The multiple roles of trichomes in two Croton species.

Trichomes are common in plants from dry environments, and despite their recognized role in protection and defense, little is known about their role as absorptive structures and in other aspects of leaf ecophysiology. We combine anatomical and ecophysiological data to evaluate how trichomes affect leaf gas exchange and water balance during drought. We studied two congeneric species with pubescent leaves which co-occur in Brazilian Caatinga: Croton blanchetianus (dense trichomes) and Croton adenocalyx (sparse trichomes). We found a novel foliar water uptake (FWU) pathway in C. blanchetianus composed of stellate trichomes and underlying epidermal cells and sclereids that interconnect the trichomes from both leaf surfaces. The water absorbed by these trichomes is redistributed laterally by pectin protuberances on mesophyll cell walls. This mechanism enables C. blanchetianus leaves to absorb water more efficiently than C. adenocalyx. Consequently, the exposure of C. blanchetianus to dew during drought improved its leaf gas exchange and water status more than C. adenocalyx. C. blanchetianus trichomes also increase their leaf capacity to reflect light and maintain lower temperatures during drought. Our results emphasize the multiple roles that trichomes might have on plant functioning and the importance of FWU for the ecophysiology of Caatinga plants during drought.

Exploring spiritual/religious coping strategies among mothers of children with severe or profound intellectual disability during genetic counseling in Brazil.

Parents use several coping strategies to deal with the challenges of caring for children with disabilities. This qualitative study explored the spiritual/religious coping strategies adopted by Brazilian mothers of children with severe or profound intellectual disabilities who were attending the medical genetics clinic for genetic counseling. Individual semi-structured interviews were conducted with 15 participants, selected by convenience. Thematic content analysis was used to investigate the data. Five major themes were recognized: (1) spirituality/religion as a source of resilience; (2) surrender to God's plan; (3) a feeling of predestination; (4) children with a disability perceived/conceived as a blessing; and (5) pleading for divine intervention. Participants highlighted the ability to recover and adapt to bad circumstances and stressful events with God's support using spiritual/religious resources and practices. They attributed the cause and control of events in their lives to an external and transcendental source, showing themselves to be resigned to the condition of their child with a disability and his/her demands. The feeling of predestination appeared as a form of divine intervention as well as a way of attributing meaning to the situation. Their child with a disability was compared constantly to an "angel," a celestial being created by God to be a messenger and fulfill divine purposes. From the participants' perspective, these coping mechanisms appeared to have helped them adjust to the situation. Spirituality and religiousness have become crucial in cultures such as Brazil, where religious practices, often highly syncretic, are common. A more detailed and comprehensive understanding of how spiritual/religious coping strategies are mobilized during the genetic counseling process can improve the cultural competence of genetic counselors and help guide proposals for more effective clinical interventions.

Effectiveness of a New App in Improving Oral Hygiene in Orthodontic Patients: A Pilot Study.

OBJECTIVES: The aim of this randomised clinical trial was to evaluate the effects of a mobile application (app) on the oral hygiene (OH) of adolescents undergoing fixed orthodontic treatment. METHODS: Eight volunteers (14-19 years old) were randomly allocated to the experimental or control groups. Volunteers in the control group received standard OH (SOH) instructions, whilst volunteers in the experimental group received SHO + OH guidance and motivation through an app tailor-made for this study. Clinical assessments were made using the visible plaque index (VPI) and gingival bleeding index (GBI) at 5 different time points: before orthodontic device installation (T0); at baseline (T1); and 30 (T2), 60 (T3), and 90 (T4) days after randomisation. Significant differences were evaluated using Student t test and multilevel logistic regression analysis. RESULTS: Although no significant difference could be observed, VPI at T1 and T2 were lower for volunteers in the experimental group (33.20 ± 19.29; 32.10 ± 7.72) than for the volunteers in the control group (42.11 ± 8.56; 43.59 ± 34.71). The same was observed for GBI, in which volunteers in the experimental group presented lower GBI at T1 and T2 (12.70 ± 8.10; 13.72 ± 7.39) than volunteers in the control group (27.53 ± 17.89; 20.38 ± 9.95). Good acceptance for using the app was shown by volunteers. CONCLUSIONS: This study shows the potential utility of the mobile app for improving the OH of adolescents.

Deficiência intelectual grave ou profunda: investigação qualitativa de estratégias maternas de enfrentamento / Discapacidad intelectual grave o profunda: investigación cualitativa de estrategias de afrontamiento materno / Severe or profound intellectual disability: a qualitative investigation of maternal coping strategies

RESUMO Objetivou-se investigar estratégias de enfrentamento relatadas por uma amostra de mães brasileiras de filhos com deficiência intelectual grave ou profunda. Os poucos estudos brasileiros sobre este objeto justificaram a exploração qualitativa do tema. Participaram quinze mães recrutadas por conveniência em serviços de saúde de um município do Estado de São Paulo, Brasil. Foram feitas entrevistas semiestruturadas individuais e uma análise temática de conteúdo. Os resultados compreendem quinze temas, induzidos diretamente do corpus e alocados em três pré-categorias baseadas em estudos teóricos sobre coping. Houve um predomínio de menções a estratégias de enfrentamento centradas no problema e nas relações interpessoais, mescladas com estratégias centradas na emoção. Nossas entrevistadas não pareceram considerar-se alvos das políticas indutoras da atenção integral às pessoas com deficiência do Sistema Único de Saúde brasileiro, vigentes há cerca de duas décadas, e cuja efetiva implementação poderia ajudar a extrapolar o cuidado baseado preponderantemente na responsabilidade parental, em suas visões. Em suas falas, há demandas de maior efetividade também dos setores de serviço social, educação e transporte. Apontaram necessidades de maior interação e apoio sociocomunitário, expressando expectativas de um progressivo redesenho cultural da ética do cuidado que fomente ações no âmbito extrafamiliar, diminuindo suas sobrecargas. Esses aspectos das falas das entrevistadas podem ser abordados no manejo clínico dos filhos. Um enfrentamento progressivamente mais saudável da condição por que passam traria benefícios diretos também aos indivíduos com deficiência.

RESUMEN El objetivo fue investigar las estrategias de afrontamiento reportadas por una muestra de madres brasileñas de niños con discapacidades intelectuales severas o profundas. Los pocos estudios brasileños sobre este objeto justificaron la exploración cualitativa del tema. Quince madres participaron, reclutadas por conveniencia en los servicios de salud de un municipio del estado de São Paulo, Brasil. Se realizaron entrevistas semiestructuradas individuales y un análisis de contenido temático. Los resultados comprenden quince temas, inducidos directamente del corpus; fueron asignados en tres categorías previas teóricamente basadas. Las menciones predominantes de estrategias de afrontamiento se referían a aquellos centrados en problemas y relaciones interpersonales, que se mezclaron con estrategias centradas en la emoción. Nuestras entrevistadas no parecían considerarse objetivos de políticas inductoras de una atención integral para las personas con deficiencia en el Sistema Único de Salud de Brasil, en vigor durante aproximadamente dos décadas, y cuya implementación efectiva podría ayudar a extrapolar la atención basada principalmente sobre responsabilidad parental, en sus opiniones. Expresaron demandas de una mayor efectividad de los sectores de servicio social, educación y transporte. Señalaron la necesidad de una mayor interacción social y apoyo sociocomunitario, y parecían expresar las expectativas de un rediseño cultural progresivo de una ética de la atención que fomente acciones en el ámbito extrafamiliar, reduciendo sus sobrecargas. Estos aspectos de las declaraciones de los entrevistados pueden abordarse en el manejo clínico de sus hijos. Un afrontamiento más saludable de la condición que están experimentando también beneficiaría a las personas con discapacidades.

ABSTRACT. The objective was to investigate coping strategies reported by a sample of Brazilian mothers of children with severe or profound intellectual disabilities. The few Brazilian studies on this object justified the present qualitative exploration of the theme. Fifteen mothers participated, recruited by convenience in health services from a municipality in the interior of the state of São Paulo, Brazil. Individual semi-structured interviews and a thematic content analysis were carried out. The results comprise fifteen themes, induced directly from the corpus; they were allocated into three pre-categories based on theoretical studies on coping. Predominant mentions of coping strategies concerned those centered on problem and interpersonal relationships, which were mixed with strategies focused on emotion. Our interviewees did not seem to consider themselves targets of policies that induce a comprehensive care for people with disability in the Brazilian Unified Health System, in force for about two decades, and whose effective implementation could help extrapolate care based predominantly, on parental responsibility in the views of the participants. They expressed demands for a greater effectiveness also from the sectors of social service, education and transport. They pointed out the need for greater social interaction and socio-community support, seeming to express expectations of a progressive cultural redesign of an ethics of care that fosters actions in the extra-family sphere, reducing their overloads. These aspects of the interviewees' statements can be addressed in the clinical management of their children. A progressively healthier coping with the condition they are experiencing would also benefit individuals with disabilities.

Paroxysmal Hemicrania-Trigeminal Neuralgia (PH-Tic) syndrome with no structural lesion in a Brazilian woman: the first case-report / Síndrome de Neuralgia Paroxística Hemicrânia-Trigêmea (PH-Tic) sem lesão estrutural em mulher brasileira: primeiro relato de caso

Introduction: In Brazil there is only one case report of a patient diagnosed with Paroxysmal Hemicrania-Trigeminal (PH-Tic) syndrome reported, however it was observed in a patient with Chiari I malformation. Objective: Here, we describe the first case of primary PH-Tic syndrome in the country. Method: Case report. CARE guideline was used to guide the structuring of this article. This case report was approved by the ethics committee and has been registered under the protocol number 70705623.7.0000.5440 on "Plataforma Brasil". Results:A 72-year-old woman with a five-month history of headaches was admitted at our headache outpatient clinic. The pain was sharp, intense, localized in the periorbital and left temporal regions. Blood counts, liver, renal and thyroid function were normal, as well as brain magnetic resonance imaging. Despite using carbamazepine, the patient had pain in only the left side of the face. Indomethacin was added until the dose of 100 mg a day and resulted in improvement of headache frequency. Conclusion: PH-Tic should be hypothesized in patients with short-lasting headaches associated with facial pain that partially improve with carbamazepine or indomethacin.

Introdução: No Brasil há apenas um relato de caso de paciente com diagnóstico de síndrome Paroxística Hemicrania-Trigeminal (PH-Tic), porém foi observado em um paciente com malformação de Chiari I. Objetivo: Descrevemos aqui o primeiro caso de síndrome PH-Tic primária no país. Método: Relato de caso. A diretriz CARE foi utilizada para orientar a estruturação deste artigo. Este relato de caso foi aprovado pelo comitê de ética e registrado sob o número de protocolo 70705623.7.0000.5440 na "Plataforma Brasil". Resultados: Uma mulher de 72 anos com história de cefaleias há cinco meses foi internada em nosso ambulatório de cefaleias. A dor era aguda, intensa, localizada nas regiões periorbital e temporal esquerda. Os hemogramas, as funções hepática, renal e tireoidiana estavam normais, assim como a ressonância magnética cerebral. Apesar do uso de carbamazepina, o paciente apresentava dor apenas no lado esquerdo da face. A indometacina foi adicionada até a dose de 100 mg ao dia e resultou em melhora da frequência da cefaleia. Conclusão: O PH-Tic deve ser hipotetizado em pacientes com cefaleias de curta duração associadas a dores faciais que melhoram parcialmente com carbamazepina ou indometacina.

Drought response strategies of deciduous and evergreen woody species in a seasonally dry neotropical forest.

Deciduous and evergreen trees are usually considered the main coexisting functional groups in seasonally dry tropical forests (SDTF). We compared leaf and stem traits of 22 woody species in the Brazilian Caatinga to investigate whether deciduous (DC) and evergreen (EV) species have divergent water-use strategies. Our hypothesis was that DC trees compensate for their short leaf longevity by being less conservative in water use and showing higher variation in the seasonal water potential after leaf shedding. Evergreen species should exhibit a highly conservative water use strategy, which reduces variations in seasonal water potential and the negative effects of desiccation. Our leaf dynamics results indicate that the crown area of DC trees is more sensitive to air and soil drought, whereas EV trees are only sensitive to soil drought. Deciduous species exhibit differences in a set of leaf traits confirming their acquisitive strategy, which contrasts with evergreen species. However, when stomatal traits are considered, we found that DC and EV have similar stomatal regulation strategies (partially isohydric). We also found divergent physiological strategies within DC. For high wood density DC, the xylem water potential (Ψxylem) continued to drop during the dry season. We also found a negative linear relationship between leaf life span (LL) and the transpiration rate per unit of hydraulic conductivity (Λ), indicating that species with high LL are less vulnerable to hydraulic conductivity loss than early-deciduous species. Collectively, our results indicate divergence in the physiology of deciduous species, which suggests that categorizing species based solely on their leaf phenology may be an oversimplification.

Assembly rules in a resource gradient: Competition and abiotic filtering determine the structuring of plant communities in stressful environments.

The relative importance of different community assembly mechanisms varies depending on the environment. According to the stress-dominance hypothesis (SDH), assembly mechanisms range from strong abiotic filtering to competition as the environment becomes more favourable. Most evidence for the SDH comes from studies in gradients of conditions (i.e. abiotic environmental factors that influence the functioning of organisms but are not consumed by them). However, we hypothesized that in resource gradients, competition increases as abiotic filtering becomes stronger. To test our hypothesis, we set up eight plots at different sites along an abiotic severity gradient in the Brazilian semi-arid region (BSAR). In each plot, we identified and measured each woody plant species found, and we recorded 11 functional traits of the main species, dividing the traits into alpha (competition effects) and beta (abiotic filtering effects). We investigated the presence of phylogenetic signal in the traits, the community phylogenetic and phenotypic patterns, and associated the variation in these patterns with the availability of water and soil nutrients. We found phylogenetic signal for most (91%) of the traits analysed. The phylogenetic patterns varied from clustered in stressful sites to random or overdispersed in favourable sites, and we concluded that these phylogenetic patterns were the result of historical processes influencing community assembly in different environments in the BSAR. In general, the phenotypic patterns varied from clustered at the most stressful end to random at less stressful sites. Our results show that in resource gradients, any restriction of the resource (hydric or edaphic) intensifies abiotic filtering and, at the same time, increases the competitive hierarchy among species. On the other hand, stochastic processes seem to have a stronger influence under more favourable abiotic conditions, where abiotic filtering and competition are weaker. Thus, we conclude that the SDH is not supported in resource gradients.

Lignin composition is related to xylem embolism resistance and leaf life span in trees in a tropical semiarid climate.

Wood properties influence the leaf life span (LL) of tree crowns. As lignin is an important component of wood and the water transport system, we investigated its relationship with embolism resistance and the LL of several tree species in a seasonally dry tropical ecosystem. We determined total lignin and the monomer contents of guaiacyl (G) and syringyl (S) and related them to wood traits and xylem vulnerability to embolism (Ψ50 ) for the most common species of the Brazilian semiarid, locally known as Caatinga. Leaf life span was negatively related to Ψ50 and positively related to S : G, which was negatively related to Ψ50 . This means that greater S : G increases LL by reducing Ψ50 . Lignin content was not correlated with any variable. We found two apparently unrelated axes of drought resistance. One axis, associated with lignin monomeric composition, increases LL in the dry season as a result of lower xylem embolism vulnerability. The other, associated with wood density and stem water content, helps leafless trees to withstand drought and allows them to resprout at the end of the dry season. The monomeric composition of lignin (S : G) is therefore an important functional wood attribute affecting several key functional aspects of tropical tree species in a semiarid climate.