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In Mediterranean regions, severe summers are becoming more common, leading to restrictions to vine productivity and yield quality, requiring sustainable practices to support this sector. We assessed the behaviour of three red grapevine varieties from the Douro Region to examine their tolerance to summer climate stress from the perspective that the less common varieties may have potential for increased use in a climate change scenario. Leaf and fruit biochemical profile, antioxidant activity and fruit colorimetric parameters were assessed at different phenological stages in Aragonez (AR), Tinto Cão (TC) and Touriga Nacional (TN) grape varieties. All three varieties exhibit significant variability in phenological timing, influenced by genetic and environmental factors. Photosynthetic pigment strategies differed among varieties. Chlorophyll content in AR was high to cope with high radiation, while TN displaying a balanced approach, and TC had lower pigment levels, with higher levels of phenolics, antioxidants, and soluble sugars, particularly during stress. The variations in berry biochemical profile highlight the distinct characteristics of the varieties. TC and TN show potential for coping with climate change, having elevated total acidity, while AR has larger and heavier berries with distinct coloration. These findings reinforce the need to study the behaviour of different varieties in each Terroir, to understand their diverse strategies to deal with summer climate stress. This will help in selecting the most suitable variety for these conditions under vineyard management in the Douro Region.
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Antioxidantes , Clorofila , Frutas , Vitis , Vitis/crescimento & desenvolvimento , Vitis/fisiologia , Vitis/metabolismo , Clorofila/metabolismo , Frutas/crescimento & desenvolvimento , Frutas/metabolismo , Antioxidantes/metabolismo , Região do Mediterrâneo , Mudança Climática , Estações do Ano , Folhas de Planta/metabolismo , Folhas de Planta/crescimento & desenvolvimento , Clima , Fotossíntese/fisiologiaRESUMO
Radiotherapy developed empirically through experience balancing tumour control and normal tissue toxicities. Early simple mathematical models formalized this practical knowledge and enabled effective cancer treatment to date. Remarkable advances in technology, computing, and experimental biology now create opportunities to incorporate this knowledge into enhanced computational models. The ESTRO DREAM (Dose Response, Experiment, Analysis, Modelling) workshop brought together experts across disciplines to pursue the vision of personalized radiotherapy for optimal outcomes through advanced modelling. The ultimate vision is leveraging quantitative models dynamically during therapy to ultimately achieve truly adaptive and biologically guided radiotherapy at the population as well as individual patient-based levels. This requires the generation of models that inform response-based adaptations, individually optimized delivery and enable biological monitoring to provide decision support to clinicians. The goal is expanding to models that can drive the realization of personalized therapy for optimal outcomes. This position paper provides their propositions that describe how innovations in biology, physics, mathematics, and data science including AI could inform models and improve predictions. It consolidates the DREAM team's consensus on scientific priorities and organizational requirements. Scientifically, it stresses the need for rigorous, multifaceted model development, comprehensive validation and clinical applicability and significance. Organizationally, it reinforces the prerequisites of interdisciplinary research and collaboration between physicians, medical physicists, radiobiologists, and computational scientists throughout model development. Solely by a shared understanding of clinical needs, biological mechanisms, and computational methods, more informed models can be created. Future research environment and support must facilitate this integrative method of operation across multiple disciplines.
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Neoplasias , Radiobiologia , Humanos , Neoplasias/radioterapia , Medicina de Precisão/métodosRESUMO
PURPOSE: We explored and compared perspectives of reproductive endocrinology and infertility specialists (REIs) and in vitro fertilization (IVF) patients regarding polygenic embryo screening (PES), a new type of preimplantation screening that estimates the genetic chances of developing polygenic conditions and traits in the future. METHODS: Qualitative thematic analysis of semi-structured interviews with US-based REIs and IVF patients. RESULTS: Clinicians and patients often held favorable views of screening embryos for physical or psychiatric conditions, though clinicians tended to temper their positive attitudes with specific caveats. Clinicians also expressed negative views about screening embryos for traits more frequently than patients, who generally held more positive views. Most clinicians were either unwilling to discuss or offer PES to patients or were willing to do so only under certain circumstances, while many patients expressed interest in PES. Both stakeholder groups envisioned multiple potential benefits or uses of PES and raised multiple potential, interrelated concerns about PES. CONCLUSION: A gap exists between clinician and patient attitudes toward PES; clinicians generally maintained reservations about such screening and patients indicated interest in it. Clinicians and patients sometimes imagined using PES to prepare for the birth of a predisposed or "affected" individual-a rationale that is often associated with prenatal testing. Many clinicians and patients held different attitudes depending on what is specifically screened, despite the sometimes blurry distinction between conditions and traits. Considerations raised by clinicians and patients may help guide professional societies in developing guidelines to navigate the uncertain terrain of PES.
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Fertilização in vitro , Diagnóstico Pré-Implantação , Humanos , Feminino , Adulto , Testes Genéticos , Masculino , Herança Multifatorial/genética , Gravidez , Infertilidade/genética , Infertilidade/psicologia , Infertilidade/diagnóstico , Pesquisa Qualitativa , Atitude do Pessoal de SaúdeRESUMO
Appendicectomy is a common procedure in children with a low risk of mortality, however, complication rates and risk factors are largely unknown. This study aimed to characterise the incidence and epidemiology of postoperative complications in children undergoing appendicectomy in the UK. This multicentre prospective observational cohort study, which included children aged 1-16 y who underwent surgery for suspected appendicitis, was conducted between November 2019 and January 2022. The primary outcome was 30-day postoperative morbidity. Data collected included: patient characteristics; comorbidities; and physiological status. Multivariable regression analysis was used to identify independent risk factors for poor outcomes. Data from 2799 children recruited from 80 hospitals were analysed, of which 185 (7%) developed postoperative complications. Children from black and 'other' minority ethnic groups were at significantly higher risk of poor outcomes: OR (95%CI) 4.13 (1.87-9.08), p < 0.001 and 2.08 (1.12-3.87), p = 0.021, respectively. This finding was independent of socio-economic status and type of appendicitis found on histology. Other risk factors for complications included: ASA physical status ≥ 3 (OR (95%CI) 4.05 (1.70-9.67), p = 0.002); raised C-reactive protein (OR 95%CI 1.01 (1.00-1.01), p < 0.001); pyrexia (OR (95%CI) 1.77(1.20-2.63), p = 0.004); and peri-operative oxygen supplementation (OR (95%CI) 4.20 (1.44-12.24), p = 0.009). In the UK NHS, which is a universally accessible healthcare system, ethnicity, but not socio-economic status, was associated with an increased risk of postoperative complications in children having surgery for acute appendicitis. Further evaluations and interventions are required to address this health inequality in keeping with NHS and international priorities.
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Apendicite , Criança , Humanos , Apendicite/cirurgia , Apendicite/complicações , Estudos Prospectivos , Disparidades nos Níveis de Saúde , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Apendicectomia/efeitos adversos , Apendicectomia/métodos , Fatores de RiscoRESUMO
Identifying causal factors to intervene on to delay age-related declines in cognitive function is urgently needed. We examined associations between non-exercise testing cardiorespiratory fitness (NETCRF; estimated using sex, age, body mass index, resting heart rate, and physical activity) at 45 years and cognitive function outcomes (immediate and delayed verbal memory; verbal fluency; visual processing speed) at 50 years in 8130 participants from the 1958 British birth cohort. In unadjusted models, higher NETCRF was associated with better cognitive function across all outcomes. When adjusted for confounding factors, associations disappeared. In this cohort, associations between 45 years NETCRF and 50 years cognitive function likely result from confounding factors.
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Aptidão Cardiorrespiratória , Transtornos Cognitivos , Humanos , Adulto , Pessoa de Meia-Idade , Coorte de Nascimento , Exercício Físico/fisiologia , Cognição/fisiologia , Transtornos Cognitivos/etiologia , Aptidão Física/fisiologiaRESUMO
Optical singularities indicate zero-intensity points in space where parameters, such as phase, polarization, are undetermined. Vortex beams such as the Laguerre-Gaussian modes are characterized by a phase factor eilθ, and contain a phase singularity in the middle of its beam. In the case of a transversal optical singularity (TOS), it occurs perpendicular to the propagation, and its phase integral is 2π in nature. Since it emerges within a nano-size range, one expects that TOSs could be sensitive in the light-matter interaction process and could provide a great possibility for accurate determination of certain parameters of nanostructure. Here, we propose to use TOSs generated by a three-wave interference to illuminate a step nanostructure. After interaction with the nanostructure, the TOS is scattered into the far field. The scattering direction can have a relation with the physical parameters of the nanostructure. We show that by monitoring the spatial coordinates of the scattered TOS, its propagation direction can be determined, and as consequence, certain physical parameters of the step nanostructure can be retrieved with high precision.
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Decision-making in patients with vertebral metastases is highly complex. Different factors of the patient, their cancer disease and treatment options are involved in it. Treatment schemes and strategies have been modified with the evolution of knowledge and treatment of disseminated oncological disease. This paper analyzes the bibliography that has been used for decision-making in the last three decades, as well as the evolution to the schemes that we could consider contemporary.
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This study aimed to identify the variables associated with fixation failure in intertrochanteric fractures treated with cephalomedullary nailing (CMN). We retrospectively analyzed 251 consecutive patients who underwent surgery between January 2016 and July 2019. In order to identify predictors of failure (cut-out, cut-through, and/or nonunion), we analyzed: gender, age, fracture stability (according to the AO/OTA Classification), femoral neck angle (FNA), FNA as compared to the contralateral hip, lag screw position, and tip-apex distance (TAD). The failure rate was 9.6%: there were 10 cut-outs (4%), 7 non-unions (2.8%), and 7 cut-throughs (2.8%). Univariate logistic regression analysis showed that the risk factors for fixation failure were: female sex (p= 0.018), FNA <125° (p= 0.003), a difference in FNA of 7.5° as compared to the contralateral hip on the lateral radiograph (p= <0.0001), superior (p= 0.0141) and anterior position (p= <0.0001) of the lag screw, and TAD >25mm (p= 0.016). According to the multivariate analysis, female gender (OR 12.92 ; p 0.0019), the difference in FNA on the lateral view (OR 1.36; p < 0.001), and the anterior position of the screw in the femoral head (OR14.01;p <0.001) were confirmed as independent predictors of failure. In order to avoid failures in intertrochanteric hip fractures treated with CMN, this study confirmed the importance of achieving an accurate reduction on the lateral plane and avoiding the anterior position of the screw on the femoral head.
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Fixação Intramedular de Fraturas , Fraturas do Quadril , Humanos , Feminino , Fixação Intramedular de Fraturas/efeitos adversos , Estudos Retrospectivos , Pinos Ortopédicos , Fraturas do Quadril/cirurgia , Fatores de Risco , Resultado do TratamentoRESUMO
BACKGROUND: Cross-sectional studies suggest a relationship between diabetes status and weaker grip strength (GS) in adulthood and limited evidence from longitudinal studies has focussed on the association with average change in GS. We aimed to investigate whether diabetes status was related to membership of distinct GS trajectories in mid-to-late adulthood in 2,263 participants in the Medical Research Council National Survey of Health and Development. METHODS: Grip strength (kg) was measured at 53, 60-64 and 69 years. Pre-/diabetes was defined at 53 years based on HbA1c > 5.6% and/or doctor-diagnosis of diabetes. Sex-specific latent class trajectory models were developed and multinomial logistic regression was used to investigate the association between pre-/diabetes status and membership into GS trajectory classes. RESULTS: For both males and females, a 3-class solution ('High', 'Intermediate', 'Low') provided the best representation of the GS data and the most plausible solution. There was no evidence that pre-/diabetes status was associated with class membership in either sex: e.g., adjusted odds ratios of being in the 'Low' class (vs. 'High') for males with pre-/diabetes (vs. no-diabetes) was 1.07 (95% CI:0.45,2.55). CONCLUSION: Using a flexible data-driven approach to identify GS trajectories between 53 and 69 years, we observed three distinct GS trajectories, all declining, in both sexes. There was no association between pre-/diabetes status at 53 years and membership into these GS trajectories. Understanding the diabetes status-GS trajectories association is vital to ascertain the consequences that projected increases in pre-/diabetes prevalence's are likely to have.
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Diabetes Mellitus , Força da Mão , Feminino , Humanos , Masculino , Estudos Transversais , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Seguimentos , Estudos Longitudinais , Pessoa de Meia-Idade , IdosoRESUMO
BACKGROUND: Patent ductus arteriosus (PDA) diameter is a frequently measured echocardiographic parameter when assessing the PDA. Though, there are recommendations to use 2D echocardiography to measure the PDA diameter, there is paucity of data on how PDA diameter compares when measured using 2D and color echocardiography. The aim of this work was to examine the bias and limits of agreement between measuring PDA diameter using color and 2D echocardiography in newborn infants. METHODS: This retrospective study examined the PDA using the high parasternal ductal view. Using colour compare, three consecutive cardiac cycles were used to measure PDA diameter at the narrowest point where the PDA joined the left pulmonary artery in both 2D and colour echocardiography by a single operator. RESULTS: The bias between PDA diameter using color and 2D echocardiography was examined in 23 infants (mean gestation: 28.7weeks). The mean (SD, 95% LoA) bias between color and 2D were 0.45(0.23, -0.005 to 0.91) mm. CONCLUSION: Color measurements exaggerated PDA diameter measurements when compared to 2D echocardiography.
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Permeabilidade do Canal Arterial , Recém-Nascido , Humanos , Lactente , Permeabilidade do Canal Arterial/diagnóstico por imagem , Estudos Retrospectivos , Ecocardiografia , Artéria Pulmonar , CoraçãoRESUMO
Decision-making in patients with vertebral metastases is highly complex. Different factors of the patient, their cancer disease and treatment options are involved in it. Treatment schemes and strategies have been modified with the evolution of knowledge and treatment of disseminated oncological disease. This paper analyzes the bibliography that has been used for decision-making in the last three decades, as well as the evolution to the schemes that we could consider contemporary.
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Bacterial diseases are important factors that limit productivity in aquaculture. To reduce negative economic impacts, fish farmers use antimicrobials, often indiscriminately, and this action has led to bacterial resistance to drugs. The objectives of this study were to isolate and identify the main putative pathogenic bacterial species in tambaqui (Colossoma macropomum), establish the profile of resistance to antimicrobials by the methods of disc diffusion, and determine the minimum inhibitory concentration (MIC) values. Two hundred and ninety asymptomatic fish were collected between March and November 2015 from ten fish farms in the Amazonas state (Brazil). Of the total strains recovered from tambaqui, seven were identified as Aeromonas spp. by sequencing the 16S rRNA gene. These seven isolates showed resistance to ampicillin, 28% to erythromycin, and 28% to sulfonamide. Additionally, the seven isolates showed a MIC higher than the range evaluated for amoxicillin, penicillin, novobiocin, tylosin tartrate, and clindamycin, and 85% showed resistance to erythromycin. The results of this study indicate the need to increase the awareness of fish farmers and, most importantly, the government, about the lack of drug regulations for use in aquaculture, and good management practices, so the indiscriminate prophylactic and systemic use of antimicrobials be inhibited.
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Aeromonas , Caraciformes , Animais , Antibacterianos/farmacologia , Farmacorresistência Bacteriana/genética , Aeromonas/genética , Brasil , RNA Ribossômico 16S , Eritromicina , Testes de Sensibilidade MicrobianaRESUMO
Accurate determination of the physical parameters of nanostructures from optical far-field scattering is an important and challenging topic in the semiconductor industry. Here, we propose a novel metrology method to determine simultaneously the height and side-wall angle of a step-shaped silicon nanostructure. By employing an optical singular beam into a typical coherent Fourier scatterometry system, both parameters can be retrieved through analyzing the intensity profile of the far-field scattering pattern. The use of singular beam is shown to be sensitive to slight changes of the parameters of the step. By changing the relative direction between the singularity and structure, the height and side-wall angle can both be retrieved with high precision. This new method is robust, simple, and can provide valuable means for micro-and-nano- metrologies.
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We present an erratum to our article Kolenov, D., et al. "Direct detection of polystyrene equivalent nanoparticles with a diameter of 21 nm ( â¼ λ/19) using coherent Fourier scatterometry." Opt. Express29, 16487 (2021)10.1364/OE.421145.
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Mastocytosis is characterized by clonal expansion of mast cells, with abnormal accumulation in different organs. Perioperatively, numerous stimuli may lead to the release of vasoactive substances by mast cells. Parturients with systemic mastocytosis pose a challenge to the anesthesiologist: on one hand, the pain and stress of labor may lead to greater mast cell activation and, on the other, the administration of drugs that may possibly trigger the release of mast cell mediators. The authors describe a case of a 34-year-old pregnant woman with systemic mastocytosis who requests labor analgesia. An epidural analgesia was performed after induction of labor, after considering anesthetic particularities. The epidural procedure, labor and delivery were uneventful. A review of systemic mastocytosis is provided and its anesthetic considerations are discussed.
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Analgesia Epidural , Anestesia , Anestesiologia , Mastocitose Sistêmica , Mastocitose , Adulto , Feminino , Humanos , Mastocitose Sistêmica/complicações , GravidezRESUMO
Recent advances in developing polygenic scores have made it possible to screen embryos for common, complex conditions and traits. Polygenic embryo screening (PES) is currently offered commercially, and though there has been much recent media and academic coverage, reproductive specialists' points of view have not yet been prominent in these discussions. We convened a roundtable of multidisciplinary experts, including reproductive specialists to discuss PES and its implications. In this Opinion, we describe four clinically relevant issues associated with the use of PES that have not yet been discussed in the literature and warrant consideration.
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Programas de Rastreamento , Herança Multifatorial , Atenção , Embrião de Mamíferos , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Humanos , FenótipoRESUMO
INTRODUCTION: Obesity in adulthood is associated with reduced physical functioning (PF) at older ages. However, mechanisms underpinning this association are not well understood. We investigated whether and the extent to which C-reactive protein (CRP) mediates the association between early-adult obesity and mid-life PF. METHODS: We used data from 8495 participants in the 1958 British birth cohort study. Body mass index (BMI), CRP and PF were measured at 33, 45 and 50y, respectively. Poor PF was defined as the lowest (sex-specific) 10% on the Short-form 36 Physical Functioning subscale. We accounted for prospectively measured confounders in early-life (e.g., social class at birth) and in mid-adulthood (e.g., 42y comorbidities). We decomposed the total effect of early-adult obesity on mid-life PF into direct and indirect (via CRP) effects, by employing a mediation analysis based on parametric g-computation. RESULTS: The estimated total effect of obesity at 33y on poor PF at 50y, expressed as an odds ratio (OR), was 2.41 (95% CI: 1.89, 3.08). The direct effect of obesity on poor PF (i.e., not operating via CRP), was 1.97 (95% CI: 1.51, 2.56), with an indirect effect of 1.23 (95% CI: 1.10, 1.37). As such, the proportion of the total effect which was mediated by the effect of obesity on CRP at 45y, was 23.27% (95% CI: 8.64%, 37.90%). CONCLUSION: Obesity in early-adulthood was associated with over twice the odds of poor PF in mid-life, with approximately 23% of the obesity effect operating via a downstream effect on CRP. As current younger generations are likely to spend greater proportions of their life course in older age and with obesity, both of which are associated with poor PF, there is an urgent need to identify mechanisms, and thus potential modifiable intermediaries, linking obesity to poor PF.