Genome-Wide Analysis in Brazilian Xavante Indians Reveals Low Degree of Admixture

Characterization of population genetic variation and structure can be used as tools for research in human genetics and population isolates are of great interest. The aim of the present study was to characterize the genetic structure of Xavante Indians and compare it with other populations. The Xavante, an indigenous population living in Brazilian Central Plateau, is one of the largest native groups in Brazil. A subset of 53 unrelated subjects was selected from the initial sample of 300 Xavante Indians. Using 86,197 markers, Xavante were compared with all populations of HapMap Phase III and HGDP-CEPH projects and with a Southeast Brazilian population sample to establish its population structure. Principal Components Analysis showed that the Xavante Indians are concentrated in the Amerindian axis near other populations of known Amerindian ancestry such as Karitiana, Pima, Surui and Maya and a low degree of genetic admixture was observed. This is consistent with the historical records of bottlenecks experience and cultural isolation. By calculating pair-wise F-st statistics we characterized the genetic differentiation between Xavante Indians and representative populations of the HapMap and from HGDP-CEPH project. We found that the genetic differentiation between Xavante Indians and populations of Ameridian, Asian, European, and African ancestry increased progressively. Our results indicate that the Xavante is a population that remained genetically isolated over the past decades and can offer advantages for genome-wide mapping studies of inherited disorders.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (Fapesp)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)INCT Obesidade e DiabetesINCT- Obesidade e Diabete

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Evaluation of body adiposity index (BAI) to estimate percent body fat in an indigenous population

Background & aims: the aim of this study was to evaluate the usefulness of Body Adiposity Index (BAI) as a predictor of body fat in Xavante Indians and to investigate which anthropometric measures of adiposity best correlate with body fat in this population.Methods: We evaluated 974 individuals (476 male), aged 423 +/- 19.5 years. Percentage of body fat (%BF) determined by bioimpedance analysis (BIA) was used as the reference measure of adiposity. Bland-Altman analysis was used to assess the agreement between the two methods: BAI and BIA. Associations between anthropometric measures of adiposity were investigated by Pearson correlation analysis.Results: BAI overestimates %BF (mean difference: 4.10%), mainly at lower levels of adiposity. Significant correlations were found between %BF and all measurements, being the strongest correlation with BAI. However, stratified analyses according to gender showed that among men waist circumference has the strongest correlation (r = 0.73, p <0.001) and among women BAI (r = 0.71, p < 0.001), BMI (r = 0.69, p < 0.001) and waist circumference (r = 0.70, p < 0.001) performed similarly.Conclusion: BAI can be a useful tool to predict %BF in Xavante Indians, although it has some limitations. However, it is not a better predictor of adiposity than waist circumference in men or BMI and waist circumference in women. (C) 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, Discipline Endocrinol, Escola Paulista Med, BR-04039001 São Paulo, BrazilUniv São Paulo, Fac Med Ribeirao Preto, Dept Med Social, BR-14049 Ribeirao Preto, BrazilUniversidade Federal de São Paulo, Discipline Endocrinol, Escola Paulista Med, BR-04039001 São Paulo, BrazilFAPESP: 2010/05634-0CNPq: 573856/2008-7Web of Scienc

Biological activities of extracts from aerial parts from Almeidea coerulea (Nees & Mart.) A.St.-Hil. and Conchocarpus gaudichaudianus subsp. bahiensis Kallunki (Rutaceae)

Extratos brutos obtidos com solventes orgânicos de polaridades crescentes, obtidos das partes aéreas de Almeidea coerulea e Conchocarpus gaudichaudianus subsp. bahiensis foram avaliadas a atividade moluscicida, determinda a concentração mínima inibitória (CMI) e a concentração mínima inibitória (CMI) antimicrobiana e antifúngica pelo método de bioautografia. Dos oito extratos testados o obtido em diclorometano das folhas Almeidea coerulea demonstraram atividade moluscicida frente ao caramujo Biomphalaria glabrata na concentração de 100 ppm. Os extratos com atividade antimicrobiana foram metanólico das folhas de Conchocarpus gaudichaudianus, extrato metanólico e hexânico dos caules de Almeidea coerulea sobre a bactéria Bacillus subtilis com CMI e CMB de 500 µg/ml, 250 µg/ml e 250 µg/ml respectivamente. Na bioautorafia frente ao fungo Aspergillus niger o extrato em dicolorometano do caule de Almeidea coerulea apresentou uma moderada inibição e das folhas apresentou uma inibição superior ao da nistatinaExtracts from aerial parts of Almeidea coerulea and Conchocarpus gaudichaudianus subsp. bahiensis, obtained with organic solvents of increasing polarities, were evaluated concerning the molluscicidal activity. The minimum inhibitory concentration (MIC), minimum bactericide concentration (MBC) and antifungal activity were determined by using the bioautography method. From the eight extracts assessed, the dichloromethane extract from Almeidea coerulea leaves showed molluscicidal activity against Biomphalaria glabrata at 100 ppm. The methanol extract from the Conchocarpus gaudichaudianus leaves, as well as the methanol and the hexane exracts from Almeidea coerulea stems exhibited antibacterial activity against Bacillus subtilis with MIC and MBC of 500 µg/ml, 250 µg/ml and 250 µg/ml, respectively. The bioautography method showed that the dichloromethane extract from Almeidea coerulea stems has a strong activity against Aspergillus niger, with a inhibition degree superior to that exhibited by nistatinColegio de Farmacéuticos de la Provincia de Buenos Aire

Biological activities of extracts from aerial parts from Almeidea coerulea (Nees & Mart.) A.St.-Hil. and Conchocarpus gaudichaudianus subsp. bahiensis Kallunki (Rutaceae)

Extratos brutos obtidos com solventes orgânicos de polaridades crescentes, obtidos das partes aéreas de Almeidea coerulea e Conchocarpus gaudichaudianus subsp. bahiensis foram avaliadas a atividade moluscicida, determinda a concentração mínima inibitória (CMI) e a concentração mínima inibitória (CMI) antimicrobiana e antifúngica pelo método de bioautografia. Dos oito extratos testados o obtido em diclorometano das folhas Almeidea coerulea demonstraram atividade moluscicida frente ao caramujo Biomphalaria glabrata na concentração de 100 ppm. Os extratos com atividade antimicrobiana foram metanólico das folhas de Conchocarpus gaudichaudianus, extrato metanólico e hexânico dos caules de Almeidea coerulea sobre a bactéria Bacillus subtilis com CMI e CMB de 500 µg/ml, 250 µg/ml e 250 µg/ml respectivamente. Na bioautorafia frente ao fungo Aspergillus niger o extrato em dicolorometano do caule de Almeidea coerulea apresentou uma moderada inibição e das folhas apresentou uma inibição superior ao da nistatinaExtracts from aerial parts of Almeidea coerulea and Conchocarpus gaudichaudianus subsp. bahiensis, obtained with organic solvents of increasing polarities, were evaluated concerning the molluscicidal activity. The minimum inhibitory concentration (MIC), minimum bactericide concentration (MBC) and antifungal activity were determined by using the bioautography method. From the eight extracts assessed, the dichloromethane extract from Almeidea coerulea leaves showed molluscicidal activity against Biomphalaria glabrata at 100 ppm. The methanol extract from the Conchocarpus gaudichaudianus leaves, as well as the methanol and the hexane exracts from Almeidea coerulea stems exhibited antibacterial activity against Bacillus subtilis with MIC and MBC of 500 µg/ml, 250 µg/ml and 250 µg/ml, respectively. The bioautography method showed that the dichloromethane extract from Almeidea coerulea stems has a strong activity against Aspergillus niger, with a inhibition degree superior to that exhibited by nistatinColegio de Farmacéuticos de la Provincia de Buenos Aire

Molecular and Kinetic Characterization of Two Extracellular Xylanases Isolated from Leucoagaricus gongylophorus

In this work, the xylanolytic profile of Leucoagaricus gongylophorus was studied, and two extracellular enzymes with xylanolytic activity (XyLg1 and XyLg2) were isolated, purified, and characterized. XyLg1 has a molecular mass of about 38 kDa and pI greater than 4.8. For beechwood xylan substrate, XyLg1 showed an optimum temperature of 40 A degrees C, optimum pH between 8.5 and 10.5, and Km = 14.7 A +/- 7.6 mg mL(-1). Kinetic studies of the XyLg1 using polygalacturonic acid as substrate were developed, and the enzyme showed optimum pH 5.5, optimum temperature between 50 and 60 A degrees C, and Km = 2.2 A +/- 0.5 mg mL(-1). XyLg2 has molecular weight of about 24 kDa and pI less than 4.8, and thus is an acid protein. Parameters such as optimum temperature (70 A degrees C) and pH (4.0), as well as the kinetic parameters (Km = 7.4 A +/- 2.0 mg mL(-1)) using beechwood xylan as substrate, were determined for XyLg2. This enzyme has no activity for polygalacturonic acid as substrate. XyLg1 and XyLg2 are the first native xylanases isolated and characterized from L. gongylophorus fungi and, due to their biochemistry and kinetic features, they have potential to be used in biotechnological processes.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.13Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

International Impact of COVID-19 on the Diagnosis of Heart Disease

Background: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. Objectives: The study sought to assess COVID-19's impact on global cardiovascular diagnostic procedural volumes and safety practices. Methods: The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. Results: Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p &lt; 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower–middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth. Conclusions: COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted

Impact of COVID-19 on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Objectives: The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region. Methods: A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. The percentage change in procedure volume was measured between March 2019 and April 2020, compared by test type and by facility. Results: In Oceania, the total cardiac diagnostic procedure volume was reduced by 52.2% from March 2019 to April 2020, compared to a reduction of 75.9% seen in the rest of the world (p&lt;0.001). Within Oceania sites, this reduction varied significantly between procedure types, but not between types of health care facility. All procedure types (other than stress cardiac magnetic resonance [CMR] and positron emission tomography [PET]) saw significant reductions in volume over this time period (p&lt;0.001). In Oceania, transthoracic echocardiography (TTE) decreased by 51.6%, transoesophageal echocardiography (TOE) by 74.0%, and stress tests by 65% overall, which was more pronounced for stress electrocardiograph (ECG) (81.8%) and stress echocardiography (76.7%) compared to stress single-photon emission computerised tomography (SPECT) (44.3%). Invasive coronary angiography decreased by 36.7% in Oceania. Conclusion: A significant reduction in cardiac diagnostic procedure volume was seen across all facility types in Oceania and was likely a function of recommendations from cardiac societies and directives from government to minimise spread of COVID-19 amongst patients and staff. Longer term evaluation is important to assess for negative patient outcomes which may relate to deferral of usual models of care within cardiology