Bridging Knowledge Gaps in the Management of Acute Coronary Syndromes

Contexte L’occlusion d’une artère du cœur cause un syndrome coronarien aigu (SCA) soit avec une élévation du segment ST (IAMEST) ou sans élévation du segment ST (1). Le traitement des patients avec un IAMEST requiert soit une intervention coronarienne d’urgence (ICP primaire) ou une thérapie fibrinolytique (FL). La thérapie FL peut être administrée soit dans un contexte pré-hospitalier (PHL) ou à l’hôpital. Une prise en charge précoce des patients avec SCA peut être améliorée par un simple indice de risque. Objectifs Les objectifs de cette thèse étaient de : 1) comparer l’ICP primaire et la thérapie FL (2); décrire plusieurs systèmes internationaux de PHL; (3) développer et valider un indice de risque simplifié pour une stratification précoce des patients avec SCA. Méthodes Nous complétons des méta-analyses, de type hiérarchique Bayésiennes portant sur l’effet de la randomisation, d’études randomisées et observationnelles; complétons également un sondage sur des systèmes internationaux de PHL; développons et validons un nouvel indice de risque pour ACS (le C-ACS). Résultats Dans les études observationnelles, l’ICP primaire, comparée à la thérapie FL, est associée à une plus grande réduction de la mortalité à court-terme; mais ce sans bénéfices concluants à long terme. La FL pré-hospitalière peut être administrée par des professionnels de la santé possédant diverses expertises. Le C-ACS a des bonnes propriétés discriminatoires et pourrait être utilisé dans la stratification des patients avec SCA. Conclusion Nous avons comblé plusieurs lacunes importantes au niveau de la connaissance actuelle. Cette thèse de doctorat contribuera à améliorer l’accès à des soins de qualité élevée pour les patients ayant un SCA.

Addressing animal health knowledge gaps in Southern Countries: the creation of a 2D animal health resource room

Livestock are a key asset for the global poor. However, access to relevant information is a critical issue for both livestock development practitioners and the poor themselves. Therefore, the following paper details the creation of an on-line Animal Health Resource Room. The aim was to create an immersive environment, which mimics the benefits of a 3D Virtual Learning Environment without the constraints on download times. Therefore, in the following paper key issues in the dissemination of such a platform such as connectivity and speed are explored within the wider context of the development of the tool itself.

Measuring the economic value of pollination services: principles, evidence and knowledge gaps

An increasing degree of attention is being given to the ecosystem services which insect pollinators supply, and the economic value of these services. Recent research suggests that a range of factors are contributing to a global decline in pollination services, which are often used as a “headline” ecosystem service in terms of communicating the concept of ecosystem services, and how this ties peoples׳ well-being to the condition of ecosystems and the biodiversity found therein. Our paper offers a conceptual framework for measuring the economic value of changes in insect pollinator populations, and then reviews what evidence exists on the empirical magnitude of these values (both market and non-market). This allows us to highlight where the largest gaps in knowledge are, where the greatest conceptual and empirical challenges remain, and where research is most needed.

Knowledge gaps and bibliographical revision about descriptions of free-swimming anuran larvae from Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Ebola vaccine R&D: Filling the knowledge gaps

With an emphasis on systems analyses, the VSV-EBOVAC project harnesses state-of-the-art technologies that illuminate mechanisms behind the observed immunogenicity and reactogenicity of the rVSV-ZEBOV vaccine and ensures that such information is shared among stakeholders.

Bottom-up risk regulation? How nanotechnology risk knowledge gaps challenge federal and state environmental agencies

Nanotechnologies have been called the "Next Industrial Revolution." At the same time, scientists are raising concerns about the potential health and environmental risks related to the nano-sized materials used in nanotechnologies. Analyses suggest that current U.S. federal regulatory structures are not likely to adequately address these risks in a proactive manner. Given these trends, the premise of this paper is that state and local-level agencies will likely deal with many "end-of-pipe" issues as nanomaterials enter environmental media without prior toxicity testing, federal standards, or emissions controls. In this paper we (1) briefly describe potential environmental risks and benefits related to emerging nanotechnologies; (2) outline the capacities of the Toxic Substances Control Act, the Clean Air Act, the Clean Water Act, and the Resources Conservation and Recovery Act to address potential nanotechnology risks, and how risk data gaps challenge these regulations; (3) outline some of the key data gaps that challenge state-level regulatory capacities to address nanotechnologies' potential risks, using Wisconsin as a case study; and (4) discuss advantages and disadvantages of state versus federal approaches to nanotechnology risk regulation. In summary, we suggest some ways government agencies can be better prepared to address nanotechnology risk knowledge gaps and risk management.

Filling knowledge gaps:knowledge sharing across inter-firm boundaries and occupational communities

This paper explores the micro-level processes of interaction across organisational boundaries and occupational communities. Based on a retrospective processual analysis, this study shows that in filling knowledge gaps, organisations put in place a series of knowledge mechanisms, which lead them to socially interact with their alliance partners. Both the deployment of existing knowledge and the creation of new knowledge are based on processes of interaction, which derive from the interplay between alliance actors. It is suggested that through both social interaction and the use of boundary objects, individuals are able to communicate, engage in problem-solving activities and share their ideas to fill knowledge gaps.

Nature-based solutions to climate change mitigation and adaptation in urban areas: perspectives on indicators, knowledge gaps, barriers, and opportunities for action

Nature-based solutions promoting green and blue urban areas have significant potential to decrease the vulnerability and enhance the resilience of cities in light of climatic change. They can thereby help to mitigate climate change-induced impacts and serve as proactive adaptation options for municipalities. We explore the various contexts in which nature-based solutions are relevant for climate mitigation and adaptation in urban areas, identify indicators for assessing the effectiveness of nature-based solutions and related knowledge gaps. In addition, we explore existing barriers and potential opportunities for increasing the scale and effectiveness of nature-based solution implementation. The results were derived from an inter- and transdisciplinary workshop with experts from research, municipalities, policy, and society. As an outcome of the workshop discussions and building on existing evidence, we highlight three main needs for future science and policy agendas when dealing with nature-based solutions: (i) produce stronger evidence on nature-based solutions for climate change adaptation and mitigation and raise awareness by increasing implementation; (ii) adapt for governance challenges in implementing nature-based solutions by using reflexive approaches, which implies bringing together new networks of society, nature-based solution ambassadors, and practitioners; (iii) consider socio-environmental justice and social cohesion when implementing nature-based solutions by using integrated governance approaches that take into account an integrative and transdisciplinary participation of diverse actors. Taking these needs into account, nature-based solutions can serve as climate mitigation and adaptation tools that produce additional cobenefits for societal well-being, thereby serving as strong investment options for sustainable urban planning.

Beyond pollinator reward: steps forward and knowledge gaps on the role of floral nectar in plant-animal interactions.

The work done within the framework of my PhD project has been carried out between November 2019 and January 2023 at the Department of Biological, Geological and Environmental Sciences of the University of Bologna, under the supervision of Prof. Marta Galloni and PhD Gherardo Bogo. A period of three months was spent at the Natural History Museum of Rijeka, under the supervision of Prof. Boštjan Surina. The main aim of the thesis was to investigate further the so-called pollinator manipulation hypothesis, which states that when a floral visitor gets in contact with a specific nectar chemistry, the latter affects its behavior of visit on flowers, with potential repercussions on the plant reproductive fitness. To the purpose, the topic was tackled by means of three main approaches: field studies, laboratory assessments, and bibliographic reviews. This research project contributes to two main aspects. First, when insects encounter nectar-like concentrations of a plethora of secondary metabolites in their food-environment, various aspects of their behavior relevant to flower visitation can be affected. In addition, the results I gained confirm that the combination of field studies and laboratory assessments allows to get more realistic pictures of a given phenomenon than the single approaches. Second, reviewing the existent literature in the field of nectar ecology has highlighted how crucial is to establish the origin of nectar biogenic amines to either confirm or reject the multiple speculations made on the role of nectar microbes in shaping plant-animal interactions.

NanoImpactNet - Stakeholders' knowledge needs for research on the health and environmental impact of nanomaterials

NanoImpactNet (NIN) is a multidisciplinary European Commission funded network on the environmental, health and safety (EHS) impact of nanomaterials. The 24 founding scientific institutes are leading European research groups active in the fields of nanosafety, nanorisk assessment and nanotoxicology. This 4−year project is the new focal point for information exchange within the research community. Contact with other stakeholders is vital and their needs are being surveyed. NIN is communicating with 100s of stakeholders: businesses; internet platforms; industry associations; regulators; policy makers; national ministries; international agencies; standard−setting bodies and NGOs concerned by labour rights, EHS or animal welfare. To improve this communication, internet research, a questionnaire distributed via partners and targeted phone calls were used to identify stakeholders' interests and needs. Knowledge gaps and the necessity for further data mentioned by representatives of all stakeholder groups in the targeted phone calls concerned: potential toxic and safety hazards of nanomaterials throughout their lifecycles; fate and persistence of nanoparticles in humans, animals and the environment; risks associated to nanoparticle exposure; participation in the preparation of nomenclature, standards, methodologies, protocols and benchmarks; development of best practice guidelines; voluntary schemes on responsibility; databases of materials, research topics and themes. Findings show that stakeholders and NIN researchers share very similar knowledge needs, and that open communication and free movement of knowledge will benefit both researchers and industry. Consequently NIN will encourage stakeholders to be active members. These survey findings will be used to improve NIN's communication tools to further build on interdisciplinary relationships towards a healthy future with nanotechnology.

A Grey Area of Rights and Knowledge: Displacement in Colombia, South-South Migration and Health Equity

Globalization and liberalization of the economies have produced among others drastic effects on the human mobility, generating confusion, enhancing discrimination and a lack of respect to the rights of several migrant collectives. In this article we analyse several challenges for the study of these phenomena, based on the case of the neglected health rights of Colombian women, who have been forced to displace by the country's internal conflict, and are thus pushed to cross the border to Ecuador. The article identifies several knowledge gaps that could allow and advance a better understanding of these critical subjects. The paper - a think piece -is based upon a general review of documents and studies on the relation between migration and health. The supporting theory on the research comes from international organisations such as the WHO and IOM, NGOs, grass-roots organisations and academic research. This paper shows the need for focusing on the reality of supra states which globalization has generated, and t e urgency of securing the access to essential health preconditions to migrant populations. These issues can no longer be neglected and should be included on agendas at international level, widening the approach of programs to the displaced/immigrant population by taking into account the need to ensure the essential health preconditions (equity), prevention, and protection. Further, it is clear that women and children require a better protection with enhanced prevention and responding measures to sexual abuse, stigmatisation, violence and the respect of their rights.

Employing knowledge networks as tools for the development of Caribbean Small Island Developing States

Expertise, skills, experiences, understandings and capabilities (knowledge) aid development, not just by informing decision-making, but also by providing ideas for actions and activities that can be taken. Due to their size, and economic and environmental vulnerabilities, Caribbean Small Island developing States (SIDS) faces special challenges when working towards their economic, social and environmental development goals. These challenges have contributed to the creation of knowledge gaps, and that which is already available is located in isolated pockets, throughout the Caribbean. Migration of skilled persons compounds the issue, thereby removing much needed knowledge to beyond the traditional borders of the Caribbean. It is necessary to find ways to connect these dispersed knowledge resources. Knowledge networks are tools that can connect the existing skills, expertise, experiences and understandings accessible and create new ones to move towards greater development in the Caribbean. The purpose of this paper is to explore and highlight the role that knowledge networks can play as an aid in the development of Caribbean SIDS. It offers, with Caribbean examples, definitions and discussions of the components, types, and the advantages and disadvantages they hold for the subregion. The paper goes further to provide some ideas on assembling and analysing the different types of knowledge networks. It concludes with a few recommendations geared toward improving the availability of knowledge in the Caribbean.

Trace organic compounds in the marine environment

Trace organic chemicals include a range of compounds which, due to a combination of their physico-chemical properties and toxicological implications, have been described as a serious threat to the biotic environment. A global treaty to regulate the manufacture and release of some of the most persistent trace chemicals has been promulgated and signed. The marine environment is an important sink for many trace chemicals, some of which accumulate in the marine food chain and in particular in marine mammals. With respect to the global distribution of trace organic chemicals, the levels of organohalogen compounds in the Southern Hemisphere are comparatively lower for a given environmental compartment and latitude compared to the Northern Hemisphere. A debate is currently evolving about the toxicity of alternative halogen substitutions such as bromine instead of chlorine and also of mixed halogen substitution. Recently a series of potentially natural bioaccumulative and persistent organohalogen chemicals have been found in marine mammals and turtles at levels in excess of those of anthropogenic trace organochlorines including PCBs and DDE. Little is known about the sources, behaviour and effects of natural trace organic chemicals. This manuscript presents an overview on the occurrence of trace organic chemicals in different compartments of the aquatic environment. Important knowledge gaps with regards to trace chemicals in the marine environment are presented. Crown Copyright (C) 2002 Published by Elsevier Science Ltd. All rights reserved.