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Letter from the editor | 299

Take care

Surgeon Angelita Habr-Gama has dedicated her career to developing treatment strategies that aim to prevent rectal cancer patients from needing to have the organ removed. The results of research carried out by her group since the 1990s were published last month, showing that patients need not undergo a proctocolectomy if the tumor regresses completely after radio and chemotherapy. The doctor, aged 87, spent almost 50 days in an ICU with COVID-19, before recovering and resuming her work as a surgeon and researcher (see Pesquisa FAPESP issue no. 298).

Many people have long, active lives and careers. However, with an aging population, the number of individuals needing care in their old age increases, leading several countries to rethink their care systems. In addition to higher life expectancies, the growing number of women working outside the home makes it more difficult for families to take care of dependent relatives.

This issue’s cover story describes the results of a study that identified how people with varying degrees of dependence, such as children, the elderly, and people with disabilities, have been provided with care over the last 20 years. In some countries, the state is the main service provider; in others, it is private institutions. There are also family arrangements, which are still the most common in Brazil.

The leading COVID-19 vaccine candidates target the S (or spike) protein that allows the virus to infiltrate human cells. As a result, mutations in the SARS-CoV-2 genome, especially in the part that encodes this protein, raise concerns that new variants of the virus may render the new vaccines ineffective. The article on page 28 explains that genetic changes to these pathogens are common and do not necessarily affect immunological strategies, but they do require attention and close monitoring. Our COVID-19 coverage in this issue also includes an overview of the logistical challenges involved in distributing vaccines, the story of two startups that produced the first approved vaccines using previously experimental technology, and the development of CoronaVac, the vaccine closest to being authorized in Brazil after clinical trials were partly conducted in the country.

Rankings having an impact on scientific practice is not a new phenomenon. Amid their proliferation, the criteria they use must be carefully examined to understand exactly what is being measured. An annual report issued by Clarivate Analytics listing the most highly cited scientists showed promising advances for Brazilian researchers. Brazil produces the 15th most scientific articles, but is 26th in terms of researchers whose works were frequently cited in 2020. In 2015, there were five Brazilians on the list; this year, there were 19. The improvement is the result of a positive change—from a science perspective—to the criteria used to create the list: cross-field citations were included, recognizing articles highly cited in papers from other fields.

The Editorial Board, established in 2011 to support the journal’s development, is to be reformed. Pesquisa FAPESP would like to thank all board members for their valuable contributions (see list)