Mapeamento e caracterização geoacústica na identificação de gatilhos de instabilidade ambiental de um grande sistema lagunar costeiro no sul do Brasil

Os gatilhos de instabilidade ambiental são variáveis distintas interligadas em um só ecossistema. As implicações ocasionadas por esses estímulos acontecem simultaneamente, mas pouco discutidas de forma integrada, e as atividades antrópicas são os maiores contribuintes para que isso ocorra. O presente trabalho através de uma análise holística, caracteriza e mapeia a partir de dados geoacústicos de alta resolução, 3,5 kHz, os elementos arquiteturais de fundo e sub fundo da Lagoa dos Patos (LP) e relaciona aos diversos parâmetros do ambiente lagunar, associando ao acúmulo de problemáticas como adsorção química por agrotóxicos em regiões de maiores concentrações de argilominerais, presença de metano em camadas sedimentares rasas e atividades de dragagem que podem contribuir tanto para a redisponibilização desses poluentes ao longo da lagoa, quanto para a liberação do metano na coluna d’água e consequentemente para atmosfera, contribuindo com o efeito estufa. As análises indicam as instabilidades no ambiente a partir da caracterização das assinaturas sísmicas (eco carateres) e pela definição dos gatilhos, que colabora com o estresse local e estimula a sensibilidade presente nesse ecossistema lagunar.The environmental instability triggers are distinct variables interconnected in a single ecosystem. The implications caused by these triggers take place simultaneously, but are little discussed in an integrated way, and anthropic activities are the largest contributors for this to occur. This study, through a holistic analysis, aims to characterize and map out based on high-resolution seismic data (3,5 kHz) the bottom and sub-bottom architectural elements of the Patos Lagoon (LP), relating it to the many parameters found in this lagoon environment, making an association with the accumulation of various issues such as the chemical adsorption of agrochemicals in areas with large concentrations of clay minerals, the presence of methane in shallow sedimentary layers and dredging activities that may contribute to the re-availability of these pollutants across the lagoon as well as to the release of methane to its water columns and consequently to the atmosphere, also contributing to the greenhouse effect. The analyses carried out indicate environmental stabilities based on the characterization of seismic signatures (echo characters) and the definition of triggers, which contributes to local stress and stimulates the sensitivity found in this lagoon ecosystem

Prevalence of serological inability of blood donors in regional blood center of Montes Claros, Minas Gerais

Objective: to estimate the prevalence of disability serological of blood donors at the Regional Blood Center of Montes Claros, in the period 2009 to 2013. Methods: this is a transversal study, exploratory, through retrospective data collection, involving 2.101 donors unfit serologically. The study was approved by the CEP of Hemominas Foundation 381/2014. Results: of the 82.743 candidates suitable for blood collection, 2.101 (2,5%) had reactive serologic tests, but only 1.434 (1,9%) confirmed the result through the 2nd sample collection. Among the diseases investigated, there was the following distribution prevalence of hepatitis B (anti-HBc) donors with 0,77% about the total of suitable, syphilis (0,41%), Chagas (0,40%), and others showed values below 0,08%. Conclusion: we concluded that in comparison with other studies, it was found that the prevalence of disability in our blood bank serological is similar, showing that the measures taken are safe

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

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

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

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

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Prevalence of serological inability of blood donors in regional blood center of Montes Claros, Minas Gerais Prevalência de inaptidão sorológica dos doadores de sangue no hemocentro regional de Montes Claros, Minas Gerais

Resumo OBJETIVO: estimar a prevalência da inaptidão sorológica dos doadores de sangue no Hemocentro Regional de Montes Claros, no período de 2009 a 2013. MÉTODOS: trata-se de um estudo transversal, de caráter exploratório, através da coleta de dados retrospectivos, que envolveu 2.101 doadores inaptos sorologicamente. O estudo foi aprovado pelo CEP da Fundação Hemominas nº381/2014. RESULTADOS: do total de 82.743 candidatos aptos para a coleta de sangue, 2.101(2,5%) apresentaram testes sorológicos reativos, porém apenas 1.434 (1,9%) confirmaram o resultado através da coleta de 2ª amostra. Dentre as doenças pesquisadas, houve a seguinte distribuição de prevalência: hepatite B (anti-HBc) com 0,77% doadores em relação ao total dos aptos; sífilis (0,41%); Chagas (0,40%); e demais apresentaram valores abaixo de 0,08%. CONCLUSÃO: concluímos que em comparação com outros estudos, verificou-se que a prevalência de inaptidão sorológica em nosso hemocentro é semelhante, mostrando que as medidas adotadas são seguras. DESCRITORES: Sorologia; Doadores de Sangue; Doenças Transmissíveis.    

Prevalence of serological inability of blood donors in regional blood center of Montes Claros, Minas Gerais

OBJETIVO: estimar a prevalência da inaptidão sorológica dos doadores de sangue no Hemocentro Regional de Montes Claros, no período de 2009 a 2013. MÉTODOS: trata-se de um estudo transversal, de caráter exploratório, através da coleta de dados retrospectivos, que envolveu 2.101 doadores inaptos sorologicamente. O estudo foi aprovado pelo CEP da Fundação Hemominas nº381/2014. RESULTADOS: do total de 82.743 candidatos aptos para a coleta de sangue, 2.101(2,5%) apresentaram testes sorológicos reativos, porém apenas 1.434 (1,9%) confirmaram o resultado através da coleta de 2ª amostra. Dentre as doenças pesquisadas, houve a seguinte distribuição de prevalência: hepatite B (anti-HBc) com 0,77% doadores em relação ao total dos aptos; sífilis (0,41%); Chagas (0,40%); e demais apresentaram valores abaixo de 0,08%. CONCLUSÃO: concluímos que em comparação com outros estudos, verificou-se que a prevalência de inaptidão sorológica em nosso hemocentro é semelhante, mostrando que as medidas adotadas são seguras.DESCRITORES: Sorologia; Doadores de Sangue; Doenças Transmissíveis.