Socio-economic sustainability with circular economy - An alternative approach

As the global population and living standards rise, it pushes the demand for basic amenities like food, health, and energy resources. Additionally, manufacturing automation has led to mass production and consumption, triggering waste production. The existing linear economy approach has led to increasing waste production and resource depletion, posing significant environmental and public health threats. To overcome these impediments, an alternative model called the circular economy concept has gained popularity in the global industry community. This closed-loop, restorative, waste-free concept has the potential to protect the environment and improve economics by reducing energy and resource consumption. Thus, major impetus should be given to strengthening the backbone of the economy where tools such as green technologies, decarbonization strategies, bio refinery processes, material flow analysis, life cycle assessment, ecological footprints (water, carbon, and material), substance flow analysis, circularity index, eco-designing, bioresource management, new business models, and policy play an essential role in the areas of socio-economic sustainability, ecological facts, and industrial aspects to enhance socio-economic growth in a sustainable manner. Sectoral awareness, collaborations, and partnerships among the Government, stakeholders, policymakers, and competent authorities are also essential to enabling circularity within the eco-systems.

Neglected tropical diseases and systemic racism especially in Brazil: from socio-economic aspects to the development of new drugs

Neglected tropical diseases (NTDs) are highly prevalent communicable diseases in tropical and subtropical countries, generally not economically attractive for drug development and related to poverty. In Brazil, more specifically, socioeconomic inequalities and health indicators are strongly influenced by skin color, race, and ethnicity, due to the historical process of slavery. In this context, it is important to understand the concept of systemic racism: a form of indirect racial discrimination present in many institutions, which determines the process of illness and death of the black population, the ethnic group most affected by these diseases. The main objective of this paper was to carry out a literature review on the socioeconomic aspects of these diseases, relating them to institutional racism, and to encourage reflection on the influence of this type of racism in the NTDs context. Therefore, we present a paper that brings a evident correlation between racism versus neglected populations, which are affected by equally neglected diseases. A more humane and comprehensive view is needed to realize that these illnesses affect neglected and vulnerable populations, who require decent living conditions, health, and social justice. We hope to provide, with this paper, enough, but not exhaust, knowledge to initiate the discussion about neglected diseases, their socioeconomic aspects and institutional racism.

Global COVID-19 pandemic trends and their relationship with meteorological variables, air pollutants and socioeconomic aspects

Meteorological variables, air pollutants, and socioeconomic factors are associated with COVID-19 transmission. However, it is unclear what impact their interactions have on COVID-19 transmission, whether their impact on COVID-19 transmission is linear or non-linear, and where the inflexion points are. This study examined 1) the spatial and temporal trends in COVID-19 monthly infection rate of new confirmed cases per 100,000 people (R_n) in 188 countries/regions worldwide from March to November 2020; 2) the linear correlation between meteorological variables (temperature (T), rainfall (R), wind speed (WS), relative humidity (RH), air pressure (AP)), air pollutants (nitrogen dioxide (NO₂), sulfur dioxide (SO₂), carbon monoxide (CO), ozone (O₃)) and socioeconomic aspects (population density (PD), gross domestic product per capita (GDP), domestic general government health expenditure per capita (GHE)) and R_n, and 3) the interaction and non-linear effects of the different variables on R_n, based on GeoDetector and Boosted regression tree. The results showed that the global R_n had was spatially clustered, and the average R_n increased From March to November 2020. Global R_n was negatively correlated with meteorological variables (T, R, WS, AP) and positively correlated with air pollutants (NO₂, SO₂, O₃) and socioeconomic aspects (GDP, GHE). The interaction of SO₂ and O₃, SO₂ and RH, and O₃ and T strongly affected R_n. The variables effect on COVID-19 transmission was non-linear, with one or more inflexion points. The findings of this work can provide a basis for developing a global response to COVID-19 for global sustainable development.

Invasive Chinook Salmon in Chile: Stakeholder Perceptions and Management Conflicts around a New Common-use Resource

Since the last decade, the Chinook salmon has become an invasive species in southern Chilean rivers, affecting their environment and displacing native species due to predation and competition. The socioeconomic valuation of this species is complex, due to its high economic, touristic, and culinary value. The tourism industry and artisanal fishing groups see the salmon as a new common-use resource to be regulated. The Chilean regulatory framework, in turn, has made the presence, danger, and economic importance of the species invisible. This document analyzes the social construction of salmonids according to different interest groups and their interaction with the legal invisibility of this species. Our study delves into a particular group: the artisanal fishermen of La Barra del Toltén, in the Araucania Region, whose main economic activity has been illegal Chinook salmon fishing, pressing for their legalization. This case raises reflections on the perennially complex relationship between nature and society, as well as the management of common problems and common resources.

Status of the neuromyelitis optica spectrum disorder in Latin America

BACKGROUND

Neuromyelitis optica spectrum disorders (NMOSD) is an increasing diagnostic and therapeutic challenge in Latin America (LATAM). Despite the heterogeneity of this population, ethnic and socioeconomic commonalities exist, and epidemiologic studies from the region have had a limited geographic and population outreach. Identification of some aspects from the entire region are lacking.

OBJECTIVES

To determine ethnic, clinical characteristics, and utilization of diagnostic tools and types of therapy for patients with NMOSD in the entire Latin American region.

METHODS

The Latin American Committee for Treatment and Research in MS (LACTRIMS) created an exploratory investigational survey addressed by Invitation to NMOSD Latin American experts identified through diverse sources. Data input closed after 30 days from the initial invitation. The questionnaire allowed use of absolute numbers or percentages. Multiple option responses covering 25 themes included definition of type of practice; number of NMOSD cases; ethnicity; utilization of the 2015 International Panel criteria for the diagnosis of Neuromyelitis optica (IPDN); clinical phenotypes; methodology utilized for determination of anti-Aquaporin-4 (anti- AQP4) antibodies serological testing, and if this was performed locally or processed abroad; treatment of relapses, and long-term management were surveyed.

RESULTS

We identified 62 investigators from 21 countries reporting information from 2154 patients (utilizing the IPDN criteria in 93.9% of cases), which were categorized in two geographical regions: North-Central, including the Caribbean (NCC), and South America (SA). Ethnic identification disclosed Mestizos 61.4% as the main group. The most common presenting symptoms were concomitant presence of optic neuritis and transverse myelitis in 31.8% (p=0.95); only optic neuritis in 31.4% (more common in SA), p<0.001); involvement of the area postrema occurred in 21.5% and brain stem in 8.3%, both were more frequent in the South American cases (p<0.001). Anti-AQP4 antibodies were positive in 63.9% and anti-Myelin Oligodendrocyte Glycoprotein (MOG) antibodies in 4.8% of total cases. The specific laboratorial method employed was not known by 23.8% of the investigators. Acute relapses were identified in 81.6% of cases, and were treated in 93.9% of them with intravenous steroids (IVS); 62.1% with plasma exchange (PE), and 40.9% with intravenous immunoglobulin-G (IVIG). Therapy was escalated in some cases due to suboptimal initial response. Respondents favored Rituximab as long-term therapy (86.3%), whereas azathioprine was also utilized on 81.8% of the cases, either agent used indistinctly by the investigators according to treatment accessibility or clinical judgement. There were no differences among the geographic regions.

CONCLUSIONS

This is the first study including all countries of LATAM and the largest cohort reported from a multinational specific world area. Ethnic distributions and phenotypic features of the disease in the region, challenges in access to diagnostic tools and therapy were identified. The Latin American neurological community should play a determinant role encouraging and advising local institutions and health officials in the availability of more sensitive and modern diagnostic methodology, in facilitating the the access to licensed medications for NMOSD, and addressing concerns on education, diagnosis and management of the disease in the community.

Do Black and Asian individuals wait longer for treatment? A survival analysis investigating the effect of ethnicity on time-to-clinic and time-to-treatment for diabetic eye disease

AIMS/HYPOTHESIS

This study explored the impact of ethnicity on time-to-clinic, time-to-treatment and rates of vision loss in people referred to hospital with diabetic eye disease.

METHODS

A survival analysis was performed on all referrals from an inner-city diabetic eye screening programme to a tertiary hospital eye service between 1 October 2013 and 31 December 2017. Exclusion criteria were failure to attend hospital, distance visual acuity in both eyes too low to quantify with the Early Treatment Diabetic Retinopathy Study (ETDRS) letter chart and treatment received prior to referral. Demographic and screening grade data were collected at the point of referral. Small-area statistics and census data were used to calculate indices of multiple deprivation. The main outcome measures were time taken from the date of referral for an individual to achieve the following: (1) attend the first hospital clinic appointment; (2) receive the first macular laser, intravitreal anti-vascular endothelial growth factor injection or pan-retinal photocoagulation treatment, in either eye; and (3) lose at least ten ETDRS letters of distance visual acuity, in either eye.

RESULTS

Of 2062 referrals, 1676 individuals were included. Mean age (± SD) was 57.6 ± 14.7 years, with 52% male sex and 86% with type 2 diabetes. The ethnicity profile was 52% Black, 30% White, 10% Asian and 9% mixed/other, with similar disease severity at the time of referral. Time-to-clinic was significantly longer for Asian people than for Black people (p = 0.03) or White people (p = 0.001). Time-to-treatment was significantly longer for Black people than for White people (p = 0.02). Social deprivation did not significantly influence time-to-treatment. There were no significant differences in the rates of vision loss between ethnic groups.

CONCLUSIONS/INTERPRETATION

Black people wait longer for hospital eye treatment compared with their White counterparts. The reasons for this delay in treatment warrant further investigation.

Trends in type 2 diabetes incidence and mortality in Scotland between 2004 and 2013

AIMS/HYPOTHESIS

The relative contribution of increasing incidence and declining mortality to increasing prevalence of type 2 diabetes in Scotland is unclear. Trends in incidence and mortality rates are described for type 2 diabetes in Scotland between 2004 and 2013 by age, sex and socioeconomic deprivation.

METHODS

Data for incident and prevalent cases of type 2 diabetes were obtained from the Scottish national diabetes register with number of deaths identified from linkage to mortality records. Population size and death data for Scotland by age, sex and socioeconomic deprivation were obtained from National Records of Scotland. Age- and sex-specific incidence and mortality rates stratified by year and deciles of socioeconomic status were calculated using Poisson models.

RESULTS

There were 180,290 incident cases of type 2 diabetes in Scotland between 2004 and 2013. Overall, incidence of type 2 diabetes remained stable over time and was 4.88 (95% CI 4.84, 4.90) and 3.33 (3.28, 3.32) per 1000 in men and women, respectively. However, incidence increased among young men, remained stable in young women, and declined in older men and women. Incidence rates declined in all socioeconomic groups but increased after 2008 in the most deprived groups. Standardised mortality ratios associated with diabetes, adjusted for age and socioeconomic group, were 1.38 (1.36, 1.41) in men and 1.49 (1.45, 1.52) in women, and remained constant over time.

CONCLUSIONS/INTERPRETATION

Incidence of type 2 diabetes has stabilised in recent years suggesting that increasing prevalence may be primarily attributed to declining mortality. Prevention of type 2 diabetes remains important, particularly among socioeconomically deprived populations.

Multiple ecosystem services landscape index: a tool for multifunctional landscapes conservation

The contribution of ecosystems to human well-being has been widely recognised. Taking into account existing trade-offs between ecosystem services (ES) at the farm scale and the dependence of multiple ES on processes that take place at the landscape scale, long-term preservation of multifunctional landscapes must be a priority. Studies carried out from such perspective, and those that develop appropriate indicators, could provide useful tools for integrating ES in landscape planning. In this study we propose a new integrative environmental indicator based on the ES provided by the landscape and named "multiple ecosystem services landscape index" (MESLI). Because synergies and trade-offs between ES are produced at regional or local levels, being different from those perceived at larger scales, MESLI was developed at municipality level. Furthermore, in order to identify main drivers of change in ES provision at the landscape scale an analysis of the relationship between the environmental and the socioeconomic characteristics of the municipalities was carried out. The study was located in the Basque Country and the results demonstrated that the MESLI index is a good tool to measure landscape multifunctionality at local scales. It is effective evaluating landscapes, distinguishing between municipalities based on ES provision, and identifying the drivers of change and their effects. This information about ES provisioning at the local level is usually lacking; therefore, MESLI would be very useful for policy-makers and land managers because it provides relevant information to local scale decision-making.