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In North America, public-private partnerships (P3s) are increasingly using pre-development agreements to enhance collaboration between the public and private sectors. Known colloquially as "progressive P3s", these agreements allow the private sector to help scope and shape the structure of projects at the front end. However, concerns about their efficacy persist. Our Commentary contextualizes this ongoing debate by outlining the potential benefits and pitfalls of this new approach to P3s. We conclude that both practitioners and academics have a crucial role to play in our experience with and understanding of the progressive P3 experiment. [ABSTRACT FROM AUTHOR]

Objective: The rising prevalence of obesity in childhood and adolescence in North America has been paralleled by the emergence of type 2 diabetes in the adolescent age group. We have examined trends in the prevalence of type 2 diabetes in adolescents attending a diabetes clinic in Auckland, New Zealand.Methods: Surveys of the prevalence of type 2 diabetes in attendees at the adolescent diabetes clinic at the Auckland Diabetes Centre were undertaken in 1996 and 2002. The proportion of type 2 diabetes in incident cases of diabetes diagnosed between these years was also calculated.Results: The prevalence of type 2 diabetes was 1.8% (2/110) in 1996, and 11.0% (18/163) in 2002 (P = 0.008). Type 2 diabetes accounted for 12.5% (6/48) of incident cases of diabetes in the years 1997-1999, and 35.7% (10/28) of cases in the years 2000-2001, indicating a sharp rise in the incidence (P = 0.017) between the two periods. At diagnosis the mean age of the type 2 diabetes subjects was 15 years and the mean body mass index 34.6 kg/m2. Risk factors for cardiovascular disease were common in the subjects with type 2 diabetes: 85% had dyslipidaemia, 58% had increased albumin excretion rates and 28% had systolic hypertension.Conclusions: Obesity-related type 2 diabetes now accounts for a substantial proportion of newly recognized diabetes in the adolescent age group - and this proportion is escalating rapidly. Adverse cardiovascular risk factors are prevalent in this population. Public health measures to curtail the rise of obesity in childhood and adolescence are required urgently. [ABSTRACT FROM AUTHOR]

Today, the only living genus of coelacanth, Latimeria is represented by two species along the eastern coast of Africa and in Indonesia. This sarcopterygian fish is nicknamed a "living fossil", in particular because of its slow evolution. The large geographical distribution of Latimeria may be a reason for the great resilience to extinction of this lineage, but the lack of fossil records for this genus prevents us from testing this hypothesis. Here we describe isolated bones (right angular, incomplete basisphenoid, fragments of parasphenoid and pterygoid) found in the Cenomanian Woodbine Formation in northeast Texas that are referred to the mawsoniid coelacanth Mawsonia sp. In order to assess the impact of this discovery on the alleged characteristic of "living fossils" in general and of coelacanths in particular: 1) we compared the average time duration of genera of ray-finned fish and coelacanth in the fossil record; 2) we compared the biogeographic signal from Mawsonia with the signal from the rest of the vertebrate assemblage of the Woodbine formation; and 3) we compared these life traits with those of Latimeria. The stratigraphical range of Mawsonia is at least 50 million years. Since Mawsonia was a fresh, brackish water fish with probably a low ability to cross large sea barriers and because most of the continental components of the Woodbine Fm vertebrate assemblage exhibit Laurasian affinities, it is proposed that the Mawsonia's occurrence in North America is more likely the result of a vicariant event linked to the break-up of Pangea rather than the result of a dispersal from Gondwana. The link between a wide geographic distribution and the resilience to extinction demonstrated here for Mawsonia is a clue that a similar situation existed for Latimeria, which allowed this genus to live for tens of millions of years., Competing Interests: The authors have declared that no competing interests exist.

Background: Overweight and obesity are increasing worldwide. To help assess their relevance to mortality in different populations we conducted individual-participant data meta-analyses of prospective studies of body-mass index (BMI), limiting confounding and reverse causality by restricting analyses to never-smokers and excluding pre-existing disease and the first 5 years of follow-up., Methods: Of 10 625 411 participants in Asia, Australia and New Zealand, Europe, and North America from 239 prospective studies (median follow-up 13·7 years, IQR 11·4-14·7), 3 951 455 people in 189 studies were never-smokers without chronic diseases at recruitment who survived 5 years, of whom 385 879 died. The primary analyses are of these deaths, and study, age, and sex adjusted hazard ratios (HRs), relative to BMI 22·5-<25·0 kg/m(2)., Findings: All-cause mortality was minimal at 20·0-25·0 kg/m(2) (HR 1·00, 95% CI 0·98-1·02 for BMI 20·0-<22·5 kg/m(2); 1·00, 0·99-1·01 for BMI 22·5-<25·0 kg/m(2)), and increased significantly both just below this range (1·13, 1·09-1·17 for BMI 18·5-<20·0 kg/m(2); 1·51, 1·43-1·59 for BMI 15·0-<18·5) and throughout the overweight range (1·07, 1·07-1·08 for BMI 25·0-<27·5 kg/m(2); 1·20, 1·18-1·22 for BMI 27·5-<30·0 kg/m(2)). The HR for obesity grade 1 (BMI 30·0-<35·0 kg/m(2)) was 1·45, 95% CI 1·41-1·48; the HR for obesity grade 2 (35·0-<40·0 kg/m(2)) was 1·94, 1·87-2·01; and the HR for obesity grade 3 (40·0-<60·0 kg/m(2)) was 2·76, 2·60-2·92. For BMI over 25·0 kg/m(2), mortality increased approximately log-linearly with BMI; the HR per 5 kg/m(2) units higher BMI was 1·39 (1·34-1·43) in Europe, 1·29 (1·26-1·32) in North America, 1·39 (1·34-1·44) in east Asia, and 1·31 (1·27-1·35) in Australia and New Zealand. This HR per 5 kg/m(2) units higher BMI (for BMI over 25 kg/m(2)) was greater in younger than older people (1·52, 95% CI 1·47-1·56, for BMI measured at 35-49 years vs 1·21, 1·17-1·25, for BMI measured at 70-89 years; pheterogeneity<0·0001), greater in men than women (1·51, 1·46-1·56, vs 1·30, 1·26-1·33; pheterogeneity<0·0001), but similar in studies with self-reported and measured BMI., Interpretation: The associations of both overweight and obesity with higher all-cause mortality were broadly consistent in four continents. This finding supports strategies to combat the entire spectrum of excess adiposity in many populations., Funding: UK Medical Research Council, British Heart Foundation, National Institute for Health Research, US National Institutes of Health., (Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC-BY license. Published by Elsevier Ltd.. All rights reserved.)