The Arabidopsis immune receptor EFR increases resistance to the bacterial pathogens Xanthomonas and Xylella in transgenic sweet orange

Citrus agribusiness faces major economic losses due to bacterial diseases (Caserta et al., 2020). Citrus canker (CC) and citrus variegated chlorosis (CVC) caused by Xanthomonas citri subsp. citri (Xcc) and Xylella fastidiosa subsp. pauca (Xfp), respectively, are important threats in commercial citrus orchards. All sweet orange (Citrus sinensis) commercial varieties are susceptible to both pathogens, and no natural resistance has been found so far

Abordagens cirúrgicas na obesidade e síndrome metabólica: uma revisão abrangente das terapias e perspectivas futuras

A obesidade e a síndrome metabólica são condições de saúde crônicas e multifatoriais que representam grandes desafios para a saúde pública. Abordagens cirúrgicas têm sido exploradas como opções terapêuticas promissoras para pacientes com essas condições. Este artigo fornece uma revisão abrangente das abordagens cirúrgicas na obesidade e síndrome metabólica, incluindo cirurgia bariátrica restritiva, cirurgia bariátrica malabsortiva e procedimentos endoscópicos. A estratégia de busca utilizada incluiu bases de dados como PubMed, Web of Science e Scopus, resultando em uma seleção de estudos primários publicados entre janeiro de 2010 e junho de 2023. Os resultados indicaram que a gastrectomia vertical e o bypass gástrico em Y de Roux são procedimentos eficazes na perda de peso e melhora das comorbidades metabólicas. Os procedimentos endoscópicos, como o balão intragástrico, também demonstraram resultados promissores, embora mais pesquisas sejam necessárias para avaliar sua eficácia a longo prazo. A escolha da abordagem cirúrgica deve ser individualizada, considerando os riscos e benefícios, além do perfil clínico e preferências do paciente. Recomenda-se a realização de estudos de longo prazo e ensaios clínicos randomizados para aprimorar o conhecimento sobre os desfechos e a segurança dessas intervenções. Em conclusão, as abordagens cirúrgicas representam uma opção valiosa no manejo da obesidade e da síndrome metabólica, mas devem ser integradas a abordagens multidisciplinares e personalizadas para alcançar melhores resultados

II Diretriz Brasileira de Transplante Cardíaco

Universidade de São Paulo Faculdade de Medicina Hospital das ClínicasIIHospital de Messejana Dr. Carlos Alberto Studart GomesUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaInstituto Dante Pazzanese de CardiologiaUniversidade Federal de Minas Gerais Hospital das ClínicasFaculdade de Medicina de São José do Rio PretoPontifícia Universidade Católica do ParanáIHospital Israelita Albert EinsteinInstituto Nacional de Cardiologia, Fundação Universitária do Rio Grande do Sul Instituto de CardiologiaReal e Benemérita Sociedade de Beneficência Portuguesa, São PauloHospital Pró-Cardíaco do Rio de JaneiroSanta Casa do Rio de JaneiroUNIFESP, EPMSciEL

III Diretriz Brasileira de Insuficiência Cardíaca Crônica

Universidade de São Paulo Faculdade de Medicina Hospital das ClínicasUniversidade Federal do Rio Grande do Sul Hospital de Clínicas de Porto AlegreUniversidade de Pernambuco Faculdade de Ciências Médicas de PernambucoUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUniversidade Federal de Minas Gerais Faculdade de MedicinaFaculdade de Medicina de São José do Rio PretoFundação Universitária de Cardiologia do Rio Grande do Sul Instituto de CardiologiaRede Labs D'OrUniversidade Federal FluminenseUniversidade do Estado do Rio de Janeiro Faculdade de Ciencias MédicasInstituto Dante Pazzanese de CardiologiaSanta Casa de MisericórdiaUniversidade de Pernambuco Pronto Socorro Cardiológico de PernambucoHospital Pró CardíacoHospital de MessejanaPontifícia Universidade Católica do ParanáUniversidade Federal de Goiás Faculdade de MedicinaUniversidade de São Paulo Faculdade de Medicina de Ribeirão PretoReal e Benemerita Sociedade de Beneficência PortuguesaFaculdade de Ciências Médicas de Minas GeraisUNIFESP, EPMSciEL

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 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 or ganism 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 ne glected 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 lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 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,18,19 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

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.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Pathogen derived resistance mediated by toxin of toxin-antitoxin system from Xylella fastidiosa

Orientador: Alessandra Alves de SouzaDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de BiologiaResumo: A laranja doce é uma das culturas mais importantes produzidas no Brasil dada a sua importância econômica para a agricultura nacional. Contudo, esse setor vem sofrendo grandes perdas econômicas devido a problemas de ordem fitossanitária como doenças e pragas. Dentre esses, as doenças bacterianas como a Clorose Variegada dos Citros (CVC), causada pela bactéria Xylella fastidiosa, e o Cancro Cítrico, causado pela bactéria Xanthomonas citri subsp. citri, causam grandes prejuízos para a produção de laranja doce. Dentre as tecnologias que visam a obtenção de plantas resistentes a fitopatógenos, a transgenia apresenta-se como uma ferramenta biotecnológica para a obtenção de variedades tolerantes/resistentes a diferentes patógenos. Dentro das estratégias de transgenia, a resistência derivada do patógeno (RDP) tem demonstrado ser promissora para o controle dos fitopatógenos de citros. Nesta vertente, um possível candidato para conferir tolerância a CVC e ao cancro cítrico seria o gene mqsR que codifica uma toxina de um sistema toxina-antitoxina de X. fastidiosa. Essa toxina é uma endorribonuclease e já foi descrita por abolir a patogenicidade de X. fastidiosa quando a bactéria superexpressa a mesma. Dessa forma, MqsR possui potencial para transformação genética de plantas visando tolerância a X. fastidiosa, podendo levar à inibição do crescimento e, consequentemente, redução na colonização da bactéria e dos sintomas. X. citri não possui esse sistema toxina-antitoxina homólogo em seu genoma, em função disso, plantas transgênicas superexpressando a toxina MqsR poderiam também interferir na colonização dessa bactéria, diminuindo os sintomas de Cancro Cítrico. Nesse estudo, plantas transgênicas de tabaco e citros superexpressando a toxina MqsR foram obtidas, e a presença do transgene foi confirmada por GUS, PCR, expressão gênica e proteica. Essas plantas foram desafiadas com X. fastidiosa e demonstraram redução da sintomatologia comparadas às plantas não transformadas. Também foi verificado que a população de X. fastidiosa foi significativamente menor nas plantas transgênicas, demonstrando que possivelmente a toxina interferiu na multiplicação e colonização da bactéria e, consequentemente, reduziu os sintomas da doença. Também foi verificado que a toxina MqsR pôde penetrar nas células de X. citri e inibir o seu crescimento. Em folhas destacadas das plantas transgênicas de citros infiltradas com X. citri foi verificada redução da colonização e população da bactéria, sendo possível detectar a toxina dentro da célula da bactéria, demonstrando que, assim como observado para X. fastidiosa, a toxina MqsR também alterou o comportamento de X. citri. Dando suporte ao fenótipo observado, foi demonstrada a repressão de genes associados à multiplicação e colonização da bactéria. Em casa de vegetação também foi observada redução na severidade de sintomas nas plantas transgênicas ao longo do tempo. Desse modo os resultados sugerem que a toxina superexpressa pela planta pode interferir na multiplicação e colonização de X. fastidiosa e X. citri, promovendo tolerância a ambos os patógenosAbstract: Sweet orange is one of the most important cultures produced in Brazil given its economic importance for national agriculture. However, this sector suffers big losses due phytosanitary problems as diseases and pests. Among them, the bacterial diseases such as Citrus Variegated Chlorosis (CVC) caused by Xylella fastidiosa, and citrus canker, caused by Xanthomonas citri subsp. citri generate big losses to sweet orange production. Among the technologies that aim to obtain resistance to plant pathogens, transgenesis can be used as a biotechnological tool to obtain tolerant/resistant plants for different pathogens. Among strategies of transgenesis, pathogen derived resistance (PDR) has been showed promising to control citrus pathogens. In this way, a possible candidate gene to confer tolerance against CVC and citrus canker would be the mqsR gene, which encodes a toxin of a toxin-antitoxin system from X. fastidiosa. This toxin is an endoribonuclease and was already described to abolish the pathogenicity of X. fastidiosa when the bacterium overexpress the toxin. In this way MqsR has potential for genetic transformation of plants aiming tolerance to X. fastidiosa, being able to inhibit growth, consequentely, reduce bacterial colonization and symptoms. X. citri does not have an homologous of this TA system in its genome, thus, transgenic plants overexpresing MqsR toxin could also interfere in X. citri colonization, decreasing the symptoms of citrus canker. In this study, were obtained transgenic plants of tobacco and citrus overexpressing the MqsR toxin, which were confirmed by GUS, PCR, gene and protein expression. These plants were challenged with X. fastidiosa and showed a reduction of symptoms when compared with non-transformed plants. Also it was verified that the population of X. fastidiosa was significantly smaller in transgenic plants, showing that the toxin possibly interfered with bacterial multiplication and colonization and, consequently, decreased the disease symptoms. It was also verified that the MqsR toxin could penetrate in X. citri cells and inhibit their growth. In detached leaves of transgenic citrus plants infiltrated with X. citri was verified a reduction of bacterial colonization and population, and the toxin was detected inside the bacterial cells, showing that, as observed in X. fastidiosa, the MqsR toxin altered the behavior of X. citri. Supporting the observed phenotype, it was showed a repression of genes associated with bacterial multiplication and colonization. In greenhouse conditions, it was also verified a reduction of severity of symptoms in transgenic plants in a time course experiment. Therefore, the findings suggest that the toxin overexpressed by the plant can be interfering with the multiplication and colonization of X. fastidiosa and X. citri, leading to tolerance to both pathogensMestradoGenetica Vegetal e MelhoramentoMestre em Genética e Biologia Molecular2013/21924-6FAPES