Viral genetic clustering and transmission dynamics of the 2022 mpox outbreak in Portugal

Pathogen genome sequencing during epidemics enhances our ability to identify and understand suspected clusters and investigate their relationships. Here, we combine genomic and epidemiological data of the 2022 mpox outbreak to better understand early viral spread, diversification and transmission dynamics. By sequencing 52% of the confirmed cases in Portugal, we identified the mpox virus sublineages with the highest impact on case numbers and fitted them into a global context, finding evidence that several international sublineages probably emerged or spread early in Portugal. We estimated a 62% infection reporting rate and that 1.3% of the population of men who have sex with men in Portugal were infected. We infer the critical role played by sexual networks and superspreader gatherings, such as sauna attendance, in the dissemination of mpox virus. Overall, our findings highlight genomic epidemiology as a tool for the real-time monitoring and control of mpox epidemics, and can guide future vaccine policy in a highly susceptible population.info:eu-repo/semantics/publishedVersio

Entre consumos suntuários e comuns: a posse de objetos exóticos entre alguns habitantes do Porto (séculos XVI – XVII)

O estudo da documentação referente aos doadores da Misericórdia do Porto entre os séculos XVI e XVII, através dos objetos exóticos patentes nos respectivos testamentos e inven- tários – estes últimos provenientes de uma área que se estende de Macau ao Brasil –, permite discernir uma panóplia de objetos que mudaram a cultura material dos portuenses em contato com os territórios da expansão portuguesa. Um levantamento sistemático permitiu já rastrear, até o ano de 1699, 257 doadores, dos quais se apresentarão aqui apenas alguns, referentes a benfeitores que, não obstante possuírem bens móveis nesse âmbito, não são dados como tendo estado nos territórios de expansão transoceânica. Argumentar-se-á que essa circulação de objetos não foi exclusiva das elites nobiliárquicas, nem dos grandes centros urbanos, pelo que a sua difusão atingiu maiores proporções do que aquelas que a historiografia tem admitido até agora. A cidade em observação neste estudo – o Porto dos séculos XVI e XVII – estava longe de ser das maiores da Europa nesse período, quer em dimensão territorial, quer em efetivos populacionais, embora se situasse numa região de demografia pujante, que canalizou os seus excedentes desde cedo para a emigração interna e externa – o Entre Douro e Minho. Como teremos ocasião de verificar, fidalgos e nobres possuíam bens exóticos, mas estes encontravam-se também entre mercadores e até artesãos mais desafogados. Por outro lado, nem todos os objetos provenientes dos espaços da expansão transoceânica devem ser conotados com bens de luxo.The study of the sources referring to the donors of the Misericórdia of the city of Porto during the sixteenth and seventeenth centuries has revealed the presence of numerous exotic objects in their last wills and inventories. A survey has traced 257 donors until 1699, some of them having died in an area that extends from Macao to Brazil. Only a small number of cases shall be presented here, pertaining to benefactors who, in spite of owning objects of transoceanic origin, seem to have remained in mainland Portugal. It shall be argued that the circulation of objects has not been exclusive either to the elites of the nobility or to the large urban centres, their diffusion having been on a larger scale than what has been admitted until now. The city under scrutiny in this study – Porto during the sixteenth and seventeenth centuries – was not one of the bigger cities in this period, either in what respects to size or population, although it was located in an area of flourishing demography, that channelled its surplus population early on to internal and external emigration. Fidalgos and noblemen owned exotic goods, but these were to be found among merchants and even well-to-do artisans. On the other hand, not all objects originating from the areas of transoceanic expansion should be considered as luxury goods.info:eu-repo/semantics/publishedVersio

O impacto da ultrassonografia no atendimento multidisciplinar na UTI

Introduction: The introduction of ultrasound in the Intensive Care Unit (ICU) represents a significant milestone, fostering substantial advancements in multidisciplinary practice and positively influencing the management of various critical conditions. The application of pulmonary ultrasound, in particular, emerges as a versatile and essential tool, directly impacting the quality of care provided. Methodology: A bibliographic search was conducted on the PUBMED platform, utilizing specific Mesh descriptors: Ultrasonography, Intensive Care Units, Patient Care Team. The search period spanned from 2013 to 2021, encompassing a total of 33 articles. Results: The application of ultrasound in the ICU has proven to be an extremely relevant tool for multidisciplinary care. Pulmonary ultrasound, when employed by intensivists, not only provides a precise assessment of the mentioned conditions but also plays a fundamental role in rapid decision-making and treatment optimization. Conclusion: Ultrasound emerges as a transformative tool in the ICU, shaping multidisciplinary practice and ushering in an era of more advanced and patient-centered intensive care. Its crucial role in swift decision-making and treatment optimization reinforces its position as an indispensable element in the toolkit of healthcare professionals in both the present and future ICU settings.Introdução: A introdução da ultrassonografia na Unidade de Terapia Intensiva (UTI) representa um marco significativo, promovendo avanços substanciais na prática multidisciplinar e influenciando positivamente o manejo de diversas condições críticas. A aplicação da ultrassonografia pulmonar, em particular, surge como uma ferramenta versátil e essencial, impactando diretamente a qualidade do atendimento prestado. Metodologia: A pesquisa bibliográfica foi conduzida na plataforma PUBMED, utilizando descritores Mesh específicos: Ultrasonography, Intensive Care Units, Patient Care Team. O período de busca abrangeu os anos de 2013 a 2021, totalizando 33 artigos. Resultado: Aplicação da ultrassonografia na UTI tem se mostrado uma ferramenta de extrema relevância para o atendimento multidisciplinar. A ultrassonografia pulmonar, quando utilizada pelos intensivistas, não apenas oferece uma avaliação precisa das condições mencionadas, mas também desempenha um papel fundamental na rápida tomada de decisões e na otimização do tratamento. Conclusão: A ultrassonografia emerge como uma ferramenta transformadora na UTI, moldando a prática multidisciplinar e promovendo uma era de cuidados intensivos mais avançados e centrados no paciente. Seu papel crucial na rápida tomada de decisões e na otimização do tratamento reforça sua posição como um elemento indispensável na caixa de ferramentas dos profissionais de saúde nas UTIs do presente e do futuro

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

Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress

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

Population and fertility by age and sex for 195 countries and territories, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017

BACKGROUND: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. METHODS: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10-54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10-14 years and 50-54 years was estimated from data on fertility in women aged 15-19 years and 45-49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories

Unveiling dynamic metabolic signatures in human induced pluripotent and neural stem cells.

Metabolism plays an essential role in cell fate decisions. However, the methods used for metabolic characterization and for finding potential metabolic regulators are still based on characterizing cellular metabolic steady-state which is dependent on the extracellular environment. In this work, we hypothesized that the response dynamics of intracellular metabolic pools to extracellular stimuli is controlled in a cell type-specific manner. We applied principles of process dynamics and control to human induced pluripotent stem cells (hiPSC) and human neural stem cells (hNSC) subjected to a sudden extracellular glutamine step. The fold-changes of steady-states and the transient profiles of metabolic pools revealed that dynamic responses were reproducible and cell type-specific. Importantly, many amino acids had conserved dynamics and readjusted their steady state concentration in response to the increased glutamine influx. Overall, we propose a novel methodology for systematic metabolic characterization and identification of potential metabolic regulators