Double Standards in Global Health: Medicine, Human Rights Law and Multidrug-Resistant TB Treatment Policy

Abstract The human rights arguments that underpinned the fight against HIV over the last three decades were poised, but ultimately failed, to provide a similar foundation for success against multidrug-resistant TB (MDR-TB) and other diseases of the poor. With more than 1.5 million deaths since 2000 attributed to strains of MDR-TB, and with half a million new, and mostly untreated, MDR-TB cases in the world each year, the stakes could not be higher. The World Health Organization (WHO), whose mandate is to champion the attainment by all peoples of the highest possible level of health, recommended unsound medical treatment for MDR-TB patients in resource-poor settings from 1993-2002. Citing cost considerations, WHO did not recommend the available standard of care that had been successfully used to contain and defeat MDR-TB in rich countries. By acting as a strategic gatekeeper in its technical advisory role to donor agencies and countries, it also facilitated the global implementation of a double standard for TB care in low- and middle-income countries (LMICs), upending important legal and scientific priorities. This raises serious questions about whether the organization violated international human rights standards and those established in its own constitution. While calling for additional analysis and discussion on this topic, the authors propose that policymakers should reject double standards of this kind and instead embrace the challenge of implementing the highest standard of care on a global level

4CeeD: Real-Time Data Acquisition and Analysis Framework for Material-related Cyber-Physical Environments

In this paper, we propose a data acquisition and analysis framework for materials-to-devices processes, named 4CeeD, that focuses on the immense potential of capturing, accurately curating, correlating, and coordinating materials-to-devices digital data in a real-time and trusted manner before fully archiving and publishing them for wide access and sharing. In particular, 4CeeD consists of: (i) a curation service for collecting data from experimental instruments, curating, and wrapping of data with extensive metadata in real-time and in a trusted manner, (ii) a cloudlet for caching collected data from curation service and coordinating data transfer with the back-end, and (iii) a cloud-based coordination service for storing data, extracting meta-data, analyzing and finding correlations among the data. Our evaluation results show that our proposed approach is able to help researchers significantly save time and cost spent on experiments, and is efficient in dealing with high-volume and fast-changing workload of heterogeneous types of experimental data.National Science Foundation/NSF ACI 1443013Ope

The Association Between Hip-Shoulder Separation Angles and Technique Characteristics in World-Class High Jumpers

Hip-shoulder separation (H-Ssep) has been widely researched in many sporting activities (e.g., golf) to provide information on the contribution of torso rotation to performance and injury. Although it is necessary for high jumpers to generate significant long-axis rotation to successfully clear the bar, limited information exists on H-Ssep for high jump athletes. As such, this study aimed to (a) characterize the H-Ssep of world-class high jump athletes during competition, (b) determine if differences exist between male and female athletes and (c) to examine the relationship between H-Ssep and the biomechanical parameters used to describe high jump technique. Twenty-nine world-class high jumpers (17 males, 12 females) were video recorded (frame rate: 120–200 Hz) during the 2017 and 2018 World Athletics Championship finals. H-Ssep was quantified at touchdown (TD) and take-off (TO) following manual digitizing (SIMI motion) and a number of other common biomechanical parameters were computed. The observed levels of H-Ssep at TD (−46±12°) and TO (16 ±11°) were in line with those reported previously for other sports. The magnitude of H-Ssep varied between individuals and showed significant associations with other approach and take-off characteristics. Significant differences in H-Ssep were not evident between male and female athletes despite significant differences in other performance- and technique-related parameters. These findings highlight the divergent take-off characteristics of world-class performers and their reliance on hip-shoulder interactions when generating long axis rotation. Coaches should be mindful of the mechanical and physical consequences of H-Ssep when developing technical models, conditioning interventions and coaching strategies

Biodiversity offsets may miss opportunities to mitigate impacts on ecosystem services

© The Ecological Society of America Biodiversity offsets are most commonly used to mitigate the adverse impacts of development on biodiversity, but some offsets are now also designed to support ecosystem services (ES) goals. Here, we assemble a global database of biodiversity offsets (n = 70) to show that 41% already take ES into consideration, with the objective of enhancing cultural, regulating, and provisioning services. We found that biodiversity offsets were more likely to consider ES when (1) development projects reported impacts on services, (2) offsets had voluntary biodiversity goals, and (3) conservation organizations were involved. However, offsets that considered ES were similar in design (eg offsetting approach, extent, and location) to offsets focused solely on biodiversity, suggesting that including ES goals may represent an attempt to strengthen community support for development projects, rather than to offset known ES impacts. We also found that 34% of all offsets displaced people and negatively affected livelihoods. Therefore, when biodiversity and ES are linked, current practices may not actually improve outcomes, instead incurring additional costs to communities and companies

APP vs COVID

Across the world, the coronavirus (COVID-19) pandemic is changing the landscape of the way in which people live and behave. Practicing infection control behaviors as set forth by the CDC, WHO, and other public health organizations is imperative on college campuses around the country where population density is high and frequent interactions are practiced by students. Behavioral interventions have been documented to work in industry to reduce injury, as well as in health promotion and infection prevention; therefore, behavioral interventions are predicted to be effective in slowing the spread of COVID-19. While most studies are looking at the outcomes of contracting COVID-19, this study aims to proactively tackle the health behaviors related to the spread of the virus. Health behaviors that are of interest to this study, and will be quantified are: hand washing and sanitizing, mask wearing, mask removal procedures, and proper social distancing practices. Student observers will be reporting the prevalence of these behaviors through an application created for this study called Habitood. The more students and observers who participate in the study, the more individuals it is surmised will adjust their safety practices to combat COVID-19. This notion is one that is referred to as the observer effect and has been empirically supported in many independent studies (Alvero et al., 2008; Alvero & Austin, 2004). Overall, the goal of the study is to enable students to actively participate in slowing the spread of the virus by motivating infection control behaviors across campus

Bourbon Virus in Wild and Domestic Animals, Missouri, USA, 2012–2013

Bourbon virus (BRBV) was first isolated from a febrile patient with a history of tick bites in Bourbon County, Kansas, USA; the patient later died from severe illness in 2014 (1). Several additional human BRBV infections were reported subsequently from the midwestern and southern United States (2). BRBV belongs to the family Orthomyxoviridae, genus Thogotovirus, which is distributed worldwide and includes Araguari, Aransas Bay, Dhori, Jos, Thogoto, and Upolu viruses (1,3). Thogoto and Dhori viruses have been associated with human disease (4–6). Viruses within the genus Thogotovirus have been associated with hard or soft ticks (7). Recent studies suggest that the lone star tick (Amblyomma americanum) is involved with BRBV transmission (2,3,8). These ticks feed primarily on mammals, which might play a role in BRBV ecolog

Randomized Comparison of a CrossBoss First Versus Standard Wire Escalation Strategy for Crossing Coronary Chronic Total Occlusions: The CrossBoss First Trial

OBJECTIVES: The authors performed a multicenter, randomized-controlled, clinical trial comparing upfront use of the CrossBoss catheter versus antegrade wire escalation for antegrade crossing of coronary chronic total occlusions. BACKGROUND: There is equipoise about the optimal initial strategy for crossing coronary chronic total occlusions. METHODS: The primary endpoints were the time required to cross the chronic total occlusion or abort the procedure and the frequency of procedural major adverse cardiovascular events. The secondary endpoints were technical and procedural success, total procedure time, fluoroscopy time required to cross and total fluoroscopy time, total air kerma radiation dose, total contrast volume, and equipment use. RESULTS: Between 2015 and 2017, 246 patients were randomized to the CrossBoss catheter (n = 122) or wire escalation (n = 124) at 11 U.S. centers. The baseline clinical and angiographic characteristics of the study groups were similar. Technical and procedural success were 87.8% and 84.1%, respectively, and were similar in the 2 groups. Crossing time was similar: 56 min (interquartile range: 33 to 93 min) in the CrossBoss group and 66 min (interquartile range: 36 to 105 min) in the wire escalation group (p = 0.323), as was as the incidence of procedural major adverse cardiovascular events (3.28% vs. 4.03%; p = 1.000). There were no significant differences in the secondary study endpoints. CONCLUSIONS: As compared with wire escalation, upfront use of the CrossBoss catheter for antegrade crossing of coronary chronic total occlusions was associated with similar crossing time, similar success and complication rates, and similar equipment use and cost