Wolbachia has been introduced into Aedes aegypti mosquitoes to control the spread of arboviruses, such as dengue, chikungunya and Zika. Studies showed that certain Wolbachia strains (such as wMel) reduce replication of dengue viruses in the laboratory, prompting the release of mosquitoes carrying the bacterium into the field, where vectorial capacity can be realistically assessed in relation to native non-carriers. Here we apply a new analysis to two published datasets, and show that wMel increases the mean and the variance in Ae. aegypti susceptibility to dengue infection when introgressed into Brazil and Vietnam genetic backgrounds. In the absence of other processes, higher mean susceptibility should lead to enhanced viral transmission. The increase in variance, however, widens the basis for selection imposed by unexplored natural forces, retaining the potential for reducing transmission overall.
Certain subterranean environments of Earth have naturally accumulated longlived radionuclides, such as 238 U, 232 Th and 40 K, near the presence of liquid water. In these natural radioactive environments (NRE), water radiolysis can produce chemical species of biological importance, such as H2. Although the proposal of radioactive decay as an alternative source of energy for living systems has existed for more than thirty years, this hypothesis gained strength after the recent discovery of a peculiar ecosystem in a gold mine in South Africa, whose existence is dependent on chemical species produced by water radiolysis. In this work, we calculate the chemical disequilibrium generated locally by water radiolysis due gamma radiation and analyse the possible contribution of this disequilibrium for the emergence of life, considering conditions of early Earth and having as reference the alkaline hydrothermal vent (AHV) theory. Results from our kinetic model points out the similarities between the conditions caused by water radiolysis and those found on alkaline hydrothermal systems. Our model produces a steady increase of pH with time, which favours the precipitation of minerals with catalytic activity for protometabolism, as well as a natural electrochemical gradient in this aqueous environment. In conclusion, we described a possible free-energy conversion mechanism that could be a requisite for emergence of life in Hadean Earth.
RESUMOObjetivo: Revisar as evidências clínicas da estenose valvular aórtica em suas dimensões médica e econômica, analisando as alternativas de tratamento cirúrgico em pacientes de alto risco cirúrgico com foco na tecnologia do implante transcateter de válvula aórtica (TAVI). Métodos: Foi elaborada uma revisão narrativa das publicações relacionadas à estenose vascular aórtica e às metodologias de tratamento cirúrgico, assim como a comparação entre a metodologia TAVI e as abordagens convencionais (substituição cirúrgica de válvula aórtica por esternotomia, valvuloplastia por balão intra--aórtico e tratamento farmacológico), abordando ainda dados sobre algumas diferentes marcas e gerações de dispositivos de TAVI oferecidas no mercado brasileiro, avaliando a eficácia, a segurança e o custo de tratamento. Resultados: Em pacientes portadores de estenose aórtica grave sintomá-tica e inoperáveis pela abordagem convencional, o uso do TAVI mostrou ser uma alternativa mais segura, eficaz e econômica em comparação aos tratamentos convencionais. Estudos com robustez metodológica mostram que esse procedimento alcança taxas superiores a 80% de sobrevida em um ano e aproximadamente 30% em cinco anos, mesmo em pacientes de alto risco. No entanto, foram observadas diferenças significativas nos desfechos entre diferentes estudos, que podem ser atribuídas não apenas ao desenho e à amostragem, mas às diferenças entre as diversas opções de gerações e marcas de dispositivos para TAVI disponíveis no mercado. Essas opções diferem principalmente na estrutura, via de inserção e modo de expansão. As válvulas de terceira geração vêm apresentando os melhores resultados em termos de eficácia, segurança e facilidade no procedimento, que resultam em mais benefícios aos pacientes e equilibram os custos de tratamento em médio e longo prazos. Conclusões: Estudos com evidências robustas avaliando desfechos representativos para o tratamento da estenose aórtica grave e sintomática mostram que a tecnologia minimamente invasiva TAVI é eficaz, segura no tratamento de pacientes de alto risco ou inoperáveis, com melhorias significativas nos dispositivos de terceira geração. ABSTRACTObjective: To review the clinical evidences of aortic valve stenosis in its medical and economical settings, reviewing the surgical treatment alternatives in patients at high surgical risk focused on the transcatheter aortic valve implantation (TAVI) technology. Methods: A structured review of the publications related to the disease and to the surgical treatment methodologies was conducted, followed by a search for information about the TAVI methodology, with comparisons between this method and conventional approaches (surgical aortic valve replacement by means of sternotomy, valvuloplasty via intra-aortic balloon and pharmacological treatment) and comparisons between different brands and generations of TAVI devices, evaluating the treatment efficacy, safety and cost.
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