Variação das taxas de cesariana no Piauí durante o período de 2015-2020

Atualmente o parto tem sido caracterizado como fenômeno que requer inúmeras intervenções médicas que menosprezam o protagonismo da mulher e esta por sua vez, é tendenciada pela cultura medicalicista e se vê tomada pelo medo deste evento desconhecido e mistificado. O que ocasiona muitas vezes que a mulher não escolha como irá ser seu parto deixando essa responsabilidade para a equipe do estabelecimento de saúde. O presente estudo tem como objetivo analisar a tendência da proporção de partos cesáreos e fatores associados no estado do Piauí no período de 2015-2020 segundo dados disponíveis no Sistema de Informações sobre Nascidos Vivos (SINASC) da Secretaria de Vigilância em Saúde do Ministério da Saúde. Trata-se de um estudo epidemiológico descritivo, retrospectivo com abordagem quantitativa, utilizando dados do Sistema de Informação sobre Nascidos Vivos (SINASC) e do Cadastro Nacional de Estabelecimentos de Saúde (CNES), disponíveis no site do Departamento de Informática do SUS (DATASUS) e gerenciados pelo Ministério da Saúde. Para realização deste estudo, foi selecionado o período de tempo de 2015-2020. Com relação a distribuição do número de partos por cesárea foi visto que com passar dos anos ocorreu um aumento progressivo no número de nascimentos por cesárea com um total de 159.695 partos que representou 55,6% do total de nascimentos sendo o ano de 2020 com a maior quantidade de partos por cesariana em relação ao número de nascimentos (n=26498; 58,60%). Existe uma dualidade no atual modelo de assistência ao parto no Brasil. O setor público, de um lado, é marcado pela maior frequência de partos vaginais, geralmente com pequeno controle da dor e mais intervenções desnecessárias. De outro lado, o setor privado exibe as cesáreas como o tipo de parto quase universal, com procedimentos convenientemente agendados, mais rápidos, defendidos como mais seguros que os partos vaginais. Se considerarmos que a cesárea é um procedimento essencial na assistência obstétrica, capaz de salvar a vida das gestantes e dos fetos quando indicada adequadamente, o debate sobre a igualdade de acesso à assistência ao parto deve ser centrado na oferta da cesárea para as mulheres que dela necessitarem

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

Cold-rolled multiphase boron steels: microstructure and mechanical properties

The influence of the boron concentration on phase transformation characteristics, microstructure and mechanical properties of multiphase steels was investigated using computational thermodynamics (Thermo-Calc®), dilatometry, quantitative metallography and tensile tests. Pilot scale 50 kg steel ingots were prepared in an induction furnace operating under an argon gas atmosphere with boron contents between 0 and 47 ppm. The ingots were cut into 35 mm thick blocks, which were reheated to 1250 °C for 1 h and hot rolled for seven passes to attain a thickness of 7.0 mm. The hot-rolled sheets were machined and then cold rolled to a final thickness of 1.2 mm. Continuous annealing cycles were performed in a Bähr dilatomer and in a Gleeble machine. Continuous annealing laboratory simulations showed that boron did not significantly influence the amount of austenite formed during heating and soaking steps. However, boron influenced austenite transformation during the cooling step, which reduced the amount of ferrite and increased the amount of bainite. Regarding the mechanical properties, adding boron increased strength and decreased ductility of the product. The steels with boron concentrations up to 27 ppm exhibited the greatest effect. The amount of austenite, which was calculated using Thermo-Calc®, was slightly overestimated compared with that obtained by dilatometry and metallography, particularly for soaking temperatures lower than 800 °C

Sistema de Plantio direto: conservação e manutenção da capacidade produtiva dos solos do Cerrado Goiano

ResumoSendo reconhecido como um grande pacote tecnológico o plantio direto é uma das formas diferenciadas de manejo do solo, onde visa diminuir os impactos da agricultura e de máquinas agrícolas, promovendo a conservação do solo. Desta forma, estudos relacionados ao sistema de plantio direto (SPD) tem merecido cada vez mais atenção, devido ao potencial de contribuição para o esclarecimento de questões conservacionistas. Neste contexto, o trabalho objetivou realizar um levantamento bibliográfico sobre o uso do sistema de plantio direto como medida mitigatória dos problemas qualitativos dos solos do Cerrado brasileiro. Considerando que o plantio direto é de uma importante opção de manejo do solo, pois é uma técnica conservacionista que visa manutenção vegetal e seus demais resíduos sobre o solo, trazendo assim uma grande eficiência estratégica no que se refere à sustentabilidade para os sistemas agrícolas. O aporte tecnológico disponível atualmente permite a adaptação do sistema de plantio direto nas mais variadas condições de clima, solo e espécies cultivadas. Ao longo de décadas de pesquisas, os ganhos ambientais com uso da técnica estão comprovados, permitindo afirmar que, o plantio direto constitui numa das mais eficientes práticas conservacionistas em áreas de cultivos.Palavras-chave: Sustentabilidade agrícola. Manejo do solo. Qualidade do solo. AbstractBeing recognized as a great technological package, no-tillage is one of the differentiated forms of soil management, where it aims to reduce the impacts of agriculture and agricultural machinery, promoting soil conservation. In this way, studies related to the no-tillage system (SPD) have deserved more and more attention, due to the potential contribution to the clarification of conservationist issues. In this context, the objective of this work was to carry out a bibliographical survey on the use of no-tillage system as a mitigating measure of the qualitative problems of Brazilian Cerrado soils. Considering that no-tillage is an important land management option, it is a conservationist technique that aims to maintain plant and other residues on the soil, thus bringing a great strategic efficiency with regard to sustainability for agricultural systems. The currently available technological support allows the adaptation of the no-tillage system in the most varied climatic conditions, soil and cultivated species. Throughout decades of research, the environmental gains with the use of the technique are proven, allowing to affirm that, no-tillage constitutes one of the most efficient conservationist practices in crop areas.Keywords: Agricultural sustainability. Soil management.Soilquality

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P <.01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P =.15). Secondary end points did not differ between groups after follow-up. Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death. © 2019 The Author