Chronic kidney disease and valvular heart disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies conference

Chronic kidney disease (CKD) is a major risk factor for valvular heart disease (VHD). Mitral annular and aortic valve calcifications are highly prevalent in CKD patients and commonly lead to valvular stenosis and regurgitation, as well as complications including conduction system abnormalities and endocarditis. VHD, especially mitral regurgitation and aortic stenosis, is associated with significantly reduced survival among CKD patients. Knowledge related to VHD in the general population is not always applicable to CKD patients because the pathophysiology may be different, and CKD patients have a high prevalence of comorbid conditions and elevated risk for periprocedural complications and mortality. This Kidney Disease: Improving Global Outcomes (KDIGO) review of CKD and VHD seeks to improve understanding of the epidemiology, pathophysiology, diagnosis, and treatment of VHD in CKD by summarizing knowledge gaps, areas of controversy, and priorities for research

Avanços no Entendimento do Desenvolvimento Infantil em Crianças com Transtorno do Espectro Autista (TEA): Implicações Clínicas e Terapêuticas.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects social communication and involves repetitive or restrictive behaviors. With its increasing prevalence, the need to understand and effectively intervene in ASD is urgent. This review focuses on recent advancements related to understanding child development in children with ASD and the subsequent clinical and therapeutic implications. Behavioral interventions continue to be the cornerstone of treatment, with intensive and well-structured approaches showing improvements in areas such as communication and social skills. However, play-based therapies have gained prominence, providing natural environments for social development. Simultaneously, the field of pharmacological interventions has evolved, aiming to address specific symptoms and associated comorbidities of ASD. Despite promising individualized approaches, combining multiple interventions proves to be more effective, considering the multifaceted nature of ASD. Future research should continue to focus on evidence-based and individualized treatments, with an emphasis on a deep understanding of the underlying neurobiological mechanisms and long-term assessment of interventions.O Transtorno do Espectro Autista (TEA) é uma condição neurodesenvolvimental que afeta a comunicação social e comportamentos repetitivos ou restritos. Com uma prevalência crescente, a necessidade de entender e intervir de forma eficaz no TEA é urgente. Esta revisão foca nos avanços recentes relacionados ao entendimento do desenvolvimento infantil em crianças com TEA e as subsequentes implicações clínicas e terapêuticas. Intervenções comportamentais continuam a ser a espinha dorsal do tratamento, com abordagens intensivas e bem-estruturadas demonstrando melhorias em áreas como comunicação e habilidades sociais. No entanto, terapias baseadas em jogo têm ganhado destaque, proporcionando ambientes naturais para desenvolvimento social. Paralelamente, o campo das intervenções farmacológicas tem evoluído, visando tratar sintomas específicos e comorbidades associadas ao TEA. Apesar das promissoras abordagens individualizadas, combinar múltiplas intervenções se mostra mais eficaz, considerando a natureza multifacetada do TEA. As pesquisas futuras devem continuar focando em tratamentos individualizados e baseados em evidências, com ênfase em uma compreensão profunda dos mecanismos neurobiológicos subjacentes e avaliação de longo prazo das intervenções

CropPol: a dynamic, open and global database on crop pollination

Seventy five percent of the world's food crops benefit from insect pollination. Hence, there has been increased interest in how global change drivers impact this critical ecosystem service. Because standardized data on crop pollination are rarely available, we are limited in our capacity to understand the variation in pollination benefits to crop yield, as well as to anticipate changes in this service, develop predictions, and inform management actions. Here, we present CropPol, a dynamic, open and global database on crop pollination. It contains measurements recorded from 202 crop studies, covering 3,394 field observations, 2,552 yield measurements (i.e. berry weight, number of fruits and kg per hectare, among others), and 47,752 insect records from 48 commercial crops distributed around the globe. CropPol comprises 32 of the 87 leading global crops and commodities that are pollinator dependent. Malus domestica is the most represented crop (32 studies), followed by Brassica napus (22 studies), Vaccinium corymbosum (13 studies), and Citrullus lanatus (12 studies). The most abundant pollinator guilds recorded are honey bees (34.22% counts), bumblebees (19.19%), flies other than Syrphidae and Bombyliidae (13.18%), other wild bees (13.13%), beetles (10.97%), Syrphidae (4.87%), and Bombyliidae (0.05%). Locations comprise 34 countries distributed among Europe (76 studies), Northern America (60), Latin America and the Caribbean (29), Asia (20), Oceania (10), and Africa (7). Sampling spans three decades and is concentrated on 2001-05 (21 studies), 2006-10 (40), 2011-15 (88), and 2016-20 (50). This is the most comprehensive open global data set on measurements of crop flower visitors, crop pollinators and pollination to date, and we encourage researchers to add more datasets to this database in the future. This data set is released for non-commercial use only. Credits should be given to this paper (i.e., proper citation), and the products generated with this database should be shared under the same license terms (CC BY-NC-SA). This article is protected by copyright. All rights reserved

The relationship between greenspace and the mental wellbeing of adults: A systematic review

INTRODUCTION: The view that interacting with nature enhances mental wellbeing is commonplace, despite a dearth of evidence or even agreed definitions of 'nature'. The aim of this review was to systematically appraise the evidence for associations between greenspace and mental wellbeing, stratified by the different ways in which greenspace has been conceptualised in quantitative research. METHODS: We undertook a comprehensive database search and thorough screening of articles which included a measure of greenspace and validated mental wellbeing tool, to capture aspects of hedonic and/or eudaimonic wellbeing. Quality and risk of bias in research were assessed to create grades of evidence. We undertook detailed narrative synthesis of the 50 studies which met the review inclusion criteria, as methodological heterogeneity precluded meta-analysis. RESULTS: Results of a quality assessment and narrative synthesis suggest associations between different greenspace characteristics and mental wellbeing. We identified six ways in which greenspace was conceptualised and measured: (i) amount of local-area greenspace; (ii) greenspace type; (iii) visits to greenspace; (iv) views of greenspace; (v) greenspace accessibility; and (vi) self-reported connection to nature. There was adequate evidence for associations between the amount of local-area greenspace and life satisfaction (hedonic wellbeing), but not personal flourishing (eudaimonic wellbeing). Evidence for associations between mental wellbeing and visits to greenspace, accessibility, and types of greenspace was limited. There was inadequate evidence for associations with views of greenspace and connectedness to nature. Several studies reported variation in associations between greenspace and wellbeing by life course stage, gender, levels of physically activity or attitudes to nature. CONCLUSIONS: Greenspace has positive associations with mental wellbeing (particularly hedonic wellbeing), but the evidence is not currently sufficient or specific enough to guide planning decisions. Further studies are needed, based on dynamic measures of greenspace, reflecting access and uses of greenspace, and measures of both eudaimonic and hedonic mental wellbeing