Global tree-ring response and inferred climate variation following the mid-thirteenth century Samalas eruption

The largest explosive volcanic eruption of the Common Era in terms of estimated sulphur yield to the stratosphere was identified in glaciochemical records 40 years ago, and dates to the mid-thirteenth century. Despite eventual attribution to the Samalas (Rinjani) volcano in Indonesia, the eruption date remains uncertain, and the climate response only partially understood. Seeking a more global perspective on summer surface temperature and hydroclimate change following the eruption, we present an analysis of 249 tree-ring chronologies spanning the thirteenth century and representing all continents except Antarctica. Of the 170 predominantly temperature sensitive high-frequency chronologies, the earliest hints of boreal summer cooling are the growth depressions found at sites in the western US and Canada in 1257 CE. If this response is a result of Samalas, it would be consistent with an eruption window of circa May–July 1257 CE. More widespread summer cooling across the mid-latitudes of North America and Eurasia is pronounced in 1258, while records from Scandinavia and Siberia reveal peak cooling in 1259. In contrast to the marked post-Samalas temperature response at high-elevation sites in the Northern Hemisphere, no strong hydroclimatic anomalies emerge from the 79 precipitation-sensitive chronologies. Although our findings remain spatially biased towards the western US and central Europe, and growth-climate response patterns are not always dominated by a single meteorological factor, this study offers a global proxy framework for the evaluation of paleoclimate model simulations.

HER2 Positive Gastric and Gastroesophageal Adenocarcinoma: A Tertiary Center Experience in (NICRH) Bangladesh

Background: Gastric cancer is the fourth commonest cancer worldwide. It is also recognized as the second commonest cause of cancer related death in the global perspective. Although the incidence of gastric cancer has gradually decreased over the last half of the century, it varies among the different part of the world and different ethnic group. Mortality from gastric cancer extremely high, and it is second only to lung cancer. Gastric cancer occurs more frequently in men than in women. Aim of the study: Aim of the study was to find the clinic-profile outcome HER2 Positive Gastric and Gastroesophageal Adenocarcinoma.Methods:This cross sectional study was conducted in the Department of Surgical Oncology of National Institute of Cancer, Research and Hospital, Mohakhali, Dhaka. The study period was from March, 2014 to April, 2015. A total of 80 patients were included for the study. After receiving the gastrectomy specimen, it was fixed in 10% formaldehyde. Data were compiled and necessary statistical analysis were carried out using computer based software package for social science (SPSS 16.1). Ethical clearance was taken from the ethical committee of NICRH.Results:The highest patients were from 61-70 years’ age group and the lowest were from 71-80 years. The mean age of the patients was 59.71 (±10.19) years. The female to male ratio in this study was 1: 2.48. 66 (82.5%) patients were presented with anemia which was followed by 39 (48.75%) cases with dehydration. Most of the tumors were located in the distal part of the stomach (11.67%). Regarding staging 79(12.65%) patients were in the advanced stage of the disease. The correlation between HER2 overexpression and TNM staging has been tabulated below where it is shown that only Nodal (N) staging has the significant correlation with the HER2 overexpression.Conclusion:It is already mentioned that, in early history of immunohistochemistry, HER2 overexpression in case of carcinoma stomach was highly varied in different studies (from 9-92%). But recently, it was found around 9-32%, in several studies all over the world. It is necessary to conduct further studies with larger samples and long term follow-up in order to draw definite conclusions regarding the role of HER2/neu overexpression.

The Consumer Revolution, 1650–1800

The production, acquisition, and use of consumer goods defines our daily lives, and yet consumerism is seen as increasingly controversial. Movements for sustainable and ethical consumerism are gaining momentum alongside an awareness of how our choices in the marketplace can affect public issues. How did we get here? This volume advances a bold new interpretation of the 'consumer revolution' of the eighteenth century, when European elites, middling classes, and even certain labourers purchased unprecedented quantities of clothing, household goods, and colonial products. Michael Kwass adopts a global perspective that incorporates the expansion of European empires, the development of world trade, and the rise of plantation slavery in the Americas. Kwass analyses the emergence of Enlightenment material cultures, contentious philosophical debates on the morality of consumption, and new forms of consumer activism to offer a fresh interpretation of the politics of consumption in the age of abolitionism and the Atlantic Revolutions.

Talking to children about their HIV diagnosis: a discussion rooted in different global perspectives

An online meeting was arranged with four professionals representing four countries to debate current practices and future steps in naming HIV to children (disclosing HIV status). This article considers the evidence and reports on the commentary and debate from the meeting. Naming HIV to children remains a challenge. Although studies identify some of the facilitators and barriers to informing children of their HIV diagnosis, further review of practice is required. This article presents a global perspective of naming practices from different settings. The article comprises commentary and a report of the online debate, along with supporting evidence. The four participating authors concluded that health professionals must work in collaboration with families to support early naming of HIV to children or having an open discussion about HIV in clinics. Naming when a child is younger reduces self-stigma and empowers children and young people to adhere to their medication, make informed decisions and share their own diagnosis appropriately. The authors concluded that health professionals play a key role in educating colleagues and the public to reduce stigma and discrimination. Professionals working with children and families living with HIV require support and resources to instil confidence in naming and facilitate naming of HIV status to a child.

Political rationale, aims, and outcomes of health-related high-level meetings and special sessions at the UN General Assembly: A policy research observational study

Background Recognising the substantial political weight of the United Nations General Assembly (UNGA), a UN General Assembly special session (UNGASS) and high-level meetings (HLMs) have been pursued and held for 5 health-related topics thus far. They have focused on human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS, 2001), non-communicable diseases (NCDs, 2011), antimicrobial resistance (AMR, 2016), tuberculosis (TB, 2018), and universal health coverage (UHC, 2019). This observational study presents a comprehensive analysis of the political and policy background that prompted the events, as well as an assessment of aims, approaches, and ultimate outcomes. Methods and findings We investigated relevant agencies’ official documents, performed a literature search, and accessed international institutions’ websites for the period 1990–2020. Knowledgeable diplomatic staff and experts provided additional information. Outcomes were evaluated from a United Nations perspective based on national and international commitments, and funding trends. Eliciting an effective governmental response through UNGASSs/HLMs is a challenge. However, increased international commitment was evident after the HIV/AIDS (2001), NCDs (2011), and AMR (2016) meetings. The more recent TB (2018) and UHC (2019) HLMs have received general endorsements internationally, although concrete commitments are not yet documented. Although attribution can only be hypothesized, financial investments for HIV/AIDS following the UNGASS were remarkable, whereas following HLMs for NCDs, AMR, and TB, the financial investments remained insufficient to face the burden of these threats. Thus far, the HIV/AIDS UNGASS was the only one followed by a level of commitment that has likely contributed to the reversal of the previous burden trend. Limitations of this study include its global perspective and aerial view that cannot discern the effects at the country level. Additionally, possible peculiarities that modified the response to the meetings were not looked at in detail. Finally, we assessed a small sample of events; thus, the list of strategic characteristics for success is not exhaustive. Conclusions Overall, UNGASSs and HLMs have the potential to lay better foundations and boldly address key health challenges. However, to succeed, they need to (i) be backed by large consensus; (ii) engage UN authorities and high-level bodies; (iii) emphasise implications for international security and the world economy; (iv) be supported by the civil society, activists, and champions; and (v) produce a political declaration containing specific, measurable, achievable, relevant, and time-bound (SMART) targets. Therefore, to ensure impact on health challenges, in addition to working with the World Health Assembly and health ministries, engaging the higher political level represented by the UNGA and heads of state and government is critical.