A mudança do clima representa séria ameaça para a população humana, causando impactos em diferentes setores. Conhecer os fatores que elevam a vulnerabilidade do ser humano à mudança do clima permite identificar pontos críticos e direcionar ações imediatas para reduzi-la. Assim, este estudo desenvolveu e aplicou um índice de vulnerabilidade à mudança do clima para as microrregiões do Espírito Santo, abarcando os elementos fundamentais da vulnerabilidade - exposição, sensibilidade e capacidade adaptativa. Anomalias climáticas de precipitação e temperatura também foram usadas para estimar as alterações para o futuro. A construção dos indicadores se baseou na atribuição de notas indicativas de vulnerabilidade para cada grupo de municípios (clustering), com posterior média aritmética e padronização dos valores para gerar índices variando entre 0 e 1. Verificou-se que a microrregião Noroeste apresenta vulnerabilidade extremamente elevada, em virtude de características, sociodemográficas, econômicas e ambientais. Todo o estado poderá ser afetado por alterações do clima futuro, principalmente pelo aumento de temperaturas médias. O norte do estado poderá ter aumento no número de dias secos consecutivos. Espera-se que esses resultados contribuam para orientar ações de adaptação à mudança do clima e aumentar a resiliência do território a partir da identificação das vulnerabilidades existentes.

Wound healing is important for skin after deep injuries or burns, which can lead to hospitalization, long-term morbidity, and mortality. In this field, tissue-engineered skin substitutes have therapy potential to assist in the treatment of acute and chronic skin wounds, where many requirements are still unmet. Hence, in this study, a novel type of biocompatible ternary polymer hybrid hydrogel scaffold was designed and produced through an entirely eco-friendly aqueous process composed of carboxymethyl cellulose, chitosan, and polyvinyl alcohol and chemically cross-linked by citric acid, forming three-dimensional (3D) matrices, which were biofunctionalized with L-arginine (L-Arg) to enhance cellular adhesion. They were applied as bilayer skin biomimetic substitutes based on human-derived cell cultures of fibroblasts and keratinocytes were seeded and grown into their 3D porous structures, producing cell-based bio-responsive hybrid hydrogel scaffolds to assist the wound healing process. The results demonstrated that hydrophilic hybrid cross-linked networks were formed via esterification reactions with the 3D porous microarchitecture promoted by foam templating and freeze-drying. These hybrids presented chemical stability, physicochemical properties, high moisture adsorption capacity, surface properties, and a highly interconnected 3D porous structure well suited for use as a skin substitute in wound healing. Additionally, the surface biofunctionalization of these 3D hydrogel scaffolds with L-arginine through amide bonds had significantly enhanced cellular attachment and proliferation of fibroblast and keratinocyte cultures. Hence, the in vivo results using Hairless mouse models (an immunocompromised strain) confirmed that these responsive bio-hybrid hydrogel scaffolds possess hemocompatibility, bioadhesion, biocompatibility, adhesiveness, biodegradability, and non-inflammatory behavior and are capable of assisting the skin wound healing process.

Health determinants might play an important role in shaping the impacts related to long-term disasters such as droughts. Understanding their distribution in populated dry regions may help to map vulnerabilities and set coping strategies for current and future threats to human health. The aim of the study was to identify the most vulnerable municipalities of the Brazilian semiarid region when it comes to the relationship between drought, health, and their determinants using a multidimensional index. From a place-based framework, epidemiological, socio-economic, rural, and health infrastructure data were obtained for 1135 municipalities in the Brazilian semiarid region. An exploratory factor analysis was used to reduce 32 variables to four independent factors and compute a Health Vulnerability Index. The health vulnerability was modulated by social determinants, rural characteristics, and access to water in this semiarid region. There was a clear distinction between municipalities with the highest human welfare and economic development and those municipalities with the worst living conditions and health status. Spatial patterns showed a cluster of the most vulnerable municipalities in the western, eastern, and northeastern portions of the semiarid region. The spatial visualization of the associated vulnerabilities supports decision making on health promotion policies that should focus on reducing social inequality. In addition, policymakers are presented with a simple tool to identify populations or areas with the worst socioeconomic and health conditions, which can facilitate the targeting of actions and resources on a more equitable basis. Further, the results contribute to the understanding of social determinants that may be related to medium- and long-term health outcomes in the region.