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Alfalfa (Medicago sativa L.) is a common element of oasis agriculture in the Middle East; however, germplasm from this region has not been widely used in alfalfa breeding elsewhere. Previous research in Arizona showed that ecotypes from the southern portion of the Arabian Peninsula possess traits that may be useful in breeding very nondormant cultivars. The objectives of this research were to describe morphological and agronomic variation among 41 accessions from Oman, Yemen and southwestern Saudi Arabia, and eight accessions representing basic germplasm groups from elsewhere in the Arabian Peninsula and North Africa. Results of this research will be useful in preservation and utilization of these germplasm resources. Data collected from a 2-yr field trial at Tucson, AZ, were evaluated by average linkage cluster and principal components analyses. Southern Arabian accessions collected below elevations of 1000 m were distinct from those collected at higher elevations. The most distinctive accessions were from low-elevation oases in Yemen and were extremely susceptible to frost damage. Accessions from the Salalah Coastal Plain in Oman were especially variable, perhaps reflecting recent importation. Based largely on poor response to low winter temperatures, accessions from low elevations in Yemen were shown to be separable from those from Oman. Germplasm from the Batinah Coastal Plain and the Hajar Foothills in Oman could not generally be separated. The Saudi Arabian ecotype Hasawi was similar to germplasm from northern Oman. Utilization of alfalfa germplasm from subtropical environments in southern Arabia may be complicated outside this region by its adaptation to intensive management under frost-free conditions.

Reciprocal ST segment changes are frequent during acute inferior myocardial infarction, yet their significance remains controversial. In order to investigate the implications of these changes, the ECG obtained on admission for 83 patients with acute inferior myocardial infarction was compared with the clinical course and the results of angiographic and coronary arteriographic studies performed an average of 3 weeks after the onset of symptoms. Group 1 consisted of 59 patients with at least 1 mm of horizontal on downsloping ST segment depression in at least 1 of leads V to V. Group 2 consisted of 24 patients without precordial ST depression in this area. Group 1 patients were generally older than group 2 patients (59.6 ± 6.4 versus 54 ± 5.3 yr, P<0.01) had higher total creatine kinase (CK) levels and MB fractions (1835 ± 940 versus 875 ± 305, P < 001, 269 ± 102 versus 95 ± 35 for MB fraction) and more complications during the hospital course (80% versus 38% P<0.01) and greater left ventricular dysfunction (ejection fraction 52.2 ± 6% for group I versus 59.2±7% for group 2; cardiac index 2.75±0.41min m for group 1 versus 3.25 ± 0.3 lmin m for group 2 P<0.005). No difference was observed on biplane angiography as far as left ventricular wall kinesis was concerned. By contrast, coronary arteriography revealed more frequent left coronary artery disease in group 1 patients (84%) than in group 2 patients (37%) P<0.005, the left anterior descending and circumflex arteries being equally often affected. Finally, the persistence of ST segment depression for more than 48 hours was associated with a more severe depression of the ejection fraction than transient depression (less than 48 hours). In summary, the presence of ST segment depression in the precordial leads during the acute phase of inferior myocardial infarction was associated with greater myocardial necrosis and more frequent left coronary artery disease, thus identifying a subset of high risk patients. [ABSTRACT FROM PUBLISHER]

The International Centre for Research in Agroforestry (ICRAF) coordinates a research network in the Semi-arid Lowlands of West Africa (SALWA) in four countries: Burkina Faso, Niger, Mali and Senegal. Prosopis africana, an important agroforestry tree species is seriously threatened in this eco-region. ICRAF organized seed collections of this species for long-term conservation and subsequent utilization by small-scale farmers in the West African Sahel. Prior to the collection, ICRAF, the International Plant Genetic Resources Institute (IPGRI) and International Crops Research Institute for the Semi-Arid Tropics (ICRISAT) organized a planning workshop with collaborating national research institutes. Out of this workshop came a consensus on the strategy, logistics and choice of collection sites. To collect as much genetic diversity of P. africana in the SALWA region as possible, 34 collection sites were selected: 15 in Niger, eight in Mali, seven in Burkina Faso and four in Senegal. The main aim of the collection was to capture the genetic diversity within P. africana before the valuable genetic resources are lost. This paper reviews the methodology and results of the germplasm collection. [ABSTRACT FROM AUTHOR]

Background: Free tissue transfer is considered the gold standard in reconstruction of extensive defects in head and neck surgery. The aim of this 15-year retrospective study is to analyze the outcomes of free tissue transfers in the head and neck area in a tertiary referral university hospital., Materials and Methods: A retrospective, single-center study of all patients undergoing free tissue transfers for head and neck reconstruction between 2006 and 2020 was performed. Patient demographics, comorbidities, flap characteristics, outcomes and complications were assessed., Results: A total of 353 free flaps were performed. The most common defect etiology was synchronous oncologic resection (74.2%). The majority of patients had at least one comorbidity (70.3%), with smoking recorded in 46.2% of the cases and alcohol consumption in 31.7%. The anterolateral thigh flap was the most commonly used flap (37.7%), followed by the osteoseptocutaneous fibula flap (26.9%). Our overall flap success rate was 97.7%, while the overall complication rate was 45.9%., Conclusions: Free tissue transfer in head and neck reconstruction is reliable. However, complication rates remain high due to the complexity of such cases and frequent presence of comorbidities. Nonetheless, when effectively managed within a multidisciplinary team, complications rarely jeopardize the overall reconstruction outcome.

Type-2 diabetes mellitus (DM) represents one of the most important risk factors for cardiovascular diseases (CVD). Hyperglycemia and glycemic variability are not the only determinant of the increased cardiovascular (CV) risk in diabetic patients, as a frequent metabolic disorder associated with DM is dyslipidemia, characterized by hypertriglyceridemia, decreased high-density lipoprotein (HDL) cholesterol levels and a shift towards small dense low-density lipoprotein (LDL) cholesterol. This pathological alteration, also called diabetic dyslipidemia, represents a relevant factor which could promotes atherosclerosis and subsequently an increased CV morbidity and mortality. Recently, the introduction of novel antidiabetic agents, such as sodium glucose transporter-2 inhibitors (SGLT2i), dipeptidyl peptidase-4 inhibitors (DPP4i) and glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1 RAs), has been associated with a significant improvement in CV outcomes. Beyond their known action on glycemia, their positive effects on the CV system also seems to be related to an ameliorated lipidic profile. In this context, this narrative review summarizes the current knowledge regarding these novel anti-diabetic drugs and their effects on diabetic dyslipidemia, which could explain the provided global benefit to the cardiovascular system.

Background: Studies investigating clinical outcomes of patients with or without endothelial disfunction (ED) treated with percutaneous coronary intervention (PCI) for stable coronary artery disease (CAD) using second generation drug eluting stents (DES) are lacking., Methods: We prospectively collected data from 109 patients undergoing PCI with second generation DES due to stable CAD between December 2014 and September 2016. ED was evaluated evaluating the flow mediated dilation (FMD) at the brachial artery level and defined by an FMD < 7 %. Primary outcome were major adverse cardiovascular events (MACE), secondary outcomes were target vessel failure (TVR), myocardial infarction (MI) and all-cause death., Results: Five-year follow-up was available in all patients. Median FMD didn't significantly differ between patients who experienced the outcome and those who didn't [no TVR vs. TVR: p = 0.358; no MI vs. MI: p = 0.157; no death vs. death: p = 0.355; no MACE vs. MACE: p = 0.805]. No association between ED and an increased risk for the primary outcome as well as for the secondary ones was evident [MACE: 17.0 % vs. 14.3 %, HR 0.87 (0.33-2.26), log rank p = 0.780; TVR: 9.4 % vs. 5.4 %, HR 0.53 (0.12-2.24), log rank p = 0.384; MI: 3.7 % vs. 8.9 %, HR 2.46 (0.47-12.76), log rank p = 0.265; death: 7.5 % vs. 3.6 %, HR 0.53 (0.09-2.90), log rank p = 0.458]. These findings were confirmed using a lower threshold of FMD to define ED and at one-year landmark analysis., Conclusions: ED is not associated with an increased risk of adverse events at long-term follow-up in a contemporary cohort of patients undergoing PCI with second generation DES., Competing Interests: Declaration of competing interest Authors report the absence of any conflict of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

The resilience and sustainability of food systems depend on crop diversity. It is used by breeders to produce new and better varieties, and by farmers to respond to new challenges or demands and to spread risk. However, crop diversity can only be used if it has been conserved, can be identified as the solution for a given problem, and is available. As the ways in which crop diversity is used in research and breeding change and expand, the global conservation system for crop diversity must keep pace; it must provide not only the biological materials themselves, but also the relevant information presented in a comprehensive and coherent way-all while ensuring equitable access and benefit sharing. Here we explore the evolving priorities for global efforts to safeguard and make available the diversity of the world's crops through ex situ genetic resource collections. We suggest that collections held by academic institutions and other holders that are not standard gene banks should be better integrated in global efforts and decision-making to conserve genetic resources. We conclude with key actions that we suggest should be taken to ensure that crop diversity collections of all types are able to fulfill their role to foster more diverse, equitable, resilient, and sustainable food systems globally.

Background: Return to a normal diet is a crucial step after bariatric surgery. Proximal anastomosis is a source of concern for early feeding as the passage of solid food through a recent anastomosis could well increase pressure and the risk of leakage. This study aims to assess the safety of an early normal diet after a laparoscopic Roux-en-Y gastric bypass (LRYGB)., Materials and Methods: All consecutive patients undergoing primary LRYGB between January 2015 and December 2020 were included prospectively. Three postoperative pureed diets were compared at 4 weeks, 2 weeks, and 1 week. All-cause morbidity at 90 days was the main outcome. Overall complications, severe complications (Clavien-Dindo ≥ grade 3a), length of hospital stay, number of emergency, and unplanned consultations during the 3 postoperative months were recorded for each group., Results: Three hundred and sixty-seven patients with a mean BMI of 42.10 kg/m 2 (± SD: 4.78) were included. All-cause morbidity at 90 days was 11.7% (43/367) and no significant difference was observed between the 3 groups. Adjustment for patients and operative cofounders did not demonstrate any increased risk of postoperative complications between the 3 groups, with an odds ratio of 1, 1.23(95% CI [0. 55-2.75]), and 1.14 (95% CI [0.49, 2.67]) for groups 1, 2, and 3 respectively. Severe complications (Clavien-Dindo ≥ grade 3a) and emergency or unplanned consultations were also similar in the 3 groups., Conclusion: Return to a normal diet 1 week after LRYGB did not increase short-term morbidity and unplanned consultations. It may be safe and contribute to patient comfort., (© 2022. The Author(s).)

The Adapting Agriculture to Climate Change Project set out to improve the diversity, quantity, and accessibility of germplasm collections of crop wild relatives (CWR). Between 2013 and 2018, partners in 25 countries, heirs to the globetrotting legacy of Nikolai Vavilov, undertook seed collecting expeditions targeting CWR of 28 crops of global significance for agriculture. Here, we describe the implementation of the 25 national collecting programs and present the key results. A total of 4587 unique seed samples from at least 355 CWR taxa were collected, conserved ex situ, safety duplicated in national and international genebanks, and made available through the Multilateral System (MLS) of the International Treaty on Plant Genetic Resources for Food and Agriculture (Plant Treaty). Collections of CWR were made for all 28 targeted crops. Potato and eggplant were the most collected genepools, although the greatest number of primary genepool collections were made for rice. Overall, alfalfa, Bambara groundnut, grass pea and wheat were the genepools for which targets were best achieved. Several of the newly collected samples have already been used in pre-breeding programs to adapt crops to future challenges.

Crop landraces have unique local agroecological and societal functions and offer important genetic resources for plant breeding. Recognition of the value of landrace diversity and concern about its erosion on farms have led to sustained efforts to establish ex situ collections worldwide. The degree to which these efforts have succeeded in conserving landraces has not been comprehensively assessed. Here we modelled the potential distributions of eco-geographically distinguishable groups of landraces of 25 cereal, pulse and starchy root/tuber/fruit crops within their geographic regions of diversity. We then analysed the extent to which these landrace groups are represented in genebank collections, using geographic and ecological coverage metrics as a proxy for genetic diversity. We find that ex situ conservation of landrace groups is currently moderately comprehensive on average, with substantial variation among crops; a mean of 63% ± 12.6% of distributions is currently represented in genebanks. Breadfruit, bananas and plantains, lentils, common beans, chickpeas, barley and bread wheat landrace groups are among the most fully represented, whereas the largest conservation gaps persist for pearl millet, yams, finger millet, groundnut, potatoes and peas. Geographic regions prioritized for further collection of landrace groups for ex situ conservation include South Asia, the Mediterranean and West Asia, Mesoamerica, sub-Saharan Africa, the Andean mountains of South America and Central to East Asia. With further progress to fill these gaps, a high degree of representation of landrace group diversity in genebanks is feasible globally, thus fulfilling international targets for their ex situ conservation., (© 2022. The Author(s).)

Crop diversity underpins the productivity, resilience and adaptive capacity of agriculture. Loss of this diversity, termed crop genetic erosion, is therefore concerning. While alarms regarding evident declines in crop diversity have been raised for over a century, the magnitude, trajectory, drivers and significance of these losses remain insufficiently understood. We outline the various definitions, measurements, scales and sources of information on crop genetic erosion. We then provide a synthesis of evidence regarding changes in the diversity of traditional crop landraces on farms, modern crop cultivars in agriculture, crop wild relatives in their natural habitats and crop genetic resources held in conservation repositories. This evidence indicates that marked losses, but also maintenance and increases in diversity, have occurred in all these contexts, the extent depending on species, taxonomic and geographic scale, and region, as well as analytical approach. We discuss steps needed to further advance knowledge around the agricultural and societal significance, as well as conservation implications, of crop genetic erosion. Finally, we propose actions to mitigate, stem and reverse further losses of crop diversity., (© 2021 The Authors. New Phytologist © 2021 New Phytologist Foundation.)

Genebanks were established out of a recognised need not just to provide genetic variation to support breeding objectives but to prevent crop diversity from being lost entirely for future users. Such conservation objectives may have led, over the past few decades, to a gradually diminishing connection between genebanks and current users of diversity. While there continues to be large-scale distribution of germplasm from genebanks to recipients worldwide, relatively little is known or published about the detailed trends in the demand for genebank materials. Meanwhile, the rapid expansion of the applications and uses of modern genomic technologies and approaches is, undoubtedly, having a transformational impact on breeding, research and the demand for certain genetic resources and associated data. These trends will require genebanks to be responsive and to adapt. They also provide important opportunities for genebanks to reorganize and become more efficient individually and as a community. Ultimately, future challenges and opportunities are likely to drive more demand for genetic diversity and provide an important basis for genebanks to gear up.

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a technically demanding procedure. The learning curve of LRYGB is challenging and potentially associated with increased morbidity. This study evaluates whether a general laparoscopic surgeon can be safely trained in performing LRYGB in a peripheral setting, by comparing perioperative outcomes to global benchmarks and to those of a senior surgeon., Methods: All consecutive patients undergoing primary LRYGB between January 2014 and December 2017 were operated on by a senior (A) or a trainee (B) bariatric surgeon and were prospectively included. The main outcome of interest was all-cause morbidity at 90 days. Perioperative outcomes were compared with global benchmarks pooled from 19 international high-volume centers and between surgeons A and B for their first and last 30 procedures., Results: The 213 included patients had a mean all-cause morbidity rate at 90 days of 8% (17/213). 95.3% (203/213) of the patients were uneventfully discharged after surgery. Perioperative outcomes of surgeon B were all within the global benchmark cutoffs. Mean operative time for the first 30 procedures was significantly shorter for surgeon A compared with surgeon B, with 108.6 min (± 21.7) and 135.1 min (± 28.1) respectively and decreased significantly for the last 30 procedures to 95 min (± 33.7) and 88.8 min (± 26.9) for surgeons A and B respectively., Conclusion: Training of a new bariatric surgeon did not increase morbidity and operative time improved for both surgeons. Perioperative outcomes within global benchmarks suggest that it may be safe to teach bariatric surgery in peripheral setting.

The international collections of plant genetic resources for food and agriculture (PGRFA) hosted by 11 CGIAR Centers are important components of the United Nations Food and Agriculture Organization's global system of conservation and use of PGRFA. They also play an important supportive role in realizing Target 2.5 of the Sustainable Development Goals. This paper analyzes CGIAR genebanks' trends in acquiring and distributing PGRFA over the last 35 years, with a particular focus on the last decade. The paper highlights a number of factors influencing the Centers' acquisition of new PGRFA to include in the international collections, including increased capacity to analyze gaps in those collections and precisely target new collecting missions, availability of financial resources, and the state of international and national access and benefit-sharing laws and phytosanitary regulations. Factors contributing to Centers' distributions of PGRFA included the extent of accession-level information, users' capacity to identify the materials they want, and policies. The genebanks' rates of both acquisition and distribution increased over the last decade. The paper ends on a cautionary note concerning the potential of unresolved tensions regarding access and benefit sharing and digital genomic sequence information to undermine international cooperation to conserve and use PGRFA., Competing Interests: N.L.A., P.W., T.P., M.-N.N., M.Y., A.M., V.A., M.T., C.S.J., V.R., N.R., P.L.K., E.R. work in the management of CGIAR Centers’ genebanks (and/or germplasm health units) that are the subject of this paper. N.J., C.L., L.G. work at the Crop Trust. M.H., I.L.N. are co-coordinators of the Genebank Platform Policy Module.

Aim of Study: To report our experience of late correction after infancy in patients with tetralogy of Fallot (ToF)., Methods: Observational single-centre retrospective analysis of the surgical techniques and perioperative development of patients from developing countries undergoing total surgical correction of ToF after infancy, between 1 November 2011 and 30 November 2016. Variables are presented as numbers with percentages or as mean &plusmn; standard deviation. Due to the setting of the humanitarian programme, clinical and echocardiographic follow-up procedures could be conducted for only one month postoperatively., Results: Twenty-five children (mean age: 70.8 &plusmn; 42 months, range 23-163; 44% female) underwent total surgical correction of ToF. Two patients (0.8%) initially received a Blalock-Taussig shunt and underwent subsequent correction 24 and 108 months later, respectively. Preoperative mean right ventricular/pulmonary artery (RV/PA) gradient was 84 &plusmn; 32 mm Hg, with a Nakata index of 164 &plusmn; 71 mm2/m2. Major aortopulmonary collateral arteries (MAPCAs) were observed in eight children (32%), six (26%) of whom underwent transcatheter closure before surgery. 24 children (96%) underwent a valve-sparing pulmonary valve repair and one patient received a transannular patch (TAP). There were no cases which saw major adverse cardiac and cerebrovascular events (MACCE). Mean duration of mechanical ventilation was 28 &plusmn; 19.6 hours (range 7-76). Pre-discharge echocardiography demonstrated a mean RV/PA gradient of 25 &plusmn; 5.7 mm Hg, with left ventricular ejection fraction &gt;60% in all cases. Overall length of hospital stay was 11.7 &plusmn; 4.5 days. There were no in-hospital mortality cases., Conclusions: Late surgical correction of ToF can be safely performed and produce highly satisfying early postoperative results comparable to those of classical &ldquo;timely&rdquo; correction. A valve-sparing technique can be applied in the majority of children.

The impact of climate change is causing challenges for the agricultural production and food systems. More nutritious and climate resilient crop varieties are required, but lack of available and accessible trait diversity is limiting crop improvement. Crop wild relatives (CWR) are the wild cousins of cultivated crops and a vast resource of genetic diversity for breeding new, higher yielding, climate change tolerant crop varieties, but they are under-conserved (particularly in situ), largely unavailable and therefore underutilized. Here we apply species distribution modelling, climate change projections and geographic analyses to 1261 CWR species from 167 major crop genepools to explore key geographical areas for CWR in situ conservation worldwide. We identify 150 sites where 65.7% of the CWR species identified can be conserved for future use., Competing Interests: The authors declare no competing interests.

The analysis of Pleurotus ostreatus genome reveals the presence of automatically annotated 53 lipase and 34 carboxylesterase putative coding-genes. Since no biochemical or physiological data are available so far, a functional approach was applied to identify lipases from P. ostreatus. In the tested growth conditions, four lipases were found expressed, with different patterns depending on the used C source. Two of the four identified proteins (PleoLip241 and PleoLip369), expressed in both analysed conditions, were chosen for further studies, such as an in silico analysis and their molecular characterization. To overcome limits linked to native production, a recombinant expression approach in the yeast Pichia pastoris was applied. Different expression levels were obtained: PleoLip241 reached a maximum activity of 4000 U/L, whereas PleoLip369 reached a maximum activity of 700 U/L. Despite their sequence similarity, these enzymes exhibited different substrate specificity and diverse stability at pH, temperature, and presence of metals, detergents and organic solvents. The obtained data allowed classifying PleoLip241 as belonging to the "true lipase" family. Indeed, by phylogenetic analysis the two proteins fall in different clusters. PleoLip241 was used to remove the hydrophobic layer from wool surface in order to improve its dyeability. The encouraging results obtained with lipase treated wool led to forecast PleoLip241 applicability in this field.