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Background & Aims: We aimed to estimate the prevalence of the inadequate intake and status of magnesium, zinc, and vitamins A, C, E, and D and identify factors associated with micronutrient deficiency in serum/plasma among residents of São Paulo, Brazil., Methods: Data from 824 individuals aged ≥14 years were obtained from the 2015 ISA-Nutrition, a population-based, cross-sectional survey. Dietary and supplement intakes were assessed using two 24-h dietary recalls, and the micronutrient inadequacies were estimated using the National Cancer Institute method. Micronutrient status was measured in serum or plasma, and deficiency was established according to the lower limit of the reference values. Receiver operating characteristic curve analysis was used to identify the effect of intake on the micronutrient status in serum/plasma. Logistic regression analysis was applied to assess the association between micronutrient status and individual characteristics., Results: More than 80% of the population had an inadequate dietary intake of magnesium, vitamin E, and vitamin D. Males had a high prevalence of inadequate dietary intake of vitamin A and zinc. A high-to-moderate prevalence of inadequate vitamin C intake was observed. Vitamin D was the only nutrient with a deficient status comparable to its dietary inadequacy. The other nutrients demonstrated a lower deficiency prevalence compared to dietary inadequacy, and vitamin A demonstrated the lowest prevalence of deficiency in plasma. Generally, dietary intake showed a non-notable association with micronutrient deficiency in serum/plasma. Individuals with fasting glucose concentrations ≥100 mg/dL and those using diuretic drugs had a higher risk of serum magnesium deficiency. Those using lipid-lowering drugs and those with high plasma adiponectin concentrations had a higher risk of serum zinc deficiency. Individuals who smoked and those with hypertension showed a higher risk of plasma vitamin C deficiency. Individuals with average leptin concentrations had a higher risk of plasma vitamin E deficiency. Finally, those with sufficient leisure-time physical activity had a lower risk of serum vitamin D deficiency., Conclusions: Residents of the urban areas of São Paulo demonstrated substantially inadequate intakes of most of the assessed micronutrients; however, micronutrient deficiency in serum/plasma was not associated with dietary inadequacy, and it usually demonstrated a lower prevalence than dietary indicators. Thus, using micronutrient intake to determine the serum/plasma profile should be done with caution. The status of the micronutrients varied according to individual characteristics, indicating the interplay of complex mechanisms underlying micronutrient balance., Competing Interests: Conflict of interest All authors declare no conflicts of interest that could inappropriately influence this article., (Copyright © 2022 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

The present study documents, for the first time, the ingestion of microplastics (MPs) by Longnose stingrays in the Western Atlantic Ocean. We examined 23 specimens of Hypanus guttatus from the Brazilian Amazon coast and found microplastic particles in the stomach contents of almost a third of the individuals. Fibers were the most frequent item (82%), blue was the most frequent color (47%) and Polyethylene Terephthalate (PET) was the most frequent polymer recorded (35%), as identified by 2D imaging - Fourier Transform Infrared (FTIR). The ingestion of microplastics by Longnose stingray has not been previously recorded. The findings of the present study thus provide an important baseline for future studies of microplastic ingestion by dasyatid rays and other batoid species in the Atlantic Ocean, and contribute to the broader understanding of the spatial and temporal dimensions of the growing problem of plastic pollution in aquatic ecosystems and organisms., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

This study reports for the first time the ingestion of meso- (5.01-25 mm) and microplastics (1 μm-5 mm) by the sea anemone Bunodosoma cangicum, the most abundant actiniarian species on the Amazon coast. At three sites on the coast of Pará, Brazil, anemones were collected from beachrocks in the intertidal zone (30 at each site), measured (pedal disc diameter, mm) and weighed (wet weight, g). The contents of the gastrovascular cavity were extracted and analyzed under a stereoscope. The recovered plastic particles were characterized by Fourier Transform Infrared (FTIR) spectroscopy. Overall, 139 microplastic and 2 mesoplastic items were identified in 68 individuals (75.6%) among the 90 examined, with a mean of 1.6 (±1.5) items per individual. Plastic fibers comprised about 84% of the ingested plastics, followed by fragments (∼12%) and films (∼4%). Particle diameters ranged from 0.10 to 9.17 mm (1.57 ± 1.23 mm). A weak positive correlation was found between the weight of anemones and the number of plastic particles in the gastrovascular cavity (p = 0.03) and between the number of prey items and the number of plastic particles in the gastrovascular cavity (p < 0.01). The main polymers identified by FTIR analysis were polyethylene terephthalate (PET), polypropylene (PP), polyamide (PA), polyurethane (PU), polyethylene (PE), acrylonitrile butadiene styrene (ABS), polystyrene (PS) and rayon. Sea anemones ingested significantly more plastic debris at the most urbanized and populous sampling sites. This study provides the first evidence of microplastics contamination of marine invertebrates from the Amazon coast. Abundant species such as B. cangicum have the potential to monitor the levels of plastic contamination in the region. Our results support this potential, as the species showed a high frequency of plastic ingestion and allowed detection of plastic contamination even in the best-preserved area where anemones were collected., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objectives: The aim of this study was to investigate the effects of primary healthcare decentralization on type 2 diabetes mellitus mortality and morbidity in different municipalities of a developing country., Study Design: This was a retrospective study based on a panel of annual data from 5560 Brazilian municipalities from 2000 to 2011., Methods: The investigation used the staggered municipal adoption of a federal health information program as a quasi-experiment to identify the treatment effects of health decentralization on diabetes indicators. Using Difference-in-Differences models and instrumental variables, we analyzed the effects of primary healthcare decentralization on diabetes rates (i.e. diabetes deaths and hospitalizations by the number of people with a diabetes diagnosis and by population)., Results: Evidence suggests improvements in universal access to primary health care and progress in the average health outcomes related to diabetes mortality (reduction of 30%) and hospitalization (reduction of 2.3%) due to decentralization. Effects are further pronounced in developed regions with higher incomes, while the poorest and less developed regions showed virtually no effect., Conclusions: These results demonstrate that there are particular preconditions for successful primary health decentralization, especially related to returns of scale (big health facilities are associated with low cost per treatment), lack of human and physical capital, and government coordination problems., (Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)