ALBERT

Description: Pregnancy and childbirth associated with a high risk of severe maternal and fetal complications in women with paroxysmal nocturnal hemoglobinuria (PNH). Recently the management of PNH during pregnancy has been challenging and childbearing was practically contraindicated in these patients. Eculizumab treatment improved the prognosis in PNH and made it possible to minimize complications during pregnancy. Establishment of effective and safe algorithms for the management of pregnancy, delivery and postpartum period in PNH patients is crucial to their lives. Since 1999, we have analyzed 15 pregnancies in six women with PNH. The median age at PNH diagnosis was 22 years (18-27), the median age at the start of pregnancy - 25 years (21-34). All of them were diagnosed with PNH following treatment for aplastic anemia (AA) with antithymocyte globulin, cyclosporine A and splenectomy in two cases before pregnancy. The median of PNH granulocyte clone at the start of pregnancy was 74,7% (17,8-94,1). Pregnancy occurred during complete remission of AA with PNH clinical signs in 5 (33,3%) cases. Most patients were in partial remission at the time of pregnancy-7 (46,7%) or continued to receive immunosuppressive therapy with minimal effect-3 (20%). Progression of aplasia observed during 4 (26,7%) pregnancies, but it was not severe and special treatment delayed until the completion of pregnancy. Two patients exposed to eculizumab before conceiving and remained on the treatment during pregnancy. Other women received only symptomatic therapy. Anticoagulation with low molecular weight heparin was used in 5 (33,3%) pregnancies. No thrombotic events during pregnancy and postpartum have been observed. Skin hemorrhages were revealed in 2 (13,3%) patients. During 4 (26,7%) gestations patients underwent erythrocytes and/or platelets transfusion. Pregnancies resulted in the birth of healthy infants in 7 (46,7%) cases - two girls and five boys. There were no adverse effects in the newborns from PNH patients both on eculizumab and without it. Successful outcomes were in 2/2 pregnancies on eculizumab treatment and in 5/13 (38,5%) cases without the drug. Caesarean sections were performed in all of births, early surgical delivery (30-34 weeks)-in 4/7 cases (preeclampsia-2, placenta previa-1, breakthrough hemolysis-1). Adverse pregnancy outcomes occurred only in patients not receiving eculizumab and amounted to 8/13 (61,5%). Only three patients had planned the pregnancy, other 12 cases were unplanned. Consequently, in 4 (30,8%) cases of pregnancy in the midst of illness was performed the abortion for medical reasons. Spontaneous miscarriage was registered in 2 (15,4%) patients. Two pregnancies (15,4%) ended in fetal death on 27th and 20th gestation weeks. Transfusion requirements increased in two pregnancies with symptomatic therapy, but did not increase on eculizumab. One of patients had first pregnancy without eculizumab and developed complications such as preeclampsia, postpartum severe epistaxis and high transfusion requirement (an average of 1,2 units per month). During second pregnancy on eculizumab she had no obstetric complications and transfusion requirements were less (0,5 units monthly). Second patient continued to have evidence of intravascular hemolysis despite the treatment, and so received eculizumab more frequent (one time in 10 days) in the third trimester. PNH granulocyte clone size decreased in both cases of eculizumab treatment during pregnancy. The risk of complications in PNH patients during pregnancy may be minimized by applying the management algorithm with eculizumab treatment. Despite the small number of observations, we can safely conclude that pregnancy outcomes in PNH patients with eculizumab are better than with only symptomatic therapy. Our experience confirms that eculizumab can be safely used in PNH throughout pregnancy to reduce the risk of complications and adverse outcomes. There is no difference in health between infants born by mothers with PNH and the newborns from general population. Disclosures No relevant conflicts of interest to declare.

Description: Total soil carbon (TSC) is a composite (total) stock, which is the sum of soil organic carbon (SOC) and soil inorganic carbon (SIC). Total soil carbon, and its individual two components, are all important criteria for assessing ecosytems services (ES) and for achieving United Nations (UN) Sustainable Development Goals (SDGs). The objective of this study was to assess the value of TSC stocks, based on the concept of the avoided social cost of carbon dioxide emissions, for the contiguous United States (U.S.) by soil order, soil depth (0–20, 20–100, 100–200 cm), land resource region (LRR), state, and region using information from the State Soil Geographic (STATSGO) database. The total calculated monetary value for TSC storage in the contiguous U.S. was between $8.13T (i.e., $8.13 trillion U.S. dollars, where T = trillion = 1012) and $37.5T, with a midpoint value of $21.1T. Soil orders with the highest TSC storage midpoint values were Mollisols ($7.78T) and Aridisols ($2.49T). Based on area, however, the soil orders with highest midpoint TSC values were Histosols ($21.95 m−2) and Vertisols ($5.84 m−2). Soil depth was important, with the highest values of TSC storage being found in the interval 20–100 cm ($9.87T—total midpoint value, and $1.34 m−2—midpoint area density). The soil depth interval 0–20 cm had the lowest TSC storage ($4.30T) and lowest area-density ($0.58 m−2) value, which exemplifies the prominence of TSC in the deeper subsurface layers of soil. The LRRs with the highest midpoint TSC storage values were: M—Central Feed Grains and Livestock Region ($2.82T) and D—Western Range and Irrigated Region ($2.64T), whereas on an area basis the LRRs with the highest values were I—Southwest Plateaus and Plains Range and Cotton Region ($6.90 m−2) and J—Southwestern Prairies Cotton and Forage Region ($6.38 m−2). Among the U.S. states, the highest midpoint TSC storage values were Texas ($4.03T) and Minnesota ($1.29T), while based on area this order was reversed (i.e., Minnesota: $6.16 m−2; Texas: $6.10 m−2). Comprehensive assessment of regulating ES requires TSC, which is an important measure in achieving the UN SDGs. Despite the known shortcomings of soil databases, such as their static nature and the wide ranges of uncertainty reported for various soil properties, they provide the most comprehensive information available at this time for making systematic assessments of ecosystem services at large spatial scales.

Description: Soil organic carbon (SOC) generates several ecosystem services (ES), including a regulating service by sequestering carbon (C) as SOC. This ES can be valued based on the avoided social cost of carbon (SC-CO2) from the long-term damage resulting from emissions of carbon dioxide (CO2). The objective of this study was to assess the value of SOC stocks, based on the avoided SC-CO2 ($42 per metric ton of CO2 in 2007 U.S. dollars), in the contiguous United States (U.S.) by soil order, soil depth (0–20, 20–100, 100–200 cm), land resource region (LRR), state, and region using information from the State Soil Geographic (STATSGO) database. The total calculated monetary value for SOC storage in the contiguous U.S. was between $4.64T (i.e., $4.64 trillion U.S. dollars, where T = trillion = 1012) and $23.1T, with a midpoint value of $12.7T. Soil orders with the highest midpoint SOC storage values were 1): Mollisols ($4.21T), 2) Histosols ($2.31T), and 3) Alfisols ($1.48T). The midpoint values of SOC normalized by area within soil order boundaries were ranked: 1) Histosols ($21.58 m−2), 2) Vertisols ($2.26 m−2), and 3) Mollisols ($2.08 m−2). The soil depth interval with the highest midpoint values of SOC storage and content was 20–100 cm ($6.18T and $0.84 m−2, respectively), while the depth interval 100–200 cm had the lowest midpoint values of SOC storage ($2.88T) and content ($0.39 m−2). The depth trends exemplify the prominence of SOC in the upper portions of soil. The LRRs with the highest midpoint SOC storage values were: 1) M – Central Feed Grains and Livestock Region ($1.8T), 2) T – Atlantic and Gulf Coast Lowland Forest and Crop Region ($1.26T), and 3) K – Northern Lake States Forest and Forage Region ($1.16T). The midpoint values of SOC normalized by area within LRR boundaries were ranked: 1) U – Florida Subtropical Fruit, Truck Crop, and Range Region ($6.10 m−2), 2) T – Atlantic and Gulf Coast Lowland Forest and Crop Region ($5.44 m−2), and 3) K – Northern Lake States Forest and Forage Region ($3.88 m−2). States with the highest midpoint values of SOC storage were: 1) Texas ($1.08T), 2) Minnesota ($834B) (i.e., $834 billion U.S. dollars, where B = billion = 109), and 3) Florida ($742B). Midpoint values of SOC normalized by area within state boundaries were ranked: 1) Florida ($5.44 m−2), 2) Delaware ($4.10 m−2), and 3) Minnesota ($3.99 m−2). Regions with the highest midpoint values of SOC storage were: 1) Midwest ($3.17T), 2) Southeast ($2.44T), and 3) Northern Plains ($2.35T). Midpoint values of SOC normalized by area within region boundaries were ranked: 1) Midwest ($2.73 m−2), 2) Southeast ($2.31 m−2), and 3) East ($1.82 m−2). The reported values and trends demonstrate the need for policies with regards to SOC management, which requires incentives within administrative boundaries but informed by the geographic distribution of SOC.

Description: Ecosystem services (ESs) are increasingly being used by many countries around the world as a framework for addressing the United Nations (UN) Sustainable Development Goals (SDGs). This review article of the usability of Libyan soil databases for ESs and SDGs is the first of its kind for North Africa. The objectives of the article are to: describe the available soil resources of Libya in relation to an ES framework; provide examples of the usability of Libyan soil databases for ES applications (e.g., provisioning, Healthy Eating Plate), and describe some of the typical disservices in the country. Desertification, salinization, and limited freshwater resources are the largest challenges (disservices) for agriculture and future development in Libya. Seawater intrusion in coastal areas due to rising sea levels has resulted in high concentrations of salts in irrigation waters, which can lead to low soil productivity. These challenges can be addressed by integrating Libyan soil resources into a market that transforms resources into goods and services to meet human demand in a sustainable manner, with non-market institutions mediating the interactions between humans and the environment. If Libyan soil resources are taken into account by both market and non-market institutions, it will lead to more efficient use of soil resources and also should enable the implementation of innovative strategies, such as integrated farming systems, non-soil-based agricultural production (e.g., hydroponics), and alternative farming practices.

Description: Soil databases are very important for assessing ecosystem services at different administrative levels (e.g., state, region etc.). Soil databases provide information about numerous soil properties, including soil inorganic carbon (SIC), which is a naturally occurring liming material that regulates soil pH and performs other key functions related to all four recognized ecosystem services (e.g., provisioning, regulating, cultural and supporting services). However, the ecosystem services value, or “true value,” of SIC is not recognized in the current land market. In this case, a negative externality arises because SIC with a positive value has zero market price, resulting in the market failure and the inefficient use of land. One potential method to assess the value of SIC is by determining its replacement cost based on the price of commercial limestone that would be required to amend soil. The objective of this study is to assess SIC replacement cost value in the contiguous United States (U.S.) by depth (0–20, 20–100, 100–200 cm) and considering different spatial aggregation levels (i.e., state, region, land resource region (LRR) using the State Soil Geographic (STATSGO) soil database. A replacement cost value of SIC was determined based on an average price of limestone in 2014 ($10.42 per U.S. ton). Within the contiguous U.S., the total replacement cost value of SIC in the upper two meters of soil is between $2.16T (i.e., 2.16 trillion U.S. dollars, where T = trillion = 1012) and $8.97T. States with the highest midpoint total value of SIC were: (1) Texas ($1.84T), (2) New Mexico ($355B, that is, 355 billion U.S. dollars, where B = billion = 109) and (3) Montana ($325B). When normalized by area, the states with the highest midpoint SIC values were: (1) Texas ($2.78 m−2), (2) Utah ($1.72 m−2) and (3) Minnesota ($1.35 m−2). The highest ranked regions for total SIC value were: (1) South Central ($1.95T), (2) West ($1.23T) and (3) Northern Plains ($1.01T), while the highest ranked regions based on area-normalized SIC value were: (1) South Central ($1.80 m−2), (2) Midwest ($0.82 m−2) and (3) West ($0.63 m−2). For land resource regions (LRR), the rankings were: (1) Western Range and Irrigated Region ($1.10T), (2) Central Great Plains Winter Wheat and Range Region ($926B) and (3) Central Feed Grains and Livestock Region ($635B) based on total SIC value, while the LRR rankings based on area-normalized SIC value were: (1) Southwest Plateaus and Plains Range and Cotton Region ($3.33 m−2), (2) Southwestern Prairies Cotton and Forage Region ($2.83 m−2) and (3) Central Great Plains Winter Wheat and Range Region ($1.59 m−2). Most of the SIC is located within the 100–200 cm depth interval with a midpoint replacement cost value of $2.49T and an area-normalized value of $0.34 m−2. Results from this study provide a link between science-based estimates (e.g., soil order) of SIC replacement costs within the administrative boundaries (e.g., state, region etc.).