Strengthening preparedness against global health threats: A paradigm shift based on One Health approaches.

The implementation of preparedness strategies to prevent and mitigate the impact of global health threats poses several challenges. It should promptly identify cross-cutting drivers of pandemic threats, assess context-specific risks, engage multiple stakeholders, and translate complex data from multiple sources into accessible information for action. This requires a coordinated, multidisciplinary and multisectoral effort engaging systems that, most of the time, work in isolation. The One Health (OH) approach promotes the collaboration and communication among different disciplines and sectors, and could be applied across the preparedness phases at national and international level. We discuss here gaps and needs in preparedness strategies, which can benefit from the OH approach, and a set of actionable recommendations, as shared with the G20-2021 with a dedicated Policy Brief. The discussion adds to the current debate about OH operationalization and promotes a paradigm shift towards coordinated prevention and preparedness strategies for early assessment and management of global health threats.

Espécies bioativas em áreas úmidas do Planalto Catarinense / Bioactive species in wetlands of the uplands of Santa Catarina

O objetivo deste trabalho foi levantar e identificar as espécies vegetais que ocorrem em áreas úmidas (banhados) do Planalto Catarinense e associá-las aos seus respectivos potenciais bioativos, validados em testes laboratoriais ou relatados em estudos etnobotânicos. O estudo foi realizado em 12 áreas de banhados localizadas em fazendas com reflorestamentos comerciais de espécies exóticas de propriedade da Empresa Klabin S.A. A amostragem da vegetação foi realizada por meio de transecção no sentido transversal na maior largura dos banhados e na área de transição destes com a área mais drenada (em faixa limitada de três metros), onde foram coletados os espécimes férteis a cada metro da transecção. Após a identificação das espécies foi realizada uma revisão bibliográfica sobre o potencial bioativo das mesmas junto à bases de dados científicos utilizando-se os trabalhos que atestam o potencial e também os trabalhos que valorizam o conhecimento de populações locais. Nas áreas amostradas foram identificadas 235 espécies classificadas em 40 famílias botânicas. Destas, 28 espécies, classificadas em 11 famílias, possuem potencial bioativo. Do total de espécies identificadas, 18 apresentaram potencial validado cientificamente e 10 são citadas quanto ao seu potencial em trabalhos de etnobotânica. Ainda é pouco conhecida a diversidade de banhados no Planalto Catarinense sendo necessário mais estudo para o conhecimento da flora local. O estudo mostrou um grande número de espécies com potencial validado e que poderiam ser utilizadas pela população, enquanto outras que merecem pesquisas complementares.

Our objective was to survey and identify the species that occur in wetlands of the uplands of the state of Santa Catarina and associate them to their bioactive potential, validated by laboratory tests or reported in ethnobotanical studies. The study was conducted in 12 wetland areas, located in farms with commercial reforestation of exotic species (these areas belong to the Klabin S.A. Company). The sampling of the vegetation was performed by transection in the transverse direction, in the widest portion of the wetlands and in the transition area to the drier portion (a limited strip of approximately 3 meters). Fertile specimens were collected at every meter of the transection. After the identification of the species, a literature review on the bioactive potential of these species was carried out on the scientific databases, using the studies that attest the potential value of the species and also studies that value the expertise from local populations. In the sampled areas, 235 species were identified and classified into 40 botanical families. From these, 28 species, classified into 11 families, have bioactive potential. Among all species identified, 18 showed scientifically accredited bioactive potential and 10 were cited as to their potential in ethnobotanical studies. Little is known about the diversity of the wetlands in the uplands of the state of Santa Catarina, and further studies are needed to increase the knowledge on the local flora. This study showed a large number of species with validated potential and that could be used by the population, while others have not yet been studied, but that are potential candidates for further researches.

Reproductive effects of low-to-moderate medical radiation exposure.

Medical radiation from x-rays and nuclear medicine is the largest man-made source of radiation exposure in Western countries, accounting for a mean effective dose of 3.0 mSv per capita per year, comparable to the radiologic risk of 150 chest x-rays, and in many cases gonads fall in the imaging field, with > 20 millions examinations per year in US being abdominal and pelvic CT, and > 0.5 million barium enema. Of the over 7 million workers exposed to medical radiation, special attention has been paid to those working in the interventional cardiology and radiology labs, with high and increasing professional exposures, two-to three times higher than diagnostic radiologists. Thus, adverse effects of radiation exposure are well worth of the scientific community's interest. Aims of this review are: 1) to assess gonad dose to patients undergoing diagnostic testing or interventional fluoroscopy therapy and in professionally exposed interventional fluoroscopists; and 2) to evaluate the evidence linking radiation exposure in the low-to-moderate range (besides the radiotherapy high dose range) to adverse reproductive effects. In patients, the gonad radiation exposure can reach 5 mSv for a lower limb angiography, 20 mSv for a CT pelvis and hips, and 36 (in females) to 90 mSv (for males) for a lower gastrointestinal series. For interventional cardiologists, the gonad dose (below lead apron) is in the same order of magnitude of the shielded thyroid dose, with a median of 50 to 100 microSievert per cine-angiography procedure. The dose can be ten-fold higher for a complex interventional procedure. This leads to a cumulative exposure in the 0.5-1 Sv range over a professional lifetime of 30 years. At present, the epidemiological approach provided inconclusive results, inadequate for a robust evidence-based advice to exposed subjects, since large groups followed-up for decades would be required to detect a small increase in risk. A molecular epidemiology approach and/or the use of integrated biomarkers of reproductive health (e.h., reproductive hormone balance, sperm quality, sperm DNA damage) might be more fruitful in future research focused in the low-to-moderate dose range (< 1000 mSv) of greatest interest for diagnostic and professional exposures.

Plantas medicinais de um remascente de Floresta Ombrófila Mista Altomontana, Urupema, Santa Catarina, Brasil / Medicinal plants in a remnant of High Montane Araucaria Moist Forest, Urupema Municipality, Santa Catarina State, Brazil

O objetivo deste trabalho foi pesquisar dados químicos, biológicos e etnobotânicos na literatura científica de espécies medicinais de um remanescente de Floresta Ombrófila Mista Altomontana. A base para este estudo foi um levantamento florístico realizado na Fazenda das Nascentes, Urupema-SC entre agosto de 2007 e setembro de 2008. A partir da lista de espécies que resultou deste levantamento, foi realizada uma revisão bibliográfica sobre o potencial medicinal das espécies inventariadas. Para as espécies com dados de ação medicinal, foi elaborada chave de identificação vegetativa. Das 64 espécies listadas foram encontradas informações na bibliografia consultada sobre o potencial medicinal de 29. As principais familias foram Asteraceae (oito espécies) e Myrtaceae (três espécies). O hábito que mais se destacou entre as plantas com potencial medicinal foi o arbóreo (13 espécies). O componente químico de maior ocorrência entre as espécies foi o óleo essencial (60 por cento das espécies). As atividades terapêuticas mais citadas na literatura consultadas foram antimicrobiana, anti-oxidante, anti-inflamatória, antiviral, antifúngica e anestésica. Os resultados encontrados indicam o imenso potencial econômico da Floresta Ombrófila Mista e ambientes associados como fonte de recursos naturais que fazem parte da cultura e do patrimônio catarinense.

The aim of this work was to search for chemical, biological and ethnobotanical data in the scientific literature on medicinal species from a remnant of High Montane Araucaria Moist Forest. This study was based on the floristics performed in "Fazenda das Nascentes", Urupema Municipality, Santa Catarina State, Brazil between August 2007 and September 2008. From the list of species obtained in this survey, a review on the medicinal potential of these recorded species was done. A vegetative identification key was elaborated for species with medicinal action Information about medicinal potential was found in the researched bibliography for 29 off the 64 listed species. The main families were Asteraceae (eight species) and Myrtaceae (three species). The arboreal habit predominated among plants with medicinal potential (13 species). The most frequent chemical component among species was essential oil (60 percent species). The most cited therapeutic activities in the researched literature were antimicrobial, antioxidant, anti-inflammatory, antiviral, antifungal and anesthetic. The present results indicate the huge economic potential of Araucaria Moist Forest and associated environments as sources of natural resources that are part of the culture and inheritance from the Santa Catarina State.

Estrutura populacional e incremento corrente anual de casca-de-anta (Drimys brasiliensis Miers - Winteraceae) em Caçador, Santa Catarina, Brasil / Population structure and annual increment in "casca-de-anta" (Drimys brasiliensis Miers - Winteraceae) from Caçador Municipality, Santa Catarina State, Brazil

Drimys brasiliensis Miers, conhecida como cataia ou casca-de-anta, é árvore nativa da Mata Atlântica e as cascas tem sido utilizadas medicinalmente a partir da exploração de plantas em populações naturais. Este trabalho teve como objetivo estudar a demografia de duas populações naturais de D. brasiliensis, (1) Reserva Genética Florestal de Caçador (RGFC) e (2) Floresta Nacional de Caçador (FLONA), ambas no município de Caçador (SC), visando fundamentar estratégias de exploração sustentável e conservação deste recurso florestal não-madeireiro. A maior luminosidade no sub-bosque existente na FLONA atuou positivamente na espécie, aumentado a capacidade de incremento em diâmetro à altura do peito (DAP), altura (H) e área basal (AB), além de antecipar a reprodução em plantas de menor porte. A análise do padrão espacial das plantas reprodutivas na RGFC mostrou padrão agregado, e na FLONA até a distância de 25 metros. Esse comportamento indicou que a espécie apresenta potencial de manejo em florestas secundárias, formação sucessional em que se encontra a maioria dos remanescentes de Mata Atlântica, além de indicar potencial para cultivo em sistemas agroflorestais.

Known as "cataia" or "casca-de-anta", Drimys brasiliensis Miers is a tree native to the Atlantic Forest and its barks have been medicinally used by exploring natural populations. The present work aimed to study the demography of two D. brasiliensis natural populations, (1) Caçador Forest Genetic Reserve (RGFC) and(2) Caçador National Forest (FLONA), both located in Caçador Municipality, Santa Catarina State, Brazil, in order to establish strategies for sustainable exploration and conservation of such non-timber forest resource. The higher luminosity in FLONA understory was beneficial to the species by increasing their increment capability regarding diameter at breast height (DBH), height (H) and basal area (BA), and made the reproduction in smaller plants earlier. The spatial analysis of reproductive plants in RGFC had an aggregate pattern, whereas in FLONA until 25m distance was detected. Such results indicated that this species presents potential for management in secondary forests, the successional formation where the major Atlantic Forest remnants are found, as well as potential for cultivation in agroforestry systems.

Inflammatory bowel disease and intestinal cancer: a paradigm of the Yin-Yang interplay between inflammation and cancer.

Colon cancer represents a paradigm for the connection between inflammation and cancer in terms of epidemiology and mechanistic studies in preclinical models. Key components of cancer promoting inflammation include master transcription factors (for example, nuclear factor kappaB, STAT3), proinflammatory cytokines (for example, tumor necrosis factor, interleukin-6 (IL-6)), cyclooxygenase-2 and selected chemokines (for example, CCL2). Of no less importance are mediators that keep inflammation in check, including IL-10, transforming growth factorbeta, toll-like receptor and the IL-1 receptor inhibitor TIR8/SIGIRR, and the chemokine decoy and scavenger receptor D6. Dissection of molecular pathways involved in colitis-associated cancer may offer opportunities for innovative therapeutic strategies.

Cancer and inflammation: implications for pharmacology and therapeutics.

Smoldering, nonresolving inflammation is a component of the tumor microenvironment. The linkage between inflammation and cancer, first perceived in the nineteenth century, is now part of an accepted paradigm of carcinogenesis.

[Folic acid and congenital malformation: scientific evidence and public health strategies]. / Acido folico e difetti congeniti: evidenze scientifiche e strategie di sanità pubblica.

In Italy at least 3% of babies are born with some congenital malformation. The intake of folic acid (FA) prior to conception and during the early stages of pregnancy plays an important role in preventing neural tube defects, severe anomalies of brain embryogenesis, and other malformations such as cardiac and urinary tract anomalies, oro-facial clefts and limb reduction defects. The Italian Network for Folic Acid Promotion, coordinated by the National Center on Rare Diseases of the Italian National Institute of Health, has elaborated and diffused a recommendation for the periconceptional FA supplementation: "Women of child-bearing age, are recommended to consume 0,4 mg/day of FA, to reduce the risk of congenital defects. The intake of folic acid should start at least one month before the conception and should continue for the first quarter of pregnancy". This paper discusses various strategies in order to promote FA intake during periconceptional period. Food fortification, adopted in several countries such as USA, has raised concerns about the risk of an excessive FA intake which may lead to adverse effect such as tumour promotion. Currently, periconceptional supplementation and healthy dietary habits promotion appear to be the most effective strategies.

Endocrine effects in the hazard assessment of drugs used in animal production.

Criteria of toxicological assessment are currently reviewed to ensure an adequate protection to susceptible groups, such as infants and children; in particular, concern arises about altered endocrine homeostasis in the developing organism, eliciting possible persistent effects such as reproductive disturbances and increased risk of tumours in target organs. Such items are obviously relevant also for veterinary drugs, whose main safety issue is potential lifetime exposure to residues. Two groups of chemicals, nitroimidazoles and imidazole antifungals, are reviewed as examples of the relevance of endocrine toxicity to the hazard assessment of compounds used in animal production. Nitroimidazoles are metabolized into genotoxic intermediates; in rodents they induce testicular toxicity and carcinogenicity. In particular, mammary neoplasms, mostly fibroadenomas, are consistently induced in rats as the most important effect in chronic studies; this may hint to possible endocrine-related mechanisms. Accordingly, evidences on other chemicals (e.g., triazines) show mammary tumorigenicity in rodents associated to hormonal alterations. In fact, nitroimidazoles affect synthesis of both pituitary and steroid hormones in vitro and rise progesterone and FSH levels in rats; also, limited clinical data in humans indicate endocrine-related effects. Overall, nitroimidazoles appear to affect the endocrine balance; however, the actual importance of such alterations, especially in regards to rat mammary tumours, has yet to be clarified. Imidazole antimycotics are broad-spectrum inhibitors of steroid synthesis; accordingly, diverse reproductive and developmental alterations are observed, depending on age and sex of animals exposed. Effects include pregnancy loss, delayed pup growth as well as reduced weight of androgen-dependent tissue; however, it is still difficult to identify the most susceptible biological phase. Overall the potential for inducing endocrine-related alterations should be carefully evaluated also for drugs used in animal production. A screening battery should produce a distinct fingerprint for each major endocrine activity, thus targeting longer-term tests (such as the two-generation study) on the most relevant endpoints. Moreover, the validation of molecular approaches would contribute to a biologically-based evaluation, by providing insights on such items as early effects and species-specificity.

Enhanced anti-HIV-1 activity and altered chemotactic potency of NH2-terminally processed macrophage-derived chemokine (MDC) imply an additional MDC receptor.

Posttranslational processing of chemokines increases (IL-8) or decreases (monocyte chemotactic protein-1) their chemotactic potency. Macrophage-derived chemokine (MDC) attracts monocytes, dendritic cells, activated lymphocytes, and NK cells and has reportedly anti-HIV-1 activity. Here we report that truncation of MDC by deletion of two NH2-terminal residues resulted in impaired binding to CC chemokine receptor (CCR)4, the only identified MDC receptor so far. Truncated MDC(3-69) failed to desensitize calcium mobilization by MDC(1-69) or thymus- and activation-regulated chemokine (TARC), another CCR4 ligand. MDC(3-69) lacked HUT-78 T cell chemotactic activity but retained its capacity to attract monocytes and to desensitize chemotaxis. Compared with MDC(1-69), MDC(3-69) had weak but enhanced antiviral activity against M- and T-tropic HIV-1 strains. Furthermore, both MDC forms failed to signal through the orphan receptors Bonzo/STRL33 and BOB/GPR15 and to desensitize RANTES and stromal cell-derived factor (SDF)-1 responses in CCR5-transfected and CXC chemokine receptor (CXCR)4-transfected cells, respectively. These findings suggest that MDC recognizes another, yet unidentified, receptor. We conclude that minimal NH2-terminal truncation of MDC differentially affects its various immunologic functions.

Interleukin 1, a prototypic pleiotropic lymphokine.

Interleukin 1 (IL-1) is an endogenous mediator produced by monocytes/macrophages, endothelial cells and other cell types. It was originally identified as the main endogenous pyrogen. It was later found that IL-1 was identical to other factors that had been defined leukocytic endogenous mediator, lymphocyte activating factor. It is now clear that IL-1 has two main aspects. On one side it is an immunostimulatory molecule and on the other side is a mediator of shock and inflammation. As an immunostimulating molecule, IL-1 is a potential immuno-modulating drug, while with respect to its proinflammatory action it might be important to identify antagonists or inhibitors that could be useful in the therapy of chronic inflammatory diseases.

Physiological and pathological influences of central nervous system on the immune system: a critical appraisal.

There is considerable evidence of intricate links between central nervous and immune systems. This paper makes a critical assessment of these relationships. Recent experimental data on hypothalamic influences on Natural Killer activity in mice have been presented and the problems met with in defining causal nexuses discussed. Some information on immune reactivity in patients with mental disorders has briefly been reviewed.