Southeast Region Research Articles

Asthma in the Brazilian Unified Health Care System: an epidemiological analysis from 2008 to 2021.

To analyze the number of hospitalizations, the length of hospital stay, and mortality due to asthma, as well as the costs to the Unified Health Care System in Brazil between 2008 and 2021. This was a cross-sectional epidemiological study using data from the Information Technology Department of the Brazilian Unified Health Care System. Proportional hospitalization and death rates were estimated per 100,000 population by age, microregion, and year. The number of hospitalizations and deaths due to asthma decreased from 2008 to 2021 (205,392 vs. 55,009 and 822 vs. 327, respectively). In addition, a between-sex difference was observed in asthma-related hospitalizations in 2008, and more men were hospitalized in 2021 (51.8%). Asthma mortality rates were similar for both sexes (50.0% each) in 2008, and a slight increase was observed in women's deaths in 2021 (52.9%). Even so, approximately one death/day and more than 55,000 hospitalizations were observed yearly, with a mean length of hospital stay of three days. Additionally, the Southeast region allocated more financial resources to asthma-related hospitalizations. Our results showed that the number of deaths and hospitalizations due to asthma substantially declined during the study period.

Ethnopharmacological survey of medicinal plants used in traditional treatment of respiratory system disorders in the Southeast region of Morocco

The use of medicinal plants in primary healthcare in Africa, especially among populations in developing countries, is a common practice. To identify the most commonly used medicinal plants in traditional medicine for treating common respiratory disorders, an ethnobotanical survey was conducted in the Draa Tafilalet region, South-Eastern Morocco, involving 235 herbalists and sellers of medicinal plants from three provinces (Errachidia, Tinghir, and Zagora). Ethnobotanical data were evaluated using use value (UV), frequency of citation (FC), relative frequency of citation (RFC), and family importance value (FIV). The survey identified a total of 76 species belonging to 39 families, with the most represented being Lamiaceae, Apiaceae, and Asteraceae, followed by Fabaceae. As for the most commonly used species against respiratory disorders, they include Origanum vulgare L. (UV = 0.413), Artemisia herba-alba (UV = 0.370), Foeniculum vulgare (UV = 0.357), Thymus vulgaris (UV = 0.332), Lavandula dentata (UV = 0.319), Matricaria chamomilla (UV = 0.311), Nigella sativa (UV = 0.302), Allium sativum L. (UV = 0.298), Eucalyptus globulus (UV = 0.289), and Plantago major L. (UV= 0.281). Decoction (48.68%) and infusion (47.37%) are the most recommended preparation methods by herbalists for remedies. Leaves are the most prescribed part, while the majority of plants are exclusively administered orally (92.11%). This ethnobotanical survey holds the potential to aid scientists and researchers in identifying plants that treat common respiratory disorders, potentially invaluable for the development of novel drugs.

Substantial increase of heat-induced labor and economic loss in China under rapid economic and environmental temperature growth

Exposure to heat stress causes diminished work performance and leads to economic loss. In the last two decades, China has experienced both rapid economic development and environmental warming; however, the spatiotemporal variations of association between environmental heat and labor loss have been rarely investigated behind this double impact. Here, we evaluated the variation in China's heat-induced labor productivity loss and related economic cost from 2001 to 2019 and investigated the effect of economic development and regional warming. We found that decline in labor productivity because of heat stress increased significantly (p < 0.05 for heavy-intensity work), and the corresponding economic loss also exhibited a drastic increase by 6- to 9-fold. The relative economic loss showed a slight but nonsignificant increase with an average value of 0.54% of the annual total earnings. At the sub-regional and sectoral level, adverse effects were more prominent in the southeast region, and the secondary industry sectors, such as construction and manufacturing, contributed to larger proportions of economic losses. The transformation of industrial structure made economic sectors more vulnerable to heat exposure, and increasingly preventive effects of air-conditioning use were noted on economic damage due to heat-induced productivity decline (36.0% relative economic benefits in 2019 compared to 9.7% in 2001). Our findings could provide a deep insight into heat burden on occupational health and heat adaptation strategies regionally under climate change, especially in developing areas with higher temperature and humidity environment.

DEMANDS AND OFFERS OF PRIMARY CARE IN CHILDREN’S MENTAL HEALTH

The objective was to understand the demands and offers of Primary Care with regard to mental health care for children and adolescents, from the perspective of workers. This is a qualitative research, made with 41 primary care (BA) health workers in a municipality in the Southeast region. As an adopted methodology semi-structured interviews were used and two focus groups, in the latter, 20 workers participated among those who were interviewed. This was followed by a lexical analysis of the Descending Hierarchical Classification type with the help of the IRAMUTEQ software, resulting in five classes. Conceptions of childhood and adolescence appeared in the reports, still marked by ideas of incompleteness and a logic of specialized care.

Free Drawing to assess food consumption information in comparison with the Free Listing: An intracultural study in Brazil with adolescents and dairy products

This study aimed to evaluate the Free Drawing method to assess food consumption information compared to the Free Listing method. Furthermore, the citation frequencies of dairy products consumed by adolescents were compared in Brazilian regions. Adolescents (14–17 years old, n = 265, n = 53 for each region, North, South, Northeast, Midwest, and Southeast regions) listed or drew the dairy products they consumed using Free Listing or Free Drawing. The contingency tables were constructed, and the cognitive saliency indexes (CSI) were calculated. Multiple Factor Analysis (MFA) was performed, and the RV indices were determined. The adolescents listed/drew 55 dairy products, grouped into 10 categories. The Free Listing method resulted in greater citation frequencies of dairy products. The Free Drawing method resulted in richer and more detailed information, with specifications of the type of product consumed within the category, flavor, type of packaging, and brand. The dairy products with the highest citation frequencies/CSI by adolescents were milk, cheese, and fermented milk. The South and Southeast regions observed greater citation frequencies and diversity of dairy products (prevalence in 6 categories). The CSI did not depend on the method, but it was affected by the region (p < 0.05). The sensory methods showed high similarity considering the categories of dairy products (RV = 0.80) and regions (RV = 0.79). It is concluded that the Free Drawing method proved to be an alternative to Free Listing for evaluating adolescents’ consumption information of dairy products in an intracultural study in Brazil.

Factors associated with early-stage lung cancer diagnosis (ESLCD) in Brazil, 2013-2019: A multivariable analysis.

e20091 Background: Lung cancer has the highest mortality rate among the leading deadly cancers worldwide. Despite improvements in tobacco cessation and treatment over the years, disparities in access to care, timely diagnosis, and proper treatment remain prevalent. This study aims to identify the factors associated (FA) with Early-Stage Lung Cancer Diagnosis (ESLCD) in Brazil. Methods: This retrospective cohort study includes individuals diagnosed with lung cancer from January 2013 to December 2019, registered in the Brazilian hospital-based Cancer Registry (HBCR). Descriptive and bivariate analysis was performed, and T-tests and Chi-square were used to compare early vs late-stage groups. Multivariable backward stepwise logistic regression identified FA with ESLCD at a 95% confidence interval (CI). Results: The study was conducted with data on 86,558 individuals registered in the HBCR; 56.6% were men, 64 years old on average, and 54.8% were white. We found a high percentage of patients without education information (23.9%), and 70% had completed high school. As for behavioral characteristics, only 20% of the patients had never smoked; the others were current smokers (40%) or former smokers (40%). Almost half of the patients were from the Southeast region of Brazil (44.6%), 27% from the South, 19.9% from the Northeast, 3.9% from the North and 3.9% from the Midwest. The vast majority of the individuals were diagnosed at a late stage (85.6%), while 14.4% were ESLCD. In the bivariate analysis, being less than 65 years old, being female, white, never smoking, having a college degree, and living in the south or southeast regions were associated with ESLCD. In the final multivariable model the Factors Associated with ESLCD were having less than 65 years (OR=1.28 [95% CI: 1.22-1.34]), of the female gender (OR=1.26 [95% CI: 1.22-1.32]), having education greater than a college degree (OR=1.49 [95% CI: 1.38-1.61]), and living on the southeast (OR=1.22 [95% CI: 1.15-1.30]); and in the south region (OR=1.21 [95% CI: 1.18-1.32]); which are the wealthiest regions in the country. Conclusions: The education level was the most decisive factor associated with ESLCD. Geographic location played an important role in ESLCD, indicating issues related to wealth and access to health services. Improving access to lung cancer diagnosis, especially for vulnerable populations, can reduce disparities in the rates of early-stage diagnosis and improve overall survival. [Table: see text]

Geminiviridae and Alphasatellitidae Diversity Revealed by Metagenomic Analysis of Susceptible and Tolerant Tomato Cultivars across Distinct Brazilian Biomes.

The diversity of Geminiviridae and Alphasatellitidae species in tomatoes was assessed via high-throughput sequencing of 154 symptomatic foliar samples collected from 2002 to 2017 across seven Brazilian biomes. The first pool (BP1) comprised 73 samples from the North (13), Northeast (36), and South (24) regions. Sixteen begomoviruses and one Topilevirus were detected in BP1. Four begomovirus-like contigs were identified as putative novel species (NS). NS#1 was reported in the semi-arid (Northeast) region and NS#2 and NS#4 in mild subtropical climates (South region), whereas NS#3 was detected in the warm and humid (North) region. The second pool (BP2) comprised 81 samples from Southeast (39) and Central-West (42) regions. Fourteen viruses and subviral agents were detected in BP2, including two topileviruses, a putative novel begomovirus (NS#5), and two alphasatellites occurring in continental highland areas. The five putative novel begomoviruses displayed strict endemic distributions. Conversely, tomato mottle leaf curl virus (a monopartite species) displayed the most widespread distribution occurring across the seven sampled biomes. The overall diversity and frequency of mixed infections were higher in susceptible (16 viruses + alphasatellites) in comparison to tolerant (carrying the Ty-1 or Ty-3 introgressions) samples, which displayed 9 viruses. This complex panorama reinforces the notion that the tomato-associated Geminiviridae diversity is yet underestimated in Neotropical regions.

Global, regional and national trends and impacts of natural floods, 1990-2022.

To assess global, regional and national trends in the impact of floods from 1990 to 2022 and determine factors influencing flood-related deaths. We used data on flood disasters from the International Disaster Database for 1990-2022 from 168 countries. We calculated the annual percentage change to estimate trends in the rates of people affected and killed by floods by study period, World Health Organization (WHO) region, country income level and flood type. We used multivariable logistic regression analysis to assess the factors associated with death from floods. From 1990 to 2022, 4713 floods were recorded in 168 countries, which affected > 3.2 billion people, caused 218 353 deaths and were responsible for more than 1.3 trillion United States dollars of economic losses. The WHO Western Pacific Region had the most people affected by floods (> 2.0 billion), accounting for 63.19% (2 024 599 380/3 203 944 965) of all affected populations. The South-East Asia Region had the most deaths (71 713, 32.84%). The African and Eastern Mediterranean Regions had the highest number of people affected and killed by floods per 100 000 population in 2022. The odds of floods causing more than 50 deaths were significantly higher in low-income countries (adjusted odds ratio: 14.34; 95% confidence interval: 7.46 to 30.04) compared with high-income countries. Numbers of people affected and mortality due to floods declined over time. Despite the decreases in populations affected and deaths, floods still have a serious impact on people and economies globally, particularly in lower-income countries. Action is needed to improve disaster risk management and flood mitigation.

Interventions of the nurse navigator in the identification and management of toxicities after the start of treatment in patients with cancer using antineoplastic therapy.

12139 Background: Monitoring symptoms during chemotherapy is crucial as patients experience adverse effects, requiring therapeutic modifications, supportive care, and education. Patient navigation provides individualized assistance, overcoming barriers to healthcare access for patients, families, and caregivers. A previous study (Tabriz et al. JAMA Netw Open 2023) has shown that 52% of emergency room (ER) visits can be preventable. Thus, this study sought to determine effect of a nurse navigation program on reducing the rate of ER visit. Methods: This retrospective study was conducted from June to December 2023 in two cancer centers within the Oncoclinicas Network, located in the Southeast and Northwest regions of Brazil. Eligible patients were diagnosed with breast, lung, and gastrointestinal cancer, and were undergoing treatment with chemotherapy and/or immunotherapy. These patients were monitored by nurse navigators at post-therapy. Interventions were categorized as home management (care provided at patient’s home), outpatient (referral to the treatment clinic), and hospital (referral to emergency care). All toxicities were graded according to the Common Terminology Criteria for Adverse Events 5.0. Results: A total of 531 patients were included in the analysis, with the majority aged over 61 years old (44.4%), diagnosed breast (%) or colon (%) cancers. Throughout the six month study period, 3,201 toxicities were identified, with the majority graded between 1 and 2 (95.9%). This resulted in 91.9% of patients being managed at home or referred to the outpatient care. The cumulative proportion of patients having their symptoms managed at home or outpatient care is significantly higher than historical controls (P=0.001). Conclusions: Our findings highlight the effectiveness of a nurse navigation program in managing toxicities and symptoms, preventing ER visit. These findings underscore the importance of this program in optimizing patient care and reducing the burden on healthcare facilities. Further research and implementation of such programs may contribute to improved outcomes and patient satisfaction in oncological care.

Assessment of the genetic diversity of the alleles of gliadin-coding loci in common wheat (Triticum aestivum L.) collections in Kazakhstan and Russia.

The study of genetic resources using prolamin polymorphism in wheat cultivars from countries with different climatic conditions makes it possible to identify and trace the preference for the selection of the alleles of gliadine-coding loci characteristic of specific conditions. The aim of the study was to determine the "gliadin profile" of the collection of common wheat (Triticum aestivum L.) from breeding centers in Russia and Kazakhstan by studying the genetic diversity of allelic variants of gliadin-coding loci. Intrapopulation (μ ± Sμ) and genetic (H) diversity, the proportion of rare alleles (h ± Sh), identity criterion (I) and genetic similarity (r) of common wheat from eight breeding centers in Russia and Kazakhstan have been calculated. It has been ascertained that the samples of common wheat bred in Kostanay region (Karabalyk Agricultural Experimental Station, Kazakhstan) and Chelyabinsk region (Chelyabinsk Research Institute of Agriculture, Russia) had the highest intrapopulation diversity of gliadin alleles. The proportion of rare alleles (h) at Gli-B1 and Gli-D1 loci was the highest in the wheat cultivars bred by the Federal Center of Agriculture Research of the South-East Region (Saratov region, Russia), which is explained by a high frequency of occurrence of Gli-B1e (86 %) and Gli-D1a (89.9 %) alleles. Based on identity criterion (I), the studied samples of common wheat from different regions of Kazakhstan and Russia have differences in gliadin-coding loci. The highest value of I = 619.0 was found when comparing wheat samples originated from Kostanay and Saratov regions, and the lowest I = 114.4, for wheat cultivars from Tyumen and Chelyabinsk regions. Some region-specific gliadin alleles in wheat samples have been identified. A combination of Gli-A1f, Gli-B1e and Gli-Da alleles has been identified in the majority of wheat samples from Kazakhstan and Russia. Alleles (Gli-A1f, Gli-A1i, Gli-A1m, Gli-A1o, Gli-B1e, Gli-D1a, Gli-D1f, Gli-A2q, Gli-B2o, and Gli-D2a) turned out to be characteristic and were found with varying frequency in wheat cultivars in eight regions of Russia and Kazakhstan. The highest intravarietal polymorphism (51.1 %) was observed in wheat cultivars bred in Omsk region (Russia) and the lowest (16.6 %), in Pavlodar region (Kazakhstan). On the basis of the allele frequencies, a "gliadin profile" of wheat from various regions and breeding institutions of Russia and Kazakhstan was compiled, which can be used for the selection of parent pairs in the breeding process, the control of cultivars during reproduction, as well as for assessing varietal purity.

Collaborative projects: sustainable development and risk management in the corrugated cardboard industry

The high costs of environmentally responsible and socially just approaches are some of the factors that hinder the implementation of sustainable projects in the industrial sector. However, upstream collaborative integration in the corrugated cardboard industry in southeastern Brazil is a reality. In this context, this study aimed to highlight the structure of a collaborative sustainable project in the context of the corrugated cardboard industry, to analyze ESG risk management in the corrugated cardboard industry in the Southeast Region of Brazil, the relationship between ESG risk management and social responsibility in corrugated cardboard industries, the strengths and weaknesses of risk management models in use by the consulted participants, and to propose innovations regarding risk analysis, applicable in sustainable projects with a collaborative bias. The methodology adopted was the case study, with consultation with managers in professional activity in the industrial sector, corroborated by document analysis and systematic review of the literature. We identified preliminary risk analysis (PRA) and failure mode analysis (FMEA) as key practices used by managers in the corrugated paper industry in the region. These practices are insufficient in the convergence of objectives, engagement with the community, and extension of the lifecycle of products and processes. Our findings show that the sustainability of a project may be an extension of the risk analyses carried out in the initial phase, mainly about strategic decision-making and the operationalization of investments. Without bias to the need for risk analysis, the life cycle analysis is also an effective way of highlighting the critical factors, weaknesses, and strengths of a sustainable project. The study indicates the so-called GUT matrix approach (gravity – urgency – tendency) as the most suitable for innovation in risk analyses oriented towards sustainable projects in the analyzed sector.

Spatiotemporal Evolution of the Yellow Fever Epidemic in Southeast Brazil from 2016 to 2019.

Background: Yellow fever (YF) is a zoonotic disease transmitted by mosquitoes among humans and nonhuman primates. Although urban YF is eradicated, the sylvatic YF has reemerged in some areas of Brazil in the twenty-first century. From 2016 to 2019, a sylvatic YF epidemic occurred in Southeast Brazil, where it had been eradicated in the 1940s. Methods: This study's objective was to describe the epidemic in the states of the Southeast region, based on descriptive, cluster, and mobility analyses. Results: Both the descriptive and cluster analyses showed that the YF cases spread from the state of Minas Gerais southward, causing peaks in cases during the summer months. None of the state capitals was included in the clusters, but the connectivity between the municipalities in Greater Metropolitan São Paulo highlighted potential paths of spread. Despite differences in sociodemographic profiles between the Southeast and North of Brazil (the latter region considered endemic), the epidemiological profile was similar, except for patients' occupation, which was not related to rural work in the Southeast. Conclusion: The results contributed to our understanding of the paths by which YF spread across Southeast Brazil and the epidemiological profile in an area that had gone decades without autochthonous cases.

Epidemiological study of antibiotic-resistant Helicobacter pylori in Brazil a meta-analysis

Objectives: To evaluate the proportion of Helicobacter pylori resistant to tetracyclines, amoxicilline, furazolidone, clarithromycin, fluoroquinolones and amoxicillin in Brazil and to present genotypic characteristics of strains. Methodology: Search in PubMed, SciELO, VHL and Medline. Twelve Brazilian studies on resistant Helicobacter pylori were selected, with a total of 2,038 patients. The options were performed with a confidence interval of 95% and an alpha of 0.05 using the software RStudio5.0. Results: low resistance rate for 04 antibiotics, being lower than the 15% threshold considered for empirical treatment. However, for metronidazole the rate of 43% and clarithromycin 16% macrolide and amoxicillin increased resistance when compared to previous years. The Southeast region had the highest rates. A clarithromycin ae A2147 in the 23s 23s RNA gene was the most prevalent conferring clear resistance. Conclusion: The increase in resistance to clarithromycin and amoxicillin resistance demonstrates that the factors that still increase for the acquisition of resistance still exist. Therefore, constant epidemiological surveillance is necessary so that we are aware of the resistance profile, performing assertive therapy.

Carbon Emissions and Intensity of Land Use: A Rural Setting Analysis in Ningde City, China

Carbon emissions and land use intensity serve as crucial indicators of land management. This paper proposes a methodological framework to elucidate the sustainability of carbon emissions in rural areas via a coordination model, scrutinizes the correlation with land use intensity, and investigates the significance of influential factors. The study focuses on village-level units within Ningde City, and finds the pronounced spatial heterogeneity characterizing the distribution of carbon emissions across different villages: (1) Villages exhibiting high levels of carbon emissions are predominantly concentrated in the southeast region, whereas those with low carbon emission levels are primarily clustered in the northwest region. The majority of the villages serve as net carbon emission sources. (2) Spatial disparities exist in the impact of land use intensity on economic benefits from carbon sources, ecological benefits from carbon sinks, and carbon emission sustainability. (3) Significant variations exist in the influence of factors affecting land use intensity, economic benefits of carbon sources, ecological benefits of carbon sinks, and the sustainability of carbon emissions in rural areas. These findings could guide governments in implementing distinct land use control policies and provide a framework for assessing carbon emission sustainability within land management strategies.

Impact of Exogenous Factors and Anesthetic Risk in Premature Birth during the Pandemic Period.

Premature birth remains a public health problem worldwide, involving a broader context and a multidisciplinary team aimed at combating this phenomenon as much as possible. The consumption of addictive substances by women who are pregnant can occur in different social contexts and at different stages of their lives, which modulate its extent. Obstetricians and anesthetists should consider the anesthetic maternal risks that may arise due to these addictive behaviors. The maternal anesthetic risk is higher in women who are pregnant with a medium-level of education, imbalanced nutrition, stress associated with physical or mental activity, affected sleep hygiene, and failed marriages. The objectives of the study refer to analyzing the impact of exogenous factors and the anesthetic risk on premature birth for women who were pregnant during the pandemic period and in women who were pregnant without COVID-19 infection. The authors studied a significant sample of 3588 women who were pregnant without COVID-19 infection, among whom 3291 gave birth at term and 297 gave birth prematurely. The methods analyzed consist of studying the specialized literature regarding the impact of exogenous factors and parturient's anesthetic risk on premature birth and identifying the regional risk profile of women who are pregnant in the southeast region of Romania compared to that identified in the specialized literature. In the analytical methods, we used a linear regression to study the incidence of exogenous risk factors on anesthetic risk in women who were pregnant with premature births compared to those with full-term births. The results confirm the significant impact of exogenous factors on anesthetic risk and the significant impact of anesthetic risk on premature births. The novelty of the study lies in highlighting the modification of the regional exogenous risk profile during the pandemic period in southeast Romania due to unfavorable socio-economic causes and the translation of grade I and II prematurity events to higher frequencies with an increased level of maternal anesthetic risk. The study findings show that the anesthetic risk is maximized in parturients with a middle school education. Additionally, the anesthetic risk of patients who are pregnant increases with the intensification of smoking adherence and its maintenance throughout the pregnancy at the same intensity. Our study aims to provide a basis for the diversification and development of community intervention programs in the post-COVID-19 era, considering the reshaping of social models and the repositioning of social principles and values. Obstetricians and anesthetists must know and promote family values to harmonize the lives of family members and provide a better life for the mother and child.

Новый гибрид подсолнечника ЮВС 8

A new promising hybrid UVS 8 was developed at the Federal State Budgetary Scientific Organization “Federal Center of Agriculture Research of the South-East Region”. The vegetative period is 89–93 days. Over the years of research in competitive variety trials, the new hybrid surpassed the standard UVS 3 in yield by 0.66 t/ha and in oil yield by 0.3 t/ha. The hybrid UVS 8 was included in the State Register of Breeding Achievements in 2023 and approved for production in the Low Volga region.

Socioeconomic, Ethnographic and Political Integrations and Challenges of Igbo Migrants in Lafia, Nasarawa State, Nigeria

The study examines the socioeconomic, ethnographic and political integrations and challenges of Igbo migrants in Lafia. Quantitative and qualitative techniques were adopted to collect data on integration variables via the administration of questionnaires to groups of Igbos from the five states of the Southeast region, and the conduct of In-depth Interviews (IDIs) with Igbo elders. Fifty copies of questionnaires were distributed to each group, totaling 250. Data were analysed by SPSS version 25, and tables and charts were generated and the qualitative data were content analysed. On socioeconomic integration, the results showed that the majority (88.1%) of Igbos were first generation migrants, who arrived to start business in Lafia over 40 years ago, whereby, almost three-fifths (59.5%) of them started their current occupation. Majority (37.6%) of Igbo migrants’ present occupation was facilitated by ‘master’, ‘family’ (66.8%) facilitated their accommodation, close to 70 per cent of them possessed their personal houses, and over two-fifths (43.1%) of them got landed property through ‘friend’ while close to three-quarters (74.8%) got married to Lafia indigenes. On ethnographic integration, three-quarters were proficient in Hausa language, with half rated their proficiency in Hausa language ‘excellent,’ while Gwandara language became the best secondary proficient language. As par political integration, over half (52.0%) of Igbo migrants held political office within their association politics but few with the wider politics. In summary, Igbo migrants have been experiencing dynamic and positive integrations but facing challenges of ethnic divide and nepotism.

RETROSPECTIVE ANALYSIS OF ESOPHAGEAL CANCER MORTALITY IN BRAZIL (1998-2022): Gender disparities, ethnic contrasts, temporal dynamics, and regional variations

Introduction: The esophageal cancer is derived from numerous dysplastic mutations usually located in the most distal portion of the esophagus, and is an aggressive neoplasm with a low survival rate. Environmental factors and gastroesophageal reflux disease (GERD) are the main precursors of this pathology, and its risk factors include males aged over 50, obesity, smoking and alcohol consumption. Its diagnosis can be made through upper digestive endoscopy (UDE). Methodology: Data was collected from the Mortality Information System (SIM) from 1998 to 2022 in order to analyse the evolution of esophageal cancer mortality and compare demographic, temporal and regional trends in esophageal malignant neoplasm mortality in Brazil. Results and discussion: There has been an increase in mortality over time, with a predominance of Caucasians and males in all races. The southeast and south regions have the highest incidence and mortality rates. The disparity between the sexes is attributed to men's greater exposure to smoking and alcohol. In the South, the consumption of mate is highlighted as a significant risk factor, and its higher incidence in white people is explained by the high proportion of elderly people in this region, as esophageal cancer is more common in the elderly due to prolonged exposure to carcinogens. Conclusion: The scientific analysis carried out provides mortality trends in Brazil with regard to esophageal cancer and allows these data to be correlated with the ethnic groups, sexes and regions most affected. Finally, the study highlights the importance of environmental factors in causing this pathology, indicating public health interventions mainly in the South and Southeast regions in order to reduce mortality figures.

Does Covid-19 influence the dynamics of envenomation by animals in a country strongly affected by both conditions? Epidemiological data from Brazil

The impact of Covid-19 on envenomations by venomous animals in countries heavily affected by both conditions has not been quantified yet. Brazil shows high incidence of envenomations by scorpions, spiders and snakes and was heavily affected by waves of Covid-19. To determine how the pandemic impacted the epidemiology of envenomations by those three groups of venomous animals, we used online databases from two surveillance sources on number of cases and mortality. During the years before and during the pandemic, scorpion stings typically occurred in adults of both sexes in urban zones in the Southeast and Northeast regions. Spider bites occurred mainly in the South region, in adults of both sexes in urban zone. Snakebites affected mainly rural adult men in the Amazon. Between 2007 and 2021, overall incidence of cases by scorpions, spiders and snakes decreased after the beginning of the pandemic, snakebites did not show changes after the pandemic started in Brazil, but cases by scorpions and spiders decreased. No changes in the incidence of deaths were observed. On national level, Covid-19 affected some demographic, clinical and epidemiological aspects in cases by scorpions, spiders and snakes.

Sustainability indicator for evaluating the ATES system in Halabja-Khurmal sub-basin NE-Iraq using GIS-based MCDA method

Thermal energy is utilized as an environmentally friendly energy source for seasonal heat and cold storage on a global scale. Specifically, the aquifer thermal energy storage system is highlighted for being cost-effective in cooling and heating applications. The study assesses the sustainability of the aquifer thermal energy storage in the Halabja-Khurmal sub-basin by evaluating six critical criteria: groundwater transmissivity, groundwater temperature, groundwater discharge, groundwater chemistry, population density, and per capita GDP. A multi-criteria decision analysis judgment is applied to analyze all criteria, resulting in a consistency ratio of 0.3% in the analytical hierarchy process. Consequently, the sustainability map for Aquifer Thermal Energy Storage in the Halabja-Khurmal sub-basin for heating reveals that 26.45% of the area is strongly sustainable located in the north and southwestern part of the sub-basin, 73.53% is moderate in the east, central, southeast, and southern regions, 0.02% is weakly sustainable as a tiny area in the southwestern. On the other hand, the sustainability map for Aquifer Thermal Energy Storage in the Halabja-Khurmal sub-basin for cooling reveals that 19% of the area is strongly sustainable located in the north, and southwestern parts of the sub-basin, 78% is moderate in the northeast, east, southeast, west, central, and southern regions, 3% is weakly sustainable as spots in the west and southwestern areas.