South America Research Articles

Factors associated with social determinants of health mentions in PubMed clinical case reports from 1975 to 2022: A natural language processing analysis

Social determinants of health (SDoH) significantly influence health outcomes, accounting for nearly 40% of such outcomes globally. These determinants, pivotal in understanding health disparities, are insufficiently documented in clinical settings and academic clinical narratives. To address this gap, we examined clinical case reports from PubMed (1975–2022) to identify mentions of six specific SDoH, employing a pre-trained named-entity recognition (NER) model from Spark natural language processing (NLP). Multivariate logistic regression was utilized to investigate associations between article characteristics and the documentation of SDoH. From 463,546 reports, 4.4% mentioned SDoH, with race/ethnicity being the most dominant mention. Race/ethnicity was often cited by sub-Saharan African authors (adjusted odds ratio [AOR]: 4.47) and in general medicine (AOR: 2.18). Marital status mentions appeared predominantly in psychiatry (AOR: 2.60) and gynecology (AOR: 2.47). Sexual orientation mentions were correlated with infectious diseases (AOR: 25.00) and varied by authorship regions, with stronger associations observed in South America (AOR: 4.04) and North America (AOR: 2.15), and comparatively weaker associations noted in the Indian subcontinent and the Middle East (AOR: 0.16). Immigrant status mentions were closely related to infectious diseases (AOR: 4.51), gynecology (AOR: 4.25), and certain geographies. Homelessness mentions were more prominent in forensic medicine (AOR: 14.92) and in both infections (AOR: 6.36) and mental disorders (AOR: 5.80). Spiritual belief mentions were more prominent with sub-Saharan authors (AOR: 9.17) and psychiatry (AOR: 7.61). SDoH mentions in medical literature were also determined by the diagnosis, cultural background, and journal type. The limited SDoH registration emphasized their overlooked significance. Disproportionate emphasis on specific relationships, such as sexual orientation with infectious diseases, can perpetuate biases and stereotypes. Innovative tools such as Spark NLP offer promise in advancing research using electronic health records (EHRs), but a standardized approach to SDoH reporting and vigilant AI training is crucial for unbiased health-care analysis.

Genetic diversity, disease resistance, and environmental adaptation of Arachis duranensis L.: New insights from landscape genomics.

The genetic diversity that exists in natural populations of Arachis duranensis, the wild diploid donor of the A subgenome of cultivated tetraploid peanut, has the potential to improve crop adaptability, resilience to major pests and diseases, and drought tolerance. Despite its potential value for peanut improvement, limited research has been focused on the association between allelic variation, environmental factors, and response to early (ELS) and late leaf spot (LLS) diseases. The present study implemented a landscape genomics approach to gain a better understanding of the genetic variability of A. duranensis represented in the ex-situ peanut germplasm collection maintained at the U.S. Department of Agriculture, which spans the entire geographic range of the species in its center of origin in South America. A set of 2810 single nucleotide polymorphism (SNP) markers allowed a high-resolution genome-wide characterization of natural populations. The analysis of population structure showed a complex pattern of genetic diversity with five putative groups. The incorporation of bioclimatic variables for genotype-environment associations, using the latent factor mixed model (LFMM2) method, provided insights into the genomic signatures of environmental adaptation, and led to the identification of SNP loci whose allele frequencies were correlated with elevation, temperature, and precipitation-related variables (q < 0.05). The LFMM2 analysis for ELS and LLS detected candidate SNPs and genomic regions on chromosomes A02, A03, A04, A06, and A08. These findings highlight the importance of the application of landscape genomics in ex situ collections of peanut and other crop wild relatives to effectively identify favorable alleles and germplasm for incorporation into breeding programs. We report new sources of A. duranensis germplasm harboring adaptive allelic variation, which have the potential to be utilized in introgression breeding for a single or multiple environmental factors, as well as for resistance to leaf spot diseases.

Potential global distribution of Setaria italica, an important species for dryland agriculture in the context of climate change.

Setaria italica (S. italica, Linnaeus, 1753) is a drought-resistant, barren-tolerant, and widely adapted C-4 crop that plays a vital role in maintaining agricultural and economic stability in arid and barren regions of the world. However, the potential habitat of S. italica under current and future climate scenarios remains to be explored. Predicting the potential global geographic distribution of S. italica and clarifying its ecological requirements can help promote sustainable agriculture, which is crucial for addressing the global food crisis. In this study, we predicted the potential global geographic distribution of S. italica based on 3,154 global distribution records using the Maxent model and ArcGIS software. We assessed the constraints on its potential distribution based on the contribution of environmental factors variables. The predictive accuracy of the Maxent model was evaluated using AUC values, TSS values, and Kappa statistics, respectively. The results showed that the Maxent model had a high prediction accuracy, and the simulation results were also reliable; the total suitable habitats of S. italica is 5.54×107 km2, which mainly included the United States (North America), Brazil (South America), Australia (Oceania), China, India (Asia), and the Russian Federation (Europe). The most suitable habitat of S. italica was 0.52×107 km2, accounting for 9.44% of the total areas, mainly in the United States, India, the Russian Federation, and China. Soil and precipitation (driest monthly precipitation, hottest seasonal precipitation) are the most critical factors limiting the potential distribution of S. italica. Compared with the modern potential distribution, we predict that the four future climate change scenarios will result in varying reductions in the possible geographic ranges of S. italica. Overall, climate change may significantly affect the global distribution of S. italica, altering its worldwide production and trade patterns.

Marine introgressions and Andean uplift have driven diversification in neotropical Monkey tree frogs (Anura, Phyllomedusinae).

The species richness in the Neotropics has been linked to environmental heterogeneity and a complex geological history. We evaluated which biogeographic processes were associated with the diversification of Monkey tree frogs, an endemic clade from the Neotropics. We tested two competing hypotheses: the diversification of Phyllomedusinae occurred either in a "south-north" or a "north-south" direction in the Neotropics. We also hypothesized that marine introgressions and Andean uplift had a crucial role in promoting their diversification. We used 13 molecular markers in a Bayesian analysis to infer phylogenetic relationships among 57 species of Phyllomedusinae and to estimate their divergence times. We estimated ancestral ranges based on 12 biogeographic units considering the landscape modifications of the Neotropical region. We found that the Phyllomedusinae hypothetical ancestor range was probably widespread throughout South America, from Western Amazon to Southern Atlantic Forest, at 29.5 Mya. The Phyllomedusines' ancestor must have initially diverged through vicariance, generally followed by jump-dispersals and sympatric speciation. Dispersal among areas occurred mostly from Western Amazonia towards Northern Andes and the South American diagonal of dry landscapes, a divergent pattern from both "south-north" and "north-south" diversification hypotheses. Our results revealed a complex diversification process of Monkey tree frogs, occurring simultaneously with the orogeny of Northern Andes and the South American marine introgressions in the last 30 million years.

Saving the Amazon in South America by a regional approach on climate change: the need to consider the health perspective

Saving the Amazon in South America by a regional approach on climate change: the need to consider the health perspective

Alteration of Gut Microbiota Composition in the Progression of Liver Damage in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a complex disorder whose prevalence is rapidly growing in South America. The disturbances in the microbiota-gut-liver axis impact the liver damaging processes toward fibrosis. Gut microbiota status is shaped by dietary and lifestyle factors, depending on geographic location. We aimed to identify microbial signatures in a group of Chilean MASLD patients. Forty subjects were recruited, including healthy controls (HCs), overweight/obese subjects (Ow/Ob), patients with MASLD without fibrosis (MASLD/F-), and MASLD with fibrosis (MASLD/F+). Both MASLD and fibrosis were detected through elastography and/or biopsy, and fecal microbiota were analyzed through deep sequencing. Despite no differences in α- and β-diversity among all groups, a higher abundance of Bilophila and a lower presence of Defluviitaleaceae, Lachnospiraceae ND3007, and Coprobacter was found in MASLD/F- and MASLD/F+, compared to HC. Ruminococcaceae UCG-013 and Sellimonas were more abundant in MASLD/F+ than in Ow/Ob; both significantly differed between MASLD/F- and MASLD/F+, compared to HC. Significant positive correlations were observed between liver stiffness and Bifidobacterium, Prevotella, Sarcina, and Acidaminococcus abundance. Our results show that MASLD is associated with changes in bacterial taxa that are known to be involved in bile acid metabolism and SCFA production, with some of them being more specifically linked to fibrosis.

Helicobacter pylori and gastric cancer: a critical approach to who really needs eradication

It is generally accepted that eradication of Helicobacter pylori (H. pylori) infection may reduce the risk of the development of gastric cancer. Recommendations for global generalized tests and treat all individuals detected positive for H. pylori infection are currently proposed. However, the bacterium is commensal and harmless for the vast majority of the infected population. Moreover, eradication may have detrimental consequences in several groups of patients. In the present review, the current epidemiological data and recommendations for eradication in connection with the possible beneficial effects of the colonization with H. pylori in diseases such as asthma and allergies or chronic gastro-intestinal disorders such as inflammatory bowel disease and Barrett’ esophagus are presented the problems with increasing antibiotic resistance were also examined. Specific groups of patients where eradication of H. pylori may be necessary and endoscopic surveillance is advised were identified. Finally, based on the paradox of high H. pylori prevalence and low gastric risk as reported for areas of Africa, Asia, South America, and Greece, alternatives that may replace the widespread eradication of H. pylori with equal if not better results and more prudent use of the available financial resources are proposed. Mediterranean diets and alcohol and smoking reduction are among the well documented alternatives.

The 4DEnVar-based weakly coupled land data assimilation system for E3SM version 2

Abstract. A new weakly coupled land data assimilation (WCLDA) system based on the four-dimensional ensemble variational (4DEnVar) method is developed and applied to the fully coupled Energy Exascale Earth System Model version 2 (E3SMv2). The dimension-reduced projection four-dimensional variational (DRP-4DVar) method is employed to implement 4DVar using the ensemble technique instead of the adjoint technique. With an interest in providing initial conditions for decadal climate predictions, monthly mean anomalies of soil moisture and temperature from the Global Land Data Assimilation System (GLDAS) reanalysis from 1980 to 2016 are assimilated into the land component of E3SMv2 within the coupled modeling framework with a 1-month assimilation window. The coupled assimilation experiment is evaluated using multiple metrics, including the cost function, assimilation efficiency index, correlation, root-mean-square error (RMSE), and bias, and compared with a control simulation without land data assimilation. The WCLDA system yields improved simulation of soil moisture and temperature compared with the control simulation, with improvements found throughout the soil layers and in many regions of the global land. In terms of both soil moisture and temperature, the assimilation experiment outperforms the control simulation with reduced RMSE and higher temporal correlation in many regions, especially in South America, central Africa, Australia, and large parts of Eurasia. Furthermore, significant improvements are also found in reproducing the time evolution of the 2012 US Midwest drought, highlighting the crucial role of land surface in drought lifecycle. The WCLDA system is intended to be a foundational resource for research to investigate land-derived climate predictability.

Histopathological Lesions Caused by a Digenean Trematode in a Pest Apple Snail, Pomacea canaliculata, in Its Native Geographic Distribution Area.

Pomacea canaliculata is one of the most dangerous invasive species. Morphological and molecular analyses have revealed that a digenean species belonging to the family Echinostomatidae parasitizes this snail at two sites in Buenos Aires Province, Argentina, South America. Molecular results confirmed that the species belongs to a genus closely related to Patagifer. Analysis of the 28S rDNA showed that the sequences of the rediae and metacercariae are identical, indicating that the apple snail acts as the first and second intermediate host. The cercariae may encyst as metacercaria inside the redia and also emerge and re-infect the same snail or another snail. The prevalence of digeneans was higher in one of the sampling locations (15.1% vs. 0.72%), probably because the bird species that acts as the definitive host is more abundant in that area. Histopathological examination showed that the parasite quickly invades multiple host organs (gills, intestines, albumen gland, lung, kidney, and mantle border) besides the gonad and digestive gland, as is usual in digeneans. In addition, the partial or total castration of snails was observed in cases of moderate and high infection intensity. In males, there was loss of integrity in testicular tubules, while in females, the replacement of ovarian tissue by rediae was found.

Language policy and planning for heritage language maintenance: a scoping review

ABSTRACT The study of language maintenance and shift (LMS) has attracted a large body of empirical work in language policy and planning (LPP) contexts, including allochthonous (immigrant) and autochthonous (indigenous) languages. However, some critical ontological questions that relate to the scope and terminology of language maintenance studies remain unanswered, and there seems to be a lack of consistency in the definitions of the relevant terms, such as what ‘heritage’ language refers to, whose heritage it is when a language can be classified as a heritage language, and what ‘language’ is at all. Therefore, this review summarises existing literature on LPP for language maintenance by employing a scoping review methodology, providing an overview of empirical studies of LPP in migration context over the past two decades (2001-2023), focusing on terminology, geographical settings, research focus and methods. The findings reveal that most studies (66.3%) use the term ‘heritage language’ to refer to the ‘language of transnational minorities’ among other terms. The results also highlight geographical gaps and imbalances in the literature, calling for more LPP studies from South American and East Asian contexts. In addition, further investigations are needed to explore the transnational and translocal aspects of language maintenance.

Evidence for 3-hydroxyhexan-2-one as a shared pheromone component for 12 South American species of cerambycid beetles.

3-Hydroxyhexan-2-one (3-C6-ketol) has emerged as the most conserved pheromone structure within the beetle family Cerambycidae. In this study, we report the sex-specific production of this compound by males of 12 species of South American cerambycid beetles. Males of Chrysoprasis chalybea Redtenbacher and Mallosoma zonatum (Sahlberg) (Tribe Dichophyiini), and Ambonus lippus (Germar), Eurysthea hirta (Kirby), Pantonyssus nigriceps Bates, Stizocera plicicollis (Germar), and Stizocera tristis (Guérin-Méneville) (Elaphidiini) produced 3R-C6-ketol as a single component, whereas males of Neoclytus pusillus (Laporte & Gory) (Clytini), Aglaoschema concolor (Gounelle), Orthostoma abdominale (Gyllenhal) (Compsocerini), Dorcacerus barbatus (Olivier), and Retrachydes thoracicusthoracicus (Olivier) (Trachyderini) produced 3R-C6-ketol, along with lesser amounts of other compounds. In field trials testing 8 known cerambycid pheromone compounds, C. chalybea, E. hirta, and R. t. thoracicus were attracted in significant numbers to traps baited with 3-C6-ketol. A second field experiment provided support for the strategy of using the attraction of cerambycid species to test lures as a method of providing leads to their likely pheromone components. Because both sexes are attracted to these aggregation-sex pheromones, live beetles can be obtained from baited traps to verify they produce the compound(s) to which they were attracted, that is, that the compounds are indeed pheromone components.

PROJECTILE Point Stem Repairs. Some Examples from Southeastern South America

ABSTRACT This study explores the reworking of projectile point stems by hunter-gatherers in southeastern South America. Techniques employed to rework stems included pressure and percussion flaking and, eventually, light abrasion of fractured sections, methods that were applied opportunistically to resolve various types of stem fractures. Although the local literature has often overlooked the presence of reworked stems, it appears that point rebasing was a relatively common practice in the region, especially for points made from microcrystalline rocks and other highly silicified rocks. The reworking of points was likely carried out to preserve high-quality raw materials and to reduce the cost of manufacturing new points. Although the recognition of reworked stems can be challenging, it is a crucial task for subsequent morphometric and stylistic analysis. This allows for the identification of one of the sources of point variation thus avoiding an artificial increase in the variability of the original designs.

Perkinsus spp. Occurrence in South America: A review

Marine mollusk production is increasing worldwide, and this trend is being evidenced in South American countries, where several species of bivalves are produced, exploited, and traded. This activity brings benefits either for the ecosystem, as it is a less impactful and polluting than other aquaculture practices, and to coastal human communities, as it provides food and income. However, emergence of outbreaks by pathogens is a major concern and can put an entire developing sector at risk. Perkinsosis is a disease caused by Perkinsus spp. protozoans that affect mollusks worldwide. In this review we provide information on Perkinsus spp. among bivalves from South America. Infections by these parasites were only reported to date among coastal Atlantic bivalves of Argentina, Uruguay, and Brazil. The vast majority of cases and studies are reported from Brazil. We comprehensively review those results here. Finally, we suggest some considerations for future investigations that may expand our knowledge of these parasites.

Morphological and molecular characterization of brown-banded broodsacs and metacercariae of Leucochloridium (Trematoda: Leucochloridiidae) parasitizing the semi-slug Omalonyx unguis (Succineidae) in Argentina

Trematodes of the genus Leucochloridium exhibit an unusual transmission strategy among mollusks (intermediate host). The fully developed sporocyst, housing encysted metacercariae, displays vivid coloration and rhythmic activity in the snail's tentacle, mimicking insect larvae. These strategies attract insectivorous birds, their final hosts, thereby increasing the chances of completing their life cycle. In South America, the reports of adults and larval stages of Leucochloridium are scarce. Brown-banded broodsac of Leucochloridium sp. were obtained from Omalonyx unguis collected in a shallow lake from Corrientes Province, Argentina. Here, we morphologically characterized the larval stages (broodsac and metacercaria), identified the parasite through DNA sequences from nuclear 28S-rRNA (28S) and the mitochondrial cytochrome c oxidase I (COI) genes, and explored its evolutionary affinities with the Leucochloridium species available in GenBank. The present broodsac displays brown bands, with a yellowish background in the first two-thirds and yellowish-white in the last third. Based on morphological comparisons, the broodsac and metacercaria described in this study could not be conclusively categorized under any known South American species of Leucochloridium. In relation to the phylogenetic reconstructions, Leucochloridium sp. consistently clustered with L. perturbatum, and species delimitation analyses resulted in recognized Leucochloridium sp. from Argentina as a distinct species. The DNA sequences obtained in this study constitute the first genetic data generated for sporocyst broodsacs in South America. Future studies, incorporating morphology, genetic, and biological data, will be essential for both species identification and the elucidation of leucochloridiid diversity in the region.

Molecular phylogeny and biogeography of the dwarf boas of the family Tropidophiidae (Serpentes: Alethinophidia)

Although present in the South American continent, dwarf boas (Tropidophiidae) show their greatest extant diversification in the Caribbean region, reaching their highest diversity in Cuba. Despite their remarkable species richness, phylogenetic affinities among species of Tropidophis and Trachyboa are still poorly known. Here, we provide a multi-locus phylogenetic hypothesis of the family that includes 25 of the 37 known continental and insular species, including most of its highly diverse Cuban endemic radiation (16 out of 17 species sampled). We also provide a time-calibrated tree derived from our molecular data. Our phylogenetic results indicate that the genus Tropidophis and its mainland and Cuban radiations are paraphyletic, while the Caribbean radiation forms a well-supported clade. We therefore synonymize Trachyboa with Tropidophis and provide new definitions for the species groups. Our time-calibrated tree suggests that tropidophiids originated along the northwestern Andean region of continental South America, diverging from its known sister-group genus Anilius during the late Cretaceous. The Atlantic Rainforest radiation diverged from the Andean radiation during the late Eocene. A mainland tropidophiid ancestor subsequently dispersed from northern South America to the Caribbean region in the latest Eocene. Dispersal likely took place through a near-continuous terrestrial land bridge that connected South America to the Greater Antilles during the late Eocene to early Oligocene (35–33 Ma). The existence of this land bridge, whether formed by the Aves Ridge (GAARlandia Hypothesis) or by a more southernly positioned landmass connecting the Greater Antilles and the northern Lesser Antilles Ridge (GRANoLA hypothesis), remains a topic of debate, which we address in this paper. After that main dispersal event, West Indian tropidophiids underwent over ten speciation events, rapidly colonizing the Caribbean islands. We also address the vertebral morphology of fossil and extant Tropidophiidae, with our observations challenging the current classification of several fossil taxa within crown-Tropidophiidae.

Estuarine front dynamics drive ichthyoplankton assemblage in the tidal freshwater zone of the Río de la Plata, South America

Frontal zones are critical in the retention and dispersal of ichthyoplankton. This study evaluates the response of ichthyoplankton assemblage to frontal zone dynamics in one of the world's largest estuaries, the Río de la Plata, South America. Surveys were conducted between October 2014 and December 2017 in a nearshore habitat of the tidal freshwater zone of the estuary. Ichthyoplankton was collected using conical nets, and physico-chemical variables were registered in situ. The frontal zone dynamics were evaluated through the turbidity front (TF) location, determined by satellite imagery. Although most larval taxa belonged to the freshwater category, the estuarine category had the highest abundances. The highest species richness and abundance occurred during spring and summer, linked to the season and proximity of spawning areas. The dynamics of the TF emerged as the primary driver of interannual variability in ichthyoplankton assemblages within the tidal freshwater zone. A seaward shift of the TF correlated with a reduction in total abundance and the prevalence of freshwater larvae, whereas a retraction of the TF location corresponded to an increased abundance of marine larvae in the tidal freshwater zone. These interannual shifts in TF location and fish larvae assemblages were closely tied to significant variations in river discharges resulting from the ENSO events during the study period. The findings suggest that marine and estuarine fish eggs exhibit effective retention near the frontal zone and the outer regions of the estuary. In contrast, larvae from these categories disperse along the main axis of the estuary in response to the displacement of the frontal zone. Finally, we discuss into the role of the frontal zone in the Río de la Plata as a pivotal environmental cue for fish larvae, influencing their behavior to regulate dispersal patterns.

Diet of the Invasive Atlantic Blue Crab Callinectes sapidus Rathbun, 1896 (Decapoda, Portunidae) in the Guadalquivir Estuary (Spain)

The Atlantic blue crab Callinectes sapidus (Decapoda, Portunidae) Rathbun, 1896 is native to the east coasts of North and South America and has recently expanded its distribution in the non-native range into the Gulf of Cadiz (SW Iberian Peninsula, Europe). Considering the impacts caused by this invasive species in numerous estuarine ecosystems and its generalist feeding behavior, this study aims to provide the first account of the Atlantic blue crab diet on the East Atlantic coast. We studied the species’ feeding habits using stomach content analyses to predict food web interactions and putative impacts. Samples were obtained in the Guadalquivir estuary (SW Spain, Europe), which was colonized in 2017. The main food items identified on their stomach were, fish (49.9%), mollusks (44.4%) and crabs (32.3%). They also consumed plant material (27.2%), and the sediment (32.3%) in their digestive tract was likely the result of secondary ingestion. The Atlantic blue crab exhibited the same omnivorous behavior as in the native area. There was no sexual variation in diet composition or feeding activity in general, but there was a seasonal variation in the diet composition of females. The decrease of the caramote prawn Penaeus kerathurus (Forskål 1775) observed in the Guadalquivir estuary since 2021 is likely not due to the Atlantic blue crab because they seldomly eat this prey. Overall, our study provides clear baseline information to expand the knowledge about the ecological roles of the Atlantic blue crab in non-native ecosystems.

A theropod tooth from the Missão Velha Formation (Late Jurassic-Early Cretaceous) of the Araripe Basin: oldest Brazilian Abelisaurid record

ABSTRACT The Missão Velha Formation (Late Jurassic-Early Cretaceous), often referred to as Brejo Santo Formation, is one of the stratigraphic units of the Araripe Basin, included within the Vale do Cariri Group. This locality, characterised by its fluvio-estuarine paleoenvironment, yielded a diverse paleoichthyofauna while its terrestrial vertebrate record is still poorly known, with a single isolated theropod lateral tooth being briefly cited until now. This study aims to revisit this specimen (UERJ-PMB R008) in order to identify it through the current quantitative and qualitative methods. The quantitative analyses were unable to properly classify the Missão Velha specimen to a single theropod group, indicating paravian, piatnitzkysaurid and abelisaurid affinities, while most of cladistic analyses assigned the UERJ-PMB R008 as an abelisaurid tooth. The specimen was finally assigned as an abelisaurid lateral tooth due to its almost straight distal margin, hooked denticles, similarly sized mesial and distal denticles, a lanceolate cross section and an irregular enamel texture. This assignment represents not only the first definitive theropod record for Missão Velha Formation as it is also the oldest abelisaurid record in the South America, filling part of the 30-million-year gap between Eoabelisaurus and Spectrovenator.

Pediatric anesthesiology in Brazil, Chile, and Mexico.

Latin America comprises an extensive and diverse territory composed of 33 countries in the Caribbean, Central, and South America where Romance languages-languages derived from Latin are predominantly spoken. Economic disparities exist, with inequitable access to pediatric surgical care. The Latin American Surgical Outcomes Study in Pediatrics (LASOS-Peds), a multi-national collaboration, will determine safety of pediatric anesthesia and perioperative care. Below, we provide a descriptive initiative to share how pediatric anesthesia in Brazil, Chile, and Mexico operate. Theses descriptions do not represent all of Latin America. Brazil an upper middle-income country, population 203 million, has a public system insufficiently resourced and a private system, resulting in inequitable safety and accessibility. Surgical complications constitute the third leading cause of mortality. Anesthesiology residency is 3 years, with required rotations in pediatric anesthesia; five hospitals offer pediatric anesthesia fellowships. Anesthesiology is a physician-only practice. A Pediatric Anesthesia Committee within the Brazilian Society of Anesthesiology offers education through seasonal courses and workshops including pediatric advanced life support. Chile is a high-income country, population 19.5 million, the majority cared for in the public system, the remainder in university, private, or military systems. Government efforts have gradually corrected the long-standing anesthesiology shortage: twenty 3-year residency programs prepare graduates for routine pediatric cases. The Chilean Society of Anesthesiology runs a 1-month program for general anesthesiologists to enhance pediatric anesthesia skills. Pediatric anesthesia fellowship training occurs in Europe, USA, and Australia, or in two 2-year Chilean university programs. Public health policies have increased the medical and surgical pediatric specialists and general anesthesiologists, but not pediatric anesthesiologists, which creates safety concerns for neonates, infants, and medically complex. Chile needs more pediatric anesthesia fellowship programs. Mexico, an upper middle-income country, with a population of about 126 million, has a five-sector healthcare system: public, social security for union workers, state for public employees, armed forces for the military, and a private "self-pay." There are inequities in safety and accessibility for children. Pediatric Anesthesiology fellowship is 2 years, after 3 years residency. A shortage of pediatric anesthesiologists limits accessibility and safety for surgical care, driven by added training at low salary and hospital under appreciation. The Mexican Society of Pediatric Anesthesiology conducts refresher courses, workshops, and case conferences. Insufficient resources and culture limits research.

Progress and challenges in remotely sensed terrestrial carbon fluxes

ABSTRACT Accurate evaluation of terrestrial carbon balance is essential for designing climate change mitigation policies, and capabilities of remote sensing techniques in monitoring carbon fluxes are widely recognized for their great contributions to regional and global carbon budget accounting. In this review, we synthesized satellite-based data and methodologies to estimate the main flux components of terrestrial carbon balance and their uncertainties over the past two decades. The global gross primary production (GPP) during the period 2001–2022 is 134 ± 14 PgC yr−1, and nearly half of them occurs in tropical forest regions such as South America and Africa. Less than 2% of global GPP is converted into a net carbon sink of 2.28 ± 1.12 PgC yr−1 using satellite-based atmospheric inversion during 2015–2020, and this sink is comparable to the stock change-based estimate (2.49 PgC yr−1) but twice as large as model-based estimate (1.08 ± 0.78 PgC yr−1). By decomposing satellite-derived net carbon balance into different terms including satellite-derived carbon emissions from land-use change and wildfires (3.55 PgC yr−1), we inferred that ~ 43% of global GPP would be respired through soil microbes (57.1 PgC yr−1), but which is higher than the previous bottom-up estimate (39–46 PgC yr−1). We then propose that an accurate remote sensing of terrestrial carbon balance requires to enhance representations of photosynthetic responses to rising CO2 and disturbances, develop satellite-constrained belowground carbon dynamics and separate natural fluxes from anthropogenic CO2 emissions, by integrating multi-source satellite sensors in orbit, revolutionized remote sensing capabilities with focused field campaigns in data-scarce regions.