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

Panoramic snapshot of serum soluble mediator interplay in pregnant women with convalescent COVID-19: an exploratory study

IntroductionSARS-CoV-2 infection during pregnancy can induce changes in the maternal immune response, with effects on pregnancy outcome and offspring. This is a cross-sectional observational study designed to characterize the immunological status of pregnant women with convalescent COVID-19 at distinct pregnancy trimesters. The study focused on providing a clear snapshot of the interplay among serum soluble mediators.MethodsA sample of 141 pregnant women from all prenatal periods (1st, 2nd and 3rd trimesters) comprised patients with convalescent SARS-CoV-2 infection at 3-20 weeks after symptoms onset (COVID, n=89) and a control group of pre-pandemic non-infected pregnant women (HC, n=52). Chemokine, pro-inflammatory/regulatory cytokine and growth factor levels were quantified by a high-throughput microbeads array.ResultsIn the HC group, most serum soluble mediators progressively decreased towards the 2nd and 3rd trimesters of pregnancy, while higher chemokine, cytokine and growth factor levels were observed in the COVID patient group. Serum soluble mediator signatures and heatmap analysis pointed out that the major increase observed in the COVID group related to pro-inflammatory cytokines (IL-6, TNF-α, IL-12, IFN-γ and IL-17). A larger set of biomarkers displayed an increased COVID/HC ratio towards the 2nd (3x increase) and the 3rd (3x to 15x increase) trimesters. Integrative network analysis demonstrated that HC pregnancy evolves with decreasing connectivity between pairs of serum soluble mediators towards the 3rd trimester. Although the COVID group exhibited a similar profile, the number of connections was remarkably lower throughout the pregnancy. Meanwhile, IL-1Ra, IL-10 and GM-CSF presented a preserved number of correlations (≥5 strong correlations in HC and COVID), IL-17, FGF-basic and VEGF lost connectivity throughout the pregnancy. IL-6 and CXCL8 were included in a set of acquired attributes, named COVID-selective (≥5 strong correlations in COVID and <5 in HC) observed at the 3rd pregnancy trimester.Discussion and conclusionFrom an overall perspective, a pronounced increase in serum levels of soluble mediators with decreased network interplay between them demonstrated an imbalanced immune response in convalescent COVID-19 infection during pregnancy that may contribute to the management of, or indeed recovery from, late complications in the post-symptomatic phase of the SARS-CoV-2 infection in pregnant women

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

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

Experiência de reorganização do processo de trabalho da atenção primária de um município brasileiro

Introduction: Primary Health Care (PHC) is a care setting that must present constant changes in the work process, due to the dynamics of the territory and the health needs of the population. In this sense, it is necessary to think about sharing experiences that bring these changes in practice. Objective: To report an experience that induces changes related to the work process in PHC. Methods: This is a report of the experience lived by the authors during an action research that aimed to build collaborative competencies from the reorganization of the work process, empowering the protagonism of health professionals. This experience took place in the PHC of a municipality in the state of Minas Gerais, Brazil, during May 2019 to December 2020, and was based on Paulo Freire's theoretical framework. Results: The connection with the social reality/actors involved constitutes a potentiating element of this experience and of the changes brought about in the work process at hand. This experimentation can be understood as a movement that must occur longitudinally, so that the work process in health is continuously modified and responds to the nature, also dynamic, of health needs. Conclusion: It is hoped that this report will inspire and bring about changes in the work process in other PHC realities, considering the potential of the strategic actions adopted in this experimentation. Keywords: Primary Health Care; Patient Care Team; Workflow; Change Management; Capacity Building.Introducción: La Atención Primaria de Salud (APS) es un escenario de atención que debe presentar cambios constantes en el proceso de trabajo, debido a la dinámica del territorio y a las necesidades de salud de la población. En este sentido, es necesario pensar en compartir experiencias que lleven estos cambios a la práctica. Objetivo: Relatar una experiencia que induce cambios relacionados con el proceso de trabajo en APS. Métodos: Se trata de un relato de experiencia vivida por los autores durante una investigación-acción que tuvo como objetivo construir habilidades colaborativas a partir de la reorganización del proceso de trabajo, potenciando el protagonismo de los profesionales de la salud. Esta experiencia tuvo lugar en la APS de un municipio del estado de Minas Gerais, Brasil, durante los meses de mayo de 2019 a diciembre de 2020 y se basó en el marco teórico de Paulo Freire. Resultados: La conexión con la realidad social/actores involucrados constituye un elemento potenciador de esta experiencia y de los cambios producidos en el proceso de trabajo en cuestión. Esta experimentación puede ser entendida como un movimiento que debe ocurrir longitudinalmente, para que el proceso de trabajo en salud se modifique continuamente y responda a la naturaleza, también dinámica, de las necesidades de salud. Conclusión: Se espera que este informe inspire y suscite cambios en el proceso de trabajo en otras realidades de APS, considerando el potencial existente en las acciones estratégicas adoptadas en esta experimentación. Palabras-clave: Atención Primaria de Salud; Grupo de Atención al Paciente; Flujo de Trabajo; Gestión del Cambio; Creación de Capacidad.Introdução: A Atenção Primária à Saúde (APS) é um cenário de atenção que deve apresentar mudanças constantes no processo de trabalho, em função da dinamicidade do território e das necessidades de saúde da população. Neste sentido, há que se pensar no compartilhamento de experiências que tragam essas mudanças na prática. Objetivo: Relatar uma experiência indutora de mudanças relacionadas ao processo de trabalho na APS. Métodos: Trata-se de um relato da experiência vivenciado pelos autores durante uma pesquisa-ação que teve como objetivo construir competências colaborativas a partir da reorganização do processo de trabalho, potencializando para isto o protagonismo dos profissionais de saúde. A referida experiência se deu na APS de um município do estado de Minas Gerais, Brasil, durante maio de 2019 a dezembro de 2020 e teve como subsídio o referencial teórico de Paulo Freire. Resultados: A conexão com a realidade social/atores envolvidos constitui-se um elemento potencializador desta experiência e das mudanças agenciadas no processo de trabalho em pauta. Pode-se compreender esta experimentação como um movimento que deve ocorrer longitudinalmente, a fim de que o processo de trabalho em saúde se modifique continuamente e responda à natureza, também dinâmica, das necessidades de saúde. Conclusão: Espera-se que este relato inspire e suscite mudanças no processo de trabalho em outras realidades de APS, considerando o potencial existente nas ações estratégicas adotadas na presente experimentação. Palavras-chave: Atenção Primária à Saúde; Equipe de Assistência ao Paciente; Fluxo de Trabalho; Gestão de Mudança; Fortalecimento Institucional

Long-term cognitive outcomes among unselected ventilated and non-ventilated ICU patients

Abstract Background Cognitive dysfunction is an important long-term complication of critical illness associated with reduced quality of life, increase in healthcare costs, and institutionalization. Delirium, an acute form of brain dysfunction that is common during critical illness has been shown to be associated with long-term cognitive dysfunction. The aim of this prospective cohort study was to estimate the prevalence and severity of cognitive dysfunction in an unselected population of medical and surgical ICU patients. Methods This prospective observational cohort study included all adult patients admitted to the surgical (13 beds) and medical (32 beds) ICUs of a tertiary hospital over a 12-month period. Patients with impaired cognition were excluded. At least 3 months after hospital discharge, patients were assessed for cognition using a validated battery of tests and were classified as having no cognitive impairment, mild to moderate cognitive impairment, or severe cognitive impairment. Results Four hundred thirteen patients were tested an average of 11 (3–18) months after discharge. Fifty-five (13.3%) patients included in the follow-up cohort had delirium. Cognitive impairment was identified in 206 (49.9%) patients, 120 (29.1%) patients had mild or moderate cognitive impairment, and 86 (20%) patients had severe cognitive dysfunction. Conclusions This investigation in an unselected and lower severity population of critically ill patients demonstrates that cognitive dysfunction is a frequent and severe long-term complication