Neglected Dimensions of Global Security: The Global Health Risk Framework Commission

The world has experienced global health crises ranging from novel influenzas (H5N1 and H1N1) and coronaviruses (SARS and MERS) to the Ebola and Zika viruses. In each case, governments and international organizations seemed unable to react quickly and decisively. Health crises have unmasked critical vulnerabilities— weak health systems, failures of leadership, and political overreaction and underreaction. The Global Health Risk Framework Commission, for which the National Academy of Medicine served as the secretariat, recently set out a comprehensive strategy to safeguard human and economic security from pandemic threats

Grantmaking to Communities of Color in Oregon

This report, prepared by the Foundation Center at the request of Grantmakers of Oregon and Southwest Washington, examines the extent to which domestically focused grantmaking by Oregon foundations in 2008 reached Oregon's communities of color, and situates this in the context of the state's changing demographics

Untapped Potential: European Foundation Funding for Women and Girls

Analyzes trends in European foundation giving and programmatic activities focused on women and girls, including as a percentage of funding and number of grants, issue areas, and approaches to funding. Highlights best practices in effective engagement

Non-ST Elevation MI as a Unique Presentation of Angioimmunoblastic T-cell Lymphoma

Case A 61-year-old Chinese female with a history of hypertension, hyperlipidemia, asthma, and gastroesophageal reflux disease presented with four days of chest pressure that radiated to her left arm and jaw. On exam, her vital signs were within normal limits and cardiac and pulmonary exams were unremarkable. Her initial electrocardiogram (ECG) demonstrated ischemic ST segment depressions in leads II, III, and aVF; her first troponin I was elevated at 2.3 ng/mL (normal \u3c0.05 ng/mL) and peaked at 6.8 ng/mL. She was given sublingual nitroglycerin and metoprolol, which controlled her symptoms, and she was started on a heparin infusion to prevent further ischemia. The patient’s medications included: amlodipine was notable for the following daily medications: amlodipine 5 mg, olmesartan 20mg, atorvastatin 20mg, esomeprazole 20mg, montelukast 10mg, and mometasone 110mcg twice daily. Her family history was significant for a brother who had a coronary stent placed at age 57. She denied drug, tobacco, or alcohol use. She was non-English speaking, and immigrated to the United States from China five years ago

Prospects and current challenges of extracellular vesicle-based biomarkers in cancer

Cancer continues to impose a substantial global health burden, particularly among the elderly, where the ongoing global demographic shift towards an ageing population underscores the growing need for early cancer detection. This is essential for enabling personalised cancer care and optimised treatment throughout the disease course to effectively mitigate the increasing societal impact of cancer. Liquid biopsy has emerged as a promising strategy for cancer diagnosis and treatment monitoring, offering a minimally invasive method for the isolation and molecular profiling of circulating tumour-derived components. The expansion of the liquid biopsy approach to include the detection of tumour-derived extracellular vesicles (tdEVs) holds significant therapeutic opportunity. Evidence suggests that tdEVs carry cargo reflecting the contents of their cell-of-origin and are abundant within the blood, exhibiting superior stability compared to non-encapsulated tumour-derived material, such as circulating tumour nucleic acids and proteins. However, despite theoretical promise, several obstacles hinder the translation of extracellular vesicle-based cancer biomarkers into clinical practice. This critical review assesses the current prospects and challenges facing the adoption of tdEV biomarkers in clinical practice, offering insights into future directions and proposing strategies to overcome translational barriers. By addressing these issues, EV-based liquid biopsy approaches could revolutionise cancer diagnostics and management

Outcome reporting bias in Cochrane systematic reviews: a cross-sectional analysis

Background Discrepancies in outcome reporting (DOR) between protocol and published studies include inclusions of new outcomes, omission of prespecified outcomes, upgrade and downgrade of secondary and primary outcomes, and changes in definitions of prespecified outcomes. DOR can result in outcome reporting bias (ORB) when changes in outcomes occur after knowledge of results. This has potential to overestimate treatment effects and underestimate harms. This can also occur at the level of systematic reviews when changes in outcomes occur after knowledge of results of included studies. The prevalence of DOR and ORB in systematic reviews is unknown in systematic reviews published post-2007. Objective To estimate the prevalence of DOR and risk of ORB in all Cochrane reviews between the years 2007 and 2014. Methods A stratified random sampling approach was applied to collect a representative sample of Cochrane systematic reviews from each Cochrane review group. DOR was assessed by matching outcomes in each systematic review with their respective protocol. When DOR occurred, reviews were further assessed if there was a risk of ORB (unclear, low or high risk). We classified DOR as a high risk for ORB if the discrepancy occurred after knowledge of results in the systematic review. Results 150 of 350 (43%) review and protocol pairings contained DOR. When reviews were further scrutinised, 23% (35 of 150) of reviews with DOR contained a high risk of ORB, with changes being made after knowledge of results from individual trials. Conclusions In our study, we identified just under a half of Cochrane reviews with at least one DOR. Of these, a fifth were at high risk of ORB. The presence of DOR and ORB in Cochrane reviews is of great concern; however, a solution is relatively simple. Authors are encouraged to be transparent where outcomes change and to describe the legitimacy of changing outcomes in order to prevent suspicion of bias

Comparison of higher-order mode suppression and Q-switched laser performance in thulium-doped large mode area and photonic crystal fibers

We report the influence of higher order modes (HOMs) in large mode fibers operation in Q-switched oscillator configurations at similar to 2 mu m wavelength. S-2 measurements confirm guiding of LP11 and LP02 fiber modes in a large mode area (LMA) step-index fiber, whereas a prototype photonic crystal fiber (PCF) provides nearly single-mode performance with a small portion of light in the LP11 mode. The difference in HOM content leads to a significant difference in Q-switched oscillator performance. In the step-index fiber, the percentage of cladding light increases by 20% to \u3e 40% with increasing pulse energy to similar to 250 mu J. We accredit this degradation to saturation of the gain in the fundamental mode leading to more light generated in the HOMs, which is eventually converted into cladding light. No such degradation is seen in PCF laser system for \u3e 400 mu J energies

Difficult encounters around "monkey cheeks": Farmers' interests and the design of flood retention areas in Thailand

Flood retention areas are being increasingly promoted for flood risk management. People living in these areas will accept them if their interests are taken into account. The present study analyses the extent to which farmers' interests were taken into account in two flood retention projects in Thailand. A feasibility study was conducted in preparation for the first project which included public participation. The second project was a pilot project implemented in the same zone at a small scale. Participants in the public participation process and farmers living in proposed flood retention areas were interviewed for the purpose of the present study. Agreement could have been reached between the farmers and the public agencies concerning the flood retention areas. However, the participation process did not enable frank discussion about the conditions under which farmers would accept the project. The second project was designed without public participation and offered very little compensation to farmers. In countries marked by power imbalances in water resources management, public agencies may impose flood retention areas, but the absence of agreements with farmers can reduce the effectiveness of the measure. Reaching such agreements requires challenging the imbalanced power relationships between farmers and public agencies