Single-centre case series report of regional anaesthesia for pain management in vaso-occlusive crisis.

Sickle cell disease is characterised by episodes of vaso-occlusive crisis, a painful complication. Regional anaesthesia has shown promising results in reducing opioid consumption and pain scores. Patients with vaso-occlusive crises who underwent regional anaesthesia in the paediatric intensive care unit were studied. Data regarding pain location, regional analgesia technique, the local anaesthetic used and dose, daily opioid consumption, daily pain scores, use of adjuvants and complications were recorded. The primary outcome was to evaluate the effect of regional anaesthesia on opioid consumption. In this study, we describe 10 cases, referring to six paediatric patients with the vaso-occlusive crisis who underwent regional anaesthesia for severe pain and were unresponsive to increasing doses of opioids. Six cases received epidural analgesia, three continuous peripheral nerve blocks and one received both techniques. Opioid consumption was reduced (58%), and pain scores decreased (72%), both statistically significant reductions.

KRAS silencing alters chromatin physical organization and transcriptional activity in colorectal cancer cells.

Clinical data revealed that KRAS mutant tumors, while initially sensitive to treatment, rapidly bypass KRAS dependence to acquire a drug-tolerant phenotype. However, the mechanisms underlying the transition from a drug-sensitive to a drug-tolerant state still elude us. Here, we show that global chromatin reorganization is a recurrent and specific feature of KRAS-dependent cells that tolerated KRAS silencing. We show that KRAS-dependent cells undergo G0/G1 cell cycle arrest after KRAS silencing, presenting a transcriptomic signature of quiescence. Proteomic analysis showed upregulated chromatin-associated proteins and transcription-associated biological processes. Accordingly, these cells shifted euchromatin/heterochromatin states, gained topologically associating domains, and altered the nanoscale physical organization of chromatin, more precisely by downregulating chromatin packing domains, a feature associated with the induction of quiescence. In addition, they also accumulated transcriptional alterations over time leading to a diversification of biological processes, linking chromatin alterations to transcriptional performance. Overall, our observations pinpoint a novel molecular mechanism of tolerance to KRAS oncogenic loss driven not by specific gene alterations but by global reorganization of genomic information, in which cells transition chromatin domain structure towards a more quiescent state and gain transcriptional reprogramming capacity.

Phylogenetics, Epidemiology and Temporal Patterns of Dengue Virus in Araraquara, São Paulo State.

Dengue virus (DENV) is a prominent arbovirus with global spread, causing approximately 390 million infections each year. In Brazil, yearly epidemics follow a well-documented pattern of serotype replacement every three to four years on average. Araraquara, located in the state of São Paulo, has faced significant impacts from DENV epidemics since the emergence of DENV-1 in 2010. The municipality then transitioned from low to moderate endemicity in less than 10 years. Yet, there remains an insufficient understanding of virus circulation dynamics, particularly concerning DENV-1, in the region, as well as the genetic characteristics of the virus. To address this, we sequenced 37 complete or partial DENV-1 genomes sampled from 2015 to 2022 in Araraquara. Then, using also Brazilian and worldwide DENV-1 sequences we reconstructed the evolutionary history of DENV-1 in Araraquara and estimated the time to the most recent common ancestor (tMRCA) for serotype 1, for genotype V and its main lineages. Within the last ten years, there have been at least three introductions of genotype V in Araraquara, distributed in two main lineages (L Ia and L Ib, and L II). The tMRCA for the first sampled lineage (2015/2016 epidemics) was approximately 15 years ago (in 2008). Crucially, our analysis challenges existing assumptions regarding the emergence time of the DENV-1 genotypes, suggesting that genotype V might have diverged more recently than previously described. The presence of the two lineages of genotype V in the municipality might have contributed to the extended persistence of DENV-1 in the region.

White matter hyperintensities in bipolar disorder: systematic review and meta-analysis.

Background: White matter hyperintensities are lesions of presumed vascular origin associated with Cerebral small vessel disease. WMH are common findings that and are associated with increased risk of cognitive impairment and dementia. A higher prevalence of WMH has been also reported in patients with bipolar disorder (BD), although the evidence is conflicting. Objective: To compare the prevalence of WMH in adults with BD, with the prevalence found in healthy controls. Methods: We searched the Embase, Medline/PubMed, and references cited in articles retrieved on May 20, 2023. We included case-control studies that compared the prevalence of WMH in adult BD patients with the prevalence of WMH in healthy controls, using T2-weighted magnetic resonance imaging. We performed a meta-analysis using a random-effects method based on the inverse-variance approach. Findings: We included 22 case-control studies reporting data of 1313 people. The overall rate of WMH was 46.5% in BD patients and 28% in controls (pooled Odds Ratio 2.89, 95% CI 1.76; 4.75). We found a moderate heterogeneity across studies (I2 = 0.49). Publication bias was not significant. Interpretation: We found evidence that BD patients have a higher burden of WMH than healthy controls. Main limitations were impossibility of analyzing gender differences and bipolar type, moderate heterogeneity between studies, non-representative samples, lack of control for major confounders and search in two electronic databases. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023428464.

Quality of life of older adults in Family Health Strategy: a cross-sectional study

ABSTRACT BACKGROUND: With the increase in the older adult population, it is essential to identify the living and health conditions that can impact the quality of life of these individuals. OBJECTIVES: To identify the domains and factors associated with the quality of life of older adults under the Family Health Strategy program. DESIGN AND SETTING: This was a cross-sectional analytical study was conducted in the municipality of Palmas, Tocantins, Brazil. METHODS: We assessed 449 older adults enrolled in the Family Health Strategy program. Data were collected between April and July, 2018. World Health Organization Quality of Life Assessment (WHOQOL-OLD) was used to assess the quality of life (QoL) and multiple linear regression was used to estimate the factors associated with QoL. RESULTS: The QoL domain with the highest score was death and dying (mean = 70.4), and the lowest score was for sensory functions (mean = 61.0 points). The factors associated with QoL were single marital status (β = -4.55; P = 0.014), level of independence for daily living activities (β = 4.92; P < 0.001), self-assessment of regular health (β = 5.35; P < 0.001), and poor health (β = -8.67; P < 0.001). CONCLUSION: The death and dying domain of QoL presented the highest score. Marital status, impairment in daily activities, and health self-assessment were associated with QoL.

Food Addiction and Grazing-The Role of Difficulties in Emotion Regulation and Negative Urgency in University Students.

University students are a vulnerable population to the development of disordered eating, such as food addiction (FA) and grazing. FA is an emerging concept characterized by an intense desire to eat hyper-palatable foods. Grazing is characterized by the repetitive and unplanned ingestion of food throughout a period of time. Both FA and grazing have been associated with increased scores of negative urgency (NU) and difficulties in emotion regulation (ER). This study aims to evaluate the frequency of FA and grazing in a university population and to test the direct, total, and indirect effects-via FA-of ER and NU on repetitive eating and compulsive grazing. A total of 338 participants responded to a set of psychological measures assessing these variables. Thirty-six (10.7%) participants met the criteria for FA diagnosis and 184 (54.4%) presented grazing. Confirmatory factor analysis showed acceptable fit indexes for the model tested (χ2(1695) = 3167.575; p < 0.001; CFI = 0.955; NFI = 0.908; TLI = 0.953; SRMR = 0.085; RMSEA = 0.051; CI 90% (0.048; 0.053); P[RMSEA ≤ 0.05] = 0.318) and suggested that FA partially mediated the effect of difficulties in ER and NU on grazing, specifically on compulsive grazing. The results indicate that individuals with difficulties in ER and impulse control under negative emotions are more likely to engage in grazing if food addiction scores are higher. These results highlight the importance of assessing these variables, particularly in at-risk populations such as university students.

Quality of life of older adults in Family Health Strategy: a cross-sectional study.

BACKGROUND: With the increase in the older adult population, it is essential to identify the living and health conditions that can impact the quality of life of these individuals. OBJECTIVES: To identify the domains and factors associated with the quality of life of older adults under the Family Health Strategy program. DESIGN AND SETTING: This was a cross-sectional analytical study was conducted in the municipality of Palmas, Tocantins, Brazil. METHODS: We assessed 449 older adults enrolled in the Family Health Strategy program. Data were collected between April and July, 2018. World Health Organization Quality of Life Assessment (WHOQOL-OLD) was used to assess the quality of life (QoL) and multiple linear regression was used to estimate the factors associated with QoL. RESULTS: The QoL domain with the highest score was death and dying (mean = 70.4), and the lowest score was for sensory functions (mean = 61.0 points). The factors associated with QoL were single marital status (ß = -4.55; P = 0.014), level of independence for daily living activities (ß = 4.92; P < 0.001), self-assessment of regular health (ß = 5.35; P < 0.001), and poor health (ß = -8.67; P < 0.001). CONCLUSION: The death and dying domain of QoL presented the highest score. Marital status, impairment in daily activities, and health self-assessment were associated with QoL.

Central adiposity as a predictor of mortality in older adults: Identification of cutoffs using generalized additive models.

Background: Obesity is associated with premature mortality in adults; however, this association has been inconsistent in the older adult population. In addition, there is a lack of specific cutoff points for indicators of negative health outcomes in older adults. Methods: This is a prospective study with 796 non-institutionalized older adults. Data on sociodemographic characteristics, lifestyle, food consumption, and nutritional status were obtained at baseline. Generalized additive models were used to identify cutoff points for the waist circumference (WC) and waist-to-height ratio (WHtR) and Cox proportional hazards models to assess the independent association between adiposity and mortality. Results: Over the 9 years of follow-up, 197 deaths (24.7%) occurred, of which 51.8% were men, with a mean age of 76.1 ± 9.0 years. Older adults at higher risk of death had WHtR of <0.52 or ≥0.63 and WC of <83 cm or ≥101 cm. An increased risk of death was observed in older adults with high WC (HR: 2.03 95% CI: 1.20-3.41) and high WHtR (HR: 1.51 95% CI: 1.01-2.26) in the adjusted models, and an increase in WC was a risk factor for higher CVD mortality (HR: 2.09, 95% CI: 1.12-3.88) in the adjusted models. Conclusion: Adiposity was associated with an increased risk of death in older adults. In view of these results and considering the lack of cutoff points for anthropometric indices in Brazilian older adults, further studies are needed to confirm the WC and WHtR cutoff values found in this study.

COVID-19 Infodemic and Impacts on the Mental Health of Older People: Cross-sectional Multicenter Survey Study.

BACKGROUND: The COVID-19 pandemic received widespread media coverage due to its novelty, an early lack of data, and the rapid rise in deaths and cases. This excessive coverage created a secondary "infodemic" that was considered to be a serious public and mental health problem by the World Health Organization and the international scientific community. The infodemic particularly affected older individuals, specifically those who are vulnerable to misinformation due to political positions, low interpretive and critical analysis capacity, and limited technical-scientific knowledge. Thus, it is important to understand older people's reaction to COVID-19 information disseminated by the media and the effect on their lives and mental health. OBJECTIVE: We aimed to describe the profile of exposure to COVID-19 information among older Brazilian individuals and the impact on their mental health, perceived stress, and the presence of generalized anxiety disorder (GAD). METHODS: This cross-sectional, exploratory study surveyed 3307 older Brazilians via the web, social networks, and email between July 2020 and March 2021. Descriptive analysis and bivariate analysis were performed to estimate associations of interest. RESULTS: Major proportions of the 3307 participants were aged 60 to 64 years (n=1285, 38.9%), female (n=2250, 68.4%), and married (n=1835, 55.5%) and self-identified as White (n=2364, 71.5%). Only 295 (8.9%) had never started or completed a basic education. COVID-19 information was mainly accessed on television (n=2680, 81.1%) and social networks (n=1943, 58.8%). Television exposure was ≥3 hours in 1301 (39.3%) participants, social network use was 2 to 5 hours in 1084 (32.8%) participants, and radio exposure was ≥1 hour in 1223 (37%) participants. Frequency of exposure to social networks was significantly associated with perceived stress (P=.04) and GAD (P=.01). A Bonferroni post hoc test revealed significantly different perceived stress in participants who were exposed to social networks for 1 hour (P=.04) and those who had no exposure (P=.04). A crude linear regression showed that "some" social media use (P=.02) and 1 hour of exposure to social media (P<.001) were associated with perceived stress. Adjusting for sociodemographic variables revealed no associations with this outcome variable. In a crude logistic regression, some social media use (P<.001) and 2 to 5 hours of exposure to social media (P=.03) were associated with GAD. Adjusting for the indicated variables showed that some social network use (P<.001) and 1 hour (P=.04) and 2 to 5 hours (P=.03) of exposure to social media were associated with GAD. CONCLUSIONS: Older people, especially women, were often exposed to COVID-19-related information through television and social networks; this affected their mental health, specifically GAD and stress. Thus, the impact of the infodemic should be considered during anamnesis for older people, so that they can share their feelings about it and receive appropriate psychosocial care.

Pickering Emulsions Based in Inorganic Solid Particles: From Product Development to Food Applications.

Pickering emulsions (PEs) have attracted attention in different fields, such as food, pharmaceuticals and cosmetics, mainly due to their good physical stability. PEs are a promising strategy to develop functional products since the particles' oil and water phases can act as carriers of active compounds, providing multiple combinations potentiating synergistic effects. Moreover, they can answer the sustainable and green chemistry issues arising from using conventional emulsifier-based systems. In this context, this review focuses on the applicability of safe inorganic solid particles as emulsion stabilisers, discussing the main stabilisation mechanisms of oil-water interfaces. In particular, it provides evidence for hydroxyapatite (HAp) particles as Pickering stabilisers, discussing the latest advances. The main technologies used to produce PEs are also presented. From an industrial perspective, an effort was made to list new productive technologies at the laboratory scale and discuss their feasibility for scale-up. Finally, the advantages and potential applications of PEs in the food industry are also described. Overall, this review gathers recent developments in the formulation, production and properties of food-grade PEs based on safe inorganic solid particles.

Memory footprint: Predictors of flashbulb and event memories of the 2016 Euro Cup final.

Two years after Portugal won the UEFA European Championship, we examined what the Portuguese remember of this momentous occasion. We investigated if flashbulb memories (FBMs) and event memories (EMs) were determined by distinct factors, and whether EM was a predictor of FBM. Participants responded to an online questionnaire about their FBM, EM and set of predictors. Structural equation modeling revealed that FBM and EM were associated with different pathways. Interest in football predicted importance which triggered emotional intensity which predicted personal rehearsal, a direct determinant of FBMs. On the other pathway, interest determined knowledge about football, the main predictor of EMs. Importantly, EM was a causal determinant of FBM which shows that the memory trace for the original event enhances memory for the reception context. The findings suggests that even though the two types of memories are determined by independent factors, they interact very closely.

Neighborhood obesogenic environment and cardiometabolic risk in Brazilian children: The mediation role of the mother's body mass index.

OBJECTIVE: We aimed to evaluate the association of neighborhood obesogenic and leptogenic environments with cardiometabolic risk clustering among Brazilian schoolchildren, mediated by child's ultra-processed food consumption and the mother's body mass index (BMI). METHODS: A total of 367 children aged 8-9 years, enrolled in urban schools of Viçosa, Minas Gerais, Brazil, were evaluated. Waist circumference, insulin resistance, blood pressure, high-density lipoprotein-cholesterol, and triglycerides concentrations were measured. The child's ultra-processed food consumption assessment was performed by applying three 24-hour dietary recall. The mother's weight and height values were used to calculate the BMI. The neighborhood income, walkability index, predominantly ultra-processed food stores, public spaces for leisure, and/or physical activities, traffic accidents, crime, and green spaces densities were assessed in four hundred road network buffers around households. From neighborhood and cardiometabolic risk variables, four latent variables were obtained from confirmatory factor analysis: neighborhood "obesogenic", and "leptogenic" environments; "high cardiometabolic risk," and "low atherogenic risk". A structural equation model was used to test the direct and indirect associations between neighborhood environment and cardiometabolic risk clusters. RESULTS: The neighborhood obesogenic environment had a significant total association (Standardized Coefficient = 0.172, p = .011) and was indirectly associated with the child's "high cardiometabolic risk" cluster, mediated by the mother's body mass index (Standardized Coefficient = 0.066, p = .049). CONCLUSIONS: Our results reinforce the role of the urban environment on maternal obesity and child's cardiometabolic risk and provide evidence for public health policies aimed to prevent such conditions.

Obesogenic environment around schools is associated with atherogenic risk in Brazilian children.

INTRODUCTION: Cardiometabolic risk factors often emerge in childhood, increasing the risk of cardiovascular diseases in adulthood. The school environments represent an important active space in a child's routine and may influence their health status. METHODS: In this cross-sectional study, we aimed to evaluate the clustering of cardiometabolic risk factors and its association with the obesogenic and leptogenic environment around schools. A total of 378 children (181 boys; 197 girls) aged 8 and 9 years, enrolled in all urban schools of Viçosa, Minas Gerais, Brazil, were evaluated. Concentrations of high-density lipoprotein-cholesterol (HDL-c) and triglycerides (TG), and the insulin resistance (HOMA-IR), waist circumference (WC), and mean arterial pressure (MAP) were measured. The neighborhood income, walkability index, predominantly ultra-processed food stores, public spaces for leisure and/or physical activities, traffic accidents, crime and green spaces densities were assessed in 400 road network buffers around schools. To test association of the obesogenic and leptogenic environment around schools with cardiometabolic risk clustering, binary logistic regression models were performed with generalized estimating equations. RESULTS: "Obesogenic school environments" had greater densities of ultra-processed food stores, crime and traffic accidents, and higher walkability. The "↓ Atherogenic risk" cluster consisted of higher HDL-c values. There was an inverse association between the obesogenic environment around schools and a child's "↓ atherogenic risk" clustering (OR = 0.63; p < 0.001). CONCLUSION: We concluded that public policies aimed at modifying the environment around schools, by providing healthier food options and safe conditions for active mobility, are essential to prevent child's atherogenic risk.

Nutritional indicators of food and nutrition security of families: 2008/2009 Household Budget Survey / Indicadores nutricionais da segurança alimentar e nutricional de famílias: Pesquisa de Orçamentos Familiares 2008/2009

ABSTRACT Objective To evaluate the food and nutrition insecurity of Brazilian families, according to indicators of food consumption and nutritional status, by location and situation of the households investigated using the 2008/2009 Household Budget Survey. Methods Inadequate consumption of macronutrients and nutritional dystrophies (underweight, short stature or overweight) in at least one family member were used as indicators, according to location and geographical situation of households. The prevalence of food and nutritional insecurity and their confidence intervals were calculated. Results Food consumption was assessed in a total of 13,569 households; a total of 67.55%, 43.96% and 6.85% revealed inadequacy for lipids, carbohydrates and proteins, respectively. Among the 53,640 households assessed by nutritional status, 15.10%, 35.15% and 45.50% had, at least one resident with low weight, short stature or overweight respectively. The Northeastern Region showed statistically higher prevalence than other Brazilian macro-regions for inadequate lipids (24.88%) and carbohydrates (15.32%), as well as for the presence of underweight (6.15%), overweight (14.77%) and short stature (15.17%), in at least one of the residents of the household. Conclusion Assessing the nutritional aspect of food insecurity allows for a better understanding of the dimensions of this situation by considering the effects of access and availability of food, as well as biological use and stability, based on indicators of inadequate food consumption and the presence of nutritional dystrophy. The results found in this study enhance the need to include nutritional indicators in the assessment of food security.

RESUMO Objetivo Avaliar a insegurança alimentar e nutricional de famílias brasileiras segundo indicadores de consumo alimentar e estado nutricional, por localização e situação dos domicílios investigados pela Pesquisa de Orçamento Familiar 2008/2009. Métodos Foram utilizados, como indicadores de insegurança alimentar e nutricional, o consumo inadequado de macronutrientes e distrofias nutricionais (baixo peso, baixa estatura ou excesso de peso) em pelo menos um membro da família, conforme localização e situação geográfica dos domicílios. Calculou-se a prevalência de insegurança alimentar e nutricional e seus intervalos de confiança. Resultados Foram avaliados 13.569 domicílios pelo consumo alimentar, sendo que 67,55%, 43,96% e 6,85% apresentaram inadequação para lipídios, carboidratos e proteínas, respectivamente. Entre os 53.640 domicílios avaliados pelo estado nutricional, 15,10%, 35,15% e 45,50% apresentam, respectivamente, pelo menos um morador com baixo peso, baixa estatura ou excesso de peso. O Nordeste apresentou prevalências estatisticamente maiores do que as demais macrorregiões para as inadequações de lipídios (24,88%) e de carboidratos (15,32%), bem como para presença de baixo peso (6,15%), excesso de peso (14,77%) e baixa estatura (15,17%), em pelo menos um dos moradores do domicílio. Conclusão Avaliar a vertente nutricional da insegurança alimentar permite maior compreensão das dimensões dessa situação por considerar os reflexos do acesso e disponibilidade de alimentos, bem como a utilização biológica e estabilidade, a partir dos indicadores de consumo alimentar inadequado e presença de distrofia nutricional. Os resultados encontrados reforçam a necessidade de incluir indicadores nutricionais na avaliação da segurança alimentar.

Microplastic Contamination and Ecological Status of Freshwater Ecosystems: A Case Study in Two Northern Portuguese Rivers.

BACKGROUND: Most European rivers have not yet achieved "good" ecological status. In addition, the presence and abundance of microplastics (MPs) in freshwater is a matter of great concern to the scientific community. METHODOLOGY: This study assesses the ecological status of four sampling sites of Selho (S1-S4) and Costa-Couros (C1-C4) rivers (Guimarães, Portugal), and the abundance of MPs in sediments and benthic macroinvertebrates (Oligochaeta) from those sites. RESULTS: All sites of both rivers under higher pressure did not reach a "good" ecological status (S2-S3, C2-C4) based on the macroinvertebrate community. High levels of nutrients were observed at all sites in both rivers (except C2), especially phosphorus. In the Oligochaeta's gut of Costa-Couros river, the high number of MPs seems to be associated with their weight (95.25 ± 25.61 to 1069.00 ± 385.30 MPs g/fresh weight), suggesting the existence of malnutrition and digestive disorders, whereas the highest number of MPs in gut (134.00 ± 30.36 to 558.6 ± 100.70 MPs g/fresh weight) were found for the heaviest organisms of Selho. CONCLUSIONS: Thus, sites with higher ecological status do not necessarily have lower abundance of MPs. In the sediments, urbanization seems to be the main driver for MP contamination. MP contamination is pervasive across the sediments and Oligochaeta's gut in both rivers. Since MPs have the potential to cause harm to environmental and human health, it is essential to monitor not only the ecological status of freshwaters, but also emerging pollutants such as MPs.

Mutant KRAS modulates colorectal cancer cells invasive response to fibroblast-secreted factors through the HGF/C-MET axis.

Genetic alterations influence the malignant potential of cancer cells, and so does the tumor microenvironment. Herein, we combined the study of KRAS oncogenic effects in colorectal cancer cells with the influence of fibroblast-derived factors. Results revealed that mutant KRAS regulates cell fate through both autonomous and nonautonomous signaling mechanisms. Specifically, processes such as proliferation and cell-cell aggregation were autonomously controlled by mutant KRAS independently of the stimulation with fibroblasts conditioned media. However, cancer cell invasion revealed to be a KRAS-dependent nonautonomous effect, resulting from the cooperation between fibroblast-derived HGF and mutant KRAS regulation of C-MET expression. C-MET downregulation upon KRAS silencing rendered cells less responsive to HGF and thus less invasive. Yet, in one cell line, KRAS inhibition triggered invasion upon stimulation with fibroblasts conditioned media. Inhibition of PIK3CA oncogene did not promote invasion, thus showing a KRAS-specific effect. Moreover, the invasive capacity also depended on the HGF-C-MET axis. Overall, our study awards oncogenic KRAS an important role in modulating the response to fibroblast-secreted factors either by promoting or impairing invasion, and depicts the HGF-C-MET axis as a putative therapeutic target to impair the invasive properties of mutant KRAS cancer cells.

Availability of food stores around Brazilian schools.

The aim of this study was to analyze the availability of food stores in the territory of schools. Ecological study conducted in Viçosa, Minas Gerais, Brazil, with all schools (N=42) and food stores (N=656). Data were collected through the objective evaluation of the environment, and the stores were categorized into healthy, unhealthy, mixed and supermarkets. Bivariate Ripley´s K function assessed the existence of clustering of categories of stores in the territory of schools. All the schools had at least one food store in their territory. Unhealthy stores were the most common and closest to the schools. There were more stores around private schools, offering high school education, located in the central region and in the highest per capita income tercile. The bivariate Ripley´s K function showed evidence of clustering of stores at all analyzed distances (400 to 1.5 km) with up to 3 times more establishments than would be expected if they were randomly distributed. Therefore, schoolchildren were likely exposed to unhealthy food environments, regardless of neighborhood income and location, which may contribute to inadequate food choices.

Availability of food stores around Brazilian schools / Disponibilidade de estabelecimentos de venda de alimentos no entorno de escolas brasileiras

Abstract The aim of this study was to analyze the availability of food stores in the territory of schools. Ecological study conducted in Viçosa, Minas Gerais, Brazil, with all schools (N=42) and food stores (N=656). Data were collected through the objective evaluation of the environment, and the stores were categorized into healthy, unhealthy, mixed and supermarkets. Bivariate Ripley´s K function assessed the existence of clustering of categories of stores in the territory of schools. All the schools had at least one food store in their territory. Unhealthy stores were the most common and closest to the schools. There were more stores around private schools, offering high school education, located in the central region and in the highest per capita income tercile. The bivariate Ripley´s K function showed evidence of clustering of stores at all analyzed distances (400 to 1.5 km) with up to 3 times more establishments than would be expected if they were randomly distributed. Therefore, schoolchildren were likely exposed to unhealthy food environments, regardless of neighborhood income and location, which may contribute to inadequate food choices.

Resumo O objetivo deste estudo foi analisar a disponibilidade de estabelecimentos de venda de alimentos no território das escolas. Estudo ecológico conduzido em Viçosa, Minas Gerais, Brasil, com todas as escolas (N=42) e estabelecimentos de venda de alimentos (N=656). Dados foram coletados através de avaliação objetiva do ambiente, e estabelecimentos foram categorizados em saudáveis, não saudáveis, mistos e supermercados. Função K de Ripley bivariada avaliou a existência de agrupamento das categorias de estabelecimentos no território das escolas. Todas as escolas tinham no mínimo um estabelecimento de venda de alimentos em seu território. Estabelecimentos não saudáveis foram mais frequentes e próximos das escolas. Havia mais estabelecimentos no entorno de escolas particulares com ensino médio, localizadas na região central e de maior tercil de renda per capita. A função K de Ripley bivariada evidenciou o agrupamento de estabelecimentos em todas as distâncias analisadas (400 a 1,5 km), com três vezes mais estabelecimentos do que o esperado em uma distribuição aleatória. Portanto, escolares provavelmente estavam expostos a um ambiente alimentar não saudável, independentemente da renda da vizinhança e da localização das escolas, o que pode contribuir para escolhas alimentares inadequadas.

Maternal and child characteristics correlated with frequency of consuming ultra-processed food by children aged 6 to 24 months old / Características maternas e infantis correlacionadas à frequência do consumo de alimentos ultraprocessados por crianças de 6 a 24 meses

Abstract Objectives: to verify the correlation between the consumption of ultra-processed food among mothers and children under two years of age and the main characteristics related to this consumption. Methods: cross-sectional study conducted in public health services. Three 24-hour recalls were applied to assess food intake. The ultra-processed food was grouped into: sugary drinks; meat; sauces and creams; dairy products; snacks; pastas; and mucilage. Themother's body mass index and waist/hip ratio, and the child's weight/height, height/age, weight/age and body mass index/age were calculated. The children's ultra-process frequency as correlated with: anthropometric dyadic variables; ultra-process frequency on breastfeeding. The children's average ultra-process intake was compared to pacifier, bottle, breastfeeding and socioeconomic status. Linear regression models were conducted. Results: 172 pairs were evaluated. Similarity was found in the mothers and children's consumption of ultra-processed products. The higher frequency of ultra-processed products was correlated with older child and the higher body mass/age index and weight/age index. Of the 39 ultra-processed food present in the mothers' diet, 22 were correlated to child's Conclusion: the consumption of ultra-processed food by children is similar to their mothers and correlates with higher z-score values of weight/age and body mass/age index.

Resumo Objetivos: verificar a correlação do consumo de alimentos ultraprocessados de mães e filhos menores de dois anos de idade e as principais características relacionadas a este consumo. Métodos: estudo transversal conduzido nos serviços públicos de saúde. Aplicaram-se três recordatórios de 24 horas para avaliar o consumo alimentar. Os alimentos ultraprocessados foram agrupados em: bebidas açucaradas; carnes; molhos e cremes; lácteos; lanches; massas; e mucilagens. Calculou-se o Índice de Massa Corporal e a relação cintura/quadril da mãe, índice peso/estatura, estatura/idade, peso/idade e índice de massa corporal/idade da criança. Correlacionou-se a frequência de ultraprocessados na alimentação das crianças com: variáveis antropométricas da díade; frequência de ultraprocessados na alimentação materna. Comparou-se a média do consumo de ultraprocessados das crianças com uso de chupeta, mamadeira, aleitamento materno e condição socioeconômica. Modelos de regressão linear foram conduzidos. Resultados: avaliou-se 172 pares. Foi verificada semelhança no consumo de ultraprocessados de mães e filhos. A maior frequência de ultraprocessados correlacionou-se a maior idade da criança e ao maior índice de massa corporal/idade e índice peso/idade. Dos 39 alimentos ultraprocessados presentes na alimentação das mães, 22 correlacionaram com os da criança. Conclusão: o consumo de ultraprocessados pelas crianças se assemelha ao das mães e correlacionase com maiores valores dos índices peso/idade e índice de massa corporal/idade.

Persistence versus dynamical seasonal forecasts of cereal crop yields.

Climate change is expected to have impacts on the balance of global food trade networks and food security. Thus, seasonal forecasts of precipitation and temperature are an essential tool for stakeholders to make timely choices regarding the strategies required to maximize their expected cereal yield outcomes. The availability of state-of-the-art seasonal forecasts such as the European Centre for Medium-Range Weather Forecasts (ECMWF) system 5 (SEAS5) may be an asset to help decision making. However, uncertainties and reduced skill may hamper the use of seasonal forecasts in several applications. Hence, in this work, we aim to understand the added value of such dynamical forecasts when compared to persistent anomalies of climate conditions used to predict the production of wheat and barley yields. With that in mind, empirical models relating annual wheat and barley yields in Spain to monthly values of precipitation and temperature are developed by taking advantage of ECMWF ERA5 reanalysis. Then, dynamical and persistence forecasts are issued at different lead times, and the skill of the subsequent forecasted yield is verified through probabilistic metrics. The results presented in this study demonstrate two different outcomes: (1) wheat and barley yield anomaly forecasts (dynamical and persistent) start to gain skill later in the season (typically from April onwards); and (2) the added value of using the SEAS5 forecast as an alternative to persistence ranges from 6 to 16%, with better results in the southern Spanish regions.