Government of Portugal

Characteristic cytokine patterns have been described in different cancer patients and they are related to their diagnosis, prognosis, prediction of treatment responses and survival. A panel of cytokines was evaluated in the plasma of non-small cell lung cancer (NSCLC) patients and healthy controls to investigate their profile and relationship with clinical characteristics and overall survival. The case-controlled cross-sectional study design recruited 77 patients with confirmed diagnosis of NSCLC (cases) and 91 healthy subjects (controls) aimed to examine peripheral pro-inflammatory and anti-inflammatory cytokines (IL-2, IL-4, IL-6, IL-10, IL-17A, TNF and IFN-γ) by Cytometry Beads Arrays (CBA Flex) in. The cytokine IL-6 showed a statistically significant difference among groups with increased expression in the case group (p < 0.001). The correlation between the cytokines expression with patient's clinical characteristics variables revealed the cytokine IL-6 was found to be associated with gender, showing higher levels in male (p = 0.036), whereas IL-17A levels were associated with TNM stage, being higher in III-IV stages (p = 0.044). We observed worse overall survival for individuals with high levels of IL-6 when compared to those with low levels of this cytokine in 6, 12 and 24 months. Further studies of IL-6 levels in independent cohort could clarify the real role of IL-6 as an independent marker of prognostic of NSCLC.

Blockchain remains a hot topic for digital transformation and innovation. In the private sector, blockchain has demonstrated disruptive potential through proven use cases. However, despite strong interest and greater awareness, blockchain has had minimal impact on the public sector, where few projects have moved beyond small pilots. At the same time, there is a growing scepticism and cynicism about public sector blockchain. This paper seeks to understand why this is, by analysing the latest research in the area and identifying and analysing government experiences with successful and unsuccessful projects. It provides early findings on beliefs, characteristics, and practices related to government blockchain projects and the organisations that seek to implement them, with a focus on factors contributing to success or non-success. Although blockchain has yet to affect government in the ways that early hype predicted, government decision makers will nonetheless need to understand and monitor this emerging technology.

INTRODUCTION: The early identification of precursor lesions followed by appropriate treatment prevents development of cervical cancer and its consequences. OBJECTIVE: The present study evaluated the influence of the COVID-19 pandemic on cervical cancer screening by comparing the quantity of tests to detect cervical cellular changes performed in São Paulo state in 2019, prior to the detection of SARS-CoV-2 in Brazil, to the first (2020) and second (2021) years following its appearance. MATERIALS AND METHODS: Data from Fundação Oncocentro de São Paulo (FOSP), the agency that analyses approximately 220,000 Papanicolaou (Pap) tests annually, were reviewed. RESULTS: A median of 1,835 Pap tests were performed in 55 municipalities in 2019. This was reduced to 815 tests in 2020, a 56% decrease (p = 0.0026). In 2021, the median number was 1,745, a 53% increase over 2020 levels (p = 0.0233). The 26 municipalities with >1,000 tests in 2020 had a median reduction from 4,433 in 2019 to 2,580 in 2020 (p = 0. 0046). The 29 municipalities with <1,000 tests had a median reduction from 951 in 2019 to 554 in 2020 (p < 0.0001). There was a 44% reduction in the number of follow-up cytological evaluations from 2019 to 2020, followed by a 30% increase in the following year. However, the percentage of women with a normal finding or with any abnormality remained unchanged. The findings from a histological evaluation of women in São Paulo city indicated that the percent of cases positive for CIN-1 (p < 0.0410) and CIN-3 (p < 0.0012) increased in 2020 and 2021 as compared to 2019 levels. CONCLUSION: A reduction in testing for cervical cancer in the first year of the COVID-19 pandemic, accompanied by an elevated incidence of precancerous lesions in each of the first 2 years following its initiation, may portend a subsequent increased occurrence of cervical cancer in Brazil.

We document the main cyclical features of the trade balance and the terms of trade in European Union as a whole and in the four Cohesion Countries, in particular. S-curve describes also well the dynamic effect of terms of trade on the trade balance in these set of countries. We use the Backus, Kehoe and Kydland (1994) model to replicate the empirical data. We show that only one variable in the model is robust to cross-country differences: the trade balance. Key-Words: Real Business Cycles, Trade Balance, Terms of Trade, S-curve

Cervical cancer is a significant public health problem, especially in low- and middle-income countries, where women have little access to cervical cancer screening; consequently 80% of cervical cancer related mortality occurs in these regions. The development of screening methods that need less infrastructure thus represents an urgent medical need. The study aims to compare the detection rates of high-risk human papillomavirus 16 and 18 E6 oncoprotein in urine, vaginal self-collected, and cervical scrapes of women using the OncoE6™ Cervical Test and compare the HPV16 and/or HPV18 E6 detection rates with the HPV DNA testing. Paired urine, vaginal self-collected and cervical specimens were collected from 124 women who participated in cervical cancer screening or treatment in this proof-of-concept study and underwent to HPV16/18-E6 testing and high-risk HPV DNA testing prior to treatment of cervical neoplasia or cancer. Concordance between urinary, vaginal and cervical HPV16/18-E6 and HPV-DNA testing was evaluated for patients classified as negative group (<CIN2) and histological positive group (CIN2, CIN3 and invasive carcinoma). Overall, HPV16/18-E6 oncoprotein was detected in 30.6% of cervical samples, 20.3% of self-collected vaginal samples and 21% of urine samples. Regarding the clinical sensitivity, the HPV16/18-E6 oncoprotein was not detected in CIN2 cases, and was detected at low rates in CIN3 cases. The clinical sensitivity of the HPV16/18-E6 oncoprotein for detecting invasive cervical cancer was 70% for cervical scrapes, 55% for self-collected vaginal samples and 52% for urine samples. This study reports the urinary detection of E6 oncoprotein in vivo for the first time and our results suggest that this detection is only for invasive/microinvasive lesions. Then, further protocol development and standardization to achieve a clinical sensitivity for CIN2/3 detection close to what can be achieved for invasive lesions using the physician collected cervical is needed.

BACKGROUND: The development of efficient strategies for managing high-risk human papillomavirus (HR-HPV)-positive women is a major challenge when human papillomavirus-based primary screening is being performed. The objectives of this study were to evaluate the comparative effectiveness of HR-HPV testing based on self-collection (SC) and HR-HPV testing based on collection by a health professional (HP) and to assess the potential usefulness of HR-HPV testing combined with testing with the biomarkers p16/Ki-67, α-mannosidase, and superoxide dismutase 2 (SOD2). METHODS: This was a cross-sectional study of 232 women admitted for colposcopy because of an abnormal Papanicolaou smear. The collected material underwent liquid-based cytology, HR-HPV detection, and immunocytochemical testing (p16/Ki-67, α-mannosidase, and SOD2). The gold standard was the histopathological result; the positive reference was CIN2+. RESULTS: The overall accuracy of HR-HPV testing was 76.6%; the results for the SC group (78.1%) and the HP group (75.2%) were similar. The positive predictive values (HP, 76.5%; SC, 80.0%), the negative predictive values (HP, 66.7%; SC, 64.3%), the positive likelihood values (HP, 1.35; SC, 1.36), and the negative likelihood values (HP, 0.21; SC, 0.19) were also similar. p16/Ki-67 showed higher sensitivity than the other 2 biomarkers: 78.1% versus 45.8% for α-mannosidase and 44.5% for SOD2. The specificities of the biomarkers were equivalent: 71.4% for p16/Ki-67, 77.8% for α-mannosidase, and 71.2% for SOD2. In the HP group, accuracy also leaned more heavily toward the final score (using α-mannosidase and SOD2) without statistical significance (80.8% vs 77.9%). The contrast with the SC group yielded the same level of accuracy. CONCLUSIONS: SC, when associated with testing with biomarkers, is as accurate as collection by HPs in the detection of women at risk for cervical cancer.

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OBJECTIVES: The diagnostic performance of cytology in esophageal squamous cell carcinoma (ESCC) is meticulously described. METHODS: Cytological and biopsy specimens were prospectively taken during esophagogastroduodenoscopy of 123 individuals in 2013 and 2014. Cytology samples were maintained in preservative fluid until processing and biopsies were formalin-fixed and paraffin-embedded. RESULTS: Based on endoscopic biopsy results, 70 cases were positive for ESCC whilst 53 were negative for cancer. In addition, brush cytology showed high sensitivity and specificity (98.57 and 96.23%, respectively) in detecting the disease, and high accuracy (97.5%) comparable to that provided by histopathology which is the accepted gold standard. CONCLUSION: Brush cytology specimens preserved in liquid medium may be a good alternative for ESCC diagnosis.

OBJECTIVES: Genotyping HPV from samples tested positive to careHPV™ assay in rural and remote areas of Brazilian territory. METHODS: A total of 5079 women were enrolled in an opportunistic screening from the Barretos Cancer Hospital, through mobile units or ambulatory unit. All careHPV™ hr-HPV positive samples were tested by a Luminex-based protocol in order to evaluate the HPV infecting types. RESULTS: Positive hr-HPV results were obtained in 10.6% (536/5068) of women. Among these cases, HPV-56 and HPV-51 were the most common types detected in 32.3% and 31.4%, respectively. HPV-53 (20.5%), HPV-18 (18.5%), HPV-58 (17.6%), HPV-52 (16.0%) and HPV-16.6%) were the other most frequent types detected. These frequencies represent prevalences of 2.35%, 2.12%, 2.02%, 1.84% and 1.80% respectively, within the population studied. Regarding low-risk HPVs, HPV-6 was detected in 12.9% of the samples. The less frequent types (<3%) were: HPV-70, HPV-11 and HPV-26. CONCLUSIONS: The most frequent types detected were: HPV-56, HPV-51, HPV-53, HPV-18, HPV-58, HPV-52 and HPV-16 according to decreasing rates.

La Ley 28/2010, de 3 de agosto, que prohibió corridas de toros en Catalunya, fue recurrida por el partido popular. Seis años después, el Tribunal Constitucional estimó el recurso mediante la Sentencia 177/2016, del Tribunal Constitucional, analizándolo desde la perspectiva competencial, pero en una clara contradicción e inconsistencia respecto a resoluciones anteriormente dictadas. Se han examinado los elementos de referencia que tomó en consideración el Tribunal para concluir que la previsión autonómica invadía y menoscabía el ejercicio de las competencias estatales en materia de cultura, tomando como foco de atención la tramitación y aprobación de la Ley 18/2013, de 12 de noviembre, para la regulación de la Tauromaquia como patrimonio cultural. La Sentencia sin embargo, reconoce la protección animal como un interés o derecho protegido contrapuesto a la tauromaquia, razón por la cual acaba admitiendo que las Comunidades Autónomas tiene potestades plenas para regular, y no prohibir, las corridas de toros en aras a garantizar la protección y el cuidado de los animales. A raíz de esta doctrina instaurada por dicha Sentencia, se ha realizado un análisis jurídico del alcance de la normativa vigente en materia taurina y protección de los animales a nivel estatal y autonómico, que concluye que dentro de los parámetros constitucionales y límites legales, las Comunidades Autónomas están legitimadas para regular dicho espectáculo incorporando aquellos condicionantes que tengan como finalidad la protección de los animales. Tal es el caso de la reciente Ley 9/2017, de 3 de agosto, de regulación de las corridas de toros y de protección de los animales en las Iles Balears.Act 28/2010, of August 3, which prohibited bullfights in Catalonia, was appealed by the popular party. Six years later, the Constitutional Court (Judgment 177/2016) upheld the appeal analysing it from a competence perspective, but in a clear contradiction and inconsistency with previous rulings. The reference elements that the Court took into consideration to conclude that the autonomic law invaded and impaired the exercise of state powers in the field of culture, are analysed, taking as focus of attention the processing and approval of Law 18/2013, of November 12, for the regulation of Bullfighting as cultural heritage. The judgment recognizes animal welfare as an interest or right protected opposed to bullfighting, admitting that the Autonomous Communities have full powers to regulate bullfights in order to ensure protection and care of the animals. As a result of the doctrine established by the Judgment, a legal analysis of the scope of the current legislation on bullfighting and protection of animals at the State and Autonomic level has been carried out, concluding that the autonomous community are within constitutional parameters and legal limits, entitled to regulate bullfighting incorporating those requirements which are designed to protect the bull. Such is the case of the recent Law 9/2017, of August 3, regulating bullfighting and animal protection in the Balearic Islands.

Purpose: To find out the policies in fulfilling human rights related to health that are adhered to by everyone in Indonesia, both since the birth of the Universal Declaration of Human Rights through the Constitutional Court Decision. Theoretical framework: Human Rights (HAM) were ratified starting in 1948. Every human being in Indonesia must get their right to health. The most important means of achieving this goal are national, legal, and political policies, especially laws. Method/design/approach: The methodology used is normative legal research using a qualitative approach. This study examines the fundamental right to health protection guaranteed by the Constitution, which the government must uphold for its citizens. Results and conclusion: The findings of this study show how the decisions of the Constitutional Court can protect and fulfill human rights in the health sector while ensuring that various statutory provisions made by the DPR and the President guarantee the protection of citizens' rights. Research implications: If the government makes a wrong policy in protecting the community. So, the government has violated human rights. This problem will result in an attitude of protest by the public in general so that the importance of a decision through the Constitutional Court Decision. Originality/value: The government has a significant role in making policies to protect its people. Because every human being in Indonesia has human rights regulated by the laws of the Republic of Indonesia.

This article addresses different implications of nationality in international cooperation in criminal matters, especially in extradition law. Most States, particularly of the civil law tradition, have a longstanding practice not to deliver their own citizens to foreign criminal justice systems. This article begins by reviewing the rationales of the classic nationality exception and contrasts it with the approach of States of the common law tradition, which have no objections of principle to extraditing their own nationals. It then looks into the extradition relations between Brazil and Portugal, following which it provides a brief critical appraisal of the adequacy of the nationality exception in an increasingly globalised world. With these foundational issues settled, the article moves on to questioning what are the effects of interstate affinity upon extradition. It concludes that, in addition to (immediate or direct) effects between the States involved, affinity can also have meaningful (indirect) implications to third States: States which are linked by peculiar (historical, legal, political) bonds sometimes refuse to extradite each other’s nationals to other States. In this regard, the article analyses of the state affairs among the Member States of the European Union following the groundbreaking case law initiated by the Court of Justice in 2016, and compares this recent legal development with the regime that has been in place between Brazil and Portugal since 1971.

Marketing initiatives can influence and change people's lifestyles. Similarly, they can be used in innovative ways to encourage healthier lifestyles.1Public Health EnglandPublic Health England social marketing strategy: 2017 to 2020.https://www.gov.uk/government/publications/public-health-england-marketing-strategy-2017-to-2020Date: 2017Date accessed: January 28, 2019Google Scholar Governments can improve health by implementing collaborative initiatives with different sectors of society,2Goiana-da-Silva F Cruz-e-Silva D Gregório MJ et al.Bringing government sectors together to address noncommunicable diseases: Portugal's interministerial healthy eating strategy.http://www.euro.who.int/__data/assets/pdf_file/0018/380331/php-4-3-cs2-eng.pdf?ua=1Date: 2018Date accessed: January 28, 2019Google Scholar as recently exemplified in Portugal. In Portugal, television has the largest share of advertising investment, accounting for around 46%. According to a study led by the Portuguese Regulatory Authority for the Media, 99% of all people surveyed regularly watch television.4Correia F Martins C Media landscapes: Portugal.https://medialandscapes.org/country/portugalDate: 2018Date accessed: January 28, 2019Google Scholar Therefore, television stations could be key partners in promoting public health. However, because of high broadcasting costs, health authorities have not generally been able to use these platforms. In 2018, the Portuguese Ministry of Health approached all major national television stations, appealing to their social responsibility. The four major Portuguese television stations (RTP, SIC, TVI, and Porto Canal) accepted this challenge and signed a 3-year agreement with no cost to the government. These stations committed to broadcasting three non-communicable disease prevention campaigns per year, for 3 weeks each and with at least two broadcasts per day. For 2018, the campaigns addressed healthy eating, tobacco control, and physical activity. The four stations involved represent a total of 19 television channels. Four of these are open access channels, and include the most watched channels in Portugal, with an audience share of 57·5% in 2017. The remaining 15 channels are pay television channels, which have a strong affinity with their target audience, and increase the coverage of the campaigns. A preliminary assessment has estimated that the agreement is worth more than €3·9 million per year (according to rate card prices), and has an average reach of 7·5 million people per campaign. This innovative joint venture has allowed the Portuguese national health service to vastly increase the number of Portuguese citizens it is reaching, and to potentially drive changes in behaviour that will improve public health. The tobacco control campaign, which used the slogan “Quit Smoking! Choose to love more!” was broadcast according to the media agreement and had the biggest reach a public health campaign has ever had in Portugal. According to the annual ranking from Meios de Publicidade, the campaign was among the most striking mass media campaigns of 2018,5Marques RO 10 campanhas que marcaram o ano.http://www.meiosepublicidade.pt/2018/12/10-campanhas-marcaram-ano-2Date: 2018Date accessed: January 28, 2019Google Scholar prevailing over heavily funded campaigns from private international brands and companies. On the basis of data from the major national television stations, it is estimated that 73·1% of all Portuguese people older than 4 years of age watched this campaign an average of 5·2 times on television. This value is well above the minimum threshold of touchpoints that is required to drive behavioural change.3Lusch RF Vargo SL The service-dominant logic of marketing: dialog, debate, and directions. Taylor & Francis, New York2014Google Scholar Although further evidence is needed to analyse the effectiveness of television health promotion campaigns in changing lifestyles, the Portuguese example showcases the potential of partnering with media channels. Through use of the same communication channels as multinational food and tobacco companies, governments could get the reach required to start reversing unhealthy lifestyle trends among the general population. We declare no competing interests.

Many of the Constitutions adopted after the Second World War established basic principles to regulate collective dimensions of social life, beyond the traditional rules regarding the exercise of public power and the relationship between the State and its citizens. Within this scope, and considering their catalogues of fundamental rights, constitutional texts incorporate a complex concept of person and/or subject of rights, which is nowadays very different from the classic representation in constitutional theory that presupposes the existence of a rational, autonomous and self-determined person in every circumstance. It is, therefore, urgent to think about the use of the concept of vulnerability in law, departing from the significance of vulnerability in social sciences and moral philosophy, in order to analyse its current meaning in the legal field and its methodological potential for constitutional analysis.

This paper analyze how after the State designed, at the beginning of the century, public policies to promote investment and increase renewable energy sources, it appeared the global economic crisis that led to the reform of such policies, which was materialized in a subsequent amendment of the regulation that changed the original terms of investments, and put at risk the State’s responsibility in relation with its obligations under the Treaty on the Energy Charter, which led investors to try liability claims before national courts as well as international arbitration, whose decisions will analyzed.

O objetivo deste artigo é provocar uma discussão sobre a importância do princípio da tolerância e as suas consequências na área jurídica, especialmente no Direito Constitucional. Tolerância é um conceito filosófico cuja importância tem sido identificada como fundamentalpara a resolução de problemas trazidos pelas sociedades atuais pluralistas. Pretende-se abordar a questão principalmente no contexto histórico e nas semelhanças entre tolerância e solidariedade para depois verificar a sedimentação desses princípios ao longo do tempo, especialmente na ordem jurídica brasileira. As várias guerras civis, os problemas de intolerância religiosa, a discriminaçãosexual, conflitos étnicos demonstram a crise que domina as sociedades contemporâneas, com destaque para a intensificação dessas diferenças e dos processos de exclusão. Esses problemas não podem ser resolvidos exclusivamente no âmbito privado das relações individuais, mas como eles se relacionam com a aceitação das diferenças entre os grupos sociais, a distribuição de bense o acesso às garantias jurídicas. Através dos autores pesquisados pode ser visto, ao longo do tempo, as ligações entre a tolerância e a liberdade de consciência, o desejo de igualdade e as reivindicações para a diferença. Assim, a teoria constitucional do Estado de Direito deve refletirsobre estas questões, pois os temas são constituídos como parâmetros objetivos para a realização da democracia.

O presente artigo toma como ponto de partida o Programa Nacional para a Coesão Territorial, para debater a importância de modelos adequados de governança que apoiem a promoção do desenvolvimento e da coesão territoriais. Mais concretamente, advoga-se que os desafios da coesão territorial e a definição de um plano de desenvolvimento para o interior do país exigem, a par do quadro de medidas a implementar, a definição de um modelo de governança que seja alargada e confira o necessário protagonismo aos atores locais na busca de soluções para os desafios enfrentados.

BACKGROUND/OBJECTIVES: The Portuguese NHS has embarked on an administrative restructuring aimed at enabling healthcare professionals, particularly family doctors, to focus on direct patient care and improve overall healthcare outcomes. This article details these measures, their initial benefits for patients and professionals, and explores future strategies to further integrate levels of care and leverage technology to enhance efficiency, patient-centeredness, and ultimately, population health. METHODS: Each measure was evaluated to estimate its potential impact on the four pillars of the value-based healthcare (VBHC) framework. RESULTS: We found that most measures aimed at reducing bureaucracy had an estimated impact on more than two of the four pillars. CONCLUSIONS: Thus, we conclude that the reduction in bureaucracy will tend to address several of the pillars of the VBHC framework and should be considered as a steppingstone in the process of increasing VBHC.

general, est sometida a cierta confusin y, desde luego, a una erosin crtica en amplios sectores de nuestro hbitat social.

La Constitución Política del Perú es una Carta política abierta a la posibilidad de que sea reformada observando los parámetros establecidos en el mismo articulado. De igual forma es una Carta de derechos que guarda la posibilidad de ser utilizada para la protección de las libertades políticas y, sobre todo, que imponga límites o parámetros a la actuación libre y discrecional del legislador. Entre los sujetos que pueden interpretar la Constitución se encuentra el Tribunal Constitucional, órgano jurisdiccional superior que se encarga de interpretar o dotar de contenido a los valores constitucionales. El presente artículo describe la forma como el juez constitucional peruano actúa como legislador positivo cuando expide sentencias interpretativas; precedentes vinculantes crean doctrina jurisprudencial, pues ello implicaría el ejercicio real de facultades legislativas (legislador positivo).