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− The role of the state as an agent of earth system governance has become more complex, contingent, and interdependent. − Although participatory and collaborative processes have contributed to more effective, equitable, and legitimate environmental governance outcomes in some instances, analyses of these processes should be situated within a broader governance perspective, which recasts questions of policy change around questions of power and justice. −The complexity and normative aspects of agency in earth system governance requires new forms of policy evaluation that account for social impacts and the ability of governance systems to adapt. − Many of the core analytical concepts in ESG–Agency scholarship, such as agency, power, authority, and accountability, remain under-theorized. In addition, some types of actors, including women, labor, non-human agents, those who work against earth system governance, and many voices from the Global South, remain largely hidden. − ESG–Agency scholars need to develop research projects and collaborations in understudied regions while also recruiting and supporting scholars in those regions to engage with this research agenda.
Carbapenemase-producing Enterobacteriaceae (CPE) pose a significant global health threat.
To conduct a systematic review of health outcomes and long-term sequelae attributable to CPE infection.
We followed PRISMA reporting guidelines and published our review protocol on PROSPERO (CRD42018097357). We searched Medline, Embase, CINAHL and the Cochrane Library. We included primary studies with a carbapenem-susceptible control group in high-income countries, published in English. Quality appraisal was completed using Joanna Briggs Institute checklists. We qualitatively summarized frequently reported outcomes and conducted a meta-analysis.
Our systematic review identified 8,671 studies; 17 met the eligibility criteria for inclusion. All studies reported health outcomes; none reported health-related quality-of-life. Most studies were from Europe (65%), were conducted in teaching or university-affiliated hospitals (76%), and used case-control designs (53%). Mortality was the most commonly reported consequence of CPE-infections; in-hospital mortality was most often reported (62%). Our meta-analysis (n = 5 studies) estimated an absolute risk difference (ARD) for in-hospital bloodstream infection mortality of 0.25 (95% confidence interval [CI], 0.17–0.32). Duration of antibiotic therapy (range, 4–29.7 vs 1–23.6 days) and length of hospital stay (range, 21–87 vs 15–43 days) were relatively higher for CPE-infected patients than for patients infected with carbapenem-susceptible pathogens. Most studies (82%) met >80% of their respective quality appraisal criteria.
The risk of in-hospital mortality due to CPE bloodstream infection is considerably greater than carbapenem-susceptible bloodstream infection (ARD, 0.25; 95% CI, 0.17–0.32). Health outcome studies associated with CPE infection are focused on short-term (eg, in-hospital) outcomes; long-term sequelae and quality-of-life are not well studied.
Following pioneering work in Norway, cirque glaciers have widely been viewed as rigidly rotating bodies. This model is incorrect for basin-filling cirque glaciers, as we have demonstrated at West Washmawapta Glacier, a small glacier in the Canadian Rocky Mountains. Here we report observations at the same glacier that assess whether complex temporal variations of flow also occur. For parts of three summers, we measured daily displacements of the glacier surface. In one year, four short-duration speed-up events were recorded. Three of the events occurred during the intervals of warmest weather, when melt was most rapid; the fourth event occurred immediately following heavy rain. We interpret the speed-up events as manifestations of enhanced water inputs to the glacier bed and associated slip lubrication by increased water volumes and pressures. No further speed-ups occurred in the final month of the melt season, despite warm temperatures and several rainstorms; the dominant subglacial water system likely transformed from one of poorly connected cavities to one with an efficient channel network. The seasonal evolution of hydrology and flow resembles behaviors documented at other, larger temperate glaciers and indicates that analyses of cirque erosion cannot rely on simple assumptions about ice dynamics.
Supergiant X-ray Binaries host a compact object, generally a neutron star, orbiting an evolved O/B star. Mass transfer proceeds through the intense radiatively-driven wind of the stellar donor, a fraction of which is captured by the gravitational field of the neutron star. The subsequent accretion process onto the neutron star is responsible for the abundant X-ray emission from those systems. They also display variations in time of the X-ray flux by a factor of a few 10, along with changes in the hardness ratios believed to be due to varying absorption along the line-of-sight. We used the most recent results on the inhomogeneities (aka clumps) in the non-stationary wind of massive hot stars to evaluate their impact on the time-variable accretion process. We ran three-dimensional simulations of the wind in the vicinity of the accretor to witness the formation of the bow shock and follow the inhomogeneous flow over several spatial orders of magnitude, down to the neutron star magnetosphere. In particular, we show that the impact of the clumps on the time-variability of the intrinsic mass accretion rate is severely damped by the crossing of the shock, compared to the purely ballistic Bondi-Hoyle-Lyttleton estimation. We also account for the variable absorption due to clumps passing by the line-of-sight and estimate the final effective variability of the mass accretion rate for different orbital separations. These results are confronted to recent analysis of Vela X-1 observations with Chandra by Grinberg et al. (2017). It shows that clumps account well for time-variability at low luminosity but can not generate, per se, the high luminosity activity observed.
Understanding the complex behavior of High Mass X-ray binaries (HMXBs) is not possible without detailed information about their donor stars. While crucial, this turns out to be a challenge on multiple fronts. First, multi-wavelength spectroscopy is vital. As such systems can be highly absorbed, this is often already hard to accomplish. Secondly, even if the spectroscopic data is available, the determination of reliable stellar parameters requires sophisticated model atmospheres that accurately describe the outermost layers and the wind of the donor star.
For early-type donors, the stellar wind is radiatively driven and there is a smooth transition between the outermost layers of the star and the wind. The intricate non-LTE conditions in the winds of hot stars complicate the situation even further, as proper model atmospheres need to account for a multitude of physics to accurately provide stellar and wind parameters. The latter are especially crucial for the so-called “wind-fed” HXMBs, where the captured wind of the supergiant donor is the only source for the material accreted by the compact object.
In this review I will briefly address the different approaches for treating stellar winds in the analysis of HMXBs. The fundamentals of stellar atmosphere modeling will be discussed, also addressing the limitations of modern models. Examples from recent analysis results for particular HMXBs will be outlined. Furthermore, the path for the next generation of stellar atmosphere models will be outlined, where models can be used not only for measurement purposes, but also to make predictions and provide a laboratory for theoretical conclusions. Stellar atmospheres are a key tool in understanding HMXBs, e.g. by providing insights about the accretion of stellar winds onto the compact object, or by placing the studied systems in the correct evolutionary context in order to identify potential gravitational wave (GW) progenitors.
Classical Wolf-Rayet stars are evolved, hydrogen depleted massive stars that exhibit strong mass-loss. In theory, these stars can form either by intrinsic mass loss (stellar winds or eruptions), or via mass-removal in binaries. The Wolf-Rayet stars in the Magellanic Clouds are often thought to have originated through binary interaction due to the low ambient metallicity and, correspondingly, reduced wind mass-loss. We performed a complete spectral analysis of all known WR binaries of the nitrogen sequence in the Small and Large Magellanic Clouds, as well as additional orbital analyses, and constrained the evolutionary histories of these stars. We find that the bulk of Wolf-Rayet stars are luminous enough to be explained by single-star evolution. In contrast to prediction, we do not find clear evidence for a large population of low-luminosity Wolf-Rayet stars that could only form via binary interaction, suggesting a discrepancy between predictions and observations.
Previously known to form only under high pressure synthetic conditions, here we report that the T′-type 214-structure cuprate based on the rare earth atom Tb is stabilized for ambient pressure synthesis through partial substitution of Pd for Cu. The new material is obtained in purest form for mixtures of nominal composition Tb1.96Cu0.8Pd0.2O4. The refined formula, in orthorhombic space group Pbca, with a = 5.5117(1) Å, b = 5.5088(1) Å, and c = 11.8818(1) Å, is Tb2Cu0.83Pd0.17O4. An incommensurate structural modulation is seen along the a axis by electron diffraction and high resolution imaging. Magnetic susceptibility measurements reveal long-range antiferromagnetic ordering at 7.9 K, with a less pronounced feature at 95 K; a magnetic moment reorientation transition is observed to onset at a field of approximately 1.1 T at 3 K. The material is an n-type semiconductor.
We present deep low radio frequency (230-470 MHz) observations from the Karl G. Jansky Very Large Array of the Perseus cluster, probing the non-thermal emission from the old particle population of the AGN outflows. Our observations of this nearby relaxed cool core cluster have revealed a multitude of new structures associated with the mini-halo, extending to hundreds of kpc in size. Its irregular morphology seems to have been influenced both by the AGN activity and by the sloshing motion of the cluster’ gas. In addition, it has a filamentary structure similar to that seen in radio relics found in merging clusters. These results illustrate the high-quality images that can be obtained with the new JVLA at low radio-frequencies.
Although financing represents a critical component of health system strengthening and also a defining concern of efforts to move towards universal health coverage, many countries lack the tools and capacity to plan effectively for service scale-up. As part of a multi-country collaborative study (the Emerald project), we set out to develop, test and apply a fully integrated health systems resource planning and health impact tool for mental, neurological and substance use (MNS) disorders.
A new module of the existing UN strategic planning OneHealth Tool was developed, which identifies health system resources required to scale-up a range of specified interventions for MNS disorders and also projects expected health gains at the population level. We conducted local capacity-building in its use, as well as stakeholder consultations, then tested and calibrated all model parameters, and applied the tool to three priority mental and neurological disorders (psychosis, depression and epilepsy) in six low- and middle-income countries.
Resource needs for scaling-up mental health services to reach desired coverage goals are substantial compared with the current allocation of resources in the six represented countries but are not large in absolute terms. In four of the Emerald study countries (Ethiopia, India, Nepal and Uganda), the cost of delivering key interventions for psychosis, depression and epilepsy at existing treatment coverage is estimated at US$ 0.06–0.33 per capita of total population per year (in Nigeria and South Africa it is US$ 1.36–1.92). By comparison, the projected cost per capita at target levels of coverage approaches US$ 5 per capita in Nigeria and South Africa, and ranges from US$ 0.14–1.27 in the other four countries. Implementation of such a package of care at target levels of coverage is expected to yield between 291 and 947 healthy life years per one million populations, which represents a substantial health gain for the currently neglected and underserved sub-populations suffering from psychosis, depression and epilepsy.
This newly developed and validated module of OneHealth tool can be used, especially within the context of integrated health planning at the national level, to generate contextualised estimates of the resource needs, costs and health impacts of scaled-up mental health service delivery.
Although resilience among victims of child abuse is commonly understood as a process of interaction between individuals and their environments, there have been very few studies of how children's individual coping strategies, social supports and formal services combine to promote well-being.
For this study, we conducted a multi-phase analysis of a qualitative dataset of 608 interviews with young people from five countries using grounded theory strategies to build a substantive theory of young people's service and support use patterns. We started with an analysis of ten interviews (two from each country) and then compared these findings to patterns found in each country's full dataset.
The substantive theory that emerged explains young people's transience between individual coping strategies (cognitive and behavioral), reliance on social supports (family members, peers and teachers), and engagement with formal service providers whose roles are to provide interventions and case management. Young people's patterns of navigation were shown to be contingent upon the individual's risk exposure, his or her individual capacity to cope, and the quality of the formal and informal supports and services that are available and accessible.
Differing amounts of formal resources in low-, middle- and high-income countries influence patterns of service use. Implications for better coordination between formal mental health services and social supports are discussed.
Findings from family and twin studies support a genetic contribution to the development of sexual orientation in men. However, previous studies have yielded conflicting evidence for linkage to chromosome Xq28.
We conducted a genome-wide linkage scan on 409 independent pairs of homosexual brothers (908 analyzed individuals in 384 families), by far the largest study of its kind to date.
We identified two regions of linkage: the pericentromeric region on chromosome 8 (maximum two-point LOD = 4.08, maximum multipoint LOD = 2.59), which overlaps with the second strongest region from a previous separate linkage scan of 155 brother pairs; and Xq28 (maximum two-point LOD = 2.99, maximum multipoint LOD = 2.76), which was also implicated in prior research.
Results, especially in the context of past studies, support the existence of genes on pericentromeric chromosome 8 and chromosome Xq28 influencing development of male sexual orientation.
Stripe rust, caused by Puccinia striiformis f. sp. tritici (Pst), is a major wheat disease that can inflict yield losses of up to 70% on susceptible varieties under favourable environmental conditions. The timely identification of plant genetic resources likely to possess novel resistance to this disease would facilitate the rapid development of resistant wheat varieties. The focused identification of germplasm strategy (FIGS) approach was used to predict stripe rust resistance in a collection of wheat landraces conserved at ICARDA genebank. Long-term climate data for the collection sites, from which these accessions originated and stripe rust evaluation scores for one group of accessions were presented to three different non-linear models to explore the trait×collection site environment interactions. Patterns in the data detected by the models were used to predict stripe rust resistance in a second and different set of accessions. The results of the prediction were then tested against actual evaluation scores of the disease in the field. The study mimics the real scenario where requests are made to plant genetic resources curators to provide accessions that are likely to possess variation for specific traits such as disease resistance.
The models used were able to identify stripe rust-resistant accessions with a high degree of accuracy. Values as high as 0·75 for area under the curve and 0·45 for Kappa statistics, which quantify the agreement between the models’ predictions and the curator's disease scores, were achieved. This demonstrates a strong environmental component in the geographic distribution of resistance genes and therefore supports the theoretical basis for FIGS. It is argued that FIGS will improve the rate of gene discovery and efficiency of mining genetic resource collections for adaptive traits by reducing the number of accessions that are normally required for evaluation to identify such variation.
The aim of the study was to investigate the influence of agomelatine and venlafaxine on driving skills and on driving performance in an on-road driving test in depressed inpatients.
40 depressed inpatients were randomly assigned to treatment with either agomelatine (n=20) or venlafaxine (n=20). Patients were tested before pharmacologic treatment (t0), and on days 14 (t1) and 28 (t2) with computerized tests and additionally were rated in an on-road driving test on day 28 by a licensed driving instructor. To control for retest effects a group of 20 healthy subjects was examined in the same time schedule.
After two weeks of treatment with agomelatine or venlafaxine patients showed a significant reduction in depressive symptoms, and a distinct improvement in concentration and stress-tolerance. Furthermore, prior discharge to outpatient treatment (day 28), 72.5% of patients were labeled abundantly fit to drive in the on-road driving test, in 22.5% of cases a satisfactory performance was certified and in 5% of our patient sample there were slight concerns with respect to fitness to drive. Patients did not however reach performance level in functional domains of healthy controls. Significant differences between treatment groups could not be observed.
Our results indicate that depressed patients treated with agomelatine or venlafaxine show a better test performance on tasks related to driving skills than do untreated patients Besides, most patients could be rated as fit to drive, on an actual driving test conducted by a licensed driving instructor, prior discharge to outpatient treatment.
High-precision analysis using accelerator mass spectrometry (AMS) was performed upon known-age Holocene and modern, pre-bomb coral samples to generate a marine reservoir age correction value (ΔR) for the Houtman-Abrolhos Archipelago (28.7°S, 113.8°E) off the Western Australian coast. The mean ΔR value calculated for the Abrolhos Islands, 54 ± 30 yr (1 σ) agrees well with regional ΔR values for Leeuwin Current source waters (N-NW Australia-Java) of 60 ± 38 yr. The Abrolhos Islands show little variation with ΔR values of the northwestern and north Australian coast, underlining the dominance of the more equilibrated western Pacific-derived waters of the Leeuwin Current over local upwelling. The Abrolhos Islands ΔR values have remained stable over the last 2896 cal yr BP, being also attributed to the Leeuwin Current and the El Niño Southern Oscillation (ENSO) signal during this period. Expected future trends will be a strengthening of the teleconnection of the Abrolhos Islands to the climatic patterns of the equatorial Pacific via enhanced ENSO and global warming activity strengthening the Leeuwin Current. The possible effect upon the trend of future ΔR values may be to maintain similar values and an increase in stability. However, warming trends of global climate change may cause increasing dissimilarity of ΔR values due to the effects of increasing heat stress upon lower-latitude coral communities.
Recent studies have claimed the existence of very massive stars (VMS) up to 300 M⊙ in the local Universe. As this finding may represent a paradigm shift for the canonical stellar upper-mass limit of 150 M⊙, it is timely to discuss the status of the data, as well as the far-reaching implications of such objects. We held a Joint Discussion at the General Assembly in Beijing to discuss (i) the determination of the current masses of the most massive stars, (ii) the formation of VMS, (iii) their mass loss, and (iv) their evolution and final fate. The prime aim was to reach broad consensus between observers and theorists on how to identify and quantify the dominant physical processes.
The burden of respiratory infections is mainly seen in primary healthcare. To evaluate the potential impact of new preventive strategies against respiratory infections, such as the implementation of pneumococcal conjugate vaccines for infants in 2006 in The Netherlands, we conducted a baseline retrospective cohort study of electronic primary-care patient records to assess consultation rates, comorbidities and antibiotic prescription rates for respiratory infections in primary care. We found that between 1995 and 2005, overall registered consultation rates for lower respiratory tract infections had increased by 42·4%, upper respiratory infections declined by 4·9%, and otitis media remained unchanged. Concomitantly, there was a steady rise in overall comorbidity (75·7%) and antibiotic prescription rates (67·7%). Since Dutch primary-care rates for respiratory infections changed considerably between 1995 and 2005, these changes must be taken into account to properly evaluate the effect of population-based preventive strategies on primary-care utilization.