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The yellowfin tuna is a very abundant tropical tuna species in the western equatorial Atlantic Ocean and an important fishery resource for the Brazilian tuna fleet. In this study we performed stable isotope analysis to better understand the spatial trophodynamics and dietary changes in yellowfin tuna around two insular marine protected areas in Brazil. A total of 65 yellowfin tuna specimens measuring between 47 and 138 cm LT (total length) were sampled around the archipelagos of Fernando de Noronha (FNA; n = 34) and Saint Peter and Saint Paul (SPSPA; n = 31) between July 2018 and September 2019. Bayesian mixing models and generalized additive models were used to investigate the contributions of four different prey items (zooplankton, cephalopods, fish larvae, and flying fish) to yellowfin tuna diet in each area and their potential changes in relation to predator growth. The four prey items were found to have different overall contributions between the two studied areas, with zooplankton being the most important prey in FNA, whereas flying fish was the most relevant prey to the species' diet in SPSPA. Significant changes in the species diet by size were also found, with fish smaller than 90 cm (TL) having a more generalist diet and larger animals relying more on consuming larger and more nutritious prey (i.e., flying fish). Our results suggest that these two marine protected areas play an important role in ocean dynamics, providing important and different foraging grounds for the development of this predator species.

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Background: Lower limbs are frequently involved in vascular trauma, but it is still not clear which factors lead to unfavorable clinical outcomes. Objectives: To determine the clinical profile of patients with femoropopliteal injuries, the trauma mechanisms, and treatment and identify which factors led to unfavorable outcomes. Methods: A retrospective study based on the medical records of patients treated from 2017 to 2021. The following data were assessed: sex, age, distance to reach the hospital, trauma mechanism, hypovolemic shock, additional injuries, treatment of vascular injuries, whether fasciotomy was needed, inappropriate intraoperative decisions, and injury severity score. Need for surgical reintervention, amputation, and death were defined as unfavorable outcomes. Univariate, bivariate, and logistic regression analyses were conducted. Results: The sample comprised 94 patients; 83% were men; mean age was 30.8 years; combined arterial and venous injuries prevailed (57.5%); and superficial femoral vessels were the most affected (61.7%). Penetrating mechanisms prevailed (80.9%). Arterial injuries were most frequently treated with venous graft (59.6%) and venous injuries underwent ligation (81.4%). In 15% of cases, inappropriate surgical decisions were detected; most often use of the ipsilateral great saphenous vein for arterial reconstruction. Unfavorable outcomes occurred in 44.7%: surgical reintervention was necessary in 21.3% and limb amputation in 25.5%, while 9.5% of the patients died. Conclusions: These injuries mainly involved young men, victims of gunshot wounds. Superficial femoral vessels were the most injured; concomitant non-vascular trauma was frequent, mainly fractures. Inappropriate surgical decisions increased the need for reinterventions by 34 times. Need for fasciotomy, presence of fracture/dislocation, blunt trauma mechanism, and popliteal artery injury increased the risk of amputation.

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OBJECTIVE: To evaluate the direct and indirect associations of obesogenic and leptogenic neighborhood environments with body fat, and pro- and anti-inflammatory adipokines in Brazilian children. DESIGN: Cross-sectional study. The body fat distribution was assessed using dual-energy X-ray absorptiometry (DXA). Concentrations of leptin and adiponectin were measured. Four hundred meters (0·25 miles) road network buffer was the neighborhood unit used to assess the environmental characteristics around households. Obesogenic and leptogenic environments were the latent variables obtained from the observed characteristics. The mother's BMI, ultra-processed food consumption, and physical activity before and after school, were tested as mediating variables. A hybrid model of structural equations was used to test the direct and indirect associations of obesogenic and leptogenic environments with body fat, leptin and adiponectin concentrations. SETTING: Urban area of Viçosa, Minas Gerais, Brazil. PARTICIPANTS: Children aged 8- and 9-years (n 367). RESULTS: Obesogenic environment was directly associated with the mother's BMI (ß: 0·24, P = 0·02) and the child's body fat (ß: 0·19, P = 0·02). The mother's BMI and body fat mediated the association of the obesogenic environment with leptin concentrations (ß: 0·05, P = 0·02). CONCLUSIONS: Obesogenic neighborhood environment was directly associated with body fat and mother's BMI, and indirectly associated with leptin concentrations in Brazilian children, mediated by the mother's BMI and body fat.

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OBJECTIVE: To assess the association of obesogenic environmental characteristics around schools with body adiposity and adipokine concentrations in Brazilian children. DESIGN: Cross-sectional study. Body adiposity was assessed using the dual-energy X-ray absorptiometry. Concentrations of leptin, adiponectin, retinol-binding protein 4 (RBP4) and chemerin were measured. Predominantly ultra-processed food (UPF) stores, public physical activity (PA) facilities, green spaces, walkability, traffic accidents and crime were evaluated. The neighbourhood unit was the 400 m (0·25 miles) road network buffer around schools. The association of environmental characteristics with body adiposity and adipokine concentrations was assessed by linear regression models using generalised estimating equations. SETTING: Urban schools (n 24), Viçosa, Minas Gerais, Brazil. PARTICIPANTS: Children aged 8 and 9 years (n 378). RESULTS: A higher density of predominantly UPF stores and a lower percentage of green space were associated with higher total (ß: 0·12; 95 % CI 0·06, 0·18 and ß: -0·10; 95 % CI -0·16, -0·04, respectively) and android body fat (ß: 0·28; 95 % CI 0·13, 0·43 and ß: -0·18; 95 % CI -0·32, -0·04, respectively). In addition, the densities of PA facilities and crime were inversely associated with leptin concentrations. Traffic accidents density and percentage of green spaces around schools had, respectively, a positive and an inverse association with concentrations of adiponectin and RBP4. CONCLUSIONS: Obesogenic environmental characteristics around schools were associated with total and android body fat, as well as with pro-inflammatory adipokine concentrations in Brazilian children from a medium-sized city.

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OBJECTIVE: We aimed to analyze the relationship of community food environments with childhood obesity in a medium-sized Brazilian city. METHODS: This is a cross-sectional study with 366 schoolchildren aged 8 and 9 years. Children's body mass index (BMI), waist circumference and concentrations of total cholesterol (TC), high cholesterol density lipoprotein (HDL-c), low cholesterol density lipoprotein (LDL-c) and triglycerides (TG) were measured. The parent's nutritional status was assessed by calculating the BMI. All food stores within a 200- and 400-m radius buffers of schools and households were evaluated. The food stores were classified as healthy, unhealthy, and mixed according to the predominance of foods commercialized. Binary logistic regression models were proposed for each category. RESULTS: Over seventy percent (70.2%) of the food stores were categorized as "unhealthy". The prevalence of obesity was 15.6%. In the 200-m buffer around schools, there was an inverse and direct association between obesity and the presence of healthy food stores and unhealthy food stores, respectively. Around the households, there was an inverse association between the presence of healthy food stores and obesity in both buffers. CONCLUSION: The community food environment may be protective or potentiating childhood obesity, depending on the access and types of food sold.

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OBJECTIVE: The aim of this study was to evaluate the association of serum uric acid (SUA) with adiposity, adipokines, and anti- and oxidative markers in Brazilian children. METHODS: This was a cross-sectional investigation with 378 children ages 8 to 9 y in Viçosa, Minas Gerais, Brazil. Information on sociodemographic and lifestyle characteristics was obtained via questionnaires, and body fat was determined by dual energy x-ray absorptiometry. We compared the distributions of adiposity (total and central), adipokines (adiponectin, chemerin, leptin, and retinol-binding protein 4 [RBP4]), anti- and oxidative markers (plasma ferric reducing antioxidant power [FRAP], superoxide dismutase [SOD], and malondialdehyde [MDA]) by SUA categories using linear regression. RESULTS: SUA was positively associated with total and central fat. Every standard deviation (SD) of SUA was related, respectively, to a 3.4 (95% confidence interval [CI], 2.4-4.4), 4 (95% CI, 2.8-5.1), 4.2 (95% CI, 2.9-5.5), and 3.5 (95% CI, 2.4-4.6) units higher of total, truncal, android, and gynoid fat. We found a positive association of SUA with RBP4 and FRAP, and a negative association with MDA. Every SD of SUA was related, respectively, to 0.1 (95% CI, 0.01-0.1) and 7.8 (95% CI, 5.5-10.1) units higher of RBP4 and FRAP; and to -0.3 (95% CI, -0.5 to -0.1) units lower of MDA. CONCLUSIONS: SUA was positively associated with adiposity, RBP4, and antioxidative status in Brazilian children.

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Studies indicating the influence of masticatory dysfunction, due to a soft diet or lack of molars, on impairing spatial memory and learning have led to research about neuronal connections between areas and cell populations possibly affected. In this sense, with scarce detailed data on the subfields of hippocampus in dementia neurodegeneration, there is no information about astrocytic responses in its different layers. Thus, considering this context, the present study evaluated the effects of deprivation and rehabilitation of masticatory activity, aging, and environmental enrichment on the stereological quantification of hippocampal astrocytes from layers CA1, CA3, and DG. For this purpose, we examined mature (6-month-old; 6M), and aged (18-month-old; 18M) mice, subjected to distinct masticatory regimens and environments. Three different regimens of masticatory activity were applied: continuous normal mastication with hard pellets (HD); normal mastication followed by deprived mastication with equal periods of pellets followed by soft powder (HD/SD); or rehabilitated masticatory activity with equal periods of HD, followed by powder, followed by pellets (HD/SD/HD). Under each specific regimen, half of the animals were raised in standard cages (impoverished environment (IE)) and the other half in enriched cages (enriched environment (EE)), mimicking sedentary or active lifestyles. Microscopic stereological, systematic, and random sampling approaches with an optical dissector of GFAP-immunolabeled astrocytes were done, allowing for an astrocyte numerical estimate. Stratum moleculare and hilus, from the dentate gyrus (DG) and Strata Lacunosum-Moleculare, Oriens, and Radiatum, similarly to the dentate gyrus, showed no significant change in any of the investigated variables (age, diet, or environment) in these layers. However, in Stratum radiatum, it was possible to observe significant differences associated with diet regimens and age. Therefore, diet-related differences were found when the HD 18M IE group was compared to the HD/SD/HD 18-month-old group in the same environment (IE) (p = 0.007). In the present study, we present modulatory factors (masticatory function, environmental enrichment, and aging) for the differentiated quantitative laminar response in the hippocampal regions, suggesting other studies to read the plasticity and responsiveness of astrocytes, including the molecular background.

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OBJECTIVE: The aim of this study was to evaluate the association of body fat, anti- and inflammatory adipokines with anti- and oxidative markers. METHODS: We conducted a cross-sectional study with 378 schoolchildren ages 8 to 9 y in Viçosa, Minas Gerais, Brazil. We obtained information on sociodemographic and lifestyle characteristics via questionnaires, measured height and weight, and estimated body fat by dual energy x-ray absorptiometry. Blood sample was collected to analyze the adipokines (adiponectin, leptin, chemerin, and retinol-binding protein 4) by enzyme-linked immunosorbent assay based on the sandwich principle; and anti- and oxidant markers (plasma ferric reducing antioxidant power [FRAP], superoxide dismutase [SOD], and malondialdehyde [MDA]) by enzymatic methods. Concentrations of anti- and oxidant markers were compared by percent body fat quartiles and adipokine concentrations terciles using of linear regression adjusted for potential confounders. RESULTS: Total and central body fat were positively associated with FRAP. Every 1 standard deviation (SD) of total fat was associated with 4.8 higher FRAP (95% confidence interval [CI], 2.7-7). Additionally, every 1 SD of truncal, android, and gynoid fat were associated with, respectively, 5, 4.6, and 4.6 higher FRAP (95% CI, 2.9-7.1; 2.6-6.7; and 2.4-6.8, respectively). However, adiponectin was inversely associated with FRAP; every adiponectin SD was related to -2.2 lower FRAP (95% CI, -3.9 to -0.5). Chemerin was positively associated with SOD [5.4 (95% CI, 1.9-8.8) SOD units per chemerin SD]. CONCLUSIONS: The body fat measures and adiposity-related inflammation (chemerin) were positively associated with antioxidative markers in children, whereas the adiponectin (anti-inflammatory marker) was inversely associated with FRAP (antioxidative marker).

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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.

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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.

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Resumo Contexto O trauma vascular acomete frequentemente os membros inferiores; entretanto, ainda há dúvidas sobre quais fatores levam a desfechos desfavoráveis. Objetivos Determinar o perfil das vítimas de traumatismo femoropoplíteo, o tratamento utilizado e fatores relacionados a desfechos desfavoráveis. Métodos Estudo retrospectivo, baseado em prontuários de pacientes operados entre 2017 e 2021. Foram analisados: sexo, idade, distância percorrida para atendimento, mecanismo de trauma, presença de choque hipovolêmico, lesões associadas, tratamento, realização de fasciotomia, decisões intraoperatórias inadequadas e índice de severidade de trauma. Necessidade de reintervenção, amputação e óbito foram considerados desfechos desfavoráveis. Foram utilizadas análises univariadas, bivariadas e regressão logística. Resultados Noventa e quatro pacientes foram selecionados, sendo 83% homens, com idade média de 30,8 anos. Lesões arteriais e venosas simultâneas ocorreram em 57,5% dos casos; vasos femorais superficiais foram mais acometidos (61,7%), e mecanismos penetrantes, mais prevalentes (80,9%). Lesões arteriais foram frequentemente tratadas com enxerto venoso (59,6%), e lesões venosas foram submetidas à ligadura (81,4%). Em 15% houve decisões cirúrgicas inadequadas, sendo o uso da safena magna ipsilateral para reconstrução arterial a mais comum. Ocorreram desfechos desfavoráveis em 44,7% dos casos; em 21,3%, foi necessária reintervenção; amputação em 25,5%; e ocorreu óbito em 9,5% dos pacientes. Conclusões As lesões acometeram principalmente homens jovens, vítimas de ferimento por arma de fogo. Vasos femorais superficiais foram os mais lesados, e traumatismos não vasculares concomitantes foram frequentes, principalmente fraturas. Decisões cirúrgicas inadequadas aumentaram em 34 vezes a necessidade de reintervenções. Necessidade de realização de fasciotomia, presença de fratura/luxação, mecanismo contuso de trauma e lesão de artéria poplítea aumentaram o risco de amputação.

Abstract Background Lower limbs are frequently involved in vascular trauma, but it is still not clear which factors lead to unfavorable clinical outcomes. Objectives To determine the clinical profile of patients with femoropopliteal injuries, the trauma mechanisms, and treatment and identify which factors led to unfavorable outcomes. Methods A retrospective study based on the medical records of patients treated from 2017 to 2021. The following data were assessed: sex, age, distance to reach the hospital, trauma mechanism, hypovolemic shock, additional injuries, treatment of vascular injuries, whether fasciotomy was needed, inappropriate intraoperative decisions, and injury severity score. Need for surgical reintervention, amputation, and death were defined as unfavorable outcomes. Univariate, bivariate, and logistic regression analyses were conducted. Results The sample comprised 94 patients; 83% were men; mean age was 30.8 years; combined arterial and venous injuries prevailed (57.5%); and superficial femoral vessels were the most affected (61.7%). Penetrating mechanisms prevailed (80.9%). Arterial injuries were most frequently treated with venous graft (59.6%) and venous injuries underwent ligation (81.4%). In 15% of cases, inappropriate surgical decisions were detected; most often use of the ipsilateral great saphenous vein for arterial reconstruction. Unfavorable outcomes occurred in 44.7%: surgical reintervention was necessary in 21.3% and limb amputation in 25.5%, while 9.5% of the patients died. Conclusions These injuries mainly involved young men, victims of gunshot wounds. Superficial femoral vessels were the most injured; concomitant non-vascular trauma was frequent, mainly fractures. Inappropriate surgical decisions increased the need for reinterventions by 34 times. Need for fasciotomy, presence of fracture/dislocation, blunt trauma mechanism, and popliteal artery injury increased the risk of amputation.

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RESUMO A vulnerabilidade programática diz respeito a acesso e utilização dos recursos de saúde, como programas direcionados a prevenção, assistência e reabilitação de saúde. Para a pessoa idosa LGBTQIA+, as questões de vulnerabilidade são ainda mais significativas, uma vez que o referido grupo enfrenta outras questões de cunho social que refletem no preparo dos profissionais ante o atendimento nos serviços de saúde. Objetivou-se mapear a ocorrência da vulnerabilidade programática de pessoas idosas LGBTQIA+. Trata-se de uma revisão de escopo, orientada pelas recomendações JBI mediante o mnemônico P (Idosos LGBTQIA+), C (vulnerabilidade) e C (programas de atenção à saúde). Os documentos foram analisados qualitativamente com suporte do software Interface de R, IRaMuTeQ. Foram identificadas duas categorias temáticas: A construção do cuidado integral: o papel das instituições de saúde e social no desenvolvimento de ações voltadas para as necessidades da pessoa idosa LGBTQIA+; Vulnerabilidade programática: lacunas no cuidado à pessoa idosa pertencente a minorias sexuais. O presente estudou permitiu identificar que as pessoas idosas LGBTQIA+ podem vivenciar situações de vulnerabilidade programática, sobretudo nos serviços de saúde, instituições de longa permanência e nos atendimentos ofertados pelos profissionais de saúde, sob a ótica do estigma e preconceito.

ABSTRACT Programmatic vulnerability concerns access to and use of health resources, such as programs aimed at health prevention, care, and rehabilitation. For LGBTQIA+ older people, vulnerability issues are even more significant, since that group faces other social issues that reflect on the preparation of professionals to provide care in health services. The aim was to map the occurrence of programmatic vulnerability among LGBTQIA+ older people. This is a scoping review, guided by the JBI recommendations using the mnemonic P (LGBTQIA+ older people), C (vulnerability), and C (healthcare programs). The documents were analyzed qualitatively using the R Interface software, IRaMuTeQ. Two thematic categories were identified: The construction of comprehensive care: the role of health and social institutions in developing actions aimed at the needs of LGBTQIA+ older people; Programmatic vulnerability: gaps in care for older people belonging to sexual minorities. This study identified that situations of vulnerability are more evident in health services, long-term care institutions, and in care provided by health professionals, suffering from stigma and prejudice.

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Infectious aneurysms, formerly known as mycotic aneurysms, are rare, most often involve the aorta in young patients, and have a greater tendency to rupture than aneurysms of other etiologies. The most characteristic shape is saccular and the most common etiologic agents are Staphylococcus sp. and Salmonella sp. There is scant and imprecise information in the literature about correct nomenclature, diagnosis, and treatment. The authors present three cases in which diagnostic and therapeutic procedures were documented. In addition to reporting this case series, the authors also present a review of the subject, outlining pertinent diagnostic and therapeutic strategies.

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CONTEXT: The community food environment covers the type, quantity, density, location, and access to retail food outlets, and its influence on eating behavior, obesity, and metabolic syndrome has been investigated. OBJECTIVE: To evaluate the evidence on longitudinal associations between objectively measured retail food outlets and metabolic syndrome components in children, adolescents, and adults. DATA EXTRACTION: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality and risk of bias were assessed with the Newcastle-Ottawa Scale. DATA SOURCES: The Scopus, Embase, Web of Science, Scielo, PubMed, MEDLINE, and Lilacs databases were searched without any restriction on publication dates. DATA ANALYSIS: Of the 18 longitudinal studies included, significant associations were reported in 9 between retail food outlets and metabolic syndrome components in adults (6 positive associations, 2 negative, and 1 both positive and negative), and in 3 studies of children and adolescents (2 negative associations and 1 both positive and negative). Six studies with adults found no association. CONCLUSION: Limited evidence was found for longitudinal associations between retail food outlets and metabolic syndrome components. In future studies, researchers should consider the use of standardized retail food outlet measurements and accurate analysis to better understand the influence of the community food environment on metabolic syndrome. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no: CRD42020177137.

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Resumo Aneurismas infecciosos, anteriormente chamados de aneurismas micóticos, são raros; acometem com maior frequência a aorta de pacientes jovens e apresentam maior tendência à rotura do que aneurismas de outras etiologias. O formato sacular é o mais característico, e os agentes etiológicos mais comuns são Staphylococcus sp e Salmonella sp. A literatura fornece informações limitadas e imprecisas sobre a correta nomenclatura, diagnóstico e tratamento da doença. Os autores reuniram três casos cujos procedimentos diagnósticos e terapêuticos foram documentados. Além de relatar essa série de casos, realiza-se uma revisão sobre o tema, a fim de estabelecer estratégias diagnósticas e terapêuticas pertinentes.

Abstract Infectious aneurysms, formerly known as mycotic aneurysms, are rare, most often involve the aorta in young patients, and have a greater tendency to rupture than aneurysms of other etiologies. The most characteristic shape is saccular and the most common etiologic agents are Staphylococcus sp. and Salmonella sp. There is scant and imprecise information in the literature about correct nomenclature, diagnosis, and treatment. The authors present three cases in which diagnostic and therapeutic procedures were documented. In addition to reporting this case series, the authors also present a review of the subject, outlining pertinent diagnostic and therapeutic strategies.

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Pro- and anti-inflammatory adipokines have been regarded as potential markers of obesity and cardiometabolic comorbidities. However, few studies have evaluated this association in children. We aimed to evaluate the relationship between adipokine concentrations and cardiometabolic risk markers in Brazilian schoolchildren. This was a cross-sectional study with 378 children aged 8-9 years from Viçosa, Minas Gerais, Brazil. We measured adipokines (leptin, retinol-binding protein 4, adiponectin, and chemerin) and cardiometabolic risk markers (fasting glucose, HOMA-IR, lipid profile, and blood pressure). Cardiometabolic risk markers were compared by quintiles of adipokines with linear regression adjusted for potential confounders. Leptin was positively associated with diastolic blood pressure (P = 0.03) and HOMA-IR (P = 0.01), and retinol-binding protein 4 was positively associated with total cholesterol (P = 0.04). Each standard deviation of leptin and retinol-binding protein 4 was associated to, respectively, a 0.1 (95%CI: 0.1; 0.2), 0.3 (95%CI: 0.1; 0.6), and 2.5 (95%CI: 0.1; 4.9) units increase in diastolic blood pressure, HOMA-IR, and total cholesterol. Adiponectin was negatively associated with diastolic blood pressure (P = 0.01) and HOMA-IR (P = 0.01), and chemerin was negatively associated with glucose (P = 0.001). Each standard deviation of adiponectin and chemerin was associated to, respectively, a -0.1 (95%CI: -0.2; -0.1), -0.2 (95%CI: -0.3; -0.1), and -1.2 (95%CI: -1.9; -0.5) units decrease in diastolic blood pressure, HOMA-IR, and glucose.Conclusion: Pro- and anti-inflammatory adipokines were positively and negatively associated with cardiometabolic risk markers, respectively, among schoolchildren, indicating this relationship may be identified at earlier ages. What is Known: • Although leptin, retinol-binding protein 4, and adiponectin are well-known adipokines, a consensus regarding their relationship with cardiometabolic risk markers, especially in schoolchildren, has not yet been reached. • Chemerin is an adipokine that has been studied recently. Yet, due to its dependence on the target cell type, its functions are still a controversial topic. What is New: • Leptin was positively associated with diastolic blood pressure and HOMA-IR, and retinol-binding protein 4 was positively associated with total cholesterol. • Adiponectin was negatively associated with diastolic blood pressure and HOMA-IR, and chemerin was negatively associated with glucose.

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Abstract Objective: To evaluate the ability of neck circumference to identify excess android fat and to propose cutoff points for Brazilian children. Method: This was a cross-sectional study with 376 children aged 8 and 9 years enrolled in public and private schools in the urban area of the municipality of Viçosa, Minas Gerais. A semi-structured questionnaire containing sociodemographic and lifestyle information was applied. The following were collected: neck circumference, weight, and height for the calculation of body mass index. The percentage of fat in the android region was determined by dual energy X-ray absorptiometry. Linear regression analysis was used to evaluate the association between neck circumference and android fat, adopting a significance level of 5%. Receiver operating characteristic curves were used to evaluate the capacity of neck circumference to determine the excess android fat, as well as to estimate the cutoff points of neck circumference according to gender. Results: Multiple linear regression showed an association between neck circumference and android fat (β: 2.94, 95% CI: 2.41, 3.47). Neck circumference was able to identify excess android fat in girls (AUC: 0.909, 95% CI: 0.999, 0.945) and boys (AUC: 0.938, 95% CI: 0.892, 0.968). The proposed cutoff points showed satisfactory sensitivity, specificity, and predictive values. Conclusions: Neck circumference is capable of identifying excess android fat in children and can be used in clinical practice and in population studies to determine central adiposity. The proposed cutoff points were satisfactory, but should be validated for other populations.

Resumo Objetivo: Avaliar a capacidade do perímetro do pescoço em identificar o excesso de gordura androide e propor pontos de corte para crianças brasileiras. Método: Estudo transversal com 376 crianças de oito e nove anos, matriculadas em escolas públicas e privadas da área urbana de Viçosa, Minas Gerais. Foi aplicado um questionário semiestruturado com informações sociodemográficas e de estilo de vida. Foram coletados: perímetro do pescoço, peso e estatura para o cálculo do índice de massa corporal. O percentual de gordura na região androide foi determinado pela absorciometria de raios X de dupla energia. A análise de regressão linear foi utilizada para avaliar a associação entre o perímetro do pescoço e a gordura androide, adotando-se o nível de significância de 5%. Por meio das curvas Receiver Operating Characteristic avaliou-se a capacidade do perímetro do pescoço de determinar o excesso de gordura androide, bem como estimaram-se os pontos de corte de perímetro do pescoço segundo o sexo. Resultados: A regressão linear múltipla demonstrou associação entre o perímetro do pescoço e a gordura androide (β: 2,94; IC95%: 2,41; 3,47). O perímetro do pescoço foi capaz de identificar o excesso de gordura androide em meninas (AUC: 0,909; IC95%: 0,859; 0,945) e meninos (AUC: 0,938; IC95%: 0,892; 0,968). Os pontos de corte propostos tiveram valores de sensibilidade, especificidade e preditivos satisfatórios. Conclusões: O perímetro do pescoço é uma medida capaz de identificar o excesso de gordura androide em crianças, pode ser usado na prática clínica e em estudos populacionais para determinar a adiposidade central. Os pontos de corte propostos foram satisfatórios, entretanto devem ser validados para outras populações.

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Saint Peter and Saint Paul's Archipelago (SPSPA), one of the smallest and most isolated island groups in the world, is situated on the Mid-Atlantic Ridge, between Brazil and the African continent. SPSPA has low species richness and high endemism; nonetheless, the diversity of fishes from deep habitats (>30 m depth) had not been previously studied in detail. Several expeditions conducted between 2009 and 2018 explored the shallow and deep reefs of SPSPA using scuba, closed-circuit rebreathers, manned submersibles, baited remote underwater stereo-videos (stereo-BRUV) and fishing between 0 and 1050 m depth. These expeditions yielded 41 new records of fishes for SPSPA: 9 in open waters, 9 in shallow waters (0-30 m), 8 in mesophotic ecosystems (30-150 m) and 15 in deeper reefs (>150 m). Combined with literature records of adult pelagic, shallow and deep-reef species, as well as larvae, the database of the fish biodiversity for SPSPA currently comprises 225 species (169 recorded as adult fishes and 79 as larvae, with 23 species found in both stages). Most of them (112) are pelagic, 86 are reef-associated species and 27 are deep-water specialists. Species accumulation curves show that the number of fish species has not yet reached an asymptote. Whereas the number of species recorded in SPSPA is similar to that in other oceanic islands in the Atlantic Ocean, the proportion of shorefishes is relatively lower, and the endemism level is the third highest in the Atlantic. Twenty-nine species are listed as threatened with extinction. Observations confirm the paucity of top predators on shallow rocky reefs of the island, despite the presence of several pelagic shark species around SPSPA. Because all of the endemic species are reef associated, it is argued that the new marine-protected areas created by the Brazilian government do not ensure the protection and recovery of SPSPA's biodiversity because they allow exploitation of the most vulnerable species around the archipelago itself. This study suggests a ban on reef fish exploitation inside an area delimited by the 1000 m isobath around the islands (where all known endemics are concentrated) as the main conservation strategy to be included in the SPSPA management plan being prepared by the Brazilian government.

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BACKGROUND/OBJECTIVES: To evaluate serum 25(OH)D concentrations and determine a cutoff point for cardiometabolic risk in children. SUBJECT/METHODS: This is a cross-sectional study with a representative sample of 378 8-9-year-old children from all urban schools in the city of Viçosa, MG, Brazil. Sociodemographic data and information on lifestyle, and food consumption were collected. Biochemical evaluation included glucose, triglycerides, leptin, calcidiol [25(OH)D], and parathormone. Body composition was assessed by dual energy X-ray absorptiometry. Cardiometabolic risk was considered when nontraditional risk markers were detected, including triglyceride × glycemia index (TyG index), hyperleptinemia, and hypertriglyceridemic waist phenotype (HWP). The receiver operating characteristic curve (ROC) was used to define the cutoff point for serum 25(OH)D to predict cardiometabolic risk. RESULTS: 25(OH)D showed better predictive capacity for grouping of cardiometabolic risk markers than for either single or paired markers. The area under the curve for grouping of risk markers was 0.636 (95% CI: 0.585, 0.685, P < 0.001). The cutoff point to predict cardiometabolic risk was defined as 32.0 ng/mL. CONCLUSION: 25(OH)D presented good predictive capacity for cardiometabolic risk and 25(OH)D concentration higher than 32 ng/mL was associated with a 49% reduction of cardiometabolic risk prevalence in prepubertal Brazilian children.

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Background: Congenital heart disease (CHD) affects 1% of all newborns and is a major public health problem. Most children with CHD benefit from early diagnosis to optimize management. However, in many places there are no specialized professionals to do so. Introduction: A screening method for CHD was developed between two states in Northeast Brazil. It was based upon the performance of an echocardiogram by local pediatricians with support of pediatric cardiologists through telemedicine. Objective: To determine if the continuous performance of examinations together with online supervision increased the level of understanding of the pediatricians about the echocardiograms. Methods: Pediatricians received online support to perform echocardiograms for 7 years (2012-2018). Although the project aimed to teach them to acquire images and send to the cardiologists for analysis and interpretation, they were encouraged to describe their own diagnostic impressions. The level of agreement between pediatricians and cardiologists was calculated. Results: A large number (n = 3,951) echocardiograms was analyzed. From them, 2,818 were classified as abnormal, inconclusive, or normal by both the pediatricians and the cardiologists. The 7-year analysis demonstrated an overall agreement of 63.7%. As for the final diagnosis, it was possible to compare 1,457 echocardiograms. The combined analysis of the 7 years demonstrated agreement in 62.2%. Discussion: The screening of CHD under online support led to more in-depth learning of echocardiography by the pediatricians. This approach potentialized the accuracy of the screening through the years. Conclusion: By enrolling in a telemedicine-based screening program, the pediatricians' degree of understanding of echocardiography increased considerably.

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