Irrigation Management Transfer and WUAs’ dynamics: evidence from the South-Kazakhstan province

Since the collapse of the Soviet Union, in Kazakhstan, as in the other Central Asian republics, significant changes in both the water and agricultural sectors have emerged; water management shifted from a purely technical issue to a sociopolitical and economic one leading to several institutional and organizational changes. To address this transitional context and its issues, since the 1990s international donors have supported the establishment of Irrigation Management Transfer (IMT) and the Water Users Associations (WUAs), both initiatives sponsored and related to the IWRM framework. This paper discusses these processes in the South-Kazakhstan Province, 10 years since the enactment of the law formalizing WUAs; three districts were selected for the analysis. The paper concludes that the IMT has been implemented in different and ambiguous methods and times, reflecting specific district dynamics and issues; furthermore, government support of IMT has decreased, leading to unexpected changes in its role in local water management and a reconsideration of the future scenario

The circle of hydro-hegemony between riparian states, development policies and borderlands: evidence from the Talas waterscape (Kyrgyzstan-Kazakhstan)

Since the 1990s, transboundary water management has come to play a key role both in global environmental politics debates and in the shaping of international development policies, specifically in the Global South. As a consequence, a growing body of literature in the framework of critical hydropolitics has emerged reflecting on the role that power, discourses, and strategies play in shaping transboundary water policies and in influencing riparian relations. The focus on a state-centric perspective, however, often has led to neglect of the role of international development actors in shaping these policies. Through a critical application of the Circle of Hydro-Hegemony (CHH) and ethnographic qualitative field research in borderlands, this contribution aims to analyse how the establishment of a development initiative known as the Chu-Talas Commission, supported by the United Nations Economic Commission for Europe (UNECE) and other donors, has influenced and shaped transboundary water politics in the Talas waterscape, which is shared by Kyrgyzstan and Kazakhstan. The evidence shows that despite the international narration of the Chu-Talas Commission as a success story for water cooperation in Central Asia, Kazakhstan, through the deployment of both material and bargaining power strategies, has been able to shape UNECE development policies in its favour, impose its agenda on Kyrgyzstan, and emerge as the basin hydro-hegemon

Critical concepts, practice recommendations, and research perspectives of pixantrone therapy in non-Hodgkin lymphoma: a SIE, SIES, and GITMO consensus paper

Objectives: In this paper, we present a review of critical concepts and research perspectives and produce recommendations on the optimal use of pixantrone in non-Hodgkin lymphoma (NHL) by group discussion from an expert panel appointed by the Italian Society of Hematology and the affiliate societies, Societa Italiana di Ematologia Sperimentale and Gruppo Italiano Trapianto di Midollo Osseo. Methods: Recommendations were produced using the Delphi process. Scientific evidence on pixantrone efficacy was analyzed using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology in the areas where at least one randomized trial was published. The following key issues were addressed for practical recommendations: pixantrone monotherapy in aggressive relapsed or refractory non-Hodgkin B-cell lymphomas and toxicity risk management in patients candidates to pixantrone. Results and conclusions: After a balanced and value-oriented discussion, the panel agreed that the benefit/risk profile was in favor of pixantrone in the treatment of adult patients with multiply relapsed or refractory aggressive NHL B-cell lymphomas. Pixantrone was deemed to be contraindicated in patients with uncontrolled cardiovascular disease. Despite a low rate of cardiotoxicity of pixantrone reported in clinical trials, the panel recommended that all patients receiving pixantrone should undergo periodical cardiac monitoring

GLUT1 expression patterns in different Hodgkin lymphoma subtypes and progressively transformed germinal centers

Background: Increased glycolytic activity is a hallmark of cancer, allowing staging and restaging with 18F-fluorodeoxyglucose-positron-emission-tomography (PET). Since interim-PET is an important prognostic tool in Hodgkin lymphoma (HL), the aim of this study was to investigate the expression of proteins involved in the regulation of glucose metabolism in the different HL subtypes and their impact on clinical outcome. Methods: Lymph node biopsies from 54 HL cases and reactive lymphoid tissue were stained for glucose transporter 1 (GLUT1), lactate dehydrogenase A (LDHA) and lactate exporter proteins MCT1 and MCT4. In a second series, samples from additional 153 HL cases with available clinical data were stained for GLUT1 and LDHA. Results: Membrane bound GLUT1 expression was frequently observed in the tumor cells of HL (49% of all cases) but showed a broad variety between the different Hodgkin lymphoma subtypes: Nodular sclerosing HL subtype displayed a membrane bound GLUT1 expression in the Hodgkin-and Reed-Sternberg cells in 56% of the cases. However, membrane bound GLUT1 expression was more rarely observed in tumor cells of lymphocyte rich classical HL subtype (30%) or nodular lymphocyte predominant HL subtype (15%). Interestingly, in both of these lymphocyte rich HL subtypes as well as in progressively transformed germinal centers, reactive B cells displayed strong expression of GLUT1. LDHA, acting downstream of glycolysis, was also expressed in 44% of all cases. We evaluated the prognostic value of different GLUT1 and LDHA expression patterns; however, no significant differences in progression free or overall survival were found between patients exhibiting different GLUT1 or LDHA expression patterns. There was no correlation between GLUT1 expression in HRS cells and PET standard uptake values. Conclusions: In a large number of cases, HRS cells in classical HL express high levels of GLUT1 and LDHA indicating glycolytic activity in the tumor cells. Although interim-PET is an important prognostic tool, a predictive value of GLUT1 or LDHA staining of the primary diagnostic biopsy could not be demonstrated. However, we observed GLUT1 expression in progressively transformed germinal centers and hyperplastic follicles, explaining false positive results in PET. Therefore, PET findings suggestive of HL relapse should always be confirmed by histology

Indolent lymphoma: the pathologist's viewpoint

Indolent lymphomas have recently been the object of numerous studies, which have focused on new aspects relevant both for the better comprehension of their histogenesis and the identification of new therapeutic strategies. As marginal-zone lymphoma (MZL) represents the category of indolent lymphomas that has obtained more benefit from such an approach, the authors focused on the most recent achievements and not yet solved controversies in this area. In spite of their postulated common derivation, the three categories of MZL of the WHO Classification appear dissimilar. In fact, they show significant molecular differences among them as well as a certain heterogeneity within each group. By no means, there is a cogent need of more refined tools to revise these neoplasms and to produce a more rational grouping. The recent identification of the IRTA gene family corresponding to IG-like receptors differentially expressed in B-cells might contribute to their better understandin

Indolent lymphoma: the pathologist's viewpoint

Abstract Indolent lymphomas have recently been the object of numerous studies, which have focused on new aspects relevant both for the better comprehension of their histogenesis and the identification of new therapeutic strategies. As marginal-zone lymphoma (MZL) represents the category of indolent lymphomas that has obtained more benefit from such an approach, the authors focused on the most recent achievements and not yet solved controversies in this area. In spite of their postulated common derivation, the three categories of MZL of the WHO Classification appear dissimilar. In fact, they show significant molecular differences among them as well as a certain heterogeneity within each group. By no means, there is a cogent need of more refined tools to revise these neoplasms and to produce a more rational grouping. The recent identification of the IRTA gene family corresponding to IG-like receptors differentially expressed in B-cells might contribute to their better understanding

Beyond Transboundary Water Cooperation: Rescaling Processes and the Hydrosocial Cycle Reconfiguration in the Talas Waterscape (Kyrgyzstan-Kazakhstan)

In the framework of the Political Ecology of Water, and specifically of international development policies and hydrosocial relations interfaces, this contribution aims to analyze how the establishment of the Chu-Talas Interstate Commission has influenced rescaling processes and reconfigured the hydrosocial cycle and power relations in the Talas waterscape (Kyrgyzstan-Kazakhstan) at the borderlands level. Through the hydrosocial cycle analysis and the focus on the role of water institutions and linked political discourses, on water users practices, and transboundary infrastructures management, data were collected through semi-structured interviews and informal talks in six villages of the waterscape. The evidence shows that whereas the establishment of the Chu-Talas Commission led to a complex multi-level rescaling process, in contrast, the hydrosocial cycle has been slightly reconfigured by the formalization of the development initiative, but rather by recent internal political transformations (in contrast between the two states) and informal practices