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Even as the evidence of global warming mounts, the international response to this serious threat is coming unraveled. The United States has formally withdrawn from the 1997 Kyoto Protocol; other key nations are facing difficulty in meeting their Kyoto commitments; and developing countries face no limit on their emissions of the gases that cause global warming. In this clear and cogent book-reissued in paperback with an afterword that comments on recent events--David Victor explains why the Kyoto Protocol was never likely to become an effective legal instrument. He explores how its collapse offers opportunities to establish a more realistic alternative. Global warming continues to dominate environmental news as legislatures worldwide grapple with the process of ratification of the December 1997 Kyoto Protocol. The collapse of the November 2000 conference at the Hague showed clearly how difficult it will be to bring the Kyoto treaty into force. Yet most politicians, policymakers, and analysts hailed it as a vital first step in slowing greenhouse warming. David Victor was not among them. Kyoto's fatal flaw, Victor argues, is that it can work only if emissions trading works. The Protocol requires industrialized nations to reduce their emissions of greenhouse gases to specific targets. Crucially, the Protocol also provides for so-called \"emissions trading,\" whereby nations could offset the need for rapid cuts in their own emissions by buying emissions credits from other countries. But starting this trading system would require creating emission permits worth two trillion dollars--the largest single invention of assets by voluntary international treaty in world history. Even if it were politically possible to distribute such astronomical sums, the Protocol does not provide for adequate monitoring and enforcement of these new property rights. Nor does it offer an achievable plan for allocating new permits, which would be essential if the system were expanded to include developing countries. The collapse of the Kyoto Protocol--which Victor views as inevitable--will provide the political space to rethink strategy. Better alternatives would focus on policies that control emissions, such as emission taxes. Though economically sensible, however, a pure tax approach is impossible to monitor in practice. Thus, the author proposes a hybrid in which governments set targets for both emission quantities and tax levels. This offers the important advantages of both emission trading and taxes without the debilitating drawbacks of each. Individuals at all levels of environmental science, economics, public policy, and politics-from students to professionals--and anyone else hoping to participate in the debate over how to slow global warming will want to read this book.

Background Sedentary behaviour (SB) has been identified as an important mortality risk factor. Health organizations have recognised SB as a public health challenge with major health, social, and economic consequences. Researchers have alerted the need to develop specific strategies, to monitor, prevent, and reduce SB. However, there is no systematic analysis of the SB changes in European Union adults. We aimed to examine SB changes between 2002 and 2017 in the European Union (EU) adult population. Methods SB prevalence (>4h30mins of sitting time/day) of 96,004 adults as a whole sample and country-by-country was analysed in 2002, 2005, 2013, and 2017 of the Sport and Physical Activity EU Special Eurobarometers’ data. The SB question of a modified version of the International Physical Activity Questionnaire was considered. SB prevalence between countries and within years was analysed with a χ2 test, and SB between genders was analysed with the Z-Score test for two population proportions. Results An association between the SB prevalence and the years was found ( p  <  0.001), with increases for the whole sample (2002: 49.3%, 48.5–50.0 95% confidence interval (CI); 2017: 54.5%, 53.9–55.0 95% CI) and men (2002: 51.2%, 50.0–52.4 95% CI; 2017: 55.8%, 55.0–56.7 95% CI) and women (2002: 47.6%, 46.6–48.7 95% CI; 2017: 53.4%, 52.6–54.1 95% CI) separately. The adjusted standardised residuals showed an increase in the observed prevalence versus the expected during 2013 and 2017 for the whole sample and women and during 2017 for men. For all years, differences were observed in the SB prevalence between countries for the whole sample, and men and women separately ( p  <  0.001). Besides, the SB prevalence was always higher in men versus women in the overall EU sample ( p  <  0.001). Conclusions SB prevalence increased between 2002 and 2017 for the EU as a whole and for both sexes separately. Additionally, differences in SB prevalence were observed for all years between EU countries in the whole sample and both sexes separately. Lastly, SB was consistently higher in men than women. These findings reveal a limited impact of current policies and interventions to tackle SB at the EU population level.

\"For decades the European Union tried changing its institutions, but achieved only unsatisfying political compromises and modest, incremental treaty revisions. In late 2009, however, the EU was successfully reformed through the Treaty of Lisbon. Reforming the European Union examines how political leaders ratified this treaty against all odds and shows how this victory involved all stages of treaty reform negotiations--from the initial proposal to referendums in several European countries. The authors emphasize the strategic role of political leadership and domestic politics, and they use state-of-the-art methodology, applying a comprehensive data set for actors' reform preferences. They look at how political leaders reacted to apparent failures of the process by recreating or changing the rules of the game. While domestic actors played a significant role in the process, their influence over the outcome was limited as leaders ignored negative referendums and plowed ahead with intended reforms. The book's empirical analyses shed light on critical episodes: strategic agenda setting during the European Convention, the choice of ratification instrument, intergovernmental bargaining dynamics, and the reaction of the German Council presidency to the negative referendums in France, the Netherlands, and Ireland.\"-- Provided by publisher.

Objective To describe the food consumption of immigrants and refugees in a city in southern Brazil and evaluate the associations with sociodemographic and housing characteristics. Method This is a cross-sectional study with users of an association specialized in assisting refugees and immigrants in Porto Alegre-RS. Individuals aged 18 or over of both sexes with an understanding of Portuguese were included. An online questionnaire with sociodemographic, housing, and food characteristics was available to service users, and data analysis was performed using SPSS, considering p < 0.05. Results The study included 68 individuals, predominantly women (76.5%) with a mean age of 34.39 (± 8.9) years and mainly from Venezuela. The food group most frequently consumed daily was the cereal group. Groups such as legumes and vegetables, meat and eggs, biscuits, and cold meats presented a higher weekly consumption frequency. Fruit, Brazil nuts and walnuts, dairy products, regular soda, ready-made desserts, frozen ready-made meals, and fried foods had the highest monthly consumption. There was an association between the consumption of fried foods and sex, cereal consumption and self-declared color, the consumption of biscuits, chocolate drinks, schooling, and cold meats consumption and age. Conclusion In this study we observed that men consumed more fried foods than women and low education level was associated with the frequent consumption of biscuits, chocolate drinks, ham, salami or mortadella and ready-made meals. This study allowed us to investigate the profile and diet of people among refugees and immigrants in the South of Brazil since most of the data on food consumption of this type of population are from the North, and these regions are different in relation to socioeconomic characteristics. It is essential to become aware of the health and food situation of this population group to assist in the acculturation process and ensure adequate reception.

Given the controversies and difficulties which preceded the coming into force of the Lisbon Treaty, it is easy to forget that the Treaty is a complex legal document in need of detailed analysis for its impact to be fully understood. Jean-Claude Piris, the Director General of the Legal Service of the Council of the European Union, provides such an analysis, looking at the historical and political contexts of the Treaty, its impact on the democratic framework of the EU and its provisions in relation to substantive law. Impartial legal analysis of the EU's functions, its powers and the treaties which govern it make this the seminal text on the most significant recent development in EU law.

Background: Care demand exceeded the availability of human and material resources during the COVID-19 pandemic, which is the reason why triage was fundamental. The objective is to know the clinical and sociodemographic factors of confirmed or suspected COVID-19 cases in triage stations from different Ecuadorian provinces. Method: A multicenter study with a retrospective and descriptive design. The patients included were those who accessed the Respiratory Triage stations deployed by the Ecuadorian Red Cross in eight Ecuadorian provinces during March and April 2021. Triage allows for selecting patients that need urgent treatment and favors efficacy of health resources. Results: The study population consisted of a total of 21,120 patients, of which 43.1% were men and 56.9% were women, with an age range between 0 and 98 years old. Severity of COVID-19 behaved differently according to gender, with mild symptoms predominating in women and severe or critical symptoms in men. Higher incidence of critical cases was observed in patients over 65 years old. It was observed that overweight predominated in critical, severe, and moderate cases, while the body mass index of patients with mild symptoms was within the normal range. Conclusions: The Ecuadorian Red Cross units identified some suspected COVID-19 cases, facilitating their follow-up and isolation. Fever was the most significant early finding.

Although extraintestinal pathogenic (ExPEC) are designated by their isolation site and grouped based on the type of host and the disease they cause, most diarrheagenic (DEC) are subdivided into several pathotypes based on the presence of specific virulence traits directly related to disease development. This scenario of a well-categorized collapsed after the German outbreak of 2011, caused by one strain bearing the virulence factors of two different DEC pathotypes (enteroaggregative and Shiga toxin-producing ). Since the outbreak, many studies have shown that this phenomenon is more frequent than previously realized. Therefore, the terms hybrid- and hetero-pathogenic have been coined to describe new combinations of virulence factors among the classic pathotypes. In this review, we provide an overview of these classifications and highlight the genomic plasticity that results in some mixed pathotypes displaying novel pathogenic strategies, which lead to a new symptomatology related to diseases. In addition, as the capacity for genome interrogation has grown in the last few years, it is clear that genes encoding some virulence factors, such as Shiga toxin, are found among different pathotypes to which they have not traditionally been associated, perhaps foreshowing their emergence in new and severe outbreaks caused by such hybrid strains. Therefore, further studies regarding hetero-pathogenic and hybrid-pathogenic isolates are necessary to better understand and control the spread of these pathogens.

Duchenne Muscular Dystrophy (DMD) is a lethal, X-linked disorder leading to muscle degeneration and premature death due to cardiopulmonary complications. Currently, there is no cure for DMD. We previously confirmed the efficacy of human Dystrophin-Expressing Chimeric (DEC) cells created via the fusion of myoblasts from normal and DMD-affected donors. The current study aimed to optimize the development of DEC therapy via the polyethylene glycol (PEG)-mediated fusion protocol of human myoblasts derived from normal, unrelated donors. The optimization of cell fusion assessed different factors influencing fusion efficacy, including myoblast passage number, the efficacy of PKH myoblast staining, the ratio of the single-stained myoblasts in the MIX, and PEG administration time. Additionally, the effect of PEG fusion procedure on cell viability was assessed. A correlation was found between the number of cells used for PKH staining and staining efficacy. Furthermore, the ratio of single-stained myoblasts in the MIX and PEG administration time correlated with fusion efficacy. There was no correlation found between the myoblast passage number and fusion efficacy. This study successfully optimized the myoblast fusion protocol for creation of human DEC cells, introducing DEC as a new Advanced Therapy Medicinal Product (ATMP) for DMD patients.