on vetch (Vicia sativa) with minor supplementation using the same D1-mix (D2). Lambs of both genotypes did not significantly differ in weight gain in the 49-day fattening period. There were no significant differences in weight gains among C, D1 and D2 diets: 14.4, 15.3 and 15.9 kg/lamb, respectively. The D2 diet reduced feeding costs by 20% and promoted high growth, notwithstanding its beneficial soil effects. The second trial was conducted on-station at the International Center for Agricultural Research in the Dry Areas (ICARDA), Syria, to assess the fattening performance of lambs of the above 2 genotypes in addition to Turkish × (Turkish × Syrian) crossbred lambs, both in indoor and outdoor conditions. Paralleling the first trial, live weight gains of the 3 genotypes did not differ significantly. Fattening lambs under a more favorable and healthier outdoor environment using a simple shed, avoiding negative effects of lack of ventilation and high temperature, produced significantly more live weight gain (5.8 kg) per lamb than indoors. No differences in smell, taste, juiciness and tenderness were found among genotypes in the second trial, confirming no negative effects of using these diets in the first trial, reported elsewhere. There were no statistical differences in smell, taste, juiciness and tenderness, in the meat with the distinct diets or the fattening (indoor/outdoor) environments. Both trials showed that whereas no gains could be expected by using the Turkish genotype for fattening, vetch grazing and molasses are suitable options for reducing high feed costs and could be safely used by farmers without compromising meat quality. Raising animals in a more favorable and healthier environment outdoors under a simple shed can also translate into substantial revenue in large batches of fattened lambs with considerable benefit for fattening systems.

Awassi lamb-fattening systems in Middle Eastern countries are popular because they can rapidly generate income. Nevertheless, feed costs constraining these systems and seasonal fluctuations in feed prices expose farmers to risk. A 90-day fattening experiment was conducted at the International Center for Agricultural Research in the Dry Areas (ICARDA), in Syria, to compare reduced-cost diets that use locally available feeds with the diet used traditionally by farmers. Thirty-six 4-month-old Awassi lambs (mean live weight 23.0 kg) were randomly assigned to three groups: (1) the control group (C), in which lambs were provided with the diet used in fattening systems in Syria; (2) the faba bean and beet molasses group (FBM), in which the lambs were fed a reduced-cost diet in which the barley given in C was replaced with faba bean and beet molasses; and (3) the wheat bran and beet molasses group (MM) replacing a large portion of the broken maize and a small portion of the barley in C. Lambs in C and the reduced-cost diets (FBM and MM) had ad libitum access to untreated (UNTWS) and urea-treated wheat straw (UTWS), respectively. An 11-day digestibility trial was conducted in a subset of the fattened lambs at the end of the growth phase. Total weight gains (24.7, 25.5 and 26.2 kg in groups C, FBM and MM, respectively) and average daily gains (0.282, 0.298 and 0.291 kg/day for C, FBM and MM, respectively) did not differ between groups (P > 0.05). The FBM and MM alternative diets were 13.5% and 11.8% less expensive, respectively, than the C diet. However, due to the higher dry matter intake of concentrate and UTWS the total feed costs per lamb on the alternative diets were 5–13% higher than in C (23.4–25.0 USD in the alternative diet groups vs. 22.2 USD in the C group). The economic returns per kilogram of weight gained did not differ, and the feed costs per kilogram weight gain were similar in the three groups (0.90, 0.98 and 0.89 USD in C, FBM and MM, respectively). No differences among groups were observed with regard to carcass traits and quality (P > 0.05). Although no cost-savings were obtained per kilogram of weight gained, the use of locally available feed resources such as molasses has the potential to reduce and stabilize fluctuating feeding grain costs during periods of high grain prices.

The north-central semiarid region of Mexico has been exposed to systematic grazing since colonial times. The grazing impact on rangelands has degraded soils and reduced diversity and productivity. The most common and detrimental cause of soil degradation is soil erosion which destroys chemical, physical and biological properties. To determine the effect of grazing systems on rangelands, several studies were performed. Such studies included a description of soil profiles to categorize degradation and the evaluation of water erosion changes due to further degradation processes under grazing systems (rotational, RG and continuous, CG). The study was carried out on a rangeland of the ejido Panuco, Zacatecas, from 2002 to 2005. Soil degradation was classified by identifying 6 groups with similar soil profiles (GSSP) which were described as: (1) low degradation soil; (2) medium degradation soil with A horizon lost; (3) high degradation soil without A and B horizons lost; (4) high degradation soil with in situ development; (5) high degradation soil with calcareous material; and (6) high degradation soil without development, which is a very shallow soil above the parental material. Further degradation was determined by soil erosion measurements performed in the study area and the surroundings. With respect to soil losses their values were systematically less for the RG system under the native vegetation conditions studied ( P

To improve the effectiveness of community-based breeding programs for increased milk production, the values of different udder measurements for predicting milk production traits during the milking period were assessed over 3 yr on 273 Awassi ewes. Machine milking of ewes began after weaning, 56 d after parturition, and continued until the milk yield of the ewes was

A performance evaluation, conducted between 2003 and 2005, compared the milk production of three genotypes of Awassi ewes: Turkish (T), Syrian (S) and the F1-cross between the Turkish and Syrian ewes (TS), at the International Center for Agricultural Research in the Dry Areas (ICARDA) experimental farm in Tel Hadya (northern Syria). After weaning, which occurred at 56days, milk yield and milking length were measured weekly during the milking period ( n = 381). Milk yield of TS and T ewes were 12% and 30% higher, respectively, than S ewes. Milk yield and milking length of TS ewes reflected additive inheritance and did not differ from the parental genotypes' average ( p ≥ 0.199). Culling of low producing ewes in 2003 and 2004 also resulted in increased milk yield. Dams of all genotypes displayed similar weights at birth ( p = 0.898) and weaning ( p ≥ 0.677). The latter suggests dams of the different genotypes olerated equally the pre-weaning lactation load. Performance tended to improve as ewes aged, with milk yield and milking length peaking at 3years of age ( p > 0.05). Ewe lambing weight, birth–weaning ewe weight decline, litter size, and litter weight weaned peaked at 4–5years of age ( p ≤ 0.016). With the exception of birth–weaning ewe weight decline, year effects influenced the traits under study ( p ≤ 0.035). Excluding litter size, the best performance was in 2005, followed by 2003 and 2004. Milk yield increased with litter size at weaning ( b = 18.7; p = 0.024). The lambing–weaning ewe weight decline (3.6kg) and ewe productivity (0.46kg litter weaned weight per kg ewe weight) did not differ between genotypes ( p ≥ 0.178). Average litter size was 1.15, with the TS ewes displaying the largest litter size (1.23; p = 0.026). Single lambs were 25% heavier than twins at birth averaging 4.73kg and 3.8kg, respectively. Male lambs were 4% heavier than female lambs at birth ( p p p ≥ 0.210). The average proportion of fat (5.95%), crude protein (5.19%) and solids non-fat (11.29%) in the milk varied across genotypes where S p ≤ 0.0037). F1 crosses with T increased the productivity of S ewes by 12.2%. It is noteworthy that this occurred under improved feeding and may not be recommended for other conditions. Culling low producing ewes led to a 12.8% increase in milk yield, which could translate into a substantial boost in revenue for farmers rearing traditional sheep flocks in milk producing areas.

The Sicilo-Sarde, the only native milking sheep in Tunisia and in North Africa has undergone a considerably population reduction from 200,000 ewes in 1995 to 25,000 ewes in the year 2000. Low sheep milk price and a shift to dairy cattle were among the reasons for this decline. The main objective of this study was to report on the impact of farmers organization, technology transfer and market on reversing the dramatic decline of this native dairy sheep breed to a promising livestock development model. Having at the grassroots a “pioneer” who chose to form the Sicilo-Sarde breed association in 2003 was a key ingredient in the process of saving this breed from disappearance. Quick steps were first taken: Selling milk through the association allowed doubling its price in one year. A new legislation benefiting dairy sheep was introduced. A trilogy principle was followed where breed owners, researchers and policy makers interacted together to find optimum solutions that fit expressed needs of breed owners. An applied multidisciplinary research program was established and tackled major constraints faced by the breed in nutrition, management, reproduction, health, breeding and product development. Encouraged by an unsatisfied market and good prices, small farmers with a few cows started shifting to dairy sheep and poor new ones managed to get loans to purchase dairy sheep breeding animals. Based on a total of 7937 lactations recorded during the period 1997–2002, average milk yield, days in milk and suckling period were 89 kg ± 47 kg, 139 d ± 47 d and 104 d ± 22 d, respectively. Given the low producing ability of the breed and the impossibility of importing proven rams for health considerations, frozen semen from 17 Sarda rams was imported from Italy and 1600 ewes from 12 flocks were inseminated by intrauterine in 2005–2006. Fertility, prolificacy, and mortality rates varied from 47% to 63%, 157% to 184% and 0 to 34%, respectively. The decline of the breed was stopped and reversed and members of the association and small farmers in the region will benefit from the produced offspring. While currently the association is accessed by more organized producers, it provides an opportunity for the integration of smaller, poorer producers to improve their livelihoods. This case has inspired another group of farmers of a native sheep meat breed to form their own association to promote their breed.

The Jabali mountain goats inhabit the extremly unfriendly and harsh environment of western Syria, where they are kept by different ethnic groups, namely, the Alawits, Druses and Bedouins. The Jabali goat is a black goat, with dropping ears and a curved head; both sexes have horns. A survey was conducted in two different sites, namely, Al-Ghab in Hama district and in As-Sweida district. Forty-three household interviews were carried out to document the current production system. The system can be characterised as a low-input, mixed crop–livestock system. Goat keeping is only of minor importance to the household income compared to crop production or off-farm activities, but provide food in the form of milk, dairy products and meat for the family. Animals are kept on natural pasture most of the year; feed is only supplemented during winter. Farmers emphasise milk production. Milk products like ghee, Shinglish or Jameed are produced for home consumption and for sale. Major constraints mentioned by farmers are government policies for the conservation of forests, feed shortage and limited access to markets because of bad infrastructure and low market prices for their products. The fact that young people migrate to urban areas or work off-farm is seen as potential problem in the near future.

Important urban market changes have been noticed in Tunisia for animals that produce thin tail carcasses in contrast to carcasses of animals with a fat tail. In response to this trend, farmers are crossing the local Barbarin (a fat-tailed breed) with thin tailed breeds (Algerian Ouled Djellel and Black Thibar). This happens while the fat tail is known as a criterion of adaptation to harsh conditions and fat-tailed animals are preferred for religious practices. The objectives of this study were to identify hidden reasons for these changes and assess the degree of crossbreeding between the Barbarin sheep and thin tailed breeds. A total of 912 surveys were conducted in three major sheep regions covering the capital (Tunis) and five departments, and including 601 sheep owners, 158 butchers and 153 consumers. The main results showed that even though raising sheep is still as an activity by itself, fattening activities (breeding–fattening or only fattening) are becoming more and more dominant and they represented 75%, 53% and 65% of the sheep activities in the capital Tunis, South East and North West regions, respectively. While breeders and consumers still prefer, in their majority (55–75%), the Barbarin fat tail lambs, butchers tend to favor thin tailed sheep because of the difficulty of selling the fat of the tail that represents up to 15% of the carcass weight. To meet the butchers’ demand, farmers are shifting to thin tail breeds and crosses and in the studied areas, market changes towards thin tailed breeds were dictated by butchers’ and not consumers’ preference. Sensory tests revealed little difference among the three studied genotypes but showed a superiority of the fat tail lambs in tenderness, flavour and smell.

This research describes the development of robust molecular descriptors that are reliable and easy to use (PCR-based) for the proper classification of the six cultivated Brassica L. species and subspecies that make up the U triangle. Sequence characterized amplified regions (SCAR) were derived from DNA fragments generated by randomly amplified polymorphic DNA (RAPD) primers that distinguished the U-triangle Brassica species: B. rapa L. (A, n = 10), B. nigra (L.) Koch (B, n = 8), B. oleracea L. (C, n = 9), B. juncea (L.) Czern (AB, n = 18), B. napus L. (AC, n = 19), and B. carinata Braun (BC, n = 17). The SCAR descriptors developed in this study reveal the presence-absence of a DNA fragment and sequence length polymorphisms to distinguish the three genomes (A, B, and C) of the six cultivated Brassica species. These markers should prove to be useful in revealing misclassifications at the subspecies level. The amplification of a single DNA fragment and reduced sensitivity to reaction conditions make these SCAR descriptors ideal to accurately classify and organize large numbers of cultivated Brassica accessions typically present in large germplasm collections.

Resume Selon la Theorie des Attentes, le comportement alcoolique est explique, entre autres, a partir des croyances que les sujets ont sur le renforcement de la consommation d’alcool. Le systeme de croyances d’un sujet serait un agent favorisant le changement d’attitudes concernant la consommation d’alcool. Notre etude vise a comparer les attentes positives envers l’alcool (APEA) des patients alcoolodependants en cure de sevrage et des abstinents, afin de trouver des differences qui temoignent d’un changement au niveau cognitif. Nous utilisons une version abregee du questionnaire AEQ de Brown, l’inventaire de depression de Beck (BDI) et le questionnaire d’anxiete de Spielberger (STAI), afin de controler ces variables qui pourraient influencer les attentes. Nos resultats montrent une difference significative dans les APEA entre les individus abstinents et ceux en sevrage, ce qui suggere l’existence d’une evolution au niveau cognitif entre le moment d’une consommation pathologique et celui ou une abstinence est plutot consolidee. Cependant, cette difference significative n’est pas correlee a la duree ni de la dependance, ni de l’abstinence.

Goat production concentrated in developing countries (tropics, dry areas), contributes largely to the livelihoods of low and medium income farmers. Farming systems in these areas have evolved to cope with the formidable constraints imposed by harsh natural and economic conditions by adapting integrated crop/livestock production strategies. In Asia, Africa and Latin America, due to its almost exclusive extensive nature, goat production relies mainly on grazing on communal lands that hardly provide the minimum nutrient requirements due to overstocking and degradation. While some of these production systems are becoming semi-intensive, appropriate breeding strategies should be designed to promote conservation and improvement of their unique attributes, such as adaptability, water use efficiency and suitability under harsh climatic conditions. In Europe, dairy goat production is more common around the Mediterranean basin, where it is important from an economic, environmental and sociological perspective to the Mediterranean countries: Spain, France, Italy and Greece. Europe owns only 5.1 % of the world's dairy goat herds, but produces 15.6 % of the world's goat milk; this is the only continent where goat milk has such an economic importance and organization. In developing countries the dairy goat sector requires a systemic approach, whereby nutrition, animal health, breeding, know-how, inputs and technologies must be assembled. This would allow the optimization of natural and local resources and would promote the transition from a risk reduction strategy towards an increased productivity strategy. Such an increase would privilege production efficiency based on clean, green and ethical practices for responsible innovation.

Increased feed costs affect the livelihoods of dairy sheep farmers in the Middle East. Farmers endure high risks with large fluctuations in the price of grain used as animal feed, which is further affected by drought and declining range productivity. Using agricultural by-products and treated straw or vetch grazing for supplementing sheep diets would provide resource-poor dairy farmers with increased options to reduce feed costs, but the effects of such feeds on the quality of yogurt (the main product) need to be better understood. Two experiments were conducted to evaluate these effects. The first trial evaluated alternative diets using locally available feedstuffs, including agricultural by-products, compared with traditional diets used by dairy sheep farmers, and was conducted on-station at the International Center for Agricultural Research in Dry Areas (ICARDA, Tel Hadya, Aleppo, Syria). Milking Awassi ewes (n=56) were used to test 6 alternative diets against a traditional control diet containing barley, wheat bran, and barley straw. The 6 alternative diets contained 4 or more of the following ingredients: barley, sugar beet pulp, molasses, cotton seed cake, wheat bran, urea-treated wheat straw, and barley straw. Ewes on one of the alternative diets grazed vetch pasture, whereas ewes on the control diet and the 5 alternative diets grazed native range pasture. The milk fat content was higher in diets containing urea-treated straw. Yogurt firmness and adhesiveness were significantly lower in energy-rich diets (e.g., the control diet) and in the diets rich in soluble sugar (molasses). The effects of diet on yogurt color and on citric and succinic acid contents were significant. A yogurt produced from the milk of the group grazing on vetch was the most yellowish in color, which is appealing to Syrian consumers. The content of citric acid tended to be higher in yogurts produced from diets containing molasses. The second trial was conducted on 3 farms in northern Syria to assess an alternative diet (1 of the 6 tested in the first trial) on 15 milking ewes compared with the farmer's traditional diet (control). The alternative diet increased yogurt firmness and adhesiveness by 7 to 9% and 10 to 16%, respectively. The use of nonconventional feeds available in the region enhances yogurt quality, may reduce requirements for expensive grains, and thus, increase farmers' livelihoods by targeting expanding markets with better quality products.

This histological study of the human ductus epididymidis in autopsy or surgical specimens revealed the presence of multiple intra-epithelial cavities or pits showing a variable degree of development. In their origin, cavities were surrounded by cells with the same staining affinity and ultrastructural features as the principal cells, except for the cavity basal surfaces that were supported by lower cells. The latter cells, although otherwise like the basal cells of the ductus epididymis, displayed short microvilli in the cavity lumen. When the cavities expanded the basal cells became principal cells, while the principal cells located at the top of the cavities degenerated, creating pits that opened into the lumen of the ductus epididymidis. The surface occupied by the pitted areas increased progressively between the end portion of the caput epididymidis and the corpus-cauda transition, where it decreased abruptly. This pitted pattern was observed in all the normal adult men studied and in the children with precocious puberty but not in the normal children or in the adult men with hypogonadotrophic hypogonadism. This observation suggests that the development of pitted cavities is androgen-dependent.

Drainage from the umbilicus may be due to the presence of structures derived from the vitelline duct or urachus, granulomas, ectopic tissue, or poor hygienic practice. This paper discusses the case of a 6-month-old infant with a wet umbilicus caused by ectopic pancreatic tissue, in urachal remains. No similar cases have been found in the literature.

Relations between geography and health have been recognized since ancient times. Investigation of such relations has been characterized by isolated and scant efforts. This article aims to explore potential links between geography's theoretical and methodological frame of reference and knowledge and interpretation of the population's health. It approaches the antecedents of medical or health-related geography and the use of the theoretical and methodological framework of geographic space, as well as identifying alternatives for its implementation. Finally, it raises several points relating to current development in the relations between geography and health in Latin America, as well as alternatives for such development.

To report a case of adult Wilms' tumor, a kidney tumor that is more common in children and has a scanty incidence in adults.A case of Wilms' tumor in a young male, aged 16 years, is described. The patient underwent partial surgical resection initially and nephrectomy due to tumor recurrence, with postoperative chemotherapy and radiotherapy.Although approximately 200 cases of adult Wilms' tumor have been reported in the literature, few meet currently accepted diagnostic criteria. The diagnosis of adult Wilms' tumor based on the findings of currently available diagnostic methods is only presumptive until the surgical specimen is analyzed. Most cases are treated as renal tumor and it is the findings of the pathological analysis that defines its nature and the need for chemotherapy and/or radiotherapy, as well as long-term follow-up. The application of therapeutic protocols for children to adults has not obtained the same percentage of cure or prognosis, although a large multicenter study is warranted to confirm the foregoing.

We report a case of prostatic melanosis in a 68-year-old patient. Although uncommon, some authors have reported an incidence of 4-10% for benign pigmented lesions of the prostate. It is important to distinguish this from the blue nevus where melanin deposits only involve the prostatic stroma. We discuss the theories explaining the origin of melanin in the prostate and its presence in the epithelium. The gross and microscopic findings of these conditions are described.

This study evaluated the effect of nutritional supplementation and socio-sexual cues upon reproductive efficiency of goats exposed to the male effect under rangeland grazing conditions (22°N). Criollo goats (n = 73) were distributed in four experimental groups: (1) continuous males (CM, n = 19) in which males (n = 2) remained together with females from 7 March to 28 July; (2) supplemented males (SM, n = 16) in which males (n = 2) were kept separately and were individually supplemented with 18% crude protein and 2.77 Mcal ME kg–1 DM, during a 30-day period; (3) supplemented males exposed to the female effect (SM + FE, n = 19), in which supplemented males (n = 2) were maintained with females induced to oestrus before being used for male effect; and (4) supplemented males and supplemented females (SM + SF, n = 19) in which males (n = 2) were supplemented as in group SM, and females received the same supplementation as males 30 days before and 30 days after male introduction. Grazing was performed from 0900 to 1900 hours; liveweight (LW) was registered weekly before grazing and (or) supplementation. Ovarian activity was evaluated (serum P4 concentrations) in the four groups before and after male introduction. At the beginning of the study and supplementation, female LW did not differ among treatments (P > 0.01). However, during the supplementation phase, LW increased in a different fashion among groups (P < 0.002), favouring the SM, SM + FE and SM + SF groups. A positive correlation between female LW at the beginning of the rainy season and the onset of ovulatory activity was observed (r = +0.90; P < 0.01). The average date for the onset of ovarian activity differed (P < 0.001) among groups, being earlier in the SM + SF group (9 May ± 4.3 days), which also depicted the shortest interval between the introduction of males until the onset of ovulatory activity (P < 0.001). Results of the present study indicate that nutritional signalling of the reproductive activity of both female and male Criollo goats reared under marginal conditions surmounts the inhibitory effects of long-day photoperiods during the non-reproductive season. An increased level of nutrition during the anestrous season may be used to increase reproductive function of both male and female goats reared in harsh nutritional conditions and applied as a green, clean, and ethical reproductive tool at these latitudes.

A retroperitoneal tumor was removed from a fifteen-day-old infant: Light micros-copy revealed a teratoma consisting mainly of immature nervous tissue. Three months later the patient had recurrence and numerous peritoneal metastases showing a histologic pattern similar r to that of the primary tumor. Twelve months later there was enlargement of the left testis due to metastases from teratoma infiltrating the tunica vaginalis of the left testis, the epididymis, and the spermatic cord. These metastases consisted of mature neurons and glial cells. The early dissemination of the tumor suggests an intracavitary spread pattern. The tumor maturation, in pi paratesticular structures suggests that mesothelial cells are involved in the differentiation of tumoral germ cells.

Light microscopy study of spermatic cord cysts in 26 men revealed three different histological patterns. First, cysts of probable mesothelial origin (14 cases) with an unilocular aspect: their epithelial cells showed poor cohesion and often appeared sloughed; subepithelial hyalinization or fibrin deposits were frequent. Second, cysts of probable embryonal (mesonephric) origin (8 cases): they were usually multilocular cysts and their epithelial cells showed great cohesion: zones of ciliated columnar epithelium associated with embryonal remnants displaying a similar epithelium were often found; the embryonal remnants and the cyst lumen contained spermatozoa in 2 cases. Third, cysts of doubtful origin (4 cases) showing abundant inflammatory infiltrates, which had destroyed the epithelium; the unilocular pattern observed in 3 cases suggests a mesothelial origin for these cysts, while the multilocular pattern and presence of embryonal remnants in the other case suggest an embryonal origin.

The histological study of epididymides obtained from autopsies (41 children, 7 young adults and 8 elderly men) and surgical specimens (10 young adults and 3 elderly men) revealed the presence of multiple diverticula in the cauda epididymis in all elderly men and in only 2 young adults (32 and 33 years old). The diverticula appeared as evaginations of the epithelial lining of the duct, disrupting the muscular coat and expanding into the surrounding connective tissue. The formation of epididymal diverticula seems to be an age-related process that might be caused by repeated increases in the intraluminal pressure in the cauda epididymis.

Two infants with complete trisomy of chromosome 9 are described. One patient, died a few minutes after birth and another survived 24 hours. The main clinical findings in this syndrome are: intrauterine growth retardation, characteristic facial dysmorphism, hypoplastic external genitalia and malformations of heart, brain and skeleton.

Five cases of cysts of the tunica albuginea and two cases of cysts of the testicular parenchyma are described. The cysts of the albuginea were located in the anterior, lateral, and inferior faces of the testis (distant from the epididymis) and covered by a thin albuginea. They extended toward the testicular parenchyma or toward the tunica vaginalis. Their epithelial lining varied from low cuboidal to columnar and consisted of ciliated or nonciliated cells. These cysts were probably of mesothelial origin. The cysts of the testicular parenchyma were also located distant from the mediastinum testis and were not in contact with the albuginea. Their epithelial lining consisted of flattened, cuboidal, nonciliated cells. The origin of the cysts of the testicular parenchyma is not clear. In one case the occurrence of spermatozoa in the cyst lumen and connections with seminiferous tubules suggests an origin in the rete testis.

The spermatic cords (SCs) obtained from: (a) autopsies of 67 adults and 50 children; (b) 3 fetuses; (c) 12 surgical specimens from 9 adults and 3 children with testicular tumors, and (d) 26 surgical specimens (14 adults and 12 children) with diagnosis of SC cysts, were studied by light microscopy. The histological study revealed the occurrence of tubular embryonal remnants (TERs) in 19 autopsied adults, 14 autopsied children, 3 fetuses, 2 surgical specimens (1 adult and 1 child) owing to testicular tumors, and 6 surgical specimens with diagnosis of SC cysts. The TERs were found in the low, middle or high thirds of the SC and consisted of a cuboidal or columnar, often ciliated epithelium surrounded by connective tissue. In the 3 fetuses and in 3 autopsied children renal glomeruli were found in close relation with the TERs. In 2 cases of SCs showing cysts and TERs both structures contained spermatozoa. The histological pattern of the TERs suggest that they are wolffian derivatives which might give rise to SC cysts.