Sustainable deltas in the Anthropocene

What are the possible trajectories of delta development over the coming decades? Trajectories will be determined by the interactions of biophysical trends such as changing sediment supplies, subsidence due to compaction of sediment and climate change, along with key socio-economic trends of migration and urbanisation, agricultural intensification, demographic transition, economic growth and structural change of the economy. Knowledge and understanding of plausible trajectories can inform management choices for deltas in the Anthropocene, including new policy perspectives and innovative adaptation. The emergence of visionary delta management plans in some large deltas, such as the Bangladesh Delta Plan 2100, is an important and necessary component. This chapter synthesises the state of knowledge and highlights key elements of science that will inform decisions on future management of deltas.<br/

Haplogroup heterogeneity of LHON patients carrying the m.14484T&#62;C mutation in India

Purpose: To investigate the clinical and mitochondrial DNA (mtDNA) haplogroup background of Indian Leber Hereditary Optic Neuropathy (LHON) patients carrying the m.14484T&#62;C mutation. Methods: Detailed clinical investigation and complete mtDNA sequencing analysis was carried out for eight Indian LHON families with the m.14484T&#62;C mutation. Haplogroup was constructed based on the evolutionarily important mtDNA variants. Results: In the present study, we characterized eight unrelated probands selected from 187 LHON cases. The overall penetrance of the disease was estimated to be 19.75% (16/81) in eight pedigrees with the m.14484T&#62;C mutation and showed substantially higher sex bias (male:female = 13:3). The mtDNA haplogrouping revealed that they belong to diverse haplogroups; i.e. F1c1, M31a, U2a, M*, I1, M6, M3a1 and R30a. Interestingly, we did not find an association of the m.14484T&#62;C mutation with any specific haplogroup within the Indian population. We also did not find any secondary mutation(s) in these pedigrees, which might affect the clinical expression of LHON. Conclusions: Contrary to earlier reports showing preferential association of the m.14484T&#62;C mutation with western Eurasian haplogroup J and increased clinical penetrance when present in J1 subhaplogroup background, the present study shows that m.14484T&#62;C arose independently in a different mtDNA haplogroup and ethnic background in India, which may influence the clinical expression of the disease

Can Students Learn from Their Co-Students About Tuberculosis? Outcomes from Student-Friendly Quasi-Experimental Intervention Study in India.

BACKGROUND The World Health Organization's "End TB Strategy" aims to end global tuberculosis (TB) epidemic through a holistic combination of health and social interventions placing the patients and communities at the heart of the response. This study aimed to assess the effectiveness of utilizing school children as ambassadors in TB advocacy. MATERIALS AND METHODS We adopted a quasi-experimental intervention design where students' awareness level was assessed before and after the intervention. A total of 185 student ambassadors were trained to conduct interventions in schools, and 920 students were randomly selected to assess the impact of the ambassador's intervention. A structured questionnaire was used to assess the correct and incorrect knowledge on specific aspects of TB. This intervention study was implemented in a phased manner which involved a participatory formative phase. A student-friendly and culturally relevant educational materials and activities for providing TB knowledge for the study student population were developed. Data collected from the baseline and end-line evaluation surveys were analyzed using STAT Ver. 16.0.- Stata Corp., June 2016, USA. RESULTS A significant increase (>80%; < 0.05) in the correct knowledge on diagnosis and prevention for TB was noted among sampled students ( = 818) before and after intervention. Reduction in incorrect knowledge, like understanding TB as hereditary disease, was found to be less (50%; < 0.05). CONCLUSIONS School students lead intervention could significantly improve correct knowledge on TB and could be replicated

Double-digest restriction-associated DNA sequencing-based genotyping and its applications in sesame germplasm management

Sesame (Sesamum indicum L.) is an ancient oilseed crop belonging to the family Pedaliaceae and a globally cultivated crop for its use as oil and food. In this study, 2496 sesame accessions, being conserved at the National Genebank of ICAR-National Bureau of Plant Genetic Resources (NBPGR), were genotyped using genomics-assisted double-digest restriction-associated DNA sequencing (ddRAD-seq) approach. A total of 64,910 filtered single-nucleotide polymorphisms (SNPs) were utilized to assess the genome-scale diversity. Applications of this genome-scale information (reduced representation using restriction enzymes) are demonstrated through the development of a molecular core collection (CC) representing maximal SNP diversity. This information is also applied in developing a mid-density panel (MDP) comprising 2515 hyper-variable SNPs, representing almost equally the genic and non-genic regions. The sesame CC comprising 384 accessions, a representative set of accessions with maximal diversity, was identified using multiple criteria such as k-mer (subsequence of length “k” in a sequence read) diversity, observed heterozygosity, CoreHunter3, GenoCore, and genetic differentiation. The coreset constituted around 15% of the total accessions studied, and this small subset had captured >60% SNP diversity of the entire population. In the coreset, the admixture analysis shows reduced genetic complexity, increased nucleotide diversity (π), and is geographically distributed without any repetitiveness in the CC germplasm. Within the CC, India-originated accessions exhibit higher diversity (as expected based on the center of diversity concept), than those accessions that were procured from various other countries. The identified CC set and the MDP will be a valuable resource for genomics-assisted accelerated sesame improvement program

Selective CO₂ capture in metal-organic frameworks with azine-functionalized pores generated by mechanosynthesis

Two new three-dimensional porous Zn(II)-based metal-organic frameworks, containing azine-functionalized pores, have been readily and quickly isolated via mechanosynthesis, by using a nonlinear dicarboxylate and linear N-donor ligands. The use of nonfunctionalized and methyl-functionalized N-donor ligands has led to the formation of frameworks with different topologies and metal-ligand connectivities and therefore different pore sizes and accessible volumes. Despite this, both metal-organic frameworks (MOFs) possess comparable BET surface areas and CO₂ uptakes at 273 and 298 K at 1 bar. The network with narrow and interconnected pores in three dimensions shows greater affinity for CO compared to the network with one-dimensional and relatively large pores-attributable to the more effective interactions with the azine groups

Mortality Associated with Surgical Site Infections Following Cardiac Surgery: Insights from the International ID-IRI Study

Objectives: Surgical site infections (SSIs) after cardiac surgery increase morbidity and mortality rates. This multicenter study aimed to identify mortality risk factors associated with SSIs after heart surgery. Methods: Conducted from January to March 2023, this prospective study included 167 patients aged &gt;16 years with post-heart surgery SSIs. The primary focus was the 30-day mortality. Univariate analysis and multivariate logistic regression utilizing the backward elimination method were used to establish the final model. Results: Several factors significantly correlated with mortality. These included urinary catheterization (odds ratio [OR] 14.197; 90% confidence interval [CI] 12.198-91.721]), emergent surgery (OR 8.470 [90% CI 2.028-35.379]), valvular replacement (OR 4.487 [90% CI 1.001-20.627]), higher quick Sequential Organ Failure Assessment scores (OR 3.147 [90% CI 1.450-6.827]), advanced age (OR 1.075 [90% CI 1.020-1.132]), and postoperative re-interventions within 30 days after SSI (OR 14.832 [90% CI 2.684-81.972]). No pathogens were isolated from the wound cultures of 53 (31.7%) patients. A total of 43.1% of SSIs (n = 72) were due to gram-positive microorganisms, whereas 27.5% of cases (n = 46) involved gram-negatives. Among the gram-positive bacteria, Staphylococci (n = 30, 17.9%) were the predominant microorganisms, whereas Klebsiella (n = 16, 9.6%), Escherichia coli (n = 9, 5.4%), and Pseudomonas aeruginosa (n = 7, 4.2%) were the most prevalent. Conclusions: To mitigate mortality after heart surgery, stringent infection control measures and effective surgical antisepsis are crucial, particularly, in the elderly. The clinical progression of the disease is reflected by the quick Sequential Organ Failure Assessment score and patient re-intervention, and effective treatment is another essential component of SSI management

Molecular Diversity Studies and Core Development in Sesame Germplasm (Sesamum indicum L.) Using SSR Markers

Sesame (Sesamum indicum L.), an ancient oilseed crop being cultivated across geographical locations in the tropics, is known for its high-quality oil with a longer shelf life. India, being the center of diversity for this crop, understanding the genetic variability of sesame germplasm being conserved in the national Genebank (NGB) of ICAR-NBPGR, will help identify genotypes for its potential use in broadening the genetic base of the cultivars for sesame crop improvement. We report here the molecular diversity analysis performed using SSR markers on a set of 2,496 sesame germplasm. Hence, the derived data was also subjected to population structure analysis, and a molecular core was generated to assess its phenotypic variability. Parallelly, they were phenotypically characterized for important qualitative and quantitative traits as per the standard descriptor developed by IPGRI, and accessions exhibiting desirable traits were identified. The sesame germplasm used in our study represents collections from 17 countries across the globe and 26 states in India. A total of 140 alleles were obtained using seven polymorphic SSR markers selected from an initial screening comprising 43 SSR markers. The observed heterozygosity was less than the expected heterozygosity since it is a self-pollinated crop (up to 35% outcrossing is reported, categorized as often cross-pollinated). The molecular diversity analysis grouped 2496 accessions into six clusters, while the population structure analysis grouped them into three major clusters or populations. A molecular core developed using the PowerCore software identified 196 accessions, representing all the alleles from the entire 2496 accessions, that can be utilized in breeding programs after phenotypic validation. This study contributes to genetic diversity assessment for sesame germplasm, identifying genetically diverse accessions, and establishing a core set that encapsulates the genetic variability of the sesame germplasm collection. These findings hold relevance for addressing agricultural challenges and enhancing the resilience and productivity of sesame crops in various environmental conditions

Characteristics of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome and its influence on tuberculosis treatment outcomes in persons living with HIV

Caian L Vinhaes e Bruno B Andrade - Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brazil.a National Institute for Research in Tuberculosis, Indian Council of Medical Research Chennai, Tamil Nadu, India b Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil c Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil d Curso de Medicina, Faculdade de Tecnologia e Ciências (UniFTC), Salvador, Brazil e Government Hospital of Thoracic Medicine, Tambaram Sanatorium, Chennai, Tamil Nadu, India f Rajiv Gandhi Government General Hospital, Park Town, Chennai, Tamil Nadu, India g Government Rajaji Hospital, Madurai, Tamil Nadu, India hWorld Health Organization, Geneva, Switzerland i Universidade Salvador (UNIFACS), Laureate Universities, Salvador, Brazil j Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil kWellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South AfricaIrini Sereti (National Institutes of Health [NIH], USA), Brian Porter (NIH), Alan Sher (NIH), Lis Antonelli (Fundação Oswaldo Cruz, Brazil), Cynthia Lassnoff (NIH), Christopher Whalen (NIH), Michael Duvenhage (NIH) and Drs Thomas Nutman, Subash Babu and Aleyamma Thomas from NIH who provided valuable input and periodical guidance. We deeply appreciate the work of the team members at the National Institute of Research in Tuberculosis (NIRT), India: Lokeshwaran Nithyananthan, Solomon Priyaku- mar, Rajasekaran Subramani and Ramesh Babu, for clinical procedures; Syed Hissar, Kannan, Murugesan, Sudha Subrama- nium, Luke Elizabeth Hanna for lab support. We also thank the entire team of medical officers and nursing staff of NIRT- Chennai, NIRT-Madurai and the Government Hospital of Thoracic Medicine. We finally acknowledge the excellent secretarial assistance given by Sanathanakumar Natarajan and Maheshwari Theyagarajan (NIRT). This retrospective study did not receive specific funding. The work from BBA was supported by the Intramural Research programme of the Fundação Oswaldo Cruz (FIOCRUZ), and the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq; senior scientist fellowship). CLV received fellowship from CNPq. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Objective: The influence of tuberculosis (TB)-immune reconstitution inflammatory syndrome (IRIS) on TB treatment outcomes and its risk factors were investigated among people with human immunodeficiency virus (HIV) and co-infected with TB. Methods: Newly diagnosed, culture-confirmed, pulmonary TB patients with HIV and enrolled in a clinical trial (NCT00933790) were retrospectively analysed for IRIS occurrence. Risk factors and TB outcomes (up to 18 months after initiation of anti-TB treatment [ATT]) were compared between people who experienced IRIS (IRIS group) and those who did not (non-IRIS group). Results: TB-IRIS occurred in 82 of 292 (28%) participants. Significant baseline risk factors predisposing to TB-IRIS occurrence in univariate analysis were: lower CD4+ T-cell count, CD4/CD8 ratio, haemoglobin levels, presence of extra-pulmonary TB focus, and higher HIV viral load; the last two retained significance in the multivariate analysis. After 2 months of ATT commencement, sputum smear conversion was documented in 45 of 80 (56.2%) vs. 124 of 194 (63.9%) (p=0.23), culture conversion was in 75 of 80 (93.7%) vs. 178 of 194 (91.7%) (p=0.57) and the median decline in viral load (log10copies/mm3) was 2.7 in the IRIS vs. 1.1 in the non-IRIS groups (p<0.0001), respectively. An unfavourable response to TB therapy was detected in 17 of 82 (20.7%) and 28 of 210 (13.3%) in the IRIS and non-IRIS groups, respectively (p=0.14). Conclusions: TB-IRIS frequently occurred in people with advanced HIV infection and in those who presented with extra-pulmonary TB lesions, without influencing subsequent TB treatment outcomes

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

Aim The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. Methods This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. Results Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P &lt; 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. Conclusion One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease