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Price collapse and oversupply have made coffee a high-profile crop in recent years: never has efficient production and crop protection been more important for reducing costs and increasing quality. Packed with illustrations, this book covers the origins, botany, agroecology and worldwide production statistics of coffee, and the insect pests, plant pathogens, nematodes and nutrient deficiencies that afflict it. With emphasis on integrated crop management, this book reviews control measures suitable for any coffee pest or disease and will enable agriculturists to design and implement sustainable pest management systems.

This book covers the origins, botany, agroecology and worldwide production statistics of coffee, and the insect pests, plant pathogens, nematodes and nutrient deficiencies that afflict it. With emphasis on integrated crop management, this book reviews control measures suitable for any coffee pest or disease and will enable agriculturists to design and implement sustainable pest management systems. This book will be an invaluable resource to professional agriculturists, entomologists and pathologists, and students of tropical agriculture.

Atrial fibrillation (AF) is prevalent in patients with type 2 diabetes mellitus (DM) and is associated with markers of poor glycemic control; however, the impact of glycemic control on incident AF and outcomes is unknown. The aims of this study were to prospectively evaluate if intensive glycemic control in patients with DM affects incident AF and to evaluate morbidity and mortality in patients with DM and incident AF. A total of 10,082 patients with DM from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) cohort were studied in a randomized, double-blind fashion. Participants were randomized to an intensive therapeutic strategy targeting a glycated hemoglobin level of <6.0% or a standard strategy targeting a glycated hemoglobin level of 7.0% to 7.9%. Incident AF occurred in 159 patients (1.58%) over the follow-up period, at a rate of 5.9 per 1,000 patient-years in the intensive-therapy group and a rate of 6.37 per 1,000 patient-years in the standard-therapy group (p = 0.52). In a multivariate model, predictors of incident AF were age, weight, diastolic blood pressure, heart rate, and heart failure history. Patients with DM and new-onset AF had a hazard ratio of 2.65 for all-cause mortality (95% confidence interval 1.8 to 3.86, p <0.0001), a hazard ratio of 2.1 for myocardial infarction (95% confidence interval 1.33 to 3.31, p = 0.0015), and a hazard ratio of 3.80 for the development of heart failure (95% confidence interval 2.48 to 5.84, p <0.0001). In conclusion, intensive glycemic control did not affect the rate of new-onset AF. Patients with DM and incident AF had an increased risk for morbidity and mortality compared with those without AF. •Intensive glycemic control did not alter the rate of incident AF.•The investigators describe a number of predictors of AF in patients with diabetes.•Incident AF is associated with adverse outcomes in patients with diabetes.

BackgroundA paediatric patient in our hospital suffers from a rare, hereditary transcobalamin II deficiency resulting in an intracellular vitamin B12 deficiency. Treatment consists of massive parenteral intake of vitamin B12. Parenteral vitamin B12 solution, suitable for children under 3 years of age, is not commercially available in our country.PurposeThe aim was to produce a preservative-free, sterile hydroxocobalamin (vitamin B12) solution at a concentration of 10 mg/2 ml for intramuscular use and to develop an analytical method of indicating the stability in order to determine the shelf life of the solution.Material and methodsThe entire manufacturing process took place under aseptic conditions. Hydroxocobalamin hydrochloride was dissolved in NaCl 0.9% to give a concentration of 10 mg/2ml. The pH value was adjusted to 4.3–4.5 using hydrochloric acid. The solution was 0.2 µm filtered and finally, 2.4 ml of solution was aseptically filled into sterilised brown glass vials. The filter integrity was tested using the bubble point method. The vials were kept in the refrigerator. Alternatively, the solution was autoclaved at 121°C for 15 min and assessed by high performance liquid chromatography (HPLC) for degradation products.ResultsThe autoclaved solution contained degradation products and the hydroxocobalamin content had decreased by 20%. In contrast, the sterile filtered solution showed no degradation products and no loss in the hydroxocobalamin content was observed after storage for 24 months at 2–8°C. The solution was stable when stored for one month at room temperature and even exposure to 56°C for 2 days did not cause the product to degrade.ConclusionWe produced a hydroxocobalamin solution for intramuscular use with a shelf life of at least 24 months if refrigerated. The treatment of our patient with this solution, administered as an intramuscular injection once a week, has been extremely successful for more than 3 years.References and/or acknowledgementsNo conflict of interest.

Primary prevention implantable cardioverter defibrillator (ICD) reduce all-cause mortality by reducing sudden cardiac death. There are conflicting data regarding whether patients with more advanced heart failure derive ICD benefit owing to the competing risk of nonsudden death. We performed a patient-level meta-analysis of New York Heart Association (NYHA) class II/III heart failure patients (left ventricular ejection fraction ≤35%) from 4 primary prevention ICD trials (MADIT-I, MADIT-II, DEFINITE, SCD-HeFT). Bayesian-Weibull survival regression models were used to assess the impact of NYHA class on the relationship between ICD use and mortality. Of the 2,763 patients who met study criteria, 68% (n=1,867) were NYHA II and 52% (n=1,435) were randomized to an ICD. In a multivariable model including all study patients, the ICD reduced mortality (hazard ratio [HR] 0.65, 95% posterior credibility interval [PCI]) 0.40-0.99). The interaction between NYHA class and the ICD on mortality was significant (posterior probability of no interaction=.036). In models including an interaction term for the NYHA class and ICD, the ICD reduced mortality among NYHA class II patients (HR 0.55, PCI 0.35-0.85), and the point estimate suggested reduced mortality in NYHA class III patients (HR 0.76, PCI 0.48-1.24), although this was not statistically significant. Primary prevention ICDs reduce mortality in NYHA class II patients and trend toward reducing mortality in the heterogeneous group of NYHA class III patients. Improved risk stratification tools are required to guide patient selection and shared decision making among NYHA class III primary prevention ICD candidates.

Background Indomethacin 1 mg is used in premature infants to close the patent ductus arteriosus. The commercial product Indocid PDA is no longer available in Switzerland. Nevertheless, on our paediatric ward there is a great need for an intravenous indomethacin solution that can be used at a dose of 0.1–0.2 mg/kg body weight. Purpose To produce a parenteral ready-to-use solution containing 0.2 mg/ml indomethacin and to determine the long-term stability using a stability indicating high-pressure liquid chromatography (HPLC) method. Materials and Methods Liometacen, containing 50 mg sterile indomethacin (as meglumine salt), was reconstituted with 2 ml water for injection and then diluted with 250 ml NaCl 0.9% to a final indomethacin concentration of 0.2 mg/ml. Finally, a 5 ml indomethacin solution was filled into 10 ml sterilised brown glass vials. The entire process took place under aseptic conditions. Sterility testing was performed before final batch release. The vials were stored for up to 18 months frozen at −20°C, at 2–8°C or at room temperature, and the solutions were assessed by HPLC for indomethacin and its degradation products. Results Indomethacin solutions were submitted to conditions of oxidative or heat degradation, and the HPLC method was found to indicate stability. The stability testing revealed that the solutions retained at least 95% of their initial indomethacin concentration when they were stored at room temperature for 12 days or at 2–8°C for 23 days. In contrast, when the solutions were stored in a deep-freezer, they were stable for at least 18 months. During this time, no degradation of indomethacin occurred and the indomethacin concentration remained stable. Conclusions Indomethacin solutions may be prepared in advance and stocked for at least 18 months at −20°C. After thawing they can be kept at room temperature for 7 days or alternatively at 2–8°C for 14 days. This procedure is used successfully in our hospital for the treatment of the patent ductus arteriosus. No conflict of interest.

Although left ventricular ejection fraction (LVEF) is the primary determinant for sudden cardiac death (SCD) risk stratification, in isolation, LVEF is a sub-optimal risk stratifier. We assessed whether a multi-marker strategy would provide more robust SCD risk stratification than LVEF alone. We collected patient-level data (n = 3355) from 6 studies assessing the prognostic utility of microvolt T-wave alternans (MTWA) testing. Two thirds of the group was used for derivation (n = 2242) and one-third for validation (n = 1113). The discriminative capacity of the multivariable model was assessed using the area under the receiver-operating characteristic curve (c-index). The primary endpoint was SCD at 24 months. In the derivation cohort, 59 patients experienced SCD by 24 months. Stepwise selection suggested that a model based on 3 parameters (LVEF, coronary artery disease and MTWA status) provided optimal SCD risk prediction. In the derivation cohort, the c-index of the model was 0.817, which was significantly better than LVEF used as a single variable (0.637, P < .001). In the validation cohort, 36 patients experienced SCD by 24 months. The c-index of the model for predicting the primary endpoint was again significantly better than LVEF alone (0.774 vs 0.671, P = .020). A multivariable model based on presence of coronary artery disease, LVEF and MTWA status provides significantly more robust SCD risk prediction than LVEF as a single risk marker. These findings suggest that multi-marker strategies based on different aspects of the electro-anatomic substrate may be capable of improving primary prevention implantable cardioverter-defibrillator treatment algorithms.

(1) A series of six years of daily catches, in a suction trap, of the coffee leaf-miners Leucoptera meyricki Ghesq. and L. caffeina Washb. (Lepidoptera: Lyonetiidae) on unsprayed, shaded, single stem, arabica coffee was analysed by Fourier analysis. (2) 88% of the variance of the logarithmically transformed catch per generation could be accounted for by a combination of four simple harmonic curves with periods which were multiples of eight generations, equivalent to an annual cycle. (3) Simultaneous estimates of leaf-miners and six of their larval parasites obtained by bag sampling of mined leaves were subjected to a similar analysis. Using only the simple curves with periods of eight and sixteen generations it was shown that in each case the rate of increase of both leaf-miners and parasites was directly proportional to the size of the host population and inversely proportional to the size of the parasite population. (4) An analytical solution of the resulting differential equations was derived and the special properties of the generations discussed. (5) The theoretical course which would be followed by the two populations by artificially lowering either or both of them casts doubt on the present strategy of pest control on coffee. (6) The possible biological interpretation of the individual harmonics led to a closer scrutiny of the species composition of the parasite complex and revealed that over a 10-year period long-term readjustment has been taking place from a state of imbalance induced by the use of D.D.T. in the 1950s.