Characterization of microRNAs and Target Genes in Musa acuminata subsp. burmannicoides, var. Calcutta 4 during Interaction with Pseudocercospora musae.

Endogenous microRNAs (miRNAs) are small non-coding RNAs that perform post-transcriptional regulatory roles across diverse cellular processes, including defence responses to biotic stresses. Pseudocercospora musae, the causal agent of Sigatoka leaf spot disease in banana (Musa spp.), is an important fungal pathogen of the plant. Illumina HiSeq 2500 sequencing of small RNA libraries derived from leaf material in Musa acuminata subsp. burmannicoides, var. Calcutta 4 (resistant) after inoculation with fungal conidiospores and equivalent non-inoculated controls revealed 202 conserved miRNAs from 30 miR-families together with 24 predicted novel miRNAs. Conserved members included those from families miRNA156, miRNA166, miRNA171, miRNA396, miRNA167, miRNA172, miRNA160, miRNA164, miRNA168, miRNA159, miRNA169, miRNA393, miRNA535, miRNA482, miRNA2118, and miRNA397, all known to be involved in plant immune responses. Gene ontology (GO) analysis of gene targets indicated molecular activity terms related to defence responses that included nucleotide binding, oxidoreductase activity, and protein kinase activity. Biological process terms associated with defence included response to hormone and response to oxidative stress. DNA binding and transcription factor activity also indicated the involvement of miRNA target genes in the regulation of gene expression during defence responses. sRNA-seq expression data for miRNAs and RNAseq data for target genes were validated using stem-loop quantitative real-time PCR (qRT-PCR). For the 11 conserved miRNAs selected based on family abundance and known involvement in plant defence responses, the data revealed a frequent negative correlation of expression between miRNAs and target host genes. This examination provides novel information on miRNA-mediated host defence responses, applicable in genetic engineering for the control of Sigatoka leaf spot disease.

Transcriptome Profiling of the Resistance Response of Musa acuminata subsp. burmannicoides, var. Calcutta 4 to Pseudocercospora musae.

Banana (Musa spp.), which is one of the world's most popular and most traded fruits, is highly susceptible to pests and diseases. Pseudocercospora musae, responsible for Sigatoka leaf spot disease, is a principal fungal pathogen of Musa spp., resulting in serious economic damage to cultivars in the Cavendish subgroup. The aim of this study was to characterize genetic components of the early immune response to P. musae in Musa acuminata subsp. burmannicoides, var. Calcutta 4, a resistant wild diploid. Leaf RNA samples were extracted from Calcutta 4 three days after inoculation with fungal conidiospores, with paired-end sequencing conducted in inoculated and non-inoculated controls using lllumina HiSeq 4000 technology. Following mapping to the reference M. acuminata ssp. malaccensis var. Pahang genome, differentially expressed genes (DEGs) were identified and expression representation analyzed on the basis of gene ontology enrichment, Kyoto Encyclopedia of Genes and Genomes orthology and MapMan pathway analysis. Sequence data mapped to 29,757 gene transcript models in the reference Musa genome. A total of 1073 DEGs were identified in pathogen-inoculated cDNA libraries, in comparison to non-inoculated controls, with 32% overexpressed. GO enrichment analysis revealed common assignment to terms that included chitin binding, chitinase activity, pattern binding, oxidoreductase activity and transcription factor (TF) activity. Allocation to KEGG pathways revealed DEGs associated with environmental information processing, signaling, biosynthesis of secondary metabolites, and metabolism of terpenoids and polyketides. With 144 up-regulated DEGs potentially involved in biotic stress response pathways, including genes involved in cell wall reinforcement, PTI responses, TF regulation, phytohormone signaling and secondary metabolism, data demonstrated diverse early-stage defense responses to P. musae. With increased understanding of the defense responses occurring during the incompatible interaction in resistant Calcutta 4, these data are appropriate for the development of effective disease management approaches based on genetic improvement through introgression of candidate genes in superior cultivars.

Prognostic Value of the Malnutrition-inflammation Score in Hospitalization and Mortality on Long-term Hemodialysis.

OBJECTIVE: Since its development, cumulative evidence has accumulated regarding the prognostic value of the Malnutrition-Inflammation Score (MIS/Kalantar score) prognostic value; however, there is a shortage of recent and large studies with comprehensive statistical methodologies that contribute to support a higher level of evidence and a consensual cutoff. The aim of this study was to assess the strength of MIS association with hospitalization and mortality in a nationwide cohort. METHODS: This was a historical cohort study of hemodialysis patients from 25 outpatient centers followed up for 48 months. Univariable and multivariable Cox additive regression models were used to analyze the data. The C-index was estimated to assess the performance of the final model. RESULTS: Two thousand four hundred forty-four patients were analyzed, 59.0% males, 32.0% diabetic, and median age of 71 years (P25 = 60, P75 = 79). During a median period of 45-month follow-up, with a maximum of 48 months (P25 = 31; P75 = 48), 875 patients presented an MIS <5 (35.8%) and 860 patients (35.2%) died. The proportion of deaths was 23.1% for patients with the MIS <5 and 41.9% if the MIS ≥5 (P < .001). A total of 1,528 patients (62.5%) were hospitalized with a median time to the first hospitalization of 26 months (P25 = 9; P75 = 45). A new cutoff point regarding the risk of death, MIS ≥6, was identified for this study data set. In multivariable analysis for hospitalization risk, a higher MIS, higher comorbidity index, and arteriovenous graft or catheter increased the risk, whereas higher Kt/V and higher albumin had a protective effect. In multivariable analysis for mortality risk, adjusting for age, albumin, normalized protein catabolic rate, Charlson comorbidity index, interdialytic weight gain, Kt/V, diabetes, hematocrit, and vascular access, patients with the MIS ≥6 showed a hazard ratio of 1.469 (95% confidence interval: 1.262-1.711; P < .001). Higher age, higher interdialytic weight gain, higher comorbidity index, and catheter increased significantly the risk, whereas higher Kt/V, higher albumin, and higher normalized protein catabolic rate (≥1.05 g/kg/d) reduced the risk. CONCLUSION: The MIS maintains its relevant and significant association with hospitalization and mortality.

Clinical Frailty Scale em idosos atendidos no Serviço Hospitalar de Emergência: a fragilidade basal é um bom preditor de mortalidade em 90 dias? / Clinical Frailty Scale in older adults admitted at Emergency Department: is baseline frailty a good predictor of Ninety-Day Mortality?

Resumo Objetivo Avaliar a capacidade da Clinical Frailty Scale (CFS) em predizer a mortalidade em até 90 dias e outros desfechos desfavoráveis em idosos admitidos em um Serviço Hospitalar de Emergência (SHE). Método Estudo de coorte prospectivo que incluiu idosos admitidos e que permaneceram por pelo menos uma noite no SHE de um hospital público terciário. O grau de fragilidade basal foi avaliado através da CFS e sua pontuação, o preditor estudado, por meio da curva Receiver Operator Characteristics (ROC). Analisou-se como desfecho primário a mortalidade em 90 dias. Considerou-se como desfechos secundários: mortalidade em 180 dias, declínio funcional, readmissão no SHE, reinternação e necessidade de atenção domiciliar. Resultados 206 participantes foram incluídos. Dos 127 idosos frágeis, 40 (31,5%) faleceram até o 90º dia comparado a 5 (6,3%) do grupo não frágil (p<0,001). Após ajuste para variáveis demográficas e clínicas, a fragilidade manteve-se no modelo como um preditor independente de mortalidade em 90 dias da admissão. A acurácia obtida pela curva ROC (AUROC) para predição de mortalidade em 90 dias foi de 0,81. Para mortalidade em 180 dias foi 0,80; para necessidade de atenção domiciliar, 0,77; e para reinternação, 0,65. Para os demais desfechos estudados, a acurácia não foi significativa. Conclusão A fragilidade basal medida pela CFS é um bom preditor de mortalidade em 90 e 180 dias e de necessidade de atenção domiciliar em idosos admitidos no SHE. Sua aplicação nesse cenário pode auxiliar na tomada de decisões clínicas.

Abstract Objective To evaluate the ability of the Clinical Frailty Scale (CFS) to predict 90-day mortality and other poor outcomes in older adults admitted at a Hospital Emergency Department (ED). Method This is a prospective cohort study including older adults admitted at ED of a Public Hospital who spent at least one night in it. The degree of baseline frailty was assessed through the CFS, and its score was the predictor studied, through the Receiver Operator Characteristics (ROC) curve analysis. We analyzed 90-day mortality as a primary outcome. The following outcomes were considered as secondary ones: mortality, functional decline, readmittance to ED, readmission and need for home care. Results 206 participants were included. Of the 127 frail older adults, 40 (31.5%) died before the 90th day compared to 5 (6.3%) in the non-frail group (p<0.001). After adjustment for demographic and clinical variables, frailty remained in the model as an independent predictor of 90-day mortality. The accuracy obtained by the ROC curve (AUROC) for predicting 90-day mortality was 0.81. For 180-day mortality, 0.80, for the need for home care, 0.77 for readmission, 0.65. For the other outcomes studied, the accuracy was not significant. Conclusion Baseline frailty measured by the CFS is a good predictor of 90 and 180-day mortality and needing for home care in older adults admitted to ED. Its application in this setting might help clinical decision-making.

Stable reference genes for RT-qPCR analysis of gene expression in the Musa acuminata-Pseudocercospora musae interaction.

Leaf pathogens are limiting factors in banana (Musa spp.) production, with Pseudocercospora spp. responsible for the important Sigatoka disease complex. In order to investigate cellular processes and genes involved in host defence responses, quantitative real-time PCR (RT-qPCR) is an analytical technique for gene expression quantification. Reliable RT-qPCR data, however, requires that reference genes for normalization of mRNA levels in samples are validated under the conditions employed for expression analysis of target genes. We evaluated the stability of potential reference genes ACT1, α-TUB, UBQ1, UBQ2, GAPDH, EF1α, APT and RAN. Total RNA was extracted from leaf tissues of Musa acuminata genotypes Calcutta 4 (resistant) and Cavendish Grande Naine (susceptible), both subjected to P. musae infection. Expression stability was determined with NormFinder, BestKeeper, geNorm and RefFinder algorithms. UBQ2 and RAN were the most stable across all M. acuminata samples, whereas when considering inoculated and non-inoculated leaf samples, APT and UBQ2 were appropriate for normalization in Calcutta 4, with RAN and α-TUB most stable in Cavendish Grande Naine. This first study of reference genes for relative quantification of target gene expression in the M. acuminata-P. musae interaction will enable reliable analysis of gene expression in this pathosystem, benefiting elucidation of disease resistance mechanisms.

Cuidados paliativos no atendimento público hospitalar: a importância do atendimento de pacientes jovens / Palliative care in public hospitals: significance of care for young patients

OBJETIVO: Avaliar se o acompanhamento pela equipe de cuidados paliativos durante a internação hospitalar associa-se com o desfecho de alta hospitalar para o domicílio ou por óbito em pacientes jovens portadores de doenças crônicas incuráveis, destacando a importância no atendimento desta faixa etária. MÉ- TODOS: Foram coletados dados de 92 dos 601 prontuários do Serviço de Cuidados Paliativos de um hospital público universitário de Belo Horizonte (MG). Foram incluídos pacientes entre 18 e 45 anos portadores de doença crônica incurável. Os dados foram divididos em dois grupos: internações com desfecho de óbito e de alta domiciliar. Foram utilizados o teste qui-quadrado, o teste exato de Fisher e teste Mann-Whitney para análise das variáveis idade, sexo, diagnóstico primário, Escala de Performance Paliativa à internação e próximo à alta; indicação de internação hospitalar; indicação de encaminhamento à equipe de cuidados paliativos e indicadores de internação hospitalar. RESULTADOS: Pacientes entre 18 e 45 anos constituíram 15,3% da amostra total, com média de idade de 34 anos e predomínio do sexo feminino. Causas oncológicas representaram 94,6% dos diagnósticos. "Controle de sintomas" destacou-se em ambos os grupos como principal motivo de encaminhamento à equipe de cuidados paliativos. Na análise multivariada apenas os valores de Escala de Performance Paliativa inicial e final foram significativos para o desfecho óbito. CONCLUSÃO: Estes resultados reafirmam a importância do preparo profissional para reconhecimento da possibilidade de morte em jovens e a valorização dos cuidados paliativos.(AU)

OBJECTIVE: To evaluate if the follow-up by the palliative care team during hospitalization is associated with the outcome of hospital discharge or death in young patients with chronic incurable diseases, highlighting the importance of attending this age group. METHODS: Data were collected from 92 of the 601 records of the palliative care service of a public university hospital in the city of Belo Horizonte. Patients between 18 and 45 years with an incurable chronic disease were included. Data were divided into two groups - hospitalizations with death and discharge to home. Chi-square test, Fisher exact test, and Mann-Whitney test were used to evaluate the following parameters: age, gender, primary diagnosis, Palliative Performance Scale at hospitalization and near medical discharge; indication of hospital admission; indication of referral to the palliative care team and hospital admission indicators. RESULTS: Patients aged between 18 and 45 years constituted 15.3% of the total sample, with a mean age of 34 years and predominance of women. Oncologic causes represented 94.6% of the diagnoses. The "control of symptoms" was highlighted in both groups as the main reason for referral to palliative care. In the multivariate analysis only the initial and final Palliative Performance Scale values were significant for the death outcome. CONCLUSION: The results reinforce the importance of professional preparation for recognition of the possibility of death in young people and valorization of palliative care.(AU)

Ostectomias - como devem ser encaradas / Ostectomies - how to face them

Ostectomias säo realizadas rotineiramente nas cirurgias orais, sendo portanto de grande interesse para o cirurgiäo saber a melhor forma de realizá-las, o instrumental a ser utilizado, como os cinzéis à pressäo manual, cinzel e martelo ou brocas, podendo ser dessa maneira avaliadas suas vantagens e desvantagens. Foram analisados os conceitos básicos dos mecanismos de regeneraçäo e reparaçäo óssea, além das diversas técnicas de ostectomias de acordo com vários autores, para chegar-se a conclusöes sobre as vantagens na utilizaçäo de uma ou outra técnica

Placas oclusais no tratamento de bruxismo e desordens têmporo-mandibulares / Using occlusal plates in bruxism and temporomandibular injuries (TMIs) / Using

O bruxismo e as Desordens Temporomandibulares (DTMs) são distúrbios do sistema mastigatório que possuem etiologia multifatorial, complexa e ainda inconclusiva para alguns autores. Com alta incidência na população, estas patologias merecem atenção especial por parte do cirurgião-dentista. Apesar de existirem diversas formas de manejo e tratamento do paciente que apresenta sintomas de bruxismo e DTMs, o uso de placas oclusais é ainda uma terapia muito preconizada pela maioria dos autores, principalmente por ser uma terapia conservadora e reversível. Os autores realizaram uma revisão da literatura sobre o uso de placas oclusais no manejo dos pacientes com bruxismo e DTMs, apresentando uma técnica de confecção de placa modificada a partir da técnica de Okeson (1992, 1998), como uma opção de tratamento reversível, de baixo custo e com alto índice de efetividade no tratamento sintomático do bruxismo e das dores comumente associadas às DTMs