A local-to-global emissions inventory of macroplastic pollution.

Negotiations for a global treaty on plastic pollution1 will shape future policies on plastics production, use and waste management. Its parties will benefit from a high-resolution baseline of waste flows and plastic emission sources to enable identification of pollution hotspots and their causes2. Nationally aggregated waste management data can be distributed to smaller scales to identify generalized points of plastic accumulation and source phenomena3-11. However, it is challenging to use this type of spatial allocation to assess the conditions under which emissions take place12,13. Here we develop a global macroplastic pollution emissions inventory by combining conceptual modelling of emission mechanisms with measurable activity data. We define emissions as materials that have moved from the managed or mismanaged system (controlled or contained state) to the unmanaged system (uncontrolled or uncontained state-the environment). Using machine learning and probabilistic material flow analysis, we identify emission hotspots across 50,702 municipalities worldwide from five land-based plastic waste emission sources. We estimate global plastic waste emissions at 52.1 [48.3-56.3] million metric tonnes (Mt) per year, with approximately 57% wt. and 43% wt. open burned and unburned debris, respectively. Littering is the largest emission source in the Global North, whereas uncollected waste is the dominant emissions source across the Global South. We suggest that our findings can help inform treaty negotiations and develop national and sub-national waste management action plans and source inventories.

Global Partnerships in Neurosurgery: Mapping the Need.

The field of global neurosurgery seeks to improve access to neurosurgery and reduce health disparities worldwide. This process depends on intensive collaboration between partners in high-income and low-to-middle income country (LMIC) settings. Several such collaborations have propelled global neurosurgery forward, and long-standing partnerships in particular have brought subspecialty care and training to new locations. Recently, there have been more reports of collaborations between LMICs themselves. In this narrative study, we summarize the state of collaboration in global neurosurgery and discuss how the field is likely to change moving forward.

Partnering in Global Health: What Is a Successful Dyad? The Duke Experience.

This article explores the transformative partnership between Duke Global Neurosurgery and Neurology (DGNN) and Uganda, emphasizing the power of dyads in international collaboration. It details the partnership's focus on service, research, and training, highlighting key accomplishments like the establishment of a neurosurgery residency program, expansion of services, and an epilepsy clinic. Challenges such as resource constraints and cross-cultural collaboration are addressed. Recommendations are provided for developing similar partnerships, underlining the importance of mutual respect, shared goals, and long-term commitment. The DGNN-Uganda dyad is a blueprint for leveraging collaboration to improve global neurosurgical care and reduce health care inequities.

Eficácia e segurança da nova geração de Mitraclip G4 versus gerações mais precoces para reparo transcateter borda a borda em pacientes com regurgitação mitral: uma revisão sistemática e metanálise / Efficacy and safety of new generation Mitraclip G4 versus earlier generations for transcatheter edge-to-edge repair in patients with mitral regurgitation: a systematic review and meta-analysis

INTRODUÇÃO: O reparo transcateter borda a borda utilizando o dispositivo MitraClip é uma ótima alternativa para tratar pacientes com insuficiência mitral e com alto risco cirúrgico. No entanto, a eficácia e segurança da nova geração de MitraClip versus as gerações anteriores não estão bem estabelecidas. OBJETIVO: Portanto, nosso objetivo foi realizar uma meta-análise explorando as gerações de MitraClip no reparo borda a borda da valva mitral por transcateter. MÉTODOS: Pesquisamos no PubMed, Embase e Cochrane Central estudos comparando dispositivos MitraClip de quarta geração com as gerações mais precoces em pacientes com regurgitação mitral (RM) tratados com reparo transcateter borda a borda. Os desfechos foram grau de RM, RM residual >2+, sucesso técnico, sucesso do dispositivo, número de clipes, NYHA III ou IV e mortalidade por todas as causas. A análise estatística foi realizada utilizando o programa R (versão 4.3.2). A heterogeneidade foi avaliada com estatística I2. RESULTADOS: Incluímos 2.123 pacientes de 6 estudos observacionais. Os resultados agrupados não revelaram diferença estatisticamente significativa no grau de RM ≤ 2+ após o procedimento (95,9% vs 95,7%; OR 1,05; IC 95% 0,68 - 1,62; p=0,839; I2 =0%), grau de RM ≤ 1+ após procedimento (OR 0,97; IC 95% 0,71 - 1,32; p=0,857; I2 =42%), sucesso do dispositivo (OR 1,20; IC 95% 0,87 - 1,68; p=0,275; I2 =0%), sucesso técnico (OR 0,98; IC 95% 0,66 - 1,46; p=0,919; I2 =0%) entre grupos de quarta geração e gerações iniciais. Entretanto, a opção pelo MitraClip de quarta geração em pacientes com insuficiência mitral foi associada a um maior número de pacientes que necessitaram de apenas 1 clipe durante o procedimento (OR 2,06; IC 95% 1,23 - 3,46; p = 0,007; I2 = 0%). CONCLUSÃO: Os dados desta meta-análise revelaram que não houve diferença significativa na redução da regurgitação mitral, na taxa de pacientes com NYHA III e IV e na mortalidade por todas as causas entre as gerações de MitraClip. Embora o uso da quarta geração estivesse associado a uma menor necessidade de clipes durante o procedimento.

Collaborative Initiatives in Neurosurgery Research and Publications Between High-Income and Low/Middle-Income Countries: A Bibliometric Analysis.

Despite the globalization of health information, collaborations between high-income countries (HICs) and low/middle-income countries (LMICs), while present, could still increase. This study builds on previous research highlighting LMIC underrepresentation in neurosurgery literature. We conducted a comprehensive bibliometric analysis using the Scopus database to investigate collaborative neurosurgical research between HIC institutions and those in low-income country (LIC)/LMICs. Articles published between 2018 and 2020 were examined. Articles were categorized into 3 groups: guidelines, conferences, and consensus statements; articles related to training and collaborations; and other articles. We categorized articles and authors by country, role, and specific subtopic. We included 238 reports from 34 neurosurgical journals for analysis. Geographic distribution indicated that India led LIC/LMIC contributions (25.21%). Among HICs, the United States had the highest contribution (47.76%). In collaborative studies, Uganda, Cameroon, Tanzania, Indonesia, and Nigeria made significant contributions. LICs and LMICs accounted for 446 authors, while HICs contributed with 592. India has presented the highest number of authors in significant positions. In HICs, significant positions are recognized in USA articles. When scoring authors' position in collaborative papers, still HICs had a clear prevalence. The highest number of collaborations between HICs and LICs/LMICs has been observed in articles related to training and collaborations. Kenya matched India's contributions in training and collaborations. Global guidelines and consensus papers can enhance patient care, but LMICs' involvement remains limited. Further attention to training and collaboration initiatives is needed. This study emphasizes the importance of promoting collaboration and training between countries with varying resources to advance neurosurgical care globally.

Together towards tomorrow: partnerships powering the digital transformation of the health sector

This editorial presents a collective vision of unity, innovation and collaboration, and a shared desire for resilient and more equitable health systems worldwide, urging the global health community to harness the collective strength of alliances and international collaboration to guide the health sector into a new era of digital transformation and innovation.

US trade policy and public health: heterogeneous effects from the North American Free Trade Agreement.

OBJECTIVE: To investigate the causal link between the North American Free Trade Agreement (NAFTA) unrestricted sugar trade agreement signed in 2008 between the USA and Mexico and the diabetes prevalence across all fifty US states. DESIGN: A quasi-experimental research design to investigate the causal effect of the NAFTA unrestricted sugar trade agreement on diabetes prevalence. Our study utilises a comprehensive panel dataset spanning from 2000 to 2016, comprising 1054 observations. To conduct our analysis, we applied both the difference-in-differences and event-study methodologies. SETTING: All the states in the USA. PARTICIPANTS: The fifty states in the USA. RESULTS: After the enactment of the NAFTA sugar trade agreement between the USA and Mexico in 2008, most states witnessed an increase in diabetes prevalence. The annual impacts displayed significant variation among states, with percentage increases spanning from 0·50 to 2·28 %. CONCLUSIONS: States with a higher percentage of their population living below the poverty line, a larger Black resident population and a lower proportion of high school graduates had more significant increases in diabetes prevalence attributed to the NAFTA sugar trade agreement.

Collaborative Study for the Calibration of the Ph.Eur. Prekallikrein Activator in Albumin Biological Reference Preparation batches 8, 9 and 10.

An international collaborative study was organised by the European Directorate for the Quality of Medicines & HealthCare (EDQM, Council of Europe) to calibrate replacement batches for the current European Pharmacopoeia (Ph. Eur.) Prekallikrein Activator (PKA) in albumin Biological Reference Preparation (BRP) whose stocks were dwindling. The study was run in the framework of the Biological Standardisation Programme (BSP) of the Council of Europe and the European Union (EU) Commission. Twenty-four laboratories from official medicines control authorities and manufacturers in Europe and outside Europe took part in the study. Three candidate replacement batches were produced with albumin solutions artificially spiked with a PKA concentrate to increase their PKA level. Participants were requested to evaluate the candidate batches against the 3rd World Health Organization (WHO) International Standard (IS) for Prekallikrein activator in albumin (16/364) using their routine assay method. The Ph. Eur. PKA in albumin BRP batch 7 (BRP7) was also included in the test panel to ensure the continuity of the consecutive BRP batches. The 3 candidate replacement batches were considered suitable for their intended use as BRPs. The study confirmed the stability of the PKA content of the current BRP7. Thermal stress study on the candidate batches confirmed the stability of their PKA activity. In December 2023, the Ph. Eur. Commission officially adopted the 3 candidate batches as Ph. Eur. PKA in albumin BRP batches 8, 9 and 10 with assigned potencies of 37 IU/vial, 33 IU/vial and 34 IU/vial, respectively. The activity of the 3 new batches of Ph. Eur. PKA in albumin BRP will be regularly monitored.

Advancing collaborative research for health: why does collaboration matter?

The calls for health research to be collaborative are ubiquitous-even as part of a recent World Health Assembly resolution on clinical trials-yet the arguments in support of collaborative research have been taken for granted and are absent in the literature. This article provides three arguments to justify why health research ought to be collaborative and discusses trade-offs to be considered among the ethical values guiding each argument.

A Collaborating Centre for animal health economics in the Americas.

Countries in the Americas play a vital role in global livestock and aquaculture production. With international trade of livestock and aquaculture products becoming an important source of income for countries, there has been an increased interest in using animal health economics for advocacy and allocation of resources. This article discusses the development of a new Collaborating Centre for the Economics of Animal Health and the applications of the Global Burden of Animal Diseases (GBADs) framework in the Americas region. Incentives for the increased use of economics in animal health decision-making and examples from the Americas region are examined. The article then discusses the newly formed World Organisation for Animal Health Collaborating Centre in the Americas region. Finally, it reviews two ongoing case studies that are implementing the GBADs framework in Peru and the United States of America.

Les pays des Amériques jouent un rôle crucial dans la production mondiale d'animaux d'élevage, qu'il s'agisse d'espèces terrestres ou aquatiques. Le commerce international des produits issus de l'élevage et de l'aquaculture étant désormais une source importante de revenus pour les pays, la possibilité d'utiliser les concepts de l'économie de la santé animale à des fins de plaidoyer et d'allocation des ressources suscite un intérêt croissant. Les auteurs abordent la désignation d'un nouveau Centre collaborateur pour l'économie de la santé animale ainsi que les applications du programme " Impact mondial des maladies animales " (GBADs) dans la région des Amériques. Ils examinent les avantages d'une meilleure prise en compte de l'économie dans les prises de décision en matière de santé animale, illustrés par quelques exemples concrets relevés dans la région. Ils décrivent ensuite la création du nouveau Centre collaborateur de l'Organisation mondiale de la santé animale dans la région des Amériques. Enfin, ils présentent deux études de cas menées actuellement concernant la mise en oeuvre du programme GBADs respectivement au Pérou et aux Etats-Unis d'Amérique.

Los países de las Américas desempeñan un papel fundamental en la producción ganadera y acuícola mundial. Dado que el comercio internacional de productos ganaderos y acuícolas se ha convertido en una importante fuente de ingresos para los países, el interés por utilizar la economía de la sanidad animal en favor de la promoción y la asignación de recursos ha ido en aumento. En este artículo se analiza la creación de un nuevo Centro colaborador para la economía de la sanidad animal y las aplicaciones del marco del impacto global de las enfermedades animales (GBADs) en la región de las Américas. Se examinan los incentivos para un mayor uso de la economía en la toma de decisiones sobre sanidad animal, así como ejemplos de la región. A continuación, en el artículo se presenta el recién creado Centro colaborador de la Organización Mundial de Sanidad Animal en la región de las Américas. Por último, se examinan dos estudios de casos en los que se está poniendo en práctica el marco del GBADs en Perú y los Estados Unidos de América.

Partnerships for policy: initiating a Global Burden of Animal Diseases case study in Indonesia.

The Global Burden of Animal Diseases (GBADs) programme aims to quantify the economic and broader societal costs of animal disease, providing information to policy-makers and other stakeholders to inform investments in animal health. Within this context, GBADs'Indonesian case study brings together a multidisciplinary and multi-national team to pilot the GBADs methodology in the Asiaâ€"Pacific region. This article describes the process of building a case study and, based on that experience, summarises key learnings to inform the development of future case studies and similar projects. Recommendations focus on the steps required to build successful partnerships to deliver a complex programme of work; the authors highlight the need to consider the local context in aligning project and country priorities, the importance of early engagement with a range of stakeholders, and the need for regular and clear communication within the project team.

Le programme " Impact mondial des maladies animales " (GBADs) vise à quantifier les coûts économiques et plus largement sociétaux des maladies animales, de manière à fournir aux décideurs politiques et aux autres parties prenantes l'information nécessaire pour étayer leurs décisions sur les investissements à réaliser en santé animale. Dans ce contexte, l'étude de cas lancée par le GBADs en Indonésie a réuni une équipe multidisciplinaire et internationale qui a eu pour tâche de piloter l'application de la méthode du GBADs dans la région Asie-Pacifique. Les auteurs décrivent le processus d'élaboration d'une étude de cas ; ils résument ensuite les principaux enseignements tirés de cette expérience, qui apporteront un éclairage précieux lors de la conception de futures études de cas et de projets similaires. Les recommandations portent principalement sur les étapes nécessaires à la mise en place de partenariats réussis et capables d'obtenir des résultats à travers un programme de travail complexe ; les auteurs soulignent ainsi la nécessité de prendre en compte le contexte local afin d'adapter les projets aux priorités du pays, l'importance de nouer des liens dès le départ avec une diversité de parties prenantes et l'exigence d'une communication claire et régulière au sein de l'équipe du projet.

El programa sobre el Impacto Global de las Enfermedades Animales (GBADs) tiene como objetivo cuantificar los costos económicos y sociales de las enfermedades animales, proporcionando información a los encargados de formular políticas y a otras partes interesadas para orientar las inversiones en sanidad animal. En este contexto, el estudio de caso del GBADs en Indonesia reúne a un equipo multidisciplinario y multinacional para poner a prueba la metodología del GBADs en la región de Asia y el Pacífico. En este artículo se describe el proceso de elaboración de un estudio de caso y, a partir de dicha experiencia, se resumen las principales enseñanzas que servirán de base para el desarrollo de futuros estudios de caso y proyectos similares. Las recomendaciones se centran en los pasos necesarios para crear alianzas fructíferas que permitan llevar adelante un programa de trabajo complejo. Los autores destacan la necesidad de tener en cuenta el contexto local a la hora de alinear las prioridades del proyecto y las del país, la importancia de establecer una pronta colaboración con diversas partes interesadas y la necesidad de que haya una comunicación regular y clara dentro del equipo del proyecto.

The South-South Dimension in International Research Collaboration.

In this paper, we looked at the collaboration publishing patterns for groups of Global South countries (Latin America, Africa, ASEAN, Asian, BRICS), as well as publishing parameters. We looked at financing and the relationships between these groups and the Global North. Data from 2002 to 2021 was collected from InCites ® (Web of Science, Clarivate Analytics) and SciVal® (Scopus Elsevier). The impact was lower for BRICS, while Latin America and Asean countries tended to have a higher Field Weighted Citation Impact. Good Health and well-being (SDG 3) dominates South-South Collaborations. Asian countries showed a higher percentage of Affordable and Clean Energy (SDG7), while Africa and Latin America had a higher rate of Zero Hunger (SDG1). Each region shows different production profiles, but collaboration with the Global North is necessary for all regions. Intra-regional shows a lower impact than inter-regional financing, calling attention to the increasing influence of China in all regions, except for Latin America. The data analysed can be used for orienting South-South scientific Collaboration programs, focusing on pre-existent synergies and on where policy changes and results can be maximised.

[The Soviet-Chinese cooperation in production of penicillin in the 1950s].

The article considers, on the basis of analysis of archival documents, issue of Soviet-Chinese cooperation in field of production of penicillin in the 1950s. The main attention is paid to history of construction of penicillin plant in Shijiazhuang. It is demonstrated that it was carried out on preferential terms for China and it was under special control of the USSR government. The building of plant was bound by great difficulties conditioned by range of project, specifics of production conditions in China, special requests of customer, necessity to manufacture non-standard equipment. The implementation of this project of enormous humanitarian significance was at the same time manifestation of concurrence between the USSR and the USA for geopolitical and ideological influence in East Asia.