Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Genomic Analyses of Potential Novel Recombinant Human Adenovirus C in Brazil

Human Adenovirus species C (HAdV-C) is the most common etiologic agent of respiratory disease. In the present study, we characterized the nearly full-length genome of one potential new HAdV-C recombinant strain constituted by Penton and Fiber proteins belonging to type 89 and a chimeric Hexon protein of types 1 and 89. By using viral metagenomics techniques, we screened out, in the states of Tocantins and Pará, Northern and North regions of Brazil, from 2010 to 2016, 251 fecal samples of children between 0.5 to 2.5 years old. These children were presenting acute diarrhea not associated with common pathogens (i.e., rotavirus, norovirus). We identified two HAdV-C strains in two distinct patients. Phylogenetic analysis performed using all complete genomes available at GenBank database indicated that one strain (HAdV-C BR-245) belonged to type 1. The phylogenetic analysis also indicated that the second strain (HAdV-C BR-211) was located at the base of the clade formed by the newly HAdV-C strains type 89. Recombination analysis revealed that strain HAdV-C BR-211 is a chimera in which the variable regions of Hexon gene combined HAdV-C1 and HAdV-C89 sequences. Therefore, HAdV-C BR-211 strain possesses a genomic backbone of type HAdV-C89 and a unique insertion of HAdV-C1 in the Hexon sequence. Recombination may play an important driving force in HAdV-C diversity and evolution. Studies employing complete genomic sequencing on circulating HAdV-C strains in Brazil are needed to understand the clinical significance of the presented data

Níveis de suplemento à base de fubá de milho para novilhos Nelore terminados a pasto na seca: desempenho, características de carcaça e avaliação do pasto Levels of corn meal based supplement in Nellore steers finished on pasture in the dry season: performance, carcass characteristics and pasture evaluation

Objetivou-se com este trabalho avaliar a disponibilidade dos componentes da pastagem, o ganho de peso e as características de carcaça de novilhos Nelore recebendo suplemento na fase de terminação durante o período seco. O experimento foi realizado em pastagem de capim-braquiária (Brachiaria brizantha, cv. Marandu), em seis piquetes de 9 hectares. Utilizaram-se 48 novilhos com 30 meses e peso inicial de 412 ± 16 kg, distribuídos ao acaso em seis lotes de oito animais. Cada lote foi alojado em um piquete e pesado no início e a cada 21 dias, durante 84 dias. Os suplementos foram fornecidos nos níveis de 0,25; 0,5; 1,0; 2,0; e 4,0 kg/animal.dia em comparação a um suplemento controle, com apenas mistura mineral. Os suplementos, à exceção do controle, apresentaram níveis variáveis de proteína bruta (87,4 a 25,0% da matéria seca) e 25:25:50, 15:15:70, 10:10:80, 5:5:90 e 2,5:2,5:95 para 0,25; 0,5; 1,0; 2,0; e 4,0 kg/animal.dia, respectivamente, uma vez que a ureia foi usada como controladora do consumo de suplemento. O delineamento foi inteiramente casualizado e os níveis de suplementação foram avaliados por análise de regressão. A proporção de colmo e folha seca aumentou no decorrer dos períodos experimentais, caracterizando déficit hídrico da estação seca. Houve efeito linear crescente dos níveis de suplemento sobre o peso vivo final, o ganho de peso médio diário e o ganho médio por período, tanto em relação ao consumo de suplemento quanto em relação ao consumo de proteína bruta e nutrientes digestíveis totais. Os níveis de suplemento têm efeito linear crescente sobre o peso de carcaça e a espessura de gordura subcutânea e efeito quadrático sobre o rendimento de carcaça.<br>The objective of this study was to evaluate the availability of pasture components, average daily gain and carcass characteristics of Nellore steers receiving supplements in the finishing phase during the dry season. The experiment was carried out on Brachiaria brizantha, cv. Marandu pasture, in six nine-hectare paddocks. Forty-eight 30 month old Nellore steers with 412 + 16 kg initial weight were randomly distributed in six groups of eight animals. Each group was placed in a paddock and was weighed at the beginning and at every 21 days, for 84 days. Increasing levels of supplements were used: 0.25, 0.5, 1.0, 2.0, and 4.0 kg/animal.day, in comparison to a supplement control that received only mineral mixture. The supplements, except the control, presented variable levels of crude protein (87.4 to 25.0% of the dry matter), and proportions of mineral mixture:urea:corn meal of 25:25:50, 15:15:70, 10:10:80, 5:5:90, and 2.5:2.5:95 for 0.25, 0.5, 1.0, 2.0, and 4.0 kg/animal.day, respectively, since that urea was used as supplement intake controller. The supplementation levels were evaluated by regression in a randomized complete design. The proportion of stem and dead leaf increased over the experimental periods, characterizing the dry season. There was increasing linear effect on the final live weight, average daily gain and average daily gain per period as a function of the supplement intake, and average daily gain as a function of the crude protein and intake of total digestible nutrients. The supplement levels have an increasing linear effect on the carcass weight and fat thickness and quadratic effect for carcass yield

Establishment and cryptic transmission of Zika virus in Brazil and the Americas

University of Oxford. Department of Zoology, Oxford, UK / Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.University of Birmingham. Institute of Microbiology and Infection. Birmingham, UK.University of Oxford. Department of Zoology. Oxford UK.University of Oxford. Department of Zoology. Oxford, UK / Harvard Medical School. Boston, MA, USA / Boston Children's Hospital. Boston, MA, USA.University of Oxford. Department of Zoology. Oxford, UK.Fred Hutchinson Cancer Research Center. Vaccine and Infectious Disease Division. Seattle, WA, USA / University of Washington. Department of Epidemiology. Seattle, WA, USA.University of São Paulo. School of Medicine &Institute of Tropical Medicine. Department of Infectious Disease. São Paulo, SP, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.University of Oxford. Department of Statistics. Oxford, UK.University of Oxford. Department of Zoology. Oxford, UK.Institut Pasteur. Biostatistics and Integrative Biology. Mathematical Modelling of Infectious Diseases and Center of Bioinformatics. Paris, FR / Centre National de la Recherche Scientifique. Paris, FR.University of Oxford. Department of Zoology. Oxford, UK.Ministry of Health. Coordenação dos Laboratórios de Saúde. Brasília, DF, Brazil.Ministry of Health. Coordenação Geral de Vigilância e Resposta às Emergências em Saúde Pública. Brasília, DF, Brazil / Fundação Oswaldo Cruz. Center of Data and Knowledge Integration for Health. Salvador, BA, Brazil.Ministry of Health. Departamento de Vigilância das Doenças Transmissíveis. Brasilia, DF, Brazil.Ministry of Health. Coordenação Geral dos Programas de Controle e Prevenção da Malária e das Doenças Transmitidas pelo Aedes. Brasília, DF, Brazil / Pan American Health Organization (PAHO). Buenos Aires, AR.Ministry of Health. Coordenação Geral dos Programas de Controle e Prevenção da Malária e das Doenças Transmitidas pelo Aedes. Brasília, DF, Brazil / Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brazil.Ministry of Health. Coordenação Geral dos Programas de Controle e Prevenção da Malária e das Doenças Transmitidas pelo Aedes. Brasília, DF, BrazilMinistry of Health. Departamento de Vigilância das Doenças Transmissíveis. Brasilia, DF, Brazil.Ontario Institute for Cancer Research. Toronto, ON, Canada.University of Nottingham. Nottingham, UKThe Scripps Research Institute. Department of Immunology and Microbial Science. La Jolla, CA, USA.The Scripps Research Institute. Department of Immunology and Microbial Science. La Jolla, CA, USA.University of California. Departments of Laboratory Medicine and Medicine & Infectious Diseases. San Francisco, CA, USA.University of California. Departments of Laboratory Medicine and Medicine & Infectious Diseases. San Francisco, CA, USA.Instituto Mexicano del Seguro Social. División de Laboratorios de Vigilancia e Investigación Epidemiológica. Ciudad de México, MC.Instituto Mexicano del Seguro Social. División de Laboratorios de Vigilancia e Investigación Epidemiológica. Ciudad de México, MC.Universidad Nacional Autónoma de México. Instituto de Biotecnología. Cuernavaca, MC.Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brazil.Paul-Ehrlich-Institut. Langen, Germany.Laboratório Central de Saúde Pública Noel Nutels. Rio de Janeiro, RJ, Brazil.Laboratório Central de Saúde Pública Noel Nutels. Rio de Janeiro, RJ, Brazil.Laboratório Central de Saúde Pública Noel Nutels. Rio de Janeiro, RJ, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Fundação Oswaldo Cruz. Salvador, BA, Brazil.Laboratório Central de Saúde Pública. Natal, RN, Brazil.Laboratório Central de Saúde Pública. Natal, RN, Brazil / Universidade Potiguar. Natal, RN, Brazil.Laboratório Central de Saúde Pública. Natal, RN, Brazil / Faculdade Natalense de Ensino e Cultura. Natal, RN, Brazil.Laboratório Central de Saúde Pública. João Pessoa, PB, Brazil.Laboratório Central de Saúde Pública. João Pessoa, PB, Brazil.Laboratório Central de Saúde Pública. João Pessoa, PB, Brazil.Laboratório Central de Saúde Pública. João Pessoa, PB, Brazil.Fundação Oswaldo Cruz. Recife, PE, Brazil.Fundação Oswaldo Cruz. Recife, PE, Brazil.Fundação Oswaldo Cruz. Recife, PE, Brazil / Colorado State University. Department of Microbiology, Immunology &Pathology. Fort Collins, CO, USA.Fundação Oswaldo Cruz. Recife, PE, Brazil.Heidelberg University Hospital. Department for Infectious Diseases. Section Clinical Tropical Medicine. Heidelberg, Germany.Fundação Oswaldo Cruz. Recife, PE, Brazil.Laboratório Central de Saúde Pública. Maceió, AL, Brazil.Laboratório Central de Saúde Pública. Maceió, AL, Brazil.Laboratório Central de Saúde Pública. Maceió, AL, Brazil.Universidade Estadual de Feira de Santana. Feira de Santana, BA, Brazil.Secretaria de Saúde de Feira de Santana. Feira de Santana, BA, Brazil.Universidade Federal do Amazonas. Manaus, AM, Brazil.University of São Paulo. School of Medicine &Institute of Tropical Medicine. Department of Infectious Disease. São Paulo, SP, Brazil.University of São Paulo. School of Medicine &Institute of Tropical Medicine. Department of Infectious Disease. São Paulo, SP, Brazil.Hospital São Francisco. Ribeirão Preto, SP, Brazil.University of São Paulo. School of Medicine &Institute of Tropical Medicine. Department of Infectious Disease. São Paulo, SP, Brazil.Universidade Federal do Tocantins. Palmas, TO, Brazil.University of São Paulo. School of Medicine &Institute of Tropical Medicine. Department of Infectious Disease. São Paulo, SP, Brazil.University of Sydney. Sydney, Australia.University of Edinburgh. Institute of Evolutionary Biology. Edinburgh, UK / National Institutes of Health. Fogarty International Center. Bethesda, MD, USA.Fred Hutchinson Cancer Research Center. Vaccine and Infectious Disease Division. Seattle, WA, USA.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / University of Texas Medical Branch. Department of Pathology. Galveston, TX, USA.University of São Paulo. School of Medicine &Institute of Tropical Medicine. Department of Infectious Disease. São Paulo, SP, Brazil.Fundação Oswaldo Cruz. Salvador, BA, Brazil.University of Birmingham. Institute of Microbiology and Infection. Birmingham, UK.University of Oxford. Department of Zoology, Oxford, UK / Metabiota. San Francisco, CA, USA.University of São Paulo. School of Medicine &Institute of Tropical Medicine. Department of Infectious Disease. São Paulo, SP, Brazil.Fundação Oswaldo Cruz. Salvador, BA, Brazil.Fundação Oswaldo Cruz. Salvador, BA, Brazil / University of Rome Tor Vergata. Rome, Italy.Transmission of Zika virus (ZIKV) in the Americas was first confirmed in May 2015 in northeast Brazil. Brazil has had the highest number of reported ZIKV cases worldwide (more than 200,000 by 24 December 2016) and the most cases associated with microcephaly and other birth defects (2,366 confirmed by 31 December 2016). Since the initial detection of ZIKV in Brazil, more than 45 countries in the Americas have reported local ZIKV transmission, with 24 of these reporting severe ZIKV-associated disease. However, the origin and epidemic history of ZIKV in Brazil and the Americas remain poorly understood, despite the value of this information for interpreting observed trends in reported microcephaly. Here we address this issue by generating 54 complete or partial ZIKV genomes, mostly from Brazil, and reporting data generated by a mobile genomics laboratory that travelled across northeast Brazil in 2016. One sequence represents the earliest confirmed ZIKV infection in Brazil. Analyses of viral genomes with ecological and epidemiological data yield an estimate that ZIKV was present in northeast Brazil by February 2014 and is likely to have disseminated from there, nationally and internationally, before the first detection of ZIKV in the Americas. Estimated dates for the international spread of ZIKV from Brazil indicate the duration of pre-detection cryptic transmission in recipient regions. The role of northeast Brazil in the establishment of ZIKV in the Americas is further supported by geographic analysis of ZIKV transmission potential and by estimates of the basic reproduction number of the virus