Sustainable intensification of agriculture is one of the main strategies to provide global food security. However, its implementation raises enormous political, technological, and social challenges. Meeting these challenges will require, among other things, accurate information on the spatial and temporal patterns of agricultural land use and yield. Here, we investigate historical patterns of agricultural land use (1940-2012) and productivity (1990-2012) in Brazil using a new high-resolution (approximately 1 km(2) ) spatially explicit reconstruction. Although Brazilian agriculture has been historically known for its extensification over natural vegetation (Amazon and Cerrado), data from recent years indicate that extensification has slowed down and was replaced by a strong trend of intensification. Our results provide the first comprehensive historical overview of agricultural land use and productivity in Brazil, providing clear insights to guide future territorial planning, sustainable agriculture, policy, and decision-making.
Background
In utero transmission of HIV-1 occurs on average in only 3%–15% of HIV-1-exposed neonates born to mothers not on antiretroviral drug therapy. Thus, despite potential exposure, the majority of infants remain uninfected. Weak HIV-1-specific T-cell responses have been detected in children exposed to HIV-1, and potentially contribute to protection against infection. We, and others, have recently shown that the removal of CD4+CD25+ T-regulatory (Treg) cells can reveal strong HIV-1 specific T-cell responses in some HIV-1 infected adults. Here, we hypothesized that Treg cells could suppress HIV-1-specific immune responses in young children.Methodology/Principal FindingsWe studied two cohorts of children. The first group included HIV-1-exposed-uninfected (EU) as well as unexposed (UNEX) neonates. The second group comprised HIV-1-infected and HIV-1-EU children. We quantified the frequency of Treg cells, T-cell activation, and cell-mediated immune responses. We detected high levels of CD4+CD25+CD127− Treg cells and low levels of CD4+ and CD8+ T cell activation in the cord blood of the EU neonates. We observed HIV-1-specific T cell immune responses in all of the children exposed to the virus. These T-cell responses were not seen in the cord blood of control HIV-1 unexposed neonates. Moreover, the depletion of CD4+CD25+ Treg cells from the cord blood of EU newborns strikingly augmented both CD4+ and CD8+ HIV-1-specific immune responses.Conclusions/SignificanceThis study provides new evidence that EU infants can mount strong HIV-1-specific T cell responses, and that in utero CD4+CD25+ T-regulatory cells may be contributing to the lack of vertical transmission by reducing T cell activation.
Objective: To verify whether parents and health professionals homogeneously evaluate presence and intensity of neonatal pain.
Methods:This cross-sectional study enrolled 52 neonates and 154 adults. Inclusion criteria for neonates were admission to neonatal intensive care unit, presence of gastric tube, tracheal tube, and venous lines. Each newborn was observed by a different group of three adults (parent, nurse assistant and pediatrician) for 1 minute at the same time to evaluate presence and intensity of infant's pain. Homogeneity of pain evaluation was analyzed by a modified BlandAltman plot and by intraclass correlation coefficient (ICC). Multiple linear regression analysis was used to evaluate association of neonatal characteristics and heterogeneity of pain scores for adults.Results: ICC showed disagreement of the pain scores given by the three groups of adults (ICC 0.066, agreement > 0.75). Bland-Altman analysis showed agreement among adults when they thought pain was absent. When they thought pain was present, there was heterogeneity of opinions regarding intensity of neonatal pain. Multiple regression analysis indicated that 10% of this disagreement could be explained by infant's gender and mode of delivery.
Conclusions:Disagreement among adults about intensity of neonatal pain is a marker of the difficulty in deciding the need for analgesia in preverbal patients.J Pediatr (Rio J). 2008;84(1):35-40: Pain, pain measurement, infant, newborn.
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