INFLUÊNCIA DO DISTANCIAMENTO SOCIAL CAUSADO PELA PANDEMIA DA COVID-19 NOS ATENDIMENTOS DE EMERGÊNCIA E INTERNAÇÕES EM PEDIATRIA

The aim of this article is to compare number of attendances to pediatric emergencies and hospital admissions, considering a period time in which measures of social distancing and restriction or urban mobility were in course, with the same period in previous years to the pandemic. We performed a case-series study in two pediatric emergencies and hospital admission between 16th March and 16th April 2020 (first month of social distancing in Rio de Janeiro State, Brazil). Data were compared with the same period, in the two previous years, using Analysis of variance (ANOVA). A p value <0.05 was considered as statistically significant.  The number of attendances in the Unit A and B, respectively, were 6.579 and 1.538 in 2018; 5.750 and 1.430 in 2019 and 1.762 and 375 in 2020. The number of hospital admissions in the Unit A and B, respectively, were 823 and 199 in 2018; of 721 and 188 in 2019; and 325 and 135 in 2020. In both units, there was a statistically significant reduction of attendances and hospitals admissions when 2020 year was compared with the two previous years (p>0.0001). Relative percentage of acute respiratory diseases and influenza-like illness was 36.7%, 36.5% and 29.2%, respectively in 2018, 2019 and 2020 in the Unit A; and 25.9%, 24.2% and 24.5%, respectively for the same years, in the Unit B. We concluded that there was a statistically significant reduction of attendances and hospitals admissions in the pediatric emergencies evaluated, being the results attributed to social distancing and restriction of urban mobility during the period studied.O objetivo deste artigo foi comparar o número de atendimentos em emergências pediátricas e internações hospitalares, considerando um período de tempo no qual vigoravam medidas de distanciamento social e restrição de mobilidade urbana, com o mesmo período em anos anteriores à pandemia da COVID-19. Realizamos um estudo de uma série de casos de atendimentos em duas emergências pediátricas e internações hospitalares entre 16 de março e 16 de abril de 2020 (primeiro mês de distanciamento social no Estado do Rio de Janeiro). Os dados foram comparados com o mesmo período dos dois anos anteriores, através de análise de variância (ANOVA). Um valor de p <0.05 foi considerado estatisticamente significativo. O número de atendimentos nas unidades A e B, respectivamente, foi de 6.579 e 1.538 em 2018; de 5.750 e 1.430 em 2019 e 1.762 e 375 em 2020. O número de internações nas unidades A e B, respectivamente, foi de 823 e 199 em 2018; de 721 e 188 em 2019; e 325 e 135 em 2020. Houve redução estatisticamente significativa de atendimentos e internações quando o ano de 2020 foi comparado com os anos anteriores nas duas unidades (p<0.0001). O percentual relativo de atendimentos de doenças respiratórias agudas e síndromes gripais foi de 36,7%, 36,5% e 29,2%, respectivamente em 2018, 2019 e 2020 na Unidade A; e 25,9%, 24,2% e 24,5%, respectivamente aos mesmos anos na Unidade B. Concluímos que houve redução estatisticamente significativa no número de atendimentos e internações nas emergências pediátricas avaliadas, sendo o resultado atribuído ao distanciamento social e restrição de mobilidade urbana no período avaliado

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

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

Zika virus infection in pregnant women in Rio de Janeiro: preliminary report

Artigo liberado em acesso aberto como parte do acordo para tornar público todos os dados produzidos sobre o vírus zika - Compartilhamento de dados em emergências de saúde pública - http://www.wellcome.ac.uk/News/Media-office/Press-releases/2016/WTP060169.htmVersão final do artigo - handle https://www.arca.fiocruz.br/handle/icict/17780Submitted by Claudete Queiroz ([email protected]) on 2016-03-08T19:16:29Z No. of bitstreams: 1 Zika Virus Infection in Pregnant Women - preliminary report.pdf: 646105 bytes, checksum: 76b9427d455f2a5cbb1aa17b53e4cfc6 (MD5)Approved for entry into archive by Claudete Queiroz ([email protected]) on 2016-03-09T11:54:02Z (GMT) No. of bitstreams: 1 Zika Virus Infection in Pregnant Women - preliminary report.pdf: 646105 bytes, checksum: 76b9427d455f2a5cbb1aa17b53e4cfc6 (MD5)Made available in DSpace on 2016-03-09T11:54:02Z (GMT). No. of bitstreams: 1 Zika Virus Infection in Pregnant Women - preliminary report.pdf: 646105 bytes, checksum: 76b9427d455f2a5cbb1aa17b53e4cfc6 (MD5) Previous issue date: 2016Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Biomedical Research Institute of Southern California. Oceanside, California, EUA.Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.David Geffen UCLA School of Medicine, Los Angeles, EUA.David Geffen UCLA School of Medicine, Los Angeles, EUA.David Geffen UCLA School of Medicine, Los Angeles, EUA.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.David Geffen UCLA School of Medicine, Los Angeles, EUA.BACKGROUND Zika virus (ZIKV) has been linked to neonatal microcephaly. To characterize the spectrum of ZIKV disease in pregnancy, we followed patients in Rio de Janeiro to describe clinical manifestations in mothers and repercussions of acute ZIKV infection in fetuses. METHODS We enrolled pregnant women in whom a rash had developed within the previous 5 days and tested blood and urine specimens for ZIKV by reverse-transcriptase–polymerasechain-reaction assays. We followed the women prospectively and collected clinical and ultrasonographic data. RESULTS A total of 88 women were enrolled from September 2015 through February 2016; of these 88 women, 72 (82%) tested positive for ZIKV in blood, urine, or both. The timing of acute ZIKV infection ranged from 5 to 38 weeks of gestation. Predominant clinical features included pruritic descending macular or maculopapular rash, arthralgias, conjunctival injection, and headache; 28% had fever (short-term and low-grade).Women who were positive for ZIKV were more likely than those who were negative for the virus to have maculopapular rash (44% vs. 12%, P=0.02), conjunctival involvement (58% vs. 13%, P=0.002), and lymphadenopathy (40% vs. 7%, P=0.02). Fetal ultrasonography was performed in 42 ZIKV-positive women (58%) and in all ZIKV-negative women. Fetal abnormalities were detected by Doppler ultrasonography in 12 of the 42 ZIKV-positive women (29%) and in none of the 16 ZIKV-negative women. Adverse findings included fetal deaths at 36 and 38 weeks of gestation (2 fetuses), in utero growth restriction with or without microcephaly (5 fetuses), ventricular calcifications or other central nervous system (CNS) lesions (7 fetuses), and abnormal amniotic fluid volume or cerebral or umbilical artery flow (7 fetuses). To date, 8 of the 42 women in whom fetal ultrasonography was performed have delivered their babies, and the ultrasonographic findings have been confirmed. CONCLUSIONS Despite mild clinical symptoms, ZIKV infection during pregnancy appears to be associated with grave outcomes, including fetal death, placental insufficiency, fetal growth restriction, and CNS injury

SARS-CoV-2 Infection Dynamics in Children and Household Contacts in a Slum in Rio de Janeiro.

OBJECTIVES: To investigate the dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a vulnerable population of children and their household contacts. METHODS: SARS-CoV-2 reverse transcription polymerase chain reaction assays and coronavirus disease 2019 (COVID-19) immunoglobulin G serology tests were performed in children and their household contacts after enrollment during primary health care clinic visits. Participants were followed prospectively with subsequent specimens collected through household visits in Manguinhos, an impoverished urban slum (a favela) in Rio de Janeiro at 1, 2, and 4 weeks and quarterly post study enrollment. RESULTS: Six hundred sixty-seven participants from 259 households were enrolled from May to September 2020. This included 323 children (0-13 years), 54 adolescents (14-19 years), and 290 adults. Forty-five (13.9%) children had positive test results for SARS-CoV-2 polymerase chain reaction. SARS-CoV-2 infection was most frequent in children aged <1 year (25%) and children aged 11 to 13 years (21%). No child had severe COVID-19 symptoms. Asymptomatic infection was more prevalent in children aged <14 years than in those aged ≥14 years (74.3% and 51.1%, respectively). All children (n = 45) diagnosed with SARS-CoV-2 infection had an adult contact with evidence of recent infection. CONCLUSIONS: In our setting, children do not seem to be the source of SARS-CoV-2 infection and most frequently acquire the virus from adults. Our findings suggest that, in settings such as ours, schools and child care potentially may be reopened safely if adequate COVID-19 mitigation measures are in place and staff are appropriately immunized

Delayed childhood neurodevelopment and neurosensory alterations in the second year of life in a prospective cohort of ZIKV-exposed children

We report neurodevelopmental outcomes in 216 infants followed since the time of PCR-confirmed maternal Zika virus (ZIKV) infection in pregnancy during the Rio de Janeiro epidemic of 2015-2016 (refs. 1,2). Neurodevelopment was assessed by Bayley Scales of Infant and Toddler Development, third edition (Bayley-III; cognitive, language and motor domains) in 146 children and through neurodevelopment questionnaires/neurological examinations in 70 remaining children. Complete eye exams (n = 137) and hearing assessments (n = 114) were also performed. Below-average neurodevelopment and/or abnormal eye or hearing assessments were noted in 31.5% of children between 7 and 32 months of age. Among children assessed by Bayley-III, 12% scored below -2 s.d. (score &lt;70; a score of 100 ± 2 s.d. is the range) in at least one domain; and 28% scored between -1 and -2 s.d. in any domain (scores &lt;85-70). Language function was most affected, with 35% of 146 children below average. Improved neurodevelopmental outcomes were noted in female children, term babies, children with normal eye exams and maternal infection later in pregnancy (P = 0.01). We noted resolution of microcephaly with normal neurodevelopment in two of eight children, development of secondary microcephaly in two other children and autism spectrum disorder in three previously healthy children in the second year of life