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Introduction: The epidemiological profile of burn patients is a useful tool when planning prevention and prioritization of resources. Objective: To describe and analyze differences in the epidemiological profile of hospitalized pediatric burn patients in reference centers throughout the country. Materials and Methods: This is a retrospective analytical multicenter study conducted in four burn units (one in the IV region, two in the Metropolitan Region, and one in the X region). We reviewed clinical records between January 2019 to December 2021. Variables included: Age, Gender, Etiology, Burned Body Surface Area (BSA), and Severity Index (SI). Incomplete records were excluded. Statistical analysis was performed using Chi-square test and ANOVA with p< 0.05. Results: 1,081 patients, 48 were from the North, 837 from the central region, and 196 from the South. We observed a decrease in the number of patients over the years. Gender: 56.24 % were male. Age: median of 1 year and a 75th percentile of 4 years. Etiology: 70.9 % were scalds. Scalds were more frequent in the North. In the South, there were more burns by hot objects, while in the central region, there were more electrical burns (p = 0.012). BSA: Median was 5 % (4–7.5 %), the distribution varied, p = 0.0007. SI: Median was 63 (61–68.5), with the North having a higher median. Conclusions: The epidemiological profile of pediatric burn patients is scald in male infants with a BSA less than 10 %. The main difference between profiles is the etiology. Towards the South, the frequency of scald decreases while hot objects increase. Level of evidence: level II - 3 of evidence

Environmental restoration and sustainable energy solutions require effective management and utilization of agricultural crop residues to reduce greenhouse gas emissions. Biowastes are a valuable resource that can be converted into biofuels and their byproducts, solving the energy crisis and reducing environmental impact. In this study, teff husk, primarily generated in Ethiopia during the production of teff within the agro-industrial sector, is used as a feedstock for slow pyrolysis. Ethiopia generates an estimated annual production of over 1.75 million tons of teff husk, a significant portion of which is incinerated, resulting in significant pollution of the environment. This study focuses on assessing teff husk as a potential material for slow pyrolysis, a crucial stage in biochar production, to tap into its biochar-producing potential. To identify the composition of biomass, the teff husk underwent an initial analysis using thermogravimetry. The significant presence of fixed carbon indicates that teff husk is a viable candidate for pyrolytic conversion into biochar particles. The process of slow pyrolysis took place at three temperatures—specifically, 400, 450, and 500 °C. The maximum biochar yield was achieved by optimizing slow pyrolysis parameters including reaction time, temperature, and heating rate. The optimized reaction time, temperature, and heating rate of 120 min, 400 °C, and 4.2 °C/min, respectively, resulted in the highest biochar yield of 43.4 wt.%. Furthermore, biochar’s physicochemical, SEM-EDX, FTIR, and TGA characterization were performed. As the temperature of biochar increases, its carbon content and thermal stability increases as well. Unlike fuel recovery, the results suggest that teff-husk can be used as a feedstock for biochar production.

AbstractUsing appropriate agricultural mechanization services is critical to increasing agricultural productivity and ensuring food security. A large portion of Ethiopian farmers have no access to agricultural mechanization services, including tractors, combine harvesters, and threshers. There are several factors responsible for the limited use of agricultural mechanization services in Ethiopia. The objective of this study was to investigate the key factors that determine smallholder farmers’ decisions in hiring tractor and combine harvester services in the Debre Elias district of the Amhara region of Ethiopia. A multistage sampling technique was used to collect data from 133 respondents. Data collection techniques included structured interviews and focus group discussions. Descriptive statistics and a binary logistic model were employed to analyze the data. The findings showed that promotion and support from different organizations, including the government and development partners, are the main factors that influence farmers’ decisions to hire mechanization services. The results also revealed that economically active family labor, off-farm income, number of oxen, goal of farming, and institutional influence are the main factors that significantly influence farmers’ decisions about hiring tractor services in the study area. Harvesting labor costs and weather uncertainty were discovered to be the factors that positively and significantly influenced the farmers’ hiring decisions for combine harvester services. It is important to create awareness among farmers about agricultural mechanization services. Systematic support for both private machinery service providers and cooperative unions is needed to improve mechanization services for farmers in the area.

The pre-construction phase of public infrastructure projects is characterized by significant uncertainty as crucial decisions are made with limited information. This early stage of project development is influenced by a multitude of factors and input from various stakeholders. While early contractor involvement (ECI) offers potential benefits for both clients and projects, the timing and selection of tasks for involving the contractor are critical to achieving these benefits. This study seeks to identify key pre-construction activities in public infrastructure projects and pinpoint the activities that stand to gain the most from ECI. The research methodology involved conducting semi-structured interviews, organizing seven workshops, and conducting the literature and document studies. Through these efforts, the study identified a total of 20 pre-construction activities, among which 5 activities emerged as the most favorable candidates for ECI, while 5 others were deemed less suitable. The findings underscore a consensus that involving contractor expertise during the Brief Development sub-phase holds significant promise. Notably, activities associated with planning, environmental considerations, and technical aspects related to the scope clarification, were found to be highly amenable to ECI. Activities addressing uncertainty management received particular attention, with clients valuing contractors’ practical experience in risk assessment and mitigation. Additionally, contractors’ insights into planning, activity dependencies, and their contributions to health, safety, and environmental plans were highly regarded. However, activities, categorized under the more technical sub-phases of Concept Development and Detailed Engineering yielded mixed results, while those falling within the predominantly social and political domain and involving political processes and societal impact, were viewed as less suitable for early contractor involvement. These findings emphasize the need to adopt a systematic and consistent approach to pre-construction activities, highlighting that ECI should not be applied as a one-size-fits-all solution. The interview results somewhat contrast with the literature findings, which indicate that the early conceptual phase is most beneficial as the contractor impact is highest. To some extent, the client, contractor, and consultant still see their benefit and strategy before the good of the project.

The broad and extensive application of public-private partnership (PPP), as well as the divergent documented definitions and experiences, have led to a translucent perspective of PPP and strained academia and industry to reach a consensus on the major practice of this concept. Early contractor involvement (ECI), governance tools, and relational contracting are only a few of the frameworks attributed to PPP. This issue has received limited attention from researchers, despite the focus of review studies on different disciplines of PPP. Hence, this paper puts forward the idea of conducting a comprehensive review to not only shed light on the major practice of PPP but also provide a wider outlook on this concept based on the research carried out since 1979. A narrative review is initially accomplished to identify the major drivers and milestones that have contributed to the evolution of PPP. Employing bibliometric analysis in the following phase assists in conducting a multi-dimensional assessment of studies published within the last five decades. The economic and societal practices of PPP throughout its evolution path signified the dominant application of this concept as a business model. The bibliometric analysis revealed that PPP has contributed to various sectors, i.e., urban development, public infrastructure, transportation, health, and education, just to name a few. In addition, economic and organizational management of PPP was revealed as a major research stream that was accompanied by sustainable development. As a matter of fact, economic and environmental sustainability are the major cross-disciplinary elements that form an interplay between the drivers and attributes of PPP. Value for money (VfM), technology, and innovation, along with smart infrastructure (SI) and smart cities (SCs), are identified as the major directions for the future research agenda associated with PPP.

Recent land-based wind deployment in the United States has been sluggish, and expectations for future growth have moderated in recent years. Berkeley Lab conducted a brief survey of wind industry stakeholders to better understand barriers and solutions. The focus of the survey was on land-based wind projects in the United States – not offshore wind or distributed small wind projects. Respondents identified challenges related to the grid and to siting as the most pressing concerns.

The Cr2O3/ZnO composite catalysts with varying the amount of chromium precursors abbreviated as 0.02CrZn, 0.04CrZn, 0.06CrZn, 0.08CrZn, 0.1CrZn, and fixed the amount of Zn precursor (0.1 M) were prepared by using water hyacinth (Eichhornia crassipes) extract as a template/capping agent. The prepared catalysts were characterized and the catalytic performances of the catalysts were also checked for the degradation of methylene blue (MB) dye. The photocatalytic MB dye degradation by 0.08CrZn catalyst was achieved and 85% of MB dye was degraded within 90 min irradiation time. However, 0.1CrZ, 0.06CrZ, 0.04CrZ, 0.02CrZ, ZnO, and Cr2O3 catalysts degrade only 80, 74, 79, 76, 52, and 74% of MB dye, respectively. The catalytic performances indicated that the addition of optimum amount of chromium precursor in the preparation of Cr2O3/ZnO composite catalysts with the aid of Eichhornia crassipes plant extract enhances the catalytic activities. This performance enhancement could be as a result of reducing the electron/hole pair separation and the porosity resulted from the plant extract in the catalyst system.

Berkeley Lab's 2024 edition of its Land-Based Wind Market Report provides an updated overview of data and trends in land-based wind energy in the U.S. Though 2023 was a relatively slow year for new wind power deployment, wind continues to see technological advancements, solid performance, and attractive prices. The Inflation Reduction Act promises new market dynamics in the years ahead, with expanded domestic manufacturing capability and an anticipated resurgence in deployment. Key highlights of the new report include:Wind comprises a significant share of electricity supply. U.S. wind power deployment was relatively low in 2023, totaling 6.5 gigawatts (GW) and representing $10.8 billion in investment. Yet wind energy contributed 10% of the nation’s electricity supply, and as much as 37% in the Southwest Power Pool. A total of 150 GW of wind was installed in the U.S. at the end of 2023. A record-high 366 GW of wind was seeking transmission interconnection.Wind turbines continue to get larger, expanding the market for wind energy. Improved plant performance over the last decades has been driven by larger turbines mounted on taller towers and featuring longer blades. In 2013, no turbines employed rotors that were 115 meters in diameter or larger, whereas 98% of newly installed turbines featured such rotors in 2023.Wind energy prices have risen but remain attractive for purchasers. Wind power purchase agreement prices have been drifting higher since about 2018, with a recent range from below $20/MWh to more than $40/MWh depending on region and other details. These prices, which are possible in part due to federal tax support, are similar to recent solar sales prices and to the projected future fuel costs of gas-fired generation.Wind’s value proposition includes grid and societal benefits. The value of wind in wholesale power markets is affected by the location of wind plants, their hourly output profiles, and how those characteristics correlate with real-time electricity prices and capacity markets. The market value of wind declined in 2023, following a drop in the price of natural gas. Wind also reduces power-sector emissions of carbon dioxide, nitrogen oxides, and sulfur dioxide. These reductions, in turn, provide public health and climate benefits that are larger than wind’s grid-system value. The combination of all three values ($183/MWh) significantly exceeded the levelized cost of wind energy in 2023.The Inflation Reduction Act has created renewed optimism for supply chain expansion. Domestic manufacturing of towers and nacelles was strong in 2023, while blade manufacturing has begun to rise after several years of decline. The Inflation Reduction Act contains, for the first time, production-based tax credits for domestic manufacturing of key wind components like nacelles, towers, and blades; it also extended the tax credit for wind deployment, inclusive of a 10% bonus for projects that meet domestic content requirements. Consequently, there have been at least 15 announcements of manufacturing facilities that plan to open, re-open, or expand to serve the land-based wind industry.Energy analysts project a resurgence of wind deployment in the years ahead. With a long-term extension of tax credits for wind energy along with opportunities for wind plants to earn two 10 percent bonus credits, analysts expect 2023 to be the low-point for wind deployment. Forecasts for wind deployment grow to an average over 15 GW/year from 2026 through 2028.

The Inflation Reduction Act has created substantial new programs that support adoption of solar power by low-income households, including the $7 billion Solar For All program and the Low-Income Communities Bonus Credit Program, which increases the investment tax credit for certain types of deployment. In addition, a growing number of states are using solar programs to reduce energy burdens and create energy justice opportunities for low-income households and disadvantaged communities.Verifying the income of participating customers is an important component of these programs. Program managers are seeking strategies to verify a large number of subscribing customers in an accurate, timely, and cost-efficient manner.To help inform program managers, Berkeley Lab investigated how a number of energy and non-energy programs manage income verification. The most common approach is to require proof through tax documents, pay stubs, or other formal income documentation, which can pose an impediment to enrolling eligible customers and create a paperwork burden for administrators. In order to reduce the burden for both the applicant and the program manager, some programs use alternative methods. We identify three common alternative verification methods:-Categorical eligibility: Customers enrolled in other, similar income-verified assistance programs are automatically eligible for enrollment in other income-qualified programs.-Geographic eligibility: Eligibility is based on the customer’s location within a specified area, typically a low-income or disadvantaged community or census tract, and;-“Self-attestation”: The participant claims eligibility with or without further documentation.We describe these options, their pros and cons, give examples of how they are used, and explore how some low-income programs address administrative issues, audits, or other quality control measures. Finally, we explore the risk of mistaken verifications (finding a participant eligible when they are not) in the different strategies.While this memo was initiated by a request relating to income-based community solar programs, the methods are applicable to any program with income eligibility requirements in the energy or non-energy sector.Funding was provided for this research by the Solar Energy Technologies Office of the US Department of Energy, through the National Community Solar Partnership.

Abstract Introduction This study is aimed at analyzing farmers’ perception and adaptation to climate change in the Dabus watershed. It is based on analysis of data collected from 734 randomly selected farm householdheads substantiated with Focus Group Discussions and field observations. Methods The study employed descriptive methods to assess farmers’ perception of climate change, localindicators of climate change and types of adaptation measures exercised to cop up with the risk of the change in climate. The study also employed the Heckman sample selection model to analyze the two-stepprocess of adaptation to climate change which initially requires farmers’ perception that climate is changingprior to responding to the changes through adaptation measures. Results Based on the model result educational attainment, the age of the head of the household, thenumber of crop failures in the past, changes in temperature and precipitation significantly influencedfarmers’ perception of climate change in wet lowland parts of the study area. In dry lowland condition,farming experience, climate information, duration of food shortage, and the number of crop failuresexperienced determined farmers’ perception of climate change. Farmers’ adaptation decision in both the wet and dry lowland conditions is influenced by household size, the gender of household head, cultivatedland size, education, farm experience, non-farm income, income from livestock, climate information, extension advice, farm-home distance and number of parcels. However, the direction of influence and significance level of most of the explanatory variables vary between the two parts of the study area. Conclusions In line with the results, any intervention that promotes the use of adaptation measures toclimate change may account for location-specific factors that determine farmers' perception of climate change and adaptive responses thereof.

Abstract Smallholder farmers can adapt to climate variability and change through sustainable land management (SLM) practices that help to offset the negative impacts at farm level. However, use of these practices as adaptation strategy remains low in Ethiopia in general and the study sites in particular. This study aimed at examining the factors that determine farmers’ decision to use SLM measures and to quantify the impact of the practices on crop productivity at household and plot level. The study was based on household- and plot-level primary data and employed nearest-neighbor matching technique to quantify the impact of using the practices on value of production at household level and plot level. The results revealed that households that implemented SLM practices within the period (2004–2009) experienced a 24.1% higher value of production over non-users in 2016. Similarly, plots that received SLM measures within the period (2004–2009) experienced a 28.6% increase in value of production in 2016. The study also made further analysis at plot level using continuous treatment effects in order to take into account the number of years a plot has been under the practice. The result showed plots with SLM structure that are maintained for at least 6 years have a positive increase in value of production at the end of the 6th year, while those that received the practices recently or those that lacked continuous maintenance did not experience a statistically significant increase in value of production. The result also showed marginal benefit of sustaining the SLM practices increases over time at an increasing rate. The implication is that use of SLM measures and maintenance of the structures are crucial to reap significant benefits from the practices. Although value of production increases given the SLM practices, implementation is labor intensive and there is trade-off with other agricultural activities. Therefore, policy measures are required to incentivize implementation and maintenance of the SLM structures.

Diabetes mellitus is a significant risk factor for the development of heart disease (HD), with heart failure (HF) being one of the early manifestations of the disease in this population. The diagnostic process is challenging and contributes to a significant number of undiagnosed cases of HD among individuals with diabetes. This is largely due to the non-specific nature of symptoms and signs in the initial stages of disease, making early detection elusive. Timely identification and prevention of HD in patients with diabetes have the potential to significantly improve patient prognosis and alleviate the growing burden of this population on the national healthcare system.Natriuretic peptides (BNP and NT-proBNP) have been recognized as reliable, cost-effective biomarkers for detecting HD and can be further used as risk assessment biomarkers in asymptomatic patients. Despite being recommended in several European and American guidelines to rule-out and rule-in HF, the routine use of these biomarkers for the diagnosis of HDs in patients with diabetes has only recently been proposed by the American Diabetes Association (ADA) and has not yet been implemented in Portugal. Therefore, a multidisciplinary panel of experts from four medical societies, the Portuguese Society of Endocrinology, Diabetes and Metabolism, the Portuguese Society of Cardiology, the Diabetes Study Group from the Portuguese Society of Internal Medicine and the Portuguese Association of Family Medicine were convened to discuss and establish consensus recommendations for natriuretic peptide screening in patients with diabetes and its integration into routine diabetes management protocols.This manuscript draws on the consensus recommendations from four Portuguese medical societies, offering clear guidance on natriuretic peptides use tailored to Portuguese clinical practice. Accordingly, this consensus advises the use of NT-proBNP analysis for all patients with diabetes aged 50 years and older, or under 50 if they have risk factors and/or comorbidities. Adjusted rule-out and rule-in values for age, sex and risk factors are provided. NT-proBNP levels above 125 pg/mL should prompt additional testing and cardiovascular investigation. Routine evaluation every two to three years for low-risk patients and annually for high-risk patients is proposed when NT-proBNP is below 125 pg/mL and in the absence of suspected heart disease. Resumo: A diabetes mellitus é um fator de risco significativo para o desenvolvimento de doenças cardíacas, sendo a insuficiência cardíaca uma das primeiras manifestações da doença nesta população. O processo de diagnóstico é complexo e contribui para um número significativo de casos não diagnosticados de doença cardíaca em doentes diabéticos, devido à natureza não específica dos sintomas e sinais, ou à impossibilidade da sua deteção em fases iniciais da doença. A deteção precoce e a prevenção da doença cardíaca em doentes diabéticos poderão contribuir para melhorar significativamente o prognóstico dos doentes e reduzir os encargos crescentes desta população sobre o Sistema Nacional de Saúde.Os peptídeos natriuréticos (BNP e NT-proBNP) têm sido reconhecidos como fidedignos, rentáveis e com um peso relevante na deteção de doença cardíaca, podendo ser utilizados como biomarcadores para avaliação de risco em doentes assintomáticos. Apesar de serem recomendados em várias diretrizes europeias e americanas na exclusão ou identificação da insuficiência cardíaca, a utilização sistemática destes biomarcadores para o diagnóstico de doenças cardíacas em doentes diabéticos só recentemente foi proposta pela American Diabetes Association (ADA), não estando ainda em prática em Portugal. Como tal, foi reunido um painel de especialistas de quatro sociedades médicas portuguesas, a SPEDM (Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo), SPC (Sociedade Portuguesa de Cardiologia), NEDM-SPMI (Núcleo de Estudos da Diabetes Mellitus da Sociedade Portuguesa de Medicina Interna) e APMGF (Associação Portuguesa de Medicina Geral e Familiar) com o objetivo de discutir e estabelecer recomendações de consenso para o rastreio de péptidos natriuréticos em doentes diabéticos, bem como a sua integração no protocolo de rotina de gestão da diabetes.Este manuscrito transpõe as recomendações de consenso das quatro sociedades médicas portuguesas, fornecendo orientações claras, e ajustadas à prática clínica portuguesa, sobre o uso dos peptídeos natriuréticos. É recomendada a análise do NT-proBNP em todos os doentes diabéticos com idade igual ou superior a 50 anos, ou inferior a 50 se tiverem fatores de risco e/ou comorbilidades. São fornecidos valores recomendados para exclusão e diagnóstico de doenças cardíacas na população diabética, tendo em conta a idade, sexo e outros fatores de risco. Os níveis de NT-proBNP superiores a 125 pg/mL devem motivar testes adicionais e investigação cardiovascular. Propõe-se uma avaliação de rotina a cada 2-3 anos para os doentes de baixo risco e anualmente para os doentes de alto risco quando o NT-proBNP é inferior a 125 pg/mL e na ausência de suspeita de doença cardíaca.

The Michigan Department of Environment, Great Lakes, and Energy (EGLE) is interested in combining community solar with weatherization programs for manufactured homes. To collect program strategies, EGLE made a request for technical assistance from the US Department of Energy’s National Community Solar Partnership (NCSP).Lawrence Berkeley National Lab developed this study in response. It briefly reviews issues relevant to the question, attempts to lay out a methodology for more in-depth analysis, and provides some recommendations for program design and implementation. While the research is specific to Michigan, the recommendations and methodologies could serve as an example for other states and regions.The paper first provides an overview of manufactured home communities in Michigan, with a discussion of demographics and energy issues they face. It then discusses weatherization opportunities for manufactured homes, opportunities for community solar, and opportunities for combining the two.The methodology proposed is intended to help EGLE:-Identify priority locations,-Set eligibility criteria for communities and households, and-Make the most of federal and other funding sourcesThe paper concludes with recommendations for a program that combines community solar with efficient electrification of manufactured homes to reduce the burden of the largest source of energy expenditure in Michigan, winter heating bills. Specifically, it envisions community solar subscriptions for occupants of manufactured homes that have been converted to high-efficiency cold weather heat pumps. The combination can be managed to alleviate seasonal variations in both solar and heating bills, such as through an annualized “budget billing” program.

Most living organisms found in the ocean are vital to human life. They can be used for a myriad of activities ranging from human consumption to making cosmetic products. The variety of usages attracted attention, and there was an influx of natural and juristic persons into coastal areas to exploit these resources. This resulted in declining living marine resources due to over-exploitation and over-reliance. The need to regulate the living marine resources to protect and preserve their existence became evident. Thus, a plethora of legislation related to the marine environment was promulgated. Amongst other legislation, the Marine Living Resources Act 18 of 1998 (MLRA) was promulgated to ensure living marine resources management, conservation, and preservation. However, even in its existence, living marine resources continue to decline. Under these circumstances, Indigenous knowledge could be adopted to assist in alleviating the decline of living marine resources and augmenting the MLRA. Indigenous knowledge boasts methods of managing, conserving, and preserving living marine resources. Therefore, this paper calls for the need to incorporate some of these Indigenous knowledge practices into the MLRA. In buttressing the need to incorporate Indigenous knowledge in the MLRA, this study shall adopt a non-empirical and qualitative research approach.

Limited data exist on educational programs for people using insulin pump (IP) therapy or those considering its initiation, and the influence of individual characteristics on their educational pathway remains unclear. Our aim was to analyze the characteristics of people with type 1 diabetes (T1D) referred for IP therapy and how these characteristics may influence their educational process. A retrospective descriptive observational study was carried out on people with T1D referred for participation in a structured pre-IP educational program in a hospital setting. Educational, sociodemographic and clinical variables were collected and analyzed. Participants were followed up 5 years after IP placement. Seventy-one people finalized the educational program, of whom 10 experienced major barriers to completing it. People with lower educational level required more sessions and weeks to complete it compared to those with higher educational levels. People referred due to suboptimal metabolic control and hypoglycemia also required more time to complete the process. It is essential for diabetes educators to recognize the diversity of characteristics, needs and challenges among the participants in an educational program. Based on this, they must adapt strategies to provide more effective, person-centered diabetes education and support, fostering positive and sustained outcomes and engagement for participants.

Community solar is emerging as a popular way to deliver a range of economic and social benefits that go beyond clean energy. The US Department of Energy (DOE) has set a goal for America to deploy enough community solar projects to power the equivalent of five million households by 2025 and create $1 billion in energy bill savings.To reach the goal, DOE has created the Community Power Accelerator, as part of the National Community Solar Partnership (NCSP). The Accelerator is an online ecosystem bringing together developers, lenders, foundations, community organizations, and other stakeholders to support the deployment of mission-aligned community solar.The Accelerator is especially focused on projects that deliver “meaningful benefits” to customers and communities, including:-Access by low- to moderate-income households-Greater bill savings-Resilience and grid benefits-Community ownership-Local workforce developmentMany philanthropic organizations are looking at community solar as a way to capture these benefits in their grant-making and investment programs, while also reducing pollution and promoting environmental justice.To help community-based organizations (CBOs), non-profit organizations, and mission-aligned developers seeking philanthropic support, Berkeley Lab and the National Renewable Energy Lab prepared Are You Philanthropy-Ready? How to Work with Foundations on Mission-Aligned Community Solar. The guide provides an overview of how foundations work, gives tips on what they seek in a fundable project, and provides guidance on crafting effective proposals. In short, this guide aims to help the fund-seeker become philanthropy-ready.

The atmospheric concentration of carbon dioxide (CO₂) has risen from pre-industrial levels of 280 parts per million (ppm) to over 410 ppm today, with projections indicating further increases. Sub-Saharan Africa (SSA), despite contributing only 3 % of global CO₂ emissions, faces significant vulnerability due to its dependence on agriculture, with smallholder farmers particularly at risk. This review focuses on the impact of elevated CO₂ levels on the nutritional quality of key staple crops in SSA. Research from Free-Air CO₂ Enrichment (FACE) and Open-Top Chamber (OTC) experiments highlights a reduction in essential micronutrients, including iron, zinc, and protein, in these crops under elevated CO₂ conditions. Given the already low micronutrient content of these crops in SSA, further reductions intensify food insecurity and malnutrition in the region, where approximately 80 % of the population relies on agriculture for their livelihoods. This review also explores potential strategies to mitigate the adverse effects of elevated CO₂ on crop nutrition in SSA. Integrated mitigation measures such as crop diversification, bio-fortification, climate-smart agriculture, and reforestation are identified as critical to improving food security. Furthermore, raising awareness about the nutritional impacts of climate change and investing in the development of resilient crop varieties are essential for long-term sustainability. The review emphasizes the need for coordinated efforts at local, national, and international levels to protect vulnerable populations and strengthen agricultural systems in SSA, ensuring that they can adapt to the ongoing challenges posed by rising atmospheric CO₂.

Background Responsiveness to chimeric antigen receptor (CAR) T cell therapy correlates with CAR T cell expansion and persistence in vivo. Multiple strategies improve persistence by increasing stem-like properties or sustaining CAR T cell activity with combination therapies. Here, we describe the intrinsic ability of CAR T cells to differentiate into memory T cells, the effect of cytokine armoring, and neoadjuvant CD4 depletion therapy on CAR and tumor-specific endogenous memory T cells.Methods TRP1-specific or NKG2D CAR T cells alone or with Super2+IL-33 (S233) armoring and/or CD4 depletion were evaluated in immunocompetent B16F10 melanoma or MC38 colon cell carcinoma models without preconditioning. We characterized CAR and endogenous tumor-specific memory T cell precursors, establishment of circulating (TCIRC) and resident (TRM) memory T cell subsets, and ability to protect against secondary tumors.Results TRP1-specific or NKG2D CAR T cells had no effect on primary tumor growth in immunocompetent mice unless they were combined with S233 armoring or CD4 depletion. Unarmored CAR T cells expressed a stem-like phenotype in the tumor-draining lymph node and differentiated into CAR TCIRC memory cells in lymphoid organs and CAR TRM cells in the skin. In contrast, S233-armored CAR T cells exhibited an activated effector phenotype and differentiated inefficiently into CAR effector and central memory T cells. Combining CD4 therapy with unarmored CAR T cells increased CAR TCIRC and TRM memory T cells. Either CD4 depletion therapy or S233-armored CAR T cells induced activation of tumor-specific endogenous T cells that differentiated into both TCIRC and TRM memory T cells. CD4 depletion and S233-armored CAR T cell combination therapy synergized to increase endogenous memory T cells.Conclusions Unarmored TRP-1-specific or NKG2D CAR T cells have intrinsic stem-like properties and differentiate into memory T cell subsets but are non-protective against primary or secondary tumors. S233 cytokine armoring alone or with CD4 depletion improved effector responses but limited CAR memory T cell generation. S233-armored CAR T cells or CD4 depletion therapy induced endogenous tumor-specific TCIRC and TRM T cells, but the combination potentiated endogenous memory T cell generation and resulted in improved protection against B16F10 rechallenge.

Objective To assess the level of maternal healthcare service utilisation and related factors to its frequency of care among mothers who gave birth in the previous 2 years before the survey in rural Wolaita, southern Ethiopia.Design Cross-sectional survey.Setting This study was undertaken in Kindo Didaye, rural Wolaita, southern Ethiopia, from February to March 2016.Participants Out of 552 who gave birth, 544 (98.5%) mothers aged between 15 and 49 years, selected using two-stage random sampling, participated in the study.Outcome measures Maternal healthcare service utilisation frequency and proportion and associated factors.Result The proportion of maternal healthcare service utilisation was 59.38% (95% CI: 55.11% to 63.53%), with 50.74% (95% CI: 46.45% to 55.01%), 16.18% (95% CI: 13.18% to 19.54%) and 31.80% (95% CI: 27.90% to 35.90%) prevalence of antenatal care (ANC), delivery care and postnatal care (PNC), respectively. The frequency of maternal healthcare service utilisation was positively related to having a favourable attitude towards maternal healthcare service utilisation, knowledge of mothers about maternal healthcare, walking distance to healthcare facilities in 30 and 30–60 min from residence and joint decision by mothers and their husbands on the place of delivery.Conclusion The proportion of maternal healthcare service utilisation in the study area was low, exacerbated by lower ANC, delivery care and PNC. The frequency of maternal healthcare service utilisation increased with a favourable attitude towards maternal healthcare service utilisation, knowledge of mothers about maternal healthcare, short travel distance to healthcare facilities and joint decisions by mothers and their husbands on the place of delivery. Based on the findings of this study, we suggest promoting strategies by the local health department and other concerned bodies to maintain and improve the attitude and knowledge of mothers towards maternal healthcare service utilisation. We also recommend increasing the accessibility to healthcare facilities and promoting joint decision-making processes by the mothers and their husbands on the place of delivery in the study area and similar settings in the country.

Documentada desde 960, Moreira de Rei foi um dos lugares mais destacados da região durante os tempos medievais. Como principal testemunho de época altomedieval, a povoação conserva uma extensa necrópole de sepulturas escavadas na rocha, de que se conheciam cerca de 150 túmulos dispersos por uma área hoje coincidente com o largo da igreja românica de Santa Marinha e construções confinantes. No âmbito do projecto de requalificação e valorização deste largo, promovido pela autarquia local, esta necrópole tem sido objecto, desde 2018, de escavações que incidem sobre todo o espaço público envolvente à igreja. Os trabalhos realizados até a data revelaram um impressionante espaço funerário, do qual se identificaram cerca de 700 sepulturas, maioritariamente escavadas no substrato rochoso granítico. Embora as escavações estejam ainda em curso, apresentam-se algumas considerações e dados genéricos sobre o contexto e as características desta necrópole altomedieval, posteriormente convertida em cemitério paroquial, e sobre as características paleobiológicas dos indivíduos exumados.