Joint environmental and social benefits from diversified agriculture.

Agricultural simplification continues to expand at the expense of more diverse forms of agriculture. This simplification, for example, in the form of intensively managed monocultures, poses a risk to keeping the world within safe and just Earth system boundaries. Here, we estimated how agricultural diversification simultaneously affects social and environmental outcomes. Drawing from 24 studies in 11 countries across 2655 farms, we show how five diversification strategies focusing on livestock, crops, soils, noncrop plantings, and water conservation benefit social (e.g., human well-being, yields, and food security) and environmental (e.g., biodiversity, ecosystem services, and reduced environmental externalities) outcomes. We found that applying multiple diversification strategies creates more positive outcomes than individual management strategies alone. To realize these benefits, well-designed policies are needed to incentivize the adoption of multiple diversification strategies in unison.

Biodiversity-production feedback effects lead to intensification traps in agricultural landscapes.

Intensive agriculture with high reliance on pesticides and fertilizers constitutes a major strategy for 'feeding the world'. However, such conventional intensification is linked to diminishing returns and can result in 'intensification traps'-production declines triggered by the negative feedback of biodiversity loss at high input levels. Here we developed a novel framework that accounts for biodiversity feedback on crop yields to evaluate the risk and magnitude of intensification traps. Simulations grounded in systematic literature reviews showed that intensification traps emerge in most landscape types, but to a lesser extent in major cereal production systems. Furthermore, small reductions in maximal production (5-10%) could be frequently transmitted into substantial biodiversity gains, resulting in small-loss large-gain trade-offs prevailing across landscape types. However, sensitivity analyses revealed a strong context dependence of trap emergence, inducing substantial uncertainty in the identification of optimal management at the field scale. Hence, we recommend the development of case-specific safety margins for intensification preventing double losses in biodiversity and food security associated with intensification traps.

Cohort profile: the Hortega Study for the evaluation of non-traditional risk factors of cardiometabolic and other chronic diseases in a general population from Spain.

PURPOSE: The Hortega Study is a prospective study, which investigates novel determinants of selected chronic conditions with an emphasis on cardiovascular health in a representative sample of a general population from Spain. PARTICIPANTS: In 1997, a mailed survey was sent to a random selection of public health system beneficiaries assigned to the University Hospital Rio Hortega's catchment area in Valladolid (Spain) (n=11 423, phase I), followed by a pilot examination in 1999-2000 of 495 phase I participants (phase II). In 2001-2003, the examination of 1502 individuals constituted the Hortega Study baseline examination visit (phase III, mean age 48.7 years, 49% men, 17% with obesity, 27% current smokers). Follow-up of phase III participants (also termed Hortega Follow-up Study) was obtained as of 30 November 2015 through review of health records (9.5% of participants without follow-up information). FINDINGS TO DATE: The Hortega Study integrates baseline information of traditional and non-traditional factors (metabolomic including lipidomic and oxidative stress metabolites, genetic variants and environmental factors, such as metals), with 14 years of follow-up for the assessment of mortality and incidence of chronic diseases. Preliminary analysis of time to event data shows that well-known cardiovascular risk factors are associated with cardiovascular incidence rates, which add robustness to our cohort. FUTURE PLANS: In 2020, we will review updated health and mortality records of this ongoing cohort for a 5-year follow-up extension. We will also re-examine elder survivors to evaluate specific aspects of ageing and conduct geolocation to study additional environmental exposures. Stored biological specimens are available for analysis of new biomarkers. The Hortega Study will, thus, enable the identification of novel factors based on time to event data, potentially contributing to the prevention and control of chronic diseases in ageing populations.

Dinámica plantar durante un circuito de habilidades técnicas básicas en fútbol / Foot dynamics during a basic technical skill circuit in football / Dinâmica plantar durante circuito de habilidades técnicas no futebol

Objetivo: Describir el comportamiento de la dinámica plantar durante la ejecución de un circuito de habilidades técnicas específicas del fútbol. Método: Se diseñó un circuito que incluyó habilidades técnicas específicas en el fútbol, se validó y aplicó a 20 jugadores de las selecciones de fútbol de La Universidad de La Sabana, para la medición de la dinámica plantar, se usaron las plantillas electrónicas Open-Go MOTICON. Resultados: La distribución del centro de presión tuvo tendencia hacia anterior y medial en la mayoría de las fases del circuito, el desplazamiento y velocidad del centro de presión fue mayor en el pie derecho con respecto al pie izquierdo en todas las fases, la fuerza de presión ejercida por los pies, fue mayor en el pie izquierdo con respecto al pie derecho. Conclusión: La presión plantar de los participantes tuvo tendencia hacia anterior y medial siendo indicador de la posición en inversión bilateral de los pies, además, la fuerza de presión fue mayor en el pie izquierdo con respecto al pie derecho (p 0.017) durante todas las fases del circuito

Objective: Describe the food dynamics during the execution of a circuit of specific technical skills of soccer. Method: A circuit was validated it included specific technical skills in soccer, it was applied to 20 players of the soccer selections of the University of La Sabana, for the measurement of the plantar dynamics, the electronic templates Open-Go MOTICON were used Results: The distribution of the center of pressure (COP) had a tendency toward anterior and medial in most phases of the circuit, the trace length and velocity of the center of pressure was greater in the right foot with respect to the left foot in all the phases, the pressure force exerted by the feet was greater in the left foot with respect to the right foot. Conclusion: The plantar pressure of the participants had a tendency towards anterior and medial, being an indicator of the position in bilateral inversion of the feet, in addition, the pressure force was greater in the left foot with respect to the right foot (p 0.017) during all phases of the circuit

Objetivo: Descrever a dinâmica plantar durante a execução do circuito de técnicas específicas do futebol. Métodos: Foi validado um circuito que incluiu habilidades técnicas específicas do futebol, que foi aplicado a 20 jogadores de futebol da selecão da Universidade de Sabana afim de medir a dinâmica plantar através do electronic templates Open-Go MOTICON. Resultados: A distribuição do centro de pressão teve uma tendência anterior e medial na maioria das fases do circuito o comprimento de traço e a velocidade do centro de pressão foram maiores no pé direito em relação ao pé esquerdo em todas as fases, a força de pressão exercida pelos pés foi maior no pé esquerdo em relação ao pé direito. Conclusão: A pressão plantar dos participantes tem uma tendência nas direções anterior e medial sendo um indicador da posição na inversão bilateral dos pés, além disso, a força de pressão foi maior no pé esquerdo em relação ao direito (p 0.017) durante todas as fases do circuito

Mortality and cardiovascular disease burden of uncontrolled diabetes in a registry-based cohort: the ESCARVAL-risk study.

BACKGROUND: Despite the epidemiological evidence about the relationship between diabetes, mortality and cardiovascular disease, information about the population impact of uncontrolled diabetes is scarce. We aimed to estimate the attributable risk associated with HbA1c levels for all-cause mortality and cardiovascular hospitalization. METHODS: Prospective study of subjects with diabetes mellitus using electronic health records from the universal public health system in the Valencian Community, Spain 2008-2012. We included 19,140 men and women aged 30 years or older with diabetes who underwent routine health examinations in primary care. RESULTS: A total of 11,003 (57%) patients had uncontrolled diabetes defined as HbA1c ≥6.5%, and, among those, 5325 participants had HbA1c ≥7.5%. During an average follow-up time of 3.3 years, 499 deaths, 912 hospitalizations for coronary heart disease (CHD) and 786 hospitalizations for stroke were recorded. We observed a linear and increasingly positive dose-response of HbA1c levels and CHD hospitalization. The relative risk for all-cause mortality and CHD and stroke hospitalization comparing patients with and without uncontrolled diabetes was 1.29 (95 CI 1.08,1.55), 1.38 (95 CI 1.20,1.59) and 1.05 (95 CI 0.91, 1.21), respectively. The population attributable risk (PAR) associated with uncontrolled diabetes was 13.6% (95% CI; 4.0-23.9) for all-cause mortality, 17.9% (95% CI; 10.5-25.2) for CHD and 2.7% (95% CI; - 5.5-10.8) for stroke hospitalization. CONCLUSIONS: In a large general-practice cohort of patients with diabetes, uncontrolled glucose levels were associated with a substantial mortality and cardiovascular disease burden.

Inside the small-scale composting of kitchen and garden wastes: Thermal performance and stratification effect in vertical compost bins.

Decentralized composting has been proposed as a best available practice, with a highly positive impact on municipal solid wastes management plans. However, in cold climates, decentralized small-scale composting performance to reach thermophilic temperatures (required for the product sanitization) could be poor, due to a lack of critical mass to retain heat. In addition, in these systems the composting process is usually disturbed when new portions of fresh organic waste are combined with previous batches. This causes modifications in the well-known composting evolution pattern. The objective of this work was to improve the understanding of these technical aspects through a real-scale decentralized composting experience carried out under cold climate conditions, in order to assess sanitization performance and to study the effects of fresh feedstock additions in the process evolution. Kitchen and garden organic wastes were composted in 500 L-static compost bins (without turning) for 244 days under cold climate conditions (Bariloche, NW Patagonia, Argentina), using pine wood shavings in a ratio of 1.5:1 v: v (waste: bulking agent). Temperature profile, stability indicators (microbial activity, carbon and nitrogen contents and ratio) and other variables (pH and electrical conductivity), were monitored throughout the experience. Our results indicate that small-scale composting (average generation rate of 7 kg d-1) is viable under cold weather conditions, since thermophilic sanitization temperatures (> 55 °C) were maintained for 3 consecutive days in most of the composting mass, according to available USEPA regulations commonly used as a reference for pathogens control in sewage sludge. On the other hand, stability indicators showed a differentiated organic matter degradation process along the compost bins height. Particularly, in the bottommost composting mix layer the process took a longer period to achieve compost stability than the upper layers, suggesting that differential organic matter transformation appears not to be necessarily associated to the order of the waste batches incorporation in a time line, as it could be expected. These findings suggest the need to discuss new ways of studying the composting process in small-scale compost bins as well as their commercial design.

Validación de un circuito que evalúa habilidades técnicas de fútbol / Validation of a circuit that assesses soccer technical skills / Validação de um circuito que avalia habilidades técnicas do futebol

Introducción.El fútbol es uno de los deportes más populares a nivel mundial, desde la prevención de lesiones se han aumentado los análisis biomecánicos que permiten conocer mejor los factores de riesgo de lesión de los futbolistas, para ello, se requiere desarrollar medidas útiles para la evaluación de diferentes gestos técnicos, y así, generar un conocimiento más objetivo acera del desempeño bio-mecánico de los jugadores. El Objetivode este estudio es conocer la validez de un circuito motor que incluye habilidades técnicas específicas de fútbol. Este proceso de validación hace parte de un estudio que busca explorar la dinámica plantar durante una situación de juego cercana a la real. Metodología. Se creó un circuito sometido a validez de contenido evaluado por 5 profesionales expertos. Resultados. Se encontró un Kappa de Fleiss 0.96 de todo el circuito, la dimensión con menos concor-dancia fue la de pase corto, las restantes se acercaron a 1. Conclusión. El circuito diseñado tiene la validez de contenido sustentado en un kappa de 0,96

Background. Football is one of the most popular sports worldwide, in order to prevent injuries, bio-mechanical analyzes have been increased to better understand the injury risk factors of footballers. For this reason, it is necessary to develop measures that may be useful for the evaluation of different technical gestures, and thus generate more objective information about the biomechanical perfor-mance of the players. The Objective of this study is to validate a motor circuit that includes specific technical soccer skills. This validation process is part of a larger study that seeks to explore the plantar dynamics during a game situation close to the real one. Methodology: a circuit was created and subjected to content validity evaluated by five professional experts. Results.A Fleiss' Kappa value of 0.96 of the whole circuit was found, the dimension with less agreement was short pass, the other ones approached 1. Conclusion. The designed circuit for this phase of research has content validity supported by a kappa of 0.96

Introdução. O futebol é um dos esportes mais populares do mundo, a partir da prevenção de lesões, análises biomecânicas tem sido aumentadas para melhorar o entendimento dos fatores de risco de lesão dos jogadores, para isto, é necessário desenvolver medidas úteis para a avaliação dos diferentes gestos técnicos e, assim, gerar um conhecimento mais objetivo sobre o desempenho biomecânico dos jogadores.O objetivo deste estudo é conhecer a validade de um circuito motor que inclua habilidades técnicas específicas do futebol. Este processo de validação faz parte de um estudo que busca explorar a dinâ-mica plantar durante uma situação de jogo próxima à real.Metodologia. Foi criado um circuito sujeito à validade de conteúdo avaliada por 5 profissionais es-pecialistas Resultados. Foi encontrado um Kappa de Fleiss 0,96 para todo o circuito, a dimensão com menor concordância foi o passe curto, os restantes aproximados 1.Conclusão. O circuito projetado tem a validade de conteúdo suportada por um kappa de 0,96

Projected climate change threatens pollinators and crop production in Brazil.

Animal pollination can impact food security since many crops depend on pollinators to produce fruits and seeds. However, the effects of projected climate change on crop pollinators and therefore on crop production are still unclear, especially for wild pollinators and aggregate community responses. Using species distributional modeling, we assessed the effects of climate change on the geographic distribution of 95 pollinator species of 13 Brazilian crops, and we estimated their relative impacts on crop production. We described these effects at the municipality level, and we assessed the crops that were grown, the gross production volume of these crops, the total crop production value, and the number of inhabitants. Overall, considering all crop species, we found that the projected climate change will reduce the probability of pollinator occurrence by almost 0.13 by 2050. Our models predict that almost 90% of the municipalities analyzed will face species loss. Decreases in the pollinator occurrence probability varied from 0.08 (persimmon) to 0.25 (tomato) and will potentially affect 9% (mandarin) to 100% (sunflower) of the municipalities that produce each crop. Municipalities in central and southern Brazil will potentially face relatively large impacts on crop production due to pollinator loss. In contrast, some municipalities in northern Brazil, particularly in the northwestern Amazon, could potentially benefit from climate change because pollinators of some crops may increase. The decline in the probability of pollinator occurrence is found in a large number of municipalities with the lowest GDP and will also likely affect some places where crop production is high (20% to 90% of the GDP) and where the number of inhabitants is also high (more than 6 million people). Our study highlights key municipalities where crops are economically important and where pollinators will potentially face the worst conditions due to climate change. However, pollinators may be able to find new suitable areas that have the potential to improve crop production. The results shown here could guide policy decisions for adapting to climate change and for preventing the loss of pollinator species and crop production.

A gene-environment interaction analysis of plasma selenium with prevalent and incident diabetes: The Hortega study.

BACKGROUND: Selenium and single-nucleotide-polymorphisms in selenoprotein genes have been associated to diabetes. However, the interaction of selenium with genetic variation in diabetes and oxidative stress-related genes has not been evaluated as a potential determinant of diabetes risk. METHODS: We evaluated the cross-sectional and prospective associations of plasma selenium concentrations with type 2 diabetes, and the interaction of selenium concentrations with genetic variation in candidate polymorphisms, in a representative sample of 1452 men and women aged 18-85 years from Spain. RESULTS: The geometric mean of plasma selenium levels in the study sample was 84.2µg/L. 120 participants had diabetes at baseline. Among diabetes-free participants who were not lost during the follow-up (N=1234), 75 developed diabetes over time. The multivariable adjusted odds ratios (95% confidence interval) for diabetes prevalence comparing the second and third to the first tertiles of plasma selenium levels were 1.80 (1.03, 3.14) and 1.97 (1.14, 3.41), respectively. The corresponding hazard ratios (95% CI) for diabetes incidence were 1.76 (0.96, 3.22) and 1.80 (0.98, 3.31), respectively. In addition, we observed significant interactions between selenium and polymorphisms in PPARGC1A, and in genes encoding mitochondrial proteins, such as BCS1L and SDHA, and suggestive interactions of selenium with other genes related to selenoproteins and redox metabolism. CONCLUSIONS: Plasma selenium was positively associated with prevalent and incident diabetes. While the statistical interactions of selenium with polymorphisms involved in regulation of redox and insulin signaling pathways provide biological plausibility to the positive associations of selenium with diabetes, further research is needed to elucidate the causal pathways underlying these associations.

Hydroxypropyl cellulose supplementation in vitrification solutions: a prospective study with donor oocytes.

PURPOSE: Hydroxypropyl cellulose (HPC), a polysaccharide that forms a viscous gel under low temperatures, is a promising substitute of the blood-derived macromolecules traditionally used in cryopreservation solutions. The performance of a protein-free, fully synthetic set of vitrification and warming solutions was assessed in a matched pair analysis with donor oocytes. METHODS: A prospective study including 219 donor MII oocytes was carried out, comparing the laboratory outcomes of oocytes vitrified with HPC-based solutions and their fresh counterparts. The primary performance endpoint was the fertilization rate. Secondary parameters assessed were embryo quality on days 2 and 3. RESULTS: 70/73 (95.9%) vitrified MII oocytes exhibited morphologic survival 2 h post-warming, with 49 (70.0%) presented normal fertilization, compared to 105 of 146 (71.9%) MII fresh oocytes. Similar embryo quality was observed in both groups. A total of 18 embryos implanted, out of 38 embryos transferred (47.3%), resulting in 13 newborns.

Renal function and attributable risk of death and cardiovascular hospitalization in patients with cardiovascular risk factors from a registry-based cohort: the Estudio Cardiovascular Valencia-risk study.

BACKGROUND: Information about the attributable risk associated with renal dysfunction in patients with cardiovascular risk factors is lacking. OBJECTIVE: We aimed to estimate the attributable risk associated with chronic kidney disease Epidemiology Collaboration-estimated glomerular filtration rate (eGFR), for all-cause mortality, and cardiovascular hospitalization. DESIGN, SETTING, AND PARTICIPANTS: Prospective study of study participants with cardiovascular risk factors in 2008-2012. We included 52 007 cardiovascular disease-free men and women aged 30 years or older with hypertension, diabetes, or dyslipidemia, who underwent routine health examinations in primary care. RESULTS: A total of 6639 (12.8%) patients had eGFR below 60 ml/min per 1.73 m and among them 1782 (3.4%) had 45 ml/min per 1.73 m or lower. During an average follow-up time of 3.2 years, 54.12 deaths, 99.98 coronary heart disease (CHD) hospitalizations, and 90.64 stroke hospitalizations/10 000 person-years were recorded. The population attributable risks associated with having a GFR lower than 60 ml/min per 1.73 m were 6.9% (95% confidence interval = 2.07, 10.65) for all-cause mortality, 6.8% (4.3, 9.4) for CHD hospitalization, and 4.1% (1.02, 7.00) for stroke hospitalization. Participants with increasing number of cardiovascular risk factors displayed increasing population attributable risks associated to a GFR less than 60 ml/min per 1.73 m for all-cause mortality and CHD (P heterogeneity 0.002 and 0.05, respectively). CONCLUSION: In a large general practice cohort of patients with cardiovascular disease risk factors, decreasing eGFR levels were associated with additional attributed risk of mortality and cardiovascular disease. Our findings underscore that intensified efforts are needed to reduce the cardiovascular disease burden associated to chronic kidney disease.

Impact of hypertension on mortality and cardiovascular disease burden in patients with cardiovascular risk factors from a general practice setting: the ESCARVAL-risk study.

OBJECTIVE: To estimate the attributable risk associated to hypertension for all-cause mortality and cardiovascular hospitalization endpoints in a prospective study of patients with at least one cardiovascular risk factors participating in the Estudio Cardiovascular Valencia-risk project, we also evaluated the attributable risk associated with other risk factors and risk factor clustering. METHODS: Prospective electronic health recording-based study in a Mediterranean population that included 52 007 cardiovascular disease-free men and women aged 30 years or older (mean age 62.6 year) with hypertension (79.0%), diabetes mellitus (37.3%), or dyslipidemia (88.2%), who underwent routine health examinations. All-cause mortality and hospitalization records for coronary heart disease (CHD) or stroke were collected. RESULTS: During an average follow-up time of 3.2 years, 928 deaths and 1682 and 1529 hospitalizations for CHD and stroke, respectively, were recorded. In both men and women, hypertension significantly increased the multiadjusted rates of death and CHD and stroke hospitalizations. Hypertension was associated with a substantial amount of avoidable deaths both in men and women, population attributable risks were 41.81 (95% confidence interval 28.02, 53.24)% and 37.84 (5.74, 61.51)%, respectively. Similarly, the population attributable risk of hospitalization for CHD and stroke associated to hypertension was among the highest in both the sexes as compared with the impact of the other main cardiovascular risk factors. Increasing cardiovascular risk factors clustering was associated with increasing burden of disease. CONCLUSION: Our results highlight the relevance of hypertension as main risk factor for mortality and cardiovascular events in a real-life setting. Although our data support the ongoing need of cardiovascular risk factors prevention, intensified actions for primary prevention of hypertension show potential to largely reduce the burden of cardiovascular disease.

Do genes modify the association of selenium and lipid levels?

The interaction of selenium, a component of antioxidant selenoproteins, with genetic variation in lipid-related pathways has not been evaluated earlier as a potential determinant of blood lipid levels. We aimed at evaluating the effects of gene-environment interactions between plasma levels of selenium and polymorphisms in lipid metabolic pathways on plasma lipid levels in a study population from Spain (N=1,315). We observed statistically significant associations between plasma selenium and lipid levels (differences in total, low-density lipoprotein [LDL]-cholesterol, and triglycerides comparing the 80th with the 20th percentiles of plasma selenium levels were, respectively, 12.0 (95% confidence interval 6.3, 17.8), 8.9 (3.7, 14.2), and 9.0 (2.9, 15.2) mg/dl). We also found statistically significant interactions at the Bonferroni-corrected significance level (p=0.0008) between selenium and rs2290201 in FABP4 for total and LDL cholesterol levels and rs1800774 in CETP for elevated LDL cholesterol. Other polymorphisms showed statistically significant differential associations of plasma selenium levels and lipids biomarkers at the nominal p-value of 0.05. Reported statistical interactions with genes involved in lipid transport and transfer provide biological support to the positive associations of selenium with lipids shown in cross-sectional studies and lead to the hypothesis that selenium and lipid levels share common biological pathways that need to be elucidated in mechanistic studies.

Cadmium exposure and clinical cardiovascular disease: a systematic review.

Mounting evidence supports that cadmium, a toxic metal found in tobacco, air and food, is a cardiovascular risk factor. Our objective was to conduct a systematic review of epidemiologic studies evaluating the association between cadmium exposure and cardiovascular disease. Twelve studies were identified. Overall, the pooled relative risks (95% confidence interval) for cardiovascular disease, coronary heart disease, stroke, and peripheral arterial disease were: 1.36 (95% CI: 1.11, 1.66), 1.30 (95% CI: 1.12, 1.52), 1.18 (95% CI: 0.86, 1.59), and 1.49 (95% CI: 1.15, 1.92), respectively. The pooled relative risks for cardiovascular disease in men, women and never smokers were 1.29 (1.12, 1.48), 1.20 (0.92, 1.56) and 1.27 (0.97, 1.67), respectively. Together with experimental evidence, our review supports the association between cadmium exposure and cardiovascular disease, especially for coronary heart disease. The number of studies with stroke, heart failure (HF) and peripheral arterial disease (PAD) endpoints was small. More studies, especially studies evaluating incident endpoints, are needed.