TRATADO DE COOPERAÇÃO ESPACIAL ENTRE BRASIL E UCRÂNIA : reflexões sobre sua criação e extinção

This article aims to analyze the project for the creation and development of the Alcântara Cyclone Space, considering it was a partnership between the Brazilian and Ukrainian governments for space exploration. The antecedents that motivated the creation of the binational, its legal and regulatory delimitations and the political context in which the company was inserted are the object of analysis, so that, in the end, it may be possible to make a more complete and detailed assessment of the problems that led to the extinction of this partnership. Throughout the preparation, creation and implementation of the ACS, international socio-environmental conflicts and administrative problems on the part of both governments emerged, hindering the effective creation of the Launch Center needed for the project. The methodology used is the bibliographic review, with the use of books and academic articles, in addition to journalistic articles. The result obtained is that the project that instituted the ACS was riddled with problems not considered in the planning, nor remedied, which hindered a partnership that could have been beneficial to boost the Brazilian aerospace sector.Este artigo tem como objetivo fazer uma análise do projeto de criação e dos desdobramentos da autarquia Alcântara Cyclone Space (ACS), enquanto uma parceria entre os governos brasileiro e ucraniano para exploração espacial. Tem-se como objeto de análise os antecedentes que motivaram a criação da autarquia binacional, suas delimitações jurídicas e regulamentares e o contexto político no qual a empresa estava inserida, para que, ao final, seja possível fazer uma avaliação mais completa e detalhada das problemáticas que levaram à extinção da parceria entre os estados-nação. Ao longo da elaboração, criação e implantação da ACS, emergiram conflitos socioambientais internacionais e problemas administrativos por parte de ambos os governos, de modo a dificultar a efetiva criação do Centro de Lançamentos necessário à consecução do projeto. A metodologia utilizada é a de revisão bibliográfica, com o recurso a livros e artigos acadêmicos, além de artigos de cunho jornalístico. O resultado obtido é que o projeto que instituiu a ACS foi eivado de problemáticas não consideradas no planejamento, tampouco sanadas ao longo da execução, as quais dificultaram uma parceria que poderia ter sido benéfica para impulsionar o setor aeroespacial brasileiro e ucraniano.

Manejo da Dor em Cirurgias de Apendicectomia Infantil

Objective: The aim of this article is to explore various anesthesia techniques employed in pediatric appendectomy, highlighting specific considerations, challenges, and alternatives. The goal is to provide a comprehensive understanding for healthcare professionals, parents, and stakeholders, focusing on improving the safety, efficacy, and postoperative experience of children undergoing this surgical procedure. Methodology: The integrative review sought to identify the most effective approaches for postoperative pain control in children undergoing appendectomy. The research was conducted on specialized databases such as PubMed, Scopus, Scielo, Lilacs, and Web of Science, using descriptors "Appendicitis," "Appendectomy," "Pain Management," and "Pediatrics," combined with Boolean operators AND and OR. Results: Effective strategies for postoperative pain control in children undergoing appendectomy were highlighted. Techniques such as epidural anesthesia, multimodal analgesia, and less invasive approaches demonstrated a positive impact on pain management, providing valuable insights for clinical practice. However, further research is needed to further refine therapeutic guidelines specific to this pediatric population. Conclusion: Thus, the importance of a multimodal approach in controlling post-pediatric appendectomy pain emphasizes the ongoing need for research to refine therapeutic strategies specific to children in this surgical context. These insights contribute to improving the quality of care and postoperative outcomes.Objetivo: O objetivo deste artigo é explorar as diversas técnicas de anestesia empregadas na apendicectomia pediátrica, destacando considerações específicas, desafios e alternativas, visando proporcionar uma compreensão abrangente para profissionais de saúde, pais e demais interessados, com foco na melhoria da segurança, eficácia e experiência pós-operatória das crianças submetidas a esse procedimento cirúrgico. Metodologia: A revisão integrativa buscou identificar as abordagens mais eficazes no controle da dor pós-operatória em crianças submetidas à apendicectomia. A pesquisa foi conduzida em bases de dados especializadas, como PubMed, Scopus, Scielo, Lilacs e Web of Science, utilizando os descritores "Apendicite", "Apendicectomia", "Manejo da Dor" e "Pediatria", combinados por operadores booleanos AND e OR. Resultados: Destacaram-se estratégias eficazes no controle da dor pós-operatória em crianças submetidas à apendicectomia. Técnicas como anestesia peridural, analgesia multimodal e abordagens menos invasivas demonstraram impacto positivo na gestão da dor, proporcionando insights valiosos para a prática clínica. Contudo, são necessárias mais pesquisas para aprimorar ainda mais as diretrizes terapêuticas específicas para essa população pediátrica. Conclusão: Assim, a importância da abordagem multimodal no controle da dor pós-apendicectomia pediátrica, enfatizando a necessidade contínua de pesquisas para refinamento das estratégias terapêuticas específicas para crianças nesse contexto cirúrgico. Esses insights contribuem para a melhoria da qualidade de cuidados e resultados pós-operatórios

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research