Panel Remarks on Regulating Genetically Modified Foods: Is Mandatory Labeling the Right Answer?

Thank you to all of our speakers. I can assure everybody in the audience that you will not be specialists on this topic after today, since we can easily spend a whole afternoon on this topic. Let me ask Jean first of all, do you want to respond to anything you’ve heard from the speakers after you

Disentangling Government Responses: How Do We Know When Accountability Work Is Gaining Traction?

Advocacy for public accountability aims to produce certain reactions from government officials or service providers. However, the reactions can be many and diverse, and it is not always clear to advocates how to interpret them and decide on next steps—whether to intensify efforts or back off; continue the same strategy or make adjustments.This paper presents a framework to help accountability advocates and practitioners interpret government reactions to their efforts and move forward appropriately. The framework arises from learning and reflection in the context of the International Budget Partnership (IBP)’s Strengthening Public Accountability with Results and Knowledge (SPARK) program. SPARK seeks to bolster the collective agency of marginalized communities and coalitions to advance democratic and equitable fiscal governance systems1 that channel public resources to services that address the priority needs of these historically excluded groups

Detecting Human-to-Human Transmission of Avian Influenza A (H5N1)

Effective surveillance, containment response, and field evaluation are essential to contain potential pandemic strain

Management and Outcome of 64 Patients with Pancreatic Serous Cystic Neoplasms

Background: The optimal management approach to pancreatic serous cystic neoplasms (SCNs) is still evolving. Methods: Consecutive patients with SCN managed at the Liverpool Pancreas Cancer Centre between 2000 and 2013 were retrospectively reviewed. Results: There were 64 patients consisting of 39 women (60.9%) and 25 men (39.1%). Forty-seven patients (73.4%) had surgical removal and 17 (26.6%) were observed. The possibility of a non-SCN malignancy was the predominant indication for resection in 27 (57.4%) patients. Postoperative morbidity occurred in 26 (55.3%) patients with 2 (4.3%) deaths. An increased risk of resection was associated with patient's age (p = 0.011), diagnosis before 2009 (p < 0.001), pain (p = 0.043), possibility of cancer (p = 0.009) and a solid SCN component on imaging (p = 0.002). Independent factors associated with resection were a diagnosis before 2009 (p = 0.005) and a solid SCN component (p < 0.001). Independent factors associated with shorter time to surgical resection were persistent pain (p = 0.003) and a solid SCN component (p = 0.007). Conclusion: There was a reduction in the proportion of resections with the application of an observe-only policy for asymptomatic patients with more definite features of SCN. Improved criteria are still required in the remainder of patients with uncertain features of SCN in deciding for intervention or surveillance

Seasonal forecasting of the European North-West shelf seas: limits of winter and summer sea surface temperature predictability

The European North-West shelf seas (NWS) support economic interests and provide environmental services to adjacent countries. Expansion of offshore activities, such as renewable energy infrastructure, aquaculture, and growth of international shipping, will place increasingly complex demands on the marine environment over the coming decades. Skilful forecasting of NWS properties on seasonal timescales will help to effectively manage these activities. Here we quantify the skill of an operational large-ensemble ocean-atmosphere coupled global forecasting system (GloSea), as well as benchmark persistence forecasts, for predictions of NWS sea surface temperature (SST) at 2–4 months lead time in winter and summer. We identify sources of and limits to SST predictability, considering what additional skill may be available in the future. We find that GloSea NWS SST skill is generally high in winter and low in summer. GloSea outperforms simple persistence forecasts by adding information about atmospheric variability, but only to a modest extent as persistence of anomalies in the initial conditions contributes substantially to predictability. Where persistence is low – for example in seasonally stratified regions – GloSea forecasts show lower skill. GloSea skill can be degraded by model deficiencies in the relatively coarse global ocean component, which lacks dynamic tides and subsequently fails to robustly represent local circulation and mixing. However, “atmospheric mode matched” tests show potential for improving prediction skill of currently low performing regions if atmospheric circulation forecasts can be improved. This underlines the importance of coupled atmosphere-ocean model development for NWS seasonal forecasting applications

Cost analysis and outcomes of endoscopic, minimal access and open pancreatic necrosectomy.

To assess both individual patient and institutional costs as well as outcomes in patients with pancreatic necrosis who underwent either endoscopic, minimal access or open pancreatic necrosectomy. These data can be used to evaluate clinical effectiveness with a view to informing local health care providers. Intervention for infected pancreatic necrosis is associated with a high morbidity, mortality and long hospital stays. Minimal access surgical step-up approaches have been the gold standard of care, however endoscopic approaches are now offered preferentially. All patients undergoing endoscopic (EN), minimal access retroperitoneal (MARPN) and open (OPN) necrosectomy at a single institution from April 2015-March 2017 were included. Patients were selected for intervention based on morphology and position of the necrosis and on clinical factors. Patient level costing systems were used to determine inpatient and outpatient costs. 86 patients were included: 38 underwent EN, 35 MARPN and 13 OPN. Pre-operative APACHEII was 6 vs 9 vs 9 (p=0.017) and CRP 107 vs 204 vs 278, (p=0.012), respectively. Post-operative stay was 19 days for EN vs. 41 for MARPN vs. 42 for OPN (p=0.007). Complications occurred in 68.4%, 68.6% and 46.2% (p=0.298) while mortality was 10.5%, 22.9% and 15.4% (p=0.379) respectively. Mean total cost was £31,364 for EN, £52,770 for MARPN (p=0.008) and £60,346 for OPN. Ward and critical care costs for EN were lower than for MARPN (ward: £9,430 vs. £14,033, p=0.024; critical care: £5,317 vs. £16,648, p=0.056)

Achieving coordinated national immunity and cholera elimination in Haiti through vaccination: a modelling study

Summary: Background: Cholera was introduced into Haiti in 2010. Since then, more than 820 000 cases and nearly 10 000 deaths have been reported. Oral cholera vaccine (OCV) is safe and effective, but has not been seen as a primary tool for cholera elimination due to a limited period of protection and constrained supplies. Regionally, epidemic cholera is contained to the island of Hispaniola, and the lowest numbers of cases since the epidemic began were reported in 2019. Hence, Haiti may represent a unique opportunity to eliminate cholera with OCV. Methods: In this modelling study, we assessed the probability of elimination, time to elimination, and percentage of cases averted with OCV campaign scenarios in Haiti through simulations from four modelling teams. For a 10-year period from January 19, 2019, to Jan 13, 2029, we compared a no vaccination scenario with five OCV campaign scenarios that differed in geographical scope, coverage, and rollout duration. Teams used weekly department-level reports of suspected cholera cases from the Haiti Ministry of Public Health and Population to calibrate the models and used common vaccine-related assumptions, but other model features were determined independently. Findings: Among campaigns with the same vaccination coverage (70% fully vaccinated), the median probability of elimination after 5 years was 0–18% for no vaccination, 0–33% for 2-year campaigns focused in the two departments with the highest historical incidence, 0–72% for three-department campaigns, and 35–100% for nationwide campaigns. Two-department campaigns averted a median of 12–58% of infections, three-department campaigns averted 29–80% of infections, and national campaigns averted 58–95% of infections. Extending the national campaign to a 5-year rollout (compared to a 2-year rollout), reduced the probability of elimination to 0–95% and the proportion of cases averted to 37–86%. Interpretation: Models suggest that the probability of achieving zero transmission of Vibrio cholerae in Haiti with current methods of control is low, and that bolder action is needed to promote elimination of cholera from the region. Large-scale cholera vaccination campaigns in Haiti would offer the opportunity to synchronise nationwide immunity, providing near-term population protection while improvements to water and sanitation promote long-term cholera elimination. Funding: Bill & Melinda Gates Foundation, Global Good Fund, Institute for Disease Modeling, Swiss National Science Foundation, and US National Institutes of Health