Promoting Renewable Energy or Environmental Problems? Environmental Politics and Sustainability in Sino-Brazilian Relations

China is now Brazil’s largest trade and investment partner, with Brazil’s exports dominated by primary products such as iron ore, soy and crude oil. China and Brazil have also become major players in international environmental and debates as emerging powers, reflecting their contribution to carbon emissions and their vulnerability to climate change and environmental disasters such as droughts, floods, deforestation, landslides and pollution. In environmental terms, Brazil’s exports to China have led to changes in land use focused on export agriculture, the construction of infrastructure in vulnerable areas such as the Amazon region and a growing need for cheap, renewable energy to fuel transport, consumption and industrial development. In the context of these intensifying trade and economic connections between Brazil and China, this article examines the environmental dimensions of this relationship, focusing in particular on the contradictions created by renewable energy production. Paradoxically, given Brazil’s key role in the international climate change debate, one of the most controversial aspects of the country’s development agenda is the promotion of renewable energy as evidenced in the conflicts around hydro-electric power generation. The latter have provoked protests against the dams’ social and environmental effects among local communities and international environmental groups. Little studied compared to the more well-known aspects of Sino-Latin American relations, such as infrastructure and trade, the article argues that Chinese involvement in hydropower in Brazil reinforces an increasingly unsustainable domestic development agenda, as reflected in the asymmetry between arguments about the general benefits of hydropower and the negative effects on local communities

Relaxation phenomenon in lumbar trunk muscles during lateral bending

This paper reports myoelectric activity measurements in the lumbar trunk muscles when subjects performed tasks involving various degrees of lateral bending. Biomechanical model analyses were made to estimate the tensions in the lumbar trunk muscles required to perform those tasks. The tensions and the activity measurements were compared to see if a muscle relaxation phenomenon occurred. A relaxation phenomenon in the erector spinae muscles was observed to occur in quiet standing in a laterally-bent position of the trunk, qualitatively similar to the flexion-relaxation phenomenon reported by Schultz et al. in 198513. However, no relaxation was observed to occur in the lateral oblique abdominal muscles in laterally-bent postures of the trunk.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/27189/1/0000192.pd

Physicochemical and Biological Characterisation of Diclofenac Oligomeric Poly(3-hydroxyoctanoate) Hybrids as β-TCP Ceramics Modifiers for Bone Tissue Regeneration

Nowadays, regenerative medicine faces a major challenge in providing new, functional materials that will meet the characteristics desired to replenish and grow new tissue. Therefore, this study presents new ceramic-polymer composites in which the matrix consists of tricalcium phosphates covered with blends containing a chemically bounded diclofenac with the biocompatible polymer-poly(3-hydroxyoctanoate), P(3HO). Modification of P(3HO) oligomers was confirmed by NMR, IR and XPS. Moreover, obtained oligomers and their blends were subjected to an in-depth characterisation using GPC, TGA, DSC and AFM. Furthermore, we demonstrate that the hydrophobicity and surface free energy values of blends decreased with the amount of diclofenac modified oligomers. Subsequently, the designed composites were used as a substrate for growth of the pre-osteoblast cell line (MC3T3-E1). An in vitro biocompatibility study showed that the composite with the lowest concentration of the proposed drug is within the range assumed to be non-toxic (viability above 70%). Cell proliferation was visualised using the SEM method, whereas the observation of cell penetration into the scaffold was carried out by confocal microscopy. Thus, it can be an ideal new functional bone tissue substitute, allowing not only the regeneration and restoration of the defect but also inhibiting the development of chronic inflammation

Natural history and surgical outcome of incidentally discovered clinically nonfunctioning pituitary macroadenomas

Objectives: The incidental diagnosis of nonfunctioning pituitary macroadenomas (NFPMAs) is becoming more prevalent with the spread of modern brain imaging techniques. We sought to uncover new data about their natural history and surgical outcome. Design: This is a retrospective single-center observational study. Methods: Among 210 patients seen for a NFPMA between 2010 and 2019, 70 ( 33%) were discovered incidentally (i-NFPMA). We analyzed outcomes in a total of 65 patients with available follow-up data. Results: Mean age at diagnosis (± s.d.) was 60 ± 14 years and mean maximal diameter was 20.0 ± 7.3 mm. At diagnosis, 29 patients (45%) had pituitary hormone deficits (LH/FSH 41%, TSH 29%, ACTH 15%) and 12% had visual field deficits. 26 patients underwent initial surgery, while 12 had delayed surgery after initial surveillance. In the surveillance group, the risk of tumor growth was estimated at 10%/year. Patients with hormonal deficits at diagnosis experienced earlier growth at 24 months (P < 0.02). Overall, surgical resection of the i-NFPMA led to stable or improved endocrine function in 91% of patients, with only 6% postoperative permanent diabetes insipidus. Moreover, surgery was more effective in preserving intact endocrine function (10/12) than restoring altered endocrine function to normal (6/22, P = 0.03). Conclusion: About one-third of NFPMAs are now discovered incidentally and a significant subset may be responsible for unrecognized endocrine and visual deficits. Under surveillance the risk of further tumor growth is significant (10 %/year) and seems to occur faster in patients already harboring an endocrine deficit. Early surgical removal before onset of endocrine deficits appears to lead to better endocrine outcome

Greek mothers' perceptions of their cooperation with the obstetrician and the midwife in the delivery room

Α Ι Μ : The objective of this study was to access the perceptions of mothers of newborns regarding their cooperationwith the midwife and the obstetrician in the delivery room.M A T E R I A L - M E T H O D : The sample consisted of 607 mothers living in Northern Greece. The KuopioInstrument for Mothers (KIM) was used for the data collection.R E S U L T S : All the participants gave birth in a hospital; 403 (66.4%) had vaginal delivery, while 204 (33.6%)gave birth by caesarean section. Women with a vaginal delivery had a better cooperation with the midwife and theobstetrician, in comparison to women who gave birth via caesarean section. The participant mothers had a morepositive experience from their cooperation with the obstetrician than with the midwife.C O N C L U S I O N S : The mothers’ preference for obstetrician’s care than for midwife’s care is probably due tothe commercialisation of gynaecology/obstetrics in Greece, the dramatic increase in the number of obstetriciansover the past decade, and the fact that deliveries carried out solely by midwives have almost disappeared in thecountry. Health policy makers should reinforce the current provision of maternity services and support midwivesto take a more central role during pregnancy, labour, and the postnatal period

Zimbabwe’s land reform: challenging the myths

Most commentary on Zimbabwe’s land reform insists that agricultural production has almost totally collapsed, that food insecurity is rife, that rural economies are in precipitous decline, that political ‘cronies’ have taken over the land and that farm labour has all been displaced. This paper however argues that the story is not simply one of collapse and catastrophe; it is much more nuanced and complex, with successes as well as failures. The paper provides a summary of some of the key findings from a ten-year study in Masvingo province and the book Zimbabwe’s Land Reform: Myths and Realities. The paper documents the nature of the radical transformation of agrarian structure that has occurred both nationally and within the province, and the implications for agricultural production and livelihoods. A discussion of who got the land shows the diversity of new settlers, many of whom have invested substantially in their new farms. An emergent group ‘middle farmers’ is identified who are producing, investing and accumulating. This has important implications – both economically and politically – for the future, as the final section on policy challenges discusses.ESR

Pembrolizumab in Combination with Ipilimumab as Second-Line or Later Therapy for Advanced Non–Small-Cell Lung Cancer: KEYNOTE-021 Cohorts D and H

Objectives Combination immunotherapy may result in improved antitumor activity compared with single-agent treatment. We report results from dose-finding and dose-expansion cohorts of the phase 1/2 KEYNOTE-021 study that evaluated combination therapy with anti‒programmed death 1 (PD-1) antibody pembrolizumab plus anti‒cytotoxic T-lymphocyte antigen-4 (CTLA-4) antibody ipilimumab in patients with previously treated advanced non–small-cell lung cancer (NSCLC). Materials and Methods Eligibility criteria stipulated histologically/cytologically confirmed advanced NSCLC and treatment failure on ≥1 prior systemic therapy (platinum-based chemotherapy or targeted therapy for patients with EGFR/ALK aberrations). In the dose-finding cohort, patients initially received pembrolizumab 10 mg/kg plus ipilimumab 1 or 3 mg/kg once every 3 weeks for 4 cycles followed by pembrolizumab 10 mg/kg monotherapy for up to 2 years. Based on emerging published data, subsequent patients received pembrolizumab 2 mg/kg plus ipilimumab 1 mg/kg. Objective response rate (ORR; primary efficacy endpoint) was assessed per RECIST version 1.1 by blinded, independent central review. Phase 2 hypothesis that ORR would be greater than the 20% rate for historical controls was evaluated using the exact binomial test. Results Fifty-one patients were enrolled; 71% received ≥2 prior lines of therapy. No dose-limiting toxicities occurred at any dose level. Among patients who received pembrolizumab 2 mg/kg plus ipilimumab 1 mg/kg (n = 44), ORR was 30% (95% CI, 17%–45%), but not statistically significantly >20% (P = 0.0858). Median progression-free survival in this group was 4.1 (95% CI, 1.4–5.8) months; median overall survival was 10.9 (95% CI, 6.1–23.7) months. With pembrolizumab 2 mg/kg plus ipilimumab 1 mg/kg, incidences of treatment-related adverse events, grade 3–5 treatment-related adverse events, and immune-mediated adverse events and infusion reactions were 64%, 29% and 42%, respectively. Conclusions In patients with heavily pretreated advanced NSCLC, pembrolizumab plus ipilimumab showed evidence of antitumor activity, but was associated with meaningful toxicity