The disease of corruption: views on how to fight corruption to advance 21st century global health goals

Corruption has been described as a disease. When corruption infiltrates global health, it can be particularly devastating, threatening hard gained improvements in human and economic development, international security, and population health. Yet, the multifaceted and complex nature of global health corruption makes it extremely difficult to tackle, despite its enormous costs, which have been estimated in the billions of dollars. In this forum article, we asked anti-corruption experts to identify key priority areas that urgently need global attention in order to advance the fight against global health corruption. The views shared by this multidisciplinary group of contributors reveal several fundamental challenges and allow us to explore potential solutions to address the unique risks posed by health-related corruption. Collectively, these perspectives also provide a roadmap that can be used in support of global health anti-corruption efforts in the post-2015 development agenda

Timing of extension in the Pioneer metamorphic core complex with implications for the spatial-temporal pattern of Cenozoic extension and exhumation in the northern U.S. Cordillera

The Pioneer core complex (PCC) in central Idaho lies along a transition between Early Eocene and ca. 40 Ma core complexes to the north and south, respectively. Thus, the age of extensional development of the PCC is important in understanding the spatial-temporal patterns of core-complex development in the North American Cordillera. New results, including structural observations and U-Pb zircon (SHRIMP and ICPMS) geochronology, constrain the early extensional history of the footwall for the first time. High-temperature strain with a top-WNW shear-sense is pervasive throughout metamorphic rocks of the northwestern footwall. An isoclinally folded dike yields a crystallization age of ∼48-47 Ma, whereas a crosscutting dike yielded an age of 46 Ma. Metamorphic rocks are also intruded by the ∼50-48 Ma Pioneer intrusive suite (PIS), a W-dipping granodiorite sheet displaying a magmatic fabric. Northwest-trending lineations are locally visible and also defined by anisotropy of magnetic susceptibility, indicating that during emplacement, the PIS was undergoing similarly oriented extensional strain as the enclosing metamorphic rocks. Therefore, WNW-directed extension spanning this structural section occurred between ∼50 and 46 Ma. Following emplacement of crosscutting 46 Ma dikes, deformation was partitioned into the WNW-directed Wildhorse detachment. Motion on the detachment occurred between ∼38 and 33 Ma, as documented by previous 40Ar/ 39Ar thermochronology. It is not clear, however, whether extension was continuous through the interval between these two time periods. Although Early Eocene extension in the PCC was synchronous with extension in core complexes to the north, rates of footwall exhumation in central Idaho were much lower. This southward slowing is compatible with N-S differences in inferred subduction zone geometry/kinematics and in the internal character of the orogenic wedge

U-Pb zircon ages of the Wildhorse gneiss, Pioneer Mountains, south-central Idaho, and tectonic implications

The gneiss complex of Wildhorse Creek (Wildhorse gneiss) forms the central component of the lowest structural plate in the Pioneer metamorphic core complex of south-central Idaho. The oldest rock in the complex is a felsic ortho-gneiss, with Neoarchean U-Pb magmatic zircon ages of 2.60-2.67 Ga. The ortho-gneiss overlaps in age and is interpreted to be part of the Grouse Creek block of the Albion Mountains to the south. This Archean metagranitoid is structurally interleaved with paragneiss containing quartzite and calc-silicate rock. Structurally below the orthogneiss, some quartzites have multiple concordant populations of detrital-zircon grains as young as ca. 1700 Ma, while others have no zircon grains younger than ca. 2500 Ma. Structurally above the Archean gneiss is a heterogeneous paragneiss that contains calc-silicate and quartzitic rocks with detrital zircons as young as ca. 1460 Ma. Amphibolite in this unit contains zircons dated at ca. 1850 Ma, indicating that this rock can be no older than that and implying considerable structural complexity. The upper part of the Wildhorse gneiss contains metaquartzites bearing zircons as young as ca. 1400 Ma. The protolith of this paragneiss is interpreted as the southernmost exposures of the Lemhi subbasin of the Mesoproterozoic Belt Supergroup. The upper Wildhorse gneiss includes ca. 695 Ma intrusive orthogneiss that is coeval with Neoproterozoic rift-related volcanic or intrusive rocks near Pocatello, House Mountain, and Edwardsburg, Idaho. This Cryogenian meta-intrusive rock is the likely source of the 650-710 Ma detrital-zircon population in the Big Lost River that drains the core complex. Initial eHf values from 675 Ma zircons are between 3.4 and -2.4, suggesting the granitoids had a mixed source in both continental crust and juvenile mantle.This research was supported by National Science Foundation grants EAR 05-10980 and 08-38425 and U.S. Geological Survey grant G14AC00136. Logistical support was provided by the Idaho State University Geology field camp at Lost River Field Station

The Legal Needs of People Living with a Sexually Transmissible Infection or Blood-Borne Virus: Perspectives From a Sample of the Australian Sexual Health and Blood Borne Virus Workforce

Law and the legal environment are important factors in the epidemiology and prevention of sexually transmissible infections (STIs) and blood-borne viruses (BBVs). However, there has been no sustained effort to monitor the legal environment surrounding STIs and BBVs. This article presents the first data on the incidence and impacts of unmet legal needs for those affected by an STI or BBV in Australia using a survey administered to a sample of the Australian sexual health and BBV workforce. Migration, Housing, Money/Debt, Health (including complaints about health services), and Crime (accused/offender) were reported as the five most common legal need areas, with 60% of respondents describing these legal problems as generating a “severe” impact on health. These results indicate that unmet legal needs generate significant negative impacts in terms of individual health, on public health, and the ability to provide sustainable services such as testing and treatment to those facing unmet legal needs

Radiation tolerance of two-dimensional material-based devices for space applications

Characteristic for devices based on two-dimensional materials are their low size, weight and power requirements. This makes them advantageous for use in space instrumentation, including photovoltaics, batteries, electronics, sensors and light sources for long-distance quantum communication. Here we present a comprehensive study on combined radiation effects in Earth's atmosphere on various devices based on these nanomaterials. Using theoretical modeling packages, we estimate relevant radiation levels and then expose field-effect transistors, single-photon sources and monolayers as building blocks for future electronics to gamma-rays, protons and electrons. The devices show negligible change in performance after the irradiation, suggesting robust suitability for space use. Under excessive gamma-radiation, however, monolayer WS2 shows decreased defect densities, identified by an increase in photoluminescence, carrier lifetime and a change in doping ratio proportional to the photon flux. The underlying mechanism is traced back to radiation-induced defect healing, wherein dissociated oxygen passivates sulfur vacancies.This work was funded by the Australian Research Council (CE170100012, FL150100019, DE140100805, DE170100169, DE160100098 and DP180103238). We acknowledge financial support from ANU PhD scholarships, the China Scholarship Council and the ANU Major Equipment Committee fund (No. 14MEC34)

Radiation tolerance of two-dimensional material-based devices for space applications

Characteristic for devices based on two-dimensional materials are their low size, weight and power requirements. This makes them advantageous for use in space instrumentation, including photovoltaics, batteries, electronics, sensors and light sources for long-distance quantum communication. Here, we present for the first time a comprehensive study on combined radiation effects in earth's atmosphere on various devices based on these nanomaterials. Using theoretical modeling packages, we estimate relevant radiation levels and then expose field-effect transistors, single-photon sources and monolayers as building blocks for future electronics to gamma-rays, protons and electrons. The devices show negligible change in performance after the irradiation, suggesting robust suitability for space use. Under excessive $\gamma$-radiation, however, monolayer WS$_2$ showed decreased defect densities, identified by an increase in photoluminescence, carrier lifetime and a change in doping ratio proportional to the photon flux. The underlying mechanism was traced back to radiation-induced defect healing, wherein dissociated oxygen passivates sulfur vacancies

Fully reduced HMGB1 accelerates the regeneration of multiple tissues by transitioning stem cells to G(ALERT)

A major discovery of recent decades has been the existence of stem cells and their potential to repair many, if not most, tissues. With the aging population, many attempts have been made to use exogenous stem cells to promote tissue repair, so far with limited success. An alternative approach, which may be more effective and far less costly, is to promote tissue regeneration by targeting endogenous stem cells. However, ways of enhancing endogenous stem cell function remain poorly defined. Injury leads to the release of danger signals which are known to modulate the immune response, but their role in stem cell-mediated repair in vivo remains to be clarified. Here we show that high mobility group box 1 (HMGB1) is released following fracture in both humans and mice, forms a heterocomplex with CXCL12, and acts via CXCR4 to accelerate skeletal, hematopoietic, and muscle regeneration in vivo. Pretreatment with HMGB1 2 wk before injury also accelerated tissue regeneration, indicating an acquired proregenerative signature. HMGB1 led to sustained increase in cell cycling in vivo, and using Hmgb1 -/- mice we identified the underlying mechanism as the transition of multiple quiescent stem cells from G0 to GAlert HMGB1 also transitions human stem and progenitor cells to GAlert Therefore, exogenous HMGB1 may benefit patients in many clinical scenarios, including trauma, chemotherapy, and elective surgery

Implementation of a Spine-Centered Care Pathway at a Regional Academic Spine Center.

Study Design: Retrospective case series. Objective: To describe the early implementation of an inpatient spinal surgery unit and measure the impact on cost and length of stay (LOS). Methods: A retrospective case review was performed for frequent spine-related diagnosis-related groups (DRGs) cared for by a dedicated multidisciplinary team: combined anterior/posterior (AP) spinal fusion with major complicating or comorbid condition (MCC), combined (AP) spinal fusion with CC, combined (AP) spinal fusion without complicating or comorbid (CC)/MCC, cervical spinal fusion with MCC, cervical spinal fusion with CC, and cervical spinal fusion without CC/MCC. Four time periods were compared: historical control, initial pathway implementation, full pathway implementation, and spine unit opening. Mean hospital LOS, mean and median total costs (USD), and ratio of costs-to-charges were analyzed. Results: The number of spine cases per interim ranged from 219 to 258. The mean overall hospital LOS and mean cost varied from 3.8 to 4.3 days for all DRGs across the time periods and was not significant. Cost also did not vary significantly throughout. Median variable cost per anterior/posterior spinal fusion procedure with a CC or MCC declined by 16 311, first with the institution of a spine pathway protocol by USD8738 and then USD7423 with the establishment of a spine care unit but did not reach significance. Conclusions: The use of a standardized, inpatient spine care pathway implemented by a multidisciplinary team may reduce the hospital length of stay and decrease overall costs

S100A9 is indispensable for survival of pneumococcal pneumonia in mice

S100A8/A9 has important immunomodulatory roles in antibacterial defense, but its relevance in focal pneumonia caused by Streptococcus pneumoniae (S. pneumoniae) is understudied. We show that S100A9 was significantly increased in BAL fluids of patients with bacterial but not viral pneumonia and correlated with procalcitonin and sequential organ failure assessment scores. Mice deficient in S100A9 exhibited drastically elevated Zn$^{2+}$ levels in lungs, which led to bacterial outgrowth and significantly reduced survival. In addition, reduced survival of S100A9 KO mice was characterized by excessive release of neutrophil elastase, which resulted in degradation of opsonophagocytically important collectins surfactant proteins A and D. All of these features were attenuated in S. pneumoniae-challenged chimeric WT→S100A9 KO mice. Similarly, therapy of S. pneumoniae-infected S100A9 KO mice with a mutant S100A8/A9 protein showing increased half-life significantly decreased lung bacterial loads and lung injury. Collectively, S100A9 controls central antibacterial immune mechanisms of the lung with essential relevance to survival of pneumococcal pneumonia. Moreover, S100A9 appears to be a promising biomarker to distinguish patients with bacterial from those with viral pneumonia. Trial registration: Clinical Trials register (DRKS00000620)