261 research outputs found
Clinical performance of bleeding risk scores for predicting major and clinically relevant non-major bleeding events in patients receiving warfarin
Background: Oral anticoagulant therapy is associated with an increased risk of hemorrhage, which can be assessed by bleeding risk scores. We evaluated the performance of five validated scores for predicting major and clinically relevant non-major bleeding events in patients receiving warfarin. Methods and results: We conducted an ambispective, single-center cohort study of 321 consecutive patients enrolled in an academic anticoagulation clinic. The following scores were calculated: modified Outpatient Bleeding Risk Index, Contemporary Bleeding Risk Model, HEMORR2HAGES (Hepatic or Renal Disease, Ethanol Abuse, Malignancy, Older Age, Reduced Platelet Count or Function, Re-Bleeding, Hypertension, Anemia, Genetic Factors, Excessive Fall Risk and Stroke), ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation), and HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile International Normalized Ratio, Elderly, Drugs/Alcohol). Main outcomes were major bleeding and a composite of major plus clinically relevant non-major bleeding. Incidence rates for all group were 3.8 (95% confidence interval [CI] 2.0-6.4) and 11.9 (95% CI 8.6-16.4) events per 100 patient-years for major bleeding and major plus clinically relevant non-major bleeding, respectively. Agreement among the five scores was low to moderate (Kendall\u27s tau-b coefficients 0.22-0.54). For major bleeding, the c-statistics ranged from 0.606 to 0.735, whereas for major plus clinically relevant non-major bleeding, they ranged from 0.549 to 0.613. For all scores, the 95% CI for the c-statistics crossed 0.5 or was very close. Among high-risk patients, the hazard ratios for major bleeding ranged from 0.90 to 39.01, whereas for major plus clinically relevant non-major bleeding, they ranged from 1.52 to 8.71. For intermediate-risk patients, no score, except the Contemporary Bleeding Risk Model, produced statistically significant hazard ratios. Conclusion: The scores demonstrated poor agreement and low to moderate discriminatory ability. General clinical implementation of these scores cannot be recommended yet. © 2013 International Society on Thrombosis and Haemostasis
Efeito da densidade do solo na incidência de Fusarium spp.
O objetivo deste trabalho foi avaliar o efeito da densidade do solo resultante de dois sistemas de manejo e seis rotações de culturas na população de Fusarium spp
Efeito de rotações de cultura sobre populações de microorganismos do solo.
A rotação de culturas afeta diretamente a diversidade e densidade de microrganismos sobreviventes no solo, entre os quais destacam-se patógenos e agentes de controle biológico
Potencial antagônico de Trichoderma spp. originários de diferentes agroecossistemas contra Sclerotinia sclerotiorum e Fusarium solani.
A partir de 40 amostras de solo, provenientes dos estados do Rio Grande do Sul, Minas Gerais, São Paulo, Bahia, Goiás e Tocantins, uma coleção de 230 isolados monospóricos de Trichoderma spp. foi estabelecida, usando o meio seletivo TSM. Com o objetivo de selecionarem-se isolados com potencial para controle biológico de doenças, foram conduzidos testes de pareamento de culturas em meio BDA, a 20 °C para Sclerotinia sclerotiorum e a 25 °C para Fusarium solani f.sp. phaseoli. Antagonismo contra os dois patógenos foi observado em 10% dos isolados. Avaliações ao microscópio eletrônico de varredura de sete isolados selecionados in vitro mostraram que nem todos promoveram o hiperparasitismo dos patógenos, sugerindo a existência de outros mecanismos de antagonismo, como antibiose ou competição
Eficiência da interceptação da radiação solar em diferentes sistemas de condução de pessegueiro.
Prioritizing forest protection, reforestation, and avoided disturbance in the eastern Amazon.
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The impact of ultra-processed food on carbon, water and ecological footprints of food in Brazil
Background
Ultra-processed foods (UPF) have been associated with major diet-related public health issues that share underlying drivers with climate change. Both challenges require major changes to the food system and so the potential benefits to health and the environment present a double motivation for transformation. Our aim is to assess the impacts of UPF on total greenhouse gas emissions (GHGE), water and ecological footprints in Brazil food purchases.
Methods
We have used data from 4 Brazilian Household Budget Surveys (1987, 1996, 2003, 2009). Each food item was classified into NOVA food groups (unprocessed/minimally processed, culinary ingredients, processed and ultra-processed). The information was linked to nutrition and footprint data. Purchases were converted into grams per capita per day to estimate total energy (kcal), percentage of energy from UPF, as well as total GHGE, water and ecological footprints. We performed linear regression to calculate year-adjusted means of footprints per 1000 Kcal by year-specific quintiles of UPF participation in the total energy. The data were analysed in R v.3.6.1 and STATA SE 14.1.
Results
The mean UPF participation in total energy varied from 13% (SD 2.4) in the 1st UPF quintile to 29% (SD 5.1) in the 5th quintile. The footprints increased linearly across quintiles: the mean g CO2eq varied from 1312 in the 1st to 1721 in the 5th UPF quintile (p-trend<0.001); the mean litres of water varied from 1420 in the 1st to 1830 in the 5th quintile (p-trend<0.001); the mean m2 varied from 9.4 in the 1st to 12.3 in the 5th quintile (p < 0.001).
Conclusions
The environmental impacts were higher for Brazilian diets with a larger fraction of energy from UPF. Specifically, low UPF diets seem to have lower GHGE, water and ecological footprints. Our findings offer new motivators for dietary change to simultaneously healthier and more sustainable eating patterns and will be of relevance to consumers and policymakers.
Key messages
Diets high in UPF cause more climate impact than diets with lower levels of UPF.
Healthy and sustainable dietary patterns should be low in ultra-processed foods
Smoking-induced aggravation of experimental arthritis is dependent of aryl hydrocarbon receptor activation in Th17 cells.
Background:
Epidemiologic studies have highlighted the association of environmental factors with the development and progression of autoimmune and chronic inflammatory diseases. Among the environmental factors, smoking has been associated with increased susceptibility and poor prognosis in rheumatoid arthritis (RA). However, the immune and molecular mechanism of smoking-induced arthritis aggravation remains unclear. The transcription factor aryl hydrocarbon receptor (AHR) regulates the generation of Th17 cells, CD4 T cells linked the development of autoimmune diseases. AHR is activated by organic compounds including polycyclic aromatic hydrocarbons (PAHs), which are environmental pollutants that are also present in cigarette smoke. In this study, we investigated the role of AHR activation in the aggravation of experiment arthritis induced by exposure to cigarette smoke.
Methods:
Mice were exposed to cigarette smoke during the developmental phase of antigen-induced arthritis and collagen-induced arthritis to evaluate the effects of smoking on disease development. Aggravation of articular inflammation was assessed by measuring neutrophil migration to the joints, increase in articular hyperalgesia and changes in the frequencies of Th17 cells. In vitro studies were performed to evaluate the direct effects of cigarette smoke and PAH on Th17 differentiation. We also used mice genetically deficient for AHR (Ahr KO) and IL-17Ra (Il17ra KO) to determine the in vivo mechanism of smoking-induced arthritis aggravation.
Results:
We found that smoking induces arthritis aggravation and increase in the frequencies of Th17 cells. The absence of IL-17 signaling (Il17ra KO) conferred protection to smoking-induced arthritis aggravation. Moreover, in vitro experiments showed that cigarette smoke can directly increase Th17 differentiation of T cells by inducing AHR activation. Indeed, Ahr KO mice were protected from cigarette smoke-induced arthritis aggravation and did not display increase in TH17 frequencies, suggesting that AHR activation is an important mechanism for cigarette smoke effects on arthritis. Finally, we demonstrate that PAHs are also able to induce arthritis aggravation.
Conclusions:
Our data demonstrate that the disease-exacerbating effects of cigarette smoking are AHR dependent and environmental pollutants with AHR agonist activity can induce arthritis aggravation by directly enhancing Th17 cell development
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Trends in the environmental impacts of unprocessed or minimally processed, processed, and ultra-processed animal products in Brazil over 30 years
Background: We aim to assess the trends in the consumption of unprocessed or minimally processed, processed, and ultra-processed animal products, and the environmental impacts associated with them.
Methods: We have used data from five Brazilian Household Budget Surveys (1987, 1996, 2003, 2009, 2017). Animal products (beef, pork, poultry, eggs, fish, milk, and cheese) were classified into NOVA food groups: unprocessed or minimally processed (G1), processed (G3), and ultra-processed (G4). We estimated the share (%) of each food group to daily kcal per capita, as well as carbon footprint (CF), water footprint (WF) and ecological footprint (EF) per 1000 kcal-day. Trends over the years were tested using linear regression considering the population size as a weighting factor.
Results: From 1987 to 2017, the dietary share of G1 animal products decreased 2% (15.5-15.2%, p-trend < 0.001), while the share of G3 and G4 products increased by 88% (1.6-3.0%, p-trend < 0.001) and 340% (4.3-1.1%, p-trend < 0.001), respectively. CF in g CO2 eq per 1000 kcal remained the same for G1 products (921.4-946.2, p-trend = 0.278) and increased by 124% (30.9-69.3, p-trend < 0.001) and 319% (50.7-212.5, p-trend < 0.001) for G3 and G4 products, respectively. WF in litres per 1000 kcal decreased by 11% for G1 products (846.7-752.5, p-trend < 0.001), and increased by 130% for G3 (24.3-55.9, p-trend < 0.001) and 323% for G4 products (42.5-179.8, p-trend < 0.001). Similarly, EF in m2 per 1000 kcal decreased by 5% for G1 products (6.06-5.73, p-trend < 0.001), and increased by 67% for G3 (0.24-0.40, p-trend < 0.001) and by 305% for G4 products (0.21-0.85, p-trend < 0.001).
Conclusion: The consumption of processed and ultra-processed animal products has been increasing along with their environmental impact, suggesting that the reduction of their consumption would be beneficial for both human and planet health
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