Coordinated intensification to reconcile the 'zero hunger' and 'life on land' Sustainable Development Goals.

The Sustainable Development Goals (SDGs) encourage nations to substantially increase food production to achieve zero hunger (SDG 2) while preserving life on land (SDG 15). A key question is how to reconcile these potentially competing goals spatially. We use integer linear programming to develop an 'integrated land use planning framework' that identifies the optimal allocation of 17 crops under different hypothetical conservation targets while meeting agricultural demands by 2030. Intensifying existing cropland to maximum yield before allocating new cropland would reduce land requirement by 43% versus cropland expansion without intensification. Even with yield gap closure, tropical and sub-tropical crops still require expansion, primarily allocated to Venezuela, eastern Brazil, Congo Basin, Myanmar and Indonesia. Enforcement of protected areas, via avoiding conversion in 75% of Key Biodiversity Areas and 65% of intact areas, is vital to attain biodiversity targets but bears large opportunity costs, with agricultural rents dropping from $4.1 to $2.8 trillion. Although nationally constrained forest conservation efforts would earn 9% less agricultural rents compared to globally coordinated conservation solutions, they were also able to reduce intact habitat and forest loss (43% and 35% reduction). Our results demonstrate that careful choice of the allocation of future cropland expansion, could dramatically reduce-but not eliminate-the tradeoffs between the SDGs for food production and land biodiversity conservation.

Herbal medications for anxiety, depression, pain, nausea and vomiting related to preoperative surgical patients: a systematic review and meta-analysis of randomised controlled trials.

OBJECTIVE: To summarise the effects of herbal medications for the prevention of anxiety, depression, pain, and postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic, obstetrical/gynaecological or cardiovascular surgical procedures. METHODS: Searches of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and LILACS up until January 2018 were performed to identify randomised controlled trials (RCTs). We included RCTs or quasi-RCTs evaluating any herbal medication among adults undergoing laparoscopic, obstetrical/gynaecological or cardiovascular surgeries. The primary outcomes were anxiety, depression, pain and PONV. We used the Grading of Recommendations Assessment, Development and Evaluation approach to rate overall certainty of the evidence for each outcome. RESULTS: Eleven trials including 693 patients were eligible. Results from three RCTs suggested a statistically significant reduction in vomiting (relative risk/risk ratio (RR) 0.57; 95% CI 0.38 to 0.86) and nausea (RR 0.69; 95% CI 0.50 to 0.96) with the use of Zingiber officinale (ginger) compared with placebo in both laparoscopic and obstetrical/gynaecological surgeries. Results suggested a non-statistically significantly reduction in the need for rescue medication for pain (RR 0.52; 95% CI 0.13 to 2.13) with Rosa damascena (damask rose) and ginger compared with placebo in laparoscopic and obstetrical/gynaecological surgery. None of the included studies reported on adverse events (AEs). CONCLUSIONS: There is very low-certainty evidence regarding the efficacy of both Zingiber officinale and Rosa damascena in reducing vomiting (200 fewer cases per 1000; 288 fewer to 205 fewer), nausea (207 fewer cases per 1000; 333 fewer to 27 fewer) and the need for rescue medication for pain (666 fewer cases per 1000; 580 fewer to 752 more) in patients undergoing either laparoscopic or obstetrical/gynaecological surgeries. Among our eligible studies, there was no reported evidence on AEs. PROSPERO REGISTRATION NUMBER: CRD42016042838.