The Limits of Pragmatism: The Rise and Fall of the Brazilian Workers’ Party (2002–2016)

Under favorable external circumstances, the pragmatic political and economic strategy of Brazil’s Partido dos Trabalhadores (Workers’ Party—PT) helped to secure short-term political stability, boosted growth, and supported an unprecedented distribution of income. However, it also meant that the PT had to accommodate to rather than transform the constraints on growth in Brazil and that stability would involve unwieldy political alliances preventing deeper reforms. When it was confronted with deteriorating global economic conditions and increasingly ineffectual economic policies, the PT’s strategy immobilized the party, facilitated the dissolution of its base of support, and expedited its ouster from power. The Brazilian experience suggests that political pragmatism can, within limits, support progressive economic change but that the outcomes depend heavily on external circumstances and the stability of the political coalitions supporting the administration. Em circunstâncias externas favoráveis, a pragmática estratégia política e econômica do Partido dos Trabalhadores (PT) ajudou a assegurar a estabilidade política no curto prazo, impulsionou o crescimento e apoiou uma distribuição de renda sem precedentes. No entanto, isso também significou que o PT teve que se acomodar a, em vez de transformar, as restrições ao crescimento no Brasil, e que a estabilidade envolveria alianças políticas comprometedoras, impedindo reformas mais profundas. Quando foi confrontada com a deterioração das condições econômicas globais e apresentando políticas econômicas cada vez mais ineficazes, a estratégia do PT imobilizou o partido, facilitou a dissolução de sua base de apoio e acelerou sua saída do poder. A experiência brasileira sugere que o pragmatismo político pode, dentro de certos limites, apoiar a mudança econômica progressista, mas que os resultados dependem muito das circunstâncias externas e da estabilidade das coalizões políticas que apóiam a administração. Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, Brazil), grant (BEX 0840/14-9

Persistence with anti-tumour necrosis factor therapies in patients with psoriatic arthritis: observational study from the British Society of Rheumatology Biologics Register

Objectives. To evaluate the risk–benefit profile of anti-TNF therapies in PsA and to study the predictors of treatment response and disease remission [disease activity score (DAS)-28 < 2.6]. Methods. The study included PsA patients (n = 596) registered with the British Society for Rheumatology Biologics Register (BSRBR). Response was assessed using the European League against Rheumatism (EULAR) improvement criteria. Univariate and multivariate logistic regression models were developed to examine factors associated with EULAR response and disease remission using a range of covariates. Poisson regression was used to calculate incidence rate ratios (IRRs) for serious adverse events (SAEs) vs seronegative RA controls receiving DMARDs, adjusting for age, sex and baseline co-morbidity. Results. At baseline, the mean (s.d.) DAS-28 was 6.4 (5.6). Of the patients, 70.3% were EULAR responders at 12 months. At 6 months, older patients [adjusted odds ratio (OR) 0.97 per year; 95% CI 0.95, 0.99], females (adjusted OR 0.51; 95% CI 0.34, 0.78) and patients on corticosteroids (adjusted OR 0.45; 95% CI 0.28, 0.72) were less likely to achieve a EULAR response. Over 1776.2 person-years of follow-up (median 3.07 per person), the IRR of SAEs compared with controls was not increased (0.9; 95% CI 0.8, 1.3). Conclusions. Anti-TNF therapies have a good response rate in PsA, and have an adverse event profile similar to that seen in a control cohort of patients with seronegative arthritis receiving DMARD therapy

A forensic acquisition and analysis system for IaaS

Cloud computing is a promising next-generation computing paradigm that offers significant economic benefits to both commercial and public entities. Furthermore, cloud computing provides accessibility, simplicity, and portability for its customers. Due to the unique combination of characteristics that cloud computing introduces (including on-demand self-service, broad network access, resource pooling, rapid elasticity, and measured service), digital investigations face various technical, legal, and organizational challenges to keep up with current developments in the field of cloud computing. There are a wide variety of issues that need to be resolved in order to perform a proper digital investigation in the cloud environment. This paper examines the challenges in cloud forensics that are identified in the current research literature, alongside exploring the existing proposals and technical solutions addressed in the respective research. The open problems that need further effort are highlighted. As a result of the analysis of literature, it is found that it would be difficult, if not impossible, to perform an investigation and discovery in the cloud environment without relying on cloud service providers (CSPs). Therefore, dependence on the CSPs is ranked as the greatest challenge when investigators need to acquire evidence in a timely yet forensically sound manner from cloud systems. Thus, a fully independent model requires no intervention or cooperation from the cloud provider is proposed. This model provides a different approach to a forensic acquisition and analysis system (FAAS) in an Infrastructure as a Service model. FAAS seeks to provide a richer and more complete set of admissible evidences than what current CSPs provide, with no requirement for CSP involvement or modification to the CSP’s underlying architecture

Prospective follow-up in various subtypes of cardiomyopathies: Insights from the ESC EORP Cardiomyopathy Registry

Aims: The European Society of Cardiology (ESC) European Observational Research Programme (EORP) Cardiomyopathy Registry is a prospective multinational registry of consecutive patients with cardiomyopathies. The objective of this report is to describe the short-term outcomes of adult patients (≥18 years old). Methods and results: Out of 3208 patients recruited, follow-up data at 1 year were obtained in 2713 patients (84.6%) [1420 with hypertrophic (HCM); 1105 dilated (DCM); 128 arrhythmogenic right ventricular (ARVC); and 60 restrictive (RCM) cardiomyopathies]. Improvement of symptoms (dyspnoea, chest pain, and palpitations) was globally observed over time (P < 0.05 for each). Additional invasive procedures were performed: prophylactic implantation of implantable cardioverter-defibrillator (ICD) (5.2%), pacemaker (1.2%), heart transplant (1.1%), ablation for atrial or ventricular arrhythmia (0.5% and 0.1%). Patients with atrial fibrillation increased from 28.7% to 32.2% of the cohort. Ventricular arrhythmias (VF/ventricular tachycardias) in ICD carriers (primary prevention) at 1 year were more frequent in ARVC, then in DCM, HCM, and RCM (10.3%, 8.2%, 7.5%, and 0%, respectively). Major cardiovascular events (MACE) occurred in 29.3% of RCM, 10.5% of DCM, 5.3% of HCM, and 3.9% of ARVC (P < 0.001). MACE were more frequent in index patients compared to relatives (10.8% vs. 4.4%, P < 0.001), more frequent in East Europe centres (13.1%) and least common in South Europe (5.3%) (P < 0.001). Subtype of cardiomyopathy, geographical region, and proband were predictors of MACE on multivariable analysis. Conclusions: Despite symptomatic improvement, patients with cardiomyopathies remain prone to major clinical events in the short term. Outcomes were different not only according to cardiomyopathy subtypes but also in relatives vs. index patients, and according to European regions

Local public health workers' perceptions toward responding to an influenza pandemic

BACKGROUND: Current national preparedness plans require local health departments to play an integral role in responding to an influenza pandemic, a major public health threat that the World Health Organization has described as "inevitable and possibly imminent". To understand local public health workers' perceptions toward pandemic influenza response, we surveyed 308 employees at three health departments in Maryland from March – July 2005, on factors that may influence their ability and willingness to report to duty in such an event. RESULTS: The data suggest that nearly half of the local health department workers are likely not to report to duty during a pandemic. The stated likelihood of reporting to duty was significantly greater for clinical (Multivariate OR: 2.5; CI 1.3–4.7) than technical and support staff, and perception of the importance of one's role in the agency's overall response was the single most influential factor associated with willingness to report (Multivariate OR: 9.5; CI 4.6–19.9). CONCLUSION: The perceived risk among public health workers was shown to be associated with several factors peripheral to the actual hazard of this event. These risk perception modifiers and the knowledge gaps identified serve as barriers to pandemic influenza response and must be specifically addressed to enable effective local public health response to this significant threat

Fetal Growth versus Birthweight: The Role of Placenta versus Other Determinants

in utero. We aimed to study the effects of maternal characteristics on both birthweight and fetal growth in third trimester and introduce placental weight as a possible determinant of both birthweight and fetal growth in third trimester.The STORK study is a prospective cohort study including 1031 healthy pregnant women of Scandinavian heritage with singleton pregnancies. Maternal determinants (age, parity, body mass index (BMI), gestational weight gain and fasting plasma glucose) of birthweight and fetal growth estimated by biometric ultrasound measures were explored by linear regression models. Two models were fitted, one with only maternal characteristics and one which included placental weight.Placental weight was a significant determinant of birthweight. Parity, BMI, weight gain and fasting glucose remained significant when adjusted for placental weight. Introducing placental weight as a covariate reduced the effect estimate of the other variables in the model by 62% for BMI, 40% for weight gain, 33% for glucose and 22% for parity. Determinants of fetal growth were parity, BMI and weight gain, but not fasting glucose. Placental weight was significant as an independent variable. Parity, BMI and weight gain remained significant when adjusted for placental weight. Introducing placental weight reduced the effect of BMI on fetal growth by 23%, weight gain by 14% and parity by 17%.In conclusion, we find that placental weight is an important determinant of both birthweight and fetal growth. Our findings indicate that placental weight markedly modifies the effect of maternal determinants of both birthweight and fetal growth. The differential effect of third trimester glucose on birthweight and growth parameters illustrates that birthweight and fetal growth are not identical entities

Appropriateness of treatment recommendations for PPI in hospital discharge letters

International audienc

Coronary artery bypass surgery in a patient with Kartagener syndrome: a case report and literature review

Kartagener syndrome consists of congenital bronchiectasis, sinusitis, and total situs inversus in half of the patients. A patient diagnosed with Kartagener syndrome was reffered to our department due to 3-vessel coronary disease. An off-pump coronary artery bypass operation was performed using both internal thoracic arteries and a saphenous vein graft. We performed a literature review for cases with Kartagener syndrome, coronary surgery and dextrocardia. Although a few cases of dextrocardia were found in the literature, no case of Kartagener syndrome was mentioned