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Alencar, R. M.

Publications and source records attributed to Alencar, R. M..

2 recordsLinked to original sources

The genome of the brackish-water malaria vector Anopheles aquasalis

Anopheles aquasalis is a primary malaria vector in coastal South America that grows in brackish waters of mangroves. Its importance has increased in recent years as it has been established as a model for parasite-vector studies for non-model Plasmodium species, such as P. yoelli. In this study, we present the complete genome of An. aquasalis and offer some insights into evolution and physiology. With a 162Mb and 12,446 coding proteins, the An. aquasalis genome is similar in size and gene content as other neotropical anophelines. 1,038 single-copy orthologs are present in An. aquasalis and all Diptera and it was possible to infer that An. aquasalis diverged from An. darlingi (the main malaria vector in inland South America) nearly 14 million years ago (mya). Ion transport and metabolism proteins is one the major gene families in An. aquasalis with 660 genes. Amongst these genes, important gene families relevant for osmosis control (e.g., aquaporins, vacuolar-ATPases, Na+/K+-ATPases and carbonic anhydrases) were identified in one-to-one orthologs with other anophelines. Evolutionary analysis suggests that all osmotic regulation genes are under strong purifying selection. We also observed low copy number variation in immunity-related genes (for which all classical pathways were described) and insecticide resistance genes. This is the third genome of a neotropical anopheline published so far. The data provided by this study may offer candidate genes for further studies on parasite-vector interactions and for studies on how brackish water anophelines deals with high fluctuation in water salinity. Significance StatementThe brackish water mosquito Anopheles aquasalis is a primary malaria vector in coastal South America. Besides its peculiar ecological features (it is one of the few anopheline mosquitoes that survives high fluctuation of water salinity), An. aquasalis has gained relevance in recent years as a model for parasite-vector studies for non-model Plasmodium parasites. Still, the physiology and genetics of An. aquasalis are poorly understood. Here we present the genome of An. aquasalis with more than 12,000 annotated genes, offering insights in genome evolution, osmoregulation related, immunity, chemosensory and insecticide resistance genes. The data presented here will help to further advance the studies on An. aquasalis genetics and physiology to better understand parasite-vector interactions in non-model organisms.

genomics↗

Impact of intensive care unit admission during handover on mortality: a propensity matched cohort study

IntroductionHandover is a process of transferring information, responsibility and authority for providing care of critically ill patients from a departing intensivist to an oncoming intensivist. The effect of i admission during a medical handover on clinical outcomes is unknown. ObjectivesOur purpose was to evaluate the impact of ICU admission during a medical handover on clinical outcomes. MethodsPost hoc analysis of a cohort study addressing the effect of ICU admissions during the handover on outcomes. This retrospective, single center, propensity matched cohort study was conducted in a 41-bed open general ICU located in a private tertiary care hospital in Sao Paulo, Brazil. Based on time of ICU admission, patients were categorized into two cohorts: handover group (ICU admission between 6:30 am to 7:30 or 6:30 pm to 7:30 pm) or control group (admission between 7:31 am to 6:29 pm or 7:31 pm to 6:29 am). Patients in the handover group were propensity matched to patients in the control group at 1:2 ratio. Our primary outcome was hospital mortality. ResultsBetween June 1, 2013 and May 31, 2015, 6,650 adult patients were admitted to the ICU. Following exclusion of ineligible participants, 5,779 patients [389 (6.7%) in handover group and 5390 (93.3%) in control group] were eligible for propensity score matching, of whom 1,166 were successfully matched [389 (33.4%) handover group and 777 (66.6%) in control group]. Before matching, hospital mortality was 14.1% (55/389 patients) in handover group compared to 11.7% (628/5,390) in control group (p=0.142). After propensity-score matching, ICU admission during handover was not associated with increased risk of ICU (OR, 1.40; 95% CI, 0.92 to 2.11; p=0.11) and hospital (OR, 1.23; 95%CI, 0.85 to 1.75; p=0.26) mortality. ICU and hospital length of stay did not differ between the groups. ConclusionIn this propensity-matched single center cohort study, ICU admission during medical handover did not affect clinical outcomes.

scientific communication and education↗