Escores de Risco Cardiovascular entre Adultos Assintomáticos com Hemofilia

Resumo Fundamento A taxa de mortalidade de pessoas com hemofilia (PCH) no Brasil está diminuindo, mas a incidência relativa de mortes associadas a doenças cardiovasculares (DCV) tem aumentado. Objetivos Nosso objetivo foi descrever o escore de risco de DCV de PCHs de acordo com a ferramenta Pooled Cohort Equations Risk (PCER) Calculator e suas recomendações de tratamento. Além disso, foram comparadas as estimativas da PCER com o respectivo escore de risco de Framingham (FRS). Métodos Este estudo transversal incluiu PCHs do sexo masculino, com idade igual ou superior a 40 anos, tratados no Centro de Tratamento Integral de Hemofilia de Pernambuco (Recife/Brasil). PCHs com um evento cardiovascular prévio ou colesterol lipídico de baixa densidade ≥ 5,0 mmol/L foram excluídas. Entrevistas, revisões de prontuários médicos e exames de sangue foram realizados. A ferramenta PCER foi utilizada para estimar o risco de DCV e compará-lo com o respectivo FRS. Um valor de p < 0,05 foi aceito como estatisticamente significativo. Resultados Trinta PCHs foram incluídas. A idade mediana foi de 51,5 [intervalo interquartil-IIQ; 46,0-59,5] anos. A prevalência de obesidade, hipertensão arterial sistêmica, diabetes mellitus, hipertrigliceridemia, hipercolesterolemia e hipoHDLemia foi de 20%, 67%, 24%, 14%, 47% e 23%, respectivamente. O escore mediano da PCER foi de 6,9% [IIQ; 3,1-13,2], com 50% de alto risco (PCER ≥ 7,5%). O uso de estatina foi sugerido para 54% das PCHs. A pressão arterial estava mal controlada em 47% das PCHs. A concordância entre PCER e FRS foi de 80% (κ = 0,60; p = 0,001). Conclusões Metade dos homens com hemofilia, com 40 anos de idade ou mais, teve um alto risco de desenvolver DCV em 10 anos, com fortes recomendações para melhorar o controle da dislipidemia e da pressão arterial

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

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 understanding 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,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 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 underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities 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 organism 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 neglected 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 lost

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 understanding 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,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 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 underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities 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 organism 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 neglected 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 lost

AMPLIAÇÃO DO ACESSO À PROFILAXIA PRÉ EXPOSIÇÃO ATRAVÉS DA DESCENTRALIZAÇÃO DA DISPENSAÇÃO NO MUNICÍPIO DO RIO DE JANEIRO, DE 2018 A 2022

Introdução: A oferta da Profilaxia Pré Exposição (PrEP) no município do Rio de Janeiro iniciou para a população geral no ano de 2018, com apenas uma unidade dispensadora de medicamentos. Importante salientar que o município do Rio de Janeiro é dividido em 10 regiões chamadas de áreas programáticas, cada uma com suas particularidades históricas, econômicas e distinção territorial, permitindo que cada coordenação local defina estratégias de acesso à saúde. Neste contexto, a Gerência do programa de Infecções Sexualmente Transmissíveis/aids do municipal decidiu realizar a descentralização da dispensação da PrEP, visando facilitar o acesso a mais usuários, sendo a oferta e acessibilidade desta tecnologia uma importante ferramenta para a prevenção do HIV. Objetivo: Analisar a estratégia de descentralização de unidades dispensadoras de PrEP como garantia de acesso no município do Rio de Janeiro no período de 2018 a 2022. Método: Com o aumento da oferta da PrEP, inicialmente foi pensado em oportunizar uma unidade dispensadora de PrEP em cada área programática. A partir da análise de demanda territorial da área, junto com a equipe da logística de medicamentos e insumos de HIV/aids do município, identificou-se a necessidade de ampliação dessas unidades, devido a busca acentuada dos usuários, principalmente após a descentralização do atendimento para as unidades de atenção primária do Município do Rio de Janeiro que aconteceu em outubro de 2022. Resultados: No ano de 2018 o município do Rio de Janeiro contava com 1 unidade dispensadora de PrEP, avançando para 25 em 2021 e totalizando 105 unidade dispensadora de medicamento em dezembro de 2022, proporcionando o alcance de novos usuários iniciando a PrEP, e deste modo observou-se um aumento de 486 usuários em 2018 para 1305 em 2021 e 3994 usuários em 2022, contabilizando, ao final deste mesmo ano, 8812 dispensas e mais de 700 mil comprimidos dispensados, um acréscimo maior que 100% quando comparado ao ano anterior. Conclusão: A descentralização das unidades dispensadoras de PrEP no município do Rio de Janeiro foi uma importante estratégia para maior alcance da população que se sente em risco aumentado de contrair o vírus do HIV, se mostrando efetiva na medida que proporcionou alcance de novos usuários retirando o medicamento próximo a sua residência, facilitando o acesso ao medicamento, favorecendo políticas públicas que vão de encontro à eliminação da transmissão do HIV

Physiological selectivity of insecticides to adult of Doru luteipes (Scudder, 1876) (Dermaptera: Forficulidae)

Doru luteipes (SCUDDER, 1876) is considered one of the best natural enemies of the fall armyworm Spodoptera frugiperda (J. E. Smith, 1797) (Lepidoptera: Noctuidae), feeding on their eggs and small caterpillars. For its conservation it is necessary to use selective insecticides to S. frugiperda and harmless to the predator. Therefore, objective of the present work was to evaluate the toxicity of insecticides registered to control of S. frugiperda. It was conducted bioassays with D. luteipes adults treated with insecticides directly by exposure to residues of compounds applied on glass plates and the consumption of eggs of S. frugiperda contaminated and offered each one, 24 and 48 hours after treatment. The insecticides were classified according to indices proposed by IOBC/WPRS. For adults D. luteipes treated directly with insecticides, triflumuron was harmless (class 1); chlorfenapyr and etofenprox as slightly harmful (class 2) teflubenzuron/α-cypermethrin and spinosad moderately harmful (class 3) and thiamethoxan/λ-cyhalothrin harmful (class 4). In bioassay exposure of D. luteipes residues of insecticides applied to glass plates, all products were harmful to the predator, except triflumuron which was considered slightly harmful. The survival of adults after consumption of contaminated eggs was 46.7% for the insecticide tiametoxam/λ-cialotrina considered slightly harmful to the predator. The other insecticides were innocuous. Due to the low toxicity presented by the triflumuron to the D. luteipes adults, this compound can be recommended in programs aimed at integrated pest management the preservation of this natural enemy. All other products must be evaluated in greenhouse and field to prove its toxicity

Effects of a dual-task training on dynamic and staticbalance control of pre-frail elderly: a pilot study

Introduction: This quasi-experimental study is justie#56256;e#57296;ied by the need to determine the effects of an interventionstrategy aimed at improving the static and dynamic balance in pre-frail elderly women. We hypothesizedthat dual-task training on a treadmill, compared to simple training on a treadmill,may promotestatistical difference in postural control of this group. Objectives: This study aimed to verify the measuresof postural control in a group of pre-frail elderly after a physical therapy intervention program based ondual-task treadmill training. Materials and methods: We selected six female pre-frail elderly subjectsliving in the community. The research was conducted twice a week for 45 minutes, for four weeks. Thesimple task training consisted only in the use of a treadmill and the dual-task training consisted on theuse of a treadmill associated with visual stimuli. Only the intervention group was submitted to the dualtasktraining. Results: Groups showed improvements in the variables of balance in different tasks, especiallyon static balance. Both groups showed the most notable changes in the variables related to gait. TheBBS scores and the baropodometric variables showed that the experimental group could keep all values similar or better even one month after completion of training, unlike the control group. Conclusion: Thedual-task performance had no additional value in relation to the improvement of balance in general, butwe observed that the effectiveness of visual stimulation seems to occur in the maintenance of short-termbalance variables

Effects of a dual-task training on dynamic and static balance control of pre-frail elderly: a pilot study

INTRODUCTION: This quasi-experimental study is justified by the need to determine the effects of an intervention strategy aimed at improving the static and dynamic balance in pre-frail elderly women. We hypothesized that dual-task training on a treadmill, compared to simple training on a treadmill,may promote statistical difference in postural control of this group. OBJECTIVES: This study aimed to verify the measures of postural control in a group of pre-frail elderly after a physical therapy intervention program based on dual-task treadmill training. MATERIALS AND METHODS: We selected six female pre-frail elderly subjects living in the community. The research was conducted twice a week for 45 minutes, for four weeks. The simple task training consisted only in the use of a treadmill and the dual-task training consisted on the use of a treadmill associated with visual stimuli. Only the intervention group was submitted to the dual-task training. RESULTS: Groups showed improvements in the variables of balance in different tasks, especially on static balance. Both groups showed the most notable changes in the variables related to gait. The BBS scores and the baropodometric variables showed that the experimental group could keep all values similar or better even one month after completion of training, unlike the control group. CONCLUSION: The dual-task performance had no additional value in relation to the improvement of balance in general, but we observed that the effectiveness of visual stimulation seems to occur in the maintenance of short-term balance variables

Crescimento de mogno-brasileiro e resistência a Hypsipyla grandella em função do cálcio e do boro

O mogno-brasileiro possui alto valor madeireiro, mas seu cultivo comercial é inviabilizado pelo ataque da broca Hypsipyla grandella. Objetivou-se avaliar o efeito de doses de cálcio e boro nas variáveis de crescimento do mogno e na resistência ao ataque da broca H. grandella . O delineamento utilizado foi o fatorial 4² em blocos ao acaso com quatro doses de cálcio (0, 100, 200 e 400 mg L-1) e quatro de boro (0; 0,5; 2; e 4 mg L-1) e três repetições com três plantas por repetição. Avaliaram-se: altura, diâmetro, massa seca aérea e de raiz, relação parte aérea:raiz, taxa de infestação e comprimento da galeria construída pela broca. Os dados foram submetidos ao teste de Tukey a 5% e à análise de correlação e regressão. Não houve interação estatística entre os nutrientes, nem significância de altura e diâmetro do coleto. A massa de raízes e da parte aérea apresentou os maiores resultados na omissão dos elementos, verificando as menores relações parte aérea:raiz nas doses de 100 mg L-1 em função do cálcio e 0,5 mg L-1 em função do boro. A dose de 100 mg Ca L-1 proporcionou a menor taxa de infestação de H. grandella. Para a resistência do mogno ao desenvolvimento da galeria, tanto o cálcio quanto o boro apresentaram significância, sendo os menores comprimentos verificados nas doses de 100 mg L-1 Ca e 0,5 mg L-1 B, respectivamente. Esses nutrientes influenciam a resistência do mogno ao ataque da broca e evidenciam a necessidade de estudos em condições de campo