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Unlike warfarin direct oral anticoagulants (DOACs) are administered in fixed doses, which raises concerns of its effectiveness on larger patients. Data from randomized trials are limited on the safety and efficacy of DOACs in morbidly obese individuals with atrial fibrillation (AF).
We analyzed a cohort of obese (≥ 120kg) and morbidly obese (BMI > 40kg/m
) patients from the Veterans Health Administration system with AF who initiated apixaban, rivaroxaban, dabigatran, or warfarin between years 2012 and 2018. We used inverse probability of treatment weighting (IPTW) and Cox proportional hazards regression models to evaluate the relative hazard of death, myocardial infarction (MI), ischemic stroke, heart failure (HF), and bleeding events between oral anticoagulant (OAC) groups while censoring for medication cessation.
We identified 6052 obese patients on apixaban, 4233 on dabigatran, 4309 on rivaroxaban, and 13,417 on warfarin (mean age 66.7years, 91% males, 80.4% whites). At baseline patients on apixaban had the lowest glomerular filtration rate and highest rates of previous stroke and MI compared to other OACs. Among patients with weight ≥ 120kg and those with BMI > 40kg/m
, all DOACs were associated with lower risk of any hemorrhage, hemorrhagic stroke, and gastrointestinal (GI) bleeding. Patients with BMI > 40kg/m
treated with DOACs had similar ischemic stroke risk with those on warfarin.
In this large cohort of obese Veterans Health Administration system patients, the use of DOACs resulted in lower hemorrhagic complications than warfarin while maintaining efficacy on ischemic stroke prevention.
In this large cohort of obese Veterans Health Administration system patients, the use of DOACs resulted in lower hemorrhagic complications than warfarin while maintaining efficacy on ischemic stroke prevention.Flavonols are important active ingredients that are found in abundance in Dendrobium officinale. Research on flavonol biosynthesis currently focuses on the more ubiquitous kaempferol and quercetin, but little is known on the biosynthesis of myricetin. Notably, flavonol synthase (FLS), which is responsible for the biosynthesis of flavonols, has not yet been identified. In this study, we isolated a flavonol synthase, DoFLS1, from Dendrobium officinale. DoFLS1 harbors conserved 2-oxoglutarate-dependent dioxygenase-specific and FLS-specific motifs. DoFLS1 is a cytoplasmic protein. DoFLS1 was universally expressed in roots, stems, and leaves of juvenile and adult D. officinale plants. DoFLS1 expression was strongly correlated in juvenile and adult D. officinale plants (R2 = 0.86 and 0.98, respectively; p less then 0.01) with the average of corresponding flavonol levels. Transgenic Arabidopsis thaliana expressing DoFLS1 exhibited a 1.24-fold increase in flavonol content and a 25.78% decrease in anthocyanin content compare to wild-type plants, possibly resulting from a 78.61% increase in myricetin level. Moreover, the loss of anthocyanin was attributed to decreased expression of dihydroflavonol reductase (DFR) and anthocyanidin synthase (ANS) genes in transgenic A. thaliana that expressed DoFLS1. DoFLS1 also complemented the deficiency in flavonol of the A. thaliana fls1-3 mutant, which had reduced anthocyanin but increased flavonol content relative to the fls1-3 mutant. In addition, DoFLS1 was significantly upregulated after treatment with cold, drought or salicylic acid. These findings provide genetic evidence for the involvement of DoFLS1 in the biosynthesis of flavonol and in response to abiotic stresses.DSS1 is a small protein, highly conserved across different species. As a member of the intrinsically disordered protein family, DSS1 interacts with different protein partners, thus forming complexes involved in diverse biological mechanisms DNA repair, regulation of protein homeostasis, mRNA export, etc. Additionally, DSS1 has a novel intriguing role in the post-translational protein modification named DSSylation. Oxidatively damaged proteins are targeted for removal with DSS1 and then degraded by proteasome. Yet, DSS1 involvement in the maintenance of genome integrity through homologous recombination is the only function well studied in Arabidopsis research. The fact that animal DSS1 shows wide multifunctionality imposes a need to investigate the additional roles of two Arabidopsis thaliana DSS1 homologs. Having in mind the universality of various biological processes, we considered the possibility of plant DSS1 involvement in cellular homeostasis maintenance during stress exposure. SCH772984 Using real-time PCR and immunoblot analysis, we investigated the profiles of DSS1 gene and protein expression under oxidative stress. We grew and selected the homozygous Arabidopsis mutant line, carrying the T-DNA intron insertion in the DSS1(V) gene. The mutant line was phenotypically described during plant development, and its sensitivity to oxidative stress was characterized. This is the first report which indicates that plant DSS1 gene expression has an altered profile under the influence of oxidative stress. dss1(V)-/- plants showed an increased sensitivity to oxidative stress, germinated faster than WT, but generally showed developmental delay in further stages. Our results indicate that the DSS1 protein could be a crucial player in the molecular mechanisms underlying plant abiotic stress responses.Radial oxygen loss is a physical phenomenon that occurs naturally in aquatic plants. Typha domingensis was chosen as a model plant because it possesses basic morphological characteristics, such as a stem (rhizome) that produces leaves and adventitious roots, which are present in many aquatic plants. This study aimed to evaluate the following the relevance of the anatomy of T. domingensis on gas diffusion among organs; the influence of plant parts on radial oxygen loss; the role of catalase in radial oxygen loss; and the proposition of a novel explanation for the downward diffusion of oxygen through the organs of this aquatic macrophyte and into the environment. Typha domingensis plants were cultivated in a greenhouse under different conditions plants with intact leaves, plants with leaves cut in half, and plants without leaves. Furthermore, we evaluated the percentage of aerenchyma in different vegetative organs, the minimum pressure required for radial oxygen loss, the daily variations of dissolved oxygen, and the roots' catalase activity.
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