Remote sensing as a tool for monitoring Paranoá Lake's water quality (Brasília, Brazil)

Este trabalho testou uma metodologia baseada no sensoriamento remoto para estimar o estado trófico de um reservatório urbano (Lago Paranoá) em Brasília (Brasil), com vistas ao monitoramento da qualidade da água. Quatro fases limnológicas do Lago Paranoá foram analisadas a partir da eutrofização do reservatório como resultado do excessivo aporte de esgotos domésticos. Dados de fósforo total, clorofila-a , transparência da água e imagens processadas do LANDSAT TM 5 foram utilizados para estimar do estado trófico. Esses dados foram correlacionados com dados limnológicos e os mapas quantificaram as variáveis para todo o espelho d'água. Com o uso do Índice de Estado Trófico de Carlson, novos mapas foram gerados, estimando o estado trófico do Lago Paranoá para cada fase limnológica analisada. O método e as estimativas testadas mostraram-se adequados para o monitoramento da qualidade da água, pois refletem as mudanças que a água do reservatório experimentou após a eutrofização.This study has tested a remote sensing method for evaluating the trophic level of an urban reservoir (Paranoá Lake) in Brasilia City (Brazil) aiming at water quality monitoring. Four limnological periods of Paranoá Lake were analyzed after the reservoir-undergone eutrophication as a result of excessive domestic sewage discharge. Data on total phosphorus, chlorophyll-a , water transparency and processed Landsat TM 5 images were used to assess reservoir trophic levels. These data were correlated to limnological data, and maps containing parameter values for the reservoir were produced. By using the Carlson's Trophic State Index, new maps were produced by means of assessing the trophic state of Paranoá Lake for each analyzed limnological period. The tested method and proceedings have shown to be appropriate for water quality monitoring, since they reproduced the changes that water reservoir experienced after eutrophication

Chronic non-communicable diseases and COVID-19: EPICOVID-19 Brazil results

OBJECTIVE Describing the prevalence of chronic diseases and associated socioeconomic and demographic factors, evaluating the patterns of social distancing and the antibodies prevalence against SARS-CoV-2 and COVID-19 symptoms in carriers and non-carriers of chronic diseases. METHODS Data from 77,075 individuals aged 20 to 59 from three steps of the EPICOVID-19 Brazil (a nationwide serological survey conducted between May and June, 2021) were assessed. The presence of antibodies against SARS-CoV-2 was examined by rapid tests. Self-reported prevalence of hypertension, diabetes, asthma, cancer, chronic kidney disease and heart disease were investigated. The prevalence of mask use, adherence to isolation measures and antibodies were evaluated separately amid carriers and non-carriers of chronic diseases. The prevalence of symptoms was analyzed among carriers and non-carriers of chronic diseases with antibodies. RESULTS The prevalence of at least one chronic disease was 43%, higher in the Southeast region, among white and indigenous individuals, women, less schooled and in lower socioeconomic position. The use of masks when leaving home was similar among carriers and non-carriers of chronic diseases (98%). The proportion of participants who reported adherence to isolation measures was higher amid carriers (15.9%) than non-carriers (24.9%) of chronic diseases. The prevalence of antibodies to SARS-CoV-2 was similar amongst carriers and non-carriers (2.4% and 2.3%). The prevalence of cough, dyspnea, palpitations and myalgia was significantly higher among carriers, but the proportion of symptomatic patients was similar between groups. CONCLUSION The prevalence of chronic diseases in Brazil is high and the COVID-19 pandemic affects carriers and non-carriers of chronic diseases similarly. Carriers present more severe forms of COVID-19 and higher prevalence of symptoms. Greater adherence to social distancing measures among chronic patients is disassociated from a lower incidence of COVID-19 in this group.OBJETIVO Descrever a prevalência de doenças crônicas e fatores socioeconômicos e demográficos associados, avaliar os padrões de distanciamento social e a prevalência de anticorpos contra SARS-CoV-2 e sintomas de covid-19 em portadores e não portadores de doenças crônicas. MÉTODOS Foram avaliados dados de 77.075 mil indivíduos de 20 a 59 anos de três etapas do inquérito sorológico de abrangência nacional Epicovid-19 Brasil, realizadas entre maio e junho de 2021. A presença de anticorpos contra SARS-CoV-2 foi avaliada por teste rápido. Foram investigadas as prevalências autorreferidas de hipertensão, diabetes, asma, câncer, doença renal crônica e doença cardíaca. A prevalência de uso de máscara, de adesão a medidas de isolamento e de anticorpos foi avaliada separadamente entre portadores e não portadores de doenças crônicas. A prevalência de sintomas foi avaliada entre doentes crônicos e não doentes portadores de anticorpos. RESULTADOS A prevalência do pelo menos uma doença crônica foi de 43%, maior na região Sudeste, entre indivíduos brancos e indígenas, mulheres, menos escolarizados e em menor posição socioeconômica. O uso de máscara ao sair do domicílio não diferiu entre doentes crônicos e não doentes (98%). A proporção de participantes que referiram adesão ao isolamento foi maior entre doentes crônicos (15,9%) que entre não doentes (24,9%). A prevalência de anticorpos contra SARS-CoV-2 foi semelhante entre doentes crônicos e não doentes (2,4% e 2,3%). A prevalência de tosse, dispneia, palpitações e mialgia foi significativamente maior entre doentes crônicos, mas a proporção de sintomáticos não diferiu entre os grupos. CONCLUSÃO A prevalência de doenças crônicas no país é alta e a pandemia de covid-19 atinge de forma semelhante doentes e não doentes. Doentes crônicos apresentam formas mais graves de covid-19 e maior prevalência de sintomas. A maior adesão às medidas de distanciamento social entre doentes crônicos não se reflete em menor incidência de covid-19 nesse grupo

Integration of HIV/AIDS services into African primary health care: lessons learned for health system strengthening in Mozambique - a case study

<p>Abstract</p> <p>Introduction</p> <p>In 2004, Mozambique, supported by large increases in international disease-specific funding, initiated a national rapid scale-up of antiretroviral treatment (ART) and HIV care through a vertical "Day Hospital" approach. Though this model showed substantial increases in people receiving treatment, it diverted scarce resources away from the primary health care (PHC) system. In 2005, the Ministry of Health (MOH) began an effort to use HIV/AIDS treatment and care resources as a means to strengthen their PHC system. The MOH worked closely with a number of NGOs to integrate HIV programs more effectively into existing public-sector PHC services.</p> <p>Case Description</p> <p>In 2005, the Ministry of Health and Health Alliance International initiated an effort in two provinces to integrate ART into the existing primary health care system through health units distributed across 23 districts. Integration included: a) placing ART services in existing units; b) retraining existing workers; c) strengthening laboratories, testing, and referral linkages; e) expanding testing in TB wards; f) integrating HIV and antenatal services; and g) improving district-level management. Discussion: By 2008, treatment was available in nearly 67 health facilities in 23 districts. Nearly 30,000 adults were on ART. Over 80,000 enrolled in the HIV/AIDS program. Loss to follow-up from antenatal and TB testing to ART services has declined from 70% to less than 10% in many integrated sites. Average time from HIV testing to ART initiation is significantly faster and adherence to ART is better in smaller peripheral clinics than in vertical day hospitals. Integration has also improved other non-HIV aspects of primary health care.</p> <p>Conclusion</p> <p>The integration approach enables the public sector PHC system to test more patients for HIV, place more patients on ART more quickly and efficiently, reduce loss-to-follow-up, and achieve greater geographic HIV care coverage compared to the vertical model. Through the integration process, HIV resources have been used to rehabilitate PHC infrastructure (including laboratories and pharmacies), strengthen supervision, fill workforce gaps, and improve patient flow between services and facilities in ways that can benefit all programs. Using aid resources to integrate and better link HIV care with existing services can strengthen wider PHC systems.</p

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

A NEW SPECIES of MINIATURIZED TOADLET, GENUS BRACHYCEPHALUS (ANURA: BRACHYCEPHALIDAE), FROM SOUTHERN BRAZIL

We describe a new species of brachycephalid frog from Atlantic forest of Serra do Morato, Municipality of Guaraquecaba, state of Parana, Brazil. Brachycephalus tridactylus sp. nov. is characterized by the absence of external trace of finger IV, orange color in life, dorsolateral and ventrolateral regions with regular small olive-gray spots, and ventral region and thighs orange with olive-grayish irregular coalescent spots and small dots; skin on the dorsum of head and central body dorsum smooth with no dermal co-ossification. The advertisement call of the new species has a single short note that decreases in dominant frequency from beginning to end.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Ancient DNA reveals the origins, colonization histories, and evolutionary pathways of two recently extinct species of giant scops owl from Mauritius and Rodrigues Islands (Mascarene Islands, south-western Indian Ocean)

International audienc

Alternative reproductive modes of Atlantic forest frogs

Diversity in reproductive modes is well known in amphibians, mainly among anurans, which are characterized by a diversity in breeding biology that exceeds that of any other tetrapod. Currently, 39 reproductive modes are recognized among anurans and some species display more than one mode. The breeding biology of some Brazilian Atlantic forest anurans was investigated for this study. We observed unreported reproductive modes for six species, variability in the reproductive modes of individuals of the same species (whereby some individuals of a given population displayed unusual reproductive modes when the physical conditions of the breeding site were suboptimal), and variations within the modes. These observations suggest possible evolutionary steps for the reproductive modes. Anuran breeding biology seems to be more diverse than previously reported, and a character matrix could be constructed to describe the total range of variation of the anuran reproductive modes.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq