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IntroductionAcute heart failure (AHF) is a critical, costly condition with high mortality rates, affecting millions annually. Despite advances in cardiovascular care, AHF treatment lacks robust evidence. AHF commonly manifests with sudden heart failure symptoms such as pulmonary congestion, and the pathophysiology involves fluid overload. Initial treatment is based on intravenous diuretics typically, but the optimal combination of drugs remains uncertain.Methods and analysisWe will systematically review randomised controlled trials enrolling patients with AHF and volume overload undergoing in-hospital diuretic treatment. We aim to investigate any diuretic intervention. Our search strategy includes the following databases: Embase, Medline, Latin American and Caribbean Health Sciences Literature, Web of Science and the Cochrane Central Register of Controlled Trials. The primary outcome is all-cause mortality. Secondary outcomes are serious adverse events, hospital readmission and kidney failure. Study results reported at the most extended follow-up will be used for all outcomes. If appropriate, we will conduct meta-analysis, trial sequential analysis and network meta-analysis.Ethics and disseminationNo ethics approval is required for this study. The results will be published in a peer-reviewed journal in this field.PROSPERO registration numberCRD42023463979.

BackgroundAcute heart failure (AHF) is a severe clinical syndrome associated with high morbidity and mortality. Effective management of congestion is a primary treatment goal and often requires hospitalisation. While loop-diuretics remain the cornerstone of AHF therapy, the optimal combination of diuretics to an effective decongestion remains uncertain. This systematic review aims to evaluate the efficacy and safety of various diuretic combinations compared with usual care in AHF patients.MethodsThe search was conducted across the databases: Medline, Embase, Latin American and Caribbean Health Sciences Literature, Web of Science, Scopus and The Cochrane Central Register of Controlled Trials. Network meta-analysis was used to compare the relative efficacy of different diuretic combinations. Trial sequential analysis (TSA) was conducted to evaluate the sufficiency of cumulative evidence for definitive conclusions. Risk of bias was assessed using the Cochrane Risk of Bias tool for randomised trials V.2. Statistical heterogeneity was evaluated via visual inspection of forest plots through the I² statistic. The primary outcome was all-cause mortality, and secondary outcomes included serious adverse events (SAEs), hospital readmissions and kidney failure. Exploratory outcomes included changes in body weight and urinary output.Results35 randomised clinical trials involving 11 743 patients were included. In pairwise meta-analyses, none of the diuretics demonstrated an influence on all-cause mortality, SAEs, hospital readmissions or kidney failure. Likewise, TSA showed no influence of combination therapy on mortality. Aggregate data meta-analyses revealed that combinations involving acetazolamide (−2.60 kg; 95% CI −4.23 to −0.97; p<0.001; I2=0.00%), thiazides (−0.80 kg; 95% CI −1.40 to −0.21; p=0.01; I2=38.53%) and vaptans (−1.00 kg; 95% CI −1.53 to −0.48; p<0.001; I2=89.53%) caused significant in-hospital body weight reduction, indicating enhanced decongestion. Network meta-analysis showed similar results, and TSA indicated that there was enough information to accept secondary diuretics influencing decongestion.ConclusionsCombination diuretic therapy improves short-term decongestion but does not reduce all-cause mortality, SAEs, hospital readmissions or kidney failure in patients with AHF.

Objectives: Elevated soluble urokinase Plasminogen Activator Receptor (suPAR) is a biomarker associated with adverse outcomes. We aimed to investigate the associations between plasma suPAR levels (testing the cut-offs ⩽4, 4-6, and ⩾6 ng/mL) with risk of 14-day mortality, and with the risk of mechanical ventilation in patients that tested positive for SARS-CoV-2. Methods: Observational cohort study of patients presenting with symptoms of COVID-19 at Department of Emergency Medicine, Amager and Hvidovre Hospital, Denmark from March 19th, 2020 to April 3rd, 2020. Plasma suPAR was measured using suPARnostic technologies. Patients were followed for development of mechanical ventilation and mortality for 14 days. Validation of our findings were carried out in a similar sized COVID-19 patient cohort from Mikkeli Central Hospital, Finland. Results: Among 386 patients with symptoms of COVID-19, the median (interquartile range) age was 64 years (46-77), 57% were women, median suPAR was 4.0 ng/mL (2.7-5.9). In total, 35 patients (9.1%) died during the 14 days follow-up. Patients with suPAR ⩽4 ng/mL (N = 196; 50.8%) had a low risk of mortality (N = 2; 1.0%; negative predictive value of 99.0%, specificity 55.3%, sensitivity 95.2%, positive predictive value 17.4%). Among patients with suPAR ⩾6 ng/mL (N = 92; 23.8%), 16 died (17.4%). About 99 patients (25.6%) tested positive for SARS CoV-2 and of those 12 (12.1%) developed need for mechanical ventilation. None of the SARS-CoV-2 positive patients with suPAR ⩽4 ng/mL (N = 28; 38.8%) needed mechanical ventilation or died. The Mikkeli Central Hospital validation cohort confirmed our findings concerning suPAR cut-offs for risk of development of mechanical ventilation and mortality. Conclusions: Patients with symptoms of COVID-19 and suPAR ⩽4 or ⩾6 ng/mL had low or high risk, respectively, concerning the need for mechanical ventilation or mortality. We suggest cut-offs for identification of risk groups in patients presenting to the ED with symptoms of or confirmed COVID-19.

Background Atrial fibrillation (AF) is associated with a higher incidence of stroke, heart failure, and mortality. Risk assessment of clinical outcomes in patients hospitalized acutely with AF remains a challenge. Purpose To investigate if soluble urokinase plasminogen activator receptor (suPAR) levels at admission to the Emergency Department (ED) are associated with 1‐year all‐cause mortality in patients admitted with AF. Methods A prospective cohort study of patients consecutively admitted to the medical ED of a university hospital in Copenhagen, Denmark, between 2020 and 2022 with symptoms of COVID‐19. Patients were included if they were admitted with AF as the primary or secondary diagnosis. All patients had suPAR measured at the index admission, and follow‐up was up to 1 year. The association between suPAR and 1‐year mortality was investigated with multivariate Cox regression. We adjusted for age, sex, smoking, C‐reactive protein, creatinine, hemoglobin, albumin, and comorbidities. Results Of the 7,258 patients included during the period, 362 (5.0%) patients were admitted with AF as the primary or secondary diagnosis. Due to missing data, 23 (6.4%) patients were excluded. Among the remaining 339 patients, 68 (20.1%) patients were dead at follow‐up. The multivariate Cox regression showed that elevated suPAR was independently associated with an increased risk of 1‐year mortality, with a hazard ratio of 1.12 (95% confidence interval: 1.05–1.20, p < 0.001). Conclusion Elevated suPAR levels were significantly associated with 1‐year all‐cause mortality in patients acutely admitted with AF to the ED. In an observational study with 339 patients admitted acutely to an Emergency Department with atrial fibrillation, elevated levels of the inflammatory biomarker, soluble urokinase plasminogen activator receptor (suPAR), measured upon admission, were significantly associated with 1‐year all‐cause mortality. Kaplan–Meier plot showing the association between suPAR, stratified according to intervals (≤4ng/mL, 4–6ng/mL, ≥6 ng/mL, and survival probability). suPAR, soluble urokinase plasminogen activator receptor.

The use of accent lighting in retail stores has focused illumination on potatoes for greater consumer awareness. Unfortunately, this directed light on displayed potatoes may impact the rate or level of tuber greening. The objective of this study was to evaluate the influence of various retail accent light sources on greening and quality of illuminated tubers. Two separate experiments exposed ‘Russet Burbank’ potato tubers to fiber optic, ceramic metal halide, fluorescent, fluorescent with filter lighting (experiment 1) and fiber optic, halogen, and fluorescent lighting (experiment 2). In each experiment, tubers were exposed to a consistent light intensity (1390 lx in experiment 1 and 1300 lx in experiment 2) in addition to a dark control. Tubers were illuminated for 22 h per day at an ambient room temperature of 22 C. Six randomly selected tubers were evaluated for level of greening, chlorophyll concentration, and weight loss at day 0, 2, 4, 7, and 9. Total glycoalkaloid content was analyzed at days 0 and 9. In experiment 1, the fiber optic and fluorescent illuminated tubers showed significantly lower chlorophyll content compared to the ceramic metal halide light source. There was no significant difference in chlorophyll level or greening rating between the fluorescent light source and fluorescent with filter. In experiment 2, the fiber optic illuminated tubers had lower chlorophyll content and less visual greening compared to the halogen illuminated tubers. Total glycoalkaloids were not significantly impacted by light source. The use of fiber optic lighting or a combination of fiber optic lighting with standard fluorescent lighting would retard the progression of greening in the retail store yet potentially highlight the commodity for consumer eye-appeal.

Potato psyllid (Bactericera cockerelli Sulc)-transmitted \"Candidatus Liberibacter solanacearum\" (Lso) has been negatively impacting the potato industry in the United States as well as other potato-producing countries. Lso has been linked to a condition known as zebra chip (ZC) that affects yield and quality of potato tubers. Efforts to find sources of resistance to ZC have primarily focused on greenhouse evaluations based on a single inoculation time prior to harvest. Plant response to infection, however, could be influenced by the developmental stage of the host plant, and ZC may continue to develop after harvest. The objectives of this study were to quantify Lso inoculation success, Lso titer, ZC severity and Lso development during storage in eight potato genotypes. These evaluations were conducted on plants infested with Lso-positive psyllids at 77, 12, and 4 days before vine removal (DBVR). The evaluated genotypes were categorized according to their relative resistance to Lso and tolerance to ZC symptoms. Lso inoculation success in the genotype family A07781, derived from Solanum chacoense, was lower than that of the susceptible control ('Russet Burbank'). A07781-4LB and A07781-3LB genotypes were characterized relatively resistant to the pathogen and highly tolerant to ZC symptoms, while A07781-10LB was categorized as susceptible to Lso but relatively tolerant to symptom expression. In stored potatoes, increase in Lso concentrations was observed for all infestation times. However, significantly higher Lso titer was detected in tubers infested 12 DBVR and the effect was similar across genotypes. Overall, the A07781 family can be considered as a promising source of resistance or tolerance to ZC.

Russet Burbank is the predominant potato ( Solanum tuberosum L.) cultivar grown and stored for fresh market and frozen processing (French fry) use in North America. Multi-year assessments of potato tuber quality under different storage regimes can provide information about a cultivar’s ability to retain process quality when challenged with seasonal variations across multiple years. The objective of a 15-year study initiated in 1999 was to evaluate the quality of Russet Burbank tubers grown and stored at the Kimberly Research and Extension Center. Potatoes were measured for specific gravity at harvest and stored for eight months under three temperatures (5.6, 7.2 and 8.9 °C) and periodically sampled throughout the storage season to determine dormancy length, sugar content, fry color and mottling severity (a quality issue), and weight loss. The year in which the crop was grown significantly ( p  < 0.001) affected all quality characteristics except specific gravity (average ranged between 1.071 and 1.081). Tubers held during the 2011–2012 and 2013–2014 storage seasons exhibited generally higher glucose, darker fry color, more severe mottling, and higher weight loss. Average sucrose content at 7.2 °C and 8.9 °C across the 15 years significantly decreased over the eight-month storage while average glucose content remained consistent after first month of storage. Average percent weight loss across the 15 years was 6.1 % after eight months in storage. This 15-year study emphasized that variation of post-harvest storage quality from year to year was likely a result of variable seasonal growing conditions. Storage temperatures between 7.2 and 8.9 °C were the optimum range for storing fry processing Russet Burbank potatoes and the warmer temperature of 8.9 °C appears to ameliorate the seasonal effects on glucose content and fry color to maintain better processing quality throughout storage.

Chlorpropham (CIPC) is a highly effective potato (Solanum tuberosum L.) sprout inhibitor. Some export regulations require CIPC or other sprout inhibitor to be applied to potatoes as a general phytosanitary measure. In addition, due to trucking and temporary storage issues, seed potatoes may be inadvertently exposed to CIPC. The objective of this 2-year study was to document the effects of several low rates of CIPC application or contamination on emergence, yield, and grade of the subsequent crop. CIPC was sprayed on whole ‘Russet Burbank’ seed tubers at rates of 0, 1.3, 2.5, 5.0, and 10.0 ppm CIPC. Seed tubers were cut, planted and grown under typical commercial practices for Idaho. Low rates of CIPC (1.3 and 2.5 ppm) applied to tubers resulted in significant delays in emergence compared to the untreated control. Some plants failed to emerge from seed treated with 5 or 10 ppm CIPC. CIPC treatment resulted in total yield decreases of 26 % (2.5 ppm CIPC) to 78 % (10 ppm CIPC) in 2009 and 36 % (1.3 ppm CIPC) to 94 % (10 ppm CIPC) in 2010 compared to the untreated controls in each respective year. Harvested tuber size profile was significantly altered by CIPC applications with higher rates producing smaller potatoes. These dramatic reductions in yield reinforce the importance of avoiding all potential for CIPC contamination of seed. The study also documents the severe consequences of planting commercial potatoes exported for consumption that have been treated with CIPC.

Dairy manure applications are common practice in southern Idaho. Questions have arisen regarding the salt accumulations commonly associated with dairy manure applications on salt-sensitive crops like potatoes. The objective of this 2-year study was to evaluate the impact of dairy manure, dairy compost, dairy lagoon water and fertilizer application on salt accumulation and tuber yields in south-central Idaho based on grower-reported nutrient applications and yields. Soil samples and grower-reported tuber yield information were collected midseason (during time period of July 1st-July 30th) from 84 cooperator potato fields in south-central Idaho in both 2009 and 2010. Soil samples were collected to a 30 cm depth and analyzed for soil electrical conductivity (EC), soluble K, Na, Ca, Mg, and pH. Information on manure application, cultural management practices, and total tuber yield was collected for each field. Average reported application rates (wet basis) of these amendments were: 128 Mg ha⁻¹ dairy manure (28 fields), 29 Mg ha⁻¹ dairy compost (11 fields), 415,000 l ha⁻¹ dairy lagoon water (9 fields), or no manure applied (33 fields) over the 4 year period prior to the study. Mean soil soluble K for dairy manure (1.6 mmolc L⁻¹) and dairy lagoon water fields (1.4 mmolc L⁻¹) were significantly greater than dairy compost (0.6 mmolc L⁻¹) or fertilizer fields (0.4 mmolc L⁻¹). Manure application history had no significant treatment effect on soil electrical conductivity (EC), sodium adsorption ratio (SAR), soluble Na, Ca, or K, soil pH, or grower-reported total tuber yield. These overall findings suggest that current dairy manure, compost, and lagoon water application practices to potato production systems in south-central Idaho are not significantly influencing tuber yield or soil salt accumulations. However, significant soluble K accumulations in the soil suggest that dairy manure and dairy lagoon water applications should still be monitored to avoid potential salt accumulations and yield losses.

Dairy manure applications are a common practice in Idaho potato (Solanum tuberosum L.) production, however the impacts on tuber yield and quality are not well understood. Our objectives were to determine (1) how repeated dairy manure applications impact soil properties and plant nutrient uptake, and (2) how these changes influence plant nutrient interactions, tuber yield, and quality. Stockpiled dairy manure was fall‐applied over a 6‐year period to two adjacent potato production fields in Kimberly, ID. Eight treatments included application frequency (annual and biennial), manure application rate (18, 36, and 52 Mg ha−1 application−1 [dry weight basis]), fertilizer‐only, and a non‐amended control. Manure treatments were supplemented with fertilizer to prevent nutrient‐limiting conditions. Compared to fertilizer treatments, mean soil organic matter, total N, and K were greater for annual manure by 53%, 47%, and 426%, and biennial manure by 24%, 23%, and 199%, respectively. For annual applications only, mean soil nitrate, P, and electrical conductivity were greater than fertilizer treatments by 247%, 431%, and 222%, respectively. Manure promoted P and K luxury consumption with increasing application rate and frequency. Foliage Ca, Mg, Zn, Mn, and Cu correlated negatively against foliage K, potentially due to cation competition and translocation disruption. Annual applications decreased mean tuber specific gravity from 1.078 to 1.073, which may be attributed to saline‐sodic conditions and delayed maturity from late‐season N mineralization. Our findings suggest that biennial manure applications may prevent specific gravity issues. Agronomic parameters related to N, K, and soluble salts should be closely monitored in these systems. Core Ideas Soil organic matter, total N, K, B, and sodium adsorption ratio were greater for annual and biennial manure compared to fertilizer. Soil electrical conductivity, NO3, P, SO4, Mg, Na, Cl, Zn, Cu, and Mn were greater for annual manure only compared to fertilizer. Manure increased P and K but lowered Ca, Mg, Zn, Cu, Mn, and Cl foliage concentrations compared to fertilizer. Tuber specific gravity declined with manure rate and frequency, while total tuber yield was unaffected. Soil salt accumulations and delayed maturity may be primary factors for lowered specific gravity.