Regulatory regionalism and anti-money-laundering governance in Asia

With the intensification of the Financial Action Task Force's (FATF's) worldwide campaign to promote anti-money-laundering regulation since the late 1990s, all Asian states except North Korea have signed up to its rules and have established a regional institution—the Asia/Pacific Group on Money Laundering—to promote and oversee the implementation of FATF's 40 Recommendations in the region. This article analyses the FATF regime, making two key claims. First, anti-money-laundering governance in Asia reflects a broader shift to regulatory regionalism, particularly in economic matters, in that its implementation and functioning depend upon the rescaling of ostensibly domestic agencies to function within a regional governance regime. Second, although this form of regulatory regionalism is established in order to bypass the perceived constraints of national sovereignty and political will, it nevertheless inevitably becomes entangled within the socio-political conflicts that shape the exercise of state power more broadly. Consequently, understanding the outcomes of regulatory regionalism involves identifying how these conflicts shape how far and in what manner global regulations are adopted and implemented within specific territories. This argument is demonstrated by a case study of Myanmar

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Anonymous Women? A Scoping Review of the Experiences of Women in Gamblers Anonymous (GA)

Women are participating in gambling at levels approaching those of men, and although levels of disordered gambling remain lower in women than in men, significant numbers are affected. Gamblers Anonymous (GA) is a mainstay of help to problem gamblers in many countries. A scoping review was conducted which specifically addressed the experiences of women who attend GA. Within the 25 identified relevant studies, only two reported empirical data on the specific numbers of women attending. A range of barriers still remain to the participation of women in these communities. These include ‘external’ barriers such as lack of referral and signposting, lack of accessible meetings, and costs of travel; ‘internal’ barriers such as shame, stigma, and fear of disclosure; and features of the GA meetings and discourse, such as a climate which is dismissive of women’s experiences

Building a tuberculosis-free world: The Lancet Commission on tuberculosis

___Key messages___ The Commission recommends five priority investments to achieve a tuberculosis-free world within a generation. These investments are designed to fulfil the mandate of the UN High Level Meeting on tuberculosis. In addition, they answer

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Inclusion of Building-Resolving Capabilities Into the FastEddy® GPU-LES Model Using an Immersed Body Force Method

As a first step toward achieving full physics urban weather simulation capabilities within the resident-GPU large-eddy simulation (LES) FastEddy® model, we have implemented and verified/validated a method for explicit representation of building effects. Herein, we extend the immersed body force method (IBFM) from Chan and Leach (2007, https://doi.org/10.1175/2006JAMC1321.1) to (i) be scale independent and (ii) control building surface temperatures. Through a specific drag-like term in the momentum equations, the IBFM is able to enforce essentially zero velocities within the buildings, in turn resulting in a no-slip boundary condition at the building walls. In addition, we propose similar forcing terms in the energy and mass conservation equations that allow an accurate prescription of the building temperature. The extended IBFM is computationally efficient and has the potential to be coupled to building energy models. The IBFM exhibits excellent agreement with laboratory experiments of an array of staggered cubes at a grid spacing of (Formula presented.) mm, demonstrating the applicability of the method beyond the atmospheric scale. In addition, the IBFM is validated at atmospheric scale through simulations of downtown Oklahoma City ((Formula presented.) m) using data collected during the Joint Urban 2003 (JU03) field campaign. Our LES IBFM results for mean wind speed, turbulence kinetic energy, and SF6 transport and dispersion compare well to observations and produce turbulence spectra that are in good agreement with sonic anemometer data. Statistical performance metrics for the JU03 simulations are within the range of other LES models in the literature.</p

Inclusion of Building-Resolving Capabilities Into the FastEddy® GPU-LES Model Using an Immersed Body Force Method

As a first step toward achieving full physics urban weather simulation capabilities within the resident-GPU large-eddy simulation (LES) FastEddy® model, we have implemented and verified/validated a method for explicit representation of building effects. Herein, we extend the immersed body force method (IBFM) from Chan and Leach (2007, https://doi.org/10.1175/2006JAMC1321.1) to (i) be scale independent and (ii) control building surface temperatures. Through a specific drag-like term in the momentum equations, the IBFM is able to enforce essentially zero velocities within the buildings, in turn resulting in a no-slip boundary condition at the building walls. In addition, we propose similar forcing terms in the energy and mass conservation equations that allow an accurate prescription of the building temperature. The extended IBFM is computationally efficient and has the potential to be coupled to building energy models. The IBFM exhibits excellent agreement with laboratory experiments of an array of staggered cubes at a grid spacing of (Formula presented.) mm, demonstrating the applicability of the method beyond the atmospheric scale. In addition, the IBFM is validated at atmospheric scale through simulations of downtown Oklahoma City ((Formula presented.) m) using data collected during the Joint Urban 2003 (JU03) field campaign. Our LES IBFM results for mean wind speed, turbulence kinetic energy, and SF6 transport and dispersion compare well to observations and produce turbulence spectra that are in good agreement with sonic anemometer data. Statistical performance metrics for the JU03 simulations are within the range of other LES models in the literature.Urban Data Scienc

High-affinity growth hormone binding protein and acute heavy resistance exercise

Purpose: The purpose of this investigation was to examine the influence of resistance training on circulating concentrations of growth hormone binding protein (GHBP) in response to acute heavy resistance exercise. Methods: Using a cross-sectional experimental design, a group of resistance-trained men (RT, N 9, 7.9 + 1.3 yr resistance training experience) and a group of untrained men (UT, N 10) performed an acute heavy resistance exercise protocol (AHREP) consisting of 6 sets of 10 repetition maximum parallel squats. Blood samples were obtained 72 h before exercise, immediately before exercise, and 0, 15, 30, 45, and 60 min after exercise. Results: Significant increases (P \u3c 0.05) in GHBP, immunoreactive growth hormone (iGH), and IGF-1 were observed in both subject groups after AHREP. There were no differences (P \u3e 0.05) between groups in GHBP at rest or after AHREP. However, RT exhibited a significantly greater iGH response to AHREP than UT subjects, and significantly higher IGF-1 values at rest and after exercise. Significant positive correlations were found between GHBP and BMI, body fat, and leptin in both groups. A significant positive correlation also was observed between resting leptin and GHBP values in UT but not RT subjects. Conclusions: In summary, these data indicate that resistance training does not increase blood GHBP. Nevertheless, the increases observed with IGF-1 concentrations in the resistance-trained subjects do suggest an apparent adaptation with the regulation of this hormone. If there was in fact an increase in GH sensitivity and GH receptor expression at the liver that was not detected by blood GHBP in this study, it may be possible that factors contributing to the circulating concentration of GHBP other than hepatocytes (e.g., leptin and adipocytes) may serve to mask training-induced increases in circulating GHBP of a hepatic origin, thus masking any detectable increase in GH receptor expression