Alteration in emergency theatre prioritisation does not alter outcome for acute appendicitis: comparative cohort study.

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.BACKGROUND: Despite dedicated emergency theatre, emergency surgery can be often delayed due to competing urgencies, suggesting a need for innovative theatre time management. AIM: To investigate if a change in the emergency theatre prioritisation affects outcomes for a common urgent operation such as appendicectomy. METHODS: We prospectively recorded data from 67 patients undergoing appendicectomy, for two cohorts of patients: before and after change in theatre prioritisation: Group 1 (Jan-Mar) and 2 (Aug-Oct) respectively. Demographic and peri-operative data, time from admission to surgery, postoperative length of stay and total length of stay and complications were compared. RESULTS: The two groups were comparable with regards to gender, age, time of admission and histological confirmation of appendicitis. No differences between the two groups were found regarding time from admission to surgery (24.4 (95% CI 11.2;27.6) hours versus 16.1 (95% CI 10.4;21.7) hours, Mann-Whitney U test, p = 0.35), postoperative length of stay (90.8 (95% CI 61.4;120.1) hours versus 70 (95% CI 48.3;91.6) hours, Mann-Whitney U test, p = 0.25) and total length of stay (115.2 (95% CI 84.6;145.7) hours versus 86 (95% CI 61.6;110.4) hours, Mann-Whitney U test, p = 0.07) as well as complication or re-admission rates. CONCLUSION: A change in the emergency theatre prioritisation does not affect outcome for appendicectomy. Provision of a second emergency theatre could be a solution to reduce the delays in acute surgical operations

Prognostic impact of Ki-67 proliferative index in resectable pancreatic ductal adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease characterized by complex biological features and poor prognosis. A prognostic stratification of PDAC would help to improve patient management. The aim of this study was to analyse the expression of Ki-67 in relation to prognosis in a cohort of patients with PDAC who had surgical treatment

Biometric traits as a tool for the identification and breeding of coffea canephora genotypes

grants n. 84320893 grants n. 420789/2016-2 n. 304687/2017-0 E-26/202.323/2017 UID/04129/2020 UIDP/04035/2020Cross-pollination and gametophytic self-incompatibility reduce the stability of Coffea canephora genotypes. This is an important crop for Brazil, the largest producer of this type of coffee and also a major exporter. The study of biometric characteristics is essential to assist in the selection of promising plant materials. We examined the diversity of morpho-agronomic traits of genotypes of C. canephora cv. Conilon through the evaluation of branch and leaf parameters. Assessments included plagiotropic branch length, number of nodes in plagiotropic branches, distance between nodes in plagiotropic branches, orthotropic branch length, number of nodes in orthotropic branch, distance between nodes in orthotropic branch, plant height, canopy diameter, leaf length, leaf width, and leaf area in two periods. The data from the 43 coffee genotypes were tested by multivariate and cluster analyses. Six groups were formed by the Tocher optimization method, and five groups by the unweighted pair group method with arithmetic mean (UPGMA) hierarchical method, suggesting an important genetic variability among plant materials. Both Tocher optimization and UPGMA hierarchical methods were consistent for clustering the genotypes, ordering them in six and five dissimilar groups, respectively, with genotypes 25 and 37 standing out with the greatest dissimilarity, constituting isolated groups by both methods. Pearson’s correlation ranged from very weak to very strong, positive and negative, among the characteristics, as also shown by principal component analyses. These analyses indicated the morpho-agronomic traits with a greater degree of correlation, assisting in the choice of promising plant materials. The genetic parameters estimates demonstrate genetic variability and thus breeding potential within the Conilon coffee genotypes studied. These results emphasize the usefulness of biometric evaluations as a tool for the identification and breeding of genotypes to compose new Conilon coffee cultivars.publishersversionpublishe

Antecipação do período de diagnose foliar em laranjeira 'Pêra' no Amazonas.

O objetivo deste trabalho foi avaliar a possibilidade de se antecipar o período de realização da diagnose foliar em laranjeira 'Pêra'. Vinte e sete pomares representativos da região produtora de laranja do Estado do Amazonas foram monitorados durante o ano agrícola de 2011/2012. Foram realizadas diagnoses da composição nutricional (CND) em amostras foliares retiradas durante a floração e quando a árvore apresentava frutos com três e seis meses de idade (época tradicional para o monitoramento nutricional). Pomares com produtividade superior a 25 Mg ha‑1 foram selecionados para o estabelecimento dos padrões de referência. O estado nutricional da laranja variou com o estádio fenológico no qual se realizou a amostragem foliar, o que fez com que fosse necessário estabelecer normas CND para cada período. Com a antecipação da diagnose para o período de floração, observouse aumento nas concentrações foliares de N, P, K e Cu diminuição e nas de Ca. A antecipação da diagnose foliar em laranja 'Pêra' depende da geração de padrões nutricionais CND específicos para cada época de amostragem

Recurrence of Pancreatic Neuroendocrine Tumors and Survival Predicted by Ki67

Background: Despite evidence of different malignant potentials, postoperative follow-up assessment is similar for G1 and G2 pancreatic neuroendocrine tumors (panNETs) and adjuvant treatment currently is not indicated. This study investigated the role of Ki67 with regard to recurrence and survival after curative resection of panNET. Methods: Patients with resected non-functioning panNET diagnosed between 1992 and 2016 from three institutions were retrospectively analyzed. Patients who had G1 or G2 tumor without distant metastases or hereditary syndromes were included in the study. The patients were re-categorized into Ki67 0–5 and Ki67 6–20%. Cox regression analysis with log-rank testing for recurrence and survival was performed. Results: The study enrolled 241 patients (86%) with Ki67 0–5% and 39 patients (14%) with Ki67 6–20%. Recurrence was seen in 34 patients (14%) with Ki67 0–5% after a median period of 34 months and in 16 patients (41%) with Ki67 6–20% after a median period of 16 months (p < 0.001). The 5-year recurrence-free and 10-year disease-specific survival periods were respectively 90 and 91% for Ki67 0–5% and respectively 55 and 26% for Ki67 6–20% (p < 0.001). The overall survival period after recurrence was 44.9 months, which was comparable between the two groups (p = 0.283). In addition to a Ki67 rate higher than 5%, tumor larger than 4 cm and lymph node metastases were independently associated with recurrence. Conclusions: Patients at high risk for recurrence after curative resection of G1 or G2 panNET can be identified by a Ki67 rate higher than 5%. These patients should be more closely monitored postoperatively to detect recurrence early and might benefit from adjuvant treatment. A clear postoperative follow-up regimen is proposed

Overexpression of water-responsive genes promoted by elevated CO2 reduces ROS and enhances drought tolerance in Coffea species

Drought is a major constraint to plant growth and productivity worldwide and will aggravate as water availability becomes scarcer. Although elevated air [CO2] might mitigate some of these effects in plants, the mechanisms underlying the involved responses are poorly understood in woody economically important crops such as Coffea. This study analyzed transcriptome changes in Coffea canephora cv. CL153 and C. arabica cv. Icatu exposed to moderate (MWD) or severe water deficits (SWD) and grown under ambient (aCO2) or elevated (eCO2) air [CO2]. We found that changes in expression levels and regulatory pathways were barely affected by MWD, while the SWD condition led to a down-regulation of most differentially expressed genes (DEGs). eCO2 attenuated the impacts of drought in the transcripts of both genotypes but mostly in Icatu, in agreement with physiological and metabolic studies. A predominance of protective and reactive oxygen species (ROS)-scavenging-related genes, directly or indirectly associated with ABA signaling pathways, was found in Coffea responses, including genes involved in water deprivation and desiccation, such as protein phosphatases in Icatu, and aspartic proteases and dehydrins in CL153, whose expression was validated by qRT-PCR. The existence of a complex post-transcriptional regulatory mechanism appears to occur in Coffea explaining some apparent discrepancies between transcriptomic, proteomic, and physiological data in these genotypes.info:eu-repo/semantics/publishedVersio

DAXX mutations as potential genomic markers of malignant evolution in small nonfunctioning pancreatic neuroendocrine tumors

Management of localized well-differentiated pancreatic neuroendocrine tumors (panNETs) is controversial and primarily dependent on tumor size. Upfront surgery is usually recommended for tumors larger than 2 cm in diameter since they frequently show metastatic potential, whereas smaller panNETs are generally characterized by an indolent clinical course, with a rate of relapse or metastasis below 15%. To explore whether increased tumor size is paralleled by genomic variations, we compared the rate and the mutational patterns of putative driver genes that are recurrently altered in these tumors by investigating differential cohorts of panNET surgical specimens smaller (n = 27) or larger than 2 cm (n = 29). We found that the cumulative number of mutations detected in panNETs &gt;2 cm was significantly higher (p = 0.03) relative to smaller tumors, while mutations of DAXX were significantly more frequent in the cohort of larger tumors (p = 0.05). Moreover, mutations of DAXX were associated with features of malignancy including increased grade, nodal involvement and lymphovascular invasion, and independently predicted both relapse after surgery (p = 0.05) and reduced DFS in multivariable analysis (p = 0.02). Our data suggest that alterations of the DAXX/ATRX molecular machinery increase the malignant potential of panNETs, and that identification of mutations of DAXX/ATRX in small, nonfunctioning tumors can predict the malignant progression observed in a minority of them

Understanding the Impact of Drought in Coffea Genotypes: Transcriptomic Analysis Supports a Common High Resilience to Moderate Water Deficit but a Genotype Dependent Sensitivity to Severe Water Deficit

Water scarcity is the most significant factor limiting coffee production, although some cultivars can still have important drought tolerance. This study analyzed leaf transcriptomes of two coffee cultivars with contrasting physiological responses, Coffea canephora cv. CL153 and Coffea. arabica cv. Icatu, subjected to moderate (MWD) or severe water deficits (SWD). We found that MWD had a low impact compared with SWD, where 10% of all genes in Icatu and 17% in CL153 reacted to drought, being mainly down-regulated upon stress. Drought triggered a genotype-specific response involving the up-regulation of reticuline oxidase genes in CL153 and heat shock proteins in Icatu. Responsiveness to drought also included desiccation protectant genes, but primarily, aspartic proteases, especially in CL153. A total of 83 Transcription Factors were found engaged in response to drought, mainly up-regulated, especially under SWD. Together with the enrollment of 49 phosphatases and 272 protein kinases, results suggest the involvement of ABA-signaling processes in drought acclimation. The integration of these findings with complementing physiological and biochemical studies reveals that both genotypes are more resilient to moderate drought than previously thought and suggests the existence of post-transcriptional mechanisms modulating the response to drought.info:eu-repo/semantics/publishedVersio

Genomic evaluation of Coffea arabica and its wild relative Coffea racemosa in Mozambique: settling resilience keys for the Coffee crop in the context of climate change

Climate change is negatively affecting the coffee value chain, with a direct effect on approximately 100 million people from 80 countries. This has been attributed to the high vulnerability of the two-mainstream species, Coffea arabica and Coffea canephora, to extreme weather events, with notable uneven increases in market prices. Taking into account the narrow genetic plasticity of the commercial coffee cultivars, wild-relatives and underutilized Coffea species are valuable genetic resources. In this work, we have assessed the occurrence of Coffea species in to understand the degree of genetic relationships between Coffea species in the country, as well as the patterns of genetic diversity, differentiation, and genetic structure. Only one wild species was found, C. racemosa, which showed a high level of genetic separation with C. arabica, based on plastid, as well as SSR and SNP analysis. C. arabica presented low levels of diversity likely related to their autogamous nature, while the allogamous C. racemosa presented higher levels of diversity and heterozygosity. The analysis of the functional pathways based on SNPs suggests that the stress signaling pathways are more robust in this species. This novel approach shows that it is vital to introduce more resilient species and increase genomic diversity in climate-smart practices.This researchwas funded by by Camões, Instituto da Cooperação e da Língua (CICL), Agência Brasileira de Cooperação (ABC), and ParqueNacional da Gorongosa (PNG), under the Triangular Project TriCafé (GorongosaCoffee), and by Fundação para a Ciência e a Tecnologia, I.P. (FCT)info:eu-repo/semantics/publishedVersio