Brazilian Maternal and Child Nutrition Consortium: establishment, data harmonization and basic characteristics.

Pooled data analysis in the field of maternal and child nutrition rarely incorporates data from low- and middle-income countries and existing studies lack a description of the methods used to harmonize the data and to assess heterogeneity. We describe the creation of the Brazilian Maternal and Child Nutrition Consortium dataset, from multiple pooled longitudinal studies, having gestational weight gain (GWG) as an example. Investigators of the eligible studies published from 1990 to 2018 were invited to participate. We conducted consistency analysis, identified outliers, and assessed heterogeneity for GWG. Outliers identification considered the longitudinal nature of the data. Heterogeneity was performed adjusting multilevel models. We identified 68 studies and invited 59 for this initiative. Data from 29 studies were received, 21 were retained for analysis, resulting in a final sample of 17,344 women with 72,616 weight measurements. Fewer than 1% of all weight measurements were flagged as outliers. Women with pre-pregnancy obesity had lower values for GWG throughout pregnancy. GWG, birth length and weight were similar across the studies and remarkably similar to a Brazilian nationwide study. Pooled data analyses can increase the potential of addressing important questions regarding maternal and child health, especially in countries where research investment is limited

Conhecimento dos estudantes do curso de enfermagem sobre os fatores de risco para o desenvolvimento do câncer / Knowledge of the nursing course students about the risk factors for cancer development

O câncer é o conjunto de mais de 100 doenças em que uma das características em comum é o crescimento desordenado de células, que se dividem com constância rápida. As células agrupam-se formado tumores, que invadem os tecidos e podem se alastrar por órgãos vizinhos e até órgãos distantes da origem do tumor, processo conhecido como metástase. O câncer é causado por mutações genéticas – alterações na estrutura genética da célula (DNA). As células sadias possuem instruções de como devem se replicar. Quando há qualquer erro nas instruções, ocorre a mutação, que pode desenvolver uma célula doente que, ao se proliferar, causará algum tipo de câncer. Qualquer parte do corpo está suscetível ao surgimento do câncer; entretanto, algumas partes e órgãos sofrem maior mutação que outros, e cada órgão poderá ser afetado por diferentes tipos de tumor que podem ser mais ou menos agressivos. Na oncologia existem prevenções, classificadas em níveis primário e secundário. A prevenção primária ocorre no período anterior à doença, onde medidas são incluídas para proteger e reduzir a exposição dos indivíduos aos fatores de risco da doença através da promoção da saúde. O presente estudo tem por objetivo mensurar o conhecimento dos alunos do curso de Enfermagem sobre os fatores de risco para o desenvolvimento do câncer. Trata-se de uma pesquisa de natureza básica, com abordagem quantitativa e objetivo descritivo, em que serão analisados os dados coletados durante o período de pesquisa feita com a população alvo do estudo. Foram entrevistados universitários do curso de bacharelado em enfermagem do 1º ao 10º período, contabilizando um total de 370 alunos. A amostra da pesquisa foi de 148 estudantes (n= 148), com margem de erro de 5% e nível de confiança de 95%. As perguntas discorrem sobre os fatores de risco para o desenvolvimento do câncer. O presente trabalho concluiu que, com base nos resultados do questionário aplicado, o conhecimento desses alunos é significativo. A média dos entrevistados que responderam as questões com “sim” foi de 89%, para 11% que responderam com “não”; concluindo que os futuros enfermeiros detêm de conhecimento sobre os fatores de risco para o desenvolvimento do câncer

Hemofilia adquirida A e B principais apresentações clínicas da doença de Pott em crianças: Hemofilia adquirida A e B main clinical presentations of Pott disease in children

A hemofilia é uma doença sanguínea caracterizada por distúrbios nos mecanismos de coagulação do sangue, podendo ser de origem hereditária ou adquirida. A hemofilia adquirida ocorre devido à produção de autoanticorpos contra a atividade pró-coagulante dos fatores VIII (Hemofilia A) e IX (Hemofilia B). O objetivo desse trabalho é a realização de um estudo observacional e exploratório sobre os artigos publicados nos últimos 5 anos sobre a hemofilia adquirida A e B, uma vez que é uma enfermidade considerada rara. Dos 68 resultados obtidos na pesquisa, apenas 7 abordaram de forma objetiva sobre o tema, sendo utilizados na confecção do estudo. Segundo a literatura, as manifestações clínicas envolvem sangramento mucocutâneo, urogenital e gastrointestinal, e são mais prevalentes em idosos. Em crianças, o sangramento pode ser menos expressivo, provocando dúvidas quanto ao diagnóstico. O tratamento da hemofilia envolve a reposição dos fatores de coagulação deficientes e o uso de imunossupressores, ainda que nas obras analisadas apenas o tratamento hemostático tenha sido descrito, revelando uma carência de estudos sobre o uso de imunossupressores nos casos de hemofilia adquirida

Efeitos da estimulação tatil-cinestésica e vestibular no recém-nascido de baixo peso e avaliação da melhor técnica: uma revisão sistemática e metanálise / Effects of tactile-kinesthetic and vestibular stimulation in low weight newborns and evaluation of best technique: a systematic review and meta-analysis

Durante anos a prematuridade tem se tornado um grande desafio dentro das Unidades de Terapia Intensiva Neonatal (UTIN), pois afeta o desenvolvimento e crescimento dos recém-nascidos (RN) decorrendo de deficiências que começariam a assumir funções normais para sua idade. A estimulação precoce tem como objetivo, devolver ao RN, seu desenvolvimento perfeito ou chegar o mais próximo da normalidade, utilizando condutas especificas, pois logo após o nascimento o cérebro apresenta uma intensa neuroplasticidade. A estimulação tátil-cinestésica proporciona ao RNPTBP, ganho de peso diário e redução do tempo de internação, pois para o recém-nascido a estimulação tátil nos seus primeiros dias de vida é maior do que qualquer outro estímulo sensorial. O objetivo do presente trabalho, foi analisar os efeitos da técnica de estimulação tátil-cinestésica com os efeitos da estimulação vestibular no recém-nascido pré-termo de baixo peso, para fazer uma comparação sobre qual será a melhor para ser aplicada no RNPTBP dentro da UTIN. Este estudo foi realizado de acordo com as recomendações dos relatórios de análises sistemáticas e metanálises (Preferred Reporting Items for Systematic Reviews and Meta- analyses PRISMA). Foram realizadas buscas nas seguintes bases de dados: LiLASC, SCOPUS, PUBMED, PEDro, MEDLINE, Web of Science; Cochrane Libary e Google Scholar. Os períodos abrangidos da pesquisa foram a partir do ano de 2.015 até o ano de 2020. Com base nas análises realizadas neste presente estudo é incontestável que a assistência à neonatos devem ser realizada de forma criteriosa e atenta as necessidades individuais de cada um, pois se essa assistência for prestada de forma inadequada, omissa, e deficiente ao recém-nascido, principalmente em condição prematura e de baixo peso, devido ao seu alto grau de vulnerabilidade, poderá acarretar sérias consequências em seu desenvolvimento que influenciará, por toda a sua vida

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

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

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

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Agreement between self-reported pre-pregnancy weight and measured first-trimester weight in Brazilian women

Background: Self-reported pre-pregnancy weight and weight measured in the first trimester are both used to estimate pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) but there is limited information on how they compare, especially in low- and middle-income countries, where access to a weight scale can be limited. Thus, the main goal of this study was to evaluate the agreement between self-reported pre-pregnancy weight and weight measured during the first trimester of pregnancy among Brazilian women so as to assess whether self-reported pre-pregnancy weight is reliable and can be used for calculation of BMI and GWG. Methods: Data from the Brazilian Maternal and Child Nutrition Consortium (BMCNC, n = 5563) and the National Food and Nutritional Surveillance System (SISVAN, n = 393,095) were used to evaluate the agreement between self-reported pre-pregnancy weight and weights measured in three overlapping intervals (30–94, 30–60 and 30–45 days of pregnancy) and their impact in BMI classification. We calculated intraclass correlation and Lin’s concordance coefficients, constructed Bland and Altman plots, and determined Kappa coefficient for the categories of BMI. Results: The mean of the differences between self-reported and measured weights was  0.90 for both datasets in all time intervals. Bland and Altman plots showed that the majority of the difference laid in the ±2 kg interval and that the differences did not vary according to measured first-trimester BMI. Kappa coefficient values were > 0.80 for both datasets at all intervals. Using self-reported pre-pregnancy or measured weight would change, in total, the classification of BMI in 15.9, 13.5, and 12.2% of women in the BMCNC and 12.1, 10.7, and 10.2% in the SISVAN, at 30–94, 30–60 and 30–45 days, respectively. Conclusion: In Brazil, self-reported pre-pregnancy weight can be used for calculation of BMI and GWG when an early measurement of weight during pregnancy is not available. These results are especially important in a country where the majority of woman do not initiate prenatal care early in pregnancy.Medicine, Faculty ofNon UBCObstetrics and Gynaecology, Department ofReviewedFacult