Autistic and non-autistic transgender youth are similar in gender development and sexuality phenotypes.

Increasing rhetoric regarding the common intersection of autism and gender diversity has resulted in legislation banning autistic transgender youth from accessing standard of care supports, as well as legislative efforts banning all youth gender care in part justified by the proportional over-occurrence of autism. Yet, no study has investigated whether autistic and non-autistic transgender youth present fundamentally different gender-related phenotypes. To address this gap, we extensively characterized autism, gender diversity, and sexuality among autistic and non-autistic transgender binary youth (N = 66, Mage = 17.17, SDage = 2.12) in order to investigate similarities and/or differences in gender and sexuality phenotypes. Neither autism diagnostic status nor continuous autistic traits were significantly related to any gender or sexuality phenotypes. These findings suggest that the developmental and experiential features of gender diversity are very similar between autistic and non-autistic transgender adolescents. Future research is needed to determine whether the similarity in profiles is maintained over time into adulthood.

Metabolic crosstalk between hydroxylated monoterpenes and salicylic acid in tomato defense response against bacteria.

Hydroxylated monoterpenes (HMTPs) are differentially emitted by tomato (Solanum lycopersicum) plants resisting bacterial infection. We have studied the defensive role of these volatiles in the tomato response to bacteria, whose main entrance are through stomatal apertures. Treatments with some HMTPs resulted in stomatal closure and pathogenesis-related protein 1 (PR1) induction. Particularly, α-terpineol induced stomatal closure in a salicylic acid (SA) and abscisic acid-independent manner and conferred resistance to bacteria. Interestingly, transgenic tomato plants overexpressing or silencing the monoterpene synthase MTS1, which displayed alterations in the emission of HMTPs, exhibited changes in the stomatal aperture but not in plant resistance. Measures of both 2-C-methyl-D-erythritol-2,4-cyclopyrophosphate (MEcPP) and SA levels revealed competition for MEcPP by the methylerythritol phosphate (MEP) pathway and SA biosynthesis activation, thus explaining the absence of resistance in transgenic plants. These results were confirmed by chemical inhibition of the MEP pathway, which alters MEcPP levels. Treatments with BTH, a SA functional analogue, conferred enhanced resistance to transgenic tomato plants overexpressing MTS1. Additionally, these MTS1 overexpressors induced PR1 gene expression and stomatal closure in neighbouring plants. Our results confirm the role of HMTPs in both intra and inter-plant immune signalling and reveal a metabolic crosstalk between the MEP and SA pathways in tomato plants.

Cognitive and Developmental Profiles Associated with Self-Reported Sexual and Gender Minority Stigmatization Among Binary Transgender Adolescents.

OBJECTIVE: Sexual and gender minority (SGM) stigmatization is a key factor related to transgender adolescent mental health. While previous research has focused on direct associations between stigmatization and mental health, the present study of transgender youth, equitably recruited across the autism spectrum, examines cognitive and developmental factors in relation to the self-report of experienced and perceived SGM stigmatization. METHOD: 65 binary transgender adolescents (43% transfeminine; ages 13-21 years) were intentionally recruited across the spectrum of autism traits from no traits to full criteria autism. Participants completed measures of autism-related social differences, cognitive abilities, and self-reported directly experienced and perceived SGM stigma. Autism-related social differences, cognitive abilities, and age were studied in relation to both SGM stigma factors. RESULTS: Autism-related social differences were negatively associated with level of directly experienced SGM stigma but unassociated with perceived stigma. Greater cognitive ability was positively associated with level of perceived SGM stigma, but unassociated with report of directly experienced stigma. Older age was positively associated with level of perceived SGM stigma. There was a statistical trend toward older age positively associated with level of directly experienced stigma. CONCLUSIONS: The present study identifies candidate cognitive and developmental influences on self-reported SGM stigmatization among transgender adolescents, evenly recruited across the autism spectrum. The factors which may impact the perception and experience of stigmatization have been notably under-explored in the mental health field. The examination of these individual characteristics may allow for more precise predictive models for research with transgender youth, and ultimately, in clinical care.

Consistent hearing aid use is associated with lower fall prevalence and risk in older adults with hearing loss.

BACKGROUND: Falls and their sequelae cost more than $50 billion every year. Older adults with hearing loss are at 2.4 times greater risk of falls than their normal hearing peers. Current research is inconclusive about whether hearing aids can offset this increased fall risk, and no previous studies considered if outcomes differed based on the consistency of hearing aid use. METHODS: Individuals 60 years and older with bilateral hearing loss completed a survey consisting of the Fall Risk Questionnaire (FRQ) and questions about hearing loss history, hearing aid use, and other common fall risk factors. In this cross-sectional study, fall prevalence, as well as fall risk (based on FRQ score), was compared between hearing aid users and non-users. A separate group of consistent hearing-aid users (at least 4 h daily use for more than 1 year) was also compared with inconsistent/non-users. RESULTS: Responses from 299 surveys were analyzed. Bivariate analysis found 50% reduced odds of experiencing a fall for hearing aid users compared with non-users (OR = 0.50 [95% CI: 0.29-0.85], p = 0.01). After adjusting for age, sex, hearing loss severity, and medication usage, those who reported any hearing aid use still had lower odds of falls (OR = 0.48 [95% CI: 0.26-0.90], p = 0.02) and lower odds of being at risk for falls (OR = 0.36 [95% CI: 0.19-0.66] p < 0.001) than non-users. Results for consistent hearing aid users demonstrate an even stronger association of lowered odds of falling (OR = 0.35 [95% CI: 0.19-0.67], p < 0.001) and lower odds of being at risk for falls (OR = 0.32 [95% CI: 0.12-0.59], p < 0.001), suggesting a potential dose-response relationship. CONCLUSIONS: These findings suggest that use of hearing aids-especially consistent hearing aid use-is associated with lower odds of experiencing a fall or being classified as at risk for falls in older individuals with hearing loss.

In vitro elution characteristics of antibiotic-loaded polymethylmethacrylate cement and a calcium sulfate bone substitute using staphylococci isolated from orthopedic implant-associated infections.

Polymethylmethacrylate (PMMA) remains the gold standard antibiotic carrier in the management of osteomyelitis. However, biodegradable ceramic carriers may exhibit more efficient antibiotic elution properties. Through zone of inhibition (ZOI) testing and biofilm killing assays, we assessed the in vitro elution efficacy of vancomycin released from calcium sulfate (PG-CSH) and PMMA beads as carriers on clinical strains of Staphylococcus aureus and Staphylococcus epidermidis, which were isolated from sonication fluid of orthopedic implant-associated infections. Overall, vancomycin-loaded PMMA and PG-CSH beads showed potency (ZOI above 4 cm2 ) for up to 14 days against ATCC and clinical strains. Vancomycin-loaded PG-CSH beads displayed higher rates, exhibited a more stable antibiotic elution, had greater impacts on bacterial colony-forming unit counts and produced higher ZOIs; additionally, statistically significant differences (Student's t test) were observed in different time sets during the experiment. In the biofilm killing assay, PG-CSH loaded with vancomycin resulted in more bacterial deaths. In conclusion, in the present study, both PG-CSH and PMMA beads acted as good carriers, but greater antimicrobial elution and biofilm bacterial killing were observed with PG-CSH than PMMA. Future in vitro research should focus on testing other difficult-to-treat clinical strains, including multidrug resistant coagulase-negative staphylococci and Gram-negative bacilli.

[Peripheral neuropathy, onycholysis and health-related quality of life in womens with breast cancer treated with taxanes. Prospective longitudinal study.] / Neuropatía periférica, onicólisis y calidad de vida en mujeres con cáncer de mama en tratamiento con taxanos. Estudio longitudinal prospectivo.

OBJECTIVE: Peripheral neuropathy and onycholysis are adverse events produced by taxanes in breast cancer that persist even after the end of treatment and negatively influence quality of life. The objectives of the study were to describe these side effects and the degree of involvement and relating them to the drug doses received. METHODS: Prospective, cross-sectional study of in 50 womens dignosed of breast cancer, treated with docetaxel and paclitaxel in Hospital Universitario Miguel Servet in Zaragoza (Aragón, Spain). CTCAE v.5.0 scale and Semes Weinsten test were used to evaluate peripheral neuropathy and onycholysis. ECOG scale was performed to measure the health-related quality of life. Study variables were evaluated before-during treatment and 1 and 6 months after finish treatment. Statistical analysis was performed using Jamovi 1.2®. For the relationship of the qualitative variables, the chi-square, Fisher's exact test, Mc's test were used. Nemar and the Odds Ratio test. Effects were considered significant if p<0.05. RESULTS: 43 subjects were included. During treatment the 9.8 presented motor neuropathy and 12.2% sensitive neuropathy, 37.2% onycholisis in upper extremities and 39.5% in lower extremities (χ2=11.3; p<0.001 / χ2=13.0; p<0.001) and 38.1% a health related quality of live limited in excessive activities (χ2=10.3; p=0.001). Post-treatment evaluation the 20.9% presented motor neuropathy and 32.6% sensitive neuropathy (χ2=3.57; p=0.059 / χ2=6.23; p=0.013), the 86% onycholisis in upper extremities and lower extremities (χ2=6.07; p=0.048 / χ2=10.1; p=0.006) and 58.5% a health related quality of live limited in excessive activities (χ2=8.47; p=0.014). 6 month later, the initials parameters were not recuperated. CONCLUSIONS: Taxanes have a negative impact on the health-related quality of life in patients, even 6 months after finishing treatment due to the peripheral neuropathy and onycholysis that they cause.

OBJETIVO: La neuropatía periférica y la onicólisis son eventos adversos producidos por los taxanos en el cáncer de mama, que perduran incluso habiendo finalizado el tratamiento e influyendo negativamente en la calidad de vida. Los objetivos del estudio fueron describir estos efectos secundarios, midiendo el grado de afectación, y relacionarlos con las dosis de fármaco recibidas. METODOS: Se realizó un estudio observacional, longitudinal prospectivo con muestreo consecutivo inicial de concuenta mujeres con cáncer de mama en tratamiento con docetaxel y/o paclitaxel en el Hospital Universitario Miguel Servet de Zaragoza (Aragón, España). Para la valoración de la neuropatía periférica (motora y sensitiva) se utilizó la escala CTCAE v.5.0 y el test de Semmes Weinsten. La valoración de la calidad de vida relacionada con la salud se midió mediante la escala ECOG. Se realizaron valoraciones previo-durante-post y a los 6 meses de haber finalizado el tratamiento. El análisis estadístico se realizó mediante Jamovi 1.2®. Para la relación de las variables cualitativas se utilizó la chi-cuadrado, el test exacto de Fisher, el test de Mc.Nemar y el test de Odds Ratio. Los efectos se consideraron significativos si p<0,05. RESULTADOS: Se incluyeron finalmente 43 mujeres. Durante el tratamiento, el 9,8% presentó neuropatía motora y el 12,2% neuropatía sensitiva, el 37,2% onicólisis en extremidades superiores y el 39,5% en inferiores (χ2=11,3; p<0,001 / χ2=13,0; p<0,001), y el 38,1% una calidad de vida restringida a actividad exagerada (χ2=10,3; p=0,001). En la valoración postratamiento, el 20,9% presentó neuropatía motora y el 32,6% neuropatía sensitiva (χ2=3,57; p=0,059 / χ2=6,23; p=0,013), el 86% onicólisis en extremidades superiores y el 90,7% en inferiores (χ2=6,07; p=0,048 / χ2=10,1; p=0,006) y el 58,5% al menos una calidad de vida restringida a actividad exagerada (χ2=8,47; p=0,014). A los seis meses no se recuperaron los valores iniciales de evaluación. CONCLUSIONES: Los taxanos repercuten negativamente en la calidad de vida de las mujeres incluso a los seis meses tras finalizar el tratamiento debido a la neuropatía periférica y la onicólisis que provocan.

Layer-Specific Changes in the Prefrontal Glia/Neuron Ratio Characterizes Patches of Gene Expression Disorganization in Children with Autism.

Autism spectrum disorder (ASD) is manifested by abnormal cell numbers and patches of gene expression disruption in higher-order brain regions. Here, we investigated whether layer-specific changes in glia/neuron ratios (GNR) characterize patches in the dorsolateral prefrontal cortex (DL-PFC) of children with ASD. We analyzed high-resolution digital images of postmortem human brains from 11 ASD and 11 non-ASD children obtained from the Autism Study of the Allen Human Brain Atlas. We found the GNR is overall reduced in the ASD DL-PFC. Moreover, layers II-III belonging to patches presented a lower GNR in comparison with layers V-VI. We here provide a new insight into how brain cells are arranged within patches that contributes to elucidate how neurodevelopmental programs are altered in ASD.

Down-regulation of tomato STEROL GLYCOSYLTRANSFERASE 1 perturbs plant development and facilitates viroid infection.

Potato spindle tuber viroid (PSTVd) is a plant pathogen naturally infecting economically important crops such as tomato (Solanum lycopersicum). Here, we aimed to engineer tomato plants highly resistant to PSTVd and developed several S. lycopersicum lines expressing an artificial microRNA (amiRNA) against PSTVd (amiR-PSTVd). Infectivity assays revealed that amiR-PSTVd-expressing lines were not resistant but instead hypersusceptible to the viroid. A combination of phenotypic, molecular, and metabolic analyses of amiRNA-expressing lines non-inoculated with the viroid revealed that amiR-PSTVd was accidentally silencing the tomato STEROL GLYCOSYLTRANSFERASE 1 (SlSGT1) gene, which caused late developmental and reproductive defects such as leaf epinasty, dwarfism, or reduced fruit size. Importantly, two independent transgenic tomato lines each expressing a different amiRNA specifically designed to target SlSGT1 were also hypersusceptible to PSTVd, thus demonstrating that down-regulation of SlSGT1 was responsible for the viroid-hypersusceptibility phenotype. Our results highlight the role of sterol glycosyltransferases in proper plant development and indicate that the imbalance of sterol glycosylation levels favors viroid infection, most likely by facilitating viroid movement.

Age, Education Years, and Biochemical Factors Are Associated with Selective Neuronal Changes in the Elderly Hippocampus.

Brain aging involves regional alterations of specific cellular subpopulations in the human hippocampus: a network hub for memory consolidation. The present study investigates whether age, sex, education years, and the concentration of neuropathological and inflammatory proteins influence neuronal-type marker expression in the elderly hippocampus. We analyzed the digital images (1 µm/pixel) of postmortem hippocampal sections from 19 non-demented individuals (from 78 to 99 years). This material was obtained from the "Aging Dementia and TBI Study" open database. Brain samples were processed through in situ hybridization (ISH) for the immunodetection of VGLUT1 (glutamatergic transporter) and GAT1 (GABAergic transporter) and mRNAs and Luminex protein quantifications. After image acquisition, we delineated the dentate gyrus, CA 3/2, and CA1 hippocampal subdivisions. Then, we estimated the area fraction in which the ISH markers were expressed. Increased VGLUT1 was observed in multiple hippocampal subfields at late ages. This glutamatergic marker is positively correlated with beta-amyloid and tau proteins and negatively correlated with interleukin-7 levels. Additionally, education years are positively correlated with GAT1 in the hippocampus of elderly women. This GABAergic marker expression is associated with interferon-gamma and brain-derived neurotrophic factor levels. These associations can help to explain how hippocampal sub-regions and neurotransmitter systems undergo distinct physiological changes during normal aging.

Diversity of the epiphytic liverworts (Marchantiophyta) of the Suasie sector in the Chingaza National Natural Park / Diversidad de hepáticas epífitas (marchantiophyta) del sector suasie en el parque nacional natural chingaza

RESUMEN Los briófitos forman un grupo conspicuo de la flora del planeta. Su contribución ecológica en términos de riqueza de especies y cobertura en muchos hábitats es fundamental para el equilibrio de los servicios ecosistémicos. En Colombia se tiene el registro aproximado de 715 especies de Marchantiophyta (hepáticas), las cuales presentan su mayor riqueza en la región Andina. El estudio se realizó en el Parque Nacional Natural Chingaza - sector Suasie dada su importancia ecológica e hídrica para los municipios aledaños. El objetivo principal de este estudio fue determinar la diversidad de la comunidad de hepáticas en el sector de Suasie del PNN Chingaza. Para ello, se hicieron tres levantamientos en transectos de 2x50 m en un gradiente altitudinal, en cada transecto se muestrearon las hepáticas presentes en cuatro forófitos escogidos al azar. Las muestras recolectadas fueron identificadas para el análisis de composición y diversidad de la comunidad. Como resultado, fue posible evidenciar la variación de la composición y abundancia de hepáticas a lo largo del gradiente, basados no solo en los índices estimados, sino también en la asociación con la cobertura vegetal de cada sitio de muestreo. Con un total de 47 especies registradas, se soporta la alta diversidad del sector en estudio. De esta manera, la riqueza encontrada en este gradiente aporta a las actuales y futuras estrategias de conservación del parque.

ABSTRACT The bryophytes form a conspicuous group of the planet's flora, their ecological contribution in terms of species richness and coverage in many habitats is essential for the balance of ecosystem. In Colombia there is an approximate record of 715 species of Marchantiophyta (liverworts), which present their greatest richness in the Andean region. The study was carried out in the Chingaza National Natural Park - Suasie sector given its ecological and water importance for the surrounding municipalities. The main objective of this study was to determine the diversity of the liverwort community in the Suasie sector of the Chingaza NNP. For this, three surveys were made in transects of 2x50 m in an altitude gradient, in each transect the liverworts present from four phorophytes (trees and shrubs), chosen at random were sampled. The collected samples were identified for analysis of composition and diversity of the community. As a result, it was possible to demonstrate the variation in the composition and abundance of liverworts along the gradient, based not only on the estimated indices, but also on the association with the vegetation cover of each sampling site. With a total of 47 registered species, the high diversity of the sector under study is supported. In this way, the richness found in this gradient contributes to current and future conservation strategies for the park.

Validity and Test-Retest Reliability of a Novel Push Low-Cost Hand-Held Dynamometer for Knee Strength Assessment during Different Force Ranges.

The objective was to assess the instrumental validity and the test-retest reliability of a low-cost hand-held push dynamometer adapted from a load-cell based hanging scale (tHHD) to collect compressive forces in different ranges of compressive forces. Three independent raters applied 50 pre-established compressions each on the tHHD centered on a force platform in three distinct ranges: ~70 N, ~160 N, ~250 N. Knee isometric strength was also assessed on 19 subjects in two sessions (48 h apart) using the tHHD anchored by an inelastic adjustable strap. Knee extension and flexion were assessed with the participant seated on a chair with the feet resting on the floor, knees, and hips flexed at 90°. The isometric force peaks were recorded and compared. The ICC and the Cronbach's α showed excellent consistency and agreement for both instrumental validity and test-retest reliability (range: 0.89-0.99), as the correlation and determination coefficients (range: 0.80-0.99). The SEM and the MDC analysis returned adequate low values with a coefficient of variation less than 5%. The Bland-Altman results showed consistency and high levels of agreement. The tHHD is a valid method to assess the knee isometric strength, showing portability, cost-effectiveness, and user-friendly interface to provide an effective form to assess the knee isometric strength.

Bryophytes of rotten logs from El Zafire biological station, Amazonas - Colombia / Briófitos de troncos en descomposición de la estación biológica el zafire, amazonas-colombia

RESUMEN En el presente trabajo se caracterizó la flora briofítica en troncos en descomposición en la estación meteorológica El Zafire, Amazonas-Colombia. Para ello se realizó un muestreo de 100 unidades muestrales en 20 troncos en diferente estado de descomposición y en dos tipos de bosque (tierra firme y varillal inundable). Se reportan 120 especies, 81 hepáticas y 39 musgos, pertenecientes a 55 géneros (33 hepáticas y 22 musgos) y 21 familias (nueve hepáticas y 12 musgos). Se registran cuatro especies nuevas para el país, 25 para la amazonia colombiana y 41 para el departamento del Amazonas. En términos de riqueza total, el bosque de varillal presentó un valor mayor al de tierra firme. Sin embargo, esta diferencia no es significativa (Kruskal Wallis X 2=0,199; p = 0,05); así mismo la diversidad fue mayor en el bosque de varillal inundable (Shanon = 3,93) en comparación con la del bosque de tierra firme (Shanon = 3,67). La composición de las comunidades de briófitos fue diferente entre los dos tipos de bosques (similitud igual a 40 %). En el estudio florístico de los dos tipos de bosques de la estación biológica, se evidenció una marcada dominancia de la familia Lejeunaceae, que representó el 55,5 % de las hepáticas y el 37,5 % del total de las especies de briófitos.

ABSTRACT The present study aims to characterize the bryophyte community on rotten logs in El Zafire biological station, Amazonas-Colombia. We sampled 100 plots on 20 trunks with different states of decomposition in two types of forest (terra firme and floodplain). 120 species are reported, 81 liverworts and 39 mosses, belonging to 55 genera (33 liverworts and 22 mosses) and 21 families (nine liverworts and 12 mosses). Four new species are registered for Colombia, 25 for the Colombia Amazon, and 41 for the department of Amazonas. In terms of richness, the floodplain presented a higher value than the terra firme forest. However, no significant difference was found between the two types of forests (Kruskal Wallis X 2c= 0.199, X 2t= 3.81). Diversity was higher in the floodplain (Shanon = 3.93) compared to the terra firme forest (Shanon = 3.67). The composition of the bryophyte communities shows differences between the two types of forests (similarity equal to 40 %). In the floristic study of the two types of forests of the biological station, the most common family was Lejeuneaceae, it represented 55.5 % of the liverworts sampled and 37.5 % of the total of the bryophyte species.

Trophic relationships and use of area of two sympatric small cetaceans in the Southwestern Atlantic Ocean determined by carbon and nitrogen stable isotopes.

As cetaceans are sentinels of the marine environment, studying their life history is of utmost importance in understanding their habits and their interaction with the environment. To achieve this goal, it is important to study their ecological niches through the investigation of their habitat use patterns and trophic relationships. This study aimed to evaluate if there are differences in the habitat use patterns and the trophic ecology of franciscana (Pontoporia blainvillei) and Guiana dolphins (Sotalia guianensis) accidentally caught off the south coast of São Paulo State, and Guiana dolphins biopsied in the Cananeia estuary, southeastern Brazil, based on the carbon and the nitrogen stable isotopes analysis. Isotopic ratios were estimated from skin samples. The isotopic niche size and overlap were calculated using the SIBER package (R software). The gathered results showed evidence of spatial segregation between Guiana dolphins and franciscanas. The Guiana dolphins sampled inside and outside the estuary showed evidence of trophic and spatial segregation. No difference in isotopic values between sexes was found for both species. Such differences between franciscanas and Guiana dolphins were expected as both species have distinct life histories as a result of different evolutionary pathways.

Apoplastic lipid barriers regulated by conserved homeobox transcription factors extend seed longevity in multiple plant species.

Cutin and suberin are lipid polyesters deposited in specific apoplastic compartments. Their fundamental roles in plant biology include controlling the movement of gases, water and solutes, and conferring pathogen resistance. Both cutin and suberin have been shown to be present in the Arabidopsis seed coat where they regulate seed dormancy and longevity. In this study, we use accelerated and natural ageing seed assays, glutathione redox potential measures, optical and transmission electron microscopy and gas chromatography-mass spectrometry to demonstrate that increasing the accumulation of lipid polyesters in the seed coat is the mechanism by which the AtHB25 transcription factor regulates seed permeability and longevity. Chromatin immunoprecipitation during seed maturation revealed that the lipid polyester biosynthetic gene long-chain acyl-CoA synthetase 2 (LACS2) is a direct AtHB25 binding target. Gene transfer of this transcription factor to wheat and tomato demonstrated the importance of apoplastic lipid polyesters for the maintenance of seed viability. Our work establishes AtHB25 as a trans-species regulator of seed longevity and has identified the deposition of apoplastic lipid barriers as a key parameter to improve seed longevity in multiple plant species.

Análise do escore CHA2DS2-VASc em pacientes com controle inadequado de anticoagulação / Analysis of the CHA2DS2-VASc score in patients with inadequate anticoagulation control

Dentre as ferramentas de avaliação do risco de eventos tromboembólicos, destaca-se o escore CHA2DS2-VASc, que contribui para a identificação de pacientes elegíveis ao uso da terapia anticoagulante, sendo um grande auxílio na profilaxia tromboembólica. O presente artigo objetiva caracterizar pacientes com controle inadequado da anticoagulação conforme o CHA2DS2-VASc. Foram coletadas informações dos pacientes em acompanhamento em um ambulatório de anticoagulação vinculado a um hospital de ensino em Minas Gerais. Foram incluídos pacientes acompanhados no ambulatório entre agosto e dezembro de 2017, em uso de varfarina por pelo menos 180 dias, com indicação crônica de anticoagulação e com no mínimo dois resultados do exame Relação Normatizada Internacional (RNI). Identificou-se 434 pacientes, sendo 202 com controle inadequado da anticoagulação. Para os pacientes com controle inadequado, calculou-se o CHA2DS2-VASc, o qual é realizado pela somatória de pontuações de fatores de risco para eventos tromboembólicos. Os pacientes foram classificados em risco baixo (0 pontos), moderado (1 ponto) ou alto (mais de 2 pontos). Também se realizou associação entre o escore e varáveis que caracterizam o contexto dos pacientes, como município de residência e a faixa terapêutica alvo da RNI. Ressalta-se que 107 (53,0%) apresentaram hipertensão; 96 (47,5%) doença arterial periférica, coronariana ou aórtica; 62 (30,7%) acidente vascular cerebral prévio; e 27 (13,4%) diabetes. Identificou-se considerável percentual de pacientes com CHA2DS2-VASc maior que 2 (n = 191; 94,5%), o que indica um risco elevado para a ocorrência de eventos tromboembólicos e reforça a importância da farmacoterapia anticoagulante adequada. Em relação a associação entre características demográficas com os resultados de escore CHA2DS2-VASc, identificou-se associação entre o escore CHA2DS2-VASc e município de residência (p<0,05), não se identificando significância estatística entre o escore CHA2DS2-VASc e a faixa terapêutica alvo da RNI (p>0,05).

Among the tools for assessing the risk of thromboembolic events, the CHA2DS2-VASc score stands out, which contributes to the identification of patients that are eligible for the use of anticoagulant therapy, which is a great aid in thromboembolic prophylaxis. The present study aims to characterize patients with inadequate control of anticoagulation according to their CHA2DS2-VASc score. Information was collected from patients being followed up at an anticoagulation clinic associated with a teaching hospital in Minas Gerais. Patients accompanied at the clinic between August and December 2017, taking warfarin for at least 180 days, with a chronic indication for anticoagulation, and with at least values from two results of the International Normalized List (INR) test were included. 434 patients were identified and 202 with inadequate anticoagulation control. For patients with inadequate control, the CHA2DS2-VASc was calculated, which is performed by the sum of risk factor scores for thromboembolic events. Patients were classified as low (0 points), moderate (1 point), or high (≥ 2 points) risk. An association was also made between the score and variables that characterize the context of the patients, such as the municipality of residence and the target therapeutic range of the INR. It is noteworthy that 107 (53.0%) had hypertension; 96 (47.5%) had peripheral arterial, coronary or aortic disease; 62 (30.7%) had a previous stroke; and 27 (13.4%) had diabetes. A considerable percentage of patients with CHA2DS2-VASc ≥ 2 (n = 191; 94.5%) was identified, which indicates a high risk for the occurrence of thromboembolic events and reinforces the importance of adequate anticoagulant pharmacotherapy. Regarding the association between demographic characteristics and the results of the CHA2DS2-VASc score, an association was identified between the CHA2DS2-VASc score and city of residence (p<0.05), with no statistical significance being identified between the CHA2DS2-VASc score and the INR target therapeutic range (p>0.05).

Tomato glycosyltransferase Twi1 plays a role in flavonoid glycosylation and defence against virus.

BACKGROUND: Secondary metabolites play an important role in the plant defensive response. They are produced as a defence mechanism against biotic stress by providing plants with antimicrobial and antioxidant weapons. In higher plants, the majority of secondary metabolites accumulate as glycoconjugates. Glycosylation is one of the commonest modifications of secondary metabolites, and is carried out by enzymes called glycosyltransferases. RESULTS: Here we provide evidence that the previously described tomato wound and pathogen-induced glycosyltransferase Twi1 displays in vitro activity toward the coumarins scopoletin, umbelliferone and esculetin, and the flavonoids quercetin and kaempferol, by uncovering a new role of this gene in plant glycosylation. To test its activity in vivo, Twi1-silenced transgenic tomato plants were generated and infected with Tomato spotted wilt virus. The Twi1-silenced plants showed a differential accumulation of Twi1 substrates and enhanced susceptibility to the virus. CONCLUSIONS: Biochemical in vitro assays and transgenic plants generation proved to be useful strategies to assign a role of tomato Twi1 in the plant defence response. Twi1 glycosyltransferase showed to regulate quercetin and kaempferol levels in tomato plants, affecting plant resistance to viral infection.

Effectiveness of the Dual Dispatch to Cardiac Arrest Policy in Houston, Texas.

CONTEXT: Houston policy is to dual dispatch medically trained firefighters, in addition to emergency medical services (EMS) units to out-of-hospital cardiac arrest (OHCA) cases. While believed to improve public health outcomes, no research exists supporting the policy that when firefighters respond before a better-equipped EMS unit, they increase the probability of survival. OBJECTIVE: To inform EMS policy decisions regarding the effectiveness of dual dispatch by determining the impact of medically trained firefighter dispatch on return of spontaneous circulation (ROSC), a measure of survivability, in OHCA 911 calls while controlling for the subsequent arrival of an EMS unit. DESIGN: This retrospective study uses logistic regression to determine the association between ROSC and response time for fire apparatus first responders controlling for arrival of the EMS unit. SETTING: Out-of-hospital cardiac arrest cases in Houston between May 2008 and April 2013 when dual dispatch was used. PARTICIPANTS: A total of 6961 OHCA cases with the complete data needed for the analysis. MAIN OUTCOME MEASURES: Logistic regression of the dependence of OHCA survival using the indicator ROSC, as related to the fire first responder response times controlling for subsequent arrival of the EMS. RESULTS: Fire apparatus arrived first in 46.7% of cases, a median value of 1.5 minutes before an EMS unit. Controlling for subsequent arrival time of EMS has no effect on ROSC achieved by the fire first responder. If the firefighters had not responded, the resulting 1.5-minute increase in response time equates to a decrease in probability of attaining ROSC of 20.1% for cases regardless of presenting heart rhythm and a 47.7% decrease for ventricular fibrillation cases in which bystander cardiopulmonary resuscitation was initiated. CONCLUSIONS: The firefighter first responder not only improved response time but also greatly increased survivability independent of the arrival time of the better-equipped EMS unit, validating the public health benefit of the dual dispatch policy in Houston.

City-Specific Air Quality Warnings for Improved Asthma Self-Management.

INTRODUCTION: This study presents a framework for identifying "high-risk" days for asthma attacks associated with elevated concentrations of criteria pollutants using local information to warn citizens on days when the concentrations differ from Environmental Protection Agency Air Quality Index (AQI) warnings. Studies that consider the unique mixture of pollutants and the health data specific to a city provide additional information for asthma self-management. This framework is applied to air pollution and asthma data to identify supplemental warning days in Houston, Texas. METHODS: A four-step framework was established to identify days with pollutant levels that pose meaningful increased risk for asthma attacks compared with baseline. Historical associations between 18,542 ambulance-treated asthma attacks and air pollutant concentrations in Houston, Texas (2004-2016; analyzed in 2018), were analyzed using a case-crossover study design with conditional logistic regression. Days with historically high associations between pollution and asthma attacks were identified as supplemental warning days. RESULTS: Days with 8-hour maximum ozone >66.6 parts per billion for the 3 previous days and same-day 24-hour nitrogen dioxide >19.3 parts per billion pose an RR of 15% above baseline; concentrations above these levels pose an increased risk of 15% (RR=1.15, 95% CI=1.14, 1.16) and 30% (RR=1.30, 95% CI=1.29, 1.32), respectively. These warnings add an additional 12% days per year over the AQI warnings. CONCLUSIONS: Houston uses this framework to identify supplemental air quality warnings to improve asthma self-management. Supplemental days reflect risk lower than the National Ambient Air Quality Standards and consecutive poor air quality days, differing from the AQI.

Correction: A model of chronic, transmissible Otitis Media in mice.

[This corrects the article DOI: 10.1371/journal.ppat.1007696.].