One-year risk of stroke after transient ischemic attack or minor stroke in Hunter New England, Australia (INSIST Study)

Background: One-year risk of stroke in transient ischemic attack and minor stroke (TIAMS) managed in secondary care settings has been reported as 5–8%. However, evidence for the outcomes of TIAMS in community care settings is limited. Methods: The INternational comparison of Systems of care and patient outcomes In minor Stroke and TIA (INSIST) study was a prospective inception cohort community-based study of patients of 16 general practices in the Hunter–Manning region (New South Wales, Australia). Possible-TIAMS patients were recruited from 2012 to 2016 and followed-up for 12 months post-index event. Adjudication as TIAMS or TIAMS-mimics was by an expert panel. We established 7-days, 90-days, and 1-year risk of stroke, TIA, myocardial infarction (MI), coronary or carotid revascularization procedure and death; and medications use at 24 h post-index event. Results: Of 613 participants (mean age; 70 ± 12 years), 298 (49%) were adjudicated as TIAMS. TIAMS-group participants had ischemic strokes at 7-days, 90-days, and 1-year, at Kaplan-Meier (KM) rates of 1% (95% confidence interval; 0.3, 3.1), 2.1% (0.9, 4.6), and 3.2% (1.7, 6.1), respectively, compared to 0.3, 0.3, and 0.6% of TIAMS-mimic-group participants. At one year, TIAMS-group-participants had twenty-five TIA events (KM rate: 8.8%), two MI events (0.6%), four coronary revascularizations (1.5%), eleven carotid revascularizations (3.9%), and three deaths (1.1%), compared to 1.6, 0.6, 1.0, 0.3, and 0.6% of TIAMS-mimic-group participants. Of 167 TIAMS-group participants who commenced or received enhanced therapies, 95 (57%) were treated within 24 h post-index event. For TIAMS-group participants who commenced or received enhanced therapies, time from symptom onset to treatment was median 9.5 h [IQR 1.8–89.9]. Conclusion: One-year risk of stroke in TIAMS participants was lower than reported in previous studies. Early implementation of antiplatelet/anticoagulant therapies may have contributed to the low stroke recurrence

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time, and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space. While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes, vast areas of the tropics remain understudied. In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity, but it remains among the least known forests in America and is often underrepresented in biodiversity databases. To worsen this situation, human-induced modifications may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge, it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Roots Are Important Sources Of Carbohydrates During Flowering And Fruiting In 'valencia' Sweet Orange Trees With Varying Fruit Load

The influence of fruit loading on flowering and fruiting, CO2 assimilation, and non-structural carbohydrates (NSC) in citrus trees was evaluated in four-year-old 'Valencia' sweet orange grafted onto 'Rangpur' lime. One group of trees was completely de-fruited (DFT) on May 14 (autumn), whereas fruit were left on the remaining trees (FT). The seasonal variation in photosynthesis and stomatal conductance was unaffected by fruit loading, with the minimum diurnal-integrated CO2 assimilation (PNI) occurring in July (98.3mmolm-2day-1) and the maximum PNI occurring in November (199.5mmolm-2day-1). Fruit loading inhibited sprouting and flowering in the citrus trees, but this effect was not correlated with NSC in the leaves, branches, or roots. The DFT trees exhibited nearly four times as many reproductive structures as the FT trees, with a high remobilization of reserves. Our data showed that flowers are stronger sinks than fruit and that flowering is the most expensive phenological stage. In the DFT trees, approximately 80% of NSC were consumed prior to the end of fruit drop, primarily until flowering. NSC reserves from leaves, branches, and roots were remobilized. Between the stages of de-fruiting and the end of physiological fruit drop, the plants remobilized approximately 312g NSC, with the roots contributing more than 230g NSC per plant. © 2014 Elsevier B.V.17418795Agustí, M., (2003) Citricultura, , Mundi-Prensa, MadridAgustí, M., Zaragoza, S., Bleiholder, H., Buhr, L., Hack, H., Klose, R., Stauss, R., Escala BBCH para la descripción de los estadios fenológicos del desarrollo de los agrios (Gén. Citrus) (1995) Levante Agricola, 3, pp. 189-199Amaral, L.I.V., Gaspar, M., Costa, P.M.F., Aidar, M.P.M., Buckeridge, M.S., Novo método enzimático rápido e sensível de extração e dosagem de amido em materiais vegetais (2007) Hoehnea, 34, pp. 425-431Bieleski, R.L., Turner, A., Separation and estimation of amino acids in crude plant extracts by thin-layer electrophoresis and chromatography (1966) Anal. Biochem., 17, pp. 278-293Bustan, A., Goldschmidt, E.E., Estimating the cost of flowering in a grapefruit tree (1998) Plant Cell Environ., 21, pp. 217-224Davies, F.S., Albrigo, L.G., Environmental constraints on growth, development and physiology of citrus (1994) Citrus, pp. 52-82. , CAB International, Wallingford, UKDovis, V.L., Rossi, S.C., Machado, E.C., Ribeiro, R.V., Medina, C.L., Efeito do tipo de brotação sob a fotossíntese em folhas de diferentes idades em laranjeira 'Valência' (2009) XII Congresso Brasileiro de Fisiologia Vegetal, , Resumos, Fortaleza, CEDubois, M., Gilles, K.A., Hamilton, J.K., Rebers, P.A., Smith, F., Colorimetric method for determination of sugars and related substances (1956) Anal. Chem., 28, pp. 350-356García-Luis, A., Almela, V., Monerri, C., Aguatí, M., Guardiola, J.L., Inhibition of flowering in vivo by existing fruits and applied growth regulators in Citrus unshiu (1986) Physiol. Planta., 66, pp. 515-520García-Luis, A., Fornes, F., Sanz, A., Guardiola, J.L., The regulation of flowering and fruit set in citrus: relationship with carbohydrates levels (1988) Isr. J. Bot., 37, pp. 189-201García-Luis, A., Fornes, F., Guardiola, J.L., Leaf carbohydrates and flower formation in Citrus (1995) J. Am. Soc. Hortic. Sci., 120, pp. 222-227Goldberg-Moeller, R., Shalom, L., Shlizerman, L., Samuels, S., Zur, N., Ophir, R., Blumwald, E., Effects of gibberellin treatment during flowering induction period on global gene expression and the transcription of flowering-control genes in Citrus buds (2013) Plant Sci., 198, pp. 46-57Goldschmidt, E.E., Golomb, A., The carbohydrate balance of alternate-bearing citrus trees end the significance of reserves for flowering and fruiting (1982) J. Am. Soc. Hortic. Sci., 107, pp. 206-208Goldschmidt, E.E., Aschkennazi, N., Herzano, Y., Shaffer, A.A., Monselise, S.P., A role for carbohydrate levels in the control of flowering in citrus (1985) Sci. Hortic., 29, pp. 159-166Goldschmidt, E.E., Carbohydrate supply as a critical factor for Citrus fruit development and productivity (1999) Hortscience, 34, pp. 1020-1024Guardiola, J.L., García-Marí, F., Agustí, M., Competition and fruit set in the 'Washington' navel orange (1984) Physiol. Planta., 62, pp. 297-302Guardiola, J.L., García-Luis, A., Increasing fruit in citrus: thinning and simulation of fruit growth (2000) Plant Growth Regul., 34, pp. 121-132Iglesias, J.D., Lliso, I., Tadeo, F.R., Talon, M., Regulation of photosynthesis through source-sink imbalance is mediated by carbohydrate in leaves (2002) Physiol. Plant., 116, pp. 563-572Iglesias, J.D., Tadeo, F.R., Primo-Millo, E., Talon, M., Fruit set dependence on carbohydrate availability in citrus trees (2003) Tree Physiol., 23, pp. 199-204Jones, W.W., Steinacker, M.L., Seasonal changes in concentration of sugar and starch in leaves and twigs on citrus trees (1951) Proc. Am. Soc. Hortic. Sci., 58, pp. 1-4Koshita, Y., Takahara, T., Ogata, T., Goto, A., Involvement of endogenous plant hormone (IAA, ABA, GAs) in leaves and flower bud formation of 'Satsuma' mandarin (Citrus unshiu Marc.) (1999) Sci. Hortic., 79, pp. 185-194Koshita, Y., Takahara, T., Effect of water stress on flower-bud formation and plant hormone content of 'Satsuma' mandarin (Citrus unshiu Marc.) (2004) Sci. Hortic., 99, pp. 301-307Léchaudel, M., Génard, M., Lescourret, F., Urban, L., Jannoyer, M., Modeling effects of weather source-sink relationships on mango fruit growth (2005) Tree Physiol., 25, pp. 583-597Li, C.Y., Weiss, D., Goldschmidt, E.E., Effects of carbohydrate starvation on gene expression in Citrus root (2003) Planta, 217, pp. 11-20Li, C.Y., Weiss, D., Goldschmidt, E.E., Girdling affects carbohydrate-related gene expression in leaves, bark and roots of alternate bearing citrus trees (2003) Ann. Bot., 92, pp. 137-143Mahouachi, J., Iglesias, D.J., Agustí, M., Talon, M., Delay of early fruitlet abscission by branch girdling in citrus coincides with previous increases in carbohydrate and gibberellin concentrations (2009) Plant Growth Regul., 58, pp. 15-23Martínez-Fuentes, A., Mesejo, C., Reig, C., Agustí, M., Timing of the inhibitory effect of frui ton return bloom of 'Valencia' sweet orange (Citrus sinensis (L.) Osbeck) (2010) J. Sci. Food Agric., 90, pp. 1936-1943Monerri, C., Fortunato-Almeida, A., Molina, R.V., Nebauer, S.G., García-Luis, A., Guardiola, J.L., Relation of carbohydrate reserves with the forthcoming crop, flower formation and photosynthetic rate, in the alternate bearing 'Salustiana' sweet orange (2011) Sci. Hortic., 129, pp. 71-78Monselise, S.P., Goldschmidt, E.E., Alternate bearing in fruits trees (1982) Hortic. Rev., 4, pp. 128-173Monselise, S.P., Citrus and related genera (1985) Handbook of flowering, pp. 275-294. , CRC Press, Boca Raton, FL, S.P. Monselise (Ed.)Muñoz-Fambuena, N., Mesejo, C., González-Mas, M.C., Primo-Millo, E., Agustí, M., Iglesias, D.J., Fruit regulates seasonal expression of flowering genes in alternate-bearing Moncada mandarin (2011) Ann. Bot., 108, pp. 511-519Muñoz-Fambuena, N., Mesejo, C., González-Mas, M.C., Iglesias, D.J., Primo-Millo, E., Agustí, M., Gibberellic acid reduces flowering intensity in sweet orange [Citrus sinensis (L.) Osbeck] by repressing CiFT gene expression (2012) Plant Growth Regul., 31, pp. 529-536Nebauer, S.G., Renau-Morata, B., Guardiola, J.L., Molina, R.-V., Photosynthesis down-regulation precedes carbohydrate accumulation under sink limitation in Citrus (2011) Tree Physiol., 31, pp. 169-177Nebauer, S.G., Arenas, C., Rodríguez-Gamir, J., Bordón, Y., Fortunato-Almeida, A., Monerri, C., Guardiola, J.L., Molina, R.-V., Crop load does not increase the photosynthetic rate in Citrus leaves under regular cropping conditions. A study throughout the year (2013) Sci. Hortic., 160, pp. 358-365Park, S.J., Dry weight and carbohydrate distribution in different tree parts of affected by various fruit-loads of young persimmon and their effect on new growth in the next season (2011) Sci. Hortic., 130, pp. 732-736Prado, A.K.S., Machado, E.C., Medina, C.L., Machado, D.F.S.P., Mazzafera, P., Florescimento e frutificação em laranjeiras 'Valência' com diferentes cargas de frutos e submetidas ou não à irrigação (2007) Bragantia, 66, pp. 173-182Ribeiro, R.V., Machado, E.C., Some aspects of citrus ecophysiology in subtropical climates: re-visiting photosynthesis under natural conditions (2007) Braz. J. Plant Physiol., 19, pp. 393-411Ribeiro, R.V., Rolim, G.S., Azevedo, F.A., Machado, E.C., 'Valencia' sweet orange tree flowering evaluation under field conditions (2008) Sci. Agric., 65, pp. 389-396Ribeiro, R.V., Machado, E.C., Santos, M.G., Oliveira, R.F., Seasonal and diurnal changes in photoshynthetic limitation of young citrus sweet orange trees (2009) Environ. Exp. Bot., 66, pp. 203-211Ribeiro, R.V., Machado, E.C., Habermann, G., Santos, M.G., Oliveira, R.F., Seasonal effects on the relationship between photosynthesis and leaf carbohydrates in orange trees (2012) Funct. Plant Biol., 39, pp. 471-480Ruiz, R., García-Luis, A., Monerri, C., Guardiola, J.L., Carbohydrate availability in relation to fruitlet abscission in citrus (2001) Ann. Bot., 87, pp. 805-812Sanz, A., Monerri, C., González-Ferrer, J., Guardiola, J.L., Changes in carbohydrate and mineral elements in citrus leaves during flowering and fruit set (1987) Physiol. Plant, 69, pp. 93-98Sekita, M.C., (2008) Floração de laranjeira 'Valência' com variação de carga pendente. Dissertação (Mestrado), , Instituto AgrÔnomico, Campinas, São Paulo, 36 pSpiegel-Roy, P., Goldschmidt, E.E., (1996) Biology of Citrus, , Cambridge University Press, CambridgeYahata, D., Matsumoto, K., Ushijima, K., Relationship between flower-bud differentiation and carbohydrate contents in spring shoots of very-early, early and late maturing cultivars of 'Satsuma' mandarin (2004) J. Jap. Soc. Hortic. Sci., 73, pp. 405-410Yamanishi, O.K., Effect of spring day/night temperature on flower development, fruit set and fruit quality on strangulated Pummelo trees. Return bloom, fruit quality and yield of pommelo trees frown in a plastic house (1994) J. Jap. Soc. Hortic. Sci., 63, pp. 493-50

Aproveitamento de resíduos madeireiros para o cultivo do cogumelo comestível Lentinus strigosus de ocorrência na Amazônia

Este trabalho teve como objetivo a utilização de resíduos madeireiros do estado do Amazonas para o cultivo de Lentinus strigosus. de ocorrência na região. A linhagem foi procedente da coleção do Instituto Nacional de Pesquisas da Amazônia - INPA. Utilizou-se separadamente serragens de Simarouba amara (marupá), Ochroma piramidale (pau de balsa) e Anacardium giganteum (cajuí) suplementadas com farelo de arroz e de trigo e CaCO3 (80:10:8:2), respectivamente, ajustando-se a umidade em torno de 75%. Os substratos (500g) foram acondicionados em sacos de polipropileno, esterilizados a 121 ºC , durante 30 minutos, inoculados e incubados em câmara climatizada a 25 ± 3 ºC e UR de 85%, até emissão dos primórdios, com redução de temperatura de 25 para 23 ± 1 ºC e aumento de UR para 85-90%, no período de "frutificação". O crescimento micelial ocorreu de 12 a 20 dias, com surgimento de primórdios com cerca de 15 a 25 dias após a inoculação. A produção de basidiocarpos ocorreu três a cinco dias após a emissão dos primórdios. Foram avaliados: eficiência biológica (EB, %), rendimento (g kg-1) e perda da matéria orgânica (PMO, %). As serragens suplementadas foram eficientes no cultivo de L. strigosus, apresentando EB de 38, 48 e 59%; rendimento de 98, 119 e 177 g kg-1; e PMO de 42, 59 e 48%, para marupá, pau de balsa e cajuí, respectivamente. Assim, há um potencial de aproveitamento desses resíduos na Amazônia, bem como uma provável utilização da linhagem selvagem, podendo contribuir para melhoria das condições sócio-econômicas da população regional e sustentabilidade dos recursos da biodiversidade.The objective of this work was to use wood residues from the state of Amazonas for the cultivation of Lentinus strigosus. found in that region. The strain came from the collection of the National Institute of Amazonian Research. Sawdust species Simarouba amara, Ochroma piramidale and Anacardium giganteum were separately used in the preparation of the substrates, supplemented with rice and wheat bran and CaCO3 (80:10:8:2), respectively, with humidity adjusted to approximately 75%. Substrates (500 g) were packed using bags polypropylene, sterilized at 121 ºC for 30 minutes, inoculated and incubated in an acclimatized chamber at 25 ± 3 ºC and relative air humidity of 85% until primordia emission, with temperature reduced from 25 to 23 ± 1 ºC and air relative humidity increased to 85-90% in the fruiting period. Micelial growth occurred within 12 to 20 days and primordia appeared within 15 to 25 days after the inoculation. Harvest occurred three to five days after primordia emission. Biological efficiency (BE, %), yield (g kg-1) and loss of organic matter (PMO, %) were evaluated. Supplemented sawdust were efficient in the cultivation of L. strigosus, presenting BE of 38, 48 and 59%, yield of 98, 119 and 177 g kg-1 and PMO of 42, 59 and 48% for Simarouba amara, Ochroma piramidale and Anacardium giganteum, respectively. The results show the potential use of those residues in the Amazon, as well as the possibility of using the wild strain, to contribute to the improvement of the social and economical conditions of the regional population and sustainability of the biodiversity resources

Crescimento micelial de Pleurotus ostreatus em resíduo de Simarouba amara Mycelial growth of Pleurotus ostreatus in Simarouba amara sawdust

O objetivo deste trabalho foi avaliar o crescimento micelial do cogumelo Pleurotus ostreatus, cultivado na serragem da espécie madeireira Simarouba amara. Avaliaram-se: o efeito das temperaturas de 22, 25, 27, 30 e 35ºC sobre o crescimento micelial de P. ostreatus, nos meios malte-ágar 3% e SDA-MA (infusão da serragem de S. amara, enriquecida com farelo de soja-dextrose-ágar); e o crescimento micelial em substrato de cultivo de serragem de S. amara, com e sem suplementação de farelo de soja, a 25 e 30ºC. O melhor desenvolvimento de P. ostreatus ocorreu em meio malte-ágar 3% a 25ºC. A suplementação de farelo de soja na serragem de S. amara favorece o crescimento micelial.<br>The objective of this work was to assess the mycelial growth of oyster mushroom (Pleurotus ostreatus) cultivated in sawdust of Simarouba amara. Evaluations were made for the effect of temperatures 22, 25, 27, 30 and 35ºC on the mycelial growth of P. ostreatus in 3% malt-agar and SDA-MA (infusion of S. amara sawdust, enriched with soybean meal-dextrose-agar) media; and the mycelial growth in cultivation substrate of S. amara sawdust, with and without supplementation of soybean meal, at 25 and 30ºC. The best development of P. ostreatus was in 3% malt-agar medium at 25ºC. Soybean meal supplementation on S. amara sawdust promoted mycelial growth