Postharvest application with propolis for controlling white rot disease of green bean pods

White rot is the most severe disease attacking green bean pods during pre and postharvest stages. Ethanol extracted propolis (EEP) at four concentrations i.e. 0, 5, 10 and 15% was tested to study its effect on growth inhibition zone of the causative fungus Sclerotinia sclerotiorum. Results indicated that all tested concentrations of EEP significantly increased the inhibition zone of S. sclerotiorum growth. The highest increase was obtained with at 15% where complete reduction in sclerotia germination occurred. At EEP 10%, the sclerotia germination was reduced by 91.6%.  When the same concentrations were tested to study their effect on white rot disease of green bean pods during storage, all EEP significantly reduced the percentage of white rot incidence and severity. The highest reduction was obtained with EEP at 15%; reducing the disease incidence and severity by 90 and 91.8% respectively, followed by EEP at 10% which reduced the incidence and severity by 78 and 82% respectively. EEP at 5% showed moderate effect. EEP is suggested as good biosystem within integrated management of pathogens and safe alternative for controlling postharvest diseases of green bean pods

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Hot water treatment in combination with silicate salts dipping for controlling apple gray mold caused by Botrytis cinerea Pers.:Fr.

Abstract Background Gray mold is the most prevalent postharvest disease of apple fruits in Egypt. In this study, five isolates of Botrytis cinerea were isolated from apple fruits that had postharvest decay symptoms. Investigations were made into the pathogenicity tests of these isolates as well as the molecular identification of the most virulent isolate. A study was done in vitro to see how B. cinerea's mycelial growth and conidial germination would be affected by hot water treatments (HWT) at temperatures of 25, 50, 52, 54, or 56 °C for 10, 20, 30, or 40 s as well as silicate salts (SS), specifically potassium silicate and sodium silicate at 0.0, 2.0, 4.0, and 6.0%. The effectiveness of hot water treatment and silicate salts dipping (SSD), both separately and together, for preventing B. cinerea infection and preserving the natural qualities of apple fruits was investigated in vivo. Results Pathogenicity tests on apples (Anna cv.) revealed that B. cinerea isolate (Bc-1) was found to be the most virulent. This isolate was identified as belonging to the fungus B. cinerea through molecular testing using internal transcribed spacer (ITS) sequencing and phylogenetic analyses, and it has since been added to Gene Bank with the accession number ON1498639.1. The lethal temperature for B. cinerea mycelial growth and spore germination in vitro was 54 °C/30 s and 54 °C/10 s, respectively. At a 6.0%, the SS, specifically potassium silicate and sodium silicate, completely prevented pathogen growth. When applied separately, HWT (60 °C/30 s) and SSD (6.0%/1 min) significantly reduced B. cinerea decay of apple fruits stored at 20 ± 2 °C for 15 days. In terms of control efficacy, the HWT (60 °C/30 s) and SSD (6.0%/1 min) combination performed better. Conclusions When apple fruits are stored at 20 ± 2 °C for 15 days, the combination of HWT (60 °C/30 s) and SSD (6.0%/1 min) may be an efficient way to control the gray mold disease. The amount of total soluble solids (TSS) in apple fruits was unaffected by these treatments, but they significantly lessened fruit weight loss after 40 days of storage at 20 ± 2 °C

Management of strawberry leaf blight disease caused by Phomopsis obscurans using silicate salts under field conditions

Abstract Background Due to the increased economic and social benefits of the strawberry crop yield in Egypt, more attention has been paid to control its pests and diseases. Leaf blight, caused by the fungus Phomopsis obscurans, is one of the important diseases of strawberry plants. Therefore, effect of silicon and potassium, sodium and calcium silicates, and a fungicide on Phomopsis leaf blight of strawberry under laboratory and field conditions was examined. Results Four concentrations, i.e., 0, 2, 4, and 6 g/l of silicon as well as potassium, sodium and calcium silicates could significantly reduce the linear growth of tested fungus in the laboratory test where complete inhibition of linear growth was obtained with 6 g/l. The other concentrations showed less but favorable effects. The highest reduction of disease severity was obtained with potassium silicate and calcium silicate separately applied as soil treatment combined with foliar spray which reduced the disease incidence by 83.3 and 86.7%, respectively. Other treatments showed significant (P ≤ 0.05) but less effect. The highest yield increase was obtained with potassium silicate and calcium silicate applied as soil treatment combined with foliar spray which increased fruit yield by 60 and 53.8%, respectively. All tested treatments increased (P ≤ 0.05) the activities of the peroxidase, polyphenol oxidase, and chitinase enzymes. Conclusions All tested concentrations of silicon salts have suppressed the fungal growth and disease spread but with different degrees. The more the concentration, the better it suppresses the fungal growth and consequent effect on damaging strawberry plants. Potassium silicate and calcium silicate separately applied as soil treatment combined with foliar spray were the best in reducing the disease incidence and increasing crop yield. Potential implications of silicate salts on enhancing activities of the tested enzymes reflected their role in protection against such a plant disease

Reduction of Stromatinia cepivora inocula and control of white rot disease in onion and garlic crops by repeated soil applications with sclerotial germination stimulants

The effect of soil-applied Allium crop products on the Stromatinia cepivora viability and the incidence of white rot in subsequent onion and garlic crops were evaluated in this work. The tested products were onion powder, garlic powder, onion oil, garlic oil and Allium waste (onion and garlic) that are described as sclerotial germination stimulants. Under in vitro conditions, data revealed that more than 80% of the sclerotia died in the soil treated with sclerotial germination stimulants. Under greenhouse conditions, soil-artificially infested with sclerotia of S. cepivora and treated with sclerotial germination stimulants for 6-months before cultivation, significantly reduced the incidence of white rot on onion and garlic. Onion oil, garlic oil and Allium waste were the most effective treatments, decreasing disease incidence by 78.6% in onion and 80.0% in garlic. Under field conditions, sclerotial germination stimulants were incorporated into the soil in commercial fields naturally infested with S. cepivora. Two fields were chosen based on differential sclerotial density. Within 6 months after treatment, more than 70% of the sclerotia died in the plots treated with sclerotial germination stimulants. In subsequent onion and garlic crops planted approximately one year after soil treatment, sclerotial germination stimulants were more effective than the control in reducing white rot symptoms coupled with low inoculum density (45.9 sclerotia/kg of soil). Reduction of white rot disease was accompanied by increased of growth and bulbs yield of onion and garlic plants. Despite the efficacy of sclerotial germination stimulants to reduce populations of viable sclerotia in soil with a high inoculum density (594.7 sclerotia/kg of soil), the pathogen caused substantial white rot and yield losses in subsequent onion and garlic crops planted approximately one year after soil treatment

Potential Association between Subclinical Hypothyroidism and Childhood Migraine

Background and Objectives: Migraine is caused by genetic susceptibility that is triggered by environmental as well as biological factors, and it is also linked to many somatic comorbidities, including clinical and subclinical hypothyroidism. We aimed to estimate the potential association between subclinical hypothyroidism (ScH) and migraine in children at our tertiary hospital. Materials and Methods: Using a case–control strategy, 200 children and adolescents were assigned to two equal groups: a case group (patients with migraine) of 100 patients and a control group of 100 patients without migraine. Clinical and biochemical parameters (TSH, FT4) were compared between the groups using statistical analysis. Results: Thyroid function comparison between the groups showed higher TSH but normal FT4 among children with migraine headache compared to the control group, which means more frequent ScH cases among the migraine group relative to the control (17% vs. 2%, p < 0.001). Obesity and overweight were more frequent among patients with migraine than the control group (8 and 5% vs. 2 and 1%, respectively). The (overweight/obese) patients with migraine had about 77% ScH and 15.4% overt hypothyroidism compared to 8% ScH and no overt hypothyroidism among normal body weight migraine patients (p < 0.001). No significant difference in the prevalence of nodular goiter between patients with migraine and controls was found. Conclusions: Based on our results, subclinical hypothyroidism is significantly linked to childhood migraine. Obesity and being overweight are more frequent among patients with migraine. Therefore, it may be logical to test the thyroid function in migraineur children, especially those with high BMI. Further studies are recommended to discover the mechanism of this association in children

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit