Pseudomonas syringae coffee blight is associated with the horizontal transfer of plasmid-encoded type III effectors.

The emergence of new pathogens is an ongoing threat to human health and agriculture. While zoonotic spillovers received considerable attention, the emergence of crop diseases is less well studied. Here, we identify genomic factors associated with the emergence of Pseudomonas syringae bacterial blight of coffee. Fifty-three P. syringae strains from diseased Brazilian coffee plants were sequenced. Comparative and evolutionary analyses were used to identify loci associated with coffee blight. Growth and symptomology assays were performed to validate the findings. Coffee isolates clustered in three lineages, including primary phylogroups PG3 and PG4, and secondary phylogroup PG11. Genome-wide association study of the primary PG strains identified 37 loci, including five effectors, most of which were encoded on a plasmid unique to the PG3 and PG4 coffee strains. Evolutionary analyses support the emergence of coffee blight in PG4 when the coffee-associated plasmid and associated effectors derived from a divergent plasmid carried by strains associated with other hosts. This plasmid was only recently transferred into PG3. Natural diversity and CRISPR-Cas9 plasmid curing were used to show that strains with the coffee-associated plasmid grow to higher densities and cause more severe disease symptoms in coffee. This work identifies possible evolutionary mechanisms underlying the emergence of a new lineage of coffee pathogens.

Advantages of treating sponge-gourd waste by mechanical refining on the properties of fiber-based poly(butylene adipate-co-terephthalate)/polylactide biocomposites.

This study compares the morphology, thermal, and dynamic-mechanical properties of composites based on polybutylene adipate terephthalate/polylactide biocomposites with sponge gourd waste treated code as R, and non-treated sponge gourd, coded as NR, by mechanical disc refining after milled process. Extrusion followed by compression molding was used to produce biocomposites with fiber contents of 0, 2.5, 5, 10, and 15% wt/wt for R and NR sponge gourd fibers. Scanning electron microscopy analysis reveals that NR has the morphology of a rigid tubular shape, whereas R is a thinner, twisted, and fibrillated fiber. Regardless of the type of sponge gourd fiber used, the thermal stability of the composite decreases as the sponge gourd content increases. At 25°C, the biocomposite with 10%wt/wt R fiber has the highest storage modulus value. The comparison of Tangent  peak values reveals that the presence of sponge gourd fibers reduces the energy dissipation of the biocomposites. The analysis of the loss modulus at 25°C reveals that R fiber contributes more to the reduction of energy dissipation of the biocomposites than NR. Furthermore, the Cole-Cole plot shows that R and NR fibers are dispersed and do not significantly change the homogeneity of the biopolymer systems.

Critical Percolation in the Ordering Kinetics of Twisted Nematic Phases.

I report on the experimental confirmation that critical percolation statistics underlie the ordering kinetics of twisted nematic phases in the Allen-Cahn universality class. Soon after the ordering starts from a homogeneous disordered phase and proceeds toward a broken Z_{2}-symmetry phase, the system seems to be attracted to the random percolation fixed point at a special timescale t_{p}. At this time, exact formulas for crossing probabilities in percolation theory agree with the corresponding probabilities in the experimental data. The ensuing evolution for the number density of hull-enclosed areas is described by an exact expression derived from a percolation model endowed with curvature-driven interface motion. Scaling relation for hull-enclosed areas versus perimeters reveals that the fractal percolation geometry is progressively morphed into a regular geometry up to the order of the classical coarsening length. In view of its universality and experimental possibilities, the study opens a path for exploring percolation keystones in the realm of nonequilibrium, phase-ordering systems.

Saúde da população idosa na atenção básica em Francisco Morato / Health of the elderly population in primary care in Francisco Morato (SP)

A população idosa está crescendo de forma acelerada no Brasil, o que demanda um preparo dos profissionais de saúde em atendê-la. A atenção básica é a porta de entrada à saúde, por isso é necessário compreender como são ofertadas as ações de saúde à pessoa idosa. Objetivo: Analisar a assistência da atenção primária à saúde para a população idosa no município de Francisco Morato, São Paulo. Metodologia: Foi aplicado um questionário denominado Instrumento de Conhecimento da Atenção Básica (ICAB) nas 12 unidades básicas de saúde do município e foram realizadas duas entrevistas de caráter qualitativo com profissionais da atenção básica. Resultados: Não há muitas ações específicas para a população idosa no município, salvo grupos educativos de hipertensão e diabetes, bem como de atividade física. Além disso, o número de profissionais é insuficiente para atender, de modo qualificado, a demanda dos usuários idosos. Conclusão: O foco na saúde da pessoa idosa ainda é muito orientado pelo campo biológico com foco na doença. Nesse sentido, é essencial preparar os profissionais para oferecer um cuidado integral à pessoa idosa e aprimorar as ações a esse público.

Energy-lowering and constant-energy spin flips: Emergence of the percolating cluster in the kinetic Ising model.

After a sudden quench from the disordered high-temperature T_{0}→∞ phase to a final temperature well below the critical point T_{F}≪T_{c}, the nonconserved order parameter dynamics of the two-dimensional ferromagnetic Ising model on a square lattice initially approaches the critical percolation state before entering the coarsening regime. This approach involves two timescales associated with the first appearance (at time t_{p_{1}}>0) and stabilization (at time t_{p}>t_{p_{1}}) of a giant percolation cluster, as previously reported. However, the microscopic mechanisms that control such timescales are not yet fully understood. In this paper, to study their role on each time regime after the quench (T_{F}=0), we distinguish between spin flips that decrease the total energy of the system from those that keep it constant, the latter being parametrized by the probability p. We show that observables such as the cluster size heterogeneity H(t,p) and the typical domain size ℓ(t,p) have no dependence on p in the first time regime up to t_{p_{1}}. Furthermore, when energy-decreasing flips are forbidden while allowing constant-energy flips, the kinetics is essentially frozen after the quench and there is no percolation event whatsoever. Taken together, these results indicate that the emergence of the first percolating cluster at t_{p_{1}} is completely driven by energy decreasing flips. However, the time for stabilizing a percolating cluster is controlled by the acceptance probability of constant-energy flips: t_{p}(p)∼p^{-1} for p≪1 (at p=0, the dynamics gets stuck in a metastable state). These flips are also the relevant ones in the later coarsening regime where dynamical scaling takes place. Because the phenomenology on the approach to the percolation point seems to be shared by many 2D systems with a nonconserved order parameter dynamics (and certain cases of conserved ones as well), our results may suggest a simple and effective way to set, through the dynamics itself, t_{p_{1}} and t_{p} in such systems.

Predictive modeling of Pseudomonas syringae virulence on bean using gradient boosted decision trees.

Pseudomonas syringae is a genetically diverse bacterial species complex responsible for numerous agronomically important crop diseases. Individual P. syringae isolates are assigned pathovar designations based on their host of isolation and the associated disease symptoms, and these pathovar designations are often assumed to reflect host specificity although this assumption has rarely been rigorously tested. Here we developed a rapid seed infection assay to measure the virulence of 121 diverse P. syringae isolates on common bean (Phaseolus vulgaris). This collection includes P. syringae phylogroup 2 (PG2) bean isolates (pathovar syringae) that cause bacterial spot disease and P. syringae phylogroup 3 (PG3) bean isolates (pathovar phaseolicola) that cause the more serious halo blight disease. We found that bean isolates in general were significantly more virulent on bean than non-bean isolates and observed no significant virulence difference between the PG2 and PG3 bean isolates. However, when we compared virulence within PGs we found that PG3 bean isolates were significantly more virulent than PG3 non-bean isolates, while there was no significant difference in virulence between PG2 bean and non-bean isolates. These results indicate that PG3 strains have a higher level of host specificity than PG2 strains. We then used gradient boosting machine learning to predict each strain's virulence on bean based on whole genome k-mers, type III secreted effector k-mers, and the presence/absence of type III effectors and phytotoxins. Our model performed best using whole genome data and was able to predict virulence with high accuracy (mean absolute error = 0.05). Finally, we functionally validated the model by predicting virulence for 16 strains and found that 15 (94%) had virulence levels within the bounds of estimated predictions. This study strengthens the hypothesis that P. syringae PG2 strains have evolved a different lifestyle than other P. syringae strains as reflected in their lower level of host specificity. It also acts as a proof-of-principle to demonstrate the power of machine learning for predicting host specific adaptation.

Discrete-event models for the simulation of computed tomography sectors according to hospital structural/organizational changes and expected patient arrival rates.

OBJECTIVE: To analyze the types of computed tomography (CT) scanners most suitable for different hospital sizes and 'scenarios' (exam rates and structural/organizational changes), using discrete-event simulation models. MATERIALS AND METHODS: CT exams were divided into stages, measured during on-site surveys at CT services in small and average size private hospitals. Ten devices in nine health units, five cities and two states of Brazil were studied to this end, and the following data were collected: Time spent in each stage for each type of exam; average monthly number of exams performed and general characteristics of exams. Three arrival rates were defined (103, 154 and 206 patients/day), representing expected demand for the studied units. From these parameters, six scenarios were simulated, consisting of changes in personnel and hospital structure (e.g., 'adding a changing room') in a base scenario (one CT, one changing room, no nursing assistance, arrival rate 1). RESULTS: It was possible to identify a scenario most useful for very large demands, such as large emergency hospitals in big cities, (a CT, nursing assistance and three changing rooms added to the base scenario). Another identified scenario was more adequate for small demands (adding a changing room to the base scenario). CONCLUSION: Administrative/organizational measures are a very important factor in defining productivity in a hospital imaging sector. The focus of these measures should be on detecting bottlenecks and improving processes, regardless of the type of equipment used.

Phase-ordering kinetics in the Allen-Cahn (Model A) class: Universal aspects elucidated by electrically induced transition in liquid crystals.

The two-dimensional (2D) Ising model is the statistical physics textbook example for phase transitions and their kinetics. Quenched through the Curie point with Glauber rates, the late-time description of the ferromagnetic domain coarsening finds its place at the scalar sector of the Allen-Cahn (or Model A) class, which encompasses phase-ordering kinetics endowed with a nonconserved order parameter. Resisting exact results sought for theoreticians since Lifshitz's first account in 1962, the central quantities of 2D Model A-most scaling exponents and correlation functions-remain known up to approximate theories whose disparate outcomes urge experimental assessment. Here we perform such assessment based on a comprehensive study of the coarsening of 2D twisted nematic liquid crystals whose kinetics is induced by a superfast electrical switching from a spatiotemporally chaotic (disordered) state to a two-phase concurrent, equilibrium one. Tracking the dynamics via optical microscopy, we first show the sharp evidence of well-established Model A aspects, such as the dynamic exponent z=2 and the dynamic scaling hypothesis, to then move forward. We confirm the Bray-Humayun theory for Porod's regime describing intradomain length scales of the two-point spatial correlators and show that their nontrivial decay beyond the Porod's scale can be captured in a free-from-parameter fashion by Gaussian theories, namely the Ohta-Jasnow-Kawasaki (OJK) and Mazenko theories. Regarding time-related statistics, we corroborate the aging hypothesis in Model A systems, which includes the collapse of two-time correlators into a master curve whose format is, actually, best accounted for by a solution of the local scaling invariance theory: the same solution that fits the 2D nonconserved Ising model correlator along with the Fisher-Huse conjecture. We also suggest the true value for the local persistence exponent in Model A class, in disfavor of the exact outcome for the diffusion and OJK equations. Finally, we observe a fractal morphology for persistence clusters and extract their universal dimension. Given its accuracy and possibilities, this experimental setup may work as a prototype to address further universality issues in the realm of nonequilibrium systems.

Accuracy of Self-Reported Arterial Hypertension in Brazil: Systematic Review and Meta-Analysis

Abstract Background Self-reported hypertension is a useful method to estimate prevalence in the population. However, it is necessary to evaluate its accuracy, in relation to the gold-standard diagnostic methods of the disease. Objectives To estimate combined measures of sensitivity and specificity for self-reported hypertension, using Brazilian validation studies that included gold standard methods. Methods A systematic review and a meta-analysis were developed. Two independent examiners evaluated 1389 and read 113 potentially eligible articles. Since self-reported morbidity is influenced by the cultural and economic characteristics of a population, as well as by its accessibility to medical care, only studies from one country (Brazil) were included. First, a qualitative analysis was performed, evaluating the relationship between self-reported hypertension and its measurement through gold-standard methods. Subsequently, a meta-analysis estimated the combined sensitivity and specificity for the included studies. Due to a high heterogeneity among studies, the meta-analysis used a random effects model. Bias risks were evaluated by the QUADAS-2 protocol and the standard significance level of 10% was used in all modelling. Results Five studies were included in the qualitative analysis; and four had the necessary information for inclusion in the meta-analysis. Patient selection and Index Test (the question allowing for self-reporting) were the domains with the highest risk of bias. In the meta-analysis, combined sensitivity and specificity were 77%(95%CI:[74.5-79.0%]) and 88%(95%CI:[86.3-88.6%]), respectively. Conclusions The analysed studies allowed for the estimation of more reliable values for combined sensitivity and specificity. These values were higher than those usually found in studies with greater population heterogeneity.

On the use of the E-value for sensitivity analysis in epidemiologic studies.

This study illustrates the use of a recently developed sensitivity index, the E-value, helpful in strengthening causal inferences in observational epidemiological studies. The E-value aims to determine the minimum required strength of association between an unmeasured confounder and an exposure/outcome to explain the observed association as non-causal. Such parameter is defined as E - v a l u e = R R + R R R R - 1 , where RR is the risk ratio between the exposure and the outcome. Our work illustrates the E-value using observational data from a recently published study on the relationship between indicators of prenatal care adequacy and the outcome low birthweight. The E-value ranged between 1.45 and 5.63 according to the category and prenatal care index evaluated, showing the highest value for the "no prenatal care" category of the GINDEX index and the minimum value for "intermediate prenatal care" of the APNCU index. For "inappropriate prenatal care" (all indexes), the E-value ranged between 2.76 (GINDEX) and 4.99 (APNCU). These findings indicate that only strong confounder/low birthweight associations (more than 400% increased risk) would be able to fully explain the prenatal care vs. low birthweight association observed. The E-value is a useful, intuitive sensitivity analysis tool that may help strengthening causal inferences in epidemiological observational studies.

Association between Prenatal Care Adequacy Indexes and Low Birth Weight Outcome.

OBJECTIVE: To investigate the association between prenatal care (PNC) adequacy indexes and the low birth weigth (LBW) outcome. METHODS: A total of 368,093 live term singleton births in the state of Rio de Janeiro (Brazil) from 2015 to 2016 were investigated using data from the Brazilian Live Birth Information System (Sistema de Informações sobre Nascidos Vivos, SINASC, in Portuguese). Seven PNC adequacy indexes were evaluated: four developed by Brazilian authors (Ciari Jr. et al., Coutinho et al., Takeda, and an index developed and used by the Brazilian Ministry of Health - MS) and three by authors from other countries (Kessner et al., the Adequacy of Prenatal Care Utilization index - APNCU, and the Graduated Prenatal Care Utilization Index - GINDEX). Adjusted odds ratios were estimated for the PNC adequacy indexes by means of multivariate logistic regression models using maternal, gestational and newborn characteristics as covariates. RESULTS: When the PNC is classified as "inadequate", the adjusted odds ratios to the LBW outcome increase between 42% and 132%, depending on which adequacy index is evaluated. Younger (15 to 17 years old) and older (35 to 45 years old) mothers, those not married, of black or brown ethnicity, with low schooling (who did not finish Elementary School), primiparous, with preterm births, as well as female newborns had increasing odds for LBW. The models presented areas under the receiver operating characteristic (ROC) curve between 80.4% and 81.0%, and sensitivity and specificity that varied, respectively, between 57.7% and 58.6% and 94.3% and 94.5%. CONCLUSION: Considering all PNC adequacy indexes evaluated, the APNCU had the best discriminatory power and the best ability to predict the LBW outcome.

OBJETIVO: Investigar a associação entre diferentes índices de adequação do cuidado pré-natal (PN) e o desfecho de nascimentos com baixo peso (BP). MéTODOS: Foram investigados 368.093 nascimentos ocorridos no estado do Rio de Janeiro entre 2015 e 2016, utilizando-se as informações do Sistema de Informações sobre Nascidos Vivos (Sinasc). Sete índices de adequação do cuidado PN foram avaliados: quatro propostos por autores nacionais (Ciari Jr et al., Coutinho et al., Takeda, e um índice atualmente em uso pelo Ministério da Saúde ­ MS), e três, por autores internacionais (Kessner et al., Adequacy of Prenatal Care Utilization index ­ APNCU, e Graduated Prenatal Care Utilization Index ­ GINDEX). As razões de chance ajustadas para BP foram estimadas considerando os índices de adequação do cuidado PN por meio de modelos de regressão logística, utilizando características maternas, da gravidez e do recém-nascido como variáveis de controle. RESULTADOS: As chances ajustadas para ocorrência de BP ao nascer aumentam de 42% a 132%, a depender do índice empregado, quando o cuidado PN é considerado inadequado. Mães entre 15 e 17 anos e entre 35 e 45 anos, sem companheiro, de cor parda ou preta, com ensino fundamental incompleto, e primíparas, com gestações pré-termo, além de bebês do sexo feminino são fatores de risco para os nascimentos com BP. CONCLUSãO: Entre os índices avaliados, o APNCU foi o que apresentou melhor poder discriminatório e capacidade de prever o desfecho de BP ao nascer.

Association between prenatal care adequacy indexes and low birth weight outcome / Associação entre índices de adequação de cuidado prénatal e desfecho de baixo peso ao nascer

Abstract Objective To investigate the association between prenatal care (PNC) adequacy indexes and the low birth weigth (LBW) outcome. Methods A total of 368,093 live term singleton births in the state of Rio de Janeiro (Brazil) from 2015 to 2016 were investigated using data from the Brazilian Live Birth Information System (Sistema de Informações sobre Nascidos Vivos, SINASC, in Portuguese). Seven PNC adequacy indexes were evaluated: four developed by Brazilian authors (Ciari Jr. et al., Coutinho et al., Takeda, and an index developed and used by the Brazilian Ministry of Health - MS) and three by authors from other countries (Kessner et al., the Adequacy of Prenatal Care Utilization index - APNCU, and the Graduated Prenatal Care Utilization Index - GINDEX). Adjusted odds ratios were estimated for the PNC adequacy indexes by means of multivariate logistic regression models using maternal, gestational and newborn characteristics as covariates. Results When the PNC is classified as "inadequate", the adjusted odds ratios to the LBWoutcome increase between 42% and 132%, depending on which adequacy index is evaluated. Younger (15 to 17 years old) and older (35 to 45 years old) mothers, those not married, of black or brown ethnicity, with low schooling (who did not finish Elementary School), primiparous, with preterm births, as well as female newborns had increasing odds for LBW. The models presented areas under the receiver operating characteristic (ROC) curve between 80.4% and 81.0%, and sensitivity and specificity that varied, respectively, between 57.7% and 58.6% and 94.3% and 94.5%. Conclusion Considering all PNC adequacy indexes evaluated, the APNCU had the best discriminatory power and the best ability to predict the LBW outcome.

Resumo Objetivo Investigar a associação entre diferentes índices de adequação do cuidado pré-natal (PN) e o desfecho de nascimentos com baixo peso (BP). Métodos Foram investigados 368.093 nascimentos ocorridos no estado do Rio de Janeiro entre 2015 e 2016, utilizando-se as informações do Sistema de Informações sobre Nascidos Vivos (Sinasc). Sete índices de adequação do cuidado PN foram avaliados: quatro propostos por autores nacionais (Ciari Jr et al., Coutinho et al., Takeda, e um índice atualmente em uso pelo Ministério da Saúde - MS), e três, por autores internacionais (Kessner et al., Adequacy of Prenatal Care Utilization index - APNCU, e Graduated Prenatal Care Utilization Index - GINDEX). As razões de chance ajustadas para BP foram estimadas considerando os índices de adequação do cuidado PN por meio de modelos de regressão logística, utilizando características maternas, da gravidez e do recém-nascido como variáveis de controle. Resultados As chances ajustadas para ocorrência de BP ao nascer aumentam de 42% a 132%, a depender do índice empregado, quando o cuidado PN é considerado inadequado. Mães entre 15 e 17 anos e entre 35 e 45 anos, sem companheiro, de cor parda ou preta, com ensino fundamental incompleto, e primíparas, com gestações pré-termo, além de bebês do sexo feminino são fatores de risco para os nascimentos com BP. Conclusão Entre os índices avaliados, o APNCU foi o que apresentou melhor poder discriminatório e capacidade de prever o desfecho de BP ao nascer.

On the use of the E-value for sensitivity analysis in epidemiologic studies / O uso do valor de E para análise de sensibilidade em estudos epidemiológicos / Sobre el uso del E-value para el análisis de sensibilidad en los estudios epidemiológicos

Abstract: This study illustrates the use of a recently developed sensitivity index, the E-value, helpful in strengthening causal inferences in observational epidemiological studies. The E-value aims to determine the minimum required strength of association between an unmeasured confounder and an exposure/outcome to explain the observed association as non-causal. Such parameter is defined as E - v a l u e = R R + R R R R - 1, where RR is the risk ratio between the exposure and the outcome. Our work illustrates the E-value using observational data from a recently published study on the relationship between indicators of prenatal care adequacy and the outcome low birthweight. The E-value ranged between 1.45 and 5.63 according to the category and prenatal care index evaluated, showing the highest value for the "no prenatal care" category of the GINDEX index and the minimum value for "intermediate prenatal care" of the APNCU index. For "inappropriate prenatal care" (all indexes), the E-value ranged between 2.76 (GINDEX) and 4.99 (APNCU). These findings indicate that only strong confounder/low birthweight associations (more than 400% increased risk) would be able to fully explain the prenatal care vs. low birthweight association observed. The E-value is a useful, intuitive sensitivity analysis tool that may help strengthening causal inferences in epidemiological observational studies.

Resumo: O estudo ilustra o uso de um índice recém-desenvolvido para análise de sensibilidade, o valor de E, útil para embasar inferências causais em estudos epidemiológicos observacionais. O valor de E busca identificar a força mínima da associação entre um fator de confusão não medido e uma exposição/desfecho que seria necessária para explicar a associação observada enquanto não causal, definido como valor de E - v a l u e = R R + R R R R - 1, onde RR é a razão de riscos entre a exposição e o desfecho. Aqui, o valor de E é exemplificado através de dados observacionais de um estudo recém-publicado sobre a relação entre indicadores de adequação da assistência pré-natal e o baixo peso ao nascer enquanto desfecho. O valor de E variou entre 1,45 e 5,63, a depender da categoria e do índice de assistência pré-natal avaliado, com o valor máximo para a categoria "sem assistência pré-natal" do índice GINDEX e o mínimo para "assistência pré-natal intermediária" do índice APNCU. Na categoria "assistência pré-natal inadequada" (todos os índices), o valor de E variou entre 2,76 e 4,99 (índices GINDEX e APNCU, respectivamente). Isso indica que apenas associações fortes entre um fator de confusão e baixo peso ao nascer (aumento de risco maior que 400%) seria capaz de explicar plenamente a associação entre assistência pré-natal e baixo peso ao nascer. O valor de E é uma ferramenta útil e intuitiva para análise de sensibilidade, que pode ajudar a fortalecer as inferências causais em estudos epidemiológicos observacionais.

Resumen: El presente estudio ilustra el uso de un índice desarrollado recientemente para el análisis de la sensibilidad, el E-value, útil para el fortalecimiento de las inferencias causales en los estudios epidemiológicos observacionales. El E-value tiene por objetivo identificar la fortaleza de asociación mínima necesaria entre un factor de confusión no calculable y una exposición/resultado que sería necesario para explicar la asociación observada como no-causal, y está definida como E - v a l u e = R R + R R R R - 1, donde RR es la ratio de riesgo entre la exposición y el resultado. Aquí, el E-value es ilustratado con datos observacionales de un estudio recientemente publicado para mostrar la relación entre indicadores de adecuación de cuidado prenatal y el resultado de bajo peso al nacer. El E-value varió entre 1,45 and 5,63, dependiendo de la categoría y el índice cuidado prenatal evaluado, con su valor más alto para la categoría "no cuidado prenatal" del índice GINDEX y el mínimo para el "cuidado prenatal intermedio" del índice APNCU. En la categoría "inapropiado cuidado prenatal" (todos los índices) el E-value varió entre 2,76 y 4,99 (los índices GINDEX y APNCU, respectivamente). Esto indica que solamente un factor de confusión fuerte/asociaciones bajo peso al nacer (incrementaron el riesgo más de un 400%) habría hecho posible explicar completamente la asociación observada cuidado prenatal vs bajo peso al nacer. El E-value es una herramienta de análisis de sensibilidad útil, intuitiva, que puede ayudar a fortalecer las inferencias causales en los estudios epidemiológicos observacionales.

Immunodiversity of the Arabidopsis ZAR1 NLR Is Conveyed by Receptor-Like Cytoplasmic Kinase Sensors.

The Arabidopsis nucleotide-binding leucine-rich repeat protein ZAR1 can recognize at least six distinct families of pathogenic effector proteins to mount an effector-triggered immune response. This remarkable immunodiversity appears to be conveyed by receptor-like cytoplasmic kinase (RLCK) complexes, which associate with ZAR1 to sense several effector-induced kinase perturbations. Here we show that the recently identified ZAR1-mediated immune responses against the HopX1, HopO1, and HopBA1 effector families of Pseudomonas syringae rely on an expanded diversity of RLCK sensors. We show that individual sensors can recognize distinct effector families, thereby contributing to the expanded surveillance potential of ZAR1 and supporting its role as a guardian of the plant kinome.

Pattern of Live Births in Rio de Janeiro State, Brazil, According to Robson Groups and the Kotelchuck Index Classification - 2015/2016.

OBJECTIVE: To investigate the patterns of hospital births in the state of Rio de Janeiro (RJ), Brazil, between 2015 and 2016; considering the classification of obstetric characteristics proposed by Robson and the prenatal care index proposed by Kotelchuck. METHODS: Data obtained from the Information System on Live Births of the Informatics Department of the Brazilian Unified Health System (SINASC/DATASUS, in the Portuguese acronym) databases were used to group pregnant women relatively to the Robson classification. A descriptive analysis was performed for each Robson group, considering the variables: maternal age, marital status, schooling, parity, Kotelchuck prenatal adequacy index and gestational age. A logistic model estimated odds ratios (ORs) for cesarean sections (C-sections), considering the aforementioned variables. RESULTS: Out of the 456,089 live births in Rio de Janeiro state between 2015 and 2016, 391,961 records were retained, 60.3% of which were C-sections. Most pregnant women (58.6%) were classified in groups 5, 2 or 3. The percentage of C-sections in the Robson groups 1, 2, 3, 4, 5 and 8 was much higher than expected. Prenatal care proved to be inadequate for women who subsequently had a vaginal delivery, had an unfavorable family structure and a lower socioeconomic status (mothers without partners and with lower schooling), compared with those undergoing cesarean delivery. For a same Robson group, the chance of C-section increases when maternal age rises (OR = 3.33 for 41-45 years old), there is the presence of a partner (OR = 1.81) and prenatal care improves (OR = 3.19 for "adequate plus"). CONCLUSION: There are indications that in the state of RJ, from 2015 to 2016, many cesarean deliveries were performed due to nonclinical factors.

OBJETIVO: Investigar os padrões dos partos hospitalares no estado do Rio de Janeiro (RJ), Brasil, entre 2015 e 2016, considerando a classificação de características obstétricas de Robson e a dos cuidados pré-natais proposta por Kotelchuck. MéTODOS: Dados sistema de informações sobre nascidos vivos (SINASC) do departamento de informática do sistema único de saúde (DATASUS) foram utilizados para agrupar gestantes relativamente à classificação de Robson. Foi efetuada uma análise descritiva para cada grupo de Robson, considerando-se as variáveis idade materna, estado civil, escolaridade, paridade, o índice de Kotelchuck de adequação do pré-natal e a idade gestacional. Também foi realizado o cálculo de razão de chances (RC) para parto cesáreo, considerando-se um modelo logístico. RESULTADOS: Dos 456.089 nascimentos vivos ocorridos no RJ de 2015 a 2016, foram incluídos 391.961 registros, sendo 60,3% cesáreas, com maioria de gestantes (58,6%) nos grupos 5, 2 ou 3. O percentual de cesáreas nos grupos 1, 2, 3, 4, 5 e 8 foi bem superior ao sugerido pela literatura. Para gestantes de um mesmo grupo (controladas as demais características), a chance de cesárea se eleva quando aumenta a idade materna (RC = 3,33 para 41­45 anos), existe a presença de um companheiro (RC = 1,81), o nível de escolaridade é maior (RC = 3,11 para ≥ 12 anos) e o pré-natal é mais cuidadoso (RC = 3,19 para "adequado plus"). CONCLUSãO: Há indícios que no RJ, de 2015 a 2016, muitos partos cesáreos foram realizados sob influência de fatores extraclínicos.

Pattern of live births in Rio de Janeiro State, Brazil, according to Robson groups and the Kotelchuck index classification - 2015/2016 / Padrão de nascidos vivos no estado do Rio de Janeiro, Brasil, segundo os grupos Robson e a classificação do índice Kotelchuck - 2015/2016

Abstract Objective To investigate the patterns of hospital births in the state of Rio de Janeiro (RJ), Brazil, between 2015 and 2016; considering the classification of obstetric characteristics proposed by Robson and the prenatal care index proposed by Kotelchuck. Methods Data obtained from the Information System on Live Births of the Informatics Department of the Brazilian Unified Health System (SINASC/DATASUS, in the Portuguese acronym) databases were used to group pregnant women relatively to the Robson classification. A descriptive analysis was performed for each Robson group, considering the variables: maternal age, marital status, schooling, parity, Kotelchuck prenatal adequacy index and gestational age. A logistic model estimated odds ratios (ORs) for cesarean sections (C-sections), considering the aforementioned variables. Results Out of the 456,089 live births in Rio de Janeiro state between 2015 and 2016, 391,961 records were retained, 60.3% of which were C-sections. Most pregnant women (58.6%) were classified in groups 5, 2 or 3. The percentage of C-sections in the Robson groups 1, 2, 3, 4, 5 and 8 was much higher than expected. Prenatal care proved to be inadequate for women who subsequently had a vaginal delivery, had an unfavorable family structure and a lower socioeconomic status (mothers without partners and with lower schooling), compared with those undergoing cesarean delivery. For a sameRobson group, the chance of C-section increases when maternal age rises (OR = 3.33 for 41-45 years old), there is the presence of a partner (OR = 1.81) and prenatal care improves (OR = 3.19 for "adequate plus"). Conclusion There are indications that in the state of RJ, from 2015 to 2016, many cesarean deliveries were performed due to nonclinical factors.

Resumo Objetivo Investigar os padrões dos partos hospitalares no estado do Rio de Janeiro (RJ), Brasil, entre 2015 e 2016, considerando a classificação de características obstétricas de Robson e a dos cuidados pré-natais proposta por Kotelchuck. Métodos Dados sistema de informações sobre nascidos vivos (SINASC) do departamento de informática do sistema único de saúde (DATASUS) foram utilizados para agrupar gestantes relativamente à classificação de Robson. Foi efetuada uma análise descritiva para cada grupo de Robson, considerando-se as variáveis idade materna, estado civil, escolaridade, paridade, o índice de Kotelchuck de adequação do pré-natal e a idade gestacional. Também foi realizado o cálculo de razão de chances (RC) para parto cesáreo, considerando-se um modelo logístico. Resultados Dos 456.089 nascimentos vivos ocorridos no RJ de 2015 a 2016, foram incluídos 391.961 registros, sendo 60,3% cesáreas, com maioria de gestantes (58,6%) nos grupos 5, 2 ou 3. O percentual de cesáreas nos grupos 1, 2, 3, 4, 5 e 8 foi bem superior ao sugerido pela literatura. Para gestantes de um mesmo grupo (controladas as demais características), a chance de cesárea se eleva quando aumenta a idade materna (RC = 3,33 para 41-45 anos), existe a presença de um companheiro (RC = 1,81), o nível de escolaridade é maior (RC = 3,11 para ≥ 12 anos) e o pré-natal é mais cuidadoso (RC= 3,19 para "adequado plus"). Conclusão Há indícios que no RJ, de 2015 a 2016, muitos partos cesáreos foram realizados sob influência de fatores extraclínicos.

The pan-genome effector-triggered immunity landscape of a host-pathogen interaction.

Effector-triggered immunity (ETI), induced by host immune receptors in response to microbial effectors, protects plants against virulent pathogens. However, a systematic study of ETI prevalence against species-wide pathogen diversity is lacking. We constructed the Pseudomonas syringae Type III Effector Compendium (PsyTEC) to reduce the pan-genome complexity of 5127 unique effector proteins, distributed among 70 families from 494 strains, to 529 representative alleles. We screened PsyTEC on the model plant Arabidopsis thaliana and identified 59 ETI-eliciting alleles (11.2%) from 19 families (27.1%), with orthologs distributed among 96.8% of P. syringae strains. We also identified two previously undescribed host immune receptors, including CAR1, which recognizes the conserved effectors AvrE and HopAA1, and found that 94.7% of strains harbor alleles predicted to be recognized by either CAR1 or ZAR1.

Body self-image disturbances in women with prolactinoma

Objective: To evaluate body dissatisfaction and distorted body self-image in women with prolactinoma. Methods: Body dissatisfaction and distorted body self-image were evaluated in 80 women with prolactinoma. All patients were in menacme, 34% had normal body mass index (BMI), and 66% were overweight. Most patients (56.2%) had normal prolactin (PRL) levels and no hyperprolactinemia symptoms (52.5%). The Body Shape Questionnaire (BSQ) was used to assess the patients' dissatisfaction with and concern about their physical form, and the Stunkard Figure Rating Scale (FRS) was used to assess body dissatisfaction and distorted body self-image. The patients were divided according to PRL level (normal vs. elevated) and the presence or absence of prolactinoma symptoms. Results: The normal and elevated PRL groups had similar incidences of body dissatisfaction and distorted body self-image. However, symptomatic patients reported a higher incidence of dissatisfaction than asymptomatic patients. Distorted body self-image was less common among symptomatic patients. Conclusion: Symptomatic patients showed higher body dissatisfaction, but lower body self-image distortion. The presence of symptoms may have been responsible for increased body awareness. The perception of body shape could have triggered feelings of dissatisfaction compared to an ideal lean body. Therefore, a distorted body self-image might not necessarily result in body dissatisfaction in women with prolactinomas.

Prevalence of corrected arterial hypertension based on the self-reported prevalence estimated by the Brazilian National Health Survey.

The objective was to correct the self-reported prevalence of systemic arterial hypertension (SAH) obtained from the Brazilian National Health Survey (PNS 2013). SAH prevalence estimates were corrected by means of sensitivity/specificity of information. Sensitivity and specificity values from a similar study (same self-report question, age range and gold standard) were used to this end. A sensitivity analysis was also performed, by using the upper and lower limits of confidence intervals as sensitivity and specificity parameters. The corrected prevalence of SAH for Brazil as a whole was 14.5% (self-reported: 22.1%). Women presented a higher rate of self-reported SAH but, after correction, men were found to have a higher prevalence. Among younger women (18-39 age range), the self-reported prevalence was 6.2%, a value that, after correction, dropped to 0.28%. There was not much difference between self-reported and corrected SAH among the elderly (51.1% vs. 49.2%). For certain groups the corrected results were greatly different from the self-reported prevalence, what may severely impact public health policy strategies.