Wild dogs at stake: deforestation threatens the only Amazon endemic canid, the short-eared dog (Atelocynus microtis)

The persistent high deforestation rate and fragmentation of the Amazon forests are the main threats to their biodiversity. To anticipate and mitigate these threats, it is important to understand and predict how species respond to the rapidly changing landscape. The short-eared dog Atelocynus microtis is the only Amazon-endemic canid and one of the most understudied wild dogs worldwide. We investigated short-eared dog habitat associations on two spatial scales. First, we used the largest record database ever compiled for short-eared dogs in combination with species distribution models to map species habitat suitability, estimate its distribution range and predict shifts in species distribution in response to predicted deforestation across the entire Amazon (regional scale). Second, we used systematic camera trap surveys and occupancy models to investigate how forest cover and forest fragmentation affect the space use of this species in the Southern Brazilian Amazon (local scale). Species distribution models suggested that the short-eared dog potentially occurs over an extensive and continuous area, through most of the Amazon region south of the Amazon River. However, approximately 30% of the short-eared dog's current distribution is expected to be lost or suffer sharp declines in habitat suitability by 2027 (within three generations) due to forest loss. This proportion might reach 40% of the species distribution in unprotected areas and exceed 60% in some interfluves (i.e. portions of land separated by large rivers) of the Amazon basin. Our local-scale analysis indicated that the presence of forest positively affected short-eared dog space use, while the density of forest edges had a negative effect. Beyond shedding light on the ecology of the short-eared dog and refining its distribution range, our results stress that forest loss poses a serious threat to the conservation of the species in a short time frame. Hence, we propose a re-assessment of the short-eared dog's current IUCN Red List status (Near Threatened) based on findings presented here. Our study exemplifies how data can be integrated across sources and modelling procedures to improve our knowledge of relatively understudied species

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants.

BACKGROUND: Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. METHODS: We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. FINDINGS: The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. INTERPRETATION: Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. FUNDING: WHO

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20–27) for women and 18% (16–21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings

Uso da Dexmedetomidina para a contenção química de uma Anta Brasileira (Tapirus terrestris) de cativeiro

Background:  The Brazilian tapir (Tapirus terrestris), considered the largest land mammal in South America, is a vulnerable species in terms of its degree of conservation. In captivity, its health is evaluated through behavioral and physical observation and laboratory exams, and in some cases, chemical restraint, to reduce stress. Dissociative anesthetics and sedatives are used for the sedation of these animals, and few studies have reported the use of dexmedetomidine and its effects when associated with other drugs in chemical containment protocols; therefore, this work reports its use, in conjunction with ketamine and midazolam, in a young Brazilian tapir. Case:  A male Brazilian tapir, male, weighing 89 kg, 1 and a half year old,  housed at CETAS in Rio Branco, Acre, was chemically restrained with dexmedetomidine (7 µg/kg), ketamine (1.5 mg/kg), and midazolam (0.2 mg/kg) for venous blood collection, oral and rectal mucosal swabs, and microchipping. The protocol was administered intramuscularly to the right triceps brachii, after physical restraint. After 5 min of application, the animal assumed sternal recumbency and presented reflux. After 15 min, the patient was placed in the right lateral decubitus position. During collection, heart rate (48 ± 10 bpm), respiratory frequency (29 ± 1 mpm), rectal temperature (38.1 ± 0.18 °C), oxyhemoglobin saturation (97 ± 1%), and electrocardiographic tracing were recorded. The tapir showed deep sedation, immobility, good muscle relaxation, discreet medial palpebral reflex, and bilateral rotation of the eyeball. After 40 min of protocol administration, sedative reversal was performed intramuscularly with 14 µg/kg atipamezole. Five min after administration, the tapir showed signs of mild sedation. After 10 min, he assumed the quadrupedal position, remained in this position for 8 min, and gently resumed the sternal decubitus. After only 20 min, he resumed the quadrupedal position, with mild ataxia and good muscular and conscious tone. After 50 min, the patient was discharged from anesthesia. Discussion: Domestic horses are phylogenetically close to tapirs, so the choice of drugs and doses of the protocol used was based on their use in horses, and on studies carried out with tapirs as well. Despite being docile and passive, the tapir was not conditioned and did not allow the manipulation and collection of samples collaboratively; therefore, it was chemically contained. The physical restraint performed did not generate satisfactory immobilization of the tapir, resulting in agitation and stress and causing the needle to break. The reflux presented by the tapir minutes after sedation and at recovery was induced by dexmedetomidine, and only the undigested banana pieces were offered to the animal. Reflux plus stress from extensive fasting and suboptimal physical restraint was responsible for the change in the tapir's eating behavior, with possible stress gastritis 24 h after chemical restraint. Only one study reported the use of dexmedetomidine in tapirs, associated with continuous infusions of ketamine, midazolam and guaiacol glyceryl ether for moderate to long-term field procedures. Sedative reversal of dexmedetomidine by atipamezole reduced the recovery time and the risk of death from cardiorespiratory depression. The anesthetic combination used was effective, promoting immobility, muscle relaxation, and stability of the physical parameters evaluated, with rapid and gentle induction and an adequate level of sedation for the objective, good sedative reversal, and anesthetic recovery. Keywords: anesthesia, anesthetic management, wild animals, mammals, sedative.Antecedentes: Considerado o maior mamífero terrestre da América do Sul, a Anta brasileira (Tapirus terrestris), é uma espécie vulnerável quanto ao seu grau de conservação. Em cativeiro, sua saúde é avaliada por meio da observação comportamental, física e por exames, sendo necessária, e alguns casos, a contenção química, reduzindo o estresse. Anestésicos dissociativos e sedativos são utilizados para a sedação destes animais, e poucos estudos relatam o uso da dexmedetomidina e seus efeitos quando associadas a outros fármacos em protocolos de contenção química, por isso, este trabalho relata o seu emprego, com cetamina e midazolam, em uma anta brasileira jovem. Caso:  Uma anta brasileira, macho, 89 kg, um ano e meio de idade, lotada no CETAS de Rio Branco, Acre, foi contida quimicamente com dexmedetomidina (7µg/kg), cetamina (1,5mg/kg) e midazolam (0,2 mg/kg), para a coleta de sangue venoso, swab da mucosa oral e retal, e microchipagem. O protocolo foi administrado por via intramuscular, no tríceps braquial direito, após contenção física. Após cinco minutos da aplicação, o animal assumiu decúbito esternal, e apresentou refluxo. Passados 15 minutos, este foi posicionado em decúbito lateral direito. Durante a coleta, foram monitoradas, a frequência cardíaca (48 ± 10 bpm), frequência respiratória (29 ± 1 mpm), temperatura retal (38,1 ± 0,18 °C), saturação da oxihemoglobina (97 ± 1%) e o traçado eletrocardiográfico pelo monitor multiparamétrico. A anta apresentou grau de sedação profundo, imobilidade, bom relaxamento muscular, reflexo palpebral medial discreto e rotação bilateral do globo ocular. Após 40 minutos da administração do protocolo, foi realizada a reversão sedativa com 14 µg/kg atipamezole, por via intramuscular. Depois de cinco minutos dessa administração, a anta apresentou sinais de grau de sedação leve. Após dez minutos, assumiu a posição quadrupedal, permaneceu nesta por oito minutos, e retomou o decúbito esternal, de modo suave. Somente após 20 minutos, reassumiu a posição quadrupedal, com leve ataxia, bom tônus muscular e consciente. Depois de 50 minutos, recebeu alta anestésica. Discussão: Os cavalos domésticos são filogeneticamente próximos das antas, por isso a escolha das drogas e das doses do protocolo utilizado foi baseada em seu uso em cavalos, e também em estudos realizados com antas. Apesar de dócil e passiva, a anta não era condicionada e não permitia a manipulação e coleta de amostras de forma colaborativa; portanto, estava quimicamente contido. A contenção física realizada não gerou uma imobilização satisfatória da anta, resultando em agitação e estresse e causando a quebra da agulha. O refluxo apresentado pela anta minutos após a sedação e na recuperação foi induzido pela dexmedetomidina, e apenas os pedaços de banana não digeridos foram oferecidos ao animal. Refluxo mais estresse de jejum prolongado e contenção física abaixo do ideal foi responsável pela mudança no comportamento alimentar da anta, com possível gastrite de estresse 24 h após a contenção química. Apenas um estudo relatou o uso de dexmedetomidina em antas, associado a infusões contínuas de cetamina, midazolam e guaiacol gliceril éter para procedimentos de campo de moderada a longa duração. A reversão sedativa da dexmedetomidina pelo atipamezol reduziu o tempo de recuperação e o risco de morte por depressão cardiorrespiratória. A combinação anestésica utilizada foi eficaz, promovendo imobilidade, relaxamento muscular e estabilidade dos parâmetros físicos avaliados, com indução rápida e suave e nível adequado de sedação para o objetivo, boa reversão sedativa e recuperação anestésica