To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The aim of the current study was to identify and describe the meal and snack patterns (breakfast, mid-morning snack, lunch, mid-afternoon snack, dinner and evening snack) of public schoolchildren.
Cross-sectional study. Information on the previous day’s food intake was obtained through the Web-CAAFE (Food Intake and Physical Activity of Schoolchildren), an interactive questionnaire, which divides daily food consumption into three meals (breakfast, lunch and dinner) and three snacks (mid-morning, mid-afternoon and evening). Each meal contains thirty-one food items and the schoolchildren clicked on the food items consumed in each meal. Factor analysis was used to identify meal and snack patterns. The descriptions of the dietary patterns (DP) were based on food items with factor loads ≥ 0·30 that were considered representative of each DP.
Schoolchildren, Florianopolis, Brazil.
Children (n 1074) aged 7–13 years.
Lunch was the most consumed meal (96·0 %), followed by dinner (86·4 %), breakfast (85·3 %) and mid-afternoon snack (81·7 %). Four DP were identified for breakfast, mid-morning snack, lunch, dinner and evening snack, and three for mid-afternoon snack. Breakfast, lunch and dinner patterns included traditional Brazilian foods. DP consisting of fast foods and sugary beverages were also observed, mainly for the evening snack.
The results of the current study provide important information regarding the meal and snack patterns of schoolchildren to guide the development of nutrition interventions in public health.
The objective of this study was to evaluate the fermentative characteristics and chemical composition of cochineal nopal cactus silage additives with urea or Lactobacillus buchneri (LB), as well as the association of both additives in four storage times (7, 15, 60 and 120 days) and during aerobic stability, with evaluations at 0, 48 and 96 h. Four silages were used: no additive, addition of 2% urea, addition of LB and addition of 2% urea and LB. The study was divided into two experiments: the first experiment evaluated the silages at different storage times, and the second experiment evaluated the silages during the aerobic stability test. In both experiments, the experimental design was completely randomized in a factorial scheme (4 × 4 and 4 × 3) with three replicates per treatment. After the ensiling process, lactic acid bacteria predominated in all treatments. The concentration of lactic acid increased significantly from 60 days of ensiling. The concentration of acetic acid varied significantly between the storage times only for the silages treated with urea and LB alone. The silage treated with urea maintained a constant pH value up to 120 days of storage. During the 96 h aerobic stability test, no breaking in the stability of silages was observed. The exclusive or associated use of urea and LB promotes improvement in the fermentative characteristics of cochineal nopal cactus silage, without major alterations in the chemical composition or interfering with the aerobic stability of the silages.
Treatment of hypoplastic left heart syndrome varies across institutions. This study examined the impact of introducing a standardised programme.
This retrospective cohort study evaluated the effects of a comprehensive strategy on 1-year transplant-free survival with preserved ventricular and atrioventricular valve (AVV) function following a Norwood operation. This strategy included standardised operative and perioperative management and dedicated interstage monitoring. The post-implementation cohort (C2) was compared to historic controls (C1). Outcomes were assessed using logistic regression and Kaplan–Meier analysis.
The study included 105 patients, 76 in C1 and 29 in C2. Groups had similar baseline characteristics, including percentage with preserved ventricular (96% C1 versus 100% C2, p = 0.28) and AVV function (97% C1 versus 93% C2, p = 0.31). Perioperatively, C2 had higher indexed oxygen delivery (348 ± 67 ml/minute/m2 C1 versus 402 ± 102ml/minute/m2 C2, p = 0.015) and lower renal injury (47% C1 versus 3% C2, p = 0.004). The primary outcome was similar in both groups (49% C1 and 52% C2, p = 0.78), with comparable rates of death and transplantation (36% C1 versus 38% C2, p = 0.89) and ventricular (2% C1 versus 0% C2, p = 0.53) and AVV dysfunction (11% C1 versus 11% C2, p = 0.96) at 1-year. When accounting for cohort and 100-day freedom from hospitalisation, female gender (OR 3.7, p = 0.01) increased and ventricular dysfunction (OR 0.21, p = 0.02) and CPR (OR 0.11, p = 0.002) or ECMO use (OR 0.15, p = 001) decreased the likelihood of 1-year transplant-free survival.
Standardised perioperative management was not associated with improved 1-year transplant-free survival. Post-operative ventricular or AVV dysfunction was the strongest predictor of 1-year mortality.
This study aimed to evaluate the inflammatory response, oxidative status, and fatty acid deposition in reproductive tissues of cats supplemented with the dried microalgae Schizochytrium spp. (Thraustochytriaceae) as docosahexaenoic acid (DHA) source. Thirty-seven cats (males, n= 21; females, n= 16; 11.5±0.5 months of age) were divided by sex into five groups. Treatment diets contained algae biomass at 4.0, 8.0, 12.0, or 16.0 g/kg replacing poultry fat (omega-6 source). Cats were fed the respective diet for 62 d and neutered on day 58. Blood samples were collected at the beginning of the experiment (day 1), before neutering (day 58), and four days after surgery (day 62) for analysis of inflammation and oxidative markers. Acute-phase protein levels were altered (P < 0•01) in the postoperative period, without any treatment effect (P > 0•05). Prostaglandin E2 (PGE2) concentrations after surgery was reduced linearly (R2 = 0.8706; P = 0•002) with microalgal inclusion. Blood platelet count was reduced (P = 0•001) after the surgery regardless treatment but, it was higher in the DHA group compared to Control (P < 0•001). The DHA deposition (testicles, R2 = 0.846; ovaries, R2 = 0.869), and the omega-6/omega-3 ratio (testicles, R2 = 0.859; ovaries, R2 = 0.955) in gonads had a pattern which fitted a quadratic model. DHA from Schizochytrium spp. modifies PGE2 response after the surgery in cats. The physiological roles of the DHA in the reproduction of cats were not investigated, but its gonadal deposition after supplementation was observed.
To assess the inflammatory potential of the Brazilian population’s diet and its association with demographic, socioeconomic, and anthropometric characteristics.
Cross-sectional study performed with 34,003 individuals aged 10 and older, evaluated by the National Diet and Nutrition Survey (INA) from the Consumer Expenditure Survey (POF 2008-2009). The Energy-adjusted Dietary Inflammatory Index (E-DIITM) was determined using 34 dietary parameters calculated through non-consecutive 2-day dietary records. Positive scores indicate a pro-inflammatory diet, while negative scores indicate an anti-inflammatory diet. A bivariate and multivariate linear regression analysis based on a hierarchical theoretical model was performed to verify the factors associated with the E-DII.
The mean of the E-DII was 1.04, with a range of -4.77 to +5.98. The highest values of the pro-inflammatory E-DII were found among adolescents (1.42; p-value<0.001) and individuals with higher income (1.10; p-value<0.001) and level of education (1.18; p-value<0.001). In the final model, the E-DII was associated with higher income quartiles, was higher in the Northeast and South regions, in white people, individuals with ≥9 years of education and adults and adolescents age group.
The Brazilian population consumes a diet with high inflammatory potential, especially adolescents, white people and those with higher income and level of education. Thus, the index presented uneven distribution among the population, emphasizing groups with higher dietary inflammatory potential. The socioeconomic risk profile of a diet with higher inflammatory potential in medium-income countries is different from what is observed in high-income nations.
The aim of this study was to investigate the effects of Cactus (Opuntia spp) levels in total mixed ration silages based on Cactus and Gliricidia (Gliricidia sepium (Jacq.) Steud) on the fermentation profile, microbial populations, aerobic stability and taxonomic diversity. The completely randomized design was used in a 4 × 4 factorial design with four replications, being four rations with different levels of Cactus (15, 30, 45, 60% based on the dry matter) and four opening periods (0, 15, 30 and 60 days of fermentation). An interaction effect (P < 0.050) was observed among the diets and opening times for mould and yeast populations. An interaction effect for the levels of acetic acid was observed, where the diets 15, 30, 45 and 60% showed higher values at 60 days (0.44, 0.41, 0.35 and 0.40 g/kg DM, respectively). A significant difference was observed for the richness and diversity index (Chao1 and Shannon). The most abundant bacterial phyla were Proteobacteria and Firmicutes and the genera Lactobacillus and Weissella. Cactus can be added in total mixed ration silages up to the level of 60% in a way that it positively affects the qualitative indicators of the silages, modulating the taxonomic communities and allowing the predominance of important groups for preservation of the ensiled mass.
Breakfast is considered as the most important meal of the day. The habit of skipping this meal in adolescence tends to remain until adulthood and has been associated with cardiometabolic risk factors. This study estimated the prevalence of skipping breakfast and its association with cardiometabolic risk factors. This is a cross-sectional study with data from the Study of Cardiovascular Risks in Adolescents (ERICA), with a nationally representative sample of 36,956 Brazilian adolescents, aged 10 to 17 years, enrolled in public and private schools. The outcomes were: excess body weight (body mass index), central obesity (waist circumference and waist/height ratio), lipid profile (total cholesterol, LDLc, HDLc, and triglycerides) and glycidic profile (fasting glycemia, fasting insulin, and glycated hemoglobin). The association between skipping breakfast and each outcome was estimated using multiple logistic regression models (Odds Ratio [OR] and 95% Confidence Interval). Prevalence of skipping breakfast was 68.7% and, after adjustments, it was associated with excess body weight (OR = 1.51), central obesity both by waist circumference (OR = 1.36) and by waist/height ratio (OR = 1.44) and high fasting glucose levels (OR = 1.54), fasting insulin (OR = 1.45), and glycated hemoglobin (OR = 1.23). Thus, skipping breakfast was high among adolescents and those who skip this meal are more likely to have total and central obesity, as well as high levels of total cholesterol, fasting insulin, fasting glycemia and glycated hemoglobin, regardless of factors relative to lifestyle and demographic and socioeconomic characteristics.
Denture-related stomatitis caused by Candida spp. affects elderly individuals using partial/total prosthesis, provoking several discomforts including burning sensation and altered taste. Herein, we have studied 52 denture-wearing individuals (>60 years-old), attended at the dentistry clinic of UNIVALE, aiming to isolate Candida spp. directly from the stomatitis lesions and to evaluate their potential to produce virulence attributes. A low prevalence of denture-related stomatitis was reported in these patients (4/52; 7.7%). Candida albicans was isolated in the 4 selected patients, with the ability to form biofilm over a polystyrene surface and to produce aspartic protease, esterase and hemolysin. However, neither phospholipase nor caseinase activities were detected. Planktonic-growing yeasts were susceptible to amphotericin B and caspofungin, while the susceptibility to azoles (fluconazol, itraconazole and voriconazole) varied depending on either the isolate or antifungal. Relevantly, biofilm-forming C. albicans cells exhibited resistance to all studied antifungals. So, new effective drugs against resistant C. albicans isolates causing denture-related stomatitis are urgently required.
Maria Firmina dos Reis was born in São Luiz do Maranhão, a remote northern province of the Brazilian Empire, probably in 1825. The daughter of a black father and a white mother, and a self-taught woman who had never received formal education, Maria Firmina became the youngest elementary teacher in a newly founded local school. In 1859, she published the novel Ursula and became the first black woman to publish a literary text in Brazil. Ursula not only offers harsh criticism of slavery and the slave-owning patriarchal family, but also gives narrative voice to enslaved characters and their reflections on life under captivity. Forgotten for more than a century, her work started to gain recognition in the 1970s. Nowadays revered as a pioneering black novelist, she is, along with Luiz Gama - former slave, also a self-taught man who became a lawyer, poet and anti-slavery militant - the founder of Afro-Brazilian literature.
We obtain large and moderate deviation estimates for both sequential and random compositions of intermittent maps. We also address the question of whether or not centering is necessary for the quenched central limit theorems obtained by Nicol, Török and Vaienti [Central limit theorems for sequential and random intermittent dynamical systems. Ergod. Th. & Dynam. Sys.38(3) (2018), 1127–1153] for random dynamical systems comprising intermittent maps. Using recent work of Abdelkader and Aimino [On the quenched central limit theorem for random dynamical systems. J. Phys. A 49(24) (2016), 244002] and Hella and Stenlund [Quenched normal approximation for random sequences of transformations. J. Stat. Phys.178(1) (2020), 1–37] we extend the results of Nicol, Török and Vaienti on quenched central limit theorems for centered observables over random compositions of intermittent maps: first by enlarging the parameter range over which the quenched central limit theorem holds; and second by showing that the variance in the quenched central limit theorem is almost surely constant (and the same as the variance of the annealed central limit theorem) and that centering is needed to obtain this quenched central limit theorem.
This is a cross-sectional analysis of data obtained in the baseline of the Longitudinal Study on the Lifestyle and Health of University Students (n=685), carried out in a public Brazilian university. Food intake was assessed using a 24-hour dietary recall. Dietary patterns (DP) for breakfast, lunch, and dinner were identified using principal component analysis. Generalized linear models were used to analyze the variables associated with each DP. Three DP were extracted for each meal: breakfast: “White bread and butter/margarine”, “Coffee and Tea”, “Sausages, whole wheat bread and cheese”; lunch: “Traditional”, “Western”, “Vegetarian”; dinner: “Beans, rice and processed juice”, “White bread and butter/margarine”, “White meat, eggs and natural juice”. Students who had meals at the campus showed greater adherence to the “White bread and butter/margarine” (exp(βadj)=1.15, 95% CI: 1.11;1.19) and “Coffee and Tea” (exp(βadj)=1.06, 95% CI: 1.02;1.10) breakfast patterns; “Western” lunch pattern (exp(βadj)=1.04, 95% CI: 1.01;1.08) and to the “Beans, rice and processed juice” dinner pattern (exp(βadj)=1.10, 95% CI: 1.06;1.14). Having meals at the campus was associated with lower adherence to the “Sausages, whole wheat bread and cheese” breakfast pattern (exp(βadj)=0.93, 95% CI: 0.89;0.97), “Traditional” lunch pattern (exp(βadj)=0.96, 95% CI: 0.93;0.99) and to the “White bread and butter/margarine” (exp(βadj)=0.96, 95% CI: 0.93;0.99) and “White meat, eggs and natural juice” (exp(βadj)=0.96, 95% CI: 0.93;0.99) dinner pattern. Food environment at campus may influence students’ DP. Recognizing meal eating patterns is important to support healthy eating promotion strategies on campus. Adjustments in the University Canteen menu could contribute to healthier eating choices among students.
Integrative taxonomy was used to evaluate two component populations of Procamallanus (Spirocamallanus) inopinatus in Brazil and the phylogeny Camallanidae. Parasite populations were collected in the characiform Anostomoides passionis from River Xingu (Amazon basin) and Megaleporinus elongatus from River Miranda (Paraguay basin). Morphology was analysed using light and scanning electron microscopy (SEM). Genetic characterization was based on partial sequences of the 18S and 28S rDNA, and COI mtDNA. Phylogenies were based on 18S and COI due to data availability. Generalized Mixed Yule Coalescent (GMYC), Poisson Tree Process (PTP) and *BEAST were used for species delimitation and validation. SEM revealed for the first time the presence of minute denticles and pore-like structures surrounding the oral opening, phasmids in females and confirmed other important morphological aspects. Statistical comparison between the two-component populations indicated morphometric variations, especially among males. The different component population of P. (S.) inopinatus showed variable morphometry, but uniform morphology and were validated as conspecific by the GMYC, PTP and *BEAST. Some camallanid sequences in GenBank have incorrect taxonomic labelling. Host, environment and geographic aspects seem to be related to some lineages within Camallanidae; however, their real phylogenetic meanings are still unclear.
To compare diet quality and its association with excess body weight (EBW: overweight/obesity), central adiposity (CA) and CVD risk factors (CVDR) among adolescents from Brazil and USA.
Data from two cross-sectional surveys: Health Survey of São Paulo (ISA-Nutrition) and Hispanic Community Health Study/Study of Latino Youth (SOL-Youth). Dietary intake was assessed from 24-h recalls, and diet quality using the Alternate Healthy Eating Index-2010 (AHEI) developed in the USA and the Revised Brazilian Healthy Eating Index (BHEI-R). CVDR was defined as ≥3 of: obesity, elevated blood pressure, dyslipidaemia, high plasma glucose and insulin resistance. Adjusted OR for EBW, CA and CVDR by diet quality were tested using logistic regression.
São Paulo, Brazil; and Chicago, IL; Miami, FL; Bronx, NY; San Diego, CA.
Adolescents (12–16 years) living in São Paulo (n 189) and USA (n 787).
ISA-Nutrition individuals with EBW (v. without) had marginally lower (unhealthier) scores for whole grains using BHEI-R and sugary beverages using AHEI. SOL-Youth individuals with EBW had lower scores of nuts/legumes using AHEI, and Na using BHEI-R, but higher scores of whole grains and dairy using BHEI-R. In ISA-Nutrition, BHEI-R was inversely associated with EBW (OR = 0·87; 95 % CI 0·80, 0·95) and CVDR (OR = 0·89; 95 % CI 0·80, 0·98). In SOL-Youth, AHEI was inversely associated with EBW (OR = 0·93; 95 % CI 0·87, 0·99).
Dietary improvements should be made by adolescents in both USA and Brazil. Healthier diet quality as measured with the country-specific index was associated with lower odds of EBW in Brazilian and USA-Hispanic/Latino adolescents, and with lower CVDR in Brazilian adolescents.
This article discusses the relationship between both poverty and food insecurity (FI) and the COVID-19 pandemic, as well as presenting possible strategies and actions for increasing social protection in the fight against these conditions in the current epidemiological context, especially for low-income countries. This is a narrative review concerning COVID-19, poverty, and food and nutritional insecurity. The COVID-19 pandemic may increase poverty and FI levels, resulting from the absence of or weak political, economic and social interventions to maintain jobs, as well as compromised food production and distribution chains and reduced access to healthy foods in different countries around the world, especially the poorest ones, where social and economic inequality was already historically high; the pandemic heightens and uncovers the vulnerability of poor populations. Public policies focused on guaranteeing the human right to adequate food must be improved and implemented for populations in contexts of poverty with the aim of providing food security.
Pelagic seabird populations have declined strongly worldwide. In the North Atlantic there was a huge reduction in seabird populations following the European colonization of the Azores, Madeira and Canary archipelagos but information on seabird status and distribution for the subtropical region of Cabo Verde is scarce, unavailable or dispersed in grey literature. We compiled and compared the historical and current distribution of all seabird species breeding in the Cabo Verde archipelago, updated their relative abundance, investigated their inland habitat preferences, and reviewed their threats. Currently, the breeding seabird community in Cabo Verde is composed of Bulwer’s Petrel Bulweria bulwerii, White-faced Storm-petrel Pelagodroma marina aedesorum, Cape Verde Shearwater Calonectris edwardsii, Cape Verde Storm-petrel Hydrobates jabejabe, Cape Verde Petrel Pterodroma feae, Boyd's Shearwater Puffinus lherminieri boydi, Brown Booby Sula leucogaster, and Red-billed Tropicbird Phaethon aethereus. One breeding species is currently extinct, the Magnificent Frigatebird Fregata magnificens. The relative abundance of Cape Verde Shearwater, Boyd’s Shearwater, Cape Verde Petrel, and Cape Verde Storm-petrel was determined from counts of their nocturnal calls in Santo Antão, São Vicente, Santa Luzia, Branco, Raso and São Nicolau. Cape Verde Petrel occurred only on mountainous islands (Santo Antão, São Nicolau, Santiago, and Fogo) from mid-to high elevations. Larger species such as the Cape Verde Shearwater and Boyd’s Shearwater exhibited a wider distribution in the archipelago, occurring close to the coastline but at lower densities on populated islands. Small procellariforms such as the Cape Verde Storm-petrel occurred at high densities only on rat-free islets and in steep areas of main islands where introduced cats and rats are unlikely to occur. The main threats to seabird populations in Cabo Verde range from predation by introduced predators, habitat alteration or destruction, and some residual human persecution.
To evaluate the association between nutritional quality of breakfast and cardiometabolic risk factors.
Cross-sectional study, 2015 Health Survey of São Paulo (2015 ISA-Capital) with Focus on Nutrition Study (2015 ISA-Nutrition).
Population-based study, with a representative sample of adults and elderlies living in São Paulo, Brazil.
The sample included 606 adults (aged 20–59 years) and 537 elderlies (aged ≥60 years) from the 2015 Health Survey of São Paulo. Dietary intake was assessed by at least one 24-h recall. Breakfast quality was evaluated using the proposed Brazilian Breakfast Quality Index (BQI), ranging scores from 0 to 10. BQI associations with sociodemographic, lifestyle, dietetic and cardiometabolic variables were estimated using survey-weighted multiple logistic regression models.
Being ≥60 years of age, self-identifying as White or Asian, having a per capita family income with ≥1 minimum wage, being sufficiently active at leisure time and non-smoker were associated with better scores of BQI. A higher BQI score was inversely associated with elevated blood pressure (OR 0·81, 95 % CI 0·70, 0·94), fasting glucose (OR 0·85, 95 % CI 0·73, 0·98), HOMA-IR (OR 0·86, 95 % CI 0·74, 0·98), total cholesterol (OR 0·87, 95 % CI 0·76, 0·99), LDL-C (OR 0·85, 95 % CI 0·74, 0·97), metabolic syndrome (OR 0·82, 95 % CI 0·72, 0·93) and being overweight (OR 0·87, 95 % CI 0·76, 0·99).
Breakfast quality of Brazilian adults needs improvement with disparities across some sociodemographic factors. BQI was associated with lower odds of cardiometabolic risk factors, suggesting a beneficial effect in this population and emphasising the role of breakfast in reducing the risk of CVD.
To provide comprehensive information on the epidemiology and burden of respiratory syncytial virus hospitalisation (RSVH) in preterm infants, a pooled analysis was undertaken of seven multicentre, prospective, observational studies from across the Northern Hemisphere (2000–2014). Data from all 320–356 weeks' gestational age (wGA) infants without comorbidity were analysed. RSVH occurred in 534/14 504 (3.7%) infants; equating to a rate of 5.65 per 100 patient-seasons, with the rate in individual wGA groups dependent upon exposure time (P = 0.032). Most RSVHs (60.1%) occurred in December–January. Median age at RSVH was 88 days (interquartile range (IQR): 54–159). Respiratory support was required by 82.0% of infants: oxygen in 70.4% (median 4 (IQR: 2–6) days); non-invasive ventilation in 19.3% (median 3 (IQR: 2–5) days); and mechanical ventilation in 10.2% (median 5 (IQR: 3–7) days). Intensive care unit admission was required by 17.9% of infants (median 6 days (IQR: 2–8) days). Median overall hospital length of stay (LOS) was 5 (IQR: 3–8) days. Hospital resource use was similar across wGA groups except for overall LOS, which was shortest in those born 35 wGA (median 3 vs. 4–6 days for 32–34 wGA; P < 0.001). Strategies to reduce the burden of RSVH in otherwise healthy 32–35 wGA infants are indicated.
A cross-sectional analysis was conducted using data from a prospective cohort study to investigate whether frailty is associated with pain intensity, disability caused by low back pain (LBP), and quality of life in an older population with acute non-specific LBP. Six hundred and two individuals with a mean age of 67.6 (standard deviation [SD] 7.0) years were included in the analysis. In relation to frailty status, 21.3 per cent of the sample were classified as robust, 59.2 per cent were classified as pre-frail, and 19.5 per cent were classified as frail. In the unadjusted analysis, pre-frail and frail groups showed significantly higher pain and disability scores than the robust group. Moreover, the same two groups exhibited lower scores in both physical and mental domains of quality of life than the robust group. After adjusting for socio-demographic and clinical variables, disability scores and the physical component of quality of life were significantly associated with frailty. In older adults with acute LBP, frailty is associated with more disability and worse scores in the physical component of quality of life.