Illegal bushmeat hunting and trade dynamics in a major road-hub region of the Brazilian Mid North

402-411This study was conducted to characterize the illegal bushmeat hunting and trade in Floriano region (Piauí State), an import road hub between Amazon and Northeast regions of Brazil. This is the first study that assesses bushmeat hunting in Mid North of Northeast Brazil. Our main hypothesis is that hunting has completely changed from a purely subsistence scenario to another under multiple demands and with the incorporation of technological resources. We collected data from August 2015 to July 2016 throughout semi-structured questionnaires with 82 hunters and rapid survey at markets. Our study revealed that 14 wild vertebrates are usually hunted in studied areas as source of meat and zootherapeutics. Hunting for subsistence was the main purpose reported by interviewees, nonetheless we detected that virtually all hunters sell wild meat and zootherapeutic products. We found that local hunting is mainly as a nocturnal activity. Our results show that bushmeat hunting and trade are facilitated by modern technologies and these activities turned into a black way supported by very diverse purposes besides subsistence. We suggest more comprehensive conservation strategies, including alternatives to supply urban demand for game meat, environmental education to mitigate involvement in hunting and improved intelligence efforts by environmental agencies

Rarity of monodominance in hyperdiverse Amazonian forests.

Tropical forests are known for their high diversity. Yet, forest patches do occur in the tropics where a single tree species is dominant. Such "monodominant" forests are known from all of the main tropical regions. For Amazonia, we sampled the occurrence of monodominance in a massive, basin-wide database of forest-inventory plots from the Amazon Tree Diversity Network (ATDN). Utilizing a simple defining metric of at least half of the trees ≥ 10 cm diameter belonging to one species, we found only a few occurrences of monodominance in Amazonia, and the phenomenon was not significantly linked to previously hypothesized life history traits such wood density, seed mass, ectomycorrhizal associations, or Rhizobium nodulation. In our analysis, coppicing (the formation of sprouts at the base of the tree or on roots) was the only trait significantly linked to monodominance. While at specific locales coppicing or ectomycorrhizal associations may confer a considerable advantage to a tree species and lead to its monodominance, very few species have these traits. Mining of the ATDN dataset suggests that monodominance is quite rare in Amazonia, and may be linked primarily to edaphic factors

Os conflitos entre natureza e cultura na implementação do Ecomuseu Ilha Grande Clashes between nature and culture in the implementation of the Ilha Grande Ecomuseum

O objetivo deste trabalho é mostrar três desafios surgidos a partir das primeiras apresentações do projeto Ecomuseu Ilha Grande, todos eles relacionados às diferentes formas de compreensão do que sejam natureza e cultura. O primeiro diz respeito ao equilíbrio entre preservação da natureza e bem-estar dos moradores, objetivos bastante conflitantes atualmente. Em segundo lugar, há a intenção de envolver a população local da Ilha Grande nos projetos de pesquisa acadêmica e de defesa do meio ambiente. Finalmente, há a tentativa de preservar a memória de práticas de violência e de arbitrariedade ética e moral, que são ou estereotipadas ou totalmente ignoradas pela sociedade.<br>The article points to three challenges that arose during initial presentations of the Ilha Grande Ecomuseum project, all of which involved different ways of understanding what constitutes 'nature' and 'culture'. The first issue had to do with balancing environmental protection with the welfare of residents, two aspirations that are quite conflicting at present. Second was the intention to involve the Ilha Grande population in academic research and environmental protection projects. Last was the endeavor to preserve the memory of practices of violence and of ethical and moral irresponsibility, which are either stereotyped or totally ignored by society

Pilar de Goiás: a vila entre a memória, a história e a materialidade

This article seeks to understand the interface established between historical archeology, history and the national policy of protection of historical, artistic, architectural and archaeological heritage - through the legal instrument of tipping - materialized in the case of the city of Pilar de Goiás, in the state of Goiás. This protection, begun in the 1950s, occurred in a conceptually and technically fragile way, led to a series of problems and challenges in the fields of history and archeology, especially in the preservation of this same national patrimony. The eighteenth-century mining town went through innumerable “gold bullfights” followed by mining abandonment and population decline (every time the metal fountains were exhausted). This process, initiated in the colonial period and still in progress, favored the construction of a series of memories that complicate the more objective interpretation of the profile of this colonial village. In the present work we seek to understand these processes and how the scientific researches - and even the policies for the patrimony - were informed in the memory, creating a somewhat confusing scenario regarding the colonial past of Pilar de Goiás. The historiography, we propose an interpretation about Pilar de Goiás based on a very plastic society, plural and multifaceted economy. This procedure, far from the grandiose and excessively grounded interpretations of the search for what would be a “mining society”, helps us to understand the processes involved in colonial occupation and the construction of networks of commerce, transit, and urbanization of the central portion of the Colony.Este artigo busca compreender a interface estabelecida entre a arqueologia histórica, a história e a política nacional de proteção do patrimônio histórico, artístico, arquitetônico e arqueológico - através do instrumento legal de tombamento - materializada no caso da cidade de Pilar de Goiás, no estado de Goiás. Essa proteção, iniciada na década de 1950, ocorrida de modo conceitual e tecnicamente frágil, acarretou uma série de problemas e desafios para os campos da história e da arqueologia, sobretudo no tocante à preservação desse mesmo patrimônio nacional. A vila mineradora setecentista passou por inúmeras “corridas do ouro” seguidas de abandono das lavras e decréscimo populacional (toda vez que se esgotavam as fontes do metal). Tal processo, iniciado em período colonial e ainda em andamento, favoreceu a construção de uma série de memórias que complicam a interpretação mais objetiva do perfil dessa vila colonial. No presente trabalho buscamos compreender esses processos e como as pesquisas científicas - e mesmo as políticas para o patrimônio - informaram-se na memória, criando um cenário algo confuso a respeito do passado colonial de Pilar de Goiás. Diante disso, e recorrendo aos documentos históricos e à historiografia, propomos uma interpretação a respeito de Pilar de Goiás, fundamentada em uma sociedade muito plástica, plural e de economia multifacetada. Procedimento que, distante das interpretações grandiosas e excessivamente fundamentadas na busca daquilo que seria uma “sociedade mineradora”, auxilia-nos a compreender os processos envolvidos na ocupação colonial e na construção de redes de comércio, de trânsito e de urbanização da parcela central da Colônia

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83-7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97-2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14-1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25-1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83–7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97–2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14–1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25–1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable

Association of Country Income Level With the Characteristics and Outcomes of Critically Ill Patients Hospitalized With Acute Kidney Injury and COVID-19

Introduction: Acute kidney injury (AKI) has been identified as one of the most common and significant problems in hospitalized patients with COVID-19. However, studies examining the relationship between COVID-19 and AKI in low- and low-middle income countries (LLMIC) are lacking. Given that AKI is known to carry a higher mortality rate in these countries, it is important to understand differences in this population. Methods: This prospective, observational study examines the AKI incidence and characteristics of 32,210 patients with COVID-19 from 49 countries across all income levels who were admitted to an intensive care unit during their hospital stay. Results: Among patients with COVID-19 admitted to the intensive care unit, AKI incidence was highest in patients in LLMIC, followed by patients in upper-middle income countries (UMIC) and high-income countries (HIC) (53%, 38%, and 30%, respectively), whereas dialysis rates were lowest among patients with AKI from LLMIC and highest among those from HIC (27% vs. 45%). Patients with AKI in LLMIC had the largest proportion of community-acquired AKI (CA-AKI) and highest rate of in-hospital death (79% vs. 54% in HIC and 66% in UMIC). The association between AKI, being from LLMIC and in-hospital death persisted even after adjusting for disease severity. Conclusions: AKI is a particularly devastating complication of COVID-19 among patients from poorer nations where the gaps in accessibility and quality of healthcare delivery have a major impact on patient outcomes

Thrombotic and hemorrhagic complications of COVID-19 in adults hospitalized in high-income countries compared with those in adults hospitalized in low- and middle-income countries in an international registry

Background: COVID-19 has been associated with a broad range of thromboembolic, ischemic, and hemorrhagic complications (coagulopathy complications). Most studies have focused on patients with severe disease from high-income countries (HICs). Objectives: The main aims were to compare the frequency of coagulopathy complications in developing countries (low- and middle-income countries [LMICs]) with those in HICs, delineate the frequency across a range of treatment levels, and determine associations with in-hospital mortality. Methods: Adult patients enrolled in an observational, multinational registry, the International Severe Acute Respiratory and Emerging Infections COVID-19 study, between January 1, 2020, and September 15, 2021, met inclusion criteria, including admission to a hospital for laboratory-confirmed, acute COVID-19 and data on complications and survival. The advanced-treatment cohort received care, such as admission to the intensive care unit, mechanical ventilation, or inotropes or vasopressors; the basic-treatment cohort did not receive any of these interventions. Results: The study population included 495,682 patients from 52 countries, with 63% from LMICs and 85% in the basic treatment cohort. The frequency of coagulopathy complications was higher in HICs (0.76%-3.4%) than in LMICs (0.09%-1.22%). Complications were more frequent in the advanced-treatment cohort than in the basic-treatment cohort. Coagulopathy complications were associated with increased in-hospital mortality (odds ratio, 1.58; 95% CI, 1.52-1.64). The increased mortality associated with these complications was higher in LMICs (58.5%) than in HICs (35.4%). After controlling for coagulopathy complications, treatment intensity, and multiple other factors, the mortality was higher among patients in LMICs than among patients in HICs (odds ratio, 1.45; 95% CI, 1.39-1.51). Conclusion: In a large, international registry of patients hospitalized for COVID-19, coagulopathy complications were more frequent in HICs than in LMICs (developing countries). Increased mortality associated with coagulopathy complications was of a greater magnitude among patients in LMICs. Additional research is needed regarding timely diagnosis of and intervention for coagulation derangements associated with COVID-19, particularly for limited-resource settings

Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19

Background: We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world's largest international, standardized data sets concerning hospitalized patients. Methods: The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV). Results: Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60&nbsp;years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%. Conclusions: Age was the strongest determinant of risk of death, with a ∼30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death.&nbsp;The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death