Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The effect of temperature on growth, stem extension and bolting in iceburg lettuce (Lactuca sativa L.)

Available from British Library Document Supply Centre-DSC:DXN033873 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Effect of rootstock on muskmelon cultivar reaction to vine decline disease and yield under arid conditions

Monosporascus cannonballus, Rhizoctonia solani and Pythium aphanidermatum are the main causal agents of muskmelon vine decline disease in Oman. This study was conducted to examine the response of six cucurbit rootstocks grafted on four muskmelon scions to the causal agents and fruit quality and quantity. The response of 10 day old Palmira seedlings to artificial inoculation with R. solani pathogen alone revealed more damage to muskmelon seedling whereas P. aphanidermatum and M. cannonballus caused less damage when inoculated singly but more disease severity index when combined with R. solani. Artificial inoculation of different rootstocks produced significantly no damping-off and very low vine decline disease severity index on Mubyeongjangsoo, Titan, Tetsukabuto, Rsscih7458, Ezra and Strong Tosa rootstocks. All rootstocks produced high grafting success and low graft failure with the four selected muskmelon cultivars. Rootstocks enhanced early harvesting of grafted Tamara but had no effect on other scions. Fruit shape was almost not significantly affected by grafting except Samit grafted on Strong Tosa and Caramel grafted on Mubyeongjangsoo produced significantly different fruit shapes compared to ungrafted controls in the spring 2013 trial. Fruits from both grafted Shahd and Tamara showed no significant differences in rind brightness, redness and yellowness from the control. An various effect of rootstock was found on harvesting, fruit number and weight, chlorophyll content, and stem diameter of the scion. Rootstocks enhanced early harvesting and increased fruit number and fruit weight in grafted Tamara scions. There was no significant effect of grafting on fruit TSS. The study shows positive effects of grafting on tolerance to vine decline and on fruit quality and yield.

Effect of rootstock on muskmelon cultivar reaction to vine decline disease and yield under arid conditions

Monosporascus cannonballus, Rhizoctonia solani and Pythium aphanidermatum are the main causal agents of muskmelon vine decline disease in Oman. This study was conducted to examine the response of six cucurbit rootstocks grafted on four muskmelon scions to the causal agents and fruit quality and quantity. The response of 10 day old Palmira seedlings to artificial inoculation with R. solani pathogen alone revealed more damage to muskmelon seedling whereas P. aphanidermatum and M. cannonballus caused less damage when inoculated singly but more disease severity index when combined with R. solani. Artificial inoculation of different rootstocks produced significantly no damping-off and very low vine decline disease severity index on Mubyeongjangsoo, Titan, Tetsukabuto, Rsscih7458, Ezra and Strong Tosa rootstocks. All rootstocks produced high grafting success and low graft failure with the four selected muskmelon cultivars. Rootstocks enhanced early harvesting of grafted Tamara but had no effect on other scions. Fruit shape was almost not significantly affected by grafting except Samit grafted on Strong Tosa and Caramel grafted on Mubyeongjangsoo produced significantly different fruit shapes compared to ungrafted controls in the spring 2013 trial. Fruits from both grafted Shahd and Tamara showed no significant differences in rind brightness, redness and yellowness from the control. An various effect of rootstock was found on harvesting, fruit number and weight, chlorophyll content, and stem diameter of the scion. Rootstocks enhanced early harvesting and increased fruit number and fruit weight in grafted Tamara scions. There was no significant effect of grafting on fruit TSS. The study shows positive effects of grafting on tolerance to vine decline and on fruit quality and yield

Effect of rootstock on muskmelon cultivar reaction to vine decline disease and yield under arid conditions

Monosporascus cannonballus, Rhizoctonia solani and Pythium aphanidermatum are the main causal agents of muskmelon vine decline disease in Oman. This study was conducted to examine the response of six cucurbit rootstocks grafted on four muskmelon scions to the causal agents and fruit quality and quantity. The response of 10 day old Palmira seedlings to artificial inoculation with R. solani pathogen alone revealed more damage to muskmelon seedling whereas P. aphanidermatum and M. cannonballus caused less damage when inoculated singly but more disease severity index when combined with R. solani. Artificial inoculation of different rootstocks produced significantly no damping-off and very low vine decline disease severity index on Mubyeongjangsoo, Titan, Tetsukabuto, Rsscih7458, Ezra and Strong Tosa rootstocks. All rootstocks produced high grafting success and low graft failure with the four selected muskmelon cultivars. Rootstocks enhanced early harvesting of grafted Tamara but had no effect on other scions. Fruit shape was almost not significantly affected by grafting except Samit grafted on Strong Tosa and Caramel grafted on Mubyeongjangsoo produced significantly different fruit shapes compared to ungrafted controls in the spring 2013 trial. Fruits from both grafted Shahd and Tamara showed no significant differences in rind brightness, redness and yellowness from the control. An various effect of rootstock was found on harvesting, fruit number and weight, chlorophyll content, and stem diameter of the scion. Rootstocks enhanced early harvesting and increased fruit number and fruit weight in grafted Tamara scions. There was no significant effect of grafting on fruit TSS. The study shows positive effects of grafting on tolerance to vine decline and on fruit quality and yield

Association of a second phase of mortality in cucumber seedlings with a rapid rate of metalaxyl biodegradation in greenhouse soils

A study was undertaken from 2004 to 2007 to investigate factors associated with decreased efficacy of metalaxyl to manage damping-off of cucumber in Oman. A survey over six growing seasons showed that growers lost up to 14.6% of seedlings following application of metalaxyl. No resistance to metalaxyl was found among Pythium isolates. Damping-off disease in the surveyed greenhouses followed two patterns. In most (69%) greenhouses, seedling mortality was found to occur shortly after transplanting and decrease thereafter (Phase-I). However, a second phase of seedling mortality (Phase-II) appeared 9-14 d after transplanting in about 31% of the surveyed greenhouses. Analysis of the rate of biodegradation of metalaxyl in six greenhouses indicated a significant increase in the rate of metalaxyl biodegradation in greenhouses, which encountered Phase-II damping-off. The half-life of metalaxyl dropped from 93 d in soil, which received no previous metalaxyl treatment to 14 d in soil, which received metalaxyl for eight consecutive seasons, indicating an enhanced rate of metalaxyl biodegradation after repeated use. Multiple applications of metalaxyl helped reduce the appearance of Phase-II damping-off. This appears to be the first report of rapid biodegradation of metalaxyl in greenhouse soils and the first report of its association with appearance of a second phase of mortality in cucumber seedlings