Genetic diversity and relationship assessment among mulberry (Morus spp) genotypes by simple sequence repeat (SSR) marker profile

Mulberry (Morus L.) is essential for sericulture industry as the primary source of food for silkworm Bombyx mori L. In India, long tradition of practising sericulture includes the use of a large number of indigenous cultivars. Since knowledge on genetic divergence of these cultivars/varieties is imperative for conservation and gainful utilization, simple sequence repeat (SSR) profiling was employed to assess genetic relatedness among 17 mulberry genotypes maintained in the Germplasm Bank of Temperate Sericulture Institute, SKUAST Kashmir, Mirgund. Six SSR primers were utilised which generates 17 alleles among the genotypes. The polymorphism information content (PIC) value varied from 0.260 (MulSTR3) to 0.623 (MulSTR4), with an average of 0.438 per locus. The highest similarity value of 0.92 was observed between Lemoncina and Kanva-2, as compared to the lowest similarity coefficient of 0.15 was between SKM-48 and Chinese white. Clustering of the genotypes was done with unweight pair group method using arithmetic average (UPGMA) which generates five clusters. Cluster-2 contained maximum (six) genotypes.Keywords: Clustering, genetic relatedness, mulberry, SSRAfrican Journal of Biotechnology Vol. 12(21), pp. 3181-318

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

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&nbsp;years; 78.2% included were male with a median age of 37&nbsp;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

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

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

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Development of Resistance in European Red Mite Panonychus ulmi (Koch.) to Commonly Used Pesticides in Kashmir.

Dose mortality response in adults of European red mite Panonychus ulmi (Koch) to various pesticides, viz., fenazaquin, dimethoate, endosulfan, chlorpyrifos and ethion and development of resistance populations to recurrent application of fenazaquin were studied in the Division of Entomology, SKUAST-K, Shalimar during the year 2007 and 2008, and genetic variation analyzed by randomly amplified polymorphic DNA polymerase chain reaction (RAPD-PCR) technique of the selected populations were carried out at the Insect Molecular Biology Laboratory, Department of Entomology, PAU Ludhiana (Pb). The findings of the investigation revealed that P. ulmi at different locations in Kashmir valley responded differently to different pesticides used. For fenazaquin the highest LC50 values of 0.0041 per cent and resistance factor of 6.54 were recorded in Mattan (District Anantnag) while as the lowest LC50 value of 0.0010 and resistance factor of 1.60 was recorded in Merihama (District Anantnag) and Rajpura (District Shopian) respectively. The LC50 value of the susceptible population was worked out to be 0.0006277 per cent. In case of dimethoate the highest LC50 value of 0.029 per cent and resistance factor of 11.47 were observed in Kunil (District Kupwara) while the lowest LC50 value of 0.014 per cent and resistance factor of 5.54 were observed in Wagoora (District Baramulla) and Kellam (District Shopian) respectively. While as the LC50 value of the susceptible population were recorded as 0.002528 per cent. Similarly, for endosulfan the highest LC50 value of 0.061 per cent and resistance factor of 2.45 were observed in Mattan (District Anantnag) and Wagoora (District Baramulla) respectively. However, the lowest LC50 value of 0.027 per cent and resistance factor of 1.08 observed in Rajpura (District Shopian). The LC50 value of the susceptible population were worked out to be 0.02486 per cent. For chlorpyrifos the highest LC50 value of 0.022 per cent and resistance factor of 2.97 were recorded in Achabal (District Anantnag). While as the lowest LC50 value of 0.008 per cent and resistance factor of 1.19 were obtained in Bonkoot (District Bandipora) and Malangpora(District Pulwama) respectively. Similarly the LC50 value of the susceptible population was recorded as 0.006728 per cent. However in case of ethion the highest LC50 value of 0.057 per cent and resistance factor of 2.83 were obtained in Zakura (District Srinagar) while as the lowest LC50 value of 0.025 per cent and resistance factor of 1.24 were recorded in Achabal (District Baramulla), and the LC50 value of the susceptible population was worked out to be 0.02016 per cent. Development of resistance in eight generations of P. ulmi was exhibited when the different generations were exposed to recurrent selection pressure with fenazaquin. When 1st generation was exposed to selection pressure of 0.001 per cent it resulted in no resistance. However, when the 8th generation was exposed to selection pressure of 0.004 per cent, it resulted in 15-fold resistance. This increase in resistance could be attributed to the recurrent selection pressure which may have led to reorganization of genes of the resistant individuals in P. ulmi populations. In this study the genetic variations in P. ulmi populations bred through selection pressure with fenazaquin were analyzed using RAPD-PCR. The comparative RAPD profile with five primers viz., OPA-01, OPF-04, OPF-07, OPR-07 and OPL-08 led to the identification of many polymorphic DNA bands that were amplified in selected population individuals and were absent in susceptible population. This implied that selection pressure of fenazaquin resulted in numerous genetic changes in populations of P.ulmi which could be attributed to resistance development. Resistance factor of 15.0 obtained in 8th generation was found to be associated with 54 per cent genetic similarity as compared to susceptible population which resulted in 95 per cent genetic similarity in generation 1st. These alterations in P. ulmi DNA could be related to unknown genes responsible for imparting resistance of selected populations of P. ulmi. Genetic variation amongst the eleven P. ulmi populations collected from different locations of Valley, and subjected to bioassay to various pesticides were also investigated by RAPD-PCR. The comparative RAPD profile with two primers, viz., OPR-07 and OPL-08 showed high level of genetic variation amongst all the eleven populations evaluated. The genetic similarity in the eleven populations evaluated against endosulfan was computed to be 100 per cent at Shalimar, Zakura and Kunil but it was 55.0 per cent when all the populations were compared with Wagoora population, rest of the population lie in between. Similarly the genetic relatedness of the eleven populations evaluated against dimethoate was computed to be 95.0 per cent at Mattan and Zakura but it was 67.5 per cent when Merihama and Shalimar populations were compared with Wagoora, Malangpora, Kunil, Rajpora and Achabal populations. Whileas Mattan and Zakura populations showed genetic similarity of 77 per cent when compared with Kupwara population. Genetic relatedness of the eleven population evaluated against fenazaquin was recorded to be 100.0 per cent at Shalimar, Zakura, Rajpura and Malangpora and it was 62.6 per cent when the populations from Achabal and Merihama were compared with all other populations. The genetic similarity of the eleven populations evaluated against ethion was computed to be 100.00 per cent at Shalimar, Kunil, Madar, and Malangpora and lowest of 63.0 per cent when all the populations were compared with Merihama population. While as the eleven populations evaluated against chlorpyrifos for genetic relatedness was evaluated to be 100.00 per cent at Wagoora, Kupwara, Mattan Shalimar, Merihama and Rajpora but it was 66.8 per cent when all the populations were compared with Wagoora and Kupwara populations. Highest amount of genetic similarity was observed in populations evaluated against endosulfan while as lowest amount of genetic similarity was registered in populations evaluated against dimethoate

Studies on the currendt status on San Jose scale quadraspidiotus perniciosus (Comstock) and its management on apple

Survey on the pest incidence and severity of San Jose scale (Quadraspidiotus perniciosus) was conducted during 2004 in thirteen blocks of district Baramulla and three blocks of district Srinagar. The results revealed highest mean incidence of 27.4 per cent at location Ajas (karewa) among both the altitudes of district Baramulla. Among the blocks the highest (24.25%) and lowest (5.6%) mean pest incidence was recorded in Hajan and Bandipora blocks whereas highest (7.98%) and the lowest (1.37%) mean per cent pest severity was recorded from Pattan and Bandipora blocks respectively. The observations from district Srinagar on the basis of pest incidence and severity of the San Jose scale revealed that mean per cent incidence was 16.85 per cent at location Nunar (low lying). Among the blocks, the highest (16.85%) and lowest (12.5%) mean pest incidence was recorded at Ganderbal and Lar blocks respectively, whereas highest (6.14%) and lowest (4.08%) mean per cent severity was recorded from Ganderbal and Srinagar blocks, respectively. Highest twig infestation (live/dead) both in managed and unmanaged orchards, was recorded (12.11/cm2) on 15th August and lowest infestation (2.17/cm2) on 15th April. For the management of the pest on apple field and laboratory experiments were conducted to study the effectiveness of five mineral oils viz., D.C. tron plus, P.D. spray oil, H.P. spray oil, Atso spray oil and diesel oil alone at 2% and in combination with chemical pesticides viz., endosulfan (0.05%), ethion (0.05%), chlorpyrifos (0.025%), dimethoate (0.03%), and quinalphos (0.03%) used at one-half green tip stage of the crop. Maximum number of live San Jose scale 60 DAT (day after treatment) was recorded (10.62/cm2) in combination Atso spray oil + endosulfan while least number (4.90/cm2) in combination P.D. spray oil + quinalphos. In oils alone maximum number of (12.27) was observed in D.C. tron plus. The per cent mortality worked out on the basis of live scales over pre-treatment, recorded at 10, 20, 40, 50 and 60 days after application of treatments, was significantly effective against the pest. However, these treatments varied in their efficacy at these intervals and some of these proved to be at par with one another in their efficacy against the pest. Among oils highest per cent mortality of 59.20 was observed in H.P. spray oil and least 49.17 per cent in D.C. tron plus. Among combinations highest mortality of 78.53/cm2 was recorded in P.D. spray oil + quinalphos and least mortality percentage (54.44 cm2) in combination Atso spray oil + endosulfan. It was observed that in all the treatments, the residual effect remained upto 50 days after application, because increase in the scale population was observed after 60th day post count. Observations recorded to find the impact of these oils and chemicals on the natural enemies of the San Jose scale revealed that highest population of parasitoids (Aphytis sp., Encarsia perniciosus) was recorded with P.D. spray oil + ethion of 2.55/15 cm2 and least recorded (0.11/15 cm2) in D.C. tron + chlorpyrifos. The zero per cent incidence of the San Jose scale on fruit after the application of treatments was recorded in oil H.P. spray oil whereas similar severity was also recorded in oil H.P. spray oil