ANÁLISE DOS POLUENTES ATMOSFÉRICOS NO2 E O3 VIA AMOSTRADORES PASSIVOS DE BAIXO CUSTO

O uso de equipamentos que monitorem a concentração de poluentes pode contribuir para prevenção de possíveis danos à saúde humana. Esse trabalho consiste no desenvolvimento de amostradores passivos de baixo custo para a determinação dos poluentes NO2 e O3 no campus Alto Paraopeba, através da análise fatorial e superfície de resposta. Os amostradores foram construídos em placas de Petri com filtros de papel contendo diferentes soluções absorvedoras para cada tipo de gás monitorado. Os amostradores de NO2 foram expostos no refeitório da Universidade e os amostradores de O3 foram expostos na sala de máquinas fotocopiadoras. Nos amostradores foram usadas diferentes quantidades de solução absorvedora e, também, diferentes tempos de exposição. Os resultados mostraram que a melhor condição para o NO2 foi obtida com 4,6 mL de solução absorvedora e no tempo de 68 horas de exposição. Nessas condições, a concentração de NO2 no Restaurante Universitário foi de 10,5 µg/m3. Para o ozônio, as concentrações variaram entre 4,2 µg/m3 e 40 µg/m3, e a melhor condição (3 mL de solução absorvedora e tempo de 77 horas) está localizada no ponto sela e não na região ótima do gráfico. Isso ocorre devido ao fato do ozônio se decompor rapidamente a oxigênio. Os amostradores passivos apresentaram resultados satisfatórios e recomenda-se seu uso como uma alternativa de baixo custo para o monitoramento de NO2 e O3 no Restaurante Universitário e sala de Fotocopiadoras.  ABSTRACTThe use of equipment that monitors the concentration of pollutants can contribute to the prevention of possible damages to human health. This work is to develop inexpensive passive samplers for the determination of NO2 and O3 pollution in the campus Alto Paraopeba beyond the optimization of analytical methods by software that provides a complete environment for data analysis; by factor analysis and response surface generated by it. The samplers were constructed on Petri dishes with paper filter containing different absorbing solutions according to each monitored gas. The samplers were exposed to NO2 at university restaurant and others samplers were exposed to O3 at the photocopier room of the campus. In samplers were used different amounts of absorber solution and also different exposure times. The results showed that the best condition for NO2 was obtained with 4.6 mL of absorbing solution in time of 68 hours exposure. Under these conditions, the concentration of NO2 in the university restaurant was 10.5 µg/m3. For ozone, the concentrations ranged from 4.2 µg/m3 and 40 µg/m3, and the best condition (3 mL absorbing solution and time of 77 hours) is located at saddle point and not at the optimal region of the graph. This is because ozone has rapidly decomposes to oxygen. Passive samplers presented satisfactory results and it is recommended to use them as a low cost alternative for the monitoring of NO2 and O3 in the University Restaurant and Photocopiers room

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

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

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

Prevalence of endocervical Chlamydia trachomatis infection in university students from Pará State, Amazon Region, Brazil

Superintendência de Assistência Estudantil e Pró-Reitoria de Extensão da UFPA.Universidade Federal do Pará. Núcleo de Medicina Tropical. Laboratório de Biologia Molecular e Celular. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Citopatologia. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Citopatologia. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Citopatologia. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Citopatologia. Belém, PA, Brasil.Universidade Federal do Pará. Núcleo de Medicina Tropical. Laboratório de Biologia Molecular e Celular. Belém, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Citopatologia. Belém, PA, Brasil.Universidade Federal do Pará. Instituto de Ciências Biológicas. Laboratório de Citopatologia. Belém, PA, Brasil.Universidade Federal do Pará. Núcleo de Medicina Tropical. Laboratório de Biologia Molecular e Celular. Belém, PA, Brasil.Universidade Federal do Pará. Núcleo de Medicina Tropical. Laboratório de Biologia Molecular e Celular. Belém, PA, Brasil.OBJETIVOS: Descrever a prevalência e os fatores associados à infecção endocervical por Chlamydia trachomatis em estudantes de uma universidade da capital e de três de seus campi do interior do estado do Pará, Amazônia, Brasil. MATERIAIS E MÉTODOS: Estudo transversal, com mulheres de idade igual ou superior a 18 anos, que realizaram o preventivo do câncer do colo uterino, de setembro de 2010 a outubro de 2014. O DNA da secreção cérvico-vaginal foi extraído pelo método fenol-clorofórmio e submetido à amplificação dos genes da β-globina humana e ompA de C. trachomatis por reação em cadeia da polimerase. Foram utilizados os testes de Mann-Whitney, estimação da proporção e odds ratio para análises estatísticas. O p ≤ 0,05 foi considerado estatisticamente significativo para um intervalo de confiança (IC) de 95%. RESULTADOS: A prevalência de C. trachomatis foi de 11,9% [54/454 (IC 95% 8,9–14,9)]. A infecção foi identificada em 10,4% [36/345 (IC 95% 7,2–13,7)] das estudantes da Capital e em 16,5% [18/109 (IC 95% 10,3–24,6)] das estudantes dos campi do interior (p = 0,12), sendo de 7,1% (2/28) no Interior 1, 22,2% (6/27) no Interior 2 e 18,5% (10/54) no Interior 3. Não foi observada associação entre as variáveis investigadas e a infecção endocervical por C. trachomatis. CONCLUSÃO: A prevalência da infecção por C. trachomatis entre as universitárias se assemelhou à média encontrada no Brasil e não se mostrou associada às condições sociodemográficas e comportamentais das universitárias investigadas.OBJECTIVES: To describe the prevalence and factors associated with endocervical infection by Chlamydia trachomatis in students from a university in the capital and three campuses in inland towns of Pará State, Amazon, Brazil. MATERIALS AND METHODS: A cross-sectional study with women aged 18 years or older who underwent cervical cancer prevention from September 2010 to October 2014. DNA from cervicovaginal secretion was extracted using the phenol-chloroform method and subjected to the amplification of the human β-globin and ompA genes of C. trachomatis by polymerase chain reaction. Mann-Whitney tests, proportion estimation, and odds ratio were used for statistical analysis. The p ≤ 0.05 was considered statistically significant for a confidence interval (CI) of 95%. RESULTS: The prevalence of C. trachomatis was 11.9% [54/454 (95% CI 8.9–14.9)]. Infection was identified in 10.4% [36/345 (95% CI 7.2–13.7)] of the students in the Capital and in 16.5% [18/109 (95% CI 10.3–24.6) of students from the campuses in the inland towns (p = 0.12), with 7.1% (2/28) in the Town 1, 22.2% (6/27) in the Town 2, and 18.5% (10/54) in the Town 3. No association between the investigated variables and the endocervical infection by C. trachomatis was observed. CONCLUSION: The prevalence of C. trachomatis infection among those university students was similar to the average found in Brazil and was not associated with the sociodemographic and behavioral conditions of the university students investigated

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally