Процеси сучасної інтернаціоналізації в Азійсько-Тихоокеанському регіоні у вимірах глобальної конкуренції

In 2012, governments worldwide renewed their commitments to a more sustainable development that would eradicate poverty, halt climate change and conserve ecosystems, and initiated a process to create a long-term vision by formulating Sustainable Development Goals (SDGs). Although progress in achieving a more sustainable development has been made in some areas, overall, actions have not been able to bend the trend in critical areas (including those related to the so-called food-water-energy nexus). Here, we analyze how different combinations of technological measures and behavioral changes could contribute to achieving a set of sustainability objectives, taking into account the interlinkages between them. The objectives include eradicating hunger, providing universal access to modern energy, preventing dangerous climate change, conserving biodiversity and controlling air pollution. The analysis identifies different pathways that achieve these objectives simultaneously, but they all require substantial transformations in the energy and food systems, that go far beyond historic progress and currently formulated policies. The analysis also shows synergies and trade-offs between achieving the different objectives, concluding that achieving them requires a comprehensive approach. The scenario analysis does not point at a fundamental trade-off between the objectives related to poverty eradication and those related to environmental sustainability. The different pathways of achieving the set of long-term objectives and their implications for short-term action can contribute to building a comprehensive strategy to meet the SDGs by proposing near-term actions

Different oral corticosteroid regimens for acute asthma.

BACKGROUND: Asthma is a common long-term breathing condition that affects approximately 300 million people worldwide. People with asthma may experience short-term worsening of their asthma symptoms; these episodes are often known as 'exacerbations', 'flare-ups', 'attacks' or 'acute asthma'. Oral steroids, which have a potent anti-inflammatory effect, are recommended for all but the most mild asthma exacerbations; they should be initiated promptly. The most often prescribed oral steroids are prednisolone and dexamethasone, but current guidelines on dosing vary between countries, and often among different guideline producers within the same country. Despite their proven efficacy, use of steroids needs to be balanced against their potential to cause important adverse events. Evidence is somewhat limited regarding optimal dosing of oral steroids for asthma exacerbations to maximise recovery while minimising potential side effects, which is the topic of this review. OBJECTIVES: To assess the efficacy and safety of any dose or duration of oral steroids versus any other dose or duration of oral steroids for adults and children with an asthma exacerbation. SEARCH METHODS: We identified trials from the Cochrane Airways Group Specialised Register (CAGR), ClinicalTrials.gov (www.ClinicalTrials.gov), the World Health Organization (WHO) trials portal (www.who.int/ictrp/en/) and reference lists of all primary studies and review articles. This search was up to date as of April 2016. SELECTION CRITERIA: We included parallel randomised controlled trials (RCTs), irrespective of blinding or duration, that evaluated one dose or duration of oral steroid versus any other dose or duration, for management of asthma exacerbations. We included studies involving both adults and children with asthma of any severity, in which investigators analysed adults and children separately. We allowed any other co-intervention in the management of an asthma exacerbation, provided it was not part of the randomised treatment. We included studies reported as full text, those published as abstract only and unpublished data. DATA COLLECTION AND ANALYSIS: Two review authors independently screened the search results for included trials, extracted numerical data and assessed risk of bias; all data were cross-checked for accuracy. We resolved disagreements by discussion with the third review author or with an external advisor.We analysed dichotomous data as odds ratios (ORs) or risk differences (RDs) using study participants as the unit of analysis; we analysed continuous data as mean differences (MDs). We used a random-effects model, and we carried out a fixed-effect analysis if we detected statistical heterogeneity. We rated all outcomes using the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) system and presented results in 'Summary of findings' tables. MAIN RESULTS: We included 18 studies that randomised a total of 2438 participants - both adults and children - and performed comparisons of interest. Included studies assessed higher versus lower doses of prednisolone (n = 4); longer versus shorter courses of prednisolone (n = 3) or dexamethasone (n = 1); tapered versus non-tapered courses of prednisolone (n = 4); and prednisolone versus dexamethasone (n = 6). Follow-up duration ranged from seven days to six months. The smallest study randomised just 15 participants, and the largest 638 (median 93). The varied interventions and outcomes reported limited the number of meaningful meta-analyses that we could perform.For two of our primary outcomes - hospital admission and serious adverse events - events were too infrequent to permit conclusions about the superiority of one treatment over the other, or their equivalence. Researchers in the included studies reported asthma symptoms in different ways and rarely used validated scales, again limiting our conclusions. Secondary outcome meta-analysis was similarly hampered by heterogeneity among interventions and outcome measures used. Overall, we found no convincing evidence of differences in outcomes between a higher dose or longer course and a lower dose or shorter course of prednisolone or dexamethasone, or between prednisolone and dexamethasone.Included studies were generally of reasonable methodological quality. Review authors assessed most outcomes in the review as having low or very low quality, meaning we are not confident in the effect estimates. The predominant reason for downgrading was imprecision, but indirectness and risk of bias also reduced our confidence in some estimates. AUTHORS' CONCLUSIONS: Evidence is not strong enough to reveal whether shorter or lower-dose regimens are generally less effective than longer or higher-dose regimens, or indeed that the latter are associated with more adverse events. Any changes recommended for current practice should be supported by data from larger, well-designed trials. Varied study design and outcome measures limited the number of meta-analyses that we could perform. Greater emphasis on palatability and on whether some regimens might be easier to adhere to than others could better inform clinical decisions for individual patients

The Spitzer c2d Survey of Weak-Line T Tauri Stars. III. The Transition from Primordial Disks to Debris Disks

We present 3.6 to 70 {\mu}m Spitzer photometry of 154 weak-line T Tauri stars (WTTS) in the Chamaeleon, Lupus, Ophiuchus and Taurus star formation regions, all of which are within 200 pc of the Sun. For a comparative study, we also include 33 classical T Tauri stars (CTTS) which are located in the same star forming regions. Spitzer sensitivities allow us to robustly detect the photosphere in the IRAC bands (3.6 to 8 {\mu}m) and the 24 {\mu}m MIPS band. In the 70 {\mu}m MIPS band, we are able to detect dust emission brighter than roughly 40 times the photosphere. These observations represent the most sensitive WTTS survey in the mid to far infrared to date, and reveal the frequency of outer disks (r = 3-50 AU) around WTTS. The 70 {\mu}m photometry for half the c2d WTTS sample (the on-cloud objects), which were not included in the earlier papers in this series, Padgett et al. (2006) and Cieza et al. (2007), are presented here for the first time. We find a disk frequency of 19% for on-cloud WTTS, but just 5% for off- cloud WTTS, similar to the value reported in the earlier works. WTTS exhibit spectral energy distributions (SEDs) that are quite diverse, spanning the range from optically thick to optically thin disks. Most disks become more tenuous than Ldisk/L* = 2 x 10^-3 in 2 Myr, and more tenuous than Ldisk/L* = 5 x 10^-4 in 4 Myr.Comment: 40 pages, 13 figures, 4 tables. Accepted for publication in ApJ on September 20, 201

The T Tauri star RY Tau as a case study of the inner regions of circumstellar dust disks

We study the inner region of the circumstellar disk around the TTauri star RY Tau. Our aim is to find a physical description satisfying the available interferometric data, obtained with the mid-infrared interferometric instrument at the Very Large Telescope Interferometer, as well as the spectral energy distribution. We also compare the findings with the results of similar studies, including those of intermediate-mass stars. Our analysis is done within the framework of a passive circumstellar disk, which is optionally supplemented by the effects of accretion and an added envelope. To achieve a more consistent and realistic model, we used our continuum transfer code MC3D. In addition, we studied the shape of the 10um silicate emission feature in terms of the underlying dust population, both for single-dish and for interferometric measurements. We show that a modestly flaring disk model with accretion can explain both the observed spectral energy distribution and the mid-infrared visibilities obtained with the mid-infrared infrared instrument. We found an interesting ambiguity: a circumstellar active disk model with an added envelope, and a lower accretion rate than in the active disk model without envelope, could represent the observations equally as well. This type of model with the envelope should be considered a viable alternative in future models of other TTauri stars. The approach of a disk with a puffed-up inner rim wall and the influence of a stellar companion is also discussed. From the study of the silicate emission feature we see evidence for dust evolution in a TTauri star, with a decreasing fraction of small amorphous and an increasing fraction of crystalline particles closer to the star.Comment: 19 pages, 23 figures; accepted by Astronomy & Astrophysic

Use of Short Tandem Repeat Sequences to Study Mycobacterium leprae in Leprosy Patients in Malawi and India

Molecular typing has provided an important tool for studies of many pathogens. Such methods could be particularly useful in studies of leprosy, given the many outstanding questions about the pathogenesis and epidemiology of this disease. The approach is particularly difficult with leprosy, however, because of the genetic homogeneity of M. leprae and our inability to culture it. This paper describes molecular epidemiological studies carried out on leprosy patients in Malawi and in India, using short tandem repeat sequences (STRS) as markers of M. leprae strains. It reveals evidence for continuous changes in these markers within individual patients over time, and for selection of different STRS-defined strains between different tissues (skin and nerve) in the same patient. Comparisons between patients collected under different circumstances reveal the uses and limitations of the approach—STRS analysis may in some circumstances provide a means to trace short transmission chains, but it does not provide a robust tool for distinguishing between relapse and reinfection. This encourages further work to identify genetic markers with different stability characteristics for incorporation into epidemiological studies of leprosy

Primordial Circumstellar Disks in Binary Systems: Evidence for Reduced Lifetimes

We combine the results from several multiplicity surveys of pre-main-sequence stars located in four nearby star-forming regions with Spitzer data from three different Legacy Projects. This allows us to construct a sample of 349 targets, including 125 binaries, which we use to to investigate the effect of companions on the evolution of circumstellar disks. We find that the distribution of projected separations of systems with Spitzer excesses is significantly different (P ~2.4e-5, according to the KS test for binaries with separations < 400 AU) from that of systems lacking evidence for a disk. As expected, systems with projected separations < 40 AU are half as likely to retain at least one disk than are systems with projected separations in the 40-400 AU range. These results represent the first statistically significant evidence for a correlation between binary separation and the presence of an inner disk (r ~ 1 AU). Several factors (e.g., the incompleteness of the census of close binaries, the use of unresolved disk indicators, and projection effects) have previously masked this correlation in smaller samples. We discuss the implications of our findings for circumstellar disk lifetimes and the formation of planets in multiple systems.Comment: Accepted for publication by ApJ

A systematic review of the use of dosage form manipulation to obtain required doses to inform use of manipulation in paediatric practice

This study sought to determine whether there is an evidence base for drug manipulation to obtain the required dose, a common feature of paediatric clinical practice. A systematic review of the data sources, PubMed, EMBASE, CINAHL, IPA and the Cochrane database of systematic reviews, was used. Studies that considered the dose accuracy of manipulated medicines of any dosage form, evidence of safety or harm, bioavailability, patient experience, tolerability, contamination and comparison of methods of manipulation were included. Case studies and letters were excluded. Fifty studies were eligible for inclusion, 49 of which involved tablets being cut, split, crushed or dispersed. The remaining one study involved the manipulation of suppositories of one drug. No eligible studies concerning manipulation of oral capsules or liquids, rectal enemas, nebuliser solutions, injections or transdermal patches were identified. Twenty four of the tablet studies considered dose accuracy using weight and/or drug content. In studies that considered weight using adapted pharmacopoeial specifications, the percentage of halved tablets meeting these specifications ranged from 30% to 100%. Eighteen studies investigated bioavailability, pharmacokinetics or clinical outcomes following manipulations which included nine delayed or modified release formulations. In each of these nine studies the entirety of the dosage form was administered. Only one of the 18 studies was identified where drugs were manipulated to obtain a proportion of the dosage form, and that proportion administered. The five studies that considered patient perception found that having to manipulate the tablets did not have a negative impact on adherence. Of the 49 studies only two studies reported investigating children. This review yielded limited evidence to support manipulation of medicines for children. The results cannot be extrapolated between dosage forms, methods of manipulation or between different brands of the same drug

Pathobiology of highly pathogenic H5 avian influenza viruses in naturally infected Galliformes and Anseriformes in France during winter 2015-2016

In late 2015, an epizootic of Highly Pathogenic Avian Influenza (H5Nx) was registered in Southwestern France, including more than 70 outbreaks in commercial poultry flocks. Phylogenetic analyses suggested local emergence of H5 viruses which differed from A/goose/Guangdong/1/1996 clade 2.3.4.4b lineage and shared a unique polybasic cleavage site in their hemagglutinin protein. The present work provides an overview of the pathobiological picture associated with this epizootic in naturally infected chickens, guinea fowls and ducks. Upon necropsy examination, selected tissues were sampled for histopathology, immunohistochemistry and quantitative Real Time Polymerase Chain Reaction. In Galliformes, HPAIVs infection manifested as severe acute systemic vasculitis and parenchymal necrosis and was associated with endothelial expression of viral antigen. In ducks, lesions were mild and infrequent, with sparse antigenic detection in respiratory and digestive mucosae and leukocytes. Tissue quantifications of viral antigen and RNA were higher in chickens and guinea fowls compared to duck. Subsequently, recombinant HA (rHA) was generated from a H5 HPAIV isolated from an infected duck to investigate its glycan-binding affinity for avian mucosae. Glycan-binding analysis revealed strong affinity of rHA for 3'Sialyl-LacNAc and low affinity for Sialyl-LewisX, consistent with a duck-adapted virus similar to A/Duck/Mongolia/54/2001 (H5N2). K222R and S227R mutations on rHA sequence shifted affinity towards Sialyl-LewisX and led to an increased affinity for chicken mucosa, confirming the involvement of these two mutations in the glycan-binding specificity of the HA. Interestingly, the rHA glycan binding pattern of guinea fowl appeared intermediate between duck and chicken. The present study presents a unique pathobiological description of the H5 HPAIVs outbreaks that occurred in 2015-2016 in Southwestern France

The Spitzer Survey of Interstellar Clouds in the Gould Belt. IV. Lupus V and VI Observed with IRAC and MIPS

We present Gould's Belt (GB) Spitzer IRAC and MIPS observations of the Lupus V and VI clouds and discuss them in combination with near-infrared (2MASS) data. Our observations complement those obtained for other Lupus clouds within the frame of the Spitzer "Core to Disk" (c2d) Legacy Survey. We found 43 Young Stellar Object (YSO) candidates in Lupus V and 45 in Lupus VI, including 2 transition disks, using the standard c2d/GB selection method. None of these sources was classified as a pre-main sequence star from previous optical, near-IR and X-ray surveys. A large majority of these YSO candidates appear to be surrounded by thin disks (Class III; ~79% in Lupus V and ~87% in Lupus VI). These Class III abundances differ significantly from those observed for the other Lupus clouds and c2d/GB surveyed star-forming regions, where objects with optically thick disks (Class II) dominate the young population. We investigate various scenarios that can explain this discrepancy. In particular, we show that disk photo-evaporation due to nearby OB stars is not responsible for the high fraction of Class III objects. The gas surface densities measured for Lupus V and VI lies below the star-formation threshold (AV {\eqsim}8.6 mag), while this is not the case for other Lupus clouds. Thus, few Myrs older age for the YSOs in Lupus V and VI with respect to other Lupus clouds is the most likely explanation of the high fraction of Class III objects in these clouds, while a higher characteristic stellar mass might be a contributing factor. Better constraints on the age and binary fraction ofComment: 42 Pages, 19 Figures, Accepted for publication on Ap

Microbial Translocation Is Associated with Increased Monocyte Activation and Dementia in AIDS Patients

Elevated plasma lipopolysaccharide (LPS), an indicator of microbial translocation from the gut, is a likely cause of systemic immune activation in chronic HIV infection. LPS induces monocyte activation and trafficking into brain, which are key mechanisms in the pathogenesis of HIV-associated dementia (HAD). To determine whether high LPS levels are associated with increased monocyte activation and HAD, we obtained peripheral blood samples from AIDS patients and examined plasma LPS by Limulus amebocyte lysate (LAL) assay, peripheral blood monocytes by FACS, and soluble markers of monocyte activation by ELISA. Purified monocytes were isolated by FACS sorting, and HIV DNA and RNA levels were quantified by real time PCR. Circulating monocytes expressed high levels of the activation markers CD69 and HLA-DR, and harbored low levels of HIV compared to CD4+ T-cells. High plasma LPS levels were associated with increased plasma sCD14 and LPS-binding protein (LBP) levels, and low endotoxin core antibody levels. LPS levels were higher in HAD patients compared to control groups, and were associated with HAD independently of plasma viral load and CD4 counts. LPS levels were higher in AIDS patients using intravenous heroin and/or ethanol, or with Hepatitis C virus (HCV) co-infection, compared to control groups. These results suggest a role for elevated LPS levels in driving monocyte activation in AIDS, thereby contributing to the pathogenesis of HAD, and provide evidence that cofactors linked to substance abuse and HCV co-infection influence these processes