Establishment of a Genetically Diverse, Disease-Resistant Acacia koa A. Gray Seed Orchard in Kokee, Kauai: Early Growth, Form, and Survival

Background and Objectives: Koa (Acacia koa A. Gray) is an economically, ecologically, and culturally valuable tree species endemic to Hawaii. A vascular wilt disease caused by the fungal pathogen Fusarium oxysporum f. sp. koae Gardner (FOXY) induces high rates of mortality in plantings and threatens native koa forests as well. Landowners are reluctant to consider koa for reforestation purposes in many areas due to the risk of mortality caused by FOXY. Producing seeds with genetic resistance to FOXY is vital to successful koa reforestation and restoration. The Hawaii Agriculture Research Center (HARC), with both public and private partners, operates a tree improvement program to develop wilt-resistant koa populations in Hawaii. The population genetics of koa is poorly understood and seed zones are evolving. Thus, HARC uses provisional seed zones based on genetic and biogeographic variables and has selected wilt-resistant koa populations that are locally found in Kokee, Kauai (eco-regions) of Hawaii. Materials and Methods: To make these selections, virulent FOXY isolates were used in previous seedling inoculation trials to evaluate resistance levels among koa families in greenhouse experiments, and the most resistant families were used in the field trial reported here. Results: In this trial, survival rates two years after planting varied by family, and ranged from 45% to 95%, but all resistant families had greater survival rates than the susceptible control (25%). The trial has been converted to a seed orchard. Conclusions: The higher survival rates of the families are encouraging and seeds coming from the orchard will improve the success of future restoration and reforestation efforts. Within these resistant families it was also possible to make some selections based on height, growth, diameter, and stem form. Thus, the establishment of a wilt-resistant seed orchard results in locally adapted, eco-region specific, disease-resistant koa seed that will allow for the restoration of this iconic species and provide plant material for commercial reforestation opportunities at the landscape level.

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Racial and Sex Disparities in Trauma Outcomes Based on Geographical Region

The American Surgeon ◽

10.1177/0003134820960063 ◽

2020 ◽

pp. 000313482096006

Author(s):

William Q. Duong ◽

Areg Grigorian ◽

Cyrus Farzaneh ◽

Jeffry Nahmias ◽

Theresa Chin ◽

...

Keyword(s):

United States ◽

The United States ◽

Trauma Patients ◽

Improvement Program ◽

Trauma Outcomes ◽

Risk Of Death ◽

Hospital Access ◽

Risk Of Mortality ◽

Sex Disparities ◽

Male Patients

Objectives Disparities in outcomes among trauma patients have been shown to be associated with race and sex. The purpose of this study was to analyze racial and sex mortality disparities in different regions of the United States, hypothesizing that the risk of mortality among black and Asian trauma patients, compared to white trauma patients, will be similar within all regions in the United States. Methods The Trauma Quality Improvement Program (2010-2016) was queried for adult trauma patients, separating by U.S. Census regions. Multivariable logistic regression analyses were performed for each region, controlling for known predictors of morbidity and mortality in trauma. Results Most trauma patients were treated in the South (n = 522 388, 40.7%). After risk adjustment, black trauma patients had a higher associated risk of death in all regions, except the Northeast, compared to white trauma patients. The highest associated risk of death for blacks (vs. whites) was in the Midwest (odds ratio [OR] 1.30, P < .001). Asian trauma patients only had a higher associated risk of death in the West (OR 1.39, P < .001). Male trauma patients, compared to women, had an increased associated risk of mortality in all four regions. Discussion This study found major differences in outcomes among different races within different regions of the United States. There was also both an increased rate and associated risk of mortality for male patients in all regions. Future prospective studies are needed to identify what regional differences in trauma systems including population density, transport times, hospital access, and other trauma resources explain these findings.

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Abstract 252: The Association of Award Recognition From Get With the Guidelines-Resuscitation with Improved Survival Rates in In-Hospital Cardiac Arrest Events

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.9.suppl_2.252 ◽

2016 ◽

Vol 9 (suppl_2) ◽

Author(s):

Kathie Thomas ◽

Art Miller ◽

Greg Poe

Keyword(s):

Cardiac Arrest ◽

Quality Improvement ◽

Survival Rate ◽

Discharge Rate ◽

Survival Rates ◽

Improvement Program ◽

Award Winning ◽

National Survival ◽

Get With The Guidelines ◽

Hospital Cardiac Arrest

Background and Objectives: It is estimated that over 200,000 adults experience in-hospital cardiac arrest each year. Overall survival to discharge has remained relatively unchanged for decades and survival rates remain at about 20% (Elenbach et al., 2009). Get With The Guidelines-Resuscitation (GWTG-R) is an in-hospital quality improvement program designed to improve adherence to evidence-based care of patients who experience an in-hospital resuscitation event. GWTG-R focuses on four achievement measures. The measures for adult patients include time to first chest compression of less than or equal to one minute, device confirmation of correct endotracheal tube placement, patients with pulseless VF/VT as the initial documented rhythm with a time to first shock of less than or equal to two minutes, and events in which patients were monitored or witnessed at the time of cardiac arrest. The objective of this abstract is to examine the association between hospital adherence to GWTG-R and in-hospital cardiac arrest survival rates. Methods: A retrospective review of adult in-hospital cardiopulmonary arrest (CPA) patients (n=1849) from 21 Michigan, Illinois, and Indiana hospitals using the GWTG-R database was conducted from January 2014 through December 2014. This study included adult CPA patients that did and did not survive to discharge. Results: The review found that hospitals that had attained 84.6% or higher thresholds in all four achievement measures for at least one year, which is award recognition status, had a significantly improved in-hospital CPA survival to discharge rate of 29.6%. Hospitals that did not obtain award status had a CPA survival to discharge rate of 24.3%. The national survival rate for in-hospital adult CPA survival to discharge is 20%. Hospitals that did not achieve award recognition status still demonstrated improvement in survival rate when compared to the national survival rate, indicating the importance of a quality improvement program such as GWTG-R. No significant difference was found between in-hospital adult CPA survival rate and race between GWTG-R award winning and non-award winning hospitals. Hospitals that earned award recognition from GWTG-R had a survival to discharge rate of 30.2% for African Americans and 29.6% for whites. Hospitals that were did not earn award recognition from GWTG-R had a survival to discharge rate of 20.0% for African Americans and 20.1% for whites. Conclusions: Survival of in-hospital adult CPA patients improved significantly when GWTG-R measures are adhered to. Survival of in-hospital adult CPA patients also improves with implementation of GWTG-R. It is crucial that hospitals collect and analyze data regarding resuscitation processes and outcomes. Quality improvement measures can then be implemented in order to assist with improving in-hospital CPA survival rates.

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P1377ANEMIA MANAGEMENT IN DIALYSIS PATIENTS IN SWITZERLAND

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1377 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Rebecca Winzeler ◽

Patrice Max Ambühl

Keyword(s):

Odds Ratio ◽

Cox Regression ◽

Reference Group ◽

Survival Rates ◽

Age Groups ◽

Age Group ◽

Dialysis Patients ◽

Public And Private ◽

Anemia Management ◽

Kdigo Guidelines

Abstract Background and Aims Anemia is highly prevalent in dialysis patients and is associated with increased morbidity and mortality. The purpose of the present analysis is to evaluate current anemia management in dialysis patients in Switzerland collected from the Swiss Dialysis Registry (srrqap), which covers all dialysis patients in Switzerland. Method All medical establishments in Switzerland (both public and private; N=92) providing chronic treatment by either hemo- and/or peritoneal dialysis, had to provide relevant data for the year 2018. All individuals being on chronic dialytic therapy in the year 2018 were enrolled (N=4646). To calculate survival probabilities, all deaths from incident dialysis patients between 2014 and 2018 were analyzed. Results: 65 percent of all dialysis patients receive iron and EPO. Regardless of anemia management, 82% of patients reach target hemoglobin levels 10 g/dL. In 18% of patients inadequate management to reach Hb targets may be suspected. The distribution of iron and EPO substitution is similar in all age groups. However, 26% of the age group 20-44 years receive EPO, but no iron, compared to only 15% in the other age groups. Survival analysis by Cox regression adjusted for age, Charlson score and treatment modality revealed that patients with Hb levels equal or greater than 11 g/dl have the best survival (reference group). In comparison, patients in the Hb categories below 9, 9-9.9 and 10-10.9 g/dl have an odds ratio of 3.9, 2.0 and 1.3, respectively, to die. Conclusion Anemia management to reach Hb target levels following KDIGO guidelines seems to be adequately implemented among dialysis patients in Switzerland. In 18% of patients treatment might be optimized to achieve Hb targets. As expected, patients with Hb levels equal or greater than 11 g/dl have better survival rates compared to patients with lower Hb values.

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Clinical Course, Prognosis, and Causes of Death in Mixed Connective Tissue Disease

The Journal of Rheumatology ◽

10.3899/jrheum.121272 ◽

2013 ◽

Vol 40 (7) ◽

pp. 1134-1142 ◽

Cited By ~ 36

Author(s):

Agota Hajas ◽

Peter Szodoray ◽

Britt Nakken ◽

Janos Gaal ◽

Eva Zöld ◽

...

Keyword(s):

Connective Tissue ◽

Connective Tissue Disease ◽

Mixed Connective Tissue Disease ◽

Cardiovascular Events ◽

Causes Of Death ◽

Survival Rates ◽

Prognostic Indicators ◽

Mortality Data ◽

Risk Of Mortality ◽

Cardiovascular Morbidity And Mortality

Objective.To study the survival rate and prognostic indicators of mixed connective tissue disease (MCTD) in a Hungarian population.Methods.Two hundred eighty patients with MCTD diagnosed between 1979 and 2011 were followed prospectively. Clinical features, autoantibodies, and mortality data were assessed. Prognostic factors for survival were investigated and survival was calculated from the time of the diagnosis by Kaplan-Meier method.Results.A total of 22 of 280 patients died: the causes of death were pulmonary arterial hypertension (PAH) in 9 patients, thrombotic thrombocytopenic purpura in 3, infections in 3, and cardiovascular events in 7. The 5, 10, and 15-year survival rates after the diagnosis was established were 98%, 96%, and 88%, respectively. The deceased patients were younger at the diagnosis of MCTD compared to patients who survived (35.5 ± 10.4 vs 41.8 ± 10.7 yrs; p < 0.03), while there was no difference in the duration of the disease (p = 0.835). Our cohort study showed that the presence of cardiovascular events (p < 0.0001), esophageal hypomotility (p = 0.04), serositis (p < 0.001), secondary antiphospholipid syndrome (p = 0.039), and malignancy (p < 0.001) was significantly higher in the deceased patients with MCTD. The presence of anticardiolipin (p = 0.019), anti-β2-glycoprotein I (p = 0.002), and antiendothelial cell antibodies (p = 0.002) increased the risk of mortality.Conclusion.Overall, PAH remained the leading cause of death in patients with MCTD. The prevalence of cardiovascular morbidity and mortality, malignancy, and thrombotic events increased during the disease course of MCTD. The presence of antiphospholipid antibodies raised the risk of mortality.

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Eastern Black Walnut (Juglans nigra L.) Originating From Native Range Varies in Their Response to Inoculation With Geosmithia morbida

Frontiers in Forests and Global Change ◽

10.3389/ffgc.2021.627911 ◽

2021 ◽

Vol 4 ◽

Author(s):

Rachael A. Sitz ◽

Emily K. Luna ◽

Jorge Ibarra Caballero ◽

Ned A. Tisserat ◽

Whitney S. Cranshaw ◽

...

Keyword(s):

United States ◽

Genetic Resistance ◽

Common Garden ◽

The United States ◽

Black Walnut ◽

Native Range ◽

Management Options ◽

Improvement Program ◽

Geosmithia Morbida ◽

Walnut Twig Beetle

Thousand cankers disease (TCD) is caused by the walnut twig beetle (Pityophthorus juglandis) vectoring the fungal canker pathogen Geosmithia morbida, which can result in severe dieback and eventual death to species of walnut (Juglans spp.) and wingnut (Pterocarya spp.). This disease is most devastating to the highly valued species J. nigra (black walnut). This species is primarily grown and harvested for timber production in the Central Hardwood Region of the United States, which comprises part of its native range. Management options for TCD are limited; therefore, finding resistant genotypes is needed. Initial studies on black walnut susceptibility to G. morbida documented some genetic variation and suggested potential resistance. Furthermore, G. morbida is thought to be native to the United States, which may have allowed for co-evolution. To capture the representative genetic diversity and screen for resistance to G. morbida, J. nigra families were collected from across the native range. These wild trees, in conjunction with seedlings developed in a black walnut timber improvement program, were planted in a common garden in Fort Collins, Colorado and repeatedly inoculated with G. morbida over the course of four years and three growing seasons. Improved seedlings exhibited larger cankered areas than wild J. nigra of the same provenance. Cankers induced by G. morbida in wild germplasm were smaller on J. nigra collected from the western and central portions of the native range compared to those collected from the eastern portion. Although trees from the western and central part of the range still incurred cankers, our findings indicate that variation in genetic resistance to G. morbida is present in black walnut. This study was performed with G. morbida independent of the walnut twig beetle, but our results suggest the limited G. morbida resistance observed in J. nigra will prevent the full compromise of black walnut to TCD. Results from this study should be taken into consideration in future black walnut breeding programs.

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Long-term survival in patients with isolated pulmonary valve stenosis: a not so benign disease?

Open Heart ◽

10.1136/openhrt-2021-001836 ◽

2021 ◽

Vol 8 (2) ◽

pp. e001836

Author(s):

Kristofer Skoglund ◽

Annika Rosengren ◽

Georgios Lappas ◽

Maria Fedchenko ◽

Zacharias Mandalenakis

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Early Diagnosis ◽

Congenital Heart ◽

Pulmonary Valve ◽

Survival Rates ◽

Pulmonary Valve Stenosis ◽

Term Survival ◽

Risk Of Mortality

Background and objectivesDuring the last decades, the survival rates in patients with congenital heart disease have increased dramatically, particularly in patients with complex heart malformations. However, the survival in patients with simple defects is still unknown. We aimed to determine the characteristics and the risk of mortality in patients with isolated pulmonary valve stenosis (PS).MethodsSwedish inpatient, outpatient and cause of death registries were used to identify patients born between 1970 and 2017 with a diagnosis of PS, without any other concomitant congenital heart lesion. For each patient with PS, 10 control individuals without congenital heart disease were matched by birth year and sex from the total population registry. We used median-unbiased method and Kaplan-Meier survival analysis to examine the risk of mortality.ResultsWe included 3910 patients with PS and 38 770 matched controls. The median age of diagnosis of PS was 0.7 years (IQR 0.3–7.0). During a median follow-up of 13.5 years (IQR 6.5–23.5), 88 patients with PS and 192 controls died; 500 patients with PS (12%) underwent at least one transcatheter or surgical valve intervention. The overall mortality rate was significantly higher in patients with PS compared with matched controls (HR 4.67, 95% CI 3.61 to 5.99, p=0.001). Patients with an early diagnosis of PS (0–1 year) had the highest risk of mortality (HR 10.99, 95% CI 7.84 to 15.45).ConclusionsIn this nationwide, register-based cohort study, we found that the risk of mortality in patients with PS is almost five times higher compared with matched controls. Patients with an early diagnosis of PS appears to be the most vulnerable group and the regular follow-up in tertiary congenital heart units may be the key to prevention.

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The Impact of Comorbidity Burden on The Association between Vascular Access Type and Clinical Outcomes among Elderly Patients Undergoing Hemodialysis

Scientific Reports ◽

10.1038/s41598-019-54191-1 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 2

Author(s):

Jong Hyun Jhee ◽

Seun Deuk Hwang ◽

Joon Ho Song ◽

Seoung Woo Lee

Keyword(s):

Vascular Access ◽

Survival Rates ◽

Hemodialysis Patients ◽

Korean Society ◽

Hospitalization Rates ◽

Risk Of Mortality ◽

Increased Risk ◽

Comorbidity Burden ◽

The Impact ◽

Elderly Hemodialysis Patients

AbstractThe optimal vascular access type for elderly hemodialysis patients is controversial. We evaluated the impact of comorbidity burden on the association between vascular access type and mortality risk among 23,100 hemodialysis patients aged ≥65 years from the Korean Society of Nephrology End-Stage Renal Disease registry data. Subjects were stratified into tertiles according to the simplified Charlson comorbidity index (sCCI), and the survival and hospitalization rates were compared with respect to vascular access type: arteriovenous fistula (AVF), arteriovenous graft (AVG), and central venous catheter (CVC). Among all tertiles of sCCI, CVC use showed highest risk of mortality than AVF use. In the lowest to middle tertile, no difference was observed in survival rates between the use of AVF and AVG. However, in the highest tertile, AVG use showed higher risk of mortality than AVF use. When subjects were classified according to a combination of sCCI tertile and access type (AVF vs. AVG), patients with the highest CCI with AVG showed 1.75-folded increased risk of mortality than those with the lowest sCCI with AVF. Hospitalization rates due to access malfunction were highest in patients with CVC in all sCCI tertiles. In the highest tertile, patients with AVG showed increased rates of hospitalization compared to those with AVF due to access malfunction. However, hospitalization rates due to access infection were highest in patients with AVG in all tertiles. The use of AVF may be of benefit and switching to AVF should be considered in elderly hemodialysis patients with a high burden of comorbidity.

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ESTIMATIVAS DE PARÂMETROS GENÉTICOS PARA CARACTERES QUANTITATIVOS EM PROGÊNIES DE POLINIZAÇÃO ABERTA DE Eucalyptus urophylla

FLORESTA ◽

10.5380/rf.v41i4.25348 ◽

2011 ◽

Vol 41 (4) ◽

Cited By ~ 2

Author(s):

Cidinei Santos de Souza ◽

Miguel Luiz Menezes Freitas ◽

Mário Luiz Teixeira de Moraes ◽

Alexandre Magno Sebbenn

Keyword(s):

Quantitative Traits ◽

Seed Orchard ◽

Tree Breeding ◽

Eucalyptus Urophylla ◽

Effective Population ◽

Stem Form ◽

Lattice Design ◽

Seedling Seed Orchard ◽

Introduced Populations ◽

Test Tree

Eucalyptus urophylla S. T. Blake destaca-se pelo potencial de utilização de sua madeira, plasticidade de adaptação a diferentes condições ambientais e por ser tolerante ao cancro. Entretanto, o melhoramento genético da espécie no Brasil depende da existência de variabilidade genética nas populações introduzidas. O objetivo deste estudo foi investigar a variação genética e estimar ganhos na seleção para caracteres quantitativos de uma população base de E. urophylla instalada em 1992 em Selvíria (MS). O teste de progênies foi instalado no delineamento experimental em Látice 8 x 8, quíntuplo, parcialmente balanceado, com 64 progênies provenientes da Estação Experimental de Anhembi (IPEF/ESALQ/USP). As parcelas continham oito árvores, no espaçamento de 3 x 3 m. Foram detectadas variações genéticas entre progênies para diâmetro à altura do peito (DAP), tipo de casca, forma e sobrevivência. As estimativas de herdabilidade, em nível de média, foram altas para DAP, tipo de casca e forma, variando de 0,50 a 0,85. A seleção pelo índice multiefeitos demonstrou que o número variável de plantas por progênie foi mais indicada para a maximização de ganhos genéticos (7,24%) e tamanho efetivo populacional (69,3). Esses resultados subsidiarão a transformação do teste em pomar de sementes por mudas e fornecimento de material para formação de pomar de sementes clonal.Palavras-chave: Ganhos na seleção; herdabilidade; melhoramento genético; variância genética. AbstractEstimates of genetic parameters for quantitative traits in open-pollinated families of Eucalyptus urophylla. Eucalyptus urophylla S. T. Blake is outstanding for valuable wood production potential, adaptation plasticity for different environmental conditions, and for tolerance to canker. However, genetic improvement of this specie in Brazil depends on the existence of genetic variability in the introduced populations. The objective of this study was to investigate the genetic variation and gains in quantitative traits in a population established in 1992 in Selvíria - MS. The progeny trial was established in a partially balanced, 8 x 8 lattice design, with 64 families, collected at Anhembi Experimental Station (IPEF/ESALQ/USP). Each plot was made up of eight trees planted in a 3 x 3 m spacing. Significant among families genetic variations were observed in diameter at breast height (DBH), bark type, stem form, and survival. Estimates of average family heritability were high for all traits, ranging from 0.50 to 0.85. The simulated selection by using multi-effect index showed that under a varying number of plants per family. This method is the most indicated to maximize genetic gains (7.24%) and the effective population size (69.3). These results are a useful support for the transformation of this test into a seedling seed orchard and to become a source of vegetative material to build a clonal seed orchard.Keywords: Heritability; gains in selection; genetic variance; progeny test; tree breeding.

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Specimen Collection Volumes for Laboratory Tests

Archives of Pathology & Laboratory Medicine ◽

10.5858/2003-127-162-scvfl ◽

2003 ◽

Vol 127 (2) ◽

pp. 162-168 ◽

Cited By ~ 8

Author(s):

Jane C. Dale ◽

Stephen G. Ruby

Keyword(s):

Blood Cell ◽

Laboratory Tests ◽

Private Institutions ◽

Routine Laboratory ◽

Improvement Program ◽

Public And Private ◽

Cell Counts ◽

Clinical Laboratories ◽

Blood Cell Counts ◽

Specimen Collection

Abstract Context.—Unnecessary tests, inefficient ordering practices, and collection of more blood than is required for testing contribute to iatrogenic anemia in hospitalized patients. Laboratories accredited by the College of American Pathologists are expected to review phlebotomy practices for specimen collection volumes periodically. Objective.—To report specimen collection, analytic, and discard volumes for routine laboratory tests and to identify practice variables associated with overcollection and blood wastage. Design.—Clinical laboratories participating in the College of American Pathologists Q-Probes laboratory improvement program recorded collection container size, laboratory-defined requested volume, manufacturer-defined analytic volume, and average discard volume for routine complete blood cell counts and electrolyte panels ordered for patients in intensive care units. Participants provided information about their specimen collection, processing, and analytic practices in a questionnaire. Setting and Participants.—A total of 140 public and private institutions. Main Outcome Measures.—Overcollections for routine collections and for situations in which a reduced volume of specimen is collected, and average discard volume per tube. Results.—Laboratories collected a median of 2.76 mL (or 8.5 times) more than their instrument's analytic volume for routine complete blood cell counts and 1.75 mL (or 12 times) more than their instrument's analytic volume for routine electrolyte panels. For clinical situations in which reduced collection volumes were necessary, overcollection for the same analytes was 0.5 mL (3 times) and 0.44 mL (4.2 times), respectively. The median discard volume was 2.8 mL/tube for complete blood cell counts and 2.0 mL/tube for electrolyte panels. Specimen collection container size was directly associated with overcollections and discard volumes. Instrument analytic volume was not a determinant of blood wastage. Conclusions.—Most laboratories can decrease collection volumes without compromising the ability of the laboratory to report a reliable and timely result. Use of smaller collection tubes can help reduce blood wastage.

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