THE REVENGE OF PROMETHEUS: SCIENCE, TECHNOLOGY, INNOVATION AND THE RECONFIGURATION OF INTERNATIONAL POWER IN THE 21ST CENTURY

This article analyzes the reconfiguration of international power since the end of the Cold War by incorporating crucial dimensions of Science, Technology, and Innovation (ST&I). We track the evolution of relative positions occupied by the United States, the European Union, China, Japan, India, Russia, Brazil, and South Korea in the global economy between 1990 and 2020 in three dimensions: production dynamism (measured by relative share in world GDP calculated by Purchasing Power Parity), scientific and technological dynamism (measured by relative share in authorship of articles published in indexed international journals), and innovation dynamism (measured by relative share in world patent registration). To measure and evaluate the structural changes in progress, we adapted the Rae and Taylor as well as the Laakso and Taagepera indexes, commonly used to assess fragmentation degrees in political systems, to elaborate relative power concentration/dispersion indexes in each dimension and indicate the number and composition of “relative powers” within them. The results show the erosion of relative power of the “traditional powers” (United States, Europe and Japan), the accelerated Chinese ascension and the emergence of new “relevant powers” (especially India and South Korea), but with different diffusion/concentration degrees according to the dimension considered. They reinforce the understanding that national capacities in ST&I have become a central vector in the reconfiguration of world power

Soil preparation and NPK fertilization in the planting of five Atlantic Rainforest species in a clay extraction area

The occurrence of degraded areas worldwide grows each year and measures must be taken to mitigate degradation and to recover these areas. The aim of this study was to assess the effect of soil preparation and NPK levels on the growth of five native species of the Atlantic Rainforest in clay extraction area. The experimental design was randomized block in a split-split plot arrangement with four replications. Subsoiling and scarification soil preparation represented main plots.  Doses of NPK 04-14-08: 0; 40; 80;160; and 320 g pit-1 represented subplots and Atlantic Rainforest native species represented sub-subplots. Absolute growth rate, stem diameter and number of leaves were evaluated, 210 days after planting. The type of soil preparation did not influence the development of the species. The best dose for Dalbergia ecastaphyllum, Inga laurina, Protium heptaphyllum and Psidium cattleyanum were 176.49, 150.18, 199.25 and 166.48 g pit-1 of NPK, respectively. Schinus terebinthifolius was highly responsive to planting fertilization, being recommended 320 g pit-1 of NPK. All species are indicated for area recovery.The occurrence of degraded areas worldwide grows each year and measures must be taken to mitigate degradation and to recover these areas. The aim of this study was to assess the effect of soil preparation and NPK levels on the growth of five native species of the Atlantic Rainforest in clay extraction area. The experimental design was randomized block in a split-split plot arrangement with four replications. Subsoiling and scarification soil preparation represented main plots.  Doses of NPK 04-14-08: 0; 40; 80;160; and 320 g pit-1 represented subplots and Atlantic Rainforest native species represented sub-subplots. Absolute growth rate, stem diameter and number of leaves were evaluated, 210 days after planting. The type of soil preparation did not influence the development of the species. The best dose for Dalbergia ecastaphyllum, Inga laurina, Protium heptaphyllum and Psidium cattleyanum were 176.49, 150.18, 199.25 and 166.48 g pit-1 of NPK, respectively. Schinus terebinthifolius was highly responsive to planting fertilization, being recommended 320 g pit-1 of NPK. All species are indicated for area recovery

Do Saber ao Criar: experiências tecnoromanas na Villa de Milreu

O programa DiVaM pretende contribuir para destacar a importância das comunidades locais na valorização do património cultural, indo ao encontro dos princípios da “Convenção de Faro”, pois tenta promover o património cultural como factor de aproximação, de diálogo, de coesão social e de uma cidadania cada vez mais inclusiva. O Centro Ciência Viva do Algarve, no âmbito deste programa, levou “experiências” às ruínas de Milreu pelo quarto ano consecutivo, tendo-se considerado imperativo dedicar pela primeira vez um dia inteiro ao público escolar. A presente comunicação visa dar a conhecer as atividades desenvolvidas.info:eu-repo/semantics/publishedVersio

Quem salva quem? Saviour siblings e seus aspectos bioéticos

INTRODUÇÃO: A ideia do artigo surgiu durante uma disciplina na qual os alunos foram organizados em grupo para a discussão de um assunto dentro da temática da bioética, sendo o assunto escolhido "saviour siblings". O “saviour sibling” é uma criança concebida na esperança de que ela seja geneticamente compatível com um irmão mais velho que possui alguma patologia cujo tratamento consista na doação de tecidos. OBJETIVO: Debater a concepção de irmãos doadores e a delicadeza e complexidade do tema na perspectiva bioética. METODOLOGIA: Revisão bibliográfica realizada em agosto de 2019, na base de dados PubMed, utilizando o descritor “saviour siblings.” O material obtido foi utilizado para discussão e elaboração de um caso clínico. RESULTADOS: Foram encontrados 40 artigos, nove excluídos pelo resumo por divergirem do tema. O caso clínico foi desenvolvido coletivamente e os autores incumbidos de se colocarem no lugar dos envolvidos nesta decisão e narrar os possíveis pensamentos e sentimentos em cada um deles. Em seguida, utilizaram-se as referências bibliográficas para discutir o caso clínico construído, sob a perspectiva bioética. CONCLUSÃO:  São delicadas e complexas as questões bioéticas relacionadas ao tema saviour siblings. Por um lado, há o benefício de se salvar uma criança doente e trazer alívio a seus pais. Por outro, esta técnica pode remeter a práticas eugênicas como a seleção de indivíduos a partir de sua genética. A perda de autonomia do irmão salvador precisa ser enfoque de futuras discussões éticas a fim de proteger seus direitos. É imprescindível o ensino de Bioética para a formação de profissionais da saúde

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries

Background: Adenovirus-based COVID-19 vaccines are extensively used in low- and middle-income countries (LMICs). Remarkably, cases of cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) have rarely been reported from LMICs. Aims: We studied the frequency, manifestations, treatment, and outcomes of CVST-VITT in LMICs. Methods: We report data from an international registry on CVST after COVID-19 vaccination. VITT was classified according to the Pavord criteria. We compared CVST-VITT cases from LMICs to cases from high-income countries (HICs). Results: Until August 2022, 228 CVST cases were reported, of which 63 were from LMICs (all middle-income countries [MICs]: Brazil, China, India, Iran, Mexico, Pakistan, Turkey). Of these 63, 32 (51%) met the VITT criteria, compared to 103 of 165 (62%) from HICs. Only 5 of the 32 (16%) CVST-VITT cases from MICs had definite VITT, mostly because anti-platelet factor 4 antibodies were often not tested. The median age was 26 (interquartile range [IQR] 20–37) versus 47 (IQR 32–58) years, and the proportion of women was 25 of 32 (78%) versus 77 of 103 (75%) in MICs versus HICs, respectively. Patients from MICs were diagnosed later than patients from HICs (1/32 [3%] vs. 65/103 [63%] diagnosed before May 2021). Clinical manifestations, including intracranial hemorrhage, were largely similar as was intravenous immunoglobulin use. In-hospital mortality was lower in MICs (7/31 [23%, 95% confidence interval (CI) 11–40]) than in HICs (44/102 [43%, 95% CI 34–53], p = 0.039). Conclusions: The number of CVST-VITT cases reported from LMICs was small despite the widespread use of adenoviral vaccines. Clinical manifestations and treatment of CVST-VITT cases were largely similar in MICs and HICs, while mortality was lower in patients from MICs.</p

May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension

Aims Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) hypertension. Conclusion May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk

Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19

Introduction: Cerebral venous sinus thrombosis associated with vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) is a severe disease with high mortality. There are few data on sex differences in CVST-VITT. The aim of our study was to investigate the differences in presentation, treatment, clinical course, complications, and outcome of CVST-VITT between women and men. Patients and methods: We used data from an ongoing international registry on CVST-VITT. VITT was diagnosed according to the Pavord criteria. We compared the characteristics of CVST-VITT in women and men. Results: Of 133 patients with possible, probable, or definite CVST-VITT, 102 (77%) were women. Women were slightly younger [median age 42 (IQR 28–54) vs 45 (28–56)], presented more often with coma (26% vs 10%) and had a lower platelet count at presentation [median (IQR) 50x109/L (28–79) vs 68 (30–125)] than men. The nadir platelet count was lower in women [median (IQR) 34 (19–62) vs 53 (20–92)]. More women received endovascular treatment than men (15% vs 6%). Rates of treatment with intravenous immunoglobulins were similar (63% vs 66%), as were new venous thromboembolic events (14% vs 14%) and major bleeding complications (30% vs 20%). Rates of good functional outcome (modified Rankin Scale 0-2, 42% vs 45%) and in-hospital death (39% vs 41%) did not differ. Discussion and conclusions: Three quarters of CVST-VITT patients in this study were women. Women were more severely affected at presentation, but clinical course and outcome did not differ between women and men. VITT-specific treatments were overall similar, but more women received endovascular treatment.</p

Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19

Introduction: Cerebral venous sinus thrombosis associated with vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) is a severe disease with high mortality. There are few data on sex differences in CVST-VITT. The aim of our study was to investigate the differences in presentation, treatment, clinical course, complications, and outcome of CVST-VITT between women and men. Patients and methods: We used data from an ongoing international registry on CVST-VITT. VITT was diagnosed according to the Pavord criteria. We compared the characteristics of CVST-VITT in women and men. Results: Of 133 patients with possible, probable, or definite CVST-VITT, 102 (77%) were women. Women were slightly younger [median age 42 (IQR 28–54) vs 45 (28–56)], presented more often with coma (26% vs 10%) and had a lower platelet count at presentation [median (IQR) 50x109/L (28–79) vs 68 (30–125)] than men. The nadir platelet count was lower in women [median (IQR) 34 (19–62) vs 53 (20–92)]. More women received endovascular treatment than men (15% vs 6%). Rates of treatment with intravenous immunoglobulins were similar (63% vs 66%), as were new venous thromboembolic events (14% vs 14%) and major bleeding complications (30% vs 20%). Rates of good functional outcome (modified Rankin Scale 0-2, 42% vs 45%) and in-hospital death (39% vs 41%) did not differ. Discussion and conclusions: Three quarters of CVST-VITT patients in this study were women. Women were more severely affected at presentation, but clinical course and outcome did not differ between women and men. VITT-specific treatments were overall similar, but more women received endovascular treatment.</p