Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Reproductive Biology of Butea monosperma (Fabaceae)

The reproductive biology encompassing phenology, ¯oral biology, pollination and breeding systems, of Butea monosperma, a beautiful tree of the Indian subcontinent, was investigated in a protected dry, deciduous forest located in New Delhi. Phenological studies indicated that although the species shows a regular ¯owering season, all trees do not ¯ower every year. Flowers are typically papilionaceous; the stigma is wet papillate and the style is hollow. The ¯owers show characteristics of bird pollination being large and bright orange-red in colour with copious amounts of nectar, and exhibiting diurnal anthesis. Although the ¯owers are frequented by as many as seven species of birds belonging to six families, only one species, the purple sunbird (Nectarinia asiatica), is theeffective pollinator. The ¯owers are also pollinated by the three-striped squirrel (Funambulus tristiatus). Unlike other ¯ower visitors, these two pollinators forage the nectar from the open side of the keel (legitimate path) during which pollen grains are deposited on their body parts. After the ®rst visit of a sunbird or a squirrel, virgin ¯owers showed pollen load on the stigma and developed into fruits. B. monosperma shows a weak form of selfincompatibility. Fruit set following manual self-pollination (5´25 %) was comparable with open-pollination (approx. 5 %) but was signi®cantly lower than manual cross-pollination (22´51 %). This indicates that there is a high degree of geitonogamous pollination in this species, which may lead to a weakening of self-incompatibility as a means of reproductive assurance. The results are analysed in the light of prevailing discussions on specialized vs. generalized pollination systems

Flower architecture and sex determination: how does Atriplex halimus play with floral morphogenesis and sex genes?

Atriplex halimus, a monoecious Chenopodiaceae, produces flowers displaying two basic architectures. The first architectural pattern is made of staminate pentamerous flowers with an external whorl of yellowish tepals and an internal whorl of stamens. The second architectural pattern consists of female flowers with a single carpel enclosed within two opposite bracts. In both architectures, bisexual flowers and flowers of the un-expected sex were detected leading to the occurrence of up to six floral phenotypes on the same individual. Daylength and light intensity affected sex ratio and flower distribution between both architectural patterns. Short days and low light irradiance promoted femaleness and bracteate floral architecture. Flower position on a reproductive axis and geographical origin of the plant (genotype) also affected sex and architecture ratios. Thus, all the genetic information required for the production of both floral architecture and sexual organ types is present in each A. halimus plant but endogenous and environmental cues determine the fate of the floral meristems. These results are discussed in relation to classical models of genetic control of floral morphogenesis

Not the one, but the only one: about Cannabis cryptic virus in plants showing ‘hemp streak’ disease symptoms

Interveinal chlorosis and leaf margin wrinkling are widespread symptoms of Cannabis sativa. They are traditionally attributed to the so-called hemp streak virus (HSV), but its existence has not been demonstrated yet. To our knowledge, no molecular investigation has so far been performed in order to identify the causal agent of this symptomatology, we therefore decided to use traditional and molecular virology techniques to better characterize symptoms and pursue the etiological agent. No pathogenic virus was found by using targeted PCR reactions and by RNA sequencing, whereas we were able to detect the Cannabis cryptic virus (CanCV) with both techniques. We, therefore, developed an RT-qPCR assay based on a CanCV-specific TaqMan probe and applied it to a wide range of symptomatic and symptomless plants, using a two-step (for quantification), or a one-step (for fast detection) protocol. Both symptoms and the virus were only shown to be transmitted vertically and did not pass via mechanical inoculation or grafting, though we could not find any cause-effect correlation between them. In fact, the virus was found in all the tested hemp samples, and its abundance varied greatly between different accessions and individuals, independently from the presence and severity of symptoms. The suggestion that hemp streak is caused by a virus is therefore questioned. Some abiotic stresses seem to play a role in triggering the symptoms but this aspect needs further investigation. For breeding purposes, a selection of parental plants based on the absence of symptoms proved to be efficient in containment of the disease