Differential responses of Brassica oleracea and B. rapa accessions to seven isolates of Peronospora parasitica at the cotyledon stage

Nineteen accessions of Brassica oleracea var. italica (broccoli), 31 of B. oleracea var. boirytis (cauliflower), two of B. oleracea var. capitata (cabbage), three of B. rapa subsp, rapifera (turnip), one of B. rapa subsp, pekinensis (Chinese cabbage), and three of Raphanus sativus (radish) were tested for their response to isolates of Peronospora parasitica (downy mildew) at the cotyledon stage. Of the seven isolates tested, four were from crops of cauliflower in France, two from oilseed rape (B. napus subsp, oleifera) in the UK, and one was from mustard (B. juncea) in India. Twenty-one differential responses to P. parasitica isolates from B. oleracea and two from B. rapa were identified. All Raphanus sativus accessions were resistant to all seven isolates. Accessions for which seedling populations exhibited a heterogeneous reaction to some isolates were classified in a separate category. The differential resistance to P. parasitica identified in B. oleracea and B. rapa can be used for future studies of the genetics of the host-pathogen interaction and for breeding for disease resistanc

Pathological and biochemical changes in Brassica juncea (mustard) infected with Albugo candida (white rust)

Components of disease reaction, including incubation period, pustule types, inoculum production and disease index (DI); and contents of protein, phenols, soluble sugars and reducing and non-reducing sugars were investigated in cotyledonary and true leaves of six genotypes of Brassica juncea: Varuna, Kranti, EC-399296, EC-399299, EC-399313 and EC-399301, inoculated with Albugo candida. Cotyledonary leaves were examined 14 days after inoculation (d.a.i.), whereas true leaves were scored 14 and 21 d.a.i. Disease indices were assessed on a 0% (resistant) to 100% (susceptible) scale. DIs at the cotyledonary leaf stage in the above six genotypes were 67, 65, 32, 31, 31 and 38%, respectively, whereas at the true-leaf stage they were 21, 28, 12, 17, 9 and 4%, respectively at 14 d.a.i., and 35, 45, 17, 19, 20 and 6%, respectively at 21 d.a.i. Protein contents were highest in the genotypes with the highest DIs, such as Varuna at the cotyledonary leaf stage and Kranti at the true-leaf stage, and lowest in the genotypes with the lowest DIs, such as EC-399299 at the cotyledonary stage and EC-399301 at the true-leaf stage. Total phenols, total sugars, reducing sugars and non-reducing sugars were generally negatively correlated with DI, but were not always consistent, particularly when differences in DI were small. The results indicated that factors conditioning the response of host genotypes to A. candida may differ or operate in different ways at different growth stages

Drought effects on yield and its components in Indian mustard (Brassica juncea L.)

Effects of drought on yield and yield components were investigated during the spring season 2000-2001 by growing 14 Indian mustard genotypes under irrigated and rain-fed conditions at Bharatpur and Jobner. A disease and pest management schedule was followed when required. The drought susceptibility index (DSI) for seed yield and component characteristics was calculated to characterize the relative tolerance of genotypes. Plant height, primary branches, secondary branches per plant, 1000-seed weight and seed yield were reduced under rain-fed conditions. The top five genotypes at 13haratpur that showed tolerance to moisture stress for seed yield, as indicated by their lowest DSI, were, in descending order PSR-20, PRO-97024, JMMWR-941, IS-1787 and PCR-7, whereas at Jobner these were JMMWR-941, RC-1446, PSR-20, RH-819 and 'Varuna'. Of these, PSR-20 and JMMWR-941 were among the top six at both locations. These genotypes also showed relatively low DSI for one or more characteristics, such as primary branches per plant, secondary branches per plant, harvest index and seed : husk ratio. Genotypes with the lowest DSI, particularly for seed yield at both locations, would serve as useful donors in the breeding programme for improving the drought tolerance of existing Indian mustard cultivars

Dual role of the exocyst in AMPA receptor targeting and insertion into the postsynaptic membrane

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102104/1/emboj7601065.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/102104/2/emboj7601065-sup-0001.pd

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

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

Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)