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The International Health Regulations (IHR), which is legally binding in 196 countries, provides the foundation for global health security (GHS). Although the IHR aligns with human rights principles, it presents no explicit ethical framework. A more explicit engagement with ethics in the IHR, and GHS more generally, is urgently needed to improve global readiness for and responses to future pandemics. Addressing existing inequities and power imbalances in GHS requires a framework for balancing existing ethics frameworks for public health, research, and healthcare delivery. Public health measures should be framed and evaluated in terms of human dignity and values, taking marginalized persons into account. Recommendations are presented on how ethics and human rights can be better integrated into the IHR to support GHS. Existing models for balancing ethics during public health emergencies may be a useful model for developing a framework for ethics and GHS. © 2023 Elsevier Inc. All rights reserved.

The International Health Regulations (IHR), which is legally binding in 196 countries, provides the foundation for global health security (GHS). Although the IHR aligns with human rights principles, it presents no explicit ethical framework. A more explicit engagement with ethics in the IHR, and GHS more generally, is urgently needed to improve global readiness for and responses to future pandemics. Addressing existing inequities and power imbalances in GHS requires a framework for balancing existing ethics frameworks for public health, research, and healthcare delivery. Public health measures should be framed and evaluated in terms of human dignity and values, taking marginalized persons into account. Recommendations are presented on how ethics and human rights can be better integrated into the IHR to support GHS. Existing models for balancing ethics during public health emergencies may be a useful model for developing a framework for ethics and GHS. © 2023 Elsevier Inc. All rights reserved.

Background: Cardiac rehabilitation (CR) is a clinically-effective but complex model of care. The purpose of this study was to characterize the nature of CR programs around the world, in relation to guideline recommendations, and compare this by World Health Organization (WHO) region. Methods: In this cross-sectional study, a piloted survey was administered online to CR programs globally. Cardiac associations and local champions facilitated program identification. Quality (benchmark of ≥ 75% of programs in a given country meeting each of 20 indicators) was ranked. Results were compared by WHO region using generalized linear mixed models. Findings: 111/203 (54.7%) countries in the world offer CR; data were collected in 93 (83.8%; N = 1082 surveys, 32.1% program response rate). The most commonly-accepted indications were: myocardial infarction (n = 832, 97.4%), percutaneous coronary intervention (n = 820, 96.1%; 0.10), and coronary artery bypass surgery (n = 817, 95.8%). Most programs were led by physicians (n = 680; 69.1%). The most common CR providers (mean = 5.9 ± 2.8/program) were: nurses (n = 816, 88.1%; low in Africa, p < 0.001), dietitians (n = 739, 80.2%), and physiotherapists (n = 733, 79.3%). The most commonly-offered core components (mean = 8.7 ± 1.9 program) were: initial assessment (n = 939, 98.8%; most commonly for hypertension, tobacco, and physical inactivity), risk factor management (n = 928, 98.2%), patient education (n = 895, 96.9%), and exercise (n = 898, 94.3%; lower in Western Pacific, p < 0.01). All regions met ≥ 16/20 quality indicators, but quality was < 75% for tobacco cessation and return-to-work counseling (lower in Americas, p ≤ 0.05). Interpretation: This first-ever survey of CR around the globe suggests CR quality is high. However, there is significant regional variation, which could impact patient outcomes.

Background: Despite the epidemic of cardiovascular disease and the benefits of cardiac rehabilitation (CR), availability is known to be insufficient, although this is not quantified. This study ascertained CR availability, volumes and its drivers, and density. Methods: A survey was administered to CR programs globally. Cardiac associations and local champions facilitated program identification. Factors associated with volumes were assessed using generalized linear mixed models, and compared by World Health Organization region. Density (i.e. annual ischemic heart disease [IHD] incidence estimate from Global Burden of Disease study divided by national CR capacity) was computed. Findings: CR was available in 111/203 (54.7%) countries; data were collected in 93 (83.8% country response; N = 1082 surveys, 32.1% program response rate). Availability by region ranged from 80.7% of countries in Europe, to 17.0% in Africa (p < 0.001). There were 5753 programs globally that could serve 1,655,083 patients/year, despite an estimated 20,279,651 incident IHD cases globally/year. Volume was significantly greater where patients were systematically referred (odds ratio [OR] = 1.36, 95% confidence interval [CI] = 1.35–1.38) and programs offered alternative models (OR = 1.05, 95%CI = 1.04–1.06), and significantly lower with private (OR = 0.92, 95%CI = 0.91–0.93) or public (OR = 0.83, 95%CI = 0.82–0.84) funding compared to hybrid sources. Median capacity (i.e., number of patients a program could serve annually) was 246/program (Q25–Q75 = 150–390). The absolute density was one CR spot per 11 IHD cases in countries with CR, and 12 globally. Interpretation: CR is available in only half of countries globally. Where offered, capacity is grossly insufficient, such that most patients will not derive the benefits associated with participation.

Introduction. Geese are one of the most ancient poultry species, domesticated about 3000–2500 B.C. There are currently several different goose production techniques, some of them known from time immemorial: 1) force-feeding for fat liver (Egypt, 2686–2181 B.C.); 2) selection for extremely large body size, exceeding that of modern Toulouse geese (Egypt, 600 B.C. – 200 A.D.); and 3) feather plucking, introduced by ancient Egyptians and Romans. Commercial goose breeding today is dispersed as almost cosmopolitan. The majority of world goose flocks are concentrated in Asia, predominantly in China. In Europe, especially eastern Europe, we observe plentiful goose breed diversity (Fig. 1). The main goose products are raw and processed foodstuffs (meat, fat liver, and goose fat) and down and feathers for stuffing... Conclusion. Further progress in goose production will depend on new tendencies in world market development and diversification, and will rely on advances in selection and management utilizing goose biological and economic features. Integration of genetic, nutritional, reproductive and management approaches — all of which are necessary for more complete utilization of goose genetic potential and adjustment to specific production systems — will aid sustainable production of a variety of healthy and high-quality goose products.

Introduction. Geese are one of the most ancient poultry species, domesticated about 3000–2500 B.C. There are currently several different goose production techniques, some of them known from time immemorial: 1) force-feeding for fat liver (Egypt, 2686–2181 B.C.); 2) selection for extremely large body size, exceeding that of modern Toulouse geese (Egypt, 600 B.C. – 200 A.D.); and 3) feather plucking, introduced by ancient Egyptians and Romans. Commercial goose breeding today is dispersed as almost cosmopolitan. The majority of world goose flocks are concentrated in Asia, predominantly in China. In Europe, especially eastern Europe, we observe plentiful goose breed diversity (Fig. 1). The main goose products are raw and processed foodstuffs (meat, fat liver, and goose fat) and down and feathers for stuffing... Conclusion. Further progress in goose production will depend on new tendencies in world market development and diversification, and will rely on advances in selection and management utilizing goose biological and economic features. Integration of genetic, nutritional, reproductive and management approaches — all of which are necessary for more complete utilization of goose genetic potential and adjustment to specific production systems — will aid sustainable production of a variety of healthy and high-quality goose products.

High harmonic generation (HHG) of intense infrared laser radiation (Ferray et al., J. Phys. B: At. Mol. Opt. Phys. 21:L31, 1988; McPherson et al., J. Opt. Soc. Am. B 4:595, 1987) enables coherent vacuum-UV (VUV) to soft-X-ray sources. In the usual setup, energetic femtosecond laser pulses are strongly focused into a gas jet, restricting the interaction length to the Rayleigh range of the focus. The average photon flux is limited by the low conversion efficiency and the low average power of the complex laser amplifier systems (Keller, Nature 424:831, 2003; Südmeyer et al., Nat. Photonics 2:599, 2008; Röser et al., Opt. Lett. 30:2754, 2005; Eidam et al., IEEE J. Sel. Top. Quantum Electron. 15:187, 2009) which typically operate at kilohertz repetition rates. This represents a severe limitation for many experiments using the harmonic radiation in fields such as metrology or high-resolution imaging. Driving HHG with novel high-power diode-pumped multi-megahertz laser systems has the potential to significantly increase the average photon flux. However, the higher average power comes at the expense of lower pulse energies because the repetition rate is increased by more than a thousand times, and efficient HHG is not possible in the usual geometry. So far, two promising techniques for HHG at lower pulse energies were developed: external build-up cavities (Gohle et al., Nature 436:234, 2005; Jones et al., Phys. Rev. Lett. 94:193, 2005) and resonant field enhancement in nanostructured targets (Kim et al., Nature 453:757, 2008). Here we present a third technique, which has advantages in terms of ease of HHG light extraction, transverse beam quality, and the possibility to substantially increase conversion efficiency by phase-matching (Paul et al., Nature 421:51, 2003; Ren et al., Opt. Express 16:17052, 2008; Serebryannikov et al., Phys. Rev. E (Stat. Nonlinear Soft Matter Phys.) 70:66611, 2004; Serebryannikov et al., Opt. Lett. 33:977, 2008; Zhang et al., Nat. Phys. 3:270, 20

We present the first passively modelocked thin disk laser (TDL) with sub-100-fs pulse duration using the broadband sesquioxide gain material Yb:LuScO3 and an optimized SEmiconductor Saturable Absorber Mirror (SESAM). In this proof-of-principle experiment, we obtained 5.1W of average power at a repetition rate of 77.5MHz and a pulse duration of 96fs. We carefully explored and optimized the different parameters on the soliton pulse formation process for the generation of short pulses. In particular, SESAMs combining fast recovery time, high modulation depth and low nonsaturable losses proved crucial to achieve this result even though they are expected to only play a minor role in soliton modelocking. To our knowledge, these are the shortest pulses ever obtained with a modelocked TDL, reaching for the first time the sub-100-fs milestone. This result opens the door to sub-100-fs oscillators with substantially higher power levels in the near future

© 2015 Tran et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction. Institutions play a central role in advancing the field of reproductive health in humanitarian settings (RHHS), yet little is known about organizational capacity to deliver RHHS and how this has developed over the past decade. This study aimed to document the current institutional experiences and capacities related to RHHS. Materials and Methods. Descriptive study using an online questionnaire tool. Results. Respondents represented 82 institutions from 48 countries, of which two-thirds originated from low-and middle-income countries. RHHS work was found not to be restricted to humanitarian agencies (25%), but was also embraced by development organizations (25%) and institutions with dual humanitarian and development mandates (50%). Agencies reported working with refugees (81%), internally-displaced (87%) and stateless persons (20%), in camp-based settings (78%), and in urban (83%) and rural settings (78%). Sixtyeight percent of represented institutions indicated having an RHHS-related policy, 79% an accountability mechanism including humanitarian work, and 90% formal partnerships with other institutions. Seventy-three percent reported routinely appointing RH focal points to ensure coordination of RHHS implementation. There was reported progress in RHHSrelated disaster risk reduction (DRR), emergency management and coordination, delivery of the Minimum Initial Services Package (MISP) for RH, comprehensive RH services in post-crisis/recovery situations, gender mainstreaming, and community-based programming. Other reported institutional areas of work included capacity development, program delivery, advocacy/policy work, followed by research and donor activities. Except for abortion-related services, respo

© 2015 Tran et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction. Institutions play a central role in advancing the field of reproductive health in humanitarian settings (RHHS), yet little is known about organizational capacity to deliver RHHS and how this has developed over the past decade. This study aimed to document the current institutional experiences and capacities related to RHHS. Materials and Methods. Descriptive study using an online questionnaire tool. Results. Respondents represented 82 institutions from 48 countries, of which two-thirds originated from low-and middle-income countries. RHHS work was found not to be restricted to humanitarian agencies (25%), but was also embraced by development organizations (25%) and institutions with dual humanitarian and development mandates (50%). Agencies reported working with refugees (81%), internally-displaced (87%) and stateless persons (20%), in camp-based settings (78%), and in urban (83%) and rural settings (78%). Sixtyeight percent of represented institutions indicated having an RHHS-related policy, 79% an accountability mechanism including humanitarian work, and 90% formal partnerships with other institutions. Seventy-three percent reported routinely appointing RH focal points to ensure coordination of RHHS implementation. There was reported progress in RHHSrelated disaster risk reduction (DRR), emergency management and coordination, delivery of the Minimum Initial Services Package (MISP) for RH, comprehensive RH services in post-crisis/recovery situations, gender mainstreaming, and community-based programming. Other reported institutional areas of work included capacity development, program delivery, advocacy/policy work, followed by research and donor activities. Except for abortion-related services, respo

Introduction. Geese are one of the most ancient poultry species, domesticated about 3000–2500 B.C. There are currently several different goose production techniques, some of them known from time immemorial: 1) force-feeding for fat liver (Egypt, 2686–2181 B.C.); 2) selection for extremely large body size, exceeding that of modern Toulouse geese (Egypt, 600 B.C. – 200 A.D.); and 3) feather plucking, introduced by ancient Egyptians and Romans. Commercial goose breeding today is dispersed as almost cosmopolitan. The majority of world goose flocks are concentrated in Asia, predominantly in China. In Europe, especially eastern Europe, we observe plentiful goose breed diversity (Fig. 1). The main goose products are raw and processed foodstuffs (meat, fat liver, and goose fat) and down and feathers for stuffing... Conclusion. Further progress in goose production will depend on new tendencies in world market development and diversification, and will rely on advances in selection and management utilizing goose biological and economic features. Integration of genetic, nutritional, reproductive and management approaches — all of which are necessary for more complete utilization of goose genetic potential and adjustment to specific production systems — will aid sustainable production of a variety of healthy and high-quality goose products.

Introduction. Geese are one of the most ancient poultry species, domesticated about 3000–2500 B.C. There are currently several different goose production techniques, some of them known from time immemorial: 1) force-feeding for fat liver (Egypt, 2686–2181 B.C.); 2) selection for extremely large body size, exceeding that of modern Toulouse geese (Egypt, 600 B.C. – 200 A.D.); and 3) feather plucking, introduced by ancient Egyptians and Romans. Commercial goose breeding today is dispersed as almost cosmopolitan. The majority of world goose flocks are concentrated in Asia, predominantly in China. In Europe, especially eastern Europe, we observe plentiful goose breed diversity (Fig. 1). The main goose products are raw and processed foodstuffs (meat, fat liver, and goose fat) and down and feathers for stuffing... Conclusion. Further progress in goose production will depend on new tendencies in world market development and diversification, and will rely on advances in selection and management utilizing goose biological and economic features. Integration of genetic, nutritional, reproductive and management approaches — all of which are necessary for more complete utilization of goose genetic potential and adjustment to specific production systems — will aid sustainable production of a variety of healthy and high-quality goose products.

Clear cell sarcoma of soft tissue (CCSST), also known as malignant melanoma of soft parts, represents a rare lesion of the musculoskeletal system usually affecting adolescents and young adults. CCSST is typified by a chromosomal t(12;22)(q13;q12) translocation resulting in a fusion between the Ewing sarcoma gene (EWSR1) and activating transcription factor 1 (ATF1), of which the activity in nontransformed cells is regulated by cyclic AMP. Our aim was to identify critical differentially expressed genes in CCSST tumor cells in comparison with other solid tumors affecting children and young adults to better understand signaling pathways regulating specific features of the development and progression of this tumor entity. We applied Affymetrix Human Genome U95Av2 oligonucleotide microarrays representing similar to12,000 genes to generate t e expression profiles of the CCSST cell lines GG-62, DTC-1, KAO, MST2, MST3, and Su-CC-S1 in comparison with 8 neuroblastoma, 7 Ewing tumor, and 6 osteosarcoma cell lines. Subsequent hierarchical clustering of microarray data clearly separated all four of the tumor types from each other and identified differentially expressed transcripts, which are characteristically up-regulated in CCSST. Statistical analysis revealed a group of 331 probe sets, representing similar to300 significant (P < 0.001) differentially regulated genes, which clearly discriminated between the CCSST and other tumor samples. Besides genes that were already known to be highly expressed in CCSST, like S100A11 (S100 protein) or MITF (microphthalmia-associated transcription factor), this group shows an obvious portion of genes that are involved in cyclic AMP response or regulation, in pigmentation processes, or in neuronal structure and signaling. Comparison with other expression profile analyses on neuroectodermal childhood tumors confirms the high robustness of this strategy to characterize tumor entities based on their gene expression. We found the avian erythrobla

Clear cell sarcoma of soft tissue (CCSST), also known as malignant melanoma of soft parts, represents a rare lesion of the musculoskeletal system usually affecting adolescents and young adults. CCSST is typified by a chromosomal t(12;22)(q13;q12) translocation resulting in a fusion between the Ewing sarcoma gene (EWSR1) and activating transcription factor 1 (ATF1), of which the activity in nontransformed cells is regulated by cyclic AMP. Our aim was to identify critical differentially expressed genes in CCSST tumor cells in comparison with other solid tumors affecting children and young adults to better understand signaling pathways regulating specific features of the development and progression of this tumor entity. We applied Affymetrix Human Genome U95Av2 oligonucleotide microarrays representing similar to12,000 genes to generate t e expression profiles of the CCSST cell lines GG-62, DTC-1, KAO, MST2, MST3, and Su-CC-S1 in comparison with 8 neuroblastoma, 7 Ewing tumor, and 6 osteosarcoma cell lines. Subsequent hierarchical clustering of microarray data clearly separated all four of the tumor types from each other and identified differentially expressed transcripts, which are characteristically up-regulated in CCSST. Statistical analysis revealed a group of 331 probe sets, representing similar to300 significant (P < 0.001) differentially regulated genes, which clearly discriminated between the CCSST and other tumor samples. Besides genes that were already known to be highly expressed in CCSST, like S100A11 (S100 protein) or MITF (microphthalmia-associated transcription factor), this group shows an obvious portion of genes that are involved in cyclic AMP response or regulation, in pigmentation processes, or in neuronal structure and signaling. Comparison with other expression profile analyses on neuroectodermal childhood tumors confirms the high robustness of this strategy to characterize tumor entities based on their gene expression. We found the avian erythrobla

Clear cell sarcoma of soft tissue (CCSST), also known as malignant melanoma of soft parts, represents a rare lesion of the musculoskeletal system usually affecting adolescents and young adults. CCSST is typified by a chromosomal t(12;22)(q13;q12) translocation resulting in a fusion between the Ewing sarcoma gene (EWSR1) and activating transcription factor 1 (ATF1), of which the activity in nontransformed cells is regulated by cyclic AMP. Our aim was to identify critical differentially expressed genes in CCSST tumor cells in comparison with other solid tumors affecting children and young adults to better understand signaling pathways regulating specific features of the development and progression of this tumor entity. We applied Affymetrix Human Genome U95Av2 oligonucleotide microarrays representing similar to12,000 genes to generate t e expression profiles of the CCSST cell lines GG-62, DTC-1, KAO, MST2, MST3, and Su-CC-S1 in comparison with 8 neuroblastoma, 7 Ewing tumor, and 6 osteosarcoma cell lines. Subsequent hierarchical clustering of microarray data clearly separated all four of the tumor types from each other and identified differentially expressed transcripts, which are characteristically up-regulated in CCSST. Statistical analysis revealed a group of 331 probe sets, representing similar to300 significant (P < 0.001) differentially regulated genes, which clearly discriminated between the CCSST and other tumor samples. Besides genes that were already known to be highly expressed in CCSST, like S100A11 (S100 protein) or MITF (microphthalmia-associated transcription factor), this group shows an obvious portion of genes that are involved in cyclic AMP response or regulation, in pigmentation processes, or in neuronal structure and signaling. Comparison with other expression profile analyses on neuroectodermal childhood tumors confirms the high robustness of this strategy to characterize tumor entities based on their gene expression. We found the avian erythrobla

Ultrafast thin disk laser oscillators achieve the highest average output powers and pulse energies of any mode-locked laser oscillator technology. The thin disk concept avoids thermal problems occurring in conventional high-power rod or slab lasers and enables high-power TEM00 operation with broadband gain materials. Stable and self-starting passive pulse formation is achieved with semiconductor saturable absorber mirrors (SESAMs). The key components of ultrafast thin disk lasers, such as gain material, SESAM, and dispersive cavity mirrors, are all used in reflection. This is an advantage for the generation of ultrashort pulses with excellent temporal, spectral, and spatial properties because the pulses are not affected by large nonlinearities in the oscillator. Output powers close to 100W and pulse energies above 10μJ are directly obtained without any additional amplification, which makes these lasers interesting for a growing number of industrial and scientific applications such as material processing or driving experiments in high-field science. Ultrafast thin disk lasers are based on a power-scalable concept, and substantially higher power levels appear feasible. However, both the highest power levels and pulse energies are currently only achieved with Yb:YAG as the gain material, which limits the gain bandwidth and therefore the achievable pulse duration to 700 to 800fs in efficient thin disk operation. Other Yb-doped gain materials exhibit a larger gain bandwidth and support shorter pulse durations. It is important to evaluate their suitability for power scaling in the thin disk laser geometry. In this paper, we review the development of ultrafast thin disk lasers with shorter pulse durations. We discuss the requirements on the gain materials and compare different Yb-doped host materials. The recently developed sesquioxide materials are particularly promising as they enabled the highest optical-to-optical efficiency (43%) and shortest pulse duration (227fs) ev

High harmonic generation (HHG) of intense infrared laser radiation (Ferray et al., J. Phys. B: At. Mol. Opt. Phys. 21:L31, 1988; McPherson et al., J. Opt. Soc. Am. B 4:595, 1987) enables coherent vacuum-UV (VUV) to soft-X-ray sources. In the usual setup, energetic femtosecond laser pulses are strongly focused into a gas jet, restricting the interaction length to the Rayleigh range of the focus. The average photon flux is limited by the low conversion efficiency and the low average power of the complex laser amplifier systems (Keller, Nature 424:831, 2003; Südmeyer et al., Nat. Photonics 2:599, 2008; Röser et al., Opt. Lett. 30:2754, 2005; Eidam et al., IEEE J. Sel. Top. Quantum Electron. 15:187, 2009) which typically operate at kilohertz repetition rates. This represents a severe limitation for many experiments using the harmonic radiation in fields such as metrology or high-resolution imaging. Driving HHG with novel high-power diode-pumped multi-megahertz laser systems has the potential to significantly increase the average photon flux. However, the higher average power comes at the expense of lower pulse energies because the repetition rate is increased by more than a thousand times, and efficient HHG is not possible in the usual geometry. So far, two promising techniques for HHG at lower pulse energies were developed: external build-up cavities (Gohle et al., Nature 436:234, 2005; Jones et al., Phys. Rev. Lett. 94:193, 2005) and resonant field enhancement in nanostructured targets (Kim et al., Nature 453:757, 2008). Here we present a third technique, which has advantages in terms of ease of HHG light extraction, transverse beam quality, and the possibility to substantially increase conversion efficiency by phase-matching (Paul et al., Nature 421:51, 2003; Ren et al., Opt. Express 16:17052, 2008; Serebryannikov et al., Phys. Rev. E (Stat. Nonlinear Soft Matter Phys.) 70:66611, 2004; Serebryannikov et al., Opt. Lett. 33:977, 2008; Zhang et al., Nat. Phys. 3:270, 20

We present the first passively modelocked thin disk laser (TDL) with sub-100-fs pulse duration using the broadband sesquioxide gain material Yb:LuScO3 and an optimized SEmiconductor Saturable Absorber Mirror (SESAM). In this proof-of-principle experiment, we obtained 5.1W of average power at a repetition rate of 77.5MHz and a pulse duration of 96fs. We carefully explored and optimized the different parameters on the soliton pulse formation process for the generation of short pulses. In particular, SESAMs combining fast recovery time, high modulation depth and low nonsaturable losses proved crucial to achieve this result even though they are expected to only play a minor role in soliton modelocking. To our knowledge, these are the shortest pulses ever obtained with a modelocked TDL, reaching for the first time the sub-100-fs milestone. This result opens the door to sub-100-fs oscillators with substantially higher power levels in the near future