Impact of nonpharmaceutical strategies on trends of COVID-19 in São Paulo State

Interrupted time series analyses were conducted to measure the impact of social distancing policies (instituted on March 22, 2020) and of subsequent mandatory masking in the community (instituted on May 4, 2020) on the incidence and effective reproductive number of COVID-19 in São Paulo State, Brazil. Overall, the impact of social distancing both on incidence and Rt was greater than the incremental effect of mandatory masking. Those findings may reflect either a small impact of face masking or the loosening of social distancing after mandatory use of masks

COVID-19 diagnosis and SARS-CoV-2 viral load in hospitalized patients versus people with Flu-Like Syndrome

At the beginning of the pandemic, the Brazilian Public Health System (SUS) did not to test all suspects cases of COVID-19, thus, hospitalized individuals, health professionals, and symptomatic contacts were prioritized. Contrary to the criteria adopted by the government, the municipality of Botucatu chose to test all people who manifested flu-like syndrome. We aimed to investigate whether positive cases for COVID-19 were more frequent in patients seeking diagnosis via SUS or in the group of people seeking diagnosis via Municipal Health Center and whether the viral load was expressed differently in hospitalized patients (HP) compared to mild symptoms (MHC). Results showed that there were no differences in the percentage between the groups. Regarding the viral load, significant differences were found between the samples from HP and MHC (3-10 days of symptoms), with HP presenting a lower viral load. The results provide significant information about the viral load at different time-lapses

FRATURA ISOLADA DO PROCESSO CORACOIDE

Scapular fractures are relatively rare, especially isolated coracoid process fractures, corresponding to approximately 2 to 13% of shoulder girdle fractures.. Because of it, in this paper, we describe the case of a 55-year-old male patient who was admitted complaining right shoulder pain 10 days ago, after a 3-meter fall from a scaffolding while working, ending up in direct trauma on right shoulder. On physical examination, the patient  reported pain while moving right arm, was also noticed partial ROM limitation and preserved neurovascular local system. Right shoulder radiographs from trauma series were requested for his case, which showed a right coracoid process fracture. As medical behavior, we opted for surgical treatment to correct the fracture. This way, this study's purpose is to report an isolated coracoid process fracture case, emphasizing the low incidence of this fracture type compared to other cases, contributing with this data to literature, so that the medical community can have knowledge to better understand the subject exposed and provide better treatment to future patients.Las fracturas escapulares son relativamente raras, especialmente las fracturas aisladas de la apófisis coracoides, correspondiente a aproximadamente 2 a 13% de las fracturas de cintura escapular. En este trabajo describimos el caso de un paciente varón de 55 años que ingresó por dolor en el hombro derecho de 10 días de evolución, tras caer de un andamio de unos 3 metros durante el trabajo con impacto directo en la extremidad. Al examen físico presentaba dolor a la movilidad, limitación parcial del ADM y neurovascular preservado. Se solicitan radiografías de la serie traumatológica de hombro derecho, en las que se evidencia fractura de apófisis coracoides derecha. Como conducta se optó por tratamiento quirúrgico para corregir la fractura. Así, el objetivo de este estudio es relatar un caso de fractura aislada de la apófisis coracoides, destacando la baja incidencia de fractura en comparación con otros casos, contribuyendo con datos para enriquecer la literatura, para que la comunidad médica pueda tener conocimiento para comprender mejor el tema expuesto y brindar un mejor tratamiento a los futuros pacientes.Fraturas da escápula são relativamente raras, com destaque para as fraturas isoladas do processo coracoide, correspondendo cerca de 2 a 13% das fraturas da cintura escapular. Neste trabalho, descrevemos o caso clínico de um paciente masculino, de 55 anos, que deu entrada com queixa de dor em ombro direito há 10 dias, após queda de andaime de cerca de 3 metros durante serviço, com impacto direto em membro. Ao exame físico, paciente apresentava dor à movimentação, limitação parcial de ADM e neurovascular preservado. Solicitou-se radiografias da série trauma para ombro direito, evidenciando fratura do processo coracoide direito. Como conduta, optou-se pelo tratamento cirúrgico para correção da fratura. Desta forma, o objetivo deste trabalho é relatar um caso de fratura isolada do processo coracoide, destacando-se a baixa incidência da fratura frente aos demais casos, contribuindo com os dados para enriquecer a literatura, fazendo com que a comunidade médica possa ter conhecimento para poder compreender melhor o tema exposto e propiciar melhor tratamento aos futuros pacientes.Fraturas da escápula são relativamente raras, com destaque para as fraturas isoladas do processo coracoide, correspondendo cerca de 2 a 13% das fraturas da cintura escapular. Neste trabalho, descrevemos o caso clínico de um paciente masculino, de 55 anos, que deu entrada com queixa de dor em ombro direito há 10 dias, após queda de andaime de cerca de 3 metros durante serviço, com impacto direto em membro. Ao exame físico, paciente apresentava dor à movimentação, limitação parcial de ADM e neurovascular preservado. Solicitou-se radiografias da série trauma para ombro direito, evidenciando fratura do processo coracoide direito. Como conduta, optou-se pelo tratamento cirúrgico para correção da fratura. Desta forma, o objetivo deste trabalho é relatar um caso de fratura isolada do processo coracoide, destacando-se a baixa incidência da fratura frente aos demais casos, contribuindo com os dados para enriquecer a literatura, fazendo com que a comunidade médica possa ter conhecimento para poder compreender melhor o tema exposto e propiciar melhor tratamento aos futuros pacientes

Modeling the impact of child vaccination (5–11 y) on overall COVID-19 related hospitalizations and mortality in a context of omicron variant predominance and different vaccination coverage paces in Brazil

Background Developing countries have experienced significant COVID-19 disease burden. With the emergence of new variants, particularly omicron, the disease burden in children has increased. When the first COVID-19 vaccine was approved for use in children aged 5–11 years of age, very few countries recommended vaccination due to limited risk-benefit evidence for vaccination of this population. In Brazil, ranking second in the global COVID-19 death toll, the childhood COVID-19 disease burden increased significantly in early 2022. This prompted a risk-benefit assessment of the introduction and scaling-up of COVID-19 vaccination of children. Methods To estimate the potential impact of vaccinating children aged 5–11 years with mRNA-based COVID-19 vaccine in the context of omicron dominance, we developed a discrete-time SEIR-like model stratified in age groups, considering a three-month time horizon. We considered three scenarios: No vaccination, slow, and maximum vaccination paces. In each scenario, we estimated the potential reduction in total COVID-19 cases, hospitalizations, deaths, hospitalization costs, and potential years of life lost, considering the absence of vaccination as the base-case scenario. Findings We estimated that vaccinating at a maximum pace could prevent, between mid-January and April 2022, about 26,000 COVID-19 hospitalizations, and 4200 deaths in all age groups; of which 5400 hospitalizations and 410 deaths in children aged 5–11 years. Continuing vaccination at a slow/current pace would prevent 1450 deaths and 9700 COVID-19 hospitalizations in all age groups in this same time period; of which 180 deaths and 2390 hospitalizations in children only. Interpretation Maximum vaccination of children results in a significant reduction of COVID-19 hospitalizations and deaths and should be enforced in developing countries with significant disease incidence in children

Measurement of the cosmic ray spectrum above 4×10184{\times}10^{18} eV using inclined events detected with the Pierre Auger Observatory

A measurement of the cosmic-ray spectrum for energies exceeding $4{\times}10^{18}$ eV is presented, which is based on the analysis of showers with zenith angles greater than $60^{\circ}$ detected with the Pierre Auger Observatory between 1 January 2004 and 31 December 2013. The measured spectrum confirms a flux suppression at the highest energies. Above $5.3{\times}10^{18}$ eV, the "ankle", the flux can be described by a power law $E^{-\gamma}$ with index $\gamma=2.70 \pm 0.02 \,\text{(stat)} \pm 0.1\,\text{(sys)}$ followed by a smooth suppression region. For the energy ($E_\text{s}$) at which the spectral flux has fallen to one-half of its extrapolated value in the absence of suppression, we find $E_\text{s}=(5.12\pm0.25\,\text{(stat)}^{+1.0}_{-1.2}\,\text{(sys)}){\times}10^{19}$ eV.Comment: Replaced with published version. Added journal reference and DO

Energy Estimation of Cosmic Rays with the Engineering Radio Array of the Pierre Auger Observatory

The Auger Engineering Radio Array (AERA) is part of the Pierre Auger Observatory and is used to detect the radio emission of cosmic-ray air showers. These observations are compared to the data of the surface detector stations of the Observatory, which provide well-calibrated information on the cosmic-ray energies and arrival directions. The response of the radio stations in the 30 to 80 MHz regime has been thoroughly calibrated to enable the reconstruction of the incoming electric field. For the latter, the energy deposit per area is determined from the radio pulses at each observer position and is interpolated using a two-dimensional function that takes into account signal asymmetries due to interference between the geomagnetic and charge-excess emission components. The spatial integral over the signal distribution gives a direct measurement of the energy transferred from the primary cosmic ray into radio emission in the AERA frequency range. We measure 15.8 MeV of radiation energy for a 1 EeV air shower arriving perpendicularly to the geomagnetic field. This radiation energy -- corrected for geometrical effects -- is used as a cosmic-ray energy estimator. Performing an absolute energy calibration against the surface-detector information, we observe that this radio-energy estimator scales quadratically with the cosmic-ray energy as expected for coherent emission. We find an energy resolution of the radio reconstruction of 22% for the data set and 17% for a high-quality subset containing only events with at least five radio stations with signal.Comment: Replaced with published version. Added journal reference and DO

Measurement of the Radiation Energy in the Radio Signal of Extensive Air Showers as a Universal Estimator of Cosmic-Ray Energy

We measure the energy emitted by extensive air showers in the form of radio emission in the frequency range from 30 to 80 MHz. Exploiting the accurate energy scale of the Pierre Auger Observatory, we obtain a radiation energy of 15.8 \pm 0.7 (stat) \pm 6.7 (sys) MeV for cosmic rays with an energy of 1 EeV arriving perpendicularly to a geomagnetic field of 0.24 G, scaling quadratically with the cosmic-ray energy. A comparison with predictions from state-of-the-art first-principle calculations shows agreement with our measurement. The radiation energy provides direct access to the calorimetric energy in the electromagnetic cascade of extensive air showers. Comparison with our result thus allows the direct calibration of any cosmic-ray radio detector against the well-established energy scale of the Pierre Auger Observatory.Comment: Replaced with published version. Added journal reference and DOI. Supplemental material in the ancillary file

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