Clinical, epidemiological, and care profile of hospitalized patients with retinoblastoma in Brazil

ABSTRACT Purpose: To describe the epidemiological and clinical profile of hospitalized patients with retinoblastoma in Brazil. Methods: Using data from the Hospital Cancer Registry of the Instituto Nacional de Câncer, patients with the morphological codes of retinoblastoma who were diagnosed between 2000 to 2018, aged 0-19 years, and followed up in registered hospitals (analytical cases) were selected. The relative and absolute frequencies of demographic, clinical, diagnostic, therapeutic, and outcome variables were described. Hospital performance indicators were calculated and compared between hospitals qualified and not qualified to treat pediatric oncology cases and between hospitals with different case volumes (<20, 20-75, >75 cases). Results: Of the 2,269 identified analytical cases from 86 institutions, 48% were from the Southeast, 54% were male, and 66% were aged <4 years. The proportion of missing data (NA) was too high for several variables. Approximately 84% of the patients were from the public health system, 40% had a positive family history, and 88% had unilateral involvement. The first treatment included surgery in 58.3% of the patients (NA=2), Approximately 36.6% of these patients achieved complete remission, 10.8% achieved partial remission, and 12.7% died (NA=59%). Hospital performance indicators were within the target in >90% of the patients. The median time between the first appointment and diagnosis (6 days, interquartile range [IQR] 1-14) was significantly lower and the median time to death was longer (343 days, IQR, 212-539) in high-volume hospitals (>75 cases) than in medium- and low-volume hospitals. Conclusions: Despite the high proportion of missing data, we found that the delay in diagnosis is due to prehospital factors. Additionally, there is a need for educational programs for healthcare professionals and families that emphasize early identification and referral to specialized centers. Future studies should focus on the impact of Hospital Cancer Registry data completeness on outcomes, causes of delay in diagnosis, regional inequalities, and barriers to accessing specialized services.

Bartonella spp. in Phlebotominae Sand Flies, Brazil.

Bartonella spp. are opportunistic, vectorborne bacteria that can cause disease in both animals and humans. We investigated the molecular occurrence of Bartonella spp. in 634 phlebotomine sand fly specimens, belonging to 44 different sand fly species, sampled during 2017-2021 in north and northeastern Brazil. We detected Bartonella sp. DNA in 8.7% (55/634) of the specimens by using a quantitative real-time PCR targeting the 16S-23S internal transcribed spacer intergenic region. Phylogenetic analysis positioned the Lutzomyia longipalpis sand fly-associated Bartonella gltA gene sequence in the same subclade as Bartonella ancashensis sequences and revealed a Bartonella sp. sequence in a Dampfomyia beltrani sand fly from Mexico. We amplified a bat-associated Bartonella nuoG sequence from a specimen of Nyssomyia antunesi sand fly. Our findings document the presence of Bartonella DNA in sand flies from Brazil, suggesting possible involvement of these insects in the epidemiologic cycle of Bartonella species.

Building a National Policy for Rare Disease in Brazil.

Rare diseases (RD) are individually rare, although encompass a significant proportion of the population, affecting not only the individuals but also their families. In Brazil RD is defined by the Ministry of Health as a disorder that affects up to 65 individuals in 100,000, or 1.3 individuals in every 2,000. In this review the environment that led to the publication of a National Policy for Comprehensive Care for People of Rare Disease in 2014, a national plan with the aim to decrease morbidity and mortality of RD, improving the care of people with RD in the public health system are described. The process that finally led to such policy took over a decade, moving forward not only due to technical needs, but having patient organizations as essential actors and advocates. Specialized centers in RD were licensed and, since its publication, 33 centers have been accredited; such process, however, has been slow and concentrated in specific regions and larger cities of the country. Despite the incorporation of genetic tests in 2014 and exome sequencing later in 2020, many genetic tests are not offered by specialized centers, with unequal availability across the country. Public health system in Brazil uses ICD-10 for disease coding, preventing appropriate epidemiologic knowledge of RD in Brazil. Incorporation of new technologies as orphan drugs has been in place and regulation for expedite licensing for new RD drugs were issued, although high cost and availability to RD population has been a challenge.

The profile of adolescents assisted by the emergency department of a Brazilian private tertiary hospital.

INTRODUCTION: Adolescents represent an important demographic percentage in the studied population and in Emergency Departments (ED). It is imperative that health professionals and services are prepared to address this population. This work aims to characterize adolescents at the ED of a Brazilian private tertiary hospital. METHODS: The study was an observational, retrospective longitudinal cohort that included 37,450 visits of patients aged 10 to 21 years of age, between January 2018 and June 2022 in the ED of a private tertiary hospital. The study evaluated the reason for the consultation, diagnosis, need for hospitalization, the medical professional responsible for the care, severity, and paying source of care. RESULTS: 53.7% were female. Mean age was 16.2y for girls and 15.6y for boys (p < 0.005). The most common complaints were flu-like symptoms (17.4%), sore throat (8.2%), fever (6.7%) and limb trauma (6.3%). Flu-like symptoms were the main consultations caused in all age groups and genders. 36.8% were attended by a general practitioner, 35.8% by a pediatrician, 15.1% by orthopedics and 5.6% by surgeons. The hospitalization rate was 5.5%. There was a strong correlation between age and hospitalization rate (correlation coefficient [r = 0.93]; p < 0.001). The most prevalent diagnoses in hospitalizations were acute abdomen (12.7%) and trauma (9.4%). 78.2% of the consultations were classified as "not urgent". There was a strong correlation between age and severity (r = 0.86; p < 0.001). 92.7% of the consultations were paid by medical insurance. CONCLUSION: In this study, flu-like symptoms were the single main reason for adolescents to search for immediate health care, in every age subgroup and gender, but represented a small risk for hospital admission. Limb trauma was more common in younger male teenagers. Acute abdominal pain and trauma were the most frequent causes of hospital admissions. There was a significant and strong correlation between age and both admission rate and severity.

Revision of the Neotropical Genus Solepyris Azevedo (Hymenoptera, Bethylidae).

The bethylid genus Solepyris Azevedo (Scleroderminae) is studied and revised. Five species are recognized, including three previously described ones: †S. electromexicanus Brazidec and Perrichot, S. montuosus Azevedo, and S. unicus Azevedo. Additionally, two new species are described and illustrated: S. maleku sp. nov. from Costa Rica and S. pataxo sp. nov. from Brazil. An emended diagnosis and a detailed discussion regarding the morphological diagnostic characters of this genus are also presented. A taxonomic key for all species is provided.

Assembly structures of coastal woody species of eastern South America: Patterns and drivers.

Tropical regions have provided new insights into how ecological communities are assembled. In dry coastal communities, water stress has been hypothesized to determine plant assembly structure by favoring preadapted lineages from neighboring ecosystems, consistent with functional clustering. However, it is unclear whether this hypothesis is sufficient to explain how coastal communities in tropical ecosystems are assembled. Here, we test whether water stress or other factors drive community assembly in woody plant communities across the coastal zone of Brazil, a tropical ecosystem. We characterized functional and phylogenetic structures of these communities and determined the underlying environmental factors (e.g., water stress, historical climate stability, edaphic constraints, and habitat heterogeneity) that drive their community assembly. Assemblages of coastal woody species show geographically varied patterns, including stochastic arrangements, clustering, and overdispersion of species relative to their traits and phylogenetic relatedness. Topographic complexity, water vapor pressure, and soil nutrient availability best explained the gradient in the functional structure. Water deficit, water vapor pressure, and soil organic carbon were the best predictors of variation in phylogenetic structure. Our results support the water-stress conservatism hypothesis on functional and phylogenetic structure, as well as the effect of habitat heterogeneity on functional structure and edaphic constraints on functional and phylogenetic structure. These effects are associated with increased phenotypic and phylogenetic divergence of woody plant assemblages, which is likely mediated by abiotic filtering and niche opportunities, suggesting a complex pattern of ecological assembly.

The soil conservation agenda of Brazil: A review of "edge-to-edge" science contributions.

Soil conservation adheres to various United Nations Sustainable Development Goals while in Brazil is a constitutional obligation. To attain the goals and fulfil the obligation, laws, policies, governance and science must be imbricated to deliver suitable conservation solutions for the long term, namely appropriate to positively influence other downstream chains such as the food chain. However, in Brazil, a major world producer and exporter of food, weaknesses were recently diagnosed by judicial authorities concerning soil governance and coordinated land use policies. Integrated scientific assessments on soil conservation and mitigation of degraded soil are also lacking in this country. This was enough motivation and the purpose to present here a holistic view over the soil conservation agenda and promoting policies in Brazil, based on a literature review that followed the guidelines and criteria of PRISMA approach. We termed this analysis a review hinged on "edge-to-edge" science contributions for two reasons. Firstly, the intent of retrieving from the recently published literature solely papers centered on a relevant soil conservation topic (e.g., soil characterization, here called an "edge") but with complementary analyses over boundary topics (frontier "edges", such as soil degradation). Secondly, the intent of underlining the urgency to assist decision-makers with scientific evidence in all dimensions of the soil conservation agenda ("edge-to-edge" science), namely soil characterization (e.g., quality reference values), soil degradation assessment (e.g., anthropogenic-related soil erosion or contamination), soil degradation consequences focused on the carbon cycle (e.g., net CO2 emissions and climate warming), sustainable management practices and production systems (e.g., no-tillage agriculture and integrated crop-livestock-forestry systems), and scientific evaluation of existing laws as well as of governance and policy programs with potential implications on soil quality (e.g., the Forest Code). Thus, this literature review addressed all these topics following a multidisciplinary discourse, which produced an extensive but comprehensive document about soil conservation in Brazil.

Leprosy in Brazil: an analysis of the Global Burden of Disease estimates between 1990 and 2019.

OBJECTIVE: To analyze the occurrence of leprosy in Brazil and its states between 1990 and 2019, according to Global Burden of Disease (GBD) estimates, and its correlation with development status. STUDY DESIGN: A descriptive and analytical ecological epidemiological study. METHODS: Rates of incidence, prevalence, and years lived with disability (YLD) due to leprosy, standardized by age, per 100,000 inhabitants, were analyzed. The trend analysis consisted of the joinpoint regression model and the average annual percentage change. The correlation between the incidence rate and the sociodemographic index (SDI) was investigated (Spearman test) at a 5% significance level. Incidence, prevalence and YLD rates were presented by country's states, sex, and age. RESULTS: There was an average percentage decrease of -1.1% per year (P < 0.001) in the incidence rate in the country and, between 1990 and 2019, a decline from 4.8 to 3.5 per 100,000 inhabitants; prevalence from 26.1 to 22.2, and YLD from 1.1 to 1.0. The incidence rate was higher among men and the elderly. Maranhão (7.0 in 1990; 4.2 in 2019), Alagoas (6.6 in 1990; 4.1 in 2019), Acre (6.1 in 1990; 4.0 in 2019), Mato Grosso (5.2 in 1990 and 3.7 in 2019), and Mato Grosso do Sul (4.8 in 1990 and 3.7 in 2019) presented the highest incidence rates. A negative correlation was observed between SDI levels and leprosy incidence rates in 1990 (R = -0.71; P < 0.0001) and 2019 (R = -0.81; P < 0.0001). CONCLUSIONS: Despite the decrease in the rates of leprosy incidence, prevalence, and YLDs over the analyzed period, Brazil has a long way towards achieving its eradication. The greater burden of the disease in males stands out. The estimated risk of the disease was higher in the states with the lowest SDI levels. Therefore, interventions must consider the heterogeneity of the disease burden geographically and between sociodemographic groups.

Characterisation of the novel HLA-B*18:37:03 allele, first identified in a Brazilian individual.

The novel HLA-B*18:37:03 allele, first described in a potential bone marrow donor from Brazil.

Evaluation of Seasonal and Climatic Variations Associated With Femoral Fracture Incidence Among the Elderly Population in Brazil.

INTRODUCTION: Femur fractures represent a significant public health concern for individuals over 60 years of age. In Brazil, the incidence of these fractures has shown a rising trend in line with population aging. Besides intrinsic risk factors like osteoporosis, seasonal and climatic variables have been suggested to significantly influence the occurrence of these fractures. METHODS: Epidemiological data were sourced from the Hospital Information System of the Unified Health System (SIH-SUS) using the TABNET tool provided by the Department of Informatics of the Unified Health System (DATASUS). Information on hospital admissions for femur fractures in individuals over 60 years, categorized by diagnosis, region, and month, was collected from 2008 to 2023. Climatic data were obtained from the Brazilian National Institute of Meteorology (INMET) for the period from 1991 to 2020. Monthly average temperatures were compared with epidemiological data and analyzed to uncover correlations using ANOVA and Tukey's honestly significant difference (HSD) test. RESULTS: During Brazil's winter months (June to August: 22.8 to 23.5º Celsius), average temperatures are at their lowest. This period also coincides with the peak incidence of femur fractures among the elderly. ANOVA revealed significant differences in fracture rates across various temperature ranges. Subsequent analysis using Tukey's HSD test identified significant differences between temperature ranges of 22-23°C and 25-26°C, as well as 23-24°C and 25-26°C. These results indicate that lower temperatures are associated with a higher incidence of femur fractures among the elderly. CONCLUSION: The analysis reveals a seasonal pattern in fracture incidence among older adults, with a notable increase during the colder months. To mitigate this risk, it is recommended to implement strategies such as heightened surveillance during colder months, targeted fall prevention measures, and effective osteoporosis management. These interventions aim to reduce the incidence of fractures in this vulnerable population.

First record of the rare tubeshoulder Holtbyrnia anomala Krefft 1980 (Teleostei, Platytroctidae) in the southwest Atlantic.

Holtbyrnia anomala is a bathypelagic platytroctid widely distributed in the Atlantic Ocean. In this contribution, we report, for the first time, the occurrence of this species in the tropical southwest Atlantic. A single specimen was collected in 2000 on the continental slope off Rio de Janeiro, Brazil, at an average depth of 1158 m. This report also represents the first record of Holtbyrnia anomala in the Brazilian Economic Exclusive Zone.

A study protocol for a randomized clinical trial on exposure and effects of pesticides consumption - the PEST-EXPO Brazil study.

Randomized clinical trials are considered the gold standard for studies with dietary interventions, which is mainly due to the fact that they can establish causal relationships between food exposure and body composition measures or biomarkers. The aim of this study was to describe the details of a double-blind, randomized, clinical trial protocol to identify, characterize and evaluate the effects of human dietary exposure to pesticide residues in food. Specific aspects of planning (development of a research question, determination of objectives, selection of participants, randomization and blinding) and performance (recruitment of participants, measures to improve adherence, data collection, follow-up and evaluation of results) are addressed in this study. The study design proved effective in characterizing dietary patterns with foods originating from both conventional and organic agriculture. A total of 148 individuals were recruited for the study. The conventional group was represented by 47 % of the sample and the organic group was represented by 53 %. The practice of evidence-based nutrition has demanded that trials be well designed and systematically performed in the field of clinical nutrition. Therefore, this clinical trial emphasizes the importance of improving studies with toxicological nutrition that assess sources of exposure through food.•This double-blind, randomized clinical trial details the protocol for identifying, characterizing, and evaluating the effects of dietary exposure to pesticide residues.•The protocol demonstrates that well-designed and systematically conducted trials emphasize the importance of robust methodologies in evidence-based nutrition.•In the face of the global climate crisis, this clinical trial underscores the importance of enhancing studies in toxicological nutrition, particularly those evaluating sources of exposure through food, to better understand the dietary impacts on health.

Association Between Juvenile Psychotic Experiences and Problematic Gaming.

Background and Hypothesis: Problematic gaming (PG) is an emerging mental health condition associated with significant adverse outcomes. Even though PG has been linked to other psychiatric disorders, its association with psychotic experiences (PEs) remains poorly explored to date. The aim of our study was to examine the association between both conditions in a large Brazilian community sample. We hypothesized that adolescents with PG were more likely to report PE compared with those without the disorder. Study Design: Our investigation was based on a cross-sectional subsample of a large Brazilian cohort (n = 1616; 13- to 21-year age range). Using the 7-item version of the Game Addiction Scale, participants were classified according to their gaming status: no PG, PG, or gaming addiction (GA). The association between PG, GA, and PE was assessed through linear regression analyses, which were adjusted for the presence of significant covariates, including other psychiatric conditions. Study Results: 9.5% (n = 154) presented PG and 2.7% (n = 43) had GA. 28.0% received any Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnosis and the mean PE score was 9.39 (SD = 4.35). Participants presenting PG had greater levels of PE, compared with participants with no PG, even controlled by sociodemographic variables and the presence of any DSM-IV diagnosis (b = 0.96, 95% CI = 0.17-1.75, P = .017). Conclusions: According to our results, PG was significantly associated with PE, even in the presence of other covariates. Although preliminary, these results suggest that PG and PE may have shared neurobiological and/or behavioral pathways.

Occurrence of coccidioidomycosis in a tertiary hospital in the Brazilian semi-arid region: diagnostic challenges.

Coccidioidomycosis is a systemic fungal infection that primarily affects the lungs in mammals. It is endemic to certain areas of the Americas. In Brazil, the disease occurs exclusively in the Northeast of the country, and the only etiological agent described is Coccidioides posadasii, typically found in the soil of arid regions with low rainfall. Given the scarcity of cases in Brazil, a descriptive study was conducted based on cases diagnosed with coccidioidomycosis between 2012 and 2022 at a tertiary hospital in the northeastern region of Brazil. The study analyzed medical records to identify cases of coccidioidomycosis diagnosed by clinical and/or laboratory data, discussing their clinical-epidemiological aspects. Thirteen patients were identified from seven municipalities in Ceará, all of whom were male, with a mean age of 19 years. The main risk factor was armadillo hunting, and the clinical manifestations included cough, fever, and chest pain. In this study, two patients were diagnosed by serology, one by microscopy, and ten suspected cases were diagnosed based on the clinical and epidemiological picture. Twelve patients were treated with antifungals. Clinical improvement with hospital discharge occurred in twelve patients, while one patient died. The data corroborate information from the scientific literature that the area covered by the referral hospital is endemic for coccidioidomycosis. However, local resources for diagnosing this disease were found to be deficient, with a high rate of presumptive diagnoses. This study highlights the need for actions by health surveillance systems and greater efficiency in diagnosing coccidioidomycosis in endemic areas of Brazil.

The sicariid spiders in the state of Bahia, Brazil (Arachnida: Araneae).

Background: Sicariidae is a small family of cryptic and recluse spiders, with 178 species grouped into three genera: Hexophtalma, Loxosceles and Sicarius. Only the last two occur in Brazil, where 29 species are recorded, with a greater number of records in the Southeast and South regions. To date, there is no regionalized study of the distribution of these spiders in the Northeast of Brazil. We presented more than four decades of data on the distribution of sicariid spiders in the state of Bahia. Our research aimed to identify and evaluate the distribution of sicariid species in this region, characterizing them in their biomes and phytophysiognomies. Methods: Data covers a period from 1983 to 2024, obtained from articles describing species recorded in Bahia and from three scientific collections from Brazilian institutions: Universidade Federal da Bahia (MHNBA); Instituto Butantan (IBSP); Universidade Federal de Minas Gerais (UFMG). Maps were produced using the QGIS 3.34.1 software, based on geographic coordinates obtained from the original literature, when provided. Species without information on geographic coordinates were georeferenced using the SpeciesLink (geoLoc tool) for the municipalities. Biomes were consulted on the georeference Brazilian institute website and the phytophysiognomies were ignored when not specified in the data of collections or original literature. Results: We confirmed 14 species of sicariid spiders in the state of Bahia, eight from the genus Loxosceles (i) and six from Sicarius. The species were recorded in 48 municipalities, located mainly in the Caatinga biome. We recorded a distribution expansion of seven species: Loxosceles amazonica, L. chapadensis, L. karstica, L. similis, Sicarius cariri, S. ornatus and S. tropicus. There is a difference in species composition in the two regions separated by the São Francisco River, an important geographic barrier especially for small invertebrates. More than 75% of the species were registered in the east side and about 20% exclusively in the west side: L. boqueirao, L. cardosoi, L. carinhanha. This suggests the need for future studies to evaluate additional variables that determine community structure, especially considering their low vagility and reclusive behavior. Although Sicarius are found almost exclusively in the Caatinga, there are isolated records from Restinga and dry forest enclaves in the Cerrado domain and Atlantic Forest areas. This reinforces the possibility of them being able to adapt to slightly wetter environments erase colonize and survive in seasonally dry rainforest areas. Unlike Sicarius (i), Loxosceles (i) occupy a wide variety of habitats in natural, urban and domiciliary situations. Many of the records here such as for Loxosceles boqueirao, L. cardosoi, L. carinhanha, L. chapadensis, L. karstica and L. troglobia were obtained at caves or nearby areas, which appear to be attractive habitats for these nocturnal spiders.

Marine macrolitter and cigarette butts hazard multiple-use marine protected area and fishing community at Brazil.

Wide marine litter (ML) contamination impacts human health and economic sectors including fishing, navigation, and tourism. Perequê beach, Brazil, is an authentic fishing community within a touristic multiple-use marine protected area. However, no ML contamination monitoring were so far performed in the region. This study evaluated the spatiotemporal abundance, composition, sources, and associated ML hazards at Perequê beach using a multi-index approach. The 2579 items (0.64 ± 0.72 items.m-2) yielded a high contamination level (CCI = 12.6 ± 14.4) with plastic (44.6-50.9 %) and cigarette butts (20.6-28.4 %) prevalence, while primary sources were smoking (cigarette butts, lighters, others-21.2-30.1 %) and packaging (17.8-22.8 %). Levels of pollutants leaked from cigarette butts (CBPI = 30.5 ± 47.5) and hazardous items (HALI = 3.06 ± 2.64) were among the highest globally. Heightened levels occurred in summer, at dry sand strip, where short-term buoyant items prevailed. Multi-indexing approaches offer valuable insights for local authorities to implement mitigation programs, while contributing to global discussions, promoting awareness, and facilitating replicability.

Spinocerebellar Ataxia in Brazil: A Comprehensive Genotype - Phenotype Analysis.

Spinocerebellar ataxias (SCAs) are a diverse group of hereditary neurodegenerative disorders characterized by progressive degeneration of the cerebellum and other parts of the nervous system. In this study, we examined the genotype‒phenotype correlations in SCAs within the Brazilian population by leveraging a comprehensive dataset of 763 individuals from SARAH Network of Rehabilitation Hospitals. Using a retrospective, cross-sectional, observational, multicentric approach, we analysed medical records and conducted standardized molecular testing to explore epidemiological characteristics, clinical manifestations, and genetic profiles of SCAs in Brazil. Our findings revealed the predominance of SCA3, followed by SCA7 and SCA2, which aligns with global trends and reflects the specific genetic landscape of Brazil. A significant inverse relationship between the age of symptom onset and CAG repeat length in the mutated allele was observed across SCAs 2, 3, and 7. This study also highlights a trend towards paternal inheritance in SCA2 and details the distribution of CAG repeat expansions, which correlates larger expansions with earlier onset and specific symptomatology. This extensive analysis underscores the critical importance of genetic testing in the diagnosis and management of SCAs and enlightens the intricate genotype‒phenotype interplay within a genetically diverse population. Despite certain limitations, such as potential selection bias and the retrospective nature of the study, our research provides invaluable insights into the prevalence, genetic underpinnings, and clinical variability of SCAs in Brazil. We suggest a broader demographic scope and investigations into nonmotor symptoms in future studies to obtain a more comprehensive understanding of SCAs.

Reckoning with COVID-19 denial: Brazil's exemplary model for global response.

In the aftermath of the coronavirus disease 2019 (COVID-19) pandemic in Brazil, accountability is crucial for those who denied the severity of the virus, spreading false information and causing harm. Some individuals have already faced legal proceedings against them, revealing economic motivations behind their actions. It is equally important to hold doctors accountable for prescribing ineffective treatments, putting the population at risk. The leaders of the denial movement and the federal government, who mishandled the pandemic, should be held accountable for the high death toll. Seeking justice from the legislative and executive branches is necessary, along with exemplary measures for those who spread misinformation about COVID-19.

Noncommunicable disease burden in Brazil and its states from 1990 to 2021, with projections for 2030.

OBJECTIVES: The aim of this study was to analyse the burden of disease due to noncommunicable diseases (NCDs) between 1990 and 2021 in Brazil. In addition, this study compared mortality from NCDs with mortality from all causes and COVID-19, analysed NCD mortality trends and projections for 2030, and analysed NCD mortality rates and risk factors attributed to these deaths among the 27 states of Brazil. STUDY DESIGN: Ecological studies. METHODS: This study used the Global Burden of Disease study (GBD) database from 1990 to 2021. Premature deaths from four NCDs (neoplasms, cardiovascular disease, chronic respiratory diseases and diabetes mellitus) were analysed. The following metrics were used to analyse the burden of NCDs in Brazil: absolute number of deaths, proportional mortality, mortality rate, years of life lost due to premature death (YLL), years lived with disabilities (YLD) and disability-adjusted years of life lost due to premature death (DALY). For comparison between the years studied and states, age-standardised rates were used. RESULTS: Finding from this study showed that there was increase in the proportion of premature deaths due to NCDs between 1990 and 2019 (29.4 % in 1990, 30.8 % in 2019), and a reduction in 2021 (24.7 %). The mortality rates, DALY and YLL from NCDs declined between 1990 and 2019 (-37.7 %, -34.5 % and -38.3 %, respectively); however, a stability in mortality rates, DALY, YLD, YLL was observed between 2019 and 2021 (-0.1 %, 0.7 %, -0.1 % and 0.8 %, respectively). Between 1990 and 2021, there was a decline in mortality rates, DALY and YLL for most states and an increase in YLD rates. However, results suggest that the Sustainable Development Goal (SDG) for the reduction in mortality from NCDs by one-third by 2030 will not be achieved. The main risk factors associated with premature death from NCDs in 2021 were high blood pressure, tobacco use, dietary risks, high body mass index (BMI) and high blood glucose levels. The correlation between sociodemographic index and percentage change in mortality rates was significant for the following total NCDs, cardiovascular disease, chronic respiratory disease, diabetes and neoplasms. CONCLUSIONS: The current study highlights the importance of deaths from NCDs in Brazil and the worsening of mortality rates since 2016, as a result of austerity measures and the COVID-19 pandemic, which compromises the achievement of the SDG reduced mortality targets for NCDs. There was a reduction in risk factors for NCDs, mainly behavioural, although metabolic risk factors are of great concern and require new strategies to promote health, prevention and comprehensive care.

Pelage variation and morphometrics of closely related Callithrix marmoset species and their hybrids.

BACKGROUND: Hybrids are expected to show greater phenotypic variation than their parental species, yet how hybrid phenotype expression varies with genetic distances in closely-related parental species remains surprisingly understudied. Here, we investigate pelage and morphometric trait variation in anthropogenic hybrids between four species of Brazilian Callithrix marmosets, a relatively recent primate radiation. Marmoset species are distinguishable by pelage phenotype and morphological specializations for eating tree exudates. In this work, we (1) describe qualitative phenotypic pelage differences between parental species and hybrids; (2) test whether significant quantitative differences exist between parental and hybrid morphometric phenotypes; and (3) determine which hybrid morphometic traits show heterosis, dysgenesis, trangression, or intermediacy relative to the parental trait. We investigated cranial and post-cranial morphometric traits, as most hybrid morphological studies focus on the former instead of the latter. Finally, we estimate mitogenomic distances between marmoset species from previously published data. RESULTS: Marmoset hybrid facial and overall body pelage variation reflected novel combinations of coloration and patterns present in parental species. In morphometric traits, C. jacchus and C. penicillata were the most similar, while C. aurita was the most distinct, and C. geoffroyi trait measures fell between these species. Only three traits in C. jacchus x C. penicillata hybrids showed heterosis. We observed heterosis and dysgenesis in several traits of C. penicillata x C. geoffroyi hybrids. Transgressive segregation was observed in hybrids of C. aurita and the other species. These hybrids were also C. aurita-like for a number of traits, including body length. Genetic distance was closest between C. jacchus and C. penicillata and farthest between C. aurita and the other species. CONCLUSION: We attributed significant morphometric differences between marmoset species to variable levels of morphological specialization for exudivory in these species. Our results suggest that intermediate or parental species-like hybrid traits relative to the parental trait values are more likely in crosses between species with relatively lesser genetic distance. More extreme phenotypic variation is more likely in parental species with greater genetic distance, with transgressive traits appearing in hybrids of the most genetically distant parental species. We further suggest that fewer developmental disturbances can be expected in hybrids of more recently diverged parental species, and that future studies of hybrid phenotypic variation should investigate selective pressures on Callithrix cranial and post-cranial morphological traits.