154 research outputs found

    Is evolution faster at ecotones? A test using rates and tempo of diet transitions in Neotropical Sigmodontinae (Rodentia, Cricetidae)

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    We evaluated whether evolution is faster at ecotones as niche shifts may be needed to persist under unstable environment. We mapped diet evolution along the evolutionary history of 350 sigmodontine species. Mapping was used in three new tipbased metrics of trait evolution – Transition Rates, Stasis Time, and Last Transition Time – which were spatialized at the assemblage level (aTR, aST, aTL). Assemblages were obtained by superimposing range maps on points located at core and ecotone of the 93 South American ecoregions. Using Linear Mixed Models, we tested whether ecotones have species with more changes from the ancestral diet (higher aTR), have maintained the current diet for a shorter time (lower aST), and have more recent transitions to the current diet (lower aLT) than cores. We found lower aTR, and higher aST and aLT at ecotones than at cores. Although ecotones are more heterogeneous, both environmentally and in relation to selection pressures they exert on organisms, ecotone species change little from the ancestral diet as generalist habits are necessary toward feeding in ephemeral environments. The need to incorporate phylogenetic uncertainty in tip-based metrics was evident from large uncertainty detected. Our study integrates ecology and evolution by analyzing how fast trait evolution is across space

    Implementation of inpatient models of pharmacogenetics programs

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    The operational elements essential for establishing an inpatient pharmacogenetic service are reviewed, and the role of the pharmacist in the provision of genotype-guided drug therapy in pharmacogenetics programs at three institutions is highlighted

    Impactos económicos y ecológicos de la participación en las cadenas globales de valor en los países latinoamericanos, 1995-2011.

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    En esta tesis se analizan los impactos económicos y ecológicos asociados a la evolución y características de la participación en las Cadenas Globales de Valor (CGV) de siete países latinoamericanos, Argentina, Brasil, Chile, Colombia, Costa Rica, México y Perú, desde una perspectiva multirregional y multisectorial en el periodo 1995-2011. La participación en las CGV y sus impactos económicos se fundamentó en un modelo MRIO denominado GVC income (Timmer et al., 2013, 2015, 2016). Para el análisis de los impactos ecológicos se extiende el modelo MRIO a la consideración de los flujos ambientales (Miller y Blair, 2009; Wiedmann et al., 2011). Nuestra hipótesis es que los países latinoamericanos participan relativamente con mayor intensidad en las etapas iniciales que en las etapas intermedias-finales de las CGV. Esta participación no se concretó en cambios robustos en las estructuras económicas, ni en la configuración de tendencias sostenidas hacia la mejora de los términos de intercambio de los países latinoamericanos. Adicionalmente, los intercambios ecológicos incorporados directa e indirectamente en el comercio internacional se relacionan con mayores presiones sobre la explotación de recursos naturales, como el uso de la superficie agrícola, el consumo de agua, los flujos de materias primas intercambiadas, así como mayores emisiones de carbono. Por ello, analizamos cómo ha evolucionado la participación de los países latinoamericanos en las etapas de producción de las CGV y cuáles han sido sus impactos económicos considerando el rol dinamizador de la industria en el cambio de las estructuras económicas, asimismo se analizó el valor añadido incorporado en los flujos de comercio internacional, para determinar los beneficios/pérdidas del comercio de los países latinoamericanos con el resto del mundo, Norteamérica, Unión Europea, Asia, Otros Países Europeos y Medio Oriente y África. Finalmente, se estudiaron los impactos ecológicos asociados a la participación de los países latinoamericanos en las CGV y sus relaciones con siete regiones desarrolladas, basándonos en indicadores que muestran el uso de la tierra agrícola, el consumo de agua, los flujos de materias primas y las emisiones de carbono en el periodo 1990-2015. La tesis se estructuró en seis capítulos. En el primero se describe el panorama general de los países latinoamericanos en el proceso de transformación estructural de la economía mundial. En el segundo se presentan los elementos teóricos esenciales del concepto CGV como marco articulador en el análisis de la participación de los países en los procesos de integración productiva y comercial, directa e indirectamente, derivadas de la fragmentación internacional de la producción. Esto se complementa con la incorporación del concepto comercio internacional de valor añadido, que es clave en la investigación empírica fundamentada en el marco de análisis input-output bajo los criterios del modelo MRIO denominado GVC income. En los capítulos tres y cuarto, se analizan los impactos económicos de la participación de los países latinoamericanos en las CGV, desde la perspectiva de la estructura de la producción, estimando para ellos indicadores de las capacidades de arrastre e impulso para la clasificación de las industrias en clave, de arrastre, de impulso y no relevantes. En el cuarto capítulo se examinan los términos de intercambio de los países latinoamericanos en diferentes escalas industriales y geográficas con el propósito de determinar cómo han evolucionado las transferencias internacionales de la renta entre países y regiones durante el periodo. El análisis de los impactos ecológicos de la región latinoamericana en el contexto de las CGV se analizó en el capítulo cinco. Finalmente, en el capítulo seis, se enumeran las conclusiones generales.<br /

    CYTOTOXICITY, ANTI-POLIOVIRUS ACTIVITY AND IN SILICO BIOLOGICAL EVALUATION OF CONSTITUENTS FROM MAYTENUS GONOCLADA (CELASTRACEAE)

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    Objective: The in silico free access web tools PASS online and ChemMapper were used to predict potential biological activities of compounds 1 to 8 isolated from Maytenus gonoclada (Celastraceae). The constituents 4'-O-methylepigalocatequin (6), tingenone (7) and proanthocyanidin A (8), and ethanolic extracts were subjected to in vitro cytotoxicity using VERO cells and anti-Poliovirus assays. Methods: QSAR and molecular superposition, correlating the average number of pharmacophores were used in the prediction studies. Cellular line VERO ATCC CCL-81 was used to determine anti-Poliovirus effect, observed by colorimetric (MTT) method. The annexing V/propidium iodide assay was used to determine the occurrence of apoptosis in the cytotoxicity assays. Results: The experimental results found for constituents 6-8 were in accordance with observed data obtained through PASS online and ChemMapper simulation. Conclusion: Compound 7 showed higher cytotoxic and apoptosis induction properties, and 6 and 8 presented anti-Poliovirus activity

    Challenges in the diagnosis and management of acromegaly : a focus on comorbidities

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    Q2Q1Introduction: Acromegaly is a rare, insidious disease resulting from the overproduction of growth hormone (GH) and insulin-like growth factor 1 (IGF-1), and is associated with a range of comorbidities. The extent of associated complications and mortality risk is related to length of exposure to the excess GH and IGF-1, thus early diagnosis and treatment is imperative. Unfortunately, acromegaly is often diagnosed late, when patients already have a wide range of comorbidities. The presence of comorbid conditions contributes significantly to patient morbidity/mortality and impaired quality of life. Methods: We conducted a retrospective literature review for information relating to the diagnosis of acromegaly, and its associated comorbidities using PubMed. The main aim of this review is to highlight the issues of comorbidities in acromegaly, and to reinforce the importance of early diagnosis and treatment. Findings and conclusions: Successful management of acromegaly goes beyond treating the disease itself, since many patients are diagnosed late in disease evolution, they present with a range of comorbid conditions, such as cardiovascular disease, diabetes, hypertension, and sleep apnea. It is important that patients are screened carefully at diagnosis (and thereafter), for common associated complications, and that biochemical control does not become the only treatment goal. Mortality and morbidities in acromegaly can be reduced successfully if patients are treated using a multimodal approach with comprehensive comorbidity management.https://orcid.org/0000-0002-8433-5435N/

    Applying agroclimatic seasonal forecasts to improve rainfed maize agronomic management in Colombia

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    Climate variability affects crop production in multiple and often complex ways. The development and use hybrid crops with greater productivity and tolerance to climate shocks is one of the approaches to climate adaptation and agricultural intensification. Since hybrid crops are more expensive for the producer, risk management is of paramount importance. Here, we pose that there is high potential for the Colombian maize sector to use crop-specific climate services for risk reduction. We used the CERES-Maize crop model connected to seasonal climate forecasts developed via Canonical Correlation Analysis (CCA) across key maize growing areas in Colombia to assess the performance of a maize-specific agroclimatic forecast to inform two key decisions, namely, the choice of sowing dates and genotypes. We find that the agroclimatic models perform well at discriminating yield categories (above, below, and normal) with discrimination capacity of up to 70–80 % for the ‘below normal’ and ‘above + below normal’ categories. Consistent with this, agroclimatic forecasts typically predict the optimal planting date with an error of 3 pentads or less. They also predict the optimal choice of genotype correctly around 50–70 % of the time depending on the site or season of interest. Notably, we identify specific cases in which the agroclimatic forecast is misleading but argue that the overall value of the forecasts outweighs these cases. Future work should focus on expanding the scope of the agroclimatic prediction to include other relevant farming decisions that are influenced by climate, and on the improvement of climate forecast performance

    Multi-site investigation of strategies for the implementation of CYP2C19 genotype-guided antiplatelet therapy

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    CYP2C19 genotype-guided antiplatelet therapy following percutaneous coronary intervention is increasingly implemented in clinical practice. However, challenges such as selecting a testing platform, communicating test results, building clinical decision support processes, providing patient and provider education, and integrating methods to support the translation of emerging evidence to clinical practice are barriers to broad adoption. In this report, we compare and contrast implementation strategies of 12 early adopters, describing solutions to common problems and initial performance metrics for each program. Key differences between programs included the test result turnaround time and timing of therapy changes which are both related to CYP2C19 testing model and platform used. Sites reported the need for new informatics infrastructure, expert clinicians such as pharmacists to interpret results, physician champions, and ongoing education. Consensus lessons learned are presented to provide a path forward for those seeking to implement similar clinical pharmacogenomics programs within their institutions. This article is protected by copyright

    Effects of genetic variation in H3K79 methylation regulatory genes on clinical blood pressure and blood pressure response to hydrochlorothiazide

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    <p>Abstract</p> <p>Background</p> <p>Nearly one-third of the United States adult population suffers from hypertension. Hydrochlorothiazide (HCTZ), one of the most commonly used medications to treat hypertension, has variable efficacy. The renal epithelial sodium channel (ENaC) provides a mechanism for fine-tuning sodium excretion, and is a major regulator of blood pressure homeostasis. <it>DOT1L, MLLT3, SIRT1</it>, and <it>SGK1 </it>encode genes in a pathway that controls methylation of the histone H3 globular domain at lysine 79 (H3K79), thereby modulating expression of the ENaCα subunit. This study aimed to determine the role of variation in these regulatory genes on blood pressure response to HCTZ, and secondarily, untreated blood pressure.</p> <p>Methods</p> <p>We investigated associations between genetic variations in this candidate pathway and HCTZ blood pressure response in two separate hypertensive cohorts (clinicaltrials.gov NCT00246519 and NCT00005520). In a secondary, exploratory analysis, we measured associations between these same genetic variations and untreated blood pressure. Associations were measured by linear regression, with only associations with <it>P </it>≤ 0.01 in one cohort and replication by <it>P </it>≤ 0.05 in the other cohort considered significant.</p> <p>Results</p> <p>In one cohort, a polymorphism in <it>DOT1L </it>(rs2269879) was strongly associated with greater systolic (<it>P </it>= 0.0002) and diastolic (<it>P </it>= 0.0016) blood pressure response to hydrochlorothiazide in Caucasians. However, this association was not replicated in the other cohort. When untreated blood pressure levels were analyzed, we found directionally similar associations between a polymorphism in <it>MLLT3 </it>(rs12350051) and greater untreated systolic (<it>P </it>< 0.01 in both cohorts) and diastolic (<it>P </it>< 0.05 in both cohorts) blood pressure levels in both cohorts. However, when further replication was attempted in a third hypertensive cohort and in smaller, normotensive samples, significant associations were not observed.</p> <p>Conclusions</p> <p>Our data suggest polymorphisms in <it>DOT1L, MLLT3, SIRT1</it>, and <it>SGK1 </it>are not likely associated with blood pressure response to HCTZ. However, a possibility exists that rs2269879 in <it>DOT1L </it>could be associated with HCTZ response in Caucasians. Additionally, exploratory analyses suggest rs12350051 in <it>MLLT3 </it>may be associated with untreated blood pressure in African-Americans. Replication efforts are needed to verify roles for these polymorphisms in human blood pressure regulation.</p

    Cost-effectiveness of CYP2C19-guided antiplatelet therapy in patients with acute coronary syndrome and percutaneous coronary intervention informed by real-world data

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    Current guidelines recommend dual antiplatelet therapy (DAPT) consisting of aspirin and a P2Y12 inhibitors following percutaneous coronary intervention (PCI). CYP2C19 genotype can guide DAPT selection, prescribing ticagrelor or prasugrel for loss-of-function (LOF) allele carriers (genotype-guided escalation). Cost-effectiveness analyses (CEA) are traditionally grounded in clinical trial data. We conduct a CEA using real-world data using a 1-year decision-analytic model comparing primary strategies: universal empiric clopidogrel (base case), universal ticagrelor, and genotype-guided escalation. We also explore secondary strategies commonly implemented in practice, wherein all patients are prescribed ticagrelor for 30 days post PCI. After 30 days, all patients are switched to clopidogrel irrespective of genotype (nonguided de-escalation) or to clopidogrel only if patients do not harbor an LOF allele (genotype-guided de-escalation). Compared with universal clopidogrel, both universal ticagrelor and genotype-guided escalation were superior with improvement in quality-adjusted life years (QALY’s). Only genotype-guided escalation was cost-effective (42,365/QALY)anddemonstratedthehighestprobabilityofbeingcosteffectiveacrossconventionalwillingnesstopaythresholds.Inthesecondaryanalysis,comparedwiththenonguideddeescalationstrategy,althoughgenotypeguideddeescalationanduniversalticagrelorweremoreeffective,withICERof42,365/QALY) and demonstrated the highest probability of being cost-effective across conventional willingness-to-pay thresholds. In the secondary analysis, compared with the nonguided de-escalation strategy, although genotype-guided de-escalation and universal ticagrelor were more effective, with ICER of 188,680/QALY and $678,215/QALY, respectively, they were not cost-effective. CYP2C19 genotype-guided antiplatelet prescribing is cost-effective compared with either universal clopidogrel or universal ticagrelor using real-world implementation data. The secondary analysis suggests genotype-guided and nonguided de-escalation may be viable strategies, needing further evaluation

    Multisite Investigation of Outcomes With Implementation of CYP2C19 Genotype-Guided Antiplatelet Therapy After Percutaneous Coronary Intervention

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    OBJECTIVES: This multicenter pragmatic investigation assessed outcomes following clinical implementation of CYP2C19 genotype-guided antiplatelet therapy after percutaneous coronary intervention (PCI). BACKGROUND: CYP2C19 loss-of-function alleles impair clopidogrel effectiveness after PCI. METHODS: After clinical genotyping, each institution recommended alternative antiplatelet therapy (prasugrel, ticagrelor) in PCI patients with a loss-of-function allele. Major adverse cardiovascular events (defined as myocardial infarction, stroke, or death) within 12 months of PCI were compared between patients with a loss-of-function allele prescribed clopidogrel versus alternative therapy. Risk was also compared between patients without a loss-of-function allele and loss-of-function allele carriers prescribed alternative therapy. Cox regression was performed, adjusting for group differences with inverse probability of treatment weights. RESULTS: Among 1,815 patients, 572 (31.5%) had a loss-of-function allele. The risk for major adverse cardiovascular events was significantly higher in patients with a loss-of-function allele prescribed clopidogrel versus alternative therapy (23.4 vs. 8.7 per 100 patient-years; adjusted hazard ratio: 2.26; 95% confidence interval: 1.18 to 4.32; p = 0.013). Similar results were observed among 1,210 patients with acute coronary syndromes at the time of PCI (adjusted hazard ratio: 2.87; 95% confidence interval: 1.35 to 6.09; p = 0.013). There was no difference in major adverse cardiovascular events between patients without a loss-of-function allele and loss-of-function allele carriers prescribed alternative therapy (adjusted hazard ratio: 1.14; 95% confidence interval: 0.69 to 1.88; p = 0.60). CONCLUSIONS: These data from real-world observations demonstrate a higher risk for cardiovascular events in patients with a CYP2C19 loss-of-function allele if clopidogrel versus alternative therapy is prescribed. A future randomized study of genotype-guided antiplatelet therapy may be of value
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