Seagrass and submerged aquatic vegetation (VAS) habitats off the Coast of Brazil: state of knowledge, conservation and main threats

Seagrass meadows are among the most threatened ecosystems on earth, raising concerns about the equilibrium of coastal ecosystems and the sustainability of local fisheries. The present review evaluated the current status of the research on seagrasses and submerged aquatic vegetation (SAV) habitats off the coast of Brazil in terms of plant responses to environmental conditions, changes in distribution and abundance, and the possible role of climate change and variability. Despite an increase in the number of studies, the communication of the results is still relatively limited and is mainly addressed to a national or regional public; thus, South American seagrasses are rarely included or cited in global reviews and models. The scarcity of large-scale and long-term studies allowing the detection of changes in the structure, abundance and composition of seagrass habitats and associated species still hinders the investigation of such communities with respect to the potential effects of climate change. Seagrass meadows and SAV occur all along the Brazilian coast, with species distribution and abundance being strongly influenced by regional oceanography, coastal water masses, river runoff and coastal geomorphology. Based on these geomorphological, hydrological and ecological features, we characterised the distribution of seagrass habitats and abundances within the major coastal compartments. The current conservation status of Brazilian seagrasses and SAV is critical. The unsustainable exploitation and occupation of coastal areas and the multifold anthropogenic footprints left during the last 100 years led to the loss and degradation of shoreline habitats potentially suitable for seagrass occupation. Knowledge of the prevailing patterns and processes governing seagrass structure and functioning along the Brazilian coast is necessary for the global discussion on climate change. Our review is a first and much-needed step toward a more integrated and inclusive approach to understanding the diversity of coastal plant formations along the Southwestern Atlantic coast as well as a regional alert the projected or predicted effects of global changes on the goods and services provided by regional seagrasses and SAV

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\ub74% vs 44\ub72%; absolute difference \u20131\ub769 [\u20139\ub758 to 6\ub711] p=0\ub767; 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\u20138] vs 6 [5\u20138] cm H2O; p=0\ub70011). ICU mortality was higher in MICs than in HICs (30\ub75% vs 19\ub79%; p=0\ub70004; adjusted effect 16\ub741% [95% CI 9\ub752\u201323\ub752]; p<0\ub70001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0\ub780 [95% CI 0\ub775\u20130\ub786]; p<0\ub70001). 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. Funding: No funding

Mucopolysaccharidosis I, II, and VI: Brief review and guidelines for treatment

Mucopolysaccharidoses (MPS) are rare genetic diseases caused by the deficiency of one of the lysosomal enzymes involved in the glycosaminoglycan (GAG) breakdown pathway. This metabolic block leads to the accumulation of GAG in various organs and tissues of the affected patients, resulting in a multisystemic clinical picture, sometimes including cognitive impairment. Until the beginning of the XXI century, treatment was mainly supportive. Bone marrow transplantation improved the natural course of the disease in some types of MPS, but the morbidity and mortality restricted its use to selected cases. The identification of the genes involved, the new molecular biology tools and the availability of animal models made it possible to develop specific enzyme replacement therapies (ERT) for these diseases. At present, a great number of Brazilian medical centers from all regions of the country have experience with ERT for MPS I, II, and VI, acquired not only through patient treatment but also in clinical trials. Taking the three types of MPS together, over 200 patients have been treated with ERT in our country. This document summarizes the experience of the professionals involved, along with the data available in the international literature, bringing together and harmonizing the information available on the management of these severe and progressive diseases, thus disclosing new prospects for Brazilian patients affected by these conditions

Controle de mosquitos com base em larvicidas no Estado do Rio Grande do Sul, Brasil: a escolha do agente de controle Mosquito control based on larvicides in the State of Rio Grande do Sul, Brazil: choice of the control agent

Desenvolveu-se neste estudo uma comparação entre larvicidas químicos e biológicos usados em programas de controle de mosquitos no Rio Grande do Sul. Em bioensaios de laboratório contra Culex quinquefasciatus constatou-se que as formulações biológicas líquidas Vectobac 12 AS e Teknar 3000 (Bacillus thuringiensis israelensis), ABG 6262 líquido e em pó (B. sphaericus 2362), foram altamente eficazes. Também as formulações experimentais de B. thuringiensis israelensis produzidas em laboratórios brasileiros foram consideradas adequadas. Entre as formulações químicas, os compostos piretróides Pirisa e K-Othrine produziram resultados melhores do que os organo-fosforados Lebaycid e Abate. Estes últimos produziram respostas dez vezes mais fracas do que o previsto em outros estudos. Em condições de campo, a dose de 1250 mg/m² para as formulações biológicas foi considerada adequada para a rotina das aplicações, porque permite superar as influências físicas do meio sobre os resultados. Somente as formulações de B. sphaericus produziram interrupções nas reinfestações dos focos de culicídeos observados. Períodos de até 39 semanas sem reinfestações foram observados em focos naturais e de um mês sem sobrevivência foi observado em tanques, onde procedia-se a reinfestação artificial. Este estudo sugere que as alternativas biológicas devem ser consideradas em programas de controle de mosquitos. Elas podem superar os problemas de resistência e eliminação, bem como da ausência de efeito residual nas aplicações de larvicidas.<br>A comparison between chemical and biological larvicides in routine operations against mosquitoes in Rio Grande do Sul State was carried out in this study. In laboratory bioassays against Culex quinquefasciatus, biological formulations Vectobac 12 AS and Teknar 3000 (Bacillus thuringiensis israelensis) as well as ABG 6262 (B. sphaericus 2362), both in liquid and powder form, were highly effective. Locally produced B.thuringiensis israelensis, formulations also yielded good results. Among chemical larvicides, pyrethroid compounds Pirisa and K-Othrine yielded better results than the organophosphates Lebaycid and Abate. These last formulations yielded responses ten weaker than predicted in other studies. Under field conditions, a dose of 1250 mg/m² for biological formulations was considered adequate for routine application because at this level it is possible to overcome physical influences on results. Only B.sphaericus preparations caused important disruption of mosquito colonization in active breeding sites. Up to 39 weeks were tabulated without complete colonization in natural conditions and one month in artificially colonized tanks. This study suggests that biological alternatives should be considered in mosquito control programs. They may be a solution to such problems as resistance to larvicides, elimination of natural enemies, and short-lasting effects of applications