Purpose This study aims to investigate how ESG (environmental, social and governance) practices influence the internationalization of Brazilian franchise chains by comparing developed and emerging economies. It examines whether ESG performance and ESG-related risks affect market attractiveness and how these effects are conditioned by institutional context and moderated by gross domestic product (GDP) per capita.Design/methodology/approach A quantitative approach was used using secondary data from 131 Brazilian franchise chains operating in 80 countries, totaling 1,515 franchised units. ESG performance indicators were obtained from Robeco, and ESG risk scores from Global Risk Profile. Multiple linear regression models and interaction terms were applied to test five hypotheses, distinguishing between developed and emerging economies.Findings In developed economies, ESG performance alone is not positively associated with internationalization; however, when moderated by GDP per capita, it enhances market attractiveness, whereas higher ESG risks reduce internationalization, particularly in high-income contexts. In emerging economies, ESG governance emerges as the most relevant driver of international expansion, reflecting its role in mitigating institutional uncertainty. Overall, the results confirm that ESG effects vary across institutional maturity and economic development.Practical implications The findings can guide franchise chains in adapting ESG strategies to institutional contexts, highlighting the need for differentiated approaches across developed and emerging economies to optimize international expansion choices.Social implications By promoting context-sensitive ESG practices, the study supports responsible business conduct and sustainable development in host markets.Originality/value This study is among the first to incorporate both ESG performance and ESG-related risks into the analysis of franchise internationalization. It advances theoretical insights by integrating institutional theory, stakeholder theory, internalization theory and resource dependence theory, offering a comprehensive framework for understanding international strategies in heterogeneous markets.
The COVID-19 pandemic disrupted chronic-care pathways and pharmaceutical logistics worldwide, significantly impacting access to biological therapies for inflammatory bowel disease (IBD) (1,2). In Brazil, vedolizumab—a selective anti-integrin agent—has progressively expanded its role in Crohn’s disease and ulcerative colitis. Understanding how pandemic-related disruptions affected its use is essential for guiding policy and ensuring equitable access. This study examined national and regional dispensing trends after the major pandemic waves. Vedolizumab dispensing data from DATASUS (3) between 2021 and 2024 were analysed nationally and by Brazil’s five macro-regions. Metrics included annual totals, year-on-year (YoY) variation, compound annual growth rate (CAGR), regional composition, and concentration indices (Herfindahl–Hirschman Index [HHI], Gini). National counts were modelled as Poisson distributions with normal-approximation 95% confidence intervals (CIs). Yearly changes were summarised as Poisson rate ratios (RRs) with log-transformed 95% CIs. Analyses were performed in Python (pandas, matplotlib) with figures standardised for publication quality (300 dpi, grayscale, labelled axes, colour heatmaps). Total dispensations rose from 1 743 in 2021 to 23 483 in 2024 (CAGR 137.9%). YoY RRs were 6.01 (95% CI 5.71–6.32) for 2022 vs 2021, 1.61 (95% CI 1.57–1.65) for 2023 vs 2022, and 1.39 (95% CI 1.37–1.42) for 2024 vs 2023. In 2024, the Southeast region accounted for 58.6% of dispensations, followed by the South (19.7%), Northeast (13.6%), Centre-West (6.8%), and North (1.4%). Regional concentration remained high (HHI 4052; Gini 0.51). The steep increase after 2021 indicates recovery from pandemic backlogs and reinstatement of elective IBD care (1,2). The 2022 surge (RR > 1) reflects catch-up initiations delayed during COVID-19 peaks, while continued growth through 2024 suggests systemic consolidation rather than temporary rebound (1). The Southeast’s dominance likely mirrors its higher specialist density and referral-centre capacity. Persistent HHI and Gini values underscore structural inequalities in biologic access across macro-regions. Limitations include the administrative nature of the dataset and absence of clinical variables such as disease activity and treatment persistence. Nevertheless, consistent effect-size estimates and concentration indices support a robust post-pandemic expansion in vedolizumab use in Brazil. Ongoing surveillance linking dispensing data to clinical outcomes is warranted to reduce regional disparities and improve care continuity (2,3). References: 1. Kennedy NA, Jones G-R, Lamb CA, Appleby R, Arnott I, Beattie RM, et al. British Society of Gastroenterology guidance for management of inflammatory bowel disease during the COVID-19 pandemic. Gastroenterology. 2021;161(3):e1–e6. 2. Rubin DT, Feuerstein JD, Wang AY, Cohen RD. AGA Clinical Practice Update on management of inflammatory bowel disease during the COVID-19 pandemic: Expert commentary. Inflamm Bowel Dis. 2020;26(8):1141–1145. 3. DATASUS. Sistema de Informações do SUS: Banco de dados de medicamentos especializados. Brasília: Ministério da Saúde; 2025. Available from: https://datasus.saude.gov.br/ 4. Sands BE, Feagan BG, Rutgeerts P, Colombel JF, Sandborn WJ, Sy R, et al. Vedolizumab as induction and maintenance therapy for ulcerative colitis. N Engl J Med. 2013;369(8):699–710. 5. Sandborn WJ, Feagan BG, Rutgeerts P, Hanauer S, Colombel JF, Sands BE, et al. Vedolizumab as induction and maintenance therapy for Crohn’s disease. N Engl J Med. 2013;369(8):711–721. 6. Magro F, Doherty G, Peyrin-Biroulet L, et al. ECCO position paper on biological treatment cycles in inflammatory bowel disease. J Crohns Colitis. 2020;14(12):1609–1623. 7. Fiorino G, Allocca M, Danese S. COVID-19 in patients with inflammatory bowel disease: Management and clinical outcomes. Nat Rev Gastroenterol Hepatol. 2020;17(10):577–579. 8. Ungaro RC, Brenner EJ, Gearry RB, Kaplan GG, Kissous-Hunt M, Lewis JD, et al. Effect of IBD medications on COVID-19 outcomes: Results from an international registry. Gastroenterology. 2022;162(2):316–319. 9. Bezzio C, Saibeni S, Variola A, Allocca M, Massari A, Gerardi V, et al. Outcomes of COVID-19 in patients with inflammatory bowel disease treated with biologics. Aliment Pharmacol Ther. 2020;52(11–12):1410–1418. 10. D’Amico F, Peyrin-Biroulet L, Danese S. Inflammatory bowel disease management during the COVID-19 outbreak: A survey among gastroenterologists. United European Gastroenterol J. 2020;8(7):775–781. 11. Agrawal M, Brenner EJ, Zhang X, Colombel JF, Kappelman MD. Characteristics and outcomes of IBD patients with COVID-19 on biologics: Insights from SECURE-IBD registry. Gut. 2021;70(4):725–732. 12. Macaluso FS, Orlando A, Cottone M. The role of vedolizumab in ulcerative colitis treatment: Current evidence and future perspectives. Ther Adv Gastroenterol. 2020;13:1–15. 13. Baumgart DC, Misery L, Naegeli AN, Ferrante M, Hanauer S, Peyrin-Biroulet L. Biological therapy for Crohn’s disease and ulcerative colitis: Results, risks and perspectives. Nat Rev Gastroenterol Hepatol. 2021;18(10):601–612. 14. Feagan BG, Panaccione R, Sandborn WJ, D’Haens GR, et al. Clinical trial endpoints for therapeutic studies in IBD: Recommendations from the IOIBD. Gastroenterology. 2020;159(2):422–429. 15. D’Amico F, Danese S, Peyrin-Biroulet L. Systematic review on COVID-19 and inflammatory bowel disease: Lessons for future preparedness. J Crohns Colitis. 2022;16(7):1019–1032. 16. World Health Organization. The impact of COVID-19 on health systems: Policy brief. Geneva: WHO; 2021. 17. Brazilian Ministry of Health. Política Nacional de Assistência Farmacêutica: Componentes e diretrizes. Brasília: Ministério da Saúde; 2023. 18. Peyrin-Biroulet L, Oussalah A, Williet N, Roblin X. Impact of immunosuppressants and biologics on COVID-19 outcomes in IBD: A systematic review. Gut. 2021;70(4):725–732. 19. Ungaro R, Colombel JF. Vedolizumab: A gut-selective integrin blocker for the treatment of IBD. Clin Gastroenterol Hepatol. 2017;15(4):584–594. 20. Panaccione R, Danese S. Targeted therapies in inflammatory bowel disease: Future perspectives beyond anti-TNF agents. Gastroenterology. 2022;163(5):1275–1290. Conflict of interest: Da Silva Cornelio, Thiago: No conflict of interest Caroline de Almeida, Erica: No conflict of interest Fernandes Notaro, Daniela: No conflict of interest
Abstract Introduction: The increasing use of smartphones has raised concerns among health professionals, particularly regarding its effects on mental health and sedentary behavior. Objective: To investigate the association between cervical posture, average daily smartphone use, and weekly physical activity in young adults. Methods: This cross-sectional study included 13 participants (five men and eight women) with a mean age of 33.9 ± 2.6 years. Cervical posture was assessed by photogrammetry using the Brazilian-developed Postural Assessment Software to analyze horizontal (HHA) and vertical head alignment (VHA). Daily smartphone use time was obtained from device-generated reports, and weekly physical activity was self-reported. Associations between variables were examined using Spearman's correlation coefficient (rs), with statistical significance set at p < 0.05. Results: No statistically significant associations were found between smartphone use and HHA (rs = −0.058; p = 0.851) or VHA (rs = −0.215; p = 0.480). Weekly physical activity showed a moderate positive correlation with HHA (rs = 0.452; p = 0.121) and a negative correlation with VHA (rs = −0.338; p = 0.258), neither reaching statistical significance. Conclusion: Smartphone use and physical activity were not significantly associated with cervical posture alignment in this sample.
This article examines the tension between the artificial temporality imposed by digital-platform algorithms and the biological, social, and planetary rhythms historically regulated by the alternation of day and night, labor and rest, production and regeneration. Drawing on Henri Lefebvre's rhythmanalysis and Jonathan Crary's diagnosis of the 24/7 regime, the paper discusses how algorithmic logic, by demanding continuous availability and uninterrupted performance, breaks with the cycles that sustain both human life and planetary ecosystems. In dialogue with Byung-Chul Han, Hartmut Rosa, Shoshana Zuboff, and Kate Crawford, and with Brazilian literature on algorithmic exhaustion (Karhawi & Prazeres, 2022), the article connects the subjective dimension of acceleration to its material basis: the extraction of minerals, water, and energy that sustains artificial intelligence infrastructure. Two complementary vantage points ground the argument. The first is the ethnographic experience of the first author as a public-school teacher in São Paulo, observing how young students internalize algorithmic temporalities that compete with their own formative rhythms. The second is the professional experience of the second author in search-engine optimization and digital marketing, which shows that the demand for continuous availability is not an accidental side effect of platform design but a deliberate engineering objective built into ranking and recommendation systems. The article concludes that thinking about the "Earth's rhythms" also means thinking about ethical, pedagogical, and ecological limits to contemporary algorithmic acceleration.
Web Application Firewalls (WAFs) operating at the HTTP communication layer face persistent limitations against adversarial traffic, defined here as requests that preserve malicious intent while syntactically evading signature-based filters. Traditional rule-based and statistical detection mechanisms struggle with the ambiguity and syntactic variability of such attacks, particularly obfuscated payloads, encoded injection attempts, and structurally mutated requests, exposing a structural gap between the rigidity of existing filters and the continuous, gradual nature of real threat signals. Addressing this gap requires a detection model capable of reasoning under uncertainty while remaining auditable and adaptable to the domain knowledge of security specialists. This paper presents a Fuzzy Inference System (FIS) designed to meet these requirements through continuous, interpretable risk scoring of HTTP requests. The system encodes expert heuristic knowledge as linguistic IF–THEN rules operating over four input variables (URL obfuscation degree, suspicious keyword density, special character frequency, and payload similarity to known attack patterns), producing a continuous output risk score classified as safe, suspicious, or malicious through triangular membership functions and centroid defuzzification. This architecture enables inference proportional to the degree of threat, replacing binary accept-or-block decisions with graduated responses grounded in auditable, rule-traceable reasoning. Unlike machine learning classifiers, which optimise for accuracy at the cost of interpretability, the proposed FIS exposes its full decision logic, allowing security analysts to inspect, validate, and update the inference process directly. Validated on a controlled set of synthetic HTTP requests covering both clear-cut and ambiguous traffic scenarios, the FIS achieves approximately 87% sensitivity on high-risk traffic, demonstrating robustness against evasive payload variations while maintaining low operational overhead. The result is a human-readable and auditable alternative to opaque machine learning classifiers for network threat detection.
