Reducing energy and carbon footprint in semi-arid irrigated cropping systems through crop diversification.

Energy and carbon (C) footprints of agricultural production practices have garnered high attention due to rising energy costs and increasing global warming. However, the contribution of conservation and regenerative farming practices, including cover cropping, on energy and C footprints have not yet been documented for cropping systems in arid and semi-arid regions. This study evaluated the energy and C footprint of cover crop integrated silage maize (Zea mays L.) and sorghum (Sorghum bicolor L. Moench) production systems in the semi-arid region of the southwestern US. The treatments were mixtures of winter cover crops: i) grasses and legumes (GL), ii) grasses, brassicas, and legumes (GBL), iii) grasses and brassicas (GB), and iv) no cover crops (NCC) control for each crop production system. Results showed cover crops had 24.1-24.5% greater energy input than NCC. In silage maize rotation, energy output was 17-22% greater in GBL and GL than in NCC. In silage sorghum rotation, the energy output was 15-24% greater in all cover crops than in NCC. The resulting net energy was 16-21% greater in GBL and GL than in NCC under silage maize, while it was 18-24% greater in GBL and GB than in NCC under silage sorghum. In the silage maize system, the C-footprint per kg yield was not different among treatments, whereas in silage sorghum, it was 58% greater in GBL than in NCC. The benefit-to-cost ratio was greater than one for all treatments, but the additional revenue through C credit programs could make cover cropping a more feasible and beneficial approach, improving economic and environmental sustainability while producing silage crops. While the C footprint was crop rotation specific, cover cropping should be encouraged over crop-fallow systems to producers in semi-arid environments to reduce energy usage and increase C-credit benefits. Clear national and state policy on the C credit program will also enhance economic and environmental benefits by adopting cover cropping and other regenerative farming practices.

Net greenhouse gas balance with cover crops in semi-arid irrigated cropping systems.

Climate smart agriculture has been emphasized for mitigating anthropogenic greenhouse gas (GHG) emissions, yet the mitigation potential of individual management practices remain largely unexplored in semi-arid cropping systems. This study evaluated the effects of different winter cover crop mixtures on CO2 and N2O emissions, net GHG balance (GHGnet), greenhouse gas intensity (GHGI), yield-scaled GHG emissions, and soil properties in irrigated forage corn (Zea mays L.) and sorghum (Sorghum bicolor L. Moench) rotations. Four cover crop treatments: (1) grasses, brassicas, and legumes mixture (GBL), (2) grasses and brassicas mixture (GB), (3) grasses and legumes mixture (GL), and (4) a no-cover crop (NCC) control, each replicated four times under corn and sorghum phase of the rotations, were tested in the semi-arid Southern Great Plains of USA. Results showed 5-10 times higher soil respiration with cover crop mixtures than NCC during the cover crop phase and no difference during the cash crop phase. The average N2O-N emission in NCC was 44% lower than GL and 77% lower than GBL in corn and sorghum rotations. Cash crop yield was 13-30% greater in cover crop treatments than NCC, but treatment effects were not observed for GHGnet, yield-scaled emissions, and GHGI. Integrating cover crops could be a climate smart strategy for forage production in irrigated semi-arid agroecosystems.

Clostridioides difficile Pyogenic Liver Abscess With an Empyema.

INTRODUCTION: Reports of extraintestinal manifestations of Clostridioides difficile (C difficile) infections are rare. The frequency of these infections comprises approximately 0.17% to 0.6% of all C difficile infections. While they are becoming more frequent worldwide, the precise trend is unclear. CASE PRESENTATION: An 83-year-old female patient presented with pleuritic chest pain 2 to 3 months after a needle biopsy of her liver abscess confirmed C difficile. She was found to have extension of the liver abscess into the chest cavity, leading to empyema, and was treated with intravenous antimicrobials. DISCUSSION: This is the fifth known reported case of C difficile leading to a pyogenic liver abscess and the first case where the C difficile liver abscess was associated with an empyema. While long-term metronidazole is considered effective for managing extra intestinal C difficile infection, our patient was treated with vancomycin and meropenem. CONCLUSION: To determine epidemiology and a proper treatment regimen for extraintestinal C difficile infection, a greater accumulation of cases is necessary.

Association between COVID-19 pandemic and the suicide rates in Nepal.

BACKGROUND: Past works have linked the COVID-19 pandemic and subsequent public health responses such as isolation, quarantine, and lockdown to increased anxiety, sleep disorders, depressive symptoms, and suicidal ideation. Only a few studies, mostly carried out in high-income countries, have investigated the association between the pandemic and suicide rate. We seek to investigate the changes in the monthly suicide rates during the COVID-19 pandemic in Nepal, compared to the pre-pandemic suicide rates. METHODS AND FINDINGS: This is a retrospective study investigating the changes in suicide rates in Nepal during the COVID-19 pandemic period (April 2020 to June 2021), compared to the pre-pandemic period (July 2017 to March 2020), adjusted for seasonality and long-term trend in the suicide rate. We performed analysis for the entire country as well as sub-sample analyses stratified by gender and provinces. A total of 24350 suicides deaths during four years of the study window were analyzed. We found an overall increase in the monthly suicide rate in Nepal with an average increase of 0.28 (CI: 0.12,0.45) suicide per 100,000 during the pandemic months. The increase in suicide rate was significant both among males (increase in rate = 0.26, CI: 0.02,0.50) and females (increase in rate = 0.30, CI: 0.18,0.43). The most striking increments in suicide rates were observed in June, July, and August 2020. The pattern of increased suicide rates faded away early on among males, but the effect was sustained for a longer duration among females. Sudurpaschim and Karnali provinces had the highest increase in suicide rates associated with the COVID-19 pandemic. CONCLUSIONS: The COVID-19 pandemic is associated with an increased suicide rate in Nepal. The findings may inform policymakers in designing appropriate public health responses to the pandemic that are considerate of the potential impact on mental health and suicide.

Comparison of endoscopic findings in patients from different ethnic groups undergoing endoscopy for upper gastrointestinal bleed in eastern Nepal.

Upper gastrointestinal (UGI) bleed is one of the commonest medical emergencies. Cultural customs and practices may influence the development of disease conditions that may lead to UGI bleed. The purpose of this study was to compare the causes of UGI bleed in different ethnic groups among patients presenting to a large tertiary care hospital with acute UGI bleed. A retrospective study was conducted examining data available in the endoscopy register at the B. P. Koirala Institute of Health Sciences (BPKIHS) in Nepal for patients presenting with UGI bleed over one calendar year. Study subjects were categorized into one of a few broad categories of ethnic groups: Khas, Newar, SeTaMaGuRaLi, Maithali and others. Demographic information and endoscopic diagnoses were abstracted. The relative frequencies of different causes of UGI bleed were compared across the ethnic groups using the chi2 test. One hundred and eighty-nine patients underwent endoscopy for UGI bleed in the time period studied. The mean age of the study cohort was 49.6 years and consisted of 71.0% males and 29.0% females. Overall the commonest cause of upper GI bleed was gastric ulcer. Esophageal varices was the commonest cause in the SeTaMaGuRaLi group, accounting for 33.3%. The relative frequency of esophageal varices as the cause of upper GI bleed was statistically significantly different among the various ethnic groups, with the SeTaMaGuRaLi group having the highest relative frequency (p-value 0.02). Physicians taking care of patients with upper GI bleed in Nepal should be aware of the high relative frequency of esophageal varices as a cause of upper GI bleed, and especially so among certain ethnic groups.