Irradiance of phototherapy equipment in maternity wards in Maceió

La eficacia del tratamiento de la hiperbilirrubinemia neonatal depende directamente de la cantidad de energía emitida por la luz (irradiación). Este es un estudio transversal que objetivó determinar la irradiación de los aparatos de fototerapia en las maternidades de Maceió. Es un muestreo por censo, ya que incluyó todos los aparatos en uso en las unidades neonatales de Maceió, en el total de treinta y seis aparatos (36), excluyéndose aquellos que estaban en manutención. La medición de la irradiación fue realizada con un radiómetro. Se observó que 72,20% de los aparatos presentaron irradiación eficaz y 27,76% de los aparatos fueron ineficaces. Se concluye que la mayoría de los aparatos de fototerapia está emitiendo la irradiación mínima terapéutica para el tratamiento de la ictericia neonatal.The effectiveness of neonatal hyperbilirubinaemia treatment depends directly on the amount of energy emitted by light (irradiance). This cross-sectional study aimed to determine the irradiance of phototherapy equipment in maternity wards in Maceió, AL, Brazil. All equipment in use in the neonatal units in Maceió was included in the study, totaling 36 devices, except those in maintenance. The measurement of irradiance was carried out with a radiometer. We observed that 72.20% of the equipment presented efficient irradiance and 27.76% were inefficient. The conclusion is that the majority of phototherapy devices are emitting the minimum required irradiance for neonatal jaundice treatment.A eficácia do tratamento da hiperbilirrubinemia neonatal está na dependência direta da quantidade de energia emitida pela luz (irradiância). Este é um estudo transversal que objetivou determinar a irradiância dos aparelhos de fototerapia nas maternidades de Maceió. A amostragem foi censitária, pois incluiu todos os aparelhos em uso nas unidades neonatais de Maceió, no total de trinta e seis aparelhos (36), excluindo-se aqueles que estavam em manutenção. A medição da irradiância foi realizada com um radiômetro. Observou-se que 72,20% dos aparelhos apresentaram eficácia quanto à sua irradiância e 27,76% dos aparelhos foram ineficazes. Concluiu-se que a maioria dos aparelhos de fototerapia está emitindo a irradiância mínima terapêutica para o tratamento da icterícia neonatal

Frequência de lesão nasal em neonatos por uso de pressão positiva contínua nas vias aéreas com pronga

Continuous positive airway pressure (CPAP) with prongs is the ventilatory support most used in newborns. Nasal injuries are complications that may arise due to the prolonged use of this device. This study aimed to determine the frequency of nasal injuries in newborns through the use of continuous positive airway pressure with prongs. A convenience sample composed of hospitalized newborns using prongs for more than two days was used. Data were collected through a structured form. Lesions were observed in all newborns, which were classified as: mild (79.6%), moderate (19.7%) and severe (0.7%). The conclusion is that the use of prongs for more than two days represents a risk factor for the lesions to develop.La presión positiva continua en las vías aéreas con prongs es la asistencia ventiladora más utilizada en neonatología. Las lesiones nasales son complicaciones que pueden surgir debido al uso prolongado de ese dispositivo. Este estudio tuvo por objetivo determinar la frecuencia de las lesiones nasales en neonatos causadas debido al uso de presión positiva continua en las vías aéreas utilizando un prong. El muestreo fue por conveniencia, constituido de recién nacidos internados y usando prongs, y se excluyeron aquellos que utilizaban el dispositivo por un período inferior a dos días. Los datos fueron recolectas a través de un formulario estructurado. Se observaron lesiones en todos los recién nacidos, clasificadas en: ligera (79,6%), moderada (19,7%) y severa (0,7%). Se concluyó que el tiempo de permanencia de las prongs, por más de dos días, es un factor de riesgo para la evolución de las etapas de las lesiones nasales.A pressão positiva contínua nas vias aéreas com pronga é a assistência ventilatória mais utilizada em neonatologia. Lesões nasais são complicações que podem surgir pelo uso prolongado desse dispositivo. Este estudo objetivou determinar a frequência de lesões nasais em neonatos por uso de pressão positiva contínua nas vias aéreas com pronga. A amostragem foi por conveniência, constituída de recém-nascidos internados e em uso de pronga, e excluiu-se aqueles que utilizavam o dispositivo por período inferior a dois dias. Os dados foram coletados através de um formulário estruturado. Observaram-se lesões em todos recém-nascidos, graduadas em: leve (79,6%), moderada (19,7%) e severa (0,7%). Concluiu-se que o tempo de permanência de pronga, por mais de dois dias, é fator de risco para a evolução do estágio das lesões nasais

Transição alimentar do recém-nascido prematuro para introdução do aleitamento materno / Food transition from premature newborn to introduction of breastfeeding

Objetivo: Analisar o conhecimento do enfermeiro sobre a transição alimentar no recém nascido pré termo. Método: Estudo exploratório, descritivo, com abordagem qualitativa, realizado com 16 enfermeiras da unidade neonatal de um hospital universitário que aceitaram participar do estudo de forma voluntária, assinando o Termo de Consentimento Livre e Esclarecido. Para análise dos dados foi utilizado a análise de conteúdo de Minayo.  Resultados: Foram delimitados os seguintes núcleos temáticos: sinais clínicos para o início do processo da transição alimentar e assistência de enfermagem; Aspectos considerados pelo enfermeiro para a promoção ao aleitamento materno na transição; Desafios e limitações encontrados pela equipe multidisciplinar. Conclusão: O estudo demonstrou que o enfermeiro como profissional responsável pela administração alimentar do recém-nascido prematuro deve possuir conhecimento quanto o segmento da aceitação da dieta e a forma como ela é ofertada, assim como em que momento deve ocorrer à transição alimentar, para que o sucesso desta prática seja garantido

Beyond trees: Mapping total aboveground biomass density in the Brazilian savanna using high-density UAV-lidar data

Tropical savanna ecosystems play a major role in the seasonality of the global carbon cycle. However, their ability to store and sequester carbon is uncertain due to combined and intermingling effects of anthropogenic activities and climate change, which impact wildfire regimes and vegetation dynamics. Accurate measurements of tropical savanna vegetation aboveground biomass (AGB) over broad spatial scales are crucial to achieve effective carbon emission mitigation strategies. UAV-lidar is a new remote sensing technology that can enable rapid 3-D mapping of structure and related AGB in tropical savanna ecosystems. This study aimed to assess the capability of high-density UAV-lidar to estimate and map total (tree, shrubs, and surface layers) aboveground biomass density (AGBt) in the Brazilian Savanna (Cerrado). Five ordinary least square regression models esti-mating AGBt were adjusted using 50 field sample plots (30 m × 30 m). The best model was selected under Akaike Information Criterion, adjusted coefficient of determination (adj.R2), absolute and relative root mean square error (RMSE), and used to map AGBt from UAV-lidar data collected over 1,854 ha spanning the three major vegetation formations (forest, savanna, and grassland) in Cerrado. The model using vegetation height and cover was the most effective, with an overall model adj-R2 of 0.79 and a leave-one-out cross-validated RMSE of 19.11 Mg/ha (33.40%). The uncertainty and errors of our estimations were assessed for each vegetation formation separately, resulting in RMSEs of 27.08 Mg/ha (25.99%) for forests, 17.76 Mg/ha (43.96%) for savannas, and 7.72 Mg/ha (44.92%) for grasslands. These results prove the feasibility and potential of the UAV-lidar technology in Cerrado but also emphasize the need for further developing the estimation of biomass in grasslands, of high importance in the characterization of the global carbon balance and for supporting integrated fire management activities in tropical savanna ecosystems. Our results serve as a benchmark for future studies aiming to generate accurate biomass maps and provide baseline data for efficient management of fire and predicted climate change impacts on tropical savanna ecosystems

Hundreds of variants clustered in genomic loci and biological pathways affect human height

Most common human traits and diseases have a polygenic pattern of inheritance: DNA sequence variants at many genetic loci influence the phenotype. Genome-wide association (GWA) studies have identified more than 600 variants associated with human traits, but these typically explain small fractions of phenotypic variation, raising questions about the use of further studies. Here, using 183,727 individuals, we show that hundreds of genetic variants, in at least 180 loci, influence adult height, a highly heritable and classic polygenic trait. The large number of loci reveals patterns with important implications for genetic studies of common human diseases and traits. First, the 180 loci are not random, but instead are enriched for genes that are connected in biological pathways (P = 0.016) and that underlie skeletal growth defects (P < 0.001). Second, the likely causal gene is often located near the most strongly associated variant: in 13 of 21 loci containing a known skeletal growth gene, that gene was closest to the associated variant. Third, at least 19 loci have multiple independently associated variants, suggesting that allelic heterogeneity is a frequent feature of polygenic traits, that comprehensive explorations of already-discovered loci should discover additional variants and that an appreciable fraction of associated loci may have been identified. Fourth, associated variants are enriched for likely functional effects on genes, being over-represented among variants that alter amino-acid structure of proteins and expression levels of nearby genes. Our data explain approximately 10% of the phenotypic variation in height, and we estimate that unidentified common variants of similar effect sizes would increase this figure to approximately 16% of phenotypic variation (approximately 20% of heritable variation). Although additional approaches are needed to dissect the genetic architecture of polygenic human traits fully, our findings indicate that GWA studies can identify large numbers of loci that implicate biologically relevant genes and pathways.

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

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele