Background The COVID-19 pandemic has entailed a significant socio-economic impact on various layers of the population. In many countries, attempts to control viral dissemination involved lockdown measures that limited citizens' overall mobility and professional and leisure activities. Objective This systematic review investigates the impact of COVID-19-induced lockdowns on university student physical activity and sedentary behav-ior, as these relate to physical and mental well-being. Methods Data was collected through PubMed/MEDLINE, Embase, SCOPUS, and APA PsycInfo databases until January 2021. Results Seven studies conducted in five different countries (United States, Spain, Italy, China, and United Kingdom) were included in the final review. Overall, most studies reported a significant decrease in mild physical activity (i.e., walking) among undergraduate students but not among graduate students. Consistently, most studies reported a significant increase in sedentary time (i.e., sitting time on weekdays) in undergraduate students but not in graduate students. We observed that students who were more sedentary previous to lockdown, increased or did not change their moderate and/or vigorous physical activity. In contrast, those who were less sedentary previous to lockdown decreased their moderate and/or vigorous physical activity. Conclusions COVID 19 induced lockdowns appear to have negatively affected walking and sedentary behavior among undergraduate students but not among graduate students. Our results highlight the importance of promoting the World Health Organization recommendations for physical activity and sedentary behavior among university students to improve health outcomes.

Objective The objective of this study was to investigate whether glycated hemoglobin (HbA1c) is a valid surrogate for evaluating the effectiveness of antihyperglycemic drugs in diabetes mellitus (DM) trials. Methods We conducted a systematic review of placebo-controlled randomized clinical trials (RCTs) evaluating the effect of a treatment on HbA1c (mean difference between groups) and clinical outcomes (relative risk of mortality, myocardial infarction, stroke, heart failure, and/or kidney injury) in patients with DM. Then, we investigated the association between treatment effects on HbA1c and clinical outcomes using regression analysis at the trial level. Lastly, we interpreted the correlation coefficients (R) using the cut-off points suggested by the Institute for Quality and Efficiency in Healthcare (IQWiG). HbA1c was considered a valid surrogate if it demonstrated a strong association: lower limit of the 95 percent confidence interval (95 percent CI) of R greater than or equal to .85. Results Nineteen RCTs were identified. All studies included adults with type 2 DM. None of the associations evaluated was strong enough to validate HbA1c as a surrogate for any clinical outcome: mortality (R = .34; 95 percent CI −.14 to .69), myocardial infarction (R = .20; −.30 to .61), heart failure (R = .08; −.40 to .53), kidney injury (R = −.04; −.52 to .47), and stroke (R = .81; .54 to .93). Conclusions The evidence from multiple placebo-controlled RCTs does not support the use of HbA1c as a surrogate to measure the effectiveness of antihyperglycemic drugs in DM studies.

Objetivo: Analizar la prevalencia y componentes del Síndrome Metabólico (SM) premórbido en trabajadores asegurados al seguro social de salud en una zona de altitud moderada (Chachapoyas, Perú). Materiales y métodos: Se realizó un estudio transversal con datos de diverso tipo de trabajadores pertenecientes a un programa de EsSalud enfocado a diagnosticar SM premórbido, obesidad y sobrepeso en trabajadores en sus centros laborales durante el periodo octubre 2017 a agosto 2018. Se trabajó con datos previamente registrados por el programa mencionado. El SM se diagnosticó según los criterios de la guía “Harmonizing the Metabolic Syndrome”. Resultados: Se incluyeron un total de 1021 sujetos. La prevalencia global de SM premórbido fue de 32,8 % (312/952). En hombres, la prevalencia fue de 35,4 % (160/452) y en mujeres de 30,4 % (152/500), no existiendo diferencias estadísticamente significativas entre ambos sexos (p=0,101). La frecuencia de los componentes del SM en la población total del estudio fue: Obesidad central 73,4 %, hipertrigliceridemia 45,6 %, HDL-C bajo 66,3 %, hiperglicemia 10,0 % y presión arterial elevada 6,5 %. Los participantes con SM premórbido fueron significativamente mayores en edad que aquellos sin SM premórbido (44 versus 36 años, p<0,001). Conclusiones: Existe una alta prevalencia de SM premórbido en trabajadores residentes en Chachapoyas, contrariamente a lo sugerido por la evidencia previa.

s231 produced a statistically significant reduction over placebo in rTNSS (standardized mean difference [SMD] -0.390; 95% CI -0.476 to -0.303, p< 0.001) in both the short (less than 6 weeks) and long term (52 weeks or more). A greater improvement was also established in iTNSS (-0.360, -0.484 to -0.236, p< 0.001), rTOSS (-0.163, -0.293 to -0.033, p= 0.014), iTOSS (-0.165, -0.295 to -0.035, p= 0.013) and QoL (-0.322, -0.452 to -0.191, p< 0.001) in the short term. All effect sizes were greater than -0.5, indicating small changes according to Cohen's guidelines. The incidence of most adverse events with FFNS was similar to that with placebo, with the exception of epistaxis, which was more frequent with FFNS in both the short (FFNS 7%, placebo 4%, p= 0.004) and long term (FFNS 25%, placebo 13%, p< 0.001). ConClusions: FFNS in adults and adolescents with PAR resulted in statistically significant but not clinically relevant improvements in symptoms and QoL compared with placebo.

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