Prevalence of chronic pain in Brazil: A systematic review and meta-analysis

Objective: This review synthesized existing studies on the prevalence of chronic pain in Brazil and its associated factors to produce a recent estimation to guide public health politics. Methods: A search was carried out in the Ovid Medline, Embase, Web of Science, and BVS Regional/Lilacs databases to identify population-based cross-sectional studies from 2005 to 2020, which reported the prevalence of benign chronic pain in Brazil (more than three months). The risk of bias was assessed using design, sample size determination, and random selection as essential issues. Pooled prevalence estimates were calculated for chronic pain in the general and elderly populations. The protocol was registered on Prospero (CRD42021249678). Results: Of the 682 identified, 15 macheted the authors’ inclusion criteria. Chronic pain prevalence in the general adult population ranged from 23.02% to 42.33% (pooled estimate 35.70%, 95% Cis 30.42 to 41.17) and was described as moderate to intense. It was associated with female sex, old age, lower education, intense professional activity, excessive alcohol consumption, smoking, central obesity, mood disorder, and sedentarism. The Southeastern and Southern regions presented a higher prevalence. The prevalence in the elderly population ranged from 29.3% to 76.2% (pooled estimate 47.32%, 95% Cis 33.73 to 61.11). In addition, this population visited doctors more frequently, had more sleep disorders, and was more dependent on daily living activities. Almost fifty percent of both populations with chronic pain reported pain-induced disability. Conclusion: Chronic Pain is highly prevalent in Brazil and associated with significant distress, disability, and poorly controlled

Search for high-mass protostars with ALMA revealed up to kilo-parsec scales (SPARKS). II. Complex organic molecules and heavy water in shocks around a young high-mass protostar

Context. Classical hot cores are rich in molecular emission, and they show a high abundance of complex organic molecules (COMs). The emergence of molecular complexity that is represented by COMs, in particular, is poorly constrained in the early evolution of hot cores. Aims: We put observational constraints on the physical location of COMs in a resolved high-mass protostellar envelope associated with the G328.2551-0.5321 clump. The protostar is single down to ~400 au scales and we resolved the envelope structure down to this scale. Methods: High angular resolution observations using the Atacama Large Millimeter Array allowed us to resolve the structure of the inner envelope and pin down the emission region of COMs. We use local thermodynamic equilibrium modelling of the available 7.5 GHz bandwidth around ~345 GHz to identify the COMs towards two accretion shocks and a selected position representing the bulk emission of the inner envelope. We quantitatively discuss the derived molecular column densities and abundances towards these positions, and use our line identification to qualitatively compare this to the emission of COMs seen towards the central position, corresponding to the protostar and its accretion disk. Results: We detect emission from 10 COMs, and identify a line of deuterated water (HDO). In addition to methanol (CH3OH), methyl formate (CH3OCHO) and formamide (HC(O)NH2) have the most extended emission. Together with HDO, these molecules are found to be associated with both the accretion shocks and the inner envelope, which has a moderate temperature of Tkin ~ 110 K. We find a significant difference in the distribution of COMs. O-bearing COMs, such as ethanol, acetone, and ethylene glycol are almost exclusively found and show a higher abundance towards the accretion shocks with Tkin ~ 180 K. Whereas N-bearing COMs with a CN group, such as vinyl and ethyl cyanide peak on the central position, thus the protostar and the accretion disk. The molecular composition is similar towards the two shock positions, while it is significantly different towards the inner envelope, suggesting an increase in abundance of O-bearing COMs towards the accretion shocks. Conclusions: We present the first observational evidence for a large column density of COMs seen towards accretion shocks at the centrifugal barrier at the inner envelope. The overall molecular emission shows increased molecular abundances of COMs towards the accretion shocks compared to the inner envelope. The bulk of the gas from the inner envelope is still at a moderate temperature of Tkin ~ 110 K, and we find that the radiatively heated inner region is very compact (<1000 au). Since the molecular composition is dominated by that of the accretion shocks and the radiatively heated hot inner region is very compact, we propose this source to be a precursor to a classical, radiatively heated hot core. By imaging the physical location of HDO, we find that it is consistent with an origin within the moderately heated inner envelope, suggesting that it originates from sublimation of ice from the grain surface and its destruction in the vicinity of the heating source has not been efficient yet. A copy of the reduced datacubes is available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (ftp://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/cat/J/A+A/632/A5