Morphogenesis of Cynodon cultivars fertilized with nitrogen

To evaluate the biomass flow of two cultivars of Cynodon (Tifton 85 grass and vaquero grass) fertilized with increasing levels of nitrogen (N) (control – without nitrogen; 200; 400 and 600 mg dm-3) under greenhouse conditions, this study was carried out, in a completely randomized design, with factorial arrangement. Forages were examined during three regrowth cycles, with results presented as mean values of the cycles. In the analysis of the effect of nitrogen fertilization, the Tifton 85 grass showed an increasing response to nitrogen levels for the leaf elongation rate (LER). The vaquero grass had a quadractic response for the LER with increasing levels of N. As for the stem elongation rate, there was an increasing linear response in both grasses according to increasing levels of N. The leaf senescence rate (LSR) of the Tifton 85 grass has been enhanced by nitrogen fertilization. The vaquero grass revealed a quadractic response for this variable LSR with nitrogen fertilization, with a minimum value of 0.96 cm tiller-1 day-1 with nitrogen level of 42.5 mg dm-3. The phyllochron and the total number of leaves of both grasses have been influenced by nitrogen fertilization, with downward and upward linear responses, respectively, with increasing levels of nitrogen. For the final mean leaf length (MLL) of both forages, we verified an increasing response with increasing levels of nitrogen. Tifton 85 grass and vaquero grass presented similar LER in the absence of nitrogen, but higher values were observed for the fertilized Tifton 85 grass. The fertilization using nitrogen leads to positive responses of the biomass flow of Tifton 85 grass and vaquero grass under the conditions of the present study

Risk of SARS-CoV-2 infection among front-line healthcare workers in Northeast Brazil : a respondent-driven sampling approach

Objectives We assessed the prevalence of SARS-CoV-2 infection, personal protective equipment (PPE) shortages and occurrence of biological accidents among front-line healthcare workers (HCW). Design, setting and participants Using respondent-driven sampling, the study recruited distinct categories of HCW attending suspected or confirmed patients with COVID-19 from May 2020 to February 2021, in the Recife metropolitan area, Northeast Brazil. Outcome measures The criterion to assess SARS-CoV-2 infection among HCW was a positive self-reported PCR test. Results We analysed 1525 HCW: 527 physicians, 471 registered nurses, 263 nursing assistants and 264 physical therapists. Women predominated in all categories (81.1%; 95% CI: 77.8% to 84.1%). Nurses were older with more comorbidities (hypertension and overweight/obesity) than the other staff. The overall prevalence of SARS-CoV-2 infection was 61.8% (95% CI: 55.7% to 67.5%) after adjustment for the cluster random effect, weighted by network, and the reference population size. Risk factors for a positive RT-PCR test were being a nursing assistant (OR adjusted: 2.56; 95% CI: 1.42 to 4.61), not always using all recommended PPE while assisting patients with COVID-19 (OR adj: 2.15; 95% CI: 1.02 to 4.53) and reporting a splash of biological fluid/respiratory secretion in the eyes (OR adj: 3.37; 95% CI: 1.10 to 10.34). Conclusions This study shows the high frequency of SARS-CoV2 infection among HCW presumably due to workplace exposures. In our setting, nursing assistant comprised the most vulnerable category. Our findings highlight the need for improving healthcare facility environments, specific training and supervision to cope with public health emergencies

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

O perfil semiológico do paciente portador de hemorragia digestiva alta

OBJETIVO: O seguinte estudo objetivou descrever a semiologia do paciente portador de hemorragia digestiva alta, considerando como determinante na avaliação de potencias focos hemorrágicos. METODOLOGIA: Foram realizadas buscas nas plataformas do SciELO, LILACS, PubMed, Scopus e Google Scholar,utilizando os descritores gastrointestinal bleeding, peptic ulcerous disease e varicose hemorrhage, sendo identificados 35 estudos, dos quais foram incluídos 13 artigos completos. Desses estudos, 5 avaliaram as principais etiologias, 2 o surgimento de novos testes diagnósticos, 2 analisaram os aspectos epidemiológicos e 1 a sintomatologia apresentada pelo acometimento da hemorragia digestiva alta. Observou-se inicialmente a abundâncias de informações conceituais sobre o sangramento, como um transtorno clínico comum, acompanhada de inúmeras manifestações, considerando que o foco hemorrágico pode ocorrer em qualquer porção do trato gastrointestinal. Neste estudo, todas as publicações eleitas apresentaram o quadro semiológico composto por algia abdominal, indícios de choque hipovolêmico e taquicardia, alguns exibiram quedas abruptas da pressão arterial, odinofagia, êmese, náuseas e estado ictérico. Os pacientes implicados, cronicamente, já manifestaram ocorrências prévias, devido ao caráter recidivante torna-se essencial investigar a existência de varizes, fístula aorto-entérica, angiodisplasia e doença ulcerosa. CONCLUSÃO: Elucida-se que a hemorragia digestiva alta representa a principal causa de sangramento do trato gastrointestinal, majoritamente manifesta-se como hematêmese ou melena e cursam com o quadro sintomatológico que auxilia na avaliação da gravidade deste e o embasamento de potenciais focos de sangramento e que contribuam para disseminação de informações e intervenções futuras

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

Morphogenesis and biomass production of cultivars of Cynodon subjected to increasing levels of nitrogen

Objetivou-se avaliar o fluxo de biomassa e os componentes da biomassa de dois cultivares do gÃnero Cynodon (capim-Tifton 85 e capim-vaquero) adubados com doses crescentes de nitrogÃnio (N) (controle - sem nitrogÃnio; 200; 400 e 600 mg dm-3) em condiÃÃes de casa de vegetaÃÃo, em um delineamento inteiramente casualizado, em arranjo fatorial. As forrageiras foram estudas durante trÃs ciclos de rebrotaÃÃo, com os resultados apresentados na mÃdia dos ciclos. No estudo do efeito da adubaÃÃo nitrogenada, o capim-Tifton 85 apresentou para a taxa de alongamento foliar (TAlF) resposta crescente Ãs doses de N. O capim-vaquero apresentou resposta quadrÃtica para TAlF com o incremento das doses de nitrogÃnio. Analisando-se a taxa de alongamento dos colmos, verificou-se resposta linear crescente para ambas as gramÃneas com o aumento das doses de nitrogÃnio. A taxa de senescÃncia foliar (TSF) do capim-Tifton 85 foi incrementada pela adubaÃÃo nitrogenada. O capim-vaquero revelou para TSF resposta quadrÃtica com a adubaÃÃo nitrogenada, com valor mÃnimo de 0,96 cm perf-1 dia-1 na dose de nitrogÃnio de 42,5 mg dm-3. O filocrono e o nÃmero total de folhas do capim-Tifton 85 e do capim-vaquero foram influenciados pela adubaÃÃo nitrogenada, revelando resposta linear decrescente e crescente, respectivamente, com o incremento nas doses de nitrogÃnio. Para o comprimento mÃdio final das folhas (CMF) das duas forrageiras, constatou-se resposta crescente com a elevaÃÃo nas doses de nitrogÃnio. Os capins-Tifton 85 e vaquero apresentaram TAlF semelhante na ausÃncia de nitrogÃnio, porÃm para as plantas adubadas verificou-se valores superiores para o capim-Tifton 85. Para a TAlC e TSF constatou-se diferenÃa entre as forrageiras em todas as doses estudadas, com maiores valores para o capim-vaquero. O capim-Tifton 85 apresentou maior filocrono em comparaÃÃo ao capim-vaquero para todas as doses de nitrogÃnio estudadas. O capim-vaquero apresentou maior NTF em comparaÃÃo ao capim-Tifton 85 em todas as doses de nitrogÃnio estudadas. O capim-Tifton 85 apresentou maior CMF em comparaÃÃo ao capim-vaquero para todas as doses de nitrogÃnio avaliadas. No estudo do efeito da adubaÃÃo nitrogenada, os capins-Tifton 85 e vaquero apresentaram para as biomassas de forragem total (BFT), de forragem verde (BFV), de lÃmina foliar verde (BLV), de colmo verde (BCV), de forragem morta (BFM) e densidade populacional de perfilhos (DPP) respostas crescentes Ãs doses de N. Observou-se maior produÃÃo de BFT, BFV, BCV e BFM para o capim-vaquero em comparaÃÃo ao capim-Tifton 85 em todas as doses de N. Constataram-se maior produÃÃo de BLV do capim-Tifton 85 em relaÃÃo ao capim-vaquero em todas as doses de N avaliadas. Constatou-se maior DPP do capim-vaquero em comparaÃÃo ao capim-Tifton 85 para todas as doses de N. O capim-Tifton 85 apresentou maior relaÃÃo LF/C em comparaÃÃo ao capim-vaquero, para todas as doses de N. A adubaÃÃo nitrogenada proporciona respostas positivas sobre o fluxo de biomassa e produÃÃo de forragem dos capins-Tifton 85 e vaquero nas condiÃÃes do presente estudo. O capim-vaquero mostra-se superior ao capim-Tifton 85 nas caracterÃsticas alongamento de colmo, senescÃncia foliar, nÃmero total de folhas e produÃÃo de biomassa (forragem total, forragem verde e colmo) nas doses de nitrogÃnio estudadas. Contudo, o capim-Tifton 85 apresenta-se superior para o alongamento foliar, filocrono, comprimento das folhas e produÃÃo de biomassa foliar nas doses de nitrogÃnio avaliadas.We evaluated the flow of biomass and its components in two cultivars of Cynodon (Tifton 85 grass and vaquero grass) fertilized with increasing levels of nitrogen (N) (control â without nitrogen; 200; 400 and 600 mg dm-3) under greenhouse conditions, in a completely randomized design, with factorial arrangement. Forages were studied during three regrowth cycles, with results presented as mean values of the cycles. In the study of the effect of nitrogen, Tifton 85 grass had a positive response to increasing levels of N for the leaf elongation rate (LER). The vaquero grass showed a quadractic response for the LER with increasing levels of N. As for the stem elongation rate, there was an increasing linear response in both grasses according to increasing levels of N. The leaf senescence rate (LSR) of the Tifton 85 grass has been enhanced by nitrogen fertilization. The vaquero grass revealed a quadractic response for this variable with nitrogen fertilization, with a minimum value of 0.96 cm tiller-1 day-1 with nitrogen level of 42.5 mg dm-3. The phyllochron and the total number of leaves of both grasses have been influenced by nitrogen fertilization, with downward and upward linear responses, respectively, with increasing levels of nitrogen. For the final mean leaf length (MLL) of both forages, we verified an increasing response with increasing levels of nitrogen. Tifton 85 grass and vaquero grass presented similar LER in the absence of nitrogen, but higher values were observed for the fertilized Tifton 85 grass. A difference was detected between forages for culm elongation rate (CER) and LSR in all levels studied, with higher values for the vaquero grass. The Tifton 85 grass had greater phyllochron for all levels of nitrogen studied. The vaquero grass showed a greater NTF compared with Tifton 85 grass in all nitrogen levels examined. The Tifton 85 grass presented higher MLL for all levels of nitrogen studies. In relation to the effect of nitrogen fertilization, Tifton 85 grass and vaquero grass presented increasing responses to N levels for the biomass of total forage (BTF), of green forage (BGF), of green leaf blade (BGL), of green culm (BGC), of dry forage (BDF) and of tiller population density (TPD). There was a greater production of BTF, BGF, BGC and BDF for the vaquero grass in all N levels. A higher production of BGL was observed in the Tifton 85 grass in all evaluated levels of N. We verified a greater TPD of the vaquero grass for all levels of N. The Tifton 85 grass showed a higher BL/C ratio for all levels of N evaluated. The nitrogen fertilization provides positive responses of the biomass flow and forage production of Tifton 85 grass and vaquero grass under the conditions of the present study. The vaquero grass proved to be better than Tifton 85 grass in the characteristics stem elongation, leaf senescence, total number of leaves and biomass production (total forage, green forage and culm). However, the Tifton 85 grass is superior as for the leaf elongation, phyllochron, leaf length, and leaf biomass production in the nitrogen levels evaluated