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BACKGROUND: Sustainable Development Goal (SDG) 3 aims to "ensure healthy lives and promote well-being for all at all ages". While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to measure progress in financing the priority areas of SDG3, examine the association between outcomes and financing, and identify where resource gains are most needed to achieve the SDG3 indicators for which data are available. METHODS: We estimated domestic health spending, disaggregated by source (government, out-of-pocket, and prepaid private) from 1995 to 2017 for 195 countries and territories. For disease-specific health spending, we estimated spending for HIV/AIDS and tuberculosis for 135 low-income and middle-income countries, and malaria in 106 malaria-endemic countries, from 2000 to 2017. We also estimated development assistance for health (DAH) from 1990 to 2019, by source, disbursing development agency, recipient, and health focus area, including DAH for pandemic preparedness. Finally, we estimated future health spending for 195 countries and territories from 2018 until 2030. We report all spending estimates in inflation-adjusted 2019 US$, unless otherwise stated. FINDINGS: Since the development and implementation of the SDGs in 2015, global health spending has increased, reaching $7·9 trillion (95% uncertainty interval 7·8-8·0) in 2017 and is expected to increase to $11·0 trillion (10·7-11·2) by 2030. In 2017, in low-income and middle-income countries spending on HIV/AIDS was $20·2 billion (17·0-25·0) and on tuberculosis it was $10·9 billion (10·3-11·8), and in malaria-endemic countries spending on malaria was $5·1 billion (4·9-5·4). Development assistance for health was $40·6 billion in 2019 and HIV/AIDS has been the health focus area to receive the highest contribution since 2004. In 2019, $374 million of DAH was provided for pandemic preparedness, less than 1% of DAH. Although spending has increased across HIV/AIDS, tuberculosis, and malaria since 2015, spending has not increased in all countries, and outcomes in terms of prevalence, incidence, and per-capita spending have been mixed. The proportion of health spending from pooled sources is expected to increase from 81·6% (81·6-81·7) in 2015 to 83·1% (82·8-83·3) in 2030. INTERPRETATION: Health spending on SDG3 priority areas has increased, but not in all countries, and progress towards meeting the SDG3 targets has been mixed and has varied by country and by target. The evidence on the scale-up of spending and improvements in health outcomes suggest a nuanced relationship, such that increases in spending do not always results in improvements in outcomes. Although countries will probably need more resources to achieve SDG3, other constraints in the broader health system such as inefficient allocation of resources across interventions and populations, weak governance systems, human resource shortages, and drug shortages, will also need to be addressed. For complete list of authors see http://dx.doi.org/10.1016/S0140-6736(20)30608-5

Unreinforced masonry (URM) buildings are one of the most common constructions all around the world, but they are significantly prone to structural damage in case of earthquake. Due to the high vulnerability of URM buildings to seismic loading , a quantitative risk assessment along with identification of additional protection measures has become necessary. Even though base isolation is a suitable seismic protection option, its conventional cost may prevent a wide implementation in developing countries. In this context, this study presents a comparative seismic fragility analysis of a single-storey URM building before and after base isolation using both classical laminated rubber bearings (LRBs) and recycled-rubber fibre-reinforced elastomeric isolators (RR-FREIs). The main aim of the study is to assess the effectiveness of RR-FREIs as alternative to LRBs for seismic vulnerability reduction of low-resistance URM buildings located in Himalayan regions. Fragility analysis accounted for uncertainties associated with both material properties and earthquake records. The Latin hypercube sampling (LHS) technique was used to reduce the computational work while maintaining acceptable accuracy. The building response was obtained using nonlinear layered shell element models, through nonlinear time history analysis of fixed-base (FB) building models and fast nonlinear analysis of base-isolated (BI) building models. Fragility curves show a significant reduction in the vulnerability of BI buildings in comparison to their FB counterpart, as well as a satisfactory performance of RR-FREIs in comparison with LRBs. A parametric study is also discussed to identify the influence of different intensity measures, fragility analysis method, and variability in isolator properties.

This paper addresses gender differences in the social capital of entrepreneurs in a developing country. Social networks are often an important asset for accessing resources; however, they may also be a liability in developing countries, since entrepreneurs are often expected to support their contacts. Using a recent survey among urban and rural Ugandan entrepreneurs, we focus on the financial resources that entrepreneurs can obtain from their contacts on the one hand, and requests for financial support made to the entrepreneurs from these contacts on the other hand. Our results show that there are gender differences associated with access to, and requests for, financial resources.

This work proposes a new device for air treatment with dehumidification and water recovery/storage, with possible mitigation of indoor environmental conditions. The system is based on Peltier cells coupled with a horizontal earth-to-air heat exchanger, it is proposed as an easy-to-implement alternative to the heat pumps and air handling units currently used on the market, in terms of cost, ease of installation, and maintenance. The process provides the water collection from the cooling of warm-humid air through a process that leads to condensation and water vapor separation. The airflow generated by a fan splits into two dual flows that lap the two surfaces of the Peltier cells, one flow laps the cold surfaces undergoing sensible, latent cooling with dehumidification; the other flow laps the hot surfaces and heats up. The airflow undergoes thermal pre-treatment through the underground horizontal geothermal pipe that precedes the Peltier cells. In the water storage tank, which also works as a mixing chamber, the two air streams are mixed to regulate the outlet temperature. The system can be stand-alone if equipped with a photovoltaic panel and a micro wind turbine, able to be used in places where electricity is absent. The system, with different configurations, is modeled in the African city Kigali, in Rwanda.

Objectives: Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) are broadly studied in high-income countries, but data concerning their functioning are lacking in developing countries. Therefore, we analyzed their reliability and sensitivity to change in children with cerebral palsy in Tanzania. Methods: GMFCS and MACS are two ordinal grading systems used to assess motor functions while observing children’s performances. Forty-nine children were classified by two independent physiotherapy students at baseline, after one month and after one year. Reliability and sensitivity to change were analyzed using intraclass correlation coefficient (ICC), effect size (ES), standard response mean (SRM), standard error of measurement (SEM), and minimal detectable change (MDC). Results: Inter- (ICC = 0.97/0.95 for GMFCS/MACS) and intra-rater reliability (ICC = 0.98/0.96 GMFCS/MACS) were excellent. Sensitivity to change was small (ES = −0.14/0.11, SRM = −0.24;/0.24 GMFCS/MACS). SEM was 0.2 points, resulting in MDC = 0.5/0.7 for GMFCS/MACS, respectively. Conclusions: GMFCS and MACS demonstrated excellent reliability, but not sensitivity to change.

The introduction of new vehicles technology has been projected for advanced technologically places. Their use and operation, is a theme of big concern for developing countries. This work is part of the study for the creation and establishment of a maintenance strategy and policy, which will be acceptable in developing countries. The paper proposes a methodology for the identification of critical components of the electronic fuel injection system with failure mode, effects and criticality analysis tool (FMECA). With the elaboration of this work, was possible to visualize that the maintenance strategy for each component depends strongly on the availability of equipment for the diagnosis (fail detection). As future work, would be important to study the influence of others parameters that influence the maintenance and vehicle operation, as cost, environment, human aspect and vehicle operation. Another useful analyses would be, to analyses the data in a probabilistic interpretation in order to visualize influence of each component failure in the system failure.

Globalization caused a shift in trial locations towards low-middle income countries, raising ethical concerns. These include the risk that conditions primarily affecting children in these countries will be neglected in favor of those affecting developed countries. We analyzed 253 published and 69 ongoing pharmacological RCTs performed in Latin America between 2000 and 2015 involving exclusively children. While over 50% of the previously highly investigated diseases were no longer priorities, other diseases acquired greater attention in recent years. Brazil and Mexico resulted as the most active countries. A large gap remains between the real needs of children in these countries and scientific research.

Great advances have been made in the treatment of paediatric non-Hodgkin lymphoma (NHL). In high-income countries (HIC), cure rates now exceed 85%. However, in low- and middle-income countries (LMIC), cure rates remain less than 50%. It is estimated that over 90% of paediatric NHL worldwide occur in LMIC; therefore, even modest improvements in outcome would have significant impact in reducing the burden of paediatric NHL globally. This article will discuss some of the issues required to improve the outcome of paediatric NHL in LMIC using data presented at the Fifth International Symposium on Childhood, Adolescent and Young Adult Non-Hodgkin Lymphoma held in Varese, Italy, 2015 to illustrate these issues. Additionally, potential bi-directional benefits for patients in both LMIC and HIC from future collaborations will be discussed.

The purpose of the present study was to propose an optimized 2D technique (2D-conformal) for radiotherapy (RT) of pancreatic cancer (CaP). This technique is based on double simulation which resolves the problems of radiographic image distortion. Five patients with locally advanced CaP were identified and enrolled. Treatment planning was simulated in 3 different ways: Two dimensional-standard (2D-SRT), 2D-conformal (2D-CRT), and three dimensional-conformal (3D-CRT) techniques for 10 MV LINAC. Simulation for a cobalt machine was also performed using only the 2D techniques. 2D-SRT technique was planned with fields definition based on anatomical landmarks (bone and duodenum). 3D-CRT was planned with standard virtual simulation technique, and 3D dose evaluation and optimization. 2D-CRT technique was based on manual information transfer from a diagnostic CT-scan to simulation radiograms. To eliminate the X-ray image distortion, a double simulation was employed and the profile of the GTV was delineated on radiographs bearing the simulator isocenter into the target center. Concerning target irradiation of either LINAC (10 MV) or cobalt source, the PTV constraints (ICRU 62) were met in all patients (Dmin >95%, Dmax

This paper examines the impact of strengthening Intellectual Property Rights (IPRs) on within-country income inequality for a cross-section of 65 developed and developing countries for the time period 1995-2009.The results indicated that strengthening of IPRs led to an increase in income inequality in WTO-member developing countries after they started modifying their national IPR regimes to conform to the TRIPs requirements. IPRs tend to raise income inequality by generating a more skewed distribution of wages. Stronger IPRs increased the demand for skilled labor force as it raised the return on R&D activities. This caused a relative increase in skilled labor wages, creating a wage bias in favor of skilled labor against unskilled labor, thus aggravating income inequality within a developing country. Moreover, the effect on inequality was more pronounced for developing countries that were experiencing higher per capita GDP growth rates. As for the developed countries included in the sample, the analysis seemed to suggest that IPRs led to a decline in income inequality over the study period.

Cytomegalovirus (CMV) is the most frequent cause of congenital infection worldwide, with an estimated incidence in developed countries of 0.6–0.7% of all live births. The burden of disease related to congenital CMV in substantial, as it is the leading non-genetic cause of sensorineural hearing loss and an important cause of neurodevelopmental disabilities in children. Despite its clinical significance, congenital CMV infection often goes undetected because the majority of infected infants are asymptomatic at birth and screening programs have not been substantially implemented. Other than behavioral measures, effective interventions aimed at the prevention of maternal infection and of mother-to-child transmission are lacking. Due to a convergence of recent advances in both diagnostic and therapeutic strategies in infants with congenital CMV, though, the field likely will be changing rapidly over just the next few years. Specifically, a highly-sensitive screening test with high throughput potential has been developed, and treatment of infants symptomatically infected with congenital CMV has proven to be well-tolerated and effective in improving long-term hearing and neurodevelopmental outcomes. This review highlights the clinical importance of congenital CMV infection, the developments in laboratory diagnostics, and the benefits of antiviral therapy. It also identifies the global efforts still required in the prevention of maternal infection and in the optimization of antiviral therapy to further reduce the burden of congenital CMV disease.

The aim of this paper is to assess the dynamic impact of banking crises on output for a panel of developing economies. Using an unbalanced panel of 159 countries from 1970 to 2006, the paper shows that banking crises produce significant output losses. Output losses are larger for relatively richer economies, characterized by a higher level of financial deepening and larger current account imbalances. Flexible exchange rates, fiscal and monetary policy, and liquidity support policies have been found to attenuate the effect of the crises. © 2012 Elsevier Ltd.

Acute liver failure affects previously healthy and often young people and has a very high mortality due to rapid multi-organ failure. The diagnosis is based on the presence of coagulopathy (International normalized ratio >2 or prothrombin rate 4.0 μmol/l; gastroprotective drugs (e.g., ranitidine and sucralfate) should be used for prevention of gastrointestinal bleeding, and sepsis should be prevented with broad spectrum antibiotics. Large-volume infusions of hypotonic fluids, which may result in hyponatremia and cerebral swelling, should be avoided. Due to the high protein catabolism, 1.0–1.5 g of enteral protein/kg/day can be given with blood ammonia levels monitoring. Antifungal therapy should be started in patients who do not improve with antibiotics. Fever may favor development of cerebral edema, by increasing body metabolism and production of ammonia, and its cerebral uptake and metabolism. Body temperature should be kept at 35–36°C using external cooling and suppressing shivering. Routine computerized tomography scan to detect brain edema should not be performed as moving the patient to the scanner might facilitate increase in intracranial pressure; computerized tomography scan (where available) should be done only when focal neurological signs or pupillary abnormalities (suggesting intracranial bleeding or cerebral herniation) are present. Cerebral edema can be diagnosed clinically based on the presence of spontaneous decerebrate posturing alone or two of the following: hypertension, bradycardia, pupillary changes, neurogenic hyperventilation (13). For clinical signs of increased intracranial pressure, a bolus of intravenous hypertonic saline (at a dose of 20 ml of 30% sodium chloride, keeping serum sodium at

Helicobacter pylori (Hp) is found in half the population of the world. Its prevalence is highly variable in relation to geography, ethnicity, age, and socioeconomic factors high in developing countries and lower in the developed world. In general, however, there has been a decreasing trend in the prevalence of Hp in many parts of the world in recent years. Direct epidemiologic comparisons of peptic ulcer disease (PUD) between developing and developed countries are complex, as peptic ulcers may be asymptomatic and the availability and accessibility of the tests required for diagnosis vary widely. In developing countries, Hp infection is a public-health issue. The high prevalence of the infection means that public-health interventions may be required. Therapeutic vaccination is probably the only strategy that would make a decisive difference in the prevalence and incidence of Hp throughout the world. The short-term approach, however provided that resources allow for this would be a test-andtreat strategy for those who are at risk for peptic ulcer disease or gastric cancer, as well as for those with troublesome dyspepsia. EDuCATION IN GASTROENTEROLOGy

In this paper we introduce a novel algorithm, called Exogenous Fitness, to calculate the Fitness of subnational entities and we apply it to the states of Brazil. In the last decade, several indices were introduced to measure the competitiveness of countries by looking at the complexity of their export basket. Tacchella et al (2012) developed a non-monetary metric called Fitness. In this paper, after an overview about Brazil as a whole and the comparison with the other BRIC countries, we introduce a new methodology based on the Fitness algorithm, called Exogenous Fitness. Combining the results with the Gross Domestic Product per capita (GDP(p)), we look at the dynamics of the Brazilian states in the Fitness-Income plane. Two regimes are distinguishable: one with high predictability and the other with low predictability, showing a deep analogy with the heterogeneous dynamics of the World countries. Furthermore, we compare the ranking of the Brazilian states according to the Exogenous Fitness with the ranking obtained through two other techniques, namely Endogenous Fitness and Economic Complexity Index.

We use a dynamic specification to estimate the impact of trade on within-country income inequality in a sample of 65 developing countries (DCs) over the 1980-99 period. Our results suggest that trade with high income countries worsen income distribution in DCs, through both imports and exports. These findings provide support to the hypothesis that technological differentials and the skill biased nature of new technologies may be important factors in shaping the distributive effects of trade. Moreover, we observe that the previous results only hold for middle-income countries (MICs); we interpret this evidence by considering the greater potential for technological upgrading in MICs. © 2008 Elsevier Ltd. All rights reserved.

We report the results of a protocol for the diagnosis and treatment of pediatric non-Hodgkin lymphomas (NHL) conducted in Nicaragua in the context of an international collaborative program. Fifty-three children with NHL treated between 1996 and 2003 were retrospectively evaluated. Therapy was designed based on local drug availability and affordability with dose and schedule adaptations for Burkitt and lymphoblastic lymphomas. With a median follow-up of 3 years, the projected 9-year overall survival was 63% and event-free survival 53%. The treatment was efficacious, feasible, and well tolerated in spite of the local socio-economical conditions.

Pediatric cancer programs in low-income countries (LIC) can improve outcomes. However, treatment must be tailored to the patient's living conditions and the availability of supportive care. In some cases, a more intense regimen will decrease survival since the increase in death from toxicity may exceed any decrease in relapse. Attempts to practice evidence-based pediatric oncology are thwarted by the lack of evidence derived from local experience in LIC to determine optimal therapy. This report summarizes treatment regimens used by pediatric oncologists from 15 countries of the Caribbean, Central and South America who participate in the Monza International School of Pediatric Hematology/Oncology (MISPHO). Patients with hepatoblastoma, Wilms tumor, and histiocytosis treated on unmodified published protocols had outcomes comparable to those in high-income countries (HIC). Those with rhabdomyosarcoma, osteosarcoma, Hodgkin lymphoma, and acute myeloid leukemia treated with unmodified regimens had event-free survival estimates 10%-20% lower than those reported in HIC due to higher rates of toxic death, abandonment of therapy, and relapse. Treatment of retinoblastoma is complicated by advanced stages and extraocular disease at diagnosis; improved outcomes depend on education of pediatricians and the public to recognize early signs of this disease. Use of unmodified protocols for Burkitt lymphoma and acute lymphoblastic leukemia have been associated with unacceptable toxicity in LIC, so MISPHO centers have modified published regimens by giving lower doses of methotrexate and reducing use of anthracyclines. Despite the use of all-trans-retinoic acid during induction for acute promyelocytic leukemia, the incidence of fatal hemorrhage remains unacceptably high.

In many developing countries, the growth of the Information and Communication Technology (ICT) sector is becoming a remarkable phenomenon. Such growth is influenced by a huge variety of economic (infrastructure and social development), institutional (finance and legal system) and environmental (education system and culture) factors. In this context, forms of partnerships between local firms and multinational companies can play a key role in fostering the development of the ICT- sector.This article presents a study of the state of the art of the ICT sector in North Africa. Additionally, an in depth study of the situation in Morocco was carried out. It investigates, using several case studies, the value of the different models of partnership that have been created in the ICT service sector.

Objective Some of the conventional serological tests for coeliac disease (CD) are expensive, time-consuming and not readily available in developing countries, leading to a delay in diagnosis. Recently, point-of-care tests (POCT) have been manufactured and tested in Europe but have not been validated in our setting. We therefore aimed to study the diagnostic accuracy of the POCT ‘Biocard’ test in diagnosing CD in Indian children. Design Cross-sectional study. Setting Tertiary care centre in north India. Patients Children, aged 2–18 years, with chronic diarrhoea, short stature or refractory anaemia underwent serological testing for CD with antiendomysial antibodies (AEA), antitissue transglutaminase (tTG) antibodies and Biocard test followed by duodenal biopsy irrespective of serological results. CD was diagnosed with positive AEA and duodenal biopsy showing >grade 2 changes using modified Marsh criteria. Those who were both AEA negative and had normal histology were considered CD negative. Results Of 319 children who underwent the serological testing, 170 agreed for biopsy. Of these, 110 were diagnosed with CD and 30 were found to be CD negative. Remaining 30 had discordant AEA and histology results and were not included in analysis. Biocard test agreed with 92/110 positive and 27/30 negative diagnoses based on reference tests (83.6% sensitivity and 90% specificity). tTG was found to be 93.8% sensitive and 96.4% specific. Conclusions We successfully validated the POCT for CD in our setting. It could be used to increase case detection rates in developing countries with a large undiagnosed CD burden.

Background In developing countries, diarrhoea causes around 500,000 child deaths annually. Zinc supplementation during acute diarrhoea is currently recommended by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF). Objectives To evaluate oral zinc supplementation for treating children with acute or persistent diarrhoea. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (the Cochrane Library 2016, Issue 5), MEDLINE, Embase, LILACS, CINAHL, mRCT, and reference lists up to 30 September 2016. We also contacted researchers. Selection criteria Randomized controlled trials (RCTs) that compared oral zinc supplementation with placebo in children aged one month to five years with acute or persistent diarrhoea, including dysentery. Data collection and analysis Both review authors assessed trial eligibility and risk of bias, extracted and analysed data, and drafted the review. The primary outcomes were diarrhoea duration and severity. We summarized dichotomous outcomes using risk ratios (RR) and continuous outcomes using mean differences (MD) with 95% confidence intervals (CI). Where appropriate, we combined data in meta-analyses (using either a fixed-effect or random-effects model) and assessed heterogeneity. We assessed the certainty of the evidence using the GRADE approach. Main results Thirty-three trials that included 10,841 children met our inclusion criteria. Most included trials were conducted in Asian countries that were at high risk of zinc deficiency. Acute diarrhoea There is currently not enough evidence from well-conducted RCTs to be able to say whether zinc supplementation during acute diarrhoea reduces death or number of children hospitalized (very low certainty evidence). In children older than six months of age, zinc supplementation may shorten the average duration of diarrhoea by around half a day (MD −11.46 hours, 95% CI −19.72 to −3.19; 2581 children, 9 trials, low certainty evidence), and probably reduces the number of children whose diarrhoea persists until day seven (RR 0.73, 95% CI 0.61 to 0.88; 3865 children, 6 trials, moderate certainty evidence). In children with signs of malnutrition the effect appears greater, reducing the duration of diarrhoea by around a day (MD −26.39 hours, 95% CI −36.54 to −16.23; 419 children, 5 trials, high certainty evidence). Conversely, in children younger than six months of age, the available evidence suggests zinc supplementation may have no effect on the mean duration of diarrhoea (MD 5.23 hours, 95% CI −4.00 to 14.45; 1334 children, 2 trials, moderate certainty evidence), or the number of children who still have diarrhoea on day seven (RR 1.24, 95% CI 0.99 to 1.54; 1074 children, 1 trial, moderate certainty evidence). None of the included trials reported serious adverse events. However, zinc supplementation increased the risk of vomiting in both age groups (children greater than six months of age: RR 1.57, 95% CI 1.32 to 1.86; 2605 children, 6 trials, moderate certainty evidence; children less than six months of age: RR 1.54, 95% CI 1.05 to 2.24; 1334 children, 2 trials, moderate certainty evidence). Persistent diarrhoea In children with persistent diarrhoea, zinc supplementation probably shortens the average duration of diarrhoea by around 16 hours (MD −15.84 hours, 95% CI −25.43 to −6.24; 529 children, 5 trials, moderate certainty evidence). Authors' conclusions In areas where the prevalence of zinc deficiency or the prevalence of malnutrition is high, zinc may be of benefit in children aged six months or more. The current evidence does not support the use of zinc supplementation in children less six months of age, in well-nourished children, and in settings where children are at low risk of zinc deficiency. Oral zinc supplementation for treating diarrhoea in children In low- and middle-income countries, millions of children suffer from severe diarrhoea every year and many die from dehydration. Giving fluids by mouth (using an oral rehydration solution (ORS)) has been shown to save children's lives, but it has no effect on the length of time the children suffer with diarrhoea. Zinc supplementation could help reduce the duration and the severity of diarrhoea, and therefore have an additional benefit over ORS in reducing children mortality. What is oral zinc and how may it shorten the duration and severity of diarrhoea Zinc is usually given as zinc sulphate, zinc acetate, or zinc gluconate, which are all water-soluble compounds. The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommend 10 mg to 20 mg of zinc per day for children with diarrhoea. There are several mechanism of action of zinc on acute diarrhoea, some of which are specific to the gastrointestinal system: zinc restores mucosal barrier integrity and enterocyte brush-border enzyme activity, it promotes the production of antibodies and circulating lymphocytes against intestinal pathogens, and has a direct effect on ion channels, acting as a potassium channel blocker of adenosine 3-5-cyclic monophosphate-mediated chlorine secretion. Cochrane researchers examined the evidence available up to 30 September 2016. What the evidence in the review suggests Thirty-three trials that included 10,841 children met the inclusion criteria of this review. Among children with acute diarrhoea, we don't know if treating children with zinc has an effect on death or number of children hospitalized (very low certainty evidence). In children older than six months, zinc supplementation may shorten the average duration of diarrhoea by around half a day (low certainty evidence), and probably reduces the number of children whose diarrhoea persists until day seven (moderate certainty evidence). In children with signs of malnutrition the effect appears greater, reducing the duration of diarrhoea by around a day (high certainty evidence). Conversely, in children younger than six months, the available evidence suggests zinc supplementation may have no effect on the mean duration of diarrhoea (moderate certainty evidence), or the number of children who still have diarrhoea on day seven (moderate certainty evidence). Zinc supplementation increased the risk of vomiting in both age groups (moderate certainty evidence). No other adverse effects were reported. Among children with persistent diarrhoea, zinc supplementation probably shortens the average duration of diarrhoea by around 16 hours (moderate certainty) but it probably increases the risk of vomiting (moderate certainty evidence). In areas where the prevalence of zinc deficiency or the prevalence of malnutrition is high, zinc may be of benefit in children aged six months or more. The current evidence does not support the use of zinc supplementation in children less six months of age, in well-nourished children, and in settings where children are at low risk of zinc deficiency.

Few attempts have been proposed in order to describe the statistical features and historical evolution of the export bipartite matrix countries/products. An important standpoint is the introduction of a products network, namely a hierarchical forest of products that models the formation and the evolution of commodities. In the present article, we propose a simple dynamical model where countries compete with each other to acquire the ability to produce and export new products. Countries will have two possibilities to expand their export: innovating, i.e. introducing new goods, namely new nodes in the product networks, or copying the productive process of others, i.e. occupying a node already present in the same network. In this way, the topology of the products network and the country-product matrix evolve simultaneously, driven by the countries push toward innovation., 8 figures, 8 tables

Tuberculosis (TB) can develop soon after antiretroviral treatment initiation, as the result of restoration of the anti-TB specific immune response. This form of the disease is often defined as "unmasked TB", and it represents a major challenge for severely immune-suppressed HIV-infected subjects initiating treatment. Emergence of previously unrecognised TB disease occurs frequently in countries where TB/HIV co-infection is common, and where antiretroviral treatment has become increasingly accessible. The challenges posed by unmasked TB, such as its high incidence, the lack of reliable diagnostic tools and the uncertainties on its optimal management, may hamper our ability to face the TB/HIV epidemic. Therefore, unmasked TB appears a major threat to global health and poses additional barriers to successful HIV/AIDS care and treatment programmes. This review focuses on the epidemiology, immunopathogenesis and clinical manifestations of unmasked TB, and provides evidence-based recommendations for management and care of the disease. Copyright©ERS 2012.

Differences in culture and resources between low-income and high-income countries have resulted in unequal rights to health. In the past few decades, developing countries have had an increase in chronic-disease burden, including cancer. Cancer registries are urgently needed in developing countries because the cancer burden is usually poorly known. To fight this burden, the extent of the cancer must be known so that programmes for cancer control can be planned efficiently, not only to implement standards of care but also to define prevention strategies. In this Review, we advocate the need for availability of cancer data and discuss potential opportunities for hospital-based and population-based cancer registries to collaborate in providing these data in low-income countries.

International audience; We consider a transitional country with three sectors in economy: con- sumption goods, new technology, and education. Productivity of the con- sumption goods sector depends on new technology and skilled labor used for production of the new technology. Then there might be three stages of economic growth. In the ¯rst stage the country concentrates on produc- tion of consumption goods; in the second stage the country imports both physical capital and new technology capital; in the last stage the country imports new technology capital and invests in training and education of high skilled labor in the same time

Hepatitis B virus (HBV) infection has shown an intermediate or high endemicity level in low-income countries over the last five decades. In recent years, however, the incidence of acute hepatitis B and the prevalence of hepatitis B surface antigen chronic carriers have decreased in several countries because of the HBV universal vaccination programs started in the nineties. Some countries, however, are still unable to implement these programs, particularly in their hyperendemic rural areas. The diffusion of HBV infection is still wide in several low-income countries where the prevention, management and treatment of HBV infection are a heavy burden for the governments and healthcare authorities. Of note, the information on the HBV epidemiology is scanty in numerous eastern European and Latin-American countries. The studies on molecular epidemiology performed in some countries provide an important contribution for a more comprehensive knowledge of HBV epidemiology, and phylogenetic studies provide information on the impact of recent and older migratory flows.

Background In developing countries, implementation of effective pediatric cancer programs can reduce the overall rate of childhood mortality. To promote this objective, Monzas International School of Pediatric Hematology-Oncology (MISPHO)—for 14 countries with limited resources in Latin America—was launched in 1996. Methods A survey was conducted to evaluate the possible impact of MISPHO on the following areas: research, educational, and clinical activities, diagnostic services, transfusion medicine, supportive care, ancillary staffing complement, and parents' associations—before and after 1996. Results No institution lost resources or activities after 1996 and there were overall gains, in particular in educational activities, diagnostic capabilities, creation of single and multiple institutional treatment protocols. Conclusions Although notable improvements have occurred, there are still important needs that have to be satisfied. © 2004 Wiley-Liss, Inc.

International Society of Hypertension Low and Middle Income Countries Committee Review of the Goals of the Committee and of 5 years of ISH activities in Low and Middle Income Countries

Treatment of hematologic disorders in low-income countries (LIC) is difficult. This report summarizes treatment of sickle cell disease and aplastic anemia by pediatric hematologists from 15 LIC who participate in the Monza International School of Pediatric Hematology/Oncology (MISPHO). Patients with severe sickle cell disease were treated with low dose hydroxyurea, which safely reduced vaso-occlusive crises. Patients with severe aplastic anemia fared poorly due to lack of availability and high cost of anti-thymocyte globulin and cyclosporine and lack of access to stem cell transplantation. Appropriate therapy was most likely to occur in MISPHO centers with an active twinning program with a center in a high-income country. Pediatr Blood Cancer 2007;48:598–599. © 2006 Wiley-Liss, Inc.

We investigate a recent methodology we have proposed to extract valuable information on the competitiveness of countries and complexity of products from trade data. Standard economic theories predict a high level of specialization of countries in specific industrial sectors. However, a direct analysis of the official databases of exported products by all countries shows that the actual situation is very different. Countries commonly considered as developed ones are extremely diversified, exporting a large variety of products from very simple to very complex. At the same time countries generally considered as less developed export only the products also exported by the majority of countries. This situation calls for the introduction of a non-monetary and non-income-based measure for country economy complexity which uncovers the hidden potential for development and growth. The statistical approach we present here consists of coupled non-linear maps relating the competitiveness/fitness of countries to the complexity of their products. The fixed point of this transformation defines a metrics for the fitness of countries and the complexity of products. We argue that the key point to properly extract the economic information is the non-linearity of the map which is necessary to bound the complexity of products by the fitness of the less competitive countries exporting them. We present a detailed comparison of the results of this approach directly with those of the Method of Reflections by Hidalgo and Hausmann, showing the better performance of our method and a more solid economic, scientific and consistent foundation.