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Objectives: To assess the effectiveness of four doses of the vaccine against SARS-CoV-2 in the general population and the impact of this on the severity of the disease by age group. Methods: By using data from the health authority public data base, we build statistical models using R and the GAMLSS library to explain the behavior of new SARS-CoV-2 infections, active COVID-19 cases, ICU bed requirement total and by age group, and deaths at the national level. Results: The four doses of vaccine and at least the interaction between the first and second doses were important explanatory factors for the protective effect against COVID-19. The R2 for new cases per day was 0.5644 and for occupied ICU beds the R2 is 0.9487. For occupied ICU beds for >70 years R2 is 0.9195 and with the interaction between 4 doses as the main factor. Conclusions: Although the increase in the number of vaccine doses did not adequately explain the decrease in the number of COVID-19 cases, it explained the decrease in ICU admissions and deaths nationwide and by age group.

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BACKGROUND: Tuberculosis (TB) is a disease that is influenced by social determinants of health. However, the specific structural and intermediary determinants of TB in Eastern Amazonia remain unclear. Despite being rich in natural resources, the region faces significant challenges related to poverty, inequality, and neglected diseases. The objective of this study was to use mathematical modeling to evaluate the influence of structural and intermediary determinants of health on TB in Eastern Amazonia, Brazil. METHODS: This cross-sectional included all TB cases diagnosed and registered in the Notifiable Diseases Information System (SINAN) from 2001 to 2017. Data on social determinants were collected at the census tract level. The generalized additive model for location, scale, and shape (GAMLSS) framework was employed to identify the effect of social determinants on communities with a high TB prevalence. The Double Poisson distribution (DPO) was chosen, and inclusion of quadratic effects was tested. RESULTS: A total of 1730 individuals were diagnosed with TB and reported in SINAN during the analyzed period. The majority were female (59.3%), aged 31 to 59 years (47.6%), identified as blacks (67.9%), and had incomplete elementary education (46.6%). The prevalence of alcoholism was 8.6% and mental illness was 0.7%. GAMLSS analyses demonstrated that the risk of community incidence of TB is associated with the proportion of the population lacking basic sanitation, as well as with the age groups of 16-31 years and > 61 years. CONCLUSIONS: The study highlights the strategic utility of GAMLSS in identifying high-risk areas for TB. Models should encompass a broader range of social determinants to inform policies aimed at reducing inequality and achieving the goals of the End TB strategy.

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Objectives: To assess the impact of the initial two-dose-schedule mass vaccination campaign in Chile toward reducing adverse epidemiological outcomes due to SARS-CoV-2 infection. Methods: Publicly available epidemiological data ranging from 3 February 2021 to 30 September 2021 were used to construct GAMLSS models that explain the beneficial effect of up to two doses of vaccination on the following COVID-19-related outcomes: new cases per day, daily active cases, daily occupied ICU beds and daily deaths. Results: Administered first and second vaccine doses, and the statistical interaction between the two, are strong, statistically significant predictors for COVID-19-related new cases per day (R2 = 0.847), daily active cases (R2 = 0.903), ICU hospitalizations (R2 = 0.767), and deaths (R2 = 0.827). Conclusion: Our models stress the importance of completing vaccination schedules to reduce the adverse outcomes during the pandemic. Future work will continue to assess the influence of vaccines, including booster doses, as the pandemic progresses, and new variants emerge. Policy Implications: This work highlights the importance of attaining full (two-dose) vaccination status and reinforces the notion that a second dose provides increased non-additive protection. The trends we observed may also support the inclusion of booster doses in vaccination plans. These insights could contribute to guiding other countries in their vaccination campaigns.

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The Atlantic thread herring (Opisthonema oglinum) is the most common sardine in Santa Cruz Chan-nel landings, which is located on the Northern coast of Pernambuco state, in Brazil. The species spends part of its life cycle at sea and enters estuaries at strategic times. Its high exploitation and importance to the economy in the municipalities surrounding the channel led us to reflect on the need for investi-gations to promote sustainable fishing and a better understanding of its behavior in that place. In this study, the standard length of the specimens was estimated using generalized additive models for loca-tion, scale, and shape, and the factors that drive the length pattern along the estuary were discussed. It was identified the presence of larger individuals in the rainy season and greater concentration in the Center-South region of the channel. The smaller sardines were concentrated near the outflow of the Botafogo River, an area of secondary channels with greater mangrove coverage. Few adults enter the channel and the vast majority of specimens captured were young. Thus, it would be pertinent to explore specimens that have at least reached sexual maturity, since the capture of young individuals can cause an imbalance of species sustainability.(AU)

A manjuba (Opisthonema oglinum) é a sardinha mais frequente nos desembarques do Canal de Santa Cruz, localizado no litoral norte de Pernambuco, no Brasil. A espécie vive parte de seu ciclo de vida no mar e penetra nos estuários em períodos estratégicos. Sua elevada exploração e relevância para a economia dos municípios no entorno provocaram-nos reflexões acerca da necessidade de investiga-ções que promovam a pesca sustentável e que ampliem a compreensão a respeito da manjuba naquele local. A investigação foi realizada por meio de estimativas do comprimento padrão, com a utilização de modelos aditivos generalizados para locação, escala e forma, e os fatores que impulsionam o padrão de comprimento ao longo do estuário foram discutidos. Identificou-se a presença de indivíduos maio-res no período chuvoso e maior concentração na região centro-sul do canal. Já os de menor tamanho concentraram-se próximo à desembocadura do rio Botafogo, área de canais secundários e com maior cobertura de manguezal. Poucos adultos ingressam no canal, e a grande maioria dos exemplares cap-turados era jovem. Assim, seria pertinente a exploração de exemplares que já completaram ao menos a maturidade sexual, uma vez que a captura de indivíduos jovens pode provocar desequilíbrio na sustentabilidade da espécie.(AU)

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Governments have been challenged to provide timely medical care to face the COVID-19 pandemic. Under this pandemic, the demand for pharmaceutical products has changed significantly. Some of these products are in high demand, while, for others, their demand falls sharply. These changes in the random demand patterns are connected with changes in the skewness (asymmetry) and kurtosis of their data distribution. Such changes are critical to determining optimal lots and inventory costs. The lot-size model helps to make decisions based on probabilistic demand when calculating the optimal costs of supply using two-stage stochastic programming. The objective of this study is to evaluate how the skewness and kurtosis of the distribution of demand data, collected through sensors, affect the modeling of inventories of hospital pharmacy products helpful to treat COVID-19. The use of stochastic programming allows us to obtain results under demand uncertainty that are closer to reality. We carry out a simulation study to evaluate the performance of our methodology under different demand scenarios with diverse degrees of skewness and kurtosis. A case study in the field of hospital pharmacy with sensor-related COVID-19 data is also provided. An algorithm that permits us to use sensors when submitting requests for supplying pharmaceutical products in the hospital treatment of COVID-19 is designed. We show that the coefficients of skewness and kurtosis impact the total costs of inventory that involve order, purchase, holding, and shortage. We conclude that the asymmetry and kurtosis of the demand statistical distribution do not seem to affect the first-stage lot-size decisions. However, demand patterns with high positive skewness are related to significant increases in expected inventories on hand and shortage, increasing the costs of second-stage decisions. Thus, demand distributions that are highly asymmetrical to the right and leptokurtic favor high total costs in probabilistic lot-size systems.

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The article presents some aspects related to the COVID-19 pandemic in Brazil including public health, challenges facing healthcare workers and adverse impacts on the country's economy. Its main contribution is the availability of two web applications for online monitoring of the evolution of the pandemic in Brazil and South America. The applications provide the possibility to download data in different formats, view interactive maps and graphs of the cumulative confirmed cases, deaths and lethality rates, in addition to presenting plots of moving averages for states and municipalities. The predictions about new cases and new deaths caused by COVID-19, in states and regions of Brazil, are also reported using GAMLSS models. The forecasts can be easily used by public managers for effective decision-making.

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Climate regulates the fern phenology and climatic triggers influence plants from tropical and subtropical regions differently. Ferns depend on climate to regulate their life cycle, because they do not require animal interaction to reproduce. Through the pioneering study of the phenology of Araucaria forest understory in subtropical climate of Brazil, our main aims were (i) to verify which climatic variables influenced the phenological pattern of the community, (ii) to identify the differences in seasonality of ferns in distinct climatic zones of Brazil, and (iii) to compare the phenological pattern of ferns growing in other subtropical regions of the world. In an Araucaria forest fragment, we monitored the phenology of the fern community (leaf production, leaf senescence, and sporangium formation) over 2 years. At the same time, we collected photoperiod, temperature, and precipitation data. Ferns phenology was classified as continuous, discontinuous, regular, and irregular. Our results showed photoperiod and mean temperature as the best predictors for phenology. The reproductive event was seasonal, and the fern community presented themselves as continuous, irregular (activity index), and regular (intensity index) phenophases. Unlike ferns from tropical regions that generally regulate themselves by the rainfall, some ferns in a non-seasonal environment have seasonal behavior in their phenophases due to the greater amplitude of photoperiod and temperature. The community showed the same pattern of leaf production observed in populations of other subtropical regions in the world. This behavior represented the biological response of the vegetation dynamics in relation to the climatic variability of subtropical environment.

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Data with excess zeros are frequently found in practice, and the recommended analysis is to use models that adequately address the counting of zero observations. In this study, the Zero Inflated Beta Regression Model (BeZI) was used on experimental data to describe the mean incidence of leaf citrus canker in orange groves under the influence of genotype and rootstocks of origin. Based on the model, it was possible to quantify the odds that a null observation to mean incidence comes from a particular plant according to genotype and rootstock, and estimate its expected value according to this combination. Laranja Caipira rootstock proved to be the most resistant to leaf citrus canker as well as Limão Cravo proved to be the most fragile. The Ipiguá IAC, Arapongas, EEL and Olímpia genotypes have statistically equivalent chances.(AU)

Dados com excesso de zeros são encontrados muitas vezes na prática, e a análise recomendada é utilizar modelos que suportem adequadamente a contagem de observações nulas. Neste artigo, o Modelo de Regressão Beta Inflacionado de Zeros (BeZI) foi aplicado a dados experimentais para descrever a incidência média de cancro cítrico foliar em pomares de laranja sob a influência do genótipo e do portaenxerto de origem. Com base no modelo, foi possível quantificar as chances de que uma observação nula para a incidência média seja proveniente de uma determinada planta, de acordo com o genótipo e o portaenxerto, além de estimar o seu valor esperado conforme essa combinação. O porta-enxerto Laranja Caipira mostrou ser o mais resistente ao cancro cítrico foliar, assim como o Limão Cravo mostrou ser o mais suscetível. Os genótipos Ipiguá IAC, Arapongas, EEL e Olímpia apresentaram chances estatisticamente equivalentes.(AU)

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Data with excess zeros are frequently found in practice, and the recommended analysis is to use models that adequately address the counting of zero observations. In this study, the Zero Inflated Beta Regression Model (BeZI) was used on experimental data to describe the mean incidence of leaf citrus canker in orange groves under the influence of genotype and rootstocks of origin. Based on the model, it was possible to quantify the odds that a null observation to mean incidence comes from a particular plant according to genotype and rootstock, and estimate its expected value according to this combination. Laranja Caipira rootstock proved to be the most resistant to leaf citrus canker as well as Limão Cravo proved to be the most fragile. The Ipiguá IAC, Arapongas, EEL and Olímpia genotypes have statistically equivalent chances.

Dados com excesso de zeros são encontrados muitas vezes na prática, e a análise recomendada é utilizar modelos que suportem adequadamente a contagem de observações nulas. Neste artigo, o Modelo de Regressão Beta Inflacionado de Zeros (BeZI) foi aplicado a dados experimentais para descrever a incidência média de cancro cítrico foliar em pomares de laranja sob a influência do genótipo e do porta-enxerto de origem. Com base no modelo, foi possível quantificar as chances de que uma observação nula para a incidência média seja proveniente de uma determinada planta, de acordo com o genótipo e o porta-enxerto, além de estimar o seu valor esperado conforme essa combinação. O porta-enxerto Laranja Caipira mostrou ser o mais resistente ao cancro cítrico foliar, assim como o Limão Cravo mostrou ser o mais suscetível. Os genótipos Ipiguá IAC, Arapongas, EEL e Olímpia apresentaram chances estatisticamente equivalentes.

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OBJECTIVES: Growth standards and references currently used to assess population and individual health are derived primarily from urban populations, including few individuals from indigenous or subsistence groups. Given environmental and genetic differences, growth may vary in these populations. Thus, there is a need to assess whether international standards are appropriate for all populations, and to produce population specific references if growth differs. Here we present and assess growth references for the Tsimane, an indigenous population of Bolivian forager-horticulturalists. METHODS: Mixed cross-sectional/longitudinal anthropometrics (9,614 individuals; 30,118 observations; ages 0-29 years) were used to generate centile curves and Lambda-Mu-Sigma (LMS) tables for height-for-age, weight-for-age, body mass index (BMI)-for-age, and weight-for-height (WFH) using Generalized Additive Models for Location Shape and Scale (GAMLSS). Velocity curves were generated using SuperImposition by Translation and Rotation (SITAR). Tsimane ≤5 years were compared to World Health Organization (WHO) standards while those >5 years were compared to WHO school age references. All ages were compared to published references for Shuar forager-horticulturalists of the Ecuadorian Amazon. RESULTS: Tsimane growth differs from WHO values in height and weight, but is similar for BMI and WFH. Tsimane growth is characterized by slow height velocity in childhood and early adolescent peak height velocity at 11.3 and 13.2 years for girls and boys. Tsimane growth patterns are similar to Shuar, suggesting shared features of growth among indigenous South Americans. CONCLUSIONS: International references for BMI-for-age and WFH are likely appropriate for Tsimane, but differences in height-for-age and weight-for-age suggest Tsimane specific references may be useful for these measures.

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Introducción: El uso de curvas de crecimiento para supervisar el desarrollo físico de los niños es esencial en la práctica pediátrica. Las normas cubanas de talla se elaboraron en la década de los 70 siguiendo procedimientos recomendados en ese momento. En los últimos años se han obtenido métodos estadísticos automatizados capaces de modelar correctamente el proceso del crecimiento. La OMS, en su Estudio Multicéntrico, utilizó el método Box-Cox PowerExponential (BCPE). Es importante determinar si introducir este nuevo procedimiento para construir curvas induce modificaciones en los valores de los perpercentiles que habitualmente se estiman. Objetivo: evaluar las discrepancias entre los valores de los perpercentiles estimados por ambos procedimientos. Material y Métodos: se usaron los datos de longitud en decúbito supino y estatura, de sujetos cubanos menores de 20 años medidos en el primer Estudio Nacional de Crecimiento y Desarrollo (ENCD). Se construyeron curvas usando el método BCPE implementado en el paquete GAMLSS de R. Las diferencias se evaluaron comparando los valores de los perpercentiles suavizados obtenidos por ambos métodos. Resultados: los modelos que mejor ajustaron fueron: para la longitud en decúbito supino, sexo femenino NO (GLµ=10;GLÏ­=5;edad0.001); sexo masculino NO(GLlµ=14;GLÏ­=6;edad0.006); para estatura, sexo femenino NO(GLµ=16;GLÏ­=10;edad0.544); sexo masculino NO(GLµ=16;GLÏ­=12;edad0.117). Las estimaciones de los perpercentiles de estatura fueron muy similares con ambos procedimientos. En los perpercentiles extremos de la longitud en decúbito supino se detectaron diferencias, debidas muy probablemente a correcciones introducidas en el cómputo de la desviación estándar durante el procesamiento del ENCD. Conclusiones: para la longitud en decúbito supino se detectaron diferencias, no así en la estatura. Se recomienda el uso del procedimiento automatizado pues disminuye considerablemente la carga subjetiva presente en el método anterior(AU)

Introduction: The use of growth curves to monitor physical development in children is essential for pediatric health care. Cuban height charts were created during the seventies decade following technics recommended at that time. In the last years, statistical methods based computational technics have been obtained a better model pattern for growth process. In particular WHO in the Multicenter Growth Study used the Box-Cox Power Exponential (BCPE) method. It is important to determine whether the application of such procedure in drawing curves introduce changes in the percentiles' estimates commonly used. Objective: To evaluate discrepancies between percentiles' estimates from both methods. Material and methods: supine-decubitus length data and height from Cubans under 20 years old from the first National Growth and Development Study (ENCD) were examined. Perpercentiles were estimated viEl método BCPE a the BCPE method implemented in GAMLSS' package supported in R language. Comparison of smoothed percentiles obtained from both procedures were plotted to evaluate discrepancies. Results: The best fitted models were: for female supine-decubitus lengths the NO (DFµ=10;DFÏ­=5;age0.001) and NO(DFµ=14;DFÏ­=6;age0.006) for male respectively and NO(DFµ=16;DFÏ­=10;age0.544) and NO(DFµ=16;DFÏ­=12;age0.117) for female and male height. Height percentiles estimates were closely enough using either method. Some differences were detected for length percentiles, possibly due to computational corrections done while calculating standard deviations of ENCD. Conclusions: Some differences were detected for length percentiles estimations but not for the height. The use of computational procedure is recommended because its considerable reduction of the subjective charge as compare with the method used before(AU)

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La construcción de curvas de crecimiento para dimensiones antropométricas es un proceso engorroso que hasta ahora, en el país, se ha realizado manualmente. Con el objetivo de automatizar este proceso se realizó una actualización del estado del arte de métodos para ajuste de curvas de crecimiento basados en programas de computación. Se presenta una experiencia realizada con datos de circunferencia de cintura de varones entre 8 y 19 años de edad, residentes en Ciudad de La Habana en el año 1998, donde se aplicaron los métodos adoptados por la Organización Mundial de la Salud (OMS) para la elaboración de patrones internacionales de crecimiento. El soporte computacional de dichos métodos se basa en el paquete GAMLSS del proyecto R, software de código abierto y completamente libre(AU)

Child growth curves construction is a tiresome and time consuming process that has been done manually till now in our country. A review of methods for adjusting growth curve was carried out in order to automate this process. Techniques and procedures adopted by the World Health Organization (WHO) for the construction of child growth standards were applied to adjust waist circumference curve for boys from 8 to 19 years old. The methods recommended by WHO rest in the use of the computational package GAMLSS, which was developed in R, free and open source software for statistical computing(AU)

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