Fruit quality of Tahiti acid lime and Sicilian lemon trees grown on different rootstocks and spacings in the semi-arid region

The objective of this work was to evaluate the fruit quality of Tahiti acid lime and Sicilian lemon trees grownon different rootstocks and planting spacings in the semi-arid region of the state of Minas Gerais, Brazil. Twoexperiments were conducted, using Tahiti acid lime tree scions (Citrus latifolia Tanaka) (1) and Sicilian lemontrees scions [Citrus limon (L.) Burm] (2). A randomized block design was used, with a 6×2 factorial arrangement consisted of six rootstocks: Cravo Santa Cruz lemon (Citrus limonia Osbeck), Swingle citrumelo [Citrus paradisi Macfaden × Poncirus trifoliata (L.) Rafinesque], Indio citrandarin and Riverside citrandarin [Citrus sunki (Hayata) hort. ex Tanaka × Poncirus trifoliata (L.) Rafinesque], Hybrid TSKC × (LCR × TR) - 059 [Citrus sunki (Hayata) hort. ex Tanaka × (Citrus limonia Osbeck × Poncirus trifoliata (L.) Rafinesque)], and Sunki Tropical tangerine [Citrus sunki (Hayata) hort. ex Tanaka]; and two planting spacings: 6.0 × 4.0 m and 6.0 × 2.0 m, with three replications and four plants per plot. The physical and chemical characteristics of fruits were evaluated. Most quality characteristics of Tahiti acid lime and Sicilian lemon are not affected by the different rootstocks and spacings used, but the fruits present excellent quality for the national and international markets. Tahiti acid lime plants grown on less vigorous rootstocks under denser spacings have fruits with higher pH, whereas those grown on more vigorous rootstocks have fruits with thicker mesocarps and lower soluble solid contents. The use of Sunki Tropical tangerine rootstock results in bigger Sicilian lemons, however, with lower soluble solid contents, whereas an opposite result is found with the use of Swingle citrumelo rootstocks.Objetivou-se com este trabalho avaliar a qualidade dos frutos da limeira ácida ‘Tahiti’ e do limão ‘Siciliano’, em diferentes porta-enxertos e espaçamentos no semiárido de Minas Gerais. O trabalho foi dividido em dois experimentos, (1) copas da limeira ácida ‘Tahiti’ e (2) copas do limoeiro ‘Siciliano’. Utilizou-se delineamento em blocos casualizados, em esquema fatorial 6 x 2, sendo seis porta-enxertos: limão ‘Cravo Santa Cruz’, Citrumelo ‘Swingle’, ‘Índio’, ‘Riverside’, ‘059’ e tangerina ‘Sunki Tropical’; distribuídas em dois espaçamentos: 6,0 m x 4,0 m e 6,0 m x 2,0 m, com três repetições e quatro plantas por parcela. Foram avaliadas as características físicas e químicas dos frutos. Os frutos do limão ‘Siciliano’ não apresentaram diferenças no comprimento, rendimento do suco e coloração da casca e polpa entre os diferentes porta-enxertos e espaçamentos. Das características avaliadas apenas o teor de sólidos solúveis (SS), teor de vitamina C, a massa fresca e o diâmetro foram influenciados. O SS e teor de vitamina C pelo porta-enxerto Citrumelo ‘Swingle’, enquanto que a massa fresca e o diâmetro pelo porta-enxerto Tangerina ‘Sunki Tropical’. Os frutos da lima ácida ‘Tahiti’ foram influenciados pelo porta-enxerto limão ‘Cravo Santa Cruz’ e pelo Citrumelo ‘Swingle’. O primeiro afetou o mesocarpo, formando frutos com maior espessura e menor teor de sólidos solúveis, enquanto o Citrumelo ‘Swingle’ incrementou o teor de sólidos solúveis nos frutos

Floral biology and artificial polinization in physic nut in the north of Minas Gerais state, Brazil

O objetivo deste trabalho foi avaliar alguns aspectos da biologia floral e do sistema reprodutivo de Jatropha curcas, em Janaúba, MG. Foram registrados: o número de flores femininas e masculinas; o intervalo de abertura das flores femininas; e a formação de frutos por apomixia, autofecundação, geitonogamia e xenogamia. A proporção de flores masculinas para femininas foi de 20:1. O intervalo de abertura das flores femininas variou de um a sete dias, conforme o número delas na inflorescência. No teste de apomixia, houve formação de frutos em apenas 5% das flores avaliadas. A percentagem de frutificação variou de 79 a 88% na autofecundação manual, na geitonogamia e na xenogamia. Na autofecundação sem a polinização manual a frutificação foi de 20%, e os frutos formados foram significativamente menores, com número inferior de sementes por fruto e menor índice de velocidade de emergência. As sementes foram semelhantes às formadas por polinização natural. É possível a realização de cruzamentos controlados em pinhão-manso, e não há autoincompatibilidade nesta espécie.The aim of this work was to evaluate some aspects of the floral biology and of the reproductive system of Jatropha curcas, in Janaúba county, MG, Brazil. The number of female and male flowers, the interval between the opening of female flowers, and the formation of fruits by apomixis, self-pollination, geitonogamy and by xenogamy were registered. The ratio of male to female flowers was 20:1. The interval of opening of female flowers was of one to seven days, depending on the number of female flowers in the inflorescence. On the apomixy test, the formation of fruits occurred in only 5% of the evaluated flowers. The fruit set was between 79 and 88% through the manual self-pollination, and through the geitonogamy, and the xenogamy. In the self-pollination treatment, without the hand-pollination, the fruit set was of 20%, and the fruits formed were significantly smaller, with a lesser number of seeds per fruit and lower rate of emergence. The seeds were similar to the ones formed by natural pollination. Artificial cross-pollination is possible on physic nuts, and there is no self-incompatibility within this species

Morphological characterization of new banana clones-elites

Abstract The characterization of clones is a very important step in genetic certification programs, as it describes and recognizes the plant material at every stage of production, allowing the monitoring of genetic quality, improvement and conservation of the germplasm. The aim of this work was to morphologically characterize two elite banana clones. The experimental design applied was in randomized blocks, with four replications, with six plants per parcel. The treatments consisted of two elite banana clones, Prata Gorutuba R1 and Prata Gorutuba R2 and four commercial cultivars: Prata Gorutuba, Prata Ana, Grande Naine and BRS Princesa. The morphological characterization was carried out in the second production cycle (daughter plant), using 23 qualitative descriptors, visually evaluated, classified according to the instructions for carrying out the distinguishability, homogeneity and stability (DHS) tests of banana cultivars. The elite clones Prata Gorutuba R1 and R2 differed from the cultivars Grande Naine and BRS Princesa regarding the descriptors tapering of the pseudostem, predominant color of the pseudostem, intensity of anthocyanin coloration and color of the underside of the basal sheath. The descriptors made it possible to group elite clones into the Prata group, a group that predominates in crops in Brazil, with characteristics already widely accepted by the market

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

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

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

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

Background 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&lt;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&lt;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

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

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)