Socioeconomic dimensions,migration, and deforestation: An integrated model of territorial organization for the Brazilian Amazon

The territory organization of the Brazilian Amazon, understood as a socioeconomic network of municipalities, reflects the diversity of human settlements and their potentials for environmental changes, especially deforestation. This paper characterizes the urban network in the Brazilian Amazon through a model that integrates the levels of socioeconomic organization of municipalities and their interrelationships, as determined through migratory movements. The model of territorial organization combines five components: (i) the hierarchy of central places (poles) established by the concentration of urban specialized services, (ii) the geographical distance between central poles and other centers, (iii) the poles’ populations, (iv) the migratory movements among them, and (v) a socioeconomic dimension index. These components are combined into a gravitational model to produce measures and maps of the socioeconomic municipality network of the Brazilian Amazon. As a result, out of 792 municipalities in the Brazilian Amazon, 9 were classified as macro-poles, 29 were classified as meso-poles and 48 as micro-poles. The areas of influence of these poles were determined according to the three hierarchy levels. The Amazon region network comprises a nested spatial pattern of municipalities not constrained by the state boundaries. Socioeconomic space and population movements influence the mobility of the deforestation frontier. This analysis provides insights to predict deforestation as well as to guide formulation of sustainable development policies suitable for each region's specificity.     

Mobile Money,Smallholder Farmers,and Household Welfare in Kenya

The use of mobile phones has increased rapidly in many developing countries, including in rural areas. Besides reducing the costs of communication and improving access to information, mobile phones are an enabling technology for other innovations. One important example are mobile phone based money transfers, which could be very relevant for the rural poor, who are often underserved by the formal banking system. We analyze impacts of mobile money technology on the welfare of smallholder farm households in Kenya. Using panel survey data and regression models we show that mobile money use has a positive impact on household income. One important pathway is through remittances received from relatives and friends. Such remittances contribute to income directly, but they also help to reduce risk and liquidity constraints, thus promoting agricultural commercialization. Mobile money users apply more purchased farm inputs, market a larger proportion of their output, and have higher profits than non-users of this technology. These results suggest that mobile money can help to overcome some of the important smallholder market access constraints that obstruct rural development and poverty reduction.     

Life Cycle Assessment of ICT

The use of information and communication technology (ICT) is growing throughout society, and new products and solutions are developed at an increasing rate. To enable environmental assessment of specific ICT products and other products that rely on ICT in some way, a more complete, detailed, and up‐to‐date study based on real measurements is needed. To date, similar studies have not been readily available or fully comprehensive. This study assessed the overall operational electricity use and life‐cycle–based carbon footprint (CF) relating to ICT in Sweden, including activities not commonly addressed previously, such as shared data transport networks and data centers and manufacturing of network infrastructure. Specific, detailed inventory data are presented and used for assessment of the Internet Protocol core network, data transmission, operator activities, and access network. These specific data, in combination with secondary, more generic data for end‐user equipment, allow a comprehensive overall assessment. The majority of the ICT network CF is the result of end‐user equipment, mainly personal computers, followed by third‐party enterprise networks and data centers and then access networks. The parts closest to the user proved to be clearly responsible for the majority of the impact. The results are presented for Swedish ICT networks and for ICT networks in general based on a global average electricity mix.     

Land Use Patterns in the Brazilian Amazon: Comparative Farm-Level Evidence from Rondônia

Since the 1970s the Brazilian Amazon has received over 1 million migrant farm households from other regions of the country, many of whom were attracted to government-sponsored frontier settlement programs that offered free tropical forest land. As a result, pressures on tropical forests have intensified along several settlement corridors throughout the region. Despite their importance as agents of landscape change, surprisingly little is known about the land use practices of these farmers. This paper briefly reviews the research literature on smallholder land use patterns in Amazonia, describes the recent history of one important agricultural land settlement program in the western Brazilian Amazon state of Rondônia, and, based on 240 household surveys conducted in three separate settlement locations in the state, highlights key differences in land use patterns among the rural population. Typologies of farming systems are presented on the basis of cluster analysis of land use data and ANOVA tests. The findings indicate considerable complexity and heterogeneity in smallholder farming systems. Spatial variations in farming system types may be due to geographic differences in soil regimes, the social histories of specific communities, and site-specific responses to exogenous variables.     

A painful journey to antivenom: The therapeutic itinerary of snakebite patients in the Brazilian Amazon (The QUALISnake Study)

Access to antivenoms is not guarranteed for vulnerable populations that inhabit remote areas in the Amazon. The study of therapeutic itineraries (TI) for treatment of snakebites would support strategies to provide timely access to users. A TI is the set of processes by which individuals adhere to certain forms of treatment, and includes the path traveled in the search for healthcare, and practices to solve their health problems. This study aims to describe TIs of snakebite patients in the Brazilian Amazon. This study was carried out at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, in Manaus, state of Amazonas, Brazil. The itinerary from the moment of the bite to the patient’s admission to the reference unit was analyzed. Sample size was defined by saturation. After an exploratory survey to collect epidemiological variables, in-depth interviews were conducted following a semi-structured guide. Patients originated from rural areas of 11 different municipalities, including ones located >500 kilometers from Manaus. A great fragmentation was observed in the itineraries, marked by several changes of means of transport along the route. Four themes emerged from the analysis: exposure to snakebite during day-to-day activities, use of traditional therapeutic practices, and personal perception of the severity, as well as the route taken and its contingencies. Access to healthcare requires considerable effort on the part of snakebite patients. Major barriers were identified, such as the low number of hospitals that offer antivenom treatment, poor access to healthcare due to long distances and geographic barriers, low acceptability of healthcare offered in countryside, lack of use of personal protective equipment, common use of ineffective or deleterious self-care practices, late recognition of serious clinical signs and resistance to seeking medical assistance. Health education, promotion of immediate transport to health centers and decentralization of antivenom from reference hospitals to community healthcare centers in the Brazilian Amazon are more effective strategies that would to maximize access to antivenom treatment.     

Trypanosoma cruzi IV Causing Outbreaks of Acute Chagas Disease and Infections by Different Haplotypes in the Western Brazilian Amazonia

Background

Chagas disease is an emergent tropical disease in the Brazilian Amazon Region, with an increasing number of cases in recent decades. In this region, the sylvatic cycle of Trypanosoma cruzi transmission, which constitutes a reservoir of parasites that might be associated with specific molecular, epidemiological and clinical traits, has been little explored. The objective of this work is to genetically characterize stocks of T. cruzi from human cases, triatomines and reservoir mammals in the State of Amazonas, in the Western Brazilian Amazon.

Methodology/Principal Findings

We analyzed 96 T. cruzi samples from four municipalities in distant locations of the State of Amazonas. Molecular characterization of isolated parasites from cultures in LIT medium or directly from vectors or whole human blood was performed by PCR of the non-transcribed spacer of the mini-exon and of the 24 S alfa ribosomal RNA gene, RFLP and sequencing of the mitochondrial cytochrome c oxidase subunit II (COII) gene, and by sequencing of the glucose-phosphate isomerase gene. The T. cruzi parasites from two outbreaks of acute disease were all typed as TcIV. One of the outbreaks was triggered by several haplotypes of the same DTU. TcIV also occurred in isolated cases and in Rhodnius robustus. Incongruence between mitochondrial and nuclear phylogenies is likely to be indicative of historical genetic exchange events resulting in mitochondrial introgression between TcIII and TcIV DTUs from Western Brazilian Amazon. TcI predominated among triatomines and was the unique DTU infecting marsupials.

Conclusion/Significance

DTU TcIV, rarely associated with human Chagas disease in other areas of the Amazon basin, is the major strain responsible for the human infections in the Western Brazilian Amazon, occurring in outbreaks as single or mixed infections by different haplotypes.     

Real-life quantitative G6PD screening in Plasmodium vivax patients in the Brazilian Amazon: A cost-effectiveness analysis

BackgroundAs quantitative glucose 6-phosphate dehydrogenase deficiency (G6PDd) screening tools are evaluated in operational studies, questions remain as to whether they are cost-effective. Here, a cost-effectiveness analysis (CEA) was performed to estimate the Incremental Cost-effectiveness Ratio (ICER) of the introduction of quantitative screening test to detect G6PDd among P. vivax carriers in two municipalities in the Brazilian Amazon.Methodology/Principal findingsThis cost-effectiveness analysis evaluated the use of the Standard G6PD quantitative screening test in vivax malaria treatment units in two municipalities of the Brazilian Amazon. Using the perspective of the Brazilian public health system, the analysis was performed for the outcome ‘PQ-associated hospitalization avoided’, based on a decision tree model. The results indicated that the G6PDd screening strategy compared with the routine strategy was highly cost-effective, with an ICER of US$495 per additional hospitalization avoided, which represented less than 8% of one Brazilian gross domestic product per capita (US$6,822). The uncertainties evaluated in the sensitivity analysis did not significantly affect the ICER identified in the base-case.Conclusions/SignificanceThis cost-effectiveness analysis showed the quantitative G6PD testing was effective in avoiding PQ-associated hospitalizations. The incorporation of G6PD screening is of paramount importance towards P. vivax malaria elimination in the Amazon to promote the safe use of primaquine and tafenoquine.     

Chagas disease: from bush to huts and houses. Is it the case of the Brazilian Amazon?

Two of the major problems facing the Amazon - human migration from the other areas and uncontrolled deforestation - constitute the greatest risk for the establishment of endemic Chagas disease in this part of Brazil. At least 18 species of triatomines had been found in the Brazilian Amazon, 10 of them infected with Trypanosoma cruzi, associated with numerous wild reservoirs. With wide-range deforestation, wild animals will perforce be driven into other areas, with tendency for triatomines to become adapted to alternative food sources in peri and intradomicilies. Serological surveys and cross-sectional studies for Chagas disease, carried out in rural areas of the Rio Negro, in the Brazilian Amazon, showed a high level of seropositivity for T. cruzi antibodies. A strong correlation of seroreactivity with the contact of gatherers of pia?ava fibers with wild triatomines could be evidenced.     

Electricity Intensity of Internet Data Transmission: Untangling the Estimates

In order to understand the electricity use of Internet services, it is important to have accurate estimates for the average electricity intensity of transmitting data through the Internet (measured as kilowatt‐hours per gigabyte [kWh/GB]). This study identifies representative estimates for the average electricity intensity of fixed‐line Internet transmission networks over time and suggests criteria for making accurate estimates in the future. Differences in system boundary, assumptions used, and year to which the data apply significantly affect such estimates. Surprisingly, methodology used is not a major source of error, as has been suggested in the past. This article derives criteria to identify accurate estimates over time and provides a new estimate of 0.06 kWh/GB for 2015. By retroactively applying our criteria to existing studies, we were able to determine that the electricity intensity of data transmission (core and fixed‐line access networks) has decreased by half approximately every 2 years since 2000 (for developed countries), a rate of change comparable to that found in the efficiency of computing more generally.     

Frequency of the HFE C282Y and H63D polymorphisms in Brazilian malaria patients and blood donors from the Amazon region

Malaria is an endemic parasitosis and its causitive agent, Plasmodium, has a metabolism linked to iron supply. HFE is a gene with the polymorphisms C282Y and H63D, which are associated with a progressive iron accumulation in the organism leading to a disease called hereditary hemochromatosis. The aim of the present study was to determine the allelic and genotypic frequencies of the HFE gene polymorphisms in malaria patients and blood donors from the Brazilian Amazon region. We screened 400 blood donors and 400 malaria patients for the HFE C282Y and H63D polymorphisms from four states of the Brazilian Amazon region by polymerase chain reaction and restriction fragment length polymorphism analysis. We did not find any C282Y homozygous individuals, and the only five heterozygous individuals detected were from Pará State. The most frequent genotype in the North region of Brazil was the H63D heterozygote, in both study groups. Our results contribute to the concept that the Brazilian Amazon region should not be regarded as a single entity in South America. These polymorphisms did not influence the symptoms of malaria in the population studied, as neither severe signs nor high parasitemia were observed. Therefore, different hereditary hemochromatosis diagnostic and control measures must be developed and applied within its diverse locations. Investigations are currently being carried out in our laboratory in order to determine the importance of the coexistence of hereditary hemochromatosis in patients affected by parasitic diseases, such as malaria.     

Genetic Diversity and Natural Population Structure of Cacao (Theobroma cacao L.) from the Brazilian Amazon Evaluated by Microsatellite Markers

A sample of 94 accessions of Theobroma cacao L. (cacao), representing four populations from the Brazilian Amazon (Acre, Rondônia, lower Amazon and upper Amazon) were analyzed using microsatellite markers to assess the genetic diversity and the natural population structure. From the 19 microsatellite loci tested, 11 amplified scorable products, revealing a total of 49 alleles, including two monomorphic loci. The Brazilian upper Amazon population contained the largest genetic diversity, with the most polymorphic loci, the highest observed heterozygosity; and the majority of rare alleles, thereby this region might be considered part of the center of diversity of the species. The observed heterozygosity for all the Brazilian populations (H _o = 0.347) was comparable with values reported for other similar upper Amazon Forastero cacao populations, with the Acre and Rondônia displaying the lowest values. The lower Amazon population, traditionally defined as highly homozygous, presented an unexpectedly high observed heterozygosity (H _o = 0.372), disclosing rare and distinct alleles, with large identity with the upper Amazon population. It was hypothesized that part of the lower Amazon population might derive from successive natural or intentional introduction of planting material from other provenances, mainly upper Amazon. Most of the loci exhibited a lower observed heterozygosity than expected, suggesting that self-pollination might be more common than usually assumed in cacao, but excess of homozygotes might also derive from sub-grouping (Wahlund effect) or from sampling related individuals. Most of the gene diversity was found to occur within groups, with small differentiation between the four Brazilian Amazon populations, typical of species with high gene flow.     

Local environmental risk assessment of anticancer drugs in a developing country

Abstract

Anticancer drugs used in cancer treatment are excreted unchanged or as metabolites by feces and urine in hospitals and households. These drugs enter the municipal sewage system but wastewater treatment plants are not capable of removing all of these micro pollutants. In many countries such as Brazil, sanitation departments do not provide service, nor have access to all of the population, therefore most sewage is still released into untreated receiving bodies. This study analyzes the consumption of anticancer drugs in a Brazilian hospital located in one of the 10 municipalities with the best sanitation index in the country. It estimates its environmental risk in aquatic matrixes by the European Guideline on the Environmental Risk Assessment of Medicinal Products for Human Use. Among the 20 drugs analyzed, the three most consumed (cyclophosphamide, 5-fluoruracil, and cytarabine) show a predicted environmental concentration value greater than the action limit of 0.01?µg/L recommended by the guideline. The risk assessment was performed on all pharmaceuticals consumed to get a greater awareness of risk. Results do not indicate local environmental risk but, considering that the study was performed under the best sanitation scenario, it cannot be extrapolated in the other municipalities. The study highlights that development of suitable methodologies should be considered to perform environmental risk assessment of pharmaceuticals in developing countries sanitation conditions.     

Snakebites in “Invisible Populations”: A cross-sectional survey in riverine populations in the remote western Brazilian Amazon

In the Brazilian Amazon, long distances, low healthcare coverage, common use of ineffective or deleterious self-care practices, and resistance to seeking medical assistance have an impact on access to antivenom treatment. This study aimed to estimate snakebite underreporting, and analyze barriers that prevent victims from obtaining healthcare in communities located in 15 municipalities on the banks of the Solimões, Juruá and Purus Rivers, in the remote Western Brazilian Amazon. Information on the participants’ demographics, previous snakebites, access to healthcare, time taken to reach medical assistance, use of self-care practices, and the reason for not accessing healthcare were collected through semi-structured interviews. In the case of deaths, information was collected by interviewing parents, relatives or acquaintances. A total of 172 participants who reported having suffered snakebites during their lifetime were interviewed. A total of 73 different treatment procedures was reported by 65.1% of the participants. Participants living in different river basins share few self-care procedures that use traditional medicine, and 91 (52.9%) participants reported that they had access to healthcare. Living in communities along the Juruá River [OR = 12.6 (95% CI = 3.2–49.7; p<0.001)] and the use of traditional medicine [OR = 11.6 (95% CI = 3.4–39.8; p<0.001)] were variables that were independently associated to the lack of access to healthcare. The main reasons for not accessing healthcare were the pprioritization of traditional treatments (70.4%), and the failure to recognize the situation as being potentially severe (50.6%). Four deaths from complications arising from the snakebite were reported, and three of these were from communities on the banks of the Juruá River. Only one of these received medical assistance. We found an unexpectedly high underreporting of snakebite cases and associated deaths. Snakebite victims utilized three main different healing systems: 1) self-care using miscellaneous techniques; 2) official medical healthcare generally combined with traditional practices; and 3) self-care using traditional practices combined with Western medicines. To mitigate snakebite burden in the Brazilian Amazon, an innovative intervention that would optimize timely delivery of care, including antivenom distribution among existing community healthcare centers, is needed.     

Protect children from EMF

Abstract

The twenty-first century is marked with aggressive development of the wireless communications (satellite, mobile phones, Internet, Wi-Fi). In addition to thousand of satellites that deliver radio and TV signals, large satellite and base station networks secure intensive instant delivery of audio and video information. It is fair to say that that the entire civilization, both biosphere and mankind are exposed to continuous exposure of multitude of radiofrequency (RF) signals. It should be taken into account that the entire world population is exposed to exponentially increasing RF radiation from base stations and satellite antennas. While several years ago the potential hazard was connected with placement of mobile phones close to human head, today “smart phones” represent small, but powerful computers continuously receiving audio and video data. The largest group of users is the children and teenagers who “need” to communicate nearly 24?h a day. This is even more important because cell phones and tablets may be seen in the hands of children as little as two years in age. There is no way to assess and predict the potential damages of children brain, vision and hearing under exposure to RF radiation. The WHO precautionary principle and IARC classification must be applied in discussing the potential hazard of the use of today’s and tomorrow’s communication devices.     

Testing the effectiveness of small radiation shields for mobile phones

Nine small radiation shields made to adhere to the case of mobile phones were tested at 914 and 1880 MHz. Five popular products were tested because advertisements typically claim they are up to 99% effective in blocking radio frequency (RF) radiation emitted from mobile phones. Also, four other conceptually unusual products were tested because advertisements typically claim they emit oscillations that counteract the RF radiation from mobile phones. Each shield was tested on the same mobile phone, and measurements were made to compare the absorption of RF energy in the head with and without each shield attached to the phone. The phone was positioned against a head model, and an automated measurement process was used to determine specific absorption rate (SAR) in the same way it is used at Motorola to test the compliance of mobile phones with respect to human exposure limits. The location of the peak SAR was not observed to change with any of the shields attached to the phone, and the 1 g, peak spatial average SAR did not change by any statistically significant amount. These results indicate the small shields are ineffective in reducing the exposure of the head to RF energy emitted by a mobile phone.     

Historical Shifts in Brazilian P. falciparum Population Structure and Drug Resistance Alleles

Previous work suggests that Brazilian Plasmodium falciparum has limited genetic diversity and a history of bottlenecks, multiple reintroductions due to human migration, and clonal expansions. We hypothesized that Brazilian P. falciparum would exhibit clonal structure. We examined isolates collected across two decades from Amapá, Rondônia, and Pará state (n = 190). By examining more microsatellites markers on more chromosomes than previous studies, we hoped to define the extent of low diversity, linkage disequilibrium, bottlenecks, population structure, and parasite migration within Brazil. We used retrospective genotyping of samples from the 1980s and 1990s to explore the population genetics of SP resistant dhfr and dhps alleles. We tested an existing hypothesis that the triple mutant dhfr mutations 50R/51I/108N and 51I/108N/164L developed in southern Amazon from a single origin of common or similar parasites. We found that Brazilian P. falciparum had limited genetic diversity and isolation by distance was rejected, which suggests it underwent bottlenecks followed by migration between sites. Unlike Peru, there appeared to be gene flow across the Brazilian Amazon basin. We were unable to divide parasite populations by clonal lineages and pairwise FST were common. Most parasite diversity was found within sites in the Brazilian Amazon, according to AMOVA. Our results challenge the hypothesis that triple mutant alleles arose from a single lineage in the Southern Amazon. SP resistance, at both the double and triple mutant stages, developed twice and potentially in different regions of the Brazilian Amazon. We would have required samples from before the 1980s to describe how SP resistance spread across the basin or describe the complex internal migration of Brazilian parasites after the colonization efforts of past decades. The Brazilian Amazon basin may have sufficient internal migration for drug resistance reported in any particular region to rapidly spread to other parts of basin under similar drug pressure.     

BioWAP, mobile Internet service for bioinformatics

We have developed a new Internet service, which provides mobile access to bioinformatics databases and software tools. The BioWAP service facilitates access to basic bioinformatics databases and analysis tools from everywhere without a PC or a laptop computer. Both open source bioinformatics program suites and Internet services, which are not designed for mobile Internet access, were utilized in the BioWAP service. AVAILABILITY: The BioWAP service starting page can be browsed with any WAP terminal from http://bioinf.uta.fi/wml/welcome.wml.     

Science out of the classroom

A recent survey estimates that 65% of secondary-age school children (11–16 years) in the UK have access tothe Internet at home.Most pupils are, therefore, already learning through information and communicationtechnology (ICT). Butthere are still questions about how ICT is being used for teaching science in schoolswithin the UK.     

Surveillance,health promotion and control of Chagas disease in the Amazon Region - Medical attention in the Brazilian Amazon Region: a proposal

We refer to Oswaldo Cruz''s reports dating from 1913 about the necessities of a healthcare system for the Brazilian Amazon Region and about the journey of Carlos Chagas to 27 locations in this region and the measures that would need to be adopted. We discuss the risks of endemicity of Chagas disease in the Amazon Region. We recommend that epidemiological surveillance of Chagas disease in the Brazilian Amazon Region and Pan-Amazon region should be implemented through continuous monitoring of the human population that lives in the area, their housing, the environment and the presence of triatomines. The monitoring should be performed with periodic seroepidemiological surveys, semi-annual visits to homes by health agents and the training of malaria microscopists and healthcare technicians to identify Trypanosoma cruzi from patients'' samples and T. cruzi infection rates among the triatomines caught. We recommend health promotion and control of Chagas disease through public health policies, especially through sanitary education regarding the risk factors for Chagas disease. Finally, we propose a healthcare system through base hospitals, intermediate-level units in the areas of the Brazilian Amazon Region and air transportation, considering the distances to be covered for medical care.