Time series analysis of comprehensive maternal deaths in Brazil during the COVID-19 pandemic.

The effects of the COVID-19 pandemic on comprehensive maternal deaths in Brazil have not been fully explored. Using publicly available data from the Brazilian Mortality Information (SIM) and Information System on Live Births (SINASC) databases, we used two complementary forecasting models to predict estimates of maternal mortality ratios using maternal deaths (MMR) and comprehensive maternal deaths (MMRc) in the years 2020 and 2021 based on data from 2008 to 2019. We calculated national and regional standardized mortality ratio estimates for maternal deaths (SMR) and comprehensive maternal deaths (SMRc) for 2020 and 2021. The observed MMRc in 2021 was more than double the predicted MMRc based on the Holt-Winters and autoregressive integrated moving average models (127.12 versus 60.89 and 59.12 per 100,000 live births, respectively). We found persisting sub-national variation in comprehensive maternal mortality: SMRc ranged from 1.74 (95% confidence interval [CI] 1.64, 1.86) in the Northeast to 2.70 (95% CI 2.45, 2.96) in the South in 2021. The observed national estimates for comprehensive maternal deaths in 2021 were the highest in Brazil in the past three decades. Increased resources for prenatal care, maternal health, and postpartum care may be needed to reverse the national trend in comprehensive maternal deaths.

Spatial and temporal analysis of breast cancer mortality in a state in northeastern Brazil.

Breast cancer (BC) is the most common neoplasm, and its global burden has become one of the most important factors jeopardizing the health of the world population, especially women. The aim of this study was to analyze mortality trends and the spatial distribution of BC in women in the capital and state of Sergipe, aiming to contribute to the implementation and improvement of strategies for the prevention and health promotion of women with BC. Trends were calculated using the Joinpoint Regression Program 5.0.2. Spatial analyses were performed using the empirical Bayesian model, thematic maps were created using QGIS 3.10.7 and Moran's I indices were calculated using TerraView 4.2.2. Between 1996 and 2022, 1384 and 3128 BC deaths were recorded in the capital and state of Sergipe, respectively. The mortality trend increased in the age groups of 45-75+ for the state of Sergipe, while in the capital, we observed stability in all age groups. The highest AAPC was 4.6213, with a 95 % confidence interval (2.16; 7.14). Univariate global Moran's I analysis indicated spatial autocorrelation during the study period. A direct relationship was found between mortality rates and the more economically developed regions.

How much rainwater contributes to a spring discharge in the Guarani Aquifer System: insights from stable isotopes and a mass balance model.

Outcrops play an important role in groundwater recharge. Understanding groundwater origins, dynamics and its correlation with different water sources is essential for effective water resources management and planning in terms of quantity and quality. In the case of the Guarani Aquifer System (GAS) outcrop areas are particularly vulnerable to groundwater pollution due to direct recharge processes. This study focuses on the Alto Jacaré-Pepira sub-basin, a watershed near Brotas, a city in the central region of the state of São Paulo, Brazil, where groundwater is vital for supporting tourism, agriculture, urban water supply, creeks, river and wetlands. The area has a humid tropical climate with periods of both intense rainfall and drought, and the rivers remain perennial throughout the year. Therefore, the aim of this study is to investigate the interconnections between a spring and its potential sources of contribution, namely rain and groundwater, in order to elucidate the relationships between the different water sources. To achieve this, on-site monitoring of groundwater depth, rainfall amount, and stable isotope ratios (deuterium (2H) and oxygen-18 (18O)) from rain, spring discharge, and a monitoring well was carried out from 2013 to 2021. The results indicate that the mean and standard deviations for δ18O in rainwater exhibit higher variability, resulting in -4.49 ± 3.18 ‰ VSMOW, while δ18O values from the well show minor variations, similar to those of the spring, recording -7.25 ± 0.32 ‰ and -6.94 ± 0.28 ‰ VSMOW, respectively. The mixing model's outcomes reveal seasonal variations in water sources contribution and indicate that groundwater accounts for approximately 80 % of spring discharge throughout the year. Incorporating stable isotopes into hydrological monitoring provides valuable data for complementing watershed analysis. The values obtained support the significance of the aquifer as a primary source, thereby offering critical insights into stream dynamics of the region.

The relationship between online searches and suicide.

AIMS: In this study, we examined the relationship between 131 suicide related Google search terms, grouped into nine categories, and the number of suicide cases per month in Ecuador from January 2011 to December 2021. METHODS: First, we applied time-series analysis to eliminate autocorrelation and seasonal patterns to prevent spurious correlations. Second, we used Pearson's correlation to assess the relationship between Google search terms and suicide rates. Third, cross-correlation analysis was used to explore the potential delayed effects between these variables. Fourth, we extended the correlation and cross-correlation analyses by three demographic characteristics - gender, age, and region. RESULTS: Significant correlations were found in all categories between Google search trends and suicide rates in Ecuador, with predominantly positive and moderate correlations. The terms 'stress' (.548), 'prevention' (.438), and 'disorders' (.435) showed the strongest associations. While global trends indicated moderate correlations, sensitivity analysis revealed higher coefficients in men, young adults, and the Highlands region. Specific patterns emerged in subgroups, such as 'digital violence' showing significant correlations in certain demographics, and 'trauma' presenting a unique temporal pattern in women. In general, cross correlation analysis showed an average negative correlation of -.191 at lag 3. CONCLUSION: Google search data do not provide further information about users, such as demographics or mental health records. Hence, our results are simply correlations and should not be interpreted as causal effects. Our findings highlight a need for tailored suicide prevention strategies that recognize the complex dynamics of suicide risk across demographics and time periods.

The COVID-19 pandemic in Brazil: space-time approach of cases, deaths, and vaccination coverage (February 2020 - April 2024).

OBJECTIVE: To assess the evolution of the COVID-19 pandemic in Brazil and its macro-regions, considering disease incidence and mortality rates, as well as identifying territories with still rising disease indices and evaluating vaccine coverage and population adherence to COVID-19 immunization. METHODS: An ecological study conducted in Brazil with COVID-19 cases and deaths reported between February 2020 and April 2024, obtained through the Coronavirus Panel. Historical series were constructed from incidence and mortality rates to assess the pandemic's evolution, and temporal trends were estimated using the Seasonal Trend Decomposition using Loess (STL) method. The Spatial Variation in Temporal Trends (SVTT) technique was employed to identify clusters with significant variations in temporal trends. Vaccination was analyzed considering the percentage of vaccinated and unvaccinated population in each municipality of the country. RESULTS: Brazil recorded a total of 38,795,966 cases and 712,038 deaths from COVID-19 during the study period. Incidence and mortality rates showed three waves of the disease, with a fourth wave of smaller amplitude. Four clusters with significant case growth and two with increased deaths were identified. Vaccine coverage varied among municipalities, with some regions showing low vaccination rates and others with high immunization adherence. CONCLUSION: The study provided a comprehensive overview of coronavirus behavior in Brazil, and its results highlight the ongoing importance of vaccination and the need to direct efforts and resources to areas of higher risk.

Maternal and perinatal health indicators in Brazil over a decade: assessing the impact of the COVID-19 pandemic and SARS-CoV-2 vaccination through interrupted time series analysis.

Background: Few studies have evaluated the effects of the Coronavirus disease 2019 (COVID-19) pandemic, caused by the SARS-CoV-2 virus, on maternal and perinatal health at a populational level. We investigated maternal and perinatal health indicators in Brazil, focusing on the effects of the COVID-19 pandemic, and SARS-CoV-2 vaccination campaign for pregnant women. Methods: Utilizing interrupted time series analysis (January 2013-December 2022), we examined Maternal Mortality Ratio, Perinatal Mortality Rate, Preterm Birth Rate, Cesarean Section Rate, and other five indicators. Interruptions occurred at the pandemic's onset (March 2020) and pregnant women's vaccination (July 2021). Results were expressed as percent changes on time series' level and slope. Findings: The COVID-19 onset led to immediate spikes in Maternal Mortality Ratio (33.37%) and Perinatal Mortality Rate (3.20%) (p < 0.05). From March 2020 to December 2022, Cesarean Section and Preterm Birth Rates exhibited upward trends, growing monthly at 0.13% and 0.23%, respectively (p < 0.05). Post start of SARS-CoV-2 vaccination (July 2021), Maternal Mortality Ratio (-34.10%) and Cesarean Section Rate (-1.87%) promptly declined (p < 0.05). Subsequently, we observed a monthly decrease of Maternal Mortality Ratio (-9.43%) and increase of Cesarean Section Rate (0.25%) (p < 0.05), while Perinatal Mortality Rate and Preterm Birth Rate showed a stationary pattern. Interpretation: The pandemic worsened all analyzed health indicators. Despite improvements in Maternal Mortality Ratio, following the SARS-CoV-2 vaccination campaign for pregnant women, the other indicators continued to sustain altered patterns from the pre-pandemic period. Funding: No funding.

Assessment of the impact of Uber system implementation on mortality from traffic injuries in Brazilian capital cities.

The rapid expansion of Uber Technologies, Inc.'s ride-sharing, courier service, and food delivery system and e-hailing applications has been transforming the logistics network and urban mobility around the world. We aimed to evaluate the impact of the Uber system on traffic injury (TI) mortality during its implementation in Brazilian capital cities. A quasiexperimental design of interrupted time series was used. The monthly mortality rates for TI standardized by age were analyzed. The date of availability of the Uber app, specific to each capital, was considered the start date. Data from the Brazilian Mortality Information System and the Brazilian Institute of Geography and Statistics were used. For the data analysis, from an interrupted time-series design, autoregressive integrated moving average (ARIMA) models with a transfer function were fitted. In 92.6% (n = 25) of Brazilian capitals, there was no impact of Uber system implementation, 12 months after the start of its activities, on TI mortality. A reduction in mortality from this cause was observed after the system was implemented in Belo Horizonte and Rio de Janeiro. The impact on TI mortality was progressive and continuous in both. More studies are needed to establish the factors associated with the inequalities observed in the impact of Uber system implementation between different locations and the heterogeneity of effects.

Temporal Trends of Age-Adjusted Mortality Rates for Rheumatic Heart Disease in Brazil From 2000 to 2021.

Background Rheumatic heart disease (RHD) is a chronic cardiovascular condition stemming from an infectious origin, posing a substantial health burden, particularly in economically disadvantaged regions. It starts with acute rheumatic fever (ARF), a complication following group A Streptococcus infection, leading to heart valve damage and, over time, structural heart abnormalities. RHD contributes to premature deaths, especially in low-middle-income countries. Although the incidence and prevalence have generally reduced globally due to antibiotics and improved healthcare, it remains a significant public health concern in Brazil, echoing its prevalence in many developing nations around the world. RHD stands as a poignant testament to the intersection of socio-economic disparities and healthcare challenges within Brazil's diverse population. In Brazil, despite advancements in healthcare, RHD continues to impact communities, highlighting the urgent need for enhanced prevention strategies, access to quality healthcare services, and heightened awareness to combat this preventable, yet persistent, cardiac condition. Understanding the epidemiological landscape and socio-cultural factors influencing RHD in Brazil is crucial for developing targeted interventions aimed at mitigating its burden on individuals, families, and the healthcare system at large. Thus, our study focuses on analyzing age-related mortality rates linked to ARF and chronic RHD (ARHD) in Brazil from 2000 to 2021, particularly examining gender disparities. Materials and methods This retrospective cohort study employed a descriptive time-series approach, utilizing comprehensive nationwide data from Brazil spanning from 2000 to 2021 to assess trends in diverse age groups, among both sexes, enabling a detailed analysis of temporal patterns. Mortality data, extracted and categorized meticulously, were subjected to Joinpoint statistical analyses enabling comparative assessments, with average annual percent change (AAPC) and annual percent change (APC) serving as key metrics to quantify and interpret trends over the analyzed period. Results The acute RHD (ARHD)-related mortality declined over the analyzed years supported by AAPC, with higher mortality reduction in females. The age-adjusted mortality rate for "males and females" decreased from 78 to 67 deaths/100,000 from 2000 to 2021. Female mortality dropped from 85 to 69/100,000, and male mortality decreased from 73 to 63/100,000 over the same period. For ARHD, male age groups (20-29, 60-69, 70-79, 80+) showed declining mortality, while the 30-59 age group exhibited an upward. Females AAMR for chronic RHD (CRHD) decreased across all age groups, with significant reductions in the 80 years and above age group from 2000-2002 (APC: -11.94*) and steadily from 2002 onwards (APC: -1.33). Conclusions Our study revealed an overall decline in mortality rates for both acute and CRHD across both sexes. Females consistently exhibited higher mortality rates and a more pronounced reduction compared to males in both acute and CRHD. In ARHD, males experience the highest mortality in the 50-59 age group, while females have a peak in the 40-49 age group. The 60-69 age group had the highest mortality in CRHD for both sexes. Conversely, the 20-29 age group displayed the lowest mortality in CRHD, and the 80-89 age group had the lowest mortality in ARHD.

Impact of the COVID-19 pandemic on the services provided by the Peruvian health system: an analysis of people with chronic diseases.

During the pandemic, many individuals with chronic or infectious diseases other than COVID-19 were unable to receive the care they needed due to the high demand for respiratory care. Our study aims to assess the impact of the COVID-19 pandemic on services provided to people with chronic diseases in Peru from 2016 to 2022. We performed a secondary database analysis of data registered by the comprehensive health insurance (SIS), the intangible solidarity health fund (FISSAL), and private healthcare institutions (EPS), using interrupted time series analysis. Our study identified 21,281,128 individual users who received care. The pooled analysis revealed an average decrease of 1,782,446 in the number of users receiving care in the first month of the pandemic compared with the expected values for that month based on pre-pandemic measurements. In addition, during the pandemic months, there was an average increase of 57,911 in the number of new additional single users who received care per month compared with the previous month. According to the time-series analysis of users receiving care per month based on each chronic disease group, the most significant decreases included people with diabetes without complications and chronic lung disease.

Tendência da taxa de mortalidade por câncer de mama em mulheres com 20 anos ou mais no Brasil, 2005-2019 / Trend in breast cancer mortality rate among women aged 20 years or older in Brazil, 2005-2019

Resumo O objetivo é analisar a tendência da taxa de mortalidade por câncer de mama e sua correlação com o status de desenvolvimento socioeconômico no Brasil. Estudo ecológico de séries temporais realizado nos 26 estados, Distrito Federal e regiões do Brasil. As fontes de dados foram o Sistema de Informação sobre Mortalidade (número de óbitos), o Instituto Brasileiro de Geografia e Estatística (população residente) e o estudo da Carga Global de Doenças (socio-demographic index - SDI). Foram usados dados de 2005 a 2019. A tendência foi analisada pelos modelos de regressão de Prais-Winsten. A relação entre a taxa de mortalidade e o SDI foi analisada pelo coeficiente de correlação de Spearman. No período do estudo ocorrerem 207.683 óbitos por câncer de mama. A taxa padronizada de mortalidade média foi de 19,95 óbitos por 100.000 mulheres no Brasil. O Brasil e todas as regiões apresentaram tendência crescente da mortalidade. Do total de estados, 22 apresentaram tendência crescente. Verificou-se relação positiva entre a taxa de mortalidade e o SDI. A taxa de mortalidade padronizada por câncer de mama apresentou tendência crescente no Brasil, em todas as regiões e na maioria das unidades da federação. Verificou-se associação direta entre mortalidade e SDI, indicando maior magnitude em regiões mais desenvolvidas.

Abstract The aim is to analyze the trend in breast cancer mortality rates and its correlation with the socioeconomic development status in Brazil. It involved an ecological time series study carried out in the 26 units of the federation, Federal District and regions of Brazil. Data sources included the Mortality Information System (number of deaths), the Brazilian Institute of Geography and Statistics (resident population) and the study of the Global Burden of Disease (Socio-demographic Index - SDI). Data from 2005 to 2019 were used. The trend was analyzed using Prais-Winsten regression models. The relationship between the mortality rate and the SDI was analyzed using Spearman's correlation coefficient. During the study period, 207,683 deaths from breast cancer occurred. The average standardized mortality rate was 19.95 deaths per 100,000 women in Brazil. All the regions of Brazil showed an increasing trend in mortality. Of the total federative units, 22 showed an increasing trend. There was a positive relationship between the mortality rate and the SDI. The standardized mortality rate for breast cancer showed an increasing trend in Brazil, in all regions and in most states. There was a direct association between mortality and SDI, indicating a greater magnitude in more developed regions.

Desigualdades regionais na enumeração dos registros de óbitos fetais nos sistemas de informações sobre estatísticas vitais no Brasil / Regional inequalities in the enumeration of stillbirth records in information systems on vital statistics in Brazil / Desigualdades regionales en la enumeración de los registros de muertes fetales en los sistemas de información sobre estadísticas vitales en Brasil

Resumo Este estudo tem por objetivo analisar a variação do número de óbitos fetais informados entre o Sistema de Estatísticas Vitais do Registro Civil (RC) e o Sistema de Informações sobre Mortalidade (SIM) e comparar a tendência da taxa de mortalidade fetal (TMF) de ambos os sistemas no Brasil, para o período 2009-2019. A variação percentual (VP) foi analisada por meio da comparação entre as fontes de dados para os óbitos fetais precoces (<28 semanas) e tardios (≥28 semanas). Os clusters de unidades da federação foram obtidos pelo método k-means. Aplicou-se a regressão linear generalizada de Prais-Winsten na análise da tendência da TMF. O SIM demonstrou percentual de captação 27,7% superior ao RC no período estudado. Houve maior número de óbitos fetais informados no SIM para o Brasil e regiões, em ambos os estratos de óbitos. As regiões Norte e Nordeste apresentaram as maiores VP em oposição às regiões mais desenvolvidas do país, Sudeste e Sul, onde verificou-se uma convergência de 95%. Apesar da redução da VP na década analisada, as estimativas de tendência da TMF permaneceram subestimadas no RC. Conclui-se que a captação dos óbitos fetais foi maior no SIM, sobretudo nas regiões Norte e Nordeste, reconhecidas como as mais vulneráveis do país.

Abstract This study aimed to analyze the variation in the number of stillbirths reported between the vital statistics system of the Civil Registry (RC) and the Mortality Information System (SIM) as well as to compare the trend in stillbirth rates (SBR) in both systems in Brazil between 2009 and 2019. Percent change (PC) was analyzed by comparing data sources for early (<28 weeks) and late (≥28 weeks) stillbirths. Clusters of Federation Units were obtained using the k-means method. Prais-Winsten generalized linear regression was applied in the analysis of the SBR trend. The SIM showed a percentage of uptake 27.7% higher than RC in the period. A higher number of fetal deaths were reported on the SIM for Brazil and its regions, in both death strata. The North and Northeast regions presented the highest PC, as opposed to the most developed regions of the country, Southeast and South, where there was a convergence of 95%. Despite the reduction in PC in the decade analyzed, the SBR trend estimates remained underestimated in the RC. The conclusion, that the capture of fetal deaths was higher in the SIM, demonstrates the need for improvements in civilian registration of stillbirths, especially in the North and Northeast regions, recognized as the most vulnerable in the country.

Resumen Este estudio tuvo como objetivo analizar la variación en el número de muertes fetales notificadas entre el sistema de estadísticas vitales del Registro Civil (RC) y el Sistema de Información de Mortalidad (SIM) y comparar la tendencia de la Tasa de Mortalidad Fetal (TMF) de ambos sistemas en Brasil entre 2009 y 2019. El cambio porcentual (CP) se analizó comparando fuentes de datos para muertes fetales tempranas (< 28 semanas) y tardías (≥ 28 semanas). Los conglomerados de unidades de la federación se obtuvieron mediante el método de k-means. Se aplicó la regresión lineal generalizada Prais-Winsten en el análisis de la tendencia TMF. El SIM mostró un porcentaje de captación 27,7 % superior al del RC en el período. Hubo mayor número de muertes fetales reportadas en el SIM para Brasil y regiones, en ambos estratos de muerte. Las regiones Norte y Noreste tuvieron el CP más alto en comparación con las regiones más desarrolladas del país, Sudeste y Sur, donde hubo convergencia del 95 %. A pesar de la reducción del CP en la década analizada, las estimaciones de tendencia de la TMF permanecieron subestimadas en el RC. Se concluye que la captura de las defunciones fetales fue mayor en el SIM, demostrando la necesidad de mejoras en el registro civil de las defunciones fetales, especialmente en las regiones Norte y Nordeste, reconocidas como las más vulnerables del país.

Tendência da mortalidade por tuberculose e relação com o índice sóciodemográfico no Brasil entre 2005-2019 / Tuberculosis mortality trends and the correlation with the socio-demographic index in Brazil between 2010 and 2019

Resumo O objetivo do artigo é analisar a tendência da taxa de mortalidade padronizada (TMP) por tuberculose e sua correlação com o status de desenvolvimento no Brasil. Estudo ecológico de séries temporais que analisou dados de óbitos por tuberculose notificados entre 2005 e 2019 de todos os estados. Os dados foram extraídos do Sistema de Informação sobre Mortalidade, do Instituto Brasileiro de Geografia e Estatística e do estudo da Carga Global de Doenças. A tendência temporal foi analisada pela regressão de Prais-Winsten. A análise da correlação de Spearman entre a TMP e o índice sociodemográfico (socio-demographic index - SDI) também foi realizada. De 2005 a 2019, foram registrados 68.879 óbitos por tuberculose no Brasil. A taxa média de mortalidade foi de 2,3 óbitos por 100.000 habitantes. A tendência decrescente da TMP por tuberculose foi observada no Brasil e em todas as regiões. Verificou-se correlação negativa significativa entre o SDI e a TMP. A maioria dos estados apresentou tendência decrescente e nenhum deles teve tendência crescente. Uma relação inversa foi verificada entre o SDI e a mortalidade por tuberculose.

Abstract The scope of this article is to analyze the trend of the standardized mortality rate (SMR) for tuberculosis and its correlation with the developmental status in Brazil. An ecological time series study was conducted to analyze data of deaths from tuberculosis reported between 2005 and 2019 in all states. Data were extracted from the Mortality Information System, the Brazilian Institute of Geography and Statistics, and the Global Burden of Disease study. The temporal trend was analyzed using Prais-Winsten regression. Spearman's correlation analysis between SMR and Socio-Demographic Index (SDI) was also performed. From 2005 to 2019, 68,879 deaths from tuberculosis were recorded in Brazil. The average mortality rate was 2.3 deaths per 100,000 inhabitants. The decreasing trend of SMR due to tuberculosis was observed in Brazil and in all regions. There was a significant negative correlation between SDI and TMP. TMP due to tuberculosis revealed a decreasing trend in Brazil and in all regions. Most states showed a decreasing trend and none of them had an increasing trend. An inverse relationship was found between developmental status and mortality due to tuberculosis.

Impact of COVID-19 on tuberculosis notifications

ABSTRACT The COVID-19 pandemic has significantly impacted the control of diseases by overwhelming healthcare systems, and tuberculosis (TB) notifications may have been affected. This study aimed to analyze the impact of COVID-19 on TB notifications in the Sao Paulo State. This is a retrospective study examining TB notifications extracted from the TBweb database (Jan 2015 to Dec 2022). We conducted an interrupted time series (ITS) analysis of TB notifications using the declaration of the COVID-19 pandemic as the interrupting event (Bayesian causal impact analysis). A total of 177,103 notifications of TB incident cases were analyzed, revealing a significant decrease in 2020 (13%) and in 2021 (9%), which lost significance in 2022. However, changes were not associated with population density or the area of the regions. Future analyses of the effects of TB underdiagnosis might help describe the impact of underreporting on future TB incidence and mortality.

Tuberculosis incidence in Brazil: time series analysis between 2001 and 2021 and projection until 2030 / Incidência de tuberculose no Brasil: análise de série temporal entre 2001 e 2021 e projeção até 2030

ABSTRACT Objective: To assess the incidence of tuberculosis in Brazil between 2001 and 2022 and estimate the monthly incidence forecast until 2030. Methods: This is a time-series study based on monthly tuberculosis records from the Notifiable Diseases Information System and official projections of the Brazilian population. The monthly incidence of tuberculosis from 2001 to 2022 was evaluated using segmented linear regression to identify trend breaks. Seasonal autoregressive integrated moving average (Sarima) was used to predict the monthly incidence from 2023 to 2030, deadline for achieving the sustainable development goals (SDGs). Results: There was a decrease in incidence between January/2001 and December/2014 (4.60 to 3.19 cases-month/100,000 inhabitants; β=-0.005; p<0.001), followed by an increase between January/2015 and March /2020 (β=0.013; p<0.001). There was a sharp drop in cases in April/2020, with the onset of the pandemic, and acceleration of the increase in cases since then (β=0.025; p<0.001). A projection of 124,245 cases in 2030 was made, with an estimated incidence of 4.64 cases-month/100,000 inhabitants, levels similar to those in the 2000s. The Sarima model proved to be robust, with error of 4.1% when removing the pandemic period. Conclusion: The decreasing trend in tuberculosis cases was reversed from 2015 onwards, a period of economic crisis, and was also impacted by the pandemic when there was a reduction in records. The Sarima model can be a useful forecasting tool for epidemiological surveillance. Greater investments in prevention and control need to be made to reduce the occurrence of tuberculosis, in line with the SDGs.

RESUMO Objetivo: Avaliar a incidência de tuberculose no Brasil entre 2001 e 2022 e estimar a previsão de incidência mensal até 2030. Métodos: Trata-se de estudo de série temporal que partiu de registros mensais de tuberculose do Sistema de Informação de Agravos de Notificação e projeções oficiais da população brasileira. Avaliou-se a incidência mensal de tuberculose entre 2001 e 2022 por meio de regressão linear segmentada para identificar quebras de tendências. Utilizou-se o modelo autorregressivo integrado de médias móveis sazonais (Sarima) para prever a incidência mensal de 2023 a 2030, prazo para alcançar os objetivos de desenvolvimento sustentável (ODS). Resultados: Observou-se diminuição da incidência entre janeiro/2001 e dezembro/2014 (de 4,60 para 3,19 casos-mês/100 mil habitantes; β=-0,005; p<0,001), seguida de aumento entre janeiro/2015 e março/2020 (β=0,013; p<0,001). Houve queda abrupta de casos em abril/2020, com início da pandemia e aceleração do aumento de casos desde então (β=0,025; p<0,001). Projetaram-se 124.245 casos de tuberculose em 2030, com incidência estimada em 4,64 casos-mês/100 mil habitantes, patamares da década de 2000. O modelo Sarima mostrou-se robusto, com erro de 4,1% ao remover o período pandêmico. Conclusão: A tendência decrescente nos casos de tuberculose foi revertida a partir de 2015, período de crises econômicas, e foi também impactada pela pandemia quando houve redução nos registros. O modelo Sarima pode ser uma ferramenta de previsão útil para a vigilância epidemiológica. Maiores investimentos na prevenção e controle precisam ser aportados para reduzir a ocorrência de tuberculose, em linha com os ODS.

Changes to balance dynamics following a high-intensity run are associated with future injury occurrence in recreational runners.

Background: Fatigue is associated with increased injury risk along with changes in balance control and task performance. Musculoskeletal injury rates in runners are high and often result from an inability to adapt to the demands of exercise and a breakdown in the interaction among different biological systems. This study aimed to investigate whether changes in balance dynamics during a single-leg squat task following a high-intensity run could distinguish groups of recreational runners who did and did not sustain a running-related injury within 6 months. Methods: Thirty-one healthy recreational runners completed 60 s of single-leg squat before and after a high-intensity run. Six months after the assessment, this cohort was separated into two groups of 13 matched individuals with one group reporting injury within this period and the other not. Task performance was assessed by the number of repetitions, cycle time, amplitude, and speed. To evaluate balance dynamics, the regularity and temporal correlation structure of the center of mass (CoM) displacements in the transverse plane was analyzed. The interaction between groups (injury, non-injured) and time (pre, post) was assessed through a two-way ANOVA. Additionally, a one-way ANOVA investigated the percent change difference of each group across time. Results: The injured group presented more regular (reduced entropy; 15.6%) and diffusive (increased short-term persistence correlation; 5.6%) CoM displacements after a high-intensity run. No changes were observed in the non-injured group. The within-subject percent change was more sensitive in demonstrating the effects of fatigue and distinguishing the groups, compared to group absolute values. No differences were observed in task performance. Discussion: Runners who were injured in the future demonstrate changes in balance dynamics compared to runners who remain injury-free after fatigue. The single-leg squat test adopted appears to be a potential screening protocol that provides valuable information about balance dynamics for identifying a diminished ability to respond to training and exercise.

Recurrent Quantification Analysis Based Study of Wide-Field Calcium Imaging Data in Relation to Brain's Wake/Sleep Condition

Wide-Field Calcium Images (WFCI) directly reflect neuronal excitation, but their poor frame rate could be a drawback for time series analysis. This work was aimed at exploring the diagnostic capability retained by a time series obtained from calcium imaging data. To that purpose, we analyzed publicly available data from 2.88 hour continuous recordings of calcium images obtained from seven mice at different wake/sleep stages. Data were obtained from the Physionet portal and were submitted to Recurrence Quantification Analysis (RQA). The association between retrosplenial and parietal areas was also assessed. Nonlinear RQA analysis allowed to identify the right retrosplenial and parietal areas as particularly sensitive to changes in sleep walking condition. Specifically, our results suggested that the RQA feature lmean decreases in non-REM sleep_1 stage as compared to waking stage. Sleep (both sleep_1 stage and REM) apparently elicits an increase in the association between retrosplenial and parietal areas. Overall, these results suggest that RQA and association analysis are appropriate to assess modifications associated to changes in brain condition, in spite of the low sampling rate of WFCI signals.

Las Imágenes de Calcio de Campo Ancho (Wide-Field Calcium Images, WFCI) reflejan directamente la excitación neuronal, pero su escasa resolución temporal pudiera resultar un impedimento para el análisis de series temporales. El presente trabajo tuvo por finalidad explorar la capacidad diagnostica que retiene una serie temporal extraída de imágenes de calcio. Para ello, se estudió una base de datos disponible en la red que contiene registros de 2.88 horas de duración de imágenes de calcio correspondientes a 7 ratones transgénicos a diferentes estadios de sueño/vigilia. Los datos fueron descargados del portal Physionet y sometidos a Análisis de Cuantificación Recurrente (Recurrent Quantification Analysis, RQA). La asociación entre las áreas retrosplenial y parietal derechas fue también evaluada. El análisis no lineal mediante RQA permitió identificar las áreas retrosplenial y parietal derechas como zonas particularmente sensibles a cambios en el estado de sueño/vigilia. Específicamente, nuestros resultados sugieren que el índice l mean se redujo en el estadio 1 de sueño no REM en comparación con el estado de vigilia. El estado de sueño, tanto REM como no-REM aparentemente induce un reforzamiento en la apreciación entre las áreas retrosplenial y parietal derechas. En su conjunto, estos resultados apuntan que el análisis de RQA y de asociación entre áreas son pertinentes para sensar las modificaciones asociadas a cambios en el estado del cerebro, a pesar de la baja resolución temporal de las señales WFCI.

Time-Dependent Proteomic Signatures Associated with Embryogenic Callus Induction in Carica papaya L.

Sex segregation increases the cost of Carica papaya production through seed-based propagation. Therefore, in vitro techniques are an attractive option for clonal propagation, especially of hermaphroditic plants. Here, we performed a temporal analysis of the proteome of C. papaya calli aiming to identify the key players involved in embryogenic callus formation. Mature zygotic embryos used as explants were treated with 20 µM 2,4-dichlorophenoxyacetic acid to induce embryogenic callus. Total proteins were extracted from explants at 0 (zygotic embryo) and after 7, 14, and 21 days of induction. A total of 1407 proteins were identified using a bottom-up proteomic approach. The clustering analysis revealed four distinct patterns of protein accumulation throughout callus induction. Proteins related to seed maturation and storage are abundant in the explant before induction, decreasing as callus formation progresses. Carbohydrate and amino acid metabolisms, aerobic respiration, and protein catabolic processes were enriched throughout days of callus induction. Protein kinases associated with auxin responses, such as SKP1-like proteins 1B, accumulated in response to callus induction. Additionally, regulatory proteins, including histone deacetylase (HD2C) and argonaute 1 (AGO1), were more abundant at 7 days, suggesting their role in the acquisition of embryogenic competence. Predicted protein-protein networks revealed the regulatory role of proteins 14-3-3 accumulated during callus induction and the association of proteins involved in oxidative phosphorylation and hormone response. Our findings emphasize the modulation of the proteome during embryogenic callus initiation and identify regulatory proteins that might be involved in the activation of this process.

Analysis of landslide explicative factors and susceptibility mapping in an andean context: The case of Azuay province (Ecuador).

Landslides are one of the natural phenomena with more negative impacts on landscape, natural resources, and human health worldwide. Andean geomorphology, urbanization, poverty, and inequality make it more vulnerable to landslides. This research focuses on understanding explanatory landslide factors and promoting quantitative susceptibility mapping. Both tasks supply valuable knowledge for the Andean region, focusing on territorial planning and risk management support. This work addresses the following questions using the province of Azuay-Ecuador as a study area: (i) How do EFA and LR assess the significance of landslide occurrence factors? (ii) Which are the most significant landslide occurrence factors for susceptibility analysis in an Andean context? (iii) What is the landslide susceptibility map for the study area? The methodological framework uses quantitative techniques to describe landslide behavior. EFA and LR models are based on a historical inventory of 665 records. Both identified NDVI, NDWI, altitude, fault density, road density, and PC2 as the most significant factors. The latter factor represents the standard deviation, maximum value of precipitation, and rainfall in the wet season (January, February, and March). The EFA model was built from 7 latent factors, which explained 55% of the accumulated variance, with a medium item complexity of 1.5, a RMSR of 0.02, and a TLI of 0.89. This technique also identified TWI, fault distance, plane curvature, and road distance as important factors. LR's model, with AIC of 964.63, residual deviance of 924.63, AUC of 0.92, accuracy of 0.84, and Kappa of 0.68, also shows statistical significance for slope, roads density, geology, and land cover factors. This research encompasses a time-series analysis of NDVI, NDWI, and precipitation, including vegetation and weather dynamism for landslide occurrence. Finally, this methodological framework replaces traditional qualitative models based on expert knowledge, for quantitative approaches for the study area and the Andean region.

Provision of community mental health care before and during the COVID-19 pandemic: A time series analysis in Peru.

BACKGROUND: A consequence of the COVID-19 pandemic was that the provision of mental health services was reduced in several countries around the world, while the demand for mental health services increased. AIMS: Our study aims to determine any variation in the number of users served, health appointments, and care activities conducted at 58 Peruvian community mental health centers (CMHCs) between March 2019 and October 2021. METHODS: Our study used an observational design and analyzed information from the care provided in CMHCs. We evaluate the number of users served, health appointments, and care activities performed per month. The main statistical analysis used segmented regression with Newey-West standard errors, taking into account each month of the evaluation. RESULTS: We had 988,456 unique users during the period evaluated. Regarding diagnoses, 7.4% (n = 72,818) had a severe mental problem, 39.4% (n = 389,330) a common mental problem, and 53.2% (n = 526,308) others health problems. The study found a reduction in the number of users served and health care appointments at the 58 CMHCs in March 2020, the month in which the closure measures were declared to reduce COVID-19 infections in Peru. This reduction was followed by an upward trend in the three variables during the pandemic in the 58 CMHCs studied. In, November 2020, 9 months after the pandemic started, the deficit in the average number of users served per month was recovered. CONCLUSIONS: Our study suggests that CMHCs in the Peruvian system were able to regain care capacity approximately 1 year after the pandemic. In addition, we discuss the efforts made to respond to mental health needs in the context of a global health crisis.

COVID-19, waste production and municipal recycling programs: Insights from Chile to the global south.

The amount and characterization of municipal and industrial waste generated in numerous cities worldwide have changed dramatically in recent years due to the COVID-19 pandemic. Consequently, assessing the impact of COVID-19-related policies is important to provide decision-makers with adequate knowledge to respond effectively to future events and create successful policies that respond to specific contexts. This study focuses on Chile, Latin America's second-largest municipal and industrial solid waste producer, with tight quarantine procedures placed to prevent the virus from spreading, and a series of monetary incentives implemented to minimize the economic and social impact of the quarantines. The time series of municipal solid waste (MSW) and recycling in the metropolitan region show a decrease in the amount collected during the initial months of lockdown and a subsequent increase during monetary incentive implementation. The country recovered and exceeded pre-pandemic MSW generation and recycling levels. Furthermore, the lockdown and the withdrawal of retirement funds (WRF) had a varied impact on each municipality in the region. However, WRF had a larger direct impact than a lockdown, indicating that purchasing power has a greater impact than mobility in waste generation and recycling, at least in this region of Chile.