Genome size data for eight endemic plant species from the Nanda Devi Biosphere Reserve (Western Himalaya).

The Himalaya harbors a large number of plant endemics but information on their genome size is largely lacking. This study aims to fulfill this gap by reporting genome sizes for 8 endemic Himalayan plant species (Impatiens devendrae Pusalkar, Impatiens scabrida DC., Impatiens sulcata Wall., Geranium robertianum L., Geranium wallichianum D.Don ex Sweet, Thalictrum cultratum Wall., Thalictrum elegans Wall. ex Royle, Thalictrum foliolosum DC.) from the Western Indian Himalayan state of Uttarakhand. The study involved collecting leaf tissues from each of the 8 plant species, chopping, staining and estimating nuclear DNA content using CyFlow Cube 8 flow cytometer with 532 nm laser light source and an orange-red fluorescence emission (>590 nm). The CyFlow Cube 13 programme was utilised to obtain the median fluorescence value from PI-stained G0/G1 (quiescent phase/first growth phase) nuclei, devoid of cellular debris. The DNA 2C value of each sample was then estimated by comparing the median fluorescence intensity values of both sample and standard (Solanum lycopersicum L.) using the standard scientific formula. The highest DNA 2C-values were observed in Geranium, which ranged from 5.29 ± 0.02 pg to 2.49 ± 0.02 pg. The genome size of Impatiens species varied from 1.49 ± 0.08 pg to 3.14 ± 0.04 pg while the three species of genus Thalictrum had nearly similar genome sizes varying between 1.53 ± 0.01 pg to 1.96 ± 0.06 pg. The coefficient of variation among nuclei varied from 3.52 % to 5.38 % with 103 to 1811 numbers of stained nuclei. The results and framework presented in the current study can serve as a template for future studies that attempt to estimate the genome sizes of endemic plant species in the Himalaya, a global biodiversity epicentre and one of the least studied biodiversity hotspots of the world.

Hydropower: A low-hanging sour-sweet energy option for India.

India is the world's second largest populous nation, fifth largest economy with seventh largest geographical area but experiences high energy poverty. With the lowest per capita energy consumption among world's top ten economies, India ranks at 137 out of 218 nations. Hydropower has the potential to alleviate India's energy asymmetry as well as realize its sustainable growth aspiration of a low-carbon regime. However, hydropower in India has been plagued by debates on human displacement, loss of biodiversity, increased risk of natural disasters, and socio-economic conflicts making it an unpopular energy alternative. Here, we review and address various concerns related to India's hydropower sector, examine scientific evidence, analyze energy policy imperatives, geopolitical considerations, and future directions for a sustainable hydropower policy in India in the context of ongoing climate change. Evidence indicates that besides electricity generation, hydropower infrastructure helps: (i) avert floods, (ii) mitigate the impacts of global warming, and (iii) ensure redistribution of water to arid regions and improve water security. As a part of sustainable hydropower policy, we propose that most of the ecological and social problems associated with hydropower development can be avoided to a great extent through careful planning, proper project design, responsible ownership, and public participation. As short-term measures, we propose: (i) entrepreneurs and planners follow credible and transparent pre-project investigations, (ii) mandatory implementation of environmental management plans, and (iii) better accountability and transparency of statutory bodies as well as hydropower developers. For long-term measures, we suggest: (i) create a 'National Institute of Energy & Environmental Sustainability' to oversee post-project hydropower developmental activities, (ii) streamline various bureaucratic and institutional procedures, and (ii) establish a trans-boundary water management system for seamless and coordinated implementation of hydropower development programs across upstream-downstream nations.

Increasing collaboration between China and India in the environmental sciences to foster global sustainability.

As the two largest countries by population, China and India have pervasive effects on the ecosphere. Because of their human population size and long international boundary, they share biodiversity and the threats to it, as well as crops, pests and diseases. We ranked the two countries on a variety of environmental challenges and solutions, illustrating quantitatively their environmental footprint and the parallels between them regarding the threats to their human populations and biodiversity. Yet we show that China and India continue to have few co-authorships in environmental publications, even as their major funding for scientific research has expanded. An agenda for collaboration between China and India can start with the shared Himalaya, linking the countries' scientists and institutions. A broader agenda can then be framed around environmental challenges that have regional patterns. Coordinated and collaborative research has the potential to improve the two countries' environmental performance, with implications for global sustainability.

Variations in origin of the superior thyroid artery: an update for the head and neck surgeon.

Head and neck surgeons must have a thorough knowledge of head and neck vascular anatomy and its variations. This case report documents a variation in the superior thyroid artery encountered during a neck dissection and discusses the surrounding literature. A 55-year-old female with squamous cell carcinoma of the tongue underwent a partial glossectomy, right level I-IV neck dissection and reconstruction with a radial forearm free flap. During the procedure, an arterial branch was encountered arising 2-3cm caudal to the common carotid bifurcation. This variant branch was shown to represent the superior thyroid artery. On review of the literature, various classification systems of the superior thyroid artery origin have been described. Awareness of such anatomical variation is vital for the head and neck surgeon to avoid unexpected complication.

Contrasting Composition, Diversity and Predictive Metabolic Potential of the Rhizobacterial Microbiomes Associated with Native and Invasive Prosopis Congeners.

Invasive plants are known to alter the soil microbial communities; however, the effects of co-occurring native and invasive congeners on the soil bacterial diversity and their predictive metabolic profiles are not known. Here, we compared the rhizosphere bacterial communities of invasive Prosopis juliflora and its native congener Prosopis cineraria using high-throughput sequencing of the 16S rRNA gene. Unweighted Pair Group Method with Arithmetic mean (UPGMA) based dendrogram revealed significant variation in the communities of these co-occurring Prosopis species. Additionally, Canonical Correspondence Analysis (CCA) based on microbial communities in addition to the soil physiochemical parameters viz. soil pH, electrical conductivity, moisture content and sampling depth showed ~ 80% of the variation in bacterial communities of the rhizosphere and control soil. We observed that Proteobacteria was the predominant phylum of P. juliflora rhizosphere and the control soil, while P. cineraria rhizosphere was dominated by Cyanobacteria. Notably, the invasive P. juliflora rhizosphere showed an enhanced abundance of bacterial phyla like Actinobacteria, Chloroflexi, Firmicutes and Acidobacteria compared to the native P. cineraria as well as the control soil. Predictive metagenomics revealed that the bacterial communities of the P. juliflora rhizosphere had a higher abundance of pathways involved in antimicrobial biosynthesis and degradation, suggesting probable exposure to enemy attack and an active response mechanism to counter it as compared to native P. cineraria. Interestingly, the higher antimicrobial biosynthesis predicted in the invasive rhizosphere microbiome is further corroborated by the fact that the bacterial isolates purified from the rhizosphere of P. juliflora belonged to genera like Streptomyces, Isoptericola and Brevibacterium from the phylum Actinobacteria, which are widely reported for their antibiotic production ability. In conclusion, our results demonstrate that the co-occurring native and invasive Prosopis species have significantly different rhizosphere bacterial communities in terms of composition, diversity and their predictive metabolic potentials. In addition, the rhizosphere microbiome of invasive Prosopis proffers it a fitness advantage and influences invasion success of the species.

Paludisphaera soli sp. nov., a new member of the family Isosphaeraceae isolated from high altitude soil in the Western Himalaya.

A novel strain of Planctomycetes, designated JC670T, was isolated from a high altitude (~ 2900 m above sea level) soil sample collected from Garhwal region in the Western Himalaya. Colonies of this strain were observed to be light pink coloured with spherical to oval shaped cells having crateriform structures distributed all over the cell surface. The cells divide by budding. Strain JC670T was found to grow well at pH 7.0 and pH 8.0 and to tolerate up to 2% NaCl (w/v). MK6 was the only respiratory quinone identified. The major fatty acids of strain JC670T were identified as C18:1ω9c, C18:0 and C16:0, and phosphatidylcholine, two unidentified phospholipids and six unidentified lipids are present as the polar lipids. The polyamines putrescine and sym-homospermidine were detected. Strain JC670T shows high 16S rRNA gene sequence identity (95.4%) with Paludisphaera borealis PX4T. The draft genome size of strain JC670T is 7.97 Mb, with G + C content of 70.4 mol%. Based on phylogenetic analyses with the sequences of ninety-two core genes, low dDDH value (20.6%), low gANI (76.8%) and low AAI (69.1%) results, differential chemotaxonomic and physiological properties, strain JC670T (= KCTC 72850T = NBRC 114339T) is recognised as the type strain of a new species of the genus Paludisphaera, for which we propose the name Paludisphaera soli sp. nov.

Point-of-care CD4+ technology implementation in Free State, South Africa, was associated with improved patient health outcomes.

BACKGROUND: Point-of-care (POC) CD4+ technologies have the potential to increase patient access to treatment and care through rapid testing and result delivery at or close to where patients seek care. South African (SA) guidelines suggest the use of CD4+ testing to prioritise patients most in need of antiretroviral therapy (ART) and to support identification of patients with advanced HIV disease and opportunistic management of patients on ART. Understanding the patient impact of implementing POC CD4+ testing in the intended setting and operated by lower cadres of healthcare worker or non-professional healthcare facility staff will provide valuable insight into the appropriate use and placement of POC CD4+ technologies throughout SA. OBJECTIVES: To determine the patient impact (turnaround time of tests, loss to follow-up, and proportions of eligible patients proceeding to the next steps in the testing and treatment cascade) of implementing POC CD4+ testing technologies compared with conventional laboratory-based CD4+ testing. METHODS: This retrospective cohort study included all HIV-positive adults from 30 healthcare facilities in Free State Province, SA. Healthcare facilities were placed into two groups (POC and laboratory referral) using a stratified randomisation technique based on the presence of a POC CD4+ technology and minimal ART volumes. Patients who received a CD4+ test prior to ART initiation between September 2012 and September 2014 were included. Data were collected from patient charts and the POC devices. RESULTS: For new patients, the average time from HIV diagnosis and CD4+ testing was reduced from 7.6 days in the laboratory referral group to 4.5 days in the POC group, a decrease of almost 60%. Additionally, 59.6% of patients in the POC group received their HIV diagnosis and CD4+ test result on the same day, compared with 37.5% in the laboratory referral group (risk ratio (RR) 1.49; 95% confidence interval (CI) 1.01 - 2.18). Fewer patients were lost between HIV diagnosis and CD4+ testing (2.7% v. 8.6%) (RR 0.02; 95% CI 0.05 - 0.78) in the POC group. The average test error rate across the study time period was 8.4%; however, the error rate remained <5% for the final 5 months of the study. CONCLUSIONS: Introduction of the Alere Pima POC CD4+ technology in the Free State, operated by nurses and lay counsellors, was associated with positive patient outcomes across all parameters analysed. While this study highlighted an effective conventional laboratory network, a full costing and affordability analysis coupled with patient impact and access data from this study will provide further insight into the potential deployment strategies of POC CD4+ technologies in SA.

Asystole during Le Fort 1 osteotomy: the trigeminovagal reflex.

The trigeminovagal reflex is a phenomenon that occurs rarely during maxillofacial surgery. Previously described as the oculocardiac reflex, this reflex can occur during ocular and periocular surgery. To be more anatomically precise, it was renamed the trigeminocardiac or trigeminovagal reflex, since stimulation of any part of the trigeminal nerve can elicit this reflex arc. We describe a case of asystole during mobilization of a maxilla following a Le Fort 1 osteotomy.

Solitary pulmonary nodule and the surgeon.

A solitary pulmonary nodule is a single, well-circumscribed radiographic opacity that will be encountered by every thoracic surgeon, and management is dependent on the malignant potential of the nodule. The nodules are usually first encountered on a chest radiograph. Anatomical characteristics on computed tomography can help to better differentiate the malignant potential of the nodule. These characteristics include nodule size, volume change over time, edge morphology, presence of calcification and nodule attenuation. Other adjuncts to evaluate the malignant potential of the nodule include a functional assessment using positron emission tomography. The role of the thoracic surgeon includes both diagnostic and surgical intervention to assist with management of the malignant nodule.

Submental island flap for oropharyngeal reconstruction: UK experience of 25 cases.

Since the first description of the submental island flap 24 years ago, advances in techniques have expanded the indications for its use and improved its characteristics to make it a favourable reconstructive option for orofacial oncological defects. We describe our experience (particularly perioperatively) of its use, the complications, and the precautions adopted. We retrospectively reviewed the cases of 25 patients and focused on the operating time, use of tracheostomy, duration of postoperative inpatient stay, oropharyngeal function, and associated morbidities. Eighteen patients had defects of the tongue. Other defects were retromolar (n=2), buccal (n=1), mandibular (n=2), and maxillary (n=2). The mean (range) operating time was 250 (152-370) minutes and the mean (range) postoperative stay was 11 (4-16) days. Only four patients required a tracheostomy, and four required postoperative monitoring in the intensive care unit (ICU). The complications were partial flap loss (n=6), sialocele (n=1), and seroma (n=1). The flap has shown its merit as an option for oral reconstruction because of its reliability, versatility, and relative ease of application. To our knowledge, our case series is the largest in the United Kingdom, and we hope that in future, this humble flap will be a standard reconstructive option for small to medium oral resection defects.

Designing primary healthcare systems for future in India.

Changing epidemiology, rapid urbanization, and rising expectations of populations are creating new challenges and opportunities for India's primary healthcare system. A group of primary care experts, practitioners, and researchers got together to design key elements of primary healthcare models for the future that would address these challenges and make use of emergent opportunities in rural and urban India. Based on experiences and evidence from India and across the globe shared in the consultation, the article lays out a vision and components of India's primary healthcare for future. It provides answers to questions such as how will healthcare be financed and organized, what mechanisms will assure quality of services, who will provide primary healthcare, and what role will technology have. Finally, it provides an agenda for primary healthcare practitioners and researchers to translate this vision into action.

The Effect of Hydroxyurea Therapy on Adverse Clinical Events and Haematological Indices in Paediatric Patients with Sickle Cell Anaemia / Efecto de la Terapia con Hidroxiurea en los Eventos Clínicos Adversos y los Indices Haematológicos de Pacientes Paediátricos con Aanemia de Células Falciformes

ABSTRACT Objective: The aim of this study was to determine the effect of hydroxyurea on adverse clinical events and haematological indices in paediatric patients with sickle cell anaemia. Method: This study compared the same cohort of patients before and after hydroxyurea therapy, monitoring the rate of adverse events, pre- and post-treatment and haematological indices. Results: Of the 40 patients, the incidence rate of painful crises post-treatment was 80% lower than pre-treatment. Post-treatment incidence rates of painful crises managed at home, requiring emergency department care or requiring admission to the ward were also lower - 79%, 81% and 84%, respectively. There was no significant difference in the incidence of other clinical events. The haemoglobin concentration increased within the first month and plateaued while the mean corpuscular volume (MCV) and mean corpuscular haemoglobin concentration (MCHC) continued to increase until six months before plateauing out. The white blood cell count (WBC) and absolute neutrophil count (ANC) decreased over the first month before levels stabilized. The reticulocyte percentage and the absolute reticulocyte count (ARC) decreased over the first three months before plateauing while the platelet count remained stable. Conclusion: Hydroxyurea significantly reduced the incidence of painful crises. There were significant increases in haemoglobin, MCV and MCHC with decreases in WBC, ANC, ARC, and reticulocyte percentage while the platelet count remained relatively stable.

RESUMEN Objetivo: El objetivo de este estudio fue determinar el efecto de la hidroxiurea sobre los eventos clínicos adversos y los índices hematológicos en pacientes pediátricos con anemia falciforme. Método: Este estudio comparó una misma cohorte de pacientes antes y después del tratamiento con hidroxiurea, monitoreando la tasa de eventos adversos, el tratamiento previo y posterior, y los índices hematológicos. Resultados: En los 40 pacientes, la tasa de incidencia de postratamiento de crisis dolorosas fue 80% inferior a la del pretratamiento. Las tasas de incidencia de postratamientos de crisis dolorosas que fueron tratadas en el hogar, atendidas en el departamento de emergencias, o requirieron ingreso hospitalario, fueron también menores -79%, 81%y 84%, respectivamente. No hubo diferencias significativas en la incidencia de otros eventos clínicos. La concentración de hemoglobina aumentó en el primer mes y se estabilizó, mientras que el volumen corpuscular medio (VCM) y la concentración de hemoglobina corpuscular media (CHCM) continuaron aumentando hasta seis meses antes de estabilizarse. nivelarse. El conteo de glóbulos blancos (CGB) y el conteo absoluto de neutrófilos (CAN) disminuyeron durante el primer mes antes de que los niveles se estabilizaran. El porcentaje de reticulocitos y el conteo absoluto de reticulocitos (CAR) disminuyeron durante los primeros tres meses antes de estabilizarse, mientras que el conteo de plateletas permaneció estable. Conclusión: La hidroxiurea redujo significativamente la incidencia de crisis dolorosas. Hubo aumentos significativos de hemoglobina, VCM y CHCM con disminuciones de CGB, CAN, CAR, y porcentaje de reticulocitos mientras que el conteo plaquetario permaneció relativamente estable.

Geophysical upheavals and evolutionary diversification of plant species in the Himalaya.

The Himalaya is one of the youngest and the loftiest mountain chains of the world; it is also referred to as the water tower of Asia. The Himalayan region harbors nearly 10,000 plant species constituting approximately 2.5% of the global angiosperm diversity of which over 4,000 are endemics. The present-day Himalayan flora consists of an admixture of immigrant taxa and diversified species over the last 40 million years. The interesting questions about the Himalayan flora discussed here are: how did the Himalaya achieve high endemic plant diversity starting with immigrant taxa and what were the main drivers of this diversity? This contribution aims to answer these questions and raise some more. We review and analyze existing information from diverse areas of earth and climate sciences, palaeobiology and phytogeography to evolve a bio-chronological record of plant species divergence and evolution in the Himalaya. From the analysis we infer the effects of major environmental upheavals on plant diversity in the region. The understanding developed in the following discussion is based on the idea that Himalaya experienced at least five phases of major geophysical upheavals, namely: (i) mega-collision between India and Eurasian plates, (ii) tectonic uplift in phases and progressive landform elevation, (iii) onset of southwest (SW) Indian monsoon, (iv) spurring of arid conditions in Central Asia, and (v) cyclic phases of cooling and warming in the Quaternary. The geophysical upheavals that were potentially disrupting for the ecosystem stability had a key role in providing impetus for biological diversification. The upheavals produced new geophysical environments, new ecological niches, imposed physical and physiological isolation barriers, acted as natural selection sieves and led to the formation of new species. This contribution aims to develop a comprehensive understanding of the plant biodiversity profile of the Himalaya in the context of complex, interconnected and dynamic relationship between earth system processes, climate and plant diversity.

Research priorities in Maternal, Newborn, & Child Health & Nutrition for India: An Indian Council of Medical Research-INCLEN Initiative.

In India, research prioritization in Maternal, Newborn, and Child Health and Nutrition (MNCHN) themes has traditionally involved only a handful of experts mostly from major cities. The Indian Council of Medical Research (ICMR)-INCLEN collaboration undertook a nationwide exercise engaging faculty from 256 institutions to identify top research priorities in the MNCHN themes for 2016-2025. The Child Health and Nutrition Research Initiative method of priority setting was adapted. The context of the exercise was defined by a National Steering Group (NSG) and guided by four Thematic Research Subcommittees. Research ideas were pooled from 498 experts located in different parts of India, iteratively consolidated into research options, scored by 893 experts against five pre-defined criteria (answerability, relevance, equity, investment and innovation) and weighed by a larger reference group. Ranked lists of priorities were generated for each of the four themes at national and three subnational (regional) levels [Empowered Action Group & North-Eastern States, Southern and Western States, & Northern States (including West Bengal)]. Research priorities differed between regions and from overall national priorities. Delivery domain of research which included implementation research constituted about 70 per cent of the top ten research options under all four themes. The results were endorsed in the NSG meeting. There was unanimity that the research priorities should be considered by different governmental and non-governmental agencies for investment with prioritization on implementation research and issues cutting across themes.

Elevational plant species richness patterns and their drivers across non-endemics, endemics and growth forms in the Eastern Himalaya.

Despite decades of research, ecologists continue to debate how spatial patterns of species richness arise across elevational gradients on the Earth. The equivocal results of these studies could emanate from variations in study design, sampling effort and data analysis. In this study, we demonstrate that the richness patterns of 2,781 (2,197 non-endemic and 584 endemic) angiosperm species along an elevational gradient of 300-5,300 m in the Eastern Himalaya are hump-shaped, spatial scale of extent (the proportion of elevational gradient studied) dependent and growth form specific. Endemics peaked at higher elevations than non-endemics across all growth forms (trees, shrubs, climbers, and herbs). Richness patterns were influenced by the proportional representation of the largest physiognomic group (herbs). We show that with increasing spatial scale of extent, the richness patterns change from a monotonic to a hump-shaped pattern and richness maxima shift toward higher elevations across all growth forms. Our investigations revealed that the combination of ambient energy (air temperature, solar radiation, and potential evapo-transpiration) and water availability (soil water content and precipitation) were the main drivers of elevational plant species richness patterns in the Himalaya. This study highlights the importance of factoring in endemism, growth forms, and spatial scale when investigating elevational gradients of plant species distributions and advances our understanding of how macroecological patterns arise.