Pregestational fructose-induced metabolic syndrome in Wistar rats causes sexually dimorphic behavioral changes in their offspring.

Metabolic syndrome (MetS), marked by enduring metabolic inflammation, has detrimental effects on cognitive performance and brain structure, influencing behavior. This study aimed to investigate whether maternal MetS could negatively impact the neurodevelopment and metabolism of offspring. To test this hypothesis, 2 months old female Wistar rats were subjected to a 10-week regimen of tap water alone or supplemented with 20% fructose to induce MetS. Dams were mated with healthy males to generate litters: OC (offspring from control dams) and OMetS (offspring from dams with MetS). To isolate prenatal effects, all pups were breastfed by control nurse dams, maintaining a standard diet and water ad libitum until weaning. Behavioral assessments were conducted between postnatal days (PN) 22 and 95, and metabolic parameters were analyzed post-sacrifice on PN100. Results from the elevated plus maze, the open field, and the marble burying tests revealed a heightened anxiety-like phenotype in OMetS females. The novel object recognition test showed that exclusively OMetS males had long-term memory impairment. In the reciprocal social interaction test, OMetS displayed a lower number of social interactions, with a notable increase in "socially inactive" behavior observed exclusively in females. Additionally, in the three-chamber test, social preference and social novelty indexes were found to be lower solely among OMetS females. An increase in visceral fat concomitantly with hypertriglyceridemia was the relevant postmortem metabolic finding in OMetS females. In summary, maternal MetS leads to enduring damage and adverse effects on offspring neurobehavior and metabolism, with notable sexual dimorphism.

Soil macrofauna communities in Brazilian land-use systems.

Background: Soil animal communities include more than 40 higher-order taxa, representing over 23% of all described species. These animals have a wide range of feeding sources and contribute to several important soil functions and ecosystem services. Although many studies have assessed macroinvertebrate communities in Brazil, few of them have been published in journals and even fewer have made the data openly available for consultation and further use. As part of ongoing efforts to synthesise the global soil macrofauna communities and to increase the amount of openly-accessible data in GBIF and other repositories related to soil biodiversity, the present paper provides links to 29 soil macroinvertebrate datasets covering 42 soil fauna taxa, collected in various land-use systems in Brazil. A total of 83,085 georeferenced occurrences of these taxa are presented, based on quantitative estimates performed using a standardised sampling method commonly adopted worldwide to collect soil macrofauna populations, i.e. the TSBF (Tropical Soil Biology and Fertility Programme) protocol. This consists of digging soil monoliths of 25 x 25 cm area, with handsorting of the macroinvertebrates visible to the naked eye from the surface litter and from within the soil, typically in the upper 0-20 cm layer (but sometimes shallower, i.e. top 0-10 cm or deeper to 0-40 cm, depending on the site). The land-use systems included anthropogenic sites managed with agricultural systems (e.g. pastures, annual and perennial crops, agroforestry), as well as planted forests and native vegetation located mostly in the southern Brazilian State of Paraná (96 sites), with a few additional sites in the neighbouring states of São Paulo (21 sites) and Santa Catarina (five sites). Important metadata on soil properties, particularly soil chemical parameters (mainly pH, C, P, Ca, K, Mg, Al contents, exchangeable acidity, Cation Exchange Capacity, Base Saturation and, infrequently, total N), particle size distribution (mainly % sand, silt and clay) and, infrequently, soil moisture and bulk density, as well as on human management practices (land use and vegetation cover) are provided. These data will be particularly useful for those interested in estimating land-use change impacts on soil biodiversity and its implications for below-ground foodwebs, ecosystem functioning and ecosystem service delivery. New information: Quantitative estimates are provided for 42 soil animal taxa, for two biodiversity hotspots: the Brazilian Atlantic Forest and Cerrado biomes. Data are provided at the individual monolith level, representing sampling events ranging from February 2001 up to September 2016 in 122 sampling sites and over 1800 samples, for a total of 83,085 ocurrences.

Lipid peroxidation and neuroinflammation: A possible link between maternal fructose intake and delay of acquisition of neonatal reflexes in Wistar female rats.

Fructose is a common sweetener found in the daily diet supplemented to many processed and ultra-processed foods and beverages. Consumption of fructose-sweetened beverages has drastically increased in the last decades and is widely associated with metabolic disease, systemic pro-inflammatory status, and adverse transgenerational effects. To date, the impact of maternal fructose intake in brain function of the offspring is less explored. Therefore, the aim of this study was first, to investigate adverse effects in developmental milestones of the progeny of mothers with metabolic syndrome (MetS), induced by ad libitum consumption of a 20% fructose solution, and second to identify possible molecular changes in the nervous system of the newborns associated with maternal fructose intake. Wistar rats were randomly separated into two groups with access to water or fructose (20% w/v in water) for 10 weeks. After MetS was confirmed, dams were mated with control males and continued drinking water or fructose solution during gestation. At postnatal day (PN) 1, a subgroup of offspring of each sex was sacrificed and brains were dissected for oxidative stress and inflammatory status analysis. Changes in the developmental milestones due to maternal fructose consumption were studied (PN3-PN21) in another subgroup of offspring. Sexually dimorphic effects were found on the progeny's acquisition of neurodevelopmental milestones, in brain lipid peroxidation, neuroinflammation, and antioxidative defensive response. Our results suggest that dams' MetS, induced by fructose intake, disrupts brain redox homeostasis in female offspring and affects sensorimotor brain circuitry which may have a translational value for studying neurodevelopmental diseases.

Amazonian earthworm biodiversity is heavily impacted by ancient and recent human disturbance.

Despite the importance of earthworms for soil formation, more is needed to know about how Pre-Columbian modifications to soils and the landscape. Gaining a deeper understanding is essential for comprehending the historical drivers of earthworm communities and the development of effective conservation strategies in the Amazon rainforest. Human disturbance can significantly impact earthworm diversity, especially in rainforest soils, and in the particular case of the Amazonian rainforest, both recent and ancient anthropic practices may be important. Amazonian Dark Earths (ADEs) are fertile soils found throughout the Amazon Basin, created by sedentary habits and intensification patterns of pre-Colombian societies primarily developed in the second part of the Holocene period. We have sampled earthworm communities in three Brazilian Amazonian (ADEs) and adjacent reference soils (REF) under old and young forests and monocultures. To better assess taxonomic richness, we used morphology and the barcode region of the COI gene to identify juveniles and cocoons and delimit Molecular Operational Taxonomic Units (MOTUs). Here we suggest using Integrated Operational Taxonomical units (IOTUs) which combine both morphological and molecular data and provide a more comprehensive assessment of diversity, while MOTUs only rely on molecular data. A total of 970 individuals were collected, resulting in 51 taxonomic units (IOTUs, MOTUs, and morphospecies combined). From this total, 24 taxonomic units were unique to REF soils, 17 to ADEs, and ten were shared between both soils. The highest richness was found in old forest sites for ADEs (12 taxonomic units) and REFs (21 taxonomic units). The beta-diversity calculations reveal a high species turnover between ADEs and REF soils, providing evidence that ADEs and REFs possess distinct soil biota. Furthermore, results suggest that ADE sites, formed by Pre-Columbian human activities, conserve a high number of native species in the landscape and maintain a high abundance, despite their long-term nature.

COVID-19, Climate Change, and Conflict in Honduras: A food system disruption analysis.

In Honduras, as in many settings between 2020 and 2022, food security was affected by the COVID-19 pandemic, climate change, and conflicts-what some refer to as "The Three Cs." These challenges have had overlapping impacts on food supply chains, food assistance programs, food prices, household purchasing power, physical access to food, and food acceptability. This article applies a food system disruption analysis-adapted from a fault tree analysis originally developed for a municipal context in the United States-to the context of Honduras to systematically examine how the Three Cs affected food availability, accessibility, and acceptability. This article demonstrates the value of approaching food security through a disruption analysis, especially for settings impacted by multiple, interconnected, ongoing crises.

Earthworms in the conversion of natural grasslands to agropastoral systems-a preliminary study in Vale Verde, Rio Grande do Sul, Brazil.

Soils, in addition to supporting agricultural production, are the source of a wide diversity of essential ecosystem functions and services performed by invertebrate organisms. Earthworms play a key role as ecosystem engineers, but little is known about the diversity of the state of Rio Grande do Sul, Brazil, and even less concerning land-use conversion scenarios. Earthworms were sampled using the TSBF method in natural grassland (NG1) in July 2018 and subsequently converted to soybean in an agropastoral system (AP) in December 2018 and July 2019. In July 2019 a nearby natural grassland (NG2) was also sampled and considered as a reference. The earthworms were identified to family, genus and/or species, and the total number of individuals and proportion of native and exotic species were calculated and presented. A total of 583 individuals were collected and seven species were identified: three native species-Kerriona sp.7, Kerriona sp.8, Eukerria rosea; and four exotic/peregrine species-Amynthas corticis, Dichogaster bolaui, Bimastos parvus, Pontoscolex corethrurus. The two native Kerriona species are new to science and were found after the conversion of the area. The other native species (Eukerria rosea), also found after the conversion, had a high number of individuals in the last sample. The results can be related to the availability and changing of resources, due to the conversion of the land use with a high rain preceding the winter season.

Earthworms in natural grasslands and agropastoral systems in the Brazilian Pampa.

In this study, we sampled grazed natural grassland and agropastoral systems in two regions (Alegrete and Aceguá) in the highly diverse Brazilian Pampa region which is undergoing significant change in land use cover. By hand sorting the soil, a total of five species were found, belonging to the families Glossoscolecidae (Glossoscolex sp.50 and Glossoscolex sp.51), Ocnerodrilidae (Kerriona sp.6 and Eukerria sp.3), and Lumbricidae (Aporrectodea trapezoides). The former four were identified as native-new to science-and the latter as exotic. Differences were observed in both earthworm species richness and abundance between regions and land-use systems, likely due to environmental conditions and agricultural practices, respectively. Agropastoral systems had higher abundance and species richness than natural grasslands, though these differences varied by location. This suggests that conversion from natural grassland to agropastoral systems can maintain native earthworms and, possibly, enhance ecosystem services. However, an exotic species was found in high abundance at one agropastoral site. These results highlight the need for additional biodiversity studies on earthworms in the Brazilian Pampa and for research on the impacts of land use changes in this region.

Earthworm richness in no-tillage farming systems and riparian forests in Southern and Southeastern Brazil.

No-tillage (NT) is a soil conservation management practice that can sustain important earthworm populations due the maintenance of soil cover and absence of soil disturbance. Sites with NT can also support native earthworm species, but few studies have identified the earthworms collected under NT. Therefore, the present study evaluated earthworm diversity in 14 sites under NT and seven with riparian forest (RF) in Atlantic Forest located in Rolândia, Cambé, Toledo (Paraná), Coxilha, Sarandi (Rio Grande do Sul) and Itaí (São Paulo). The earthworms were collected by handsorting using quantitative and qualitative methods. The 1471 individuals collected were classified into 23 species belonging to five families: Glossoscolex sp.71, sp.72, sp.73 and sp.74, Fimoscolex sp.23 sp.24 and sp.25 (Glossoscolecidae); Pontoscolex corethrurus, Urobenus brasiliensis (Rhinodrilidae); Haplodrilus sp.1 and sp.2, Ocnerodrilidae sp.1, sp.15, sp.16, sp.48, sp.49 and sp.50 (Ocnerodrilidae); Amynthas gracilis, Metaphire californica (Megascolecidae); Dichogaster affinis, D. gracilis, D. bolaui and D. saliens (Benhamiidae). Of the total, 15 were native and eight were exotic species. In general NT sites had higher species richness than the forest sites (except at Itaí), mainly due to the invasion of NT fields by exotic species, particularly Ocnerodrilidae sp.1 and Dichogaster spp. Six of the seven forests had native species, but only four NT fields had native earthworms, and these were generally found in low abundance.

Earthworm communities in long-term no-tillage systems and secondary forest fragments in Paraná, Southern Brazil.

The area destined for agricultural production in Paraná state in Brazil is ~6 million hectares, of which 79% are under no-tillage systems (NTS) that can positively affect earthworm populations. Furthermore, earthworm abundance and richness can be valuable soil quality. This study assessed earthworm communities in long-term no-tillage sites (NTS) and nearby secondary Atlantic Forest (SF) fragments. Sampling was performed in June 2018 and May 2019 using the quantitative Tropical Soil Biology and Fertility handsorting method (ISO-TSBF), complemented by qualitative sampling in three municipalities: Faxinal, Mauá da Serra and Palmeira, in NTS and SF. Eleven earthworm species, belonging to five families (Benhamiidae, Glossoscolecidae, Megascolecidae, Ocnerodrilidae, and Rhinodrilidae) were found along with seven native species (Glossoscolex sp.22, Glossoscolex sp.23, Fimoscolex sp.21, Fimoscolex sp.24, Fimoscolex sp.42, Andiorrhinus duseni and Urobenus brasiliensis) and four exotic or cosmopolitan species (Dichogaster gracilis, Amynthas gracilis, Metaphire californica and Pontoscolex corethrurus). The cosmopolitan P. corethrurus dominated Faxinal and Mauá da Serra, while in Palmeira Fimoscolex and Glossoscolex were the most abundant. Six species belonging to Glossoscolex and Fimoscolex were new to science and must be described. Overall, 239 individuals were found. In 2018 126 individuals were found (76 in NTS and 50 in SF) and in 2019, only 112 individuals were found (45 in NTS and 67 in SF). The highest earthworm abundance was in Faxinal (123 individuals), with 76 individuals in NTS and 47 in SF. In Mauá da Serra the same pattern was observed (SF>NTS), while in Palmeira in overall, fewer individuals (38) were collected (24 in NTS and 14 in SF). The NTS at Faxinal and SF Mauá da Serra in 2019 had only/more exotic/cosmopolitan species, while at the other dates and sites >50% of the specimens sampled were native species. Overall, forests had more native species than exotics: in 2018, natives represented > 75% of all specimens, but in 2019 both Faxinal and Mauá da Serra had more exotic species (> 65%), while at Palmeira, they represented 50% of the individuals. Earthworm total biomass for forest sites was higher in Faxinal (3.2 g) and NTS in Mauá da Serra (1.7 g) in 2019. Overall, the total biomass was higher in SF sites than NTS. Using a classification available for earthworm populations in no-tillage systems, all three sites were considered to have poor quality in terms of abundance (ind m-2), while for species richness, they were considered to have moderate (Faxinal and Mauá da Serra) and good quality (Palmeira).

Urban green areas as earthworm species maintainers in Curitiba, Paraná, Brazil.

Urban green areas can have a high impact on soil fauna due the environmental changes caused by human activities. This work aimed to assess earthworm populations in urban sites in the city of Curitiba, Paraná, Brazil. Earthworms were sampled in two urban sites: the Campus Ecoville of the Universidade Positivo and the Casa Verde space and in two land use systems (Grass Lawn and Native Vegetation), in the summer of 2018 and 2019 and winter of 2019. A total of 1052 individuals were found, belonging to five families and 12 species were identified, of which five are native: Glossoscolex sp.55, Fimoscolex sp.36, Fimoscolex sp.37 (Glossoscolecidae), Andiorrhinus duseni (Rhinodrilidae) and Ocnerodrilidae sp.43 (Ocnerodrilidae) and seven are exotic species: Amynthas corticis, Amynthas morrisi, Metaphire californica, Metaphire schmardae (Megascolecidae), Dendrodrilus rubidus (Lumbricidae) and Pontoscolex corethrurus (Rhinodrilidae). Of the five native species found, four are new species and will be described in the future and the specie A. duseni belongs to the group known as giant earthworms (minhocuçu) with specimens larger than 30cm. Despite the predominance of exotic species (n=932) compared to native species (n=114), the presence of new species may indicate that the managed environments can preserve native species. Moreover, the difference in the total number (native vs. exotic) can be attributed to the ability of the exotic species to survive human disturbances.

Earthworms in various agricultural and forest ecosystems in São Carlos-SP, Brazil.

Integrated agricultural systems have been greatly expanding in Brazil and currently cover over 30 million hectares. Although these land use systems help soil and environmental quality, little is known of their impacts on earthworm communities. In the present study we evaluated earthworm abundance, biomass and species richness in various integrated and conventional agricultural production systems (pasture, crops), as well as native forest and Eucalyptus plantations. The research was carried out at Fazenda Canchim (Embrapa Livestock Southeast) and at the neighboring campus of the University de São Carlos (UFSCar), in São Carlos municipality in São Paulo state, Brazil. Two earthworm sampling methods, i.e., quantitative (25 x 25 x 20 cm deep monoliths) and qualitative (holes of similar size and niche sampling), were used in three integrated production systems, three conventional systems and two forest systems, totaling 232 quantitative samples and over 160 qualitative samples. Earthworms were counted and identified using available keys. Eight earthworm species of five families (Rhinodrilidae, Ocnerodrilidae, Megascolecidae, Benhamiidae and Glossoscolecidae) were found, with most of the 2,145 individuals being exotic or peregrine species, particularly Pontoscolex corethrurus (88% of total) and various Dichogaster spp. (8% of total). Two native species were encountered in low abundance (55 individuals), both of which are new to science (Fimoscolex n.sp.7 and Glossoscolex n.sp.9) and must still be formally described. The new species were found in the agricultural systems, but not in the native forest and the Eucalyptus plantation, where P. corethrurus and Megascolecids predominated. One unidentified Ocnerodrilid sp. was found only in the intensive pasture. Species richness was highest in the intensive pasture (7 spp.), followed by the agrosilvopastoral and agropastoral systems, highlighting the importance of integrated and pastoral systems in preserving earthworm richness and native species.

Earthworm species in different land use systems in the state of Goiás and the Federal District of Brazil.

The state of Goiás and the Federal District together cover an area of about 346 thousand km2, including the diversified Cerrado vegetation, also known as the Brazilian Savanna, a biodiversity hotspot with many endangered and endemic species. Much of the Cerrado has been converted to agriculture, but little is known of its earthworms, and the impacts of land use management and agricultural practices on their density and diversity. In the present paper we review the known earthworm species in Goiás and the Federal District based on historical and museum records, and update information on their distribution and populations in different counties and land use systems with data from recent samplings. Five additional species are reported here for the first time, raising the total to 12 species currently known from Goiás, from the families Benhamiidae (1), Glossoscolecidae (1), Megascolecidae (3), Ocnerodrilidae (2) and Rhinodrilidae (5). In the Federal District, an additional 10 species are reported, bringing the total to 23 earthworm species, belonging to the families Benhamiidae (4), Eudrilidae (1), Glossoscolecidae (2), Ocnerodrilidae (1), Lumbricidae (2), Megascolecidae (1) and Rhinodrilidae (12). Native species in Goiás (6) were found in areas with lesser disturbance, such as in native forest and flooded areas/river banks, a phenomenon also observed in the Federal District. On the other hand, the exotic and peregrine species found in Goiás (6) and in the Federal District (9) dominated in disturbed sites, such as perennial crops, agroforestry, annual crops, urban areas, secondary forests, pastures and agropastoral systems, among others. Given the many new species found and the extension of Goiás and the Federal District, further effort is needed to adequately characterize the earthworm fauna of the region, from where many other species are expected.

Earthworms from natural and managed ecosystems in Southern Bahia, Brazil.

The earthworms (Crassiclitellata) of the Northern Atlantic Forest region are poorly known, and many new species are expected to be found in the region. Hence, quantitative and qualitative samples were taken in the Atlantic Forest region of southern Bahia State, Brazil, at eight sites to assess species presence and abundance in different land uses (forests, pastures, plantations). Earthworms were also qualitatively collected at an additional eight sites. Only one to two species per site were found in quantitative samples, while qualitative samples generally resulted in higher species recoveries, with highest richness observed at the native Atlantic Forest of Veracel in Porto Seguro. Pontoscolex corethrurus (Müller, 1857) was the dominant species at all sites and in most land use systems, probably favored by human migration and agricultural activities; it was only absent in one primary forest site where native Ocnerodrilidae species predominated. In total at least 14 species were found of which eight were new, belonging to the genus Rhinodrilus and three new genera in the Ocnerodrilidae family (Pauqueba, Parabauba and Diplomoela). Contrary to sites in Southern and Southeastern Brazil, where many native species belong to the Glossoscolecidae family, in southern Bahia, Ocnerodrilidae species tend to be more prevalent, occupying various habitats. More intensive sampling of these habitats, including surface litter, in and under fallen logs and dead tree trunks, under rocks, in bromeliad leaf tanks and deeper soil layers is essential in order to properly characterize earthworm communities in Brazilian Atlantic Forests.

New Ocnerodrilidae genera, species and records from Brazil (Annelida: Crassiclitellata).

We describe three new species of Eukerria, six of Kerriona, one of Ocnerodrilus and two of Belladrilus (Clitellata: Ocnerodrilidae) from Brazil, mostly from wet habitats including bromeliad leaf axils, plus some from forest soils in Bahia state. We also provide new morphological and distribution data on Kerriona luederwaldti Michaelsen, 1924. We describe the new genus Pauqueba and its two new species, both from bromeliad leaf axils and forest floor litter in the state of Bahia. It has two pairs of calciferous glands, the balantine reduction of the male terminalia but spermathecae in ix, and no gizzard. The new genus Parabauba found in deeper (30 cm) soil layers is distinctive for the combination of two pairs of calciferous glands, a large gizzard in v, acanthodriline male terminalia, and no typholosole. The new genus Diplomoela from a mesic soil in Bahia is meronephric, unusually large for the Ocnerodrilidae, and has two well-developed gizzards.

Age-dependent impairment in antibody responses elicited by a homologous CoronaVac booster dose.

The emergence of the SARS-CoV-2 Omicron sublineages resulted in increased transmission rates and reduced protection from vaccines. To counteract these effects, multiple booster strategies were used in different countries, although data comparing their efficiency in improving protective immunity remain sparse, especially among vulnerable populations, including older adults. The inactivated CoronaVac vaccine was among the most widely distributed vaccine worldwide and was essential in the early control of SARS-CoV-2-related hospitalizations and deaths. However, it is not well understood whether homologous versus heterologous booster doses in those fully vaccinated with CoronaVac induce distinct humoral responses or whether these responses vary across age groups. We analyzed plasma antibody responses from CoronaVac-vaccinated younger or older individuals who received a homologous CoronaVac or heterologous BNT162b2 or ChAdOx1 booster vaccine. All three evaluated boosters resulted in increased virus-specific IgG titers 28 days after the booster dose. However, we found that both IgG titers against SARS-CoV-2 Spike or RBD and neutralization titers against Omicron sublineages were substantially reduced in participants who received homologous CoronaVac compared with the heterologous BNT162b2 or ChAdOx1 booster. This effect was specifically prominent in recipients >50 years of age. In this group, the CoronaVac booster induced low virus-specific IgG titers and failed to elevate neutralization titers against any Omicron sublineage. Our results point to the notable inefficiency of CoronaVac immunization and boosting in mounting protective antiviral humoral immunity, particularly among older adults, during the Omicron wave. These observations also point to benefits of heterologous regimens in high-risk populations fully vaccinated with CoronaVac.

A "Dirty" Footprint: Macroinvertebrate diversity in Amazonian Anthropic Soils.

Amazonian rainforests, once thought to be pristine wilderness, are increasingly known to have been widely inhabited, modified, and managed prior to European arrival, by human populations with diverse cultural backgrounds. Amazonian Dark Earths (ADEs) are fertile soils found throughout the Amazon Basin, created by pre-Columbian societies with sedentary habits. Much is known about the chemistry of these soils, yet their zoology has been neglected. Hence, we characterized soil fertility, macroinvertebrate communities, and their activity at nine archeological sites in three Amazonian regions in ADEs and adjacent reference soils under native forest (young and old) and agricultural systems. We found 673 morphospecies and, despite similar richness in ADEs (385 spp.) and reference soils (399 spp.), we identified a tenacious pre-Columbian footprint, with 49% of morphospecies found exclusively in ADEs. Termite and total macroinvertebrate abundance were higher in reference soils, while soil fertility and macroinvertebrate activity were higher in the ADEs, and associated with larger earthworm quantities and biomass. We show that ADE habitats have a unique pool of species, but that modern land use of ADEs decreases their populations, diversity, and contributions to soil functioning. These findings support the idea that humans created and sustained high-fertility ecosystems that persist today, altering biodiversity patterns in Amazonia.

Population attributable fractions of mortality in people living with HIV: roles of delayed antiretroviral therapy, hepatitis coinfections and social factors.

OBJECTIVES: Despite free access to antiretroviral therapy (ART) from 1996 onward, and treatment for all people living with HIV (PLWHIV) from 2013, mortality in Brazil has not homogeneously decreased. We investigated to what extent delayed ART, hepatitis coinfections and sociodemographic factors predict all-cause mortality in Brazilian PLWHIV. DESIGN: We included PLWHIV at least 18 years, with complete CD4 cell count data, followed up between 2007 and 2015 in Brazil. METHODS: After multiple imputation, an extended Cox model helped estimate the effects of fixed and time-varying covariates on mortality. RESULTS: The study population (n = 411 028) were mainly male (61%), white (55%), 40 years or less (61%), heterosexually HIV infected (71%), living in the Southeast region (48%) and had basic education (79%). Hepatitis C virus and hepatitis B virus coinfection prevalences were 2.5 and 1.4%, respectively. During a 4-year median follow-up, 61 630 deaths occurred and the mortality rate was 3.45 (95% confidence interval: 3.42-3.47) per 100 person-years. Older age, male sex, non-white ethnicity, illiteracy/basic education and living outside the Southeast and Central-West regions were independently associated with increased mortality. The main modifiable predictors of mortality were delayed ART (i.e. CD4 cell count <200 cells/µl at ART initiation) (adjusted population attributable fraction: 14.20% [95% confidence interval: 13.81-14.59]), being ART-untreated (14.06% [13.54-14.59]) and ART-treated with unrecorded CD4 at ART initiation (5.74% [5.26-6.21]). Hepatitis C virus and hepatitis B virus coinfections accounted for 2.44 [2.26-2.62] and 0.42% [0.31-0.53] of mortality, respectively. CONCLUSION: The current study demonstrates that besides early ART and coinfection control, actions targeting males, non-whites and illiterate people and those with basic education are important to reduce avoidable deaths among Brazilian PLWHIV.

Providing Early Attending Physician Expertise via Telemedicine to Improve Rapid Response Team Evaluations.

OBJECTIVES: To evaluate the effect of providing early attending physician involvement via telemedicine to improve the decision process of rapid response teams. DESIGN: Quasi-experimental; three pairs of control/intervention months: June/July; August/October; November/December. SETTING: Single-center, urban, quaternary academic children's hospital with three-member rapid response team: critical care fellow or nurse practitioner, nurse, respiratory therapist. Baseline practice: rapid response team leader reviewed each evaluation with an ICU attending physician within 2 hours after return to ICU. SUBJECTS: 1) Patients evaluated by rapid response team, 2) rapid response team members. INTERVENTIONS: Implementation of a smartphone-based telemedicine platform to facilitate early co-assessment and disposition planning between the rapid response team at the patient's bedside and the attending in the ICU. MEASUREMENTS AND MAIN RESULTS: As a marker of efficiency, the primary provider outcome was time the rapid response team spent per patient encounter outside the ICU prior to disposition determination. The primary patient outcome was percentage of patients requiring intubation or vasopressors within 60 minutes of ICU transfer. There were three pairs of intervention/removal months. In the first 2 pairs, the intervention was associated with the rapid response team spending less time on rapid response team calls (June/July: point estimate -5.24 min per call; p < 0.01; August/October: point estimate -3.34 min per call; p < 0.01). During the first of the three pairs, patients were significantly less likely to require intubation or vasopressors within 60 minutes of ICU transfer (adjusted odds ratio, 0.66; 95 CI, 0.51-0.84; p < 0.01). CONCLUSIONS: Early in the study, more rapid ICU attending involvement via telemedicine was associated with rapid response team providers spending less time outside the ICU, and among patients transferred to the ICU, a significant decrease in likelihood of patients requiring vasopressors or intubation within the first 60 minutes of transfer. These findings provide evidence that early ICU attending involvement via telemedicine can improve efficiency of rapid response team evaluations.

Earthworm species in various land use systems in the Campos Gerais region of Lapa, Paraná, Brazil.

The Campos Gerais region of Paraná are on an ancient plateau of sandstone origin and are covered with a diverse vegetation including mainly grasslands and various types of Atlantic Forest (particularly Araucaria forest). The region represents an important natural capital for biodiversity conservation as well as for agricultural and forestry production. However, little is known of the species richness and diversity of soil macroinvertebrates in this region. In the present study we evaluated earthworm species occurrence and richness in five land use systems (LUS) in the southern part of the Campos Gerais in Lapa county. Earthworms were handsorted from up to 18 soil monoliths on five occasions over three years (Feb. 2014, Feb., Mar., Nov. 2015, Jul. 2016) in the following LUS: old native forest, native grassland, young regenerating forest and grass lawn in the Uru Reserve and annual crop fields (soybean) in neighboring private farms (not all systems were sampled on all occasions). Nine earthworm species belonging to four families and five genera were found, of which six were native and three exotic species (Dichogaster gracilis, Amynthas gracilis, A. corticis). Of the native species, Urobenus brasiliensis and Andiorrhinus duseni (a large bodied-worm) are already well known from S and SE Brazil, while the remaining four were new species that require further description (Fimoscolex n.sp.1 and n.sp.2, Glossoscolex n.sp.1 and n.sp.2). In general, more species were found in February (summer) than March and November. The cropping system (soybean) had the lowest abundance and species richness in relation to other sites, although in the young and old forests no earthworms were found on some sample dates. Given the several new species found in this small reserve, and the relatively few sites studied thus far in the Campos Gerais, further efforts are needed to adequately characterize the earthworm fauna of the region, from which many other species are expected.

Earthworm species in no-tillage agroecosystems and native Atlantic forests in Western Paraná, Brazil.

Earthworm populations often increase with the adoption of no-tillage (NT) practices, but few studies have evaluated earthworm diversity in these agroecosystems. In the present study we assessed earthworm species richness in 40 sites under NT and six native Atlantic forest fragments in Western Paraná, Southern Brazil. At each site earthworms were sampled quantitatively (n=5) and qualitatively (n=5), by handsorting soil monoliths (20 x 20 cm width x 20 cm depth), totaling 460 samples overall. Earthworms were killed and fixed in 96% ethanol, counted and identified. Overall, 18 species were found, in the families Acanthodrilidae, Glossoscolecidae, Megascolecidae, Rhinodrilidae and Ocnerodrilidae, of which 10 were native and eight exotic. No-tillage agroecosystems had larger earthworm populations and higher species richness overall than native forests, although this was mainly due to colonization of these agricultural fields by exotic species. Mostly native species were found in the Atlantic forests, highlighting the importance of these habitats as refugia for native earthworm species conservation.