Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Role of growth elicitors and microbes in stress management and sustainable production of Sorghum

Sorghum (Sorghum bicolor L. Moench) is an important tropical species of the Poaceae family with wide distribution in Africa, Asia, and Latin America. It is one of the significant cereal crops that is being cultivated widely across the world with diversified applications in various fields such as agriculture, beverage, and food industries. Because of its high nutritious values, it is being consumed as a source of carbohydrate by human beings, as an animal feed, and also utilized as a raw material by alcoholic and other industries. Hence, on the basis of ever-increasing human population size and most countries policies aimed at improving the processing and industrial usage of sorghum, the demand for its cultivation is rising in all the developing countries. On the other hand, the crop plants are facing the stressful environmental changes that are considerably affecting the metabolism, growth, and yield of Sorghum. In recent times, it has been observed that microbes and growth elicitors plays an important role in alleviating the plants response to stressful conditions. In view of this background, the present review paper provides an overview of the literature available on the role of growth elicitors and microbes that can increase the tolerance levels of Sorghum towards environmental stresses