Distribution, composition and genesis of the silica deposits in the Branca Opala volcanic cave (Terceira, Azores Islands)

La cueva de Branca Opala es un tubo volcánico localizado en la zona basáltica fisural de la isla de Terceira (Islas Azores, Portugal). Se identifican dentro de la cueva tres tipos de depósitos: estromatolitos, depósitos terrígenos siliciclásticos provenientes de la roca volcánica y depósitos formados por restos vegetales con sedimentos terrígenos. En el exterior, y en zonas próximas, se estudian también tobas silíceas. En los estromatolitos se definen tres partes desde el substrato de crecimiento: laminar inferior, arborescente-esferoidal y laminar superior, encontrándose en todas ellas estructuras filamentosas interpretadas como bacterias. La única fase silícea que forma los estromatolitos es un ópalo A inmaduro, por lo que se deduce que son relativamente recientes. Los basaltos de la cueva, y los sedimentos volcanoclásticos finos no presentan casi alteración, por lo que aguas freáticas y de escorrentía aportarían la sílice a la cueva, siendo fijada por bacterias, y formándose estromatolitos en condiciones subacuáticasThe Branca Opala cave is a lava-tube located in the basaltic fissurale zone of the island of Terceira (Azores archipelago, Portugal). Three types of deposits are identified inside the cave: stromatolites, terrigenous siliciclastic deposits from the volcanic rock and deposits formed by vegetal remains and terrigenous sediments. In the outer parts of the cave a siliceous tuff is also studied. From the growth substrate three parts are defined in the stromatolites: lower laminar, dendriform-spheroidal and superior laminar. In all of them, filamentous structures are found, and are interpreted as bacteria. The only silica phase forming stromatolites is an inmature, thus relatively recent, opal A. The silica source is not found either in the basaltic host rocks or in the fine volcanoclastic deposits because they are little altered. Groundwaters and runoff would contribute the silica to the cave, where the bacteria would fix the silica, forming stromatolites under subaquatic environment

An overview of migratory birds in Brazil

We reviewed the occurrences and distributional patterns of migratory species of birds in Brazil. A species was classified as migratory when at least part of its population performs cyclical, seasonal movements with high fidelity to its breeding grounds. Of the 1,919 species of birds recorded in Brazil, 198 (10.3%) are migratory. Of these, 127 (64%) were classified as Migratory and 71 (36%) as Partially Migratory. A few species (83; 4.3%) were classified as Vagrant and eight (0,4%) species could not be defined due to limited information available, or due to conflicting data.Fil: Somenzari, Marina. Centro Nacional de Pesquisa e Conservação de Aves Silvestres. Instituto Chico Mendes de Conservação da Biodiversidade; BrasilFil: Amaral, Priscilla Prudente do. Centro Nacional de Pesquisa e Conservação de Aves Silvestres. Instituto Chico Mendes de Conservação da Biodiversidade; BrasilFil: Cueto, Víctor. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Centro de Investigación Esquel de Montaña y Estepa Patagóica. Universidad Nacional de la Patagonia "San Juan Bosco". Facultad de Ciencias Naturales - Sede Esquel. Centro de Investigación Esquel de Montaña y Estepa Patagónica; ArgentinaFil: Guaraldo, André de Camargo. Universidade Federal do Paraná; BrasilFil: Jahn, Alex. Universidade Estadual Paulista Julio de Mesquita Filho; BrasilFil: Lima, Diego Mendes. Centro Nacional de Pesquisa e Conservação de Aves Silvestres. Instituto Chico Mendes de Conservação da Biodiversidade; BrasilFil: Lima, Pedro Cerqueira. Fundação BioBrasil; BrasilFil: Lugarini, Camile. Centro Nacional de Pesquisa e Conservação de Aves Silvestres. Instituto Chico Mendes de Conservação da Biodiversidade; BrasilFil: Machado, Caio Graco. Universidade Estadual de Feira de Santana; BrasilFil: Martinez, Jaime. Universidade de Passo Fundo; BrasilFil: do Nascimento, João Luiz Xavier. Centro Nacional de Pesquisa e Conservação de Aves Silvestres. Instituto Chico Mendes de Conservação da Biodiversidade; BrasilFil: Pacheco, José Fernando. Comitê Brasileiro de Registros Ornitológicos; BrasilFil: Paludo, Danielle. Centro Nacional de Pesquisa e Conservação de Aves Silvestres. Instituto Chico Mendes de Conservação da Biodiversidade; BrasilFil: Prestes, Nêmora Pauletti. Universidade de Passo Fundo; BrasilFil: Serafini, Patrícia Pereira. Centro Nacional de Pesquisa e Conservação de Aves Silvestres. Instituto Chico Mendes de Conservação da Biodiversidade; BrasilFil: Silveira, Luís Fábio. Universidade de Sao Paulo; BrasilFil: de Sousa, Antônio Emanuel Barreto Alves. Centro Nacional de Pesquisa e Conservação de Aves Silvestres. Instituto Chico Mendes de Conservação da Biodiversidade; BrasilFil: de Sousa, Nathália Alves. Centro Nacional de Pesquisa e Conservação de Aves Silvestres. Instituto Chico Mendes de Conservação da Biodiversidade; BrasilFil: de Souza, Manuella Andrade. Centro Nacional de Pesquisa e Conservação de Aves Silvestres. Instituto Chico Mendes de Conservação da Biodiversidade; BrasilFil: Telino-Júnior, Wallace Rodrigues. Universidade Federal de Pernambuco; BrasilFil: Whitney, Bret Myers. State University of Louisiana; Estados Unido

Durvalumab Plus Carboplatin/Paclitaxel Followed by Maintenance Durvalumab With or Without Olaparib as First-Line Treatment for Advanced Endometrial Cancer: The Phase III DUO-E Trial

PURPOSE Immunotherapy and chemotherapy combinations have shown activity in endometrial cancer, with greater benefit in mismatch repair (MMR)-deficient (dMMR) than MMR-proficient (pMMR) disease. Adding a poly(ADP-ribose) polymerase inhibitor may improve outcomes, especially in pMMR disease. METHODS This phase III, global, double-blind, placebo-controlled trial randomly assigned eligible patients with newly diagnosed advanced or recurrent endometrial cancer 1:1:1 to: carboplatin/paclitaxel plus durvalumab placebo followed by placebo maintenance (control arm); carboplatin/paclitaxel plus durvalumab followed by maintenance durvalumab plus olaparib placebo (durvalumab arm); or carboplatin/paclitaxel plus durvalumab followed by maintenance durvalumab plus olaparib (durvalumab + olaparib arm). The primary end points were progression-free survival (PFS) in the durvalumab arm versus control and the durvalumab + olaparib arm versus control. RESULTS Seven hundred eighteen patients were randomly assigned. In the intention-to-treat population, statistically significant PFS benefit was observed in the durvalumab (hazard ratio [HR], 0.71 [95% CI, 0.57 to 0.89]; P = .003) and durvalumab + olaparib arms (HR, 0.55 [95% CI, 0.43 to 0.69]; P < .0001) versus control. Prespecified, exploratory subgroup analyses showed PFS benefit in dMMR (HR [durvalumab v control], 0.42 [95% CI, 0.22 to 0.80]; HR [durvalumab + olaparib v control], 0.41 [95% CI, 0.21 to 0.75]) and pMMR subgroups (HR [durvalumab v control], 0.77 [95% CI, 0.60 to 0.97]; HR [durvalumab + olaparib v control] 0.57; [95% CI, 0.44 to 0.73]); and in PD-L1-positive subgroups (HR [durvalumab v control], 0.63 [95% CI, 0.48 to 0.83]; HR [durvalumab + olaparib v control], 0.42 [95% CI, 0.31 to 0.57]). Interim overall survival results (maturity approximately 28%) were supportive of the primary outcomes (durvalumab v control: HR, 0.77 [95% CI, 0.56 to 1.07]; P = .120; durvalumab + olaparib v control: HR, 0.59 [95% CI, 0.42 to 0.83]; P = .003). The safety profiles of the experimental arms were generally consistent with individual agents. CONCLUSION Carboplatin/paclitaxel plus durvalumab followed by maintenance durvalumab with or without olaparib demonstrated a statistically significant and clinically meaningful PFS benefit in patients with advanced or recurrent endometrial cancer

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

ABC₂-SPH risk score for in-hospital mortality in COVID-19 patients

Objectives: The majority of available scores to assess mortality risk of coronavirus disease 2019 (COVID-19) patients in the emergency department have high risk of bias. Therefore, this cohort aimed to develop and validate a score at hospital admission for predicting in-hospital mortality in COVID-19 patients and to compare this score with other existing ones. Methods: Consecutive patients (≥ 18 years) with confirmed COVID-19 admitted to the participating hospitals were included. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients admitted between March–July, 2020. The model was validated in the 1054 patients admitted during August–September, as well as in an external cohort of 474 Spanish patients. Results: Median (25–75th percentile) age of the model-derivation cohort was 60 (48–72) years, and in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. Seven significant variables were included in the risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO2/FiO2 ratio, platelet count, and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829–0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833–0.885]) and Spanish (0.894 [95% CI 0.870–0.919]) validation cohorts, and displayed better discrimination ability than other existing scores. It is implemented in a freely available online risk calculator (https://abc2sph.com/). Conclusions: An easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation was designed and validated for early stratification of in-hospital mortality risk of patients with COVID-19.</p

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Núcleos de Ensino da Unesp: artigos 2008

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p&lt;0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p&lt;0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially