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Abdulmajeed Alshabanat,1 Michael C Otterstatter,2,3 Don D Sin,4,5 Jeremy Road,5,6 Carmen Rempel,6 Jane Burns,6 Stephan F van Eeden,4,5 JM FitzGerald5–7 On behalf of the COPD Transition Team Program 1Department of Experimental Medicine, University of British Columbia, 2British Columbia Centre for Disease Control, 3School of Population and Public Health, 4Department of Medicine, Centre for Heart Lung Innovation, St Paul’s Hospital, 5Division of Respirology, Department of Medicine, 6Department of Medicine, Faculty of Medicine, Institute for Heart and Lung Health, University of British Columbia, 7Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Institute, Vancouver, BC, Canada Background: COPD accounts for the highest rate of hospital admissions among major chronic diseases. COPD hospitalizations are associated with impaired quality of life, high health care utilization, and poor prognosis and result in an economic and a social burden that is both substantial and increasing.Aim: The aim of this study is to determine the efficacy of a comprehensive case management program (CCMP) in reducing length of stay (LOS) and risk of hospital admissions and readmissions in patients with COPD.Materials and methodology: We retrospectively compared outcomes across five large hospitals in Vancouver, BC, Canada, following the implementation of a systems approach to the management of COPD patients who were identified in the hospital and followed up in the community for 90 days. We compared numbers, rates, and intervals of readmission and LOS during 2 years of active program delivery compared to 1 year prior to program implementation.Results: A total of 1,564 patients with a clinical diagnosis of COPD were identified from 2,719 hospital admissions during the 3 years of study. The disease management program reduced COPD-related hospitalizations by 30% and hospitalizations for all causes by 13.6%. Similarly, the rate of readmission for all causes showed a significant decline, with hazard ratios (HRs) of 0.55 (year 1) and 0.51 (year 2) of intervention (P

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Globalization affects the agribusiness sector and affects the base of primary production in the world. Naturally, the need for professionalization appears in milk producing establishments. This study aimed to analyze the (non) use of management indicators in milk producing establishments, from the data collected in the interviews in 25 properties located in the provinces of Lugo and A Coruña, Galicia, Spain. We tried to heterogeneity in the sample, characterized as non-probabilistic, in order to understand the behavior of properties on the control of its variables, through management indicators. It follows that the properties have different realities, and observed properties at an early stage of monitoring of management and property indicators using systematic tools. From this observation, we present a University of intervention opportunity in qualifying offer to enhance the outcome of farms milk producers. [ABSTRACT FROM AUTHOR]

The process of urbanity and standard agricultural practice occur constantly, changing the natural environmental conditions and transforming continuous vegetated areas into forest fragments. The aim of this study was to verify the existence of a connection among population density, land cover and land use, and the existing hotspots and firepoints in Vale do Taquari/RS/Brazil. Therefore, maps of population density and of ecological-economical zoning areas suitable for conservation were generated. By analyzing the results, we discuss the best way of preserving and at the same time of producing. In addition to the alternatives introduced by agroecology, it is suggested that the suitable areas for production have to be well explored, while the regions with restrictions maintain more extensive and preserved areas. Tiny fragments, despite of serving as connective islands, do not carry out the same environmental function as the extensive fragments, mainly due to the influence of edge effect. [ABSTRACT FROM AUTHOR]

A response by D. I. Gustafson, M. J. Horak, S. G. Metz and D. R. Gigax to a letter to the editor about their article "An Empirical Model for Pollen-Mediated Gene Flow in Wheat," previously published in the journal "Crop Science" is presented.

Background: The assessment of clinical prognosis of pregnant COVID-19 patients at hospital presentation is challenging, due to physiological adaptations during pregnancy. Our aim was to assess the performance of the ABC 2 -SPH score to predict in-hospital mortality and mechanical ventilation support in pregnant patients with COVID-19, to assess the frequency of adverse pregnancy outcomes, and characteristics of pregnant women who died., Methods: This multicenter cohort included consecutive pregnant patients with COVID-19 admitted to the participating hospitals, from April/2020 to March/2022. Primary outcomes were in-hospital mortality and the composite outcome of mechanical ventilation support and in-hospital mortality. Secondary endpoints were pregnancy outcomes. The overall discrimination of the model was presented as the area under the receiver operating characteristic curve (AUROC). Overall performance was assessed using the Brier score., Results: From 350 pregnant patients (median age 30 [interquartile range (25.2, 35.0)] years-old]), 11.1% had hypertensive disorders, 19.7% required mechanical ventilation support and 6.0% died. The AUROC for in-hospital mortality and for the composite outcome were 0.809 (95% IC: 0.641-0.944) and 0.704 (95% IC: 0.617-0.792), respectively, with good overall performance (Brier = 0.0384 and 0.1610, respectively). Calibration was good for the prediction of in-hospital mortality, but poor for the composite outcome. Women who died had a median age 4 years-old higher, higher frequency of hypertensive disorders (38.1% vs. 9.4%, p < 0.001) and obesity (28.6% vs. 10.6%, p = 0.025) than those who were discharged alive, and their newborns had lower birth weight (2000 vs. 2813, p = 0.001) and five-minute Apgar score (3.0 vs. 8.0, p < 0.001)., Conclusions: The ABC 2 -SPH score had good overall performance for in-hospital mortality and the composite outcome mechanical ventilation and in-hospital mortality. Calibration was good for the prediction of in-hospital mortality, but it was poor for the composite outcome. Therefore, the score may be useful to predict in-hospital mortality in pregnant patients with COVID-19, in addition to clinical judgment. Newborns from women who died had lower birth weight and Apgar score than those who were discharged alive., (© 2023. The Author(s).)

Patients' perspectives on the impact of the COVID-19 pandemic on their access to asthma and COPD healthcare could inform better, more equitable care delivery. We demonstrate this topic using British Columbia (BC), Canada, where the impact of the pandemic has not been described. We co-designed a cross-sectional survey with patient partners and administered it to a convenience sample of people living with asthma and COPD in BC between September 2020 and March 2021. We aimed to understand how access to healthcare for these conditions was affected during the pandemic. The survey asked respondents to report their characteristics, access to healthcare for asthma and COPD, types of services they found disrupted and telehealth (telephone or video appointment) use during the pandemic. We analysed 433 responses and found that access to healthcare for asthma and COPD was lower during the pandemic than pre-pandemic ( p < 0.001). Specialty care services were most frequently reported as disrupted, while primary care, home care and diagnostics were least disrupted. Multivariable logistic regression revealed that access during the pandemic was positively associated with self-assessed financial ability (OR = 22.0, 95% CI: 7.0 - 84.0, p < 0.001, reference is disagreeing with having financial ability) and living in medium-sized urban areas (OR = 2.3, 95% CI: 1.0 - 5.2, p = 0.04, reference is rural areas). These disparities in access should be validated post-pandemic to confirm whether they still persist. They also indicate the continued relevance of exploring approaches for more equitable healthcare.

The COVID-19 pandemic caused unprecedented pressure over health care systems worldwide. Hospital-level data that may influence the prognosis in COVID-19 patients still needs to be better investigated. Therefore, this study analyzed regional socioeconomic, hospital, and intensive care units (ICU) characteristics associated with in-hospital mortality in COVID-19 patients admitted to Brazilian institutions. This multicenter retrospective cohort study is part of the Brazilian COVID-19 Registry. We enrolled patients ≥ 18 years old with laboratory-confirmed COVID-19 admitted to the participating hospitals from March to September 2020. Patients' data were obtained through hospital records. Hospitals' data were collected through forms filled in loco and through open national databases. Generalized linear mixed models with logit link function were used for pooling mortality and to assess the association between hospital characteristics and mortality estimates. We built two models, one tested general hospital characteristics while the other tested ICU characteristics. All analyses were adjusted for the proportion of high-risk patients at admission. Thirty-one hospitals were included. The mean number of beds was 320.4 ± 186.6. These hospitals had eligible 6556 COVID-19 admissions during the study period. Estimated in-hospital mortality ranged from 9.0 to 48.0%. The first model included all 31 hospitals and showed that a private source of funding (β = - 0.37; 95% CI - 0.71 to - 0.04; p = 0.029) and location in areas with a high gross domestic product (GDP) per capita (β = - 0.40; 95% CI - 0.72 to - 0.08; p = 0.014) were independently associated with a lower mortality. The second model included 23 hospitals and showed that hospitals with an ICU work shift composed of more than 50% of intensivists (β = - 0.59; 95% CI - 0.98 to - 0.20; p = 0.003) had lower mortality while hospitals with a higher proportion of less experienced medical professionals had higher mortality (β = 0.40; 95% CI 0.11-0.68; p = 0.006). The impact of those association increased according to the proportion of high-risk patients at admission. In-hospital mortality varied significantly among Brazilian hospitals. Private-funded hospitals and those located in municipalities with a high GDP had a lower mortality. When analyzing ICU-specific characteristics, hospitals with more experienced ICU teams had a reduced mortality., (© 2022. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).)

Fungal entomopathogens can greatly reduce the fitness of their hosts, and it is therefore expected that susceptible insects will be selected to avoid exposure to pathogens. Metarhizium brunneum is a fungal pathogen that can infect Agriotes obscurus, which in its larval form is a destructive agricultural pest and is repelled by the presence of M. brunneum conidia. Due to the subterranean nature of larval A. obscurus, recent research has focused on targeting adult A. obscurus with M. brunneum. No-choice and choice behavioural assays were conducted to determine if male adult A. obscurus avoid M. brunneum mycosed cadavers, or conidia applied to either food or soil. To further investigate the response of A. obscurus beetles to conspecific cadavers, the movement and behaviour of beetles placed at the centre of a semi-circular arrangement of mycosed or control cadavers was examined using motion tracking software. We found little evidence to suggest that A. obscurus male beetles avoid M. brunneum conidia or mycosed conspecific cadavers or alter their behaviour in their presence., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier Inc.)

There is a trend toward the use of natural substances present in plants and vegetables. In general, foods rich in antioxidants are complex matrices; therefore, understanding its absorption effects is extremely relevant to know its bioactive potential. Thus, this systematic review focused on clinical trials involving plants (or compounds) registered on the National List of Medicinal Plants of Interest to the Unified Health System (RENISUS) with antioxidant properties. Following the reporting guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyzes studies of interest indexed in the PubMed and ClinicalTrials.gov databases were analyzed. Of the 59 clinical trials found, Allium sativum and Curcuma longa are the plant species with the highest percentage of clinical research. Prevention/attenuation of oxidative stress was one of the main antioxidant mechanisms indicated in the studies. The most tested compounds of the RENISUS plants in clinical trials were curcumin and soy isoflavone. In this review, we selected studies in advanced stages that highlight plants' value in optimizing antioxidant status; however, even with high-quality studies, it is not prudent to overstate the clinical efficacy of these plants., (© 2021 John Wiley & Sons Ltd.)

Introduction: The chronic metabolic disorder diabetes mellitus is a fast-growing global problem with huge social, health, and economic consequences, having one of the highest morbidities and mortality rates. Prolonged use of many available medications can produce undesirable side effects. Thus, plants appear as an important source of bioactive resources for the discovery of new treatments for diabetes., Areas Covered: In this sense, this systematic review focused on clinical trials involving plants of National List of Medicinal Plants of Interest to the Unified Health System (RENISUS) (or compounds) with antidiabetic properties. We analyzed indexed studies in PubMed following the reporting guidelines of PRISMA., Expert Opinion: Of the 51 clinical trials found, Curcuma longa, Glycine max, Zingiber officinale, Punica granatum, Aloe vera, Momordica charantia are the species with the greatest amount of clinical trials and the attenuation of insulin resistance, decreased fasting blood glucose and glycosylated hemoglobin levels are some of the main mechanisms by which these plants exert hypoglycemic effects. Thus, we speculate that the Clinical Pharmacology should explore the field of plant-based compounds that will keep concentrating the attention of researchers, and therefore, we gathered studies in advanced stages that highlight the role of plants in the diabetes therapy.

Introduction: The COVID-19 global pandemic is a public health emergency due to its high virulence and mortality. Many vaccine development studies at clinical trials are currently conducted to combat SARS-CoV-2. Plants are a rich source of phytochemicals with different biological activities, including antiviral activities, which are the focus of many studies., Areas Covered: This review shows compounds of traditional plants listed on RENISUS list have therapeutic properties against SARS-CoV-2 targets., Expert Opinion: The rise of new variants, more pathogenic and virulent, impacts in the increase of mortality from SARS-CoV-2 infection, and thus, the control of the outbreaks of disease remains a global challenge. Other's drug and vaccines development is an essential element in controlling SARS-COV-2. Therefore, it is imperative that approach to tackle this pandemic has to be solidly evidence-informed. It should be noticed that the immune system does play critical roles in fighting viruses. Studies show that T cells levels decreased continuously as the disease progressed. T cell-mediated cellular immune response, probably by immunological memory, is essential for direct virus eradication after infection whilst B cells functions in producing antibodies that neutralize virus.But, have distinct patterns of T cell response exist in different patients, suggesting the possibility of distinct clinical approaches. Efforts are concentrated to elucidate the underlying immunological mechanisms in SARS-CoV-2 pathogenesis and progression for better design of diagnostic, therapeutic and preventive strategies. We seek to identify biomolecules with the potential to act in biomarkers that predict how severe the disease can get. But it is important to warn that the plants that produce the compounds mentioned here should not be used without a physician prescription. Finally, we speculate that these compounds may eventually attract the attention of physicians and researchers to perform tests in specific contexts of SARS-CoV-2 infection, and if they show positive results, be tested in Clinical trials.

Cancer is a significant cause of morbidity and mortality. Scientific advances, coupled with potential flaws in current treatments, are driving research into the discovery of new bioactive molecules. This systematic review focused on scientific studies with clinical trials and patents registered on the National Relation of Medicinal Plants of Interest to the Unified Health System (RENISUS) plants (or derivative compounds) with antitumor potential. Studies with 19 different forms of cancer were found, the prostate being the organ with the highest research incidence and the species Glycine max , Curcuma longa , and Zingiber officinale , beside the phytochemicals curcumin and soy isoflavone were the most tested in clinical trials/patents.

The dairy industry can contribute to global food security in a sustainable way by efficiently converting milk into dairy ingredients and products, even though they are polluting on a large scale. In this context, this study aimed to conduct a systematic literature review on sustainable indicators and dairy industries. The methodology used has a qualitative and quantitative approach and its technical procedure was the systematic literature review. The bases of journals consulted, using the keywords "sustainability indicator" and "dairy industry" which resulted in 130 valid scientific articles. The main results show that the sustainability indicators in the dairy industry are emerging and lacking research; being found seven papers, that highlight 12 indicators of the environmental, 11 of the social and eight economic dimensions, that may be considered fragile and initial. The studied problems are related to wastewater treatment methods, electric power consumption, efficiency of the industrial plant, among others, and the benefits on the theme are related to solutions to the difficulties, such as electricity reduction, sustainable practices. Among others, it is concluded that the dairy industries address the sustainability theme since 2011, with an ambiguous trend, being found evidence of the fragility of the sustainability indicators was found, mainly in the initial stage of their conception, when considering holistic approach (triple bottom line).

Background: Air classification was used to fractionate canola meal (CM). The effect of combinations of air classification conditions, including rotor speed ranging from 300 to 1200 rpm, air stream rate from 700 to 860 cfpm, and secondary air from 0 to 30%, on particle size and nutritive composition was investigated. Response surface methodology was used to develop response surface equations to estimate these effects., Results: Protein concentration increased in almost all the fine fractions. Effects of both secondary air and rotor speed of the air classifier were significant at P ≤ 0.1 and P ≤ 0.01, respectively. Almost all the fine fractions contained more oil. Rotor speed, air stream rate, and their interaction were significant at P ≤ 0.01. Both acid detergent fiber (ADF) and neutral detergent fiber (NDF) were shifted to the coarse fractions during the air classification. The rotor speed was significant for both ADF and NDF at P ≤ 0.01., Conclusions: Protein shifted to the fine fractions. The highest protein concentration in the fine CM fraction was estimated to be 404.2 g kg -1 , demonstrating an enhancement of 10.7%. ADF and NDF shifted to the coarse CM fractions and were respectively estimated to be 294.8 and 332 g kg -1 , which were increased by 52.7% and 43.7%. Oil shifted to the fine fractions. The highest concentration was predicted to be 59.7 g kg -1 , increased by 45.6%. Fine or coarse fraction yields were estimated to be 35-50%, indicating that they are acceptable for an industrial manufacture. © 2019 Society of Chemical Industry., (© 2019 Society of Chemical Industry.)

This study determined influence of industrial scale milling and air classification on separation of pea flours into fine and coarse fractions. Three commercial field pea flours were chosen from field peas grown in Manitoba, Canada, - whole green pea flour (WGPF), split green pea flour (SGPF), and organic split yellow pea flour (OSYPF). The ranges of 85-87% protein, 74-95% fat, and 66-76% minerals were enriched in the pea fine fractions. A range of 78-91% starch was enriched in the coarse fractions. Scanning electron microscopy and proximate analysis confirmed compositional shift between the fine and coarse fractions. The particle size analysis demonstrated that the milling in this study was sufficient and effective in reducing the flour particle size to smaller than 22 µm, which was considered to be the cut-point. The yield of the fine fraction was as high as 44% and acceptable for an industrial manufacture., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: To evaluate the quality of life and to analyze the epidemiological profile of people with diabetes treated in Family Health Strategies., Method: A cross-sectional study carried out with 350 people with diabetes., Results: Most people with diabetes are women, elderly, married, white, with low educational level, retired/pensioners, family income of up to two minimum wages. As the time of people with the disease increases, their quality of life decreases. People with complications from diabetes have a lower quality of life, with a statistically significant difference., Conclusion: Knowledge of the sociodemographic characteristics, clinical evaluation and quality of life of people with diabetes can improve the care process provided to this population.

Objective: The aim of this study was to conduct a systematic review of the healing potential of medicinal plants belonging to the Brazilian National List of Medicinal Plants of Interest to the Unified Health System (RENISUS)., Method: PubMed and ScienceDirect databases were searched for relevant articles, regardless of the language, from 2010 to June 2016. Two reviewers independently assessed study eligibility. Articles were included if they presented evidence of healing potential of medicinal plants. Only those available as full and open access texts were considered., Results: A total of 1381 articles met the inclusion criteria. Of these, 156 studies were considered eligible and were reviewed as full text. Following full analysis, 64 studies were included in this review. The studies covered 27 of the 71 plants belonging to RENISUS, nine of which are native to Brazil. In addition, two species are currently available in the Brazilian public health system as herbal medicine., Conclusion: This review may encourage and contribute to the appropriate use of medicinal plants in the public health system in Brazil.