The unmet need for critical care at a quaternary paediatric intensive care unit in South Africa

Paediatric intensive care, a valuable resource that improves the outcomes of critically ill children, is often scarce. Objective. To evaluate the need for paediatric intensive care beds and compare the outcomes of admitted and non-admitted deserving cases. Methods. A prospective evaluation of all bed requests, in terms of need for intensive care and outcomes of those admitted and not admitted to a paediatric intensive care unit (PICU), was performed between July 2017 and June 2018. Factors for refusal and for poor outcomes were evaluated. Results. Of the 811 bed requests, 32.6% (n=264, p<0.001) were denied access. Of the 231 deserving cases who were denied access, 85.7% (n=198) were due to unavailability of a PICU bed. Patients not admitted to PICU had a twofold increased risk of dying compared with those admitted (34.4% v. 15.5% respectively, p<0.001), even though the patient characteristics of both groups were similar (age, gender and nutritional status). In those admitted, risk factors for mortality were requiring transfusion of blood and platelets (56.0%, p<0.001), requiring two or more inotropes (52.5%, p<0.001), instability on admission (41.3%, p<0.001), prior cardiac arrest (32.0%, p=0.021), severe acute malnutrition (26.9%, p=0.043), fungal infection (22.2%, p=0.004) and emergency admission (18.0%, p<0.001). In those not admitted, prior cardiac arrest (100%, p<0.001) and emergency referral (42.3%, p<0.001) were associated with adverse outcomes. Conclusion. The need for PICU beds exceeds availability, with a consequent twofold increase in mortality among cases not admitted to PICU. Paediatric critical care services have increased at appropriate sites of need following completion of this study

Heritability and correlation among some selected morphological traits and their relationship with fall armyworm damage in sweet corn

ABSTRACT: Fall armyworm [Spodoptera frugiperda J. E. Smith] (FAW) is a serious pest in field corn and sweet corn [Zea mays L.] in many parts of the world. Sweet corn germplasm with effective levels of resistance to damage by the fall armyworm is needed to transfer resistance to commercial hybrids. The objectives of this study were to estimate heritability and to estimate the correlation among some selected morphological traits and their relationship with FAW damage. Seven shrunken-2 (sh2) inbred lines and four commercial sh2 hybrids of sweet corn were crossed to Mp708, a FAW-resistant field corn line. The F2 populations were subdivided with one half being selected for the sh2 trait and the other half was left unselected. Parent, F2, and F3 populations were artificially infested with FAW and evaluated for leaf damage caused by FAW. Heritability estimates for FAW resistance ranged from 0.22 to 0.61 depending on method of estimation used. The highest correlations occurred between silk color and anther color (0.70) and silk color and glume color (0.49). There were no consistent correlations of most morphological traits with FAWdamage. A linkage between white silk and shrunken-2 was observed.

Heritability and correlation among some selected morphological traits and their relationship with fall armyworm damage in sweet corn

Fall armyworm [Spodoptera frugiperda J. E. Smith] (FAW) is a serious pest in field corn and sweet corn [Zea mays L.] in many parts of the world. Sweet corn germplasm with effective levels of resistance to damage by the fall armyworm is needed to transfer resistance to commercial hybrids. The objectives of this study were to estimate heritability and to estimate the correlation among some selected morphological traits and their relationship with FAW damage. Seven shrunken-2 (sh2) inbred lines and four commercial sh2 hybrids of sweet corn were crossed to Mp708, a FAW-resistant field corn line. The F2 populations were subdivided with one half being selected for the sh2 trait and the other half was left unselected. Parent, F2, and F3 populations were artificially infested with FAW and evaluated for leaf damage caused by FAW. Heritability estimates for FAW resistance ranged from 0.22 to 0.61 depending on method of estimation used. The highest correlations occurred between silk color and anther color (0.70) and silk color and glume color (0.49). There were no consistent correlations of most morphological traits with FAW damage. A linkage between white silk and shrunken-2 was observed

Slavery, salt, and survival: a hypothesis of the greater prevalence of high blood pressure in Western Hemisphere blacks

High blood pressure of unknown cause (essential hypertension) is the major chronic illness contributing to premature morbidity and mortality in Western Hemisphere Blacks. As a group, Blacks in the Western hemisphere have higher mean blood pressure levels than Blacks from Sub-Sahara Africa where essential hypertension is strikingly less common. Because of the similiar heritage of these populations it has been suggested that blood pressure differences between them is most likely due to environmental differences between them is most likely due to environmental differences such as variations in diet or behavioral stress. We suggest a new hypothesis: selective survival related to sodium (Na+) metabolism during the slavery period of Western hemisphere history has led to inherited genetic differences between Western hemisphere Blacks and Sub-Sahara African Blacks which now play a major role in these geographic variations in blood pressure. Most Blacks in the Western hemisphere are descendants from a population of sub-Saharan Africans that survived the select pressure of the trans-Atlantic slave trade and New World slavery; ancestors of most current Black Africans had no such experience. The present article reviews the importance of Na+ metabolism in the causes of mortality during the slave trade and estimates Na+ losses due to sweating, diarrhea and vomitting. The magnitude of these potential losses make it likely that fatal Na+ depletion was a major contributor to the high mortality. Thus, we suggest that slave trade imposed severe demands on Na+ homeostasis and those most likely to survive were more capable of conserving Na+ than those who did not. In today's high dietary Na+ environment the descendents of African slaves may be more susceptible to "Na+ sensitive" hypertension than the descendents of Black Africans without this heritage