ESTUDO PRELIMINAR DA MORFOMETRIA DA CABEÇA ESPERMÁTICA DO MACACO-DE-CHEIRO DE VIDA LIVRE

The objectiveofthisstudywastodescribeand compare theheadmorphometryof normal andpathologicalspermfromSaimirimacrodon. In themorphologicalanalysis, 39% ofthespermhad normal morphology, and 61% had major orminordefects, withpathology in thetailsbeingthemostfrequentwith 47% (38% curledtail, 7% foldedtailand 2% stronglyfoldedtail). Amongtheevaluatedheadmorphometryparameters, area (A), width (L) andellipticity (E) showedstatisticaldifference (p<0.05) between normal andpathologicalsperm. The averageheadareaandwidthwaslower in normal sperm (p=0,01 e p=0,04, respectively), andthemeanellipticitywashigher (p=0,038), whencomparedtopathologicalsperm. ThisdefinitionofthespermmorphometricparametersofS. macrodonisimportant for the samples selectiondestinedtoreproductionbiotechnologiesand for theclarificationoftaxonomicandevolutionaryissues in the genus Saimiri.The objectiveofthisstudywastodescribeand compare theheadmorphometryof normal andpathologicalspermfromSaimirimacrodon. In themorphologicalanalysis, 39% ofthespermhad normal morphology, and 61% had major orminordefects, withpathology in thetailsbeingthemostfrequentwith 47% (38% curledtail, 7% foldedtailand 2% stronglyfoldedtail). Amongtheevaluatedheadmorphometryparameters, area (A), width (L) andellipticity (E) showedstatisticaldifference (p<0.05) between normal andpathologicalsperm. The averageheadareaandwidthwaslower in normal sperm (p=0,01 e p=0,04, respectively), andthemeanellipticitywashigher (p=0,038), whencomparedtopathologicalsperm. ThisdefinitionofthespermmorphometricparametersofS. macrodonisimportant for the samples selectiondestinedtoreproductionbiotechnologiesand for theclarificationoftaxonomicandevolutionaryissues in the genus Saimiri

ANÁLISE MORFOMÉTRICA DA CABEÇA ESPERMÁTICA EM Saimiri cassiquiarensis

The objective was to evaluate the sperm morphometry between normal and pathological cells in Saimiri cassiquiarensis aiming at the future use of data in CASA (Computer Assisted Sperm Analysis). Semen was collected from a male (S. cassiquiarensis) by electroejaculation. After collection, a smear in the proportion of 1: 1 (semen and eosin-nigrosin stain) was performed, and 100 sperm were measured and morphologically classified as normal and pathological defects (major and minor). Of the total sperm analyzed, 48% were classified as normal and 52% pathological. Of the pathologies, the most frequent was a folded tail (40%), followed by a strongly folded tail (5%), curled tail (2%) and isolated head (5%). The morphometric data showed no statistical difference (p<0.05) between normal and pathological defects. This is the first description for the sperm morphometry in Saimiri cassiquiarensis, therefore, from this database, future assessments at CASA can be conducted for this species.O objetivo foi avaliar a morfometria espermática entre células normais e patológicas em Saimiri cassiquiarensis visando futura utilização de dados em CASA (Computer Assisted Sperm Analysis). O sêmen foi coletado de um macho (S. cassiquiarensis) por eletroejaculação. Após a coleta, foi realizado esfregaço na proporção de 1:1 (sêmen e coloração eosina-nigrosina), sendo mensurados 100 espermatozoides e classificados morfologicamente em normais e defeitos patológicos (maiores e menores). Do total de espermatozoides analisados, 48% foram classificados como normais e 52% patológicos. Das patologias, a mais frequente foi cauda dobrada (40%), seguida de cauda fortemente dobrada (5%), cauda enrolada (2%) e cabeça isolada (5%). Os dados morfométricos não mostraram diferença estatística (p<0,05) entre defeitos normais e patológicos. Esta é a primeira descrição da morfometria espermática em Saimiri cassiquiarensis, portanto, a partir desta base de dados, futuras avaliações no CASA poderão ser realizadas para esta espécie.   &nbsp

EFEITOS DA VITRIFICAÇÃO NA PRESERVAÇÃO MORFOLÓGICA DO TECIDO TESTICULAR DE GATO DOMÉSTICO

This study aimed to evaluate the effect of domestic cats (Felis Catus) testicular parenchyma vitrification by Ovarian Tissue Cryosystem and conventional straw. Three (n=3) adult cats were submitted to routine orchiectomy. For the vitrification, the samples were exposed to equilibrium solution composed by RPMI, containing 20% of ethylene glycol (EG) and 0,1M of sucrose at 20 °C, for 3 minutes. Subsequently, exposed to vitrification solution, containing RPMI added to 40% of EG and 0,1 M of sucrose at 20 °C, for 2 minutes. After devitrification, 10 seminiferous tubules of each treatment were analyzed by histology assay. The viability of spermatic and Sertoli cells were analysed with light histology, as well as the seminiferous tubules morphometry. The vitrified groups were inferior to the control group in the morphologically integral cells analysis. However, the OTC was superior to straw in terms of morphological preservation of the germinative cells. Nevertheless, in morphometric analysis there was no statistical difference between the treatments (control, OTC and straw). Therefore, the vitrification in OTC method showed better results than vitrification in straw based on histological evaluation of germ and Sertoli cells of domestic cats.Este estudo teve como objetivo avaliar o efeito da vitrificação do parênquima testicular de gatos domésticos (Felis Catus) pelo criossistema de tecido ovariano e palha convencional. Três (n=3) gatos adultos foram submetidos à orquiectomia de rotina. Para a vitrificação, as amostras foram expostas a solução de equilíbrio composta por RPMI, contendo 20% de etilenoglicol (EG) e 0,1M de sacarose a 20 °C, por 3 minutos. Posteriormente, expostos à solução de vitrificação, contendo RPMI adicionado a 40% de EG e 0,1 M de sacarose a 20 °C, por 2 minutos. Após a desvitrificação, 10 túbulos seminíferos de cada tratamento foram analisados por ensaio histológico. A viabilidade das células espermáticas e de Sertoli foram analisadas com histologia de luz, bem como a morfometria dos túbulos seminíferos. Os grupos vitrificados foram inferiores ao grupo controle na análise de células morfologicamente integrais. No entanto, o OTC foi superior à palha em termos de preservação morfológica das células germinativas. No entanto, na análise morfométrica não houve diferença estatística entre os tratamentos (controle, COT e palha). Portanto, a vitrificação em OTC apresentou melhores resultados do que a vitrificação em palha com base na avaliação histológica de células germinativas e de Sertoli de gatos domésticos

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Update on the Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Guideline of the Brazilian Society of Cardiology-2019

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