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Abstract Obstructive sleep apnea (OSA) and hypertension are two important modifiable risk factors for cardiovascular disease and mortality. Numerous studies have highlighted the interplay between these two conditions. We provide a critical review of the current literature on the role of the OSA as a risk factor for hypertension and its effect on blood pressure (BP). We discuss several key topics: the effect of OSA on nocturnal BP, BP response to continuous positive airway pressure (CPAP) treatment, CPAP effect on BP in refractory hypertension, the role of OSA in BP variability (BPV), and maladaptive cardiac remodeling mediated by OSA’s effect on BP. Finally, we discuss the unique aspects of ethnicity and social determinants of health on OSA with a focus on Asian populations and the disparity in BP control and cardiovascular outcomes.

Polymer optical fibers (POFs) are an essential component of photonic textile sensors for the development of healthcare@home technologies. However, fabricating tailored POFs exhibiting the required properties for such applications remains challenging. Here, an innovative method to fabricate soft POFs based on polydimethylsiloxane is introduced: the hydrogel-assisted microfluidic wet spinning (HA-MWS) technology. Combined with a straightforward post-processing step, the HA-MWS enabled the production of soft POFs with tailored moduli (0.35 MPa to 5.0 MPa), low surface roughness (Rq< 6 nm), and, consequently, low attenuation (

ABSTRACT The use of unmanned aerial vehicles (UAVs) to apply pesticides has grown significantly, but technical data to support improvements in application efficiency are lacking, especially for perennial crops. This study aimed to determine the best operational parameters for the application of pesticides to coffee plants using UAVs. The experiment consisted of 8 treatments and 4 replicates in a 2x2x2 factorial design: two spray mixture compositions (solutions with spreading adjuvant and mineral oil), two spray nozzles (XR flat-fan nozzle and Airmix flat-fan nozzle with air induction) and two spray volumes (10 and 20 L ha-1). Spray solution deposition was evaluated by spectrophotometric detection of a tracer in leaves from the upper and lower parts of the coffee canopy, and spray coverage, droplet density and droplet size were evaluated using water-sensitive paper. The surface tension, pH and electrical conductivity of the solutions were also evaluated. The air induction nozzle was more suitable than the standard nozzle for UAV application, as the former yielded greater deposition of spray solution. Mineral oil improved the spray deposition on the coffee leaves, although the spreader reduced the surface tension to a greater extent. The higher spray volume increased the droplet density, as well as the coverage, which is very relevant, especially whit contact pesticides.

Abstract The distribution of a species reflects its ecological adaptability and evolutionary history, which is shaped by the environment and represents a dynamic area subject to anthropogenic environmental change. We used the MaxEnt algorithm to construct ecological niche models for four thrush species within the Turdus genus; T. amaurochalinus, T. chiguanco, T. falcklandii and T. rufiventris. These models were used to predict the potential geographic distributions of these species that are expanding their ranges in South America. Using occurrence records, we estimated currently occupied areas for each species. We also identified suitable habitats and projected possible areas to be colonized by the four species at continental scale. Temperature annual range had the highest influence for T. falcklandii, while human modification was the main variable explaining the distribution of the other three species. The potential distribution area ranged from 2.5 million km2 for T. falcklandii to nearly seven million km2 for T. amaurochalinus. Large proportions of suitable area remain unoccupied by all four species, being 50% for T. amaurochalinus and T. rufiventris, and about 70% for T. chiguanco and T. falcklandii. Anthropogenic disturbances, such as habitat loss and ecosystem transformation, lead to non-random species extinction and biotic homogenization, highlighting the importance of predictive models as valuable tools for informing mitigation policies and conservation strategies. Thrushes are progressively expanding their ranges, and the colonization of new habitats could bring new challenges.

Abstract Background Government-led, population-wide initiatives are crucial for advancing the management of hypertension − a leading cause of cardiovascular disease (CVD) morbidity and mortality. An urban population health initiative was conducted against this backdrop, focussing on hypertension in the primary health system in São Paulo, Brazil. Within the frame of the initiative and under the supervision and leadership of the municipal health authorities, a situational analysis was conducted on the needs in hypertension management, marking the first phase of a Design Thinking process. This article describes the situational analysis process and presents the identified elements to be strengthened considering hypertension diagnosis, treatment and control. Methods First, a mixed-methods approach was used, starting with a literature review of municipal hypertension data followed by meetings (N = 20) with the local public health administration to assess health system level components. To investigate activities on hypertension diagnosis, treatment and control, nine primary healthcare units were selected from two districts of São Paulo city– Itaquera and Penha– which received an online form addressed to managers, participated in conversation circles of staff and patients, and underwent shadowing of community health agents. Results Data gave rise to two main outputs: (i) a patient care journey map; and (ii) a matrix summarizing the identified needs at patient, healthcare professional and health system level for diagnosis, treatment and control of hypertension. Patient awareness and knowledge of hypertension was found to be insufficient and its management needs to be improved. For health professionals, disease awareness, technical training, more time dedicated to patients, and simplified guidelines and clinical decision-making tools for hypertension management were identified as principal needs. The situational analysis found that the healthcare systems efficiency might be improved by establishing defined treatment and care delivery goals with a focus on outcomes and implemented through action plans. Conclusions This situational analysis identified several needs related to hypertension control in São Paulo that are in line with global challenges to improve the control of CVD risk factors. Findings were also confirmed locally in an expansion phase of this situational analysis to additional primary care facilities. As a consequence, solutions were designed, promptly taken up and implemented by the municipal health secretariat.

Resumo Fundamento: A Cardiomiopatia Chagásica Crônica (CCC) é causada por um processo inflamatório induzido pelo Trypanosoma cruzi, que leva à miocardite com fibrose reativa e reparativa. A CCC progride com alterações de perfusão miocárdica e eventos histopatológicos que afetam a Aptidão Cardiorrespiratória (ACR). Objetivos: Avaliamos os efeitos do Treinamento Físico Aeróbico (TFA) na perfusão miocárdica e nos comprometimentos morfológicos e funcionais relacionados à inflamação e fibrose em hamsters sírios com CCC. Como objetivo secundário, analisamos as áreas de secção transversa do músculo esquelético. Métodos: Hamsters com CCC e seus respectivos controles foram divididos em quatro grupos: CCC sedentário, CCC-TFA, controle sedentário e controle TFA. Sete meses após a infecção, os animais foram submetidos à ecocardiografia, à cintilografia de perfusão miocárdica e ao teste de esforço cardiopulmonar. TFA de intensidade moderada foi realizado durante cinquenta minutos, cinco vezes por semana, por oito semanas. Posteriormente, os animais foram reavaliados. A análise histopatológica foi realizada após os procedimentos acima mencionados. O nível de significância foi estabelecido em 5% em todas as análises (p

Introduction Portable respiratory monitoring (PM) has been used to diagnose obstructive sleep apnea (OSA) in the general population. However, its validation in patients with both OSA and chronic obstructive pulmonary disease (COPD), remains unclear.

El jabalí, el cerdo silvestre y sus híbridos (Sus scrofa) se encuentran entre las especies exóticas invasoras más dañinas y ampliamente distribuidas en el mundo. En la Argentina, el jabalí ocupa casi la mitad de la superficie del país; invade todos los ecosistemas y expande anualmente su distribución. Como en otras partes del planeta donde fue introducido, provoca impactos negativos sobre la biodiversidad, la economía y la salud. Esta especie omnívora amenaza la conservación de otras especies por depredación y competencia, alteración del suelo y perturbación de las interacciones biológicas. El jabalí afecta actividades productivas, y ello genera costos económicos considerables asociados a la mitigación de daños y al manejo de sus poblaciones. Además, la especie puede impactar en la salud pública, dado que es un importante reservorio y diseminador de patógenos. Asimismo, puede impactar de forma positivamente —directa e indirectamente— con actividades como la caza deportiva y la obtención de carne y derivados. Si bien sus impactos están documentados en varias regiones de la Argentina, existen vacíos de información sobre sus efectos económicos sobre las principales actividades productivas y sobre su rol epidemiológico en la salud de la fauna nativa, el ganado y las personas. A nivel país, su manejo y control es limitado e insuficiente, con muy pocos casos exitosos registrados. La dinámica poblacional del jabalí, combinada con otros factores (e.g., cambios en el uso de la tierra y cambio climático), plantea un escenario desafiante a futuro. La Argentina debe enfrentar las amenazas que representa el jabalí desarrollando e implementando una estrategia de manejo a nivel nacional. Para lograr este propósito, es indispensable realizar una planificación cuidadosa y una toma de decisiones orientada a controlar efectivamente las poblaciones de jabalí, a contener su dispersión geográfica y a mitigar sus impactos negativos.

ObjectivesThe majority of patients with respiratory illness are seen in primary care settings. Given COVID-19 is predominantly a respiratory illness, the INTernational ConsoRtium of Primary Care BIg Data Researchers (INTRePID), assessed the pandemic impact on primary care visits for respiratory illnesses.DesignDefinitions for respiratory illness types were agreed on collectively. Monthly visit counts with diagnosis were shared centrally for analysis.SettingPrimary care settings in Argentina, Australia, Canada, China, Norway, Peru, Singapore, Sweden and the United States.ParticipantsOver 38 million patients seen in primary care settings in INTRePID countries before and during the pandemic, from January 1st, 2018, to December 31st, 2021.Main outcome measuresRelative change in the monthly mean number of visits before and after the onset of the pandemic for acute infectious respiratory disease visits including influenza, upper and lower respiratory tract infections and chronic respiratory disease visits including asthma, chronic obstructive pulmonary disease, respiratory allergies, and other respiratory diseases.ResultsINTRePID countries reported a marked decrease in the average monthly visits for respiratory illness. Changes in visits varied from −10.9% [95% confidence interval (CI): −33.1 to +11.3%] in Norway to −79.9% (95% CI: −86.4% to −73.4%) in China for acute infectious respiratory disease visits and − 2.1% (95% CI: −12.1 to +7.8%) in Peru to −59.9% (95% CI: −68.6% to −51.3%) in China for chronic respiratory illness visits. While seasonal variation in allergic respiratory illness continued during the pandemic, there was essentially no spike in influenza illness during the first 2 years of the pandemic.ConclusionThe COVID-19 pandemic had a major impact on primary care visits for respiratory presentations. Primary care continued to provide services for respiratory illness, although there was a decrease in infectious illness during the COVID pandemic. Understanding the role of primary care may provide valuable information for COVID-19 recovery efforts and planning for future global emergencies.

(1) Background: After the COVID-19 pandemic, there is concern regarding the immunity of the population to SARS-CoV-2 variants, particularly the Omicron variant and its sub-lineages. (2) Methods: The study involved analyzing the immune response and symptomatology of 27 vaccinated individuals who were subsequently infected by Omicron sub-lineages. Blood samples were collected for serological analysis, including the detection of IgG antibodies reactive to the Nucleocapsid (N) and Spike (S) antigens of SARS-CoV-2. Additionally, participants were interviewed to assess the intensity of symptoms during the infection. (3) Results: Despite the high levels of anti-Spike IgG observed after vaccination, all participants were infected by Omicron sub-lineages. The most common symptoms reported by participants were fever or chills, sore throat, and cough. The levels of anti-Spike IgG found prior to infection did not correlate with symptom intensity post-infection. However, it was observed that high post-infection anti-Nucleocapsid IgG levels correlated with mild symptoms during the course of the disease, suggesting a potential role for anti-N antibodies in symptom intensity. (4) Conclusions: In line with previous studies, the high levels of IgG anti-Spike resulting from vaccination did not provide complete protection against infection by the Omicron variant. Additionally, our data suggest that anti-Nucleocapsid IgG titers are negatively correlated with the intensity of the symptoms during mild infections.

Primary aldosteronism (PA) is commonly associated with resistant hypertension. Biochemical tests can be clinically useful in the screening and diagnosis of primary aldosteronism. This study aimed to identify the cutoff values of aldosterone levels (A) and the aldosterone–renin ratio (ARR) for an accurate prediction of PA in patients with apparent resistant hypertension in a real-life scenario. This database-based study included a historical cohort of male and female patients with apparent resistant hypertension, aged 18 years or older and surveyed for PA in a specialized center from 2008 to 2018. Aldosterone and plasma renin activity (PRA) or the plasma renin concentration (PRC) were measured in the treated hypertensive patients. The patients with positive screening results were subsequently referred to the endocrinology department for confirmatory tests. The patients with confirmed PA were included in the case group, and the others remained as controls. Receiver-operating characteristic (ROC) curves were used to identify the cutoff points for aldosterone and the ARR, thereby analyzing their sensitivity and specificity for confirmed PA. Among the 3464 patients (59 ± 13 years old, 41% male) who had apparent resistance hypertension screened, PA was confirmed in 276 individuals (8%). A ≥ 16.95 ng/dL (95% CI: 0.908–0.933) had an odds ratio of 6.24 for PA, while A/PRA ≥ 29.88 (95% CI: 0.942–0.984) or an A/PRC ≥ 2.44 (95% CI: 0.978–0.990) had an odds ratio of 216.17 for PA diagnoses. Our findings suggest that a positive PA screening with aldosterone ≥ 17 ng/dL associated with A/PRA ≥ 29.88 or an A/PRC ratio of ≥2.44 should be sufficient to confirm the diagnosis of PA without confirmatory testing.

PII proteins are signal transduction proteins that belong to a widely distributed family of proteins involved in the modulation of different metabolisms in bacteria. These proteins are homotrimers carrying a flexible loop, named T-loop, which changes its conformation due to the recognition of diverse key metabolites, ADP, ATP, and 2-oxoglutarate. PII proteins interact with different partners to primarily regulate a set of nitrogen pathways. In some organisms, PII proteins can also control carbon metabolism by interacting with the biotin carboxyl carrier protein (BCCP), a key component of the acetyl-CoA carboxylase (ACC) enzyme complex, inhibiting its activity with the consequent reduction of fatty acid biosynthesis. Most bacteria contain at least two PII proteins, named GlnB and GlnK, with different regulatory roles. In mycobacteria, only one PII protein was identified, and the three-dimensional structure was solved, however, its physiological role is unknown. In this study we purified the Mycobacterium tuberculosis (M. tb) PII protein, named GlnB, and showed that it weakly interacts with the AccA3 protein, the α subunit shared by the three different, and essential, Acyl-CoA carboxylase complexes (ACCase 4, 5, and 6) present in M. tb. A M. smegmatis deletion mutant, ∆MsPII, exhibited a growth deficiency on nitrate and nitrite as unique nitrogen sources, and accumulated nitrite in the culture supernatant. In addition, M. tb PII protein was able to interact with the C-terminal domain of the ammonium transporter Amt establishing the ancestral role for this PII protein as a GlnK functioning protein.

Abstract The aim of this study was to evaluate the effects of the inclusion of palm oil on the ruminal environment and nutrient digestibility of sheep diets. Twenty rumen-cannulated sheep were kept in individual stalls equipped with feeding and drinking troughs The animals were fed five diets based on Elephant grass (Pennisetum purpureum Schum. cv. Roxo) silage and supplemented with 0, 25, 50, 75, or 100 g kg-1 of palm oil (based on total DM). The Elephant grass was harvested at 90 days of regrowth and the concentrate was based on ground corn grain, soybean meal and mineral mix (20 g kg-1 DM), offered to the sheep at a ratio of 1.5 g kg-1d-1 of body weight (restricted intake) to maintain a forage-to-concentrate ratio of 1:1, based on DM. There were no differences (P = 0.324) in ruminal disappearance and degradability parameters with up to 75 g of oil per kg of DM. Organic matter showed a linear reduction in apparent digestibility, while ether extract increased linearly. Palm oil affected the digestibility and nutritional parameters in ruminant diets.

Abstract This study estimated biomass and carbon from components, future carbon values and to obtain economic productive value of carbon fixation of a Seasonal Semideciduous Forest. Biomass and carbon were estimated using adjusted equations and selected using regression statistics. The prognosis of the diametric distribution was performed using the movement ratio method. In the economic evaluation, it was estimated productive value of the stand, referring to the current and future carbon fixation capacity. The coefficients of determination (adjusted R²) of the equations ranged from 0.11 to 0.90 and the standard error of the estimate (Syx) ranged from 41.53% to 141.89% for the biomass of the components, and from 0.03 to 0.87 for adjusted R² and from 46.20% to 143.64% for the error, for stored carbon in the components. The total biomass of the tree component estimated was 56.25 t ha-1 and 25.88 t ha-1 of total carbon. Using the future distributions by the method of the ratio of movements, total stored carbon (aerial + roots) estimated was 14.44 t. ha-1 over the 20-year period. The productive value for the fragment reached R$ 299.95 per ha. year-1.

Abstract Effective vaccination against coronavirus mitigates the risk of hospitalisation and mortality; however, it is unclear whether vaccination status influences long COVID symptoms in patients who require hospitalisation. The available evidence is limited to outpatients with mild disease. Here, we evaluated 412 patients (age: 60 ± 16 years, 65% males) consecutively admitted to two Hospitals in Brazil due to confirmed coronavirus disease 2019 (COVID-19). Compared with patients with complete vaccination (n = 185) before infection or hospitalisation, those with no or incomplete vaccination (n = 227) were younger and had a lower frequency of several comorbidities. Data during hospitalisation revealed that the no or incomplete vaccination group required more admissions to the intensive care unit (ICU), used more corticosteroids, and had higher rates of pulmonary embolism or deep venous thrombosis than the complete vaccination group. Ninety days after hospital discharge, patients with no or incomplete vaccination presented a higher frequency of symptoms (≥ 1) than patients with complete vaccination (40 vs. 27%; p = 0.013). After adjusting for confounders, no or incomplete vaccination (odds ratio [OR] 1.819; 95% confidence interval [CI] 1.175–2.815), female sex (OR 2.435; 95% CI 1.575–3.764) and ICU admission during hospitalisation (OR 1.697; 95% CI 1.062–2.712) were independently associated with ≥ 1 symptom 90 days after hospital discharge. In conclusion, even in patients with severe COVID-19, vaccination mitigates the probability of long COVID symptoms.

This clinical guideline supported by the Brazilian Sleep Association comprises a brief history of the development of Brazilian sleep physiotherapy, outlines the role of the physiotherapist as part of a sleep health team, and describes the clinical guidelines in respect of the management of some sleep disorders by the physiotherapist (including sleep breathing disorders, i.e., obstructive sleep apnea, central sleep apnea, upper airway resistance syndrome, hypoventilation syndromes and overlap syndrome, and pediatric sleep breathing disorders; sleep bruxism; circadian rhythms disturbances; insomnia; and Willis-Ekbom disease/periodic limb movement disorder. This clinical practice guideline reflects the state of the art at the time of publication and will be reviewed and updated as new information becomes available.

Polydimethylsiloxane (PDMS) based soft polymer optical fibers (POFs) have recently demonstrated their intriguing potential for different sensing applications like strain or temperature sensing. Recent studies have elaborated on the sensing capability of PDMS POFs, yet the in-depth analysis of the processing-property relationship of PDMS POFs remains unexplored. A straightforward processing strategy was developed for core only PDMS POFs and PDMS/THV (terpolymer of tetrafluoroethylene, hexafluoropropylene, and vinylidene fluoride) core/clad POFs. The optimization of chemical formulations and process parameters such as curing temperature and curing time provided the development of POFs with tailored mechanical and optical properties. The tensile modulus of the moulded PDMS POFs could be tuned in the range of 0.2–3.0 MPa, with attenuations as low as 0.11 dB/cm in the near infrared region (NIR). Furthermore, the load and pressure sensing capability of the PDMS POFs was demonstrated with sensitivity to loads as low as 0.1 N and highly accurate pressure sensing up to 300 kPa. The systematic approach presented in this study enables the processing of elastic PDMS POFs with tunable mechanical and optical properties, which can be tailored to suitable sensing applications in the field of healthcare monitoring, biomedicine, and soft robotics.

This study aimed to assess the impact of palm oil deodorizer distillate (POD) on the ruminal environment, including (i) microbial community, (ii) ruminal degradability, and (iii) apparent digestibility in sheep. The data used were derived from twenty rumen-cannulated sheep fed five isoproteic and isofiber diets based on elephant grass (Pennisetum purpureum Schum. cv. Roxo) silage supplemented with 0, 25, 50, 75, or 100 g kg−1 POD on a dry matter (DM) basis. Rumen fluid samples were collected three hours after feeding directly from the ventral sac of the rumen via a cannula and then subjected to DNA extraction, which was subsequently used for 16S rDNA amplification, followed by sequencing and diversity analysis. In this study, the microbial diversity was dominated by Bacteroidetes and Firmicutes, followed by Euryarchaetoa, Actinobacteria, and Tenericutes, in the ruminal environment, and was slightly modified when supplemented with the POD up to 100 g/kg (10%), leading to only a slight decrease in the diversity index. The ruminal degradability, ruminal fermentation parameters, and apparent digestibility were slightly compromised by the inclusion of up to 25 g of POD per kg of DM, and larger inclusions interfered with the ruminal degradability of fibrous fractions and the apparent digestibility of dry matter. This lipid supplement showed good results for feeding sheep and is an inexpensive and abundant alternative in the regional market.

Abstract Introduction: There is disagreement between data on sleep duration obtained from questionnaires and objective measurements. Whether this is also true for individuals with CKD is unknown. Here we compared self-reported sleep duration with sleep duration obtained by actigraphy. Methods: This prospective study included adult individuals with stage 3 CKD recruited between September/2016 and February/2019. We evaluated subjective sleep duration by asking the following question: “How many hours of actual sleep did you get at night?” Results: Patients (N=34) were relatively young (51 ± 13 years). Self-reported and measured sleep duration were 7.1 ± 1.7 and 6.9 ± 1.6 hours, respectively, with no correlation between them (p=0.165). Although the mean difference between measurements was 0.21 h, the limits of agreement ranged from -3.7 to 4.1 h. Conclusion: Patients with CKD who are not on dialysis have an erroneous sleep perception. Data on sleep duration should be preferentially obtained from objective measurements in patients with CKD.

Abstract The Amazon River basins present distinct natural and anthropogenic characteristics that influence the structure of stream habitats and their associated biota. The influence of these characteristics can be evaluated through different spatial scales. We aimed to assess the influence (with and without the effect of spatial-geographical factors) of local, macroscale, and land-use variables in the structure of stream fish assemblages of Amazonian catchments with different deforestation levels. A partial redundancy analysis and a reduced metrics model were used to assess these influences. With geographic-spatial effects, we verified that the macroscale and local variables explained the variation in fish composition, and, without the effects, land use also explained the variation in this composition. In the forested catchments, the biota was associated with streams with natural characteristics (e.g., leaf banks). In the deforested catchments, it was associated with land use, sandy catchments with higher soil density (higher capacity of degradation), and less complex streams (fewer leaf banks, more sand). The associated fish have life features linked to these characteristics (e.g., Gymnorhamphichthys rondoni associated with sand). This configuration seems to be a result of both the impact of land use in the catchment (i.e., increased erosion, increased sedimentation) and the naturally sandy constitution of the catchment as well, reflecting the sandy substrate.

RESUMO Objetivo: Este artigo tem como objetivo investigar a relação entre o gerenciamento de projetos (GP) e a transformação digital (TD) nas organizações. Originalidade/valor: Este trabalho contribui para ampliar o conhecimento da relação existente entre o GP e a TD, indicando que o GP e suas diferentes abordagens são utilizados de forma estratégica para viabilizar a execução da TD nas organizações. Além disso, é evidenciado que a TD demanda indivíduos com competências técnicas e comportamentais para trabalharem em contextos inovadores e de rápidas mudanças organizacionais, culturais e tecnológicas, advindas com a adoção de novas tecnologias digitais. Design/metodologia/abordagem: A pesquisa é caracterizada como exploratória com abordagem qualitativa. A metodologia adotada foi a revisão sistemática da literatura, e busca compreender a relação e a convergência entre o GP e a TD. A pesquisa foi realizada de forma ampla e os artigos foram selecionados nas bases Web of Science, Scopus e Google Scholar, formando o corpus de análise com 104 artigos publicados no período de 2015 a 2020. Resultados: Os resultados convergiram para a formação de quatro fatores: competências; estratégia; tecnologias digitais; e portfólio, programas e projetos, demonstrando a capacidade evolutiva e adaptativa do GP para suportar grandes mudanças, como a TD. / ABSTRACT Purpose: This article aims to investigate the relationship between project management (PM) and digital transformation (DT) in organizations. Originality/value: This article contributes to expanding the knowledge of the relationship between PM and DT, indicating that PM and its different approaches are used strategically to enable DT implementation in organizations. In addition, it is evidenced that DT demands individuals with technical and behavioral competencies to work in innovative and rapid organizational, cultural, and technological contexts arising from adopting new digital technologies. Design/methodology/approach: The research is characterized as exploratory with a qualitative approach. The methodology adopted was the systematic literature review and sought to understand the relationship and convergence between PM and DT. The research was carried out broadly, and the articles were selected on the Web of Science, Scopus, and Google Scholar bases, forming the analysis corpus with 104 articles published from 2015 to 2020. Findings: The results converged in the composition of four factors: competencies; strategy; digital technologies; and portfolio, programs, and projects, demonstrating the evolutionary and adaptive capacity of PM to support major changes such as DT.

Resumo Fundamento A maioria da evidência sobre o impacto da síndrome COVID pós-aguda (PACS, do inglês, post-acute COVID-19 syndrome) descreve sintomas individuais sem correlacioná-los com exames de imagens. Objetivos Avaliar sintomas cardiopulmonares, seus preditores e imagens relacionadas em pacientes com COVID-19 após alta hospitalar. Métodos Pacientes consecutivos, que sobreviveram à COVID-19, foram contatados 90 dias após a alta hospitalar. A equipe de desfechos clínicos (cega quanto aos dados durante a internação) elaborou um questionário estruturado avaliando sintomas e estado clínico. Uma análise multivariada foi realizada abordando a evolução da COVID-19, comorbidades, ansiedade, depressão, e estresse pós-traumático durante a internação, e reabilitação cardíaca após a alta. O nível de significância usado nas análises foi de 5%. Resultados Foram incluídos 480 pacientes (idade 59±14 anos, 67,5% do sexo masculino) que receberam alta hospitalar por COVID-19; 22,3% necessitaram de ventilação mecânica. A prevalência de pacientes com sintomas cardiopulmonares relacionados à PACS (dispneia, cansaço/fadiga, tosse e desconforto no peito) foi de 16,3%. Vários parâmetros de tomografia computadorizada do tórax e de ecocardiograma foram similares entre os pacientes com e sem sintomas cardiopulmonares. A análise multivariada mostrou que sintomas cardiopulmonares foram relacionados de maneira independente com sexo feminino (OR 3,023; IC95% 1,319-6,929), trombose venosa profunda durante a internação (OR 13,689; IC95% 1,069-175,304), nível elevado de troponina (OR 1,355; IC95% 1,048-1,751) e de proteína C reativa durante a internação (OR 1,060; IC95% 1,023-1,097) e depressão (OR 6,110; IC95% 2,254-16,558). Conclusão Os sintomas cardiopulmonares relacionados à PACS 90 dias após a alta hospitalar são comuns e multifatoriais. Além dos marcadores trombóticos, inflamatórios e de lesão miocárdica durante a internação, sexo feminino e depressão foram associados independentemente com sintomas cardiopulmonares relacionados à PACS. Esses resultados destacaram a necessidade de uma abordagem multifacetada direcionada a pacientes susceptíveis.

Objective: This study aimed firstly to describe sleep-related and mental health symptoms before and during the COVID-19 pandemic in a national-wide sample and, secondly, to verify attitudes towards help-seeking to treat these symptoms. Material and Methods: Data were collected through an online questionnaire sent through the Brazilian Sleep Association’s social media. The questionnaire included sociodemographic and sleep aspects questions currently and before the pandemic period. In addition, the survey addressed current and previous anxiety, depression, and burnout symptoms. The outcome help-seeking was addressed in the questionnaire as well by a single question asked when the participant reported mental or sleep problems. Results: The study covered 6,360 participants, mean age 43.5 years (SD=14.3), 76.7% female and 63.7% with undergraduate or higher degree filled out the survey. Seventy percent of participants reported sleep disturbances and 80% reported symptoms of anxiety during the pandemic. Help-seeking behavior was found only in one third of them. Hours of sleep reduced from 7.12 to 6.2h, which can be related with the increase in 28.2% of dissatisfaction with sleep duration during the pandemic. The highest frequency of complaints related to sleep was difficulty to fall asleep three or more times a week (going from 27.6% before the pandemic to 58.9% during the pandemic; p

In this paper, we investigate the solubility effects of Co in ZnO (Zn1−xCoxO, where x = 0, 0.03, 0.05, 0.1, 0.2, 0.25, 0.4, 0.8, and 1) by combining the results of perturbed angular correlation (PAC) spectroscopy using highly diluted 111Cd as probe nuclei and ab initio calculations based on spin-density functional theory (SDFT). This combined approach enables us to characterize the local structure around Cd ions, where, through PAC technique, it was possible to measure the EFG as a function of temperature and Co concentration and thereby monitor the changes in the structure and the Co solubility threshold in ZnO and the ZnO/CoO/Co3O4 mixed phase. The full-potential linear augmented plane wave plus local orbital (APW+lo) formalism were used here to describe the electronic structure of the supercells, including the atomic relaxations. These Ab initio calculations show an interesting behavior of the Cd and Co impurity levels in the band structure of ZnO, which explains the experimental results in terms of the origin of EFG and the evidence of ferromagnetic response.

Objective: This study aimed to assess sleep quality and the independent predictors of poor sleep quality in the Brazilian population. Methods: An online survey was conducted in adults from all five Brazilian regions. Participants answered a structured questionnaire including variables such as sex, age, geographic region, state, socioeconomic class, education level, the existence of a partner/roommate, self-reported insomnia, and smart phone/interactive media use. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. A logistic regression model was built to assess potential independent predictors of poor sleep quality (PSQI >5). Results: A total of 2,635 adult individuals were included in the study (median age: 35 years, 54.1% females). Median PSQI score was 7.0 (IQR: 4.0; 65.5% of poor sleepers). Multivariate model showed that females (OR: 1.079; 95% CI: 1.041-1.119); age

Abstract In this study, we assessed the effects of multiple land uses and local habitat variables on the composition of fish functional trophic groups (FTG’s) and on the ecomorphological traits of fish in Amazonian streams. We evaluated land use types and local habitat variables in 26 streams distributed within a land use gradient. Land use and habitat variables affected the composition of FTG’s, as evidenced by the increased abundance of diurnal channel drift feeders in areas with high dissolved oxygen and deeper thalweg. At the same time, diurnal surface pickers, as well as diggers, and ambush and stalker predators were more abundant in streams with higher canopy density. Only habitat variables affected the ecomorphological characteristics of the species. Fish with higher values of relative caudal peduncle length were positively associated with high canopy density, while fish with greater relative mouth width were negatively associated with the variables impact in the riparian zone and cover of fish shelter. The stream fish functional structure was mainly affected by the impacts caused to the local habitat resulting from different land uses. Thus, preserving forest remnants, as well as recovering degraded areas, is essential for the maintenance of aquatic biodiversity in the region.

Abstract We herein report a comprehensive investigation on the magnetic, structural, and electric properties of CoO nanoparticles with different sizes by local inspection through hyperfine interactions measured in a wide range of temperatures (10–670 K) by using radioactive $$^{111}$$ 111 In( $$^{111}$$ 111 Cd) tracers with the perturbed angular correlations technique. Small cobalt oxide nanoparticles with the characteristic size of 6.5 nm have been prepared by the wet chemical route that turned out to be essential to incorporate radioactivity tracers during nucleation and growth of the particles. Nanocrystalline samples with 22.1 nm size were obtained by thermal treatments under low pressure of helium at 670 K. The hyperfine data were correlated with X-ray diffraction, ZFC–FC magnetic measurements, and transmission electron microscopy to describe the structure, magnetic properties, size, and shape of samples. An analysis of the temperature evolution of hyperfine parameters revealed that the structural distortion and the magnetic disorder in the core and on the surface layer play an important role in the magnetic behavior of CoO nanoparticles.

‘Mavuno’ is a newly released brachiariagrass (Urochloa hybrid) cultivar with limited information available in the literature. The objective of this study was to compare forage characteristics of this cultivar and ‘Marandu’ palisadegrass [Urochloa brizantha (Hochst. ex A. Rich.) R.D. Webster cv. Marandu] harvested at 2 different stubble heights during 2 growing seasons (January‒April). The study was conducted in Araguaína, TO, Brazil in 2017 and 2018. Treatments were the factorial arrangement of 2 brachiariagrass cultivars, Mavuno and Marandu, harvested at 2 harvest intensities, 5 and 15 cm stubble height, distributed in a randomized complete block design with 4 replicates. Response variables were canopy height, forage accumulation, proportion of leaf, stem and dead material, and concentration of crude protein (CP) and in vitro digestible organic matter (IVDOM). Mavuno and Marandu did not differ (P>0.05) in forage accumulation (mean = 3,800 kg DM/ha/harvest) and IVDOM concentration (mean = 637 g/kg); however, Mavuno had lower CP concentration (101 vs. 110 g/kg), greater proportion of stems (16 vs. 13%) and less dead material (4 vs. 6%) than Marandu (P

ABSTRACT The investigation of antibodies raised against different severe acute respiratory syndrome coronavirus (SARS-CoV-2) antigens can help to determine the extent of previous SARS-CoV-2 infections in the population and track the humoral response to vaccination. Therefore, serological surveys can provide key information to better manage the pandemic and/or to implement the most effective vaccination program. Here we describe a time series anti-nucleocapsid, anti-spike IgG serological survey analysis in the city of Matinhos, PR, Brazil during the year of 2021. Seroconversion rates to the nucleocapsid antigen were not influenced by gender or age. The serological data support that the coronavirus disease 2019 (COVID-19) infection rate is ~50% higher than official numbers. Furthermore, by applying serological data, the corrected infection fatality rate was estimated to be lower than 2.4% in contrast with the official estimative of 3.6%. The rates of IgG reactive to spike antigen resembled the curve of the fraction the population that had taken the second vaccine dose. Up to 82% of spike seroconversion was detected in the end of 2021, confirming the effectiveness of the COVID-19 vaccination program in the city. This SARS-CoV-2 serological study unraveled the SARS-CoV-2 infection rates and the response to vaccination in the city of Matinhos. IMPORTANCE The investigation of antibodies raised against SARS-CoV-2 can help to determine the extent of previous SARS-CoV-2 infections and track the humoral response to vaccination. Here we describe a time series anti-nucleocapsid, anti-spike IgG serological survey in the city of Matinhos, PR, Brazil during the year of 2021. The data depicted the progression of SARS-CoV-2 infections in the city allowing the correction of the number of citizens who experienced COVID-19 and the disease fatality rate. The seroconversion rates to the spike antigen resembled the curve of the fraction of the population that had taken the second vaccine dose, thereby confirming the effectiveness of the COVID-19 vaccination program in the city.

Background: Primary prevention of cardiovascular disease (CVD) remains a major challenge, especially in communities of low- and middle-income countries with poor medical assistance influenced by distinct local, financial, infrastructural, and resource-related factors. Objective: This a community-based study aimed to determine the proportion and prevalence of uncontrolled cardiovascular risk factors (CRF) in Brazilian communities. Methods: The EPICO study was an observational, cross-sectional, and community clinic-based study. Subjects were living in Brazilian communities and were of both sexes and ≥18 years old, without a history of a stroke or myocardial infarction but presenting at least one of the following cardiovascular risk factors: hypertension, diabetes mellitus and hypercholesterolemia. The study was carried out in Brazil, including 322 basic health units (BHU) in 32 cities. Results: A total of 7,724 subjects with at least one CRF were evaluated, and one clinical visit was performed. Mean age was 59.2 years-old (53.7% were >60 years old). A total of 66.7% were women. Of the total, 96.2% had hypertension, 78.8% had diabetes mellitus type II, 71.1% had dyslipidemia, and 76.6% of patients were overweight/obese. Controlled hypertension (defined by

Abstract The damping properties and specifically the bend losses of polymer optical fibres (POFs) have so far only been documented by experimental work, investigating bending parameters such as bending radius, length, and distance of the bends. Even though damping mechanisms and causes are well-known, no simple, generally valid formula exists. Here, a simulation technique is shown that allows producing an optical model for any bending geometries of melt-spun polymer optical fibres. The developed model takes all relevant loss mechanisms into account, especially regarding the scattering losses at the interface of core and cladding as well as those of the cladding-air interface. The latter is caused by interfacial roughness for which experimental data have been obtained by atomic force microscopy measurements. To show the validity of the simulation, the model is compared to experimental results for several fibres and a variety of geometries. The variance between model and experimental data is low (S

ABSTRACT The Northern Pará Drainage System encompasses the left-bank tributaries of the Amazonas River in the southern Guiana Shield region of Pará state, Brazil. Five of the region’s state protected areas are considered strategic for the conservation of its biodiversity. In the present study, we assessed the ichthyofauna of the five state protected areas of the Northern Pará Drainage System. Seven expeditions were conducted between January 2008 and January 2009, which surveyed stretches of the Cuminá, Cuminapanema, Curuá, Jari, Mapuera, Nhamundá, and Paru rivers. These surveys yielded 286 species belonging to 38 families and eight orders, including seven new records of fish species for Brazil, six of which are also new records for the Amazon basin. Our results provide a valuable database for future research and conservation programs in the protected areas of the region.

The concentration of glucose in the body's fluids is an important parameter that can indicate pathological conditions such as the progress of infected wounds. Several wearables and implantable detection approaches have been developed with high selectivity and sensitivity for glucose. However, all of them have drawbacks such as low stability, limited selectivity, and often require complex technology. In this work, we present a fluorescent-based cost-efficient imprinted hydrogel (MIH_GSH) capable of detecting glucose within 30 ​min. The imprinting approach allows us to improve the selectivity for glucose, overcoming the low specificity and limited binding efficiency at neutral pH of boronic acid-based detection mechanisms. The binding affinity determined for glucose-MIH_GSH was indeed 6-fold higher than the one determined for the non-imprinted hydrogel with a calculated imprinting factor of 1.7. The limit of detection of MIH_GSH for glucose in artificial wound exudate was calculated as 0.48 ​mM at pH 7.4 proving the suitability of the proposed approach to diagnose chronic wounds (ca. 1 ​mM). MIH_GSH was compared with a commercial colorimetric assay for the quantification of glucose in wound exudate specimens collected from hospitalized patients. The results obtained with the two methods were statistically similar confirming the robustness of our approach. Importantly, whereas with the colorimetric assay sample preparation was required to limit the interference of the sample background, the fluorescent signal of MIH_GSH was not affected even when used to measure glucose directly in bloody samples. The sensing mechanism here proposed can pave the way for the development of cost-efficient and wearable point-of-care tools capable of monitoring the glucose level in wound exudate enabling the quick assessment of chronic injuries.

This study was carried out with the objective of determining the antioxidant properties and quantification of total phenolics and flavonoids in relation to quercetin and rutin in some of the monofloral honeys produced in Minas Gerais (Brazil). In this study, 15 monofloral honey samples were obtained from different geographic regions of Minas Gerias, Brazil. The honeys were obtained from Cooperative of Beekeepers and Family Farmers of Northern Minas. To determine the antioxidant properties of honey samples, the test methods of total phenolic content, flavonoids (rutin and quercetin) and DPPH were used. As a result of the analysis of phenolic and flavonoid contents, the samples with the best results were A1-Aroeira and A4-Assa peixe. In antioxidant activity, the honey with the best EC50 results was A6-Aroeira. Differences between the antioxidant activities of the honey samples were found significantly (p< 0.01).

Objective: Every one-hour change in sleep duration (SDUR) has a dose-response impact on cardiovascular disease and mortality. However, self-reported SDUR may not represent the real sleep time in a significant proportion of the adult population. This study was designed to determine the frequency of potential SDUR under/overestimation when comparing subjective versus objective SDUR data. Methods: Consecutive adults from the ELSA-Brasil study collected subjective SDUR and underwent wrist actigraphy for seven days. We defined SDUR underestimation (underSDUR) and overestimation (overSDUR) when the differences between subjective and objective SDUR reached at least -1/+1-hour, respectively. We performed multinomial logistic regression analyses to identify independent factors of under- and overSDUR. Results: Data from 2,036 participants were used in the final analysis (42.7% males; age: 49±8 years). The frequency of underSDUR and overSDUR were 19.4% and 19.7%, respectively. The predictors of underSDUR included black race (OR: 1.65; 95% CI: 1.79–3.93), mixed-race (OR: 1.69; 95% CI: 1.20–2.38); daytime sleepiness (OR: 1.37; 95% CI: 1.05–1.80); longer objective SDUR (OR: 3.00; 95% CI: 2.54–3.56); longer wake time after sleep onset time, WASO (OR: 2.19; 95% CI: 1.22–3.95), and moderate/severe insomnia (OR: 2.54; 95% CI: 1.78–3.63). Longer WASO (OR: 2.26; 95% CI: 1.33–3.82), and a higher number of awakenings (OR: 1.02; 95% CI: 1.00–1.03) were independently associated with overSDUR. Conclusions: We found a significant rate of SDUR under/overestimation when comparing subjective versus objective data. While underSDUR was independently associated with black/mixed race, daytime sleepiness, longer SDUR and WASO, overSDUR was specifically associated with markers of sleep fragmentation.

ABSTRACT The reproductive strategy of a species must be adjusted to variations in environmental conditions to guarantee population balance. Hydrological fluctuations in Amazonian streams of terra firme (non-flooded) are controlled primarily by local rainfall. Fish assemblages are composed predominantly of species of small size. We investigated the reproductive strategy of the cryptic catfish Helogenes marmoratus and assessed the influence of environmental variables (e.g., rainfall, conductivity, habitat descriptors) on its reproductive activity in a catchment of the Guamá River in the eastern Brazilian Amazon. Through monthly collections between March 2019 and March 2020, we identified an extended reproductive period between July 2019 and March 2020. Males mature at smaller sizes than females (♂ = 27.41 mm; ♀ = 31.36 mm). We confirmed batch spawning, low fecundity (59.55 ± 22.76 stage IV oocytes), and large oocytes (1.24 ± 0.15 mm). Our results indicated that H. marmoratus strategy occupies an intermediate place between opportunistic and equilibrium gradient. Multiple regressions showed that thalweg depth, electrical conductivity, leaf litter, and rainfall are important drivers of reproductive activity of females of H. marmoratus, explaining 32% of the variation of the GSI. Our study provides evidence of differentiated reproductive response between the sexes to environmental variables.

An ultrasonic reactor (UR) was developed and coupled to a digital movie-based flow-batch analyzer (DM-FBA) for the ultrasonic-assisted extraction (UAE) and fast determination of catalase and lipase activities in bovine and poultry livers. The lab-made UR mainly consisted of a borosilicate glass container and a piezoelectric disc. The DM-FBA mainly consisted of a webcam, an ultrasonic actuator controller, a peristaltic pump, six solenoid valves, a valve driver, a mixing chamber, a magnetic stirrer, an Arduino Mega 2560, and a personal computer. This setup, named UR-DM-FBA, was controlled by custom software. Ultrasound (US) frequency, US power, sonication time, and concentration of extraction agent were optimized using the Taguchi method. Experiments at silent conditions (mechanical stirring at 1500 rpm) were carried out to evaluate extraction efficiency. Optimized parameters for the UAE of catalase were US frequency of 30 kHz, 2.0 mL of Triton X-100, sonication time of 270 s, and US power of 10.8 W. For the UAE of lipase, the optimized parameters were US frequency of 20 kHz, 0.30 mL of triethanolamine, sonication time of 270 s, and US power of 18 W. Catalase and lipase activities obtained with the UR were, on average, 1.9 × 103% and 2.0 × 103% higher than those obtained at silent conditions, respectively, which indicates that that the lab-made UR was capable of extracting these enzymes more efficiently. Determinations using the UR-DM-FBA were highly accurate (relative error ranging from −1.98% to 1.96% for bovine catalase, −0.65% to 0.76% for bovine lipase, −2.03 to 2.08% for poultry catalase, and −0.55% to 0.64% for poultry lipase) and precise (overall coefficient of variation 69 h−1) and low sample/reagent consumption (

(1) Background: COVID-19 vaccination in Brazil has been performed mostly with CoronaVac (Sinovac), ChAdOx1-S (AstraZeneca-University of Oxford) and BNT162b2 (Pfizer-BioNTech) vaccines. The titers of IgG antibodies reactive to the SARS-CoV-2 spike protein correlate with vaccine efficacy. Studies comparing vaccine immunogenicity in a real-world scenario are lacking. (2) Methods: We performed a population-based study to analyze the immunoglobulin G response to different COVID-19 vaccines. Citizens older than 18 years (n = 2376) provided personal data, a self-declaration of any previous COVID-19 positive tests and information regarding COVID-19 vaccination: the vaccine popular name and the date of each dose. Blood samples were collected and the levels of IgG reactive to SARS-CoV-2 antigens were determined and compared between different vaccine groups. (3) Results: The seroconversion for anti-spike IgG achieved > 95% by February 2022 and maintained stable until June 2022. Higher anti-spike IgG titers were detected in individuals vaccinated with BNT162b2, followed by ChAdOx1-S and CoronaVac. The anti-spike IgG response was negatively correlated with age and interval after the second dose for the BNT162b2 vaccine. Natural infections boosted anti-spike IgG in those individuals who completed primary vaccination with ChAdOx1-S and CoronaVac, but not with BNT162b2. The levels of anti-spike IgG increased with the number of vaccine doses administered. The application of BNT162b2 as a 3rd booster dose resulted in high anti-spike IgG antibody titers, despite the type of vaccine used during primary vaccination. (4) Conclusions: Our data confirmed the effectiveness of the Brazilian vaccination program. Of the vaccines used in Brazil, BNT162b2 performed better to elicit anti-spike protein IgG after primary vaccination and as a booster dose and thus should be recommended as a booster whenever available. A continuous COVID-19 vaccination program will be required to sustain anti-spike IgG antibodies in the population.

Abstract The expansion of agriculture in the southeast Amazon-Savanah transitional area has greatly decreased forest cover and influenced stream structure and functioning. We assessed the effects of forest cover loss on the integrity of streams by assessing stream physical conditions and the taxonomic and functional diversity of fish assemblages in this transitional area. We hypothesize that low forest cover, especially adjacent to streams, results in poor physical conditions (e.g., warmer temperatures, less physical structure, etc.), which in turn will decrease the taxonomic and functional diversity of fish assemblages. We detected that loss of forest cover negatively affects natural stream conditions and reduces the functional diversity of fish assemblages, but we did not find a strong effect on taxonomic diversity. Ambush and stalking predators, diurnal surface pickers (groups that exhibit opportunistic life history strategies), grazers, pickers, and browsers (groups that exhibit equilibrium life history strategies) were the functional groups with the strongest relation to altered environments. These groups can explore different niches, both with natural characteristics or altered by human activities. Our results suggest that the preservation of riparian zones can minimize the loss of specialized fish species in assemblages of Amazon-Savannah stream systems.

Background: Patients with Coronavirus Disease 2019 (COVID-19) may present high risk features during hospitalization, including cardiovascular manifestations. However, less is known about the factors that may further increase the risk of death in these patients. Methods: We included patients with COVID-19 and high risk features according to clinical and/or laboratory criteria at 21 sites in Brazil from June 10th to October 23rd of 2020. All variables were collected until hospital discharge or in-hospital death. Results: A total of 2546 participants were included (mean age 65 years; 60.3% male). Overall, 70.8% were admitted to intensive care units and 54.2% had elevated troponin levels. In-hospital mortality was 41.7%. An interaction among sex, age and mortality was found (p = 0.007). Younger women presented higher rates of death than men (30.0% vs 22.9%), while older men presented higher rates of death than women (57.6% vs 49.2%). The strongest factors associated with in-hospital mortality were need for mechanical ventilation (odds ratio [OR] 8.2, 95% confidence interval [CI] 5.4–12.7), elevated C-reactive protein (OR 2.3, 95% CI 1.7–2.9), cancer (OR 1.8, 95 %CI 1.2–2.9), and elevated troponin levels (OR 1.8, 95% CI 1.4–2.3). A risk score was developed for risk assessment of in-hospital mortality. Conclusions: This cohort showed that patients with COVID-19 and high risk features have an elevated rate of in-hospital mortality with differences according to age and sex. These results highlight unique aspects of this population and might help identifying patients who may benefit from more careful initial surveillance and potential subsequent interventional therapies.

OBJECTIVES: To describe the MORPHEOS (Morbidity in patients with uncontrolled HTN and OSA) trial, and describe the challenges imposed by the COVID-19 pandemic. METHODS: MORPHEOS is a multicenter (n=6) randomized controlled trial designed to evaluate the blood pressure (BP) lowering effects of treatment with continuous positive airway pressure (CPAP) or placebo (nasal strips) for 6 months in adult patients with uncontrolled hypertension (HTN) and moderate-to-severe obstructive sleep apnea (OSA). Patients using at least one antihypertensive medication were included. Uncontrolled HTN was confirmed by at least one abnormal parameter in the 24-hour ABPM and ≥80% medication adherence evaluated by pill counting after the run-in period. OSA was defined by an apnea-hypopnea index ≥15 events/hours. The co-primary endpoints are brachial BP (office and ambulatory BP monitoring, ABPM) and central BP. Secondary outcomes include hypertension-mediated organ damage (HMOD) to heart, aorta, eye, and kidney. We pre-specified several sub-studies from this investigation. Visits occur once a week in the first month and once a month thereafter. The programmed sample size was 176 patients but the pandemic prevented this final target. A post-hoc power analysis will be calculated from the final sample. ClinicalTrials.gov: NCT02270658. RESULTS: The first 100 patients are predominantly males (n=69), age: 52±10 years, body mass index: 32.7±3.9 kg/m2 with frequent co-morbidities. CONCLUSIONS: The MORPHEOS trial has a unique study design including a run-in period; pill counting, and detailed analysis of hypertension-mediated organ damage in patients with uncontrolled HTN that will allow clarification of the impact of OSA treatment with CPAP.

A single species of electric eel, Electrophorus electricus, has been described. Here, de Santana et al. show that there are three major lineages of Electrophorus distributed across Greater Amazonia and describe two new species, one with a much stronger electric discharge than was previously known.

Objective: Polygraphy (PG) is an attractive alternative for diagnosing obstructive sleep apnea (OSA) in patients with high pre-test probability. However, several patients may not present typical symptoms. In this scenario, it is unclear the performance of PG for diagnosing OSA in nonreferred populations to sleep laboratories. Methods: Data from participants of the ELSA-Brasil cohort were used for this analysis. We performed an overnight home PG (Embletta GoldTM) synchronized with a wrist actigraphy (Actiwatch model 2TM). The validation strategy comprised three scorings from each participant: 1) Original scoring (PG): Routine scoring using data from the exclamation button mark to define “analysis start” and “analysis stop”; 2) Scoring using actigraphy data (PG+actigraphy): total sleep time defined by the actigraphy data; 3) Scoring using diaries (PG+diary): “analysis start” and “analysis stop” based on the diaries. Bland-Altman plots were generated to assess the agreements (Kappa) between each scoring strategy. Results: A total of 300 participants were included in the final analysis (45% males, mean age: 48±8 years). The frequency of OSA using the PG score was 27.3%. Despite small differences in the OSA severity index, we obtained a high concordance of AHI comparing the PG vs. PG+actigraphy (Kappa: 0.95) as well as PG+diary vs. PG+actigraphy (Kappa: 0.96). No significant changes in the OSA classification (mild, moderate and severe) were observed in the 3 protocols. Conclusion: Using a pragmatic approach to address OSA at home, our results suggest that PG is a useful tool for OSA diagnosis even in subjects not referred to sleep studies.

Background: Whether continuous positive airway pressure (CPAP) treatment can improve depression or anxiety symptoms in obstructive sleep apnoea (OSA) patients remains uncertain. Methods: Secondary analysis of the Sleep Apnea Cardiovascular Endpoints (SAVE) trial, combined with a systematic review of randomised evidence. The SAVE secondary analyses involved 2410 patients with co-existing moderate–severe OSA and established cardiovascular disease randomly allocated to CPAP treatment plus usual care or usual care alone and followed up for 3·7 (SD 1·6) years. We evaluated the effect of CPAP treatment on depression and anxiety caseness (scores ≥8 on the Hospital Anxiety and Depression Scale depression and anxiety subscales [HADS-D and HADS-A]) for OSA patients. Findings: CPAP treatment was associated with reduced odds of depression caseness (adjusted odds ratio [OR] 0·80, 95% confidence interval [CI] 0·65–0·98, P = 0·031) compared to usual care in the SAVE trial and the treatment effect was greater in those with pre-existing depression symptoms. A systematic review of 20 randomised trials including 4255 participants confirmed a benefit of CPAP in reducing depression symptoms in OSA patients: the overall effect (standardised mean difference) was −0·18 (95% CI −0·24 to −0·12). No effect of CPAP treatment on anxiety caseness was found both in patients of the SAVE study (adjusted OR 0·98, 95% CI 0·78–1·24, P = 0·89) and the systematic review. Interpretation: CPAP reduces depression symptoms in patients with co-existing OSA and CVD independently of improvements in sleepiness. Keywords: Continuous positive airway pressure, Depression, Anxiety, Mood, Obstructive sleep apnoea, OSA, Cardiovascular diseases

Honeys can be classified as polyfloral or monofloral and have been extensively studied due to an increased interest in their consumption. There is concern with the correct identification of their flowering, the use of analyses that guarantee their physicochemical quality and the quantification of some compounds such as phenolics, to determine their antioxidant and antimicrobial action. This study aims at botanical identification, physicochemical analyses, and the determination of total polyphenols, chromatographic profile and antiradical and antimicrobial activity of honey from different regions of Minas Gerais. Seven different samples were analyzed for the presence of pollen, and color determination. The physicochemical analyses performed were total acidity, moisture, HMF, reducing sugar, and apparent sucrose. The compound profile was determined by UHPLC/MS, the determination of total phenolics and antiradical activity (DPPH method) were performed by spectrophotometry, and minimum inhibitory and bacterial concentrations were determined for cariogenic bacteria. All honey samples met the quality standards required by international legislation, twenty compounds were detected as the main ones, the polyfloral honey was the only honey that inhibited all of the bacteria tested. Sample M6 (Coffee) was the one with the highest amount of total polyphenols, while the lowest was M4 (Cipó-uva). Regarding the antioxidant activity, M5 (Velame) had the best result and M4 (Cipó-uva) was the one that least inhibited oxidation. Of the polyfloral honeys, there was not as high a concentration of phenolic compounds as in the others. Coffee, Aroeira, Velame and Polyfloral have the best anti-radical actions. Betônica, Aroeira, Cipó-uva and Pequi inhibited only some bacteria. The best bacterial inhibition results are from Polyfloral.