A influência do direito internacional no processo de empoderamento econômico das mulheres e a inclusão do gênero na política comercial brasileira

The research discusses gender integration in trade policy as a mechanism of concretizing the right of gender equality and women’s economic empowerment. The research proposes to systemize social and economic aspects and juridical fundaments that authorizes the Brazilian State to include gender standards in Brazilian public policies. Further, the investigation aims to analyze the functions of Law as an intrinsic element to public policies and as mechanism to incorporate gender in the Brazilian trade policy. As to the study objective, goals and approach, it consisted of applied, descriptive and qualitative research, based on hypothetical-deductive method and bibliographical and documental procedures of investigation. The United Nations 2030 Agenda for Sustainable Development sets a series of gender related objectives and goals that shall be reached by the international community in the following years. Among them, women’s economic empowerment imposes itself as a global imperative as to gain potential to economic grow and States development. Also, women with their own income become independent and less vulnerable. To the long term, women’s economic empowerment results in the change of social standards and in women’s right improvement. By stimulating competitiveness, incorporation of new technologies and creation of business and labor positions, trade can contribute to women’s economic empowerment. To do so, trade negotiations and national policies must include gender standards that possibilitate to breach barriers that restrain the full participation of women in economic and commercial activities. Final, the research presents and discusses propositions to elaborate an Agenda on Trade and Gender to Brazil.A pesquisa discute a integração do gênero na política comercial como mecanismo de concretização do direito à igualdade de gênero e ao empoderamento econômico das mulheres. Propõe sistematizar os aspectos socioeconômicos e fundamentos jurídicos que autorizam o Estado brasileiro a incluir padrões de gênero em suas políticas públicas. Objetiva também responder quais as funções desempenhadas pelo direito como elemento intrínseco às políticas públicas e como tecnologia de incorporação do gênero na política comercial brasileira. Quanto à finalidade, aos objetivos e à abordagem, a pesquisa é do tipo aplicada, descritiva e qualitativa. Apoia-se no método hipotético-dedutivo e nos procedimentos de pesquisa bibliográfica e documental. Constatou-se que a Agenda 2030 para o Desenvolvimento Sustentável das Nações Unidas estabelece uma série de objetivos e metas relacionados ao gênero que deverão ser alcançados pela comunidade internacional nos próximos anos. Entre eles, o empoderamento econômico das mulheres impõe-se como imperativo global diante dos potenciais ganhos para o crescimento econômico e desenvolvimento dos Estados. Além disso, mulheres com renda própria tornam-se mais independentes e menos vulneráveis. A longo prazo, o empoderamento econômico resulta na mudança de padrões sociais e na melhoria dos direitos das mulheres, contribuindo para a realização do projeto constitucional de construção de uma sociedade livre, justa e solidária. Ao estimular a competitividade, a incorporação de novas tecnologias e a criação de negócios e postos de trabalho, o comércio pode ter um efeito catalítico sobre o empoderamento econômico das mulheres. Para tanto, as negociações comerciais e as políticas nacionais devem incluir padrões de gênero que possibilitem romper com as barreiras que impedem a plena participação das mulheres nas atividades econômicas e comerciais. Ao final da pesquisa, são apresentadas e discutidas propostas para elaboração de uma Agenda sobre Comércio e Gênero para o Brasil.2019-04-3

A polícia na Constituição Federal de 1988: apontamentos sobre a manutenção de um órgão militarizado de policiamento e a sua incompatibilidade com a ordem democrática vigente no Brasil

O artigo tem como objetivo analisar o Sistema Constitucional de Segurança Pública no que concerne à manutenção de um órgão de policiamento militarizado, e busca demonstrar que a existência de uma polícia como força auxiliar e reserva do Exército não se coaduna com a ordem democrática inaugurada após a promulgação da Constituição Federal de 1988, principalmente em tempos de paz e de estabilidade institucional. Para tanto, explora a proposta que pretende reformar a organização da instituição policial por meio da desmilitarização das polícias estaduais e de sua união em um único corpo policial, de natureza civil

O PODER REGULATÓRIO DOS ESTADOS E A PROTEÇÃO DOS INVESTIMENTOS ESTRANGEIROS: O CASO URUGUAI VERSUS PHILIP MORRIS

O artigo pretende analisar a regulamentação dos investimentos estrangeiros traçada por meio de Tratados Bilaterais sobre Investimentos e o impacto sobre o policy space dos Estados, notadamente no que concerne à possibilidade de indenização do investidor em caso de expropriação indireta. A metodologia aplicada consistiu na pesquisa bibliográfica e documental e a análise da decisão arbitral proferida no caso envolvendo a Philip Morris, uma das maiores empresas multinacionais produtoras de tabaco e seus derivados do mundo, e o Uruguai, no Centro Internacional para Resolução de Controvérsias sobre Investimentos (CIRDI), em razão de medidas antitabagistas adotadas pelo governo Uruguaio.

PET/MR outperforms PET/CT in suspected occult tumors

BACKGROUND To compare the diagnostic accuracy of PET/MR and PET/CT in patients with suspected occult primary tumors. METHODS This prospective study was approved by the institutional review board. Sequential PET/CT-MR was performed in 43 patients (22 male subjects; median age, 58 years; range, 20-86 years) referred for suspected occult primary tumors. Patients were assessed with PET/CT and PET/MR for the presence of a primary tumor, lymph node metastases, and distant metastases. Wilcoxon signed-rank test was performed to compare the diagnostic accuracy of PET/CT and PET/MR. RESULT According to the standard of reference, a primary lesion was found in 14 patients. In 16 patients, the primary lesion remained occult. In the remaining 13 patients, lesions proved to be benign. PET/MR was superior to PET/CT for primary tumor detection (sensitivity/specificity, 0.85/0.97 vs 0.69/0.73; P = 0.020) and comparable to PET/CT for the detection of lymph node metastases (sensitivity/specificity, 0.93/1.00 vs 0.93/0.93; P = 0.157) and distant metastases (sensitivity/specificity, 1.00/0.97 vs 0.82/1.00; P = 0.564). PET/CT tended to misclassify physiologic FDG uptake as malignancy compared with PET/MR (8 patients vs 1 patient). CONCLUSIONS PET/MR outperforms PET/CT in the workup of suspected occult malignancies. PET/MR may replace PET/CT to improve clinical workflow

Comparing Reactogenicity of COVID-19 vaccines: a systematic review and meta-analysis.

OBJECTIVES: A number of vaccines have now been developed against COVID-19. Differences in reactogenicity and safety profiles according to the vaccine technologies employed are becoming apparent from clinical trials. METHODS: Five databases (Medline, EMBASE, Science Citation Index, Cochrane Central Register of Controlled Trials, London School of Hygiene and Tropical Medicine COVID-19 vaccine tracker) were searched for relevant randomised controlled trials between 1 January 2020 and 12 January 2022 according to predetermined criteria with no language limitations. RESULTS: Forty-two datasets were identified, with 20 vaccines using four different technologies (viral vector, inactivated, mRNA and protein sub-unit). Adults and adolescents over 12 years were included. Control groups used saline placebos, adjuvants, and comparator vaccines. The most consistently reported solicited adverse events were fever, fatigue, headache, pain at injection site, redness, and swelling. Both doses of mRNA vaccines, the second dose of protein subunit and the first dose of adenovirus vectored vaccines were the most reactogenic, while the inactivated vaccines were the least reactogenic. CONCLUSIONS: The different COVID-19 vaccines currently available appear to have distinct reactogenicity profiles, dependent on the vaccine technology employed. Awareness of these differences may allow targeted recommendations for specific populations. Greater standardization of methods for adverse event reporting will aid future research in this field

Reproducibility of Standardized Uptake Values Including Volume Metrics Between TOF-PET-MR and TOF-PET-CT.

Purpose To investigate the reproducibility of tracer uptake measurements, including volume metrics, such as metabolic tumor volume (MTV) and tumor lesion glycolysis (TLG) obtained by TOF-PET-CT and TOF-PET-MR. Materials and Methods Eighty consecutive patients with different oncologic diagnoses underwent TOF-PET-CT (Discovery 690; GE Healthcare) and TOF-PET-MR (SIGNA PET-MR; GE Healthcare) on the same day with single dose-18F-FDG injection. The scan order, PET-CT following or followed by PET-MR, was randomly assigned. A spherical volume of interest (VOI) of 30 mm was placed on the liver in accordance with the PERCIST criteria. For liver, the maximum and mean standard uptake value for body weight (SUV) and lean body mass (SUL) were obtained. For tumor delineation, VOI with a threshold of 40 and 50% of SUVmax was used (VOI40 and VOI50). The SUVmax, SUVmean, SUVpeak, MTV and TLG were calculated. The measurements were compared between the two scanners. Results In total, 80 tumor lesions from 35 patients were evaluated. There was no statistical difference observed in liver regions, whereas in tumor lesions, SUVmax, SUV mean, and SUVpeak of PET-MR were significantly underestimated (p < 0.001) in both VOI40 and VOI50. Among volume metrics, there was no statistical difference observed except TLG on VOI50 (p = 0.03). Correlation between PET-CT and PET-MR of each metrics were calculated. There was a moderate correlation of the liver SUV and SUL metrics (r = 0.63-0.78). In tumor lesions, SUVmax and SUVmean had a stronger correlation with underestimation in PET-MR on VOI 40 (SUVmax and SUVmean; r = 0.92 and 0.91 with slope = 0.71 and 0.72, respectively). In the evaluation of MTV and TLG, the stronger correlations were observed both on VOI40 (MTV and TLG; r = 0.75 and 0.92) and VOI50 (MTV and TLG; r = 0.88 and 0.95) between PET-CT and PET-MR. Conclusion PET metrics on TOF-PET-MR showed a good correlation with that of TOF-PET-CT. SUVmax and SUVpeak of tumor lesions were underestimated by 16% on PET-MRI. MTV with % threshold can be regarded as identical volumetric markers for both TOF-PET-CT and TOF-PET-MR

A elucidação acerca dos Mecanismos de Nocicepção e Dor / The elucidation about mechanisms of Nociception and Pain

Introdução: A dor é a percepção da nocicepção, fenômeno que ocorre através de uma cascata complexa de eventos que envolvem estruturas periféricas e do sistema nervoso central, ou seja, a nocicepção é um tipo de dor. Objetivo: Revisar a literatura sobre os aspectos neurofisiológicos que envolvem a sensibilização periférica e central. Métodos: Este estudo é representado por uma revisão bibliográfica, conduzida a partir da pergunta de pesquisa: Quais os aspectos neurofisiológicos que envolvem a sensibilização periférica e central? A pesquisa foi realizada em bases de dados eletrônicas de pesquisa, incluindo estudos  dos últimos 12 anos, entre 2009-2017. Discussão e Resultados: Como resultados as evidências indicaram que os mecanismos da nocicepção e de dor são divididos em etapas para que ocorra a formulação e interpretação de sensações, sendo o principal pilar para a formação do fenômeno sensitivo doloroso devido à presença de nociceptores. Além disso, foi possível, também, classificar a dor quanto a sua duração, sendo ela dor rápida ou dor lenta, e fisiopatologicamente em somática, visceral, neuropática e/ou psicogênica. Com isso, é de suma importância aprofundar os conhecimentos dos mecanismos de nocicepção e dor objetivando o alcance de um melhor prognóstico. Considerações finais: Foi notório a relevância da temática abordada, visto que a dor aliada a nocicepção é uma condição que pode tornar o indivíduo menos funcional. Além disso, é importante pontuar que essa situação ainda carece de estudos que possam contribuir, gradativamente, desde seu diagnóstico até sua forma de tratamento e/ou cura. Assim, visando uma melhor prática médica e, por fim, proporcionando um desfecho mais adequado ao paciente.  

Safety, immunogenicity, and efficacy of a COVID-19 vaccine (NVX-CoV2373) co-administered with seasonal influenza vaccines: an exploratory substudy of a randomised, observer-blinded, placebo-controlled, phase 3 trial

BACKGROUND: The safety and immunogenicity profile of COVID-19 vaccines when administered concomitantly with seasonal influenza vaccines have not yet been reported. We therefore aimed to report the results of a substudy within a phase 3 UK trial, by evaluating the safety, immunogenicity, and efficacy of NVX-CoV2373 when co-administered with licensed seasonal influenza vaccines. METHODS: We did a planned exploratory substudy as part of the randomised, observer-blinded, placebo-controlled, phase 3 trial of the safety and efficacy of the COVID-19 vaccine (NVX-CoV2373) by co-administrating the influenza vaccine at four study hospitals in the UK. Approximately, the first 400 participants meeting the main study entry criteria-with no contraindications to influenza vaccination-were invited to join the substudy. Participants of the main study were randomly assigned (1:1) to receive two intramuscular injections of either NVX-CoV2373 (5 μg) or placebo (normal saline) 21 days apart; participants enrolled into the substudy were co-vaccinated with a single (0·5 mL) intramuscular, age-appropriate (quadrivalent influenza cell-based vaccine [Flucelvax Quadrivalent; Seqirus UK, Maidenhead] for those aged 18-64 years and adjuvanted trivalent influenza vaccine [Fluad; Seqirus UK, Maidenhead] for those ≥65 years), licensed, influenza vaccine on the opposite deltoid to that of the first study vaccine dose or placebo. The influenza vaccine was administered in an open-label manner and at the same time as the first study injection. Reactogenicity was evaluated via an electronic diary for 7 days after vaccination in addition to monitoring for unsolicited adverse events, medically attended adverse events, and serious adverse events. Immunogenicity was assessed with influenza haemagglutination inhibition and SARS-CoV-2 anti-spike protein IgG assays. Vaccine efficacy against PCR-confirmed, symptomatic COVID-19 was assessed in participants who were seronegative at baseline, received both doses of study vaccine or placebo, had no major protocol deviations affecting the primary endpoint, and had no confirmed cases of symptomatic COVID-19 from the first dose until 6 days after the second dose (per-protocol efficacy population). Immunogenicity was assessed in participants who received scheduled two doses of study vaccine, had a baseline sample and at least one post-vaccination sample, and had no major protocol violations before unmasking (per-protocol immunogenicity population). Reactogenicity was analysed in all participants who received at least one dose of NVX-CoV2373 or placebo and had data collected for reactogenicity events. Safety was analysed in all participants who received at least one dose of NVX-CoV2373 or placebo. Comparisons were made between participants of the substudy and the main study (who were not co-vaccinated for influenza). This study is registered with ClinicalTrials.gov, number NCT04583995. FINDINGS: Between Sept 28, 2020, and Nov 28, 2020, a total of 15 187 participants were randomised into the main phase 3 trial, of whom 15 139 received treatment (7569 received dose one of NVX-CoV2373 and 7570 received dose one of placebo). 431 participants were co-vaccinated with a seasonal influenza vaccine in the substudy (217 received NVX-CoV2373 plus the influenza vaccine and 214 received placebo plus the influenza vaccine). In general, the substudy participants were younger, more racially diverse, and had fewer comorbid conditions than those in the main study. Reactogenicity events were more common in the co-administration group than in the NVX-CoV2373 alone group: tenderness (113 [64·9%] of 174 vs 592 [53·3%] of 1111) or pain (69 [39·7%] vs 325 [29·3%]) at injection site, fatigue (48 [27·7%] vs 215 [19·4%]), and muscle pain (49 [28·3%] vs 237 [21·4%]). Incidences of unsolicited adverse events, treatment-related medically attended adverse events, and serious adverse events were low and balanced between the co-administration group and the NVX-CoV2373 alone group. No episodes of anaphylaxis or deaths were reported within the substudy. Co-administration resulted in no change to influenza vaccine immune response although a reduction in antibody responses to the NVX-CoV2373 vaccine was noted. NVX-CoV2373 vaccine efficacy in the substudy (ie, participants aged 18 to <65 years) was 87·5% (95% CI -0·2 to 98·4) and in the main study was 89·8% (95% CI 79·7-95·5). INTERPRETATION: To our knowledge, this substudy is the first to show the safety, immunogenicity, and efficacy profile of a COVID-19 vaccine when co-administered with seasonal influenza vaccines. Our results suggest concomitant vaccination might be a viable immunisation strategy. FUNDING: Novavax

Community seroprevalence of SARS-CoV-2 in children and adolescents in England, 2019–2021

Objective: To understand community seroprevalence of SARS-CoV-2 in children and adolescents. This is vital to understanding the susceptibility of this cohort to COVID-19 and to inform public health policy for disease control such as immunisation. Design: We conducted a community-based cross-sectional seroprevalence study in participants aged 0–18 years old recruiting from seven regions in England between October 2019 and June 2021 and collecting extensive demographic and symptom data. Serum samples were tested for antibodies against SARS-CoV-2 spike and nucleocapsid proteins using Roche assays processed at UK Health Security Agency laboratories. Prevalence estimates were calculated for six time periods and were standardised by age group, ethnicity and National Health Service region. Results: Post-first wave (June–August 2020), the (anti-spike IgG) adjusted seroprevalence was 5.2%, varying from 0.9% (participants 10–14 years old) to 9.5% (participants 5–9 years old). By April–June 2021, this had increased to 19.9%, varying from 13.9% (participants 0–4 years old) to 32.7% (participants 15–18 years old). Minority ethnic groups had higher risk of SARS-CoV-2 seropositivity than white participants (OR 1.4, 95% CI 1.0 to 2.0), after adjusting for sex, age, region, time period, deprivation and urban/rural geography. In children <10 years, there were no symptoms or symptom clusters that reliably predicted seropositivity. Overall, 48% of seropositive participants with complete questionnaire data recalled no symptoms between February 2020 and their study visit. Conclusions: Approximately one-third of participants aged 15–18 years old had evidence of antibodies against SARS-CoV-2 prior to the introduction of widespread vaccination. These data demonstrate that ethnic background is independently associated with risk of SARS-CoV-2 infection in children. Trial registration number: NCT04061382