Environmental and Health Impacts of Crop Residue Burning: Scope of Sustainable Crop Residue Management Practices.

The burning of crop residue in the open field has become a significant concern for climate change mitigation efforts worldwide. This practice has led to air quality impairment, smog, haze, heat waves, and different health problems. These could be avoided by adopting sustainable crop residue management practices (SCRMPs) and enabling farmers to engage in SCRMPs. Assessing the health effects at the household level is critical for understanding this problem and finding a solution. Using the primary dataset of 420 farmers from Punjab, Pakistan, we estimated the incurred impacts and costs of crop residue burning. We calculated the health and environmental benefits associated with adopting SCRMPs by comparing the two groups of farmers (adopters and non-adopters). Furthermore, we used a propensity score matching technique to measure the causal impact of SCRMPs adoption on health costs. The findings showed that a surprisingly large number of farmers are all aware of the adverse effects of residue burning, and many do not burn crop residues and instead use SCRMPs. This study found that households with chronic and non-chronic diseases become acute, and the severity increases during the burning period. They spend USD 13.37 to USD 8.79 on chronic and non-chronic diseases during the burning season, respectively. Consequently, the use of SCRMPs has a positive effect on healthcare costs. Our study findings highlight the meaningful implications for developing a new policy to promote the sustainable utilization of crop residues and enhance their adoption in Pakistan.

Perceptions, Vulnerability and Adaptation Strategies for Mitigating Climate Change Effects among Small Livestock Herders in Punjab, Pakistan.

Pakistan is an agrarian nation that is among the most vulnerable countries to climatic variations. Around 20% of its GDP is produced by agriculture, and livestock-related production contributes more than half of this value. However, few empirical studies have been conducted to determine the vulnerability and knowledge of livestock herders, and particularly the smaller herders. Comprehending individual perceptions of and vulnerabilities to climate change (CC) will enable effective formulation of CC mitigation strategies. This study intended to explore individual perceptions of and vulnerabilities to CC based on a primary dataset of 405 small livestock herders from three agro-ecological zones of Punjab. The results showed that livestock herders' perceptions about temperature and rainfall variations/patterns coincide with the meteorological information of the study locations. The vulnerability indicators show that Dera Ghazi Khan district is more vulnerable than the other two zones because of high exposure and sensitivity to CC, and lower adaptive capacity. However, all zones experience regular livelihood risks due to livestock diseases and deaths resulting from extreme climatic conditions, lower economic status, and constrained institutional and human resource capabilities, thus leading to increased vulnerability. The results indicate that low-cost local approaches are needed, such as provision of improved veterinary services, increased availability of basic equipment, small-scale infrastructure projects, and reinforcement of informal social safety nets. These measures would support cost-effective and sustainable decisions to enable subsistence livestock herders to adopt climate smart practices.

Comparison of Efficacy and Safety Profile of Sodium-Glucose Cotransporter-2 Inhibitors as Add-On Therapy in Patients With Type 2 Diabetes.

Background Type 2 diabetes is a chronic metabolic disorder that is escalating at an alarming rate worldwide. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are recent oral antihyperglycemic drugs (OADs) with a unique mechanism of action. Objectives This study aimed compared the efficacy and safety profiles of two SGLT-2 inhibitors, empagliflozin and dapagliflozin, in patients with type 2 diabetes as add-on therapy to traditional first-line OADs. Methods We conducted a randomized controlled trial comparing empagliflozin and dapagliflozin in patients with type 2 diabetes. Patients were included in the study if they had type 2 diabetes with inadequate glycemic control, defined as glycated hemoglobin (HbA1c) of 7.5% to 11.0%, treated with conventional first-line OADs. Study participants were randomly assigned into two groups. Group A patients received oral empagliflozin, 10 to 25 mg, and Group B patients received oral dapagliflozin, 5 to 10 mg, for 12 weeks. The primary endpoint was the efficacy profile for each SGLT-2 agent in terms of body weight changes, body mass index (BMI), fasting blood glucose (FBG), and HbA1c. The secondary endpoint was to determine the safety and tolerability profiles of each SGLT-2 agent. Results After 12 weeks of treatment, the mean body weight was reduced significantly in both groups from baseline (empagliflozin: -3.2 kg ± 5.5 kg, p = 0.003; dapagliflozin -2.1 kg ± 4.6 kg, p = 0.008). However, the mean body weight reduction between groups was not statistically significant (p = 0.078). BMI was significantly reduced in both groups (empagliflozin from 28.5 ± 4.9 kg/m2 to 25.8 ± 5.2 kg/m2, p = 0.002; dapagliflozin from 29 ± 5.2 kg/m2 to 27.7 ± 4.8 kg/m2, p = 0.003). However, the patients who received empagliflozin experienced a significantly greater reduction in BMI than patients who received dapagliflozin (p = 0.007). The mean FBG was also reduced in both study groups (empagliflozin: -88.5 mg/dL ± 39.7 mg/dl, p = 0.003; dapagliflozin: -59.8 mg/dL ± 48.5 mg/dL; p = 0.007). However, the patients who received empagliflozin experienced a significantly greater reduction in mean FBG than patients who received dapagliflozin (p = 0.001). HbA1c was also significantly reduced in both groups (empagliflozin: -2.1% ± 1.1%, p = 0.002; dapagliflozin: -1.4% ± 0.9%; p = 0.004). However, patients who received empagliflozin experienced a significantly greater reduction in HbA1c than patients who received dapagliflozin (p = 0.001). The tolerability profiles of both SGLT-2 agents were quite good, and no major adverse effects were reported in the study groups. Urinary infection occurred more often in patients who received dapagliflozin (9.3%) than in patients who received empagliflozin (4.5%; p = 0.002). Patients in the dapagliflozin group also had a higher incidence of genital infections (7.3%) than those in the empagliflozin group (3.8%; p = 0.001). Conclusion Both empagliflozin and dapagliflozin demonstrated excellent efficacy and safety profiles in our study. These agents should be considered as add-on therapy in patients with type 2 diabetes taking conventional first-line OADs.

Do risk perceptions and constraints influence the adoption of climate change practices among small livestock herders in Punjab, Pakistan?

Climate change is severely damaging the agricultural system of many food producing regions worldwide. Small/subsistent livestock herders are the most vulnerable and less resilient group towards climatic disasters within South Asian region including Pakistan. The adoption of climate-smart practices would be beneficial for small livestock herders because of its potential to ensure food security, improve income, and sustain development simultaneously. The purpose of this paper is to investigate factors influencing small livestock herders' adaptation decisions towards changing climate by conducting field-based research. We intend to understand how institutional factors, risk perceptions, adaptations, and personal constraints affect the adaptation decisions related to climate change mitigation and choice of adaptation strategies. For this purpose, a primary data set of 405 small livestock herders from Punjab, Pakistan was used. The regression results of empirical models reveal the probability of adopting specific climate change strategies. The study results showed that zero adaptation (non-adoption) to climate change is higher when there is low literacy rate, less experience, nuclear family system, lack of institutional services, and low level of risk perception about climate change. The marginal outcome showed that the livestock herders with positive risk perception and access to the institutional services do participate more frequently in a higher number of adaptations options for economic and ecological benefits. Therefore, it is suggested that government and other development actors should strengthen institutions for trust building among local community groups and to reduce individuals' risks. Moreover, effective insurance schemes could facilitate small livestock herders to keep less but more productive livestock. The study recommends building viable and potential weather index insurance schemes which will result meaningful marginal scale benefits for smallholders. Finally, the results of major constraints suggest that it is necessary to provide awareness of climatic vulnerabilities, timely information delivery, and adequate financial facilities to offset resource constraints of livestock herders in order to adopt sustainable strategies at their farms.

Modeling smallholder livestock herders' intentions to adopt climate smart practices: An extended theory of planned behavior.

Climate change is persistently causing adverse effects to the agriculture sector of developing countries, specifically in Asia. Pakistan is no exception to this effect and is ranked among the top 10 countries, which are most vulnerable to climate change. A huge upcoming challenge is to sustain an equilibrium among production and environmental protection. In this context, adaptation to climate change is considered as a win-win strategy for agriculture sectors in developing countries. However, numerous studies have focused on current farm-level adaptation while a scant interest has been shown on the role of physiological factors in the process of shaping small livestock herders' intentions towards environmental enrichment measures. A possible explanation of their lagging intentions is particular significance as they may comply with requisite climate adaptation measures or not. For deeper understanding, the current study investigates different psychological factors that affect the small livestock herder's intentions on adopting climate smart practices by using theory of planned behavior (TPB) with additional constructs (moral norms, risk perception, and social attributes). To this end, 405 small livestock herders from Punjab, Pakistan, were selected on the basis of multistage random sampling. The results of structural equation model showed that all constructs accounted for 57% of the variances in small livestock herders' adoption intentions. The outcome of this research offers a new indication regarding the interrelationship of numerous variables which are crucial to understand behavioral changes and psychological interventions. Overall attitude was the most prominent construct in the extended TPB model, which is mainly influenced by risk perception awareness. The results suggest that veterinary experts and extension agents should focus on psychological factors to explore different prospects to increase the involvement of livestock herders in environmental enrichment measures with little effort rather than tackling with traditional practices because it will be more likely to affect people's consideration of the external obstructions to act. Findings also offer public and private intervention for enabling technical and policy environment and strengthen social networks to keep livestock herders on track of updates of running government policies to ensure them to adopt climate change measures for their prosperous future.

Preconditioning diabetic mesenchymal stem cells with myogenic medium increases their ability to repair diabetic heart.

INTRODUCTION: Mesenchymal stem cells (MSCs) have the potential for treatment of diabetic cardiomyopathy; however, the repair capability of MSCs declines with age and disease. MSCs from diabetic animals exhibit impaired survival, proliferation, and differentiation and therefore require a strategy to improve their function. The aim of the study was to develop a preconditioning strategy to augment the ability of MSCs from diabetes patients to repair the diabetic heart. METHODS: Diabetes was induced in C57BL/6 mice (6 to 8 weeks) with streptozotocin injections (55 mg/kg) for 5 consecutive days. MSCs isolated from diabetic animals were preconditioned with medium from cardiomyocytes exposed to oxidative stress and high glucose (HG/H-CCM). RESULTS: Gene expression of VEGF, ANG-1, GATA-4, NKx2.5 MEF2c, PCNA, and eNOS was upregulated after preconditioning with HG/H-CCM, as evidenced by reverse transcriptase/polymerase chain reaction (RT-PCR). Concurrently, increased AKT phosphorylation, proliferation, angiogenic ability, and reduced levels of apoptosis were observed in HG/H-CCM-preconditioned diabetic MSCs compared with nontreated controls. HG/H-CCM-preconditioned diabetic-mouse-derived MSCs (dmMSCs) were transplanted in diabetic animals and demonstrated increased homing concomitant with augmented heart function. Gene expression of angiogenic and cardiac markers was significantly upregulated in conjunction with paracrine factors (IGF-1, HGF, SDF-1, FGF-2) and, in addition, reduced fibrosis, apoptosis, and increased angiogenesis was observed in diabetic hearts 4 weeks after transplantation of preconditioned dmMSCs compared with hearts with nontreated diabetic MSCs. CONCLUSIONS: Preconditioning with HG/H-CCM enhances survival, proliferation, and the angiogenic ability of dmMSCs, augmenting their ability to improve function in a diabetic heart.

Mesenchymal stem cells conditioned with glucose depletion augments their ability to repair-infarcted myocardium.

Mesenchymal stem cells (MSCs) are an attractive candidate for autologous cell therapy, but their ability to repair damaged myocardium is severely compromised with advanced age. Development of viable autologous cell therapy for treatment of heart failure in the elderly requires the need to address MSC ageing. In this study, MSCs from young (2 months) and aged (24 months) C57BL/6 mice were characterized for gene expression of IGF-1, FGF-2, VEGF, SIRT-1, AKT, p16(INK4a) , p21 and p53 along with measurements of population doubling (PD), superoxide dismutase (SOD) activity and apoptosis. Aged MSCs displayed senescent features compared with cells isolated from young animals and therefore were pre-conditioned with glucose depletion to enhance age affected function. Pre-conditioning of aged MSCs led to an increase in expression of IGF-1, AKT and SIRT-1 concomitant with enhanced viability, proliferation and delayed senescence. To determine the myocardial repair capability of pre-conditioned aged MSCs, myocardial infarction (MI) was induced in 24 months old C57BL/6 wild type mice and GFP expressing untreated and pre-conditioned aged MSCs were transplanted. Hearts transplanted with pre-conditioned aged MSCs showed increased expression of paracrine factors, such as IGF-1, FGF-2, VEGF and SDF-1α. This was associated with significantly improved cardiac performance as measured by dp/dt(max), dp/dt(min), LVEDP and LVDP, declined left ventricle (LV) fibrosis and apoptosis as measured by Masson's Trichrome and TUNEL assays, respectively, after 30 days of transplantation. In conclusion, pre-conditioning of aged MSCs with glucose depletion can enhance proliferation, delay senescence and restore the ability of aged cells to repair senescent infarcted myocardium.

Growth factor preconditioning increases the function of diabetes-impaired mesenchymal stem cells.

Bone marrow-derived mesenchymal stem cells (MSCs) possess multilineage differentiation potential and can be used for the treatment of diabetic heart failure. However, hyperglycemia can affect the function of MSCs adversely and merits the requirement for a strategy to correct this anomaly. MSCs were isolated from the tibias and femurs of C57BL/6 wild-type mice at 60 days after induction of diabetes by streptozotocin. MSCs were characterized by flow cytometry for CD44 (97.7%), CD90 (95.4%), and CD105 (92.3%) markers and were preconditioned with insulin-like growth factor-1 (IGF-1) (50 ng/mL) and fibroblast growth factor-2 (FGF-2) (50 ng/mL) in combination for 1 h in serum-free Iscove's modified Dulbecco's medium. This was followed by hypoxic and high glucose insults to mimic diabetic heart microenvironment and to study the effect of preconditioning. Diabetic MSCs after treatment showed upregulation of IGF-1, FGF-2, Akt, GATA-4, and Nkx 2.5 and downregulation of p16(INK4a), p66(shc), p53, Bax, and Bak. Under hypoxic stress, preconditioned diabetic MSCs showed high superoxide dismutase activity (52.3%) compared with untreated cells (36.9%). This was concomitant with low numbers of annexin-V-positive cells, high in vitro tube-forming ability, and high chemotactic mobility to stromal cell-derived factor-1α after preconditioning in diabetic MSCs. Upregulation of Ang-I and VEGF and downregulation of p16(INK4a) were also observed in preconditioned cells under conditions of high glucose insult. Therefore, preconditioning with IGF-1 and FGF-2 in combination represents a novel strategy to augment MSC function affected by diabetes and holds significance for future strategies to treat diabetic heart failure.