Impact of MELD allocation policy on survival outcomes after liver transplantation: a single-center study in northeast Brazil

OBJECTIVE: To analyze the impact of model for end-stage liver disease (MELD) allocation policy on survival outcomes after liver transplantation (LT). INTRODUCTION: Considering that an ideal system of grafts allocation should also ensure improved survival after transplantation, changes in allocation policies need to be evaluated in different contexts as an evolutionary process. METHODS: A retrospective cohort study was carried out among patients who underwent LT at the University of Pernambuco. Two groups of patients transplanted before and after the MELD allocation policy implementation were identified and compared using early postoperative mortality and post-LT survival as end-points. RESULTS: Overall, early postoperative mortality did not significantly differ between cohorts (16.43% vs. 8.14%; p = 0.112). Although at 6 and 36-months the difference between pre-vs. post-MELD survival was only marginally significant (p = 0.066 and p = 0.063; respectively), better short, medium and long-term post-LT survival were observed in the post-MELD period. Subgroups analysis showed special benefits to patients categorized as nonhepatocellular carcinoma (non-HCC) and moderate risk, as determined by MELD score (15-20). DISCUSSION: This study ensured a more robust estimate of how the MELD policy affected post-LT survival outcomes in Brazil and was the first to show significantly better survival after this new policy was implemented. Additionally, we explored some potential reasons for our divergent survival outcomes. CONCLUSION: Better survival outcomes were observed in this study after implementation of the MELD criterion, particularly amongst patients categorized as non-HCC and moderate risk by MELD scoring. Governmental involvement in organ transplantation was possibly the main reason for improved survival

A biodiversidade terrestre e dulçaquícola dos arquipélagos da Madeira e das Selvagens

As ilhas atlânticas dos Açores, Madeira, Selvagens, Canárias e Cabo Verde constituem uma das regiões da Europa mais ricas em diversidade de fungos, plantas e animais. Desde 2004 que a inventariação detalhada da diversidade destas ilhas tem sido um dos principais objectivos dos projectos ATLÂNTICO e BIONATURA (incluídos no projecto EU INTERREG IIIB). Este livro é a mais recente contribuição destes projectos, apresentando uma lista de todos os fungos, flora e fauna terrestre conhecida, incluindo a dulçaquícola, para dois arquipélagos atlânticos (Madeira e Selvagens). A lista abrange o arquipélago da Madeira, constituído por duas ilhas de maiores dimensões (Madeira e Porto Santo) e três pequenas, cujo conjunto constitui as Desertas (Ilhéu Chão, Deserta Grande e Bugio), e ainda o arquipélago das Selvagens, formado por duas pequenas ilhas (Selvagem Grande e Selvagem Pequena) e um ilhéu (Ilhéu de Fora).ABSTRACT: The Azores, Madeira, Selvagens, Canary Islands and Cape Verde are among the richest regions in Fungi, plant and animal diversity in Europe. The main objectives of the EU INTERREG IIIB projects ATLÂNTICO and BIONATURA have been, since 2004, to carry out a detailed inventory of the terrestrial Fungi, Flora and Fauna of these archipelagos. This book, encompassing a checklist of all the known terrestrial and freshwater Fungi, Flora and Fauna of Madeira and Selvagens archipelagos is the latest contribution towards that goal. The geographic scope of this checklist includes the Madeira archipelago, composed of two large islands (Madeira and Porto Santo) and three small islands, which are globally named Desertas (Ilhéu Chão, Deserta Grande and Bugio), and the archipelago of Selvagens with two small islands (Selvagem Grande and Selvagem Pequena) and one islet (Ilhéu de Fora)

Os fósseis de Santa Maria (Açores) : a jazida da Prainha.

PREFÁCIO: O trabalho que agora se apresenta de Sérgio Ávila e colaboradores é mais um precioso contributo para a divulgação científica que emerge de trabalho de investigação académica da Universidade dos Açores. É um trabalho que procura conciliar um rigor e uma descrição exaustiva e profusamente ilustrada dos elementos factuais paleontológicos e geológicos associados à jazida da Prainha, com uma obra apelativa e agradável de desfolhar, ler e consultar. Este tipo de produtos académicos para a comunidade, de extensão universitária como agora se fala, é de extrema importância para a Região Autónoma dos Açores, em particular, e para Portugal, em geral, por três ordens de razões. Em primeiro lugar porque, contrariamente aos ditados e sabedoria popular, as rochas e outros elementos do património geológico, são frágeis e efémeros. Um dos aspectos de maior fragilidade são os fósseis, propriamente ditos, o que é mais fácil de entender. Mais difícil é reconhecer que as próprias jazidas fossilíferas, fósseis e seu enquadramento geológico, o qual pode incluir filões, falhas, minerais, seixos rolados, etc., são igualmente bastante frágeis quer a acções de erosão e alteração naturais quer a acções antrópicas. Quanto às primeiras a única e melhor atitude é proceder ao seu estudo e registo documental, nomeadamente fotográfica, como generosamente se apresenta nesta obra. Quanto às segundas, o modo mais eficaz de as preservar é dar a conhecer às populações, em geral, e às autarquias e entidades de gestão do território, em particular, no sentido de prevenir o licenciamento de obras ou infra-estruturas que poderão comprometer irremediavelmente esse Património Natural. Efectivamente, numa região balnear como a da Praia Formosa, uma eventual pressão urbanística pode levar à destruição destes seus elementos patrimoniais únicos. Únicos, não só no contexto da Ilha de Santa Maria, como no contexto da Região Autónoma dos Açores, ou mesmo do Continente. Em segundo lugar, estão em curso vários esforços no sentido de que o conjunto das nove ilhas açorianas venham a ser integradas na Rede Europeia de Geoparques e, como tal, sejam reconhecidas pela UNESCO como mais um elemento da Global Network of Geoparks. Tal galardão é consagrado pela excelência do seu Património geológico e paleontológico, o qual encontra neste livro um excelente aliado e um repositório de informação da qual se irão retirar elementos necessários à subsequente produção de textos de divulgação em língua estrangeira, fundamentalmente anglo-saxónica. Por outro lado, ficam bem expressos, os argumentos da necessidade desta jazida se converta em mais um dos magníficos e bem sucedidos exemplos de geoconservação e valorização ambiental que estão a registar-se por todo o arquipélago açoriano. Em terceiro lugar, obras como a que agora se edita ajudam à interiorização por parte da população de Santa Maria, e por todos quantos a visitam, da singularidade geológica desta ilha e do valor científico e patrimonial que as suas unidades fossilíferas representam. Elas ilustram de modo particularmente exuberante as alterações climáticas que o nosso Planeta tem vindo a sofrer, actualmente acompanhadas com maior acuidade pela sociedade e os media. Estes afloramentos particularmente ricos em conteúdo fóssil, intercalados ou embutidos em sequências de rochas vulcânicas e sedimentares, são os únicos testemunhos que restam das comunidades bióticas que povoaram as águas superficiais e as regiões costeiras insulares do Atlântico Norte, há milhares de anos (no caso da Prainha ou Lagoinhas) ou mesmos há milhões de anos, como as jazidas do Monumento Natural Regional da Pedreira do Campo, Pedreira da Cré, “Pedra que Pica” ou Ponta da Malbusca, para citar só algumas. Todas elas são singulares excepções que complementam os registos sedimentares das bacias oceânicas envolventes, os quais têm sido, e continuarão a ser, alvo de investigação paleoceanográfica do Global Change. No entanto, estas jazidas, são os únicos testemunhos das comunidades costeiras pretéritas, com as quais é possível estabelecer comparações e mapas de distribuição biogeográfica, um dos temas fortes presentes nesta obra. (Mário Cachão)Universidade dos Açores; Departamento de Biologia da UAÇ; CIBIO-Açores; IMAR; Câmara Municipal de Vila do Porto; Clube Naval de Santa Maria; GEOBIOTEC; Viagens de Turismo MELO; Hotel Praia de Lobos; Governo dos Açores; Secretaria Regional da Ciência, Tecnologia e Equipamentos

Impact of MELD allocation policy on survival outcomes after liver transplantation: a single-center study in northeast Brazil

OBJECTIVE: To analyze the impact of model for end‐stage liver disease (MELD) allocation policy on survival outcomes after liver transplantation (LT). INTRODUCTION: Considering that an ideal system of grafts allocation should also ensure improved survival after transplantation, changes in allocation policies need to be evaluated in different contexts as an evolutionary process. METHODS: A retrospective cohort study was carried out among patients who underwent LT at the University of Pernambuco. Two groups of patients transplanted before and after the MELD allocation policy implementation were identified and compared using early postoperative mortality and post‐LT survival as end‐points. RESULTS: Overall, early postoperative mortality did not significantly differ between cohorts (16.43% vs. 8.14%; p = 0.112). Although at 6 and 36‐months the difference between pre‐ vs. post‐MELD survival was only marginally significant (p = 0.066 and p = 0.063; respectively), better short, medium and long‐term post‐LT survival were observed in the post‐MELD period. Subgroups analysis showed special benefits to patients categorized as non‐hepatocellular carcinoma (non‐HCC) and moderate risk, as determined by MELD score (15‐20). DISCUSSION: This study ensured a more robust estimate of how the MELD policy affected post‐LT survival outcomes in Brazil and was the first to show significantly better survival after this new policy was implemented. Additionally, we explored some potential reasons for our divergent survival outcomes. CONCLUSION: Better survival outcomes were observed in this study after implementation of the MELD criterion, particularly amongst patients categorized as non‐HCC and moderate risk by MELD scoring. Governmental involvement in organ transplantation was possibly the main reason for improved survival

Recent geospatial dynamics of Terceira (Azores, Portugal) and the theoretical implications for the biogeography of active volcanic islands

Ongoing work shows that species richness patterns on volcanic oceanic islands are shaped by surface area changes driven by longer time scale (>1 ka) geological processes and natural sea level fluctuations. A key question is: what are the rates and magnitudes of the forces driving spatial changes on volcanic oceanic islands which in turn affect evolutionary and biogeographic processes? We quantified the rates of surface-area changes of a whole island resulting from both volcanogenic flows and sea level change over the last glacial-interglacial (GI) cycle (120 ka) for the volcanically active island of Terceira, (Azores, Macaronesia, Portugal). Volcanogenic activity led to incidental but long-lasting surface area expansions by the formation of a new volcanic cone and lava-deltas, whereas sea level changes led to both contractions and expansions of area. The total surface area of Terceira decreased by as much as 24% per time step due to changing sea levels and increased by 37% per time step due to volcanism per time step of 10 ka. However, while sea levels nearly continuously changed the total surface area, volcanic activity only impacted total surface area during two time steps over the past 120 ka. The surface area of the coastal and lowland region (here defined as area <300 m) was affected by sea level change (average change of 11% / 10 ka for 120–0 ka) and intra-volcanic change (average change of 17% / 10 ka for 120–0 ka). We discuss the biogeographic implications of the quantified dynamics, and we argue that surface area change is mainly driven by volcanic processes in the early stages of the island’s life cycle, while during the later stages, area change becomes increasingly affected by sea level dynamics. Both environmental processes may therefore affect biota differently during the life cycle of volcanic oceanic islands.S.J.N. received funding from the Portuguese National Funds, through Fundação para a Ciência e a Tecnologia (FCT), within the project UID/BIA/00329/2013 and the Research Fellowship PD/BD/114380/2016. S.P.A. acknowledges his research contract (IF/00465/2015) funded by the Portuguese Science Foundation (FCT). C.S.M. is benefiting from a PhD grant M3.1.a/F/100/2015 from FRCT/Açores 2020 by Fundo Regional para a Ciência e Tecnologia (FRCT). Financial support to R.A. was received from the Laboratory of Excellence ‘TULIP’ (PIA-10-LABX-41). This work was supported by FEDER funds through the Operational Programme for Competitiveness Factors – COMPETE and by National Funds through FCT under the UID/BIA/50027/2013, POCI-01-0145-FEDER-006821 and under DRCT-M1.1.a/005/Funcionamento-C-/2016 (CIBIO-A) project from FRCT. This work was also supported by FEDER funds (in 85%) and by funds of the Regional Government of the Azores (15%) through Programa Operacional Açores 2020, in the scope of the project “AZORESBIOPORTAL – PORBIOTA”: ACORES‑01‑0145-FEDER-000072.info:eu-repo/semantics/publishedVersio

Secreted Human Amyloid Precursor Protein Binds Semaphorin 3a and Prevents Semaphorin-Induced Growth Cone Collapse

The amyloid precursor protein (APP) is well known for giving rise to the amyloid-β peptide and for its role in Alzheimer's disease. Much less is known, however, on the physiological roles of APP in the development and plasticity of the central nervous system. We have used phage display of a peptide library to identify high-affinity ligands of purified recombinant human sAPPα695 (the soluble, secreted ectodomain from the main neuronal APP isoform). Two peptides thus selected exhibited significant homologies with the conserved extracellular domain of several members of the semaphorin (Sema) family of axon guidance proteins. We show that sAPPα695 binds both purified recombinant Sema3A and Sema3A secreted by transfected HEK293 cells. Interestingly, sAPPα695 inhibited the collapse of embryonic chicken (Gallus gallus domesticus) dorsal root ganglia growth cones promoted by Sema3A (Kd≤8·10−9 M). Two Sema3A-derived peptides homologous to the peptides isolated by phage display blocked sAPPα binding and its inhibitory action on Sema3A function. These two peptides are comprised within a domain previously shown to be involved in binding of Sema3A to its cellular receptor, suggesting a competitive mechanism by which sAPPα modulates the biological action of semaphorins

Genetic Diversity and Population History of a Critically Endangered Primate, the Northern Muriqui (Brachyteles hypoxanthus)

Social, ecological, and historical processes affect the genetic structure of primate populations, and therefore have key implications for the conservation of endangered species. The northern muriqui (Brachyteles hypoxanthus) is a critically endangered New World monkey and a flagship species for the conservation of the Atlantic Forest hotspot. Yet, like other neotropical primates, little is known about its population history and the genetic structure of remnant populations. We analyzed the mitochondrial DNA control region of 152 northern muriquis, or 17.6% of the 864 northern muriquis from 8 of the 12 known extant populations and found no evidence of phylogeographic partitions or past population shrinkage/expansion. Bayesian and classic analyses show that this finding may be attributed to the joint contribution of female-biased dispersal, demographic stability, and a relatively large historic population size. Past population stability is consistent with a central Atlantic Forest Pleistocene refuge. In addition, the best scenario supported by an Approximate Bayesian Computation analysis, significant fixation indices (ΦST = 0.49, ΦCT = 0.24), and population-specific haplotypes, coupled with the extirpation of intermediate populations, are indicative of a recent geographic structuring of genetic diversity during the Holocene. Genetic diversity is higher in populations living in larger areas (>2,000 hectares), but it is remarkably low in the species overall (θ = 0.018). Three populations occurring in protected reserves and one fragmented population inhabiting private lands harbor 22 out of 23 haplotypes, most of which are population-exclusive, and therefore represent patchy repositories of the species' genetic diversity. We suggest that these populations be treated as discrete units for conservation management purposes