An index to identify stroke-related vs incidental patent foramen ovale in cryptogenic stroke.

OBJECTIVE: We aimed to create an index to stratify cryptogenic stroke (CS) patients with patent foramen ovale (PFO) by their likelihood that the stroke was related to their PFO. METHODS: Using data from 12 component studies, we used generalized linear mixed models to predict the presence of PFO among patients with CS, and derive a simple index to stratify patients with CS. We estimated the stratum-specific PFO-attributable fraction and stratum-specific stroke/TIA recurrence rates. RESULTS: Variables associated with a PFO in CS patients included younger age, the presence of a cortical stroke on neuroimaging, and the absence of these factors: diabetes, hypertension, smoking, and prior stroke or TIA. The 10-point Risk of Paradoxical Embolism score is calculated from these variables so that the youngest patients with superficial strokes and without vascular risk factors have the highest score. PFO prevalence increased from 23% (95% confidence interval [CI]: 19%-26%) in those with 0 to 3 points to 73% (95% CI: 66%-79%) in those with 9 or 10 points, corresponding to attributable fraction estimates of approximately 0% to 90%. Kaplan-Meier estimated stroke/TIA 2-year recurrence rates decreased from 20% (95% CI: 12%-28%) in the lowest Risk of Paradoxical Embolism score stratum to 2% (95% CI: 0%-4%) in the highest. CONCLUSION: Clinical characteristics identify CS patients who vary markedly in PFO prevalence, reflecting clinically important variation in the probability that a discovered PFO is likely to be stroke-related vs incidental. Patients in strata more likely to have stroke-related PFOs have lower recurrence risk.

An integrated encyclopedia of DNA elements in the human genome.

The human genome encodes the blueprint of life, but the function of the vast majority of its nearly three billion bases is unknown. The Encyclopedia of DNA Elements (ENCODE) project has systematically mapped regions of transcription, transcription factor association, chromatin structure and histone modification. These data enabled us to assign biochemical functions for 80% of the genome, in particular outside of the well-studied protein-coding regions. Many discovered candidate regulatory elements are physically associated with one another and with expressed genes, providing new insights into the mechanisms of gene regulation. The newly identified elements also show a statistical correspondence to sequence variants linked to human disease, and can thereby guide interpretation of this variation. Overall, the project provides new insights into the organization and regulation of our genes and genome, and is an expansive resource of functional annotations for biomedical research.

Respiração e produção de etanol e de etileno em mangas armazenadas sob diferentes concentrações de dióxido de carbono e oxigênio

O objetivo deste trabalho foi avaliar a respiração e produção de etanol e etileno em mangas armazenadas sob reduzidas concentrações de oxigênio (O2) e elevadas concentrações de dióxido de carbono (CO2). Mangas pré-climatéricas das cultivares Kent e Tommy Atkins foram armazenadas, sob fluxo contínuo, por 14 ou 21 dias, a 12°C em três concentrações de O2: 3%, 5% ou 21% em mistura com concentrações de 5%, 15%, 25%, 35%, 45%, 50% ou 70% de CO2. O tratamento-testemunha constou de armazenagem em ar sob fluxo contínuo. Após o período em atmosfera controlada (AC), as mangas foram transferidas e mantidas por 5 dias em ar a 20°C. Mangas sob concentrações de 50% e 70% de CO2 produziram mais etanol que nas demais concentrações de CO2. A redução para 3% de O2 na atmosfera de armazenagem aparentemente não teve efeito adicional ao CO2 na produção de etanol. A atividade respiratória de mangas em AC com CO2 acima de 45% foi muito mais intensa do que a respiração sob as concentrações de CO2 mais baixas; a produção de etileno, no entanto, esteve suprimida, e, mesmo após a transferência para ar, não se recuperou, permanecendo inferior aos demais tratamentos. A queda na atividade respiratória das mangas armazenadas a 50% e 70% de CO2, quando foram transferidas para ar a 20°C indica que as elevadas concentrações de CO2 causaram dano irreparável aos tecidos.

Field Performance and Evaluation of Slurry Seals, HR-195, 1980

As part of the overall research program of evaluating asphalt emulsion slurry seal as a pavement maintenance material, 31 duplicate 500-ft test sections were constructed on U.S. 6 between Adel and Waukee in Dallas County during September and October of 1978. These test sections included combinations of eight aggregates, two gradings, three asphalt emulsions, two mineral fillers, and a range of emulsion contents determined by laboratory mix designs. The emulsion contents of the test sections varied from 10.3% for Section 7A (Ferguson coarse) to 32.9% for Section 31A (lightweight aggregate). The post-construction performance evaluation of the test sections, consisting primarily of the friction tests and surface appearance observations, was conducted at different time intervals up to 24 months after construction. At the 24-month final evaluation, most of the test sections had carried a total of 1.4 million vehicles.

Diallel analysis for frogeye leaf spot resistance in soybean

Seven soybean cultivars (Bossier, Cristalina, Davis, Kent, Lincoln, Paraná and Uberaba), with different levels of resistance to Cercospora sojina, were crossed in a diallel design to determine the general (GCA) and specific (SCA) combining abilities relative to the inheritance of the resistance. Race 04 of the fungus was inoculated in the parents and in the 21 F1 hybrids in a greenhouse in a completely randomized design, with 12 replications. The reactions to the disease were evaluated 20 days after the inoculation, always on the most infected leaflet. Both GCA and SCA were significant for all the evaluated characters, being inferred that, for the expression of the characters, the additive, dominant and, possibly, epistatic genic actions were important. The largest values of estimated SCA effect (ij) were observed in the hybrid combinations where at least one parent presented high GCA. Cristalina, Davis and Uberaba cultivars showed the largest estimates for GCA effect (i), and from the analysis of ii, the contribution of these parents to heterosis of their hybrids will be towards the reduction of the disease symptoms. Therefore, these cultivars are indicated as parents in breeding programs that seek the development of soybean cultivars with resistance to frogeye leaf spot.

The genome sequence of taurine cattle: a window to ruminant biology and evolution.

To understand the biology and evolution of ruminants, the cattle genome was sequenced to about sevenfold coverage. The cattle genome contains a minimum of 22,000 genes, with a core set of 14,345 orthologs shared among seven mammalian species of which 1217 are absent or undetected in noneutherian (marsupial or monotreme) genomes. Cattle-specific evolutionary breakpoint regions in chromosomes have a higher density of segmental duplications, enrichment of repetitive elements, and species-specific variations in genes associated with lactation and immune responsiveness. Genes involved in metabolism are generally highly conserved, although five metabolic genes are deleted or extensively diverged from their human orthologs. The cattle genome sequence thus provides a resource for understanding mammalian evolution and accelerating livestock genetic improvement for milk and meat production.

Structure of the glycosyl-phosphatidylinositol membrane anchor of the Leishmania major promastigote surface protease.

In common with many other plasma membrane glycoproteins of eukaryotic origin, the promastigote surface protease (PSP) of the protozoan parasite Leishmania contains a glycosyl-phosphatidylinositol (GPI) membrane anchor. The GPI anchor of Leishmania major PSP was purified following proteolysis of the PSP and analyzed by two-dimensional 1H-1H NMR, compositional and methylation linkage analyses, chemical and enzymatic modifications, and amino acid sequencing. From these results, the structure of the GPI-containing peptide was found to be Asp-Gly-Gly-Asn-ethanolamine-PO4-6Man alpha 1-6Man alpha 1-4GlcN alpha 1-6myo-inositol-1-PO4-(1-alkyl-2-acyl-glycerol). The glycan structure is identical to the conserved glycan core regions of the GPI anchor of Trypanosoma brucei variant surface glycoprotein and rat brain Thy-1 antigen, supporting the notion that this portion of GPIs are highly conserved. The phosphatidylinositol moiety of the PSP anchor is unusual, containing a fully saturated, unbranched 1-O-alkyl chain (mainly C24:0) and a mixture of fully saturated unbranched 2-O-acyl chains (C12:0, C14:0, C16:0, and C18:0). This lipid composition differs significantly from those of the GPIs of T. brucei variant surface glycoprotein and mammalian erythrocyte acetylcholinesterase but is similar to that of a family of glycosylated phosphoinositides found uniquely in Leishmania.

Meta-analysis and imputation refines the association of 15q25 with smoking quantity.

Smoking is a leading global cause of disease and mortality. We established the Oxford-GlaxoSmithKline study (Ox-GSK) to perform a genome-wide meta-analysis of SNP association with smoking-related behavioral traits. Our final data set included 41,150 individuals drawn from 20 disease, population and control cohorts. Our analysis confirmed an effect on smoking quantity at a locus on 15q25 (P = 9.45 x 10(-19)) that includes CHRNA5, CHRNA3 and CHRNB4, three genes encoding neuronal nicotinic acetylcholine receptor subunits. We used data from the 1000 Genomes project to investigate the region using imputation, which allowed for analysis of virtually all common SNPs in the region and offered a fivefold increase in marker density over HapMap2 (ref. 2) as an imputation reference panel. Our fine-mapping approach identified a SNP showing the highest significance, rs55853698, located within the promoter region of CHRNA5. Conditional analysis also identified a secondary locus (rs6495308) in CHRNA3.

Patent foramen ovale in patients with ischaemic stroke of unknown cause: to close? "pro closure" position

There is ample epidemiological and anecdotal evidence that a PFO increases the risk of stroke both in young and elderly patients, although only in a modest way: PFOs are more prevalent in patients with cryptogenic (unexplained) stroke than in healthy subjects, and are more prevalent in cryptogenic stroke than in strokes of other causes. Furthermore, multiple case series confirm an association of paradoxical embolism across a PFO in patients with deep vein thrombosis and/or pulmonary emboli.2. Is stroke recurrence risk in PFO-patients really not elevated when compared to PFO-free patients, as suggested by traditional observational studies? This finding is an epidemiological artifact called "the paradox of recurrence risk research" (Dahabreh & Kent, JAMA 2011) and is due to one (minor) risk factor, such as PFO, being wiped out by other, stronger risk factors in the control population.3. Having identified PFO as a risk factor for a first stroke and probably also for recurrences, we have to treat it, because treating risk factors always has paid off. No one would nowadays question the aggressive treatment of other risk factors of stroke such as hypertension, atrial fibrillation, smoking, or hyperlipidemia.4. In order to be effective, the preventive treatment has to control the risk factor (i.e. close effectively the PFO), and has to have little or no side effects. Both these conditions are now fulfilled thanks to increasing expertise of cardiologists with technically advanced closure devices and solid back up by multidisciplinary stroke teams.5. Closing a PFO does not dispense us from treating other stroke risk factors aggressively, given that these are cumulative with PFO.6. The most frequent reason why patients have a stroke recurrence after PFO closure is not that closure is ineffective, but that the initial stroke etiology is insufficiently investigated and not PFO related, and that the recurrence is due to another mechanism because of poor risk factor control.7. Similarly, the randomized CLOSURE study was negative because a) patients were included who had a low chance that their initial event was due to the PFO, b) patients were selected with a low chance that a PFO-related recurrence would occur, c) there was an unacceptable high rate of closure-related side effects, and d) the number of randomized patients was too small for a prevention trial.8. It is only a question of time until a sufficiently large randomized clinical trial with true PFO-related stroke patients and a high PFO-related recurrence risk will be performed and show the effectiveness of this closure9. PFO being a rather modest risk factor for stroke does not mean we should prevent our patients from getting the best available prevention by the best physicians in the best stroke centers Therefore, a PFO-closure performed by an excellent cardiologist following the recommendation of an expert neurovascular specialist after a thorough workup in a leading stroke center is one of the most effective stroke prevention treatments available in 2011.

Flutuação populacional de moscas-das-frutas (Diptera: Tephritidae) associadas a variedades de manga no município de José de Freitas-Piauí

O Piauí possui uma área considerável de manga, sendo um grande produtor dessa fruta no Brasil. Contudo, a presença de pragas, como as moscas-das-frutas, tem provocado grandes impactos na cadeia produtiva, pois estes insetos fazem parte de um grupo responsável por grandes prejuízos econômicos na cultura da mangueira. O conhecimento da flutuação populacional e a época de maior ocorrência de uma determinada espécie de inseto de importância econômica são requisitos indispensáveis para o estabelecimento de um controle eficiente e racional. O presente trabalho visou registrar a flutuação populacional das espécies de moscas-das-frutas associadas a variedades de manga, bem como correlacionar a ocorrência das moscas com as médias mensais de temperatura, precipitação e umidade relativa, e também avaliar os atrativos alimentares utilizados na captura dos insetos. A pesquisa foi conduzida de junho de 2004 a maio de 2005, em pomar comercial de manga (Mangifera indica L.-Anacardiaceae), das variedades Tommy Atkins, Keitt, Kent e Palmer, localizado no município de José de Freitas-Piauí-Brasil, na latitude 04º50'S e longitude 42º41'W. Anastrepha obliqua e Anastrepha serpentina são as espécies de tephritídeos predominantes na cultura da manga.

Monitoramento de coleobrocas associadas à mangueira no município de José de Freitas, Estado do Piauí

Este trabalho foi desenvolvido de junho de 2004 a maio de 2005, objetivando o reconhecimento de espécies de coleobrocas (Insecta: Coleoptera) que se encontram associadas a pomar comercial de manga (Mangifera indica) das variedades Tommy Atkins, Keitt, Kent e Palmer, no município de José de Freitas, Estado do Piauí. Foram instaladas duas armadilhas etanólicas modelo Carvalho 47 em cada área das referidas variedades e realizadas coletas semanais. As coleobrocas foram separadas dos resíduos vegetais, secas sob lâmpada e quantificadas. Posteriormente, exemplares de cada morfoespécie coletada foram identificados. Coleobrocas das famílias Bostrichidae, Cerambycidae, Curculionidae estão associadas às variedades de manga cultivadas no município de José de Freitas, Estado do Piauí, onde se destacam as espécies Hylettus seniculus (Germar) (Coleoptera: Cerambycidae), Hypothenemus sp. 1 e sp. 2. (Coleoptera: Curculionidae: Scolytinae), apresentando maior expressão numérica e variedade de morfoespécies durante o período de menor precipitação pluviométrica, fator correlacionado positivamente à família Cerambycidae.

Points to consider for prioritizing clinical genetic testing services: a European consensus process oriented at accountability for reasonableness.

Given the cost constraints of the European health-care systems, criteria are needed to decide which genetic services to fund from the public budgets, if not all can be covered. To ensure that high-priority services are available equitably within and across the European countries, a shared set of prioritization criteria would be desirable. A decision process following the accountability for reasonableness framework was undertaken, including a multidisciplinary EuroGentest/PPPC-ESHG workshop to develop shared prioritization criteria. Resources are currently too limited to fund all the beneficial genetic testing services available in the next decade. Ethically and economically reflected prioritization criteria are needed. Prioritization should be based on considerations of medical benefit, health need and costs. Medical benefit includes evidence of benefit in terms of clinical benefit, benefit of information for important life decisions, benefit for other people apart from the person tested and the patient-specific likelihood of being affected by the condition tested for. It may be subject to a finite time window. Health need includes the severity of the condition tested for and its progression at the time of testing. Further discussion and better evidence is needed before clearly defined recommendations can be made or a prioritization algorithm proposed. To our knowledge, this is the first time a clinical society has initiated a decision process about health-care prioritization on a European level, following the principles of accountability for reasonableness. We provide points to consider to stimulate this debate across the EU and to serve as a reference for improving patient management.

Pronounced species divergence in corticospinal tract reorganization and functional recovery after lateralized spinal cord injury favors primates.

Experimental and clinical studies suggest that primate species exhibit greater recovery after lateralized compared to symmetrical spinal cord injuries. Although this observation has major implications for designing clinical trials and translational therapies, advantages in recovery of nonhuman primates over other species have not been shown statistically to date, nor have the associated repair mechanisms been identified. We monitored recovery in more than 400 quadriplegic patients and found that functional gains increased with the laterality of spinal cord damage. Electrophysiological analyses suggested that corticospinal tract reorganization contributes to the greater recovery after lateralized compared with symmetrical injuries. To investigate underlying mechanisms, we modeled lateralized injuries in rats and monkeys using a lateral hemisection, and compared anatomical and functional outcomes with patients who suffered similar lesions. Standardized assessments revealed that monkeys and humans showed greater recovery of locomotion and hand function than did rats. Recovery correlated with the formation of corticospinal detour circuits below the injury, which were extensive in monkeys but nearly absent in rats. Our results uncover pronounced interspecies differences in the nature and extent of spinal cord repair mechanisms, likely resulting from fundamental differences in the anatomical and functional characteristics of the motor systems in primates versus rodents. Although rodents remain essential for advancing regenerative therapies, the unique response of the primate corticospinal tract after injury reemphasizes the importance of primate models for designing clinically relevant treatments.