Eduardo Ribes Kohn

Background : Women remain underrepresented in academic leadership globally, particularly in health fields. In Latin America, limited funding, centralized research systems, and institutional inequities further restrict women’s advancement. In physical activity and health research, these disparities may limit perspectives shaping evidence and policy. We examined institutional environments, authorship patterns, and factors associated with women researchers’ progression across Latin America. Methods : We conducted an observational study across 13 Latin American countries using 3 approaches: (1) a cross-sectional survey using the Culture Conducive to Women’s Academic Success (CCWAS) instrument, with normalized domain scores analyzed descriptively and visualized with equiplots in R; (2) a network analysis of institutional, demographic, and productivity variables using least absolute shrinkage and selection operator regularization and centrality metrics; and (3) bibliometric analysis of PubMed-indexed publications to assess gendered authorship trajectories and team composition. Results : Among 121 participants, midcareer researchers reported the lowest CCWAS scores, particularly for work–life balance, whereas senior researchers reported the highest supportive leadership scores. Academic culture perceptions varied across countries. Network analysis identified principal investigator roles, coauthorship, and supportive leadership perceptions as central factors associated with academic productivity. Bibliometrics showed that women more often progressed from contributor to first-author roles than to last-author positions. Teams with female first and last authors had the highest proportion of women contributors. Conclusions : Achieving gender equity in physical activity and health research in Latin America requires more than representation. Institutional efforts to promote inclusive leadership, supportive environments, and midcareer advancement are essential for equitable, resilient research systems.

Introduction: The covid-19 pandemic led to substantial disruptions in daily routines worldwide, with potential impacts on physical activity and sedentary behavior. Objective: This study evaluated self-reported changes in physical activity (PA) and sitting time (ST) during the covid 19 pandemic in Brazil and examined sociodemographic correlates of these behaviors. Methods: Data were obtained from the nationwide EPICOVID 2.0 survey, which included 33,250 participants. Changes in PA and ST were self-reported, and weighted multinomial logistic regression analyses were conducted. Results: Overall, 29.3% (95% CI: 28.8 – 29.8) reported never practicing PA, 30.1% (95% CI: 29.6 – 30.7) reported decreased PA, 8.6% (95% CI: 8.3 – 8.9) increased PA, and 31.9% (95% CI: 31.5 – 32.5) no change. Regarding ST, 34.4% (95% CI: 33.8 – 34.9) reported an increase, 9.7% (95% CI: 9.4 – 10.1) a reduction, and 55.9% (95% CI: 55.4 – 56.5) no change. Participants reporting a decrease in ST had lower odds of reporting a decrease in PA (OR = 0.29; 95% CI: 0.22 – 0.40). Women had higher odds of decreased PA than men, with no gender differences observed for ST. Higher education was associated with higher odds of decreased PA and increased ST. Conclusion: These findings indicate that the pandemic affected PA and ST differently across population subgroups, with sociodemographic factors playing a key role. Targeted public health strategies are needed to promote PA and reduce ST, particularly among vulnerable groups.

Background: Fluid overload may worsen pulmonary mechanics in patients with kidney failure. We evaluated the acute impact of a single hemodialysis (HD) session on lung volumes, flows, respiratory muscle strength, and the prevalence of preserved ratio impaired spirometry. Methods: A pre-post observational study was conducted at a university hospital dialysis unit. Forced expiratory volume in one second (FEV1), peak expiratory flow, and FEV1 to forced vital capacity (FVC) ratio (FEV1/FVC) were measured by spirometry, while maximum inspiratory pressure and maximum expiratory pressure were measured by manovacumetry. Evaluations were performed before and after the HD session. The association between changes in respiratory volumes and pressures and the volume of ultrafiltration (UF) removed during the HD session was evaluated using adjusted linear regression. Results: The study included 104 patients (57% male), with a mean age of 54.7 (15.8) years. Both maximum expiratory pressure (71.3 ± 39.6 to 79.7 ± 35.4% predicted) and maximum inspiratory pressure (64.5 ± 29.0 to 69.9 ± 32.1% predicted) significantly increased from before to after the HD session (P < .001 for both). The ratio (FEV1/FVC) was 80.1 (77.1 to 83.14) % before and 83.5 (80.7 to 86.3) % after the HD session (P = .02). The proportion of participants meeting preserved ratio impaired spirometry criteria significantly decreased from 56.0% to 43.5% after HD (P < .001). The UF volume was positively correlated with changes in % FEV1/FVC ratio (β = 1.84, P = .04) and FEV1 (β = .09, P = .006). Conclusion: HD was associated with acute improvements in respiratory muscle strength and in spirometry pattern (reduction in preserved ratio impaired spirometry prevalence). The magnitude of improvement in FEV1/FVC and FEV1 correlated with UF volume, suggesting a role of fluid removal. Further studies should confirm these findings longitudinally and investigate clinical outcomes.

This study aimed to investigate the association between functional dentition and a prior diagnosis of diabetes mellitus (DM) and/or chronic kidney disease (CKD) in a nationally representative sample of the Brazilian population. We conducted a cross-sectional analysis using data from the 2019 Brazilian National Health Survey (PNS). The PNS is representative of the Brazilian population. The associations between self-reported diagnoses of DM and/or CKD and the absence of functional dentition were assessed using multilevel logistic regression models, adjusted for sociodemographic and behavioral variables, such as age, sex, skin color, income, education, and smoking status. Functional dentition was absent in 9.3% of the sample (95%CI, 8.9-9.7). Additionally, 8.8% (95%CI, 8.5-9.0) reported a previous diagnosis of DM, and 1.4% (95%CI, 1.3-1.5) a prior diagnosis of CKD. The proportion of individuals with both CKD and DM was 0.29% (95%CI, 0.27-0.32). In adjusted models, DM was significantly associated with the absence of functional dentition (OR, 1.16; 95%CI, 1.07; 1.23, p<0.001). No significant association was observed for CKD (OR, 1.06; 95%CI, 0.89; 1.26, p=0.48) or for individuals with both DM and CKD (OR, 1.08; 95%CI, 0.74; 1.57, p=0.66). Diabetes is associated with a higher risk of functional dentition loss in the Brazilian population. Promoting collaboration between dental and medical professionals is essential to improve the prevention and management of tooth loss, particularly among individuals with diabetes, ultimately contributing to better overall health outcomes.

Background : Physical activity research is pivotal in shaping policies and interventions that promote health. However, disparities in research contributions across authors and institutions can impact the equity and representation of evidence-based practices. Objective: This study aimed to assess the dispersion of authors and institutions publishing research on physical activity and health within countries. Methods: A global bibliometric analysis was conducted, including articles on physical activity and health published between 1950 and 2019. Countries with 10 or more publications were analyzed. Data on authors’ names and institutions were extracted, and the Gini coefficient, a measure of inequality, was calculated using the “Descogini” command in Stata. Gini coefficients were generated for authors in 94 countries and for institutions in 98 countries. Results: The Gini coefficient for authors ranged from 0.03 in Cuba, Bangladesh, and Lebanon (low concentration) to 0.59 in Belgium and 0.65 in Portugal (high concentration). For institutions, the lowest coefficient was 0.08 in Guatemala, and the highest was 0.84 in Belgium and Portugal. Regions such as the Americas, Europe, and the Western Pacific exhibited higher average Gini coefficients for authors and institutions. Similarly, high-income and upper middle-income countries showed greater research concentration than low-income and lower middle-income nations. Conclusion: To promote a more equitable and impactful global research landscape, it is crucial to invest strategically in developing and multiplying high-quality research groups across regions. Supporting emerging centers of excellence will foster innovation, capacity building, and more inclusive scientific production. Future research should further explore these factors to guide effective policies and investments.

Objectives This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of incorporating bioimpedance spectroscopy into the clinical assessment for estimating target weight in maintenance haemodialysis recipients compared with physical examination alone.

Background: The interplay between oral health and chronic kidney disease (CKD) is not fully understood, but both conditions may influence each other through chronic inflammatory states. This systematic review and meta-analysis aim to investigate the association between CKD and oral health. Methods: The review included observational studies (cross-sectional, case-control, and cohort) involving adults (≥18 years) comparing individuals with and without CKD regarding the number of missing teeth, edentulism, or the decayed, missing, and filled teeth (DMFT) index, a recognized indicator of oral health. The databases PubMed, Scopus, and Web of Science, together with references, were searched up to October 10, 2024. The results were synthesized using meta-analysis in RevMan software. Results: Eight case-control studies from Portugal, Turkey, Japan, Brazil, and Thailand were included, with sample sizes ranging from 30 to 204 participants. CKD patients had significantly more missing teeth (mean difference +3.17; 95% CI 2.07–4.28), fewer filled teeth (mean difference −1.23; 95% CI -1.82; −0.64), and higher DMFT scores (mean difference +2.60; 95% CI 1.34; 3.86) compared to controls. No significant difference was found in the number of decayed teeth (mean difference 0.31; 95% CI -0.15; 0.76). The methodological quality of studies ranged from 4 to 7 stars. Conclusions: Patients with CKD, especially those on hemodialysis, experience more tooth loss and higher DMFT scores, highlighting a gap in oral health care within dialysis units. Although the findings highlight the importance of addressing oral health in CKD patients, further studies are needed in developed countries to better understand the interplay between both conditions.

Background: Physical activity benefits both individuals and societies. This article evaluates progress in physical activity surveillance, research, policy, and authorship gender equity in Brazil (1950–2019). Methods: We used data from a systematic review and the country cards produced by the Global Observatory for Physical Activity. Brazilian articles identified in the review were classified according to research theme and gender distribution in authorship. We also assessed the changes in physical activity policy and surveillance in Brazil. Results: Of the 23,860 articles identified in the global review, 1200 (5.0%) were from Brazil. There was a sharp increase in publications from the 2000s, but a slight decline has been observed since 2015. Most studies were on physical activity surveillance (37%). The proportion of females as first authors was 51.2% in the last decade analyzed (2010–2019)—however, the proportion of female senior authors was below 40%. Brazil has a comprehensive surveillance system that includes all ages in periodic physical activity monitoring. Brazil has a physical activity policy embedded in noncommunicable diseases and health promotion policies, has recently launched guidelines for the population, and has a wide range of policies embedded in the national public health system. Conclusion: Brazil is a leading middle-income country regarding physical activity research, policy, and surveillance. The results revealed some gender disparity in leadership roles in publications. The next challenge is translating this progress into increased physical activity levels among the Brazilian population.

Objetivo: Estimar a prevalência de consumo abusivo de bebidas alcoólicas, hábito de beber e dirigir e relato de consumo de bebidas alcoólicas, comparando os primeiros trimestres de 2022 e 2023.

Objective: To estimate the prevalence of abusive alcohol consumption, drinking and driving habits and reports of alcohol consumption comparing the first quarters of 2022 and 2023.