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Climate change has global consequences, and is already being experienced, mainly by the most vulnerable groups of people in the Global South. Face-to-face on site interviews by two groups with an interpreter showed that farming activities in Tambuu Village, Morogoro Region, Tanzania are being complicated by additional uncertainties in weather patterns, climate change and changes in climate variability. To design future hybrid mobile climate services, we explored local information demands and current mobile usage patterns. The qualitative interview content analysis pinpointed a number of basic information demands, like seasonal climate outlooks and warnings for droughts or floods. The interviews revealed three interesting outliers. First, exceptionally large growing areas of the farm meant in practice need for information to support the maintenance for mechanized farming tools. Second, with a single exception, farmers showed a reluctant pattern to use services of agricultural extension officers. As third outlier, we found - among predominantly used ordinary button- the rising use of smartphones for farming activities. Our abductive analysis of the last outlier in Tambuu indicated the demand to take preparatory steps to design and develop integrated future hybrid climate services together with local farmers.

Small-scale farmers in Chamwino Tanzania, lack reliable means of communication for facilitating information flow between farmers themselves and other crop farming stakeholders. This study, therefore, sought to develop a mobile phone application system to support farming decision-making. The study employed a participatory design approach that used interviews, focus group discussions, and brainstorming for data collection and a software developer for the creation of a prototype. Thematic analysis was conducted, and the findings show that farmers require information on farming input, weather, transportation, market, crop farming policies and on agricultural research reports. Thereafter, convergent thinking facilitated the development of a mobile phone application system (mobileCHAPONA). The system enables two-way farming information flow among stakeholders (farmers, extension officers, advisory services and mediators). The system assists in the coordination of stakeholders towards improving production. Also, it is easily usable and adoptable by stakeholders aged between 24 to 44 years old, while elders above 45 years old may require a long run training to cope with innovation. It is expected that in the future, software developers, development practitioners, and policy experts will use the system, and improve it further in a manner that keeps into consideration the ecological perspectives in Sub-Saharan Africa.

Small scale farmers (SSF) in Tanzania are challenged by food insecurity, lack of infrastructure, lack of access to credit and services, and lack of reliable channels for farming information. Despite various initiatives the agriculture sector in Tanzania has remained poor. Unreliable information has been found as one factor that hinders decision-making and productivity. This study is the first step in a design science research (DSR) approach to address farmers’ challenges directly with technology. This research studied the acute challenges, information channels, and information gaps of SSFs in Chamwino, Tanzania. Based on our previous qualitative results, a structured questionnaire containing 76 items on a Likert scale was administered to 150 small scale farmers in Chamwino, Tanzania. A response rate of 83% (n=124) was reached. The data was analyzed for descriptive statistics as well as basic measures of statistical association. The results show that farmers rely on tacit knowledge in regards of weather information, market data, plant and disease identification, and business management, and are vulnerable to middlemen frauds and inaccurate decision making. Many of these challenges can potentially be solved by technology. A number of engineering solutions for the basis of future DSR projects are proposed.

This paper explains our efforts in regards of hybrid climate services.As one part of our research efforts and exploration in Africa, we have worked with the Marigat District in Baringo County, Kenya, where we first intended to help the farmers to replace the invasive Prosopis juliflora deep-root species by another deep-root species easier to keep under control. Data was collected through questionnaires with open-ended and closed-ended questions to find a baseline of community challenges and technology use. The lessons learned in the project inspired us to analyze the data by using the lens of Heeks’ [3] design theories. The main outcome of this study is a hybrid evaluation and its discussion with future implications for future climate services.

As one part of our research efforts and exploration in Africa, we have visited the Chokwe Irrigation System area in Mozambique in order to develop hybrid grass-root mobile climate services for and with local farmers to support their cultivation practices. The lessons learned along the explorations inspired us to elaborate an appropriate design research framework for the particular action design research process, which would facilitate us to develop holistic grass-root mobile climate services for local farmers in a developing country. The main outcome of the study was the updated design research framework for the task.

The increased relative poverty and migration crisis in Europe are determining a raise of food insecurity levels. Cities and regions are experiencing—and to some extent stimulating—a growth of food recovery initiatives. Food redistribution activities (FRAs) are acknowledged as a tool for addressing food insecurity and preventing food surplus wastage ensuring economic, environmental, and social benefits. This paper aimed to identify the characteristics of FRAs and their social impact in the context of the Emilia Romagna region (Italy). A literature review and two experts’ consultations were carried out to inventory and categorize relevant social impacts. A questionnaire was then drafted and submitted to a sample of FRAs operating in the region. Results provided a profile of the surveyed food redistribution activities in terms of type of food redistributed, service provided, and workforce. In addition, the qualitative investigation allowed the identification of hotspots in terms of social, economic, psychological, health, and political impacts as perceived by engaged stakeholders.

Scientific literature suggests that in developed countries food is predominantly wasted at the consumption stage of the food supply chain. This study aims to profile consumers' attitude to waste food in Italy investigating households' behaviours leading to food waste generation by addressing what is being wasted and why it is wasted. The work is based on a survey performed in Italy on a heterogeneous sample of 3,087 respondents. A cluster analysis was performed to detect consumers' profiles. Results, based on self-reporting, allow to sketch different 'waster' types, providing a picture of food waste related to eating, shopping, and storage behaviours and suggesting a number of differences existing in terms of perceived quantities and causes of generated food waste. Out of seven profiles identified, four are the most representative ones in terms of size: the conscious-fussy type, who wastes because food doesn't smell or look good; the conscious-forgetful type, who forgets what is in the fridge or on the shelves; the frugal consumer who tends not to consume fruits and vegetables and declares to waste nothing (or almost nothing); and the exaggerated cook, who overbuys and overcooks. Profiling specific waste types can help to better understand if groups with common characteristics exist, what their specific features are and what levers can be employed to stimulate a change in their behaviour.

This study focuses on food waste generated by households in four Nordic countries: Finland, Denmark, Norway, and Sweden. Based on existing literature we present (A) comparable data on amounts and monetary value of food waste; (B) explanations for food waste at household level; (C) a number of public and private initiatives at national levels aiming to reduce food waste; and (D) a discussion of ethical issues related to food waste with a focus on possible contributions from ecocentric ethics. We argue that reduction of food waste at household level, which has an impact on issues such as climate change and unjust distribution of food resources, needs to be based on an appreciative and relational understanding of nature and food and not only on economic and moralizing arguments. This is done by drawing on an ecocentric perspective where food is seen as one of the areas where new narratives need to be developed to establish cultural habits replacing a focus on affluence and individual choice with a focus on participatory embeddedness in a more-than-human lifeworld.

The hyperdynamic circulation of cirrhosis participates in the pathophysiology of portal hypertension. P450-dependent epoxyeicosatrienoic acids (EET) are potent vasodilators. We evaluated plasma levels of EETs in cirrhotic patients and the effect of epoxygenase and nitric oxide synthase (NOS) inhibition on skin blood flow, measured by laser Doppler flowmetry, in normal subjects and cirrhotic patients with and without ascites. Free plasma EETs were increased in cirrhotic patients compared to normal subjects, while the ratio between 8,9-, 11,12-, and 14-15-EET was the same. In cirrhotic patients without ascites, skin blood flow was significantly increased compared to normal subjects. In patients with ascites skin blood flow was significantly reduced compared to control subjects and patients without ascites. Inhibition of epoxygenase with miconazole and of NOS with l -NG-Nitroarginine methyl ester ( l -NAME) decreased basal skin flow in normal subjects and in cirrhotic patients, the effect being higher in cirrhotic patients. Miconazole caused a further decrease in flow when administered with l -NAME, both in normal subjects and in cirrhotic patients. In conclusion, EETs participate in the control of peripheral circulation of normal subjects and in the pathophysiology of peripheral vasodilatation of cirrhotic patients with ascites.

Splenic Doppler impedance indices are measurements of splenic congestion in chronic liver disease. It is not known whether they can also assess splenic congestion in patients affected by right-sided or congestive heart failure. We analyzed splanchnic hemodynamics with Doppler ultrasound and systemic hemodynamics with right-sided heart catheterization in patients with heart failure. Splenic pulsatility index (PI) was higher in patients with heart failure (48 patients) compared with healthy subjects (39 patients) (1.19 ± 0.41 vs. 0.73 ± 0.11, p0.0001) and was related to hepatic vein diameter (p = 0.02). Splenic PI was not related to systemic arterial pressure, cardiac output, systemic vascular resistance or splenic arterial resistance, whereas it was related to right atrial mean pressure (p = 0.0003) and to right ventricle end-diastolic pressure (p = 0.011) (34 patients). In conclusion, splenic PI is a measurement of splenic congestion caused by an increase in venous outflow resistance. It can estimate splenic congestion in patients with right-sided or congestive heart failure.

Background Abdominal ultrasound can detect non-invasively the presence of abdominal portal-systemic collaterals in patients with liver cirrhosis. Abdominal portal-systemic collaterals may be protective from the formation and growth of oesophageal varices, but available data are inconclusive. Aim We aimed at investigating the relationship between abdominal portal-systemic collaterals and variceal formation and growth. Methods We studied 126 cirrhotic patients without (n = 43) or with small (n = 83) oesophageal varices who entered a protocol of serial ultrasonographic and endoscopic examinations for a median of 55 months. Presence and kind of abdominal portal-systemic collaterals was recorded on first ultrasonography and on each control thereafter. Results At inclusion, abdominal portal-systemic collaterals were found in 19/43 patients without varices and in 23/83 patients with small varices (NS). There was no difference in variceal formation and growth between patients with and without abdominal portal-systemic collaterals at inclusion. However, patients developing new abdominal portal-systemic collaterals during follow-up had a significantly higher rate of variceal formation (56.2% vs. 22.2%; p = 0.024) and growth (52.9% vs. 30.6%; p = 0.041) compared with patients with unchanged ultrasonography. Conclusions Abdominal collaterals are not protective from the formation or growth of oesophageal varices. Conversely, new abdominal portal-systemic collaterals emergence is a non-invasive clue of formation and progression of varices. Therefore, endoscopy is probably indicated whenever new abdominal portal-systemic collaterals are detected in cirrhotic patients.

The work in this report is done in the frame of FUSIONS “Quantitative techniques and data integrity”. The aim of the task is to provide recommendations on standard approaches on techniques to be used to estimate the level of wasted food in EU-28. Another aim was to provide a general framework for monitoring food waste for the different steps in the food supply chain. The outcomes are based on the criteria document (ref “FUSIONS definitional framework for food waste”, Annex A) and an extensive literature review and the combined knowledge and experience of the FUSIONS Consortium.

Small scale farmers (SSFs) rely on information sources, which range from traditional means to modern information channels. This research explores the current decision making and information gaining mechanisms of small scale farmers in Chamwino District, Tanzania, where small scale farmers are experiencing low productivity, lack of infrastructures, and malnutrition. In-depth focus group discussions (FGD) were conducted with a total of 94 participants. The interviews were built around several themes (crop farming activities, types of information sources, decision making processes) divided between the farming seasons (pre-farming, tilling, weeding, post-weeding, harvesting, post-harvesting). Qualitative content analysis was used to analyse the data. The results reveal a number of contextual challenges in small scale farming. The analysis suggests a number of engineering solutions to address the identified challenges.

Objective Nonalcoholic fatty liver disease is very frequent in both type 2 diabetes mellitus (T2DM) and the metabolic syndrome (MS), which share clinical and metabolic characteristics. Whether and to which extent these characteristics can predict the degree of liver steatosis are not entirely clear. Patients and methods We determined liver fat (divided into four classes) by standard sonographic images, and clinical and biochemical variables, in 60 consecutive patients with T2DM and with features of the MS. We examined both simple and multiple correlations between the degree of liver steatosis and the variables measured. Results Increased liver fat (defined as >5% of liver mass) was detected in 88% of the participants. Using simple regression analysis, the class of steatosis correlated positively with BMI, waist, number of factors of the MS, sex (female > male), diastolic blood pressure, insulin resistance, metabolic control, inflammation, C-reactive protein, fibrinogen, and leptin, whereas it correlated negatively with high-density lipoprotein-cholesterol. Using multiple regression analysis, only metabolic control, insulin resistance and/or plasma insulin, and waist, remained correlated significantly with the degree of steatosis. Using an ordered probit statistical model, metabolic control, waist, and insulin concentration predicted the steatosis class in 58% of the cases (¡Ü97% with allowance for one class in either excess or deficit). Conclusion In patients with T2DM, the extent of liver steatosis is correlated with variables associated with metabolic control and features of the MS. The combination of metabolic control, visceral obesity, and insulin resistance may reasonably predict the degree of liver steatosis in T2DM. © 2015 Wolters Kluwer Health, Inc. All rights reserved.

To evaluate the prevalence, severity, and hemodynamic features of nonalcoholic fatty liver disease (NAFLD) in nonobese diabetics.We studied 100 consecutive nonobese (body mass index [BMI] 30) patients with type 1 (n = 17) or type 2 (n = 83) diabetes and no known causes of liver disease. Steatosis was diagnosed and graded with ultrasonography. Digital sonographic images of the liver and right kidney were analyzed with dedicated software (HDI-Lab), and the liver/kidney ratio of grey-scale intensity was calculated as an index of the severity of the steatosis. Severity scores ranging from 0 (none) to 5 (severe) were compared with sonographic and Doppler findings (right liver size, portal vein diameter and flow velocity, hepatic and splenic arterial pulsatility indices, hepatic-vein flow profile and A- and S-wave velocities).The prevalence of steatosis was 24% in type I and 80% in type II diabetes (grade 1 in 17%, grade 2 in 34%, grade 3 in 33%, grade 4 in 9%, grade 5 in 7%). In patients with steatosis (especially those with grades 4-5 disease), hepatic volume was increased (p 0.005). Portal vein diameter was increased in grade 5 steatosis. The hepatic artery pulsatility index was significantly increased, particularly in grades 4 and 5 (p 0.0001); portal and A-wave velocities were significantly reduced in grades 3-5 (p 0.001); and the hepatic vein flow profile was altered in 27% (biphasic: 20%, flat: 7%) patients with steatosis, although there was no correlation with severity.NAFLD is very frequent in nonobese diabetics with type 2 but not type 1 disease, and it is associated with hepatomegaly and liver hemodynamic alterations only when it is severe.Sommario SCOPO: Valutare la prevalenza e la gravità della steatosi nei pazienti diabetici non-obesi e le alterazioni emodinamiche epatiche associate. METODI: Sono stati studiati 100 pazienti diabetici non-obesi (BMI 30 kg/m), 17 di tipo I e 83 di tipo II, privi di cause note di epatopatia. Mediante eco-color-Doppler sono stati valutati: un'immagine digitale di confronto tra fegato e corticale del rene destro, analizzata tramite un programma dedicato per la valutazione del grado di steatosi (rapporto fegato/rene dell'intensità dei grigi), le dimensioni del lobo epatico destro, il calibro della vena porta (PV), la velocità della vena porta (PBV), gli indici di pulsatilità arteriosa epatica (PI-L) e splenica (PI-S), il profilo flussimetrico e la velocità delle onde a (HV-a) e s (HV-s) delle vene sovraepatiche. RISULTATI: La prevalenza di steatosi è stata del 24% nel diabete di tipo I e dell'80% nel tipo II ed è risultata prevalentemente di grado lieve-moderato. Nella steatosi il volume epatico è risultato aumentato (p 0,005), in particolare nei gradi superiori a 3, e il diametro della vena porta è risultato aumentato nel grado 5. Il PI-L è risultato aumentato in tutti i gradi di steatosi, in particolare in quelli di grado 4 e 5 (p 0,0001); la PBV è risultata ridotta nei gradi 3, 4 e 5 (p 0,001); la HV-a è risultata ridotta nei pazienti con grado 3, 4 e 5. Il profilo flussimetrico delle vene sovraepatiche è risultato alterato nel 27% (20% bifasico, 7% appiattito). CONCLUSIONI: La steatosi epatica è un reperto molto frequente nel diabete di tipo II senza obesità ed è associata a epatomegalia e alterazioni emodinamiche epatiche nelle forme più gravi.

Ubiquitous computing has become popular and is in demand in many fields of human activity. This kind of computing could significantly enhance applications such as an organizer by making it more agile through sensing the environment. The context-aware agriculture organizer (CAAO), which was pursued by this study, facilitates farmers work by providing relevant contextual information to the users, thus simplifying the selection of plants and resulting to better harvest and more effective resource usage. The idea behind the CAAO is not to control the process of crops growing but rather make it smoother and more productive while simultaneously providing a platform for agricultural research. The study had objectives of creating a technical framework for CAAO with basic functionality and providing ideas for further development. Literature analysis and exploratory software development served as methods of the study. Context-awareness in the CAAO can be achieved by data acquired from sensors, and sensor observation service (SOS) is used for this purpose. The main benefit of SOS is that it connects together different types of sensors. Proposed CAAO framework provides ample of opportunities for further development and makes the system a hub of agricultural services. The mix of web mash-up and ubiquitous computing can enrich the framework and provide an up to date and on demand services. Current version of the CAAO is limited to cotton crop and it does not yet establish physical connection with the sensors. The next steps in the development are to establish connection to sensor networks and to test the CAAO in a real world context.

Experimental studies show that the heme oxygenase/carbon monoxide system (HO/CO) plays an important role in the homeostasis of circulation and in the pathophysiology of hypertension. No data are available on its role in the control of peripheral circulation in humans. We evaluated the effects of inhibition of HO with stannous mesoporphyrin IX (SnMP) (200 𝜇 M) locally administered by iontophoresis, on human skin blood flow, evaluated by laser-Doppler flowmetry, in the presence and absence of nitric oxide synthase (NOS) inhibition with L-NG-Nitroarginine methyl ester (L-NAME) (100 𝜇 M). We also evaluated the effect of HO inhibition on vasodilatation induced by acetylcholine (ACh) and vasoconstriction caused by noradrenaline (NA). SnMP and L-NAME caused a similar 20–25% decrease in skin flow. After nitric oxide (NO) inhibition with L-NAME, HO inhibition with SnMP caused a further 20% decrease in skin perfusion. SnMP decreased vasodilatation induced by ACh by about 70%, while it did not affect vasoconstriction to NA. In conclusion, HO/CO participates in the control of peripheral circulation, independently from NO, and is involved in vasodilatation to ACh.

CYP450-dependent epoxyeicosatrienoic acids (EETs) are potent arterial vasodilators, while 20-hydroxyeicosatatraenoic acid (20-HETE) is a vasoconstrictor. We evaluated their role in the control of portal circulation in normal and cirrhotic (CCl(4) induced) isolated perfused rat liver. Phenylephrine (PE) and endothelin-1 (ET-1) increased portal perfusion pressure, as did arachidonic acid (AA), 20-HETE, and 11,12-EET. Inhibition of 20-HETE with 12,12-dibromododecenoic acid (DBDD) did not affect basal pressure nor the responses to PE, ET-1, or AA. However, inhibition of epoxygenase with miconazole caused a significant reduction in the response to ET-1 and to AA, without affecting neither basal pressure nor the response to PE. Hepatic vein EETs concentration increased in response to ET-1, and was increased in cirrhotic, compared to control, livers. 20HETE levels were non-measurable. Miconazole decreased portal perfusion pressure in cirrhotic livers. In conclusion, 20HETE and EETs increase portal resistance; EETs, but not 20-HETE, mediate in part the pressure response to ET-1 in the portal circulation and may be involved in pathophysiology of portal hypertension.

Information and Communication Technologies can have a strong impact on the development of a region: telecentre networks are in particular interesting model for e-learning dissemination to rural areas. The focus area of our investigation is Sri Lanka: the country has a long tradition in terms of gender equality - as it promotes an inclusive education system - and the use of ICTs is widespread. So far 600 of the planned 1000 telecentres have been started following the Nenasala network model. This paper is based upon observations and interviews of women and men working in different roles (owner, manager, operator and user) at telecentres in rural Sri Lanka. The aim of the study is to analyze and discuss the role of telecentres in rural areas and their impact on women empowerment. Findings show that telecentres open up new channels of information and create career opportunities for women in rural areas. Through telecentres, women can improve their life and be active participants in the rural development. However there still exists a need for further improvements and support for females in the Sri Lankan telecentre network.

Portal vein thrombosis (PVT) is a rare cause of portal hypertension. Its diagnosis has been facilitated by improvements in imaging techniques, in particular Doppler sonography. The prevalence is about 1% in the general population, but much higher rates are observed in patients with hepatic cirrhosis (7%, range 0.6-17%), particularly those who also have hepatocellular carcinoma (HCC) (35%). The most common causes of PVT are myeloproliferative disorders, deficiencies of anticoagulant proteins, prothrombotic gene mutations, cirrhosis with portal hypertension, and HCC. Its development often requires the presence of two or more risk factors (local and/or systemic), e.g., a genetically determined thrombophilic state plus an infectious episode or abdominal surgery. It is clinically useful to distinguish between cirrhotic and noncirrhotic forms. Portal vein thrombosis is also traditionally classified as acute or chronic, but this distinction is often difficult. Color Doppler ultrasound is the first-line imaging study for diagnosis of PVT; magnetic resonance angiography and CT angiography are valid alternatives. The main complications are ischemic intestinal necrosis (in acute PVT) and esophageal varices (in chronic cases); the natural history of the latter differs depending on whether or not the thrombosis is associated with cirrhosis. The treatment of choice for PVT has never been adequately investigated. It is currently based on the use of anticoagulants associated, in some cases, with thrombolytics, but experience with the latter agents is too limited to draw any definite conclusions. In chronic thrombosis (even forms associated with cirrhosis), anticoagulant therapy is recommended and possibly, beta-blockers as well. Naturally, treatment of the underlying pathology is essential.SommarioLa trombosi portale rappresenta una causa rara di ipertensione portale che oggi viene diagnosticata con maggior facilità per l'affinamento delle metodiche di imaging, in particolare quelle ecografiche. La prevalenza è dell'1% circa, del 7% (0,6–17%) nella cirrosi epatica, del 35% circa nell'epatocarcinoma. Le cause più comuni di trombosi portale sono: i disordini mieloproliferativi, il deficit di proteine anticoagulanti, le mutazioni geniche protrombotiche, la cirrosi con ipertensione portale, l'epatocarcinoma. Per lo sviluppo di trombosi portale è spesso necessaria la presenza di due o più fattori, locali e sistemici, come uno stato trombofilico su base genetica e un episodio infettivo o un intervento chirurgico addominale. È utile clinicamente dividere la trombosi portale in cirrotica e non-cirrotica. La trombosi portale è inoltre tradizionalmente classificata in acuta e cronica, ma spesso è difficile distinguerle. L'indagine di primo livello per la diagnosi di trombosi portale è rappresentata dall'eco-color-Doppler; in alternativa possono essere usate angio-RM e angio-TC. Le conseguenze della trombosi portale sono rappresentate principalmente dalla necrosi intestinale ischemica nelle forme acute e dalle varici esofagee, che hanno una storia naturale diversa a seconda della presenza o meno di cirrosi, nelle forme croniche. Non vi sono studi adeguati sulla terapia della trombosi portale, che attualmente consiste nell'anticoagulazione, a cui può essere associata la trombolisi, sulla quale non vi è però casistica adeguata. Nella trombosi cronica è indicata l'anticoagulazione, probabilmente anche nella cirrosi, ed eventualmente il beta-bloccante. Ovviamente importante è la terapia della patologia di base.

Bright Times for Patients With Cirrhosis and Delayed Sleep Habits: A Case Report on the Beneficial Effect of Light Therapy

To develop reliable food waste estimates, which can be accurately repeated over time, it is necessary to produce data within a robust methodological framework. This must comprise a consistent definition of food waste and its components, and consistent system boundaries for the food supply chain. The absence of a framework for defining food waste to date has led to the production of datasets that are not always comparable or transparent as to which fractions are included. A common definitional framework will support policy-makers at both EU and Member State level, and stakeholders across the food supply chain, by enabling them to accurately track the rate of food waste reduction, and the effectiveness of their waste prevention strategies. The development of this framework for defining food waste signals a key step towards improving our understanding of the food waste challenge in Europe and its consistent use will help measure progress towards both resource efficiency and food security goals.