Ex Vitro Rooting and Simultaneous Micrografting of the Walnut Hybrid Rootstock ‘Paradox’ (Juglans hindsi × Juglans regia) cl. ‘Vlach’

In vitro micropropagation is already a current multiplication tool for walnut self-rooted cultivars and rootstocks, but walnut grafting is still performed in the field or in greenhouses, mainly using seedlings as rootstocks. The present work describes a new approach to obtain clonal walnut-grafted plants, involving in vitro shoot production of ‘Paradox’ (Juglans hindsi × Juglans regia) cl. ’Vlach’, to be used as rootstock, and J. regia cv. ‘Chandler’, to be used as scion. After completing the in vitro multiplication phase and a seven-day root induction treatment, ‘Vlach’ explants are transferred to ex vitro conditions for root expression while being simultaneously grafted using the in vitro produced ‘Chandler’ scions. The importance of the presence of leaves on both the scion and the rootstock for the success rate of the technique was evaluated. Under optimal conditions, average success rates of 82% for rootstock rooting, 72% for micrografting survival, and 84% for grafted plant acclimatization were achieved. This rooting/grafting combination technique seems able to compete with the traditional techniques of nursery grafting, allowing obtaining high-quality walnut-grafted plants independently of the external weather conditions in a significantly shorter time

A estação arqueológica das Boucinhas, Regueira, Vitorino de Piães, Ponte de Lima (Norte de Portugal)

Publicam-se os resultados das sondagens arqueológicas realizadas no povoado da Idade do Bronze da Boucinha, em Vitorino de Piães, Ponte de Lima.Projeto FCT: The Entre-Douro-e-Minho landscape since middle of 3rd to the end of 2nd millenia BC.info:eu-repo/semantics/publishedVersio

PERFIL ANTROPOMÉTRICO E BIOQUÍMICO RELACIONADO À SÍNDROME DA FRAGILIDADE EM IDOSOS INSTITUCIONALIZADOS

ResumoObjetivo: traçar o perfil antropométrico e bioquímico relacionado à Síndrome da Fragilidade (SF) em idosos institucionalizados. Materiais e métodos: a amostra foi constituída por 36 idosos de ambos os sexos (23 Masculino e 13 Feminino) com média de idade de 76,3 ± 7,8 anos, residentes em Instituições de Longa Permanência. Foram coletados dados referentes às medidas antropométricas, funcionais, perfil bioquímico e, posteriormente, identificada a SF. Os dados foram apresentados em média, desvio padrão e frequência relativa. Para comparar as variáveis de acordo com o sexo e SF, adotou-se o teste T independente e qui-quadrado, com um nível de significância de 95%. Resultados: os participantes do gênero masculino apresentaram valores mais elevados em estatura, circunferência do pescoço e força de preensão palmar. Entre os idosos de perfil pré-frágil e frágil, as variáveis antropométricas e bioquímicas foram semelhantes. Conclusão: não houve diferença nas variáveis bioquímicas e antropométricas entre os idosos classificados como pré-frágeis e frágeis.Palavras-chave: síndrome da fragilidade; idosos; perfil antropométrico. AbstractObjective: trace the anthropometric and laboratory parameters related to the Frailty Syndrome (FS) in institutionalized elderly.. Materials and methods: The sample consisted of 36 elderly men and women (23 male and 13 female) with a mean age of 76.3 ± 7.8 years, living in long-term care institutions. Data were collected regarding anthropometric measurements, biochemical profile and additionally identified frailty syndrome. Data were presented as mean, standard deviation and percentage frequency. To compare the variables according to gender, to test the comparisons between the proportions and to correlate the variables, were used the independent t-test, chi-square and pearson linear correlation respectively, with a significance level of p <0.05. Results: Male participants had higher values in height, neck circumference and handgrip strength. Among the elderly with a pre-frail and frail profile, anthropometric and biochemical variables were similar. Conclusion: There was no difference in biochemical and anthropometric variables between the elderly classified as pre-fragile and fragile. In addition to the absence of elderly classified as non-fragile in the long-term care institutions of the present studyKeywords: frailty syndrome; elderly; anthropometric profile. Figshare DOI: 10.6084/m9.figshare.1187406

ACALABRUTINIBE NO TRATAMENTO DE LEUCEMIA LINFOCÍTICA CRÔNICA

Introduction: Chronic lymphocytic leukemia is the most common adult leukemia. It is characterized by clonal expansion of mature CD5+ B cells into blood, bone marrow, and lymphoid tissues. Objectives: To evaluate the efficacy and adverse events of the use of acalabrutinib in the treatment of chronic lymphocytic leukemia. Materials and methods: This is an integrative review, in which the guiding question was “Is acalabrutinib effective in the treatment of chronic lymphocytic leukemia?”. The search for articles was carried out in the main databases (PubMed and Scielo) using the terms “acalabrutinib” and “chronic lymphocytic leukemia”, combined using Boolean operators. Results and Discussion: Compared to ibrutinib, acalabrutinib is highly selective and characterized by a lack of inhibition towards other kinases. Overall survival comparisons favored acalabrutinib alone and in combination with obinutuzumab over all comparators. Acalabrutinib monotherapy was also associated with statistically improved progression-free survival over obinutuzumab-chlorambucil. Conclusion: Acalabrutinib is an effective and safe treatment of chronic lymphocytic leukemia. Acalabrutinib plus obinutuzumab or acalabrutinib monotherapy were associated with improved efficacy over standard immunochemotherapy.Introducción: La leucemia linfocítica crónica es la leucemia más frecuente en adultos. Se caracteriza por la expansión clonal de células B CD5+ maduras en la sangre, la médula ósea y los tejidos linfoides. Objetivos: Evaluar la eficacia y los eventos adversos del uso de acalabrutinib en el tratamiento de la leucemia linfocítica crónica. Materiales y métodos: Se trata de una revisión integradora, en la que la pregunta orientadora fue “¿Es efectivo el acalabrutinib en el tratamiento de la leucemia linfocítica crónica?”. La búsqueda de artículos se realizó en las principales bases de datos (PubMed y Scielo) utilizando los términos “acalabrutinib” y “crónica linfocítica leucemia”, combinados mediante operadores booleanos. Resultados y Discusión: Comparado con ibrutinib, acalabrutinib es altamente selectivo y se caracteriza por una falta de inhibición hacia otras quinasas. Las comparaciones de supervivencia general favorecieron a acalabrutinib solo y en combinación con obinutuzumab sobre todos los comparadores. La monoterapia con acalabrutinib también se asoció con una supervivencia libre de progresión estadísticamente superior a la de obinutuzumab-clorambucilo. Conclusión: Acalabrutinib es un tratamiento eficaz y seguro de la leucemia linfocítica crónica. Acalabrutinib más obinutuzumab o la monoterapia con acalabrutinib se asociaron con una mayor eficacia en comparación con la inmunoquimioterapia estándar.A leucemia linfocítica crônica é a leucemia adulta mais comum. É caracterizada pela expansão clonal de células B maduras CD5 + no sangue, medula óssea e tecidos linfóides. Objetivos: Avaliar a eficácia e os eventos adversos ao uso do Acalabrutinibe no tratamento de leucemia linfocítica crônica. Materiais e métodos: Trata-se de uma revisão integrativa, em que a questão norteadora foi “O acalabrutinibe é eficaz no tratamento de leucemia linfocítica crônica?”. A busca pelos artigos ocorreu nas principais bases de dados (PubMed e Scielo) a partir dos termos “acalabrutinib” e “chronic lymphocytic leukemia”, combinados entre si por operadores booleanos. Resultados e discussão: Em comparação com o ibrutinibe, o acalabrutinibe é altamente seletivo e caracterizado pela falta de inibição em relação a outras quinases. As comparações de sobrevida global favoreceram a monoterapia com acalabrutinibe e em combinação com obinutuzumabe sobre todos os comparadores. A monoterapia com acalabrutinibe também foi associada a sobrevida livre de progressão estatisticamente melhorada em relação a obinutuzumabe-clorambucil. Conclusão: O acalabrutinib é um tratamento eficaz e seguro da leucemia linfocítica crônica. O acalabrutinibe mais obinutuzumabe ou a monoterapia com acalabrutinibe foram associados a uma eficácia melhorada em relação à imunoquimioterapia padrão. A leucemia linfocítica crônica é a leucemia adulta mais comum. É caracterizada pela expansão clonal de células B maduras CD5 + no sangue, medula óssea e tecidos linfóides. Objetivos: Avaliar a eficácia e os eventos adversos ao uso do Acalabrutinibe no tratamento de leucemia linfocítica crônica. Materiais e métodos: Trata-se de uma revisão integrativa, em que a questão norteadora foi “O acalabrutinibe é eficaz no tratamento de leucemia linfocítica crônica?”. A busca pelos artigos ocorreu nas principais bases de dados (PubMed e Scielo) a partir dos termos “acalabrutinib” e “chronic lymphocytic leukemia”, combinados entre si por operadores booleanos. Resultados e discussão: Em comparação com o ibrutinibe, o acalabrutinibe é altamente seletivo e caracterizado pela falta de inibição em relação a outras quinases. As comparações de sobrevida global favoreceram a monoterapia com acalabrutinibe e em combinação com obinutuzumabe sobre todos os comparadores. A monoterapia com acalabrutinibe também foi associada a sobrevida livre de progressão estatisticamente melhorada em relação a obinutuzumabe-clorambucil. Conclusão: O acalabrutinib é um tratamento eficaz e seguro da leucemia linfocítica crônica. O acalabrutinibe mais obinutuzumabe ou a monoterapia com acalabrutinibe foram associados a uma eficácia melhorada em relação à imunoquimioterapia padrão.

SARS-CoV-2 introductions and early dynamics of the epidemic in Portugal

Genomic surveillance of SARS-CoV-2 in Portugal was rapidly implemented by the National Institute of Health in the early stages of the COVID-19 epidemic, in collaboration with more than 50 laboratories distributed nationwide. Methods By applying recent phylodynamic models that allow integration of individual-based travel history, we reconstructed and characterized the spatio-temporal dynamics of SARSCoV-2 introductions and early dissemination in Portugal. Results We detected at least 277 independent SARS-CoV-2 introductions, mostly from European countries (namely the United Kingdom, Spain, France, Italy, and Switzerland), which were consistent with the countries with the highest connectivity with Portugal. Although most introductions were estimated to have occurred during early March 2020, it is likely that SARS-CoV-2 was silently circulating in Portugal throughout February, before the first cases were confirmed. Conclusions Here we conclude that the earlier implementation of measures could have minimized the number of introductions and subsequent virus expansion in Portugal. This study lays the foundation for genomic epidemiology of SARS-CoV-2 in Portugal, and highlights the need for systematic and geographically-representative genomic surveillance.We gratefully acknowledge to Sara Hill and Nuno Faria (University of Oxford) and Joshua Quick and Nick Loman (University of Birmingham) for kindly providing us with the initial sets of Artic Network primers for NGS; Rafael Mamede (MRamirez team, IMM, Lisbon) for developing and sharing a bioinformatics script for sequence curation (https://github.com/rfm-targa/BioinfUtils); Philippe Lemey (KU Leuven) for providing guidance on the implementation of the phylodynamic models; Joshua L. Cherry (National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health) for providing guidance with the subsampling strategies; and all authors, originating and submitting laboratories who have contributed genome data on GISAID (https://www.gisaid.org/) on which part of this research is based. The opinions expressed in this article are those of the authors and do not reflect the view of the National Institutes of Health, the Department of Health and Human Services, or the United States government. This study is co-funded by Fundação para a Ciência e Tecnologia and Agência de Investigação Clínica e Inovação Biomédica (234_596874175) on behalf of the Research 4 COVID-19 call. Some infrastructural resources used in this study come from the GenomePT project (POCI-01-0145-FEDER-022184), supported by COMPETE 2020 - Operational Programme for Competitiveness and Internationalisation (POCI), Lisboa Portugal Regional Operational Programme (Lisboa2020), Algarve Portugal Regional Operational Programme (CRESC Algarve2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF), and by Fundação para a Ciência e a Tecnologia (FCT).info:eu-repo/semantics/publishedVersio

Nationwide access to endovascular treatment for acute ischemic stroke in portugal

Publisher Copyright: Copyright Ordem dos M dicos 2021.Introduction: Since the publication of endovascular treatment trials and European Stroke Guidelines, Portugal has re-organized stroke healthcare. The nine centers performing endovascular treatment are not equally distributed within the country, which may lead to differential access to endovascular treatment. Our main aim was to perform a descriptive analysis of the main treatment metrics regarding endovascular treatment in mainland Portugal and its administrative districts. Material and Methods: A retrospective national multicentric cohort study was conducted, including all ischemic stroke patients treated with endovascular treatment in mainland Portugal over two years (July 2015 to June 2017). All endovascular treatment centers contributed to an anonymized database. Demographic, stroke-related and procedure-related variables were collected. Crude endovascular treatment rates were calculated per 100 000 inhabitants for mainland Portugal, and each district and endovascular treatment standardized ratios (indirect age-sex standardization) were also calculated. Patient time metrics were computed as the median time between stroke onset, first-door, and puncture. Results: A total of 1625 endovascular treatment procedures were registered. The endovascular treatment rate was 8.27/100 000 inhabitants/year. We found regional heterogeneity in endovascular treatment rates (1.58 to 16.53/100 000/year), with higher rates in districts closer to endovascular treatment centers. When analyzed by district, the median time from stroke onset to puncture ranged from 212 to 432 minutes, reflecting regional heterogeneity. Discussion: Overall endovascular treatment rates and procedural times in Portugal are comparable to other international registries. We found geographic heterogeneity, with lower endovascular treatment rates and longer onset-to-puncture time in southern and inner regions. Conclusion: The overall national rate of EVT in the first two years after the organization of EVT-capable centers is one of the highest among European countries, however, significant regional disparities were documented. Moreover, stroke-onset-to-first-door times and in-hospital procedural times in the EVT centers were comparable to those reported in the randomized controlled trials performed in high-volume tertiary hospitalspublishersversionpublishe

Acesso a Tratamento Endovascular para Acidente Vascular Cerebral Isquémico em Portugal

Introduction: Since the publication of endovascular treatment trials and European Stroke Guidelines, Portugal has re-organized stroke healthcare. The nine centers performing endovascular treatment are not equally distributed within the country, which may lead to differential access to endovascular treatment. Our main aim was to perform a descriptive analysis of the main treatment metrics regarding endovascular treatment in mainland Portugal and its administrative districts. Material and Methods: A retrospective national multicentric cohort study was conducted, including all ischemic stroke patients treated with endovascular treatment in mainland Portugal over two years (July 2015 to June 2017). All endovascular treatment centers contributed to an anonymized database. Demographic, stroke-related and procedure-related variables were collected. Crude endovascular treatment rates were calculated per 100 000 inhabitants for mainland Portugal, and each district and endovascular treatment standardized ratios (indirect age-sex standardization) were also calculated. Patient time metrics were computed as the median time between stroke onset, first-door, and puncture. Results: A total of 1625 endovascular treatment procedures were registered. The endovascular treatment rate was 8.27/100 000 inhabitants/year. We found regional heterogeneity in endovascular treatment rates (1.58 to 16.53/100 000/year), with higher rates in districts closer to endovascular treatment centers. When analyzed by district, the median time from stroke onset to puncture ranged from 212 to 432 minutes, reflecting regional heterogeneity. Conclusion: The overall national rate of EVT in the first two years after the organization of EVT-capable centers is one of the highest among European countries, however, significant regional disparities were documented. Moreover, stroke-onset-to-first-door times and in-hospital procedural times in the EVT centers were comparable to those reported in the randomized controlled trials performed in high-volume tertiary hospitals.Introdução: A aprovação do tratamento endovascular para o acidente vascular cerebral isquémico obrigou à reorganização dos cuidados de saúde em Portugal. Os nove centros que realizam tratamento endovascular não estão distribuídos equitativamente pelo território, o que poderá causar acesso diferencial a tratamento. O principal objetivo deste estudo é realizar uma análise descritiva da frequência e métricas temporais do tratamento endovascular em Portugal continental e seus distritos. Material e Métodos: Estudo de coorte nacional multicêntrico, incluindo todos os doentes com acidente vascular cerebral isquémico submetidos a tratamento endovascular em Portugal continental durante um período de dois anos (julho 2015 a junho 2017). Foram colhidos dados demográficos, relacionados com o acidente vascular cerebral e variáveis do procedimento. Taxas de tratamento endovascular brutas e ajustadas (ajuste indireto a idade e sexo) foram calculadas por 100 000 habitantes/ano para Portugal continental e cada distrito. Métricas de procedimento como tempo entre instalação, primeira porta e punção foram também analisadas. Resultados: Foram registados 1625 tratamentos endovasculares, indicando uma taxa bruta nacional de tratamento endovascular de 8,27/100 000 habitantes/ano. As taxas de tratamento endovascular entre distritos variaram entre 1,58 e 16,53/100 000/ano, com taxas mais elevadas nos distritos próximos a hospitais com tratamento endovascular. O tempo entre sintomas e punção femural entre distritos variou entre 212 e 432 minutos. Conclusão: Portugal continental apresenta uma taxa nacional de tratamento endovascular elevada, apresentando, contudo, assimetrias regionais no acesso. As métricas temporais foram comparáveis com as observadas nos ensaios clínicos piloto

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701