COVID-19 in Brazilian children and adolescents: findings from 21 hospitals / COVID-19 em crianças e adolescentes brasileiros: registros de 21 hospitais

Introdução: Crianças e adolescentes com Covid-19 apresentam menor mortalidade e sintomas menos intensos quando comparados aos adultos. Os estudos no Brasil baseiam-se apenas no sistema de notificação compulsória. Objetivo: Analisar as características clínicas, laboratoriais, radiológicas e desfechos de pacientes hospitalizados com menos de 20 anos de idade com Covid-19. Métodos: Série de casos de pacientes internados com Covid-19, confirmado, com idade inferior a 20 anos, obtida em estudo de coorte em 21 hospitais de cinco estados brasileiros. Resultados: Dos 36 pacientes, 20 (55,5%) eram adolescentes, 20 (55,5%) eram do sexo masculino, 18 (50,0%) apresentavam comorbidades, 2 estavam grávidas; e em 7 (19,4%) os sintomas iniciais ocorreram durante a internação por outras causas, dos quais 3 foram possivelmente infectados no hospital. Febre (61,1%), dispneia (33,3%) e sintomas neurológicos (33,0%) foram as queixas mais comuns. A proteína C reativa estava acima de 50mg / L em 16,7% e o dímero-D estava acima do limite de referência em 22,2%. Radiografias de tórax foram realizadas em 20 (55,5%) pacientes, 9 apresentavam anormalidades; e tomografias computadorizadas de tórax em 5. O tempo de internação variou de 1-40 dias (mediana 5 [intervalo interquartil 3-10]), 16 (44,4%) necessitaram de cuidados intensivos, 6 (16,7%) necessitaram de ventilação mecânica e um paciente (2,8%) faleceu. Conclusão: Em uma amostra de pacientes menores de 20 anos, procedentes de hospitais de 5 estados do Brasil, as comorbidades foram frequentes e os sintomas mais comuns foram febre, dispneia e sintomas neurológicos. Quarenta e quatro por cento dos pacientes necessitaram de cuidados intensivos, mostrando que na amostra avaliada a doença não era tão leve quanto o esperado, e um paciente morreu. 

Mental health and burnout syndrome among postgraduate students in medical and multidisciplinary residencies during the COVID-19 pandemic in Brazil : protocol for a prospective cohort study

Background: The COVID-19 pandemic has led to high levels of physical, psychological, and social stress among health care professionals, including postgraduate students in medical and multidisciplinary residencies. This stress is associated with the intense fear of occupational exposure to SARS-CoV-2, the virus known to cause COVID-19. These professionals are at risk of developing physical and mental illnesses not only due to the infection but also due to prolonged exposure to multidimensional stress and continued work overload. Objective: This study aims to evaluate the prevalence of symptoms suggestive of mental disorders and burnout syndrome and determine the risk factors for burnout among postgraduate students in medical and multidisciplinary residencies in Brazil during the COVID-19 pandemic. Methods: For this prospective cohort study with parallel groups, participants were recruited between July and September 2020 to achieve a sample size of at least 1144 participants. Research instruments such as Depression, Anxiety, and Stress Scale; Patient Health Questionnaire; Brief Resilient Coping Scale; and Oldenburg Burnout Inventory will be used to collect data. Data will be collected in 2 waves: the first wave will include data related to sample characterization and psychosocial evaluation, and the second wave will be launched 12 weeks later and will include an evaluation of the incidence of burnout as well as correlations with the potential predictive factors collected in the first wave. Additionally, we will collect data regarding participants’ withdrawal from work. Results: The recruitment took place from July 29 to September 5, 2020. Data analyses for this phase is already in progress. The second phase of the study is also in progress. The final data collection began on December 1, 2020, and it will be completed by December 31, 2020. Conclusions: We believe the findings of this study will help evaluate the impact of the COVID-19 pandemic on the mental health conditions of health professionals in Brazil as well as contribute to the planning and implementation of appropriate measures that can alleviate these mental health challenges. International Registered Report Identifier (IRRID): DERR1-10.2196/2429

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

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Diretriz da Sociedade Brasileira de Cardiologia sobre Diagnóstico e Tratamento de Pacientes com Cardiomiopatia da Doença de Chagas

This guideline aimed to update the concepts and formulate the standards of conduct and scientific evidence that support them, regarding the diagnosis and treatment of the Cardiomyopathy of Chagas disease, with special emphasis on the rationality base that supported it.  Chagas disease in the 21st century maintains an epidemiological pattern of endemicity in 21 Latin American countries. Researchers and managers from endemic and non-endemic countries point to the need to adopt comprehensive public health policies to effectively control the interhuman transmission of T. cruzi infection, and to obtain an optimized level of care for already infected individuals, focusing on diagnostic and therapeutic opportunistic opportunities.   Pathogenic and pathophysiological mechanisms of the Cardiomyopathy of Chagas disease were revisited after in-depth updating and the notion that necrosis and fibrosis are stimulated by tissue parasitic persistence and adverse immune reaction, as fundamental mechanisms, assisted by autonomic and microvascular disorders, was well established. Some of them have recently formed potential targets of therapies.  The natural history of the acute and chronic phases was reviewed, with enhancement for oral transmission, indeterminate form and chronic syndromes. Recent meta-analyses of observational studies have estimated the risk of evolution from acute and indeterminate forms and mortality after chronic cardiomyopathy. Therapeutic approaches applicable to individuals with Indeterminate form of Chagas disease were specifically addressed. All methods to detect structural and/or functional alterations with various cardiac imaging techniques were also reviewed, with recommendations for use in various clinical scenarios. Mortality risk stratification based on the Rassi score, with recent studies of its application, was complemented by methods that detect myocardial fibrosis.  The current methodology for etiological diagnosis and the consequent implications of trypanonomic treatment deserved a comprehensive and in-depth approach. Also the treatment of patients at risk or with heart failure, arrhythmias and thromboembolic events, based on pharmacological and complementary resources, received special attention. Additional chapters supported the conducts applicable to several special contexts, including t. cruzi/HIV co-infection, risk during surgeries, in pregnant women, in the reactivation of infection after heart transplantation, and others.     Finally, two chapters of great social significance, addressing the structuring of specialized services to care for individuals with the Cardiomyopathy of Chagas disease, and reviewing the concepts of severe heart disease and its medical-labor implications completed this guideline.Esta diretriz teve como objetivo principal atualizar os conceitos e formular as normas de conduta e evidências científicas que as suportam, quanto ao diagnóstico e tratamento da CDC, com especial ênfase na base de racionalidade que a embasou. A DC no século XXI mantém padrão epidemiológico de endemicidade em 21 países da América Latina. Investigadores e gestores de países endêmicos e não endêmicos indigitam a necessidade de se adotarem políticas abrangentes, de saúde pública, para controle eficaz da transmissão inter-humanos da infecção pelo T. cruzi, e obter-se nível otimizado de atendimento aos indivíduos já infectados, com foco em oportunização diagnóstica e terapêutica. Mecanismos patogênicos e fisiopatológicos da CDC foram revisitados após atualização aprofundada e ficou bem consolidada a noção de que necrose e fibrose sejam estimuladas pela persistência parasitária tissular e reação imune adversa, como mecanismos fundamentais, coadjuvados por distúrbios autonômicos e microvasculares. Alguns deles recentemente constituíram alvos potenciais de terapêuticas. A história natural das fases aguda e crônica foi revista, com realce para a transmissão oral, a forma indeterminada e as síndromes crônicas. Metanálises recentes de estudos observacionais estimaram o risco de evolução a partir das formas aguda e indeterminada e de mortalidade após instalação da cardiomiopatia crônica. Condutas terapêuticas aplicáveis aos indivíduos com a FIDC foram abordadas especificamente. Todos os métodos para detectar alterações estruturais e/ou funcionais com variadas técnicas de imageamento cardíaco também foram revisados, com recomendações de uso nos vários cenários clínicos. Estratificação de risco de mortalidade fundamentada no escore de Rassi, com estudos recentes de sua aplicação, foi complementada por métodos que detectam fibrose miocárdica. A metodologia atual para diagnóstico etiológico e as consequentes implicações do tratamento tripanossomicida mereceram enfoque abrangente e aprofundado. Também o tratamento de pacientes em risco ou com insuficiência cardíaca, arritmias e eventos tromboembólicos, baseado em recursos farmacológicos e complementares, recebeu especial atenção. Capítulos suplementares subsidiaram as condutas aplicáveis a diversos contextos especiais, entre eles o da co-infecção por T. cruzi/HIV, risco durante cirurgias, em grávidas, na reativação da infecção após transplante cardíacos, e outros.    Por fim, dois capítulos de grande significado social, abordando a estruturação de serviços especializados para atendimento aos indivíduos com a CDC, e revisando os conceitos de cardiopatia grave e suas implicações médico-trabalhistas completaram esta diretriz.&nbsp

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

Dinâmica da reprodução e da nutrição de Salminus maxillosus Valenciennes, 1849 (Pisces, Characidae) do rio Mogi Guaçu, Estado de São Paulo, Brasil

The reproductive and nutritional dynamics of Salminus maxillosus Val. were studied in 327 specimens (195 females and 132 males) collected in the Mogi Guaçu river, São Paulo, Brazil from August, 1996 to July, 1997. Reproductive dynamics were assessed through analysis of monthly variation in gonadosomatic index, hepatosomatic index, relative frequencies of gonadal maturity stages and first sexual maturation size. Reproduction occurred from November to January (the highest values recorded in December),when the highest water temperatures and pluviometric index were observed. The size of S. maxillosus at first sexual maturation (Lpm) was calculated to be 346.7 mm (males) and 447.4 mm (females), the age being two years for both males and females. The L100 values calculated were 525.0 mm for males and 625.0 mm for females, respectively. The nutritional dynamics were estimated through analysis of the monthly variation and the relative frequency of the repletion stages. S. maxillosus from Mogi Guaçu River is in its optimum feeding condition before and during the reproductive seasonA dinâmica da reprodução e a dinâmica da alimentação de Salminus maxillosus Val. foram estudadas em 327 exemplares (195 fêmeas e 132 machos) capturados no rio Mogi-Guaçu, estado de São Paulo, Brasil, no período de agosto de 1996 a julho de 1997. A dinâmica da reprodução foi analisada pela análise das variações médias mensais do índice gonadossomático, índice hepatossomático, freqüência relativa dos estádios de maturação gonadal e tamanho de primeira maturação gonadal. A reprodução ocorreu no período de novembro a janeiro (a maior atividade reprodutiva foi registrada no mês de dezembro), época em que foram registradas as maiores temperaturas da água e os maiores índices pluviométricos na região. O tamanho de primeira maturação gonadal foi estimado em 346,7 mm (machos) e 447,4 (fêmeas), quando os exemplares atingiram 2 anos de idade. O valor de L100 foi estimado em 525,0 mm para machos e 625,0 mm para fêmeas. A análise da dinâmica da alimentação, estudada pela variação mensal do índice de repleção e das freqüências relativas dos estádios de repleção, permitiu concluir que os exemplares encontram-se em melhores condições alimentares durante a reproduçã

Crescimento e tamanho de primeira maturação gonadal de Salminus maxillosus Valenciennes, 1849 (Characiformes, Characidae), no rio Mogi Guaçu, Estado de São Paulo, Brasil

Age and growth were estimated from counts of hyaline zones in scales of dourado, Salminus maxillosus Valenciennes, 1849, of Mogi-Guaçu River, state of São Paulo. The time of annuli formation was established by the scales’ marginal growth quotient variation. The first sexual maturation size was determined, and the reproductive period was defined by the analysis of the maturation curve, based on the gonadosomatic index variation, the relative frequency of the maturation stages and of the hepatosomatic index. Annulus formation is annual, occurring during the spawning period. The first annulus formation was observed in the second year of the fish life, corresponding to 346.7 mm and 447.4 mm for males and females, respectively. Up to seven annulus for males and eight for females were observed. The growth curve in length were adjusted by the mathematical expression of von Bertalanffy (1938) and the growth curve in weight by the deductive method from the expressions of the length growth curve and weight/length relationship. The L∞ and W∞ values were 874.0 mm and 8804 g for females and 713.0 mm and 4416.0 g for males. The growth rates were 0.3917 and 0.3572 for females and males, respectivelyEstimativas de idade e crescimento do dourado, Salminus maxillosus Valenciennes, 1849, do Rio Mogi-Guaçu, estado de São Paulo, foram feitas a partir de anéis de crescimento presentes nas escamas. O estabelecimento da época de formação dos anéis foi baseado na variação do quociente de crescimento marginal das escamas e foi determinado o tamanho de primeira maturação gonadal. O período reprodutivo foi estabelecido pela análise da curva de maturação baseada na variação do índice gonadossomático, da freqüência relativa dos estádios de maturação gonadal e do índice hepatossomático. A formação do anel mostrou-se anual, ocorrendo por ocasião do período reprodutivo. O primeiro anel se forma no 2o. ano de vida, correspondendo a 346,7 mm para machos e 447,4 mm para fêmeas. Foram detectados até 7 anéis etários para machos e 8 para fêmeas. As curvas de crescimento em comprimento foram ajustadas pela expressão de von Bertalanffy (1938) e as curvas de crescimento em peso pelo método dedutivo, a partir das expressões das curvas de crescimento em comprimento e das relações peso/comprimento. Os valores de L∞ e W∞ encontrados foram 874,0 mm e 8804 g e 713,0 mm e 4416 g para fêmeas e machos respectivamente. A taxa de crescimento para fêmeas foi calculada em 0,3917 e 0,3572 para macho

<b>Estratégias reprodutivas do dourado, Salminus maxillosus e do curimbatá, Prochilodus lineatus no Rio Mogi Guaçu, Estado de São Paulo, com ênfase nos parâmetros matemáticos da dinâmica populacional</b> - DOI: 10.4025/actascibiolsci.v26i2.1631

O presente trabalho trata da situação das populações do curimbatá Prochilodus Lineatus e do dourado Salminus maxillosus no rio Mogi Guaçu/SP, através da análise de parâmetros da dinâmica populacional. Os dados foram analisados em função de resultados obtidos anteriormente para as mesmas espécies do mesmo ecossistema. Os parâmetros analisados foram: tamanho e idade de primeira maturação gonadal, comprimento médio máximo dos exemplares, tamanho mínimo de exemplares adultos capturados taxa de crescimento e proporção sexual. Os resultados obtidos indicam que as espécies estão apresentando táticas reprodutivas responsáveis pela sobrevivência e manutenção do equilíbrio populacional, apesar da intensa sobrepesca e das adversidades abióticas a que estão submetida