O uso e ocupação do solo nas margens do rio Comprido, Rio de Janeiro - RJ

Desde o início da colonização as bacias hidrográficas da cidade do Rio de Janeiro vêm incorporando dinâmicas de transformações antrópicas oriundas do processo de urbanização, com intervenções mais intensas no século XX, tendo efeitos em seus canais fluviais. O presente trabalho visa avaliar os tipos de uso e ocupação do solo que são predominantes nas margens do rio Comprido e sua respectiva relação com a sua drenagem. Os dados utilizados foram adquiridos através do Instituto Pereira Passos que, em ambiente SIG, foram manipulados, gerando o perfil longitudinal do rio Comprido e a cena ambiental de 2018 das suas margens. Posteriormente, os dados foram quantificados e os valores organizados em uma tabela para fins comparativos. Como resultados temos o predomínio da ocupação pelas Áreas residenciais nos locais de menor altitude, e da Cobertura arbórea e arbustiva nas áreas de maior altitude, que se encontra ameaçada pela expansão das favelas em direção ao Parque Nacional da Tijuca. Assim, este trabalho pode fornecer subsídio ao poder público no planejamento desta área ambientalmente suscetível

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. Methods: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. Findings: Global DALYs increased from 2·63 billion (95% UI 2·44–2·85) in 2010 to 2·88 billion (2·64–3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7–17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8–6·3) in 2020 and 7·2% (4·7–10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0–234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7–198·3]), neonatal disorders (186·3 million [162·3–214·9]), and stroke (160·4 million [148·0–171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3–51·7) and for diarrhoeal diseases decreased by 47·0% (39·9–52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54–1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5–9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0–19·8]), depressive disorders (16·4% [11·9–21·3]), and diabetes (14·0% [10·0–17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7–27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6–63·6) in 2010 to 62·2 years (59·4–64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6–2·9) between 2019 and 2021. Interpretation: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. Funding: Bill & Melinda Gates Foundation

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

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

Mudanças nos canais fluviais induzidas pelo processo de urbanização: o caso da sub-bacia do Canal do Cunha (RJ)

O processo de urbanização ocorrido na cidade do Rio de Janeiro transformou os canais fluviais. Anterior à urbanização, os rios da cidade eram mêandricos e sinuosos e, percorriam a área de baixada nos antigos terrenos úmidos. Os rios foram canalizados, aterrados e/ou cobertos pela malha urbana. O objetivo geral desta dissertação consiste em avaliar as mudanças têmporo-espaciais ocorridas nos rios da Sub-bacia do Canal do Cunha. A pesquisa foi realizada através do levantamento bibliográfico, dados oficiais e da cartografia histórica e atual. A ocupação da área de estudo foi impulsionada por marcos históricos, como a ampliação da linha férrea no século XIX e sua proximidade em relação à área central da cidade e a industrialização na primeira metade do século XX. Por meio da elaboração de mapas da rede de drenagem nos anos de 1908, 1931, 1961 e 2012 foi possível identificar as alterações na drenagem. A pesquisa demonstrou que a rede de drenagem - submetida à urbanização - apresentou mudanças no padrão de drenagem ao longo do século XX. Além do padrão de drenagem modificado, a densidade hidrográfica e densidade de drenagem apresentaram alterações: entre 1908 e 2012 houve encurtamento dos canais devido as intervenções realizadas (redução de 6,43 km de rios), porém aumentou o número de canais, pois para drenar a área aterrada construíram canais artificiais. Atualmente a sub-bacia compreende 0,55 canais/km² e 0,58 km/km². As canalizações realizadas nos rios da sub-bacia concentraram entre as décadas de 1940 a 1980, ou seja, ao longo destes 40 anos sucederam-se estas obras realizadas através do DNOS e SURSAN. As obras estruturais realizadas nos canais fluviais foram motivadas pela expansão do espaço urbano e no combate incansável as inundações. O conhecimento prévio de como eram estes rios e suas características morfológicas, assim como seu padrão de drenagem, poderão auxiliar projetos de planejamento urbanístico e ambiental, para assim, melhor gerir a sub-bacia.The urbanization process occurred in the city of Rio de Janeiro has turned the river channels. Prior to urbanization, the city's rivers were mêandricos and meandering and roamed the area of marshland in the old wet land. The rivers were channeled, grounded and / or covered by the urban fabric. The overall objective of this work is to evaluate the temporo-spatial changes in the rivers of Sub-basin of the Cunha Canal. The survey was conducted through literature, official data and the historical and current cartography. The occupation of the study area was driven by landmarks such as the expansion of the railway in the nineteenth century and its proximity to the downtown area and industrialization in the first half of the twentieth century. Through the development of the network maps of drainage in the years 1908, 1931, 1961 and 2012 it was possible to identify changes in the drainage. Research has shown that the drainage network - submitted to urbanization - introduced changes in the drainage pattern throughout the twentieth century. In addition to the modified drainage pattern, the drainage density and drainage density showed changes: between 1908 and 2012 there was shortening of the channels due to interventions (reduction of 6.43 km of rivers), but increased the number of channels as to drain the grounded area built artificial channels. Currently the sub-basin comprises 0.55 channels / km and 0.58 km / km². The pipes made in the sub-basin rivers concentrated between the decades from 1940 to 1980, ie, over these 40 years followed up these works performed by DNOS and SURSAN. Structural works carried out in the river channels were motivated by the expansion of urban space and the relentless combat flooding. Prior knowledge of how were these rivers and their morphological characteristics, as well as its drainage pattern may help urban and environmental planning projects, so as to better manage the sub-basin.141 p

MUDANÇAS NOS CANAIS FLUVIAIS DA SUB-BACIA DO CANAL DO CUNHA (RJ): intervenções antrópicas

O processo de urbanização ocorrido no município do Rio de Janeiro alterou os canais fluviais. Anterior à urbanização, os rios da cidade eram mêandricos e sinuosos e, percorriam os antigos terrenos úmidos na área de baixada. Os rios foram canalizados, aterrados e/ou cobertos pela malha urbana. Neste contexto, o objetivo deste trabalho consiste em analisar as mudanças têmporo-espaciais ocorridas nos rios da Sub-bacia do Canal do Cunha decorrentes das intervenções antrópicas, entre 1908 e 2012, a partir de parâmetros morfométricos. O trabalho foi realizado através do levantamento bibliográfico, dados oficiais e da cartografia histórica e atual. A pesquisa demonstrou que a rede de drenagem - submetida à urbanização - apresentou mudanças no padrão de drenagem ao longo do século XX. Além do padrão de drenagem modificado, a densidade hidrográfica e densidade de drenagem, que relaciona o número e a extensão dos canais com a área de drenagem, apresentaram alterações. O conhecimento prévio de como eram estes rios e suas características morfológicas, assim como seu padrão de drenagem, poderão auxiliar projetos de planejamento urbanístico e ambiental, para assim, melhor gerir a sub-bacia

Alterações têmporo-espacais em canais fluviais urbanos (1908-2012): o caso da sub-bacia do Canal do Cunha (RJ)

O processo de urbanização ocorrido na cidade do Rio de Janeiro transformou os canais fluviais. Anterior à urbanização, os rios da cidade eram mêandricos e sinuosos. Os rios foram canalizados, aterrados e/ou cobertos pela malha urbana. O objetivo deste trabalho consiste em analisar as mudanças de densidade de drenagem (Dd) e densidade hidrográfica (Dh) ocorridas na Sub-bacia do Canal do Cunha decorrentes das intervenções antrópicas, no período entre 1908 e 2012. O trabalho foi realizado através do levantamento cartográfico (cartografia histórica e atual), georreferenciamento e mensuração dos parâmetros morfométricos (Dd e Dh). A pesquisa demonstrou que a rede de drenagem - submetida à urbanização - apresentou mudanças no padrão de drenagem ao longo do século XX, assim como, a Dd e Dh sofreram alterações. O conhecimento prévio de como eram estes rios e suas características morfológicas poderão auxiliar projetos de planejamento urbanístico e ambiental, para assim, melhor gerir a sub-bacia