Hubs and Authorities in the World Trade Network Using a Weighted HITS Algorithm

We investigate the economic hubs and authorities of the world trade network (WTN) from to , an era of rapid economic globalization. Using a well-defined weighted hyperlink-induced topic search (HITS) algorithm, we can calculate the values of the weighted HITS hub and authority for each country in a conjugate way. In the context of the WTN, authority values are large for countries with significant imports from large hub countries, and hub values are large for countries with significant exports to high-authority countries. The United States was the largest economic authority in the WTN from to . The authority value of the United States has declined since , and China has now become the largest hub in the WTN. At the same time, China''s authority value has grown as China is transforming itself from the “factory of the world” to the “market of the world.” European countries show a tendency to trade mostly within the European Union, which has decreased Europe''s hub and authority values. Japan''s authority value has increased slowly, while its hub value has declined. These changes are consistent with Japan''s transition from being an export-driven economy in its high economic growth era in the latter half of the twentieth century to being a more mature, economically balanced nation.     

Tracking Protests Using Geotagged Flickr Photographs

Recent years have witnessed waves of protests sweeping across countries and continents, in some cases resulting in political and governmental change. Much media attention has been focused on the increasing usage of social media to coordinate and provide instantly available reports on these protests. Here, we investigate whether it is possible to identify protest outbreaks through quantitative analysis of activity on the photo sharing site Flickr. We analyse 25 million photos uploaded to Flickr in 2013 across 244 countries and regions, and determine for each week in each country and region what proportion of the photographs are tagged with the word “protest” in 34 different languages. We find that higher proportions of “protest”-tagged photographs in a given country and region in a given week correspond to greater numbers of reports of protests in that country and region and week in the newspaper The Guardian. Our findings underline the potential value of photographs uploaded to the Internet as a source of global, cheap and rapidly available measurements of human behaviour in the real world.     

A Network Analysis of Countries’ Export Flows: Firm Grounds for the Building Blocks of the Economy

In this paper we analyze the bipartite network of countries and products from UN data on country production. We define the country-country and product-product projected networks and introduce a novel method of filtering information based on elements’ similarity. As a result we find that country clustering reveals unexpected socio-geographic links among the most competing countries. On the same footings the products clustering can be efficiently used for a bottom-up classification of produced goods. Furthermore we mathematically reformulate the “reflections method” introduced by Hidalgo and Hausmann as a fixpoint problem; such formulation highlights some conceptual weaknesses of the approach. To overcome such an issue, we introduce an alternative methodology (based on biased Markov chains) that allows to rank countries in a conceptually consistent way. Our analysis uncovers a strong non-linear interaction between the diversification of a country and the ubiquity of its products, thus suggesting the possible need of moving towards more efficient and direct non-linear fixpoint algorithms to rank countries and products in the global market.     

How Often Are Antibiotic-Resistant Bacteria Said to “Evolve” in the News?

Media plays an important role in informing the general public about scientific ideas. We examine whether the word “evolve,” sometimes considered controversial by the general public, is frequently used in the popular press. Specifically, we ask how often articles discussing antibiotic resistance use the word “evolve” (or its lexemes) as opposed to alternative terms such as “emerge” or “develop.” We chose the topic of antibiotic resistance because it is a medically important issue; bacterial evolution is a central player in human morbidity and mortality. We focused on the most widely-distributed newspapers written in English in the United States, United Kingdom, Canada, India, and Australia. We examined all articles that focused primarily on the evolution of antibiotic resistance, were published in 2014 or earlier, and were accessible in online archives, for a total of 1639 articles. The total years examined per newspaper ranged from 5 to 37 years with a median of 27 years, and the overall range was 1978–2014. We quantified how many articles included the term “evolve” and analyzed how this varied with newspaper, country, and time. We found that an overall rate of 18% of articles used the term “evolve” but with significant variation among countries. Newspapers in the United Kingdom had the highest rate (24%), more than double of those in India (9%), the country with the lowest rate. These frequencies were lower than those found in scientific papers from both evolutionary journals and biomedical journals. There were no statistically significant changes in frequency and no trends when “evolve” usage was compared against variables such as newspaper circulation, liberal/conservative bias, time, and state evolution acceptance in U.S. newspapers. This study highlights the globally low usage of the word “evolve” in the popular press. We suggest this low usage may affect public understanding and acceptance of evolutionary concepts.     

The Hallucinations of Widowhood

227 widows and 66 widowers were interviewed to determine the extent to which they had hallucinatory experiences of their dead spouse. The people interviewed formed 80·7% of all widowed people resident within a defined area, in mid-Wales, and 94·2% of those suitable, through the absence of incapacitating illness, for interview.Almost half the people interviewed had hallucinations or illusions of the dead spouse. The proportion of men and women who had these experiences was similar. The hallucinations often lasted many years but were most common during the first 10 years of widowhood. Social isolation did not affect the incidence of hallucination, nor was it related to the incidence of known depressive illness. There was no variation within cultural groups and there was no variation with place of residence, whether this was within town, country, or village, or within England and Wales.Young people were less likely to be hallucinated than those widowed after the age of 40. The incidence of hallucination increased with length of marriage and was particularly associated with a happy marriage and parenthood. Members of the “professional and managerial” group were particularly likely to be hallucinated, while widows of “non-manual and sales workers” were the ones least likely to be hallucinated. The incidence was greater with hysteroid than obsessoid people. It was unusual for the hallucinations to have been disclosed, even to close friends or relatives.These hallucinations are considered to be normal and helpful accompaniments of widowhood.     

An Epidemic of Dengue-1 in a Remote Village in Rural Laos

In the Lao PDR (Laos), urban dengue is an increasingly recognised public health problem. We describe a dengue-1 virus outbreak in a rural northwestern Lao forest village during the cool season of 2008. The isolated strain was genotypically “endemic” and not “sylvatic,” belonging to the genotype 1, Asia 3 clade. Phylogenetic analyses of 37 other dengue-1 sequences from diverse areas of Laos between 2007 and 2010 showed that the geographic distribution of some strains remained focal overtime while others were dispersed throughout the country. Evidence that dengue viruses have broad circulation in the region, crossing country borders, was also obtained. Whether the outbreak arose from dengue importation from an urban centre into a dengue-naïve community or crossed into the village from a forest cycle is unknown. More epidemiological and entomological investigations are required to understand dengue epidemiology and the importance of rural and forest dengue dynamics in Laos.     

The Emergence of Three Human Development Clubs

We examine the joint distribution of levels of income per capita, life expectancy, and years of schooling across countries in 1960 and in 2000. In 1960 countries were clustered in two groups; a rich, highly educated, high longevity “developed” group and a poor, less educated, high mortality, “underdeveloped” group. By 2000 however we see the emergence of three groups; one underdeveloped group remaining near 1960 levels, a developed group with higher levels of education, income, and health than in 1960, and an intermediate group lying between these two. This finding is consistent with both the ideas of a new “middle income trap” that countries face even if they escape the “low income trap”, as well as the notion that countries which escaped the poverty trap form a temporary “transition regime” along their path to the “developed” group.     

STRETCHING OF THE SCIATIC NERVE—A Means of Relieving Postoperative Pain Following Removal of Ruptured Lumbar Intervertebral Discs

Stretching the sciatic nerve for the relief of “sciatica” was frequently employed before 1900 and was subsequently abandoned, probably because it was done without sufficient scrutiny of the indications. The procedure has recently been employed in cases in which “sciatica” remains following the operative removal of ruptured intervertebral discs, and it has been instrumental in relieving postoperative “sciatica” when the cause was the formation of adhesions about the lumbar nerve roots. If the nerve root is compressed by recurrent disc protrusion or by adjacent bone, the manipulation usually increases the pain, a phenomenon that has been helpful from a diagnostic standpoint.     

Anatomic Characteristics Associated with Head Splitting in Cabbage (Brassica oleracea var. capitata L.)

Cabbage belonging to Brassicaceae family is one of the most important vegetables cultivated worldwide. The economically important part of cabbage crop is head, formed by leaves which may be of splitting and non-splitting types. Cabbage varieties showing head splitting causes huge loss to the farmers and therefore finding the molecular and structural basis of splitting types would be helpful to breeders. To determine which anatomical characteristics were related to head-splitting in cabbage, we analyzed two contrasting cabbage lines and their offspring using a field emission scanning electron microscope. The inbred line “747” is an early head-splitting type, while the inbred line “748” is a head-splitting-resistant type. The petiole cells of “747” seems to be larger than those of “748” at maturity; however, there was no significant difference in petiole cell size at both pre-heading and maturity stages. The lower epidermis cells of “747” were larger than those of “748” at the pre-heading and maturity stages. “747” had thinner epidermis cell wall than “748” at maturity stage, however, there was no difference of the epidermis cell wall thickness in the two lines at the pre-heading stage. The head-splitting plants in the F₁ and F₂ population inherited the larger cell size and thinner cell walls of epidermis cells in the petiole. In the petiole cell walls of “747” and the F₁ and F₂ plants that formed splitting heads, the cellulose microfibrils were loose and had separated from each other. These findings verified that anomalous cellulose microfibrils, larger cell size and thinner-walled epidermis cells are important genetic factors that make cabbage heads prone to splitting.     

Fish Invasions in the World's River Systems: When Natural Processes Are Blurred by Human Activities

Because species invasions are a principal driver of the human-induced biodiversity crisis, the identification of the major determinants of global invasions is a prerequisite for adopting sound conservation policies. Three major hypotheses, which are not necessarily mutually exclusive, have been proposed to explain the establishment of non-native species: the “human activity” hypothesis, which argues that human activities facilitate the establishment of non-native species by disturbing natural landscapes and by increasing propagule pressure; the “biotic resistance” hypothesis, predicting that species-rich communities will readily impede the establishment of non-native species; and the “biotic acceptance” hypothesis, predicting that environmentally suitable habitats for native species are also suitable for non-native species. We tested these hypotheses and report here a global map of fish invasions (i.e., the number of non-native fish species established per river basin) using an original worldwide dataset of freshwater fish occurrences, environmental variables, and human activity indicators for 1,055 river basins covering more than 80% of Earth's surface. First, we identified six major invasion hotspots where non-native species represent more than a quarter of the total number of species. According to the World Conservation Union, these areas are also characterised by the highest proportion of threatened fish species. Second, we show that the human activity indicators account for most of the global variation in non-native species richness, which is highly consistent with the “human activity” hypothesis. In contrast, our results do not provide support for either the “biotic acceptance” or the “biotic resistance” hypothesis. We show that the biogeography of fish invasions matches the geography of human impact at the global scale, which means that natural processes are blurred by human activities in driving fish invasions in the world's river systems. In view of our findings, we fear massive invasions in developing countries with a growing economy as already experienced in developed countries. Anticipating such potential biodiversity threats should therefore be a priority.     

When will it ever end? When will it ever end?

When will COVID‐19 ever end? Various countries employ different strategies to address this; time will tell what the best response was. Subject Categories: S&S: Economics & Business, Microbiology, Virology & Host Pathogen Interaction, S&S: Ethics

Peter Seeger’s anti‐war song with its poignant refrain, stretching out the second “ever” to convey hopeless fatigue with the continuing loss of life, applies to the pandemic too. “Where have all the old folks gone?” may replace the loss of young men in Seeger’s song. But they keep going, and it is not happening on distant continents; it is happening with them distanced in places they called home. At the time of writing in early March, there are a few answers to Seeger’s question from around the world. There are the isolationists who say that maintaining a tight cordon around a COVID‐free zone is the way to get out of the pandemic. There are the optimists with undiluted faith in the vaccines who say it will be all over when everyone will get a jab. And there are the fatalists who say it will eventually end when herd immunity stops the pandemic after many people have died or fallen ill.Living in Australia where there are only sporadic cases of COVID, it is tempting to see the merits of the isolationist strategy. Only a small number of international travelers can enter the continent every week. Coming back from Europe in November, arrival at Brisbane airport was followed by police‐cordoned transfer to a pre‐allocated hotel—no choice, no balcony, no open windows—where we stayed (and paid) for a 14‐day confinement. On release, it was strange to find that life was close to normal: no masks and nearly no restrictions for public and private meetings. Sporting events and concerts do not have attendance restrictions. All that was different were easy‐to‐follow rules about social distancing in shops or on the streets, limited numbers of people on lifts, and a requirement to register when going to a restaurant or bar.Since I settled back to COVID‐free life in Australia, the last incident in Queensland occurred a month ago when a cleaner at a quarantined hotel got infected. It was “treated” with an instant 3‐day “circuit‐breaker” lockdown for the whole community. Forensic contact tracing was easy, and large numbers of people lined up for testing. Seven days later, the outbreak was declared over. A police inquiry examined the case to see whether regulations needed to be changed. The same rapid and uncompromising lockdown protocols have been employed in Melbourne, Perth, or New Zealand whenever somebody in the community tested positive. There is also continuous monitoring of public wastewater for viral RNA to quickly identify any new outbreak. Small numbers of positive cases are treated with maximum restrictions until life can return to “normal”. The plan is to expand these state policies to achieve a COVID‐free in Australia along with New Zealand and eventually the Pacific Islands.The strict isolationist policy has its downsides. Only Australian citizens or permanent residents are allowed to enter the country. Families have been separated for months. Sudden closing of borders makes the country play some musical chair game: When the whistle is blown, you stay where you are. Freedoms that have been considered as human rights have been side‐stepped. Government control is overt. Nonetheless, the dominant mood is that the good of the community trumps that the individual rights, which may come as a surprise in a liberal democratic society. People benefit from the quality of (local) life, and while there is an economic hiatus for tourism and international student business, the overall economy will come out without too much damage. Interestingly, the most draconian State leaders get the highest rating in the polls and elections. Clear, unwavering leadership is appreciated.Given their geographical situation, Australia, New Zealand, and other islands have clear advantages in pursuing their successful isolationist policies. For most of the rest of the world though, the answer to “when will it ever end” points resolutely and confidently to vaccines. With amazing speed and fantastic efforts, scientists in university and industry laboratories all over the world developed these silver bullets, the Krypton that will put the virus in its place. Most countries have now placed all their chips on the vaccine square of the roulette table.However, there are some aspects to consider before COVID will raise the white flag. It will take months to achieve herd immunity; a long time during which deaths, illness, and restrictions will continue. With different vaccines in production and use, it is likely that some will protect better against the virus than others. The duration of their protection is still unclear, and hence, the vaccine roll‐out could be interminable. More SARS‐CoV‐2 variants are on the rise challenging the long‐term efficacy of the vaccine(s). The logistics and production demands are significant and will become even more acute as the vaccines go to developing countries. Anti‐vaxxers already see this as an opportunity to spread their mixture of lies, exaggerations, and selective information, which may make it more difficult to inoculate sufficient numbers in some communities. And yet, for most countries, there is no real alternative to breaking the vicious cycle of persistent local infections that are slowed by restrictions only to explode again when Christmas or business or the public mood demands a break. The optimists are realists in this scenario.The third cohort are the fatalists. The Spanish flu ended after two years, and 50 million deaths and COVID will also run out of susceptible targets in due course. But herd immunity is a crude concept when the herd is people: our families, friends, and neighbors. Fatalism could translate into doing nothing and let people die and that is not a great policy when facing disaster.The alternative of doing nothing is to combine various strategies as Israel and the UK are doing: to adopt some of the isolationist approaches while vaccinating as many people as quickly as possible. The epidemiological data indeed show that restrictions on interactions do reduce the number of cases. Some countries, Ireland for example, have seen ten‐fold reductions in daily cases even before the first needle hit an arm following tightening of social interactions. This shows that the real impact of the vaccination will only be known when a sufficient percentage of the population has been immunized and the social restrictions are lifted. Australia with its significant travel restrictions is another successful example. In addition, contact tracing and testing are very helpful to contain outbreaks and create corona‐free zones that can be expanded in a controlled manner. Of course, there are local, political, and economic factors at play, but these should not block attempts to lower infection rates until sufficient numbers of vaccine doses become available.So, the answer to the question “when will it ever end?” will require a combination of the isolationists and the optimists such that the fatalist solution does not prevail. It will be interesting to revisit this question in two years’ time to see what the correct answer turns out to be.     

Is Early Tuberculosis Death Associated with Increased Tuberculosis Transmission?

Introduction

Tuberculosis (TB) is now a relatively uncommon disease in high income countries. As such, its diagnosis may be missed or delayed resulting in death before or shortly after the introduction of treatment. Whether early TB death is associated with increased TB transmission is unknown. To determine the transmission risk attributable to early TB death we undertook a case-control study.

Methods

All adults who were: (1) diagnosed with culture-positive pulmonary TB in the Province of Alberta, Canada between 1996 and 2012, and (2) died a TB-related death before or within the first 60 days of treatment, were identified. For each of these “cases” two sets of “controls” were randomly selected from among culture-positive pulmonary TB cases that survived beyond 60 days of treatment. “Controls” were matched by age, sex, population group, +/- smear status. Secondary cases of “cases” and “controls” were identified using conventional and molecular epidemiologic tools and compared. In addition, new infections were identified and compared in contacts of “cases” that died before treatment and contacts of their smear-matched “controls”. Conditional logistic regression was used to find associations in both univariate and multivariate analysis.

Results

“Cases” were as, but not more, likely than “controls” to transmit. This was so whether transmission was measured in terms of the number of “cases” and smear-unmatched or -matched “controls” that had a secondary case, the number of secondary cases that they had or the number of new infections found in contacts of “cases” that died before treatment and their smear-matched “controls”.

Conclusion

In a low TB incidence/low HIV prevalence country, pulmonary TB patients that die a TB-related death before or in the initial phase of treatment and pulmonary TB patients that survive beyond the initial phase of treatment are equally likely to transmit.     

Negative Body Image Associated with Changes in the Visual Body Appearance Increases Pain Perception

Changing the visual body appearance by use of as virtual reality system, funny mirror, or binocular glasses has been reported to be helpful in rehabilitation of pain. However, there are interindividual differences in the analgesic effect of changing the visual body image. We hypothesized that a negative body image associated with changing the visual body appearance causes interindividual differences in the analgesic effect although the relationship between the visual body appearance and analgesic effect has not been clarified. We investigated whether a negative body image associated with changes in the visual body appearance increased pain. Twenty-five healthy individuals participated in this study. To evoke a negative body image, we applied the method of rubber hand illusion. We created an “injured rubber hand” to evoke unpleasantness associated with pain, a “hairy rubber hand” to evoke unpleasantness associated with embarrassment, and a “twisted rubber hand” to evoke unpleasantness associated with deviation from the concept of normality. We also created a “normal rubber hand” as a control. The pain threshold was measured while the participant observed the rubber hand using a device that measured pain caused by thermal stimuli. Body ownership experiences were elicited by observation of the injured rubber hand and hairy rubber hand as well as the normal rubber hand. Participants felt more unpleasantness by observing the injured rubber hand and hairy rubber hand than the normal rubber hand and twisted rubber hand (p<0.001). The pain threshold was lower under the injured rubber hand condition than with the other conditions (p<0.001). We conclude that a negative body appearance associated with pain can increase pain sensitivity.     

Socio-Economic and Health Access Determinants of Breast and Cervical Cancer Screening in Low-Income Countries: Analysis of the World Health Survey

Background

Breast and Cervical cancer are the two most common cancers among women in developing countries. Regular screening is the most effective way of ensuring that these cancers are detected at early stages; however few studies have assessed factors that predict cancer screening in developing countries.

Purpose

To assess the influence of household socio-economic status (SES), healthcare access and country level characteristics on breast and cervical cancer screening among women in developing countries.

Methods

Women ages 18–69 years (cervical cancer screening) and 40–69 years (breast cancer screening) from 15 developing countries who participated in the 2003 World Health Survey provided data for this study. Household SES and healthcare access was assessed based on self-reported survey responses. SAS survey procedures (SAS, Version 9.2) were used to assess determinants of breast and cervical cancer screening in separate models.

Results

4.1% of women ages 18–69 years had received cervical cancer screening in the past three years, while only 2.2% of women ages 40–69 years had received breast cancer screening in the past 5 years in developing countries. Cancer screening rates varied by country; cervical cancer screening ranged from 1.1% in Bangladesh to 57.6% in Congo and breast cancer screening ranged from 0% in Mali to 26% in Congo. Significant determinants of cancer screening were household SES, rural residence, country health expenditure (as a percent of GDP) as well as healthcare access.

Discussion

A lot more needs to be done to improve screening rates for breast and cervical cancer in developing countries, such as increasing health expenditure (especially in rural areas), applying the increased funds towards the provision of more, better educated health providers as well as improved infrastructure.     

Do Maternal Knowledge and Attitudes towards Childhood Immunizations in Rural Uganda Correlate with Complete Childhood Vaccination?

Improving childhood vaccination coverage and timeliness is a key health policy objective in many developing countries such as Uganda. Of the many factors known to influence uptake of childhood immunizations in under resourced settings, parents’ understanding and perception of childhood immunizations has largely been overlooked. The aims of this study were to survey mothers’ knowledge and attitudes towards childhood immunizations and then determine if these variables correlate with the timely vaccination coverage of their children. From September to December 2013, we conducted a cross-sectional survey of 1,000 parous women in rural Sheema district in southwest Uganda. The survey collected socio-demographic data and knowledge and attitudes towards childhood immunizations. For the women with at least one child between the age of one month and five years who also had a vaccination card available for the child (N = 302), the vaccination status of this child was assessed. 88% of these children received age-appropriate, on-time immunizations. 93.5% of the women were able to state that childhood immunizations protect children from diseases. The women not able to point this out were significantly more likely to have an under-vaccinated child (PR 1.354: 95% CI 1.018–1.802). When asked why vaccination rates may be low in their community, the two most common responses were “fearful of side effects” and “ignorance/disinterest/laziness” (44% each). The factors influencing caregivers’ demand for childhood immunizations vary widely between, and also within, developing countries. Research that elucidates local knowledge and attitudes, like this study, allows for decisions and policy pertaining to vaccination programs to be more effective at improving child vaccination rates.     

A Multiple Case Study of Mental Health Interventions in Middle Income Countries: Considering the Science of Delivery

In the debate in global mental health about the most effective models for developing and scaling interventions, there have been calls for the development of a more robust literature regarding the "non-specific", science of delivery aspects of interventions that are locally, contextually, and culturally relevant. This study describes a rigorous, exploratory, qualitative examination of the key, non-specific intervention strategies of a diverse group of five internationally-recognized organizations addressing mental illness in middle income countries (MICs). A triangulated approach to inquiry was used with semi-structured interviews conducted with service recipients, service providers and leaders, and key community partners (N = 159). The interview focus was upon processes of implementation and operation. A grounded theory-informed analysis revealed cross cutting themes of: a holistic conceptualization of mental health problems, an intensive application of principles of leverage and creating the social, cultural, and policy “space” within which interventions could be applied and resourced. These findings aligned with key aspects of systems dynamic theory suggesting that it might be a helpful framework in future studies of mental health service implementation in MICs.     

Expert Opinions on Improving Femicide Data Collection across Europe: A Concept Mapping Study

Femicide, defined as the killings of females by males because they are females, is becoming recognized worldwide as an important ongoing manifestation of gender inequality. Despite its high prevalence or widespread prevalence, only a few countries have specific registries about this issue. This study aims to assemble expert opinion regarding the strategies which might feasibly be employed to promote, develop and implement an integrated and differentiated femicide data collection system in Europe at both the national and international levels. Concept mapping methodology was followed, involving 28 experts from 16 countries in generating strategies, sorting and rating them with respect to relevance and feasibility. The experts involved were all members of the EU-Cost-Action on femicide, which is a scientific network of experts on femicide and violence against women across Europe. As a result, a conceptual map emerged, consisting of 69 strategies organized in 10 clusters, which fit into two domains: “Political action” and “Technical steps”. There was consensus among participants regarding the high relevance of strategies to institutionalize national databases and raise public awareness through different stakeholders, while strategies to promote media involvement were identified as the most feasible. Differences in perceived priorities according to the level of human development index of the experts’ countries were also observed.     

Farewell to the Lose–Lose Reality of Policing Plant Imports

In an age of free international shipments of mail-ordered seeds and plants, more policing will not stop the global migration of hitchhiking pests. The solution is in a preemptive response based on an internationally coordinated genomic deployment of global biodiversity in the largest breeding project since the “Garden of Eden.” This plan will enrich the narrow genetic basis of annual and perennial plants with adaptations to changing environments and resistances to the pests of the future.

“Plan for what is difficult while it is easy; do what is great while it is small.”—Sun Tzu, The Art of War

When 182 countries become party to a common cause, it is reason to rejoice. Such an opportunity was provided when the Food and Agriculture Organization of the United Nations (FAO) approved the International Plant Protection Convention (IPPC) on December 6, 1951, with the objective of developing and implementing international phytosanitary standards to reduce the risks associated with the spread of plant pests to agriculture and natural ecosystems [1]. Over the years, the IPPC has been amended to enforce safer trade of plants by preventing the entry and spread of new pests. This led to the establishment of dedicated government agencies, usually associated with the ministries of agriculture, which are responsible for inspecting and policing against the entry of pests. These agencies have grown tremendously over the years because their noble mission is simply to explain to the “want to do good” elected officials who are responsible for the allocation of funds. However, the IPPC is currently implementing a losing defensive strategy, for which a scientific alternative based on a broad view of our interconnected global reality is presented below.     

Outcomes among HIV-1 Infected Individuals First Starting Antiretroviral Therapy with Concurrent Active TB or Other AIDS-Defining Disease

Background

Tuberculosis (TB) is common among HIV-infected individuals in many resource-limited countries and has been associated with poor survival. We evaluated morbidity and mortality among individuals first starting antiretroviral therapy (ART) with concurrent active TB or other AIDS-defining disease using data from the “Prospective Evaluation of Antiretrovirals in Resource-Limited Settings” (PEARLS) study.

Methods

Participants were categorized retrospectively into three groups according to presence of active confirmed or presumptive disease at ART initiation: those with pulmonary and/or extrapulmonary TB (“TB” group), those with other non-TB AIDS-defining disease (“other disease”), or those without concurrent TB or other AIDS-defining disease (“no disease”). Primary outcome was time to the first of virologic failure, HIV disease progression or death. Since the groups differed in characteristics, proportional hazard models were used to compare the hazard of the primary outcome among study groups, adjusting for age, sex, country, screening CD4 count, baseline viral load and ART regimen.

Results

31 of 102 participants (30%) in the “TB” group, 11 of 56 (20%) in the “other disease” group, and 287 of 1413 (20%) in the “no disease” group experienced a primary outcome event (p = 0.042). This difference reflected higher mortality in the TB group: 15 (15%), 0 (0%) and 41 (3%) participants died, respectively (p<0.001). The adjusted hazard ratio comparing the “TB” and “no disease” groups was 1.39 (95% confidence interval: 0.93–2.10; p = 0.11) for the primary outcome and 3.41 (1.72–6.75; p<0.001) for death.

Conclusions

Active TB at ART initiation was associated with increased risk of mortality in HIV-1 infected patients.     

Canada's Neglected Tropical Disease Research Network: Who's in the Core—Who's on the Periphery?

Background

This study designed and applied accessible yet systematic methods to generate baseline information about the patterns and structure of Canada''s neglected tropical disease (NTD) research network; a network that, until recently, was formed and functioned on the periphery of strategic Canadian research funding.

Methodology

Multiple methods were used to conduct this study, including: (1) a systematic bibliometric procedure to capture archival NTD publications and co-authorship data; (2) a country-level “core-periphery” network analysis to measure and map the structure of Canada''s NTD co-authorship network including its size, density, cliques, and centralization; and (3) a statistical analysis to test the correlation between the position of countries in Canada''s NTD network (“k-core measure”) and the quantity and quality of research produced.

Principal Findings

Over the past sixty years (1950–2010), Canadian researchers have contributed to 1,079 NTD publications, specializing in Leishmania, African sleeping sickness, and leprosy. Of this work, 70% of all first authors and co-authors (n = 4,145) have been Canadian. Since the 1990s, however, a network of international co-authorship activity has been emerging, with representation of researchers from 62 different countries; largely researchers from OECD countries (e.g. United States and United Kingdom) and some non-OECD countries (e.g. Brazil and Iran). Canada has a core-periphery NTD international research structure, with a densely connected group of OECD countries and some African nations, such as Uganda and Kenya. Sitting predominantly on the periphery of this research network is a cluster of 16 non-OECD nations that fall within the lowest GDP percentile of the network.

Conclusion/Significance

The publication specialties, composition, and position of NTD researchers within Canada''s NTD country network provide evidence that while Canadian researchers currently remain the overall gatekeepers of the NTD research they generate; there is opportunity to leverage existing research collaborations and help advance regions and NTD areas that are currently under-developed.