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

Relação hipsométrica para Pinus caribeae var hondurensis no nordeste paraense, BRASIL

Ministério da Educação e Cultura, Faculdade de Ciências Agrárias do Pará e Serviço de Documentação e Informação.1) Nesta pesquisa procurou-se avaliar o comportamento fisiológico da semente de açaí (Euterpe oleracea, Mart,), despolpada pelo método tradicional de preparo do "vinho" de açaí, em diversos tipos de embalagens. As sementes foram acondicionadas nas embalagens: saco de papel, saco de papel envolvido por saco polietileno transparente, saco polietileno transparente, saco de juta, recipiente plástico transparente, vidro, lata e a granel (testemunha). Os resultados indicaram o saco de papel envolvido por saco polietileno transparente como mais viável. Como alternativas o recipiente plástico a lata e em última instância o recipiente de vidro. Desaconselham-se os sacos de plásticos, de juta e sistema a granel.2) Foram testados diversos tempos de imersão em água de sementes de açaí roxo (Euterpe oleracea, Mart.) despolpadas e maceradas pelo método tradicional de preparo do "vinho" de açaí. Os tratamentos constaram de imersão em água de igarapé, durante os períodos de 30, 60, 90, 120 e 180 minutos, exceto a testemunha que sofreu apenas a maceração-despolpa, comum a todos os demais tratamentos. O efeito de cada tratamento foi avaliado através da porcentagem de emergência das sementes viáveis. As semeaduras foram realizadas logo apôs cada tempo de imersão. Os resultados indicaram como melhor tempo de imersão 120 minutos após a maceração-despolpa. Como segunda opção destacou.se a maceração-despolpa (testemunha) pelo método tradicional de preparo do vinho do açaí.3) Estudou.se o efeito de diferentes espaçamentos e densidades de plantio sobre o perfilhamento e produção do arroz em cultura irrigada. O experimento foi conduzido em área de várzea da Faculdade de Ciências Agrárias do Pará, às margens do Rio Guamá, em Glei Pouco Hümico com média fertilidade natural. Os tratamentos consistiram em três espaçamentos (0,50m x 0,50m; 0,50m x 0,30m; 0,30m x 0,30m) combinados com quatro densidades de plantio (2, 3, 4 e 5 mudas por cova) perfazendo um total de doze, no arranjo experimental blocos ao acaso com 3 repetições. A cultivar usada foi a Cica. 4 em plantio por mudas. A análise estatística dos dados mostrou que para a produção níveis mais elevados foram obtidos com o espaçamento de 0,30m x 0,30m, com 5 plantas por cova quando comparado com maiores espaçamentos e menores densidades de plantio. Com relação ao perfilhamento, o espaçamento de 0,50m x 0,50m, com 4 mudas por cova proporcionou um maior número de perfilhes do que espaçamentos menores, enquanto que o menor espaçamento combinado com a maior densidade de plantio (0,30m x 0,30m com 5 mudas/cova) proporcionou plantas com menor altura quando comparado a espaçamento maiores.4) É descrito um caso de tuberculose em um büfalo (Bubalus bubalis var bubalis — Linneu, 1758), sem definição racial, do sexo masculino, com aproximadamente 2 anos de idade e originário do Município de Chaves, apresentando lesões comprometendo os pulmões, o fígado e diversos linfonódios.5) Em ensaios com feijão de metro Vigna unguiculata (L.) Walp subsp. sesquipedalis (L.) Verdcourt., instalado em 1976 e 1977 em condições do Estado do Pará, observou-se que o melhor tratamento foi o tipo de varledade Semente Preta plantado no mês de junho, numa densidade de 3 plantas por cova. Observou-se ainda uma maior incidência de doenças foliares na época chuvosa (janeiro.março) assim como uma menor intensidade de luz, em prejuízo da cultura.6) 6) O estudo preliminar do rebanho bi.mestiço Jerdi (5/8 Jersey + 3/8 Sindi), utilizou dados de 16 matrizes e 45 bezerros, sendo 25 machos e 20 fêmeas, correspondentes ao período de 1977 a 1980, na Faculdade de Ciências Agrárias do Pará, localizada em Belém, Estado do Pará. Foram analisados os efeitos do ano de nascimento do bezerro e/ou ano de produção, do período de lactação, produção total de leite e teor de gordura. A análise dos dados mostrou que o efeito do ano de nascimento, foi significativo sobre o período de lactação (P0,05). As maiores médias para a produção de leite ocorreram nos anos de 1977 e 1978, respectivamente. O período mais chuvoso e o menos chuvoso, o sexo da cria e a idade da mãe não exerceram influência significativa sobre nenhuma das características estudadas (P>0,05).7) Reúne informações sobre modelos de regressão para estimar a altura total, em função de parâmetros dendrométricos de fácil obtenção no campo, para Pinus caribeae var hondurensis no nordeste paraense, Brasil. Foram utilizadas 76 árvores, com amplitude diamétrica de 4 a 25 cm de diversos talhões. O melhor resultado foi alcançado com a equação Ht = D2 / ( — 1,633586368 + 1,2216842911) + 0,0240630453 D2) + 1,3 sendo r2 - 0,6 e Syx = 1,9.1) The physiological behaviocer of pulped mechanically açaí seeds (Euterpe oleracea, Mart.) was studied in varions package kinds. The seeds were packed in: paper bag, paper bag involved in transparent polyethylenic bagi transparent polyethylenic bag, jute bag, transparent receiver, glass, tin box and granary (testimony). The results show the use of paper bag involved in transparent polyethylènic bag as the more viable and options the plastic receiver, the tin box, at last, the glass receiver. One must not use plastic and jute bag and granary.2) Many lenght of time pulped vlolet açai (Euterpe oleracea. Mart.) seeds imersion were tested. "maceration-pulp" traditional method in preparing the açai jude. The treatments were made by imersion in " igarapé" water during varions periods, as 30, 60, 90, 120 and 180 minutes, except the testimony that bore the "maceration-pulp" only, common on other treatments. The effect of each treatments was rated by emergence percentag of viable seeds. The sowing was made subsequenty to each time imersion, 120 minutes after " maceration-pulp" and as an option the "maceration-pulp" traditional method in preparing the açai juice.3) The effects of distance hetween rows and density of planting upon tillering and grain yield of irrigated rice were studled in a trial carried out at the campus of Faculdade de Ciências Agrárias do Pará, Belém, Pará on a swamp area of Guamá river in a Low Humic Glay soil. Seedlings of Cica.4 cultivar were used Three distances hetween rows (0,50m x 0,50m; 0,50m x 0,30m; 0,30m x 0,30m) combined with four planting densities (2, 3, 4 e 5 seedlings per hole) amounting to twelve treatments were tested. The estatistical analysis of the data indicated that the' higher production was obtained with intervals between rows of 0,30m x 0,30m and planting density of 5 seedlings per hole as compared with the greatest intervals between rows and inferior planting densities, About the tillering, the distance between rows of 0,50m x 0,50m and planting density of 4 seedlings per hole provided a greater tillering than the smallest distances between rows. Finally the more narrow distance between rows (0,30m x 0,30m) combined with a greater planting density (5 seedlings per hole) provided the plants of minor height as compared with the more ample distances between rows.4) This work describes a caseous tuberculosis jn a black buffalo from Pará State Brazil, involvlng the lungs, liver and several limph nodes with lesions which are caracterizad by large and encapsulated abcess and nodules.5) Experiments in beans (Vigna unguiculata (L.) Walp. subsp. sesquipedalis (L.) Verdcourt)., were conducted in Belém, Pará, Brasil during 1976 until 1977, and the best type of variety was the "black seed" cultivated in june, in a density of three plants per place. It was also observed high incidence of leaf diseases in rainy season (january-march), as also a little light intensity, damaging the culture.6) The preliminary study of a specific mixed bred herd, "Jerdi" (5/8 Jersey + 3/8 Red-Sind) raised on the ecological conditions of the Amazon Region, utilized data of sixteen cows and forty.five calves of which were twenty five males and twenty females, raised on the campús of the "Faculdade de Ciências Agrárias do Pará" located in Belém, State of Pará from 1977 to 1980. It was analized the influences of the year of birth and sex of calves, the periods with more and less concentration of rain and the cow age on ; calves weigth of birth, period of lactation, total milk production and fat content of milk. The analysis of the data showed that the influence of years of birth had a significant effect on the lactation period (P0,05). The values of milk production occorred during 1977 and 1978. The period with more and less concentration of rain, the sex of calves and cow age, did not influenced significantly on none of the studied caracteristlcs (P>0,05).7) This work was carried out in a plantatibn of Pinus caribaea var hondurensis of the afforestation company Santa Izabel Agroflorestal, found in the northeast of the Para State, Brazil. The main objective was study and selection of regression equations estimate total heigth as a function of dendrometric varlables aasily obtained in the íield. For this study 76 trees of Pinus caribaea var hondurensis were sampled with in a diametric amplitude of 4 to 24 cm, in several stands. Of ali tested models, the best results was obtained with the equation Ht = D2 / ( — 1,633586368 + 1,2216842911) + 0,0240630453 D2) + 1,3 with r2 = 0,6 and Syx - 1,9

Correspondence: Wayne County, GA. - E. B. Rosser, James W. Poppel (Clerk of the Superior Court)

1 electronic document [PDF/A]. Includes TIFF and JP2 images. Digitized by the Digital Library of Georgia, September 2019.Correspondence, Wayne County, 1895. Handwritten Correspondence to E.B. Rosser, Atlanta Georgia with deed from the Brunswick Land and Lumber Company and deed to W.M. Scott. Wayne County, Georgia. November 30, 1895. 1 page

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora