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

Caracterização de paredes tradicionais de tabique

Neste artigo discutem-se aspectos construtivos relacionados com as paredes divisórias tradicionais de tabique, de forma a contribuir para um conhecimento mais aprofundado sobre este tipo de elementos, que são parte integrante de um estilo de construção marcante no panorama do património construído português que imperou até inícios do século XX. Informação relativa aos materiais utilizados e às soluções construtivas adoptadas é fornecida e descrita. Simultaneamente, algumas propriedades físicas avaliadas também são apresentadas com a intenção de auxiliar processos de reabilitação e outros trabalhos de investigação que visem o estudo de soluções construtivas alternativas de paredes divisórias, tendo em conta que o tabique pode ser uma técnica construtiva sustentável, económica e versátil

Optimizing hydropower dam location and removal in the São Francisco River basin, Brazil to balance hydropower and river biodiversity tradeoffs

To support eco-friendly hydropower planning in developing regions, we propose a spatial optimization model for locating dams to balance tradeoffs between hydropower generation and migratory fish species richness. Our model incorporates two special features. First, it is tailored to the dispersal of tropical migratory fishes, which require long, unimpeded river stretches to complete their life-cycle. To model fish with this type of dispersal pattern, we introduce the concept of a river pathway, which represents a novel way to describe river connectivity. Second, it combines decisions about dam placement and removal, thus facilitating opportunities for hydropower offsetting. We apply our model to the São Francisco River basin, Brazil, an area of hydropower-freshwater biodiversity conflict. We find that dams have reduced weighted migratory fish richness 51% compared to a pre-dam baseline. We also find that even limited dam removal has the potential to significantly enhance fish biodiversity. Offsetting the removal of a single dam by the optimal siting of new dams could increase fish richness by 25% above the current average. Moving forward, optimizing new dam sites to increase hydropower by 20%, rather than selecting the fewest number of dams, could reduce fish species losses by 89%. If decisions about locating new dams are combined with dam removal, then a win-win can even be achieved with 20% greater hydropower and 19% higher species richness. Regardless of hydropower targets and dam removal options, a key observation is that optimal sites for dams are mostly located in the upper reaches of the basin rather than along the main stem of the São Francisco River or its main tributaries

Copy number variation arising from gene conversion on the human Y chromosome

We describe the variation in copy number of a ~ 10 kb region overlapping the long intergenic noncoding RNA (lincRNA) gene, TTTY22, within the IR3 inverted repeat on the short arm of the human Y chromosome, leading to individuals with 0–3 copies of this region in the general population. Variation of this CNV is common, with 266 individuals having 0 copies, 943 (including the reference sequence) having 1, 23 having 2 copies, and two having 3 copies, and was validated by breakpoint PCR, fbre-FISH, and 10× Genomics Chromium linked-read sequencing in subsets of 1234 individuals from the 1000 Genomes Project. Mapping the changes in copy number to the phylogeny of these Y chromosomes previously established by the Project identifed at least 20 mutational events, and investigation of fanking paralogous sequence variants showed that the mutations involved fanking sequences in 18 of these, and could extend over > 30 kb of DNA. While either gene conversion or double crossover between misaligned sister chromatids could formally explain the 0–2 copy events, gene conversion is the more likely mechanism, and these events include the longest non-allelic gene conversion reported thus far. Chromosomes with three copies of this CNV have arisen just once in our data set via another mechanism: duplication of 420 kb that places the third copy 230 kb proximal to the existing proximal copy. Our results establish gene conversion as a previously under-appreciated mechanism of generating copy number changes in humans and reveal the exceptionally large size of the conversion events that can occur

Demanda hídrica e eficiência de irrigação pelo arroz: efeito da altura da lâmina de água.

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Dung burial by roller dung beetles (Coleoptera: Scarabaeinae):An individual and specific-level study

Dung beetles (Coleoptera: Scarabaeinae) mediate many ecological functions that are important to maintain the ecosystem functioning of terrestrial environments. Although a large amount of literature explores the dung beetle-mediated ecological processes, little is known about the individual contribution from distinct species. Here, we aimed to examine the intra and interspecific variations in dung burial rates performed by two roller dung beetle species (Canthon smaragdulus Fabricius, 1781 and Canthon sulcatus Castelnau, 1840). Furthermore, we evaluated the relationship between dung beetle biomass and dung burial rates. We set up a laboratorial experiment with three treatments (two males, two females, and a couple) and 10 replicates per treatment for each dung beetle species, and dung burial rates were measured after exposing 100 g of mixed pig and human excrement for 48 hours. Our results demonstrate that dung burial rates of males, females, and couples within each species do not differ. However, C. smaragdulus individuals performed a larger dung burial than C. sulcatus individuals did. In addition, we found no effect of individual biomass on the amount of dung burial on intra and interspecific levels. These findings highlight the need for further research considering that distinct species, even from the same genus, may perform different rates of ecological processes, as well as about the importance for considering the beetle biomass when measuring their ecological functions. We call for studies to fill in the knowledge gap about the individual species’ contribution to the maintenance of different dung beetle-mediated ecological processes

Priority setting for restoration in surrounding savannic areas of the Brazilian Pantanal based on soil loss risk and agrarian structure.

ABSTRACT. Soil health is at the core of the sustainability agenda. As in many agroecosystems in the tropics, soil erosion is a major issue in poorly managed pasturelands. A noteworthy case is located in the Upper Taquari River Basin (UTRB), as part of the Upper Paraguay Basin on the plateau with drainage waters for the Taquari megafan in the Brazilian Pantanal. Here we combine slope (S-factor), erodibility (E-factor), rainfall-rainy day ratio (R-factor), and vegetation and soil indices (C-factor) to locate erosion risk and prioritize eco-engineering interventions via palisades and small dams in UTRB. The method consisted of assessing distinct weights between Universal Soil Loss Equation (USLE) factors in a GIS platform, providing 35 combinations of classes as low, moderate, high, and very high erosive risk. The validation of the method was based on the ravine and plain ground truths obtained from high-resolution raster data. The best weight of USLE factors aids to locate critical erosive sites and vegetation patterns. Then, erosion risk and interventions were analyzed according to land use and rural property sizes in the government?s Rural Environmental Registry (CAR) database. Overall, the natural factors of slope and erodibility in a proportion of 25% and 75% in GIS algebra provided the best mapping accuracy result. About 65% of the UTRB has high or very high erosion risks, and 70% of the available area can be acknowledged as degraded pasturelands. A total of 4744 erosion interventions were recorded, with an accuracy of 65.28% and 61.15% for check dams and palisades interventions, respectively. The number of necessary interventions in areas of native vegetation was almost 50% higher than in pasturelands. Even though micro landowners occupy most of the watershed, large properties have about ten times as many areas at high risk of erosion. The mutual cooperation between properties, independently of size, is supported by governmental public policies like incentives for ecosystem services restoration of critical gullies, with CAR compliance and fiscalization