Anemia among indigenous women in Brazil:findings from the First National Survey of Indigenous People's Health and Nutrition

BACKGROUND: Anemia is recognized as a major public health problem that disproportionately affects vulnerable populations. Indigenous women of reproductive age in Brazil are thought to be at high risk, but lack of nationwide data limits knowledge about the burden of disease and its main determinants. This study aimed to assess the prevalence of anemia and associated factors in this population using data from The First National Survey of Indigenous People’s Health and Nutrition in Brazil. METHODS: Data were collected from Indigenous women between 15 and 49 years old based on a nationwide sample of villages. The outcomes of interest were hemoglobin levels (g/dL) and anemia (< 12 g/dL for nonpregnant and < 11 g/dL for pregnant women). Multilevel models were used to explore associations with contextual (village) and individual (household/woman) level variables. RESULTS: Based on data for 6692 Indigenous women, the nationwide mean hemoglobin level was 12.39 g/dL (95 % CI: 12.29–12.50). Anemia prevalence was high (33.0 %; 95 % CI: 30.40–35.61 %) and showed pronounced regional disparities. No village-level characteristics were associated with anemia or hemoglobin levels in the multilevel model. Even after controlling for upper level variables, socioeconomic status, parity, body mass index, and having been treated for malaria were associated with anemia and hemoglobin levels. CONCLUSION: The prevalence of anemia in Brazilian Indigenous women was 12 % greater than the national estimates for women of reproductive age. Anemia prevalence and mean hemoglobin levels among Indigenous women appear to be partly explained by some previously recognized risk factors, such as socioeconomic status, body mass index, and malaria; however, part of the variability in these outcomes remains unexplained. Knowledge of health status and its potential determinants is essential to guide public policies aimed at controlling anemia burden in Indigenous communities

A ingestão de bebidas energéticas antes do exercício afeta a dinâmica não linear da recuperação da variabilidade da frequência cardíaca? Um ensaio randomizado, crossover, duplo-cego e controlado por placebo

Introduction and Objectives: Energy drinks (ED) are recognized to influence the behavior of the sympathetic and parasympathetic components of the autonomic nervous system. We intended to study the influence of ED on non-linear heart rate variability (HRV) following exercise. Material and Methods: This randomized, crossover, double-blind, placebo-controlled clinical trial (Protocol number NCT02917889) was completed in a sample of 28 healthy males aged 24.11 ± 3.05 years (min-max 18-29). The first step involved the assessment of maximal oxygen consumption (VO2 max). In the second protocol, the subjects received a placebo (250ml of water) or ED (250ml of energy drink) 15 minutes before the 30-minute exercise on a treadmill. In the third protocol, participants received the alternative protocol to the previous step. The nonlinear HRV were calculated at different times during the protocols. Results: Fractal analysis via Detrended Fluctuation Analysis (DFA) revealed that in the placebo protocol there was an increase in its values compared to recovery (Rec1) vs. Rest (Cohen's d= 1.42) and continued increasing in the last recording intervals: vs. Rec6 (Cohen's d= 0.70) and vs. Rec7 (Cohen's d= 0.85). In the ED protocol, the increase in DFA was only demonstrated when comparing Rec1 vs. Rest (Cohen’s d=1.78). Conclusion: ED intake prior to modest aerobic exercise triggered a slight acceleration of recovery.Introducción y Objetivo: Se sabe que las bebidas energéticas (DE) influyen en el comportamiento de los componentes simpático y parasimpático del sistema nervioso autónomo. Pretendemos estudiar la influencia de la DE en la variabilidad no lineal de la frecuencia cardíaca (VFC) después del ejercicio. Material y métodos: este ensayo clínico aleatorizado, cruzado, doble ciego, controlado con placebo (número de protocolo NCT02917889) se completó en una muestra de 28 hombres sanos de 24,11 ± 3,05 años (mín-máx 18-29). El primer paso involucró la evaluación del consumo máximo de oxígeno (VO2 max). En el segundo protocolo, los sujetos recibieron placebo (250 ml de agua) o ED (250 ml de bebida energética) 15 minutos antes de los 30 minutos de ejercicio en cinta rodante. En el tercer protocolo, los participantes recibieron el protocolo alternativo al paso anterior. La HRV no lineal se calculó en diferentes momentos durante los protocolos. Resultados: El análisis fractal vía Detrended Fluctuation Analysis (DFA) reveló que en el protocolo placebo hubo un incremento en sus valores en relación a la recuperación (Rec1) vs. En reposo (d de Cohen= 1,42) y siguió aumentando en los últimos intervalos de registro: vs. Rec6 (d de Cohen = 0,70) y vs. Rec7 (d de Cohen = 0,85). En el protocolo ED, el aumento de DFA solo se demostró al comparar Rec1 vs. Reposo (d de Cohen=1,78). Conclusión: la ingesta de DE antes del ejercicio aeróbico moderado desencadenó una ligera aceleración de la recuperación.Introduzione e obiettivo: è noto che le bevande energetiche (DE) influenzano il comportamento delle componenti simpatiche e parasimpatiche del sistema nervoso autonomo. Intendiamo studiare l'influenza dell'ED sulla variabilità non lineare della frequenza cardiaca (HRV) dopo l'esercizio. Materiale e metodi: questo studio clinico randomizzato, incrociato, in doppio cieco, controllato con placebo (numero di protocollo NCT02917889) è stato completato su un campione di 28 uomini sani di età compresa tra 24,11 ± 3,05 anni (min-max 18-29). Il primo passo ha comportato la valutazione del consumo massimo di ossigeno (VO2 max). Nel secondo protocollo, i soggetti hanno ricevuto placebo (250 ml di acqua) o ED (250 ml di bevanda energetica) 15 minuti prima dell'esercizio di 30 minuti sul tapis roulant. Nel terzo protocollo, i partecipanti hanno ricevuto il protocollo alternativo al passaggio precedente. L'HRV non lineare è stato calcolato in momenti diversi durante i protocolli. Risultati: L'analisi frattale tramite Detrended Fluctuation Analysis (DFA) ha rivelato che nel protocollo placebo c'era un aumento dei suoi valori in relazione al recupero (Rec1) vs. A riposo (d di Cohen= 1.42) e ha continuato ad aumentare negli ultimi intervalli di registrazione: vs. Rec6 (d di Cohen = 0.70) e vs. Rec7 (d di Cohen = 0,85). Nel protocollo ED, l'aumento di DFA è stato dimostrato solo confrontando Rec1 vs. Riposo (Cohen d=1.78). Conclusione: l'ingestione di DE prima di un moderato esercizio aerobico ha innescato una leggera accelerazione del recupero.Introdução e Objetivo: As bebidas energéticas (DE) são reconhecidas por influenciar o comportamento dos componentes simpáticos e parassimpáticos do sistema nervoso autônomo. Pretendemos estudar a influência da DE na variabilidade não linear da frequência cardíaca (VFC) após o exercício. Material e Métodos: Este ensaio clínico randomizado, cruzado, duplo-cego, controlado por placebo (número do protocolo NCT02917889) foi concluído em uma amostra de 28 homens saudáveis com idade de 24,11 ± 3,05 anos (min-max 18-29). A primeira etapa envolveu a avaliação do consumo máximo de oxigênio (VO2 máx). No segundo protocolo, os sujeitos receberam placebo (250ml de água) ou ED (250ml de energético) 15 minutos antes do exercício de 30 minutos em esteira. No terceiro protocolo, os participantes receberam o protocolo alternativo à etapa anterior. A VFC não linear foi calculada em momentos diferentes durante os protocolos. Resultados: A análise fractal via Detrended Fluctuation Analysis (DFA) revelou que no protocolo placebo houve um aumento em seus valores em relação à recuperação (Rec1) vs. Repouso (Cohen's d= 1,42) e continuou aumentando nos últimos intervalos de registro: vs. Rec6 (d de Cohen = 0,70) e vs. Rec7 (d de Cohen = 0,85). No protocolo ED, o aumento do DFA só foi demonstrado ao comparar Rec1 vs. Rest (Cohen’s d=1,78). Conclusão: A ingestão de DE antes do exercício aeróbico moderado desencadeou uma ligeira aceleração da recuperação.Introdução e Objetivo: As bebidas energéticas (DE) são reconhecidas por influenciar o comportamento dos componentes simpáticos e parassimpáticos do sistema nervoso autônomo. Pretendemos estudar a influência da DE na variabilidade não linear da frequência cardíaca (VFC) após o exercício. Material e Métodos: Este ensaio clínico randomizado, cruzado, duplo-cego, controlado por placebo (número do protocolo NCT02917889) foi concluído em uma amostra de 28 homens saudáveis com idade de 24,11 ± 3,05 anos (min-max 18-29). A primeira etapa envolveu a avaliação do consumo máximo de oxigênio (VO2 máx). No segundo protocolo, os sujeitos receberam placebo (250ml de água) ou ED (250ml de energético) 15 minutos antes do exercício de 30 minutos em esteira. No terceiro protocolo, os participantes receberam o protocolo alternativo à etapa anterior. A VFC não linear foi calculada em momentos diferentes durante os protocolos. Resultados: A análise fractal via Detrended Fluctuation Analysis (DFA) revelou que no protocolo placebo houve um aumento em seus valores em relação à recuperação (Rec1) vs. Repouso (Cohen's d= 1,42) e continuou aumentando nos últimos intervalos de registro: vs. Rec6 (d de Cohen = 0,70) e vs. Rec7 (d de Cohen = 0,85). No protocolo ED, o aumento do DFA só foi demonstrado ao comparar Rec1 vs. Rest (Cohen’s d=1,78). Conclusão: A ingestão de DE antes do exercício aeróbico moderado desencadeou uma ligeira aceleração da recuperação

Does energy drink intake before exercise affect nonlinear dynamics of heart rate variability recovery? : a randomized, crossover, double-blind and placebo-controlled trial

Introduction and Objectives: Energy drinks (ED) are recognized to influence the behavior of the sympathetic and parasympathetic components of the autonomic nervous system. We intended to study the influence of ED on non-linear heart rate variability (HRV) following exercise. Material and Methods: This randomized, crossover, double-blind, placebo-controlled clinical trial (Protocol number NCT02917889) was completed in a sample of 28 healthy males aged 24.11 ± 3.05 years (min-max 18-29). The first step involved the assessment of maximal oxygen consumption (VO2 max). In the second protocol, the subjects received a placebo (250ml of water) or ED (250ml of energy drink) 15 minutes before the 30-minute exercise on a treadmill. In the third protocol, participants received the alternative protocol to the previous step. The nonlinear HRV were calculated at different times during the protocols. Results: Fractal analysis via Detrended Fluctuation Analysis (DFA) revealed that in the placebo protocol there was an increase in its values compared to recovery (Rec1) vs. Rest (Cohen's d= 1.42) and continued increasing in the last recording intervals: vs. Rec6 (Cohen's d= 0.70) and vs. Rec7 (Cohen's d= 0.85). In the ED protocol, the increase in DFA was only demonstrated when comparing Rec1 vs. Rest (Cohen’s d=1.78). Conclusion: ED intake prior to modest aerobic exercise triggered a slight acceleration of recovery

Does energy drink intake before exercise affect nonlinear dynamics of heart rate variability recovery? a randomized, crossover, double-blind and placebo-controlled trial

Introduction and Objectives: Energy drinks (ED) are recognized to influence the behavior of the sympathetic and parasympathetic components of the autonomic nervous system. We intended to study the influence of ED on non-linear heart rate variability (HRV) following exercise. Material and Methods: This randomized, crossover, double-blind, placebo-controlled clinical trial (Protocol number NCT02917889) was completed in a sample of 28 healthy males aged 24.11 ± 3.05 years (min-max 18-29). The first step involved the assessment of maximal oxygen consumption (VO2 max). In the second protocol, the subjects received a placebo (250ml of water) or ED (250ml of energy drink) 15 minutes before the 30-minute exercise on a treadmill. In the third protocol, participants received the alternative protocol to the previous step. The nonlinear HRV were calculated at different times during the protocols. Results: Fractal analysis via Detrended Fluctuation Analysis (DFA) revealed that in the placebo protocol there was an increase in its values compared to recovery (Rec1) vs. Rest (Cohen's d= 1.42) and continued increasing in the last recording intervals: vs. Rec6 (Cohen's d= 0.70) and vs. Rec7 (Cohen's d= 0.85). In the ED protocol, the increase in DFA was only demonstrated when comparing Rec1 vs. Rest (Cohen’s d=1.78). Conclusion: ED intake prior to modest aerobic exercise triggered a slight acceleration of recovery

Taxa-area relationship of aquatic fungi on deciduous leaves

One of the fundamental patterns in macroecology is the increase in the number of observed taxa with size of sampled area. For microbes, the shape of this relationship remains less clear. The current study assessed the diversity of aquatic fungi, by the traditional approach based on conidial morphology (captures reproducing aquatic hyphomycetes) and next generation sequencing (NGS; captures other fungi as well), on graded sizes of alder leaves (0.6 to 13.6 cm2). Leaves were submerged in two streams in geographically distant locations: the Oliveira Stream in Portugal and the Boss Brook in Canada. Decay rates of alder leaves and fungal sporulation rates did not differ between streams. Fungal biomass was higher in Boss Brook than in Oliveira Stream, and in both streams almost 100% of the reads belonged to active fungal taxa. In general, larger leaf areas tended to harbour more fungi, but these findings were not consistent between techniques. Morphospecies-based diversity increased with leaf area in Boss Brook, but not in Oliveira Stream; metabarcoding data showed an opposite trend. The higher resolution of metabarcoding resulted in steeper taxa-accumulation curves than morphospecies-based assessments (fungal conidia morphology). Fungal communities assessed by metabarcoding were spatially structured by leaf area in both streams. Metabarcoding promises greater resolution to assess biodiversity patterns in aquatic fungi and may be more accurate for assessing taxa-area relationships and local to global diversity ratios.This work was supported by the strategic programme UID/BIA/04050/2013 (POCI-01-0145-FEDER-007569), funded by national funds through the Portuguese Foundation for Science and Technology (FCT) I.P. (http://www.fct.pt/) and by the ERDF through the COMPETE2020 - Programa Operacional Competitividade e Internacionalizacao (POCI) and by the project PTDC/AAC-AMB/117068/2010, funded by national funds through FCT I.P. and the European Regional Development Funds through the Operational Competitiveness Program (FEDER-COMPETE). Support from FCT to SD (SFRH/BPD/47574/2008 and SFRH/BPD/109842/2015) and from NSERC Discovery grant program (http://www.nserc-crsng.gc.ca/index_eng.asp) to FB is also acknowledged. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.info:eu-repo/semantics/publishedVersio

Global wealth disparities drive adherence to COVID-safe pathways in head and neck cancer surgery

Peer reviewe

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease