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Small-scale cultivation and irrigation of planted forages can increase the availability of good-quality animal feed in smallholder farms. However, low adoption rates of improved forage technologies in most parts of sub-Saharan Africa have been observed and are partly attributed to limited understanding of gender dynamics in the context of production and utilization of planted forages. The introduction of small-scale cultivation and irrigation of planted forages is likely to interlink gender relations in the mixed crop-livestock farming system given the differences in contributions, benefits and challenges men and women farmers face. Efforts to transform livestock systems through improving adoption, scaling, and sustainability forage interventions can benefit from empirical evidence on gender relations in feed-related activities. We aim to highlight the linkage between gender relations and women's empowerment in the production and utilization of feed resources smallholder settings. We used mixed methods, drawing on quantitative data obtained from a cross-sectional survey of 250 men and 250 women, and qualitative data obtained from eight focus group discussions in smallholder settings of the Amhara and Southern Nations, Nationalities, and People's regions of Ethiopia, where small-scale irrigation was introduced to boost the production of cultivated forages by households. We used the Women's Empowerment in Livestock Index tool to elicit data and analyze the empowerment of the sampled men and women. Women's empowerment differed significantly with different dimensions of gender relations, types of forages grown, and small-scale irrigation practice. Moreover, women in households practicing small-scale irrigation of planted forages were significantly more empowered and most (80%) achieved the adequate threshold in "work balance". The study findings point to the positive link between empowerment and the likely shifts in gender relations from the practice of small-scale production and irrigation of forages., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Omondi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Competing Interests: Competing interests: The authors declare no competing interests.

We assessed the potential effectiveness of human milk banking and lactation support on provision of human milk to neonates admitted in the newborn unit (NBU) at Pumwani Maternity Hospital, Kenya. This pre-post intervention study collected data from mothers/caregivers and their vulnerable neonates or term babies who lacked sufficient mother's milk for several reasons admitted in the NBU. The intervention included establishing a human milk bank and strengthening lactation support. Preintervention data were collected between 5 October 2018 and 11 November 2018, whereas postintervention data were collected between 4 September 2019 and 6 October 2019. Propensity score-matched analysis was performed to assess the effect of the intervention on exclusive use of human milk, use of human milk as the first feed, feeding intolerance and duration of NBU stay. The surveys included 123 and 116 newborns at preintervention and postintervention, respectively, with 160 newborns (80 in each group) being included in propensity score matched analysis. The proportion of neonates who exclusively used human milk during NBU stay increased from 41.3% preintervention to 63.8% postintervention (adjusted odds ratio [OR]: 2.68; 95% confidence interval [CI]: 1.31, 5.53) and those whose first feed was human milk increased from 55.0% preintervention to 83.3% postintervention (adjusted OR: 5.09; 95% CI: 2.18, 11.88). The mean duration of NBU stay was 27% (95% CI: 5.8%, 44.0%) lower in the postintervention group than in the preintervention group. The intervention did not affect feeding intolerance. Integrating human milk banking and lactation support may improve exclusive use of human milk among vulnerable neonates in a resource limited setting., (© 2023 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

Background: Globally, almost 15 million infants are born prematurely each year, disproportionately affecting low and middle-income countries. In the absence of mother's milk, the World Health Organization recommends using donor human milk (DHM) due to its protective effect against necrotizing enterocolitis, a life-threatening intestinal disorder. The use of DHM is increasing globally, with many low and middle-income countries integrating donor milk banks into their public health strategies to reduce neonatal mortality, yet very little is known about the nutritional composition of DHM. Additional knowledge gaps include how DHM composition is influenced by milk banking practices, and whether preterm nutrient recommendations are achieved when DHM is used with commercially available fortifiers., Methods: We designed a multi-site study with eight geographically diverse milk bank partners in high, middle, and low-income settings that will examine and compare a broad range of nutrients and bioactive factors in human milk from 600 approved milk bank donors around the world to create comprehensive, geographically diverse nutrient profiles for DHM. We will then simulate the random pooling of 2 to 10 donors to evaluate the impact of pooling as a potential strategy for milk banks to manage nutrient variability in DHM. Finally, we will evaluate whether commercially available fortifiers meet nutrient recommendations when used with DHM., Discussion: We expect that results from this study will improve nutritional care globally for the growing number of preterm infants who receive donor human milk., Competing Interests: We have the following competing interests to report: MTP served on the Board of Directors for the Human Milk Banking Association of North America from 2016 to 2020 in an unpaid capacity. MTP has received funding to study donor human milk from the National Institute of Child Health and Human Development (NICHD) and the Allen Foundation. KM serves on the Board of Directors for the Northwest Mothers Milk Bank in an unpaid capacity. KIB serves on the Board of Directors for the Human Milk Banking Association of North America in an unpaid capacity. LB is UC San Diego Chair of Collaborative Human Milk Research endowed by the Family Larsson-Rosenquist Foundation (FLRF), Switzerland. LB is a co-inventor on patent applications related to the use of HMOs in preventing NEC and other inflammatory diseases. AW is a co-inventor on patent applications related to the techniques of preservation of human milk. The remaining authors have no competing interests to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Competing Interests: The authors have declared that no competing interests exist.

Sorghum plot managers in different locations have varying levels of resource endowment that in turn influence technical efficiency (TE). Therefore, plot managers operate at different levels of technology. The present study applied a stochastic metafrontier approach to assess TE and technology gaps of female, male and jointly-managed sorghum plots. A two limit-Tobit model was subsequently applied to assess determinants of TE. Results indicate that male-managed sorghum plots had the highest metafrontier technical efficiencies (MTEs) (61%, 56% and 15%) and technology gap ratios (TGRs) (98%, 92% and 20%) for Lira, Serere and Kumi districts, respectively compared to female and jointly managed plots. However, jointly managed plots had higher TE and TGRs compared to female plot managers but lower than those of the male-managed plots. Age, distance to plot and farmer group membership influenced TE positively while household size, years of farming sorghum and access to credit had negative effects on efficiency., Competing Interests: The authors declare no conflict of interest., (© 2021 The Authors.)

Groundnut is an important global food and oil crop that underpins agriculture-dependent livelihood strategies meeting food, nutrition, and income security. Aflatoxins, pose a major challenge to increased competitiveness of groundnut limiting access to lucrative markets and affecting populations that consume it. Other drivers of low competitiveness include allergens and limited shelf life occasioned by low oleic acid profile in the oil. Thus grain off-takers such as consumers, domestic, and export markets as well as processors need solutions to increase profitability of the grain. There are some technological solutions to these challenges and this review paper highlights advances in crop improvement to enhance groundnut grain quality and nutrient profile for food, nutrition, and economic benefits. Significant advances have been made in setting the stage for marker-assisted allele pyramiding for different aflatoxin resistance mechanisms- in vitro seed colonization, pre-harvest aflatoxin contamination, and aflatoxin production-which, together with pre- and post-harvest management practices, will go a long way in mitigating the aflatoxin menace. A breakthrough in aflatoxin control is in sight with overexpression of antifungal plant defensins, and through host-induced gene silencing in the aflatoxin biosynthetic pathway. Similarly, genomic and biochemical approaches to allergen control are in good progress, with the identification of homologs of the allergen encoding genes and development of monoclonal antibody based ELISA protocol to screen for and quantify major allergens. Double mutation of the allotetraploid homeologous genes, FAD2A and FAD2B , has shown potential for achieving >75% oleic acid as demonstrated among introgression lines. Significant advances have been made in seed systems research to bridge the gap between trait discovery, deployment, and delivery through innovative partnerships and action learning., (Copyright © 2020 Ojiewo, Janila, Bhatnagar-Mathur, Pandey, Desmae, Okori, Mwololo, Ajeigbe, Njuguna-Mungai, Muricho, Akpo, Gichohi-Wainaina, Variath, Radhakrishnan, Dobariya, Bera, Rathnakumar, Manivannan, Vasanthi, Kumar and Varshney.)

Background: Cervical cancer ranks as the fourth most commonly diagnosed cancer and the fourth leading cause of cancer death in women worldwide. In Kenya, cervical cancer is the second most commonly diagnosed cancer after breast cancer and the leading cause of cancer death in women. It is estimated that by the end of 2018, cervical cancer will be responsible for 5,250 (11%) new cases and 3,286 (11.84%) deaths in Kenya., Methods: We conducted a retrospective follow-up study to estimate the overall survival of women treated for cervical cancer in Kenya. Medical records were reviewed to extract information for generating a quantitative data set, and the chi-square test was used to test for associations between patient outcomes and various sociodemographic and clinical factors. To estimate overall survival after treatment, we used Kaplan-Meier survival analysis, the logrank test, and Cox proportional hazards regression., Results: A total of 481 patient records were included in this study. From the bivariate analysis, 4 factors demonstrated a statistically significant association with survival: access to care ( P =.049), stage of disease at diagnosis ( P <.001), type of treatment received ( P <.001), and whether or not treatment was initiated and completed ( P <.001). The overall 5-year survival estimate for women with cervical cancer was 59%. However, 396 (82.3%) women were lost to follow-up; with no deaths observed after the first year, the overall survival estimate is only accurate for the first year., Conclusion: The high rate of loss to follow-up appears to be characteristic of cancer care in Kenya and highlights the difficulties in conducting survival studies in low-resource settings with low coverage of vital registration and a lack of centralised national administrative systems. Despite the study's limitations, the results support evidence whereby late-stage diagnosis, deficiencies in cancer management, and limited cancer care services, in particular, have been found to contribute to poor patient outcomes in sub-Saharan Africa., Competing Interests: Competing Interests: None declared., (© The East African Health Research Commission 2018.)

Maize is the main staple crop in the East African Mountains. Understanding how the edaphic characteristics change along altitudinal gradients is important for maximizing maize production in East African Highlands, which are the key maize production areas in the region. This study evaluated and compared the levels of some macro and micro-elements (Al, Ca, Fe, K, Mg, Mn, Na and P) and other soil parameters (pH, organic carbon content, soil texture [i.e. % Sand, % Clay and % Silt], cation exchange capacity [CEC], electric conductivity [EC], and water holding capacity [HC]). Soil samples were taken from maize plots along three altitudinal gradients in East African highlands (namely Machakos Hills, Taita Hills and Mount Kilimanjaro) characterized by graded changes in climatic conditions. For all transects, pH, Ca, K and Mg decreased with the increase in altitude. In contrast, % Silt, organic carbon content, Al and water holding capacity (HC) increased with increasing altitude. The research provides information on the status of the physical-chemical characteristics of soils along three altitudinal ranges of East African Highlands and includes data available for further research.

The biotechnological approach to improve performance or yield of crops or for engineering metabolic pathways requires the expression of a number of transgenes, each with a specific promoter to avoid induction of silencing mechanisms. In maize (Zea mays), used as a model for cereals, an efficient Agrobacterium tumefaciens-mediated transformation system has been established that is applied for translational research. In the current transformation vectors, the promoters of the 35S gene of the cauliflower mosaic virus and of the ubiquitin gene of maize are often used to drive the bialaphos-selectable marker and the transgene, respectively. To expand the number of promoters, genes with either constitutive or seed-specific expression were selected in Brachypodium distachyon, a model grass distantly related to maize. After the corresponding Brachypodium promoters had been fused to the β-glucuronidase reporter gene, their activity was followed throughout maize development and quantified in a fluorimetric assay with the 4-methylumbelliferyl β-D-glucuronide substrate. The promoters pBdEF1α and pBdUBI10 were constitutively and highly active in maize, whereas pBdGLU1 was clearly endosperm-specific, hence, expanding the toolbox for transgene analysis in maize. The data indicate that Brachypodium is an excellent resource for promoters for transgenic research in heterologous cereal species.

Invasive cervical cancer (ICC) is common in areas where human immunodeficiency virus (HIV) is also prevalent. Currently, HIV seroprevalence as well as acceptability of HIV testing in ICC patients in Kenya is unknown. The objective of this study was to determine the acceptability of HIV testing among patients with ICC. Women with histologically verified ICC at Kenyatta National Hospital participated in the study. A structured questionnaire was administered to patients who gave informed consent. HIV pre- and posttesting counseling was done. Blood was tested for HIV using enzyme-linked immunosorbent assay. Overall, 11% of ICC patients were HIV seropositive. The acceptance rate of HIV testing was 99%; yet, 5% of the patients did not want to know their HIV results. Patients less than 35 years old were two times more likely to refuse the result of the HIV test (odds ratio [OR] 2.2). Patients who did not want to know their HIV results were three times more likely to be HIV seropositive (OR 3.1). Eighty four percent of the patients were unaware of their HIV seropositive status. The HIV-1 seroprevalence in ICC patients was comparable to the overall seroprevalence in Kenya. ICC patients were interested in HIV testing following pretest counseling. Offering routine HIV testing is recommended in ICC patients.

Vaginal necrosis can occur following radiation therapy for gynecological malignancies. The distal vaginal mucosa has a poorer radiation tolerance than the mucosa in the upper region. We examined the extent of vaginal shortening in patients treated by intravaginal brachytherapy with or without pelvic irradiation. Maximal extension of the vaginal cylinder above the pubis was measured for each insertion. We found that the difference in mean values between insertions (2.3 vs. 1.7 cm) was highly statistically significant (P < 0.0001). Our study shows that vaginal shortening can occur during the course of intracavity and external irradiation. These alterations in vaginal anatomy can have important consequences on doses received by the distal vaginal mucosa.