TENDÊNCIA TEMPORAL DE MORTALIDADE POR DIABETES MELLITUS NO ESTADO DE SERGIPE E SUAS REGIÕES DE SAÚDE NO PERÍODO DE 11 ANOS

The incidence and mortality rates for Diabetes Mellitus (DM) have shown progressive growth worldwide. The objective was to evaluate the trend of mortality from DM in the state of Sergipe and its health regions, between the years 2008 and 2018. This is an ecological, descriptive and time series study, with secondary data reported on death from DM, obtained through the Mortality Information System database, made available by the Informatics Department of the Unified Health System. The temporal analysis was performed using the Joinpoint Regression Analysis inflection point regression model. Deaths from DM in Sergipe were high, prevailing in females, aged over 60 years, brown and black, and with up to 3 years of schooling. In the temporal analysis, over the 11-year period, the average mortality rate in Sergipe was 1.4% per year. In the health regions, in Aracaju the rate was 3.1% and in Estância it was 2.6% per year, with significant progressive growth (p<0.05). While the health region of Lagarto showed a significant progressive reduction of -1.5% (p<0.05). The other regions showed a neutral trend of deaths from DM. It is concluded that the trend of mortality due to DM in the state of Sergipe is high and growing, and the present study is a useful tool for health professionals to optimize preventive, diagnostic and therapeutic strategies with continuous and permanent actions, in order to reduce the mortality of this chronic disease, however benign.Las tasas de incidencia y mortalidad de la diabetes mellitus (DM) han mostrado un crecimiento progresivo en todo el mundo. El objetivo fue evaluar la tendencia de la mortalidad por DM en el estado de Sergipe y sus regiones sanitarias, entre los años 2008 y 2018. Se trata de un estudio ecológico, descriptivo y de series de tiempo, con datos secundarios reportados sobre muerte por DM, obtenidos a través de la base de datos del Sistema de Información de Mortalidad, puesta a disposición por el Departamento de Informática del Sistema Único de Salud, el análisis temporal se realizó mediante el modelo de regresión de puntos de inflexión del Análisis de Regresión Joinpoint. Las muertes por DM en Sergipe fueron elevadas, predominando en mujeres, mayores de 60 años, morenos y negros, y con hasta 3 años de escolaridad. En el análisis temporal, durante el período de 11 años, la tasa de mortalidad media en Sergipe fue del 1,4% anual. En las regiones de salud, en Aracaju la tasa fue del 3,1% y en Estância fue del 2,6% anual, con un crecimiento progresivo significativo (p <0,05). Mientras que la región de salud de Lagarto mostró una reducción progresiva significativa de -1,5% (p <0,05). Las otras regiones mostraron una tendencia neutra de muertes por DM. Se concluye que la tendencia de la mortalidad por DM en el estado de Sergipe es alta y creciente, y el presente estudio es una herramienta útil para que los profesionales de la salud optimicen las estrategias preventivas, diagnósticas y terapéuticas con acciones continuas y permanentes, con el fin de reducir la mortalidad de esta enfermedad crónica, por benigna que sea.RESUMO: A incidência e as taxas de mortalidade por Diabetes Mellitus (DM) têm apresentado crescimento progressivo, no mundo. Objetivou-se avaliar a tendência de mortalidade por DM no estado de Sergipe e nas suas regiões de saúde, entre os anos de 2008 e 2018. Trata-se de um estudo ecológico, descritivo e de série temporal, com dados secundários notificados de óbito por DM, obtidos por meio da base de dados Sistema de Informações de Mortalidade, disponibilizado pelo Departamento de Informática do Sistema Único de Saúde. A análise temporal foi realizada com aplicação do modelo de regressão por pontos de inflexão Joinpoint Regression Analysis. Os óbitos por DM em Sergipe foram altos, prevalecendo no sexo feminino, com idade superior a 60 anos, cor parda e negra e com escolaridade até 3 anos. Na análise temporal, no período de 11 anos, em Sergipe a taxa média de mortalidade foi de 1,4% ao ano. Nas regiões de saúde, em Aracaju a taxa foi de 3,1% e em Estância de 2,6% ao ano, com crescimento progressivo significativo (p<0.05). Enquanto a região de saúde de Lagarto, apresentou uma redução progressiva significativa de -1.5% (p<0.05). As demais regiões apresentaram tendência neutra de óbitos por DM. Conclui-se que a tendência de mortalidade decorrente do DM no estado de Sergipe é alta e crescente, sendo o presente estudo, uma ferramenta útil para os profissionais de saúde otimizarem estratégias preventivas, diagnósticas e terapêuticas com ações contínuas e permanentes, com o intuito de reduzir a mortalidade dessa doença crônica, porém de carácter benigno

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

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

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

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

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others