National nutrition surveillance programmes in 18 countries in South-East Asia and Western Pacific Regions: a systematic scoping review.

Objective: To identify and analyse ongoing nutrition-related surveillance programmes led and/or funded by national authorities in countries in South-East Asian and Western Pacific Regions. Methods: We systematically searched for publications in PubMed® and Scopus, manually searched the grey literature and consulted with national health and nutrition officials, with no restrictions on publication type or language. We included low- and middle-income countries in the World Health Organization South-East Asia Region, and the Association of Southeast Asian Nations and China. We analysed the included programmes by adapting the United States Centers for Disease Control and Prevention's public health surveillance evaluation framework. Findings: We identified 82 surveillance programmes in 18 countries that repeatedly collect, analyse and disseminate data on nutrition and/or related indicators. Seventeen countries implemented a national periodic survey that exclusively collects nutrition-outcome indicators, often alongside internationally linked survey programmes. Coverage of different subpopulations and monitoring frequency vary substantially across countries. We found limited integration of food environment and wider food system indicators in these programmes, and no programmes specifically monitor nutrition-sensitive data across the food system. There is also limited nutrition-related surveillance of people living in urban deprived areas. Most surveillance programmes are digitized, use measures to ensure high data quality and report evidence of flexibility; however, many are inconsistently implemented and rely on external agencies' financial support. Conclusion: Efforts to improve the time efficiency, scope and stability of national nutrition surveillance, and integration with other sectoral data, should be encouraged and supported to allow systemic monitoring and evaluation of malnutrition interventions in these countries.

Silica bodies in leaves of neotropical Podostemaceae: taxonomic and phylogenetic perspectives.

Background and Aims: The presence, location and morphology of silica bodies are informative anatomical characters in angiosperms, mainly in Poales. In Podostemaceae, a strictly aquatic family, these structures are mentioned frequently, but there is limited insight into their location and morphological features. In the present study we focused on describing and analysing the morphological diversity of silica bodies in leaves of neotropical Podostemaceae at the intra- and interspecific levels to determine their taxonomic and phylogenetic relevance. Methods: We studied 103 specimens distributed across 40 species. Silica body morphological traits were analysed under light and scanning electron microscopy. Additionally, data from three species of Hypericaceae (sister group) were retrieved from the literature. A phylogenetic framework based on four molecular markers was built in order to reconstruct ancestral character states related to silica bodies in neotropical Podostemaceae. Key Results: Silica bodies were detected in epidermal, subepidermal and perivascular cells, presenting different shapes and surface morphology. Presence and location were used for primary differentiation while surface morphology and lumen (presence and shape) were used for finer distinctions. Intraspecific comparisons among samples showed that the length and width of these structures were highly variable. Maximum parsimony and maximum likelihood analyses for ancestral character reconstruction were congruent. Three out of five characters showed a statistically strong phylogenetic signal. Conclusions: Silica bodies were reported for the first time for 19 taxa, and their morphological diversity is greater than reported in previous studies. Their presence can be considered an apomorphy in Podostemaceae. Although some significant differences were detected in length and width, qualitative characters are more informative at both specific and generic ranks.

Changes in total and central adiposity and body fat distribution among 7-10-year-old schoolchildren in Brazil.

OBJECTIVE: To describe changes in total and central adiposity and body fat distribution in children over a 5-year period by investigating variations in BMI, waist circumference (WC), waist-to-height ratio (WHtR) and skinfold thicknesses (SFT). DESIGN: A school-based sample of children from 2nd to 5th grades of elementary schools participated in two cross-sectional studies in 2002 (n 2936) and 2007 (n 1232). SETTING: Public and private schools of Florianopolis, Brazil. SUBJECTS: Schoolchildren aged 7-10 years had their weight, height, WC and SFT measured according to standard procedures. Body fat distribution was assessed by triceps, subscapular, suprailiac and medial calf skinfold measurements. Changes in BMI, WC, WHtR and SFT were analysed, adjusting for type of school and monthly family income. RESULTS: Adjusted mean differences between 2002 and 2007 for BMI and WC were always positive and of similar magnitude between boys and girls. However, a statistically significant increase was observed only for BMI (raw and Z-score values) in boys. WHtR remained stable in both sexes. Adjusted median values for SFT also increased in boys and girls, except for triceps skinfold. BMI, WC and SFT tended to increase across age classes in both sexes. The relative change observed for the median central skinfolds (subscapular and suprailiac) was greater than that of peripheral skinfolds (triceps and medial calf). CONCLUSIONS: The subcutaneous adipose tissue (SFT) appeared to increase at a faster rate than total adiposity (BMI). The increase in central SFT indicates that the relative change is due primarily to a rise in central adiposity.

Trends in adiposity in Brazilian 7-10-year-old schoolchildren: evidence for increasing overweight but not obesity between 2002 and 2007.

BACKGROUND: The negative health consequences of childhood overweight/obesity (OW/OB) are well known. Therefore, an accurate monitoring of the OW/OB prevalence is essential. Anthropometry is the most practical and cost-effective method for nutritional status evaluation. AIM: To describe trends in the nutritional status among 7-10-year-old children by investigating changes in the prevalence of stunting, thinness, overweight, obesity, risk and excess abdominal adiposity, and to study changes in height-for-age, body mass index (BMI) and waist circumference (WC). SUBJECTS AND METHODS: A school-based sample of 7-10-year-old children participated in two cross-sectional studies in 2002 (n = 2936) and 2007 (n = 1232) in Florianopolis, southern Brazil. Prevalence of stunting, risk and excess abdominal adiposity and changes in the distribution of height-for-age, BMI-for-age, WC-for-age z-scores were evaluated. Three BMI-based references were used to define the prevalence of thinness, overweight and obesity. RESULTS: Between 2002-2007, the prevalence of stunting, thinness, obesity and excess abdominal adiposity remained stable, whereas overweight (including obesity) increased 10-23% in boys and 18-21% in girls, depending on the BMI reference used. The risk of abdominal adiposity increased in boys, but not in girls. No significant change was observed in mean height, BMI, WC-for-age z-scores. CONCLUSIONS: This study identified a potential levelling off in the prevalence of obesity and excess abdominal adiposity, but a continuing increase in the prevalence of overweight.

Effectiveness of the 5A Counseling Model-Based Interventions on Physical Activity Indicators in Adults: A Systematic Review.

BACKGROUND: To identify and appraise the effectiveness of the 5A-counseling-model-based interventions on indicators of physical activity in adults. METHODS: A systematic review was conducted from systematic searches in Embase, Lilacs, Pubmed, Scielo, Scopus, Sportdiscus and Web of Science, involving studies published from its inception until May 2022. To avoid potential losses, searches also were made in Google Scholar and in reference lists. The assessment of studies, data extraction, and synthesis were carried out independently by two researchers. RESULTS: Four studies composed the synthesis, which involved people with an average age between 40 and 55 years, most of the samples being women. It was observed that counseling was carried out in conjunction with other strategies, such as drawing up an action plan, sending text messages, and offering educational material. Only one study showed a statistically significant difference between the intervention and control groups in the "daily number of steps" indicator. CONCLUSIONS: Based on available studies, 5A-counseling-model-based interventions did not reflect significant findings in relation to physical activity. However, given the potential of the model, future studies are recommended with a better description of the strategies, as well as a more robust methodology, to strengthen the evidence.

Early tracheostomy and active exercise programmes in adult intensive care patients with severe burns.

BACKGROUND: Tracheostomy is a strategy often employed in patients requiring prolonged intubation in ICU settings. Evidence suggests that earlier tracheostomy and early active exercise are associated with better patient centered outcomes. Severe burn patients often require prolonged ventilatory support due to their critical condition, complex sedation management and multiple operating room visits. It is still unclear the optimal timing for tracheostomy in this population. METHODS: We conducted a service evaluation where we compared Early Tracheostomy (≤10 days) with Late Tracheostomy (>10 days) in 41 severely burned patients that required prolonged respiratory support. RESULTS: Early Tracheostomy cohort was associated with fewer days of mechanical ventilation (16 vs 33, p = 0.001), shorter hospital length of stay (65 vs 88 days, p = 0.018), earlier first day of active exercise (day 8 vs day 25, p < 0.0001) and higher Functional Assessment for Burns scores upon discharge (32 vs 28, p = 0.016). CONCLUSION: Early tracheostomy in patients with severe burns is associated with earlier active exercise, fewer days of ventilation, shorter length of hospital stay and better physical functional independence upon discharge from hospital.

Topographic laparoscopy for buffaloes in the quadruped position.

This study aimed to describe the anatomical topography of the abdominal cavity of buffaloes in the quadruped position to establish the best endosurgical access and vantage points and identify possible limitations. Laparoscopies were performed on 10 healthy female buffaloes obtained from the Universidade Federal Rural da Amazônia to explore possible access points to the abdomen. Techniques for assessing and possibly observing certain organs and structures through the left and right flanks of 10 animals have been described. In five animals, access was created through the right side of the last intercostal space to allow more cranial access to the abdominal cavity. Despite the presence of the rumen, access through the left flank allowed the visualization of the structures of the gastrointestinal tract and the genitourinary system. With access through the right flank, however, imaging was hampered by the presence of the greater omentum and its deep and superficial walls, which prevented the progression of the endoscope. Access through the last right intercostal space allowed the visualization of the cranial structures of the abdominal cavity, such as the caudate process, right lobe of the liver, right kidney, and pancreas. Laparoscopic access through the left flank and the last intercostal space in healthy buffaloes in the quadruped position is feasible, and it is promising for the exploration, diagnosis, and treatment of various disorders in buffaloes.

Phase separation of p53 precedes aggregation and is affected by oncogenic mutations and ligands.

Mutant p53 tends to form aggregates with amyloid properties, especially amyloid oligomers inside the nucleus, which are believed to cause oncogenic gain-of-function (GoF). The mechanism of the formation of the aggregates in the nucleus remains uncertain. The present study demonstrated that the DNA-binding domain of p53 (p53C) underwent phase separation (PS) on the pathway to aggregation under various conditions. p53C phase separated in the presence of the crowding agent polyethylene glycol (PEG). Similarly, mutant p53C (M237I and R249S) underwent PS; however, the process evolved to a solid-like phase transition faster than that in the case of wild-type p53C. The data obtained by microscopy of live cells indicated that transfection of mutant full-length p53 into the cells tended to result in PS and phase transition (PT) in the nuclear compartments, which are likely the cause of the GoF effects. Fluorescence recovery after photobleaching (FRAP) experiments revealed liquid characteristics of the condensates in the nucleus. Mutant p53 tended to undergo gel- and solid-like phase transitions in the nucleus and in nuclear bodies demonstrated by slow and incomplete recovery of fluorescence after photobleaching. Polyanions, such as heparin and RNA, were able to modulate PS and PT in vitro. Heparin apparently stabilized the condensates in a gel-like state, and RNA apparently induced a solid-like state of the protein even in the absence of PEG. Conditions that destabilize p53C into a molten globule conformation also produced liquid droplets in the absence of crowding. The disordered transactivation domain (TAD) modulated both phase separation and amyloid aggregation. In summary, our data provide mechanistic insight into the formation of p53 condensates and conditions that may result in the formation of aggregated structures, such as mutant amyloid oligomers, in cancer. The pathway of mutant p53 from liquid droplets to gel-like and solid-like (amyloid) species may be a suitable target for anticancer therapy.

[Preparing For the COVID-19 Pandemic: The Perspective of a Department of Anesthesiology in a Tertiary Hospital in Portugal]. / Preparação para a Pandemia COVID-19: A Perspetiva de um Serviço de Anestesiologia de um Hospital Terciário em Portugal.

Since the detection of the first cases of COVID-19, reported by the People's Republic of China on the 31st December 2019, up to the confirmation of the first cases in Portugal, on the 2nd March, countries like Italy and Spain faced the collapse of their healthcare systems. Anticipating this possibility, the Portuguese National Health Service carried out measures to prepare for this reality. This paper describes the changes implemented in the Anesthesiology department of a tertiary hospital center in Portugal, aiming to ensure the safety of both patients and healthcare professionals. The measures implemented had to do mostly with scientific preparation and team reorganization; management of personal protective equipment; redesigning the department's clinical common areas, separation of patient circuits with creation of a designated COVID Operating Room, Post-Anesthetic Care Unit; rescheduling of elective surgery and testing all patients before anesthesia procedures and consulting other hospital departments. The reported data covers the period between the 2nd March and the 30th April of 2020. In this period, 64 cases with COVID-19 or with high clinical suspicion were approached. To date, there have been no cases of in-hospital spread to other patients or to professionals in this department. With this paper we intend to start a reflection that will end up with the optimization of strategies that allows health systems to deal better with COVID-19, keeping patients and health providers safe.

Desde os primeiros casos de COVID-19 reportados pela República Popular da China, a 31 de dezembro de 2019, até à confirmação dos primeiros casos em Portugal, a 2 de março, países como Itália e Espanha depararam-se com o colapso dos seus sistemas de saúde. Antevendo essa possibilidade, o Serviço Nacional de Saúde preparou-se para enfrentar esta nova realidade. Neste documento descreve-se especificamente a preparação do serviço de Anestesiologia de um centro hospitalar terciário português, por forma a garantir a segurança dos seus doentes e profissionais de saúde. As medidas implementadas incidiram na preparação científica e reorganização das equipas; gestão do equipamento de proteção individual; reorganização dos espaços comuns do serviço; separação dos fluxos de doentes com a criação do Bloco Operatório e Unidade de Cuidados Pós-Anestésicos COVID; reprogramação da cirurgia eletiva; rastreio de todos os doentes propostos a procedimentos anestésicos e consultoria a outros serviços. Os dados apresentados compreendem a atividade desenvolvida entre 2 de março e 30 de abril de 2020. Nesse período foram abordados 64 casos com COVID-19 ou com elevada suspeita clínica, sendo que até à data não foram registados casos de contágio intra-hospitalar de outros doentes ou de profissionais neste serviço. Com este trabalho pretende-se iniciar uma reflexão que culmine numa futura otimização de estratégias que permitam aos serviços de saúde lidar com a COVID-19, mantendo a segurança dos outros doentes e dos profissionais de saúde.

Histological evaluation of sheep ovarian tissue after laparoscopic partial ovariectomy.

In the present study, there was assessment of the damage to tissue caused by partial laparoscopic ovariectomy using bipolar forceps in sheep. Fragments of ovaries of six sheep were removed using bipolar forceps by making a transverse section in the middle third of the organ via three-portals that were made using laparoscopy. The fragments were subjected to standard histological examinations and the lesions attributed to the procedure were investigated using an optical microscope and Image J software. The results were assessed using an analysis of variance and the Tukey test. All the laminae had minimal tissue damage. The mean amount of highly damaged tissue was 1.8%, and of partially damaged tissue was 5.6%. The mean total area of healthy tissue in the fragments was 94.4%. The results of the study indicate this procedure can be conducted withvery little tissue damage occurring. The use of this procedure, therefore, can be incorporated in future reproductive studies without altering the functions of the in situ ovarian tissues.

Synthesis, solubility, plasma stability, and pharmacological evaluation of novel sulfonylhydrazones designed as anti-diabetic agents.

Neuropathy is a serious complication of diabetes that has a significant socioeconomic impact, since it frequently demands high levels of health care consumption and compromises labor productivity. Recently, LASSBio-1471 (3) was demonstrated to improve oral glucose tolerance, reduce blood glucose levels, and display an anti-neuropathy effect in a murine streptozotocin-induced diabetes model. In the present work, we describe the design, synthesis, solubility, plasma stability, and pharmacological evaluation of novel sulfonylhydrazone derivatives (referred to herein as compounds 4-9), which were designed by molecular modification based on the structure of the prototype LASSBio-1471 (3). Among the compounds tested, better plasma stability was observed with 4, 5, and 9 in comparison to compounds 6, 7, and 8. LASSBio-1773 (7), promoted not only hypoglycemic activity but also the reduction of thermal hyperalgesia and mechanical allodynia in a murine model of streptozotocin-induced diabetic neuropathic pain.

Sedentary behaviors, leisure-time physical inactivity, and chronic diseases in Brazilian workers: a cross sectional study.

BACKGROUND: Our purpose was to examine the association of television viewing (hours/day), sedentary work (predominantly sitting at work), passive transportation to work (car or motorcycle), and the clustering of these behaviors ("sedentary lifestyle"), as well as leisure-time physical inactivity (LTPI), with chronic diseases (hypertension, hypercholesterolemia, type 2 diabetes, obesity, and clustering of chronic diseases) in Brazilian workers. METHODS: Cross-sectional study conducted from 2006 to 2008 in 24 Brazilian federal units (n = 47,477). A questionnaire was applied. Descriptive statistics, binary and multinomial logistic regressions were used. RESULTS: Magnitude of association with chronic diseases varied greatly across domains and gender. Sedentariness at work was the most consistent behavior associated with chronic diseases, especially in men (OR hypertension = 1.10, 95% CI: 1.01-1.20; OR hypercholesterolemia = 1.34, 95% CI: 1.21-1.48; OR obesity = 1.27, 95% CI: 1.15-1.41; OR1 chronic disease = 1.17, 95% CI: 1.09-1.26; OR ≥ 2 chronic diseases = 1.61, 95% CI: 1.46-1.78) compared with women (OR hypercholesterolemia = 1.15, 95% CI: 1.01-1.31; OR obesity = 1.24, 95% CI: 1.04-1.48). LTPI was associated with all diseases in men (except type 2 diabetes), but only with obesity in women. CONCLUSION: Adverse health consequences may be differently associated according to behavior domain and gender. Sedentary work and LTPI were consistently associated with chronic disease in Brazilian workers, especially in men.

Clustering of risk factors for non communicable diseases in adults from Florianopolis, SC.

OBJECTIVE: To investigate clustering patterns of health risk behaviors for non communicable diseases and its associated factors. METHODS: a Random telephone survey with 1,996 adults from Florianopolis, SC, was conducted in 2005. Tobacco use, high alcoholic intake episodes, fruit consumption and physical inactivity were investigated. Clustering was examined by the ratio between observed and expected prevalence of each of the 16 possible combinations. These clustered risk factors comprised the main outcome and binomial and multinomial logistic regression was conducted to examine socio-demographic correlates. RESULTS: 43% of men and 36.6% of women clustered at least two health risk factors. Three (19.2%; CI 95% 16.7 - 21.7) and five (9.8%; CI 95% 8.0 - 11.6) specific combinations exceed the expected prevalence, respectively, in men and women. Women with low schooling level and older were more likely to cluster health risk behaviors. CONCLUSION: although men showed higher prevalence of single health risk behavior and its combinations, women presented more specific combinations that clustered above the expected. Knowledge on the clustering pattern of these health risk behaviors may guide the design of more effective health promotion initiatives.

Assessment of diet and physical activity of brazilian schoolchildren: usability testing of a web-based questionnaire.

BACKGROUND: Information and communication technology (ICT) has been used with increasing frequency for the assessment of diet and physical activity in health surveys. A number of Web-based questionnaires have been developed for children and adolescents. However, their usability characteristics have scarcely been reported, despite their potential importance for improving the feasibility and validity of ICT-based methods. OBJECTIVE: The objective of this study was to describe the usability evaluation of the Consumo Alimentar e Atividade Física de Escolares (CAAFE) questionnaire (Food Consumption and Physical Activity Questionnaire for schoolchildren), a new Web-based survey tool for the self-assessment of diet and physical activity by schoolchildren. METHODS: A total of 114 schoolchildren aged 6 to 12 years took part in questionnaire usability testing carried out in computer classrooms at five elementary schools in the city of Florianopolis, Brazil. Schoolchildren used a personal computer (PC) equipped with software for recording what is on the computer screen and the children's speech during usability testing. Quantitative and qualitative analyses took into account objective usability metrics such as error counts and time to complete a task. Data on the main difficulties in accomplishing the task and the level of satisfaction expressed by the children were assessed by the observers using a standardized form and interviews with the children. Descriptive statistics and content analysis were used to summarize both the quantitative and the qualitative aspects of the data obtained. RESULTS: The mean time for completing the questionnaire was 13.7 minutes (SD 3.68). Compared to the children in 2nd or 3rd grades, those in 4th or 5th grades spent less time completing the questionnaire (median 12.4 vs 13.3 minutes, P=.022), asked for help less frequently (median 0 vs 1.0 count, P=.005), had a lower error count (median 2.0 vs 8.0 count, P<.001), and obtained a higher overall performance score (median 73.0 vs 68.0, P=.005). Children with a PC at home spent less time completing the questionnaire (median 12.3 vs 14.9 minutes, P<.001), had a lower overall error count (median 2.0 vs 9.0 count, P=.03), and had a higher performance score (median 72.0 vs 64.0, P=.005) compared to the children without a PC at home. The most common difficulty in completing the questionnaire was in using the scroll bar. The majority of children reported a positive evaluation (liked a lot or liked) for the four design elements, which were evaluated. CONCLUSIONS: The results of the present study provided feedback to improve the final version of the CAAFE questionnaire. Quantitative data showed minor errors and system failures, while qualitative data indicated that, overall, the children enjoyed the CAAFE questionnaire. Grade levels and PC use must be taken into account in Web-based tools designed for children.

Docking, synthesis and anti-diabetic activity of novel sulfonylhydrazone derivatives designed as PPAR-gamma agonists.

Diabetes is a metabolic disorder characterized by hyperglycemia. When not properly controlled, complications include neuropathy, coronary artery disease, and renal failure. Several drugs are approved for diabetes treatment; however their use is associated with side effects and lack of efficacy in attenuating the development of long-term complications. This work describes the virtual screening and synthesis of a novel series of sulfonylhydrazone derivatives designed as peroxisome proliferator-activated receptor gamma (PPARγ) agonists and investigation of the analogs for hypoglycemic activity in a murine model of diabetes. Docking studies identified LASSBio-331 (5) as having theoretical affinity for PPARγ similar to the prototype (S)-rosiglitazone. Several structural modifications were proposed for the structure of LASSBio-331, resulting in the synthesis of five novel compounds, which showed experimental affinity for PPARγ. Among these new compounds, LASSBio-1471 (15) had the best theoretical binding energy for PPARγ and was selected for testing in STZ-induced diabetes. Four weeks after single intravenous injection of STZ (60 mg/kg), Wistar rats were treated with vehicle (DMSO) or LASSBio-1471 (20 mg/kg, i.p.) for 7 days. The blood glucose levels of rats treated with LASSBio-1471 were reduced from 548.4 ± 26.0 mg/dL before treatment to 259.6 ± 73.1 mg/dL (P < 0.05). Paw withdrawal threshold was significantly reduced in diabetic rats and was restored from 21.9 ± 1.7 g to 36.7 ± 1.2 g after 7 days of treatment with LASSBio-1471 (P < 0.05). Thus, the novel sulfonylhydrazone derivative is a PPARγ ligand that is effective for treatment of diabetic neuropathy in STZ-injected rats.