Modern anthropogenic drought in Central Brazil unprecedented during last 700 years

A better understanding of the relative roles of internal climate variability and external contributions, from both natural (solar, volcanic) and anthropogenic greenhouse gas forcing, is important to better project future hydrologic changes. Changes in the evaporative demand play a central role in this context, particularly in tropical areas characterized by high precipitation seasonality, such as the tropical savannah and semi-desertic biomes. Here we present a set of geochemical proxies in speleothems from a well-ventilated cave located in central-eastern Brazil which shows that the evaporative demand is no longer being met by precipitation, leading to a hydrological deficit. A marked change in the hydrologic balance in central-eastern Brazil, caused by a severe warming trend, can be identified, starting in the 1970s. Our findings show that the current aridity has no analog over the last 720 years. A detection and attribution study indicates that this trend is mostly driven by anthropogenic forcing and cannot be explained by natural factors alone. These results reinforce the premise of a severe long-term drought in the subtropics of eastern South America that will likely be further exacerbated in the future given its apparent connection to increased greenhouse gas emissions.

Impacts on South America moisture transport under Amazon deforestation and 2 °C global warming

The increase in greenhouse gasses (GHG) anthropogenic emissions and deforestation over the last decades have led to many chemical and physical changes in the climate system, affecting the atmosphere's energy and water balance. A process that could be affected is the Amazonian moisture transport in the South American continent (including La Plata basin), which is crucial to the southeast Brazilian water regime. The focus of our research is on evaluating how local (i.e. Amazon deforestation) and global forcings (increase of atmospheric GHG concentration) may modify this moisture transport under climate change scenarios. We used two coupled land-atmosphere models forced by CMIP6 sea surface temperatures to simulate these processes for two scenarios: i) increase in carbon dioxide (CO2) - RCP8.5 atmospheric levels (00DEF), and ii) total Amazon deforestation simultaneous with atmospheric CO2 levels increased (100DEF). These scenarios were compared with a control simulation, set with a constant CO2 of 388 ppm and present-day Amazon Forest cover. The 30-year Specific Warming Level 2 (SWL2) index evaluated from the simulations is set to be reached 2 years earlier due to Amazon deforestation. A reduction in precipitation was observed in the Amazon basin (-3.1 mm·day-1) as well as in La Plata Basin (-0.5 mm·day-1) due to reductions in the Amazon evapotranspiration (-0.9 mm·day-1) through a stomatal conductance decrease (00DEF) and land cover change (100DEF). In addition, the income moisture transport decreased (22 %) in the northern La Plata basin in both scenarios and model experiments. Our results indicated a worse scenario than previously found in the region. Both Amazon and La Plata hydrological regimes are connected (moisture and energy transport), indicating that a large-scale Amazon deforestation will have additional climate, economic and social implications for South America.

AMOC decline and recovery in a warmer climate

This study presents novel insight into the mechanisms of Atlantic Meridional Overturning Circulation (AMOC) reduction and its recovery under a warmer climate scenario. An one-thousand-year-long numerical simulation of a global coupled ocean-ice-atmosphere climate model, subjected to a stationary atmospheric radiative forcing, depict a coherent picture of the Arctic sea ice melting as a trigger for the initial AMOC reduction, along with decreases in the northward fluxes of salt and heat. Further atmospheric-driven ocean processes contribute to an erosion of the stable stratification of the fresher, yet colder waters in the surface layers of the North Atlantic, contributing to the recovery of a permanently altered AMOC.

Uncovering episodic influence of oceans on extreme drought events in Northeast Brazil by ordinal partition network approaches

Since 2012, the semiarid region of Northeast Brazil (NEB) has been experiencing a continuous dry condition imposing significant social impacts and economic losses. Characterizing the recent extreme drought events and uncovering the influence from the surrounding oceans remain to be big challenges. The physical mechanisms of extreme drought events in the NEB are due to varying interacting time scales from the surrounding tropical oceans (Pacific and Atlantic). From time series observations, we propose a three-step strategy to establish the episodic coupling directions on intraseasonal time scales from the ocean to the precipitation patterns in the NEB, focusing on the distinctive roles of the oceans during the recent extreme drought events of 2012-2013 and 2015-2016. Our algorithm involves the following: (i) computing drought period length from daily precipitation anomalies to capture extreme drought events; (ii) characterizing the episodic coupling delays from the surrounding oceans to the precipitation by applying the Kullback-Leibler divergence (KLD) of complexity measure, which is based on ordinal partition transition network representation of time series; and (iii) calculating the ratio of high temperature in the ocean during the extreme drought events with proper time lags that are identified by KLD measures. From the viewpoint of climatology, our analysis provides data-based evidence of showing significant influence from the North Atlantic in 2012-2013 to the NEB, but in 2015-2016, the Pacific played a dominant role than that of the Atlantic. The episodic intraseasonal time scale properties are potential for monitoring and forecasting droughts in the NEB in order to propose strategies for drought impacts reduction.

Tree Nuts Anaphylaxis in Preschool Age Children

Summary

Introduction. The incidence of food-induced anaphylaxis (FIA) is increasing in young children. Although the commonest culprits are cow's milk and egg, FIA to tree nuts (TNs) have been increasing. Objective. Characterization of children referred to our allergy department due to TNs-induced anaphylaxis (TNs-FIA) during preschool age. Materials and methods. We have retrospectively included 25 children with clinical history of preschool TNs-FIA, proven by allergological work-up. TNs sensitization was assessed by skin prick tests and/or specific IgE. Results. The mean age of the first anaphylactic episode was 3.1±1.2 years. The majority (92%) had an allergic disease (52% asthma). The implicated TNs were cashew (11 children), walnut (8), pine nut (5), hazelnut (2) and almond (1). The reaction occurred after the first known ingestion in 68%. In 92%, symptoms appeared within 30 minutes after exposure. The most frequent clinical symptoms were mucocutaneous (96%), respiratory (80%) and gastrointestinal (52%). Twenty-one children were admitted to the emergency department, although only 48% were treated with epinephrine. An underneath IgE-mediated mechanism was proven in all cases. Immunologic cross-reactivity with other TNs was identified in 84%, and with peanut in 36%. Overall, in our center, TNs-FIA represents 18% of all causes of FIA. Conclusions. In preschool age children with TNs-FIA, cashew and walnut were the commonest implicated nuts. Most reactions occurred briefly after exposure to minimal amounts of TNs, demonstrating the high potency of these allergens. About one-third also had peanut sensitization. Potentially life-threatening TNs allergy can occur early in childhood and adequate management should be undertaken.

Self-amplified Amazon forest loss due to vegetation-atmosphere feedbacks

Reduced rainfall increases the risk of forest dieback, while in return forest loss might intensify regional droughts. The consequences of this vegetation–atmosphere feedback for the stability of the Amazon forest are still unclear. Here we show that the risk of self-amplified Amazon forest loss increases nonlinearly with dry-season intensification. We apply a novel complex-network approach, in which Amazon forest patches are linked by observation-based atmospheric water fluxes. Our results suggest that the risk of self-amplified forest loss is reduced with increasing heterogeneity in the response of forest patches to reduced rainfall. Under dry-season Amazonian rainfall reductions, comparable to Last Glacial Maximum conditions, additional forest loss due to self-amplified effects occurs in 10–13% of the Amazon basin. Although our findings do not indicate that the projected rainfall changes for the end of the twenty-first century will lead to complete Amazon dieback, they suggest that frequent extreme drought events have the potential to destabilize large parts of the Amazon forest.

Relatively little is understood about seasonal effect of climate change on the Amazon rainforest. Here, the authors show that Amazon forest loss in response to dry-season intensification during the last glacial period was likely self-amplified by regional vegetation-rainfall feedbacks.

Variation in stem mortality rates determines patterns of above-ground biomass in Amazonian forests: implications for dynamic global vegetation models

Understanding the processes that determine above-ground biomass (AGB) in Amazonian forests is important for predicting the sensitivity of these ecosystems to environmental change and for designing and evaluating dynamic global vegetation models (DGVMs). AGB is determined by inputs from woody productivity [woody net primary productivity (NPP)] and the rate at which carbon is lost through tree mortality. Here, we test whether two direct metrics of tree mortality (the absolute rate of woody biomass loss and the rate of stem mortality) and/or woody NPP, control variation in AGB among 167 plots in intact forest across Amazonia. We then compare these relationships and the observed variation in AGB and woody NPP with the predictions of four DGVMs. The observations show that stem mortality rates, rather than absolute rates of woody biomass loss, are the most important predictor of AGB, which is consistent with the importance of stand size structure for determining spatial variation in AGB. The relationship between stem mortality rates and AGB varies among different regions of Amazonia, indicating that variation in wood density and height/diameter relationships also influences AGB. In contrast to previous findings, we find that woody NPP is not correlated with stem mortality rates and is weakly positively correlated with AGB. Across the four models, basin-wide average AGB is similar to the mean of the observations. However, the models consistently overestimate woody NPP and poorly represent the spatial patterns of both AGB and woody NPP estimated using plot data. In marked contrast to the observations, DGVMs typically show strong positive relationships between woody NPP and AGB. Resolving these differences will require incorporating forest size structure, mechanistic models of stem mortality and variation in functional composition in DGVMs.

Variation in stem mortality rates determines patterns of above-ground biomass in Amazonian forests: implications for dynamic global vegetation models

Understanding the processes that determine above-ground biomass (AGB) in Amazonian forests is important for predicting the sensitivity of these ecosystems to environmental change and for designing and evaluating dynamic global vegetation models (DGVMs). AGB is determined by inputs from woody productivity [woody net primary productivity (NPP)] and the rate at which carbon is lost through tree mortality. Here, we test whether two direct metrics of tree mortality (the absolute rate of woody biomass loss and the rate of stem mortality) and/or woody NPP, control variation in AGB among 167 plots in intact forest across Amazonia. We then compare these relationships and the observed variation in AGB and woody NPP with the predictions of four DGVMs. The observations show that stem mortality rates, rather than absolute rates of woody biomass loss, are the most important predictor of AGB, which is consistent with the importance of stand size structure for determining spatial variation in AGB. The relationship between stem mortality rates and AGB varies among different regions of Amazonia, indicating that variation in wood density and height/diameter relationships also influences AGB. In contrast to previous findings, we find that woody NPP is not correlated with stem mortality rates and is weakly positively correlated with AGB. Across the four models, basin-wide average AGB is similar to the mean of the observations. However, the models consistently overestimate woody NPP and poorly represent the spatial patterns of both AGB and woody NPP estimated using plot data. In marked contrast to the observations, DGVMs typically show strong positive relationships between woody NPP and AGB. Resolving these differences will require incorporating forest size structure, mechanistic models of stem mortality and variation in functional composition in DGVMs.

Land-use and climate change risks in the Amazon and the need of a novel sustainable development paradigm

For half a century, the process of economic integration of the Amazon has been based on intensive use of renewable and nonrenewable natural resources, which has brought significant basin-wide environmental alterations. The rural development in the Amazonia pushed the agricultural frontier swiftly, resulting in widespread land-cover change, but agriculture in the Amazon has been of low productivity and unsustainable. The loss of biodiversity and continued deforestation will lead to high risks of irreversible change of its tropical forests. It has been established by modeling studies that the Amazon may have two "tipping points," namely, temperature increase of 4 °C or deforestation exceeding 40% of the forest area. If transgressed, large-scale "savannization" of mostly southern and eastern Amazon may take place. The region has warmed about 1 °C over the last 60 y, and total deforestation is reaching 20% of the forested area. The recent significant reductions in deforestation-80% reduction in the Brazilian Amazon in the last decade-opens up opportunities for a novel sustainable development paradigm for the future of the Amazon. We argue for a new development paradigm-away from only attempting to reconcile maximizing conservation versus intensification of traditional agriculture and expansion of hydropower capacity-in which we research, develop, and scale a high-tech innovation approach that sees the Amazon as a global public good of biological assets that can enable the creation of innovative high-value products, services, and platforms through combining advanced digital, biological, and material technologies of the Fourth Industrial Revolution in progress.

One-year survey of paediatric anaphylaxis in an allergy department

AIM

To determine the frequency of anaphylaxis in an allergy outpatient department, allowing a better understanding regarding aetiology, clinical manifestations and management, in children and adolescents.

METHODS

From among 3646 patients up to 18 years old observed during one-year period, we included those with history of anaphylaxis reported by allergists.

RESULTS

Sixty-four children had history of anaphylaxis (prevalence of 1.8%), with mean age 8.1±5.5 years, 61% being male. Median age of the first anaphylactic episode was 3 years (1 month-17 years). The majority of patients had food-induced anaphylaxis (84%): milk 22, egg 7, peanut 6, tree nuts 6, fresh fruits 6, crustaceans 4, fish 4 and wheat 2. Food-associated exercise-induced anaphylaxis was reported in 2 adolescents. Drug-induced anaphylaxis occurred in 8%: 4 non-steroidal anti-inflammatory drugs and 1 amoxicillin. Three children had cold-induced anaphylaxis, one adolescent had anaphylaxis to latex and one child had anaphylaxis to insect sting. The majority (73%) had no previous diagnosis of the etiologic factor. Symptoms reported were mainly mucocutaneous (94%) and respiratory (84%), followed by gastrointestinal (42%) and cardiovascular (25%). Fifty-one patients were admitted to the emergency department, although only 33% were treated with epinephrine. Recurrence of anaphylaxis occurred in 26 patients (3 or more episodes in 14).

CONCLUSIONS

In our paediatric population, the main triggering agent of anaphylaxis was IgE-mediated food allergy. Epinephrine is underused, as reported by others. Often, children have several episodes before being assessed by an allergist. We stress the importance of systematic notification and improvement of educational programmes in order to achieve a better preventive and therapeutic management of this life-threatening entity.

A seca e a crise hídrica de 2014-2015 em São Paulo

A maior parte da estação chuvosa de 2014 transcorreu com valores de chuva inferiores à média histórica sobre a porção sudeste do país, incluindo o Sistema Cantareira. A causa principal para a grande falta de chuva foi a atuação de um intenso, persistente e anômalo sistema de alta pressão atmosférica que prejudicou o transporte de umidade da Amazônia, assim como a passagem/ desenvolvimento dos principais sistemas causadores de chuva, como a Zona de Convergência do Atlântico Sul e as frentes frias. Esse sistema, denominado de bloqueio atmosférico, teve uma duração de 45 dias, fato que resulta extremamente raro. A combinação dos baixos índices pluviométricos, o grande crescimento da demanda de água e o ineficiente gerenciamento desse recurso têm gerado uma “crise hídrica” durante os anos 2014 e 2015

Aspirin desensitization in a woman with inherited thrombophilia and recurrent miscarriage

Women with inherited thrombophilia and recurrent miscarriage might benefit from preconceptional antiagreggation with low-dose acetylsalicylic acid (ASA), but concerns about severe adverse reactions may prevent physicians from performing this treatment in patients with ASA hypersensitivity. We report the first known case of ASA desensitization in a 41-year-old woman with inherited thrombophilia, who had homozygosity (4G/4G polymorphism) of the plasminogen activator inhibitor-1 (PAI-1) gene and first trimester recurrent miscarriage, and had previously presented with anaphylaxis to ASA. Desensitization was completed despite one self-limited adverse reaction, and the patient has maintained a daily ASA intake of 100 mg with good tolerance.

A new world natural vegetation map for global change studies

We developed a new world natural vegetation map at 1 degree horizontal resolution for use in global climate models. We used the Dorman and Sellers vegetation classification with inclusion of a new biome: tropical seasonal forest, which refers to both deciduous and semi-deciduous tropical forests. SSiB biogeophysical parameters values for this new biome type are presented. Under this new vegetation classification we obtained a consensus map between two global natural vegetation maps widely used in climate studies. We found that these two maps assign different biomes in ca. 1/3 of the continental grid points. To obtain a new global natural vegetation map, non-consensus areas were filled according to regional consensus based on more than 100 regional maps available on the internet. To minimize the risk of using poor quality information, the regional maps were obtained from reliable internet sources, and the filling procedure was based on the consensus among several regional maps obtained from independent sources. The new map was designed to reproduce accurately both the large-scale distribution of the main vegetation types (as it builds on two reliable global natural vegetation maps) and the regional details (as it is based on the consensus of regional maps).

An inherited p53 mutation that contributes in a tissue-specific manner to pediatric adrenal cortical carcinoma

The incidence of pediatric adrenal cortical carcinoma (ACC) in southern Brazil is 10-15 times higher than that of pediatric ACC worldwide. Because childhood ACC is associated with Li-Fraumeni syndrome, we examined the cancer history and p53 status of 36 Brazilian patients and their families. Remarkably, 35 of 36 patients had an identical germ-line point mutation of p53 encoding an R337H amino acid substitution. Differences within intragenic polymorphic markers demonstrated that at least some mutant alleles arose independently, thus eliminating a founder effect. In tumor cells, the wild-type allele was deleted, and mutant p53 protein accumulated within the nuclei. Although these features are consistent with Li-Fraumeni syndrome-associated adrenal tumors, there was no history of increased cancer incidence among family members. Therefore, this inherited R337H p53 mutation represents a low-penetrance p53 allele that contributes in a tissue-specific manner to the development of pediatric ACC.

Adrenocortical tumors in children

Childhood adrenocortical tumors (ACT) are rare. In the USA, only about 25 new cases occur each year. In Southern Brazil, however, approximately 10 times that many cases are diagnosed each year. Most cases occur in the contiguous states of São Paulo and Paraná. The cause of this higher rate has not been identified. Familial genetic predisposition to cancer (p53 mutations) and selected genetic syndromes (Beckwith-Wiedemann syndrome) have been associated with childhood ACT in general but not with the Brazilian counterpart. Most of the affected children are young girls with classic endocrine syndromes (virilizing and/or Cushing). Levels of urinary 17-ketosteroids and plasma dehydroepiandrosterone sulfate (DHEA-S), which are abnormal in approximately 90% of the cases, provide the pivotal clue to a diagnosis of ACT. Typical imaging findings of pediatric ACT consist of a large, well-defined suprarenal tumor containing calcifications with a thin capsule and central necrosis or hemorrhage. The pathologic classification of pediatric ACT is troublesome. Even an experienced pathologist can find it difficult to differentiate carcinoma from adenoma. Surgery is the single most important procedure in the successful treatment of ACT. The role of chemotherapy in the management of childhood ACT has not been established although occasional tumors are responsive to mitotane or cisplatin-containing regimens. Because of the heterogeneity and rarity of the disease, prognostic factors have been difficult to establish in pediatric ACT. Patients with incomplete tumor resection or with metastatic disease at diagnosis have a dismal prognosis. In patients with localized and completely resected tumors, the size of the tumor has predictive value. Patients with large tumors have a much higher relapse rate than those with small tumors.

[Krabbe s disease - case report]

OBJECTIVE: Report a case of Krabbés disease with necropsy. METHODS: Review of medical and necropsy records. RESULTS: An 8 months-old male patient developed tremors, swallowing difficulty and excessive salivation for 4 months prior to admission, evolving with vomiting and fever. Physical examination showed microcephaly and diffuse pigmentation of the retinae. Neurological examination showed flexion of upper limbs with spastic hyperthony, symmetrical global hyperreflexia, nystagmus and spontaneous spasms. EEG showed multifocal irritative activity. There was increase in both CSF protein and gamaglobulin. The patient evolved with transitory hyperthermia, vomiting and pneumopathy, dying on the 23rd day after admission. Post mortem studies revealed microcephaly with widening of brain sulci. Histological examination revealed several globoid cells in the deep portion of the white matter, reactive gliosis and demyelination. CONCLUSIONS: These findings were similar to those in the world literature, indicating a poor prognosis due to substantial brain damage.

[Neurocutaneous melanosis]

OBJECTIVE: Describe the morbidity associated with a rare disease due to an embryological defect. METHODS: Retrospective revision of medical and necropsy reports. Bibliographic research using MEDLINE, LILACS and Index Medicus databases. RESULTS: 1 year-old male patient, admitted with generalized tonic-clonic seizures, evolving to deep coma and death in a few hours. Necropsy showed diffuse leptomeningeal malignant melanoma in brain stem, cerebellum, spinal cord and temporal lobe associated with a giant melanocytic nevus and satellite lesions. CONCLUSIONS: Neurocutaneous melanosis is a rare congenital syndrome characterized by the presence of large and/or multiple melanocytic nevi and pigmented tumors of the leptomeninges. It has a poor prognosis as demonstrated by the present report. It's physiopathology is believed to be due to a migration defect of the cells arising from the primitive neural crest. In these cases, an early diagnosis may improve the survival time.