Amazon savannization and climate change are projected to increase dry season length and temperature extremes over Brazil.

Land use change and atmospheric composition, two drivers of climate change, can interact to affect both local and remote climate regimes. Previous works have considered the effects of greenhouse gas buildup in the atmosphere and the effects of Amazon deforestation in atmospheric general circulation models. In this study, we investigate the impacts of the Brazilian Amazon savannization and global warming in a fully coupled ocean-land-sea ice-atmosphere model simulation. We find that both savannization and global warming individually lengthen the dry season and reduce annual rainfall over large tracts of South America. The combined effects of land use change and global warming resulted in a mean annual rainfall reduction of 44% and a dry season length increase of 69%, when averaged over the Amazon basin, relative to the control run. Modulation of inland moisture transport due to savannization shows the largest signal to explain the rainfall reduction and increase in dry season length over the Amazon and Central-West. The combined effects of savannization and global warming resulted in maximum daily temperature anomalies, reaching values of up to 14 °C above the current climatic conditions over the Amazon. Also, as a consequence of both climate drivers, both soil moisture and surface runoff decrease over most of the country, suggesting cascading negative future impacts on both agriculture production and hydroelectricity generation.

AMOC decline and recovery in a warmer climate.

This study presents novel insight into the mechanisms of Atlantic Meridional Overturning Circulation (AMOC) reduction and its recovery under a warmer climate scenario. An one-thousand-year-long numerical simulation of a global coupled ocean-ice-atmosphere climate model, subjected to a stationary atmospheric radiative forcing, depict a coherent picture of the Arctic sea ice melting as a trigger for the initial AMOC reduction, along with decreases in the northward fluxes of salt and heat. Further atmospheric-driven ocean processes contribute to an erosion of the stable stratification of the fresher, yet colder waters in the surface layers of the North Atlantic, contributing to the recovery of a permanently altered AMOC.

Water balance components and climate extremes over Brazil under 1.5 °C and 2.0 °C of global warming scenarios.

This work aimed to evaluate changes in water balance components (precipitation, evapotranspiration, and water availability) and precipitation extremes projected under global warming levels (GWLs) of 1.5 °C and 2 °C, in Brazil. An ensemble of eight twenty-first-century projections with the Eta Regional Climate Model and their driving Global Climate Models (CanESM2, HadGEM2-ES, MIROC5, and BESM) were used. Projections of two Representative Concentration Pathway scenarios, RCP4.5 and RCP8.5, considered intermediate and high concentration, respectively, were used. The results indicate that the RCP8.5 scenario under 2 °C GWL is likely to have a higher impact on the water balance components, amplifying trends in drier conditions and increasing the number of consecutive dry days in some regions of Brazil, particularly in the North and Northeast regions. On the other hand, the projections indicate the opposite sign for the South region, with trends toward wetter conditions and significant increases in extreme rainfall. The 0.5 °C difference between the GWLs contributes to intensifying reductions (increases) from 4 to 7% in water availability, mainly in the North-Northeast (South) regions. The projected changes could have serious consequences, such as increases in the number of drought events in hydrographic regions of the Northeast region of Brazil and increases in flood events in the South of the country. The results here presented can contribute to the formulation of adaptive planning strategies aimed at ensuring Brazil's water security towards climate change. Supplementary Information: The online version contains supplementary material available at 10.1007/s10113-023-02042-1.

The 2019 northeast Brazil oil spill: scenarios.

During the last quarter of 2019, the beaches, mangroves, and estuaries of Northeast Brazil received an unprecedented volume of crude oil from the sea, which became the worst environmental disaster ever to reach the Brazilian coast. The oil, having reached the shores completely unnoticed, left both society and government agents completely clueless on (i) where the oil was coming from; (ii) how much oil was still in the ocean to reach the shorelines; and (iii) which beaches were going to be affected next! By exploring remote sensing data and ocean numerical modeling, along with oil dispersion chemistry on sea water, this study investigates the possible origin and path of the spill and whether it could have been detected from space. The oil dispersion modeling simulations performed for this investigation revealed a possible region and timing of the oil spill, also indicating the likelihood of it being advected toward the shoreline under the ocean surface.

[Prevalence and factors associated with non-enrollment for kidney transplant]. / Prevalência e fatores associados a não inscrição para transplante renal.

This study evaluated the prevalence and factors associated with lack of enrollment for kidney transplant among patients in chronic dialysis in Greater Metropolitan Fortaleza, Ceará, Brazil. The sample excluded patients with insufficient clinical status and those already in pre-kidney transplant evaluation. A semi-structured questionnaire was applied, including options for the question, "What is the main reason why you are not enrolled for kidney transplant?" Prevalence of patients considered fit but not enrolled or in pre- kidney transplant evaluation was 50.7%. The main reasons were fear of failure/loss of grafting (32.5%), difficulty with transportation or access to tests (20.9%), and temporary personal or family problems (13.7%). In the multivariate analysis, the variables associated with fear of failure or loss of graft were female sex (OR = 1.763; 95%CI: 1.224-2.540) and end-stage renal disease (ESRD) due to hypertension (OR = 1.732; 95%CI: 1.178-2.547), while monthly income (number of minimum wages) showed a protective association (OR = 0.882; 95%CI: 0.785-0.991). Time on dialysis (months) was a risk factor for difficulty with transportation and access to tests (OR = 1.004; 95%CI: 1.001-1.007), and female sex showed a protective association (OR = 0.576; 95%CI: 0.368-0.901). These results show high prevalence of patients in dialysis not enrolled on the kidney transplant waitlist. The main causes were lack of information and lack of access. Female sex, low income, and ESRD due to hypertension were risk factors for lack of enrollment on the kidney transplant waitlist due to fear of loss of graft, resulting from lack of information on this treatment modality. Male sex and longer time on dialysis were risk factors for difficulty in access to kidney transplant.

Este estudo avaliou a prevalência e os fatores associados a não procura por transplante renal entre pacientes em diálise crônica na Região Metropolitana de Fortaleza, Ceará, Brasil. Foram excluídos os pacientes sem condições clínicas e aqueles em avaliação pré-transplante renal. Um questionário semiestruturado foi aplicado, incluindo opções para a pergunta "Qual o principal motivo pelo qual o senhor/senhora não está inscrito(a) para o transplante renal?". A prevalência de pacientes considerados aptos, mas não inscritos e nem em avaliação pré-transplante renal foi de 50,7%. As principais causas foram: receio de insucesso/perda do enxerto (32,5%), dificuldade de transporte e acesso aos exames (20,9%) e problemas pessoais ou familiares temporários (13,7%). Em análise múltipla, as variáveis associadas a risco de receio do insucesso/perda do enxerto foram: sexo feminino (OR = 1,763; IC95%: 1,224-2,540) e doença renal dialítica (DRC 5-D) por hipertensão (OR = 1,732; IC95%: 1,178-2,547), tendo a renda mensal (salários mínimos) uma associação de proteção (OR = 0,882; IC95%: 0,785-0,991). O tempo em diálise (meses) foi um fator de risco para a dificuldade de transporte e acesso aos exames (OR = 1,004; IC95%: 1,001-1,007) e o sexo feminino apresentou uma associação de proteção (OR = 0,576; IC95%: 0,368-0,901). Esses resultados mostram elevada prevalência de pacientes em diálise fora de lista para transplante renal. As principais causas são reflexo da desinformação e falta de acesso. Sexo feminino, baixa renda e DRC 5-D por hipertensão foram os fatores de risco para a não procura por transplante renal por receio de perda do enxerto, reflexo da carência de informações sobre a modalidade. Sexo masculino e maior tempo em diálise foram os fatores de risco para a dificuldade de acesso à terapia.

Este estudio evalúo la prevalencia y los factores asociados a la no búsqueda de un trasplante renal entre pacientes con diálisis crónica en la Región Metropolitana de Fortaleza, Ceará, Brasil. Se excluyeron a pacientes sin condiciones clínicas y aquellos en evaluación pre-trasplante renal . Se aplicó un cuestionario semiestructurado, incluyendo opciones a la pregunta "¿cuál es el principal motivo por el cual usted no está inscrito(a) para un trasplante renal?" La prevalencia de pacientes considerados aptos, pero no inscritos y ni en evaluación pre-trasplante renal fue de un 50,7%. Las principales causas fueron: recelo al fracaso/pérdida del injerto (32,5%), dificultad de transporte y acceso a los exámenes (20,9%), así como problemas personales o familiares temporales (13,7%). En el análisis múltiple, las variables asociadas al riesgo del recelo al fracaso/pérdida del injerto fueron de sexo femenino (OR = 1,763; IC95%: 1,224-2,540) y enfermedad renal dialítica (DRC 5-D) por hipertensión (OR = 1,732; IC95%: 1,178-2,547), teniendo la renta mensual (salarios mínimos) una asociación de protección (OR = 0,882; IC95%: 0,785-0,991). El tiempo en diálisis (meses) fue un factor de riesgo para la dificultad en el transporte y acceso a los exámenes (OR = 1,004; IC95%: 1,001-1,007), y el sexo femenino tuvo una asociación de protección (OR = 0,576; IC95%: 0,368-0,901). Estos resultados muestran la elevada prevalencia de pacientes en diálisis fuera de la lista para transplante renal. Las principales causas son reflejo de la desinformación y falta de acceso. Sexo femenino, baja renta y DRC 5-D por hipertensión fueron factores de riesgo para la no búsqueda de trasplante renal por recelo a la pérdida del injerto, reflejo de la carencia de información sobre la modalidad. Sexo masculino y mayor tiempo en diálisis fueron factores de riesgo para la dificultad de acceso a la terapia. izará la atención a las vulnerabilidades individuales desde la perspectiva de la salud integral.

Prevalência e fatores associados a não inscrição para transplante renal / Prevalence and factors associated with non-enrollment for kidney transplant / Prevalencia y factores asociados a la no inscripción para un trasplante renal

Resumo: Este estudo avaliou a prevalência e os fatores associados a não procura por transplante renal entre pacientes em diálise crônica na Região Metropolitana de Fortaleza, Ceará, Brasil. Foram excluídos os pacientes sem condições clínicas e aqueles em avaliação pré-transplante renal. Um questionário semiestruturado foi aplicado, incluindo opções para a pergunta "Qual o principal motivo pelo qual o senhor/senhora não está inscrito(a) para o transplante renal?". A prevalência de pacientes considerados aptos, mas não inscritos e nem em avaliação pré-transplante renal foi de 50,7%. As principais causas foram: receio de insucesso/perda do enxerto (32,5%), dificuldade de transporte e acesso aos exames (20,9%) e problemas pessoais ou familiares temporários (13,7%). Em análise múltipla, as variáveis associadas a risco de receio do insucesso/perda do enxerto foram: sexo feminino (OR = 1,763; IC95%: 1,224-2,540) e doença renal dialítica (DRC 5-D) por hipertensão (OR = 1,732; IC95%: 1,178-2,547), tendo a renda mensal (salários mínimos) uma associação de proteção (OR = 0,882; IC95%: 0,785-0,991). O tempo em diálise (meses) foi um fator de risco para a dificuldade de transporte e acesso aos exames (OR = 1,004; IC95%: 1,001-1,007) e o sexo feminino apresentou uma associação de proteção (OR = 0,576; IC95%: 0,368-0,901). Esses resultados mostram elevada prevalência de pacientes em diálise fora de lista para transplante renal. As principais causas são reflexo da desinformação e falta de acesso. Sexo feminino, baixa renda e DRC 5-D por hipertensão foram os fatores de risco para a não procura por transplante renal por receio de perda do enxerto, reflexo da carência de informações sobre a modalidade. Sexo masculino e maior tempo em diálise foram os fatores de risco para a dificuldade de acesso à terapia.

Abstract: This study evaluated the prevalence and factors associated with lack of enrollment for kidney transplant among patients in chronic dialysis in Greater Metropolitan Fortaleza, Ceará, Brazil. The sample excluded patients with insufficient clinical status and those already in pre-kidney transplant evaluation. A semi-structured questionnaire was applied, including options for the question, "What is the main reason why you are not enrolled for kidney transplant?" Prevalence of patients considered fit but not enrolled or in pre- kidney transplant evaluation was 50.7%. The main reasons were fear of failure/loss of grafting (32.5%), difficulty with transportation or access to tests (20.9%), and temporary personal or family problems (13.7%). In the multivariate analysis, the variables associated with fear of failure or loss of graft were female sex (OR = 1.763; 95%CI: 1.224-2.540) and end-stage renal disease (ESRD) due to hypertension (OR = 1.732; 95%CI: 1.178-2.547), while monthly income (number of minimum wages) showed a protective association (OR = 0.882; 95%CI: 0.785-0.991). Time on dialysis (months) was a risk factor for difficulty with transportation and access to tests (OR = 1.004; 95%CI: 1.001-1.007), and female sex showed a protective association (OR = 0.576; 95%CI: 0.368-0.901). These results show high prevalence of patients in dialysis not enrolled on the kidney transplant waitlist. The main causes were lack of information and lack of access. Female sex, low income, and ESRD due to hypertension were risk factors for lack of enrollment on the kidney transplant waitlist due to fear of loss of graft, resulting from lack of information on this treatment modality. Male sex and longer time on dialysis were risk factors for difficulty in access to kidney transplant.

Resumen: Este estudio evalúo la prevalencia y los factores asociados a la no búsqueda de un trasplante renal entre pacientes con diálisis crónica en la Región Metropolitana de Fortaleza, Ceará, Brasil. Se excluyeron a pacientes sin condiciones clínicas y aquellos en evaluación pre-trasplante renal . Se aplicó un cuestionario semiestructurado, incluyendo opciones a la pregunta "¿cuál es el principal motivo por el cual usted no está inscrito(a) para un trasplante renal?" La prevalencia de pacientes considerados aptos, pero no inscritos y ni en evaluación pre-trasplante renal fue de un 50,7%. Las principales causas fueron: recelo al fracaso/pérdida del injerto (32,5%), dificultad de transporte y acceso a los exámenes (20,9%), así como problemas personales o familiares temporales (13,7%). En el análisis múltiple, las variables asociadas al riesgo del recelo al fracaso/pérdida del injerto fueron de sexo femenino (OR = 1,763; IC95%: 1,224-2,540) y enfermedad renal dialítica (DRC 5-D) por hipertensión (OR = 1,732; IC95%: 1,178-2,547), teniendo la renta mensual (salarios mínimos) una asociación de protección (OR = 0,882; IC95%: 0,785-0,991). El tiempo en diálisis (meses) fue un factor de riesgo para la dificultad en el transporte y acceso a los exámenes (OR = 1,004; IC95%: 1,001-1,007), y el sexo femenino tuvo una asociación de protección (OR = 0,576; IC95%: 0,368-0,901). Estos resultados muestran la elevada prevalencia de pacientes en diálisis fuera de la lista para transplante renal. Las principales causas son reflejo de la desinformación y falta de acceso. Sexo femenino, baja renta y DRC 5-D por hipertensión fueron factores de riesgo para la no búsqueda de trasplante renal por recelo a la pérdida del injerto, reflejo de la carencia de información sobre la modalidad. Sexo masculino y mayor tiempo en diálisis fueron factores de riesgo para la dificultad de acceso a la terapia. izará la atención a las vulnerabilidades individuales desde la perspectiva de la salud integral.

Human migration, railways and the geographic distribution of leprosy in Rio Grande do Norte State--Brazil.

INTRODUCTION: Leprosy is a public health problem in Brazil where 31,044 new cases were detected in 2013. Rio Grande do Norte is a small Brazilian state with a rate of leprosy lower than other areas in the same region, for unknown reasons. OBJECTIVES: We present here a review based on the analysis of a database of registered leprosy cases in Rio Grande do Norte state, comparing leprosy's geographic distribution among municipalities with local socio-economic and public health indicators and with historical documents about human migration in this Brazilian region. RESULTS: The current distribution of leprosy in Rio Grande do Norte did not show correlation with socio-economic or public health indicators at the municipal level, but it appears related to economically emerging municipalities 100 years ago, with spread facilitated by railroads and train stations. Drought-related migratory movements which occurred from this state to leprosy endemic areas within the same period may be involved in the introduction of leprosy and with its present distribution within Rio Grande do Norte. CONCLUSIONS: Leprosy may disseminate slowly, over many decades in certain circumstances, such as in small cities with few cases. This is a very unusual situation currently and a unique opportunity for epidemiologic studies of leprosy as an emerging disease.

Patrimônio-paisagem: função social da cidade / Landscape as patrimony: urban social function

Entende-se que paisagens singulares se constituem em patrimônios culturais das cidades, na medida em que fazem parte do cotidiano dos cidadãos e estão presentes nas representações sociais. Natal, Rio Grande do Norte, uma cidade com qualidades ambientais marcantes e se destaca pela beleza do sítio onde está assentada. A legislação urbanística procurou preservar as características da paisagem local, instituindo Areas de Controle de Gabarito, destinadas a proteger o valor cênico-paisagístico de alguns trechos da cidade. Em contrapartida, o setor da construção civil tem exercido constante pressão, no sentido de abolir ou modificar esse instrumento legal. Este trabalho tenta levantar elementos sobre o tema no âmbito local, no sentido de que a experiência de Natal e seu estudo de caso possam contribuir para formular indicativos capazes de questionar a não mensuração de valores subjetivos, como, por exemplo, o valor cultural e afetivo da paisagem.

It is understood that singular landscapes constitute the cultural patrimonies of the cities, once they are part of the daily life of the citizens and are present in their social representations. Natal, Rio Grande do Norte, is a city where the ambient qualities are well defined and known by the beauty of the area where it is located. The urban legislation tried to preserve the features of the local landscape delimiting “Areas for Controlling Building High”, destined to protect the scenic value of some parts of the city. On the other hand, the civil construction sector has made constant pressure in sense to abolish or to modify this legal instrument. This work tries to raise elements about the subject at local level, in sense to use Natal City experience to contribute for the formulation of indicators to raise the question about the lack of measure for subjective values, for example the cultural and affective value of the landscape.

Patrimônio-paisagem: função social da cidade / Landscape as patrimony: urban social function

Entende-se que paisagens singulares se constituem em patrimônios culturais das cidades, na medida em que fazem parte do cotidiano dos cidadãos e estão presentes nas representações sociais. Natal, Rio Grande do Norte, uma cidade com qualidades ambientais marcantes e se destaca pela beleza do sítio onde está assentada. A legislação urbanística procurou preservar as características da paisagem local, instituindo Areas de Controle de Gabarito, destinadas a proteger o valor cênico-paisagístico de alguns trechos da cidade. Em contrapartida, o setor da construção civil tem exercido constante pressão, no sentido de abolir ou modificar esse instrumento legal. Este trabalho tenta levantar elementos sobre o tema no âmbito local, no sentido de que a experiência de Natal e seu estudo de caso possam contribuir para formular indicativos capazes de questionar a não mensuração de valores subjetivos, como, por exemplo, o valor cultural e afetivo da paisagem.(AU)

It is understood that singular landscapes constitute the cultural patrimonies of the cities, once they are part of the daily life of the citizens and are present in their social representations. Natal, Rio Grande do Norte, is a city where the ambient qualities are well defined and known by the beauty of the area where it is located. The urban legislation tried to preserve the features of the local landscape delimiting “Areas for Controlling Building High”, destined to protect the scenic value of some parts of the city. On the other hand, the civil construction sector has made constant pressure in sense to abolish or to modify this legal instrument. This work tries to raise elements about the subject at local level, in sense to use Natal City experience to contribute for the formulation of indicators to raise the question about the lack of measure for subjective values, for example the cultural and affective value of the landscape.(AU)