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Old patients with hepatotoxicity have been scarcely studied in idiosyncratic drug-induced liver injury (DILI) cohorts. We sought for the distinctive characteristics of DILI in older patients across age groups. A total of 882 DILI patients included in the Spanish DILI Registry (33% ≥65 years) were categorized according to age: “young” (

Background: Hepatitis B virus (HBV) is a major cause of the liver disease that could lead to acute and chronic inflammation of the liver. In this study we collected anti HBC antibodies (anti hepatitis B core) results done as screening of blood donors from three hospital centers in Lebanon between Jan.2016to Jan.2019. The aim of this study is to collect epidemiological data on the prevalence of positive anti HBC antibodies in blood donors of different nationalities. Method: Blood donation records from the three hospitals were collected from Jan. 2016 till Jan. 2019 and they included 16000 volunteers for blood donation and all these donors were tested for anti HBC antibodies. Results: The total number of donors was 16000, 1224 volunteers (7.65%) had positive anti HBC test. The prevalence of anti HBC antibodies was higher in Syrian population with a prevalence of 12.9% as compared to the Lebanese donors with prevalence of 6.6%. Age was found to have a statistically significant relationship with the prevalence of hepatitis B. blood group was found not to have a statistically significant relationship with hepatitis B.

Objective:To investigate the influence of parental physical activity on offspring’s nutritional status in the 1993 Pelotas (Brazil) birth cohort.Design:Birth cohort study.Setting:The main outcomes were overweight and obesity status of children. The main exposure was parental physical activity over time, measured during the 11, 15 and 18 years of age follow-ups. The exposure was operationalised as cumulative, and the most recent measure before the birth of child. We adjusted Poisson regression models with robust variance to evaluate crude and adjusted associations between parental physical activity and offspring’s nutritional status. All analyses were stratified according to the sex of the parent.Participants:A total of 874 members from the 1993 Pelotas (Brazil) birth cohort followed-up at 22 years of age with their first-born child were analysed.Results:Children were, on average, 3·1 years old. Crude analyses showed that the mother’s cumulative physical activity measure had an indirect association with the prevalence of children’s obesity. The most recent maternal physical activity measure before the birth of the child was associated with 41 % lower prevalence of obesity in children, even after adjustment for confounders.Conclusions:The most recent maternal physical activity measure was indirectly associated with the prevalence of obesity in children. No associations were found for fathers, reinforcing the hypothesis of a biological effect of maternal physical activity on offspring’s nutritional status.

To analyze and compare the activity of the sternocleidomastoid muscle in preterm infants with bronchopulmonary dysplasia, preterm infants without bronchopulmonary dysplasia, and healthy full-term infants. A cross-sectional study was conducted with 21 infants in the first year of life, categorized into three groups: preterm infants with BPD (GBPD); preterm infants without BPD (GPT); and control group (GC) with healthy full-term infants. The band frequency (BAND), coefficient of variation (CV), median frequency of the signal (F50), and root mean square (RMS) of the surface electromyography (EMG) signal were calculated. The comparison of sternocleidomastoid (SM) activity showed lower F50 (p = 0.028) for GBPD when compared to GC; there was no statistical difference between the other features and the respective comparisons between the groups. Regarding the effect size, the results showed that there is a very large effect size between GBPD and GC in feature F50 (ES = 1.2). Additionally, there is a moderate effect size (ES = 0.5) in the features BAND (between GPT and GC), CV (between GBPD and GC), F50 (between GPT and GC), and RMS (between GPT and GC). The other comparisons have a small or very small effect size. Infants with BPD have lower F50 of the SM, in relation to full-term infant group. There was no statistical difference between the other features and the respective comparisons between the groups.

The use robotics in surgery is gaining momentum. This approach holds substantial promise in pancreas surgery. Robotic surgery for pancreatic lesions and malignancies has become well accepted and is expanding to more and more center annually. The number of centers using robotics in pancreatic surgery is rapidly increasing. The most studied robotic pancreas surgeries are pancreaticoduodenectomy and distal pancreatectomy. Most studies are in their early phases, but they report that robotic pancreas surgery is safe feasible. Robotic pancreas surgery offers several advantages over open and laparoscopic techniques. Data regarding costs of robotics versus conventional techniques is still lacking. Robotic pancreas surgery is still in its early stages. It holds promise to become the new surgical standard for pancreatic resections in the future, however, more research is still needed to establish its safety, cost effectiveness and efficacy in providing the best outcomes.

We assessed the associations of social distancing and mask use with symptomatic, laboratory-confi rmed severe acute respiratory syndrome coronavirus 2 infection in Porto Alegre, Brazil. We conducted a population-based casecontrol study during April–June 2020. Municipal authorities furnished case-patients, and controls were taken from representative household surveys. In adjusted logistic regression analyses of 271 case-patients and 1,396 controls, those reporting moderate to greatest adherence to social distancing had 59% (odds ratio [OR] 0.41, 95% CI 0.24– 0.70) to 75% (OR 0.25, 95% CI 0.15–0.42) lower odds of infection. Lesser out-of-household exposure (vs. going out every day all day) reduced odds from 52% (OR 0.48, 95% CI 0.29–0.77) to 75% (OR 0.25, 95% CI 0.18–0.36). Mask use reduced odds of infection by 87% (OR 0.13, 95% CI 0.04–0.36). In conclusion, social distancing and mask use while outside the house provided major protection against symptomatic infection.

This manuscript aims to present the recommendations of physical activity for pregnant and postpartum women developed for the Physical Activity Guidelines for the Brazilian Population. A mixed-method approach that included four steps was used: 1) review of the most recent international guidelines for physical activity during pregnancy; 2) narrative literature review on the effects of physical activity during pregnancy on the health of the woman and the baby; 3) consultation with pregnant women, postpartum women, professionals and researchers; 4) public consultation. The summarized evidence supports that physical activity during pregnancy and in the postpartum is safe, has benefits to the health of the mother and baby, and reduces the risks of some complications related to pregnancy. Pregnant women should be encouraged to do at least 150 minutes a week of moderate intensity physical activity. Pregnant women with contraindications should seek help from qualified professionals. In some cases, physical activity during pregnancy is not recommended. This document will be used as a tool to guide health professionals who work with pregnant women and women in the postpartum period. Also, it will inform and guide women during pregnancy and postpartum about the benefits of physical activity.

This paper describes the process of establishing physical activity recommendations for children up to five years old included in the Physical Activity Guidelines for the Brazilian Population. The development of these recommendations was based on the guidelines proposed by the World Health Organization in 2019. Theoretical support was gathered by using the following strategies: scoping review conducted to update the body of knowledge about the correlates and determinants of physical activity in children 0-5 years old; 2-synthesis of the existing national physical activity guidelines; 3-online interviews with parents and teachers aiming to identify their degree of difficulty in understanding the recommendations contained in the World Health Organization Physical Activity guidelines and to identify barriers and strategies for improving the involvement of children in physical activities; and, 4-public consultation. All actions were developed in the period from May to December 2020, by a working group composed of researchers with expertise in this field and representatives of the Ministry of Health. As a result, a total of 35 recommendations were included in the Brazilian guidelines, 10 of which were related to benefits, four to the dose, seven to the types of activities, seven to the strategies for improving practice, and seven others related to the reduction of sedentary behavior. When relevant and possible, these recommendations were differentiated for children from birth to one year of age, 1-2 years, and 3-5 years. The main message is that any physical activity is better than none and that sedentary behavior should be reduced.

Visando orientar a população dos benefícios da prática de atividade física à saúde, pesquisadores nacionais, em parceria com o Ministério da Saúde, elaboraram o Guia de Atividade Física para a População Brasileira (Guia). O objetivo deste estudo foi apresentar o processo de elaboração das recomendações brasileiras de atividade física para pessoas com deficiência (PCD). O processo de elaboração das recomendações específicas para PCD foi liderado por um grupo de trabalho com nove pesquisadores/profissionais que realizaram reuniões semanais, e que conduziram revisões sistemáticas e escutas com PCD, familiares, gestores, profissionais da saúde, professores e pesquisadores. Na revisão sistemática, um total de 83 estudos foram revisados e incluídos. As escutas foram realizadas por meio de formulários eletrônicos enviados por e-mail para profissionais, gestores, professores e pesquisadores que trabalhavam com PCD e de escutas virtuais, as quais foram conduzidas em dois momentos: (a) com PCD, familiares e profissionais; (b) com professores, gestores; e pesquisadores da temática. Baseado nos resultados das revisões sistemáticas e das escutas, as recomendações de atividade física para PCD foram elaboradas considerando o tempo mínimo de atividade física de acordo com faixas etárias, domínio da atividade física e recomendações para redução do comportamento sedentário. Portanto, o presente trabalho apresentou as estratégias e as etapas utilizadas para a elaboração do Guia, com recomendações de atividade física para PCD, as quais podem ser aliadas a políticas públicas, ambientes e oportunidades de atividade física, tornando-se estratégia essencial para o engajamento de PCD em atividades físicas.

Objective: The aim of this paper is to illustrate the main points of interest regarding the way treatment of infertility impacts the life of couples who struggle with this condition in Romania. The unique aspects and specific challenges regarding social, financial and psychological implications that affect Romanian couples who access specialized treatment for infertility will be thoroughly discussed. Methods: This study is a descriptive cross-sectional research. The sample population included patients who attended specialized infertility treatment (Assisted Reproductive Techniques - ART) in Fertility Clinics from Romania. The study was conducted between 2017 and 2019 and data was gathered through two infertility questionnaires. Results: The questionnaire for women was filled in by 829 female participants who struggled with infertility and resorted to ART and the questionnaire for men was completed by 227 male participants, as partners of the women, some of them as well with fertility issues. We analysed the results regarding all aspects surrounding infertility and ART, such as: psychological implications, impact of stress, access to specialized treatment, costs for treatment. Conclusion: The results showed that couples who struggle with infertility have to deal with high costs for specialized infertility treatments, in addition to stress related to treatment, creating a combination which negatively impacts their future chances of getting a pregnancy.

Motivation Identifying histone tail modifications using ChIP-seq is commonly used in time-series experiments in development and disease. These assays, however, cover specific time-points leaving intermediate or early stages with missing information. Although several machine learning methods were developed to predict histone marks, none exploited the dependence that exists in time-series experiments between data generated at specific time-points to extrapolate these findings to time-points where data cannot be generated for lack or scarcity of materials (i.e. early developmental stages). Results Here, we train a deep learning model named TempoMAGE, to predict the presence or absence of H3K27ac in open chromatin regions by integrating information from sequence, gene expression, chromatin accessibility and the estimated change in H3K27ac state from a reference time-point. We show that adding reference time-point information systematically improves the overall model’s performance. In addition, sequence signatures extracted from our method were exclusive to the training dataset indicating that our model learned data-specific features. As an application, TempoMAGE was able to predict the activity of enhancers from pre-validated in-vivo dataset highlighting its ability to be used for functional annotation of putative enhancers. Availability and implementation TempoMAGE is freely available through GitHub at https://github.com/pkhoueiry/TempoMAGE. Supplementary information Supplementary data are available at Bioinformatics online.

Mass casualty incidents can be devastating events associated with a large number of fatalities, morbidities, and long-lasting sequelae. The negative outcomes can be further amplified if the incident occurred during a pandemic surge, such as what occurred in Beirut, Lebanon with the August 4, 2020 Beirut Port explosion. To decrease the mortality and morbidity and avoid inefficiency, management depends on having an established coordinated multidisciplinary approach from transport and triage to emergency department care and in-hospital management. In this article, the mass casualty management and the impact of the coronavirus disease 2019 pandemic will be discussed based on the American University of Beirut Medical Center experience.

ObjectiveTo examine the joint associations of daily time spent in different intensities of physical activity, sedentary behaviour and sleep with all-cause mortality.MethodsFederated pooled analysis of six prospective cohorts with device-measured time spent in different intensities of physical activity, sedentary behaviour and sleep following a standardised compositional Cox regression analysis.Participants130 239 people from general population samples of adults (average age 54 years) from the UK, USA and Sweden.Main outcomeAll-cause mortality (follow-up 4.3–14.5 years).ResultsStudies using wrist and hip accelerometer provided statistically different results (I2=92.2%, Q-test pConclusionThis federated analysis shows a joint dose–response association between the daily balance of time spent in physical activity of different intensities and sedentary behaviour with all-cause mortality, while sleep duration does not appear to be significant. The strongest association is with time spent in moderate to vigorous physical activity, but it is modified by the balance of time spent in light physical activity relative to sedentary behaviour.

Drug repurposing has lately received increasing interest in several diseases especially in cancers, due to its advantages in facilitating the development of new therapeutic strategies, by adopting a cost-friendly approach and avoiding the strict Food and Drug Administration (FDA) regulations. Acriflavine (ACF) is an FDA approved molecule that has been extensively studied since 1912 with antiseptic, trypanocidal, anti-viral, anti-bacterial and anti-cancer effects. ACF has been shown to block the growth of solid and hematopoietic tumor cells. Indeed, ACF acts as an inhibitor of various proteins, including DNA-dependent protein kinases C (DNA-PKcs), topoisomerase I and II, hypoxia-inducible factor 1α (HIF-1α), in addition to its recent discovery as an inhibitor of the signal transducer and activator of transcription (STAT). Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder characterized by the expression of the constitutively active tyrosine kinase BCR-ABL. This protein allows the activation of several signaling pathways known for their role in cell proliferation and survival, such as the JAK/STAT pathway. CML therapy, based on tyrosine kinase inhibitors (TKIs), such as imatinib (IM), is highly effective. However, 15% of patients are refractory to IM, where in some cases, 20-30% of patients become resistant. Thus, we suggest the repurposing of ACF in CML after IM failure or in combination with IM to improve the anti-tumor effects of IM. In this review, we present the different pharmacological properties of ACF along with its anti-leukemic effects in the hope of its repurposing in CML therapy.

Objective: To evaluate the correlation between the prevalence of overweight condition and obesity with mortality rates due to COVID-19 in Brazil's state capitals. Materials and methods: This is an ecological study, whose units of analysis were the 26 state capitals and the Federal District of Brazil. Prevalence was estimated by the results of the Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico 2019 (VIGITEL). The general mortality rates due to COVID-19 were collected on the official website of the Brazilian Ministry of Health (MH) and stratified by the same Brazilian capitals evaluated in the VIGITEL survey. The rates included the period between the 1st and 29th Epidemiological Weeks of 2020. The Partial Correlation Test (r) was used, controlled for confounding factors, to evaluate the correlation between the prevalence of overweight/obesity and the overall mortality rates due to COVID-19. Results: The mean mortality rate for COVID-19 in the period was 65.1 deaths per 100,000 inhabitants. Regarding the prevalence of obesity and overweight, 20.2% and 54.7% were the mean values observed in the state capitals, respectively. The prevalence of obesity was positively correlated with the overall mortality rate due to COVID-19, with mean positive correlation (r=0.380) and statistically significant correlation (p=0.034). Conclusion: This study pointed out that, at the aggregate level, there is a concomitant and correlated increase in mortality rates due to COVID-19 and prevalence of obesity in Brazilian capitals. The data found may contribute to actions to cope with the pandemic aimed at this population.

Background/aims As the popularity of sports activities grows, so do the number of sport-related injuries. Furthermore, sports that use equipment or vehicles that modify the speed of the player can present more serious injuries. The aim of this systematic review was to identify the overall prevalence of orofacial trauma in wheeled non-motor sports athletes. Methods The search strategy was applied in eight electronic databases (Embase, LILACS, Livivo, PEDro, PubMed, Scopus, SportDiscus, and Web of Science). Additionally, a complementary search of the gray literature (Google Scholar, OpenGrey, and ProQuest Dissertations & Theses Global), reference lists of included articles, and studies indicated by experts on the subject was done. The included articles were observational studies with sufficient data of orofacial trauma (type and anatomical site) in wheeled non-motor sport athletes, regardless of the competition level. Risk of bias was assessed by using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. The meta-analysis was performed using R Statistics software, and the strength of cumulative evidence was assessed by The Grading of Recommendations Assessment, Development, and Evaluation. Results From 4042 identified studies, after the removal of duplicates and phase one of selection (title and abstracts screening), 251 studies remained for phase two (full-text screening). Five articles were finally included. One study was considered to have a low risk of bias and four had a moderate risk of bias. The cumulative prevalence of orofacial injuries in wheeled non-motor sport athletes was 21.7% (CI: 8.7-34.7; I2 :97.6%) and the prevalence of dental injuries in these sports was 7.5% (CI:4.3-10.7; I2 :61.9%). The certainty in cumulative evidence was considered to be very low. Conclusion About 22% of the wheeled non-motor sport athletes have suffered orofacial injuries. The most prevalent type of injury was classified as dental trauma.

The objective of this systematic review was to answer the question: “Is there association between obstructive sleep apnea (OSA) and health-related quality of life (HRQoL) in untreated adults?” We included observational studies that evaluated the health-related quality of life of patients with OSA vs control groups, through generic and disease-specific questionnaires. The searches were conducted in six databases: Embase, Lilacs, PsycINFO, PubMed, Scopus, and Web of Science. Additional search in the grey literature and hand search were performed, and also experts were consulted. Risk of bias was performed by using Joanna Briggs Institute Critical Appraisal Checklist for cross-sectional, cohort, and case-control studies. We analyzed the data using a narrative synthesis. The Grading of Recommendations Assessment, Development, and Evaluation evidence profile was used to verify the overall certainty of the assessed evidence. Nineteen studies were included for qualitative analysis. Generic questionnaires showed worse HRQoL in the OSA group compared to the control group in at least one domain of the HRQoL questionnaires. The affected domains that showed statistical and clinically relevant differences were physical functioning, physical role, pain, general health, vitality, emotional role, and mental health. The certainty of evidence assessment was very low. The available literature suggests that OSA in untreated adults is associated with worse HRQoL. However, this association seems to disappear when we consider only studies adjusted for related covariates. CRD42018114746.

Background National, regional and global scientific production and research capacity for physical activity - PA may contribute to improving public health PA policies and programs. There is an uneven distribution of research productivity by region and country income group, where countries with the highest burden of non-communicable diseases attributable to physical inactivity having low research productivity. A first step towards improving global research capacity is to objectively quantify patterns, trends, and gaps in PA research. This study describes national, regional and global trends and patterns of PA research from 1950 to 2019. Methods A systematic review using searches in PubMed, SCOPUS and ISI Web of Knowledge databases was conducted in August 2017 and updated between January and May 2020. The review was registered at the PROSPERO database number CRD42017070153. PA publications per 100,000 inhabitants per country was the main variable of interest. Descriptive and time-trend analyses were conducted in STATA version 16.0. Results The search retrieved 555,468 articles of which 75,756 were duplicates, leaving 479,712 eligible articles. After reviewing inclusion and exclusion criteria, 23,860 were eligible for data extraction. Eighty-one percent of countries (n = 176) had at least one PA publication. The overall worldwide publication rate in the PA field was 0.46 articles per 100,000 inhabitants. Europe had the highest rate (1.44 articles per 100,000 inhabitants) and South East Asia had the lowest (0.04 articles per 100,000 inhabitants). A more than a 50-fold difference in publications per 100,000 inhabitants was identified between high and low-income countries. The least productive and poorest regions have rates resembling previous decades of the most productive and the richest. Conclusion This study showed an increasing number of publications over the last 60 years with a growing number of disciplines and research methods over time. However, striking inequities were revealed and the knowledge gap across geographic regions and by country income groups was substantial over time. The need for regular global surveillance of PA research, particularly in countries with the largest data gaps is clear. A focus on the public health impact and global equity of research will be an important contribution to making the world more active.

Background Prolonged sitting time is a risk factor for chronic disease, yet recent global surveillance is not well described. The aims were to clarify: (i) the countries that have collected country-level data on self-reported sitting time; (ii) the single-item tools used to collect these data; and (iii) the duration of sitting time reported across low- to high-income countries. Methods Country-level data collected within the last 10 years using single-item self-report were included. The six-stage methodology: (1) reviewing Global Observatory for Physical Activity! Country Cards; (2–4) country-specific searches of PubMed, the Demographic and Health Survey website and Google; (5) analysing the Eurobarometer 88.4; and (6) country-specific searches for World Health Organization STEPwise reports. Results A total of 7641 records were identified and screened for eligibility. Sixty-two countries (29%) reported sitting time representing 47% of the global adult population. The majority of data were from high-income (61%) and middle income (29%) countries. The tools used were the International Physical Activity Questionnaire (IPAQ; n = 34), a modified IPAQ (n = 1) or the Global Physical Activity Questionnaire (GPAQ; n = 27). The median of mean daily sitting times was 4.7 (IQR: 3.5–5.1) hours across all countries. Higher-income countries recorded a longer duration of sitting time than lower-income countries (4.9 vs 2.7 h). Conclusions This study provides an updated collation of countries collecting self-reported sitting time data. The daily sitting time findings should be interpreted cautiously. Current surveillance of sitting time is limited by a lack of coverage. Measures of population sitting time that are valid, feasible and sensitive to change should be embedded within global surveillance systems, to help guide future policy, research and practice. Trial registration Not applicable.

Background: Many of the known solutions to the physical inactivity pandemic operate across sectors relevant to the United Nations Sustainable Development Goals (SDGs). Methods: The authors examined the contribution of physical activity promotion strategies toward achieving the SDGs through a conceptual linkage exercise, a scoping review, and an agent-based model. Results: Possible benefits of physical activity promotion were identified for 15 of the 17 SDGs, with more robust evidence supporting benefits for SDGs 3 (good health and well-being), 9 (industry, innovation, and infrastructure), 11 (sustainable cities and communities), 13 (climate action), and 16 (peace, justice, and strong institutions). Current evidence supports prioritizing at-scale physical activity-promoting transport and urban design strategies and community-based programs. Expected physical activity gains are greater for low-and middle-income countries. In high-income countries with high car dependency, physical activity promotion strategies may help reduce air pollution and traffic-related deaths, but shifts toward more active forms of travel and recreation, and climate change mitigation, may require complementary policies that disincentivize driving. Conclusions: The authors call for a synergistic approach to physical activity promotion and SDG achievement, involving multiple sectors beyond health around their goals and values, using physical activity promotion as a lever for a healthier planet.

The recent study was aimed to estimate the prevalence and develop the relationship of the clinical history like diabetes, cardiac disease and vitamin D deficiency and obesity and their impact on metabolic disorders for adolescent residing near Dawadmi and Shaqra region. Two hundred samples (142 Females & 58 Males) were utilized in the study with an age ranging 13-20 and distributed the questionnaire to record the responses. The results exhibited that 38% subjects responded positively for clinical history with cardiac disease, while 70.5 and 47% responded positively for the clinical history with diabetes and vitamin D deficiency. The clinical history with diabetes, cardiac disease and vitamin D deficiency was observed the major risk factors acting in descending order diabetes-cardiac disease-vitamin D deficiency.

COVID-19 caught everyone by surprise, and the situation quickly escalated from epidemic to pandemic. By February 21, 2020, the first positive case was reported in Lebanon, and following that, by March 12, 2020, the decision to close all educational institutes was put into effect. Online learning is not an approved form of education in Lebanon, which meant that none of the Lebanese universities was prepared to make a complete shift from face-to-face learning to online learning. Immediate actions were taken at the Lebanese International University starting at the level of the University Council, all the way to the level of individual departments. The approach of the Department of Biological and Chemical Sciences is best described as “break barriers, build bridges, and launch transitions”. An initial assessment of strengths and weaknesses helped the department develop a model of online learning that took advantage of the readily available online tools (e.g., Google Classroom) while modifying the format of content delivery and assessment with the minimal potential for disruption by inadequate Internet, interruptions in electricity, and limited access to expensive hardware and software. A SWOT analysis of the model was done based on the survey that was given to the chemistry instructors in the department while taking into consideration the emails and comments received by students.

Population-based data on COVID-19 are urgently needed. We report on three rounds of probability sample household surveys in the state of Rio Grande do Sul (Brazil), carried out in nine large municipalities using the Wondfo lateral flow point-of-care test for immunoglobulin M and G antibodies against SARS-CoV-2 (https://en.wondfo.com.cn/product/wondfo-sars-cov-2-antibody-test-lateral-flow-method-2/). Before survey use, the assay underwent four validation studies with pooled estimates of sensitivity (84.8%; 95% confidence interval (CI) = 81.4-87.8%) and specificity (99.0%; 95% CI = 97.8-99.7%). We calculated that the seroprevalence was 0.048% (2/4,151; 95% CI = 0.006-0.174) on 11-13 April (round 1), 0.135% (6/4,460; 95% CI = 0.049-0.293%) on 25-27 April (round 2) and 0.222% (10/4,500; 95% CI = 0.107-0.408) on 9-11 May (round 3), with a significant upward trend over the course of the surveys. Of 37 family members of positive individuals, 17 (35%) were also positive. The epidemic is at an early stage in the state, and there is high compliance with social distancing, unlike in other parts of Brazil. Periodic survey rounds will continue to monitor trends until at least the end of September, and our population-based data will inform decisions on preventive policies and health system preparedness at the state level.

Objective: To describe the dietary patterns and occurrence of metabolic disorders in children and adolescents with urolithiasis treatment at a referral hospital in southern Brazil in order to learn the features of urolithiasis in this population to better develop preventive actions. Methods: Descriptive study conducted between 2016 and 2017 in a tertiary care referral hospital. Fourty patients aged 2-19 years old with urolithiasis proven by imaging were included. Clinical and dietary data were obtained through interviews and medical records. For statistical analyses, the chi-squared test was performed. Results: 40 individuals were analyzed. Mean age at diagnosis was 7.2 ± 4 years. 25% were overweight or obese. 95% had metabolic disorders, hypocitraturia being the predominant type. Protein intake was adequate in all participants and carbohydrate intake, in 70% of them; 37.5% had lipid intake above recommended and 65% had low fiber intake. The mean daily sodium intake was 2.64 g (±1.74), with 55% of participants ingesting more than the recommended amount. A total of 52.5% had low potassium intake, with a mean of 4.79 g/day (±2.49). Calcium intake was adequate in 27.5%. No significant differences were identified in relation to mean daily consumption among participants with or without the various metabolic disorders. Conclusion: Pediatric urolithiasis is often accompanied by metabolic disorders; therefore, metabolic evaluation should be part of the diagnostic process and subsequent analysis of these patients' dietary patterns, helping to optimize treatment and prevent recurrences and complications. Resumo Objetivo: Descrever o padrão alimentar e a ocorrência de distúrbios metabólicos em crianças e adolescentes portadoras de urolitíase acompanhadas em hospital de referências no sul do Brasil a fim de conhecer as particularidades da urolitíase nessa população para melhor desenvolver ações de prevenção. Métodos: Estudo observacional descritivo realizado entre 2016 e 2017 em centro de referência em atenção terciária. Foram selecionados 40 pacientes de dois a 19 anos com urolitíase comprovada por exame de imagem. Dados clínicos e alimentares foram obtidos através de prontuário e entrevista. Para análise estatística, utilizou-se o teste qui-quadrado. Resultados: Foram analisados 40 indivíduos, 55% masculinos. Idade média ao diagnóstico 7,2 ± 4 anos; 25% tinham sobrepeso ou obesidade; 95% tinham distúrbios metabólicos, predominou a hipocitratúria. O consumo proteico e de carboidratos foi adequado em 100% e 70% dos participantes, respectivamente, 37,5% apresentaram ingestão de lipídeos acima do recomendado e 65% apresentaram ingestão de fibras alimentares abaixo do recomendado. O consumo diário médio de sódio foi de 2,64 g (± 1,74), com 55% acima do recomendado; 52,5% apresentaram baixa ingestão de potássio com média de 4,79 g/dia (± 2,49). O consumo de cálcio foi adequado em 27,5%. Não foram identificadas diferenças significativas em relação ao consumo médio diário dos nutrientes entre os participantes com ou sem os diversos distúrbios metabólicos. Conclusões: A urolitíase pediátrica é frequentemente acompanhada de distúrbios metabólicos, o que confirma a necessidade de avaliação metabólica adequada ao diagnóstico e análise do padrão alimentar a fim de identificar erros alimentares, aprimorar o tratamento desses distúrbios e prevenir recorrências e complicações.

Objective: To assess the prevalence, mortality and risk factors associated with the birth of very low birth weight preterm infants over a period of 33 years. Methods: Four cross‐sectional studies were analyzed, using data from perinatal interviews of birth cohorts in the city of Pelotas collected in 1982, 1993, 2004, and 2015. Based on perinatal questionnaires, anthropometric measurements of newborns and death certificates were analyzed to obtain the prevalence rate, neonatal mortality, and risk factors (maternal age, income and type of delivery) for very low birth weight. Results: A total of 19,625 newborns were included in the study. In the years 1982, 1993, 2004, and 2015, there were, respectively, 5909, 5232, 4226, and 4258 births. The prevalence of very low birth weight was, respectively, 1.1% (n = 64), 0.9% (n = 46), 1.4% (n = 61), and 1.3% (n = 54). There was no statistical evidence of an increasing trend over time (p = 0.11). Among the risk factors, family income in the three poorest quintiles was associated with prevalence rates that were approximately twice as high as in the richest quintile (p = 0.003). Mortality per 1000 live births for neonates weighing

OBJECTIVE To evaluate the prevalence of reports of symptoms of COVID-19 among individuals with and without antibodies and identify those with greater capability to predict the presence of antibodies against SARS-CoV-2. METHODS The study uses data collected in phases 5 to 8 of Epicovid-19-RS. The presence of antibodies against SARS-CoV-2 was evaluated by a rapid test. The occurrence of cough, fever, palpitations, sore throat, difficulty breathing, changes in taste and smell, vomiting, diarrhea, body pain, shaking, and headache since March 2020 was also evaluated. Then, the capability to predict the evaluated symptoms concerning the presence of antibodies was calculated. RESULTS A total of 18,000 individuals were interviewed and 181 had antibodies against COVID-19 in phases 5 to 8. The proportion of asymptomatic individuals was 19.9% among participants with antibodies and 49.7% among those without antibodies. All symptoms were reported more frequently by individuals with antibodies. The division of the prevalence of symptoms among individuals with antibodies by the prevalence among individuals without antibodies showed the following prevalence ratios: for changes in smell or taste (9.1), fever (4.2), tremors (3.9), breathing difficulty (3.2) and cough (2.8 times). Anosmia and fever were the symptoms with a greater capability to predict the presence of antibodies. CONCLUSION The prevalence of symptoms was higher among individuals with antibodies against SARS-CoV-2. The proportion of asymptomatic individuals was low. Altered smell or taste and fever were the symptoms that most predict the presence of antibodies. These results can help to identify probable cases, contributing to the clinical diagnosis and screening of patients for testing and isolation guidance in positive cases, especially in scenarios of the scarcity of diagnostic COVID-19 tests. RESUMO OBJETIVO Avaliar prevalência de relato de sintomas característicos de covid-19 entre indivíduos com e sem anticorpos e identificar aqueles com maior capacidade de predição da presença de anticorpos contra o SARS-CoV-2. MÉTODOS O presente estudo usa dados coletados nas fases de 5 a 8 do Epicovid-19-RS. A presença de anticorpos contra o SARS-CoV-2 foi avaliada por um teste rápido. Avaliou-se também a ocorrência dos sintomas tosse, febre, palpitações, dor de garganta, dificuldade para respirar, alterações no paladar e olfato, vômito, diarreia, dor no corpo, tremedeira e dor de cabeça, desde março de 2020. Então, calculou-se a capacidade de predição dos sintomas avaliados em relação a presença de anticorpos. RESULTADOS Nas fases de 5 a 8, 18 mil indivíduos foram entrevistados e 181 apresentaram anticorpos contra covid-19. A proporção de indivíduos assintomáticos foi de 19,9% entre participantes com anticorpos e 49,7% entre aqueles sem anticorpos. Todos os sintomas foram relatados com maior frequência por indivíduos com presença de anticorpos. A divisão da prevalência de sintomas entre indivíduos com anticorpos pela prevalência entre indivíduos sem anticorpos evidenciou as seguintes razões de prevalência: para alterações de olfato ou paladar (9,1), febre (4,2), tremedeira (3,9), dificuldade respiratória (3,2) e tosse (2,8 vezes). Anosmia e febre foram os sintomas com maior capacidade de predizer a presença de anticorpos. CONCLUSÃO A prevalência de sintomas foi maior entre indivíduos com anticorpos contra SARS-CoV-2. A proporção de indivíduos assintomáticos foi baixa. Alteração de olfato ou paladar e febre foram os sintomas que mais predizem a presença de anticorpos. Esses resultados podem auxiliar a identificação de casos prováveis, contribuindo para o diagnóstico clínico e triagem de pacientes para testagem e orientação de isolamento em casos positivos, especialmente em cenários de escassez de testes diagnósticos de covid-19.

Hepatic hydatid cysts are benign cysts in the liver that are the result of parasites infection. They are caused by echinoccocus granulosis or multilocularis. They caused several symptoms like pain, obstructive jaundice, and sepsis. Hydatid cyst can be complicated to cystobiliary communication (CBC) which can be frank CBC or occult CBC. Medical, endoscopic, percutaneous and surgical treatments are different approaches to treat hydatid cyst. Here we report a case of hepatic hydatid cyst with cystobiliary communication, causing obstructive jaundice and treated with sphincterotomy and insertion of biliary stent through endoscopic retrograde cholangiopancreatography (ERCP).

Immunocompromised individuals show lower vaccine immunogenicity, which may be modulated by physical activity. This prospective cohort study within a phase-4 vaccination trial investigated whether physical activity is associated with enhanced immunogenicity of Coronavac (SARS-CoV-2 inactivated vaccine) in patients with autoimmune rheumatic diseases (ARD) (n=898) and non-ARD (n=197) individuals without pre-existing immunogenicity to SARS-CoV-2 after receiving a two-dose vaccine schedule. Seroconversion rates of total anti-SARS-CoV-2 S1/S2 IgG (SC), geometric mean titers of anti-S1/S2 IgG (GMT), factor-increase in GMT (FI-GMT), frequency of neutralizing antibody (NAb), and median neutralizing activity were assessed. After controlling for covariates, active patients (≥150 min/week) exhibited greater SC (OR: 1.4 [95%CI: 1.1-2.0]), GMT (32% [95%CI: 8.8-60) and FI-GMT (33% [95%CI: 9.6-63%]) vs. inactive. Cluster analysis (physical activity/sedentary status) revealed greater GMT (43.0% [95% CI: 11.0-84.0%) and FI-GMT (48.0% [95%CI: 14.0-92.0%]) in active/non-sedentary (≥150 min/week/8h/day) ARD. A dose-response was observed, with greater benefits for ≥350 min/week of physical activity (OR: 1.6 [95%CI: 1.1-2.4]; 41% [95%CI: 10-80%]; 35% [95%CI: 4.3-74], for SC, GMT, and FI-GMT, respectively). Greater SC (OR: 9.9 [95%CI: 1.1-89.0]) and GMT (26% [95%CI: 2.2-56.0%]) were observed in active vs. inactive non-ARD. A physically active lifestyle may enhance SARS-CoV-2 vaccine immunogenicity, a finding of particular clinical relevance for immunocompromised individuals.

Background Large-scale epidemiological studies of seroprevalence of antibodies against SARS-CoV-2 often rely on point-of-care tests that provide immediate results to participants. Yet, little is known on how long rapid tests remain positive after the COVID-19 episode, or how much variability exists across different brands and even among batches of the same test. Methods In November 2020, we assessed the sensitivity of three tests applied to 133 individuals with a previous positive PCR result between April and October. All subjects provided finger prick blood samples for two batches (A and B) of the Wondfo lateral-flow IgG/IgM test, and dried blood spot samples for the S-UFRJ ELISA test. Results Overall sensitivity levels were 92.5% (95% CI 86.6–96.3), 63.2% (95% CI 54.4–71.4) and 33.8% (95% CI 25.9–42.5) for the S-UFRJ test, Wondfo A and Wondfo B tests, respectively. There was no evidence of a decline in the positivity of S-UFRJ with time since the diagnosis, but the two Wondfo batches showed sharp reductions to as low as 41.9% and 19.4%, respectively, for subjects with a positive PCR in June or earlier. Positive results for batch B of the rapid test were 35% to 54% lower than for batch A at any given month of diagnosis. Interpretation Whereas the ELISA test showed high sensitivity and stability of results over the five months of the study, both batches of the rapid test showed substantial declines, with one of the batches consistently showing lower sensitivity levels than the other. ELISA tests based on dried-blood spots are an inexpensive alternative to rapid lateral-flow tests in large-scale epidemiological studies. Funding The study was funded by the “Todos Pela Saude” initiative, Instituto Serrapilheira, Brazilian Ministry of Health, Brazilian Collective Health Association (ABRASCO) and the JBS S.A. initiative ‘Fazer o Bem Faz Bem’.

Nosso objetivo foi avaliar a validade e a clareza dos conceitos e terminologias adotados na elaboração do Guia de Atividade Física para a População Brasileira (Guia). O Grupo de Trabalho Domínios da Atividade Física (GT Domínios) conduziu a avaliação da validade e da clareza dos conceitos e terminologias relacionados a atividade física (AF), comportamento sedentário, domínios (tempo livre, deslocamento, trabalho ou estudo e tarefas domésticas) e intensidades da AF (leve, moderada e vigorosa), em três etapas: 1- Proposição dos conceitos; 2- Escuta com pesquisadores (dois momentos); 3- Consulta pública. Os conceitos propostos pelo GT Domínios foram baseados em guias internacionais, artigos científicos, relatórios nacionais e conhecimentos técnico-científicos-acadêmicos dos integrantes do GT Domínios, discutidos em reuniões (etapa 1). Na escuta com pesquisadores (etapa 2) foram testadas a validade e a clareza dos conceitos em dois momentos. Participaram 70 e 40 pesquisadores vinculados aos outros GT do Guia no primeiro e segundo momentos, respectivamente. Em ambas as escutas, todos os conceitos apresentaram índice de concordância para validade e clareza igual ou superior a 80%. As sugestões convergentes indicadas na etapa 2 foram incluídas e novas versões dos conceitos foram disponibilizadas para a terceira etapa (consulta pública), realizada pelo Ministério da Saúde. Foram realizadas 14 sugestões relacionadas aos conceitos que foram aceitas e incorporadas ao texto do Guia, quando pertinentes. Conclui-se que os conceitos e terminologias relacionados a AF propostos pelo GT Domínios para compor o Guia, após a avaliação de pesquisadores especialistas e da população consultada, são válidos e claros.

Upper gastrointestinal hemorrhage, common problem worldwide, had an estimated annual incidence of 40-150 cases per 100 000 populations. Several scores are validated for risk stratification than can aid clinical decision for urgent intervention and triage patients to in-hospital vs out-of-hospital management. Two most widely validated score were Glasgow Blatchford Score (GBS) and Rockwall score. A retrospective analysis in more than 400 000 patients with NVUGIB reported an increase mortality in patients who underwent endoscopy after 24 hours. Cyanoacrylate (CYA) Spray is a spray technique that can be used as an alternative method in emergent settings for uncontrollable GI bleeding.

Highlights • Gastrointestinal schwannomas are submucosal tumors accounting for 2–7% of mesenchymal gastro-intestinal neoplasms. • Esophageal schwannomas are more frequent in women, and are usually located in the upper to mid portion. • Symptomatic esophageal schwannomas can be excised entirely, with low rate of recurrence and favorable overall outcomes. • Large esophageal schwannomas resulting in dilated proximal segment, esophagoplasty should be considered for defect closure., Background Gastrointestinal schwannomas are submucosal tumors accounting for 2–7% of mesenchymal gastro-intestinal neoplasms; the stomach being the most common site. Esophageal schwannomas are more frequent in women, and are usually located in the upper to mid portion. Dysphagia is the main presenting symptom. A definitive diagnosis requires confirmation by histopathological and immunohistochemical studies. Case Presentation A 50-year-old healthy lady, presented with gradual increasing onset of dyspnea, with minimal dysphagia to solid food, over a period of several years. Enhanced CT scan of the chest revealed a well-defined soft tissue mass arising from the proximal third of the esophagus, measuring 7.8 × 5.4 x 10.5 cm. Esophagogastric endoscopy with ultrasonography showed an elevated, smooth surface lesion, arising from the submucosal layer of the esophagus, with a hypervascular mucosa. Enucleation of this large tumor, with preservation of the overlying mucosa, was difficult to accomplish due to its large size. Making use of a dilated proximal esophageal segment, total en-bloc excision of the mass rendered a 15 cm esophagotomy gap, which was easily closed, in two layers, without affecting the overall caliber thus achieving a good esophagoplasty result. Histologically, abundance of spindle-shaped cells with positive S-100 proteins, confirmed the diagnosis of esophageal schwannoma. Conclusion Variations in mesenchymal gastrointestinal tumors is vast, rendering diagnosis by radiology alone difficult. As such, characteristic histologic and immunostaining features are cornerstones in precise diagnosis of esophageal schwannomas. Despite being rare in incidence, symptomatic esophageal schwannoma lesions can be excised entirely, with low rate of recurrence and favorable overall outcomes.

Usually, the analysis of structures under wind loading is performed using an equivalent static analysis, where the influence of floating response is taken into account by the gust factor. This methodology can be used in case of rigid structures for not presenting a considerable dynamic response. More flexible structures, in particular those lightly damped, may show an important resonant response and their dynamic properties must be considered in the analysis. The aim of this paper is to present a methodology for dynamic analysis of structures under wind loading considering the geometric nonlinearity, the vibration caused by the kinetic energy of wind gusts and the aerodynamic damping due to the relative movement between this structure and the wind. The formulation proposed is applied to a 180-meter-high concrete chimney and the results were compared with those obtained through the recommendation given in the standard ABNT NBR 6123:1988 [2] for the dynamic structural analysis.

In the last two decades, solar energy sources have gained a remarkable place among others and have proven that it is possible to utilize green energy to satisfy a part of the global demands of electrical power. In Lebanon, solar Photovoltaic (PV) systems are being used progressively. However, soiling and dust accumulation, on the surface of these panels, minimizes their efficiency. As a first of its kind in Lebanon, this paper presents the results from a study conducted on the effectiveness of wet cleaning using a robot. This study is carried out on a part of a 1 MWp solar power plant station in Zahrani, a coastal region in Lebanon. The robot was designed, manufactured, implemented, and tested to clean the abovementioned station. The panels were cleaned in a period starting from June 15th to September 30th, 2018. The generated power was collected on a daily basis and compared to the generated power over the same period of 2017 without cleaning. The results showed that the cleaning procedure was able to effectively minimize the effect of dust on the solar panel’s power output. Thus, an increase average of 32.27% in the power generation is obtained.

Anemic patients with lower risk myelodysplastic syndromes are frequently treated with erythropoiesis stimulating agents (ESA), eventually in combination with granulocyte colony stimulating factor (G-CSF). However, the evidence for the efficacy of a combined treatment remains controversial. The goal of our analysis was to assess the available evidence for a combined treatment. We performed a systematic review and identified only nine eligible studies. In two randomized controlled trials (n = 98), erythroid response rates were 33% and 40% after low-/standard-doses of ESA alone (10,000-30,000 rHuEPO equivalents/week) versus 65% and 73% after combination treatment. In seven trials with sequential drug administration (n = 393), erythroid response rates ranged from 12% to 71% after full-doses of ESA alone (60,000-80,000 rHuEPO equivalents/week) and from 35% to 74% after combination therapy. Our analysis supports an additional efficacy of G-CSF added to low-/standard-dose ESA, but the available data remains controversial, if G-CSF is added to full-dose ESA.

This study compared functional demand (FD) between older and younger women walking at habitual and fast speed and determined strength thresholds necessary to maintain FD below 80%. FD was calculated by expressing walking flexion and extension joint torques of the ankle, knee, and hip as a percentage of maximal strength. Young women had an average FD of 65% across joint actions and speeds, whereas older women had FD of 90%. In older women, the greatest FD occurred in the hip musculature. The hip, knee, and ankle extensor strengths required to maintain FD below 80% were 1.66, 1.86, and 0.57 Nm/kg, and flexor strengths were 1.24, 0.49, and 0.69 Nm/kg, respectively. Older women have limited functional reserve to increase gait speed and rely heavily on available hip strength during walking. This study identifies strength targets for the hip, knee, and ankle that will assist in maintaining FD of older women at a sustainable level.

Aim: The ECMO (extracorporeal membrane oxygenation) Program at the American University of Beirut Medical Center was established in November 2015 as the first program serving adult and pediatric population in a low-resource setting. The aim of the study is to describe the challenges faced during the establishment of the program and factors leading to its success. Methods: The program establishment is described. The preparation phase, included the strategic, financial, and clinical planning by administration, nursing, and a multidisciplinary team of physicians. The training and education phase included all the involved nurses, perfusionists, and physicians. Concerns were heard from various stakeholders, and the challenges were analyzed and discussed. Results: The preparation committee chose the adequate equipment, responded to the concerns, defined roles and responsibilities through credentialing and privileging, wrote policies and protocols, and established a strategy to decide for the ECMO indication. Selected team of nurses, physicians, and perfusionists are identified and trained locally, and abroad. A full-time ECMO physician was recruited to launch the program. Twelve patients (6 adults, 3 children, and 3 neonates) were supported by ECMO, for cardiac and respiratory indications. Eleven patients were supported by veno-arterial ECMO, and 1 patient (a neonate) with veno-venous ECMO. Overall, 75% survived to decannulation and 41% survived to discharge. Conclusion: With limited human and financial resources, new ECMO centers need to carefully establish selection criteria that may differ from those used in developed countries. Indications should be discussed on a case by case basis, taking into account clinical, social, and financial issues. This experience might help other institutions in developing countries to build their own program despite financial and human limitations.

OBJECTIVE To estimate the prevalence of SARS-CoV-2 antibodies and the adherence to measures of social distancing in children and adolescents studied in three national surveys conducted in Brazil between May–June 2020. METHODS Three national serological surveys were conducted in 133 sentinel cities located in all 27 Federative Units. Multistage probability sampling was used to select 250 individuals per city. The total sample size in age ranges 0–9 and 10–19 years old are of 4,263 and 8,024 individuals, respectively. Information on children or adolescents was gathered with a data collection app, and a rapid point-of-case test for SARS-CoV-2 was conducted on a finger prick blood sample. RESULTS The adjusted prevalence of antibodies was 2.9% (2.2–3.6) among children 0–9 years, 2.2% (1.8–2.6) among adolescents 10-19 years, and 3.0% (2.7–3.3) among adults 20+years. Prevalence of antibodies was higher among poor children and adolescents compared to those of rich families. Adherence to social distancing measures was seen in 72.4% (71.9–73.8) of families with children, 60.8% (59.6–61.9) for adolescents, and 57.4% (56.9–57.8) for adults. For not leaving the house except for essential matters the proportions were 81.7% (80.5–82.9), 70.6% (69.6–61.9), and 65.1% (64.7–65.5), respectively. Among children and adolescents, social distancing was strongly associated with socioeconomic status, being much higher in the better-off families. CONCLUSIONS The prevalence of antibodies against SARS-CoV-2 showed comparable levels among children, adolescents, and adults. Adherence to social distancing measures was more prevalent in children, followed by adolescents. There were important socioeconomic differences in the adherence to social distancing among children and adolescents.

BackgroundThe COVID-19 pandemic has disrupted people’s routine in several ways, including the temporary cessation of face-to-face teaching activities, which may affect the mental health of the population. This study aimed to assess the mental health of the academic community of a University in South Brazil during the Covid-19 pandemic.MethodsCross-sectional web-based survey conducted between July-August 2020 through a self-administered online questionnaire. All University staff and students were eligible. Depression was assessed using the Patient Health Questionnaire-9 and anxiety by the Generalized Anxiety Disorder-7. All analyses were stratified by academic or administrative staff, undergraduate and graduate students.Results2,785 individuals participated in the study. Prevalence of depression and anxiety were 39.2% (95% Confidence Interval (CI) 37.3-41.1) and 52.5% (95% CI 50.6-54.4), respectively. On stratified analyses, undergraduate students showed a higher prevalence of the outcomes compared to other groups. In relation to social distancing, higher prevalence of mental illness was associated to strictly following the authority’s guidelines and with not leaving the house routinely, but these associations were restricted to some subgroups. Mental health care and previous diagnosis of mental illness were associated with higher rates of anxiety and depression.LimitationsThe main concerns were the representativeness of the sample and the response rate.ConclusionsAn alarming prevalence of mental illness was observed in this academic community. Despite the well-known benefits of social distancing and quarantine to public health, it requires a special surveillance on the mental health of the population, especially students and those with previous mental illness diagnosis.

Coronavirus disease-2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently the most concerning health problem worldwide. SARS-CoV-2 infects cells by binding to angiotensin-converting enzyme 2 (ACE2). It is believed that the differential response to SARS-CoV-2 is correlated with the differential expression of ACE2. Several reports proposed the use of ACE2 pharmacological inhibitors and ACE2 antibodies to block viral entry. However, ACE2 inhibition is associated with lung and cardiovascular pathology and would probably increase the pathogenesis of COVID-19. Therefore, utilizing ACE2 soluble analogs to block viral entry while rescuing ACE2 activity has been proposed. Despite their protective effects, such analogs can form a circulating reservoir of the virus, thus accelerating its spread in the body. Levels of ACE2 are reduced following viral infection, possibly due to increased viral entry and lysis of ACE2 positive cells. Downregulation of ACE2/Ang (1-7) axis is associated with Ang II upregulation. Of note, while Ang (1-7) exerts protective effects on the lung and cardiovasculature, Ang II elicits pro-inflammatory and pro-fibrotic detrimental effects by binding to the angiotensin type 1 receptor (AT1R). Indeed, AT1R blockers (ARBs) can alleviate the harmful effects associated with Ang II upregulation while increasing ACE2 expression and thus the risk of viral infection. Therefore, Ang (1-7) agonists seem to be a better treatment option. Another approach is the transfusion of convalescent plasma from recovered patients with deteriorated symptoms. Indeed, this appears to be promising due to the neutralizing capacity of anti-COVID-19 antibodies. In light of these considerations, we encourage the adoption of Ang (1-7) agonists and convalescent plasma conjugated therapy for the treatment of COVID-19 patients. This therapeutic regimen is expected to be a safer choice since it possesses the proven ability to neutralize the virus while ensuring lung and cardiovascular protection through modulation of the inflammatory response.

The groundwater quality in the Mitidja plain has known an important deterioration during the last decades due to uncontrolled industrial waste discharges, intensive use of chemical fertilizers in agriculture, and an intense exploitation of groundwater resources. In this paper, we are interested in the Eastern part of the Mitidja plain, which covers an area of 495.52 km2. This study area is characterized by its industrial and agricultural vocation, thereby the problem of groundwater pollution. The study will focus on the fluctuation of the groundwater table, and the interpretation of the water quality analysis result made by ANRH (National Water Resources Agency), during the period between 2006 and 2016. The last ones have been geostatistically approached. This allowed us to carry out a GIS-assisted mapping of the nitrate concentrations in the aquifer and to draw up an exhaustive report on the current state of the relationship between the fluctuation of water table and the nitrate concentration rates, also the spatial and temporal evolution of the aquifer. As a result, the geostatistical approach gave us the possibility to draw up Kriging maps of the nitrate level spatial distribution for the two field monitoring campaigns: 2006 and 2016 as well as groundwater fluctuation maps for the periods under consideration. The obtained result reveals that 72% of the sample’s points have nitrate concentrations higher than 50 mg/l in rainy period in the 2 years 2006 and 2016. As for the dry period, the results show that more than 54% in 2006 and more than 81% in 2016 of the water samples analyzed are contaminated (exceeding the WHO’s recommendation). A significant water table drawdown, between 2006 and 2016, is highlighted, which reached an average of around 23 m in low water and 26 m in rainy period (case of drilling F1003). This drop in the water table level can be explained by overexploitation of the groundwater caused by intensive pumping for irrigation, industry, and water supply, due essentially to the increasing scarcity of rainfall, which is a consequence of climate change, which has become increasingly prevalent over the last three decades. Given the upward trend in nitrate levels in recent years, there is a significant risk that nitrate levels will far exceed the 50 mg/l threshold recommended by the WHO in the next 10 years. It is therefore imperative to remedy this through the control of industrial discharges and the extension at the level of the agricultural community regarding the intensive use of chemical fertilizers and (in particular nitrogen) and groundwater (by controlling the pumping).

Purpose The Structured Days Hypothesis (SDH) posits that children's behaviors associated with obesity - such as physical activity - are more favorable on days that contain more `structure' (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children's moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset. Methods Data were received from the International Children's Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status. Results/findings Valid data from 15 studies representing 5794 children (61 10.7 +/- 2.1 yrs., 24obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95 9.0, 16.2) and 9.4 min/day (95 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95 6.9, 12.2) and 10.9 min/day (95 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively. Conclusions Children from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active. PurposeThe Structured Days Hypothesis (SDH) posits that children’s behaviors associated with obesity – such as physical activity – are more favorable on days that contain more ‘structure’ (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children’s moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset.MethodsData were received from the International Children’s Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status.Results/findingsValid data from 15 studies representing 5794 children (61% female, 10.7 ± 2.1 yrs., 24% with overweight/obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95% CI: 9.0, 16.2) and 9.4 min/day (95% CI: 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95% CI: 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95% CI: 6.9, 12.2) and 10.9 min/day (95% CI: 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively.ConclusionsChildren from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active.