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Aim The study aimed to evaluate the predictive factors that determined stone-free rate (SFR) after retrograde intrarenal surgery (RIRS). Materials and methods This prospective study was conducted on 183 patients undergoing RIRS for renal stones. Patients were categorized into two groups, depending on stone-free status one month following the procedure. SFR was defined as the complete absence of stones or stones <4 mm. The parameters studied included patient demographics, presence of hydronephrosis, presence of preoperative double J-stent, abnormal renal anatomy, and stone characteristics (stone burden, stone number, stone density, stone location, lower pole infundibulopelvic angle, and lower pole renal infundibular length (RIL)). Univariate and multivariate analyses were performed to identify risk factors for residual stones. We assessed the predictive ability of the RIRS score and Resorlu-Unsal stone score (RUSS) for evaluating SFR utilizing receiver operating characteristic (ROC) analysis. Results 183 patients were included in the study with a median age of 51 years. 131 (71.6%) patients were declared stone-free after the procedure. The mean stone size and density were 16.9 SD±7.5 mm and 1038 SD±342 Hounsfield units (HU) respectively. Stone-free patients had lower stone size (14.3 mm vs. 23.6 mm, p<0.01) and stone density (970 HU vs. 1211 HU, p<0.01) compared to non-stone-free patients. Patients with residual stones had steeper lower pole renal infundibulopelvic angle (RIPA) (31.3° vs. 40.7°, p<0.01) and longer RIL (26.6 mm vs. 21.1 mm, p<0.01). Stone multiplicity (p<0.01), lower pole stone location (p<0.01), and renal malformations (p<0.01) were significant influencing factors for residual renal stones after RIRS. Multivariate analysis revealed stone size, stone density (HU), and stone location as independent predictors for SFR after RIRS. Among the scoring systems, the RIRS score had the highest diagnostic accuracy for SFR (area under the curve (AUC): -0.882, 95% CI-0.828-0.936). Conclusion Stone size, stone density (HU), and stone number are important predictors of SFR after RIRS. Lower pole stone location and abnormal renal anatomy play a substantial role in determining SFR after RIRS. In lower pole stones, a long RIL and acute RIPA negatively influence SFR. Additionally, the RIRS score was found to be a better predictor for SFR than the RUSS score.

The study aimed to identify the various risk factors for infective complications following retrograde intrarenal surgery (RIRS). The study was conducted over one year, and the incidence of infectious complications after RIRS was calculated. Patients were divided into two groups based on the presence and absence of infective complications and were compared in terms of preoperative and operative characteristics. The complications were assessed and graded according to the Modified Clavien classification system (MCCS). The Fisher's exact test, Student's t-test, and Mann-Whitney U test were used for univariate analysis. Multivariate logistic regression analysis was used to identify independent risk factors for postoperative urinary tract infection (UTI). Out of 165 patients in the study, 27 (16.7%) patients developed UTI within one month of undergoing RIRS. The most frequent complication was fever, which occurred in 13 (7.8%) patients. When stratified by MCCS, 13 were grade I, nine were grade II, four were grade III, and one was a grade IV complication. High stone burden, concomitant diabetes mellitus, and multiple renal stones were identified as substantial risk factors for postoperative UTI in univariate analysis. On multivariate analysis, preoperative UTI and prolonged operative time were found to have a significant association with postoperative UTI. The present study demonstrated that preoperative UTI and prolonged operative time are independent factors responsible for postoperative UTI. Large stone burden, stone multiplicity, and diabetes mellitus contribute to a higher risk for UTI following RIRS.

Climate change across the globe has an impact on the occurrence, prevalence, and severity of plant diseases. About 30% of yield losses in major crops are due to plant diseases; emerging diseases are likely to worsen the sustainable production in the coming years. Plant diseases have led to increased hunger and mass migration of human populations in the past, thus a serious threat to global food security. Equipping the modern varieties/hybrids with enhanced genetic resistance is the most economic, sustainable and environmentally friendly solution. Plant geneticists have done tremendous work in identifying stable resistance in primary genepools and many times other than primary genepools to breed resistant varieties in different major crops. Over the last two decades, the availability of crop and pathogen genomes due to advances in next generation sequencing technologies improved our understanding of trait genetics using different approaches. Genome-wide association studies have been effectively used to identify candidate genes and map loci associated with different diseases in crop plants. In this review, we highlight successful examples for the discovery of resistance genes to many important diseases. In addition, major developments in association studies, statistical models and bioinformatic tools that improve the power, resolution and the efficiency of identifying marker-trait associations. Overall this review provides comprehensive insights into the two decades of advances in GWAS studies and discusses the challenges and opportunities this research area provides for breeding resistant varieties.

•Nitrous oxide (N2O) inhibits Vitamin B12, which can result in spinal cord injury.•Patients with gastrointestinal comorbidities are particularly at risk for injury.•Screening for B12 status prior to N2O anesthesia may decrease morbidity. Vitamin B12 deficiency can lead to subacute combined degeneration (SCD). Nitrous oxide (N2O) is an anesthetic which oxidizes the cobalt ion of vitamin B12, interfering with its function as a coenzyme. In this study, we conduct a systematic review of reported cases of SCD following nitrous oxide anesthesia. A comprehensive search of multiple databases was conducted, and information about patient characteristics, symptomatology, clinical work-up, and treatment was extracted from eligible articles. Univariate analyses were performed to identify predictors of poor neurological recovery following SCD. 32 studies, reporting 39 cases of nitrous oxide-induced SCD, were included through the screening process. These cases included 22 male patients and 17 female patients, with an average age of 51.3 years (SD 17.6). An etiology for subclinical B12 deficiency was determined in 31 reports; of these, 26 were due to vitamin malabsorption secondary to a gastrointestinal disorder. Duration of nitrous oxide exposure was described in 19 reports, and ranged from 30 min to 11 h. Univariate analysis failed to find an association between post-operative recovery and age (p = 0.41), sex (p = 0.48), positive MRI findings (p = 0.42), post-operative serum B12 (p = 0.96), post-operative hemoglobin (p = 0.17), type of surgery (p = 0.58), or post-operative high mean corpuscular volume (p = 0.14). In patients with postsurgical myelopathy, surgeons should evaluate B12 status and consider the possibility that nitrous oxide could cause a subclinical B12 deficiency to become overt, particularly in patients with malabsorptive GI comorbidities. Treatment with B12 in this population can result in significant improvement of neurological function.

Forest trees cover 30% of the earth's land surface, providing renewable fuel, wood, timber, shelter, fruits, leaves, bark, roots, and are source of medicinal products in addition to benefits such as carbon sequestration, water shed protection, and habitat for 1/3 of terrestrial species. However, the genetic analysis and breeding of trees has lagged