How developing world concerns need to be part of drug development plans: A case study of four emerging antiretrovirals

Clinical trials are usually designed to meet registration requirements in developed countries, and do not always address key concerns for use in developing countries. Four late-stage investigational new drugs - rilpivirine, etravirine, raltegravir and maraviroc - show potential to improve antiretroviral therapy. However, a number of issues could limit their use in developing countries, including dose selection, treatment strategy, combination with other drugs, use in specific populations and reliance on expensive tests. Key research questions relevant for developing countries need to be answered early in the drug development process to ensure maximum benefit for the majority

Evidence of energy and nutrient transfer from invasive pink salmon (Oncorhynchus gorbuscha) spawners to juvenile Atlantic salmon (Salmo salar) and brown trout (Salmo trutta) in northern Norway

Recent large influxes of non-native Pacific pink salmon (Oncorhynchus gorbuscha) to North European rivers have raised concern over their potential negative impacts on native salmonids and recipient ecosystems. The eggs and carcasses of semelparous pink salmon may provide a significant nutrient and energy subsidy to native biota, but this phenomenon has not been widely documented outside the species' native distribution. We analysed the stomach contents and stable isotope values (δ15N and δ13C) in muscle and liver tissues of juvenile Atlantic salmon (Salmo salar) and brown trout (Salmo trutta) to determine whether these native salmonids utilise marine-derived nutrients and energy provided by pink salmon eggs and carcasses in the subarctic river system Vesterelva, northern Norway. Although egg foraging and assimilation of marine-derived nutrients in fish body tissues were found to be minor at the population level, a few juvenile salmon and trout had recently eaten large quantities of pink salmon eggs. Some of these individuals also had high δ15N and δ13C values, indicating a long-term diet subsidised by marine-derived nutrients and energy from pink salmon eggs. Hence, our study provides novel evidence that the eggs of invasive pink salmon may provide an energetic, profitable food resource for juvenile native fish. More research is needed to understand the broader ecological implications for fishes and other biota in river ecosystems invaded by pink salmon. egg predation, marine-derived nutrients, non-native salmonids, resource subsidy, stable isotope analysis, subarctic riverpublishedVersio

Simulated heatwave and fishing stressors alter corticosteroid and energy balance in neonate blacktip reef sharks, Carcharhinus melanopterus

The increasing frequency and duration of marine heatwaves attributed to climate change threatens coastal elasmobranchs and may exacerbate existing anthropogenic stressors. While the elasmobranch stress response has been well studied, the role of the unique corticosteroid-1α-hydroxycorticosterone (1α-OHB)-in energy balance is not understood. Therefore, 1α-OHB's utility as a stress biomarker in elasmobranch conservation physiology is equivocal. Here, we analyse the roles of corticosteroids, 1α-OHB and corticosterone, and metabolites, glucose and 3-hydroxybutyrate (3-HB), in response to stress in a protected tropical shark species, the blacktip reef shark (Carcharhinus melanopterus). Wild-caught neonates were exposed to ambient (27°C) or heatwave conditions (29°C) and subsequently a simulated fishing stressor (1 min air exposure). Blood samples were taken prior to temperature exposure, prior to air exposure, and 30 min, 1 h, 24 h, and 48 h post-Air exposure at treatment temperatures. Plasma 1α-OHB was elevated for 48 h in 27°C-exposed sharks but declined over time in 29°C-exposed sharks. Plasma 1α-OHB was not correlated with either metabolite. Plasma glucose was higher and plasma 3-HB was lower in 29°C-exposed sharks. In a separate experiment, blood samples were collected from both neonate and adult sharks immediately following capture and again 5 min later, and analysed for corticosteroids and metabolites. Plasma 1α-OHB increased in neonates within 5 min, but neonates displayed lower plasma 1α-OHB and higher glucose concentrations than adults. We conclude that 1α-OHB does not serve as a classic glucocorticoid role in C. melanopterus under these stressors. Furthermore, we show for the first time, ontogenetic differences in plasma 1α-OHB. Ultimately, our findings provide insights into hormonal control of energy mobilization during stress in C. melanopterus, particularly during simulated heatwave conditions, which seem to alter both endocrine and energy mobilization. Further work is needed to determine the utility of 1α-OHB as a biomarker for the mobilization of energy during a stress event in elasmobranchs

Perspectives and experiences of community health workers in Brazilian primary care centers using m-health tools in home visits with community members

Abstract Background Mobile health (m-health) tools are a promising strategy to facilitate the work of community health workers (CHWs) in low- and middle-income countries (LMICs). Despite their potential value, little is known about CHWs’ experiences working with m-health tools in their outreach activities with community members. Methods To understand the benefits of and barriers to using m-health tools for CHWs, we conducted semi-structured interviews with 57 CHWs employed in six primary care centers in São Paulo, Brazil. All CHWs had experience using a cell phone application called Geohealth for collecting health and demographic data of community members. We assessed their experiences using Geohealth and recommendations for improvements. Results CHWs described key benefits of using Geohealth as helping them save time with bureaucratic paperwork, organizing the data that they needed to collect, and by replacing sheaves of paper, reducing the weight that they carried in the field. However, there were many technical and social barriers to the successful adoption of the m-health tool. Key among these were poor quality hardware, faulty software programs, and negative community member perceptions of the m-health program. The CHWs provided valuable input as to how Geohealth could be improved to fit their needs. Conclusion m-health tools have the potential to facilitate the work of CHWs in LMICs. However, such tools must be designed and implemented thoughtfully. Technical barriers related to both hardware and software must be anticipated and addressed to maximize their efficiency and successful adoption. CHW input on the design of the tool should be sought to maximize its utility and minimize barriers to use.https://deepblue.lib.umich.edu/bitstream/2027.42/138148/1/12960_2017_Article_245.pd

Qualidade de Vida de Adolescentes Modelos profissionais

Many adolescent girls leave their families to pursue a modeling career, dreaming of a glamorous future. Thepresent cross-sectional case-control study analyzed the quality of life of 74 female adolescents, 37 of whom were models atagencies in the city of São Paulo (Brazil), using the World Health Organization Quality of Life -BREF questionnaire, whichanalyzes physical, psychological, social and environmental domains. The Brazil Criteria 2008 were used for the assessmentof socioeconomic status and for pairing the control group. The group of models generally achieved higher mean scores thanthe non-model group, with the difference only significant on the psychological subscale. The results show that the teenagemodels had a similar quality of life to that of the non-models.Muitas meninas sonham com o futuro glamuroso que a profissão modelo oferece. Objetivo: Analisar a qualidade de vida de adolescentes modelos. Método: 37 adolescentes modelos, do sexo feminino e 37 não-modelos, responderam ao WHOQOL-BREF, para avaliação da qualidade de vida, e ao Critério Brasil 2008, para avaliação do nível sócio econômico. Para análise estatística foi utilizado t-student. Resultados: As participantes do estudo encontravam-se com boa qualidade de vida, não havendo diferença estatisticamente significante entre os grupos (p>0,05). Em geral, o grupo de modelos obteve médias superiores ao grupo de não-modelos, sendo esta diferença significante apenas no domínio Psicológico. Conclusão: As adolescentes modelos apresentaram uma qualidade de vida semelhante às não-modelos, não sendo a profissão determinante de diferenças entre os grupos

A Response to the IPCC Fifth Assessment

The Intergovernmental Panel on Climate Change\u27s (IPCC) Fifth Assessment Report presented significant data and findings about climate change. But the IPCC\u27s working groups\u27 summaries for policymakers avoid making normative statements about the IPCC\u27s findings. The authors, members of the Environmental Law Collaborative, bridge this gap by identifying the normative claims that stem from the working groups\u27 summaries to spark deeper discussion and help shape the IPCC\u27s sixth assessment

A Response to the IPCC Fifth Assessment

This collection of essays is the initial product of the second meeting of the Environmental Law Collaborative, a group of environmental law scholars that meet to discuss important and timely environmental issues. Here, the group provides an array of perspectives arising from the Fifth Assessment of the Intergovernmental Panel on Climate Change. Each scholar chose one passage from one of the IPCC’s three Summaries for Policymakers as a jumping-off point for exploring climate change issues and responding directly to the reports. The result is a variety of viewpoints on the future of how law relates to climate change, a result that is the product not only of each scholar’s individual knowledge but also of the group’s robust discussion

A Response to the IPCC Fifth Assessment

This collection of essays is the initial product of the second meeting of the Environmental Law Collaborative, a group of environmental law scholars that meet to discuss important and timely environmental issues. Here, the group provides an array of perspectives arising from the Fifth Assessment of the Intergovernmental Panel on Climate Change. Each scholar chose one passage from one of the IPCC’s three Summaries for Policymakers as a jumping-off point for exploring climate change issues and responding directly to the reports. The result is a variety of viewpoints on the future of how law relates to climate change, a result that is the product not only of each scholar’s individual knowledge but also of the group’s robust discussion

A Response to the IPCC Fifth Assessment

This collection of essays is the initial product of the second meeting of the Environmental Law Collaborative, a group of environmental law scholars that meet to discuss important and timely environmental issues. Here, the group provides an array of perspectives arising from the Fifth Assessment of the Intergovernmental Panel on Climate Change. Each scholar chose one passage from one of the IPCC’s three Summaries for Policymakers as a jumping-off point for exploring climate change issues and responding directly to the reports. The result is a variety of viewpoints on the future of how law relates to climate change, a result that is the product not only of each scholar’s individual knowledge but also of the group’s robust discussion