Meet the Moment: A Call for Progressive Philanthropic Response to the Anti-Gender Movement

In early 2020, Global Philanthropy Project worked with our member organizations and philanthropic partners to develop two related pieces of private research: 1) a report mapping the funding of the global "anti-gender ideology" or "anti-gender" movement, and 2) a report mapping the progressive philanthropic response. We offer the following public document in order to share key learning and to offer additional analysis gained in the comparison of the two reports. Additionally, we share insights based on comparing global and regional LGBTI funding data as documented in the 2017-2018 Global Resources Report: Government and Philanthropic Support for Lesbian, Gay, Bisexual, Transgender, and Intersex Communities.These findings offer a clear call to action: progressive movements and their philanthropic partners are being outspent by hundreds of millions of dollars each year, and the institutions providing that opposition funding have developed sophisticated and coordinated systems to learn, co-fund, and expand their influence. The philanthropic community is called to recognize the scale of the fight and to be both rigorous and creative in our response. Let us seize this remarkable opportunity to work together and engage our collective learning, spending power, and institutional knowledge to help transform the conditions of our communities. Together we can leverage the collective power that this generational crisis demands.

Trusting consumers: Involving communities in municipal water service decision making in Durban, South Africa

The Constitution of 1996 sets out the government’s responsibility to provide the public with the opportunity to be involved in government decisions that affect their lives (R Kasrils, Former Minister of Water Affairs and Forestry, 2001)Participation is a guiding principle of South Africa’s post-apartheid water sector reforms. Yet studies indicate that substantive and effective participation has been difficult to achieve. In an effort to develop sustainable and creative dialogue with consumers, the University of KwaZulu-Natal in partnership with eThekwini Water and Sanitation (EWS) piloted the establishment of community-based focus groups in 3 different types of communities. The goals of the project were to build trust, generate social capital and widen the store of available methods for enhancing dialogue between service providers and consumers. This paper details the methods used. This pilot formed part of a larger strategy to develop and refine a methodology to be used in a municipality-wide research and engagement strategy involving a diverse selection of wards. At the time of publication, research in 6 wards and one similar study with people with disabilities were complete.Keywords: participation, trust, water service improvemen

Integrated Transboundary Water-Climate Management Tools

The scholarly theme of the book lends itself to the discipline of earth and atmospheric sciences, with a specific focus on water-climate studies. The book is a scholarly discourse by researchers in the natural sciences, including Hydrologists, Climate Scientists, Environmental Engineers and Water Scientists. The purpose of the book is to address the limited complementarity between the water and climate studies; which is crucial in promoting scientific research that informs policy decisions and implementation of water security plans. The chapters were selected to represent water-climate models and policy research conducted in different river basins in the arid and semi-arid environments. Therefore, the water-climate management tools highlighted in this book include General Circulation Models (GCMs), Coupled Model Inter-comparison Project Phase 5 (CMIP5), Soil and Water Assessment Tool (SWAT), Africa Flood and Drought Monitor (AFDM), Extreme Precipitation Events (EPEs), R ClimDex, Mixed strategy game models, Standard Precipitation Indices (SPIs), Water Evaluation and Planning System (WEAP), Penman Calculator, and Saturated Volume Fluctuation (SVF)

Impact of Virtual Interprofessional COVID-19 disaster simulation Tabletop Exercise (VICTEr) workshop on Disaster Preparedness among Interprofessional trainees in a tertiary care teaching hospital in India

INTRODUCTION: Disaster planning is of significant importance for the healthcare professional and the healthcare setting. Hospital-based disaster protocols form the cornerstone of disaster response. There is a paucity of data on disaster preparedness training using the virtual tabletop exercise (VTTX) module for interprofessional education from in-hospital and prehospital settings. With the coronavirus disease 2019 (COVID-19) pandemic, we have seen a paradigm shift of education strategies to the virtual realm. Here we attempt to study the impact of an online tabletop exercise workshop on the knowledge and confidence of disaster preparedness among Interprofessional trainees. MATERIAL AND METHODS: Interprofessional trainees from medical, dental, nursing, respiratory therapy, and paramedic domains who consented were included in this study. Institutional ethics committee approval was received and the study was registered with the clinical trials registry India (CTRI), before initiation. The VTTX module has been adapted from the World Health Organization (WHO) COVID-19 training resources. Three international experts from the disaster medicine domain validated the module, questionnaire, and feedback. Wilcoxon signed-rank test was used to compare the parameters (Knowledge and confidence level) pre and post-workshop. RESULTS: A total of 76 candidates with a mean age was 21.67 ± 2.5 (range:19–36) were part of the workshop. Comparison of the median scores and interquartile range of confidence level and knowledge respectively before [38 (29.25–45.75), 9 (7–11)] and after [51.50 (45–60), 11 (10–12)] the workshop showed vital significance (p-value < 0.001). All participants gave positive feedback on the workshop meeting the objectives. The majority agreed that the workshop improved their self-preparedness (90%) and felt that the online platform was appropriate (97.5%). CONCLUSIONS: This study sheds light on the positive impact of the online VTTX based workshop on disaster preparedness training among interprofessional trainees. Disaster preparedness training using available online platforms may be effectively executed with the VICTEr workshop even during the COVID-19 pandemic. The VICTEr workshop serves as a primer for developing online modules for effective pandemic preparedness training in interprofessional education

Fermi Large Area Telescope Constraints on the Gamma-ray Opacity of the Universe

The Extragalactic Background Light (EBL) includes photons with wavelengths from ultraviolet to infrared, which are effective at attenuating gamma rays with energy above ~10 GeV during propagation from sources at cosmological distances. This results in a redshift- and energy-dependent attenuation of the gamma-ray flux of extragalactic sources such as blazars and Gamma-Ray Bursts (GRBs). The Large Area Telescope onboard Fermi detects a sample of gamma-ray blazars with redshift up to z~3, and GRBs with redshift up to z~4.3. Using photons above 10 GeV collected by Fermi over more than one year of observations for these sources, we investigate the effect of gamma-ray flux attenuation by the EBL. We place upper limits on the gamma-ray opacity of the Universe at various energies and redshifts, and compare this with predictions from well-known EBL models. We find that an EBL intensity in the optical-ultraviolet wavelengths as great as predicted by the "baseline" model of Stecker et al. (2006) can be ruled out with high confidence.Comment: 42 pages, 12 figures, accepted version (24 Aug.2010) for publication in ApJ; Contact authors: A. Bouvier, A. Chen, S. Raino, S. Razzaque, A. Reimer, L.C. Reye

Outcome of intracerebral hemorrhage associated with different oral anticoagulants

Objective: In an international collaborative multicenter pooled analysis, we compared mortality, functional outcome, intracerebral hemorrhage (ICH) volume, and hematoma expansion (HE) between non-vitamin K antagonist oral anticoagulation-related ICH (NOAC-ICH) and vitamin K antagonist-associated ICH (VKA-ICH). Methods: We compared all-cause mortality within 90 days for NOAC-ICH and VKA-ICH using a Cox proportional hazards model adjusted for age; sex; baseline Glasgow Coma Scale score, ICH location, and log volume; intraventricular hemorrhage volume; and intracranial surgery. We addressed heterogeneity using a shared frailty term. Good functional outcome was defined as discharge modified Rankin Scale score 33% or >6 mL from baseline within 72 hours. Results: We included 500 patients (97 NOAC-ICH and 403 VKA-ICH). Median baseline ICH volume was 14.4 mL (interquartile range [IQR] 3.6-38.4) for NOAC-ICH vs 10.6 mL (IQR 4.0-27.9) for VKA-ICH (p = 0.78). We did not find any difference between NOAC-ICH and VKA-ICH for all-cause mortality within 90 days (33% for NOAC-ICH vs 31% for VKA-ICH [p = 0.64]; adjusted Cox hazard ratio (for NOAC-ICH vs VKA-ICH) 0.93 [95% confidence interval (CI) 0.52-1.64] [p = 0.79]), the rate of HE (NOAC-ICH n = 29/48 [40%] vs VKA-ICH n = 93/140 [34%] [p = 0.45]), or functional outcome at hospital discharge (NOAC-ICH vs VKA-ICH odds ratio 0.47; 95% CI 0.18-1.19 [p = 0.11]). Conclusions: In our international collaborative multicenter pooled analysis, baseline ICH volume, hematoma expansion, 90-day mortality, and functional outcome were similar following NOAC-ICH and VKA-ICH.Peer reviewe

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Noise suppression of proton magnetic resonance spectroscopy improves paediatric brain tumour classification

Proton magnetic resonance spectroscopy (1H‐MRS) is increasingly used for clinical brain tumour diagnosis, but suffers from limited spectral quality. This retrospective and comparative study aims at improving paediatric brain tumour classification by performing noise suppression on clinical 1H‐MRS. Eighty‐three/forty‐two children with either an ependymoma (ages 4.6 ± $$\pm$$ 5.3/9.3 ± $$\pm$$ 5.4), a medulloblastoma (ages 6.9 ± $$\pm$$ 3.5/6.5 ± $$\pm$$ 4.4), or a pilocytic astrocytoma (8.0 ± $$\pm$$ 3.6/6.3 ± $$\pm$$ 5.0), recruited from four centres across England, were scanned with 1.5T/3T short‐echo‐time point‐resolved spectroscopy. The acquired raw 1H‐MRS was quantified by using Totally Automatic Robust Quantitation in NMR (TARQUIN), assessed by experienced spectroscopists, and processed with adaptive wavelet noise suppression (AWNS). Metabolite concentrations were extracted as features, selected based on multiclass receiver operating characteristics, and finally used for identifying brain tumour types with supervised machine learning. The minority class was oversampled through the synthetic minority oversampling technique for comparison purposes. Post‐noise‐suppression 1H‐MRS showed significantly elevated signal‐to‐noise ratios (P .05, Wilcoxon signed‐rank test), and significantly higher classification accuracy (P < .05, Wilcoxon signed‐rank test). Specifically, the cross‐validated overall and balanced classification accuracies can be improved from 81% to 88% overall and 76% to 86% balanced for the 1.5T cohort, whilst for the 3T cohort they can be improved from 62% to 76% overall and 46% to 56%, by applying Naïve Bayes on the oversampled 1H‐MRS. The study shows that fitting‐based signal‐to‐noise ratios of clinical 1H‐MRS can be significantly improved by using AWNS with insignificantly altered line width, and the post‐noise‐suppression 1H‐MRS may have better diagnostic performance for paediatric brain tumours

All-sky Medium Energy Gamma-ray Observatory: Exploring the Extreme Multimessenger Universe

The All-sky Medium Energy Gamma-ray Observatory (AMEGO) is a probe class mission concept that will provide essential contributions to multimessenger astrophysics in the late 2020s and beyond. AMEGO combines high sensitivity in the 200 keV to 10 GeV energy range with a wide field of view, good spectral resolution, and polarization sensitivity. Therefore, AMEGO is key in the study of multimessenger astrophysical objects that have unique signatures in the gamma-ray regime, such as neutron star mergers, supernovae, and flaring active galactic nuclei. The order-of-magnitude improvement compared to previous MeV missions also enables discoveries of a wide range of phenomena whose energy output peaks in the relatively unexplored medium-energy gamma-ray band