Real-World Data on the Adverse Metabolic Effects of Second-Generation Antipsychotics and Their Potential Determinants in Adult Patients: A Systematic Review of Population-Based Studies

This independent research and manuscript writing and editing activities were funded by unconditional grant from Angelini Pharma Espan˜a SLU. Angelini Pharma Espan˜a SLU also funded the journal’s rapid service fee.The authors thank Isabel San Andre´s (Incimed, Madrid, Spain) for performing the literature searchThis article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.Introduction To assess the risk of occurrence and potential determinants of metabolic disorders in adult patients treated with second-generation antipsychotics (SGAs) under real-world practice conditions. Methods MEDLINE, EMBASE, and PsycInfo were searched in July 2019 from database inception. We included population-based, longitudinal, comparative studies that report the results of the outcomes of interest for adult participants, including diabetes, ketoacidosis, hyperosmolar hyperglycemic state, weight gain/obesity, dyslipidemia, hypertension, and metabolic syndrome. Two reviewers independently extracted data on the study design, study quality, and study outcomes. Results We included 40 studies. Most studies showed that clozapine and olanzapine were associated with an increased likelihood of developing diabetes, while the results for risperidone and quetiapine were mixed. Although less well studied, ziprasidone and aripiprazole appeared to not be associated with the occurrence of diabetes. Information on antipsychotic-induced weight gain/obesity is extremely scarce. Regarding dyslipidemia, aripiprazole was not associated with an increased likelihood of developing dyslipidemia, clozapine was associated with an increased likelihood of developing dyslipidemia, and risperidone, olanzapine, quetiapine, and ziprasidone showed mixed results. Two studies suggested an association between ziprasidone and the occurrence of hypertension. Several studies found that the occurrence of a metabolic disorder acted as a risk factor for the development of other metabolic disorders. We did not find information on brexpiprazole, cariprazine, or lurasidone, and data on any long-acting SGA were lacking. Conclusion Although there are relevant differences among SGAs concerning the risk of metabolic disorders, it appears that none of the SGAs included in our review are fully devoid of these disturbances.Angelini Pharma Espana SL

Phylogenetic analysis of secondary metabolites in a plant community provides evidence for trade-offs between biotic and abiotic stress tolerance

Plants' responses to conflicting stresses may result in physiological trade-offs due to the inter-dependent and costly nature of physiological investments. Physiological tradeoffs have been proved within species, but to what extent these trade-offs are the result of phylogenetic constraints remains poorly known. Environmental stresses can vary widely in different biomes, and therefore assessing physiological tradeoffs across species must account for this variation. One way of doing so is to assess it within a community, where the co-occurring species have faced a shared combination of filters to establish. Considering a representative sample of species in a single community, we use a macroevolutionary approach to test the hypothesis that plant physiological trade-offs are evolutionarily conserved within this community (i.e., closely-related species tend to solve the trade-offs similarly). We analyze the content of five metabolites in thirty co-occurring plant species, capturing their range of contrasting exposures to abiotic and biotic stresses (growing solitary and in vegetation patches). Our results support that species investment in response to abiotic stress (i.e., proline and abscisic acid content) is traded off against their investment to face biotic stress (i.e., jasmonic acid and salicylic acid), shown by the contrasting loadings of these two groups of metabolites in the first axes of a principal component analysis (PCA). In addition, the metabolic strategies observed in this community are evolutionarily conserved, as closely related species tend to have similar scores in this PCA, and thus resemble each other in their balance. This is shown by a significant phylogenetic signal in the species’ scores along the first axes of the PCA. Incorporating the evolutionary history of plant species into physiological studies can help to understand the response of plants to multiple stresses currently acting in ecological communities

Factors Influencing Adherence to Training Programs in Gyms in the Northern Region of Santa Catarina, Brazil

Objective: Identify the factors that influence the adherence of Resisted Training programs in gyms located in the city of Guaratuba, Paraná/BR. Methodology: The design of the present study is cross-sectional. A total of 100 Resisted Training practitioners of both genders, aged between 18 and 75 years, participated in the research. The location for data collection included four gyms located in the city of Guaratuba-PR. Considering the nature of the research, it was chosen to apply a questionnaire adapted from Morales (2002), composed of opened and closed-ended questions. The instrument was composed with exposure variables of sociodemographic, economic, environmental factors, self-perception of lifestyle and health, stress levels indicators and physical activity. The SPSS® 16.0 program was used for statistical treatment. Considering the non-normality of the data distribution through the Kolmogorov-Smirnov test, Spearman’s correlation test was used and values of p<0.05 were considered significant.  Results: The present study showed three significant moderate correlations, demonstrating a joint variation of tobacco use with alcohol (0.655 with p-value<0.05), intake of high alcoholic beverages over others (0.802 with p-value<0.05), and men’s weekly workload (0.62 with p-value<0.05).  Conclusion: According to the obtained data, it’s possible to conclude through the significant moderate correlations, that the sociodemographic aspects and the identification of some behavioral risk factors related to the use of tobacco and alcoholic beverages, can influence the adherence to the training programs in gyms

Extranodal NK/T-cell lymphoma, nasal type with extensive cardiopulmonary involvement

Extranodal NK/T-cell lymphoma, nasal type (ENKTL-NT) is a rare type of Non-Hodgkin’s lymphoma, which usually presents with extranodal involvement and affects the nasal/upper aerodigestive tract in the classical presentation. Herein, we report the case of a 31-year-old, previously healthy, male patient diagnosed with ENKTL-NT with the involvement of the lung parenchyma and heart. Unfortunately, due to the rapid disease progression, the diagnosis was performed only at the autopsy. The authors highlight the rare clinical presentation of this type of lymphoma, as well as the challenging anatomopathological diagnosis in necrotic samples

Projeto de extensão natação na escola: implicações do período pandêmico / School swimming extension project: implications of the pandemic period

Objetivo: Este estudo teve por objetivo analisar os impactos das ações pedagógicas desenvolvidas por meio virtual durante o período de lockdown. Materiais e Métodos: Para esta pesquisa foi utilizado como modelo de investigação o método transversal. Participaram 136 indivíduos, sendo 73 pais/responsáveis, e 63 escolares. Como instrumento de pesquisa, foram utilizados dois questionários: um foi entregue para os pais/responsáveis e o outro aos escolares. Cada instrumento foi composto por nove perguntas fechadas, utilizando a Escala de Likert para classificação das respostas. Para organização da análise dos resultados, as questões foram organizadas em três categorias: “Atividades Práticas”, “Atividades Teóricas'' e “Compreensão Específica”. Os dados foram analisados através da estatística descritiva (apresentados em números absolutos, e percentuais), com tabulação e plotagem no programa Microsoft Excel® for Windows®10. Resultados: Ao analisarmos os resultados referente a  categoria “Atividades Práticas”, foi possível observar nos dois grupos (pais/responsáveis e escolares) a concordância e a relevância em se manter ativo no período de lockdown. No domínio “Atividades Teóricas”, os resultados evidenciados nos dois grupos demonstraram que as tarefas virtuais teóricas recomendadas influenciaram de forma positiva na ampliação dos conhecimentos dos escolares a respeito da modalidade e manutenção de hábitos saudáveis. Em relação a categoria “Compreensão Específica”, os grupos apresentaram a predominância de respostas  equivalentes, demonstrando  o entendimento da importância das atividades virtuais durante o período de lockdown. Conclusão: Diante das evidências encontradas neste estudo, foi possível constatar  pelos pais/responsáveis e escolares, o predomínio da aprovação das ações pedagógicas desenvolvidas por meio virtual  durante o período de lockdown do projeto de extensão Natesc

Efeitos da reabilitação cardiovascular sobre o índice de massa corporal e razão cintura/quadril de cardiopatas / Effects of cardiovascular rehabilitation on body mass index and waist/hip ratio of cardiopaths

Objetivo: A referida pesquisa almeja investigar os efeitos do programa de Reabilitação Cardiovascular (RCV) fase 3 da Univille sobre o Índice de Massa Corporal (IMC) e Razão Cintura/Quadril (RCQ) de cardiopatas após síndrome coronariana aguda. Materiais e Métodos: Este estudo trata-se de um ensaio clínico não randomizado de cunho quantitativo. A amostra foi composta por oito cardiopatas com média de idade de 71,25 ± 9,56 anos, de ambos os gêneros, que participaram do programa no ano de 2019. Foi realizado os cálculos de IMC e de RCQ pré e pós participação. Os dados foram coletados entre os meses de agosto e outubro de 2019, e armazenados em um banco de dados utilizando o Microsoft Excel® for Windows®10. O tratamento estatístico foi realizado através do software Statistica, versão 13. A normalidade da distribuição dos dados foi avaliada pelo Teste Shapiro Wilk’s e teste t de Student para observações dependentes, e o nível de significância adotado foi de p<0,05. Resultados: Mesmo tendo encontrado resultados não significativos do ponto de vista estatístico, foi observado um desfecho clínico favorável do RCQ de 25%, proporcionando a redução da porcentagem referente a quantidade de indivíduos que se mantinham fora do ponto de corte (classificação Ideal - “Baixo”). No IMC, para a classificação “obesidade” não se constatou alteração no grupo, porém, a classificação “sobrepeso” teve uma redução de 13%, consequentemente a classificação “adequado” aumentou de 25% para 38%, melhorando o IMC dos cardiopatas. Conclusão: Conclui-se que mesmo não obtendo resultados significativos estatisticamente nas variáveis de desfecho, foi possível observar a melhora clínica de alguns pacientes que se encontravam em um grupo de risco em relação ao RCQ e IMC e após a intervenção, migraram para a faixa de normalidade prevista no protocolo. 

American Gut: an Open Platform for Citizen Science Microbiome Research

McDonald D, Hyde E, Debelius JW, et al. American Gut: an Open Platform for Citizen Science Microbiome Research. mSystems. 2018;3(3):e00031-18

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

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio