Overview of literature and information on "khat-related" mortality: a call for recognition of the issue and further research

During the past 20 years or so, more has become known about the properties of khat, its pharmacology, physiological and psychological effects on humans. However, at the same time its reputation of social and recreational use in traditional contexts has hindered the dissemination of knowledge about its detrimental effects in terms of mortality. This paper focuses on this particular deficit and adds to the knowledge-base by reviewing the scant literature that does exist on mortality associated with the trade and use of khat. We sought all peer-reviewed papers relating to deaths associated with khat. From an initial list of 111, we identified 15 items meeting our selection criteria. Examination of these revealed 61 further relevant items. These were supplemented with published reports, newspaper and other media reports. A conceptual framework was then developed for classifying mortality associated with each stage of the plant's journey from its cultivation, transportation, consumption, to its effects on the human body. The model is demonstrated with concrete examples drawn from the above sources. These highlight a number of issues for which more substantive statistical data are needed, including population-based studies of the physiological and psychological determinants of khat-related fatalities. Khat-consuming communities, and health professionals charged with their care should be more aware of the physiological and psychological effects of khat, together with the risks for morbidity and mortality associated with its use. There is also a need for information to be collected at international and national levels on other causes of death associated with khat cultivation, transportation, and trade. Both these dimensions need to be understood.

On the Integration of Smalltalk and Java

After decades of development in programming languages and programming environments, Smalltalk is still one of few environments that provide advanced features and is still widely used in the industry. However, as Java became prevalent, the ability to call Java code from Smalltalk and vice versa becomes important. Traditional approaches to integrate the Java and Smalltalk languages are through low-level communication between separate Java and Smalltalk virtual machines. We are not aware of any attempt to execute and integrate the Java language directly in the Smalltalk environment. A direct integration allows for very tight and almost seamless integration of the languages and their objects within a single environment. Yet integration and language interoperability impose challenging issues related to method naming conventions, method overloading, exception handling and thread-locking mechanisms. In this paper we describe ways to overcome these challenges and to integrate Java into the Smalltalk environment. Using techniques described in this paper, the programmer can call Java code from Smalltalk using standard Smalltalk idioms while the semantics of each language remains preserved. We present STX:LIBJAVA - an implementation of Java virtual machine within Smalltalk/X - as a validation of our approach

A call for uniform reporting standards in studies assessing endovascular treatment for chronic ischaemia of lower limb arteries

Endovascular therapy is a rapidly evolving field for the treatment of patients with peripheral arterial disease, and a magnitude of studies reporting on various modern revascularization concepts have been recently published. Thus, studies assessing the efficacy of endovascular therapy of peripheral arteries do not operate with uniformly defined endpoints, rendering a direct comparison of studies difficult. The purpose of this consensus statement is to highlight differences in the terminology used in the current literature and to propose some standardized criteria that must be considered when reporting results of endovascular revascularization for chronic ischaemia of lower limb arteries.