Climate migration: what the research shows is very different from the alarmist headlines

Predictions of mass climate migration make for attention-grabbing headlines. For more than two decades, commentators have predicted "waves" and "rising tides" of people forced to move by climate change. Recently, a think-tank report warned the climate crisis could displace 1.2 billion people by 2050. Some commentators now even argue that, as the New York Times noted in a recent headline "The Great Climate Migration Has Begun", and that the climate refugees we've been warned about are, in fact, already here. These alarming statements are often well-intentioned. Their aim is to raise awareness of the plight of people vulnerable to climate change and motivate humanitarian action on their behalf. But such headlines aren't always accurate - and rarely achieve their intended effect. Our main concern is that alarming headlines about mass climate migrations risk leading to more walls, not fewer. Indeed, many on the right and far right are now setting aside their climate denialism and linking climate action to ideas of territory and ethnic purity. In this context of growing climate nationalism, even the most well-intentioned narratives risk feeding fear-based stories of invasion when they present climate migration as unprecedented and massive, urgent and destabilising. The risk is only made worse when headlines point to racialised populations from the global south as on their way to the European Union, the US or Australia: places already in the grips of moral panics about migration

Gestión por procesos para mejorar la calidad de atención en pacientes de consulta externa del Hospital San Ignacio, Casma-2022

La presente investigación tuvo como objetivo aplicar la gestión por procesos para mejorar la calidad de atención en pacientes de consulta externa del HASIC. El estudio fue de tipo aplicado y tuvo un diseño pre-experimental. La población fue conformada por los procesos del área de consulta externa, mientras que la muestra estuvo representaba por el proceso de atención de medicina general. Se determinó que las principales causas que estaban afectando la calidad de atención en los pacientes; fue los tiempos de espera en admisión de entrega de tickets y en la atención del personal médico, el nivel de calidad inicial de atención era bajo, se encontró una confiabilidad inicial de 77%, una capacidad de respuesta de 73% y una satisfacción baja de 67.54%, al implementarse la gestión por procesos se redujo y optimizo los procesos de la especialidad de medicina general ;de esta manera se logró a dar solución a la problemática presentada; después de la aplicación que se logró incrementar la confiabilidad en 20%, la capacidad de respuesta en 24% y la satisfacción en el nivel alto de 40.26%.Concluyendo que la implementación de la gestión por procesos mejoró la calidad de atención en pacientes de consulta externa del HASIC

Increased oxidative stress and severe arterial remodeling induced by permanent high-flow challenge in experimental pulmonary hypertension

<p>Abstract</p> <p>Background</p> <p>Involvement of inflammation in pulmonary hypertension (PH) has previously been demonstrated and recently, immune-modulating dendritic cells (DCs) infiltrating arterial lesions in patients suffering from idiopathic pulmonary arterial hypertension (IPAH) and in experimental monocrotaline-induced PH have been reported. Occurrence of perivascular inflammatory cells could be linked to local increase of oxidative stress (OS), as it has been shown for systemic atherosclerosis. The impact of OS on vascular remodeling in PH is still to be determined. We hypothesized, that augmented blood-flow could increase OS and might thereby contribute to DC/inflammatory cell-recruitment and smooth-muscle-cell-proliferation.</p> <p>Methods</p> <p>We applied a monocrotaline-induced PH-model and combined it with permanent flow-challenge. Thirty Sprague-Dawley rats were assigned to following groups: control, monocrotaline-exposure (MCT), monocrotaline-exposure/pneumonectomy (MCT/PE).</p> <p>Results</p> <p>Hemodynamic exploration demonstrated most severe effects in MCT/PE, corresponding in histology to exuberant medial and adventitial remodeling of pulmonary muscular arteries, and intimal remodeling of smaller arterioles; lung-tissue PCR evidenced increased expression of DCs-specific fascin, CD68, proinflammatory cytokines (IL-6, RANTES, fractalkine) in MCT/PE and to a lesser extent in MCT. Major OS enzyme NOX-4 was maximal in MCT/PE. Antioxidative stress enzymes Mn-SOD and glutathion-peroxidase-1 were significantly elevated, while HO-1 showed maximal expression in MCT with significant decrease in MCT/PE. Catalase was decreased in MCT and MCT/PE. Expression of NOX-4, but also of MN-SOD in MCT/PE was mainly attributed to a highly increased number of interstitial and perivascular CXCR4/SDF1 pathway-recruited mast-cells. Stress markers malonedialdehyde and nitrotyrosine were produced in endothelial cells, medial smooth muscle and perivascular leucocytes of hypertensive vasculature. Immunolabeling for OX62, CD68 and actin revealed adventitial and medial DC- and monocyte-infiltration; in MCT/PE, medial smooth muscle cells were admixed with CD68⁺/vimentin⁺cells.</p> <p>Conclusion</p> <p>Our experimental findings support a new concept of immunologic responses to increased OS in MCT/PE-induced PAH, possibly linking recruitment of dendritic cells and OS-producing mast-cells to characteristic vasculopathy.</p

Emerging diseases of wildlife in Europe : Lessons to draw to prevent a resurgence of avian influenza

The incursion of Highly Pathogenic Avian Influenza among wildfowl in Europe in 2006 was a new illustration of the health risk presented by wildlife to humans and domestic animals. To help anticipate similar incursions and avoid the pitfalls of poor communication, this paper describes how this risk was analysed and managed in the past for other wildlife diseases in Europe. The author also proposes a general methodology to anticipate such events.La contamination de l'avifaune sauvage en Europe, en 2006, par des foyers d'Influenza Aviaire Hautement Pathogène (IAHP) a été une nouvelle illustration du risque sanitaire que représente la faune sauvage pour l'homme ou les animaux domestiques. Afin de mieux anticiper des incursions similaires et éviter les dérives liées à une communication mal conduite, cet article décrit la façon dont le risque a été étudié et géré dans le passé pour d'autres maladies de la faune sauvage en Europe. L'auteur propose aussi une méthodologie générale pour anticiper de tels événements

An?lisis legal y propuesta de mejora del sistema de prevenci?n regulado por la ley 30424

La corrupci?n a nivel mundial est? en crecimiento y organismos internacionales han tomado las medidas necesarias para que los pa?ses que la integran, promulguen normas internas para combatirla. El Per?, no es ajeno a estos cambios normativos y el pertenecer a la OCDE, es su principal motivaci?n; es por ello que en el 2016, promulga Ley N? 30424, cuyo objeto principal, es penalizar a las personas jur?dicas inmersas en delitos de cohecho, lavado de activos, financiamiento al terrorismo, colusi?n y tr?fico de influencias. La norma, prev? un modelo de prevenci?n que, si se implementa y aplica, correctamente, puede exonerar de responsabilidad a la compa??a. Al ser la primera norma en el Per?, que regula un compliance, contiene algunos errores e imprecisiones, que puede generar consecuencias legales y econ?micas, en las empresas. La normativa debe ser analizada para verificar si podr? ser aplicada en los diferentes tipos de empresas, adem?s de identificar si es factible cambios en ella, para que, con estos sea una norma de factible aplicaci?n

Effective use of mesenchymal stem cells in human skin substitutes generated by tissue engineering

Mesenchymal stem cells (MSCs) can differentiate toward epithelial cells and may be used as an alternative source for generation of heterotypical artificial human skin substitutes, thus, enhancing their development and translation potential to the clinic. The present study aimed at comparing four types of heterotypical human bioengineered skin generated using MSCs as an alternative epithelial cell source. Adipose-tissue-derived stem cells (ADSCs), dental pulp stem cells (DPSCs), Wharton’s jelly stem cells (WJSCs) and bone marrow stem cells (BMSCs) were used for epidermal regeneration on top of dermal skin substitutes. Heterotypic human skin substitutes were evaluated before and after implantation in immune-deficient athymic mice for 30 d. Histological and genetic studies were performed to evaluate extracellular matrix synthesis, epidermal differentiation and human leukocyte antigen (HLA) molecule expression. The four cell types differentiated into keratinocytes, as shown by the expression of cytokeratin 10 and filaggrin 30 d post-grafting; also, they induced dermal fibroblasts responsible for the synthesis of extracellular fibrillar and non-fibrillar components, in a similar way among each other. WJSCs and BMSCs showed higher expression of cytokeratin 10 and filaggrin, suggesting these cells were more prone to epidermal regeneration. The absence of HLA molecules, even when the epithelial layer was differentiated, supports the future clinical use of these substitutes – especially ADSCs, DPSCs and WJSCs – with low rejection risk. MSCs allowed the generation of bioengineered human skin substitutes with potential clinical usefulness. According to their epidermal differentiation potential and lack of HLA antigens, WJSCs should preferentially be used.Spanish Ministry of Economy and Competitiveness (Instituto de Salud Carlos III), FIS PI15/2048 (co-financed by ERDF-FEDER, European Union), award number AC17/00013 (NanoGSkin) by ISCIII thorough AES 2017 and within the EuroNanoMed framework and PE-0393-20

Toward a European coastal observing network to provide better answers to science and to societal challenges : The JERICO research infrastructure

The coastal area is the most productive and dynamic environment of the world ocean, offering significant resources and services for mankind. As exemplified by the UN Sustainable Development Goals, it has a tremendous potential for innovation and growth in blue economy sectors. Due to the inherent complexity of the natural system, the answers to many scientific and societal questions are unknown, and the impacts of the cumulative stresses imposed by anthropogenic pressures (such as pollution) and climate change are difficult to assess and forecast. A major challenge for the scientific community making observations of the coastal marine environment is to integrate observations of Essential Ocean Variables for physical, biogeochemical, and biological processes on appropriate spatial and temporal scales, and in a sustained and scientifically based manner. Coastal observations are important for improving our understanding of the complex biotic and abiotic processes in many fields of research such as ecosystem science, habitat protection, and climate change impacts. They are also important for improving our understanding of the impacts of human activities such as fishing and aquaculture, and underpin risk monitoring and assessment. The observations enable us to better understand ecosystems and the societal consequences of overfishing, disease (particularly shellfish), loss of biodiversity, coastline withdrawal, and ocean acidification, amongst others. The European coastal observing infrastructure JERICO-RI, has gathered and organized key communities embracing new technologies and providing a future strategy, with recommendations on the way forward and on governance. Particularly, the JERICO community acknowledges that the main providers of coastal observations are: (1) research infrastructures, (2) national monitoring programs, and (3) monitoring activities performed by marine industries. The scope of this paper is to present some key elements of our coastal science strategy to build it on long term. It describes how the pan-European JERICO community is building an integrated and innovation-driven coastal research infrastructure for Europe. The RI embraces emerging technologies which will revolutionize the way the ocean is observed. Developments in biotechnology (molecular and optical sensors, omics-based biology) will soon provide direct and online access to chemical and biological variables including in situ quantification of harmful algae and contaminants. Using artificial intelligence (AI), Internet of Things will soon provide operational platforms and autonomous and remotely operated smart sensors. Embracing key technologies, high quality open access data, modeling and satellite observations, it will support sustainable blue growth, warning and forecasting coastal services and healthy marine ecosystem. JERICO-FP7 is the European 7th framework project named JERICO under Grant Agreement No. 262584. JERICO-NEXT is the European Horizon-2020 project under Grant Agreement No. 654410. JERICO-RI is the European coastal observing research infrastructure established and structured through JERICO-FP7 and JERICO-NEXT, and beyond

Population-based study of genetic variation in individuals with autism spectrum disorders from Croatia

<p>Abstract</p> <p>Background</p> <p>Genome-wide studies on autism spectrum disorders (ASDs) have mostly focused on large-scale population samples, but examination of rare variations in isolated populations may provide additional insights into the disease pathogenesis.</p> <p>Methods</p> <p>As a first step in the genetic analysis of ASD in Croatia, we characterized genetic variation in a sample of 103 subjects with ASD and 203 control individuals, who were genotyped using the Illumina HumanHap550 BeadChip. We analyzed the genetic diversity of the Croatian population and its relationship to other populations, the degree of relatedness via Runs of Homozygosity (ROHs), and the distribution of large (>500 Kb) copy number variations.</p> <p>Results</p> <p>Combining the Croatian cohort with several previously published populations in the FastME analysis (an alternative to Neighbor Joining) revealed that Croatian subjects cluster, as expected, with Southern Europeans; in addition, individuals from the same geographic region within Europe cluster together. Whereas Croatian subjects could be separated from a sample of healthy control subjects of European origin from North America, Croatian ASD cases and controls are well mixed. A comparison of runs of homozygosity indicated that the number and the median length of regions of homozygosity are higher for ASD subjects than for controls (p = 6 × 10^-3). Furthermore, analysis of copy number variants found a higher frequency of large chromosomal rearrangements (>2 Mb) in ASD cases (5/103) than in ethnically matched control subjects (1/197, p = 0.019).</p> <p>Conclusions</p> <p>Our findings illustrate the remarkable utility of high-density genotype data for subjects from a limited geographic area in dissecting genetic heterogeneity with respect to population and disease related variation.</p

Procalcitonin Is Not a Reliable Biomarker of Bacterial Coinfection in People With Coronavirus Disease 2019 Undergoing Microbiological Investigation at the Time of Hospital Admission

Abstract Admission procalcitonin measurements and microbiology results were available for 1040 hospitalized adults with coronavirus disease 2019 (from 48 902 included in the International Severe Acute Respiratory and Emerging Infections Consortium World Health Organization Clinical Characterisation Protocol UK study). Although procalcitonin was higher in bacterial coinfection, this was neither clinically significant (median [IQR], 0.33 [0.11–1.70] ng/mL vs 0.24 [0.10–0.90] ng/mL) nor diagnostically useful (area under the receiver operating characteristic curve, 0.56 [95% confidence interval, .51–.60]).</jats:p

Implementation of corticosteroids in treating COVID-19 in the ISARIC WHO Clinical Characterisation Protocol UK:prospective observational cohort study

BACKGROUND: Dexamethasone was the first intervention proven to reduce mortality in patients with COVID-19 being treated in hospital. We aimed to evaluate the adoption of corticosteroids in the treatment of COVID-19 in the UK after the RECOVERY trial publication on June 16, 2020, and to identify discrepancies in care. METHODS: We did an audit of clinical implementation of corticosteroids in a prospective, observational, cohort study in 237 UK acute care hospitals between March 16, 2020, and April 14, 2021, restricted to patients aged 18 years or older with proven or high likelihood of COVID-19, who received supplementary oxygen. The primary outcome was administration of dexamethasone, prednisolone, hydrocortisone, or methylprednisolone. This study is registered with ISRCTN, ISRCTN66726260. FINDINGS: Between June 17, 2020, and April 14, 2021, 47 795 (75·2%) of 63 525 of patients on supplementary oxygen received corticosteroids, higher among patients requiring critical care than in those who received ward care (11 185 [86·6%] of 12 909 vs 36 415 [72·4%] of 50 278). Patients 50 years or older were significantly less likely to receive corticosteroids than those younger than 50 years (adjusted odds ratio 0·79 [95% CI 0·70–0·89], p=0·0001, for 70–79 years; 0·52 [0·46–0·58], p80 years), independent of patient demographics and illness severity. 84 (54·2%) of 155 pregnant women received corticosteroids. Rates of corticosteroid administration increased from 27·5% in the week before June 16, 2020, to 75–80% in January, 2021. INTERPRETATION: Implementation of corticosteroids into clinical practice in the UK for patients with COVID-19 has been successful, but not universal. Patients older than 70 years, independent of illness severity, chronic neurological disease, and dementia, were less likely to receive corticosteroids than those who were younger, as were pregnant women. This could reflect appropriate clinical decision making, but the possibility of inequitable access to life-saving care should be considered. FUNDING: UK National Institute for Health Research and UK Medical Research Council