Seasonal variation in blood pressure: what is still missing?

Seasonal variation of blood pressure (BP) is a topic in cardiology that has gained more attention throughout the years. Although it is extensively documented that BP increases in seasons coupled with lower temperatures, there are still many gaps in this knowledge field that need to be explored. Notably, seasonal variation of BP phenotypes, such as masked and white coat hypertension, and the impact of air pollution, latitude, and altitude on seasonal variation of BP are still poorly described in the literature, and the levels of the existing evidence are low. Therefore, further investigations on these topics are needed to provide robust evidence that can be used in clinical practice

Consumo e digestibilidade em ovinos alimentados com dietas contendo resíduos da bananicultura

The objective of this work was to evaluate the effects of the inclusion of banana leaf or pseudostem hay in complete diets on the intake, nutrient digestibility, and ruminal short-chain fatty acid production by lambs. A total of 30 Santa Inês x Dorper lambs were allocated to five treatments: 400 g kg-1 Cynodon spp. hay; 200 g kg-1 banana leaf hay + 200 g kg-1 Cynodon spp. hay; 400 g kg-1 banana leaf hay; and 200 g kg-1 banana pseudostem hay + 200 g kg-1 Cynodon spp. hay and 400 g kg-1 banana pseudostem hay. The inclusion of banana crop residues had no effect on dry matter intake, organic matter, crude protein, neutral detergent fiber (NDF), acid detergent fiber, non-fiber carbohydrates, and total carbohydrates, which presented averages of 1,086.8, 1,000.1, 182.7, 374.3, 194.7, 390.2, and 771.6 g per day, respectively. There was a reduction in NDF digestibility with the inclusion of 400 g kg-1 leaf hay, but no differences were observed in the other treatments. The addition of both banana leaf and pseudostem hay can replace Cynodon spp. hay without affecting intake, nutrient digestibility, and ruminal concentration of short-chain fatty acids.O objetivo deste trabalho foi avaliar os efeitos da inclusão de feno de folha ou pseudocaule de banana em dietas completas sobre a ingestão, a digestibilidade de nutrientes e a produção ruminal de ácidos graxos de cadeia curta em cordeiros. Foram utilizados 30 cordeiros Santa Inês x Dorper, alocados em cinco tratamentos: 400 g kg-1 de feno de Cynodon spp.; 200 g kg-1 de feno de folha de bananeira + 200 g kg-1 de feno de Cynodon spp.; 400 g kg-1 de feno de folha de bananeira; e 200 g kg-1 de feno de pseudocaule de banana + 200 g kg-1 de feno de Cynodon spp. e 400 g kg-1 de feno de pseudocaule de banana. A inclusão de resíduos culturais de banana não teve efeito sobre consumo de matéria seca, matéria orgânica, proteína bruta, fibra em detergente neutro (FDN), fibra em detergente ácido, carboidratos não fibrosos e carboidratos totais, cujas médias foram de 1.086,8, 1.000,1, 182,7, 374,3, 194,7, 390,2 e 771,6 g por dia, respectivamente. Houve redução na digestibilidade da FDN com a inclusão de 400 g kg-1 de feno de folhas, mas não foram observadas diferenças nos outros tratamentos. A adição de feno de folha e de pseudocaule de banana pode substituir o feno de Cynodon spp. sem alterar a ingestão, a digestibilidade de nutrientes e a concentração ruminal de ácidos graxos de cadeia curta

Portuguese multidisciplinary recommendations for non-pharmacological and non-surgical interventions in patients with rheumatoid arthritis

BACKGROUND: Patients with rheumatoid arthritis (RA) report significant levels of disease impact, which are improved, but not fully abrogated by immunosuppressive therapy, even when remission is achieved. This imposes the need for adjuvant interventions targeting the uncontrolled domains of disease impact. Non-pharmacological interventions are widely used for this purpose, but they have not been the object of professional recommendations or guidelines. OBJECTIVE: To propose multidisciplinary recommendations to inform clinical care providers regarding the employment of non-pharmacological and non-surgical interventions in the management of patients with RA. METHODS: The EULAR standardized operating procedures for the development of recommendations were followed. First, a systematic literature review was performed. Then, a multidisciplinary Technical Expert Panel (TEP) met to develop and discuss the recommendations and research agenda. For each developed recommendation i) the level of evidence and grade of recommendation were determined, and ii) the level of agreement among TEP members was set. A recommendation was adopted if approved by ≥75% of the TEP members, and the level of agreement was considered high when ≥8. All relevant national societies were included in this construction process to attain their endorsement. RESULTS: Based on evidence and expert opinion, the TEP developed and agreed on five overarching principles and 12 recommendations for non-pharmacological and non-surgical interventions in patients with RA. The mean level of agreement between the TEP members ranged between 8.5 and 9.9. The recommendations include a broad spectrum of intervention areas, such as exercise, hydrokinesiotherapy, psychological interventions, orthoses, education, general management of comorbidities, among others; and they set the requirements for their application. CONCLUSIONS: These recommendations are based on the consensus judgment of clinical experts from a wide range of disciplines and patients' representatives from Portugal. Given the evidence for effectiveness, feasibility and safety, non-pharmacological and non-surgical interventions should be an integral part of standard care for people with RA. It is hoped that these recommendations should be widely implemented in clinical practice. The target audience for these recommendations includes all health professionals involved in the care of patients with RA. The target patient population includes adult Portuguese people with RA.publishersversionpublishe

Relação da profilaxia pré-exposição (PrEP) com o uso de preservativo no Brasil

Introdução: A síndrome da imunodeficiência humana adquirida (SIDA) ganhou repercussão mundial em 1981 quando tornou-se uma epidemia. Desde então, 74,9 milhões de pessoas foram infectadas e 32 milhões morreram de doenças relacionadas à aids. Assim, esforços fizeram-se necessários para prevenir a infecção do HIV. Recentemente, a profilaxia préexposição (PrEP), composta por tenofovir e entricitabina, tornou-se uma alternativa para a população alvo, mais suscetível a adquirir a infecção. Entretanto, a possibilidade de relações sexuais sem o uso de preservativo pode diminuir a adesão a esse método e aumentar as outras infecções sexualmente transmissíveis (ISTs). Objetivo: Analisar o efeito da profilaxia pré-exposição na adesão ao uso de preservativo no Brasil. Método e materiais: Trata-se de um estudo ecológico conduzido com base em dados quantitativos do ministério da saúde de uso e consequências da PrEP entre os anos de 2018 a 2021. Resultados: Em relação ao uso de preservativo houve uma queda significativa na adesão, pois no 1⁰ atendimento: 33% dos pacientes afirmaram usar todas as vezes, 36% mais da metade das vezes, 11% metade das vezes, 12% menos da metade das vezes, 10% nenhuma vez. Já no último atendimento 23% afirmaram usar todas as vezes, 25% mais da metade das vezes, 13% metade das vezes, 16% menos da metade das vezes, 23% nenhuma vez. Conclusão: Faz-se necessário o esforço de maior conscientização para os usuários de PrEP, que tendem a abandonar os preservativos, permaneçam a se prevenir contra as outras ISTs, haja vista que a PrEP previne apenas contra o HIV

One hundred SMUDGes in S-PLUS: ultra-diffuse galaxies flourish in the field

We present the first systematic study of the stellar populations of ultra-diffuse galaxies (UDGs) in the field, integrating the large area search and characterization of UDGs by the SMUDGes survey with the twelve-band optical photometry of the S-PLUS survey. Based on Bayesian modeling of the optical colors of UDGs, we determine the ages, metallicities and stellar masses of 100 UDGs distributed in an area of $\sim 330$ deg$^2$ in the Stripe 82 region. We find that the stellar masses and metallicities of field UDGs are similar to those observed in clusters and follow the trends previously defined in studies of dwarf and giant galaxies. However, field UDGs have younger luminosity-weighted ages than do UDGs in clusters. We interpret this result to mean that field UDGs have more extended star formation histories, including some that continue to form stars at low levels to the present time. Finally, we examine stellar population scaling relations that show that UDGs are, as a population, similar to other low-surface brightness galaxies.Instituto de Astrofísica de La PlataFacultad de Ciencias Astronómicas y Geofísica

Influenza Vaccination for the Prevention of Cardiovascular Disease in the Americas: Consensus document of the Inter-American Society of Cardiology and the Word Heart Federation

Background Cardiovascular mortality is decreasing but remains the leading cause of death world-wide. Respiratory infections such as influenza significantly contribute to morbidity and mortality in patients with cardiovascular disease. Despite of proven benefits, influenza vaccination is not fully implemented, especially in Latin America. Objective The aim was to develop a regional consensus with recommendations regarding influenza vaccination and cardiovascular disease. Methods A multidisciplinary team composed by experts in the management and prevention of cardiovascular disease from the Americas, convened by the Inter-American Society of Cardiology (IASC) and the World Heart Federation (WHF), participated in the process and the formulation of statements. The modified RAND/UCLA methodology was used. This document was supported by a grant from the WHF. Results An extensive literature search was divided into seven questions, and a total of 23 conclusions and 29 recommendations were achieved. There was no disagreement among experts in the conclusions or recommendations. Conclusions There is a strong correlation between influenza and cardiovascular events. Influenza vaccination is not only safe and a proven strategy to reduce cardiovascular events, but it is also cost saving. We found several barriers for its global implementation and potential strategies to overcome them

6ª Diretriz de monitorização ambulatorial da pressão arterial e 4ª diretriz de monitorização residencial da pressão arterial

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MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio