Loss of genetic diversity and inbreeding in Kashmir red deer (Cervus elaphus hanglu) of Dachigam National Park, Jammu & Kashmir, India

BACKGROUND: Hangul (Cervus elaphus hanglu), the eastern most subspecies of red deer, is now confined only to the mountains in the Kashmir region of Jammu & Kashmir State of India. It is of great conservation significance as this is the last and only hope for Asiatic survivor of the red deer species in India. Wild population of free ranging hangul deer inhabiting in and around Dachigam National Park was genetically assessed in order to account for constitutive genetic attributes of hangul population using microsatellite markers. RESULTS: In a pool of 36 multi-locus genotypes, 30 unique individuals were identified based on six microsatellite loci. The estimated cumulative probability of identity assuming all individuals were siblings (P(ID) sibs) was 0.009 (9 in 1000). Altogether, 49 different alleles were observed with mean (± s.e.) allelic number of 8.17 ± 1.05, ranging from 5 to 11 per locus. The observed heterozygosity ranged between 0.08 and 0.83, with mean 0.40 ± 0.11 and the inbreeding coefficient ranged between −0.04 and 0.87 with mean 0.38 ± 0.15. Majority of loci (5/6) were found to be informative (PIC value > 0.5). All loci deviated from Hardy-Weinberg equilibrium except Ca-38 (P > 0.05) and none of the pairs of loci showed significant linkage disequilibrium except the single pair of Ca-30 and Ca-43 (P < 0.05). CONCLUSIONS: The preliminary findings revealed that hangul population is significantly inbred and exhibited a low genetic diversity in comparison to other deer populations of the world. We suggest prioritizing the potential individuals retaining high heterozygosity for ex situ conservation and genetic monitoring of the hangul population should be initiated covering the entire distribution range to ensure the long term survival of hangul. We speculate further ignoring genetics attributes may lead to a detrimental effect which can negatively influence the reproductive fitness and survivorship of the hangul population in the wild

Combinatorial Effect of Fertigation Rate and Scheduling on Tomato Performance under Naturally Ventilated Polyhouse in Indian Humid Sub-Tropics

Protected cultivation is a resource-efficient method of crop production, however, at the same time, it is resource intensive. An optimum rate and time of fertilizer application is required in order to maximize crop yield vis-a-vis resource use efficiency. However, these aspects are scarcely studied for tomato under low- and medium-tech greenhouses in Indian humid sub-tropics. In this regard, a two-year study was conducted to assess the effect of four NPK fertilization rates (i.e., 120, 100, 80, and 60% of the recommended dose of fertilizers, RDF) and three fertigation scheduling approaches-fertigation at different stages in different proportions of NPK, along with an additional treatment, i.e., farmers' practice (soil-based application of recommended NPK) for tomatoes under a naturally ventilated polyhouse. The plant growth attributes, the tomato yield- and quality-related traits, the nutrient (NPK) accumulation by the plants, the water use efficiency (WUE), and economics were studied in response to different fertigation rates and scheduling approaches. These parameters were affected by both the rates of NPK fertilization and their time of application (scheduling) over the different growth stages. Among the different rates and time of fertigation, the recommended dose of fertilizer (100% RDF) (i.e., 300 kg N, 150 kg P2O5, and 150 kg K2O per ha and their scheduling as 15% N, 10% P2O5, and 10% K2O of RDF during 15-45 days after transplanting (P-1); 40% N, 40% P2O5, and 40% K2O of RDF during 47-76 DAT (P-2); 30% N, 40% P2O5, and 40% K2O of RDF during 77-107 DAT (P-3); and 15% N, 10% P2O5, and 10% K2O of RDF during 108-138 DAT (P-4)) was found to be the optimum for fruit yield, WUE, and economics of tomato under protected condition

Ekspresija gena za imunološki odgovor nakon izazivačke infekcije u indijskih šarana rohu (Labeo rohita) cijepljenih modificiranom formulacijom proteina R vanjske membrane bakterije Aeromonas hydrophila

Although vaccination and post-vaccination studies have gained considerable importance in the field of aquaculture diseases, little is understood about the mechanism of immune-protection in vaccinated fish following infection. In the present study, an attempt was made to discover the mechanism of protection rendered by a modified adjuvant-based recombinant outer membrane protein R (rOmpR) vaccine, in rohu, Labeo rohita (an important Indian major carp species) following a challenge with Aeromonas hydrophila. For this, expression analysis of an array of immune molecules (IgM, complement factor 3, interleukin 1β, interleukin 6, tumor necrosis factor α, interleukin 15, MHC I and MHC II) was carried out in the anterior kidney tissues of vaccinated fish, at 0, 12, 24, 48, 72 and 120 h post-challenge. Higher transcript levels of IgM, MHC I and MHC II were evident in the mineral oil-based OmpR vaccinated and modified adjuvant-based OmpR-vaccinated groups, at different time points post-challenge, including the non-challenged fish. Early onset of pro-inflammatory cytokines and expression of most of the immune genes was more pronounced in vaccinated fish at different time points post-challenge, thus indicating a better immune response in these fish. This study indicated the activation of both humoral and cell mediated immunity in vaccinated rohu following a challenge with A. hydrophila.Iako su cijepljenje i istraživanja nakon cijepljenja znatno dobila na važnosti u borbi protiv bolesti u akvakulturi, malo se zna o mehanizmu imunološke zaštite u cijepljenih riba nakon izazivačke infekcije. U ovom se istraživanju pokušalo rasvijetliti mehanizam zaštite nakon cijepljenja modificiranim cjepivom pripravljenim od rekombinantnog proteina R (rOmpR) vezanog na adjuvans u vrste Labeo rohita (za Indiju važne vrste šarana) i izazivačke infekcije vrstom Aeromonas hydrophila. U tu svrhu analizirana je ekspresija niza imunosnih molekula (IgM, faktor 3 komplementa, interleukin 1β, interleukin 6, faktor tumorske nekroze α, interleukin 15, MHC I and MHC II) u bubrežnim tkivima cijepljenih riba 0, 12, 24, 48, 72 i 120 h nakon izazivačke infekcije. Više razine transkripata IgM, MHC I i MHC II bile su očite u skupina cijepljenih OmpR-om s mineralnim uljem kao adjuvansom i modificiranim OmpR-om s mineralnim uljem u različitim vremenskim razmacima nakon izazivačke infekcije kao i onih koje nisu bile podvrgnute izazivačkoj infekciji. Rana pojava proupalnih citokina i ekspresije većine imunosnih gena bila je više izražena u cijepljenih riba u različitim vremenskim točkama nakon izazivačke infekcije što upućuje na bolji imunosni odgovor u tih riba. Ovo istraživanje naznačuje aktivaciju i humoralne i stanične imunosti u cijepljenih rohu riba nakon izazivačke infekcije bakterijom A. hydrophila

European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on arrhythmias and cognitive function::what is the best practice?

Publicado também em: https://repositorio.unifesp.br/handle/11600/45988Heart Ctr Leipzig, Dept Electrophysiol, Leipzig, GermanyTaipei Vet Gen Hosp, Taipei, TaiwanHosp Israelita Albert Einstein, Sao Paulo, BrazilCtr Privado Cardiol, San Miguel De Tucuman, ArgentinaMem Hlth, Cardiac & Vasc Inst, Hollywood, FL USABoston Univ, Sch Med, Framingham Heart Study, Boston, MA 02118 USABoston Univ, Sch Publ Hlth, Framingham Heart Study, Boston, MA 02118 USAIntermt Med Ctr, Murray, UT USAUniv Minnesota, Dept Med, Cardiovasc Div, Minneapolis, MN USAUniv Sao Paulo, Med Sch, Sao Paulo, BrazilUniv Fed Sao Paulo, Escola Paulista Med, Sao Paulo, BrazilUniv Tours, Ctr Hosp Univ Trousseau, Serv Cardiol, Tours, FranceUniv Hosp Magdeburg, St Vincenz Hosp Paderborn, Working Grp Mol Electrophysiol, Dept Cardiol & Intens Care Med, Magdeburg, GermanyUniv Melbourne, Royal Melbourne Hosp, Melbourne, Vic, AustraliaKings Coll London, London, EnglandKorea Univ, Med Ctr, Seoul, South KoreaUniv Birmingham, Inst Cardiovasc Sci, Birmingham, W Midlands, EnglandAalborg Univ, Dept Clin Med, Aalborg Thrombosis Res Unit, Aalborg, DenmarkMassachusetts Gen Hosp, Boston, MA 02114 USAInst Nacl Cardiol, Dept Electrocardiog, Mexico City, DF, MexicoUniv Belgrade, Sch Med, Belgrade, SerbiaClin Ctr Serbia, Cardiol Clin, Belgrade, SerbiaInst Cardiol Corrientes, Corrientes, ArgentinaSt Georges Univ London, Cardiol Clin Acad Grp, Mol & Clin Sci Res Inst, London, EnglandNatl Heart Ctr, Singapore, SingaporeUniv Hong Kong, Dept Med, Hong Kong, Hong Kong, Peoples R ChinaSouthlake Reg Hlth Ctr, Newmarket, ON, CanadaBeijing Fuwai Hosp, Beijing, Peoples R ChinaCleveland Clin, Cleveland, OH 44106 USAUniv Fed Sao Paulo, Escola Paulista Med, Sao Paulo, BrazilWeb of Scienc

Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

BACKGROUND: The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. METHODS: For this analysis, we constructed burden-weighted dose-response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15-95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. FINDINGS: The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15-39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0-0) and 0·603 (0·400-1·00) standard drinks per day, and the NDE varied between 0·002 (0-0) and 1·75 (0·698-4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0-0·403) to 1·87 (0·500-3·30) standard drinks per day and an NDE that ranged between 0·193 (0-0·900) and 6·94 (3·40-8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3-65·4) were aged 15-39 years and 76·9% (73·0-81·3) were male. INTERPRETATION: There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. FUNDING: Bill & Melinda Gates Foundation

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

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

Global mortality of snakebite envenoming between 1990 and 2019

Snakebite envenoming is an important cause of preventable death. The World Health Organization (WHO) set a goal to halve snakebite mortality by 2030. We used verbal autopsy and vital registration data to model the proportion of venomous animal deaths due to snakes by location, age, year, and sex, and applied these proportions to venomous animal contact mortality estimates from the Global Burden of Disease 2019 study. In 2019, 63,400 people (95% uncertainty interval 38,900-78,600) died globally from snakebites, which was equal to an age-standardized mortality rate (ASMR) of 0.8 deaths (0.5-1.0) per 100,000 and represents a 36% (2-49) decrease in ASMR since 1990. India had the greatest number of deaths in 2019, equal to an ASMR of 4.0 per 100,000 (2.3-5.0). We forecast mortality will continue to decline, but not sufficiently to meet WHO's goals. Improved data collection should be prioritized to help target interventions, improve burden estimation, and monitor progress.Peer reviewe

Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000–2018

Exclusive breastfeeding (EBF)—giving infants only breast-milk for the first 6 months of life—is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for example, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization’s Global Nutrition Target (WHO GNT) of ≥70% EBF prevalence by 2030. While six LMICs are projected to meet the WHO GNT of ≥70% EBF prevalence at a national scale, only three are predicted to meet the target in all their district-level units by 2030

Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Background In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015. Methods We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages 10–54 years by systematically compiling and processing all available data sources from 186 of 195 countries and territories, 11 of which were analysed at the subnational level. We quantified eight underlying causes of maternal death and four timing categories, improving estimation methods since GBD 2013 for adult all-cause mortality, HIV-related maternal mortality, and late maternal death. Secondary analyses then allowed systematic examination of drivers of trends, including the relation between maternal mortality and coverage of specific reproductive health-care services as well as assessment of observed versus expected maternal mortality as a function of Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Findings Only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1. Geographical disparities widened between 1990 and 2015 and, in 2015, 24 countries still had a maternal mortality ratio greater than 400. The proportion of all maternal deaths occurring in the bottom two SDI quintiles, where haemorrhage is the dominant cause of maternal death, increased from roughly 68% in 1990 to more than 80% in 2015. The middle SDI quintile improved the most from 1990 to 2015, but also has the most complicated causal profile. Maternal mortality in the highest SDI quintile is mostly due to other direct maternal disorders, indirect maternal disorders, and abortion, ectopic pregnancy, and/or miscarriage. Historical patterns suggest achievement of SDG 3.1 will require 91% coverage of one antenatal care visit, 78% of four antenatal care visits, 81% of in-facility delivery, and 87% of skilled birth attendance. Interpretation Several challenges to improving reproductive health lie ahead in the SDG era. Countries should establish or renew systems for collection and timely dissemination of health data; expand coverage and improve quality of family planning services, including access to contraception and safe abortion to address high adolescent fertility; invest in improving health system capacity, including coverage of routine reproductive health care and of more advanced obstetric care—including EmOC; adapt health systems and data collection systems to monitor and reverse the increase in indirect, other direct, and late maternal deaths, especially in high SDI locations; and examine their own performance with respect to their SDI level, using that information to formulate strategies to improve performance and ensure optimum reproductive health of their population. Funding Bill &amp; Melinda Gates Foundation