The dynamic feasibility of resisting (R), accepting (A), or directing (D) ecological change.

Ecological transformations are occurring as a result of climate change, challenging traditional approaches to land management decision-making. The resist-accept-direct (RAD) framework helps managers consider how to respond to this challenge. We examined how the feasibility of the choices to resist, accept, and direct shifts in complex and dynamic ways through time. We considered 4 distinct types of social feasibility: regulatory, financial, public, and organizational. Our commentary is grounded in literature review and the examples that exist but necessarily has speculative elements because empirical evidence on this newly emerging management strategy is scarce. We expect that resist strategies will become less feasible over time as managers encounter situations where resisting is ecologically, by regulation, financially, or publicly not feasible. Similarly, we expect that as regulatory frameworks increasingly permit their use, if costs decrease, and if the public accepts them, managers will increasingly view accept and direct strategies as more viable options than they do at present. Exploring multiple types of feasibility over time allows consideration of both social and ecological trajectories of change in tandem. Our theorizing suggested that deepening the time horizon of decision-making allows one to think carefully about when one should adopt different approaches and how to combine them over time.

La viabilidad dinámica de resistir (R), aceptar (A) o dirigir (D) el cambio ecológico Resumen Las transformaciones ecológicas ocurren por el cambio climático, lo que representa un reto para los enfoques tradicionales para decidir en torno a la gestión de tierras. El marco resistir­aceptar­dirigir (RAD) ayuda a los gestores a considerar cómo responder a este reto. Analizamos cómo la viabilidad de las opciones para resistir, aceptar y dirigir cambia de manera compleja y dinámica con el tiempo. Consideramos cuatro tipos distintos de viabilidad: regulatoria, económica, pública y de organización. Nuestro comentario está basado en la revisión bibliográfica y los ejemplos que existen, pero por necesidad tiene elementos especulativos ya que la evidencia empírica sobre esta estrategia emergente de gestión es escasa. Esperamos que las estrategias de resistir se vuelvan menos viables con el tiempo conforme los gestores encuentren situaciones en las que resistir no es viable de forma ecológica, económica, pública o por regulación. Al igual esperamos que cada vez más los marcos regulatorios permitan su uso, si el costo disminuye, y si el público los acepta, los gestores verán cada vez más viables las estrategias de aceptar y dirigir que las que utilizan actualmente. La exploración de varios tipos de viabilidad a lo largo del tiempo permite considerar las trayectorias sociales y ecológicas del cambio en conjunto. Nuestra teoría sugiere que profundizar en el horizonte temporal de las decisiones permite que se analice con cuidado sobre cuando se deben adoptar enfoques diferentes y cómo combinarlos con el tiempo.

[Recruitment, selection and retention staffing policies in health services directly managed. SESPAS Report 2024]. / Reclutamiento, selección y retención de profesionales en servicios de salud de gestión directa. Informe SESPAS 2024.

In an organization with highly specialized and changing services over the course of a working life, such as health services managed directly by public administrations (DM-NHS) are, the issues related to the recruitment, selection and retention of professionals should receive special attention. much larger than what is provided. For too long, the DM-NHS has mainly been working to resolve the problems that affect the organization, with enormous disregard for those suffer by the recipients of its services, the real population to which it provides assistance. In the DM-NHS, its administration (rather than management) of human resources is circumscribed by the contours of the Framework Statute and its implementing regulations and rulings. This is an inadequate instrument, both empirically in view of the results obtained (50% temporary employment among professionals working in the NHS), and conceptually, since it fails to comply with the reasons that normatively justify its existence: "that its legal regime is adapts to the specific characteristics of the practice of health professions, as well as the organizational peculiarities of the National Health System". The text describes the characteristics of statutory regulation and reviews how regulatory restrictions affect recruitment, selection and retention policies. Finally, possible alternatives are proposed to have coherent and rational permanent staffing policies that cover the real needs of the health services.

A cisheteronormatividade e a diversidade dos arranjos familiares: considerações à Terapia de Família Sistêmica / Cisheteronormativity and the diversity of family arrangements: considerations for Systemic Family Therapy / Cisheteronormatividad y diversidad de arreglos familiares: consideraciones para la Terapia de Família Sistêmica

INTRODUÇÃO: Neste artigo, buscamos articular questões referentes à Terapia de Família Sistêmica (TFS), estudos de sexualidade e gênero, perspectiva decolonial e interseccionalidade. Expomos como podemos pensar a partir destas problematizações as experiências familiares de pessoas que se situam no avesso ou nas margens da cisheteronormatividade e discutir sobre a diversidade que compõe a família, para além de uma visão restritiva deste termo. OBJETIVO: Fazer uma crítica construtiva à TFS, apontando o apagamento que esta disciplina possui em relação às vivências de pessoas LGBTQIAP+ (lésbicas, gays, transexuais e travestis, queer, intersexo, assexuais, pansexuais e demais orientações sexuais e identidades de gênero). METODOLOGIA: O artigo possui caráter ensaístico e sustentado em um material empírico oriundo de entrevistas de caráter biográfico/trajetórias de vida. Propomos aqui a perspectiva queer e decolonial, aliada à interseccionalidade como estratégia de análise de histórias de vida a fim de compreender os arranjos familiares de mulheres lésbicas, bissexuais e pansexuais. RESULTADOS: As entrevistadas demonstraram múltiplas realidades, baseando-se tanto em vivências de violência quanto de aceitação em suas famílias de origem, focando suas jornadas na construção de laços de apoio com suas famílias escolhidas, criando relações de irmandade entre amigas. CONCLUSÕES: A TFS poderia ampliar seu olhar e escrita sobre a população LGBTQIAP+, utilizando-se da decolonialidade/perspectiva queer e interseccionalidade como potente guia de análise das relações familiares, visto que as histórias de vida dessas mulheres concentram-se em lidar com discriminações e desafios associados aos seus diversos marcadores sociais da diferença.

INTRODUCTION: In this essay, the following themes will be analyzed: Systemic Family Therapy (SFT), sexuality and gender studies, women, and intersectionality. We expose how these themes combine in the family experiences of people who are on the other side or the margins of cisheteronormativity and discuss the diversity that makes up the family, beyond a restrictive view of this term. OBJECTIVE: Make a constructive criticism of TFS, pointing out the erasure that this discipline has in relation to the experiences of LGBTQIAP+ people (lesbians, gays, transsexuals and transvestites, queer, intersex, asexual, pansexual, and other sexual orientations and gender identities). We propose intersectionality as a strategy for analyzing life stories to understand the family arrangements of lesbian, bisexual and pansexuals women. METHODOLOGY: This essay is based on empirical material from biographical interviews/life trajectories. We propose here intersectionality as a strategy for analyzing life stories to understand the family arrangements of lesbian, bisexual and pansexual women. RESULTS: The interviewees demonstrated multiple realities, based on both experiences of violence and acceptance in their families of origin. And focusing their journeys on building supportive bonds with their chosen families, creating sisterhood relationships between friends. CONCLUSIONS: TFS could broaden its view and writing about the LGBTQIAP+ population, using intersectionality as a powerful guide for analyzing family relationships. Since these women's life stories focus on dealing with discrimination and challenges associated with their various social markers of difference.

INTRODUCCIÓN: En este artículo se analizan los siguientes temas: Terapia Familiar Sistémica (TFS), estudios de sexualidad y género, mujer e interseccionalidad. Exponemos cómo estos temas se conjugan en las experiencias familiares de personas que están del otro lado o en los márgenes de la cisheteronormatividad y discutimos la diversidad que conforma la familia, más allá de una visión restrictiva de este término. OBJETIVO: Hacer una crítica constructiva a TFS, señalando la borradura que tiene esta disciplina en relación a las vivencias de las personas LGBTQIAP+ (lesbianas, gays, transexuales y travestidos, queer, intersex, asexual, pansexual y otras orientaciones sexuales e identidades de género). METODOLOGÍA: El artículo tiene carácter ensayístico y se basa en material empírico de entrevistas de carácter biográfico/trayectorias de vida. Proponemos aquí la interseccionalidad como estrategia de análisis de las historias de vida para comprender los arreglos familiares de mujeres lesbianas, bisexuales y pansexuales. RESULTADOS: Los entrevistados evidenciaron múltiples realidades, basadas tanto en experiencias de violencia como de aceptación en sus familias de origen. Y enfocando sus viajes en construir lazos de apoyo con sus familias elegidas, creando relaciones de hermandad entre amigos. CONCLUSIONES: TFS podría ampliar su visión y escritura sobre la población LGBTQIAP+, utilizando la interseccionalidad como una poderosa guía para analizar las relaciones familiares. Dado que las historias de vida de estas mujeres se centran en lidiar con la discriminación y los desafíos asociados con sus diversos marcadores sociales de diferencia.

Ergonomics, musculoskeletal disorders, treatment and return to work: a conceptual framework for intervention programs / Ergonomía, Trastornos Musculoesqueléticos, Tratamiento y Retorno al Trabajo – Marco Conceptual para programas de intervención

Musculoskeletal disorders are one of the most recurrent diseases among manual workers worldwide. The objective of this study was to analyze primary results of a systematic review on ergonomics, musculoskeletal disorders, treatment, and return to work in blue-collar work-ers to form a new conceptual framework applicable to intervention programs in this area. This study was based on the available scientific evidence we identified. Descriptive data and their trending topics areas were used to form the conceptual framework. The trend shows that working conditions can be represented as a three-axis scheme with a multidimensional conceptual framework considering ergonomic risks, the treatment of affected workers and the determinants related to working conditions. These results may help future research in the field of ergonomics as well as emerging topics focused on intervention programs.(AU)

Los trastornos musculoesqueléticos son una de las enfermedades más recurrentes entre los trabajadores que realizan operaciones manuales a nivel mundial. El objetivo de este estudio fue analizar los resultados primarios de una revisión sistemática sobre ergonomía, trastornos musculoesqueléticos, tratamiento y retorno al trabajo en trabajadores operativos para formar un nuevo marco conceptual aplicable a los programas de intervención en esta área. Este estudio se basó en la evidencia científica disponible identificada. Se utilizaron datos descriptivos y sus áreas de temas de tendencia para formar el marco conceptual. La tendencia muestra que las condiciones de trabajo pueden representarse como un esquema de tres ejes con un marco conceptual multidimensional que considera los riesgos ergonómicos, el tratamiento de los trabajadores afectados y los determinantes relacionados con las condiciones de trabajo. Estos resultados podrían ayudar a futuras investigaciones en el campo de la ergonomía, así como a temas emergentes centrados en programas de intervención.(AU)

Loss of the scavenger receptor MARCO results in uncontrolled vomocytosis of fungi from macrophages.

Vomocytosis, also known as nonlytic exocytosis, is a process whereby fully phagocytosed microbes are expelled from phagocytes without discernible damage to either the phagocyte or microbe. Although this phenomenon was first described in the opportunistic fungal pathogen Cryptococcus neoformans in 2006, to date, mechanistic studies have been hampered by an inability to reliably stimulate or inhibit vomocytosis. Here we present the fortuitous discovery that macrophages lacking the scavenger receptor MAcrophage Receptor with COllagenous domain (MARCO), exhibit near-total vomocytosis of internalised cryptococci within a few hours of infection. Marco-/- macrophages also showed elevated vomocytosis of a yeast-locked C. albicans strain, suggesting this to be a broadly relevant observation. We go on to show that MARCO's role in modulating vomocytosis is independent of its role as a phagocytic receptor, suggesting that this protein may play an important and hitherto unrecognised role in modulating macrophage behaviour.

The inhibition of MARCO by PolyG alleviates pulmonary fibrosis via regulating mitochondrial function in a silicotic rat model.

Silicon dioxide (SiO2)-induced pulmonary fibrosis is potentially associated with the impairment of mitochondrial function. Previous research found that inhibition of macrophage receptor with collagenous structure (MARCO) could alleviate particle-induced lung injury by regulating phagocytosis and mitigating mitochondrial damage. The present study aims to explore the underlying anti-fibrosis mechanism of polyguanylic acid (PolyG, MARCO inhibitor) in a silicotic rat model. Hematoxylin and eosin and Masson staining were performed to visualize lung tissue pathological changes. Confocal microscopy, transmission electron microscope, western blot analysis, quantitative real-time PCR (qPCR), and adenosine triphosphate (ATP) content assay were performed to evaluate collagen content, mitochondrial function, and morphology changes in SiO2-induced rat pulmonary fibrosis. The results suggested that SiO2 exposure contributed to reactive oxygen species aggregation and the reduction of respiratory complexes and ATP synthesis. PolyG treatment could effectively reduce MARCO expression and ameliorate lung injury and fibrosis by rectifying the imbalance of mitochondrial respiration and energy synthesis. Furthermore, PolyG could maintain mitochondrial homeostasis by promoting peroxisome proliferator-activated receptor-coactivator 1 α (PGC1α)-mediated mitochondrial biogenesis and regulating fusion and fission. Together, PolyG could ameliorate SiO2-induced pulmonary fibrosis via inhibiting MARCO to protect mitochondrial function.

Helpful and meaningful aspects of a psychoeducational programme to treat complex dissociative disorders: a qualitative approach.

Purpose: Complex dissociative disorders (CDDs) are prevalent among psychotherapy clients, and research suggests carefully paced treatment for CDDs is helpful. The purpose of the present study is to qualitatively explore helpful and meaningful aspects of the TOP DD Network programme, a web-based adjunctive psychoeducational programme for the psychotherapeutic treatment of clients with CDDs.Methods: TOP DD Network programme participants (88 clients and 113 therapists) identified helpful and meaningful aspects of their participation in response to two open textbox questions. Framework analysis was used to qualitatively analyze client and therapist responses.Findings: Participants found the TOP DD Network programme helpful and meaningful in nuanced ways. Three themes were created: (1) Components of the Programme (subthemes: content, structure), (2) Change-Facilitating Processes (subthemes: heightened human connection, receiving external empathy and compassion, contributing to something bigger, improved therapeutic work and relationship), and (3) Outcomes (subthemes: insight, increased hope, self-compassion, increased safety and functioning). The most emphasized theme was components of the programme, which captured its content and structure.Conclusion: Clients and therapists in the TOP DD Network programme described the programme's components and processes as helpfully facilitating positive outcomes in the treatment of CDDs. Therapists may consider integrating the components and processes in the programme into their practice with clients with CDDs.

The aim of the present study was to qualitatively explore significant aspects of the TOP DD Network programme through the experiences of complex dissociative disorder (CDD) clients and psychotherapists.Helpful and meaningful aspects of the programme included its components (i.e. content and structure), processes, and outcomes.This psychoeducational programme can be effective and result in improved therapeutic processes and outcomes for individuals with CDDs in psychotherapy.

The application of MARCO for immune regulation and treatment.

Macrophage receptor with collagen structure (MARCO) is a member of scavenger receptor class A (SR-A) and shares structural and functional similarities with SR-A1. In recent years, many studies have shown that MARCO can trigger an immune response and has therapeutic potential as a target for immunotherapy. Studies have shown that alterations in MARCO expression following pathogen infection cause changes in the functions of innate and adaptive immune cells, including macrophages, dendritic cells, B cells, and T cells, affecting the body's immune response to invading pathogens; thus, MARCO plays a crucial role in triggering the immune response, bridging innate and adaptive immunity, and eliminating pathogens. This paper is a comprehensive summary of the recent research on MARCO. This review focuses on the multiple functions of MARCO, including adhesion, migration, phagocytosis, and cytokine secretion with special emphasis on the complex interactions between MARCO and various types of cells involved in the immune response, as well as possible immune-related mechanisms. In summary, in this review, we discuss the structure and function of MARCO and its role in the immune response and highlight the therapeutic potential of MARCO as a target for immunotherapy. We hope that this review provides a theoretical basis for future research on MARCO.

Blocking MARCO+ tumor-associated macrophages improves anti-PD-L1 therapy of hepatocellular carcinoma by promoting the activation of STING-IFN type I pathway.

The PD-L1/PD-1 axis is a classic immunotherapy target. However, anti-PD-L1/PD-1 therapy alone can not achieve satisfactory results in solid tumors, especially liver cancer. Among the several factors involved in tumor anti-PD-L1/PD-1 treatment resistance, tumor-associated macrophages (TAMs) have attracted attention because of their immunosuppressive ability. TAMs with a macrophage receptor with a collagenous structure (MARCO) are a macrophage subset group with strong immunosuppressive abilities. Clinical specimens and animal experiments revealed a negative correlation between MARCO + TAMs and patient prognosis with liver cancer. Transcriptional data and in vitro and in vivo experiments revealed that MARCO + TAM immunosuppressive ability was related to secretion. MARCO suppressed IFN-ß secretion from TAMs, reducing antigen presentation molecule expression, infiltration, and CD8+T cell dysfunction, thus producing an immunosuppressive microenvironment in liver cancer. MARCO can promote dying tumor cell clearance by macrophages, reducing tumor-derived cGAMP and ATP accumulation in the tumor microenvironment and inhibiting sting-IFN-ß pathway activation mediated by P2X7R in MARCO+TAMs. Animal experiments revealed that the MARCO and PD-L1 monoclonal antibody combination could significantly inhibit liver cancer growth. Conclusively, targeting MARCO+TAMs can significantly improve anti-PD-L1 resistance in liver cancer, making it a potential novel immune target for liver cancer therapy.

Progress developing the concept of other effective area-based conservation measures.

In 2010, the introduction of other effective area-based conservation measures (OECMs) into international policy caused a paradigm shift in area-based conservation, which included consideration of areas outside formal protected areas and places where biodiversity conservation may not be a management objective for the site. Despite the importance of this shift for global conservation, conservation science and policy have been slow to engage with the concept of OECMs. As the world moves toward protecting 30% of the Earth by 2030, it is imperative to develop evidence-based guidance for how to identify effective conservation measures, especially tools to help evaluate and monitor the biodiversity outcomes associated with potential OECMs. To understand the current progress in developing the concept of OECMs, I evaluated the peer-reviewed literature to consolidate and synthesize current knowledge. I conducted a thematic analysis of papers to identify the types of challenges and opportunities being discussed and lessons from studies evaluating the effectiveness of OECMs. Only 105 studies mentioned OECMs, and those that did rarely move beyond superficial mention of OECMs as part of area-based conservation. Around one-half of studies listed potential risks or benefits of OECMs but none provided evidence these issues have materialized. Twenty-three studies attempted to identify potential OECMs, although specific case studies were rare. The 7 studies that evaluated existing OECMs were highly critical of how they had been implemented to date. Studies that evaluated conservation outcomes were extremely rare, and suggested effectiveness must be judged on a case-by-case basis. The current literature not only leaves many gaps in the science required to operationalize the concept of OECMs, but also often raises additional questions that need to be addressed. If these gaps are not filled by robust science, the promised benefits for biodiversity from OECMs may never be realized.

Progreso en el desarrollo del concepto de otras medidas efectivas de conservación basadas en el área Resumen En 2010, la introducción de otras medidas eficaces de conservación basadas en zonas geográficas específicas (OECM) en la política internacional provocó un cambio de paradigma en la conservación basada en el área, que incluyó la consideración de zonas situadas fuera de las áreas protegidas formales y lugares donde la conservación de la biodiversidad puede no ser un objetivo de gestión para el sitio. A pesar de la importancia de este cambio para la conservación mundial, la ciencia y la política de la conservación han tardado en comprometerse con el concepto de OECM. A medida que el mundo avanza hacia la protección del 30% de la Tierra para 2030, es imperativo desarrollar orientaciones basadas en pruebas sobre cómo identificar medidas de conservación eficaces, especialmente herramientas que ayuden a evaluar y supervisar los resultados de biodiversidad asociados a posibles OECM. Para comprender los avances actuales en el desarrollo del concepto de OECM, evalué la bibliografía revisada por pares para consolidar y sintetizar los conocimientos actuales. Realicé un análisis temático de los artículos para identificar los tipos de retos y oportunidades que se debatían y las lecciones extraídas de los estudios que evaluaban la eficacia de las OECM. Sólo 105 estudios mencionaron las OECM, y los que lo hicieron rara vez iban más allá de la mención superficial de las OECM como parte de la conservación basada en el área. Aproximadamente la mitad de los estudios mencionaron los riesgos o beneficios potenciales de las OECM, pero ninguno aportó pruebas de que estos problemas se hubieran materializado. Veintitrés estudios intentaron identificar OECM potenciales, aunque los estudios de casos fueron escasos. Los siete estudios que evaluaron las OECM existentes fueron muy críticos con la forma en que se habían aplicado hasta la fecha. Los estudios que evaluaban los resultados de la conservación eran muy escasos y sugerían que la eficacia debía juzgarse caso por caso. La bibliografía actual no sólo deja muchos vacíos en la ciencia necesaria para hacer operativo el concepto de OECM, sino que a menudo plantea cuestiones adicionales que deben abordarse. Si estos vacíos no se cubren con una ciencia sólida, es posible que los beneficios prometidos de las OECM para la biodiversidad nunca lleguen a materializarse.

Lessons from COP15 on effective scientific engagement in biodiversity policy processes.

The Kunming-Montreal Global Biodiversity Framework was adopted by parties to the Convention on Biological Diversity in December 2022. The aftermath of these negotiations provides an opportunity to draw lessons as to how ecological and evolutionary science can more effectively inform policy. We examined key challenges that limit effective engagement by scientists in the biodiversity policy process, drawing parallels with analogous challenges within global climate negotiations. Biodiversity is multifaceted, yet represents only one framing for nature's contributions to people, complicating the nexus between evidence and values in development of the framework's targets. Processes generating biodiversity and driving its loss are multiscalar, challenging development of an evidence base for globally standardized targets. We illustrated these challenges by contrasting development of 2 key elements of the framework. The genetic diversity element of the framework's target 4 is directly related to the framework's primary goals, but its complexity required development of novel engagement skills. The target for protected areas was easily communicated but more indirectly related to biodiversity outcomes; evidence from ecological and social science was essential to communicating the context and limitations of this relationship. Scientists can strengthen the effectiveness of global agreements and address challenges arising from complexity, scaling, capacity limitations, and the interplay of science and values, if they can prioritize communication, consensus-building, and networking skills and engage throughout the process, from development of an evidence base to implementation.

Lecciones de la COP15 sobre la participación científica efectiva en los procesos políticos de biodiversidad Resumen El Marco Global de la Biodiversidad de Kunming­Montreal lo adoptaron los participantes de la Convención sobre la Diversidad Biológica en diciembre 2022. Las consecuencias de estas negociaciones proporcionan una oportunidad para tomar lecciones de cómo la ciencia evolutiva y ecológica puede orientar de mejor manera a las políticas. Examinamos los retos clave que limitan la participación efectiva de los científicos en el proceso de políticas de la biodiversidad, estableciendo paralelismos con los retos análogos en las negociaciones climáticas mundiales. La biodiversidad es multifacética y aun así representa sólo un marco para las contribuciones que tiene la naturaleza para las personas, lo que complica el nexo entre la evidencia y los valores en el desarrollo de los objetivos del marco. Los procesos que generan la biodiversidad y causan su pérdida son multiescalares, lo que representa un reto para el desarrollo de una base de evidencias para tener objetivos mundiales estandarizados. Ilustramos estos retos con el contraste del desarrollo de dos elementos clave del marco. El elemento de la diversidad genética en el objetivo 4 del marco está relacionado directamente con los objetivos principales del marco, pero su complejidad requiere el desarrollo de habilidades novedosas de participación. El objetivo para las áreas protegidas se comunicó con facilidad, pero estuvo relacionado de forma más indirecta con los resultados de biodiversidad; la evidencia de las ciencias sociales y ecológicas fue esencial para comunicar el contexto y las limitaciones de esta relación. Los científicos pueden fortalecer la efectividad de los acuerdos globales y abordar los retos que surgen de la complejidad, el escalamiento, las limitaciones en la capacidad y la interacción de la ciencia y los valores, si pueden priorizar la comunicación, la llegada a consensos y el conocimiento de redes y participan durante el proceso, a partir del desarrollo de una evidencia base hasta la implementación.

Marco conceptual del juego de apuestas y sus daños asociados / Conceptual framework of gambling and gambling-related harms

El juego de apuestas es una actividad de ocio legítima en muchos países, la cual muchas personas utilizan. Sin embargo, algunas de ellas experimentan daños significativos como resultado de estos juegos de apuestas. Estos daños, que pueden ser de carácter económico, social o de salud física y mental, no solo los sufre el individuo que juega, sino que afectan a la familia, a la comunidad y a toda la sociedad. El objetivo de este texto es proponer un marco conceptual para comprender los determinantes del juego de apuestas y sus daños asociados, que ayude a desarrollar políticas de prevención para reducir su impacto en la salud. El marco planteado en este manuscrito sitúa la evidencia actual en el modelo de desigualdades en salud y analiza la importancia del contexto socioeconómico y político, de los ejes de desigualdad, de los factores individuales y sociales, y del sistema sanitario en la desigualdad en salud asociada al juego de apuestas que sufren los grupos más vulnerables. La evidencia que se recoge en este marco sugiere que los determinantes de salud conllevan a una desigualdad en salud en relación con los juegos de apuestas y sus daños asociados.(AU)

Gambling is a legitimate leisure activity in many countries that many people use. However, some of them suffer significant harm because of gambling. This may involve economic, social, physical or mental harm. These harms are not only suffered by the individual gambler, but affect the family, the community and society. The aim of this text is to propose a conceptual framework for understanding the determinants of gambling and its related harms and thus, contribute to the development of prevention policies to reduce its impact on health. The framework proposed in this manuscript places present evidence in the model of health inequalities, analyzing the effect of the socioeconomic and political context, the axes of inequalities, individual and social factors, and the health system in generating the health inequalities of gambling suffered by the most vulnerable groups. The evidence gathered in this framework suggests that health determinants lead to health inequality in relation to gambling and its associated harms.(AU)

Quais as consequências da aprovação do novo arcabouço fiscal para o SUS? / What are the implicationsof the adoptionof the new fiscal framework for the Brazilian Unified Health System? / ¿Cuáles son los efectosde la aprobación del nuevo marco fiscal para el Sistema Único de Salud del Brasil?

Quais as consequências da aprovação do novo arcabouço fiscal para o Sistema Único de Saúde (SUS)? Esta é a pergunta que norteia este editorial que reflete, com base em estudos econômicos e normativas federais, a necessidade de aprovação de um arcabouço fiscal que dialogue com um projeto de sistema universal de saúde, não desconsiderando o contexto histórico de desfinanciamento estrutural do SUS frente aos seus princípios, objetivos e diretrizes sistematizados pela nossa Constituição Federal.

What are the implications of the approval of the new fiscal framework for the Brazilian Unified Health System (SUS)? This question is the focus this editorial, which, based on economic studies and federal regulations, reflects the need to approve a fiscal framework consistent with the project of auniversal health system, not ignoring the historical context of structural underfunding of the SUS given its principles, objectives and guidelines systematized in Brazilian Federal Constitution.

¿Cuáles son los efectos de la aprobación del nuevo marco fiscal para el Sistema Único de Salud (SUS) del Brasil? Esa es la pregunta que guía este editorial, que refleja, con base en estudios económicos y normas federales, la necesidad de aprobar un marco fiscal que dialogue con un proyecto de sistema universal de salud, sin olvidar el contexto histórico de desfinanciamiento estructural del SUS frente de sus principios, objetivos y lineamientos sistematizados por la Constitución Federal de Brasil.

Some Questions Raised by the Practice of Online Analysis.

In this paper the author explores some of the issues raised by the practice of online analysis. In particular, he emphasizes the difference between the setting and the frame and proposes a theoretical approach of the latter as emerging within the transferential dynamic.

Dans cet article, l'auteur explore certaines des questions soulevées par la pratique de l'analyse en ligne. En particulier, il souligne la différence entre le dispositif et le cadre et propose une approche théorique de ce dernier comme émergeant au sein de la dynamique transférentielle.

En este artículo, el autor explora algunas de las cuestiones que plantea la práctica del análisis virtual. En particular, hace hincapié en la diferencia entre el encuadre y el marco y propone un enfoque teórico de este último como emergente dentro de la dinámica transferencial.

MARCO Inhibits Porcine Reproductive and Respiratory Syndrome Virus Infection through Intensifying Viral GP5-Induced Apoptosis.

Studying viral glycoprotein-host membrane protein interactions contributes to the discovery of novel cell receptors or entry facilitators for viruses. Glycoprotein 5 (GP5), which is a major envelope protein of porcine reproductive and respiratory syndrome virus (PRRSV) virions, is a key target for the control of the virus. Here, the macrophage receptor with collagenous structure (MARCO), which is a member of the scavenger receptor family, was identified as one of the host interactors of GP5 through a DUALmembrane yeast two-hybrid screening. MARCO was specifically expressed on porcine alveolar macrophages (PAMs), and PRRSV infection downregulated MARCO expression both in vitro and in vivo. MARCO was not involved in viral adsorption and internalization processes, indicating that MARCO may not be a PRRSV-entry facilitator. Contrarily, MARCO served as a host restriction factor for PRRSV. The knockdown of MARCO in PAMs enhanced PRRSV proliferation, whereas overexpression suppressed viral proliferation. The N-terminal cytoplasmic region of MARCO was responsible for its inhibitory effect on PRRSV. Further, we found that MARCO was a proapoptotic factor in PRRSV-infected PAMs. MARCO knockdown weakened virus-induced apoptosis, whereas overexpression aggravated apoptosis. MARCO aggravated GP5-induced apoptosis, which may result in its proapoptotic function in PAMs. The interaction between MARCO and GP5 may contribute to the intensified apoptosis induced by GP5. Additionally, the inhibition of apoptosis during PRRSV infection weakened the antiviral function of MARCO, suggesting that MARCO inhibits PRRSV through the regulation of apoptosis. Taken together, the results of this study reveal a novel antiviral mechanism of MARCO and suggest a molecular basis for the potential development of therapeutics against PRRSV. IMPORTANCE Porcine reproductive and respiratory syndrome virus (PRRSV) has been one of the most serious threats to the global swine industry. Glycoprotein 5 (GP5) exposed on the surface of PRRSV virions is a major glycoprotein, and it is involved in viral entry into host cells. A macrophage receptor with collagenous structure (MARCO), which is a member of the scavenger receptor family, was identified to interact with PRRSV GP5 in a DUALmembrane yeast two-hybrid screening. Further investigation demonstrated that MARCO may not serve as a potential receptor to mediate PRRSV entry. Instead, MARCO was a host restriction factor for the virus, and the N-terminal cytoplasmic region of MARCO was responsible for its anti-PRRSV effect. Mechanistically, MARCO inhibited PRRSV infection through intensifying virus-induced apoptosis in PAMs. The interaction between MARCO and GP5 may contribute to GP5-induced apoptosis. Our work reveals a novel antiviral mechanism of MARCO and advances the development of control strategies for the virus.

Obstruction of biodiversity conservation by minimum patch size criteria.

Minimum patch size criteria for habitat protection reflect the conservation principle that a single large (SL) patch of habitat has higher biodiversity than several small (SS) patches of the same total area (SL > SS). Nonetheless, this principle is often incorrect, and biodiversity conservation requires placing more emphasis on protection of large numbers of small patches (SS > SL). We used a global database reporting the abundances of species across hundreds of patches to assess the SL > SS principle in systems where small patches are much smaller than the typical minimum patch size criteria applied for biodiversity conservation (i.e., ∼85% of patches <100 ha). The 76 metacommunities we examined included 4401 species in 1190 patches. From each metacommunity, we resampled species-area accumulation curves to evaluate how biodiversity responded to habitat existing as a few large patches or as many small patches. Counter to the SL > SS principle and consistent with previous syntheses, species richness accumulated more rapidly when adding several small patches (45.2% SS > SL vs. 19.9% SL > SS) to reach the same cumulative area, even for the very small patches in our data set. Responses of taxa to habitat fragmentation differed, which suggests that when a given total area of habitat is to be protected, overall biodiversity conservation will be most effective if that habitat is composed of as many small patches as possible, plus a few large ones. Because minimum patch size criteria often require larger patches than the small patches we examined, our results suggest that such criteria hinder efforts to protect biodiversity.

Obstrucción de la conservación de la biodiversidad por el criterio del tamaño mínimo del fragmento Resumen Los criterios de tamaño mínimo de los fragmentos para la protección de los hábitats reflejan el principio de conservación según el cual un fragmento único grande (UG) de hábitat tiene mayor biodiversidad que varios fragmentos pequeños (VP) de la misma superficie total (UG > VP). Sin embargo, este principio a menudo es incorrecto; en su lugar, la conservación de la biodiversidad debería enfatizar más la protección de un gran número de pequeñas parcelas (VP > UG). Utilizamos una base de datos mundial que recopila la abundancia de especies en cientos de fragmentos para evaluar el principio UG > VP en sistemas donde los fragmentos pequeños son mucho menores que los criterios comunes de tamaño mínimo de fragmento aplicados para la conservación de la biodiversidad (es decir, ∼85% de parches <100 ha). Las 76 metacomunidades analizadas incluyeron 4,401 especies en 1,190 parcelas. Volvimos a muestrear las curvas de acumulación especie-área en cada metacomunidad para evaluar cómo respondía la biodiversidad al hábitat: como unas pocas manchas grandes o como fragmentos de muchas manchas pequeñas. Contrario al principio UG > VP y en congruencia con síntesis anteriores, la riqueza de especies se acumuló con mayor rapidez al añadir varios fragmentos pequeños (45.2% VP > UG frente a 19.9% UG > VP) para alcanzar la misma área acumulada, incluso para los fragmentos muy pequeños de nuestro conjunto de datos. Las respuestas de los taxones a la fragmentación del hábitat fueron diferentes, lo que sugiere que, cuando se trata de proteger una determinada superficie total de hábitat, la conservación global de la biodiversidad será más efectiva si ese hábitat está compuesto por el mayor número posible de pequeños fragmentos, más unos cuantos fragmentos grandes. Dado que los criterios de tamaño mínimo exigen a menudo fragmentos más grandes que los pequeños que examinamos, nuestros resultados sugieren que tales criterios dificultan los esfuerzos por proteger la biodiversidad.

Species-specific MARCO-alphavirus interactions dictate chikungunya virus viremia.

Arboviruses are public health threats that cause explosive outbreaks. Major determinants of arbovirus transmission, geographic spread, and pathogenesis are the magnitude and duration of viremia in vertebrate hosts. Previously, we determined that multiple alphaviruses are cleared efficiently from murine circulation by the scavenger receptor MARCO (Macrophage receptor with collagenous structure). Here, we define biochemical features on chikungunya (CHIKV), o'nyong 'nyong (ONNV), and Ross River (RRV) viruses required for MARCO-dependent clearance in vivo. In vitro, MARCO expression promotes binding and internalization of CHIKV, ONNV, and RRV via the scavenger receptor cysteine-rich (SRCR) domain. Furthermore, we observe species-specific effects of the MARCO SRCR domain on CHIKV internalization, where those from known amplification hosts fail to promote CHIKV internalization. Consistent with this observation, CHIKV is inefficiently cleared from the circulation of rhesus macaques in contrast with mice. These findings suggest a role for MARCO in determining whether a vertebrate serves as an amplification or dead-end host following CHIKV infection.

UGRP1-modulated MARCO+ alveolar macrophages contribute to age-related lung fibrosis.

The aging lungs are vulnerable to chronic pulmonary diseases; however, the underlying mechanisms are not well understood. In this study, we compared the aging lungs of 20-24-month-old mice with the young of 10-16-week-old mice, and found that aging airway epithelial cells significantly upregulated the expression of uteroglobin-related protein 1 (UGRP1), which was responsible for the higher levels of CCL6 in the aging lungs. Alveolar macrophages (AMs) changed intrinsically with aging, exhibiting a decrease in cell number and altered gene expression. Using terminal differentiation trajectories, a population of MARCO+ AMs with the ability to produce CCL6 was identified in the aging lungs. Upregulated UGRP1was demonstrated to modulate CCL6 production of AMs in the UGRP1-MARCO pair in vivo and in vitro. Furthermore, MARCO+ AMs aggravated bleomycin-induced pulmonary fibrosis in a CCL6-dependent manner in the aged mice, and blocking MARCO or neutralizing CCL6 significantly inhibited pulmonary fibrosis, similar to the depletion of AMs. The age-related upregulation of UGRP1 and MARCO+ AMs, involved in the progression of lung fibrosis, was also observed in human lung tissues. Thus, UGRP1 modulated MARCO+ AMs regarding the age-related lung fibrosis in a CCL6-dependent manner, which is key to establishing optimal targeting for the aging population.

Colorectal cancer-derived extracellular vesicles containing HSP70 enhance macrophage phagocytosis by up-regulating MARCO expression.

In recent years, we have realized that extracellular vesicles (EVs) play a critical role in regulating the intercellular communication between tumor and immune cells in the tumor microenvironment (TME). Tumor-derived extracellular vesicles (TDEVs) profoundly affect the functional changes of tumor-associated macrophages (TAMs) and promote their M2 polarization. Meanwhile, macrophages have a strong phagocytic ability in phagocytosing apoptotic cells. Especially in the course of chemotherapy or radiotherapy, TAMs can phagocytose and remove apoptotic tumor cells, showing anti-inflammatory and pro-tumor effects. However, the underlying mechanisms by which TDEVs regulate macrophage phagocytosis of apoptotic tumor cells have not been fully elucidated. In this study, we focused on the effect of colorectal cancer-derived extracellular vesicles (CRC-EVs) on macrophages. We demonstrated that CRC-EVs enhanced macrophage phagocytosis of apoptotic CRC cells. We then determined that heat shock protein 70 (HSP70) carried in CRC-EVs was responsible for this effect by using mass spectrometry-based proteomic analysis and the CRISPR-Cas9 system. Through transcriptome sequencing of macrophages, we found that the enhanced phagocytosis of macrophages was mainly due to the up-regulation of the macrophage receptor with collagenous structure (MARCO). In addition, we confirmed that the up-regulation of MARCO was mediated by the AKT-STAT3 signaling pathway. Taken together, this study revealed a novel EVs-mediated macrophage phagocytosis mechanism involved in the clearance of apoptotic tumor cells in the TME. Targeting TDEVs may have potential therapeutic applications in tumor treatment.

MARCO is a potential prognostic and immunotherapy biomarker.

BACKGROUND: Macrophage receptor with collagenous structure (MARCO), a novel immune checkpoint expressed on tumor-associated macrophages, has antitumor therapeutic properties. However, the association between MARCO and patient prognosis, immune infiltration, and ICI immunotherapy needs to be studied urgently. METHODS: MARCO distribution in cancer tissues was investigated using the TCGA and GTEx databases. The PrognoScan and KM Plotter databases was used to assess the MARCO prognosis. TIMER2.0, GEPIA, cBioPortal, and GSEA all confirmed the link between MARCO and immune infiltration, mutation profile, and enrichment pathway analysis. Data visualization was implemented by R language. RESULTS: In general, MARCO had a substantial impact on the prognosis of cancer patients and was expressed differently in cancer and adjacent normal tissues. High expression of MARCO was associated with poorer OS in bladder urothelial carcinoma (BLCA), breast invasive carcinoma (BRCA), lung squamous cell carcinoma (LUSC), colon adenocarcinoma (COAD), and prostate adenocarcinoma (PRAD). However, high expression of MARCO had a better PFI in brain lower-grade glioma (LGG) and skin cutaneous melanoma (SKCM). We discovered that MARCO expression was lowest in pancreatic adenocarcinoma (PAAD) and rectum adenocarcinoma (READ) stage 1, BLCA stage 2, LUSC and stomach adenocarcinoma (STAD) stage 3, and liver hepatocellular carcinoma (LIHC) stage 4. Subsequently, we analyzed the correlation between MARCO and 47 immune checkpoints and observed that MARCO was positively connected with CD80, CD86, and leukocyte-associated immunoglobulin-like receptor 1(LAIR1) in most cancers. In COAD, MARCO has the most microsatellite instability (MSI). In addition, we discovered that high expression of MARCO patients had a better prognosis after immune checkpoint inhibitor (ICI) treatment in SKCM. Finally, GSEA revealed a significant correlation between MARCO and TNF/NFκB signaling, KRAS signaling, PI3K/AKT/mTOR pathway, IL-6-STAT3 signaling, TGFß pathway, and p53 pathway. CONCLUSION: This study comprehensively investigated the relationship between MARCO and clinical prognosis, immune infiltration, and ICI immunotherapy in various cancers. We demonstrated the potential of MARCO as an emerging biomarker, exploring new avenues for future tumor immunotherapy.