Effect of plant spacing on growth, yield and fruit quality of some introduced banana (Musa AAA) clones

    A field experiment was conducted at the Experimental Farm of the National Institute for the Promotion of Horticultural Exports, University of Gezira, Sudan, during 2009/10 and 2010/11. The objective of the study was to determine the effects of plant spacing on the vegetative growth, crop earliness, yield components, total yield and fruit quality of  five introduced banana clones under Gezira conditions, Sudan. Treatments consisted of three banana clones introduced from Austria, namely, Williams hybrid 172 (WH 172), Williams hybrid 1366 (WH 1366) and Grand Nain 1824 (GN 1824) and two clones introduced from South Africa, namely, Zelig and Bio. These five introduced clones were compared with the local clone Dwarf Cavendish (DC). Plant spacing was 2x2, 2x3 and 3x3 m. Treatments were arranged in a split plot design with three replicates. Plant spacing was assigned to the main plots and clones to the subplots. Results showed that vegetative growth parameters, yield and yield components were significantly affected by banana clones and plant spacing. Generally, the introduced banana clones had more vigorous vegetative growth than the local clone DC. The most vigorous vegetative growth was obtained by WH 172 followed by WH 1366 and GN 1824. Plant spacing of 2x3 m and 3x3 m resulted in significantly higher growth parameters values than 2x2 m. The earliest clone was GN 1824 and the latest were Bio and DC. Bio clone took the longest time from shooting to harvesting and both WH clones and Zelig  took the shortest. Plant spacing of 3x3 m resulted in significantly the shortest time from shooting to harvesting compared to the others. The highest yield and yield components were obtained by WH 172, WH 1366 and GN 1824 and the lowest were obtained by the local clone DC. Plant spacing of 3x3 m resulted in the highest yield components but the lowest total yield However, the close spacing of 2x2 m produced the lowest yield components but the highest total yield due to the large number of bunches per unit area. Total soluble solids were comparable in all clones, however, GN 1824 and WH 1366 had a better taste than the other clones. Plant spacing of 2x3 m and 3x3 m resulted in significantly higher TSS and taste values than 2x2 m. It is recommended to grow the banana introduced clones WH 172, WH 1366 and GN 1824 at a spacing of 2X3 m for the highest yield and best fruit quality.      أجريت التجارب بحقل بحوث المعهد القومي لتنمية الصادرات البستانية، جامعة الجزيرة، في الفترة من  2009 الي 2011. الهدف من الدراسة هو معرفة أثر مسافات الزراعة على النمو الخضري والتبكير ومكونات الإنتاج والإنتاجية ونوعية الثمار لخمسة أصناف من الموز مستجلبة من خارج السودان ، تحت ظروف الجزيرة بالسودان. اشتملت المعاملات على ثلاث سلالات من الموز مستوردة من النمسا وهي هجين الوليامز 172 (WH172) وهجين الوليامز 1366 (WH1366) وجراندنين 1824 (GN1824) وسلالتين استجلبتا من جنوب أفريقيا وهما زيلج وبايو. هذه السلالات الخمس المستجلبة من الخارج ثم تقويمها بالمقارنة مع السلالة المحلية الكافندش القزم (DC). مسافات الزراعة كانت 2 × 2م و 2 × 3م و 3×3م . نظمت المعاملات في تصميم القطع المنشقة بثلاث مكررات. اعتبرت مسافات الزراعة قطعاً رئيسية والسلالات قطعاً ثانوية. أظهرت النتائج أن تأثير السلالات ومسافات الزراعة كان معنوياً على النمو الخضري ومكونات الإنتاج والإنتاجية ونوعية الثمار. عموماً السلالات المستجلبة من الخارج أظهرت نمواً خضرياً أفضل من السلالة المحلية DC. أعطت السلالات WH172, و WH1366 وGN1824 نمواً خضرياً افضل من غيرها. مسافات الزراعة 2×3م و 3×3م أعطت نمواً خضرياً أفضل من 2×2م. أكثر السلالات تبكيراً هي  GN1824 وأكثرها تأخراً هي بايو وDC. استغرقت السلالة بايو زمناً أطول من الإزهار وحتى الحصاد أما السلالات WH172 وWH1366 وزيلج استغرقت وقتاً أقصر. مسافات الزراعة 3×3م نتج عنها زمناً أقصر من الإزهار وحتى الحصاد. السلالات WH172 وWH1366 وGN1824 أعطت أعلى إنتاجية بينما اعطت السلالة المحلية DC أقل إنتاجية. مسافات الزراعة 3×3م اعطت أعلى مكونات الإنتاج وأقل إنتاج كلي بينما أعطت مسافات الزراعة 2×2م أقل مكونات الإنتاج وأعلى إنتاج كلي نسبة للعدد الكبير من السبائط في وحدة المساحة. المواد الصلبة الذائبة الكلية كانت متقاربة في كل السلالات ولكن السلالات GN1824  و WH1366 أعطت  مذاقاً  أفضل من غيرها. مسافات الزراعة 2×3م و3×3م أعطت أعلى محتوى من المواد الصلبة الذائبة الكلية وافضل مذاق بالمقارنة مع  2x2 م. يوصى بزراعة  السلالات WH172  وWH1366 وGN1824 بمسافات  2×3م للحصول على أعلى انتاجية من الثمار ذات الجودة العالية

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

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

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

Abstract 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

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p<0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p<0·001). Interpretation Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication. Funding DFID-MRC-Wellcome Trust Joint Global Health Trial Development Grant, National Institute of Health Research Global Health Research Unit Grant