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[Display omitted] This paper advances the literature on multiple knowledge systems, showing how Traditional and Local Knowledge (TLK) systems can collaborate with scientific knowledge to advance understanding of the slow-onset effects of climate change adaptation in Latin America and the Caribbean. Such an approach implies acknowledging the cultural heterogeneity of traditional (e.g. indigenous) knowledge and local knowledge, and how this can link to practical actions to adapt to climate and global change. Integration of TLK with scientific knowledge in impact and risk assessment may be necessary to develop both short and long-term planning. The authors review how and why TLK needs to be integrated into climate change adaptation in the Latin America and the Caribbean (LAC), and offer a critical perspective and a vision toward incorporation of TLK on climate risks and adaptation in LAC. [ABSTRACT FROM AUTHOR]

Highlights • Cities predominantly focus on self-governing when it comes to adaptation. • Citizens are mainly governed by provision of information for adaptation. • Private sector is governed through partnerships for adaptation. • The more advanced a city is on adaptation planning, the more likely it will address other actors. Abstract Expectations of cooperation between local authorities, the private sector, and citizens in climate change adaptation in cities are high because involvement of many actors is seen as critical to success. Scholars and policymakers argue that the private sector could be more efficient than the public authorities in implementing adaptation measures and argue for the need to engage citizens to ensure legitimacy of adaptation and inclusion of locally relevant knowledge. To what extent do cities address the private sector and citizens in their adaptation initiatives? What modes of governance do they use to do this? What kinds of cities are the most likely to address the private sector and citizens? Going beyond the existing case study approaches, this paper answers these questions using a large N data set covering 402 cities around the world. We find that a majority of adaptation initiatives focus exclusively on the public sector and do not address the private sector or citizens. In the cases where they do, the private sector is more often governed through partnerships and participation, whereas citizen participation is relatively rare. Initiatives involving citizens rely more often on a provision of information that encourages citizens to adapt. We find that the more advanced a city is in its adaptation process, the more likely it is to address the private sector than citizens in its initiatives to adapt to climate change. Whereas with partnerships and participation the private sector can influence urban adaptation arrangements at a broader scale, the provision of information allows citizens only to implement individual adaptation measures according to their capacities. [ABSTRACT FROM AUTHOR]

Background Gastrectomy represents the main treatment for gastric adenocarcinoma. This procedure is associated with substantial morbidity and mortality. The aim of this study was to evaluate the postoperative mortality changes across the study period and to identify predictive factors of 30-day mortality after elective gastrectomy for gastric cancer. Methods This was a retrospective cohort study of a prospective database from a single centre. Patients treated with an elective gastrectomy from 1996 to 2014 for gastric adenocarcinoma were included. We compared postoperative mortality between four time periods: 1996–2000, 2001–2005, 2006–2010, and 2011–2014. Univariate and multivariate analyses were applied to identify predictors of 30-day postoperative mortality. Results We included 1066 patients (median age 65 years; 67% male). The 30-day mortality rate was 4.7%. Mortality decreased across the four time periods; from 6.5% to 1.8% ( P = 0.022). In the univariate analysis, age, ASA score, albumin <3.5, multivisceral resection, splenectomy, intrathoracic esophagojejunal anastomosis, R status, and T status were significantly associated with postoperative mortality. In the multivariate analysis, ASA class 3 (OR 10.06; CI 1.97–51.3; P = 0.005) and multivisceral resection (OR 1.6; CI 1.09–2.36; P = 0.016) were associated with higher postoperative 30-day mortality; surgery between 2011 and 2014 was associated with lower postoperative 30-day mortality (OR 0.55; CI 0.33–0.15; P = 0.030). Conclusion There was a decrease in postoperative 30-day mortality during this 18-year period at our institution. We have identified ASA score and multivisceral resection as predictors of 30-day mortality for elective gastrectomy for cancer. [ABSTRACT FROM AUTHOR]

Introduction: Adenosine is taken up via human equilibrative nucleoside transporters 1 (hENT1) and 2 (hENT2) at a physiological extracellular pH (pHo ∼7.4) in human umbilical vein endothelial cells (HUVECs). Acidic pHo increases the uptake of adenosine and 5-hydroxytryptamine (5HT) via hENT4 in this cell type. However, modulation of hENT1 and hENT2 transport activity by the pHi is unknown. We investigated whether hENT1 and hENT2-adenosine transport was regulated by acidic pHi.Methods: HUVECs loaded with a pH sensitive probe were subjected to 0.1-20 mmol/L NH4Cl pulse assay to generate 6.9-6.2 pHi. Before pHi started to recover, adenosine transport kinetics (0-500 μmol/L, 37 °C) in the absence or presence 1 or 10 μmol/L S-(4-nitrobenzyl)-6-thio-inosine (NBTI), 2 mmol/L hypoxanthine, 2 mmol/L adenine, 100 μmol/L 5HT, or 500 μmol/L adenosine, was measured.Results: Overall adenosine transport (i.e., hENT1+hENT2) was semisaturable and partially inhibited by 1 μmol/L, but abolished by 10 μmol/L NBTI in cells non-treated or treated with NH4Cl. The initial velocity and non-saturable, lineal component for overall transport were increased after NH4Cl pulse. hENT1 and hENT2-mediated adenosine transport maximal capacity was increased by acidic pHi. hENT1 activity was more sensitive than hENT2 activity to acidic pHi.Discussion: hENT1 and hENT2-adenosine transport is differentially regulated by acidic pHi in HUVECs. These findings are important in pathologies associated with pHi alterations such as gestational diabetes mellitus. [ABSTRACT FROM AUTHOR]

This paper reviews the literature on marine conservation through the lens of inclusive development. Inclusive development requires ecological preservation, the promotion of human wellbeing, and empowerment of the weakest. However, the general literature on marine conservation and findings from Chile show that achieving inclusive development is challenging. This work aims to provide some key preliminary insights into the possible adoption of an inclusive development perspective in marine conservation policies and practices. Using the relational dimension of inclusive development as a specific lens, the paper focuses on the Chilean case, showing how institutional entrepreneurs that are embedded in social networks and the implementation of appropriate institutions for marine conservation can help to promote more inclusive development globally. [ABSTRACT FROM AUTHOR]

Chilean Patagonia is a globally significant ecosystem for biodiversity, and simultaneously a global center for the aquaculture industry. Environmental crises have accelerated over the last decades with the installation of salmon farms, increasing impacts on indigenous livelihoods and the habitats of marine species. Indigenous Marine Areas (IMA) have confronted the effects of the blue Anthropocene in Chilean Patagonia, causing diverse indigenous communities to evolve mechanisms to enhance ocean health and sustainability. Based on an analysis of the main socio-spatial trends of IMA in Patagonia and their action networks in the Los Lagos Region, this study demonstrates the importance of a multiple agent network to mobilize the implementation of IMA. The study shows how indigenous people face the challenges of the UN Ocean Decade, enhancing the sustainability pathways of blue Patagonia. [ABSTRACT FROM AUTHOR]

Cities globally face significant risks from climate change, and are taking an increasingly active role in formulating and implementing climate change adaptation policy. However, there are few, if any, global assessments of adaptation taking place across cities. This study develops and applies a framework to track urban climate change adaptation policy using municipal adaptation reporting. From 401 local governments globally in urban areas with >1 m people, we find that only 61 cities (15%) report any adaptation initiatives, and 73 cities (18%) report on planning towards adaptation policy. We classified cities based on their adaptation reporting as extensive adaptors, moderate adaptors, early stage adaptors, and non-reporting . With few exceptions, extensive adaptors are large cities located in high-income countries in North America, Europe, and Oceania, and are adapting to a variety of expected impacts. Moderate adaptors usually address general disaster risk reduction rather than specific impacts, and are located in a mix of developed and developing countries. Early stage adaptors exhibit evidence of planning for adaptation, but do not report any initiatives. Our findings suggest that urban adaptation is in the early stages, but there are still substantive examples of governments taking leadership regardless of wealth levels and institutional barriers. [ABSTRACT FROM AUTHOR]

The placenta is a vital organ whose function in diseases of pregnancy is altered, resulting in an abnormal supply of nutrients to the foetus. The lack of placental vasculature homeostasis regulation causes endothelial dysfunction and altered vascular reactivity. The proper distribution of acid- (protons (H(+))) and base-equivalents through the placenta is essential to achieve physiological homeostasis. Several membrane transport mechanisms that control H(+) distribution between the extracellular and intracellular spaces are expressed in the human placenta vascular endothelium and syncytiotrophoblast, including sodium (Na(+))/H(+) exchangers (NHEs). One member of the NHEs family is NHE isoform 1 (NHE1), whose activity results in an alkaline intracellular pH (high intracellular pH (pHi)) and an acidic extracellular pH (pHo). Increased NHE1 expression, maximal transport activity, and turnover are reported in human syncytiotrophoblasts and lymphocytes from patients with diabetes mellitus type I (DMT1), and a positive correlation between NHEs activity and plasma factors, such as that between thrombin and platelet factor 3, has been reported in diabetes mellitus type II (DMT2). However, gestational diabetes mellitus (GDM) could result in a higher sensitivity of the human placenta to acidic pHo. We summarized the findings on pHi and pHo modulation in the human placenta with an emphasis on pregnancies in which the mother diagnosed with diabetes mellitus. A potential role of NHEs, particularly NHE1, is proposed regarding placental dysfunction in DMT1, DMT2, and GDM. [ABSTRACT FROM AUTHOR]

The first wave of SARS-CoV-2 infection in Chile occurred during the cold season reaching a peak by the end of June 2020, with 80 % of the cases concentrated in its capital, Santiago. The main objective of this study was to estimate the attack rate during this first wave of SARS-CoV-2 in a large, densely populated city with more than seven million inhabitants. Since the number of confirmed cases provides biased information due to individuals' potential self-selection, mostly related to asymptomatic patients and testing access, we measured antibodies against SARS-CoV-2 to assess infection prevalence during the first wave in the city, as well as estimate asymptomatic cases, and infection fatality ratio. To our knowledge this is one of the few population-based cross-sectional serosurvey during the first wave in a highly affected emerging country. The challenges of pandemic response in urban settings in a capital city like Santiago, with heterogeneous subpopulations and high mobility through public transportation, highlight the necessity of more accurate information regarding the first waves of new emerging diseases. From April 24 to June 21, 2020, 1326 individuals were sampled from a long-standing panel of household representatives of Santiago. Immunochromatographic assays were used to detect IgM and IgG antibody isotypes. Seroprevalence reached 6.79 % (95 %CI 5.58 %−8.26 %) in the first 107 days of the pandemic, without significant differences among sex and age groups; this figure indicates an attack rate 2.8 times higher than the one calculated with registered cases. It also changes the fatality rate estimates, from a 2.33 % case fatality rate reported by MOH to an estimated crude 1.00 % (CI95 % 0.97–1.03) infection fatality rate (adjusted for test performance 1.66 % [CI95 % 1.61–1.71]). Most seropositive were symptomatic (81,1 %). Despite the high number of cases registered, mortality rates, and the stress produced over the health system, the vast majority of the people remained susceptible to potential new epidemic waves. We contribute to the understanding of the initial spread of emerging epidemic threats. Consequently, our results provide better information to design early strategies that counterattack new health challenges in urban contexts. [Display omitted] • Santiago was one of the world's pandemic hotspots during the austral winter season 2020. • Seroprevalence reached 6.79 % (5.58 %−8.26 %) 107 days after detecting the first case. • Seroprevalence of infection was 2.8 times higher than officially reported cases. • The estimated infection fatality rate was 1.0 % (1.66 % adjusted for test performance), while the case fatality was 2.33 %. • 81 % of seroposive individuals were symptomatic. [ABSTRACT FROM AUTHOR]

• Residential dependence occurs not only under coresidence but between not coresident individuals. • Quasi-coresidence and recohabitation allow individuals to combine independence and dependence. • Family solution to care is preferred even when non-family care alternatives are available. • Residential dependence is not an only a survival adaptive response but a cultural kinship style. In the study of family residential dependence, Latin American literature has focused on coresidence and explained its relationship with care vulnerability trajectories in terms of the survival strategies of the poor. This approach implies the hypothesis of a substitution mechanism between family and paid care. However, this represents an incomplete picture of residential dependence in this context. Based on the contributions of three theoretical approaches—residential proximity, family configurations, and life course—and data from an ethnographic study carried out in Santiago, Chile, between 2006 and 2015, we analyze the relationship between family residential dependence configurations and care among individuals belonging to professional middle- and upper-class kinship groups. First, we show that residential dependence may occur between non-coresident individuals, mainly through quasi-coresidence and recohabitation practices. This allows individuals to remain rooted in a multigenerational network of interdependence throughout the life course at all socioeconomic levels, what the interviewees in the study called the "together but not mixed" ideal. Second, although a significant part of the residential interdependence is articulated around daily intergenerational care practices, we propose an alternative explanatory model based on the redundancy hypothesis , where the family solution to care vulnerabilities is generally preferred even when non-family care alternatives are available. The relationship between family members' care needs and residential dependence mechanisms cannot be reduced to economic deficits or strategic responses. Such needs participate in a structure of care preferences linked to culturally defined kinship styles, where frequent co-presence solidarity predominates. [ABSTRACT FROM AUTHOR]

The preferential treatment of the aquaculture industry over fisheries and marine protected areas in Chile through the demarcation of the Areas Appropriate for Aquaculture has set it on a collision course with conservation, artisanal fishing and coastal communities. This article shows how marine democratic governance can evolve through the inclusion of artisanal fisher local ecological knowledge. Artisanal fishing communities elicit how contamination from industrial aquaculture is causing natural shellfish banks, fish populations and endangered cold corals to diminish. While fisheries and aquaculture governance are nominally governed by the same body, the ideological concerns of decision makers have not left space for the original users or ecological health. The right to good water quality and ecological health of artisanal fisher, original people and the broader coastal community are highlighted. Using semi structured interviews, participatory cartography and Geographic Information Systems fishers explain how the contamination footprint has expanded across benthic habitats. Diving in the contaminated areas confirmed the impacts using comparison with control sites. The article shows how new laws are need to assess nutrient loading, antibiotics and invasive species introduction. It links these impacts to literature in other countries where harmful algal blooms result from eutrophication from aquaculture contamination. It shows how the privatisation of space has left marine governance unable to take adequate enforcement. Artisanal and indigenous common properties can lead toward participation in marine planning for ecological health, whilst governmental institutions need realignment so that marine ecological planning for conservation can evolve. [ABSTRACT FROM AUTHOR]