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Women of reproductive age are less prone to cardiovascular disease than men. However, diabetes mellitus negates this female advantage. The prevalence change of prediabetes (prediabetes mellitus) and diabetes mellitus and diabetes mellitus‒associated cardiovascular risk factors have not been clearly described in women before menopause.Using National Health and Nutrition Examination Survey data (1999-2018), this study estimated the age-adjusted prevalence of prediabetes mellitus (2005-2018), diagnosed diabetes mellitus, and undiagnosed diabetes mellitus in premenopausal women. Logistic regression was used to examine cardiovascular risk factors, including obesity, central obesity, hypercholesterolemia, hypertension, and hypertriglyceridemia, associated with prediabetes mellitus, diagnosed diabetes mellitus, or undiagnosed diabetes mellitus in premenopausal women. The magnitude of the association among age-matched men and postmenopausal women was compared. The analysis was conducted in 2022.Premenopausal women experienced an increased prevalence of prediabetes mellitus and undiagnosed diabetes mellitus, contrasting with steady trends in all U.S. adults over the last 2 decades. Premenopausal women with prediabetes mellitus or diabetes mellitus (versus those with normoglycemia) have significant obesity risk, and the risk is equivalent to that among age-matched men and higher than that among postmenopausal women. The association between prediabetes mellitus and hypercholesterolemia or hypertriglyceridemia was significant in premenopausal women only. Hypercholesterolemia and hypertension associated with undiagnosed diabetes mellitus were significant in premenopausal women and men of the same age, respectively. Diagnosed and undiagnosed diabetes mellitus was associated with hypertriglyceridemia in men and postmenopausal women, respectively.Premenopausal women had increased prediabetes mellitus and undiagnosed diabetes mellitus in the past 2 decades. They face a considerable cardiovascular risk burden associated with prediabetes mellitus and diabetes mellitus. Cardiometabolic risk screening and patient education should be improved in young and early middle-aged adults, particularly in women.

Diabetes increases the risk of Alzheimer's disease (AD). We investigated the impact of glucose concentrations on the β-amyloid (Aβ)-induced alteration of mitochondrial/cellular energetics in primary human brain microvascular endothelial cells (HBMECs). HBMECs were grown and passaged in media containing 15 mmol/l glucose (normal) based on which the glucose levels in the media were designated as high (25 mmol/L) or low (5 mmol/L). HBMECs were treated with Aβ (1-42) (5 µmol/l) or a scrambled peptide for 24 h and mitochondrial respiratory parameters were measured using Seahorse Mito Stress Test. Aβ (1-42) decreased the mitochondrial ATP production at normal glucose levels and decreased spare respiratory capacity at high glucose levels. Aβ (1-42) diminished all mitochondrial respiratory parameters markedly at low glucose levels that were not completely recovered by restoring normal glucose levels in the media. The addition of mannitol (10 mmol/l) to low and normal glucose-containing media altered the Aβ (1-42)-induced bioenergetic defects. Even at normal glucose levels, pre-senescent HMBECs (passage 15) displayed greater Aβ (1-42)-induced mitochondrial respiratory impairments than young cells (passages 7-9). Thus, hypoglycemia, osmolarity changes, and senescence are stronger instigators of Aβ (1-42)-induced mitochondrial respiration and energetics in HBMECs and contributors to diabetes-related increased AD risk than hyperglycemia.

The present study examined the acute and chronic toxicity of the neonicotinoid insecticides imidacloprid (IMI) and thiamethoxam (TIA) on the neotropical amphibian species

The present study examined the acute and chronic toxicity of the neonicotinoid insecticides imidacloprid and thiamethoxam in neotropical amphibian species from the Pampa region of Argentina. The median lethal concentration after 96h of exposure (96h-LC50) ranged between 11.28 and > 71.2 mg/L amongst all species and development stages tested; indicating that these pesticides are unlikely to cause acute toxicity in the wild. The subchronic toxicity was also low, with 21d-LC50 values ranging between 27.15 and > 71.2 mg/L. However, exposure of developing tadpoles of Rhinella arenarum to thiamethoxam from stage 27 until the completion of metamorphosis showed that treated animals present a significant reduction in metamorphic success together with a smaller size at metamorphosis and an asymmetry in the length of the left and right front arms. These effects, which are observed starting from the lowest concentration tested (9 mg/L), suggest an effect of thiamethoxam on the hypothalamic-pituitary-thyroid (HPT) axis. Given that the observed effects can clearly impair amphibian performance and survival in the wild, further studies employing the same experimental approach but looking at lower environmentally-relevant concentrations are needed.

Paired box 4 (Pax4) is a key transcription factor involved in the embryonic development of the pancreatic islets of Langerhans. Consisting of a conserved paired box domain and a homeodomain, this transcription factor plays an essential role in early endocrine progenitor cells, where it is necessary for cell-fate commitment towards the insulin-secreting β cell lineage. Knockout of Pax4 in animal models leads to the absence of β cells, which is accompanied by a significant increase in glucagon-producing α cells, and typically results in lethality within days after birth. Mutations in Pax4 that cause an impaired Pax4 function are associated with diabetes pathogenesis in humans. In adulthood, Pax4 expression is limited to a distinct subset of β cells that possess the ability to proliferate in response to heightened metabolic needs. Upregulation of Pax4 expression is known to promote β cell survival and proliferation. Additionally, ectopic expression of Pax4 in pancreatic islet α cells or δ cells has been found to generate functional β-like cells that can improve blood glucose regulation in experimental diabetes models. Therefore, Pax4 represents a promising therapeutic target for the protection and regeneration of β cells in the treatment of diabetes. The purpose of this review is to provide a thorough and up-to-date overview of the role of Pax4 in pancreatic β cells and its potential as a therapeutic target for diabetes.

O presente artigo examina o caso de uma iniciativa institucional voltada à preservação da memória dos Jogos Olímpicos de Verão Rio 2016. Procura-se mostrar de que maneira, em paralelo às ações governamentais e à performance dos atletas durante o torneio realizado no Rio de Janeiro, houve um notável investimento de parte da instituição no sentido de salvaguardar o registro dos acontecimentos desse até então inédito megaevento esportivo no Brasil, ocorrido pela primeira vez da sua história em uma cidade da América do Sul. Em que pese uma série de críticas e questionamentos feitos à organização das Olimpíadas por parte da opinião pública, e mesmo de parcelas da Academia, salientam-se aqui os esforços de uma rede de pesquisadores com vistas a construir e a fixar uma memória coletiva em torno do evento. Para destacar esse aspecto, incluído na chave nativa de um “legado”, mobilizaremos o exemplo paradigmático da Fundação Casa de Rui Barbosa, que, em conjunto com o FGV CPDOC, desenvolveu um amplo programa de acompanhamento e cobertura dos Jogos durante o ano de sua realização. Com efeito, abordaremos de início o conceito de memória e, em particular, do que denominamos “memória esportiva”. Na sequência, amparados em fontes primárias, trataremos da concepção de processos e ações dedicadas ao registro do megaevento esportivo na cidade, por parte da FCRB. Em seguida, exploraremos um de seus eixos mais importantes, a História Oral, implementado em parceria com o FGV CPDOC, na seleção de relatos dos atores envolvidos com o torneio no contexto de sua realização. Por fim, daremos a conhecer a exposição “Rio de Janeiro – cidade esportiva, cidade olímpica”, ocorrida nas dependências da Fundação, com base em seu rico acervo documental de jornais e revistas ilustradas, de modo a salientar os vínculos entre a história republicana da instituição, as competições esportivas no país e a construção de um lugar de memória olímpica para a cidade em questão.

Introduction: Despite the extensive efforts in controlling diabetes-related modifiable risk factors, two recent studies showed that the estimated prevalence of diabetes in the U.S. has still increased in the past two decades. The sleep quality has been related to the risk of diabetes. Hypothesis: We examined the secular trends of the overall sleep quality, and the joint trends in the prevalence of diabetes by the overall sleep quality among US adults from 2005 to 2018. Methods: A total of 17,046 participants aged 20 years or older, from seven cycles of National Health and Nutrition Examination Survey (NHANES) data between 2005 to 2018, were eligible for the study. A healthy sleep score was calculated based on sleep 7-8 hours, no trouble sleeping, no snoring, no nocturia and no excessive daytime sleepiness to represent an overall sleep quality. The trends in estimated prevalence of diabetes were examined in different sleep quality groups. Results: From 2005 to 2018, the overall sleep quality significantly declined among US adults ( P for trendP for trend=0.004). In contrast, the lowest prevalence of diabetes was consistently observed in the high sleep quality group in each cycle, in which no increasing trend over time was observed ( P for trend=0.346). Such differential secular trends by sleep quality were more significant among Non-Hispanic Whites than other racial/ethnic minorities. Conclusions: The overall sleep quality decreased significantly between 2005-2018 in U.S. adults. The estimated prevalence of diabetes only increased in participants with low or medium overall sleep quality but remained stable in participants with high sleep quality.

Type 2 diabetes (T2D), chronic kidney disease (CKD), atherosclerotic cardiovascular disease (ASCVD), and heart failure (HF)-along with their associated risk factors-have overlapping etiologies, and two or more of these conditions frequently occur in the same patient. Many recent cardiovascular outcome trials (CVOTs) have demonstrated the benefits of agents originally developed to control T2D, ASCVD, or CKD risk factors, and these agents have transcended their primary indications to confer benefits across a range of conditions. This evolution in CVOT evidence calls for practice recommendations that are not constrained by a single discipline to help clinicians manage patients with complex conditions involving diabetes, cardiorenal, and/or metabolic (DCRM) diseases. The ultimate goal for these recommendations is to be comprehensive yet succinct and easy to follow by the nonexpert-whether a specialist or a primary care clinician. To meet this need, we formed a volunteer task force comprising leading cardiologists, nephrologists, endocrinologists, and primary care physicians to develop the DCRM Practice Recommendations, a multispecialty consensus on the comprehensive management of the patient with complicated metabolic disease. The task force recommendations are based on strong evidence and incorporate practical guidance that is clinically relevant and simple to implement, with the aim of improving outcomes in patients with DCRM. The recommendations are presented as 18 separate graphics covering lifestyle therapy, patient self-management education, technology for DCRM management, prediabetes, cognitive dysfunction, vaccinations, clinical tests, lipids, hypertension, anticoagulation and antiplatelet therapy, antihyperglycemic therapy, hypoglycemia, nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), ASCVD, HF, CKD, and comorbid HF and CKD, as well as a graphical summary of medications used for DCRM.

BACKGROUND AND AIMS: The effect of MHT on cardiovascular disease (CVD) risk among women with prediabetes or type 2 diabetes (PreDM or T2DM) is unclear. We examined the association between ever or early use MHT and CVD risk in postmenopausal women with PreDM or T2DM, and the potential modifying effect of race. METHODS: 2,917 postmenopausal women with PreDM or T2DM were pooled from 3 prospective CVD cohorts (the Atherosclerosis Risk in Communities, the Multi-Ethnic Study of Atherosclerosis, and the Jackson Heart Study). Ever (yes vs no) or early use of MHT (MHT initiated ≤ 5 vs > 5 years since menopause), and their associations with ischemic stroke, coronary heart disease (CHD), and atherosclerotic cardiovascular disease (ASCVD) were assessed using Cox proportional hazards models. RESULTS: During a median follow-up of 15 years, 264 stroke, 484 CHD, and 659 ASCVD events were observed. In fully adjusted models, ever use of MHT was associated with reduced risk of stroke (hazard ratio 0.86, 95% CI 0.76–0.98), CHD (0.85, 0.74–0.98), and ASCVD (0.83, 0.73–0.95) in white women with PreDM or T2DM. Early use of MHT was associated with reduced risk of stroke (0.82, 0.72–0.95), CHD (0.85, 0.74–0.98), and ASCVD (0.82, 0.70–0.96) in the white group. No risk reduction with ever or early use of MHT was found for black women with PreDM or T2DM. CONCLUSIONS: MHT is associated with statistically reduced CVD risk among white but not black women with PreDM or DM. Race is an effect modifier in the association between MHT use and CVD.

The effect of Glucagon-like peptide 1 receptor agonists (GLP1 RA) on diabetic retinopathy (DR) remains controversial. Previous reviews combined data from randomized clinical trials (RCTs) with or without cardiovascular (CV) benefits and did not address confounders, therefore may have generated misleading results. The study aimed to examine the effect of GLP1RA on DR in type 2 diabetes (T2DM) in RCTs with or without CV benefits and distinguish the effect by major confounders.We conducted electronic searches of multiple databases and a manual search using references lists. We included 13 RCTs examining the effect of GLP1 RA on health outcomes/adverse events including DR or DR complications in T2DM. We performed a random-effects model meta-analysis.GLP1RA was associated with an elevated risk of rapidly worsening DR in four major RCTs with CV benefits in T2DM (OR 1.23, 95 % CI 1.05-1.44). The association between GLP1 RA and DR was significant in subgroups of RCTs with length over 52 weeks (1.2, 1.00-1.43), using placebo as a comparator (1.22, 1.05-1.42). In subgroups with patients who had T2DM ≥10 years (1.19, 0.99-1.42) or with subjects enrolled from multiple countries (1.2, 0.99-1.46), the association appeared to be evident but did not reach statistical significance.GLP1 RA including liraglutide, semaglutide, and dulaglutide are associated with an increased risk of rapidly worsening DR in RCTs with CV benefits. Further data from clinical studies with longer follow-up purposefully designed for DR risk assessment, particularly including patients of established DR are warranted.

IntroductionThe prevalence of diabetes self-management education and support (DSME/S) use among patients with newly diagnosed type 2 diabetes mellitus (T2DM) and patients with insulin prescription has not been evaluated. It is also unclear what demographic, behavioral, and clinical factors associated with use of DSME/S.Research design and methodsThis retrospective analysis was based on electronic health records from the Research Action for Health Network (2013–2019). Patients with newly diagnosed T2DM were identified as 35–94 year-olds diagnosed with T2DM≥1 year after the first recorded office visit. Patients with insulin were identified by the first insulin prescription records. DSME/S (Healthcare Common Procedure Coding System G0108 and G0109) codes that occurred from 2 months before the ‘new diagnosis date’ or first insulin prescription date through 1 year after were defined as use of DSME/S. Age-matched controls (non-users) were identified from the Electronic Health Records (EHR). The date of first DSME/S record was selected as the index date. Logistic regression was used to estimate the associations between patient factors and use of DSME/S.ResultsThe prevalence of DSME/S use was 6.5% (8909/137 629) among patients with newly diagnosed T2DM and 32.7% (13,152/40,212) among patients with diabetes taking insulin. Multivariable analysis found that among patients with newly diagnosed T2DM, black and male patients were less likely to use DSME/S, while in patients with insulin, they were more likely to use the service compared with white and female counterparts, respectively. Among patients taking insulin, those with private insurance or self-pay status were significantly less likely, while those with Medicaid were more likely to use the service compared with their Medicare counterparts. A strong positive association was found between HbA1c, obesity, and DSME/S use in both cohorts, while hypertension was negatively associated with DSME/S in both cohorts.ConclusionWe showed a low rate of DSME/S use in Louisiana, especially in patients with newly diagnosed T2DM. Our findings demonstrated heterogeneity in factors influencing DSME/S use between patients with newly diagnosed T2D and patients with insulin.

O surto do novo coronavírus foi declarado pela Organização Mundial de Saúde no dia 30 de janeiro de 2020 como uma “Emergência de Saúde Pública de Importância Internacional”. A pandemia do novo coronavirus SARS-CoV 2 afetou o funcionamento das instituições e mudou as dinâmicas das relações sociais. Considerando o contexto de isolamento social e as restrições de mobilidade urbana impostas pela necessidade de confinamento, o presente trabalho busca apresentar detalhes do esforço de adequação e mudança do formato presencial para o ambiente digital no ensino de graduação de bacharelado da Escola de Ciências Sociais FGV CPDOC. O trabalho considera a experiência de uma instituição privada em uma grande capital brasileira com menos de cem alunos matriculados e traz uma reflexão sobre os principais acontecimentos decorridos durante a transformação.

INTRODUCTION: Trachoma is the leading cause of blindness in the world, especially in undeveloped countries, due to its association with poor socioeconomic and sanitation conditions. This study aimed to estimate the prevalence of trachoma among students from the Jequitinhonha Valley, Minas Gerais, one of the poorest regions in Brazil, and to identify associated factors. METHODS: This is a cross-sectional study that utilized clinical evaluation and a socioeconomic questionnaire applied to a random and representative sample of elementary school students from the Jequitinhonha Valley, Minas Gerais, Brazil. Participants underwent conjunctival scraping and direct immunofluorescence was used to confirm the presence of the bacteria. Five or more elementary bodies in the conjunctival scrape was considered a positive result. In the study, 36.6% positive samples were detected. A culture of the conjunctival scrape, considered to be the "gold standard", was not performed due to cost and complexity. Bivariate analyses were performed, followed by binary logistic regression analysis to define the associated variables. RESULTS: In the present study, 478 students comprised the sample. The prevalence of trachoma was 6.3% and was higher among students who lived in unfinished houses (no plastering, painting, flooring, and unfinished bathrooms) (OR, 2.27; 95% CI, 1.12-6.48) without sewage systems (OR = 9.49; 95% CI = 3.52-25.60) and studied in rural areas (OR, 3.37; 95% CI, 1.53-7.35). CONCLUSIONS: The prevalence of trachoma among the students aged 7 to 16 years old, from public and private schools, is not negligible and is especially associated with inadequate living conditions.

OBJECTIVE This study evaluated the ability of the Building, Relating, Assessing, and Validating Outcomes (BRAVO) risk engine to accurately project cardiovascular outcomes in three major clinical trials (EMPA-REG, CANVAS, and DECLARE-TIMI) on sodium-glucose cotransporter-2 inhibitors (SGL2is) to treat patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Baseline data from the publications of the three trials were obtained and entered into the BRAVO model to predict cardiovascular outcomes. Projected benefits of reducing risk factors of interest (A1c, systolic blood pressure (SBP), LDL, or BMI) on cardiovascular events were evaluated, and simulated outcomes were compared to those observed in each trial. RESULTS BRAVO achieved the best prediction accuracy when simulating outcomes of the CANVAS and DECLARE-TIMI trials. For the EMPA-REG trial, a mild bias was observed (~20%) in the prediction of mortality and angina. The effect of risk reduction on outcomes in treatment vs placebo groups predicted by the BRAVO model strongly correlated with the observed effect of risk reduction on the trial outcomes as published. Finally, the BRAVO engine revealed that most of the clinical benefit associated with SGLT2i treatment are through A1c control, although reductions in SBP and BMI explain a proportion of the observed decline in cardiovascular events. CONCLUSIONS The BRAVO risk engine was effective in predicting the benefits of SGLT2i on cardiovascular health through improvements in commonly measured risk factors, including A1c, SBP, and BMI. Since these benefits are individually small, the use of the complex, dynamic BRAVO model is ideal to explain the cardiovascular outcome trial results.

To improve outcomes of patients with adult type 2 diabetes by decreasing HbASix years of outpatient electronic health record (EHR) data were analyzed for care gaps before and 2 years after implementing a QI initiative in an urban academic medical center. QI strategies includedAnalysis (January 2010 to May 2018) of 7,798 patients from Tulane Medical Center (mean age 61 years, 57% female, 62% black, 97% insured) with 136,004 visits showed target improvements. A Cox proportional hazards model controlling for age, sex, race, and HbAMultidisciplinary QI teams using EHR data to design interventions for providers and patients produced statistically significant improvements in both care process and clinical outcome goals.

In observational studies, type 2 diabetes mellitus (T2D) has been associated with an increased risk of hypertension, and vice versa; however, the causality between these conditions remains to be determined.This population-based prospective cohort study sought to investigate the bidirectional causal relations of T2D with hypertension, systolic and diastolic blood pressure (BP) using Mendelian randomization (MR) analysis.After exclusion of participants free of a history of heart failure, cardiovascular disease, cardiac procedures, and non-T2D diabetes mellitus, a total of 318 664 unrelated individuals with qualified genotyping data of European descent aged 37 to 73 from UK Biobank were included. The genetically instrumented T2D and hypertension were constructed using 134 and 233 single nucleotide polymorphisms, respectively. Seven complementary MR methods were applied, including inverse-variance weighted method, 2 median-based methods (simple and weighted), MR-Egger, MR-robust adjusted profile scores, MR-Pleiotropy Residual Sum and Outlier, and multivariate MR. The genetically instrumented T2D was associated with risk of hypertension (odds ratio, 1.07 [95% CI, 1.04-1.10], P=3.4×10T2D may causally affect hypertension, whereas the relationship from hypertension to T2D is unlikely to be causal. These findings suggest the importance of keeping an optimal glycemic profile in general populations, and BP screening and monitoring, especially systolic BP, in patients with T2D.

Este artigo tem por objetivo debater o tema do patrimônio esportivo, seus desafios conceituais, seu trato no âmbito governamental e acadêmico, os limites para pensar tal processo de patrimonialização. Ao fim, sugerimos que ações ligadas ao assunto podem contribuir para lançar novos olhares para o passado, o percebendo de forma mais múltipla, com mais matizes, com mais agentes envolvidos. Da mesma forma, tais iniciativas podem impactar a maneira de conceber a cidade ao estimular reflexões sobre o espaço público, chave para desencadear a reivindicação de formulação de políticas públicas mais abrangentes.

The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs).Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols.The Executive Summary of this document contains 87 recommendations of which 45 are Grade A (51.7%), 18 are Grade B (20.7%), 15 are Grade C (17.2%), and 9 (10.3%) are Grade D. These detailed, evidence-based recommendations allow for nuance-based clinical decision-making that addresses multiple aspects of real-world medical care. The evidence base presented in the subsequent Appendix provides relevant supporting information for Executive Summary Recommendations. This update contains 695 citations of which 203 (29.2 %) are EL 1 (strong), 137 (19.7%) are EL 2 (intermediate), 119 (17.1%) are EL 3 (weak), and 236 (34.0%) are EL 4 (no clinical evidence).This CPG is a practical tool that endocrinologists, other health care professionals, health-related organizations, and regulatory bodies can use to reduce the risks and consequences of dyslipidemia. It provides guidance on screening, risk assessment, and treatment recommendations for a range of individuals with various lipid disorders. The recommendations emphasize the importance of treating low-density lipoprotein cholesterol (LDL-C) in some individuals to lower goals than previously endorsed and support the measurement of coronary artery calcium scores and inflammatory markers to help stratify risk. Special consideration is given to individuals with diabetes, familial hypercholesterolemia, women, and youth with dyslipidemia. Both clinical and cost-effectiveness data are provided to support treatment decisions.4S = Scandinavian Simvastatin Survival Study A1C = glycated hemoglobin AACE = American Association of Clinical Endocrinologists AAP = American Academy of Pediatrics ACC = American College of Cardiology ACE = American College of Endocrinology ACS = acute coronary syndrome ADMIT = Arterial Disease Multiple Intervention Trial ADVENT = Assessment of Diabetes Control and Evaluation of the Efficacy of Niaspan Trial AFCAPS/TexCAPS = Air Force/Texas Coronary Atherosclerosis Prevention Study AHA = American Heart Association AHRQ = Agency for Healthcare Research and Quality AIM-HIGH = Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides trial ASCVD = atherosclerotic cardiovascular disease ATP = Adult Treatment Panel apo = apolipoprotein BEL = best evidence level BIP = Bezafibrate Infarction Prevention trial BMI = body mass index CABG = coronary artery bypass graft CAC = coronary artery calcification CARDS = Collaborative Atorvastatin Diabetes Study CDP = Coronary Drug Project trial CI = confidence interval CIMT = carotid intimal media thickness CKD = chronic kidney disease CPG(s) = clinical practice guideline(s) CRP = C-reactive protein CTT = Cholesterol Treatment Trialists CV = cerebrovascular CVA = cerebrovascular accident EL = evidence level FH = familial hypercholesterolemia FIELD = Secondary Endpoints from the Fenofibrate Intervention and Event Lowering in Diabetes trial FOURIER = Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects With Elevated Risk trial HATS = HDL-Atherosclerosis Treatment Study HDL-C = high-density lipoprotein cholesterol HeFH = heterozygous familial hypercholesterolemia HHS = Helsinki Heart Study HIV = human immunodeficiency virus HoFH = homozygous familial hypercholesterolemia HPS = Heart Protection Study HPS2-THRIVE = Treatment of HDL to Reduce the Incidence of Vascular Events trial HR = hazard ratio HRT = hormone replacement therapy hsCRP = high-sensitivity CRP IMPROVE-IT = Improved Reduction of Outcomes: Vytorin Efficacy International Trial IRAS = Insulin Resistance Atherosclerosis Study JUPITER = Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin LDL-C = low-density lipoprotein cholesterol Lp-PLA2 = lipoprotein-associated phospholipase A2 MACE = major cardiovascular events MESA = Multi-Ethnic Study of Atherosclerosis MetS = metabolic syndrome MI = myocardial infarction MRFIT = Multiple Risk Factor Intervention Trial NCEP = National Cholesterol Education Program NHLBI = National Heart, Lung, and Blood Institute PCOS = polycystic ovary syndrome PCSK9 = proprotein convertase subtilisin/kexin type 9 Post CABG = Post Coronary Artery Bypass Graft trial PROSPER = Prospective Study of Pravastatin in the Elderly at Risk trial QALY = quality-adjusted life-year ROC = receiver-operator characteristic SOC = standard of care SHARP = Study of Heart and Renal Protection T1DM = type 1 diabetes mellitus T2DM = type 2 diabetes mellitus TG = triglycerides TNT = Treating to New Targets trial VA-HIT = Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial VLDL-C = very low-density lipoprotein cholesterol WHI = Women's Health Initiative.

This paper aims to analyse the actions promoted by the Brazilian federal government for the promotion of Capoeira, which is a mix of dance, fight and play, practised with musical instruments. It is commonly called an Afro-Brazilian martial art. So, in this paper, we analyse the effectiveness of the proposed Safeguarding Plan to Capoeira, assuming the suggested orientations from the National Historic and Artistic Heritage Institute concerning its elaboration and execution. The elaboration of safeguarding plans aims to define and organise a group of actions willing to enhance social/environmental production, as well as reproduction and transmission conditions of the registered cultural immaterial heritage. It is important to mention that Capoeira is also much related to representations about Brazil.

IN BRIEFErectile dysfunction affects ∼ 30 million men in the United States to some extent. It may indicate the presence of a serious underlying medical condition, such as cardiovascular disease, diabetes, or depression. It compromises multiple aspects of a patient's life, including overall quality of life and interpersonal relationships.

OBJECTIVES After participating in the CME activity, primary care physicians should be able to: 1. Know the clinical features of the insulin resistance syndrome 2. Understand the role of insulin resistance in the pathogenesis of type 2 diabetes 3. Be familiar with the agents used in the management of patients with type 2 diabetes 4. Know the mechanisms known or postulated to contribute to the accelerated development of cardiovascular disease in the insulin resistance syndrome 5. Identify the pharmacologic agents used in the treatment of insulin resistance

Este artigo busca analisar as relações entre materialidade e imaterialidade nos processos de reconhecimento de bens culturais de natureza imaterial no Brasil a partir do estudo do caso da patrimonialização da capoeira. Entendendo o registro e o inventário como instrumentos privilegiados de preservação desses bens, procuro perceber como eles se colocam também como importantes meios de documentar essa categoria de patrimônio. Palavras-chaves: patrimônio imaterial; registro; inventário; capoeira; patrimonialização. Abstract This paper analyzes the relation between materiality and immateriality in the process of recognition of cultural assets of intangible nature in Brazil, using the patrimonialization of "capoeira" as a case study. Registry and inventory are understood as privileged instruments for preserving these assets in our effort to understand how they also act as important means of documenting this category of heritage. Keywords: intangible heritage; record; inventory; capoeira; patrimonialization. Resumen En este artículo se analiza las relaciones entre materialidad e inmaterialidad en los procesos de reconocimiento de bienes culturales de naturaleza inmaterial en Brasil a partir del estudio de caso del proceso de patrimonialisación de la “capoeira”. Entendiendo el registro y el inventario como instrumentos privilegiados de preservación de estos bienes, se busca percibir como ellos se presentan también como importantes medios de documentar esa categoría de patrimonio. Palabras claves: patrimonio inmaterial; registro; inventario; capoeira; patrimonialisación.

Glucagon-like peptide 1 (GLP-1) and glucagon share the same precursor molecule proglucagon, but each arises from a distinct posttranslational process in a tissue-specific manner. Recently, it has been shown that GLP-1 is co-expressed with glucagon in pancreatic islet cells. This study was aimed to investigate the progressive changes of GLP-1 versus glucagon production in pancreatic islets during the course of diabetes development.Both type 1 (non-obese diabetes mice) and type 2 (db/db mice) diabetes models were employed in this study. The mice were monitored closely for their diabetes progression and were sacrificed at different stages according to their blood glucose levels. GLP-1 and glucagon expression in the pancreatic islets was examined using immunohistochemistry assays. Quantitative analysis was performed to evaluate the significance of the changes.The ratio of GLP-1-expressing cells to glucagon-expressing cells in the islets showed significant, progressive increase with the development of diabetes in db/db mice. The increase of GLP-1 expression was in agreement with the upregulation of PC1/3 expression in these cells. Interestingly, intra-islet GLP-1 expression was not significantly changed during the development of type 1 diabetes in non-obese diabetes mice.The study demonstrated that GLP-1 was progressively upregulated in pancreatic islets during type 2 diabetes development. In addition, the data suggest clear differences in intra-islet GLP-1 production between type 1 and type 2 diabetes developments. These differences may have an effect on the clinical and pathophysiological processes of these diseases and may be a target for therapeutic approaches.

Glucose lowering should be approached by managing overall cardiovascular risk. Glycemic goals should be individualized based on duration of diabetes, preexisting cardiovascular disease, age, and life expectancy. Intensive glycemic control has consistently been shown to produce a substantial benefit for preventing long-term microvascular complications in both type 1 and type 2 diabetes mellitus. Although cardiovascular disease is the major cause of death in patients with diabetes, microvascular complications cause substantial morbidity and disability. Thus, it is apparent that additional strategies on multimodal treatment options are necessary to promote effective management and prevention of diabetic complications.