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Cellulose nanopaper is a material structure that possesses high mechanical performance and is widely regarded as a promising 2D reinforcement for polymer matrix composites. This work explores the use of low grammage bacterial cellulose (BC) nanopaper as reinforcement for poly(acrylated urethane) interlayer adhesive to increase the impact performance of multilayer acrylic composites. The BC nanopaper is impregnated with an acrylated urethane resin and laminated between acrylic sheets to create BC/acrylic composites consisting of one, three, and five layers of BC nanopaper-reinforced poly(acrylated urethane) interlayer adhesive(s). Both the poly(acrylated urethane)-filled BC nanopaper interlayer adhesive and the resulting laminated acrylic composites are optically transparent. The incorporation of BC nanopaper into the poly(acrylated urethane) interlayer adhesive improves the tensile modulus by eightfold and the single-edge notched fracture toughness by 60% compared to neat poly(acrylated urethane). It is also found that using poly(acrylated urethane)-filled BC nanopaper interlayer adhesive proves beneficial to the impact properties of the resulting laminated acrylic composites. In Charpy impact testing, the impact strength of the multilayer acrylic composites increases by up to 130% compared to the "gold-standard" impact-modified monolithic acrylic, with a BC loading of only 1.6 wt%.
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Celulose , Celulose/química , Poliuretanos/química , Resinas Acrílicas/química , Papel , Resistência à Tração , Teste de MateriaisRESUMO
Change History: This Article has been retracted; see accompanying Retraction. Corrected online 20 January: In this Article, author Frank Rigo was incorrectly listed with a middle initial; this has been corrected in the online versions of the paper.
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Salinity is a very important parameter from an environmental perspective, and therefore, efficient and accurate systems are required for marine environmental monitoring and productive industries. A plasmonic sensor based on doubly deposited tapered optical fibers (DLUWTs-double-layer uniform-waist tapers) for the measurement of salinity is presented. The physical principle of the sensor, as well as its structure, is discussed, and its performance is experimentally demonstrated, obtaining very good sensitivities. The possibility of shifting towards higher wavelength measuring ranges associated with DLUWTs is also exploited. At the same time, we have considered the necessity of an extensive characterization of the behavior of the refractive index of salty water, both with variations in temperature and the composition of the salts dissolved. This is important due to the somehow changing reality of salinity measurements and the possibility of establishing new approaches for the determination of absolute salinity as opposed to practical salinity based on electrical conductivity measurements. The results obtained, which show high sensitivity and a good performance in general without the need for the use of semi-empirical algorithms, permit, in our opinion, an advance in the tendency towards refractometric determination of salinity with optical sensors apt for in situ, real-time, accurate measurements in realistic measuring conditions.
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The clinical outcome of SARS-CoV-2 infection varies widely between individuals. Machine learning models can support decision making in healthcare by assessing fatality risk in patients that do not yet show severe signs of COVID-19. Most predictive models rely on static demographic features and clinical values obtained upon hospitalization. However, time-dependent biomarkers associated with COVID-19 severity, such as antibody titers, can substantially contribute to the development of more accurate outcome models. Here we show that models trained on immune biomarkers, longitudinally monitored throughout hospitalization, predicted mortality and were more accurate than models based on demographic and clinical data upon hospital admission. Our best-performing predictive models were based on the temporal analysis of anti-SARS-CoV-2 Spike IgG titers, white blood cell (WBC), neutrophil and lymphocyte counts. These biomarkers, together with C-reactive protein and blood urea nitrogen levels, were found to correlate with severity of disease and mortality in a time-dependent manner. Shapley additive explanations of our model revealed the higher predictive value of day post-symptom onset (PSO) as hospitalization progresses and showed how immune biomarkers contribute to predict mortality. In sum, we demonstrate that the kinetics of immune biomarkers can inform clinical models to serve as a powerful monitoring tool for predicting fatality risk in hospitalized COVID-19 patients, underscoring the importance of contextualizing clinical parameters according to their time post-symptom onset.
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Anticorpos Antivirais/sangue , COVID-19 , SARS-CoV-2/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/imunologia , COVID-19/terapia , Biologia Computacional , Diagnóstico por Computador , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Glicoproteína da Espícula de Coronavírus/imunologia , Adulto JovemRESUMO
Graphene-based materials have been increasingly incorporated to optical fiber plasmonic sensors due to the peculiar physical and chemical properties of these materials (hardness and flexibility, high electrical and thermal conductivity, and very good adsorption for many substances, etc.). In this paper, we theoretically and experimentally showed how the addition of graphene oxide (GO) to optical fiber refractometers permits the development of surface plasmon resonance (SPR) sensors with very good characteristics. We used doubly deposited uniform-waist tapered optical fibers (DLUWTs) as supporting structures because of their already proven good performance. The presence of GO as an effective third layer is useful to tune the wavelength of the resonances. In addition, the sensitivity was improved. We depict the procedures for the production of the devices and characterize the GO+DLUWTs produced in this way. We also showed how the experimental results are in agreement with the theoretical predictions and used these to estimate the thickness of deposited GO. Finally, we compared the performance of our sensors with other ones that have been recently reported, showing that our results are among the best reported. Using GO as the medium in contact with the analyte, in addition to the good overall performance of devices, permit consideration of this option as an interesting possibility for the future development of SPR-based fiber sensors.
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The rise of remote working has highlighted the importance of office spaces that support employees' social well-being. However, there is a lack of explicit knowledge on how to design such spaces. In order to address this gap, this study explored the strategies employed by practitioners in designing social office spaces. In-depth interviews with fifteen experienced interior designers were analysed using means-end chain theory. This revealed the designers' common aim to encourage informal social interactions through creating attractive, spacious, recognisable, and spatially integrated breakout spaces. Additionally, communicating group identity, promoting visibility, and offering a cosy atmosphere aimed to foster a sense of connectedness among employees. These findings not only enable more deliberate design decisions but also serve as valuable insights for less experienced designers. Moreover, the framework of design components, affordances and design objectives that emerged from this study can enhance communication between designers and stakeholders involved in office projects.
Experienced interior designers were interviewed about completed office projects to understand how they design social offices. They shared five important strategies to enhance co-worker connectedness and eleven strategies to encourage informal social interactions at work. The study identified ten types of social workplace affordances along with their specific design attributes.
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Sphingomyelinases generate ceramide from sphingomyelin as a second messenger in intracellular signaling pathways involved in cell proliferation, differentiation, or apoptosis. Children from 12 unrelated families presented with microcephaly, simplified gyral pattern of the cortex, hypomyelination, cerebellar hypoplasia, congenital arthrogryposis, and early fetal/postnatal demise. Genomic analysis revealed bi-allelic loss-of-function variants in SMPD4, coding for the neutral sphingomyelinase-3 (nSMase-3/SMPD4). Overexpression of human Myc-tagged SMPD4 showed localization both to the outer nuclear envelope and the ER and additionally revealed interactions with several nuclear pore complex proteins by proteomics analysis. Fibroblasts from affected individuals showed ER cisternae abnormalities, suspected for increased autophagy, and were more susceptible to apoptosis under stress conditions, while treatment with siSMPD4 caused delayed cell cycle progression. Our data show that SMPD4 links homeostasis of membrane sphingolipids to cell fate by regulating the cross-talk between the ER and the outer nuclear envelope, while its loss reveals a pathogenic mechanism in microcephaly.
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Artrogripose/genética , Microcefalia/genética , Transtornos do Neurodesenvolvimento/genética , Esfingomielina Fosfodiesterase/genética , Artrogripose/patologia , Linhagem da Célula , Criança , Retículo Endoplasmático/metabolismo , Feminino , Perfilação da Expressão Gênica , Células HEK293 , Humanos , Masculino , Microcefalia/patologia , Mitose , Transtornos do Neurodesenvolvimento/patologia , Linhagem , Splicing de RNARESUMO
The massive sequencing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and global genomic surveillance strategies allowed the detection of many variants of concern and interest. The variant of interest Lambda (C.37), which originated in South America, has been the most prevalent in Peru and Chile, but its dispersion in other continents still remains unknown. The current study aims to determine the phylogenetic relationship among C.37 isolates worldwide, focusing on spike mutations to understand the spread of Lambda in pandemics. A total of 7441 sequences identified as C.37 were downloaded from the GISAID database; local analysis was carried out to identify spike mutations and phylogenetic analysis was carried out to determine the rate of spread of the virus. Our results showed some spike mutations of Lambda that allowed us to detect small local outbreaks in different countries that occurred in the past and identify several clades that have not yet been designated. Although the lineage C.37 is not epidemiologically relevant in Europe or North America, the endemic behavior of this variant in Peru had a major impact on the second SARS-CoV-2 wave.
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COVID-19 , SARS-CoV-2 , COVID-19/epidemiologia , Chile , Genoma Viral , Genômica , Humanos , Mutação , Filogenia , SARS-CoV-2/genética , Glicoproteína da Espícula de Coronavírus/genéticaRESUMO
Biallelic changes in the ZNFX1 gene have been recently reported to cause severe familial immunodeficiency. Through a search of our bio/databank with information from genetic testing of >55 000 individuals, we identified nine additional patients from seven families with six novel homozygous ZNFX1 variants. Consistent with the previously described phenotype, our patients suffered from monocytosis, thrombocytopenia, hepatosplenomegaly, recurrent infections, and lymphadenopathy. The two most severely affected probands also had renal involvement and clinical presentations compatible with hemophagocytic lymphohistiocytosis. The disease was less lethal among our patients than previously reported. We identified two missense changes, two variants predicted to result in complete protein loss through nonsense-mediated decay, and two frameshift changes that likely introduce a truncation. Our findings (i) independently confirm the role of ZNFX1 in primary genetic immunodeficiency, (ii) expand the genetic and clinical spectrum of ZNFX1-related disease, and (iii) illustrate the utility of large, well-curated, and continually updated genotype-phenotype databases in resolving molecular diagnoses of patients with initially negative genetic testing findings.
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Alelos , Antígenos de Neoplasias/genética , Doenças Hematológicas/diagnóstico , Doenças Hematológicas/genética , Mutação , Doenças da Imunodeficiência Primária/diagnóstico , Doenças da Imunodeficiência Primária/genética , Mapeamento Cromossômico , Biologia Computacional/métodos , Análise Mutacional de DNA , Bases de Dados Genéticas , Fácies , Estudos de Associação Genética , Predisposição Genética para Doença , Homozigoto , Humanos , Linhagem , FenótipoRESUMO
BACKGROUND: Currently, in Latin America, including Peru, the treatment of gonorrhea is still empiric and information regarding antimicrobial resistance is scarce in some countries because of the limited resources, which can contribute to the rising rates of reported multidrug-resistant gonococcal strains. In that context, it is mandatory to continuously monitor and report antimicrobial resistance in N. gonorrhoeae to update treatment recommendations. METHODS: This descriptive study analyzed genital and anal samples from symptomatic patients who attended 15 sexually transmitted infections health facilities from 8 different regions in Peru during the years 2018 to 2019 within the framework of Sentinel Surveillance. After establishing the presumptive diagnosis, the isolates were sent to the Laboratory of Sexually Transmitted Bacteria of the National Institute of Health of Peru in Lima where the species were confirmed (N = 165) and susceptibility profiles were determined. RESULTS: Among the 165 isolates, 95.2% corresponded to male patients, between 18 and 22 years of age (40.6%), half reported having a sexual partner and being heterosexual. Clinically, 89.7% manifested the presence of urethral exudate. Microbiology showed 95.2% of the isolates resistant to ciprofloxacin and 9.1% non-susceptible to azithromycin. Reduced susceptibility to ceftriaxone and cefixime was observed in 1.2% and 3.6% of the isolates respectively. All strains tested were susceptible to spectinomycin. CONCLUSIONS: This study demonstrated that in Peru, fluoroquinolones should not be recommended or used in N. gonorrhoeae infections due to the high percentage of resistant strains. In addition, nationwide access to gonococcal resistance testing, molecular diagnostics and antimicrobial stewardship should be implemented to control the spread of gonococcal antimicrobial resistance.
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Gonorreia , Neisseria gonorrhoeae , Antibacterianos/farmacologia , Azitromicina/farmacologia , Azitromicina/uso terapêutico , Cefixima , Ceftriaxona , Ciprofloxacina , Farmacorresistência Bacteriana , Fluoroquinolonas , Gonorreia/tratamento farmacológico , Gonorreia/epidemiologia , Gonorreia/microbiologia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Peru/epidemiologia , EspectinomicinaRESUMO
PURPOSE: Within this study, we aimed to discover novel gene-disease associations in patients with no genetic diagnosis after exome/genome sequencing (ES/GS). METHODS: We followed two approaches: (1) a patient-centered approach, which after routine diagnostic analysis systematically interrogates variants in genes not yet associated to human diseases; and (2) a gene variant centered approach. For the latter, we focused on de novo variants in patients that presented with neurodevelopmental delay (NDD) and/or intellectual disability (ID), which are the most common reasons for genetic testing referrals. Gene-disease association was assessed using our data repository that combines ES/GS data and Human Phenotype Ontology terms from over 33,000 patients. RESULTS: We propose six novel gene-disease associations based on 38 patients with variants in the BLOC1S1, IPO8, MMP15, PLK1, RAP1GDS1, and ZNF699 genes. Furthermore, our results support causality of 31 additional candidate genes that had little published evidence and no registered OMIM phenotype (56 patients). The phenotypes included syndromic/nonsyndromic NDD/ID, oral-facial-digital syndrome, cardiomyopathies, malformation syndrome, short stature, skeletal dysplasia, and ciliary dyskinesia. CONCLUSION: Our results demonstrate the value of data repositories which combine clinical and genetic data for discovering and confirming gene-disease associations. Genetic laboratories should be encouraged to pursue such analyses for the benefit of undiagnosed patients and their families.
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Exoma , Deficiência Intelectual , Sequência de Bases , Exoma/genética , Humanos , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/genética , Proteínas do Tecido Nervoso , Fenótipo , Sequenciamento do ExomaRESUMO
The pandemic generated by SARS-Cov-2 has caused a large number of cases and deaths in the world, but South America has been one of the continents that were most hard hit. The appearance of new variants causes concern because of the possibility that they may evade the protection generated by vaccination campaigns, their greater capacity to be transmitted, or their higher virulence. We analyzed the circulating variants in Peru after improving our Genomic Surveillance program. The results indicate a steep increase of the lambda lineage (C.37) until becoming predominant between January and April 2021, despite the cocirculation of other variants of concern or interest. Lambda lineage deserves close monitoring and could probably become a variant of concern in the near future.
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COVID-19/epidemiologia , Genoma Viral/genética , SARS-CoV-2/genética , COVID-19/virologia , Genômica/métodos , Humanos , Mutação/genética , Pandemias/prevenção & controle , Peru/epidemiologiaRESUMO
Long-term social aggregations are maintained by multiple mechanisms, including the use of acoustic signals, which may nonetheless entail significant energetic costs. To date, however, no studies have gauged whether there are significant energetic costs to social call production in bats, which heavily rely on acoustic communication for a diversity of social tasks. We measured energetic expenditure during acoustic signaling in Spix's disc-winged bats (Thyroptera tricolor), a species that commonly uses contact calls to locate the ephemeral furled leaves that they use for roosting. To determine the cost of sound production, we measured oxygen consumption using intermittent-flow respirometry methods, with and without social signaling. Our results show that the emission of contact calls significantly increases oxygen consumption; vocal individuals spent, on average, 12.42 kJ more during social signaling trials than they spent during silent trials. We also found that as resting metabolic rate increased in males, there was a decreasing probability that they would emit response calls. These results provide support to the 'allocation model', which predicts that only individuals with lower self-maintenance costs can afford to spend energy in additional activities. Our results provide a step forward in our understanding of how physiology modulates behavior, specifically how the costs of call production and resting metabolic rate may explain the differences in vocal behavior among individuals.
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Quirópteros , Acústica , Comunicação Animal , Animais , Humanos , MasculinoRESUMO
T helper 17 (TH17) lymphocytes protect mucosal barriers from infections, but also contribute to multiple chronic inflammatory diseases. Their differentiation is controlled by RORγt, a ligand-regulated nuclear receptor. Here we identify the RNA helicase DEAD-box protein 5 (DDX5) as a RORγt partner that coordinates transcription of selective TH17 genes, and is required for TH17-mediated inflammatory pathologies. Surprisingly, the ability of DDX5 to interact with RORγt and coactivate its targets depends on intrinsic RNA helicase activity and binding of a conserved nuclear long noncoding RNA (lncRNA), Rmrp, which is mutated in patients with cartilage-hair hypoplasia. A targeted Rmrp gene mutation in mice, corresponding to a gene mutation in cartilage-hair hypoplasia patients, altered lncRNA chromatin occupancy, and reduced the DDX5-RORγt interaction and RORγt target gene transcription. Elucidation of the link between Rmrp and the DDX5-RORγt complex reveals a role for RNA helicases and lncRNAs in tissue-specific transcriptional regulation, and provides new opportunities for therapeutic intervention in TH17-dependent diseases.
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RNA Helicases DEAD-box/metabolismo , RNA Longo não Codificante/metabolismo , Células Th17/imunologia , Células Th17/metabolismo , Animais , Cromatina/genética , Cromatina/metabolismo , RNA Helicases DEAD-box/genética , Feminino , Regulação da Expressão Gênica/genética , Cabelo/anormalidades , Doença de Hirschsprung/genética , Humanos , Síndromes de Imunodeficiência/genética , Inflamação/imunologia , Inflamação/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Mutação/genética , Membro 3 do Grupo F da Subfamília 1 de Receptores Nucleares/metabolismo , Especificidade de Órgãos , Osteocondrodisplasias/congênito , Osteocondrodisplasias/genética , Doenças da Imunodeficiência Primária , Ligação Proteica , RNA Longo não Codificante/genética , Transcrição Gênica/genéticaRESUMO
Ingestion of foreign bodies is common in the pediatric population. Most foreign bodies have a benign behavior and are usually eliminated without generating greater morbidity and mortality. In relation to the intake of magnets, its frequency has increased to the point that it currently represents a public health problem in the pediatric population. The ingestion of a single magnet does not generate any risk, but the ingestion of 2 or more of these, or even of magnets and metals in succession is considered an emergency since they can attract each other and can cause serious symptoms of intestinal obstruction, bleeding, fistulas, perforation and even intestinal necrosis. We present 2 pediatric patients, who ingested multiple magnets, in these cases we highlight the variety in the clinical presentation, as well as the complications presented in relation to a late diagnosis.
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Corpos Estranhos , Obstrução Intestinal , Perfuração Intestinal , Pediatria , Criança , Ingestão de Alimentos , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Humanos , Perfuração Intestinal/diagnóstico , Perfuração Intestinal/etiologia , Perfuração Intestinal/cirurgia , ImãsRESUMO
Recyclable biocomposites based on degradable polymer systems and cellulosic plant fibers are attractive in a sustainable society, because of enhanced polymer properties and also from an end-of-life perspective. Improved understanding is required for how the degradable polymer matrix is affected during compounding in addition to effects from the cellulosic fiber structure and its chemical nature. This work reveals that a poly(ε-caprolactone) matrix undergoes localized, heterogeneous polymer degradation in the fiber-matrix interphase region during melt-compounding. The extent of localized degradation correlates with the initial moisture content in the wood cellulose fiber, where moisture content is controlled by different fiber modification methods by PCL-grafting. As an effect, high moisture content results in a destabilized and degraded fiber-matrix interphase. This was found through careful analysis of how the polymer population changed after compounding, using two different methods: molar mass distribution from SEC and end-group concentration from NMR. The results are important not only with regard to fiber/matrix interface compatibility but also to understand fiber modification for improved biocomposites recycling.
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Celulose , Polímeros , Interfase , Peso Molecular , MadeiraRESUMO
Chemical modification of wood cellulose fibers is important for tailored wood-polymer interfaces, reduced moisture sorption, and novel grades of chemical wood pulp. The present study shows how the reaction solvent system influences hydroxyl accessibility during chemical fiber modification. Surface initiated ring-opening polymerization of ε-caprolactone from wood cellulose fibers was investigated in a wide range of solvent systems. The hydrogen bond donor strength of the solvent increased graft density and the amount of grafted polycaprolactone (PCL) on the fiber surface, and on nanoscale fibrils inside the fiber. Specifically, the reaction system with acetic acid as a new, green solvent for cellulose grafting increased graft density 24 times compared to bulk polymerization conditions. The results show relationships between solvent properties, hydroxyl accessibility, and grafting results in cellulosic plant fibers. The study clarifies the opportunities provided by controlling the interior of the cellulosic plant fiber cell wall during chemical modification so that the fiber becomes a swollen cellulose nanofibril gel.
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Celulose/química , Poliésteres/química , Madeira/química , Varredura Diferencial de Calorimetria , Hidróxidos/química , Espectroscopia de Ressonância Magnética , Polimerização , Solventes/química , Espectroscopia de Infravermelho com Transformada de Fourier , TermogravimetriaRESUMO
We examined the effect of glove decontamination prior to removal on bacterial contamination of healthcare personnel hands in a laboratory simulation study. Glove decontamination reduced bacterial contamination of hands following removal. However, hand contamination still occurred with all decontamination methods, reinforcing the need for hand hygiene following glove removal.
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Carga Bacteriana , Descontaminação , Luvas Protetoras , Desinfecção das Mãos/métodos , Mãos/microbiologia , Pessoal de Saúde , Infecções Bacterianas/prevenção & controle , Infecção Hospitalar/microbiologia , Infecção Hospitalar/prevenção & controle , Fluorescência , Humanos , Treinamento por SimulaçãoRESUMO
The ambient light environment controls many aspects of plant development throughout a plant's life cycle. Such complex control is achieved because a key repressor of light signaling, the Arabidopsis (Arabidopsis thaliana) COP1/SPA E3 ubiquitin ligase causes the degradation of multiple regulators of endogenous developmental pathways. This includes the CONSTANS (CO) transcription factor that is responsible for photoperiodic control of flowering time. There are 16 CO-like proteins whose functions are only partly understood. Here, we show that 14 CO-like (COL) proteins bind CONSTITUTIVELY PHOTOMORPHOGENIC1 (COP1) and SUPPRESSOR OF PHYTOCHROME A-105 (SPA)1 in vitro. We subsequently focused on COL12 and show that COL12 binds COP1 and SPA proteins in vivo. The COL12 protein is degraded in darkness in a COP1-dependent fashion, indicating that COL12 is a substrate of the COP1/SPA ubiquitin ligase. Overexpression of COL12 causes late flowering specifically in long day conditions by decreasing the expression of FLOWERING LOCUS T This phenotype is genetically dependent on CO. Consistent with this finding, COL12 physically interacts with CO in vivo, suggesting that COL12 represses flowering by inhibiting CO protein function. We show that COL12 overexpression did not alter CO protein stability. It is therefore likely that COL12 represses the activity of CO rather than CO levels. Overexpression of COL12 also affects plant architecture by increasing the number of rosette branches and reducing inflorescence height. These phenotypes are CO independent. Hence, we suggest that COL12 affects plant development through CO-dependent and CO-independent mechanisms.
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Proteínas de Arabidopsis/metabolismo , Arabidopsis/fisiologia , Proteínas de Ciclo Celular/metabolismo , Flores/fisiologia , Ubiquitina-Proteína Ligases/metabolismo , Proteínas de Arabidopsis/genética , Proteínas de Ciclo Celular/genética , Proteínas de Ligação a DNA/genética , Proteínas de Ligação a DNA/metabolismo , Escuridão , Flores/genética , Regulação da Expressão Gênica de Plantas , Plantas Geneticamente Modificadas , Domínios e Motivos de Interação entre Proteínas , Fatores de Tempo , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Ubiquitina-Proteína Ligases/genéticaRESUMO
BACKGROUND: El Bagre endemic pemphigus foliaceus (El Bagre-EPF) is a new variant of endemic pemphigus foliaceus present in the El Bagre area of Colombia, South America. Here, we investigate the presence of complement/C5-b9 in lesional skin of patients and matched controls from the endemic area. We also aim to compare the patient's autoantibody levels using indirect immunofluorescent titers (IIF) and correlate with the lesional presence of complement/C5b-9. METHODS: A case-control study was carried out by testing for the presence of complement/C5b-9 in lesional skin in 43 patients affected by El Bagre-EPF, as well as 43 matched, healthy controls from the endemic area. Skin biopsies were obtained and evaluated via hematoxylin and eosin staining, and immunohistochemistry. RESULTS: The presence of complement/C5b-9 was observed in all cases of the patients affected by El Bagre-EPF and was not observed in the controls from the endemic area (P < 0.001). The patients' autoantibody titers utilizing IIF for IgG and IgM showed correlation between higher autoantibody titers and stronger intensity of staining with complement/C5-b9 staining (P < 0.001). CONCLUSION: Patients affected by El Bagre-EPF have lesional deposition of complement/C5b, which correlates with disease severity and previously established serologies.