Avaliação probabilística da perigosidade de tsunami ao longo da costa do Brasil a partir de fontes tectónicas do Atlântico Norte

As ondas de tsunami são pouco frequentes, mas têm um alto impacto para as sociedades costeiras. Tsunamis são conjuntos de ondas produzidas por um deslocamento abrupto de uma grande quantidade de água. Os processos geradores são geralmente processos, tais como terramotos, erupções vulcânica ou deslizamentos de terra. O Brasil tem 7500 km de longa costa atlântica que está exposta à ameaça de tsunami de fontes tectónicas ativas localizadas dentro de várias zonas sísmicas. O perigo colocado pelo tsunami ao largo da costa do Brasil não é conhecido, portanto, uma avaliação abrangente dos riscos do tsunami através de uma metodologia probabilística é de grande importância para entender melhor se algum impacto é possível na costa brasileira e também para mitigar estes possíveis impactos de eventos futuros. O presente trabalho é o primeiro estudo probabilístico do tsunami de origem tectónica ao largo da costa do Brasil. As áreas de origem sismogénica do Atlântico Norte capazes de gerar tsunami que impactam a costa do Brasil são: a Margem Sudoeste Ibérica (SWIM) e as Caraíbas (CA). A metodologia probabilística da avaliação de perigosidade de tsunami (PTHA) é executada para combinar probabilidades de fontes sísmicas, modelação numérica de tsunami e estrutura estatística. Desenvolvemos mapas PTHA ao longo de toda a costa do Brasil. Estes produtos de perigo expressam a probabilidade de exceder os níveis específicos de intensidade do tsunami (por exemplo, altura de onda) num determinado período de tempo (tempo de exposição) em determinados locais (locais de destino). Os nossos resultados mostram que a probabilidade de uma altura máxima de onda superior a 0,25 m ao largo da costa do Brasil é de até 60% para tempos de exposição de 100 anos e 100% para tempos de exposição de 500 anos e 1000 anos. Estas probabilidades tornam-se para os mesmos tempos de exposição de 100 anos, 500 anos e 1000 anos, 15%, 50%, 50%, respectivamente, quando se considera o limiar de 0,5 m. Logo, os resultados provam que a probabilidade de uma onda de tsunami chegar à costa do Brasil aumenta à medida que o tempo de exposição da costa do Brasil aumenta e diminui à medida que a amplitude da onda aumenta no litoral. Contudo, as amplitudes das ondas de tsunami na costa brasileira não seriam capazes de causar perda de vidas ou danos económicos no país e isto deve-se ao facto de a direção do plano de falha das Caraíbas estar direcionada para o Hemisfério Norte e da perda de energia da onda no Oceano Atlântico devido à topografia de fundo oceânico em tsunamis oriundos da região do SWIM.Tsunamis are low-frequency but high-impact natural hazards for coastal societies. Tsunamis are sets of waves produced by an abrupt displacement of a large amount of water. The generating processes are generally geological activities, such as earthquakes, volcanic eruptions or landslides. Brazil has 7500 km of long Atlantic coastline that is exposed to the threat of a tsunami from active tectonic sources located within various seismic zones. The danger posed by the tsunami off the coast of Brazil is not understood, therefore, a comprehensive tsunami hazard assessment using a probabilistic methodology is most importance to better understand if any impact is possible on the Brazilian coast and also to mitigate these possible impacts of future events. The present work is the first probabilistic study of tsunami of tectonic origin off the coast of Brazil. The zones of seismogenic origin of the North Atlantic capable of generating tsunami that impact the coast of Brazil are: the Southwest Iberian Margin (SWIM) and the Caribbean (CA). The probabilistic tsunami hazard assessment (PTHA) methodology is performed by combining probability from seismic sources, numerical tsunami modeling and statistical structure. We develop PTHA maps along the entire coast of Brazil. These hazard products express the probability of exceeding specific levels of tsunami intensity (eg: wave height) within a certain period of time (time of exposure) at specified locations (destination locations). Our results show that the probability of a maximum wave height exceeding 0.25 m in the coast of Brazil is up to 60%, 100% and 100% for the exposure times, 100 years, 500 years, 1000 years, respectively. These probabilities become for the same exposure times of 100 years, 500 years and 1000 years, 15%, 50%, 50%, respectively, when considering the threshold of exceeding 0.5 m. Soon the results prove that the probability of a tsunami wave reaching the coast of Brazil increases as the exposure time increases. However, the amplitudes of tsunami waves off the Brazilian coast would not be able to cause loss of life or economic damage in the country and this is due to the fact of the direction of the Caribbean fault plane and the loss of wave energy in the Atlantic Ocean due to the ocean floor topography and the distance from the focus of the earthquake's hypocenter in the SWIM

Cervical cancer tracking in Minas Gerais: assessment of data from Cervical Cancer Information System (SISCOLO)

ObjectiveTo evaluate the indicators related to cervical cytology, quality, frequency of cellular changes and informed follow-up of high-grade lesions in Minas Gerais and its macro-regions of health. Methods a descriptive study based on data from the Cervical Cancer Information System (SISCOLO) from 2006 to 2011. Results The ratio of cervical cytopathologic exams in women aged 25 to 59 years remained stable, but did not reach the goal set by the state. Approximately 75% of the exams were performed in the target population and there was a progressive reduction in the proportion of cervical cytopathologists without previous cytology. On average, 51.2% of the exams were performed within a year. Regarding the quality of the exam, the positivity index was categorized as low throughout the analyzed period. We observed a low percentage of follow-up reported in the state.Conclusion The results evidenced the need to improve the tracking program regarding the quality of the exam, as well as the correct orientation regarding the age group and the periodicity, aiming to guarantee the target population's access and referral for diagnostic investigation and treatment of precursor lesions, when indicated.Objetivo: Avaliar os indicadores relacionados à oferta de exames citopatológicos do colo do útero, sua qualidade, frequência de alterações celulares e seguimento informado de lesões de alto grau, em Minas Gerais e suas macrorregiões de saúde. Métodos: Estudo descritivo com base em dados do Sistema de Informação do Câncer do Colo do Útero (SISCOLO), de 2006 a 2011. Resultados: A razão de exames citopatológicos do colo do útero em mulheres de 25 a 59 anos manteve-se estável, porém sem alcançar a meta estadual pactuada. Aproximadamente 75% dos exames foram realizados na população-alvo e houve progressiva redução na proporção de citopatológicos do colo do útero sem citologia anterior. Em média, 51,2% dos exames foram realizados no período de até um ano. Quanto à qualidade do exame, destaca-se o índice de positividade, categorizado como baixo durante todo o período analisado. Observou-se baixo percentual de seguimento informado no estado. Conclusão: Os resultados evidenciam a necessidade de aprimoramento do programa de rastreamento em relação à oferta e qualidade do exame, bem como ao direcionamento correto quanto à faixa etária e à periodicidade, visando garantir o acesso da população-alvo e o encaminhamento para a investigação diagnóstica e tratamento das lesões precursoras, quando indicado

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

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Obesity with no metabolic syndrome and adipose tissue expansion based solely on risk factors and inflammatory marker of coronary heart disease in premenopausal women

The objective of this study was to analyze whether obese women with no metabolic syndrome (MetS) have increased cardiometabolic risk compared to non-obese women and to observe the correlations between adiposity and coronary heart disease (CHD) risk factors in metabolically healthy women. 20-40 year old non-obese (n=41), obese with no MetS (n=30) and obese with MetS (n=28) women were studied. Lipid profile, blood pressure, CHD family history, physical inactivity, high-sensitivity C-reactive protein (hs-CRP), fibrinogen, interleukin-1β and tumor necrosis factor-alpha were analyzed. A subset of obese (13) and non-obese (33) women with no major components of MetS (except waist circumference) were further compared. Obese women with no MetS and non-obese women presented a similar metabolic profile that was statistically different from those seen in obese women with MetS. The number of obese women with no MetS and non-obese women presenting two or more risk factors (23.3 and 19.5%, respectively) or presenting high Framingham Risk Score (6.7 and 2.4%, respectively) were also similar. The only pro inflammatory protein correlated to waist circumference was hs-CRP. These data suggest that obesity with no MetS induce a CHD risk comparable to the risk seen in non-obese women. However, when women with no major components of MetS alone were considered, adiposity was positively correlated to blood pressure and hs-CRP. Although CHD risk of obese women with no MetS is closer to non-obese women, adipose tissue expansion was positively correlated to blood pressure and hs-CRP that are important risk factors for CHD