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1.
Sci Total Environ ; 952: 175793, 2024 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-39191329

RESUMO

Anthropogenic pressures such as climate change and nutrient pollution are causing rapid changes in the marine environment. The relative influence of drivers of change on the plankton community remains uncertain, and this uncertainty is limiting our understanding of sustainable levels of human pressures. Plankton are the primary energy resource in marine food webs and respond rapidly to environmental changes, representing useful indicators of shifts in ecosystem structure and function. Categorising plankton into broad groups with similar characteristics, known as "lifeforms", can be useful for understanding ecological patterns related to environmental change and for assessing the state of pelagic habitats in accordance with the EU Marine Strategy Framework Directive and the OSPAR Commission, which mandates protection of the North-East Atlantic. We analysed 29 years of Continuous Plankton Recorder data (1993-2021) from the North-East Atlantic to examine how trends in plankton lifeform abundance changed in relation to one another and across gradients of environmental change associated with human pressures. Random forest models predicted between 57 % and 80 % of the variability in lifeform abundance, based on data not used to train the models. Observed variability was mainly explained by trends in other lifeforms, with mainly positively correlated trends, indicating bottom-up control and/or shared responses to environmental variability were prevalent. Longitude, bathymetry, mixed layer depth, the nitrogen-to­phosphorus ratio, and temperature were also significant predictors. However, contrasting influences of environmental drivers were detected. For example, small copepod abundance increased in warmer conditions whereas meroplankton, large copepods and fish larvae either decreased or were unchanged. Our findings highlight recent changes in stratification, reflected by variation in mixed layer depth, and imbalanced nutrient ratios are affecting multiple lifeforms, impacting the North-East Atlantic plankton community. To achieve environmental improvements in North-East Atlantic pelagic habitats, it is crucial that we continue to address climate change and reduce nutrient pollution.


Assuntos
Mudança Climática , Monitoramento Ambiental , Plâncton , Oceano Atlântico , Ecossistema , Cadeia Alimentar
3.
Sci Total Environ ; 929: 172536, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38643886

RESUMO

Oil and gas exploitation introduces toxic contaminants such as hydrocarbons and heavy metals to the surrounding sediment, resulting in deleterious impacts on marine benthic communities. This study combines benthic monitoring data over a 30-year period in the North Sea with dietary information on >1400 taxa to quantify the effects of active oil and gas platforms on benthic food webs using a multiple before-after control-impact experiment. Contamination from oil and gas platforms caused declines in benthic food web complexity, community abundance, and biodiversity. Fewer trophic interactions and increased connectance indicated that the community became dominated by generalists adapting to alternative resources, leading to simpler but more connected food webs in contaminated environments. Decreased mean body mass, shorter food chains, and the dominance of small detritivores such as Capitella capitata near to structures suggested a disproportionate loss of larger organisms from higher trophic levels. These patterns were associated with concentrations of hydrocarbons and heavy metals that exceed OSPAR's guideline thresholds of sediment toxicity. This study provides new evidence to better quantify and manage the environmental consequences of oil and gas exploitation at sea.


Assuntos
Biodiversidade , Monitoramento Ambiental , Cadeia Alimentar , Invertebrados , Poluentes Químicos da Água , Animais , Poluentes Químicos da Água/análise , Organismos Aquáticos , Mar do Norte , Metais Pesados/análise , Campos de Petróleo e Gás , Sedimentos Geológicos/química
4.
Front Microbiol ; 15: 1348171, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38389541

RESUMO

Introduction: Intensive beef cattle production systems are frequently implicated as a source of bacteria that can be transferred to nearby humans and animals via effluent water, manure used as fertilizer, or airborne particulate matter. It is crucial to understand microbial population dynamics due to manure pack desiccation, antibiotic usage, and antibiotic alternatives within beef cattle and their associated feedyard environment. Understanding how bacterial communities change in the presence of antibiotics can also improve management practices for reducing the spread of foodborne bacteria. Methods: In this study, we aimed to compare the microbiomes within cattle feces, the feedyard environment and artificially produced airborne particulate matter as a function of pen change and treatment with tylosin or probiotics. We utilized 16S rRNA sequencing to compare bacterial communities among sample types, study days, and treatment groups. Results: Bacterial community diversity varied as a function of sampling day and pen change (old or new) within fecal and manure pack samples. Manure pack samples from old pens and new pens contained diverse communities of bacteria on days 0 and 84; however, by day 119 of the study these taxonomic differences were less evident. Particulate matter samples exhibited significant differences in community diversity and predominant bacterial taxa compared to the manure pack they originated from. Treatment with tylosin did not meaningfully impact bacterial communities among fecal, environmental, or particulate matter samples; however, minor differences in bacterial community structure were observed in feces from cattle treated with probiotics. Discussion: This study was the first to characterize and compare microbial communities within feces, manure pack, and airborne particulate matter from the same location and as a function of tylosin and probiotic treatment, and pen change. Although fecal and environmental samples are commonly used in research studies and other monitoring programs to infer public health risk of bacteria and antimicrobial resistance determinants from feedyard environments, our study suggests that these samples may not be appropriate to infer public health risk associated with airborne particulate matter.

5.
Glob Chang Biol ; 29(23): 6606-6619, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37814904

RESUMO

Many studies predict shifts in species distributions and community size composition in response to climate change, yet few have demonstrated how these changes will be distributed across marine food webs. We use Bayesian Additive Regression Trees to model how climate change will affect the habitat suitability of marine fish species across a range of body sizes and belonging to different feeding guilds, each with different habitat and feeding requirements in the northeast Atlantic shelf seas. Contrasting effects of climate change are predicted for feeding guilds, with spatially extensive decreases in the species richness of consumers lower in the food web (planktivores) but increases for those higher up (piscivores). Changing spatial patterns in predator-prey mass ratios and fish species size composition are also predicted for feeding guilds and across the fish assemblage. In combination, these changes could influence nutrient uptake and transformation, transfer efficiency and food web stability, and thus profoundly alter ecosystem structure and functioning.


Assuntos
Ecossistema , Cadeia Alimentar , Animais , Mudança Climática , Teorema de Bayes , Oceanos e Mares , Peixes/fisiologia
6.
Sci Rep ; 13(1): 3110, 2023 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-36813881

RESUMO

It is important to decipher the diversity and distribution of benthic dinoflagellates, as there are many morphologically indistinct taxa that differ from one another in production of potent toxins. To date, the genus Ostreopsis comprises twelve described species, of which seven are potentially toxic and produce compounds presenting a threat to human and environmental health. In this study, isolates previously identified as "Ostreopsis sp. 3" were sampled from the area where it was first reported, Rarotonga, Cook Islands, and have been taxonomically and phylogenetically characterised as Ostreopsis tairoto sp. nov. Phylogenetically, the species is closely related to "Ostreopsis sp. 8", O. mascarenensis, "O. sp. 4", O. fattorussoi, O. rhodesiae and O. cf. siamensis. Previously, it was considered a part of the O. cf. ovata complex but can be distinguished from O. cf. ovata based on the small pores identified on this study, and from O. fattorussoi and O. rhodesiae based on relative lengths of the 2' plates. No known palytoxin -like compounds were detected in strains investigated in this study. Strains of O. lenticularis, Coolia malayensis and C. tropicalis were also identified and described. This study advances our knowledge of biogeography, distribution, and toxins of Ostreopsis and Coolia species.


Assuntos
Dinoflagellida , Humanos , Oceano Pacífico , Polinésia , Regiões Antárticas
7.
Environ Evid ; 11(1): 35, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-39294784

RESUMO

BACKGROUND: Many marine man-made structures (MMS), such as oil and gas platforms or offshore wind turbines, are nearing their 'end-of-life' and require decommissioning. Limited understanding of MMS decommissioning effects currently restricts the consideration of alternative management possibilities, often leaving complete removal as the only option in certain parts of the world. This evidence-base describes the ecosystem effects of marine MMS whilst in place and following cessation of operations, with a view to informing decision-making related to their potential decommissioning. METHOD: The protocol used to create this map was published a priori. Systematic searches of published, literature in English were conducted using three bibliographic databases, ten specialist organisational websites or repositories, and one search engine, up to early 2021. A total of 15,697 unique articles were identified as potentially relevant to our research questions, of which 2,230 were screened at the full-text level. Of that subset, 860 articles met all pre-defined eligibility criteria. A further 119 articles were identified through "snowballing" of references from literature reviews. The final database consists of 979 articles. For each article included, metadata were extracted for key variables of interest and coded into a database. REVIEW FINDINGS: The vast majority of eligible articles related to the presence of MMS (96.2%), while just 5.8% considered decommissioning. Overall, articles mainly considered artificial reefs (51.5% of all articles) but increasingly oil and gas (22%), shipwrecks (15.1%) and offshore wind (13.1%). Studies were distributed globally, but the majority focused on the United States, single countries within Europe, Australia, Brazil, China, and Israel; 25 studies spanned multiple countries. Consequently, the bulk of the studies focused on the North Atlantic (incl. Gulf of Mexico, North Sea, and Mediterranean Sea) and North Pacific Oceans. A further 12 studies had a global scope. Studies in majority reported on fish (53%) and invertebrates (41%), and were disproportionately focused on biological (81%) and ecological (48%) impacts. Physico-chemical (13%), habitat (7%), socio-cultural (7%), economic (4%) and functional (8%) outcomes have received less attention. The number of decommissioning studies has been increasing since ca. 2012 but remains noticeably low. Studies mostly focus on oil and gas infrastructures in the USA (Gulf of Mexico) and Northern Europe (North Sea), covering 9 different decommissioning options. CONCLUSIONS: This systematic map, the first of its kind, reveals a substantial body of peer-reviewed evidence relating to the presence of MMS in the sea and their impacts, but with considerable bias toward biological and ecological outcomes over abiotic and socio-economic outcomes. The map reveals extremely limited direct evidence of decommissioning effects, likely driven at least in part by international policy preventing consideration of a range of decommissioning options beyond complete removal. Despite evidence of MMS impacts continuing to grow exponentially since the early 1970s, this map reveals key gaps in evidence to support best practice in developing decommissioning options that consider environmental, social and economic effects. Relevant evidence is required to generate greater understanding in those areas and ensure decommissioning options deliver optimal ecosystem outcomes.

9.
Biol Lett ; 17(3): 20200798, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33726566

RESUMO

The relationship between body mass (M) and size class abundance (N) depicts patterns of community structure and energy flow through food webs. While the general assumption is that M and N scale linearly (on log-log axes), nonlinearity is regularly observed in natural systems, and is theorized to be driven by nonlinear scaling of trophic level (TL) with M resulting in the rapid transfer of energy to consumers in certain size classes. We tested this hypothesis with data from 31 stream food webs. We predicted that allochthonous subsidies higher in the web results in nonlinear M-TL relationships and systematic abundance peaks in macroinvertebrate and fish size classes (latter containing salmonids), that exploit terrestrial plant material and terrestrial invertebrates, respectively. Indeed, both M-N and M-TL significantly deviated from linear relationships and the observed curvature in M-TL scaling was inversely related to that observed in M-N relationships. Systemic peaks in M-N, and troughs in M-TL occurred in size classes dominated by generalist invertebrates, and brown trout. Our study reveals how allochthonous resources entering high in the web systematically shape community size structure and demonstrates the relevance of a generalized metabolic scaling model for understanding patterns of energy transfer in energetically 'open' food webs.


Assuntos
Cadeia Alimentar , Invertebrados , Animais , Tamanho Corporal , Peixes , Rios
10.
Glob Chang Biol ; 27(3): 521-535, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33159828

RESUMO

Conserving biogeographic regions with especially high biodiversity, known as biodiversity 'hotspots', is intuitive because finite resources can be focussed towards manageable units. Yet, biodiversity, environmental conditions and their relationship are more complex with multidimensional properties. Assessments which ignore this risk failing to detect change, identify its direction or gauge the scale of appropriate intervention. Conflicting concepts which assume assemblages as either sharply delineated communities or loosely collected species have also hampered progress in the way we assess and conserve biodiversity. We focus on the marine benthos where delineating manageable areas for conservation is an attractive prospect because it holds most marine species and constitutes the largest single ecosystem on earth by area. Using two large UK marine benthic faunal datasets, we present a spatially gridded data sampling design to account for survey effects which would otherwise be the principal drivers of diversity estimates. We then assess γ-diversity (regional richness) with diversity partitioned between α (local richness) and ß (dissimilarity), and their change in relation to covariates to test whether defining and conserving biodiversity hotspots is an effective conservation strategy in light of the prevailing forces structuring those assemblages. α-, ß- and γ-diversity hotspots were largely inconsistent with each metric relating uniquely to the covariates, and loosely collected species generally prevailed with relatively few distinct assemblages. Hotspots could therefore be an unreliable means to direct conservation efforts if based on only a component part of diversity. When assessed alongside environmental gradients, α-, ß- and γ-diversity provide a multidimensional but still intuitive perspective of biodiversity change that can direct conservation towards key drivers and the appropriate scale for intervention. Our study also highlights possible temporal declines in species richness over 30 years and thus the need for future integrated monitoring to reveal the causal drivers of biodiversity change.


Assuntos
Biodiversidade , Ecossistema , Conservação dos Recursos Naturais
11.
Lett Appl Microbiol ; 70(4): 274-281, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31883125

RESUMO

Enterococci are included in the United States National Antimicrobial Resistance Monitoring System to track antibiotic resistance among commensal Gram-positive enteric bacteria, largely due to their high abundance in food animals and in retail meat. In the U.S. cattle industry, macrolides are used to prevent and control liver abscesses, which cause significant economic losses. Previous studies have suggested that feeding tylosin and the intensity of the pen environment, both expand and sustain respectively the prevalence of multidrug resistance among enterococci in feedlot cattle. This has led to research into alternative feed supplements and improved stewardship practices. In a randomized controlled trial, we measured the impact of a probiotic and an altered pen environment on antimicrobial resistance among faecal Enterococcus spp. in cattle fed tylosin. Supplementing cattle with an Enterococcus faecium and Saccharomyces cerevisiae-based probiotic yielded the isolation of E. faecium of the probiotic sequence type (ST296) from faecal and environmental samples in treatment groups, as well as from cattle and the manure pack in nearby pens. Of importance, the probiotic strain also was found in a desiccated and milled manure pack sample taken 120 days after the initial trial ended. Phylogenetic and SNP analyses revealed clonal survival and spread compatible with faecal-environmental-oral recycling of the probiotic strain within and among cattle and pens. The increase in prevalence of the ST296 strain occurred concomitant with a decrease in ST240, the dominant sequence type associated with ermB and tet(M) resistance genes in this trial. SIGNIFICANCE AND IMPACT OF THE STUDY: We demonstrate that a macrolide-susceptible probiotic Enterococcus faecium ST296 strain fed to beef cattle becomes fully embedded in the microbial community cycling of bacteria via faecal-environmental-oral transmission within and among feedlot pens. An initial investment in feeding the probiotic is thereby leveraged into expanding numbers of susceptible bacteria in cattle and their environment, even among those cattle fed tylosin.


Assuntos
Antibacterianos/farmacologia , Enterococcus faecium/efeitos dos fármacos , Fezes/microbiologia , Macrolídeos/farmacologia , Probióticos/administração & dosagem , Ração Animal/análise , Ração Animal/microbiologia , Animais , Bovinos/metabolismo , Doenças dos Bovinos/microbiologia , Suplementos Nutricionais/análise , Resistência Microbiana a Medicamentos , Enterococcus faecium/classificação , Enterococcus faecium/genética , Enterococcus faecium/isolamento & purificação , Carne/microbiologia , Microbiota , Boca/microbiologia , Filogenia , Probióticos/análise , Inibidores da Síntese de Proteínas , Carne Vermelha , Tilosina/metabolismo , Estados Unidos
12.
Nat Ecol Evol ; 3(6): 919-927, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31110252

RESUMO

Predator-prey interactions in natural ecosystems generate complex food webs that have a simple universal body-size architecture where predators are systematically larger than their prey. Food-web theory shows that the highest predator-prey body-mass ratios found in natural food webs may be especially important because they create weak interactions with slow dynamics that stabilize communities against perturbations and maintain ecosystem functioning. Identifying these vital interactions in real communities typically requires arduous identification of interactions in complex food webs. Here, we overcome this obstacle by developing predator-trait models to predict average body-mass ratios based on a database comprising 290 food webs from freshwater, marine and terrestrial ecosystems across all continents. We analysed how species traits constrain body-size architecture by changing the slope of the predator-prey body-mass scaling. Across ecosystems, we found high body-mass ratios for predator groups with specific trait combinations including (1) small vertebrates and (2) large swimming or flying predators. Including the metabolic and movement types of predators increased the accuracy of predicting which species are engaged in high body-mass ratio interactions. We demonstrate that species traits explain striking patterns in the body-size architecture of natural food webs that underpin the stability and functioning of ecosystems, paving the way for community-level management of the most complex natural ecosystems.


Assuntos
Ecossistema , Cadeia Alimentar , Animais , Tamanho Corporal , Comportamento Predatório , Vertebrados
13.
J Anim Ecol ; 88(8): 1146-1157, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31032898

RESUMO

Litter breakdown in the streambed is an important pathway in organic carbon cycling and energy transfer in the biosphere that is mediated by a wide range of streambed organisms. However, most research on litter breakdown to date has focused on a small fraction of the taxa that drive it (e.g. microbial vs. macroinvertebrate-mediated breakdown) and has been limited to the benthic zone (BZ). Despite the importance of the hyporheic zone (HZ) as a bioreactor, little is known about what, or who, mediates litter breakdown in this compartment and whether breakdown rates differ between the BZ and HZ. Here, we explore the relationship between litter breakdown and the variation in community structure of benthic and hyporheic communities by deploying two standardized bioassays (cotton strips and two types of commercially available tea bags) in 30 UK streams that encompass a range of environmental conditions. Then, we modelled these assays as a response of the streambed compartment and the biological features of the streambed assemblage (Prokaryota, Protozoa and Eumetazoa invertebrates) to understand the generality and efficiency of litter processing across communities. Litter breakdown was much faster in the BZ compared with the HZ (around 5 times higher for cotton strips and 1.5 times faster for the tea leaves). However, differences in litter breakdown between the BZ and the HZ were mediated by the biological features of the benthos and the hyporheos. Biomass of all the studied biotic groups, α-diversity of Eumetazoa invertebrates and metabolic diversity of Prokaryota were important predictors that were positively related to breakdown coefficients demonstrating their importance in the functioning of the streambed ecosystem. Our study uses a novel multimetric bioassay that is able to disentangle the contribution by Prokaryota, Protozoa and Eumetazoa invertebrates to litter breakdown. In doing so, our study reveals new insights into how organic matter decomposition is partitioned across biota and streambed compartments.


Assuntos
Ecossistema , Rios , Animais , Biomassa , Invertebrados , Folhas de Planta
14.
Ecol Lett ; 21(12): 1771-1780, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30257275

RESUMO

Body mass-abundance (M-N) allometries provide a key measure of community structure, and deviations from scaling predictions could reveal how cross-ecosystem subsidies alter food webs. For 31 streams across the UK, we tested the hypothesis that linear log-log M-N scaling is shallower than that predicted by allometric scaling theory when top predators have access to allochthonous prey. These streams all contained a common and widespread top predator (brown trout) that regularly feeds on terrestrial prey and, as hypothesised, deviations from predicted scaling increased with its dominance of the fish assemblage. Our study identifies a key beneficiary of cross-ecosystem subsidies at the top of stream food webs and elucidates how these inputs can reshape the size-structure of these 'open' systems.


Assuntos
Cadeia Alimentar , Rios , Animais , Ecossistema , Peixes
15.
J R Coll Physicians Edinb ; 48(3): 217-224, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30191909

RESUMO

BACKGROUND: Communication between professionals, patients and families about palliative and end-of-life care after stroke is complex and there is a need for educational resources in this area. METHODS: To explore the key learning needs of healthcare professionals, a multidisciplinary, expert group developed a short electronic survey with open and closed questions, and then distributed it to six UK multiprofessional networks and two groups of local clinicians. RESULTS: A total of 599 healthcare professionals responded. Educational topics that were either definitely or probably needed were: ensuring consistent messages to families and patients (88%); resolving conflicts among family members (83%); handling unrealistic expectations (88%); involving families in discussions without them feeling responsible for decisions (82%); discussion of prognostic uncertainties (79%); likely mode of death (72%); and oral feeding for 'comfort' in patients at risk of aspiration (71%). The free-text responses (n = 489) and 82 'memorable' cases identified similar themes. CONCLUSION: Key topics of unmet need for education in end-of-life care in stroke have been identified and these have influenced the content of an open access, web-based educational resource.


Assuntos
Comunicação , Educação Médica Continuada , Pessoal de Saúde/educação , Avaliação das Necessidades , Acidente Vascular Cerebral/terapia , Assistência Terminal , Pessoal Técnico de Saúde/educação , Humanos , Internet , Corpo Clínico Hospitalar/educação , Recursos Humanos de Enfermagem Hospitalar/educação , Relações Médico-Paciente , Relações Profissional-Família , Serviço Social/educação , Inquéritos e Questionários , Suspensão de Tratamento
16.
Artigo em Inglês | MEDLINE | ID: mdl-28145036

RESUMO

Colorectal cancer is the second highest cause of cancer deaths. There are significant physical and psycho-social effects on quality of life with advanced disease. Despite this, there are few accounts of the patient experience from advanced illness through to dying. We elicited the longitudinal experiences of living and dying with incurable metastatic colorectal cancer by conducting serial interviews with patients for 12 months or until they died. The interviews were analysed, using a narrative approach, longitudinally as case studies and then together. Thirty-six interviews with 16 patients were conducted. Patients experience metastatic colorectal cancer in three phases; (1) Diagnosis and initial treatment; (2) Deterioration and social isolation and (3) Death and dying. Many patients initially said they hoped to survive, but, as "private" and in-depth accounts of the experience emerged in further interviews, so did the understanding that this hope co-existed with the knowledge that death was near. Palliative chemotherapy and the challenge of accessing private accounts of patient experience can inhibit care planning and prevent patients benefitting from an active holistic palliative care approach earlier in the disease trajectory. This study has immediate clinical relevance for health care professionals in oncology, palliative care and primary care.


Assuntos
Atitude Frente a Morte , Atitude Frente a Saúde , Neoplasias Colorretais/psicologia , Cuidados Paliativos/psicologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Planejamento de Assistência ao Paciente , Pesquisa Qualitativa , Qualidade de Vida
17.
J Dent Res ; 96(11): 1298-1305, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28817352

RESUMO

Nonsyndromic cleft lip and/or palate (NSCL/P) is a prevalent birth defect of complex etiology. Previous studies identified mutations in ARHGAP29 associated with an increased risk for NSCL/P. To investigate the effects of ARHGAP29 in vivo, we generated a novel murine allele by inserting a point mutation identified in a patient with NSCL/P. This single-nucleotide variation of ARHGAP29 translates to an early nonsense mutation (K326X), presumably resulting in loss-of-function (LoF). Embryos from Arhgap29K326X/+ intercrosses were harvested at various time points. No homozygous Arhgap29K326X animals were found in the 45 analyzed litters, assessed as early as embryonic day 8.5 (e8.5). Coronal sectioning of e13.5 and e14.5 heads revealed that 59% of Arhgap29K326X/+ mice ( n = 37) exhibited improper epithelial contact between developing oral structures, while none were observed in wild types ( n = 10). In addition, Arhgap29K326X/+ embryos exhibited a significantly higher percentage of maxillary epithelium in contact with mandibular epithelium. Immunofluorescent analyses of the periderm and oral adhesions revealed the presence of Arhgap29 in periderm cells. These cells were p63 negative, keratin 17 positive, and keratin 6 positive and present at sites of adhesion, although occasionally disorganized. Oral adhesions did not appear to impair palatogenesis, as all analyzed Arhgap29K326X/+ embryos showed confluent palatal mesenchyme and epithelium at e18.5 ( n = 16), and no mice were found with a cleft at birth. Collectively, our data demonstrate that ARHGAP29 is required for embryonic survival and that heterozygosity for LoF variants of Arhgap29 increases the incidence and length of oral adhesions at a critical time point during orofacial development. In conclusion, we validate the LoF nature of the human K326X mutation in vivo and reveal a previously unknown effect of Arhgap29 in murine craniofacial development.


Assuntos
Fenda Labial/genética , Fissura Palatina/genética , Proteínas Ativadoras de GTPase/genética , Alelos , Animais , Western Blotting , Adesão Celular , Fenda Labial/embriologia , Fissura Palatina/embriologia , Códon , Códon sem Sentido , Desenvolvimento Embrionário , Éxons , Estudo de Associação Genômica Ampla , Humanos , Camundongos , Camundongos Endogâmicos , Fenótipo , Mutação Puntual , Polimorfismo de Nucleotídeo Único
19.
BMJ Open ; 6(9): e012340, 2016 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-27645556

RESUMO

OBJECTIVES: 2 innovative concepts have lately been developed to radically improve the care of patients with advanced chronic conditions (PACC): early identification of palliative care (PC) needs and the 3 end-of-life trajectories in chronic illnesses (acute, intermittent and gradual dwindling). It is not clear (1) what indicators work best for this early identification and (2) if specific clinical indicators exist for each of these trajectories. The objectives of this study are to explore these 2 issues. SETTING: 3 primary care services, an acute care hospital, an intermediate care centre and 4 nursing homes in a mixed urban-rural district in Barcelona, Spain. PARTICIPANTS: 782 patients (61.5% women) with a positive NECPAL CCOMS-ICO test, indicating they might benefit from a PC approach. OUTCOME MEASURES: The characteristics and distribution of the indicators of the NECPAL CCOMS-ICO tool are analysed with respect to the 3 trajectories and have been arranged by domain (functional, nutritional and cognitive status, emotional problems, geriatric syndromes, social vulnerability and others) and according to their static (severity) and dynamic (progression) properties. RESULTS: The common indicators associated with early end-of-life identification are functional (44.3%) and nutritional (30.7%) progression, emotional distress (21.9%) and geriatric syndromes (15.7% delirium, 11.2% falls). The rest of the indicators showed differences in the associations per illness trajectories (p<0.05). 48.2% of the total cohort was identified as advanced frailty patients with no advanced disease criteria. CONCLUSIONS: Dynamic indicators are present in the 3 trajectories and are especially useful to identify PACC for a progressive PC approach purpose. Most of the other indicators are typically associated with a specific trajectory. These findings can help clinicians improve the identification of patients for a palliative approach.


Assuntos
Doença Crônica/terapia , Cuidados Paliativos/métodos , Assistência Terminal/métodos , Idoso de 80 Anos ou mais , Estudos Transversais , Progressão da Doença , Feminino , Humanos , Masculino , Índice de Gravidade de Doença , Espanha , Inquéritos e Questionários
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