Combination of survival movement strategies in cyclic game systems during an epidemic.

Disease outbreaks affect many ecosystems threatening species that also fight against other natural enemies. We investigate a cyclic game system with 5 species, whose organisms outcompete according to the rules of a generalised spatial rock-paper-scissors game, during an epidemic. We study the effects of behavioural movement strategies that allow individuals of one out of the species to move towards areas with a low density of disease vectors and a high concentration of enemies of their enemies. We perform a series of stochastic simulations to discover the impact of self-preservation strategies in pattern formation, calculating the species' spatial autocorrelation functions. Considering organisms with different physical and cognitive abilities, we compute the benefits of each movement tactic to reduce selection and infection risks. Our findings show that the maximum profit in terms of territorial dominance in the cyclic game is achieved if both survival movement strategies are combined, with individuals prioritising social distancing. In the case of an epidemic causing symptomatic illness, the drop in infection risk when organisms identify and avoid disease vectors does not render a rise in the species population because many refuges are disregarded, limiting the benefits of safeguarding against natural enemies. Our results may be helpful to the understanding of the behavioural strategies in ecosystems where organisms adapt to face living conditions changes.

How local antipredator response unbalances the rock-paper-scissors model.

Antipredator behavior is a self-preservation strategy present in many biological systems, where individuals join the effort in a collective reaction to avoid being caught by an approaching predator. We study a nonhierarchical tritrophic system, whose predator-prey interactions are described by the rock-paper-scissors game rules. We perform a set of spatial stochastic simulations where organisms of one out of the species can resist predation in a collective strategy. The drop in predation capacity is local, which means that each predator faces a particular opposition depending on the prey group size surrounding it. Considering that the interference in a predator action depends on the prey's physical and cognitive ability, we explore the role of a conditioning factor that indicates the fraction of the species apt to perform the antipredator strategy. Because of the local unbalancing of the cyclic predator-prey interactions, departed spatial domains mainly occupied by a single species emerge. Unlike the rock-paper-scissors model with a weak species because of a nonlocal reason, our findings show that if the predation probability of one species is reduced because individuals face local antipredator response, the species does not predominate. Instead, the local unbalancing of the rock-paper-scissors model results in the prevalence of the weak species' prey. Finally, the outcomes show that local unevenness may jeopardize biodiversity, with the coexistence being more threatened for high mobility.

Mobility-limiting antipredator response in the rock-paper-scissors model.

Antipredator behavior is present in many biological systems where individuals collectively react to an imminent attack. The antipredator response may influence spatial pattern formation and ecosystem stability but requires an organism's cost to contribute to the collective effort. We investigate a nonhierarchical tritrophic system, whose predator-prey interactions are described by the rock-paper-scissors game rules. In our spatial stochastic simulations, the radius of antipredator response defines the maximum prey group size that disturbs the predator's action, determining the individual cost to participate in antipredator strategies. We consider that each organism contributes equally to the collective effort, having its mobility limited by the proportion of energy devoted to the antipredator reaction. Our outcomes show that the antipredator response leads to spiral patterns, with the segregation of organisms of the same species occupying departed spatial domains. We found that a less localized antipredator response increases the average size of the single-species patches, improving the protection of individuals against predation. Finally, our findings show that although the increase of the predation risk for a more localized antipredator response, the high mobility constraining benefits species coexistence. Our results may help ecologists understand the mechanisms leading to the stability of biological systems where locality is crucial to behavioral interactions among species.

Late-onset and long-lasting immune-related adverse events from immune checkpoint-inhibitors: An overlooked aspect in immunotherapy.

BACKGROUND: Immune checkpoint inhibitors (ICIs) have revolutionised cancer therapy but frequently cause immune-related adverse events (irAEs). Description of late-onset and duration of irAEs in the literature is often incomplete. METHODS: To investigate reporting and incidence of late-onset and long-lasting irAEs, we reviewed all registration trials leading to ICI's approval by the US FDA and/or EMA up to December 2019. We analysed real-world data from all lung cancer (LC) and melanoma (Mel) patients treated with approved ICIs at the University Hospital of Lausanne (CHUV) from 2011 to 2019. To account for the immortal time bias, we used a time-dependent analysis to assess the potential association between irAEs and overall survival (OS). RESULTS: Duration of irAEs and proportion of patients with ongoing toxicities at data cut-off were not specified in 56/62 (90%) publications of ICIs registration trials. In our real-world analysis, including 437 patients (217 LC, 220 Mel), 229 (52.4%) experienced at least one grade ≥2 toxicity, for a total of 318 reported irAEs, of which 112 (35.2%) were long-lasting (≥6 months) and about 40% were ongoing at a median follow-up of 369 days [194-695] or patient death. The cumulative probability of irAE onset from treatment initiation was 42.8%, 51.0% and 57.3% at 6, 12 and 24 months, respectively. The rate of ongoing toxicity from the time of first toxicity onset was 42.8%, 38.4% and 35.7% at 6, 12 and 24 months. Time-dependent analysis showed no significant association between the incidence of irAEs and OS in both cohorts (log Rank p = 0.67 and 0.19 for LC and Mel, respectively). CONCLUSIONS: Late-onset and long-lasting irAEs are underreported but common events during ICIs therapy. Time-dependent survival analysis is advocated to assess their impact on OS. Real-world evidence is warranted to fully capture and characterise late-onset and long-lasting irAEs in order to implement appropriate strategies for patient surveillance and follow-up.

Behavioural movement strategies in cyclic models.

The spatial segregation of species is fundamental to ecosystem formation and stability. Behavioural strategies may determine where species are located and how their interactions change the local environment arrangement. In response to stimuli in the environment, individuals may move in a specific direction instead of walking randomly. This behaviour can be innate or learned from experience, and allow the individuals to conquer or the maintain territory, foraging or taking refuge. We study a generalisation of the spatial rock-paper-scissors model where individuals of one out of the species may perform directional movement tactics. Running a series of stochastic simulations, we investigate the effects of the behavioural tactics on the spatial pattern formation and the maintenance of the species diversity. We also explore a more realistic scenario, where not all individuals are conditioned to perform the behavioural strategy or have different levels of neighbourhood perception. Our outcomes show that self-preservation behaviour is more profitable in terms of territorial dominance, with the best result being achieved when all individuals are conditioned and have a long-range vicinity perception. On the other hand, invading is more advantageous if part of individuals is conditioned and if they have short-range neighbourhood perception. Finally, our findings reveal that the self-defence strategy is the least jeopardising to biodiversity which can help biologists to understand population dynamics in a setting where individuals may move strategically.

Neck and waist circumference values according to sex, age, and body-mass index: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Body fat distribution predicts cardiovascular events better than body-mass index (BMI). Waist circumference (WC) and neck circumference (NC) are inexpensive anthropometric measurements. We aimed to present the conditional distribution of WC and NC values according to BMI, stratified by age and sex, from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline data. We analyzed 15,085 ELSA-Brasil participants with complete data. We used spline quantile regression models, stratified by sex and age, to estimate the NC and WC quantiles according to BMI. To test a putative association between age and median NC or WC values, we built sex-specific median regression models using both BMI and age as explanatory variables. We present estimated 25th, 50th, 75th, and 90th percentiles for NC and WC values, according to BMI, age, and sex. Predicted interquartile intervals for NC values varied from 1.6 to 3.8 cm and, for WC values, from 5.1 to 10.3 cm. Median NC was not associated with age in men (P=0.11) nor in women (P=0.79). However, median WC increased with advancing age in both sexes (P<0.001 for both). There was significant dispersion in WC and NC values for a given BMI and age strata for both men and women. WC, but not NC values, were associated with increasing age. The smaller influence of advancing age on the relationship between BMI and NC (compared to WC) values may be useful in longitudinal studies.

Gestão do Diabetes Tipo 1: necessidades de autocuidado apoiado na transição para adolescência / Type 1 Diabetes management: self-management support needs in the transition to adolescence

Analisar as necessidades de autocuidado apoiado para a gestão do diabetes tipo 1 na transição da infância para adolescência. Pesquisa qualitativa mediada pela entrevista semiestruturada com nove pré-adolescentes atendidos em ambulatório e Unidades de Saúde da Família da Paraíba entre setembro/dezembro de 2016. Os dados foram interpretados pela análise temática. Os pré-adolescentes necessitam além do conhecimento para o manejo e a gestão da doença nos espaços que frequenta cotidianamente, do apoio da família e da rede social na transição do cuidado. A equipe multiprofissional de saúde não tem utilizado o autocuidado apoiado singular na gestão do diabetes e a da atenção primária não tem acolhido suas necessidades, fragilizando vínculos com a rede de cuidados. As necessidades para o autocuidado no diabetes versam sobre conhecimento da doença, e as relações estabelecidas com a rede de apoio social como a família, equipe multiprofissional e a escola.

To analyze the self-management support needs for the type 1 diabetes management in the transition from childhood to adolescence. This qualitative research was mediated by semi-structured interviews with nine prepubescent children attended at an outpatient clinic and Family Health Units in Paraíba between September and December 2016. The data were interpreted by thematic analysis. Prepubescent children need knowledge for the administration and management of the disease in the spaces they audit, in addition to family and social media support in the transition of care. The multidisciplinary health team has not used singular self-management support in the management of diabetes, and that of primary care has not accommodated their needs, weakening bonds with the care network. Diabetes self-management needs refer to knowledge of the disease and relationships established with social support networks such as family, multidisciplinary team, and school.

Neck and waist circumference values according to sex, age, and body-mass index: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Body fat distribution predicts cardiovascular events better than body-mass index (BMI). Waist circumference (WC) and neck circumference (NC) are inexpensive anthropometric measurements. We aimed to present the conditional distribution of WC and NC values according to BMI, stratified by age and sex, from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline data. We analyzed 15,085 ELSA-Brasil participants with complete data. We used spline quantile regression models, stratified by sex and age, to estimate the NC and WC quantiles according to BMI. To test a putative association between age and median NC or WC values, we built sex-specific median regression models using both BMI and age as explanatory variables. We present estimated 25th, 50th, 75th, and 90th percentiles for NC and WC values, according to BMI, age, and sex. Predicted interquartile intervals for NC values varied from 1.6 to 3.8 cm and, for WC values, from 5.1 to 10.3 cm. Median NC was not associated with age in men (P=0.11) nor in women (P=0.79). However, median WC increased with advancing age in both sexes (P<0.001 for both). There was significant dispersion in WC and NC values for a given BMI and age strata for both men and women. WC, but not NC values, were associated with increasing age. The smaller influence of advancing age on the relationship between BMI and NC (compared to WC) values may be useful in longitudinal studies.

Influence of strength training intensity on subsequent recovery in elderly.

Understanding the influence of strength training intensity on subsequent recovery in elderly is important to avoid reductions in physical function during the days following training. Twenty-two elderly were randomized in two groups: G70 (65.9 ±â€¯4.8 years, n = 11) and G95 (66.9 ±â€¯5.1, n = 11). Baseline tests included maximum voluntary isometric contraction (peak torque and rate of torque development - RTD), countermovement jump, and functional capacity (timed up and go, stairs ascent and descent). Then, both groups performed a single strength training session with intensities of 70% (G70) or 95% (G95) of five repetition maximum. The same tests were repeated immediately, 24 h, 48 h, and 72 h after the session. Peak torque was lower than baseline immediately after for both groups and at 24 h for G95. Compared with G70, G95 had lower peak torque at 24 h and 48 h. Countermovement jump, timed up and go, stairs ascent, and RTD at 0-50 ms only differed from baseline immediately after for both groups. RTD at 0-200 ms was lower than baseline immediately after and 24 h after the session for both groups. In conclusion, reduced physical function immediately after strength training can last for 1-2 days in elderly depending on the type of physical function and intensity of training. Higher intensity resulted in greater impairment. Exercise prescription in elderly should take this into account, e.g., by gradually increasing intensity during the first months of strength training. These results have relevance for elderly who have to be fit for work or other activities in the days following strength training.

Effects of changes in micro-weather conditions on structural features, total protein and carbohydrate content in leaves of the Atlantic rain forest tree golden trumpet (Tabebuia chrysotricha) / Efeito de alterações nas condições micro-climáticas sobre características estruturais, e proteína e carboidratos histoquimicamente marcados, de folhas da árvore da floresta Atlântica ipê amarelo

Abstract Golden trumpet, Tabebuia chrysotricha, is a native tree from the Brazilian Atlantic rain forest, with a broad latitudinal distribution. In this study, we investigated the potential effects of short-term changes in micro-weather conditions on structural features, and total protein and carbohydrate content of golden trumpet leaves, using structural and histochemical approaches. Leaves were harvested in four different micro-weather conditions: 1. Afternoon, after a hot, sunny day; 2. at dawn, after a previously hot, sunny day; 3. at noon, of a hot, sunny day; and 4. at noon, of a cold, cloudy day. Leaflets exposed to low light irradiance showed flattened chloroplasts, uniformly distributed within the cells, throughout the palisade parenchyma. Conversely, leaflets exposed to high light irradiance presented flattened and rounded chloroplasts, in the upper and lower palisade parenchyma cells, respectively. The strongest protein staining was found for leaves harvested at the coldest period, whereas the weakest protein staining was found for leaves harvested after a hot, sunny day. The largest and most numerous starch grains were found for leaves harvested in the afternoon, after a hot, sunny day. Conversely, the smallest and less numerous starch grains were found for leaves harvested at dawn. Analysis of the data reported herein suggests that the leaflet responses to transient changes in micro-weather conditions are likely to contribute to the golden trumpet successful establishment in the broad latitudinal distribution in which the species is found.

Resumo Ipê amarelo é uma árvore nativa da floresta Atlântica brasileira, encontrada em uma ampla distribuição latitudinal. Neste estudo, nós investigamos os efeitos potenciais de alterações de curto prazo nas condições micro-climáticas sobre características estruturais, proteína e carboidratos histoquimicamente marcados, de folhas de ipê amarelo, usando estratégias de análise estrutural e histoquímicas. As folhas foram marcadas em quatro condições microclimáticas distintas: 1. Tarde, após um dia quente e ensolarado; 2. Amanhecer, após um dia quente e ensolarado; 3. Ao meio-dia, de um dia quente e ensolarado; e 4. Ao meio-dia, de um dia frio e nublado. Folíolos expostos à baixa irradiância luminosa apresentaram cloroplastos achatados, uniformemente distribuídos no interior das células, por todo o parênquima paliçádico, enquanto que folíolos expostos à alta irradiância apresentaram cloroplastos achatados e arredondados, nas células superiores e inferiores do parênquima paliçádico, respectivamente. A marcação mais intensa para proteína foi observada para folhas coletadas no momento mais frio de coleta, enquanto que a marcação mais fraca foi observada para folhas coletadas após um dia quente e ensolarado. Os grãos de amido maiores e mais numerosos foram observados em folhas coletadas durante a tarde de dia quente e ensolarado, enquanto que os menores e menos numerosos grãos de amido foram observados em folhas coletadas ao amanhecer.

Effects of changes in micro-weather conditions on structural features, total protein and carbohydrate content in leaves of the Atlantic rain forest tree golden trumpet (Tabebuia chrysotricha).

Golden trumpet, Tabebuia chrysotricha, is a native tree from the Brazilian Atlantic rain forest, with a broad latitudinal distribution. In this study, we investigated the potential effects of short-term changes in micro-weather conditions on structural features, and total protein and carbohydrate content of golden trumpet leaves, using structural and histochemical approaches. Leaves were harvested in four different micro-weather conditions: 1. Afternoon, after a hot, sunny day; 2. at dawn, after a previously hot, sunny day; 3. at noon, of a hot, sunny day; and 4. at noon, of a cold, cloudy day. Leaflets exposed to low light irradiance showed flattened chloroplasts, uniformly distributed within the cells, throughout the palisade parenchyma. Conversely, leaflets exposed to high light irradiance presented flattened and rounded chloroplasts, in the upper and lower palisade parenchyma cells, respectively. The strongest protein staining was found for leaves harvested at the coldest period, whereas the weakest protein staining was found for leaves harvested after a hot, sunny day. The largest and most numerous starch grains were found for leaves harvested in the afternoon, after a hot, sunny day. Conversely, the smallest and less numerous starch grains were found for leaves harvested at dawn. Analysis of the data reported herein suggests that the leaflet responses to transient changes in micro-weather conditions are likely to contribute to the golden trumpet successful establishment in the broad latitudinal distribution in which the species is found.

Development of Canavalia ensiformis in soil contaminated with diesel oil.

Hydrocarbons are the main components of diesel oil and are toxic for the majority of plants. A few plant species, known as phytoremediators, are tolerant of hydrocarbons and can survive the stressful conditions of soils contaminated with diesel oil. Canavalia ensiformis, a plant species that is well distributed throughout the tropics, possesses advantageous features for a potential resistance to soil contamination, such as fast growth and a deep root system. Thus, the aim of the present study was to evaluate the tolerance of C. ensiformis when it was exposed to soil contaminated with diesel oil. Seedlings were subjected to two treatments: contaminated soil (CS) (95 ml/kg of diesel oil) and non-contaminated soil (NCS) for a period of 30 days; its growth, morphology, anatomy, and physiology were analyzed. Despite the high level of toxicity, some individuals were able to survive in CS. These plants had root apical meristems with high levels of mitosis and were able to issue new roots with more developed aerenchyma tissue. Because the surviving plants presented no marks of cellular damage on the organs formed (root and leaves) during the experiment, the species capacity of growth on CS was confirmed. Although, long-term field experiments, applying different contaminant concentrations, should be considered to infer about the species resistance and use as phytoremediator.

Evaluation of collected outcome measures in axial spondyloarthritis in daily-care rheumatology settings: the experience of the RHEVER network.

OBJECTIVES: Nowadays, the recommended measures for optimal monitoring of axial Spondyloarthritis (ax-SpA) disease activity are either BASDAI and CRP, or ASDAS-CRP. However, there could be a gap between recommendations and daily practice. We aimed to determine the measures collected by rheumatologists in an ax-SpA follow-up visit, and to determine the impact of a meeting (where rheumatologists reached a consensus on the measures to be collected) on the collection of such measures. METHODS: A consensual meeting of a local network of 32 rheumatologists proposed, four months later, to report at least the BASDAI score in the medical file of every ax-SpA patient at every follow-up visit. An independent investigator reviewed the medical files of 10 consecutive patients per rheumatologist, seen twice during the year (e.g. before and after the meeting). The most frequently collected measures were assessed, and then, the frequency of collection before and after the meeting was compared. RESULTS: A total of 456 medical files from 228 patients were reviewed. Treatment (>60%), CRP (51.3%) and total BASDAI (28.5%) were the most reported measures in medical files. Before/After the meeting, the frequencies of collected measures in medical files were 28.5%/51.7%, 51.3%/52.2%, 16.7%/31.6% and 0.9%/6.1% for BASDAI, CRP, BASDAI + CRP and ASDAS, respectively reaching a statistically significance for BASDAI, ASDAS and BASDAI+CRP (p<0.05). CONCLUSIONS: This study revealed a low rate of systematic report of the recommended outcome measures in ax-SpA. However, it suggests that a consensual meeting involving practicing rheumatologists might be relevant to improve the implementation of such recommendations.

Allele frequencies of combined DNA index system (CODIS) and non-CODIS short tandem repeat loci in Goiás, Central Brazil.

In studies of human identification, obtaining a high standard of outcomes and satisfactory conclusions are directly related to the use of highly polymorphic molecular markers. In addition to the combined DNA index system (CODIS) group, it is also important to implement non-CODIS markers into the analysis, as they increase the power of discrimination. During the identification process, it is essential to consider the genetic variation among distinct groups of populations, as the allele frequencies are directly associated with the power of discrimination. However, the population of Goiás, a State located in Central Brazil, is characterized by a highly mixed population due to its diverse ethnic origins. In this study, a survey of the allelic frequencies in the Goiás population was carried out using a molecular assembly composed of 21 autosomal loci both from and external to the CODIS group. The new data, for some of the markers used, were statistically similar to those from previous studies. This consistency means that the use of these markers might serve as a parameter for future population comparisons. The results from these analyses further our knowledge of the study of human identification.

[New melanoma immunotherapies: mechanisms of action, efficiency and management of toxicities]. / Nouvelles immunotherapies du mélanome: mécanismes d'action, efficacité et prise en charge des toxicities.

In recent years the therapy of metastatic melanoma has been revolutionized from a disease with very few efficient treatment options to one with access to multiple therapies which can impact on patient survival. Two main classes of therapies have been developed: 1. Immunotherapy by immune checkpoint inhibitors and 2. Small molecule inhibitors of the MAPK pathway. Immunotherapies achieved by either inhibition of CTLA-4 or the PD1/PD-Ll axes are impacting the overall survival in an important fraction of patients. In addition, the side effects of these immune therapy approaches require early detection by all the specialists involved as well as early management according to precise guidelines for optimal outcome.

Nocturnal blood pressure dipping in acute ischemic stroke.

OBJECTIVES: We aim to assess the impact of early nocturnal blood pressure (BP) variation in the functional outcome of patients after an acute ischemic stroke. MATERIALS AND METHODS: We included consecutive stroke patients treated with intravenous thrombolysis (IVrtPA) in a tertiary stroke center. BP measurements were performed at regular intervals throughout day and night during the first 48 h after stroke onset, and subjects were divided into four dipping categories (extreme dippers, dippers, non-dippers, and reverse dippers). Recanalization was assessed by transcranial color-coded Doppler and/or angiographic CT. Hemorrhagic transformation was evaluated at 24 h follow-up CT scan. Functional outcome was evaluated at 3 months after stroke using the modified Rankin Scale. RESULTS: A total of 304 patients were included, mean age 72.80 ± 11.10 years. After 24 h of systolic BP monitoring, 30.59% were classified as reverse dippers, 39.14% as non-dippers, 19.10% as dippers, and 11.18% as extreme dippers. Multivariate analysis did not show an independent association of any dipping class with 3-month functional outcome. Hemorrhagic transformation was not uniform between dipping classes: 25.81% for reverse dippers, 14.29% for non-dippers, 15.52% for dippers, and 5.88% for extreme dippers, P = 0.033. CONCLUSIONS: Nocturnal BP dipping pattern is not associated with functional outcome at 3 months in acute stroke patients treated with IVrtPA. Hemorrhagic transformation was more frequent in reverse dippers.

Waist circumference is better associated with high density lipoprotein (HDL-c) than with body mass index (BMI) in adults with metabolic syndrome.

BACKGROUND: The measurement of waist circumference (WC) is the most prevalent cause of the metabolic syndrome (MS). OBJECTIVE: The aim of this study was to correlate WC and BMI with high-density lipoprotein (HDL-c) levels in patients with MS being consulted by the Family Health Program (PSF), Brazil. METHODS: This cross-sectional study was conducted from September to November 2008 with 42 patients (29 women and 13 men) from 35 to 77 years. Dietary intake was reported, and biochemical and body composition measures were taken. RESULTS: The HDL-c levels were higher in women when compared to men (48.4 ± 8.1 mg/dL vs. 36.4 ± 7.8 mg/dL). However, the triglycerides (TG)/HDL-c ratio and TG concentrations were lower in women (3.8 ± 1.5 and 178.0 ± 57.8 mg/dL, respectively) than in men (9.4 ± 8.5 and 471.5 ± 501.5 mg/dL, respectively). Regarding skinfold profile, the triceps was greater in females (37.0 ± 8.4 cm vs. 20.7 ± 10.5 cm). The dietetic profile showed that women had a lower intake of energy, fiber, phosphorus and sodium. The fruits and vegetables intake was diminished in the participants of this study, as less than 60% of the women and 50% of men met the daily recommendations. Approximately 54% of men and 28% of women had a lower intake of dairy products daily. Moreover, the results shows that the WC was negatively correlated to HDL-c (r = -0.41, p < 0.05) whereas the BMI is not associated with HDL-c (r = -0.34, p > 0.06). CONCLUSION: Our findings showed that WC is a better predictor of changes in HDL-c than BMI.