A Decrease in Effective Renal Perfusion Pressure Is Associated With Increased Acute Kidney Injury in Patients Undergoing Cardiac Surgery.

PURPOSE: This study aimed to evaluate the relationship between intra-abdominal pressure (IAP), renal perfusion indices, and postoperative acute kidney injury (AKI) in cardiac patients. METHODS: In a prospective cohort study conducted at a single academic institution, we collected data from adult patients undergoing open-heart operations with cardiopulmonary bypass (CPB) at our institution from February 2022 to April 2022 using the Accuryn SmartFoley system® (Potrero Medical, Hayward, CA). Patients on mechanical support devices, pregnant patients, and patients on hemodialysis were excluded. Demographics, hemodynamics, and mean airway pressure (mAir) were measured at the beginning of the cardiac operations and during the first four hours of ICU. Renal perfusion indices were then calculated (mean perfusion pressure (MPP) = mean arterial pressure (MAP) - central venous pressure (CVP); abdominal perfusion pressure (APP) = MAP - IAP; and effective renal perfusion pressure (eRPP) = MAP - (CVP + mAir + IAP)). Length of stay (LOS) was measured from the day of surgery to ICU discharge (ICU LOS) and hospital discharge (hospital LOS). RESULTS: During the first four hours of ICU stay, the non-AKI group had lower IAP and higher renal perfusion indices (MPP, APP, and eRPP). Logistic regression showed high perfusion pressures correlated with lower postoperative AKI (all OR <1, p<0.05). The postoperative AKI group also had significantly longer ICU LOS (7.33 vs. 4.57 days) and hospital LOS (17.0 vs. 10.2 days). CONCLUSION: Renal perfusion indices are a promising tool to predict postoperative AKI in cardiac surgery patients.

Association of differentially expressed R-gene candidates with leaf spot resistance in peanut (Arachis hypogaea L.).

Early leaf spot (ELS) and late leaf spot (LLS) are major fungal diseases of peanut that can severely reduce yield and quality. Development of acceptable genetic resistance has been difficult due to a strong environmental component and many major and minor QTLs. Resistance genes (R-genes) are an important component of plant immune system and have been identified in peanut. Association of specific R-genes to leaf spot resistance will provide molecular targets for marker-assisted breeding strategies. In this study, advanced breeding lines from different pedigrees were evaluated for leaf spot resistance and 76 candidate R-genes expression study was applied to susceptible and resistant lines. Thirty-six R-genes were differentially expressed and significantly correlated with resistant lines, of which a majority are receptor like kinases (RLKs) and receptor like proteins (RLPs) that sense the presence of pathogen at the cell surface and initiate protection response. The largest group was receptor-like cytoplasmic kinases (RLCKs) VII that are involved in pattern-triggered kinase signaling resulting in the production reactive oxygen species (ROS). Four R-genes were homologous to TMV resistant protein N which has shown to confer resistance against tobacco mosaic virus (TMV). When mapped to peanut genomes, 36 R-genes were represented in most chromosomes except for A09 and B09. Low levels of gene-expression in resistant lines suggest expression is tightly controlled to balance the cost of R-gene expression to plant productively. Identification and association of R-genes involved in leaf spot resistance will facilitate genetic selection of leaf spot resistant lines with good agronomic traits.

Changes of Seed Weight, Fatty Acid Composition, and Oil and Protein Contents from Different Peanut FAD2 Genotypes at Different Seed Developmental and Maturation Stages.

The level of oleic acid in peanut seed is one of the most important factors in determining seed quality and is controlled by two pairs of homeologous genes ( FAD2A and FAD2B). The genotypes of eight F8 breeding lines were determined as AABB, aaBB, AAbb, and aabb by real-time polymerase chain reaction and sequencing. Fresh seeds were collected from five seed developmental stages and, after drying, were used for chemical analysis. Our results showed that (1) as seeds developed, seed weight, oil content, and oleic acid level significantly increased, whereas four other fatty acid levels decreased, but protein content and another four fatty acid levels did not significantly change, (2) FAD2A/ FAD2B significantly affected fatty acid profiles but not oil and protein contents, and (3) the data were consistent across 2 years. The variability of seed quality traits revealed here will be useful for peanut breeders, farmers, processers, and consumers.

Lymph Node Yield in Therapeutic Neck Dissection: Impact of Dissection Levels and Prior Radiotherapy.

OBJECTIVE: Lymph node yield in therapeutic neck dissection is clinically significant and incompletely studied. We quantified node yield based on extent of neck dissection and presence of preoperative radiation. We also evaluated factors affecting incidence of extracapsular spread (ECS). METHODS: Retrospective review of 499 patients undergoing therapeutic neck dissection; 414 patients met inclusion criteria and were divided into 2 groups: neck dissection alone or before radiation (surgery first: 280 patients; 385 dissections) and primary radiation before surgery (radiation first: 134 patients; 157 dissections). Node yield relative to levels dissected and incidence of ECS were examined. RESULTS: Dissection-specific node yield was greater in the surgery first group for dissection of levels I-V (31.1 ± 16.7 vs 24.0 ± 14.7, P < .001) and levels II-V (26.7 ± 14.4 vs 21.1 ± 10.7). Extracapsular spread incidence was 32.1% (98/305) in the surgery first group and 15.4% (23/149) in the radiation first group ( P < .001). CONCLUSION: This study clarifies anticipated node yield based on number of levels dissected and presence of preoperative radiation. Node yield and incidence of ECS are lower in patients undergoing preoperative radiation.

Characterization of small RNA populations in non-transgenic and aflatoxin-reducing-transformed peanut.

Aflatoxin contamination is a major constraint in food production worldwide. In peanut (Arachis hypogaea L.), these toxic and carcinogenic aflatoxins are mainly produced by Aspergillus flavus Link and A. parasiticus Speare. The use of RNA interference (RNAi) is a promising method to reduce or prevent the accumulation of aflatoxin in peanut seed. In this study, we performed high-throughput sequencing of small RNA populations in a control line and in two transformed peanut lines that expressed an inverted repeat targeting five genes involved in the aflatoxin-biosynthesis pathway and that showed up to 100% less aflatoxin B1 than the controls. The objective was to determine the putative involvement of the small RNA populations in aflatoxin reduction. In total, 41 known microRNA (miRNA) families and many novel miRNAs were identified. Among those, 89 known and 10 novel miRNAs were differentially expressed in the transformed lines. We furthermore found two small interfering RNAs derived from the inverted repeat, and 39 sRNAs that mapped without mismatches to the genome of A. flavus and were present only in the transformed lines. This information will increase our understanding of the effectiveness of RNAi and enable the possible improvement of the RNAi technology for the control of aflatoxins.

RNAi-mediated Control of Aflatoxins in Peanut: Method to Analyze Mycotoxin Production and Transgene Expression in the Peanut/Aspergillus Pathosystem.

The Food and Agriculture Organization of the United Nations estimates that 25% of the food crops in the world are contaminated with aflatoxins. That represents 100 million tons of food being destroyed or diverted to non-human consumption each year. Aflatoxins are powerful carcinogens normally accumulated by the fungi Aspergillus flavus and A. parasiticus in cereals, nuts, root crops and other agricultural products. Silencing of five aflatoxin-synthesis genes by RNA interference (RNAi) in peanut plants was used to control aflatoxin accumulation following inoculation with A. flavus. Previously, no method existed to analyze the effectiveness of RNAi in individual peanut transgenic events, as these usually produce few seeds, and traditional methods of large field experiments under aflatoxin-conducive conditions were not an option. In the field, the probability of finding naturally contaminated seeds is often 1/100 to 1/1,000. In addition, aflatoxin contamination is not uniformly distributed. Our method uses few seeds per transgenic event, with small pieces processed for real-time PCR (RT-PCR) or small RNA sequencing, and for analysis of aflatoxin accumulation by ultra-performance liquid chromatography (UPLC). RNAi-expressing peanut lines 288-72 and 288-74, showed up to 100% reduction (p ≤ 0.01) in aflatoxin B1 and B2 compared to the control that accumulated up to 14,000 ng · g(-1) of aflatoxin B1 when inoculated with aflatoxigenic A. flavus. As reference, the maximum total of aflatoxins allowable for human consumption in the United States is 20 ng · g(-1). This protocol describes the application of RNAi-mediated control of aflatoxins in transgenic peanut seeds and methods for its evaluation. We believe that its application in breeding of peanut and other crops will bring rapid advancement in this important area of science, medicine and human nutrition, and will significantly contribute to the international effort to control aflatoxins, and potentially other mycotoxins in major food crops.

In-office biopsy of upper airway lesions: safety, tolerance, and effect on time to treatment.

OBJECTIVES/HYPOTHESIS: Definitive tissue diagnosis for lesions warranting biopsy is shifting from the operating room to the office. Safety, tolerance, factors related to successful biopsy, and time to treatment are not well-defined. METHODS: Retrospective review of 116 patients undergoing in-office biopsy of oropharynx, larynx, or hypopharynx were included. Logistic regression determined if demographics, site, T-stage, or approach (transoral/transnasal) were related to success. Time to definitive treatment was also analyzed. RESULTS: Ninety-two transnasal and 24 transoral biopsies were performed on 73 laryngeal, 35 oropharyngeal, and 8 hypopharyngeal lesions. Of those, 97 of 116 diagnoses were made in-office. There were no complications; two patients did not tolerate the procedure. Success was not related to age (P = 0.374), site (P = 0.527), T-stage (P = 0.587), or approach (P = 0.566). Time to treatment was 24.2 ± 13.9 days with successful office biopsy and 48.8 ± 49.4 days without. CONCLUSIONS: High procedural completion rate was observed across patients, sites, and approaches. All patients should be considered for in-office biopsy, a more time- and cost-effective option leading to earlier treatment.

Modified method for combined DNA and RNA isolation from peanut and other oil seeds.

Isolation of good quality RNA and DNA from seeds is difficult due to high levels of polysaccharides, polyphenols, and lipids that can degrade or co-precipitate with nucleic acids. Standard RNA extraction methods utilizing guanidinium-phenol-chloroform extraction has not shown to be successful. RNA isolation from plant seeds is a prerequisite for many seed specific gene expression studies and DNA is necessary in marker-assisted selection and other genetic studies. We describe a modified method to isolate both RNA and DNA from the same seed tissue and have been successful with several oil seeds including peanut, soybean, sunflower, canola, and oil radish. An additional LiCl precipitation step was added to isolate both RNA and DNA from the same seed tissues. High quality nucleic acids were observed based on A(260)/A(280) and A(260)/A(230) ratios above 2.0 and distinct bands on gel-electrophoresis. RNA was shown to be suitable for reverse transcriptase polymerase chain reaction based on actin or 60S ribosomal primer amplification and DNA was shown to have a single band on gel-electrophoresis analysis. This result shows that RNA and DNA isolated using this method can be appropriate for molecular studies in peanut and other oil containing seeds.

Outcomes of laparoscopic and open appendectomy for acute appendicitis in patients with acquired immunodeficiency syndrome.

The aims of this study were to compare outcomes of appendectomy between acquired immunodeficiency syndrome (AIDS) and nonAIDS patients and laparoscopic appendectomy (LA) versus open appendectomy (OA) in AIDS patients. Using the Nationwide Inpatient Sample database, from 2006 to 2008, clinical data of patients with AIDS who underwent LA and OA were evaluated. A total of 800 patients with AIDS underwent appendectomy during these years. Patients with AIDS had a significantly higher postoperative complication rate (22.56% vs 10.36%), longer length of stay [(LOS) 4.9 vs 2.9 days], and higher mortality (0.61% vs 0.16%) compared with non-AIDS patients. In nonperforated cases in patients with AIDS, LA was associated with a significantly lower complication rate (11.25% vs 21.61%), lower mortality (0.0% vs 2.78%), and shorter mean LOS (3.22 days vs 4.82 days) compared with OA. In perforated cases in patients with AIDS, LA had a significantly lower complication rate (27.52% vs 57.50%), and shorter mean LOS (5.92 days vs 9.67 days) compared with OA. No mortality was reported in either group. In patients with AIDS, LA has a lower morbidity, lower mortality, and shorter LOS compared with OA. Laparoscopic appendectomy should be considered as a preferred operative option for acute appendicitis in patients with AIDS.

Outcomes of right vs. left colectomy for colon cancer.

BACKGROUND: Right colectomy (RC) is generally believed to be a simpler operation with better outcomes than left colectomy (LC). Our study was primarily intended to compare patient characteristics and perioperative outcomes between RC and LC in colon cancer patients, and secondarily to identify factors that increase the risk of developing postoperative abdominal abscess and/or anastomotic leak. METHODS: Using the 2007 Nationwide Inpatient Sample database, we evaluated patients who underwent elective RC and LC for colon cancer. RESULTS: A total of 50,799 patients underwent elective RC and LC for malignancy during 2007 (RC, 63.5%; LC, 36.5%). Overall, 9.6% were performed laparoscopically (RC, 9.7% vs. LC, 9.5%, P = 0.39). The majority of patients were Caucasian; 54.2% of RC and 46.5% LC patients were female (P < 0.01). RC patients were older (mean age, 70.8 vs. 65.8 years, P < 0.01) and had more comorbidities. While LC had more overall intraoperative complications (RC, 0.30% vs. LC, 1.32%, P < 0.01), RC had higher overall incidence of postoperative complications (28.43% vs. 26.75%, P < 0.01). Mean length of hospital stay (RC, 7.37 days vs. LC, 7.38 days) and in-hospital mortality (RC, 1.37% vs. LC, 1.49%) were similar in both groups. Multivariate analysis identified Native American race [adjusted odd ratio (AOR), 2.02], chronic renal failure (AOR, 1.97), congestive heart failure (AOR, 1.72), chronic pulmonary disease (AOR, 1.40), metastatic disease (AOR, 1.34), male gender (AOR, 1.23), and LC (AOR, 1.12) all independently increased the risk of abscess and/or leak. CONCLUSIONS: RC patients were older and had more comorbidities and postoperative complications. Patient characteristics and comorbidities were more important in determining overall postoperative complications than anastomotic types.

Development of trinucleotide (GGC)n SSR markers in peanut (Arachis hypogaea L)

Cultivated peanut (Arachis hypogaea L.) is an oilseed crop of economic importance. It is native to South America, and it is grown extensively in the semi-arid tropics of Asia, Africa, and Latin America. Given an extremely narrow genetic base, efforts are being made to develop simple sequence repeat (SSR) markers to provide useful genetic and genomic tools for the peanut research community. A SSR-enriched library to isolate trinucleotide (GGC)n SSRs in peanut was constructed. A total of 143 unique sequences containing (GGC)n repeats were identified. One hundred thirty eight primer pairs were successfully designed at the flanking regions of SSRs. A suitable polymerase was chosen to amplify these GC-rich sequences. Although a low level of polymorphism was observed in cultivated peanut by these new developed SSRs, a high level of transferability to wild species would be beneficial to increasing the number of SSRs in wild species.

A picorna-like virus from the red imported fire ant, Solenopsis invicta: initial discovery, genome sequence, and characterization.

We report the first discovery and genome sequence of a virus infecting the red imported fire ant, Solenopsis invicta. The 8026 nucleotide, polyadenylated, RNA genome encoded two large open reading frames (ORF1 and ORF2), flanked and separated by 27, 223, and 171 nucleotide untranslated regions, respectively. The predicted amino acid sequence of the 5' proximal ORF1 (nucleotides 28 to 4218) exhibited significant identity and possessed consensus sequences characteristic of the helicase, cysteine protease, and RNA-dependent RNA polymerase sequence motifs from picornaviruses, picorna-like viruses, comoviruses, caliciviruses, and sequiviruses. The predicted amino acid sequence of the 3' proximal ORF2 (nucleotides 4390-7803) showed similarity to structural proteins in picorna-like viruses, especially the acute bee paralysis virus. Electron microscopic examination of negatively stained samples from virus-infected fire ants revealed isometric particles with a diameter of 31 nm, consistent with Picornaviridae. A survey for the fire ant virus from areas around Florida revealed a pattern of fairly widespread distribution. Among 168 nests surveyed, 22.9% were infected. The virus was found to infect all fire ant caste members and developmental stages, including eggs, early (1st-2nd) and late (3rd-4th) instars, worker pupae, workers, sexual pupae, alates ( male symbol and female symbol ), and queens. The virus, tentatively named S. invicta virus (SINV-1), appears to belong to the picorna-like viruses. We did not observe any perceptible symptoms among infected nests in the field. However, in every case where an SINV-1-infected colony was excavated from the field with an inseminated queen and held in the laboratory, all of the brood in these colonies died within 3 months.

Putative protease inhibitor gene discovery and transcript profiling during fruit development and leaf damage in grapefruit (Citrus paradisi Macf.).

Seven putative protease inhibitor (PPI) cDNAs, representing four protein families, were isolated from a grapefruit (Citrus paradisi Macf. Cv. Marsh) immature fruit flavedo cDNA library. Cloned open reading frames encoded proteins with similarity to, and protein signatures for: legume Kuntiz inhibitors (lkiL-1, lkiL-2, lkiL-3), potato trypsin inhibitor I (ptiIL-1), serpins (serpL-1), cystatins (cystL-1), and gamma thionins (gthL-1). Response of transcript abundance to fruit development and leaf wounding was determined for all but lkiL-1 using real-time RT-PCR. Immature leaves had the highest transcript levels for all PPIs. The gthL-1 transcript in immature leaves was the most abundant transcript but was absent from healthy mature leaves. In fruit flavedo, transcripts for all PPIs were most abundant in youngest fruit (<15 mm dia. fruit), and declined during development, but displayed different patterns of developmental change. Mechanical or Diaprepes root weevil (DRW) feeding damage to leaves caused a <10-fold reduction or had no effect on transcript level with the exception of gthL-1 which, as a result of damage, increased >50-fold in mature leaves and decreased >1400-fold in immature leaves. This developmental control of transcript response to wounding in a woody perennial is opposite of what has been observed for defensive proteinase inhibitors (PIs) in other plants (typically herbaceous and/or annual plants), where younger leaves typically invoke a higher defensive proteinase inhibitor transcript accumulation than older tissues. Except for gthL-1, the PPI transcripts were minimally responsive or unresponsive to wounding. Changes in PPI transcript levels suggest diverse roles for the products of these genes in citrus, with only gthL-1 responding in a defense-like manner.