Adsorção de atrazina, desetilatrazina e hidroxiatrazina em latossolo vermelho escuro sob cerrado e sob plantio direto no Distrito Federal

The environmental fate of a pesticide depends on many factors, among them the soil characteristics as mineralogy, soil chemistry and organic matter content. This study aims to verify how the adaptation of chemical and mineralogical properties of a dark red latosol from the Brazilian savanna under the continuous use of no till practice can affect its affinity to atrazine and two metabolites (deethylatrazine and hydroxyatrazine). Therefore, beyond the characterization of the cited parameters, batch studies were performed with both no till and native vegetation soils. The comparison between them showed that the changes in some soil properties due to agriculture use of it were enough to change significantly its affinity for the studied compounds. Atrazine and deethylatrazine showed significant affinity to the high organic matter content horizon, while deeper horizons with smaller amounts of organic matter atrazine sorption was neglectible, deethylatrazine was present, but in smaller amounts.        O destino de um agrotóxico no meio ambiente depende de vários fatores, entre estes as alguns atributos do solo como mineralogia, composição química e conteúdo de matéria orgânica. Este estudo teve como objetivos verificar de que forma a adaptação de algumas das características de um Latossolo Vermelho Escuro do cerrado ao uso continuado do plantio direto (PD) influencia a retenção da atrazina e dois de seus principiais metabólitos (desetilatrazina e hidroxiatrazina). Desta forma, além da caracterização do solo, desenvolveram-se estudos da interação do solo com a atrazina, tanto com solos utilizados para PD, quanto solos de mata nativa nunca usados na prática agrícola. A comparação entre ambos evidenciou que as mudanças ocasionadas pelo solo agrícola, embora pequenas, foram suficientes para causar ligeira modificação na afinidade deste pelos compostos estudados. Atrazina e desetilatrazina apresentaram maior afinidade com os horizontes mais ricos em matéria orgânica, enquanto que os horizontes mais profundos, mais pobres em matéria orgânica, a adsorção da atrazina foi desprazível, desetilatrazina esta presente, porém em quantidades pequenas

Influência de práticas culturais e da resistência genética na intensidade do cancro da haste e produção de soja no Cerrado

Os efeitos de práticas culturais e resistência genética na intensidade ao cancro-da-haste da soja (Diaporthe phaseolorum f.sp. meridionalis - Dpm) foram examinados na safra 1995-96 em áreas de produção comercial, que haviam sido severamente atacadas na safra anterior (1994-95). Um experimento investigou os efeitos de cultivo mínimo (MT) e do plantio direto (NT) no desenvolvimento da doença e produtividade das cultivares FT-Cristalina e FT-Seriema. Em outro experimento, semeado em plantio direto, estudou-se o efeito da densidade de plantas (8, 15, 21 e 36 plantas/m) no desenvolvimento da doença e produtividade das cvs. FT-Cristalina (suscetivel), FT- 101 (moderadamente resistente) e FT-104 (resistente). Incidência e severidade da doença foram menores em NT do que em MT. A produtividade aumentou no sistema NT (23% para ‘FT-Cristalina’ e 14% para ‘FT-Seriema’), comparada com as produtividades em MT. As curvas de progresso da doença foram melhor descritas pelos mo- delos de Gompertz e logístico. A severidade do cancro aumentou pro- porcionalmente ao aumento das densidades de plantio nas cvs. suscetível e moderadamente resistente. No final do ciclo, 100% das plantas da cv. FT-Cristalina estavam infetadas por Dpm, em todas as densidades de plantio. Níveis intermediários de doença foram observa- dos na cv. FT-101, enquanto apenas níveis muito baixos de doença ocorreram na cv. FT-104. Estabeleceu-se uma correlação negativa entre severidade de cancro-da-haste e produção. Algumas das práticas estudadas demonstraram potential para aplicação direta no controle da doença, e poderiam ser combinadas considerando-se seus efeitos aditivos.Field experiments were conducted in the 1995-96 soybean (Glycine max) growing season to evaluate the effects of cultural practices and host genetic resistance on the intensity of soybean stem canker, caused by Diaporthe phaseolorum f.sp. meridionalis (Dpm). Experiments were conducted in a commercial field severely infected in the previous (1994-95) season. In one study, minimum tillage (MT) and no-tillage (NT) cropping systems were investigated for their effects on disease development and on plant yields in cvs. FT- Cristalina (susceptible) and FT-Seriema (moderately resistant). Another study evaluated the effects of plant densities (8, 15, 21 and 36 plants/m) on disease development in cvs. FT-Cristalina, FT-101 (moderately resistant) and FT-104 (resistant). Disease incidence and severity were consistently lower in NT than in MT, and plant yields were increased by 23% and 14% in the NT system for the susceptible and moderately resistant cultivars, respectively, compared to the yields in the MT system. The Gompertz and Logistic models described well the disease progress curves in all situations. For both susceptible and moderately resistant cultivars, disease severity increased proportionately to the increase in plant densities. At the end of the season, 100% of the plants of cv. FT-Cristalina were infected by Dpm, at all plant densities. Disease levels on cv. FT-101 were intermediate while only very low disease levels were recorded on cv. FT-104. There was a consistent negative correlation between stem canker severity and yield. Some practices demonstrated potential for direct application in disease control, and could be combined considering their additive effects

Severe Asthma Standard-of-Care Background Medication Reduction With Benralizumab: ANDHI in Practice Substudy

peer reviewedBackground: The phase IIIb, randomized, parallel-group, placebo-controlled ANDHI double-blind (DB) study extended understanding of the efficacy of benralizumab for patients with severe eosinophilic asthma. Patients from ANDHI DB could join the 56-week ANDHI in Practice (IP) single-arm, open-label extension substudy. Objective: Assess potential for standard-of-care background medication reductions while maintaining asthma control with benralizumab. Methods: Following ANDHI DB completion, eligible adults were enrolled in ANDHI IP. After an 8-week run-in with benralizumab, there were 5 visits to potentially reduce background asthma medications for patients achieving and maintaining protocol-defined asthma control with benralizumab. Main outcome measures for non–oral corticosteroid (OCS)-dependent patients were the proportions with at least 1 background medication reduction (ie, lower inhaled corticosteroid dose, background medication discontinuation) and the number of adapted Global Initiative for Asthma (GINA) step reductions at end of treatment (EOT). Main outcomes for OCS-dependent patients were reductions in daily OCS dosage and proportion achieving OCS dosage of 5 mg or lower at EOT. Results: For non–OCS-dependent patients, 53.3% (n = 208 of 390) achieved at least 1 background medication reduction, increasing to 72.6% (n = 130 of 179) for patients who maintained protocol-defined asthma control at EOT. A total of 41.9% (n = 163 of 389) achieved at least 1 adapted GINA step reduction, increasing to 61.8% (n = 110 of 178) for patients with protocol-defined EOT asthma control. At ANDHI IP baseline, OCS dosages were 5 mg or lower for 40.4% (n = 40 of 99) of OCS-dependent patients. Of OCS-dependent patients, 50.5% (n = 50 of 99) eliminated OCS and 74.7% (n = 74 of 99) achieved dosages of 5 mg or lower at EOT. Conclusions: These findings demonstrate benralizumab's ability to improve asthma control, thereby allowing background medication reduction. © 202

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

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

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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Efeito do espaçamento e da cultivar de feijoeiro sobre a intensidade do mofo-branco e a sanidade de sementes Effect of plant spacing and bean cultivar on white mold and seed sanity

Dois ensaios de campo foram realizados para avaliar o efeito do espaçamento entre linhas (30, 45 e 60 cm) e entre plantas de feijoeiro com hábitos de crescimento diferentes, sobre a intensidade do mofo-branco e a sanidade de sementes. No primeiro, foi mantida a mesma população de plantas por área, 27 plantas/m², reduzindo-se o espaçamento entre plantas. No segundo ensaio, manteve-se o mesmo espaçamento entre plantas, que resultou em populações de 40, 27 e 20 plantas/m². A porcentagem de plantas infectadas e a severidade da doença não diferiram estatisticamente quanto ao hábito de crescimento da cultivar, ao espaçamento ou à interação entre eles, mesmo a incidência tendo atingido valores de 98,4% em 1998 e de 2,7% em 1999. A porcentagem de sementes infectadas não foi afetada pelo espaçamento, mas diferiu erraticamente em relação às cultivares; em 1998, a cultivar Pérola não apresentou sementes infectadas, o mesmo acontecendo com a cultivar Diamante Negro em 1999.<br>The effect of spacing among rows and among bean plants, as well as two plant growth habits were evaluated on the intensity of white mold and seed health in two field trials in Brasilia, DF, Brazil. In the first trial, the same population of 27 plants/m² was maintained in rows of 30, 45 and 60 cm apart. In the second trial, the spacing among rows was maintained, which resulted in different plant populations of 40, 27 and 20 plants/m², respectively. Disease incidence and severity did not differ statistically within plants of different growth habits or different spacing, even with divergent disease incidences of 98.4% and 2.7% observed in 1998 and 1999, respectively. The percentage of infected seeds was not affected by spacing either, however the cultivar effect was erratic; in 1998, 'Perola' had no infected seeds and the same occurred with 'Diamante Negro' in 1999