GEOSPATIAL ANALYSIS OF PEDIATRIC TUBERCULOSIS IN BOHOL, PHILIPPINES: DISEASE CLUSTERS AND ACCESS TO CARE

Worldwide, children represent approximately 10% of global tuberculosis (TB) cases. We recently reported a high tuberculin skin test (TST)-positive prevalence (355/5,476; weighted prevalence=6.4%) among children (\u3c15 years) throughout the island of Bohol, Philippines, with some geographically isolated communities having prevalence as high as 29%. In this study, we conducted a secondary geospatial and hot-spot analysis of this household-based cluster survey to assess the association between access to care (distance to a health care facility) and TST-positive prevalence. Our analysis indicated that villages with high TST-positive prevalence (≥10%) were significantly further from Provincial Health Office based in the capital city of Tagbilaran in time-distance (p=0.0001, r=0.2387) and kilometers (p=0.0011, r=0.3170). Similarly, prevalence was positively correlated with distance to the municipal Rural Health Unit (RHU), where most receive their medical care, in time-distance (p=0.0055; r=0.0415); however, the association was not significant in kilometers (p=0.3315; r=0.0715). Distance to health care facilities could represent an obstacle to access to care, thereby limiting diagnosis and treatment and resulting in increased risk of transmission to others in the community. Health care outreach in geographically isolated areas is critical to treatment and control of efforts for pediatric TB

Joint Implementation in Climate Change Policy

The textbook economists' model of a tradable permit system cannot usually be applied perfectly at either the domestic or international scale because of the difficulty and/or expense of defining allocations to and monitoring emissions of some groups, as well as for political reasons. It may be impossible to bring these groups fully into a tradeable permit system but it is often possible to find compromise solutions to gain some benefits from trade. This paper explores this problem in the context of the Joint Implementation mechanism associated with the Kyoto Protocol. This paper starts by outlining the current international rules governing Joint Implementation. We provide a summary of key jargon for those who are unfamiliar with the complex Kyoto language. We then discuss two key international issues that are still unresolved: baseline development and monitoring. We then turn to domestic governance of Joint Implementation and how the private sector might engage in Joint Implementation. At this point we consider how Joint Implementation fits within the suite of Kyoto flexibility mechanisms, why sellers and buyers might choose to engage in each, and how the different mechanisms might interact in the market for tradeable units. We conclude with some thoughts about productive directions for future research.Climate, Joint Implementation, tradeable permits, emissions trading

Developing a Policy Framework with Indicators for a ‘Just Transition’ in Aotearoa New Zealand

As Aotearoa New Zealand responds to climate change, policymakers are being challenged to ensure a ‘just transition’ for workers, households and communities. However, no domestic consensus exists about how to define, measure, monitor or manage a ‘just transition’. Maintaining public support for ambitious domestic decarbonisation will require an integrated policy framework which operationalises principles of justice and safeguards wellbeing. This article examines the concept of a ‘just transition’ for climate change and explores three tools for improving policy: inclusive, informed and iterative processes for decision making; an assessment framework for social resilience to change; and progress indicators

Intralayer Negative Poisson's Ratio in Two-Dimensional Black Arsenic by Strain Engineering

Negative Poisson's ratio as the anomalous characteristic generally exists in artificial architectures, such as re-entrant and honeycomb structures. The structures with negative Poisson's ratio have attracted intensive attention due to their unique auxetic effect and many promising applications in shear resistant and energy absorption fields. However, experimental observation of negative Poisson's ratio in natural materials barely happened, although various two-dimensional layered materials are predicted in theory. Herein, we report the anisotropic Raman response and the intrinsic intralayer negative Poisson's ratio of two-dimensional natural black arsenic (b-As) via strain engineering strategy. The results were evident by the detailed Raman spectrum of b-As under uniaxial strain together with density functional theory calculations. It is found that b-As was softer along the armchair than zigzag direction. The anisotropic mechanical features and van der Waals interactions play essential roles in strain-dependent Raman shifts and negative Poisson's ratio in the natural b-As along zigzag direction. This work may shed a light on the mechanical properties and potential applications of two-dimensional puckered materials.Comment: 23 pages, 4 figure

Bottom-Up Growth of Graphene Nanospears and Nanoribbons

One dimensional graphene nanostructures are one of the most promising materials for next generation electronics. Here, the chemical vapor depostion growth of graphene nanoribbons (GNRs) and graphene nanospears (GNSs) on a copper surface is reported. The growth of GNRs and GNSs is enabled by a vapor-liquid-solid (VLS) mechanism guided by on-surface propagation of a liquid Cu-Si catalyst particle. The slow lateral growth and the fast VLS vertical growth give rise to spear head-shaped GNSs. In situ observations further confirm that the lateral graphene growth can be completely suppressed and thus GNRs are grown. The synthesized field effect transistor (FET) devices show that the GNRs and GNSs have high carrier mobilities of approximate to 2000 cm(2) V-1 s(-1). Both FET and Kelvin probe force microscopy measurements confirm that the Fermi levels of the synthesize GNSs shift downward from the wide part to the tip is strongly p-doped. These findings yield key insights into the growth mechanism of graphene and open a door for achieving a facile and scalable method of synthesizing free standing GNRs and GNSs and their applications, such as the Fermi-level tunable devices

Update on the use of aromatase inhibitors in early-stage breast cancer

Aromatase inhibitors are currently included in the 'optimal' management of early-stage breast cancer. Uncertainty remains, however, as to the most appropriate treatment strategy, particularly for newly diagnosed women as they seek to trade off the cost, toxicities and efficacy of the treatment options. Recent publications provide conflicting advice on the role of aromatase inhibitors in the treatment of postmenopausal patients with early-stage hormone receptor-positive breast cancer. This review provides updates on the clinical trials of aromatase inhibitors in early breast cancer and tries to provide practical clinical guidance on their optimal use