Calagem como forma de redução da toxidez por cobre em aveia preta

Soils which are cultivated with grapevines have high available copper (Cu) content, which can be toxic to cover crops cohabiting vineyards, such as black oats. This study aimed to assess the effect of liming in reducing Cu toxicity in black oats grown in sandy soils. Samples of a Typic Hapludalf were collected at 0-20cm, dried and subjected to the addition of Cu (0 to 50Mg kg-1) and limestone (0, 1.5, and 3.0Mg ha-1). The soil was placed in a rhizobox and black oats were grown for 30 days. We assessed root and shoot dry matter production, copper (Cu), calcium (Ca) and magnesium (Mg) contents in the tissues; Cu content in the root symplast and apoplast, as well as Cu, carbon and pH values in the rhizosphere and bulk soil. Liming reduced Cu toxicity in black oats. Cu was preferentially accumulated in the roots, mostly in the apoplast, which may be the result of a plant tolerance mechanism to prevent the transport of Cu to the shoots. Key words: heavy metal, phytotoxicity, limestone, rhizosphere.Solos cultivados com videiras possuem alto teor de cobre (Cu) disponível, que pode ser tóxico às plantas de cobertura do solo que coabitam vinhedos, como a aveia preta. O estudo objetivou avaliar o efeito da calagem na redução da toxidez por Cu em plantas de aveia preta cultivadas em solo arenoso. Amostras de um Argissolo Vermelho foram coletadas na camada de 0-20cm, secas e submetidas à adição de duas doses de Cu (0 e 50Mg kg-1) e três de calcário (0, 1,5 e 3,0Mg ha-1). O solo foi acondicionado em rhizobox e submetido ao cultivo de aveia preta durante 30 dias. Avaliaram-se a produção de matéria seca das raízes e da parte aérea, o teor de cobre (Cu), cálcio (Ca) e magnésio (Mg) nos tecidos; o teor de Cu no simplasto e apoplasto das raízes, e os teores de Cu, de carbono e valores de pH no solo rizosférico e não rizosférico. A aplicação de calcário reduziu a toxidez por Cu na aveia preta. O Cu foi preferencialmente acumulado nas raízes, especialmente no apoplasto, o que pode ser resultado de mecanismo de tolerância das plantas para evitar o transporte de parte do elemento para a parte aérea

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Mitochondria as central hub of the immune system

Nearly 130 years after the first insights into the existence of mitochondria, new rolesassociated with these organelles continue to emerge. As essential hubs that dictate cell fate, mitochondria integrate cell physiology, signaling pathways and metabolism. Thus, recent research has focused on understanding how these multifaceted functions can be used to improve inflammatory responses and prevent cellular dysfunction. Here, we describe the role of mitochondria on the development and function of immune cells, highlighting metabolic aspects and pointing out some metabolic- independent features of mitochondria that sustain cell function26CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPnão temnão tem2014/10910-7; 2015/15626-8; 2015/26682-6; 2016/18031-8; 2017/05264-

Imobilização de nitrogênio da uréia e do sulfato de amônio aplicado em pré-semeadura ou cobertura na cultura de milho, no sistema plantio direto Nitrogen immobilization of urea and ammonium sulphate applied to maize before planting and as top-dressing in a no-till system

Sulfato de amônio (SA) e uréia (U) marcados com 15N foram aplicados na cultura do milho, em sucessão à aveia preta (Avena strigosa Schieb.), no sistema plantio direto, 43 dias antes e 31 dias depois da semeadura, na dose de 80 kg ha-1 de N, incorporados a 5-7 cm de profundidade, em sulcos espaçados de 0,8 m, nas entrelinhas do milho. O objetivo foi quantificar o N dos fertilizantes imobilizado no solo (15N-orgânico), no sulco de adubação, e o N-recuperado na planta nos estádios de 5-6 folhas, 11-12 folhas, florescimento e maturação fisiológica. O delineamento experimental foi inteiramente casualizado com parcelas subdivididas e três repetições. As parcelas foram constituídas das fontes U e SA, e as subparcelas, das épocas de aplicação de N. O experimento foi realizado em Latossolo Vermelho ácrico típico fase cerrado subcadocifólio, na Fazenda Floresta do Lobo-Pinusplan, em Uberlândia (MG). Na aplicação em pré-semeadura, a máxima imobilização foi observada aos 19 dias da aplicação do SA (13,3 kg ha-1 ou 16,6 % do N-aplicado) e aos 40 dias da aplicação da U (13,7 kg ha-1 ou 17,1 % do N-aplicado). A maior quantidade de N fertilizante assimilado pela planta ocorreu entre os estádios de 5-6 e 11-12 folhas (44,1 e 23,4 % do N-SA e N-U, respectivamente). Na aplicação em cobertura, a imobilização do N-SA foi inferior a 3,5 % do N-aplicado, enquanto a imobilização do N-U foi de 9,9 kg ha-1 e 7,9 kg ha-1, respectivamente, nos estádios de 11-12 folhas e florescimento. Até o estádio de maturação fisiológica da cultura, 61,8 % do N-SA e 42,0 % do N-U foram recuperados pelo milho. Em média, nos estádios de 11-12 folhas e de florescimento, para cada kg de N-SA imobilizado, as plantas de milho recuperaram 8,0 e 16,7 kg ha-1 de N fertilizante em pré-semeadura e cobertura, respectivamente. Nos tratamentos com U, a média foi de 3,1 kg ha-1, independentemente da época de aplicação. As produtividades de grãos obtidas com SA e U, independentemente da época de aplicação, foram de 7.824 kg ha-1 e 6.977 kg ha-1, respectivamente. Na adubação em pré-semeadura do milho, o SA apresentou maior rapidez na ciclagem do N imobilizado-mineralizado ("turnover"), em relação a U, e, conseqüentemente, causou maior assimilação do N pela cultura. Em cobertura, no sulco de adubação, somente houve imobilização do N-U, retardando a sua assimilação pela planta.<br>In order to evaluate the amount of immobilized N and the amount of N-fertilizer recovered by corn plants at the stages:5-6 leaves, 11-12 leaves, flowering, and physiologic maturation, ammonium sulfate (AS) and urea (U), labeled with 15N, were applied to maize in a no-till system 43 days before planting and 31 days after planting at a single rate of 80 kg ha-1 of N incorporated at 5-7 cm depth and in a spacing of 0.8 m. Corn was sown after black oat (Avena strigosa Schieb.). The treatments were applied in split-plots set up in the completely randomized design with three replications. The original plots with two N sources were halved for the application time factor (pre-planting and top-dressing application). The field experiment was carried out on a Typic Acrustox on the farm Floresta do Lobo, Uberlandia, state of Minas Gerais. Results show that in pre-planting application treatments the maximum N-AS immobilization occurred 19 days after the fertilizer application (13.3 kg ha-1 or 16.6 % of N applied) whereas the maximum immobilization of N-U occurred 40 days after fertilizer application (13.7 kg ha-1 or 17.1 % of N applied). The highest amount of 15N-fertilizer taken up by corn plants was observed between the stages 5-6 leaves and 11-12 leaves, at ratios of 44.1 % of N-AS and 23.4 % of N-U. The immobilized N in the treatment with top-dressed AS was lower than 3.5 % of the applied N whereas in the treatment with top-dressed U it was 9.9 kg ha-1 and 7.9 kg ha-1 at the stages 11-12 leaves and flowering, respectively. The recovery of N-fertilizer measured at the stage of physiologic maturation in the treatments with AS and U was 61.8 % and 42.0 % respectively. The 15N-fertilizer amounts recovered by corn plants per kg of 15N immobilized in the treatments with AS were 8.0 kg ha-1 and 16.7 kg ha-1 respectively for pre-planting and top-dressing application. Independent of the application time, the ratio N-fertilizer recovery/immobilized N-fertilizer in the U treatments was 3.1 kg ha-1. The highest corn yields were obtained in the AS treatments (grain mean of 7,824 kg ha-1), independent of the application time. The average crop yield in the treatments with U in both application periods was 6,977 kg ha-1. These results show that when the fertilizers were applied at pre-planting the immobilization-mineralization turnover was faster in the AS than in the U treatment. Consequently, the N-assimilation by corn plants was higher in the AS treatments. For top-dressing application, only U was significantly immobilized

Management practices for postdural puncture headache in obstetrics: a prospective, international, cohort study

© 2020 British Journal of AnaesthesiaBackground: Accidental dural puncture is an uncommon complication of epidural analgesia and can cause postdural puncture headache (PDPH). We aimed to describe management practices and outcomes after PDPH treated by epidural blood patch (EBP) or no EBP. Methods: Following ethics committee approval, patients who developed PDPH after accidental dural puncture were recruited from participating countries and divided into two groups, those receiving EBP or no EBP. Data registered included patient and procedure characteristics, headache symptoms and intensity, management practices, and complications. Follow-up was at 3 months. Results: A total of 1001 patients from 24 countries were included, of which 647 (64.6%) received an EBP and 354 (35.4%) did not receive an EBP (no-EBP). Higher initial headache intensity was associated with greater use of EBP, odds ratio 1.29 (95% confidence interval 1.19–1.41) per pain intensity unit increase. Headache intensity declined sharply at 4 h after EBP and 127 (19.3%) patients received a second EBP. On average, no or mild headache (numeric rating score≤3) was observed 7 days after diagnosis. Intracranial bleeding was diagnosed in three patients (0.46%), and backache, headache, and analgesic use were more common at 3 months in the EBP group. Conclusions: Management practices vary between countries, but EBP was more often used in patients with greater initial headache intensity. EBP reduced headache intensity quickly, but about 20% of patients needed a second EBP. After 7 days, most patients had no or mild headache. Backache, headache, and analgesic use were more common at 3 months in patients receiving an EBP

Management practices for postdural puncture headache in obstetrics : a prospective, international, cohort study

Background: Accidental dural puncture is an uncommon complication of epidural analgesia and can cause postdural puncture headache (PDPH). We aimed to describe management practices and outcomes after PDPH treated by epidural blood patch (EBP) or no EBP. Methods: Following ethics committee approval, patients who developed PDPH after accidental dural puncture were recruited from participating countries and divided into two groups, those receiving EBP or no EBP. Data registered included patient and procedure characteristics, headache symptoms and intensity, management practices, and complications. Follow-up was at 3 months. Results: A total of 1001 patients from 24 countries were included, of which 647 (64.6%) received an EBP and 354 (35.4%) did not receive an EBP (no-EBP). Higher initial headache intensity was associated with greater use of EBP, odds ratio 1.29 (95% confidence interval 1.19-1.41) per pain intensity unit increase. Headache intensity declined sharply at 4 h after EBP and 127 (19.3%) patients received a second EBP. On average, no or mild headache (numeric rating score <= 3) was observed 7 days after diagnosis. Intracranial bleeding was diagnosed in three patients (0.46%), and backache, headache, and analgesic use were more common at 3 months in the EBP group. Conclusions: Management practices vary between countries, but EBP was more often used in patients with greater initial headache intensity. EBP reduced headache intensity quickly, but about 20% of patients needed a second EBP. After 7 days, most patients had no or mild headache. Backache, headache, and analgesic use were more common at 3 months in patients receiving an EBP

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially